The role of well-child visits in detecting developmental delay in preschool children

Background: Early detection of developmental delay (DD) in preschool children is crucial for counselling parents, initiating diagnostic work-up, and starting early intervention (EI). Methods: We conducted a register study of all preschool children referred for EI in the Canton of Zurich, Switzerland, in 2017 (N = 1,785) and used an online survey among primary care physicians (PCPs, N = 271) to evaluate the care service of DD children. Results: PCPs accounted for 79.5% of all referrals by physicians and had correctly referred over 90% of the children in need of EI at an average age of 39.3 months (SD 8.9). In the survey, which represents 59.2% of all pediatricians and 11.3% of all general practitioners in the Canton, PCPs reported performing a mean of 13.5 (range 0-50, SD 10.7) well-child visits per week to preschool children and estimated well-child visits to be the most frequent type of consultation (66.7%) for the identification of DD. Parents' hesitancy in accepting further evaluation or support were reported by 88.7%. Conclusions: Most preschool children with DD are identified in well-child visits. These visits represent an ideal opportunity for early detection of developmental impairment and initiation of EI. Carefully addressing parents' reservations could reduce the rate of refusal, thus improving early support for children with DD

Searching for solar-like oscillations in pre-main sequence stars using APOLLO

In recent years, our understanding of solar-like oscillations from main sequence to red giant stars has improved dramatically thanks to pristine data collected from space telescopes. One of the remaining open questions focuses around the observational identification of solar-like oscillations in pre-main sequence stars. We aim to develop an improved method to search for solar-like oscillations in pre-main sequence stars and apply it to data collected by the Kepler K2 mission. Our software APOLLO includes a novel way to detect low signal-to-noise ratio solar like oscillations in the presence of a high background level. By calibrating our method using known solar-like oscillators from the main Kepler mission, we apply it to T Tauri stars observed by Kepler K2 and identify several candidate pre-main sequence solar-like oscillators. We find that our method is robust even when applied to time-series of observational lengths as short as those obtained with the TESS satellite in one sector. We identify EPIC 205375290 as a possible candidate for solar-like oscillations in a pre-main sequence star with $\nu_\mathrm{max} \simeq 242\,\mu$Hz. We also derive EPIC 205375290's fundamental parameters to be $T_\mathrm{eff}$ = 3670$\pm$180 K, log $g$ = 3.85$\pm$0.3, $v$sin$i$ = 8 $\pm$ 1 km s$^{-1}$, and about solar metallicity from a high-resolution spectrum obtained from the Keck archive.Comment: 14 pages, 13 figure

Localized Deformation in Ni-Mn-Ga Single Crystals

The magnetomechanical behavior of ferromagnetic shape memory alloys such as Ni-Mn-Ga, and hence the relationship between structure and nanoscale magnetomechanical properties, is of interest for their potential applications in actuators. Furthermore, due to its crystal structure, the behavior of Ni-Mn-Ga is anisotropic. Accordingly, nanoindentation and magnetic force microscopy were used to probe the nanoscale mechanical and magnetic properties of electropolished single crystalline 10M martensitic Ni-Mn-Ga as a function of the crystallographic c-axis (easy magnetization) direction relative to the indentation surface (i.e., c-axis in-plane versus out-of-plane). Load-displacement curves from 5–10 mN indentations on in-plane regions exhibited pop-in during loading, whereas this phenomenon was absent in out-of-plane regions. Additionally, the reduced elastic modulus measured for the c-axis out-of-plane orientation was ∼50% greater than for in-plane. Although heating above the transition temperature to the austenitic phase followed by cooling to the room temperature martensitic phase led to partial recovery of the indentation deformation, the magnitude and direction of recovery depended on the original relative orientation of the crystallographic c-axis: positive recovery for the in-plane orientation versus negative recovery (i.e., increased indent depth) for out-of-plane. Moreover, the c-axis orientation for out-of-plane regions switched to in-plane upon thermal cycling, whereas the number of twins in the in-plane regions increased. We hypothesize that dislocation plasticity contributes to the permanent deformation, while pseudoelastic twinning causes pop-in during loading and large recovery during unloading in the c-axis in-plane case. Minimization of indent strain energy accounts for the observed changes in twin orientation and number following thermal cycling

Dynamical locality and covariance: What makes a physical theory the same in all spacetimes?

The question of what it means for a theory to describe the same physics on all spacetimes (SPASs) is discussed. As there may be many answers to this question, we isolate a necessary condition, the SPASs property, that should be satisfied by any reasonable notion of SPASs. This requires that if two theories conform to a common notion of SPASs, with one a subtheory of the other, and are isomorphic in some particular spacetime, then they should be isomorphic in all globally hyperbolic spacetimes (of given dimension). The SPASs property is formulated in a functorial setting broad enough to describe general physical theories describing processes in spacetime, subject to very minimal assumptions. By explicit constructions, the full class of locally covariant theories is shown not to satisfy the SPASs property, establishing that there is no notion of SPASs encompassing all such theories. It is also shown that all locally covariant theories obeying the time-slice property possess two local substructures, one kinematical (obtained directly from the functorial structure) and the other dynamical (obtained from a natural form of dynamics, termed relative Cauchy evolution). The covariance properties of relative Cauchy evolution and the kinematic and dynamical substructures are analyzed in detail. Calling local covariant theories dynamically local if their kinematical and dynamical local substructures coincide, it is shown that the class of dynamically local theories fulfills the SPASs property. As an application in quantum field theory, we give a model independent proof of the impossibility of making a covariant choice of preferred state in all spacetimes, for theories obeying dynamical locality together with typical assumptions.Comment: 60 pages, LaTeX. Version to appear in Annales Henri Poincar

Dual alpha2C/5HT1A receptor agonist allyphenyline induces gastroprotection and inhibits fundic and colonic contractility

Allyphenyline, a novel α2-adrenoceptor (AR) ligand, has been shown to selectively activate α2C-adrenoceptors (AR) and 5HT1A receptors, but also to behave as a neutral antagonist of α2A-ARs. We exploited this unique pharmacological profile to analyze the role of α2C-ARs and 5HT1A receptors in the regulation of gastric mucosal integrity and gastrointestinal motility

Modulated Martensite: Why it forms and why it deforms easily

Diffusionless phase transitions are at the core of the multifunctionality of (magnetic) shape memory alloys, ferroelectrics and multiferroics. Giant strain effects under external fields are obtained in low symmetric modulated martensitic phases. We outline the origin of modulated phases, their connection with tetragonal martensite and consequences for their functional properties by analysing the martensitic microstructure of epitaxial Ni-Mn-Ga films from the atomic to macroscale. Geometrical constraints at an austenite-martensite phase boundary act down to the atomic scale. Hence a martensitic microstructure of nanotwinned tetragonal martensite can form. Coarsening of twin variants can reduce twin boundary energy, a process we could follow from the atomic to the millimetre scale. Coarsening is a fractal process, proceeding in discrete steps by doubling twin periodicity. The collective defect energy results in a substantial hysteresis, which allows retaining modulated martensite as a metastable phase at room temperature. In this metastable state elastic energy is released by the formation of a 'twins within twins' microstructure which can be observed from the nanometre to millimetre scale. This hierarchical twinning results in mesoscopic twin boundaries which are diffuse, in contrast to the common atomically sharp twin boundaries of tetragonal martensite. We suggest that observed extraordinarily high mobility of such mesoscopic twin boundaries originates from their diffuse nature which renders pinning by atomistic point defects ineffective.Comment: 34 pages, 8 figure

The Plastid Genome of Eutreptiella Provides a Window into the Process of Secondary Endosymbiosis of Plastid in Euglenids

Euglenids are a group of protists that comprises species with diverse feeding modes. One distinct and diversified clade of euglenids is photoautotrophic, and its members bear green secondary plastids. In this paper we present the plastid genome of the euglenid Eutreptiella, which we assembled from 454 sequencing of Eutreptiella gDNA. Comparison of this genome and the only other available plastid genomes of photosynthetic euglenid, Euglena gracilis, revealed that they contain a virtually identical set of 57 protein coding genes, 24 genes fewer than the genome of Pyramimonas parkeae, the closest extant algal relative of the euglenid plastid. Searching within the transcriptomes of Euglena and Eutreptiella showed that 6 of the missing genes were transferred to the nucleus of the euglenid host while 18 have been probably lost completely. Euglena and Eutreptiella represent the deepest bifurcation in the photosynthetic clade, and therefore all these gene transfers and losses must have happened before the last common ancestor of all known photosynthetic euglenids. After the split of Euglena and Eutreptiella only one additional gene loss took place. The conservation of gene content in the two lineages of euglenids is in contrast to the variability of gene order and intron counts, which diversified dramatically. Our results show that the early secondary plastid of euglenids was much more susceptible to gene losses and endosymbiotic gene transfers than the established plastid, which is surprisingly resistant to changes in gene content

Low bone mass in microscopic colitis

<p>Abstract</p> <p>Background</p> <p>Microscopic colitis presents with similar symptoms to classic inflammatory bowel diseases. Osteoporosis is a common complication of Crohn's disease but there are no data concerning bone metabolism in microscopic colitis.</p> <p>Aims</p> <p>The aim of the present study was to evaluate bone density and metabolism in patients with microscopic colitis.</p> <p>Methods</p> <p>Fourteen patients microscopic colitis were included in the study, and 28 healthy persons and 28 age and gender matched Crohn's disease patients were enrolled as controls. Bone mineral density was measured using dual x-ray absorptiometry at the lumbar spine, femoral neck and the radius. Serum bone formation and bone resorption markers (osteocalcin and beta-crosslaps, respectively) were measured using immunoassays.</p> <p>Results</p> <p>Low bone mass was measured in 57.14% patients with microscopic colitis. Bone mineral density at the femoral neck in patients suffering from microscopic colitis and Crohn's disease was lower than in healthy controls (0.852 ± 0.165 and 0.807 ± 0.136 vs. 1.056 ± 0.126 g/cm²; p < 0.01). Bone mineral density at the non-dominant radius was decreased in microscopic colitis patients (0.565 ± 0.093 vs. 0.667 ± 0.072 g/cm²; p < 0.05) but unaffected in Crohn's disease patients (0.672 ± 0.056 g/cm²). Mean beta-crosslaps concentration was higher in microscopic colitis and Crohn's disease patients than controls (417.714 ± 250.37 and 466.071 ± 249.96 vs. 264.75 ± 138.65 pg/ml; p < 0.05). A negative correlation between beta-crosslaps concentration and the femoral and radius t-scores was evident in microscopic colitis patients.</p> <p>Conclusions</p> <p>Low bone mass is frequent in microscopic colitis, and alterations to bone metabolism are similar to those present in Crohn's disease. Therefore, microscopic colitis-associated osteopenia could be a significant problem in such patients.</p