Asthma trajectories in early childhood: identifying modifiable factors

BackgroundThere are conflicting views as to whether childhood wheezing represents several discreet entities or a single but variable disease. Classification has centered on phenotypes often derived using subjective criteria, small samples, and/or with little data for young children. This is particularly problematic as asthmatic features appear to be entrenched by age 6/7. In this paper we aim to: identify longitudinal trajectories of wheeze and other atopic symptoms in early childhood; characterize the resulting trajectories by the socio-economic background of children; and identify potentially modifiable processes in infancy correlated with these trajectories.Data and MethodsThe Millennium Cohort Study is a large, representative birth cohort of British children born in 2000–2002. Our analytical sample includes 11,632 children with data on key variables (wheeze in the last year; ever hay-fever and/or eczema) reported by the main carers at age 3, 5 and 7 using a validated tool, the International Study of Asthma and Allergies in Childhood module. We employ longitudinal Latent Class Analysis, a clustering methodology which identifies classes underlying the observed population heterogeneity.ResultsOur model distinguished four latent trajectories: a trajectory with both low levels of wheeze and other atopic symptoms (54% of the sample); a trajectory with low levels of wheeze but high prevalence of other atopic symptoms (29%); a trajectory with high prevalence of both wheeze and other atopic symptoms (9%); and a trajectory with high levels of wheeze but low levels of other atopic symptoms (8%). These groups differed in terms of socio-economic markers and potential intervenable factors, including household damp and breastfeeding initiation.ConclusionUsing data-driven techniques, we derived four trajectories of asthmatic symptoms in early childhood in a large, population based sample. These groups differ in terms of their socio-economic profiles. We identified correlated intervenable pathways in infancy, including household damp and breastfeeding initiation.<br/

Análisis de la influencia de los parámetros de digitalización en la calidad del audio producido digitalmente

La presente investigación documenta la evaluación de la influencia de los parámetros de digitalización en la calidad del audio producido digitalmente. Se produjo digitalmente el vals criollo Hilda a través de la captura del sonido de 14 instrumentos musicales digitalizados con una frecuencia de muestreo de 192 KHz y una profundidad de 24 bits y almacenados una consola digital, con el archivo de la mezcla maestra se generaron otros archivos modificando los parámetros de digitalización mediante algoritmos en Matlab, se obtuvo información relevante de los archivos para comparar su calidad con la de la señal original. El estudio determinó que el factor influyente en la calidad del audio digital es la profundidad de bits y que la frecuencia de muestreo influye en el tamaño del archivo. Se concluye que la mejor respuesta es muestrear el audio a 48 KHz con una profundidad de 24 bits.This research documents the evaluation of the influence of digitization parameters on the quality of digitally produced audio. The waltz Hilda was digitally produced by capturing the sound of 14 musical instruments digitized with a sampling frequency of 192 KHz and a depth of 24 bits and stored in a digital console, with the master mix file other files were generated by modifying the digitization parameters using algorithms in Matlab, relevant information was obtained from the files to compare their quality with that of the original signal. The study determined that the influential factor in the quality of digital audio is the bit depth and that the sampling frequency influences the file size. It is concluded that the best response is to sample the audio at 48 KHz with a bit depth of 24 bits.Tesi

Terapias para disminuir la sensibilidad por blanqueamiento dental

The most common side effect in tooth bleaching is tooth sensitivity because of the pulp reaction to free radicals produced by the hydrogen peroxide used in bleaching products. Different therapies have been used before, during and after to reduce tooth sensitivity, agents that block nerve repolarization such as potassium nitrate and agents that block dentinal tubules: amorphous calcium phosphate, calcium sodium phosilicate, calcium gluconate, hydroxyapatite, GLUMA and fluor; alternative therapies such as the use of anti-inflammatory, antioxidants and laser application which have also been mentioned in the literature. The aim of this review is to show the scientific evidence on the different methods to decrease the sensitivity on tooth bleaching.El blanqueamiento dental tiene como principal efecto adverso la sensibilidad que se da como una respuesta pulpar a los radicales libres del peróxido de hidrógeno. Existen diferentes terapias utilizadas antes, durante y después para disminuir la sensibilidad dental, como el uso de agentes que actúan inhibiendo la re polarización del nervio como el nitrato de potasio en sus distintas presentaciones de gel, dentífricos o asociado al agente blan- queador y los que obliteran los túbulos entre ellos el fofato de calcio amorfo, silicato de calcio y sodio, gluconato de calcio, hidroxiapatita, GLUMA y flúor; existen otras terapias alternativas como el uso de antiinflamatorios, vitaminas y aplicación de láser las cuales también han sido mencionadas en la literatura. La siguiente revisión tiene como objetivo analizar la evidencia científica sobre los diferentes métodos para disminuir la sensibilidad por blanqueamiento dental

Socioemotional wellbeing of mixed race/ethnic children in the UK and US: patterns and mechanisms

Existing literature suggests that mixed race/ethnicity children are more likely to experience poor socioemotional wellbeing in both the US and the UK, although the evidence is stronger in the US. It is suggested that this inequality may be a consequence of struggles with identity formation, more limited connections with racial/ethnic/cultural heritage, and increased risk of exposure to racism. Using data from the UK Millennium Cohort Study (n = 13,734) and the US Early Childhood Longitudinal Study-Birth Cohort (n ~ 6250), we examine differences in the socioemotional wellbeing of mixed and non-mixed 5/6 year old children in the UK and US and explore heterogeneity in outcomes across different mixed groups in both locations. We estimate a series of linear regressions to examine the contribution of factors that may explain any observed differences, including socio-economic and cultural factors, and examine the extent to which these processes vary across the two nations. We find no evidence of greater risk for poor socioemotional wellbeing for mixed race/ethnicity children in both national contexts. We find that mixed race/ethnicity children experience socio-economic advantage compared to their non-mixed minority counterparts and that socio-economic advantage is protective for socioemotional wellbeing. Cultural factors do not contribute to differences in socioemotional wellbeing across mixed and non-mixed groups. Our evidence suggests then that at age 5/6 there is no evidence of poorer socioemotional wellbeing for mixed race/ethnicity children in either the UK or the US. The contrast between our findings and some previous literature, which reports that mixed race/ethnicity children have poorer socioemotional wellbeing, may reflect changes in the meaning of mixed identities across periods and/or the developmental stage of the children we studied

Assessment and comparison of bacterial load levels determined by quantitative amplifications in blood culture-positive and negative neonatal sepsis

Bacterial sepsis remains a major cause of mortality and blood cultures are the gold standard of laboratory diagnosis even though they lack sensitivity in neonates. Culturenegative sepsis, also known as clinical sepsis, has long been considered a diagnosis in neonatal intensive care units because, as well as culture-positive infants, culture-negative neonates have worse prognosis in comparison with non-infected ones. Quantitative amplifications are used to detect bacterial infections in neonates but results are considered only in a qualitative way (positive or negative). The aim of the present study was to determine and compare bacterial load levels in blood culture-positive and culture-negative neonatal sepsis. Seventy neonates with clinical and laboratory evidence of infection admitted at three neonatal intensive care units were classified as blood culture-positive or culture-negative. Blood samples obtained at the same time of blood cultures had bacterial load levels assessed through a 16S rDNA qPCR. Blood cultures were positive in 29 cases (41.4%) and qPCR in 64 (91.4%). In the 29 culture-positive cases, 100% were also positive by qPCR, while in the 41 culture-negative cases, 35 (85.4%) were positive by qPCR. Bacterial load levels were in general &lt; 50 CFU/mL, but were significantly higher in culture-positive cases (Mann-Whitney, p = 0.013), although clinical and laboratory findings were similar, excepting for deaths. In conclusion, the present study has shown that blood culture-negative neonates have lower bacteria load levels in their bloodstream when compared to blood culture-positive infants

Eficiencia de la Zeolita en la remoción de metales pesados en el río Condebamba en relación a los estándares de calidad ambiental categoría 3, Cajamarca 2022

La presente investigación tuvo como objetivo evaluar la eficiencia de la zeolita en la remoción de metales pesados en el río Condebamba, que es afectado por los procesos de minería artesanal y la gran minería. Se determinó la concentración de metales en el Río Condebamba, se realizó el muestreo donde se evaluó la calidad actual del agua, la misma que es usada en actividades como la agricultura y ganadería, dichos resultados fueron comparados con el Estándar de calidad ambiental D.S. N°004-2017-MINAM, categoría 3, así mismo se propuso un tratamiento de remoción de metales en las aguas del Río Condebamba utilizando zeolita como captador, para ello se realizó agitación de muestra con 3 proporciones de zeolita: 100mg, 50mg y 25mg, por litro de muestra del Río Condebamba, obteniéndo resultados favorables de remoción, tales como, si se utiliza 100 gramos de zeolita para 1 Litro de muestra del Río Condebamba se obtuvo 51,7051% de remoción de Bario, 56,739% de remoción de Boro, 50,247% de remoción de Cobre, 53,56% de remoción de Cromo, 58,90% de remoción de Hierro , 53,68% de remoción de plomo y 49.15% de remoción de Zinc. Los resultados después del tratamiento no cumplieron con el Estándar de calidad ambiental

The performance of four molecular methods for the laboratory diagnosis of congenital toxoplasmosis in amniotic fluid samples

Introduction\ud Toxoplasmosis may be life-threatening in fetuses and in immune-deficient patients. Conventional laboratory diagnosis of toxoplasmosis is based on the presence of IgM and IgG anti-Toxoplasma gondii antibodies; however, molecular techniques have emerged as alternative tools due to their increased sensitivity. The aim of this study was to compare the performance of 4 PCR-based methods for the laboratory diagnosis of toxoplasmosis. One hundred pregnant women who seroconverted during pregnancy were included in the study. The definition of cases was based on a 12-month follow-up of the infants.\ud \ud Methods\ud Amniotic fluid samples were submitted to DNA extraction and amplification by the following 4 Toxoplasma techniques performed with parasite B1 gene primers: conventional PCR, nested-PCR, multiplex-nested-PCR, and real-time PCR. Seven parameters were analyzed, sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and efficiency (Ef).\ud \ud Results\ud Fifty-nine of the 100 infants had toxoplasmosis; 42 (71.2%) had IgM antibodies at birth but were asymptomatic, and the remaining 17 cases had non-detectable IgM antibodies but high IgG antibody titers that were associated with retinochoroiditis in 8 (13.5%) cases, abnormal cranial ultrasound in 5 (8.5%) cases, and signs/symptoms suggestive of infection in 4 (6.8%) cases. The conventional PCR assay detected 50 cases (9 false-negatives), nested-PCR detected 58 cases (1 false-negative and 4 false-positives), multiplex-nested-PCR detected 57 cases (2 false-negatives), and real-time-PCR detected 58 cases (1 false-negative).\ud \ud Conclusions\ud The real-time PCR assay was the best-performing technique based on the parameters of Se (98.3%), Sp (100%), PPV (100%), NPV (97.6%), PLR (â^ž), NLR (0.017), and Ef (99%).This work was supported by FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo; grant number 2010/15022-1), as well as by CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico; grant number 2011-0/471479)

Toxoplasma gondii SAG2, SAG3 and GRA6 alleles and single nucleotide polymorphism in congenital infections with known parasite load and clinical outcome

Amniotic fluid DNA samples were genotyped by multilocus-nested-PCR-RFLP, but only three of 11 markers amplified 113 of 122 (92.6%) samples, resulting in 12 untyped and 101 partial non-archetypal genotypes. The 101 typed samples were subdivided into four groups: G1 with 73 samples (5’and 3’ SAG2 allele I + SAG3 allele III + GRA6 allele III), 53 had parasite load ≤ 102 parasites/mL (43 asymptomatic, 10 mild infections), 17 had load &gt; 102 and ≤ 103 (one mild, 13 moderate and three severe), and three had load &gt; 103 parasites/mL (three severe); G2 with 22 samples (5’and 3’ SAG2 allele I + SAG3 allele III), all parasite load levels ≤ 102 parasites/mL (18 asymptomatic and four mild); G3 with five samples (5’ and 3’ SAG2 allele I + SAG3 allele II), parasite load ≤ 102 parasites/mL (three asymptomatic and two mild); G4 with one sample (5’ and 3’ SAG2 allele II + SAG3 allele II + GRA6 allele I), a parasite load &lt; 102 parasites/mL in an asymptomatic infant. After DNA sequencing, restriction sites confirmed SAG2, SAG3 and GRA6 alleles in 98.7%, 100% and 100% of the cases, respectively, while single nucleotide polymorphisms confirmed 90% of 5’-SAG2 allele I; 98.7% of 3’-SAG2 allele I; 98% of SAG-3 allele III, but only 40% of GRA6 allele III results. For the moment, partial non-archetypal genotypes of parasites did not show any relationship with either parasite load in amniotic fluid samples or clinical outcome of infants at the age of 12 months

A point of care neutrophil elastase activity assay identifies bronchiectasis severity, airway infection and risk of exacerbation

Introduction: Neutrophil elastase activity in sputum can identify patients at high risk of airway infection and exacerbations in bronchiectasis. Application of this biomarker in clinical practice is limited, because no point-of-care test is available. We tested whether a novel semi-quantitative lateral flow device (neutrophil elastase airway test stick - NEATstik\uae) can stratify bronchiectasis patients according to severity, airway infection and exacerbation risk. Methods: Sputum samples from 124 patients with stable bronchiectasis enrolled in the UK and Spain were tested using the NEATstik\uae, which scores neutrophil elastase concentration from 0 (&lt;8 \u3bcg\ub7mL-1 elastase activity) to 10 (maximum detectable neutrophil elastase activity). High neutrophil elastase activity was regarded as a NEATstik\uae grade &gt;6. Severity of disease, airway infection from sputum culture and exacerbations over the 12 months were recorded. An independent validation was conducted in 50 patients from Milan, Italy. Measurements and main results: Patients had a median age of 69 years and forced expiratory volume in 1 s (FEV1) 69%. High neutrophil elastase activity was associated with worse bronchiectasis severity using the bronchiectasis severity index (p=0.0007) and FEV1 ( p=0.02). A high NEATstik\uae grade was associated with a significant increase in exacerbation frequency, incident rate ratio 2.75 (95% CI 1.63-4.64, p&lt;0.001). The median time to next exacerbation for patients with a NEATstik\uae grade &gt;6 was 103 days compared to 278 days. The hazard ratio was 2.59 (95% CI 1.71-3.94, p&lt;0.001). Results were confirmed in the independent validation cohort. Conclusions: A novel lateral flow device provides assessment of neutrophil elastase activity from sputum in minutes and identifies patients at increasing risk of airway infection and future exacerbations

Prophetic Reading: Sisterhood and Psychoanalysis in H.D.’s HERmione

This article offers a comparative reading of H.D.’s 1927 kunstlerroman à clef, HERmione, and Freud’s Dora alongside an intertextual close reading of its dense web of literary allusions in order to argue that it offers a sustained critique of Freudian psychoanalysis and an alternative origin story for the condition of hysteria. Drawing on the notion of prophecy as it is thematised in the novel, the article demonstrates H.D.’s prefiguring of Juliet Mitchell’s recent reconfiguration of hysteria as a response to, replacement by, or failure of identification with a sibling