Progress of Congenital Heart Disease: The Team Approach as It Includes the Anesthesiologist

Advances in cardiac surgery have been great in the last 30 years, but further progress is anticipated, especially in infants. A cooperative effort involving referring physicians, pediatric cardiologists, physiologists, anesthesiologists, surgeons, and intensive care nurses is required to continue this trend

Comprehensive Family Hygiene Promotion in Peri-Urban Cape Town: Reduction of Respiratory Illness in Children Under Five

Background: Examination with Cone Beam CT (CBCT) is common for localizing maxillary canines with eruption disturbance. The benefits and costs of these examinations are unclear. Objectives: To measure: 1. the proportion of orthodontists' treatment decisions that were different based on intraoral and panoramic radiography (M1) compared with CBCT and panoramic radiography (M2); and 2. the costs of producing different treatment plans, regarding patients with maxillary canines with eruption disturbance. Subjects and methods: Orthodontists participated in a web-based survey and were randomly assigned to denote treatment decisions and the level of confidence in this decision for four patient cases presented with M1 or M2 at two occasions for the same patient case. Results: One hundred and twelve orthodontists made 445 assessments based on M1 and M2, respectively. Twenty-four per cent of the treatment decisions were different depending on which method the raters had access to, whereof one case differed significantly from all other cases. The mean total cost per examination was €99.84 using M1 and €134.37 using M2, resulting in an incremental cost per examination of €34.53 for M2. Limitations: Benefits in terms of number of different treatment decisions must be considered as an intermediate outcome for the effectiveness of a diagnostic method and should be interpreted with caution. Conclusions: For the patient cases presented in this study, most treatment decisions were the same irrespective of radiological method. Accordingly, this study does not support routine use of CBCT regarding patients with maxillary canine with eruption disturbance

Probabilistic Clustering of Sequences: Inferring new bacterial regulons by comparative genomics

Genome wide comparisons between enteric bacteria yield large sets of conserved putative regulatory sites on a gene by gene basis that need to be clustered into regulons. Using the assumption that regulatory sites can be represented as samples from weight matrices we derive a unique probability distribution for assignments of sites into clusters. Our algorithm, 'PROCSE' (probabilistic clustering of sequences), uses Monte-Carlo sampling of this distribution to partition and align thousands of short DNA sequences into clusters. The algorithm internally determines the number of clusters from the data, and assigns significance to the resulting clusters. We place theoretical limits on the ability of any algorithm to correctly cluster sequences drawn from weight matrices (WMs) when these WMs are unknown. Our analysis suggests that the set of all putative sites for a single genome (e.g. E. coli) is largely inadequate for clustering. When sites from different genomes are combined and all the homologous sites from the various species are used as a block, clustering becomes feasible. We predict 50-100 new regulons as well as many new members of existing regulons, potentially doubling the number of known regulatory sites in E. coli.Comment: 27 pages including 9 figures and 3 table

Prevalence of non-febrile seizures in children with idiopathic autism spectrum disorder and their unaffected siblings: a retrospective cohort study

BACKGROUND: Autism spectrum disorder (ASD) is a heterogeneous disorder characterized not only by deficits in communication and social interactions but also a high rate of co-occurring disorders, including metabolic abnormalities, gastrointestinal and sleep disorders, and seizures. Seizures, when present, interfere with cognitive development and are associated with a higher mortality rate in the ASD population. METHODS: To determine the relative prevalence of non-febrile seizures in children with idiopathic ASD from multiplex and simplex families compared with the unaffected siblings in a cohort of 610 children with idiopathic ASD and their 160 unaffected siblings, participating in the Autism Genetic Resource Exchange project, the secondary analysis was performed comparing the life-time prevalence of non-febrile seizures. Statistical models to account for non-independence of observations, inherent with the data from multiplex families, were used in assessing potential confounding effects of age, gender, and history of febrile seizures on odds of having non-febrile seizures. RESULTS: The life-time prevalence of non-febrile seizures was 8.2% among children with ASD and 2.5% among their unaffected siblings. In a logistic regression analysis that adjusted for familial clustering, children with ASD had 5.27 (95%CI: 1.51–18.35) times higher odds of having non-febrile seizures compared to their unaffected siblings. In this comparison, age, presence of gastrointestinal dysfunction, and history of febrile seizures were significantly associated with the prevalence of non-febrile seizures. CONCLUSION: Children with idiopathic ASD are significantly more likely to have non-febrile seizures than their unaffected siblings, suggesting that non-febrile seizures may be ASD-specific. Further studies are needed to determine modifiable risk factors for non-febrile seizures in ASD

Beaten into Submissiveness? An Investigation into the Protective Strategies used by Survivors of Domestic Abuse

This is a pre-copyedited, author-produced pdf of an article accepted for publication in Journal of Interpersonal Violence following peer review. Laura Irving & Ben Chi-pun Liu, 'Beaten into Submissiveness? An investigation Into the Protective Strategies Used by Survivors of Domestic Abuse', Journal of Interpersonal Violence, first published online 14 December 2016, available online at doi: 10.1177/0886260516682520 © The Author(s) 2016 Published by SAGEThe aim of the study was to identify the prevalence and perceived helpfulness of a variety of protective strategies that were used by female survivors of domestic abuse and to explore factors that may have influenced strategy usage. Forty participants were recruited from a voluntary sector domestic abuse service, commissioned by an outer London local authority in the UK. The measurement tools used were the Intimate Partner Violence Strategies Index and the CAADA Domestic Abuse, Stalking and ‘Honour’-Based Violence (DASH) Risk Assessment Checklist. The average age was 33 (SD=7.9, range: 20-57), half reported to be of Asian ethnicity, 37.5% White and 12.5% Black or Mixed ethnicity. The average DASH score was 9.8 (SD=13.2, range: 0-18) and an average of 18 (SD=6.7, range: 1-29) protective strategies were utilised by each participant. All of the most commonly used strategies were from the Placating category. Though Safety Planning strategies were rated as the most helpful by all participants, Placating strategies were also rated as helpful by two-thirds of participants. Stepwise multiple regression showed that Placating was the only significant predictor of DASH score (β=0.375, p<0.05) and accounted for 14% of the variance of DASH score. Findings showed that women utilized a diverse range of protective strategies with placating strategies being most intensely used and rated as helpful. However, placating strategy usage could be a risk factor as opposed to a protective factor. This study has also demonstrated that greater placating strategies were used by White than South Asian women, and women who were employed used more formal strategies. This research has extended the knowledge base of protective strategies that professionals can draw from to underpin decisions and interventions when working with domestic abuse survivors.Peer reviewedFinal Accepted Versio

Reverse Pygmalionism Art and Samuel Rogers’s Italy

Pictures are for use, for solace, for ornament, for parade;�as invested wealth, as an appendage of rank. Some people love pictures as they love friends; some, as they love music; some, as they love money. There are those who collect them for instruction, as a student collects grammars, dictionaries, and commentaries;�these are artists; such were the collections of Rubens, of Sir Peter Lely, of the President West, of Lawrence, of Sir Joshua Reynolds. There are those who collect pictures around them as a king assembles his court�as significant of state, as subservient to ornament or pride; such were Buckingham and Talleyrand. There are those who collect pictures as a man speculates in the funds;�picture-fanciers, like bird-fanciers, or flower-fanciers�amateur picture-dealers, who buy, sell, exchange, bargain; with whom a glorious Cuyp represents 800l. sterling, and a celebrated Claude is 3000l. securely invested�safe as in a bank; and his is not the right spirit, surely. Lastly, there are those who collect pictures for love, for companionship, for communion; to whom each picture, well-chosen at first, unfolds new beauties�becomes dearer every day; such a one was Sir George Beaumont�such a one is Mr. Roger