Neuropsychological and Neuroimaging Outcomes Following Moderate to Severe Paediatric Traumatic Brain Injury in South Africa

Paediatric traumatic brain injury (pTBI) is a leading cause of mortality and disability. South Africa is predicted to have a high pTBI rate and an adverse socioeconomic environment for recovery. Despite this, few studies have investigated the neuropsychological and/or neuroimaging outcomes of pTBI in South Africa. The study was designed as a capacity-building exercise to demonstrate the successful collection of data from different sites involved in a developing international collaboration. The aims were therefore to 1) provide a detailed description of the premorbid factors and neuropsychological and neuroimaging outcomes of a sample of South African children with moderate to severe pTBI, and 2) investigate the barriers to the successful implementation of neuropsychological and neuroimaging research in this population. Five patients with severe pTBI were enrolled during the 6-month recruitment window. These participants presented with 6-month post-TBI outcomes that ranged from mild neuropsychological deficits and no visible abnormalities on neuroimaging to severe neuropsychological deficits and evidence of multifocal pathology on imaging. There was a relatively high occurrence of adverse developmental, socioeconomic, and neuropsychological histories, which will need to be considered when selecting an appropriate control group or combining with other populations in a potential future multicentre study. Additional strategies will also be required to improve recruitment and increase the rate of successful imaging. Changes may need to be made to the neuropsychology assessment so as not to disadvantage this population, for example avoiding tests that are reliant on sequencing the alphabet. In conclusion, the study's findings will help to improve the likelihood of the much-needed large-scale research in this at-risk and understudied South African population

Interspecies hybridization on DNA resequencing microarrays: efficiency of sequence recovery and accuracy of SNP detection in human, ape, and codfish mitochondrial DNA genomes sequenced on a human-specific MitoChip

Background: Iterative DNA "resequencing" on oligonucleotide microarrays offers a high-throughput method to measure intraspecific biodiversity, one that is especially suited to SNP-dense gene regions such as vertebrate mitochondrial (mtDNA) genomes. However, costs of single-species design and microarray fabrication are prohibitive. A cost-effective, multi-species strategy is to hybridize experimental DNAs from diverse species to a common microarray that is tiled with oligonucleotide sets from multiple, homologous reference genomes. Such a strategy requires that cross-hybridization between the experimental DNAs and reference oligos from the different species not interfere with the accurate recovery of species-specific data. To determine the pattern and limits of such interspecific hybridization, we compared the efficiency of sequence recovery and accuracy of SNP identification by a 15,452-base human-specific microarray challenged with human, chimpanzee, gorilla, and codfish mtDNA genomes. Results: In the human genome, 99.67% of the sequence was recovered with 100.0% accuracy. Accuracy of SNP identification declines log-linearly with sequence divergence from the reference, from 0.067 to 0.247 errors per SNP in the chimpanzee and gorilla genomes, respectively. Efficiency of sequence recovery declines with the increase of the number of interspecific SNPs in the 25b interval tiled by the reference oligonucleotides. In the gorilla genome, which differs from the human reference by 10%, and in which 46% of these 25b regions contain 3 or more SNP differences from the reference, only 88% of the sequence is recoverable. In the codfish genome, which differs from the reference by > 30%, less than 4% of the sequence is recoverable, in short islands ≥ 12b that are conserved between primates and fish. Conclusion: Experimental DNAs bind inefficiently to homologous reference oligonucleotide sets on a resequencing microarray when their sequences differ by more than a few percent. The data suggest that interspecific cross-hybridization will not interfere with the accurate recovery of species-specific data from multispecies microarrays, provided that the species' DNA sequences differ by > 20% (mean of 5b differences per 25b oligo). Recovery of DNA sequence data from multiple, distantly-related species on a single multiplex gene chip should be a practical, highly-parallel method for investigating genomic biodiversity

Removal of AMPA receptors (AMPARs) from synapses is preceded by transient endocytosis of extrasynaptic AMPARs

AMPA receptors (AMPARs) are dynamically regulated at synapses, but the time course and location of their exocytosis and endocytosis are not known. Therefore, we have used ecliptic pHluorin-tagged glutamate receptor 2 to visualize changes in AMPAR surface expression in real time. We show that synaptic and extrasynaptic AMPARs respond very differently to NMDA receptor activation; there is a rapid internalization of extrasynaptic AMPARs that precedes the delayed removal of synaptic AMPARs

A national survey of services for the prevention and management of falls in the UK

Background: The National Health Service (NHS) was tasked in 2001 with developing service provision to prevent falls in older people. We carried out a national survey to provide a description of health and social care funded UK fallers services, and to benchmark progress against current practice guidelines. Methods: Cascade approach to sampling, followed by telephone survey with senior member of the fall service. Characteristics of the service were assessed using an internationally agreed taxonomy. Reported service provision was compared against benchmarks set by the National Institute for Health and Clinical Excellence (NICE). Results: We identified 303 clinics across the UK. 231 (76%) were willing to participate. The majority of services were based in acute or community hospitals, with only a few in primary care or emergency departments. Access to services was, in the majority of cases, by health professional referral. Most services undertook a multi-factorial assessment. The content and quality of these assessments varied substantially. Services varied extensively in the way that interventions were delivered, and particular concern is raised about interventions for vision, home hazard modification, medication review and bone health. Conclusion: The most common type of service provision was a multi-factorial assessment and intervention. There were a wide range of service models, but for a substantial number of services, delivery appears to fall below recommended NICE guidance

The efficiency of immobilised glutamate oxidase decreases with surface enzyme loading: an electrostatic effect, and reversal by a polycation significantly enhances biosensor sensitivity

The apparent Michaelis constant, KM, for glutamate oxidase (GluOx) immobilised on Pt electrodes increased systematically with enzyme loading. The effect was due, at least in part, to electrostatic repulsion between neighbouring oxidase molecules and the anionic substrate, glutamate (Glu). This understanding has allowed us to increase the Glu sensitivity of GluOx-based amperometric biosensors in the linear response region (100 ± 11 nA cmâ2µMâ1 at pH 7.4; SD, n = 23) by incorporating a polycation (polyethyleneimine, PEI) to counterbalance the polyanionic protein. Differences in the behaviour of glucose biosensors of a similar configuration highlight a limitation of using glucose oxidase as a model enzyme in biosensor design

The efficiency of immobilised glutamate oxidase decreases with surface enzyme loading: an electrostatic effect, and reversal by a polycation significantly enhances biosensor sensitivity

The apparent Michaelis constant, KM, for glutamate oxidase (GluOx) immobilised on Pt electrodes increased systematically with enzyme loading. The effect was due, at least in part, to electrostatic repulsion between neighbouring oxidase molecules and the anionic substrate, glutamate (Glu). This understanding has allowed us to increase the Glu sensitivity of GluOx-based amperometric biosensors in the linear response region (100 ± 11 nA cmâ2µMâ1 at pH 7.4; SD, n = 23) by incorporating a polycation (polyethyleneimine, PEI) to counterbalance the polyanionic protein. Differences in the behaviour of glucose biosensors of a similar configuration highlight a limitation of using glucose oxidase as a model enzyme in biosensor design

Position Paper on Adult Safeguarding, Legislation, Policy and Practice

The issue of adult safeguarding is of utmost importance for social workers and for the IASW. For those adults in need of safeguarding, the support and vindication of their integrity, autonomy, and human rights, as well as their protection and safety, may be dependent in large part on the role played by state agencies and civil society. Social workers have a particularly key role to play in adult safeguarding. The present position paper has been developed in the context of emerging legislation and new structures, policies, and services. In publishing the present position paper, which now supersedes a previous paper, the IASW seeks to influence the development and implementation of appropriate legislation, policy, and practice. This is in line with human rights values and best practices and based on our unique role, expertise, and experience as social workers, as well as being influenced by the voices and needs of the people we work with and their families. This is ultimately to seek to ensure that those adults who need professional safeguarding interventions, and their loved ones, receive the best possible services and protection

Preliminary study of proton magnetic resonance spectroscopy to assess bone marrow adiposity in the third metacarpus or metatarsus in Thoroughbred racehorses

Background: Magnetic resonance spectroscopy (MRS) has been used to investigate metabolic changes within human bone. It may be possible to use MRS to investigate bone metabolism and fracture risk in the distal third metacarpal/tarsal bone (MC/MTIII) in racehorses. Objectives: To determine the feasibility of using MRS as a quantitative imaging technique in equine bone by using the 1H spectra for the MC/MTIII to calculate fat content (FC). Study Design: Observational cross-sectional study Methods: Limbs from Thoroughbred racehorses were collected from horses that died or were subjected to euthanasia on racecourses. Each limb underwent magnetic resonance imaging (MRI) at 3T followed by single-voxel MRS at 3 regions of interest (ROI) within MC/MTIII (lateral condyle, medial condyle, proximal bone marrow (PBM)). Percentage FC was calculated at each ROI. Each limb underwent computed tomography (CT) and bone mineral density (BMD) was calculated for the same ROIs. All MR and CT images were graded for sclerosis. Histology slides were graded for sclerosis and proximal marrow space was calculated. Pearson or Spearman correlations were used to assess the relationship between BMD, FC and marrow space. Kruskall-Wallis tests were used to check for differences between sclerosis groups for BMD or FC. Results: Eighteen limbs from 10 horses were included. A negative correlation was identified for mean BMD and FC for the lateral condyle (correlation coefficient =-0.60, p=0.01) and PBM (correlation coefficient =-0.5, p=0.04). There was a significant difference between median BMD for different sclerosis grades in the condyles on both MRI and CT. A significant difference in FC was identified between sclerosis groups in the lateral condyle on MRI and CT . Main Limitations: Small sample size. Conclusions: 1H Proton MRS is feasible in the equine MC/MTIII. Further work is required to evaluate the use of this technique to predict fracture risk in racehorses