Examining the cognitive profile of children with Developmental Coordination Disorder

Background: While primarily a motor disorder, research considering the cognitive abilities in children with Developmental Coordination Disorder (DCD) is limited; even though these children often struggle academically. Aims: The present study aimed to characterise the IQ profile of children with and without DCD, and to identify whether children with DCD exhibit specific cognitive weaknesses. Methods and procedures: 104 children participated in the study. Fifty-two children (mean age, 9 years) with a diagnosis of DCD were matched to 52 typically-developing children by age and gender. Cognitive ability was assessed using the Wechsler Intelligence Scale for Children (WISC-IV). Outcomes and results: Children with DCD performed poorer than their peers on processing speed and working memory measures. Individual analyses revealed varied performance in the DCD group across all cognitive indices, despite displaying Full-Scale IQs in the typical range. Discriminant function analyses show processing speed and working memory performance predicted only 23% of between-group variability. Conclusions: Children with DCD present with a heterogeneous cognitive profile, lending support to individual case analyses in research and when designing educational assistance plans. The motorically-demanding nature of the WISC-IV processing speed tasks raises specific concerns about using this index of the IQ assessment in this population. Research and practical implications are raised

Development and validation of a novel bioassay to determine glucocorticoid sensitivity

BACKGROUND: Glucocorticoids (GCs) remain the first line treatment for almost all non-infectious inflammatory diseases, ranging from acute asthma to rheumatoid arthritis. However, across all conditions, patients have a variable response to GCs with approximately 30% being non-responders. This group of GC resistant patients is typically exposed to high-dose GCs and their side-effects before more appropriate immunotherapy is instituted. Hence, there is a pressing clinical need for a predictive biomarker of GC responsiveness. The availability of such a tool would also enable patient stratification for the conduct of smart clinical trials in GC resistance. Lymphocyte GC sensitivity has been shown to be closely associated with clinical GC sensitivity in a number of inflammatory diseases. However, the method for determining in vitro GC response is not standardized and requires the use of specialist equipment, including a radioisotope to quantify cellular proliferation, making it challenging to translate into clinical practice. RESULTS: Here we describe the optimization and validation of a novel non-radioactive in vitro bioassay based on measuring cellular proliferation by incorporation of bromodeoxyuridine (BrdU), termed the BrdU incorporation in lymphocyte steroid sensitivity assay (BLISS). In comparison to the current gold standard lymphocyte GC sensitivity assay in 101 healthy control samples, BLISS has an area under receiver operating characteristic of 0.82 and a sensitivity of 83% for correctly identifying GC resistant subjects. CONCLUSIONS: The performance of the novel BLISS bioassay makes it a strong candidate biomarker for clinical application. It now requires validation in a prospective patient cohort. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40364-016-0079-y) contains supplementary material, which is available to authorized users

A review of the evolution of robotic-assisted total hip arthroplasty.

INTRODUCTION: Total hip arthroplasty (THA) is currently a very successful operation but continues to evolve as we try to perfect techniques and improve outcomes for our patients. Robotic hip surgery (RHS) began with the 'active' ROBODOC system in the 1980s. There were drawbacks associated with the original ROBODOC and most recently, the MAKO robot was introduced with early promising results. AIM: The aim of this paper is to provide an up-to-date review surrounding this area and discuss the pros and cons of this technique. METHODS: A literature review searching Medline, Embase, Ovidsp, Cochrane library, pubmed database and google scholar was performed searching keywords including: 'Robotic hip surgery', 'Robotic orthopaedic surgery', 'Computer assisted hip surgery', 'robotic arthroplasty', and 'computer assisted orthopaedic surgery'. CONCLUSION: Robotic hip surgery aims to tackle the limitations of the human factor in surgery by promising reproducible and reliable methods of component positioning in arthroplasty surgery. However, as orthopaedic surgeons, we must critically appraise all new technology and support the use providing there is sound robust evidence backing it

Development and validation of a novel bioassay to determine glucocorticoid sensitivity

Background: Glucocorticoids (GCs) remain the first line treatment for almost all non-infectious inflammatory diseases, ranging from acute asthma to rheumatoid arthritis. However, across all conditions, patients have a variable response to GCs with approximately 30% being non-responders. This group of GC resistant patients is typically exposed to high-dose GCs and their side-effects before more appropriate immunotherapy is instituted. Hence, there is a pressing clinical need for a predictive biomarker of GC responsiveness. The availability of such a tool would also enable patient stratification for the conduct of smart clinical trials in GC resistance. Lymphocyte GC sensitivity has been shown to be closely associated with clinical GC sensitivity in a number of inflammatory diseases. However, the method for determining in vitro GC response is not standardized and requires the use of specialist equipment, including a radioisotope to quantify cellular proliferation, making it challenging to translate into clinical practice. / Results: Here we describe the optimization and validation of a novel non-radioactive in vitro bioassay based on measuring cellular proliferation by incorporation of bromodeoxyuridine (BrdU), termed the BrdU incorporation in lymphocyte steroid sensitivity assay (BLISS). In comparison to the current gold standard lymphocyte GC sensitivity assay in 101 healthy control samples, BLISS has an area under receiver operating characteristic of 0.82 and a sensitivity of 83% for correctly identifying GC resistant subjects. / Conclusions: The performance of the novel BLISS bioassay makes it a strong candidate biomarker for clinical application. It now requires validation in a prospective patient cohort

The absolute position of a resonance peak

It is common practice in scattering theory to correlate between the position of a resonance peak in the cross section and the real part of a complex energy of a pole of the scattering amplitude. In this work we show that the resonance peak position appears at the absolute value of the pole's complex energy rather than its real part. We further demonstrate that a local theory of resonances can still be used even in cases previously thought impossible

Glucocorticoid treatment in patients with newly diagnosed immune thrombocytopenia switches CD14(++)CD16(+) intermediate monocytes from a pro-inflammatory to an anti-inflammatory phenotype

Immune thrombocytopenia (ITP) is thought to result from an aberrant adaptive autoimmune response, involving autoantibodies, B and T lymphocytes, directed at platelets and megakaryocytes. Previous reports have demonstrated skewed CD4+ T-helper subset distribution and enhanced production of pro-inflammatory cytokines such as interleukin 17A and interferon gamma. The role of monocytes (MCs) in ITP is less widely described, but innate immune cells have a role in shaping CD4+ T-cell phenotypes. Glucocorticoids (GCs) are commonly used for first-line ITP treatment and modulate a broad range of immune cells including T cells and MCs. Using multiparameter flow cytometry analysis, we demonstrate the expansion of intermediate MCs (CD14++CD16+ ) in untreated patients with newly diagnosed ITP, with these cells displaying a pro-inflammatory phenotype, characterised by enhanced expression of CD64 and CD80. After 2 weeks of prednisolone treatment (1 mg/kg daily), the proportion of intermediate MCs reduced, with enhanced expression of the anti-inflammatory markers CD206 and CD163. Healthy control MCs were distinctly different than MCs from patients with ITP before and after GC treatment. Furthermore, the GC-induced phenotype was not observed in patients with chronic ITP receiving thrombopoietin receptor agonists. These data suggest a role of MCs in ITP pathogenesis and clinical response to GC therapy

Outcomes following autologous hematopoietic stem cell transplant for patients with relapsed Wilms' tumor: a CIBMTR retrospective analysis.

Despite the marked improvement in the overall survival (OS) for patients diagnosed with Wilms' tumor (WT), the outcomes for those who experience relapse have remained disappointing. We describe the outcomes of 253 patients with relapsed WT who received high-dose chemotherapy (HDT) followed by autologous hematopoietic stem cell transplant (HCT) between 1990 and 2013, and were reported to the Center for International Blood and Marrow Transplantation Research. The 5-year estimates for event-free survival (EFS) and OS were 36% (95% confidence interval (CI); 29-43%) and 45% (95 CI; 38-51%), respectively. Relapse of primary disease was the cause of death in 81% of the population. EFS, OS, relapse and transplant-related mortality showed no significant differences when broken down by disease status at transplant, time from diagnosis to transplant, year of transplant or conditioning regimen. Our data suggest that HDT followed by autologous HCT for relapsed WT is well tolerated and outcomes are similar to those reported in the literature. As attempts to conduct a randomized trial comparing maintenance chemotherapy with consolidation versus HDT followed by stem cell transplant have failed, one should balance the potential benefits with the yet unknown long-term risks. As disease recurrence continues to be the most common cause of death, future research should focus on the development of consolidation therapies for those patients achieving complete response to therapy

R-parity violating resonant stop production at the Large Hadron Collider

We have investigated the resonant production of a stop at the Large Hadron Collider, driven by baryon number violating interactions in supersymmetry. We work in the framework of minimal supergravity models with the lightest neutralino being the lightest supersymmetric particle which decays within the detector. We look at various dilepton and trilepton final states, with or without b-tags. A detailed background simulation is performed, and all possible decay modes of the lighter stop are taken into account. We find that higher stop masses are sometimes easier to probe, through the decay of the stop into the third or fourth neutralino and their subsequent cascades. We also comment on the detectability of such signals during the 7 TeV run, where, as expected, only relatively light stops can be probed. Our conclusion is that the resonant process may be probed, at both 10 and 14 TeV, with the R-parity violating coupling {\lambda}"_{312} as low as 0.05, for a stop mass of about 1 TeV. The possibility of distinguishing between resonant stop production and pair-production is also discussed.Comment: 20 pages, 4 figures, 6 tables; Version accepted by JHE