Useful residual hearing despite radiological findings suggestive of anacusis

A severe malformation of the inner ear, often referred to as severe labyrinthine dysplasia or common cavity deformity, consists of an absent or dilated cochlear basal coil, wide communication with the vestibule and a tapered internal acoustic meatus and can be associated with absent hearing. We discuss two children with severe labyrinthine dysplasia as shown by computed tomography (CT) scans and, in the first case, an absent VIIIth nerve bilaterally shown by magnetic resonance imaging (MRT). In 1995, both cases were precluded from cochlear implantation, on the basis of the absent VIIIth nerve (first case) and increased risk of CSF leak during operation (second case). However, audiometric results and vocalization patterns of both children suggested the presence of some residual hearing function, while recently reported specific surgical techniques have been found to be safe and effective in the cochlear implantation of the common cavity deformity. The management of such cases should be decided on the grounds of a full audiological assessment in conjunction with the radiological features, in the light of current surgical trends shown to be safe and effective

2009 Archaeological Investigations at the Walters, Beedle, and Lyon Lots, Lincoln Home National Historic Site

Established in 1971, the Lincoln Home National Historic Site (LIHO) commemorates the life of the 16th President of the United States. The park contains the neighborhood where Abraham Lincoln spent most of his adult life in Springfield, Illinois (Townsend 2008:76-149). The Park consists of a four-block historic neighborhood, which is partly restored to the year of Abraham Lincoln’s election as President. The centerpiece of the park consists of the restored house where Lincoln’s family lived from 1844 to 1861, when he became the 16th President of the United States

Quality of life with conservative care compared with assisted peritoneal dialysis and haemodialysis

Background. There is little information about quality of life (QoL) for patients with end-stage kidney disease (ESKD) choosing conservative kidney management (CKM). The Frail and Elderly Patients on Dialysis (FEPOD) study demonstrated that frailty was associated with poorer QoL outcomes with little difference between dialysis modalities [assisted peritoneal dialysis (aPD) or haemodialysis (HD)]. We therefore extended the FEPOD study to include CKM patients with estimated glomerular filtration rate ⌉10 mL/min/1.73m2 (i.e. individuals with ESKD otherwise likely to be managed with dialysis). Methods. CKM patients were propensity matched to HD and aPD patients by age, gender, ethnicity, diabetes status and index of deprivation. QoL outcomes measured were Short Form-12 (SF12), Hospital Anxiety and Depression Scale depression score, symptom score, Illness Intrusiveness Rating Scale (IIRS) and Renal Treatment Satisfaction Questionnaire. Frailty was assessed using the Clinical Frailty Scale. Generalized linear modelling was used to assess the impact of treatment modality on QoL outcomes, adjusting for baseline characteristics. Results. In total, 84 (28 CKM, 28 HD and 28 PD) patients were included. Median age for the cohort was 82 (79-88) years. Compared with CKM, aPD was associated with higher SF12 physical component score (PCS) [Exp B (95% confidence interval)=1.20 (1.00-1.45), P<0.05] and lower symptom score [Exp B=0.62 (0.43-0.90), P=0.01]; depression score was lower in HD compared with CKM [Exp B=0.70 (0.52-0.92), P=0.01]. Worsening frailty was associated with higher depression scores [Exp B=2.59 (1.45-4.62), P<0.01], IIRS [Exp B=1.20 (1.12-1.28), P<0.01] and lower SF12 PCS [Exp B=0.87 (0.83-0.93), P<0.01]. Conclusion. Treatment by dialysis, both with aPD and HD, improved some QoL measures. Overall, aPD was equal to or slightly better than the other modalities in this elderly population. However, as in the primary FEPOD study, frailty was associated with worse QoL measures irrespective of CKD modality. These findings highlight the need for an individualized approach to the management of ESKD in older people.Peer reviewedFinal Published versio

INTEGRAL/IBIS search for e-e+ annihilation radiation from the Galactic Center Region

Electron-positron annihilation radiation from the Galactic Center region has been detected since the seventies, but its astrophysical origin is still a topic of a scientific debate. We have analyzed data of the gamma-ray imager IBIS/ISGRI onboard of ESA's INTEGRAL platform in the e$^{-}$e$^{+}$ line. During the first year of the missions Galactic Center Deep Exposure no evidence for point sources at 511 keV has been found in the ISGRI data; the $2 \sigma$ upper limit for resolved single point sources is estimated to be $1.6\times 10^{-4} ph cm^{-2} s^{-1}$.Comment: 6 pages, 3 figures; Cospar 2004. To be published in: Advances in Space Researc

A comparative framework: how broadly applicable is a 'rigorous' critical junctures framework?

The paper tests Hogan and Doyle's (2007, 2008) framework for examining critical junctures. This framework sought to incorporate the concept of ideational change in understanding critical junctures. Until its development, frameworks utilized in identifying critical junctures were subjective, seeking only to identify crisis, and subsequent policy changes, arguing that one invariably led to the other, as both occurred around the same time. Hogan and Doyle (2007, 2008) hypothesized ideational change as an intermediating variable in their framework, determining if, and when, a crisis leads to radical policy change. Here we test this framework on cases similar to, but different from, those employed in developing the exemplar. This will enable us determine whether the framework's relegation of ideational change to a condition of crisis holds, or, if ideational change has more importance than is ascribed to it by this framework. This will also enable us determined if the framework itself is robust, and fit for the purposes it was designed to perform — identifying the nature of policy change

Understanding the factors that affect university completion for autistic people

Background: Autistic individuals may be less likely to complete their university studies, but there is no research to date that examines why this is the case. This study thus examined the factors that may affect university completion for autistic people. Method: Two-hundred and thirty autistic people who had attended university completed an online survey, whereby 151 had graduated on their first attempt, 34 graduated after several attempts, and 45 had not completed. Participants answered questions regarding the transition to university, academic and social experiences, diagnosis, mental wellbeing and sensory sensitivities. Results: Those who did not complete had a poorer academic experience, found the transition more difficult, and felt less organisational and social identification at university. Logistic regression suggested the transition to university is particularly important in predicting non-completion. Conclusions: Finding the transition challenging and struggling with academic and social aspects may contribute to the risk of dropping-out. The study has implications for universities, who must ensure all autistic students are able to achieve their full academic potential by providing appropriate transition support, fostering a sense of community at university and ensuring staff are appropriately trained

Noradrenergic α1 Receptor Antagonist Treatment Attenuates Positive Subjective Effects of Cocaine in Humans: A Randomized Trial

Preclinical research implicates dopaminergic and noradrenergic mechanisms in mediating the reinforcing effects of drugs of abuse, including cocaine. The objective of this study was to evaluate the impact of treatment with the noradrenergic α(1) receptor antagonist doxazosin on the positive subjective effects of cocaine.Thirteen non-treatment seeking, cocaine-dependent volunteers completed this single-site, randomized, placebo-controlled, within-subjects study. In one study phase volunteers received placebo and in the other they received doxazosin, with the order counterbalanced across participants. Study medication was masked by over-encapsulating doxazosin tablets and matched placebo lactose served as the control. Study medication treatment was initiated at 1 mg doxazosin or equivalent number of placebo capsules PO/day and increased every three days by 1 mg. After receiving 4 mg doxazosin or equivalent number of placebo capsules participants received masked doses of 20 and 40 mg cocaine IV in that order with placebo saline randomly interspersed to maintain the blind.Doxazosin treatment was well tolerated and doxazosin alone produced minimal changes in heart rate and blood pressure. During treatment with placebo, cocaine produced dose-dependent increases in subjective effect ratings of "high", "stimulated", "like cocaine", "desire cocaine", "any drug effect", and "likely to use cocaine if had access" (p<.001). Doxazosin treatment significantly attenuated the effects of 20 mg cocaine on ratings of "stimulated", "like cocaine", and "likely to use cocaine if had access" (p<.05). There were trends for doxazosin to reduce ratings of "stimulated", "desire cocaine", and "likely to use cocaine if had access" (p<.10).Medications that block noradrenergic α₁ receptors, such as doxazosin, may be useful as treatments for cocaine dependence, and should be evaluated further.Clinicaltrials.gov NCT01062945

Methodological implications of intra- and inter-facet microwear texture variation for human childhood paleo-dietary reconstruction: Insights from the deciduous molars of extant and medieval children from France

The present study concerns occlusal dental microwear texture variation on the deciduous molars of children. A description and evaluation of microwear texture variation within facet 9 and a comparison of microwear textures between grinding facets 9 and 11 are presented. The relationship between wear facet surface area and intra-facet microwear texture variability is evaluated. The sample is composed of naturally-exfoliated, taphonomy-free deciduous second molars from twelve extant children and four archaeologically-derived medieval children (for a total of 51 surface measurements). Dental microwear texture analysis (DMTA) was performed using a confocal microscope and scale-sensitive fractal analysis (SSFA) at three standardized locations on facet 9, and one location on facet 11. Facet shape was visually assessed and scored using a headset magnifier (3×) and composite images (20× confocal microscopy). Individuals were assigned to two groups based on a qualitative assessment of facet surface area. Microwear texture variability within facet 9 was high relative to the variability of microwear textures between individuals. No significant inter-facet variation between facets 9 and 11 was detected. No clear differences in microwear and variabilities within facet 9 were found between individuals assigned to small and large facet groups. Our study shows the existence of important intra-facet microwear variation in a sample of children. Intra-facet microwear variation can affect the ability of DMTA to distinguish between diets in contexts with small sample sizes and subtle differences in diet – such as those characterizing dietary transitions in children. Results also suggest non-dietary factors may influence microwear formation during dental exfoliation. A better understanding of intra-facet microwear variation, and when and how to account for it, can improve the application of occlusal DMTA in similar contexts

Probing Mach's principle

The principle of least action in its original form \'a la Maupertuis is used to explain geodetic and frame-dragging precessions which are customarily accounted for a curved spacetime by general relativity. The obtained least-time equations of motion agree with observations and are also in concert with general relativity. Yet according to the least-time principle, gravitation does not relate to the mathematical metric of spacetime, but to a tangible energy density embodied by photons. The density of free space is in balance with the total mass of the Universe in accord with Planck's law. Likewise, a local photon density and its phase distribution are in balance with mass and charge distribution of a local body. Here gravitational force is understood as an energy density difference that will diminish when the oppositely polarized pairs of photons co-propagate from the energy-dense system of bodies to the energy-sparse system of the surrounding free space. Thus when the body changes its state of motion, the surrounding energy density must accommodate the change. The concurrent resistance in restructuring of the surroundings, ultimately involving the entire Universe, is known as inertia. The all-around propagating energy density couples everything with everything else in accord with Mach's principle.Comment: 7 pages, to appear in MNRA