Are estimates of faces’ ages less accurate when they wear sunglasses or face masks and do these disguises make it harder to later recognise the faces when undisguised?

This study examined whether our ability to accurately estimate unfamiliar faces’ ages declines when they are wearing sunglasses or surgical-style face masks and whether these disguises make it harder to later recognise those faces when undisguised. In theory, both disguises should harm age estimation accuracy and later face recognition as they occlude facial information that is used to determine a face’s age and identity. To establish whether this is the case, we had participants estimate the age of unfamiliar faces that were pictured wearing no disguises, sunglasses, or face masks. The participants then completed a face recognition test where they had to distinguish between the previously seen faces and new faces. Importantly, none of faces wore disguises in this latter test. Participants’ estimates of the undisguised faces’ ages were inaccurate by a Median of 5.15 years. Their accuracy barely changed when the faces wore sunglasses but declined by a Median of 1.30 years when they wore face masks. Moreover, subsequent undisguised face recognition was less likely to occur when the faces previously wore sunglasses or face masks, with large effects observed. These findings demonstrate the relative importance of different facial areas when estimating faces’ ages and later recognising them. They also have implications for policing as they suggest it may be harder for eyewitnesses to accurately estimate the age of criminals who wear face masks during offences, and it may be harder for them to later recognise criminals in line-ups if the criminals wear sunglasses or face masks during offences

Quantitative magnetic resonance imaging (qMRI) in Axial Spondyloarthritis

Imaging, and particularly magnetic resonance imaging (MRI), plays a crucial role in the assessment of inflammation in rheumatic disease, and forms a core component of the diagnostic pathway in axial spondyloarthritis (axSpA). However, conventional imaging techniques are limited by image contrast being non-specific to inflammation and a reliance on subjective, qualitative reader interpretation. Quantitative MRI (qMRI) methods offer scope to address these limitations and improve our ability to accurately and precisely detect and characterise inflammation, potentially facilitating a more personalised approach to management. Here, we review qMRI methods and emerging quantitative imaging biomarkers (QIBs) for imaging inflammation in axSpA. We discuss the potential benefits as well as the practical considerations that must be addressed in the movement toward clinical translation of QIBs

Cognition and bimanual performance in children with unilateral cerebral palsy: Protocol for a multicentre, cross-sectional study

© 2018 The Author(s). Background: Motor outcomes of children with unilateral cerebral palsy are clearly documented and well understood, yet few studies describe the cognitive functioning in this population, and the associations between the two is poorly understood. Using two hands together in daily life involves complex motor and cognitive processes. Impairment in either domain may contribute to difficulties with bimanual performance. Research is yet to derive whether, and how, cognition affects a child's ability to use their two hands to perform bimanual tasks. Methods/Design: This study will use a prospective, cross-sectional multi-centre observational design. Children (aged 6-12 years) with unilateral cerebral palsy will be recruited from one of five Australian treatment centres. We will examine associations between cognition, bimanual performance and brain neuropathology (lesion type and severity) in a sample of 131 children. The primary outcomes are: Motor - the Assisting Hand Assessment; Cognitive - Executive Function; and Brain - lesion location on structural MRI. Secondary data collected will include: Motor - Box and Blocks, ABILHAND- Kids, Sword Test; Cognitive - standard neuropsychological measures of intelligence. We will use generalized linear modelling and structural equation modelling techniques to investigate relationships between bimanual performance, executive function and brain lesion location. Discussion: This large multi-centre study will examine how cognition affects bimanual performance in children with unilateral cerebral palsy. First, it is anticipated that distinct relationships between bimanual performance and cognition (executive function) will be identified. Second, it is anticipated that interrelationships between bimanual performance and cognition will be associated with common underlying neuropathology. Findings have the potential to improve the specificity of existing upper limb interventions by providing more targeted treatments and influence the development of novel methods to improve both cognitive and motor outcomes in children with unilateral cerebral palsy

Constraint-induced movement therapy in children with unilateral cerebral palsy

Background Unilateral cerebral palsy (CP) is a condition that affects muscle control and function on one side of the body. Children with unilateral CP experience difficulties using their hands together secondary to disturbances that occur in the developing fetal or infant brain. Often, the more affected limb is disregarded. Constraint‐induced movement therapy (CIMT) aims to increase use of the more affected upper limb and improve bimanual performance. CIMT is based on two principles: restraining the use of the less affected limb (for example, using a splint, mitt or sling) and intensive therapeutic practice of the more affected limb. Objectives To evaluate the effect of constraint‐induced movement therapy (CIMT) in the treatment of the more affected upper limb in children with unilateral CP. Search methods In March 2018 we searched CENTRAL, MEDLINE, Embase, CINAHL, PEDro, OTseeker, five other databases and three trials registers. We also ran citation searches, checked reference lists, contacted experts, handsearched key journals and searched using Google Scholar. Selection criteria Randomised controlled trials (RCTs), cluster‐RCTs or clinically controlled trials implemented with children with unilateral CP, aged between 0 and 19 years, where CIMT was compared with a different form of CIMT, or a low dose, high‐dose or dose‐matched alternative form of upper‐limb intervention such as bimanual intervention. Primarily, outcomes were bimanual performance, unimanual capacity and manual ability. Secondary outcomes included measures of self‐care, body function, participation and quality of life. Data collection and analysis Two review authors independently screened titles and abstracts to eliminate ineligible studies. Five review authors were paired to extract data and assess risk of bias in each included study. GRADE assessments were undertaken by two review authors. Main results We included 36 trials (1264 participants), published between 2004 and 2018. Sample sizes ranged from 11 to 105 (mean 35). Mean age was 5.96 years (standard deviation (SD) 1.82), range three months to 19.8 years; 53% male and 47% participants had left hemiplegia. Fifty‐seven outcome measures were used across studies. Average length of CIMT programs was four weeks (range one to 10 weeks). Frequency of sessions ranged from twice weekly to seven days per week. Duration of intervention sessions ranged from 0.5 to eight hours per day. The mean total number of hours of CIMT provided was 137 hours (range 20 to 504 hours). The most common constraint devices were a mitt/glove or a sling (11 studies each). We judged the risk of bias as moderate to high across the studies. Key results: Primary outcomes at primary endpoint (immediately after intervention) CIMT versus low‐dose comparison (e.g. occupational therapy) We found low‐quality evidence that CIMT was more effective than a low‐dose comparison for improving bimanual performance (mean difference (MD) 5.44 Assisting Hand Assessment (AHA) units, 95% confidence interval (CI) 2.37 to 8.51). CIMT was more effective than a low‐dose comparison for improving unimanual capacity (Quality of upper extremity skills test (QUEST) ‐ Dissociated movement MD 5.95, 95% CI 2.02 to 9.87; Grasps; MD 7.57, 95% CI 2.10 to 13.05; Weight bearing MD 5.92, 95% CI 2.21 to 9.6; Protective extension MD 12.54, 95% CI 8.60 to 16.47). Three studies reported adverse events, including frustration, constraint refusal and reversible skin irritations from casting. CIMT versus high‐dose comparison (e.g. individualised occupational therapy, bimanual therapy) When compared with a high‐dose comparison, CIMT was not more effective for improving bimanual performance (MD −0.39 AHA Units, 95% CI −3.14 to 2.36). There was no evidence that CIMT was more effective than a high‐dose comparison for improving unimanual capacity in a single study using QUEST (Dissociated movement MD 0.49, 95% CI −10.71 to 11.69; Grasp MD −0.20, 95% CI −11.84 to 11.44). Two studies reported that some children experienced frustration participating in CIMT. CIMT versus dose‐matched comparison (e.g. Hand Arm Bimanual Intensive Therapy, bimanual therapy, occupational therapy) There was no evidence of differences in bimanual performance between groups receiving CIMT or a dose‐matched comparison (MD 0.80 AHA units, 95% CI −0.78 to 2.38). There was no evidence that CIMT was more effective than a dose‐matched comparison for improving unimanual capacity (Box and Blocks Test MD 1.11, 95% CI −0.06 to 2.28; Melbourne Assessment MD 1.48, 95% CI −0.49 to 3.44; QUEST Dissociated movement MD 6.51, 95% CI −0.74 to 13.76; Grasp, MD 6.63, 95% CI −2.38 to 15.65; Weightbearing MD −2.31, 95% CI −8.02 to 3.40) except for the Protective extension domain (MD 6.86, 95% CI 0.14 to 13.58). There was no evidence of differences in manual ability between groups receiving CIMT or a dose‐matched comparison (ABILHAND‐Kids MD 0.74, 95% CI 0.31 to 1.18). From 15 studies, two children did not tolerate CIMT and three experienced difficulty. Authors' conclusions The quality of evidence for all conclusions was low to very low. For children with unilateral CP, there was some evidence that CIMT resulted in improved bimanual performance and unimanual capacity when compared to a low‐dose comparison, but not when compared to a high‐dose or dose‐matched comparison. Based on the evidence available, CIMT appears to be safe for children with CP

Implementing a national policy for hepatitis B birth dose vaccination in Philippines: Lessons for improved delivery

Background: An estimated seven million Filipinos (10-12% of the population) are chronically infected with hepatitis B virus (HBV). Achieving high birth dose coverage with hepatitis B vaccine is critical for achieving the World Health Organization's Western Pacific Regional goal of reducing the prevalence of chronic HBV among children 5 years of age to <2% by 2012. Methods: Seven months after the Philippines adopted a hepatitis B vaccine birth dose policy, hospitals with the highest number of deliveries were invited to participate in an assessment of implementation of the birth dose policy. Additionally, in metro Manila birth dose coverage was estimated before and after conducting a training workshop and supervisory follow-up for practitioners conducting home deliveries or deliveries at lying-in clinics. Results: Of the country's largest 150 hospitals in terms of authorized bed capacity, 85(56%) were included in this assessment. These hospitals had 55,719 deliveries during July-September 2007. Of these, 54% infants had a documented birth dose; however, only 22% were vaccinated within 24 h of delivery. Having a copy of the hepatitis B vaccine vaccination policy (prevalence odds ratio [pOR] = 4.7, 95% confidence interval [CI] = 1.2-18.0), having standing orders pOR = 4.8, 95% Cl = 1.3-18.1 and providing training pOR = 18.9, 95% CI = 5.3-67.0 were associated with >50% birth dose coverage in a hospital. In metro-Manila, regardless of place of birth, the training workshop and supervisory follow-up significantly improved hepatitis B vaccine administration within 24h after birth, increasing from 19% before to 74% after the training workshop and follow-up. Conclusions: Experience in the Philippines showed that actions by national, regional and health facility policy makers such as establishing national policies, distributing detailed and specific guidelines, conducting effective training and supervision, and having hospital standing orders substantially increased hepatitis B vaccine birth dose coverage

Brain magnetic resonance imaging is a predictor of bimanual performance and executive function in children with unilateral cerebral palsy

Aim To examine the association between brain magnetic resonance imaging (MRI) characteristics and executive function and bimanual performance in children with unilateral cerebral palsy (CP). Method Clinical MRI brain scans were classified as: (1) predominant pathological pattern (normal, white matter injury [WMI]; grey matter injury; focal vascular insults [FVI]; malformations; or miscellaneous); and (2) focal lesions (frontal, basal ganglia, and/or thalamus). Assessments included: (1) bimanual performance; (2) unimanual dexterity; and (3) executive function tasks (information processing, attention control, cognitive flexibility, and goal setting) and behavioural ratings (parent). Results From 131 recruited children, 60 were ineligible for analysis, leaving 71 children (47 males, 24 females) in the final sample (mean age 9y [SD 2y], 6y–12y 8mo). Brain MRIs were WMI (69%) and FVI (31%); and frontal (59%), thalamic (45%), basal ganglia (37%), and basal ganglia plus thalamic (21%). Bimanual performance was lower in FVI versus WMI (p<0.003), and with frontal (p=0.36), basal ganglia (p=0.032), and thalamic/basal ganglia lesions (p=0.013). Other than information processing, executive function tasks were not associated with predominant pattern. Frontal lesions predicted attention control (p=0.049) and cognitive flexibility (p=0.009) but not goal setting, information processing, or behavioural ratings. Interpretation Clinical brain MRI predicts cognitive and motor outcomes when focal lesions and predominate lesion patterns are considered. What this paper adds Early brain magnetic resonance imaging (MRI) predicts bimanual performance and cognitive outcomes. Brain MRI may identify children requiring targeted interventions. Basal ganglia with/without thalamic lesions predicted bimanual performance. Frontal lesions were associated with attention control and cognitive flexibility. Brain MRI predominant patterns predicted motor, not cognitive outcomes, other than information processing

Timing of hepatitis B vaccination and impact of non-simultaneous vaccination with DTP vaccine following introduction of a hepatitis B birth dose in the Philippines

Timely administration of hepatitis B vaccine beginning at birth prevents up to 95 per cent of perinatally acquired hepatitis B virus infections in infants of infected mothers. The Philippines changed its national HepB schedule in 2007 to include a dose at birth. We evaluated vaccination schedule change by reviewing infant records at selected health facilities to measure completeness and timeliness of HepB administration and frequency of recommended, simultaneous vaccination with diphtheria-tetanus-pertussis (DTP) vaccine. Of 1431 sampled infants, 1106 (77 per cent) completed the HepB series and 10 per cent followed the national schedule. The proportion with timely vaccination declined with successive doses: HepB1 (71 per cent), HepB2 (47 per cent), and HepB3 (26 per cent). Twenty-six per cent received HepB2 simultaneously with DTP1 and 34 per cent received HepB3 simultaneously with DTP3. If HepB and DTP vaccination were given simultaneously, 10 per cent more infants could have received all HepB doses. Program implementers should monitor vaccination timeliness and increase simultaneous administration to improve vaccination coverage and decrease disease incidence

Viral induction and targeted inhibition of galectin-1 in EBV + posttransplant lymphoproliferative disorders

Posttransplant lymphoproliferative disorders (PTLDs) are potentially fatal, EBVdriven B-cell malignancies that develop in immunocompromised solid organ or hematopoietic stem cell recipients. In PTLD, the expression of EBV proteins, including latent membrane protein 1 (LMP1) and LMP2A, viral immune evasion strategies, and impaired host immune surveillance foster the proliferation of EBV-transformed B cells. Current PTLD treatment strategies include reduction of immunosuppression, which increases the risk of graft rejection, anti-CD20 treatment, combination chemotherapy, and administration of EBV-specific cytotoxic T cells. In the present study, we report that EBV-transformed lymphoblastoid Bcell lines (LCLs) and primary PTLDs overexpress galectin-1 (Gal1), a carbohydratebinding lectin that induces tolerogenic dendritic cells and triggers the selective apoptosis of CD4 Th1 and Th17 cells and cytotoxic T cells. In transcriptional reporter assays, LMP2A and LMP1 each increased Gal1-driven luciferase expression, and the combination of LMP2A and LMP1 was additive. In addition, small interfering RNA (siRNA)–mediated depletion of LMP2A decreased Gal1 protein abundance in EBV-transformed LCLs. Gal1 expression in LCLs was dependent on both activating protein 1 (AP-1) and PI3K. A newly developed neutralizing Gal1 mAb selectively inhibited Gal1-mediated apoptosis of EBV-specific CD8 T cells. Given the tolerogenic and immunosuppressive function of Gal1, antibody-mediated Gal1 neutralization may represent a novel immunotherapeutic strategy for PTLD and other Gal1-expressing tumors.Fil: Ouyang, Ying. Dana-Farber Cancer Institute. Department of Medical Oncology; Estados UnidosFil: Juszczynski, Przemyslaw. Dana-Farber Cancer Institute. Department of Medical Oncology; Estados UnidosFil: Rodig, Scott J.. Brigham and Women’s Hospital. Department of Pathology; Estados UnidosFil: Green, Michael R.. Dana-Farber Cancer Institute. Department of Medical Oncology; Estados UnidosFil: O´ Donnell, Evan. Dana-Farber Cancer Institute. Department of Medical Oncology; Estados UnidosFil: Currie, Treeve. Brigham and Women’s Hospital. Department of Pathology; Estados UnidosFil: Armant, Myriam. Immune Disease Institute/Harvard Medical School. Center for Human Cell Therapy; Estados UnidosFil: Takeyama, Kunihiko. Dana-Farber Cancer Institute. Department of Medical Oncology; Estados UnidosFil: Monti, Stefano. Broad Institute; Estados UnidosFil: Rabinovich, Gabriel Adrian. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental (i); ArgentinaFil: Ritz, Jerome. Dana-Farber Cancer Institute. Department of Medical Oncology; Estados UnidosFil: Kutok, Jeffery L.. Brigham and Women’s Hospital. Department of Pathology; Estados UnidosFil: Shipp, Margaret A.. Dana-Farber Cancer Institute. Department of Medical Oncology; Estados Unido