Breastfeeding, the use of docosahexaenoic acid-fortified formulas in infancy and neuropsychological function in childhood

OBJECTIVE: To investigate the relation between breastfeeding, use of docosahexaenoic acid (DHA)-fortified formula and neuropsychological function in children. DESIGN: Prospective cohort study. SETTING: Southampton, UK. SUBJECTS: 241 children aged 4 years followed up from birth. MAIN OUTCOME MEASURES: IQ measured by the Wechsler Pre-School and Primary Scale of Intelligence (3rd edn), visual attention, visuomotor precision, sentence repetition and verbal fluency measured by the NEPSY, and visual form-constancy measured by the Test of Visual-Perceptual Skills (Non-Motor). RESULTS: In unadjusted analyses, children for whom breast milk or DHA-fortified formula was the main method of feeding throughout the first 6 months of life had higher mean full-scale and verbal IQ scores at age 4 years than those fed mainly unfortified formula. After adjustment for potential confounding factors, particularly maternal IQ and educational attainment, the differences in IQ between children in the breast milk and unfortified formula groups were severely attenuated, but children who were fed DHA-fortified formula had full-scale and verbal IQ scores that were respectively 5.62 (0.98 to 10.2) and 7.02 (1.56 to 12.4) points higher than children fed unfortified formula. However, estimated total intake of DHA in milk up to age 6 months was not associated with subsequent IQ or with score on any other test. CONCLUSIONS: Differences in children's intelligence according to type of milk fed in infancy may be due more to confounding by maternal or family characteristics than to the amount of long-chain polyunsaturated fatty acids they receive in milk

Leukemia-related chromosomal loss detected in hematopoietic progenitor cells of benzene-exposed workers.

Benzene exposure causes acute myeloid leukemia and hematotoxicity, shown as suppression of mature blood and myeloid progenitor cell numbers. As the leukemia-related aneuploidies monosomy 7 and trisomy 8 previously had been detected in the mature peripheral blood cells of exposed workers, we hypothesized that benzene could cause leukemia through the induction of these aneuploidies in hematopoietic stem and progenitor cells. We measured loss and gain of chromosomes 7 and 8 by fluorescence in situ hybridization in interphase colony-forming unit-granulocyte-macrophage (CFU-GM) cells cultured from otherwise healthy benzene-exposed (n=28) and unexposed (n=14) workers. CFU-GM monosomy 7 and 8 levels (but not trisomy) were significantly increased in subjects exposed to benzene overall, compared with levels in the control subjects (P=0.0055 and P=0.0034, respectively). Levels of monosomy 7 and 8 were significantly increased in subjects exposed to <10 p.p.m. (20%, P=0.0419 and 28%, P=0.0056, respectively) and ≥ 10 p.p.m. (48%, P=0.0045 and 32%, 0.0354) benzene, compared with controls, and significant exposure-response trends were detected (P(trend)=0.0033 and 0.0057). These data show that monosomies 7 and 8 are produced in a dose-dependent manner in the blood progenitor cells of workers exposed to benzene, and may be mechanistically relevant biomarkers of early effect for benzene and other leukemogens

Focusing on outcomes: Making the most of COPD interventions

A number of excellent intervention studies related to clinical and psychosocial aspects of chronic obstructive pulmonary disease (COPD) have been undertaken in the recent past. A range of outcomes have been examined including pulmonary function, health care use, quality of life, anxiety and depression, ambulation, exercise capacity, and self-efficacy. The purpose of this narrative review was to a) consider clinical, psychosocial, and educational interventions for people living with COPD in light of the health related outcomes that they have produced, b) identify the type of interventions most associated with outcomes, c) examine work related to COPD interventions as it has evolved regarding theory and models compared to work in asthma, and d) explore implications for future COPD research. Studies reviewed comprised large scale comprehensive reviews including randomized clinical trials and meta-analysis as these forms of investigation engender the greatest confidence in clinicians and health care researchers. Extant research suggests that the most significant improvements in COPD health care utilization have been realized from interventions specifically designed to enhance disease management by patients. A range of interventions have produced modest changes in quality of life. Evidence of impact for other outcomes and for a particular type of intervention is not strong. Research in other chronic diseases, particularly asthma, suggests that interventions grounded in learning theory and models of behavior change can consistently produce desired results for patients and clinicians. Use of a model of self-regulation may enhance COPD interventions. Although the extent to which COPD efforts can benefit from the experience in other conditions is a question, more outcome focused intervention studies using more robust theoretical approaches may enhance COPD results, especially regarding health care use and quality of life

Інтертекстуальність та гіпертекстуальні трансформації в турецьких народних оповідях

In this paper, some of the Turkish minstrel tales are analyzed in the frame of Gérard Genette’s ‘palimpsests’ approach. In the transtextuality category; the minstrel tales demonstrate both intertextual relations and hypertextual transformations. In terms of intertextuality, the tales present self-conscious intertextual relations by referring to other texts. The paper focuses on that in terms of hypertextuality, the mistrel tales transform the other texts by the process of reduction, extension, amplification and so on. Because of this process, the structure, the plot and the meaning of the previous text is transformed. As a result, the Turkish minstrel tales, as oral literary texts, can actively have role in intertextual relations as hypertexts.Türk halk hikâyelerine Fransız anlatıbilimci Gérard Genette’in “palempsest” imgesi ile yaklaşıldığında, halk hikâyelerinin ötemetinsellik sınıflandırmasında “metinlerarasılık” ve “ana metinsellik” ilişkilerini yansıttıkları görülmektedir. Halk hikâyeleri, göndermeler yoluyla bir başka metni somut olarak içinde barındırarak metinlerarasılık ilişkisi kurmaktadır. Bunun yanında, diğer sözlü ve yazılı metinleri biçimsel ve izleksel ya da anlamsal olarak dönüştürerek anlatısını yeniden kompoze etmek noktasında ana metinsellik ilişkisini kurmaktadır. Bu çalışmada Türk halk hikâyelerinin ana metinsellik dönüşümleri biçimsel ve anlamsal dönüşümler yoluyla incelenecektir. Türk halk hikâyeleri odağında yapılan çalışmalarda, genellikle kaynak ve etki alanı arayışları ile karşılaştırmalı eleştiri yaklaşımından yararlanılmıştır. Türk halk hikâyelerine metinlerarasılık ile yaklaşmak, anlatıların anlamsal ve yapısal olarak nasıl katmanlaştığını görmek ve anlatıyı metin olarak çözümlemek açısından somut veriler sağlayan bir yöntemdir

Rapid diagnostic test for antenatal syphilis screening in low-income and middle-income countries: a systematic review and meta-analysis

OBJECTIVES: To undertake a systematic review and meta-analysis to evaluate the test performance including sensitivity and specificity of rapid immunochromatographic syphilis (ICS) point-of-care (POC) tests at antenatal clinics compared with reference standard tests (non-treponemal (TP) and TP tests) for active syphilis in pregnant women. METHODS: Five electronic databases were searched (PubMed, EMBASE, CRD, Cochrane Library and LILACS) to March 2016 for diagnostic accuracy studies of ICS test and standard reference tests for syphilis in pregnant women. Methodological quality was assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). A bivariate meta-analysis was undertaken to generate pooled estimates of diagnostic parameters. Results were presented using a coupled forest plot of sensitivity and specificity and a scatter plot. RESULTS: The methodological quality of the five included studies with regards to risk of bias and applicability concern judgements was either low or unclear. One study was judged as high risk of bias for patient selection due to exclusion of pregnant women with a previous history of syphilis, and one study was judged at high risk of bias for study flow and timing as not all patients were included in the analysis. Five studies contributed to the meta-analysis, providing a pooled sensitivity and specificity for ICS of 0.85 (95% CrI: 0.73 to 0.92) and 0.98 (95% CrI: 0.95 to 0.99), respectively. CONCLUSIONS: This review and meta-analysis observed that rapid ICS POC tests have a high sensitivity and specificity when performed in pregnant women at antenatal clinics. However, the methodological quality of the existing evidence base should be taken into consideration when interpreting these results. PROSPERO REGISTRATION NUMBER: CRD42016036335

Using a composite flow law to model deformation in the NEEM deep ice core, Greenland — Part 2: The role of grain size and premelting on ice deformation at high homologous temperature

The ice microstructure in the lower part of the North Greenland Eemian Ice Drilling (NEEM) ice core consists of relatively fine-grained ice with a single maximum crystallographic preferred orientation (CPO) alternated by much coarser-grained ice with a partial (great circle) girdle or multi-maxima CPO. In this study, the grain-size-sensitive (GSS) composite flow law of Goldsby and Kohlstedt (2001) was used to study the effects of grain size and premelting (liquid-like layer along the grain boundaries) on strain rate in the lower part of the NEEM ice core. The results show that the strain rates predicted in the fine-grained layers are about an order of magnitude higher than in the much coarser-grained layers. The dominant deformation mechanisms, based on the flow relation of Goldsby and Kohlstedt (2001), between the layers is also different, with basal slip rate limited by grain boundary sliding (GBS-limited creep) being the dominant deformation mechanism in the finer-grained layers, while GBS-limited creep and dislocation creep (basal slip rate limited by non-basal slip) contribute both roughly equally to bulk strain in the coarse-grained layers. Due to the large difference in microstructure between finer-grained ice and the coarse-grained ice at premelting temperatures (T>262 K), it is expected that the fine-grained layers deform at high strain rates, while the coarse-grained layers are relatively stagnant. The difference in microstructure, and consequently in viscosity, between impurity-rich and low-impurity ice can have important consequences for ice dynamics close to the bedrock