Visuospatial deficits in children 3 - 7 years old with shunted hydrocephalus

Objective. To define non-verbal intelligence deficits in children 3- 7 years of age following shunted hydrocephalus (HCP).Design. Prospective randomised single-blinded study. Thirty shunted HCP (study) and 30 cardiac (control) patients between the ages of 3 and 7 years were compared on eight non-verbal subtests of the Junior South African Individual Scales (JSAIS).Setting. Department of Neurosurgery at Wentworth Hospital, Durban, South Africa.Results. Significant differences between the HCP and cardiac groups were recorded on all eight subtests of the JSAIS. The HCP group experienced problems with spatial orientation, perceptual planning and organisation, emotive deficits, abstract thinking and visual concepts.Conclusion. All patients with shunted HCP had specific deficiencies in defined cognitive areas of non-verbal intelligence when compared with the controls. Futher studies are warranted to determine the effects of ventriculoperitoneal shunting on non-verbal intelligence so that the special educational needs of HCP children may be met

Using tangible user interfaces for teaching concepts of internet of things: usability and learning effectiveness

Purpose This paper aims to explore the use of tangible user interfaces for teaching concepts related to internet of things by focusing on two aspects, notably, usability and learning effectiveness. Design/methodology/approach To assess the usability of IoTTT, Nielsen’s principles were used due to its relevance and popularity for usability assessment. In the usability questionnaire, four attributes were evaluated, notably, learnability, efficiency, errors and satisfaction. As for evaluating learning effectiveness, learning assessment was conducted through pre-tests and post-tests. Two groups of 20 students participated where the first group attended conventional lectures on IoT, whereas the second group used IoTTT for learning same concepts. In the process, data was collected through the usability questionnaire and tests for usability and learning effectiveness assessment. Findings Results revealed a positive score for the usability of the TUI solution with an average rating of 3.9. Although this score demonstrated an acceptable solution, different issues were identified, based on which a set of recommendations have been made in this paper. On the other hand, in the common pre-tests, an average score of 6.40 was obtained as compared to a mean score of 7.33 in the post-tests for all participants. Knowledge gains were significantly higher for students who learnt IoT concepts through the TUI-based system where performance improved by 18 per cent. Originality/value The results revealed in this study are expected to help the research community, course designers and tutors comprehend the prospects of using tangible user interfaces to foster teaching and learning of IoT concepts. In addition, educational solution providers could consider commercialisation prospects of this technology to innovate in teaching and learning, while also building-up on limitations identified within this study

Improving effectiveness of honeypots: predicting targeted destination port numbers during attacks using J48 algorithm

During recent years, there has been an increase in cyber-crime and cybercriminal activities around the world and as countermeasures, effective attack prevention and detection mechanisms are needed. A popular tool to augment existing attack detection mechanisms is the Honeypot. It serves as a decoy for luring attackers, with the purpose to accumulate essential details about the intruder and techniques used to compromise systems. In this endeavor, such tools need to effectively listen and keep track of ports on hosts such as servers and computers within networks. This paper investigates, analyzes and predicts destination port numbers targeted by attackers in order to improve the effectiveness of honeypots. To achieve the purpose of this paper, the J48 decision tree classifier was applied on a database containing information on cyber-attacks. Results revealed insightful information on key destination port numbers targeted by attackers, in addition to how these targeted ports vary within different regions around the world

Opportunities for improving the efficiency of paediatric HIV treatment programmes

Objectives: To conduct two economic analyses addressing whether to: routinely monitor HIV-infected children on antiretroviral therapy (ART) clinically or with laboratory tests; continue or stop cotrimoxazole prophylaxis when children become stabilized on ART. Design and methods: The ARROW randomized trial investigated alternative strategies to deliver paediatric ART and cotrimoxazole prophylaxis in 1206 Ugandan/Zimbabwean children. Incremental cost-effectiveness and value of implementation analyses were undertaken. Scenario analyses investigated whether laboratory monitoring (CD4 tests for efficacy monitoring; haematology/biochemistry for toxicity) could be tailored and targeted to be delivered cost-effectively. Cotrimoxazole use was examined in malaria-endemic and non-endemic settings. Results: Using all trial data, clinical monitoring delivered similar health outcomes to routine laboratory monitoring, but at a reduced cost, so was cost-effective. Continuing cotrimoxazole improved health outcomes at reduced costs. Restricting routine CD4+ monitoring to after 52 weeks following ART initiation and removing toxicity testing was associated with an incremental cost-effectiveness ratio of $6084 per quality-adjusted life-year (QALY) across all age groups, but was much lower for older children (12+ years at initiation; incremental cost-effectiveness ratio =$769/QALY). Committing resources to improve cotrimoxazole implementation appears cost-effective. A healthcare system that could pay $600/QALY should be willing to spend up to$12.0 per patient-year to ensure continued provision of cotrimoxazole. Conclusion: Clinically driven monitoring of ART is cost-effective in most circumstances. Routine laboratory monitoring is generally not cost-effective at current prices, except possibly CD4 testing amongst adolescents initiating ART. Committing resources to ensure continued provision of cotrimoxazole in health facilities is more likely to represent an efficient use of resources

Do magnetic resonance imaging features differ between persons with multiple sclerosis of various races and ethnicities?

Those of African American or Latin American descent have been demonstrated to have more severe clinical presentations of multiple sclerosis (MS) than non-Latin American White people with MS. Concurrently, radiological burden of disease on magnetic resonance imaging (MRI) in African Americans with MS has also been described as being more aggressive. Here, we review MRI studies in diverse racial and ethnic groups (adult and pediatric) investigating lesion burden, inflammation, neurodegeneration, and imaging response to disease modifying therapy. We also discuss why such disparities may exist beyond biology, and how future studies may provide greater insights into underlying differences

Internet-based medical education: a realist review of what works, for whom and in what circumstances

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Clinical Predictors and Outcome of Metabolic Acidosis in Under-Five Children Admitted to an Urban Hospital in Bangladesh with Diarrhea and Pneumonia

BACKGROUND: Clinical features of metabolic acidosis and pneumonia frequently overlap in young diarrheal children, resulting in differentiation from each other very difficult. However, there is no published data on the predictors of metabolic acidosis in diarrheal children also having pneumonia. Our objective was to evaluate clinical predictors of metabolic acidosis in under-five diarrheal children with radiological pneumonia, and their outcome. METHODS: We prospectively enrolled all under-five children (n = 164) admitted to the Special Care Ward (SCW) of the Dhaka Hospital of icddr, b between September and December 2007 with diarrhea and radiological pneumonia who also had their total serum carbon-dioxide estimated. We compared the clinical features and outcome of children with radiological pneumonia and diarrhea with (n = 98) and without metabolic acidosis (n = 66). RESULTS: Children with metabolic acidosis more often had higher case-fatality (16% vs. 5%, p = 0.039) compared to those without metabolic acidosis on admission. In logistic regression analysis, after adjusting for potential confounders such as age of the patient, fever on admission, and severe wasting, the independent predictors of metabolic acidosis in under-five diarrheal children having pneumonia were clinical dehydration (OR 3.57, 95% CI 1.62-7.89, p = 0.002), and low systolic blood pressure even after full rehydration (OR 1.02, 95% CI 1.01-1.04, p = 0.005). Proportions of children with cough, respiratory rate/minute, lower chest wall indrawing, nasal flaring, head nodding, grunting respiration, and cyanosis were comparable (p>0.05) among the groups. CONCLUSION AND SIGNIFICANCE: Under-five diarrheal children with radiological pneumonia having metabolic acidosis had frequent fatal outcome than those without acidosis. Clinical dehydration and persistent systolic hypotension even after adequate rehydration were independent clinical predictors of metabolic acidosis among the children. However, metabolic acidosis in young diarrheal children had no impact on the diagnostic clinical features of radiological pneumonia which underscores the importance of early initiation of appropriate antibiotics to combat morbidity and deaths in such population

Enterohaemorrhagic Escherichia coli and Shigella dysenteriae type 1-induced haemolytic uraemic syndrome

Haemolytic uraemic syndrome (HUS) can be classified according to the aetiology of the different disorders from which it is composed. The most prevalent form is that induced by shigatoxin producing Escherichia coli (STEC) and, in some tropical regions, by Shigella dysenteriae type 1. STEC cause a zoonosis, are widely distributed in nature, enter the food chain in different ways, and show regional differences. Not all STEC are human pathogens. Enterohaemorrhagic E. coli usually cause attachment and effacing lesions in the intestine. This is not essential, but production of a shigatoxin (Stx) is. Because Stx are encoded by a bacteriophage, this property is transferable to naïve strains. Laboratory methods have improved by identifying STEC either via the toxin or its bacteriophage. Shigella dysenteriae type 1 produces shigatoxin, identical to Stx-1, but also has entero-invasive properties that enterohaemorrhagic Escherichia coli (EHEC) do not. Shigella patients risk bacteremia and benefit from early antibiotic treatment, unlike those with EHEC

Secondary headaches: secondary or still primary?

The second edition of the International Classification of Headache Disorders makes a distinction between primary and secondary headaches. The diagnosis of a secondary headache is made if the underlying disease is thought to cause headache or if a close temporal relationship is present together with the occurrence of the headache. At first glance, this may allow clearly secondary headaches to be distinguished from primary headaches. However, by reviewing the available literature concerning several selected secondary headaches, we will discuss the hypothesis that some secondary headaches can also be understood as a variation of primary headaches in the sense that the underlying cause (e.g. infusion of glyceryl trinitrate [ICHD-II 8.1.1], epilepsy [7.6.2], brain tumours [7.4], craniotomy [5.7], etc.) triggers the same neurophysiologic mechanisms that are responsible for the pain in primary headache attacks