Choice making in Rett syndrome: a descriptive study using video data

Purpose: To describe the choice-making abilities of girls and women with Rett syndrome. Method: Females with Rett syndrome registered with the Australian Rett Syndrome Database with a pathogenic MECP2 mutation were included in this study. Video clips showing choice making in 64 females at a median age of 11.6 years (range 2.3–35.6 years) were analysed. Video clips were coded for the location and nature of the choice-making interaction, and the actions of the communication partner and female with Rett syndrome. Results: The majority (82.8%, 53/64) of females made a choice, most using eye gaze. Just under half (24/53) used one modality to communicate their choice, 52.8% used two modalities and one used three modalities. Of those who made a choice, 50% did so within 8 s. The length of time to make a choice did not appear to vary with age. During choice making, 57.8% (37/64) of communication partners used language and gestures, 39.1% (25/64) used only language and two used language, gestures and symbols within the interaction. Conclusions: The provision of adequate time allowing for a response and observation for the use of multiple modalities could promote effective choice making in females with Rett syndrome

Caesarean section for non-medical reasons at term

Background: Caesarean section rates are progressively rising in many parts of the world. One suggested reason is increasing requests by women for caesarean section in the absence of clear medical indications, such as placenta praevia, HIV infection, contracted pelvis and, arguably, breech presentation or previous caesarean section. The reported benefits of planned caesarean section include greater safety for the baby, less pelvic floor trauma for the mother, avoidance of labour pain and convenience. The potential disadvantages, from observational studies, include increased risk of major morbidity or mortality for the mother, adverse psychological sequelae, and problems in subsequent pregnancies, including uterine scar rupture and greater risk of stillbirth and neonatal morbidity. An unbiased assessment of advantages and disadvantages would assist discussion of what has become a contentious issue in modern obstetrics. Objectives: To assess, from randomised trials, the effects on perinatal and maternal morbidity and mortality, and on maternal psychological morbidity, of planned caesarean delivery versus planned vaginal birth in women with no clear clinical indication for caesarean section. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2009). Selection criteria: All comparisons of intention to perform caesarean section and intention for women to give birth vaginally; random allocation to treatment and control groups; adequate allocation concealment; women at term with single fetuses with cephalic presentations and no clear medical indication for caesarean section. Data collection and analysis: We identified no studies that met the inclusion criteria. Main results: There were no included trials. Authors' conclusions: There is no evidence from randomised controlled trials, upon which to base any practice recommendations regarding planned caesarean section for non-medical reasons at term. In the absence of trial data, there is an urgent need for a systematic review of observational studies and a synthesis of qualitative data to better assess the short- and long-term effects of caesarean section and vaginal birth

HST/ACS observations of shell galaxies: inner shells, shell colours and dust

AIM:Learn more about the origin of shells and dust in early type galaxies. METHOD: V-I colours of shells and underlying galaxies are derived, using HST Advanced Camera for Surveys (ACS) data. A galaxy model is made locally in wedges and subtracted to determine shell profiles and colours. We applied Voronoi binning to our data to get smoothed colour maps of the galaxies. Comparison with N-body simulations from the literature gives more insight to the origin of the shell features. Shell positions and dust characteristics are inferred from model galaxy subtracted images. RESULT: The ACS images reveal shells well within the effective radius in some galaxies (at 1.7 kpc in the case of NGC 5982). In some cases, strong nuclear dust patches prevent detection of inner shells. Most shells have colours which are similar to the underlying galaxy. Some inner shells are redder than the galaxy. All six shell galaxies show out of dynamical equilibrium dust features, like lanes or patches, in their central regions. Our detection rate for dust in the shell ellipticals is greater than that found from HST archive data for a sample of normal early-type galaxies, at the 95% confidence level. CONCLUSIONS: The merger model describes better the shell distributions and morphologies than the interaction model. Red shell colours are most likely due to the presence of dust and/or older stellar populations. The high prevalence and out of dynamical equilibrium morphologies of the central dust features point towards external influences being responsible for visible dust features in early type shell galaxies. Inner shells are able to manifest themselves in relatively old shell systems.Comment: accepted by A&A; 36 Figures, 25 pages. A version with full resolution Figures can be found here: http://www.astro.rug.nl/~sikkema/shells.p

Genetic switch to hypervirulence reduces colonization phenotypes of the globally disseminated group A Streptococcus M1T1 clone

Background. The recent resurgence of invasive group A streptococcal disease has been paralleled by the emergence of the M1T1 clone. Recently, invasive disease initiation has been linked to mutations in the covR/S 2-component regulator. We investigated whether a fitness cost is associated with the covS mutation that counterbalances hypervirulence