Quantification of head motion in children with cerebral palsy when testing segmental trunk control

The development of objective assessment tools to complement subjective evaluations could have a major impact in the evaluation of the consequences of neuromotor disabilities, specifically in the assessment of trunk control in children with cerebral palsy (CP). Current assessments are subjective and typically assess the general control status of a child under unbalancing situations. Only the Segmental Assessment of Trunk Control (SATCo) evaluates static, active and reactive control at six discrete trunk segmental levels and free sitting to identify the topmost trunk segment where the child does not demonstrate control. The characteristics of the SATCo make it an ideal start point to generate an objective measurement tool of control. Motion of the head is one of the main characteristics observed during a SATCo to determine the child's segmental level of control. This pilot study measured head motion during a SATCo to determine if the measurement reflected the clinical observations. Three children with different degrees of neuromotor disability were tested using the SATCo while a video camera recorded sagittal plane movements. A Head segment was defined by markers on the ear tragus and temporal fossa in vertical line with the ear when the head was aligned. Head segmental angles were calculated in relation to a real vertical, and the cumulative displacement was normalised by time (deg·s-1). One segment where external support was provided high on the trunk (Upper-Thoracic, UT) and one where external support was at the pelvis i.e. low on the trunk (Lower-Lumbar, LL) were selected for the analysis. Overall, head motion values were larger for the lower trunk tests (LL) than for the tests at the higher segment (UT) with greater external support provided. The poorer lumbar control of Child 2 and Child 3 was demonstrated in both active (39.9°·s-1, 23.3°·s-1) and reactive tests (37.3°·s-1, 13.8°·s-1). The results also showed how increasing task complexity (static to reactive) and reducing the level of support (UT to LL), increased head motion in the presence of a neuromotor disability. The results presented here corroborated the clinical evaluation of the SATCo. Head motion will have small values when children with CP are tested at a trunk segmental level where control has already been learnt or where external support is provided; children with poorer lumbar control will have an increased head motion when testing is below their trunk segmental level of assured control. This video-based approach represents a step towards the development of an objective tool for the assessment of head/trunk control in children with CP

Fully automated image-based estimation of postural point-features in children with cerebral palsy using deep learning

The aim of this study was to provide automated identification of postural point-features required to estimate the location and orientation of the head, multi-segmented trunk and arms from videos of the clinical test ‘Segmental Assessment of Trunk Control’ (SATCo). Three expert operators manually annotated 13 point-features in every fourth image of 177 short (5–10 s) videos (25 Hz) of 12 children with cerebral palsy (aged: 4.52 ± 2.4 years), participating in SATCo testing. Linear interpolation for the remaining images resulted in 30 825 annotated images. Convolutional neural networks were trained with cross-validation, giving held-out test results for all children. The point-features were estimated with error 4.4 ± 3.8 pixels at approximately 100 images per second. Truncal segment angles (head, neck and six thoraco-lumbar–pelvic segments) were estimated with error 6.4 ± 2.8°, allowing accurate classification (F1 > 80%) of deviation from a reference posture at thresholds up to 3°, 3° and 2°, respectively. Contact between arm point-features (elbow and wrist) and supporting surface was classified at F1 = 80.5%. This study demonstrates, for the first time, technical feasibility to automate the identification of (i) a sitting segmental posture including individual trunk segments, (ii) changes away from that posture, and (iii) support from the upper limb, required for the clinical SATCo

“Dolls or teddies?”: constructing lesbian identity through community-specific practice.

The concept of ‘community’ often presents a problem for queer linguists. ‘The gay community’ is often viewed as an impossible site for research due to its imagined status, whilst local communities of gay people have been considered too heterogeneous and idiosyncratic to draw conclusions from. In this article, however, it is argued that both of these aspects of community can, and should, be a central focus of an investigation into language and sexual identity. Through the analysis of a conversation emerging from a lesbian group, using a sociocultural linguistics framework, it is argued here that the community of practice approach can play a crucial role in understanding how ideologies from ‘the gay community’ are used to construct a coherent sexual identity on a local level. The analysis reveals how the group engages in practices that enable them to construct micro-level personas in direct response to broader, ideological structures of heteronormativity

Democratization and gender-neutrality in English(es)

"Democratization" and "gender-neutrality" are two concepts commonly used in recent studies on language variation. While both concepts link linguistic phenomena to sociocultural changes, the extent to which they overlap and/or interact has not been studied in detail. In particular, not much is known about how linguistic changes related to democratization and gender-neutrality spread across registers or varieties of English, as well as whether speakers are aware of the changes that are taking place. In this paper we review the main theoretical issues regarding these concepts and relate them to the main findings in the articles in this issue, all of which study lexical and grammatical variation from a corpus-based perspective. Taken together, they help unveil some of the conscious and unconscious mechanisms that operate at the interface between democratization and gender-neutrality.Peer reviewe

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

"I'm not proud, I'm just gay": lesbian and gay youths' discursive negotiation of otherness

This article outlines the shared identity construction of five gay and lesbian members of an LGBT youth group, situated in a conservative, working-class, Northern English town. It is shown that the young people’s identity work emerges in response to the homophobia and ‘othering’ they have experienced from those in their local community. Through ethnography and discourse analysis, and using theoretical frameworks from interactional sociolinguistics, the strategies that the young people employ to negotiate this othering are explored; they reject certain stereotypes of queer culture (such as Gay Pride or being ‘camp’), and aim to minimise the relevance of their sexuality to their social identity. It is argued this reflects both the influence of neoliberal, ‘homonormative’ ideology, which casts sexuality in the private rather than public domain, and the stigma their sexuality holds in their local community. These findings point to the need to understand identity construction intersectionally

Comics, graphic narratives, and lesbian lives

Lesbian comics and graphic narratives have gained unprecedented cultural presence in the twenty-first century. Yet despite the surge in interest in the work of artists such as Alison Bechdel, and despite the existence of a substantial online archive about lesbian comics created by artists, readers, and collectors, relatively little critical attention has been directed to this work. The chapter begins to fill this gap. Taking the Bechdel’s work as its start-and-end point, it provides an overview of major developments in lesbian comics and contextualises them including in relation to the gendered conditions of possibility that define comics culture

The Semiotic Fractures of Vulnerable Bodies: Resistance to the Gendering of Legal Subjects

While the turn to vulnerability in law responds to a recurrent critique by feminist scholars on the disembodiment of legal personhood, this article suggests that the mobilization of vulnerability in the criminal courts does not necessarily offer female drug mules a direct path to justice. Through an analysis of sentencing appeals of female drug mules in England and Wales, this article presents a feminist critique of the dispositif of the person and its relation to vulnerability. Discourses on drug mules’ vulnerability mobilize the trope of the colonial victim in need of protection, which is often translated into legal mercy. But mercy is rather an expression of biopower which inscribes not only fragility onto the bodies of drug mules by figuring them as exemplar paradigms of colonial subjectivity, but also reinvigorates the dispositif of gender implicit in the legal person. In this set-up, it would appear as if law and politics totalize the registers of life, in this case the contours of vulnerable body. The article suggests we must revisit the image of the wounded body in order to carve out a space for resistance. Drawing on Elaine Scarry and Judith Butler, it suggests vulnerable bodies are marked by a semiotic openness, which renders them subject to appropriation but also able to signify the precarity produced by the law through their resistance to representation

The Base Excision Repair System of Salmonella enterica serovar Typhimurium Counteracts DNA Damage by Host Nitric Oxide

Intracellular pathogens must withstand nitric oxide (NO·) generated by host phagocytes. Salmonella enterica serovar Typhimurium interferes with intracellular trafficking of inducible nitric oxide synthase (iNOS) and possesses multiple systems to detoxify NO·. Consequently, the level of NO· stress encountered by S. Typhimurium during infection in vivo has been unknown. The Base Excision Repair (BER) system recognizes and repairs damaged DNA bases including cytosine and guanine residues modified by reactive nitrogen species. Apurinic/apyrimidinic (AP) sites generated by BER glycosylases require subsequent processing by AP endonucleases. S. Typhimurium xth nfo mutants lacking AP endonuclease activity exhibit increased NO· sensitivity resulting from chromosomal fragmentation at unprocessed AP sites. BER mutant strains were thus used to probe the nature and extent of nitrosative damage sustained by intracellular bacteria during infection. Here we show that an xth nfo S. Typhimurium mutant is attenuated for virulence in C3H/HeN mice, and virulence can be completely restored by the iNOS inhibitor L-NIL. Inactivation of the ung or fpg glycosylase genes partially restores virulence to xth nfo mutant S. Typhimurium, demonstrating that NO· fluxes in vivo are sufficient to modify cytosine and guanine bases, respectively. Mutants lacking ung or fpg exhibit NO·–dependent hypermutability during infection, underscoring the importance of BER in protecting Salmonella from the genotoxic effects of host NO·. These observations demonstrate that host-derived NO· damages Salmonella DNA in vivo, and the BER system is required to maintain bacterial genomic integrity

The life history of 21 breast cancers.

Cancer evolves dynamically as clonal expansions supersede one another driven by shifting selective pressures, mutational processes, and disrupted cancer genes. These processes mark the genome, such that a cancer's life history is encrypted in the somatic mutations present. We developed algorithms to decipher this narrative and applied them to 21 breast cancers. Mutational processes evolve across a cancer's lifespan, with many emerging late but contributing extensive genetic variation. Subclonal diversification is prominent, and most mutations are found in just a fraction of tumor cells. Every tumor has a dominant subclonal lineage, representing more than 50% of tumor cells. Minimal expansion of these subclones occurs until many hundreds to thousands of mutations have accumulated, implying the existence of long-lived, quiescent cell lineages capable of substantial proliferation upon acquisition of enabling genomic changes. Expansion of the dominant subclone to an appreciable mass may therefore represent the final rate-limiting step in a breast cancer's development, triggering diagnosis