Survey of respiratory sounds in infants

Background: Over the last decade there has been an apparent increase in childhood wheeze. We speculated that much of the reported increase may be attributed to the term wheeze being adopted by parents to describe a variety of other forms of noisy breathing. Aims: To investigate terminology used by parents to describe their children’s breath sounds. Methods: An interview was carried out with the parents of 92 infants with noisy breathing, beginning with an open question and then directed towards a more detailed description. Finally, the parents were asked to choose from a wheeze, ruttle, and stridor on imitation by the investigator and video clips of children. Results: Wheeze was the most commonly chosen word on initial questioning (59%). Only 36% were still using this term at the end of the interview, representing a decrease of one third, whereas the use of the word ruttles doubled. Conclusions: Our results reflect the degree of inaccuracy involved in the use of the term wheeze in clinical practice, which may be leading to over diagnosis. Imprecise use of this term has potentially important implications for therapy and clinical trials

Genetic Assimilation and Canalisation in the Baldwin Effect

The Baldwin Effect indicates that individually learned behaviours acquired during an organism’s lifetime can influence the evolutionary path taken by a population, without any direct Lamarckian transfer of traits from phenotype to genotype. Several computational studies modelling this effect have included complications that restrict its applicability. Here we present a simplified model that is used to reveal the essential mechanisms and highlight several conceptual issues that have not been clearly defined in prior literature. In particular, we suggest that canalisation and genetic assimilation, often conflated in previous studies, are separate concepts and the former is actually not required for non-heritable phenotypic variation to guide genetic variation. Additionally, learning, often considered to be essential for the Baldwin Effect, can be replaced with a more general phenotypic plasticity model. These simplifications potentially permit the Baldwin Effect to operate in much more general circumstances

Non-linear instability of Kerr-type Cauchy horizons

Using the general solution to the Einstein equations on intersecting null surfaces developed by Hayward, we investigate the non-linear instability of the Cauchy horizon inside a realistic black hole. Making a minimal assumption about the free gravitational data allows us to solve the field equations along a null surface crossing the Cauchy Horizon. As in the spherical case, the results indicate that a diverging influx of gravitational energy, in concert with an outflux across the CH, is responsible for the singularity. The spacetime is asymptotically Petrov type N, the same algebraic type as a gravitational shock wave. Implications for the continuation of spacetime through the singularity are briefly discussed.Comment: 11 pages RevTeX, two postscript figures included using epsf.st

TRial to Assess Implementation of New research in a primary care Setting (TRAINS): study protocol for a pragmatic cluster randomised controlled trial of an educational intervention to promote asthma prescription uptake in general practitioner practices

Background There is a marked increase in unscheduled care visits in school-aged children with asthma after returning to school in September. This is potentially associated with children not taking their asthma preventer medication during the school summer holidays. A cluster randomised controlled trial (PLEASANT) was undertaken with 1279 school-age children in 141 general practices (71 on intervention and 70 on control) in England and Wales. It found that a simple letter sent from the family doctor during the school holidays to a parent with a child with asthma, informing them of the importance of taking asthma preventer medication during the summer relatively increased prescriptions by 30% in August and reduced medical contacts in the period September to December. Also, it is estimated there was a cost-saving of £36.07 per patient over the year. We aim to conduct a randomised trial to assess if informing GP practices of an evidence-based intervention improves the implementation of that intervention. Methods/design The TRAINS study—TRial to Assess Implementation of New research in a primary care Setting—is a pragmatic cluster randomised implementation trial using routine data. A total of 1389 general practitioner (GP) practices in England will be included into the trial; 694 GP practices will be randomised to the intervention group and 695 control group of usual care. The Clinical Practice Research Datalink (CPRD) will send the intervention and obtain all data for the study, including prescription and primary care contacts data. The intervention will be sent in June 2021 by postal and email to the asthma lead and/or practice manager. The intervention is a letter to GPs informing them of the PLEASANT study findings with recommendations. It will come with an information leaflet about PLEASANT and a suggested reminder letter and SMS text template. Discussion The trial will assess if informing GP practices of the PLEASANT trial results will increase prescription uptake before the start of the school year. The hope is that the intervention will increase the implementation of PLEASANT work and then increase prescription uptake during the summer holiday prior to the start of school

Impulse control disorders in Parkinson’s disease:predominant role of psychological determinants

Objectives: Impulse Control Disorders (ICDs) in Parkinson’s disease (PD) have previously almost exclusively been considered to result from anti-parkinsonian medication. However, this biomedical perspective has failed to achieve a full understanding of the phenomenon and it is argued that a failure to consider psychological factors is a critical omission. Design: The present study examined the predictive relationship between ICDs in PD and a range of psychological measures, whilst controlling for a number of biomedical determinants. Main outcome measures: One hundred participants with idiopathic PD completed questionnaires that assessed demographic and clinical characteristics, psychological measures and the presence of ICDs (QUIP-RS). Results: Increased use of a ‘negative’ coping strategy, stronger illness identity, more emotional illness representations and stress were found to be significant predictors of ICDs, and different psychological predictors were associated with different ICDs. Medication was not found to predict ICDs in the presence of psychological factors, either when total treatment levels were considered or when agonist dose was considered alone. Conclusions: This study provides the first quantitative evidence of a predominant predictive relationship between psychological factors and ICDs in PD. The results suggest that psychological interventions may have useful therapeutic role to play for ICDs in PD

Bulk experimental evidence of half-metallic ferromagnetism in doped manganites

We report precise measurements and quantitative data analysis on the low-temperature resistivity of several ferromagnetic manganite films. We clearly show that there exists a T^{4.5} term in low-temperature resistivity, and that this term is in quantitative agreement with the quantum theory of two-magnon scattering for half metallic ferromagnets. Our present results provide the first bulk experimental evidence of half-metallic ferromagnetism in doped manganites.Comment: 4 pages, 4 figure

Bridging brain and cognition: a multilayer network analysis of brain structural covariance and general intelligence in a developmental sample of struggling learners

Network analytic methods that are ubiquitous in other areas, such as systems neuroscience, have recently been used to test network theories in psychology, including intelligence research. The network or mutualism theory of intelligence proposes that the statistical associations among cognitive abilities (e.g., specific abilities such as vocabulary or memory) stem from causal relations among them throughout development. In this study, we used network models (specifically LASSO) of cognitive abilities and brain structural covariance (grey and white matter) to simultaneously model brain-behavior relationships essential for general intelligence in a large (behavioral, N = 805; cortical volume, N = 246; fractional anisotropy, N = 165) developmental (ages 5-18) cohort of struggling learners (CALM). We found that mostly positive, small partial correlations pervade our cognitive, neural, and multilayer networks. Moreover, using community detection (Walktrap algorithm) and calculating node centrality (absolute strength and bridge strength), we found convergent evidence that subsets of both cognitive and neural nodes play an intermediary role 'between' brain and behavior. We discuss implications and possible avenues for future studies.Stress and Psychopatholog

Visuo-Vestibular Information Processing by Unipolar Brush Cells in the Rabbit Flocculus

The unipolar brush cell (UBC) is a glutamatergic granular layer interneuron that is predominantly located in the vestibulocerebellum and parts of the vermis. In rat and rabbit, we previously found using juxtacellular labeling combined with spontaneous activity recording that cells with highly regular spontaneous activity belong to the UBC category. Making use of this signature, we recorded from floccular UBCs in both anesthetized and awake rabbits while delivering visuo-vestibular stimulation by using sigmoidal rotation of the whole animal. In the anesthetized rabbit, the activity of the presumed UBC units displayed a wide variety of modulation profiles that could be related to aspects of head velocity or acceleration. These modulation profiles could also be found in the awake rabbit where, in addition, they could also carry an eye position signal. Furthermore, units in the awake rabbit could demonstrate rather long response latencies of up to 0.5 s. We suggest that the UBCs recorded in this study mostly belong to the type I UBC category (calretinin-positive) and that they can play diverse roles in floccular visuo-vestibular information processing, such as transformation of velocity-related signals to acceleration-related signals

Fano Resonances in Electronic Transport through a Single Electron Transistor

We have observed asymmetric Fano resonances in the conductance of a single electron transistor resulting from interference between a resonant and a nonresonant path through the system. The resonant component shows all the features typical of quantum dots, but the origin of the non-resonant path is unclear. A unique feature of this experimental system, compared to others that show Fano line shapes, is that changing the voltages on various gates allows one to alter the interference between the two paths.Comment: 8 pages, 6 figures. Submitted to PR