Alterations in functional connectivity for language in prematurely born adolescents

Recent data suggest recovery of language systems but persistent structural abnormalities in the prematurely born. We tested the hypothesis that subjects who were born prematurely develop alternative networks for processing language. Subjects who were born prematurely (n = 22; 600–1250 g birth weight), without neonatal brain injury on neonatal cranial ultrasound, and 26 term control subjects were examined with a functional magnetic resonance imaging (fMRI) semantic association task, the Wechsler Intelligence Scale for Children-III (WISC-III) and the Clinical Evaluation of Language Fundamentals (CELF). In-magnet task accuracy and response times were calculated, and fMRI data were evaluated for the effect of group on blood oxygen level dependent (BOLD) activation, the correlation between task accuracy and activation and the functional connectivity between regions activating to task. Although there were differences in verbal IQ and CELF scores between the preterm (PT) and term control groups, there were no significant differences for either accuracy or response time for the in-magnet task. Both groups activated classic semantic processing areas including the left superior and middle temporal gyri and inferior frontal gyrus, and there was no significant difference in activation patterns between groups. Clear differences between the groups were observed in the correlation between task accuracy and activation to task at P < 0.01, corrected for multiple comparisons. Left inferior frontal gyrus correlated with accuracy only for term controls and left sensory motor areas correlated with accuracy only for PT subjects. Left middle temporal gyri correlated with task accuracy for both groups. Connectivity analyses at P < 0.001 revealed the importance of a circuit between left middle temporal gyri and inferior frontal gyrus for both groups. In addition, the PT subjects evidenced greater connectivity between traditional language areas and sensory motor areas but significantly fewer correlated areas within the frontal lobes when compared to term controls. We conclude that at 12 years of age, children born prematurely and children born at term had no difference in performance on a simple lexical semantic processing task and activated similar areas. Connectivity analyses, however, suggested that PT subjects rely upon different neural pathways for lexical semantic processing when compared to term controls. Plasticity in network connections may provide the substrate for improving language skills in the prematurely born

A roadmap for planetary caves science and exploration

2 páginas.- 1 figura.- 16 referenciasTo the Editor — 2021 is the International Year of Caves and Karst. To honour this occasion, we wish to emphasize the vast potential embodied in planetary subsurfaces. While researchers have pondered the possibility of extraterrestrial caves for more than 50 years, we have now entered the incipient phase of planetary caves exploration....Peer reviewe

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Goodman and Kruskal's λ: A new look at an old measure of association

We examine Goodman and Kruskal's λ using Efron's approach to regression and analysis of variance (ANOVA) for zero‐one outcome data. For a binary response cross‐classified by a single nominal predictor, we present a computationally simple ANOVA table in which λ is analogous to Pearson's R‐square. We characterize the relationship between λ and the commonly used apparent error rate in logistic regression, and show that λ is based implicitly on a prediction rule for a saturated model with classification level 0.5. This relationship suggests that we can correct the apparent error rate for chance by defining a natural generalization of λ that we call PRE, the proportional reduction in error. We illustrate the use of λ and PRE in an analysis of prognostic factors for one‐year survival in children with the acquired immunodeficiency syndrome (AIDS)

Survival in Children with Perinatally Acquired Human Immunodeficiency Virus Type 1 Infection

We describe our experience at Jackson Memorial Hospital in Miami, Florida, with 172 children who were given diagnoses of perinatally acquired infection with human immunodeficiency virus type 1 (HIV-1). The 146 mothers of the children acquired HIV-1 through heterosexual contact (69 percent), intravenous drug use (30 percent), or blood transfusion (1 percent). The children presented with symptomatic disease at a median age of eight months; only 21 percent presented after the age of two years. The most common first manifestations of disease were lymphoid interstitial pneumonia (in 17 percent), encephalopathy (in 12 percent), recurrent bacterial infections (in 10 percent), and candida esophagitis (in 8 percent), for which the median survival times from diagnosis were 72, 11, 50, and 12 months, respectively. Nine percent of the children had Pneumocystis carinii pneumonia at a median age of five months and had a median survival of only one month. The median survival for all 172 children was 38 months from the time of diagnosis. Mortality was highest in the first year of life (17 percent), and by proportional-hazard analysis the probability of long-term survival is low. In multi-variate analyses, early age at diagnosis and the first identifiable pattern of clinical disease were found to be independently related to survival. We conclude that children with perinatally acquired HIV-1 infection have a very poor prognosis and that most become symptomatic before one year of age. Early diagnosis is important, since there is only a short interval in which to initiate prophylactic or antiviral treatment before progressive disease begins. (N Engl J Med 1989; 321: 1791–6.) HUMAN immunodeficiency virus type 1 (HIV-1) infection and disease have been recognized in pediatric patients since 1983. 1 2 3 The initial reports described children with nonspecific conditions, such as failure to thrive, oral candidiasis, lymphadenopathy, and hepatosplenomegaly, but recurrent infections were also noted, both bacterial and opportunistic. Subsequently, it has been recognized that HIV-1 infection in infants may involve a wide spectrum of clinical disease in multiple systems. 4 , 5 Categorizing the clinical manifestations into patterns of disease provides a means of identifying and classifying infected infants, and such categorization is the basis for the current classification system of pediatric HIV-1 infection of the . .