Detail-oriented cognitive style and social communicative deficits, within and beyond the autism spectrum: independent traits that grow into developmental interdependence

At the heart of debates over underlying causes of autism is the "Kanner hypothesis" that autistic deficits in social reciprocity, and a cognitive/perceptual 'style' favouring detail-oriented cognition, co-vary in autistic individuals. A separate line of work indicates these two domains are normally distributed throughout the population, with autism representing an extremity. This realisation brings the Kanner debate into the realm of normative co-variation, providing more ways to test the hypothesis, and insights into typical development; for instance, in the context of normative functioning, the Kanner hypothesis implies social costs to spatial/numerical prowess

Primary biliary cirrhosis

Primary biliary cirrhosis (PBC) is an immune-mediated chronic cholestatic liver disease with a slowly progressive course. Without treatment, most patients eventually develop fibrosis and cirrhosis of the liver and may need liver transplantation in the late stage of disease. PBC primarily affects women (female preponderance 9–10:1) with a prevalence of up to 1 in 1,000 women over 40 years of age. Common symptoms of the disease are fatigue and pruritus, but most patients are asymptomatic at first presentation. The diagnosis is based on sustained elevation of serum markers of cholestasis, i.e., alkaline phosphatase and gamma-glutamyl transferase, and the presence of serum antimitochondrial antibodies directed against the E2 subunit of the pyruvate dehydrogenase complex. Histologically, PBC is characterized by florid bile duct lesions with damage to biliary epithelial cells, an often dense portal inflammatory infiltrate and progressive loss of small intrahepatic bile ducts. Although the insight into pathogenetic aspects of PBC has grown enormously during the recent decade and numerous genetic, environmental, and infectious factors have been disclosed which may contribute to the development of PBC, the precise pathogenesis remains enigmatic. Ursodeoxycholic acid (UDCA) is currently the only FDA-approved medical treatment for PBC. When administered at adequate doses of 13–15 mg/kg/day, up to two out of three patients with PBC may have a normal life expectancy without additional therapeutic measures. The mode of action of UDCA is still under discussion, but stimulation of impaired hepatocellular and cholangiocellular secretion, detoxification of bile, and antiapoptotic effects may represent key mechanisms. One out of three patients does not adequately respond to UDCA therapy and may need additional medical therapy and/or liver transplantation. This review summarizes current knowledge on the clinical, diagnostic, pathogenetic, and therapeutic aspects of PBC

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

Automated patient positioning in CT using a 3D camera for body contour detection: accuracy in pediatric patients

Objective: To assess the accuracy of a 3D camera for body contour detection in pediatric patient positioning in CT compared with routine manual positioning by radiographers. Methods and materials: One hundred and ninety-one patients, with and without fixation aid, which underwent CT of the head, thorax, and/or abdomen on a scanner with manual table height selection and with table height suggestion by a 3D camera were retrospectively included. The ideal table height was defined as the position at which the scanner isocenter coincides with the patient’s isocenter. Table heights suggested by the camera and selected by the radiographer were compared with the ideal height. Results: For pediatric patients without fixation aid like a baby cradle or vacuum cushion and positioned by radiographers, the median (interquartile range) absolute table height deviation in mm was 10.2 (16.8) for abdomen, 16.4 (16.6) for head, 4.1 (5.1) for thorax-abdomen, and 9.7 (9.7) for thorax CT scans. The deviation was less for the 3D camera: 3.1 (4.7) for abdomen, 3.9 (6.3) for head, 2.2 (4.3) for thorax-abdomen, and 4.8 (6.7) for thorax CT scans (p < 0.05 for all body parts combined). Conclusion: A 3D camera for body contour detection allows for automated and more accurate pediatric patient positioning than manual positioning done by radiographers, resulting in overall significantly smaller deviations from the ideal table height. The 3D camera may be also useful in the positioning of patients with fixation aid; however, evaluation of possible improvements in positioning accuracy was limited by the small sample size. Key Points: • A 3D camera for body contour detection allows for automated and accurate pediatric patient positioning in CT. • A 3D camera outperformed radiographers in positioning pediatric patients without a fixation aid in CT. • Positioning of pediatric patients with fixation aid was feasible using the 3D camera, but no definite conclusions were drawn regarding the positioning accuracy due to the small sample size

Influence of breathing state on the accuracy of automated patient positioning in thoracic CT using a 3D camera for body contour detection

Objective: To assess the influence of breathing state on the accuracy of a 3D camera for body contour detection and patient positioning in thoracic CT. Materials and methods: Patients who underwent CT of the thorax with both an inspiratory and expiratory scan were prospectively included for analysis of differences in the ideal table height at different breathing states. For a subgroup, an ideal table height suggestion based on 3D camera images at both breathing states was available to assess their influence on patient positioning accuracy. Ideal patient positioning was defined as the table height at which the scanner isocenter coincides with the patient’s isocenter. Results: The mean (SD) difference of the ideal table height between the inspiratory and the expiratory breathing state among the 64 included patients was 10.6 mm (4.5) (p < 0.05). The mean (SD) positioning accuracy, i.e., absolute deviation from the ideal table height, within the subgroup (n = 43) was 4.6 mm (7.0) for inspiratory scans and 7.1 mm (7.7) for expiratory scans (p < 0.05) when using corresponding 3D camera images. The mean (SD) accuracy was 14.7 mm (7.4) (p < 0.05) when using inspiratory camera images on expiratory scans; vice versa, the accuracy was 3.1 mm (9.5) (p < 0.05). Conclusion: A 3D camera allows for accurate and precise patient positioning if the camera image and the subsequent CT scan are acquired in the same breathing state. It is recommended to perform an expiratory planning image when acquiring a thoracic CT scan in both the inspiratory and expiratory breathing state. Key Points: • A 3D camera for body contour detection allows for accurate and precise patient positioning if the camera image and the subsequent CT scan are acquired in the same breathing state. • It is recommended to perform an expiratory planning image when acquiring a thoracic CT scan in both the inspiratory and expiratory breathing state

Automated patient positioning in CT using a 3D camera for body contour detection: accuracy in pediatric patients

Objective: To assess the accuracy of a 3D camera for body contour detection in pediatric patient positioning in CT compared with routine manual posit

Hydrogeology and simulation of ground-water flow at U.S. Marine Corps Air Station, Cherry Point, North Carolina, 1987-90 /

Shipping list no.: 95-0054-P.Includes bibliographical references (p. 67-68).Mode of access: Internet