Differences in both prevalence and titre of specific immunoglobulin E among children with asthma in affluent and poor communities within a large town in Ghana.

Background Reports from several African countries have noted an increasing prevalence of asthma in areas of extensive urbanization. Objective To investigate the relevance of allergen-specific sensitization and body mass index (BMI) to asthma/wheezing and exercise-induced bronchospasm (EIB) among children from affluent and poorer communities within a large town in Ghana. Methods Children with physician-diagnosed asthma and/or current wheezing aged 9-16 years (n=99; cases) from three schools with differing socio-economic backgrounds [urban affluent (UA), urban poor (UP) or suburban/rural (SR)] were recruited from a cross-sectional study (n=1848) in Kumasi, Ghana, and matched according to age, sex and area of residence with non-asthmatic/non-wheezy controls. We assayed sera for IgE antibodies to mite, cat, dog, cockroach, Ascaris and galactose-α-1,3-galactose. Results Children from the UA school had the lowest total serum IgE. However, cases from the UA school had a higher prevalence and mean titre of sIgE to mite (71.4%, 21.2IU/mL) when compared with controls (14.3%, 0.8IU/mL) or cases from UP (30%, 0.8IU/mL) and SR community (47.8%, 1.6IU/mL). While similar findings were observed with EIB in the whole population, among cases there was no difference in IgE antibody prevalence or titre between children with or without EIB. BMI was higher among UA children with and without asthma; in UP and SR communities, children with EIB (n=14) had a significantly higher BMI compared with children with asthma/wheezing without EIB (n=38) (18.2 vs. 16.4, respectively, P<0.01). Conclusions and Clinical Relevance In the relatively affluent school, asthma/wheezing and EIB were associated with high titre IgE antibodies to mite, decreased total IgE, and increased BMI. This contrasted with children in the urban poor school and suggests that changes relevant to a Western model of childhood asthma can occur within a short geographical distance within a large city in Africa. © 2011 Blackwell Publishing Ltd

Problem and treatment of DC offsets in FDTD simulations

Journal ArticleThis paper discusses the causes of and some solutions to the commonly observed problem of dc field offsets in finite-difference time-domain (FDTD) simulations. DC electric and magnetic field offsets are shown to be valid calculated responses of the modeled systems, resulting from interaction between the turn-on characteristics of the source and the properties of the models. The dc offsets may be avoided in the time domain by tailoring the source waveforms or in the frequency domain by post-processing the FDTD output

Testability transformation

A testability transformation is a source-to-source transformation that aims to improve the ability of a given test generation method to generate test data for the original program. This paper introduces testability transformation, demonstrating that it differs from traditional transformation, both theoretically and practically, while still allowing many traditional transformation rules to be applied. The paper illustrates the theory of testability transformation with an example application to evolutionary testing. An algorithm for flag removal is defined and results are presented from an empirical study which show how the algorithm improves both the performance of evolutionary test data generation and the adequacy level of the test data so-generated

Clinical identification of feeding and swallowing disorders in 0-6 month old infants with Down syndrome

Feeding and swallowing disorders have been described in children with a variety of neurodevelopmental disabilities, including Down syndrome (DS). Abnormal feeding and swallowing can be associated with serious sequelae such as failure to thrive and respiratory complications, including aspiration pneumonia. Incidence of dysphagia in young infants with DS has not previously been reported. To assess the identification and incidence of feeding and swallowing problems in young infants with DS, a retrospective chart review of 174 infants, ages 0-6 months was conducted at a single specialty clinic. Fifty-seven percent (100/174) of infants had clinical concerns for feeding and swallowing disorders that warranted referral for Videofluroscopic Swallow Study (VFSS); 96/174 (55%) had some degree of oral and/or pharyngeal phase dysphagia and 69/174 (39%) had dysphagia severe enough to warrant recommendation for alteration of breast milk/formula consistency or nonoral feeds. Infants with certain comorbidities had significant risk for significant dysphagia, including those with functional airway/respiratory abnormalities (OR = 7.2). Infants with desaturation with feeds were at dramatically increased risk (OR = 15.8). All young infants with DS should be screened clinically for feeding and swallowing concerns. If concerns are identified, consideration should be given to further evaluation with VFSS for identification of dysphagia and additional feeding modifications

Error reduction therapy in reducing struggle and grope behaviours in apraxia of speech

We report an intervention study focused on the speech production difficulties present in acquired apraxia of speech (AOS). The intervention was a self-administered computer therapy that targeted whole word production and incorporated error reduction strategies. The effectiveness of the therapy was contrasted to that of a visuospatial sham computer program, and performance across treated words, and two sets of matched words, was assessed. Two groups of participants completed the study which employed a two-phase cross-over treatment design. Participants were randomly assigned to a speech first or sham first condition. Treatments were administered for six weeks, with a four week rest between interventions. Participants were assessed five times in total; twice at baseline, once following each of the intervention phases, and once following a lapse of eight weeks after the end of the second phase of intervention. The occurrence of accurate word production and speech characterised by struggle and groping behaviours was recorded on a repetition task. Participants showed significant gains in speech accuracy and fluency, and reductions in articulatory groping and struggle behaviours following the use of the speech program. These gains were largely maintained once the therapy was withdrawn

Correlation of Clinical Trachoma and Infection in Aboriginal Communities

Repeated episodes of C. trachomatis infection lead to active trachoma clinically characterised by an often intense inflammatory response to chlamydial antigens with later scarring and distortion of the eyelid leading to blindness. However, the clinical signs of trachoma do not correlate well with laboratory tests to detect the presence of Chlamydia. The WHO simplified clinical grading scheme currently used for assessment of trachoma has a poor correlation with C. trachomatis genomic test findings, even though the detection of bacterial genome is strongly correlated with the prevalence and severity of active trachoma. A detailed assessment of the clinical signs using a finer grading system was studied in a population-based survey in five Australian Aboriginal communities. Much clinical activity and infection was found in those with clinical signs below the threshold used in the current WHO grading scheme. Future studies of the distribution of infection and pathogenesis should use finer grading methods than the current WHO scheme. The prevalence of trachoma in these communities confirms that trachoma remains of public health importance and sustained interventions to control trachoma are warranted

Mechanism of Pion Production in alphaalphap Scattering at 1 GeV/nucleon

The one-pion and two-pion production in the p(alpha, alpha prime)X reaction at an energy of E{alpha} = 4.2 GeV has been studied by simultaneous registration of the scattered alpha particles and the secondary pion or proton. The obtained results demonstrate that the inelastic alpha-particle scattering on the proton at the energy of the experiment proceeds either through excitation and decay of Delta resonance in the projectile or through excitation in the target proton of the Roper resonance, which decays mainly on a nucleon and a pion or a nucleon and a sigma meson - system of two pions in the isospin I = 0, S-wave.Comment: 16 pages, 10 figures. Submitted to Proceedings of the XX International Baldin Seminar on High - Energy Physics Problems, Dubna, October 4 - 9, 201

Understanding the Basis for Down Syndrome Phenotypes

Down syndrome is a collection of features that are caused by trisomy for human Chromosome 21. While elevated transcript levels of the more than 350 genes on the chromosome are primarily responsible, it is likely that multiple genetic mechanisms underlie the numerous ways in which development and function diverge in individuals with trisomy 21 compared to euploid individuals. We consider genotype–phenotype interactions with the goal of producing working concepts that will be useful for approaches to ameliorate the effects of trisomy

A New Measurement of the 1S0 Neutron-Neutron Scattering Length using the Neutron-Proton Scattering Length as a Standard

The present paper reports high-accuracy cross-section data for the 2H(n,nnp) reaction in the neutron-proton (np) and neutron-neutron (nn) final-state-interaction (FSI) regions at an incident mean neutron energy of 13.0 MeV. These data were analyzed with rigorous three-nucleon calculations to determine the 1S0 np and nn scattering lengths, a_np and a_nn. Our results are a_nn = -18.7 +/- 0.6 fm and a_np = -23.5 +/- 0.8 fm. Since our value for a_np obtained from neutron-deuteron (nd) breakup agrees with that from free np scattering, we conclude that our investigation of the nn FSI done simultaneously and under identical conditions gives the correct value for a_nn. Our value for a_nn is in agreement with that obtained in pion-deuteron capture measurements but disagrees with values obtained from earlier nd breakup studies.Comment: 4 pages and 3 figure

Rationing tests for drug-resistant tuberculosis - who are we prepared to miss?

BACKGROUND: Early identification of patients with drug-resistant tuberculosis (DR-TB) increases the likelihood of treatment success and interrupts transmission. Resource-constrained settings use risk profiling to ration the use of drug susceptibility testing (DST). Nevertheless, no studies have yet quantified how many patients with DR-TB this strategy will miss. METHODS: A total of 1,545 subjects, who presented to Lima health centres with possible TB symptoms, completed a clinic-epidemiological questionnaire and provided sputum samples for TB culture and DST. The proportion of drug resistance in this population was calculated and the data was analysed to demonstrate the effect of rationing tests to patients with multidrug-resistant TB (MDR-TB) risk factors on the number of tests needed and corresponding proportion of missed patients with DR-TB. RESULTS: Overall, 147/1,545 (9.5%) subjects had culture-positive TB, of which 32 (21.8%) had DR-TB (MDR, 13.6%; isoniazid mono-resistant, 7.5%; rifampicin mono-resistant, 0.7%). A total of 553 subjects (35.8%) reported one or more MDR-TB risk factors; of these, 506 (91.5%; 95% CI, 88.9-93.7%) did not have TB, 32/553 (5.8%; 95% CI, 3.4-8.1%) had drug-susceptible TB, and only 15/553 (2.7%; 95% CI, 1.5-4.4%) had DR-TB. Rationing DST to those with an MDR-TB risk factor would have missed more than half of the DR-TB population (17/32, 53.2%; 95% CI, 34.7-70.9). CONCLUSIONS: Rationing DST based on known MDR-TB risk factors misses an unacceptable proportion of patients with drug-resistance in settings with ongoing DR-TB transmission. Investment in diagnostic services to allow universal DST for people with presumptive TB should be a high priority