Language impairment in attention deficit hyperactivity disorder in preschool children

Language impairment (Li) is a highly prevalent comorbidity in children with psychiatric disorders and behavioral problems. The most common psychiatric diagnosis among children with Li is attention deficit hyperactivity disorder (ADHD), and conversely, Li is a frequent comorbidity found in children with ADHD. Despite the frequent cooccurrence of these two common disorders, there have been few studies that specifically investigate language abilities of children with ADHD. Therefore the main objective of this work was to evaluate language profile in ADHD children and to determine whether there is a specific ADHD related language profile in preschoolers in comparison with the control group with no ADHD. Fifty-three preschool children were diagnosed as ADHD and then they were evaluated for their language development. We recruited 36 children fulfilling our inclusion criteria and had delayed language development then we compared this case group to a sex and age matched group of children with delayed language with no ADHD (n= 25). Assessment of intelligence was done for both groups using the Stanford Binnet Test IV. Evaluation of ADHD was done for both groups using DSM-IV criteria for ADHD. Comprehensive assessment of language development was done using the Arab Linguistic Test (ALT). EEG was done for both groups. Our results revealed that children with ADHD showed a significant delay in language development. But there was no difference between ADHD children and the control group in total language age, semantics, pragmatics and expressive language age. The only scale that showed difference between children with ADHD and controls was the receptive language age and receptive age quotient. There was no significant difference between cases and controls in EEG. Weconcluded that it is important to take into consideration language abilities when assessing children with ADHD and it is informative to include ADHD screening tools when dealing with children with DLD.Keywords: Attention deficit hyperactivity disorder (ADHD); Delayed language development (DLD

Preoperative assessment and optimisation: The key to good outcomes after the pandemic

Complications following surgery are common, predictable and often preventable. New preoperative assessment and optimisation guidance recommends clear pathways with triggers for interventions, patient involvement, shared decision making and team education, to help both patients and service efficiency

Quantifying the transboundary contribution of nitrogen oxides to UK air quality

Nitrogen dioxide (NO2) pollution is an important contributor to poor air quality (AQ) and a significant cause of premature deaths in the UK. Although transboundary (i.e., international) transport of pollution to the UK is believed to have an impact on UK pollutant concentrations, large uncertainties remain in these estimates. Therefore, the extent to which emission reductions in neighbouring countries would benefit UK AQ relative to local emission reductions also remains unknown. We have used a back‐trajectory model in conjunction with synoptic scale classifications of UK circulation patterns (Lamb Weather Types [LWT]), to quantify the accumulation of nitrogen oxide (NO x = NO2 + NO) emissions in air masses en‐route to the UK. This novel method presents a computationally inexpensive and useful method of quantifying the accumulation of pollutants under different circulation patterns. We find the highest accumulated NO x totals occur under south‐easterly and southerly flows (>15 μg⋅m−2), with a substantial contribution from outwith the UK (>25%). In contrast, the total accumulated NO x under northerly and westerly flows is lower (∼10 μg⋅m−2), and dominated by UK emissions (>95%). This indicates that European emissions can contribute substantially to UK local‐scale pollution in urban areas under south‐easterly and southerly flows. The sensitivity of integrated NO x emission totals under different air masses is investigated by modelling future European emission contributions based on emission reduction targets. Under targets set by the European Union, there would be a decrease in accumulated NO x emissions in London under most wind directions except for north‐westerly, westerly and northerly flow. The largest benefits to UK AQ from transboundary contributions occur with emission reductions in the Benelux region, due to its close proximity and high NO x emission rates, emphasising the importance of international cooperation in improving local AQ

Health research improves healthcare: now we have the evidence and the chance to help the WHO spread such benefits globally

There has been a dramatic increase in the body of evidence demonstrating the benefits that come from health research. In 2014, the funding bodies for higher education in the UK conducted an assessment of research using an approach termed the Research Excellence Framework (REF). As one element of the REF, universities and medical schools in the UK submitted 1,621 case studies claiming to show the impact of their health and other life sciences research conducted over the last 20 years. The recently published results show many case studies were judged positively as providing examples of the wide range and extensive nature of the benefits from such research, including the development of new treatments and screening programmes that resulted in considerable reductions in mortality and morbidity. Analysis of specific case studies yet again illustrates the international dimension of progress in health research; however, as has also long been argued, not all populations fully share the benefits. In recognition of this, in May 2013 the World Health Assembly requested the World Health Organization (WHO) to establish a Global Observatory on Health Research and Development (R&D) as part of a strategic work-plan to promote innovation, build capacity, improve access, and mobilise resources to address diseases that disproportionately affect the world’s poorest countries. As editors of Health Research Policy and Systems (HARPS), we are delighted that our journal has been invited to help inform the establishment of the WHO Global Observatory through a Call for Papers covering a range of topics relevant to the Observatory, including topics on which HARPS has published articles over the last few months, such as approaches to assessing research results, measuring expenditure data with a focus on R&D, and landscape analyses of platforms for implementing R&D. Topics related to research capacity building may also be considered. The task of establishing a Global Observatory on Health R&D to achieve the specified objectives will not be easy; nevertheless, this Call for Papers is well timed – it comes just at the point where the evidence of the benefits from health research has been considerably strengthened

Ectopic cardiovascular fat in middle-aged men: effects of race/ethnicity, overall and central adiposity. The ERA JUMP study.

Background/objectivesHigher volumes of ectopic cardiovascular fat (ECF) are associated with greater risk of coronary heart disease (CHD). Identifying factors that are associated with ECF volumes may lead to new preventive efforts to reduce risk of CHD. Significant racial/ethnic differences exist for overall and central adiposity measures, which are known to be associated with ECF volumes. Whether racial/ethnic differences also exist for ECF volumes and their associations with these adiposity measures remain unclear.Subjects/methodsBody mass index (BMI), computerized tomography-measured ECF volumes (epicardial, pericardial and their summation) and visceral adipose tissue (VAT) were examined in a community-based sample of 1199 middle-aged men (24.2% Caucasians, 7.0% African-Americans, 23.6% Japanese-Americans, 22.0% Japanese, 23.2% Koreans).ResultsSignificant racial/ethnic differences existed in ECF volumes and their relationships with BMI and VAT. ECF volumes were the highest among Japanese-Americans and the lowest among African-Americans. The associations of BMI and VAT with ECF differed by racial/ethnic groups. Compared with Caucasians, for each 1-unit increase in BMI, African-Americans had lower, whereas Koreans had higher increases in ECF volumes (P-values<0.05 for both). Meanwhile, compared with Caucasians, for each 1-unit increase in log-transformed VAT, African-Americans, Japanese-Americans and Japanese had similar increases, whereas Koreans had a lower increase in ECF volumes (P-value<0.05).ConclusionsRacial/ethnic groups differed in their propensity to accumulate ECF at increasing level of overall and central adiposity. Future studies should evaluate whether reducing central adiposity or overall weight will decrease ECF volumes more in certain racial/ethnic groups. Evaluating these questions might help in designing race-specific prevention strategy of CHD risk associated with higher ECF

Fabrication, appraisal, and transdermal permeation of sildenafil citrate-loaded nanostructured lipid carriers versus solid lipid nanoparticles

Although sildenafil citrate (SC) is used extensively for erectile dysfunction, oral delivery of SC encounters many obstacles. Furthermore, the physicochemical characteristics of this amphoteric drug are challenging for delivery system formulation and transdermal permeation. This article concerns the assessment of the potential of nanomedicine for improving SC delivery and transdermal permeation. SC-loaded nanostructured lipid carriers (NLCs) and solid lipid nanoparticles (SLNs) were fabricated using a modified high-shear homogenization technique. Nanoparticle optimization steps included particle size analysis, entrapment efficiency (EE) determination, freeze-drying and reconstitution, differential scanning calorimetry, in vitro release, stability study and high-performance liquid chromatography analysis. Transdermal permeation of the nanocarriers compared with SC suspension across human skin was assessed using a modified Franz diffusion cell assembly. Results revealed that SLNs and NLCs could be optimized in the nanometric range (180 and 100 nm, respectively) with excellent EE (96.7% and 97.5%, respectively). Nanoparticles have significantly enhanced in vitro release and transdermal permeation of SC compared with its suspensions. Furthermore, transdermal permeation of SC exhibited higher initial release from both SLN and NLC formulations followed by controlled release, with promising implications for faster onset and longer drug duration. Nanomedicines prepared exhibited excellent physical stability for the study period. Solid nanoparticles optimized in this study successfully improved SC characteristics, paving the way for an efficient topical Viagra® product

Timing of elective surgery and risk assessment after SARS-CoV-2 infection: 2023 update

Guidance for the timing of surgery following SARS-CoV-2 infection needed reassessment given widespread vaccination, less virulent variants, contemporary evidence and a need to increase access to safe surgery. We, therefore, updated previous recommendations to assist policymakers, administrative staff, clinicians and, most importantly, patients. Patients who develop symptoms of SARS-CoV-2 infection within 7 weeks of planned surgery, including on the day of surgery, should be screened for SARS-CoV-2. Elective surgery should not usually be undertaken within 2 weeks of diagnosis of SARS-CoV-2 infection. For patients who have recovered from SARS-CoV-2 infection and who are low risk or having low-risk surgery, most elective surgery can proceed 2 weeks following a SARS-CoV-2 positive test. For patients who are not low risk or having anything other than low-risk surgery between 2 and 7 weeks following infection, an individual risk assessment must be performed. This should consider: patient factors (age; comorbid and functional status); infection factors (severity; ongoing symptoms; vaccination); and surgical factors (clinical priority; risk of disease progression; grade of surgery). This assessment should include the use of an objective and validated risk prediction tool and shared decision-making, taking into account the patient's own attitude to risk. In most circumstances, surgery should proceed unless risk assessment indicates that the risk of proceeding exceeds the risk of delay. There is currently no evidence to support delaying surgery beyond 7 weeks for patients who have fully recovered from or have had mild SARS-CoV-2 infection