Determinants of inspiratory muscle function in healthy children

AbstractBackgroundChildren are affected by disorders that have an impact on the respiratory muscles. Inspiratory muscle function can be assessed by means of the noninvasive tension–time index of the inspiratory muscles (TTImus). Our objectives were to identify the determinants of TTImus in healthy children and to report normal values of TTImus in this population.MethodsWe measured weight, height, upper arm muscle area (UAMA), and TTImus in 96 children aged 6–18 years. The level and frequency of aerobic activity was assessed by questionnaire.ResultsTTImus was significantly lower in male subjects (0.095 ± 0.038, mean ± SD) compared with female subjects (0.126 ± 0.056) (p = 0.002). TTImus was significantly lower in regularly exercising (0.093 ± 0.040) compared with nonexercising subjects (0.130 ± 0.053) (p < 0.001). TTImus was significantly negatively related to age (r = −0.239, p = 0.019), weight (r = −0.214, p = 0.037), height (r = −0.355, p < 0.001), and UAMA (r = −0.222, p = 0.030). Multivariate logistic regression analysis revealed that height and aerobic exercise were significantly related to TTImus independently of age, weight, and UAMA. The predictive regression equation for TTImus in male subjects was TTImus = 0.228 − 0.001 × height (cm), and in female subjects it was TTImus = 0.320 − 0.001 × height (cm) .ConclusionGender, age, anthropometry, skeletal muscularity, and aerobic exercise are significantly associated with indices of inspiratory muscle function in children. Normal values of TTImus in healthy children are reported

Production of belite calcium sulfoaluminate cement using sulfur as a fuel and as a source of clinker sulfur trioxide : pilot kiln trial

The authors gratefully acknowledge the financial support provided by the Gulf Organization for Research and Development (GORD), Qatar, through research grant number ENG016RGG11757. The authors would also like to acknowledge Thomas Matschei and Guanshu Li for the stimulating and fruitful discussions concerning the development of this work. The continuous support prior to, during and after the pilot kiln trial from Vadym Kuznietsov and the entire team at IBU-tec is also greatly appreciated.Peer reviewedPublisher PD

Calcium Sulfoaluminate Cement Clinkering

Non peer reviewedPublisher PD

Hospital readmission and healthcare utilization following sepsis in community settings

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108012/1/jhm2197.pd

The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda.

BackgroundThe age-specific epidemiology of child and adolescent tuberculosis (TB) is poorly understood, especially in rural areas of East Africa. We sought to characterize the age-specific prevalence and predictors of TB infection among children and adolescents living in rural Uganda, and to explore the contribution of household TB exposure on TB infection.MethodsFrom 2015-2016 we placed and read 3,121 tuberculin skin tests (TST) in children (5-11 years old) and adolescents (12-19 years old) participating in a nested household survey in 9 rural Eastern Ugandan communities. TB infection was defined as a positive TST (induration ≥10mm or ≥5mm if living with HIV). Age-specific prevalence was estimated using inverse probability weighting to adjust for incomplete measurement. Generalized estimating equations were used to assess the association between TB infection and multi-level predictors.ResultsThe adjusted prevalence of TB infection was 8.5% (95%CI: 6.9-10.4) in children and 16.7% (95% CI:14.0-19.7) in adolescents. Nine percent of children and adolescents with a prevalent TB infection had a household TB contact. Among children, having a household TB contact was strongly associated with TB infection (aOR 5.5, 95% CI: 1.7-16.9), but the strength of this association declined among adolescents and did not meet significance (aOR 2.3, 95% CI: 0.8-7.0). The population attributable faction of TB infection due to a household TB contact was 8% for children and 4% among adolescents. Mobile children and adolescents who travel outside of their community for school had a 1.7 (95% CI 1.0-2.9) fold higher odds of TB infection than those who attended school in the community.ConclusionChildren and adolescents in this area of rural eastern Uganda suffer a significant burden of TB. The majority of TB infections are not explained by a known household TB contact. Our findings underscore the need for community-based TB prevention interventions, especially among mobile youth

Strain echocardiography tracks dobutamine-induced decrease in regional myocardial perfusion in nonocclusive coronary stenosis

ObjectivesThis study was designed to determine whether strain echocardiography parameters reflect changes in regional myocardial perfusion during dobutamine stress.BackgroundStrain echocardiography depicts regional myocardial mechanical activity. Ischemia has been shown to reduce systolic strain rate (sSR) and prolong the time to regional lengthening (TRL). In an experimental model, we tested whether sSR and TRLtracked dobutamine-induced changes in regional myocardial perfusion (regional myocardial blood flow [RMBF]), as measured by colored microspheres.MethodsWe used a closed-chest pig model of nonocclusive coronary stenosis (n = 14) created by inflating an angioplasty balloon in the proximal left anterior descending artery. Invasive hemodynamics, RMBF, and strain parameters were measured at baseline and peak dobutamine stimulation before and during the coronary stenosis. We compared segments with reduced RMBF versus those with preserved RMBF at peak dobutamine stimulation.ResultsPeak sSR correlated with RMBF (r = 0.70). In the absence of coronary stenosis, dobutamine stimulation caused a significant increase in RMBF and sSR and a decrease in TRL. This response was blunted during coronary stenosis. Using the “best cutoff” method, the sensitivity and specificity for prediction of reduced RMBF (ischemia) was 81% and 91% for sSR and 65% and 91% for TRL, respectively. These changes occurred in the absence of any change in global systolic and diastolic function (dP/dTmax, dP/dTmin, and tau).ConclusionsNovel strain parameters that depict regional myocardial mechanics are able to predict changes in RMBF during dobutamine stress. Quantitative strain parameters may complement current echocardiographic techniques for ischemia detection and potentially improve the accuracy and reproducibility of stress echocardiography

Gaps in the Child Tuberculosis Care Cascade in 32 Rural Communities in Uganda and Kenya.

Background:Reducing tuberculosis (TB) deaths among children requires a better understanding of the gaps in the care cascade from TB diagnosis to treatment completion. We sought to assess the child TB care cascade in 32 rural communities in Uganda and Kenya using programmatic data. Methods:This is a retrospective cohort study of 160,851 children (ages &lt;15 years) living in 12 rural communities in Kenya and 22 in Uganda. We reviewed national TB registries from health centers in and adjacent to the 32 communities, and we included all child TB cases recorded from January 1, 2013 to June 30, 2016. To calculate the first step of the child TB care cascade, the number of children with active TB, we divided the number of reported child TB diagnoses by the 2015 World Health Organization (WHO) child TB case detection ratio for Africa of 27%. The remaining components of the Child TB Care Cascade were ascertained directly from the TB registries and included: diagnosed with TB, started on TB treatment, and completed TB treatment. Results:In two and a half years, a total of 42 TB cases were reported among children living in 32 rural communities in Uganda and Kenya. 40% of the children were co-infected with HIV. Using the WHO child TB case detection ratio, we calculated that 155 children in this cohort had TB during the study period. Of those 155 children, 42 were diagnosed and linked to TB care, 42 were started on treatment, and 31 completed treatment. Among the 42 children who started TB treatment, reasons for treatment non-completion were loss to follow up (7%), death (5%), and un-recorded reasons (5%). Overall, 20% (31/155) of children completed the child TB care cascade. Conclusion:In 32 rural communities in Uganda and Kenya, we estimate that 80% of children with TB fell off the care cascade. Reducing morbidity and mortality from child TB requires strengthening of the child TB care cascade from diagnosis through treatment completion

A life in progress: motion and emotion in the autobiography of Robert M. La Follette

This article is a study of a La Follette’s Autobiography, the autobiography of the leading Wisconsin progressive Robert M. La Follette, which was published serially in 1911 and, in book form, in 1913. Rather than focusing, as have other historians, on which parts of La Follette’s account are accurate and can therefore be trusted, it explains instead why and how this major autobiography was conceived and written. The article shows that the autobiography was the product of a sustained, complex, and often fraught series of collaborations among La Follette’s family, friends, and political allies, and in the process illuminates the importance of affective ties as well as political ambition and commitment in bringing the project to fruition. In the world of progressive reform, it argues, personal and political experiences were inseparable

‘It's a part of me, I feel naked without it': choice, agency and identity for Muslim women who wear the niqab

In the context of heightened suspicion and anti-Muslim stereotypes in a post-9/11 and 7/7 era, Muslim women who wear the niqab (face veil) are stigmatised, criminalised and marked as ‘dangerous’ to British/Western values. Several countries have imposed bans on the wearing of face veils in public places based on the premise that the niqab is a ‘threat’ to notions of gender equality, integration and national security. While the wearing of the niqab has elicited a good deal of media, political and public debates, little attention has been paid to the opinions of Muslim women who wear it. Drawing on individual and focus group interviews with Muslim women who wear the niqab in the United Kingdom (UK), this article places at the centre of the debate the voices of those women who do wear it, and explores their reasons for adopting it. The findings show that the wearing of the niqab emerges as a personal choice, an expression of religious piety, public modesty and belonging to the ‘ummah’. It is also perceived as a form of agency, resistance and non-conformity to Western consumerist culture and lifestyle. It will be concluded that wearing the niqab empowers women in their public presence and offers them a sense of ‘liberation’, which is associated with the notion of anonymity that it provides them

Strong signature of natural selection within an FHIT intron implicated in prostate cancer risk

Previously, a candidate gene linkage approach on brother pairs affected with prostate cancer identified a locus of prostate cancer susceptibility at D3S1234 within the fragile histidine triad gene (FHIT), a tumor suppressor that induces apoptosis. Subsequent association tests on 16 SNPs spanning approximately 381 kb surrounding D3S1234 in Americans of European descent revealed significant evidence of association for a single SNP within intron 5 of FHIT. In the current study, resequencing and genotyping within a 28.5 kb region surrounding this SNP further delineated the association with prostate cancer risk to a 15 kb region. Multiple SNPs in sequences under evolutionary constraint within intron 5 of FHIT defined several related haplotypes with an increased risk of prostate cancer in European-Americans. Strong associations were detected for a risk haplotype defined by SNPs 138543, 142413, and 152494 in all cases (Pearson's χ2 = 12.34, df 1, P = 0.00045) and for the homozygous risk haplotype defined by SNPs 144716, 142413, and 148444 in cases that shared 2 alleles identical by descent with their affected brothers (Pearson's χ2 = 11.50, df 1, P = 0.00070). In addition to highly conserved sequences encompassing SNPs 148444 and 152413, population studies revealed strong signatures of natural selection for a 1 kb window covering the SNP 144716 in two human populations, the European American (π = 0.0072, Tajima's D= 3.31, 14 SNPs) and the Japanese (π = 0.0049, Fay & Wu's H = 8.05, 14 SNPs), as well as in chimpanzees (Fay & Wu's H = 8.62, 12 SNPs). These results strongly support the involvement of the FHIT intronic region in an increased risk of prostate cancer. © 2008 Ding et al