Regional Low Cerebral Blood Flow Predicts Leukoaraiosis Development at 18 Months in Patients with TIA and Minor Stroke

The purpose of this study was to investigate whether low cerebral blood flow (CBF) is associated with subsequent white matter hyperintensity (WMH) development in minor stroke and transient ischemic attack (TIA) patients. New WMH at 18 months were identified by comparing follow-up with baseline FLAIR, and regions of interest (ROI) were placed in normal appearing and hyperintense white matter. Co-registered CBF maps were used to quantify relative CBF. Forty patients were evaluated, where mean age was 62+/-12 years, 78% male and 9% diabetic. A mixed effects logistic regression accounting for “within patient” clustering, showed that as CBF increases by 1mL/100g/min, the odds of having a new WMH decrease by 0.61. Results suggest that regions of white matter that develop WMH at 18 months have low baseline CBF. Future studies aiming to improve cerebral perfusion in normal appearing white matter might provide a target for arresting the development of WMH

A study of the relationship between a child's achievement and adjustment in grades one and three.

Thesis (Ed.M.)--Boston Universit

The Atlas of Legal Fictions

The Jewish Eruv is a defined physical area that symbolically extends the ‘home,’ beyond its walls and into the community. Purposefully built to be undetectable to the untrained eye, Eruvin are present, yet hidden, in the physical urban world around us. This spatial practice acts as a physical loophole; symbolically transforming space to provide leniencies to Orthodox Jewish communities. The Eruv demarcates a space of freedom on the Sabbath, but still maintains religious law that does not permit individuals to work or carry objects outside the private realm on the day of rest. Within the Eruv, the performance of daily activities becomes possible, and citizens are able to participate in their communities and cities. The establishment of these sacred boundaries creates a shared, privatized religious space within what is commonly recognized as the public realm. The Atlas of Legal Fictions plays a unique role in the world of map-making, depicting the unexplored and unseen reality of the Eruv, and its ability to negotiate space, people, community and spiritual practice within the plurality found in our urban surroundings. This atlas details the physical presence and conveys the spiritual allegory of Eruvin at all scales, which until now, have remained undocumented in the field of architectural and urban studies. Eruvin consequently alter the physical, social and symbolic interpretations and uses of cities; varying in size and shape, and utilizing many pre-existing natural or man-made elements as their boundaries, they embed themselves within the urban context. The basic construction of the Eruv, commonly made of timber posts connected with fishing line, represent the walls and roof of a house where tradition and assimilation, the new and the old, intermingle. Referred to as a legal fiction — an assertion accepted as true — the Eruv is used to create community, maintain practice, and integrate individuals into their surroundings through personal commitment and connection to their authority. By exploring its physical components, urban considerations, and social consequences, The Atlas of Legal Fictions, considers the Eruv as an architecture of necessity, critical to the practice of place-making and establishment of community. As architecture’s minimum, the Eruv transforms the existing fabric of a city into a physical space with a multiplicity of meanings. The Eruv, built by people, for people, has the potential to indicate the desired and functional scale of community. Focusing on Eruvin built for the Diaspora communities, this thesis contributes to the study of these boundaries while preserving their sacred existence, and ultimately illuminates how community and religion can harmoniously negotiate their survival in the modern world. The Atlas of Legal Fictions reveals a little known reality, uncovering the nature of these religious boundaries and exposing the factual existence of what is considered fiction in the modern world

Ebola Virus Localization in the Macaque Reproductive Tract during Acute Ebola Virus Disease.

Sexual transmission of Ebola virus (EBOV) has been demonstrated more than a year after recovery from the acute phase of Ebola virus disease (EVD). The mechanisms underlying EBOV persistence and sexual transmission are not currently understood. Using the acute macaque model of EVD, we hypothesized EBOV would infect the reproductive tissues and sought to localize the infection in these tissues using immunohistochemistry and transmission electron microscopy. In four female and eight male macaques that succumbed to EVD between 6 and 9 days after EBOV challenge, we demonstrate widespread EBOV infection of the interstitial tissues and endothelium in the ovary, uterus, testis, seminal vesicle, epididymis, and prostate gland, with minimal associated tissue immune response or organ pathology. Given the widespread involvement of EBOV in the reproductive tracts of both male and female macaques, it is reasonable to surmise that our understanding of the mechanisms underlying sexual transmission of EVD and persistence of EBOV in immune-privileged sites would be facilitated by the development of a nonhuman primate model in which the macaques survived past the acute stage into convalescence

Genetic factors are important determinants of impaired growth after infant cardiac surgery

ObjectivesWe sought to estimate the prevalence and identify the predictors of impaired growth after infant cardiac surgery.MethodsWe performed a secondary analysis of a prospective study of the role of apolipoprotein E gene polymorphisms on neurodevelopment in young children after infant cardiac surgery. Prevalence estimates for growth velocity were derived by using anthropometric measures (weight and head circumference) obtained at birth and at 4 years of age. Genetic evaluation was also performed. Growth measure z scores were calculated by using World Health Organization Child Growth Standards. Growth velocity was evaluated by using 2 different techniques: first by clustering the children into one of 3 growth velocity subgroups based on z scores (impaired growth, difference < −0.5 standard deviation; stable growth, difference of −0.5 to 0.5 standard deviation; and improving growth, difference > 0.5 SD) and second by using continuous difference scores. Statistical analyses were conducted with a combination of proportional odds models for the ordered categories and simple linear regression for the continuous outcomes.ResultsThree hundred nineteen full-term subjects had complete anthropometric measures for weight and head circumference at birth and 4 years. The cohort was 56% male. Genetic examinations were available for 97% (309/319) of the cohort (normal, 74%; definite or suspected genetic abnormality, 26%). Frequency counts for weight categories were as follows: impaired growth, 37%; stable growth, 31%; and improving growth, 32%. Frequency counts for head circumference categories were as follows: impaired growth, 39%; stable growth, 28%; and improving growth, 33%. The presence of a definite or suspected genetic syndrome (P = .04) was found to be a predictor of impaired growth for weight but not for head circumference. When growth z scores were used as continuous outcomes, the apolipoprotein E ε2 allele was found to be predictive of lower z scores for both weight (P = .02) and head circumference (P = .03).ConclusionsImpaired growth for both weight and head circumference is common (both >30%) in this cohort of children after infant cardiac surgery. Both the apolipoprotein E ε2 allele and the presence of a definite or suspected genetic syndrome were associated with impaired weight growth velocity. The apolipoprotein E ε2 allele was also associated with impaired growth velocity for head circumference. Persistent poor growth might have long-term implications for the health and development of children with congenital heart defects

Simian hemorrhagic fever virus infection of rhesus macaques as a model of viral hemorrhagic fever: Clinical characterization and risk factors for severe disease

AbstractSimian Hemorrhagic Fever Virus (SHFV) has caused sporadic outbreaks of hemorrhagic fevers in macaques at primate research facilities. SHFV is a BSL-2 pathogen that has not been linked to human disease; as such, investigation of SHFV pathogenesis in non-human primates (NHPs) could serve as a model for hemorrhagic fever viruses such as Ebola, Marburg, and Lassa viruses. Here we describe the pathogenesis of SHFV in rhesus macaques inoculated with doses ranging from 50PFU to 500,000PFU. Disease severity was independent of dose with an overall mortality rate of 64% with signs of hemorrhagic fever and multiple organ system involvement. Analyses comparing survivors and non-survivors were performed to identify factors associated with survival revealing differences in the kinetics of viremia, immunosuppression, and regulation of hemostasis. Notable similarities between the pathogenesis of SHFV in NHPs and hemorrhagic fever viruses in humans suggest that SHFV may serve as a suitable model of BSL-4 pathogens

Early Exposure to Soy Isoflavones and Effects on Reproductive Health: A Review of Human and Animal Studies

Soy isoflavones are phytoestrogens with potential hormonal activity due to their similar chemical structure to 17-β-estradiol. The increasing availability of soy isoflavones throughout the food supply and through use of supplements has prompted extensive research on biological benefits to humans in chronic disease prevention and health maintenance. While much of this research has focused on adult populations, infants fed soy protein based infant formulas are exposed to substantial levels of soy isoflavones, even when compared to adult populations that consume a higher quantity of soy-based foods. Infant exposure, through soy formula, primarily occurs from birth to one year of life, a stage of development that is particularly sensitive to dietary and environmental compounds. This has led investigators to study the potential hormonal effects of soy isoflavones on later reproductive health outcomes. Such studies have included minimal human data with the large majority of studies using animal models. This review discusses key aspects of the current human and animal studies and identifies critical areas to be investigated as there is no clear consensus in this research field

Pacifier Stiffness Alters the Dynamics of the Suck Central Pattern Generator

Variation in pacifier stiffness on non-nutritive suck (NNS) dynamics was examined among infants born prematurely with a history of respiratory distress syndrome. Three types of silicone pacifiers used in the NICU were tested for stiffness, revealing the Super Soothie™ nipple is 7 times stiffer than the Wee™ or Soothie™ pacifiers even though shape and displaced volume are identical. Suck dynamics among 20 preterm infants were subsequently sampled using the Soothie™ and Super Soothie™ pacifiers during follow-up at approximately 3 months of age. ANOVA revealed significant differences in NNS cycles/min, NNS amplitude, NNS cycles/burst, and NNS cycle periods as a function of pacifier stiffness. Infants modify the spatiotemporal output of their suck central pattern generator when presented with pacifiers with significantly different mechanical properties. Infants show a non-preference to suck due to high stiffness in the selected pacifier. Therefore, excessive pacifier stiffness may decrease ororhythmic patterning and impact feeding outcomes

Developmental Outcomes of Very Preterm Infants with Tracheostomies

Objectives To evaluate the neurodevelopmental outcomes of very preterm (<30 weeks) infants who underwent tracheostomy. Study design Retrospective cohort study from 16 centers of the NICHD Neonatal Research Network over 10 years (2001-2011). Infants who survived to at least 36 weeks (N=8,683), including 304 infants with tracheostomies, were studied. Primary outcome was death or neurodevelopmental impairment (NDI, a composite of one or more of: developmental delay, neurologic impairment, profound hearing loss, severe visual impairment) at a corrected age of 18-22 months. Outcomes were compared using multiple logistic regression. We assessed impact of timing, by comparing outcomes of infants who underwent tracheostomy before and after 120 days of life. Results Tracheostomies were associated with all neonatal morbidities examined, and with most adverse neurodevelopmental outcomes. Death or NDI occurred in 83% of infants with tracheostomies and 40% of those without [odds ratio (OR) adjusted for center 7.0 (95%CI, 5.2-9.5)]. After adjustment for potential confounders, odds of death or NDI remained higher [OR 3.3 (95%CI, 2.4-4.6)], but odds of death alone were lower [OR 0.4 (95%CI, 0.3-0.7)], among infants with tracheostomies. Death or NDI was lower in infants who received their tracheostomies before, rather than after, 120 days of life [adjusted OR 0.5 (95%CI, 0.3-0.9)]. Conclusions Tracheostomy in preterm infants is associated with adverse developmental outcomes, and cannot mitigate the significant risk associated with many complications of prematurity. These data may inform counseling about tracheostomy in this vulnerable population