International classification of functioning, disability and health core sets for children and youth with cerebral palsy: a consensus meeting

AIM: The objective of this article is to report on the Core Sets developed for children and youth aged 0 to 18 years, with cerebral palsy (CP) based on the pediatric International Classification of Functioning, Disability and Health (ICF) by the World Health Organization (WHO).METHOD: A formal decision-making and consensus process integrating evidence gathered from preparatory studies was followed. Preparatory studies included: a systematic literature review; an international expert survey; a qualitative study of children and youth with CP and their caregivers; and a clinical study. Relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. Twenty-six international experts chosen by WHO region with expertise in CP attended the consensus meeting.RESULTS: Overall, five ICF Core Sets were developed: a Comprehensive Core Set (135 ICF categories); a Common Brief (25 ICF categories); and three age-specific Core Sets: under 6 years (31 ICF categories), from 6 to &lt;14 years (35 ICF categories) and from 14 to 18 years (37 ICF categories).INTERPRETATION: These ICF Core Sets for children and youth with CP are the first ICF-based tools developed for this population. The ICF Core Sets for children and youth with CP can be applied in clinical practice, research, teaching and administration. The application of the ICF Core Sets to this population will standardize the functional assessments of CP worldwide.<br/

Left atrial trajectory impairment in hypertrophic cardiomyopathy disclosed by geometric morphometrics and parallel transport

The analysis of full Left Atrium (LA) deformation and whole LA deformational trajectory in time has been poorly investigated and, to the best of our knowledge, seldom discussed in patients with Hypertrophic Cardiomyopathy. Therefore, we considered 22 patients with Hypertrophic Cardiomyopathy (HCM) and 46 healthy subjects, investigated them by three-dimensional Speckle Tracking Echocardiography, and studied the derived landmark clouds via Geometric Morphometrics with Parallel Transport. Trajectory shape and trajectory size were different in Controls versus HCM and their classification powers had high AUC (Area Under the Receiving Operator Characteristic Curve) and accuracy. The two trajectories were much different at the transition between LA conduit and booster pump functions. Full shape and deformation analyses with trajectory analysis enabled a straightforward perception of pathophysiological consequences of HCM condition on LA functioning. It might be worthwhile to apply these techniques to look for novel pathophysiological approaches that may better define atrio-ventricular interaction

Seasonal variability of gelatinous zooplankton during an anomalously warm year at Cabo Pulmo national park, Mexico

The seasonal variability of gelatinous zooplankton (siphonophores, medusae, and thaliaceans) abundance was investigated at Cabo Pulmo National Park (CPNP) from weekly zooplankton samples collected throughout 2014. The Gulf of California had prolonged warming during 2009-2019, with 2014 as the anomalously warm year preceding El Niño 2015-2016 compared to the 2003-2020 SST time series. Gelatinous zooplankton accounted <1% of the entire zooplankton community abundance at CPNP during 2014, suggesting a low influence of predation pressure upon their zooplanktonic and micronekton preys. Siphonophores (57%), thaliaceans (42%), and medusae (1%) were present throughout the year. The abundance of gelatinous zooplankton had a significant negative association with sea surface temperature and a positive association with sea surface chlorophyll-a concentration and velocity and direction of the wind, increasing their abundance during October after the hurricane season. The gelatinous zooplankton species assemblage at the coastal CPNP was similar but less abundant than the gelatinous zooplankton species assemblage observed in the oceanic region of the southern Gulf of California during summer 2014. Tropical species Diphyes dispar, Abylopsis tetragona, Chelophyes contorta, and Thalia spp. numerically dominated the gelatinous zooplankton community associated with a regional heatwave period recorded during 2014. A high proportion of tropical zooplankton indicates that mesotrophic conditions sustain the current high biomass and diversity of nektonic and benthonic planktophagous fauna inhabiting CPNP. However, prolonged warming events might decrease zooplankton biomass in the southern region of the Gulf of California in the future.Fil: Silveyra Bustamante, Angel Antonio. Instituto Politécnico Nacional; MéxicoFil: Gómez Gutiérrez, Jaime. Instituto Politécnico Nacional; MéxicoFil: González Rodríguez, Eduardo. Consejo Nacional de Ciencia y Tecnologia de Mexico. Centro de Investigacion Cientifica y de Educacion Superior de Ensenada Baja California.; MéxicoFil: Sánchez, Carlos. Universidad Autónoma de Baja California Sur; MéxicoFil: Schiariti, Agustin. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; Argentina. Instituto Nacional de Investigaciones y Desarrollo Pesquero; ArgentinaFil: Mendoza Becerril, María A.. Consejo Nacional de Ciencia y Tecnología; Méxic

First Ex-Vivo Validation of a Radioguided Surgery Technique with beta- Radiation

Purpose: A radio-guided surgery technique with beta- -emitting radio-tracers was suggested to overcome the effect of the large penetration of gamma radiation. The feasibility studies in the case of brain tumors and abdominal neuro-endocrine tumors were based on simulations starting from PET images with several underlying assumptions. This paper reports, as proof-of-principle of this technique, an ex-vivo test on a meningioma patient. This test allowed to validate the whole chain, from the evaluation of the SUV of the tumor, to the assumptions on the bio-distribution and the signal detection. Methods: A patient affected by meningioma was administered 300 MBq of 90Y-DOTATOC. Several samples extracted from the meningioma and the nearby Dura Mater were analyzed with a beta- probe designed specifically for this radio-guided surgery technique. The observed signals were compared both with the evaluation from the histology and with the Monte Carlo simulation. Results: we obtained a large signal on the bulk tumor (105 cps) and a significant signal on residuals of $\sim$0.2 ml (28 cps). We also show that simulations predict correctly the observed yields and this allows us to estimate that the healthy tissues would return negligible signals (~1 cps). This test also demonstrated that the exposure of the medical staff is negligible and that among the biological wastes only urine has a significant activity. Conclusions: This proof-of-principle test on a patient assessed that the technique is feasible with negligible background to medical personnel and confirmed that the expectations obtained with Monte Carlo simulations starting from diagnostic PET images are correct.Comment: 17 pages, 4 Figs, Accepted by Physica Medic

Content validity of the comprehensive ICF core set for children with cerebral palsy aged 0-6 years: Iranian occupational therapists perspective

Objectives Comprehensive ICF Core Set of cerebral palsy (CP) includes a set of functions of children with CP has been created recently. This study determined the content validity of this version based on Iranian Occupational Therapists� perspectives to explore whether the ICF Core Sets for CP include the areas of function of CP in Occupational Therapy practice. Materials & Methods This qualitative study conducted from Feb 2015 to Apr 2016 in Tehran, Iran. Experts were the academic staffs selected through convenience sampling. Content validity of comprehensive ICF-Core Set of CP with 135 ICF categories was done by them. Delphi survey was used for generating consensus on the final version. Participants were 50 clinical Occupational Therapists invited via email from across Iran. An agreement of 75 was considered as the cut-off for inclusion of each code-category. Results About 60 of the code�categories of comprehensive version of ICF Core Set of CP were approved by Occupational Therapists. In the final version, 82 code-categories were listed that included 21 code-categories for Body Functions, 40 for Activity/Participation, and 21 for Environmental Factors. Conclusion The validity of the Iranian ICF Core Set for children with CP aged 0�6 yr was supported by Iranian Occupational Therapists. It could be the basis for evaluation of this population in Occupational Therapy. © 2018, Iranian Child Neurology Society. All rights reserved

Meaningful health outcomes for paediatric neurodisability: stakeholder prioritisation and appropriateness of patient reported outcome measures

BACKGROUND: Health services are increasingly focused on measuring and monitoring outcomes, particularly those that reflect patients' priorities. To be meaningful, outcomes measured should be valued by patients and carers, be consistent with what health professionals seek to achieve, and be robust in terms of measurement properties. The aim of this study was (i) to seek a shared vision between families and clinicians regarding key aspects of health as outcomes, beyond mortality and morbidity, for children with neurodisability, and (ii) to appraise which multidimensional patient reported outcome measures (PROMs) could be used to assess salient health domains. METHODS: Relevant outcomes were identified from (i) qualitative research with children and young people with neurodisability and parent carers, (ii) Delphi survey with health professionals, and (iii) systematic review of PROMs. The International Classification of Functioning Disability and Health provided a common language to code aspects of health. A subset of stakeholders participated in a prioritisation meeting incorporating a Q-sorting task to discuss and rank aspects of health. RESULTS: A total of 33 pertinent aspects of health were identified. Fifteen stakeholders from the qualitative and Delphi studies participated in the prioritisation meeting: 3 young people, 5 parent carers, and 7 health professionals. Aspects of health that emerged as more important for families and targets for health professionals were: communication, emotional wellbeing, pain, sleep, mobility, self-care, independence, mental health, community and social life, behaviour, toileting and safety. Whilst available PROMs measure many aspects of health in the ICF, no single PROM captures all the key domains prioritised as for children and young people with neurodisability. The paucity of scales for assessing communication was notable. CONCLUSIONS: We propose a core suite of key outcome domains for children with neurodisability that could be used in evaluative research, audit and as health service performance indicators. Future work could appraise domain-specific PROMs for these aspects of health; a single measure assessing the key aspects of health that could be applied across paediatric neurodisability remains to be developed

A Comparative Review of Macromedusae in Eastern Boundary Currents

Edited By: S. J. Hawkins, A. J. Lemasson, A. L. Allcock, A. E. Bates, M. Byrne, A. J. Evans, L. B. Firth, E. M. Marzinelli, B. D. Russell, I. P. Smith, S. E. Swearer, P. A. Todd.The productive eastern boundary current (EBC) systems provide significant sources of global marine protein and have been subject to intense research over the last 50 years. Yet large jellyfish, which are present in all four major systems, have seldom been included in otherwise comprehensive reviews. This undoubtedly reflects their lack of intrinsic commercial value, and the consequently slow pace of knowledge generation. We attempt to redress that imbalance here and to consolidate disparate information on the macromedusae of EBC systems. With the exception of the Canary Current system, which supports a generally low biomass of mostly subtropical taxa, 372jellyfish assemblages in the Benguela, Humboldt and California Current systems are dominated by cool water taxa that can occur at high abundances. While there are large gaps in knowledge, which are highlighted, it is clear that jellyfish can play significant ecological roles in each system. Although there may be strong similarities in faunal composition among the different systems, there are pronounced differences in population responses to the environment and in system resilience and these are reviewed and discussed.Variously, we would also like to thank the Namibian government for access to data and to the National Research Foundation (South Africa), the Royal Society (London), the EAF Nansen Programme and the University of the Western Cape for financial support over the years. We are grateful to the Chilean government and the Agencia Nacional de Investigación y Desarrollo de Chile – formerly Comisión Nacional de Investigación Científica y Tecnológica, and IMARPE for their financial support, and would like to acknowledge grants awarded by the Inter-American Institute for Global Change Research in Montevideo (GEO-0452325, EXA 470/10, PIP 12-201101-00892; CRN3070), as well as the Ministerio de Ciencia, Tecnología e Innovación Productiva in Argentina (FONCyT 01553, FONCyT PICT 2006 No. 1553). Funding was provided by NOAA Fisheries through the Northwest and Southwest Fisheries Science Centers. The CSIC research was supported by projects P07-RNM-02976 (Junta de Andalucía), CTM2011-22856 (Spanish Ministry of Science and Innovation) and 2019AEP203 (CSIC).Peer reviewe