Does Supplementation of N-3 Fatty Acids Containing DHA Throughout Pregnancy and Breastfeeding Improve Child Cognition?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the supplementation of N-3 fatty acids containing DHA throughout pregnancy and breastfeeding improve child cognition. STUDY DESIGN: Review of three double blind randomized controlled clinical trials (RCTs) published in 2003 and 2011. DATA SOURCES: Three peer-reviewed RCTs were found using PubMed and Medline. These studies compared DHA supplementation against various placebos. OUTCOMES MEASURED: enhanced child cognition was assessed via various exams, including the Kaufman Assessment Battery for Children (K-ABC) and Fagan tests. Significant outcomes were evaluated through the use of SD, Mean Scores, and p-values. RESULTS: Helland et al (2003) found significant cognitive differences between 4 year old children born to DHA and non-DHA supplemented mothers, via MPC scores on the KABC test (106.4[7.4] v. 102.3[11.3]; P=0.049). Helland (2001) and Campoy (2011), however, did not note any significant differences between children on either the Fagan ((55.2[4.5] vs. 55.4[3.7]% at 6 months and 55.5[3.8] vs. 56.2[3.5]% at 9 months) or KABC tests (110[11] vs. 110[14.5]% at 6.5 years old) respectively. CONCLUSION: Conflicting results from these three RCTs demonstrate that the effects of supplementing pregnant and breast-feeding mothers with N-3 fatty acids containing DHA on child cognition is inconclusive

Spectroscopy of very hot plasma in non-flaring parts of a solar limb active region: spatial and temporal properties

In this work we investigate the thermal structure of an off-limb active region in various non-flaring areas, as it provides key information on the way these structures are heated. In particular, we concentrate in the very hot component (>3 MK) as it is a crucial element to discriminate between different heating mechanisms. We present an analysis using Fe and Ca emission lines from both SOHO/SUMER and HINODE/EIS. A dataset covering all ionization stages from Fe X to Fe XIX has been used for the thermal analysis (both DEM and EM). Ca XIV is used for the SUMER-EIS radiometric cross-calibration. We show how the very hot plasma is present and persistent almost everywhere in the core of the limb AR. The off-limb AR is clearly structured in Fe XVIII. Almost everywhere, the EM analysis reveals plasma at 10 MK (visible in Fe XIX emission) which is down to 0.1% of EM of the main 3 MK plasma. We estimate the power law index of the hot tail of the EM to be between -8.5 and -4.4. However, we leave an open question on the possible existence of a small minor peak at around 10 MK. The absence in some part of the AR of Fe XIX and Fe XXIII lines (which fall into our spectral range) enables us to determine an upper limit on the EM at such temperatures. Our results include a new Ca XIV 943.59 \AA~ atomic model

Neurodevelopmental disorders: From genetics to functional pathways

Neurodevelopmental disorders (NDDs) are a class of disorders affecting brain development and function and are characterized by wide genetic and clinical variability. In this review, we discuss the multiple factors that influence the clinical presentation of NDDs, with particular attention to gene vulnerability, mutational load, and the two-hit model. Despite the complex architecture of mutational events associated with NDDs, the various proteins involved appear to converge on common pathways, such as synaptic plasticity/function, chromatin remodelers and the mammalian target of rapamycin (mTOR) pathway. A thorough understanding of the mechanisms behind these pathways will hopefully lead to the identification of candidates that could be targeted for treatment approaches

Electron density in the quiet solar coronal transition region from SoHO/SUMER measurements of S VI line radiance and opacity

Context: The sharp temperature and density gradients in the coronal transition region are a challenge for models and observations. Aims: We set out to get linearly- and quadratically-weighted average electron densities in the region emitting the S VI lines, using the observed opacity and the emission measure of these lines. Methods: We analyze SoHO/SUMER spectroscopic observations of the S VI lines, using the center-to-limb variations and radiance ratios to derive the opacity. We also use the Emission Measure derived from radiance at disk center. Results: We get an opacity at S VI line center of the order of 0.05. The resulting average electron density is 2.4 10^16 m^-3 at T = 2 10^5 K. This value is higher than the values obtained from radiance measurements. Conversely, taking a classical value for the density leads to a too high value of the thickness of the emitting layer. Conclusions: The pressure derived from the Emission Measure method compares well with previous determinations and implies a low opacity of 5 10^-3 to 10^-2. The fact that a direct derivation leads to a much higher opacity remains unexplained, despite tentative modeling of observational biases. Further measurements need to be done, and more realistic models of the transition region need to be used.Comment: 11 pages, 9 figure

Sustained low-efficiency dialysis (SLED) with prostacyclin in critically ill patients with acute renal failure

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The relation between the incidence of hypernatremia and mortality in patients with severe traumatic brain injury

INTRODUCTION: The study was aimed at verifying whether the occurrence of hypernatremia during the intensive care unit (ICU) stay increases the risk of death in patients with severe traumatic brain injury (TBI). We performed a retrospective study on a prospectively collected database including all patients consecutively admitted over a 3-year period with a diagnosis of TBI (post-resuscitation Glasgow Coma Score < or = 8) to a general/neurotrauma ICU of a university hospital, providing critical care services in a catchment area of about 1,200,000 inhabitants. METHODS: Demographic, clinical, and ICU laboratory data were prospectively collected; serum sodium was assessed an average of three times per day. Hypernatremia was defined as two daily values of serum sodium above 145 mmol/l. The major outcome was death in the ICU after 14 days. Cox proportional-hazards regression models were used, with time-dependent variates designed to reflect exposure over time during the ICU stay: hypernatremia, desmopressin acetate (DDAVP) administration as a surrogate marker for the presence of central diabetes insipidus, and urinary output. The same models were adjusted for potential confounding factors. RESULTS: We included in the study 130 TBI patients (mean age 52 years (standard deviation 23); males 74%; median Glasgow Coma Score 3 (range 3 to 8); mean Simplified Acute Physiology Score II 50 (standard deviation 15)); all were mechanically ventilated; 35 (26.9%) died within 14 days after ICU admission. Hypernatremia was detected in 51.5% of the patients and in 15.9% of the 1,103 patient-day ICU follow-up. In most instances hypernatremia was mild (mean 150 mmol/l, interquartile range 148 to 152). The occurrence of hypernatremia was highest (P = 0.003) in patients with suspected central diabetes insipidus (25/130, 19.2%), a condition that was associated with increased severity of brain injury and ICU mortality. After adjustment for the baseline risk, the incidence of hypernatremia over the course of the ICU stay was significantly related with increased mortality (hazard ratio 3.00 (95% confidence interval: 1.34 to 6.51; P = 0.003)). However, DDAVP use modified this relation (P = 0.06), hypernatremia providing no additional prognostic information in the instances of suspected central diabetes insipidus. CONCLUSIONS: Mild hypernatremia is associated with an increased risk of death in patients with severe TBI. In a proportion of the patients the association between hypernatremia and death is accounted for by the presence of central diabetes insipidus

Integrated strategies to prevent intradialytic hypotension: research protocol of the DialHypot study, a prospective randomised clinical trial in hypotension-prone haemodialysis patients

INTRODUCTION: In patients on maintenance haemodialysis (HD), intradialytic hypotension (IDH) is a clinical problem that nephrologists and dialysis nurses face daily in their clinical routine. Despite the technological advances in the field of HD, the incidence of hypotensive events occurring during a standard dialytic treatment is still very high. Frequently recurring hypotensive episodes during HD sessions expose patients not only to severe immediate complications but also to a higher mortality risk in the medium term. Various strategies aimed at preventing IDH are currently available, but there is lack of conclusive data on more integrated approaches combining different interventions. METHODS AND ANALYSIS: This is a prospective, randomised, open-label, crossover trial (each subject will be used as his/her own control) that will be performed in two distinct phases, each of which is divided into several subphases. In the first phase, 27 HD sessions for each patient will be used, and will be aimed at the validation of a new ultrafiltration (UF) profile, designed with an ascending/descending shape, and a standard dialysate sodium concentration. In the second phase, 33 HD sessions for each patient will be used and will be aimed at evaluating the combination of different UF and sodium profiling strategies through individualised dialysate sodium concentration. ETHICS AND DISSEMINATION: The trial protocol has been reviewed and approved by the local Institutional Ethics Committee (Comitato Etico AVEN, prot. 43391 22.10.19). The results of the trial will be presented at local and international conferences and submitted for publication to a peer-reviewed journal. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03949088)

Ichthyological Bulletin J.L.B. Smith Institute of Ichthyology; No. 68

An annotated checklist of the species of the fish families Labridae and Scaridae is presented; 541 valid species are recognized, including 68 genera and 453 species of labrids and 10 genera and 88 species of scarids. Thirty undescribed species of wrasses and two undescribed parrotfish species are also included. A list of nominal species is given, with their present assignments; nominal species of uncertain status are placed as incertae sedis and listed separately. A list of nomina nuda is also provided. The valid genera and species are listed alphabetically, with their synonyms and distributions. Examination of the original descriptions and type material (when extant) of previously unplaced nominal species of labroid fishes led to identification of 69 new synonyms. The generic names Artisia de Beaufort, 1939 and Emmeekia Jordan & Evermann, 1896 are here recognized as new synonyms of Halichoeres Ruppell, 1835. For the Labridae, 65 new synonyms of valid species are listed. Labrus psittaculus Richardson, 1840, a valid species of Pseudolabrus, is a primary homonym of Labrus psittaculus Lacepede, 1801; the next available name for this species is Labrichthys rubicunda Macleay, 1881 and the new combination Pseudolabrus rubicundus is proposed. The following new combinations are included: Pseudojulis inornatus Gilbert, 1890 is a valid species of Pseudojuloides; Xyrichtys perlas Wellington et al., 1994 is a valid species of Novaculichthys. For Scaridae, Sparus abildgaardi Bloch, 1791 is a senior synonym of Sparisoma chrysopterum (Bloch & Schneider, 1801), but a request of the International Commission has been made to reject abildgaardi in order to conserve S. chrysopterum; and Scarus visayanus Herre, 1933 is a new synonym of Scarus tricolor Bleeker, 1847. Pseudoscarus microcheilos Bleeker, 1861 is a synonym of Chlorurus strongylocephalus (Bleeker, 1854).Rhodes University Libraries (Digitisation

An annotated T2-weighted magnetic resonance image collection of testicular germ and non-germ cell tumors

open7noTesticular cancer is a rare tumor with a worldwide incidence that has increased over the last few decades. The majority of these tumors are testicular non-germ (TNGCTs) and germ cell tumors (TGCTs); the latter divided into two broad classes - seminomatous (SGCTs) and non-seminomatous germ cell tumors (NSGCTs). Although ultrasonography (US) maintains a primary role in the diagnostic workup of scrotal pathology, magnetic resonance imaging (MRI) has emerged as the imaging modality recommended for challenging cases, providing additional information to clarify inconclusive/equivocal US. In this work we describe and publicly share a collection of 44 images of annotated T2-weighted MRI lesions from 42 patients. Given that testicular cancer is a rare tumor, we are confident that this collection can be used to validate statistical models and to further investigate TNGCT and TGCT peculiarities using medical imaging features.openFeliciani G.; Mellini L.; Loi E.; Piccinini F.; Galeotti R.; Sarnelli A.; Parenti G.C.Feliciani G.; Mellini L.; Loi E.; Piccinini F.; Galeotti R.; Sarnelli A.; Parenti G.C