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In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients.
Acute Care Model introduced in 2006 in UK has revolutionised the way Adult inpatient services are provided. Here, we look at the impact of this model on detained patients, which might serve as a service evaluation tool.
Objectives
Our objective is to study the effect of the acute care model on the application of the 1983 Mental Health Act (MHA) in Adult Psychiatry Wards at Clatterbridge Hospital, England.
Aims
Our aim is to measure any difference in the number and duration of detentions, use of tribunal hearings after the inception of this new model.
Method
Data on Section 2 (for assessment) and Section 3 (for treatment) were collected retrospectively from the Register at the hospital MHA Office. As the Acute Care Model was implemented on 6th June 2007, the data were collected from 6th March 2006 to 5th Oct 2008. From these data, the number and duration of stay of detained patients were calculated.
Results
The number of people who were detained in hospital before and after the introduction of acute care did not change (n=122). However, the average duration of detention under Section 3 reduced significantly from 81.44 days to 46.25 days (43.21% reduction). There had also been a 55% decrease in the utilisation of tribunal hearings after the new model (45 tribunals before vs 18 tribunals after).
Conclusion
The Acute Care Model in Adult Psychiatry seems to have had a significant positive impact on detained patients in reducing their in-patient stay and the need for tribunal hearings.
Positive symptoms are a useful predictor of aggression in schizophrenia. Although a similar pattern of abnormal brain structures related to both positive symptoms and aggression has been reported, this observation has not yet been confirmed in a single sample.
Method
To study the association between positive symptoms and aggression in schizophrenia on a neurobiological level, a prospective meta-analytic approach was employed to analyze harmonized structural neuroimaging data from 10 research centers worldwide. We analyzed brain MRI scans from 902 individuals with a primary diagnosis of schizophrenia and 952 healthy controls.
Results
The result identified a widespread cortical thickness reduction in schizophrenia compared to their controls. Two separate meta-regression analyses revealed that a common pattern of reduced cortical gray matter thickness within the left lateral temporal lobe and right midcingulate cortex was significantly associated with both positive symptoms and aggression.
Conclusion
These findings suggested that positive symptoms such as formal thought disorder and auditory misperception, combined with cognitive impairments reflecting difficulties in deploying an adaptive control toward perceived threats, could escalate the likelihood of aggression in schizophrenia.
Enlist™ cotton contains the aad-12 and pat genes that confer resistance to 2,4-D and glufosinate, respectively. Thirty-three field trials were conducted focused on Enlist cotton injury from glufosinate as affected by cotton growth stage, application rate, and single or sequential applications. Maximum injury from a single application of typical 1X (542 g ae ha-1) and 2X use rates was 3 and 13%, respectively, regardless of growth stage. Injury from sequential applications of 1X or 2X rates was equivalent to single applications. Similar injury was observed with four commercial formulations of glufosinate. Cotton yield was never affected by glufosinate. This research demonstrates Enlist™ cotton has robust resistance to glufosinate at rates at least twice the typical use rate when applied once or twice at growth stages ranging from 2 to 12 leaves.
Our understanding of the complex relationship between schizophrenia symptomatology and etiological factors can be improved by studying brain-based correlates of schizophrenia. Research showed that impairments in value processing and executive functioning, which have been associated with prefrontal brain areas [particularly the medial orbitofrontal cortex (MOFC)], are linked to negative symptoms. Here we tested the hypothesis that MOFC thickness is associated with negative symptom severity.
Methods
This study included 1985 individuals with schizophrenia from 17 research groups around the world contributing to the ENIGMA Schizophrenia Working Group. Cortical thickness values were obtained from T1-weighted structural brain scans using FreeSurfer. A meta-analysis across sites was conducted over effect sizes from a model predicting cortical thickness by negative symptom score (harmonized Scale for the Assessment of Negative Symptoms or Positive and Negative Syndrome Scale scores).
Results
Meta-analytical results showed that left, but not right, MOFC thickness was significantly associated with negative symptom severity (βstd = −0.075; p = 0.019) after accounting for age, gender, and site. This effect remained significant (p = 0.036) in a model including overall illness severity. Covarying for duration of illness, age of onset, antipsychotic medication or handedness weakened the association of negative symptoms with left MOFC thickness. As part of a secondary analysis including 10 other prefrontal regions further associations in the left lateral orbitofrontal gyrus and pars opercularis emerged.
Conclusions
Using an unusually large cohort and a meta-analytical approach, our findings point towards a link between prefrontal thinning and negative symptom severity in schizophrenia. This finding provides further insight into the relationship between structural brain abnormalities and negative symptoms in schizophrenia.
From Neolithic Malta, there is evidence of increasing population size accompanied by increasingly elaborate material culture, including the famous megalithic architecture. Stoddart et al. (1993) argued that social tensions and controls increased as food resources diminished. One important requirement of this argument is that the Neolithic inhabitants of Malta depended entirely on domesticated plants and animals for subsistence and therefore, with increased population sizes, the poor agricultural potential of these islands was stretched. However, it is possible that the consumption of wild foods, particularly marine resources, in the Neolithic would make up any shortfall in the agricultural foods. A direct way of measuring the amounts of marine protein in human diets is through chemical analysis of human bone. Stable isotope analyses undertaken on seven Accelerator Mass Spectrometer (AMS) radiocarbon dated humans from the Neolithic at the Brochtorff Circle indicated that there is no evidence for the significant use of marine foods by these Neolithic individuals. These new data indicate that agricultural foods were the dietary staple for this sample of the Maltese Neolithic population and therefore support the argument that increasing population during the Neolithic could have resulted in increasing resource stress.
This paper gives a brief overview of the Gaia Research for European Astronomy Training (GREAT) network, including a description of the GREAT-ESF Research Network Programme and the GREAT Initial Training Network (GREAT-ITN). Scientific highlights from the GREAT-ITN are noted.
In Ontario, Canada, the number of Salmonella Enteritidis (SE) cases increased over the years 2005–2010. A population-based case-control study was undertaken from January to August 2011 for the purpose of identifying risk factors for acquiring illness due to SE within Ontario. A total of 199 cases and 241 controls were enrolled. After adjustment for confounders, consuming any poultry meat [adjusted odds ratio (aOR) 2·24, 95% confidence interval (CI) 1·31–3·83], processed chicken (aOR 3·32, 95% CI 1·26–8·76) and not washing hands following handling of raw eggs (OR 2·82, 95% CI 1·48–5·37) were significantly associated with SE infection. The population attributable fraction was 46% for any poultry meat consumption and 10% for processed chicken. Poultry meat continues to be identified as a risk factor for SE illness. Control of SE at source, as well as proper food handling practices, are required to reduce the number of SE cases.
Cutaneous leishmaniasis caused by various species of Leishmania is a significant zoonotic disease in many parts of the world. We describe the first cases of Australian cutaneous leishmaniasis in eight northern wallaroos, one black wallaroo and two agile wallabies from the Northern Territory of Australia. Diagnosis was made through a combination of gross appearance of lesions, cytology, histology, direct culture, serology and a species-specific real-time PCR. The causative organism was found to be the same unique species of Leishmania previously identified in red kangaroos. These clinical findings provide further evidence for the continuous transmission of the Australian Leishmania species and its presence highlights the importance of continued monitoring and research into the life-cycle of this parasite.
The Supernova Working Group was re-established at the IAU XXV General Assembly in Sydney, 21 July 2003, sponsored by Commissions 28 (Galaxies) and 47 (Cosmology). Here we report on some of its activities since 2005.