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Abstract Polio is a highly contagious viral disease that primarily affects children under 15, often leading to permanent paralysis, known as acute flaccid paralysis (AFP). AFP surveillance is essential for the eradication of polio, with community-based surveillance (CBS) playing a pivotal role in detecting and reporting cases. CBS improves the timeliness and accuracy of AFP detection, but challenges such as underreporting, delays, and low community awareness persist. Strategies involving use of mobile applications, awareness campaigns, and improvements in healthcare infrastructure were implemented to improve CBS of AFP. While numerous case studies from various countries illustrate the implementation of CBS, a comprehensive synthesis of these studies across diverse contexts is limited. This paper examines state-of-the-art CBS approaches for AFP, analyzing progress, challenges, and potential solutions. A targeted literature review of English-language studies published between 2004 and 2024 was conducted, focusing on the roles of communities, technological integration, and practical recommendations, while excluding studies that lacked methodological rigor or direct relevance. The review revealed that CBS has significantly advanced the global fight against polio by increasing community awareness, enabling earlier detection, and improving the reporting of AFP cases. However, issues such as security concerns, delayed reporting, low levels of community awareness, and underutilization of technology persist. This review recommends strengthening organizational structures, improving healthcare access, raising community awareness, and using technology for more efficient AFP surveillance. The implication of this work is beyond polio as it offers a comprehensive framework for integrating disease surveillance, technology and community involvement to strengthen public health strategies and build robust health systems.

The study aimed to assess the impact of YouTube Tutorials as a classroom reinforcement tool on Grade 7 students' English Language Proficiency during the 2022-2023 academic year. It sought answers to questions regarding students' language proficiency levels before and after watching YouTube Tutorials in morphology, phonology, semantics, and syntax, as well as the overall improvement in English competence. The study employed a mixed-method research approach with 54 respondents, utilizing a self-made survey questionnaire. The findings revealed that students initially had fair to poor proficiency levels in various language areas, which significantly improved after exposure to YouTube Tutorials. The mean differences demonstrated a substantial increase in English competence, with a p-value of 0.000*, indicating statistical significance. YouTube Tutorials were found to reinforce learning by enhancing comprehension, problem-solving, and advanced study. It also contributed to broader knowledge acquisition, creativity, and improved language skills. In conclusion, YouTube Tutorials proved effective in enhancing English language proficiency among Grade 7 students. Recommendations included considering YouTube Tutorials as a reinforcement tool for English teachers, providing classroom technology, encouraging parental support, and emphasizing the importance of quality video content. Further research in different contexts and with diverse respondents was suggested for result validation. [ABSTRACT FROM AUTHOR]

Introduction: Enhanced Recovery After Surgery (ERAS) is a multimodal and multidisciplinary approach intended to reduce the length of stay, postoperative complications, and readmission rates. The benefits of ERAS protocols in elective surgery are well established; however, the evidence to support their safety and efficacy in emergency surgery is rare. Aim: To compare the modified ERAS protocol with conventional management protocol following emergency laparotomy regarding the time taken to recover bowel function and the incidence of postoperative complications, duration of postoperative hospital stay, need for readmission, and 30 day mortality. Materials and Methods: The present study was a randomised controlled study conducted in the Department of General Surgery, Pt BD Sharma Institute of Medical Sciences, Rohtak, Haryana, India over a period of two years from June 2017 to May 2019. It included a total of 70 patients who presented in an emergency with perforation peritonitis. A total of 10 patients were excluded based on the exclusion criteria, and the remaining 60 patients were randomised into the Group-A (case group/ERAS group) and the control Group-B (control group/conventional group), with 30 patients in each group. Postoperative outcomes like postoperative complications, time of appearance of bowel sounds, time to first flatus, time to first defaecation, time to resumption of normal diet, and length of hospital stay were noted in both groups. Results: The length of hospital stay was shorter in the case group (8.83±4.69 days) compared to the control group (12.23±8.65 days); however, the difference was not statistically significant (p=0.064). Similarly, the difference in the time taken for the recovery of bowel sounds, postoperative complications, and 30 day mortality was also statistically insignificant between the two groups. No patient required readmission in either group. Conclusion: The use of ERAS protocols in emergency surgery is feasible, but all the elements of ERAS are difficult to apply in an emergency setting. Hence, a tailored approach to the ERAS protocols has to be used in emergency surgery. However, no significant benefit was noted in the group following modified ERAS protocols compared to the group following conventional protocols.

People with Autism Spectrum Disorder (ASD) have often been wrongly viewed as asexual. However, research suggests that their romantic and sexual experiences are more nuanced and deserving of further exploration. By addressing these areas, the study aimed to foster a more supportive and understanding environment for individuals with ASD as they navigate the complexities of relationships. This study delved into the romantic and sexual lives of young adults with ASD, focusing on a young man to understand how his condition influenced his partner preferences and relationships with friends, classmates, and family. Through a semi-structured interview and interpretative phenomenological analysis (IPA), the study uncovered three key themes: (a) navigating social interactions and boundaries; (b) understanding love and relationships; and (c) desires and expectations in relationships. These insights highlighted the need for tailored sex education, family support, and positive media portrayals. According to the study, a male adolescent with autism spectrum disorder (ASD) has difficulty interacting socially, particularly when it comes to recognizing cues and establishing limits with others. His romantic aspirations may be impacted by his inability to comprehend emotions and the impact of societal prejudices. The results show that to normalize his experiences and promote healthy relationships, family support, specialized sex education, and favorable media portrayals are essential.

Natural rubber latex (NRL), obtained from Hevea brasiliensis, comprises particles of long-chain poly(cis-1,4-isoprene) molecules. It is a naturally occurring, biocompatible polymer that acts as a stable matrix for precise drug release. Amikacin sulfate (AS) is a broad-spectrum semi-synthetic aminoglycoside antibiotic frequently used to treat Gram-negative bacterial infections. This study focuses on developing amikacin sulfate-loaded NRL (AS-NRL) films, characterizing their physicochemical properties, evaluating their antibacterial and antibiofilm activities, and assessing their cytocompatibility. The AS-NRL films were prepared using a casting method. Their physicochemical properties were characterized by fourier transform infrared spectroscopy (FTIR), mechanical testing, scanning electron microscopy (SEM), and static contact angle assessments. The antibacterial and antibiofilm efficacy of the films was evaluated against strong biofilm-forming, multi-drug resistant (MDR) strains of Klebsiella spp. and Pseudomonas spp., isolated from indwelling urinary catheters (IUCs). This investigation confirmed that amikacin sulfate was effectively incorporated into the natural rubber latex films. Surface topography analysis by SEM also confirmed the presence of amikacin sulfate on the film surface. All films possessed sufficient elasticity for catheterization. The antibacterial and antibiofilm assays confirmed the ability of the AS-NRL films to control bacterial growth and minimize biofilm formation, supported by live/dead staining assays and SEM imaging. NRLA4 films retained antibacterial activity after leaching in artificial urine for 21 days against all tested bacterial strains. The AS-NRL films showed cytocompatibility in vitro. This work demonstrates that AS-NRL films are promising biomaterials for developing urinary catheters, potentially reducing CAUTI and the undesirable side effects of high-dose antibiotics.

Demonstrates that the reflection-impulsivity dimension is related to some reading tasks but not others. Finds in particular that not all word recognition tasks are affected by conceptual tempo. (FL)

Abstract Subtitles are a crucial component of Digital Entertainment Content (DEC such as movies and TV shows) localization. With ever increasing catalog (≈ 2M titles) and localization expansion (30+ languages), automated subtitle quality checks becomes paramount. Being a manual creation process, subtitles can have errors such as missing transcriptions, out-of-sync subtitle blocks with the audio and incorrect translations. Such erroneous subtitles result in an unpleasant viewing experience and impact the viewership. Moreover, manual correction is laborious, highly costly and requires expertise of audio and subtitle languages. A typical subtitle correction process consists of (1) linear watch of the movie, (2) identification of time stamps associated with erroneous subtitle blocks, and (3) correcting procedure. Among the three, time taken to watch the entire movie by a human expert is the most time consuming step. This paper discusses the problem of missing transcription, where the subtitle blocks corresponding to some speech segments in the DEC are non-existent. We present a solution to augment human correction process by automatically identifying the timings associated with the non-transcribed dialogues in a language agnostic manner. The correction step can then be performed by either human-in-the-loop mechanism or automatically using neural transcription (speech-to-text in same language) and translation (text-to-text in different languages) engines. Our method uses a language agnostic neural voice activity detector (VAD) and an audio classifier (AC) trained explicitly on DEC corpora for better generalization. The method consists of three steps: first, we use VAD to identify the timings associated with dialogues (predicted speech blocks). Second, we refine those timings using the AC module by removing the timings associated with the leading and trailing non-speech segments identified as speech by VAD. Finally, we compare the predicted dialogue timings to the dialogue timings present in the subtitle file (subtitle speech blocks) and flag the missing transcriptions. We empirically demonstrate that the proposed method (a) reduces incorrect predicted missing subtitle timings by 10%, (b) improves the predicted missing subtitle timings by 2.5%, (c) reduces false positive rate (FPR) of overextending the predicted timings by 77%, and (d) improves the predicted speech block-level precision by a 119% over VAD baseline on a human-annotated dataset of missing subtitle speech blocks.

IntroductionIn the Philippines, scheduling the COVID-19 vaccine rollout has been a challenging task. The local government units (LGUs) have to carefully work with limited resources to avoid underutilizing vaccines while considering prioritization schemes in the rollout. As the country continues to vaccinate its population to manage the spread of COVID-19, planning the prioritization of individuals becomes more apparent in the vaccination rollout with respect to the COVID-19 situation in their respective areas.MethodsOur study develops a location-allocation model that aims to optimally schedule the COVID-19 vaccine rollout of a municipality. Here we applied the analytic hierarchy process (AHP) to determine the prioritization of communities (i.e., barangays) in the vaccine rollout based on the number of COVID-19 cases, the population density, and the proximity of the community to the available vaccine sites. Consequently, an integer programming (IP) model was formulated to determine the assignment of individuals to the vaccine stations with respect to the prioritization of their community in the rollout, as well as the minimum number of vaccine stations to open.Results and discussionThe AHP-based IP model proposed in this study not only assigns individuals to vaccination centers, but is also capable of tailoring the vaccine rollout to prioritize individuals depending on the preferences of the LGUs, and the COVID-19 situation in their areas. Furthermore, the vaccine rollout framework in this work is applicable to other vaccine-preventable diseases (e.g., rabies, measles, etc.) should LGUs embark on adapting this approach.

Abstract The potential for a Trichoderma-based compost activator was tested for in-situ rice straw decomposition, under both laboratory and field conditions. Inoculation of Trichoderma caused a 50% reduction in the indigenous fungal population after 2 weeks of incubation for both laboratory and field experiments. However, the Trichoderma population declined during the latter part of the incubation. Despite the significant reduction in fungal population during the first 2 weeks of incubation, inoculated samples were found to have higher indigenous and total fungal population at the end of the experiments with as much as a 300% increase in the laboratory experiment and 50% during day-21 and day-28 samplings in the field experiment. The laboratory incubation experiment revealed that inoculated samples released an average of 16% higher amounts of CO2 compared to uninoculated straw in sterile soil samples. Unsterile soil inoculated with Trichoderma released the highest amount of CO2 in the laboratory experiment. In the field experiment, improved decomposition was observed in samples inoculated with Trichoderma and placed below ground (WTBG). From the initial value of around 35%, the C content in WTBG was down to 28.63% after 42 days of incubation and was the lowest among treatments. This is significantly lower compared with NTBG (No Trichoderma placed below ground, 31.1% C), WTSS (With Trichoderma placed on soil surface, 33.83% C), and NTSS (No Trichoderma placed on soil surface, 34.30% carbon). The WTBG treatment also had the highest N content of 1.1%. The C:N ratio of WTBG was only 26.27, 39.51% lower than the C:N ratio of NTBG, which is 43.43. These results prove that the Trichoderma-based inoculant has the potential to hasten the decomposition of incorporated rice straw.

The high specific surface areas and porosities of aerogels can impart desirable properties to textiles. The most established application of aerogels in textiles is the enhancement of thermal insulation and this has been the subject of some excellent reviews. This review, for the first time, discusses the other applications of aerogels in textiles and considers enhancements in mechanical and acoustic properties, water repellency, permeability to air and water, acoustics, protection from radiation, chemicals and fire, and the remediation of textile processing effluent. These discussions are underpinned by the various approaches and materials employed for preparing aerogels, and the methods for incorporating them into textiles. Future prospects for aerogels in textiles are reviewed, and it is likely that innovations in aerogels driven by the energy storage, aerospace, and medical technology sectors such as lower production costs and greater use of biopolymers and hybrids, will underpin innovation in textile-aerogels. It is hoped this review will inspire collaboration between researchers in the fields of aerogels and textiles.

Recent cognitive neuropsychiatric models of psychosis emphasize the role of attentional disturbances and inappropriate incentive learning in the development of delusions. These models highlight a pre-psychotic period in which the patient experiences perceptual and attentional disruptions. Irrelevant details and numerous associations between stimuli, thoughts and percepts are imbued with inappropriate significance and the attempt to rationalize and account for these bizarre experiences results in the formation of delusions. The present paper discusses delusion formation in terms of basic associative learning processes. Such processes are driven by prediction error signals. Prediction error refers to mismatches between an organism's expectation in a given environment and what actually happens and it is signalled by both dopaminergic and glutamatergic mechanisms. Disruption of these neurobiological systems may underlie delusion formation. We review similarities between acute psychosis and the psychotic state induced by the NMDA receptor antagonist drug ketamine, which impacts upon both dopaminergic and glutamatergic function. We conclude by suggesting that ketamine may provide an appropriate model to investigate the formative stages of symptom evolution in schizophrenia, and thereby provide a window into the earliest and otherwise inaccessible aspects of the disease process. [ABSTRACT FROM AUTHOR]

Multidimensional scaling (MDS) is a multivariate statistical technique that can be used to define subsystems of functionally connected brain regions based on the analysis of functional magnetic resonance imaging (fMRI) data. Here we introduce three-way multidimensional scaling as a method for the analysis of a group of fMRI data, which yields both a generic interregional configuration in low-dimensional space and a measure of each individual''s deviation from the generic configuration. The distance between two generic interregional configurations obtained by MDS of two groups of data can be minimized by generalized Procrustes analysis, and the probability under the null hypothesis (that the two groups are sampled from the same population) of any residual group difference in interregional configurations can be assessed by a permutation test. These methods are developed and applied to activated fMRI time series acquired from 19 patients with schizophrenia and 20 normal comparison subjects during the performance of a semantic categorization and subvocal rehearsal task. The first three scaling dimensions are interpretable in terms of the major anatomical or functional subsystems of the activated system: “left–right,” “input processing–other,” and “subvocal output–other”. We found no significant global or local differences between groups in interregional configurations in this 3D space. However, there was significantly greater variability of interregional configurations within the group of patients with schizophrenia. The implications for schizophrenia as a disconnexion disorder are discussed. [Copyright &y& Elsevier]

We investigated the hypothesis that there are load-related changes in the integrated function of frontoparietal working memory networks. Functional magnetic resonance imaging time-series data from 10 healthy volunteers performing a graded n-back verbal working memory task were modeled using path analysis. Seven generically activated regions were included in the model: left/right middle frontal gyri (L/R MFG), left/right inferior frontal gyri (L/R IFG), left/right posterior parietal cortex (L/R PPC), and supplementary motor area (SMA). The model provided a good fit to the 1-back (χ2 = 7.04, df = 8, P = 0.53) and 2-back conditions (χ2 = 9.35, df = 8, P = 0.31) but not for the 3-back condition (χ2 = 20.60, df = 8, P = 0.008). Model parameter estimates were compared overall among conditions: there was a significant difference overall between 1-back and 2-back conditions (χ2diff = 74.77, df = 20, P < 0.001) and also between 2-back and 3-back conditions (χ2diff = 96.28, df = 20, P < 0.001). Path coefficients between LIFG and LPPC were significantly different from zero in both 1-back and 2-back conditions; in the 2-back condition, additional paths from LIFG to LPPC via SMA and to RMFG from LMFG and LPPC were also nonzero. This study demonstrated a significant change in functional integration of a neurocognitive network for working memory as a correlate of increased load. Enhanced inferior frontoparietal and prefrontoprefrontal connectivity was observed as a correlate of increasing memory load, which may reflect greater demand for maintenance and executive processes, respectively. [Copyright &y& Elsevier]

Functionalized carbon nanotube (FCNT) and Manganese Oxide (MnO2) nanoflower hybrid material was synthesized using hydrothermal technique as a promising electrode material for supercapacitor applications. The morphological investigation revealed the formation of ‘nanoflower’ like structure of MnO2 connected with FCNT, thus paving an easy path for the conduction of electrons during the electrochemical mechanism. A significant improvement in capacitance properties was observed in the hybrid material, in which carbon nanotube acts as a conducting cylindrical path, while the major role of MnO2 was to store the charge, acting as an electrolyte reservoir leading to an overall improved electrochemical performance. The full cell electrochemical analysis of FCNT-MnO2 hybrid using 3 M potassium hydroxide (KOH) electrolyte indicated a specific capacitance of 359.53 F g−1, specific energy of 49.93 Wh kg−1 and maximum specific power of 898.84 W kg−1 at 5 mV s−1. The results show promise for the future of supercapacitor development based on hybrid electrode materials, where high specific energy can be achieved along with high specific power and long cycle life.

The article presents abstracts of medical research for articles including "Frontal Responses During Learning Predict Vulnerability to the Psychotogenic Effects of Ketamine: Linking Cognition, Brain Activity, and Psychosis," by P. R. Corlett, G. D. Honey, M. R. F. et al.; "Comparison of Topical Methyl Aminolevulinate Photodynamic Therapy With Cryotherapy or Fluorouracil for Treatment of Squamous Cell Carcinoma in Situ: Results of a Multicenter Randomized Trial," by C. Morton, M. Horn, J. Leman, et al.; and "Variables Associated With Feeding Tube Placement in Head and Neck Center," by S. S. Cheng, J. E. Terrell, C. R. Bradford, et al.

Fundamento: Cuba, como otros países, investiga para dilucidar los mecanismos de defensa antitumoral y la obtención de productos inmunomoduladores con potencial terapéutico y antitumoral. Objetivo: Caracterizar los linfocitos T que infiltran estos tumores, a través del método de inmunofluorescencia indirecta, con la utilización de anticuerpos monoclonales anti-CD3, CD4 y CD8. Método: Se realizó un estudio descriptivo a 41 pacientes operadas de carcinoma de mama, en el Hospital Provincial Oncológico Marie Curie de la provincia de Camagüey, desde mayo de 2005 hasta mayo de 2006. Las muestras de tejido se obtuvieron por extirpación quirúrgica del tumor o glándula mamaria, con diagnóstico positivo de carcinoma. Se realizó la identificación cualitativa de estos linfocitos en los tejidos y se determinó la intensidad del marcaje. Resultados: De 41 pacientes, 37 presentaron carcinoma ductal infiltrante, 32 de tipo convencional y cinco del tipo comedocarcinoma, el resto presentó carcinoma lobulillar infiltrante; la mayor intensidad del marcaje lo tuvo el comedocarcinoma. La intensidad del marcaje del linfocito T fue mayor para CD3 y CD4 y menor para el CD8. Conclusiones: Se encontraron tres variedades histológicas, carcinoma ductal infiltrante convencional, ductal tipo comedocarcinoma y lobulillar infiltrante, el más frecuente fue el de tipo convencional; sin encontrarse diferencia de respuesta al no detectarse cambios notables en el marcaje.

Fundamento: La hipertensión arterial es un problema prioritario de salud a nivel mundial que afecta eminentemente a las sociedades desarrolladas y es extraordinariamente prevalente. Objetivo: Valorar, después del tratamiento farmacológico, la evolución de la remodelación cardiaca en pacientes hipertensos primarios. Método: Se realizó un estudio observacional, analítico transversal en tres áreas de salud del municipio Camagüey a 178 pacientes hipertensos primarios, mayores de 18 años, diagnosticados con remodelación del ventrículo izquierdo en el año 2004. Al grupo de estudio se le indicó tratamiento antihipertensivo en sus respectivos consultorios del médico de la familia. En el año 2006 se le realizaron a estos pacientes ecocardiografías, se practicaron las mediciones diastólicas del ventrículo izquierdo y se clasificaron los patrones geométricos. Las mediciones ecocardiográficas se compararon con las del 2004 y se determinó la evolución de los cambios del patrón geométrico. Resultados: Después del tratamiento farmacológico, normalizaron el patrón geométrico el 12,4 %, la remodelación concéntrica y la hipertrofia excéntrica disminuyeron hasta un 11,8 y un 23,6 % de los pacientes, respectivamente y la hipertrofia concéntrica aumentó a un 52,2 %. Se demostró que el 80,5 % de los pacientes con remodelación concéntrica evolucionó desfavorablemente. El 56,1 % de los pacientes con hipertrofia ventricular concéntrica, se mantuvieron con evolución estable. La hipertrofia ventricular excéntrica tuvo un 74% con evolución favorable. Conclusiones: Antes y después del tratamiento farmacológico existió un predominio de la hipertrofia concéntrica.

Active surfaces with bactericidal properties are of paramount importance in health care sector as a judicious approach to confront prevalent challenges presented by disastrous pathogenic infections and antibiotic-resistant microbes. Herein, we present Bayerite underpinned Ag2O/Ag (ALD), a nanohybrid with excellent antibacterial and antibiofilm functionalities against tested standard strains and clinical isolates. The multicomponent system coexists and complement each other with respect to phase and functionalities, demonstrated by XRD, XPS, and TEM analyses. In situ reduction of Ag+ ions to Ag0 over Bayerite as a stable bound phase is favoured by pH of the reaction, yielding 60-80% bound Ag protruding outwards facilitating active surface for interaction with microbes. ALD has a minimum inhibitory concentration (MIC) of 0.068 mg/ml against clinical isolates: Pseudomonas aeruginosa RRLP1, RRLP2, Acinetobactor baumannii C78 and C80. Disc diffusion assay demonstrated excellent antibacterial activity against standard strains (positive control: standard antibiotic disc, Amikacin). ALD incorporated PMMA films (5 and 10 wt%; PALD-5 and PALD-10) exhibited significant contact killing (99.9%) of clinical isolates in drop-test besides strong antibacterial activity (disc diffusion assay) comparable to that of ALD. ALD exemplified a dose (0.034 and 0.017 mg/ml) dependent biofilm inhibition (P < 0.001) and significant eradication of pre-formed biofilms (P < 0.001) by clinical isolates. PALD 5 and PALD 10 significantly declined the number of viable biofilm associated bacteria (99.9%) compared to control. Both ALD and PALD samples are proposed as green antibacterial materials with antibiofilm properties. Results also present ample opportunity to explore PALD as antibacterial and/or antibiofilm coating formulations., (© The Author(s) 2021. Published by Oxford University Press.)

Objective: Noninvasive ventilation, including nasal high-flow therapy (nHFT), provides effective neonatal respiratory support. There are limited data on nHFT use during neonatal transport. Our objective was to assess the efficacy and safety of nHFT during neonatal transport., Methods: One hundred ninety-five neonates transported on nHFT via a Neo-Pod "T" system (Westmed Inc, Tucson, AZ) were identified from Life Flight transport data. Data included demographics, transport location, distance, indication, and mode as well as pretransport and intratransport respiratory support data. We compared neonates who successfully tolerated nHFT transport with those who required support escalation (defined as increase in flow ≥2 L/min or fraction of inspired oxygen [FiO 2 ] ≥20%)., Results: Eighty-seven percent of neonates (170/195) were effectively transported on nHFT. Infants requiring escalation of nHFT support had a significantly higher pretransport FiO 2 (median = 0.60 [interquartile range, 0.36-1.00] vs. 0.36 [0.23-0.56]; P < .05) and a longer ground time for stabilization (56 ± 25 vs. 39 ± 18 minutes, P < .05) and were more frequently transported by air., Conclusion: Nasal HFT can be an effective mode of respiratory support in the transport of selected neonates. FiO 2 at the time of transport may be a key parameter to aid in determining neonates who can be safely transported on nHFT., (Copyright © 2019 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.)

Attention Deficit and Hyperactive Disorder (ADHD) and Autism Spectrum Disorders (ASD) are frequent comorbid neurodevelopmental conditions and the overlap between both disorders remains to be delineated. A more complete understanding of the shared genetic and environmental factors is needed. Using a family-based method, we evaluated the risk of ADHD in a group of relatives with an ASD proband (ASD-) and a group of relatives with an ASD and ADHD proband (ASD+). We enrolled 1245 individuals in the study: 499 probands, their 746 first-degree relatives and 140 controls. We used a multivariate generalized estimating equation (GEE) model, in which the dependent variable was the ADHD diagnosis in the relatives and the independent variable the ASD+ or ASD- in probands. We adjusted for sociodemographic factors (age, sex, IQ) and for the nature of the familial relationship with the affected proband (parent or sibling). Among the probands, there were 287 ASD- and 212 ASD+ individuals. ADHD was more frequent in relatives (19%) than in the control group (7%) (p = 0.001). The risk of ADHD was higher in the ASD+ relatives group than in the ASD- relatives group (GEE model OR 1.58 [95% CI 1.04-2.38], p = 0.032). This result was found in parents (OR 1.96 [95% CI  1.14-3.36], but not in siblings (OR 1.28 [95% CI 0.84-1.94], p = 0.434). Our study provides a representative estimate of the family distribution of ADHD in relatives of ASD probands but supports the modest effect of shared genetic and environmental factors between both disorders.

Background: Relative to intentional memory encoding, which quickly declines in Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD), incidental memory for emotional stimuli appears to deteriorate more slowly. We hypothesised that tests of incidental emotional memory may inform on different aspects of cognitive decline in MCI and AD., Methods: Patients with MCI, AD and Healthy Controls (HC) were asked to attend to emotional pictures (i.e., positive and neutral) sequentially presented during an fMRI session. Attention was monitored behaviourally. A surprise post-scan recognition test was then administered., Results: The groups remained attentive within the scanner. The post-scan recognition pattern was in the form of (HC = MCI) > AD, with only the former group showing a clear benefit from emotional pictures. fMRI analysis of incidental encoding demonstrated clusters of activation in para-hippocampal regions and in the hippocampus in HC and MCI patients but not in AD patients. The pattern of activation observed in MCI patients tended to be greater than that found in HC., Conclusions: The results suggest that incidental emotional memory might offer a suitable platform to investigate, using behavioural and fMRI measures, subtle changes in the process of developing AD. These changes seem to differ from those found using standard episodic memory tests. The underpinnings of such differences and the potential clinical use of this methodology are discussed in depth.

Background: Healthy volunteers received low-dose target-controlled infusions (TCI) of ketamine controlled by the Domino model while cognitive function tests and functional neuroimaging were performed. The aim of the current study was to assess the predictive performance of the Domino model during these studies, and compare it with that of three other ketamine models., Methods: Fifty-eight volunteers received ketamine administered by a TCI device on one or more occasions at target concentrations of either 50, 100, or 200 ng ml-1. At each target concentration, two or three venous blood samples were withdrawn during infusion, with a further sample after the infusion ended. Ketamine assays were performed by gas chromatography. The plasma concentration time courses predicted by the Hijazi, Clements 125, and Clements 250 models were calculated retrospectively, and the predictive performance of each of the models was assessed using Varvel methodology., Results: For the Domino model, bias, inaccuracy, wobble, and divergence were - 2.7%, 33.9%, 24.2%, and 0.1463% h-1, respectively. There was a systematic increase in performance error over time. The Clements 250 model performed best by all criteria, whereas the Hijazi model performed least well by all criteria except for bias., Conclusions: Performance of the Domino model during control of low-dose ketamine infusions was sub-optimal. The Clements 250 model may be a better model for controlling low-dose TCI ketamine administration.

In the past, transport of neonates with severe respiratory failure was hampered by the lack of an appropriate transport ventilator capable of providing high frequency ventilation (HFV). This article reports on the experiences of the Intermountain Health Care Life Flight Program in selecting a high frequency ventilator and preparing the transport team members for its use. Once the use of the Duotron ventilator was initiated, pre- and posttransport data were collected for the first 134 neonates requiring HFV on transport. Analysis of the data determined that 96 percent of the infants were successftslly transported using the Duotron ventilator. Inspired oxygen requirements staved the same or improved in the majority of intubated patients for whom comparison data xvere available. Ventilation and acid-base balance improved. Although HFV has been a common therapy in neonatal care for some time, its adoption for use during transport required modification and considerable education for transport team members.

Working memory dysfunction is a core component of schizophrenia, which likely contributes substantially to the pervasive and profound cognitive deficits observed in patients with this illness. Developments in functional imaging have facilitated the investigation of the neural basis of these cognitive deficits. A strong tradition within neuropsychology has been that circumscribed lesions provide observations which constrain theoretical models, and generate testable predictions on the basis of observed relationships between structural abnormalities and behavioral dysfunction. In this article, the extent to which the neuropsychological tradition can be applied to neuropsychiatry to advance understanding of the biological basis of working memory is addressed. Empirical studies in schizophrenia research are reviewed in relation to principles of normal brain function sub-serving working memory: the functional role of the lateral prefrontal cortex, physiological response capacity constraints, inter-regional functional integration, and compensatory adaptations. However, complex heterogeneous psychiatric disorders such as schizophrenia cannot be considered akin to a pure lesion model, and there are considerable methodological challenges in interpreting disruptions of working memory in psychiatric conditions, resulting from clinical, treatment and performance related confounds. The increasing use of psychopharmacological models of disease in healthy human subjects is therefore considered as an attempt to address, or to some extent circumvent these issues.

The N-methyl-D-aspartate (NMDA) receptor antagonist ketamine produces episodic memory deficits. We used functional magnetic resonance imaging to characterize the effects of ketamine on frontal and hippocampal responses to memory encoding and retrieval in healthy volunteers using a double-blind, placebo-controlled, randomized, within-subjects comparison of two doses of intravenous ketamine. Dissociation of the effects of ketamine on encoding and retrieval processes was achieved using two study-test cycles: in the first, items were encoded prior to drug infusion and retrieval tested, during scanning, on drug; in the second, encoding was scanned on drug, and retrieval tested once ketamine plasma levels had declined. We additionally determined the interaction of ketamine with the depth of processing that occurred at encoding. A number of effects upon task-dependent activations were seen. Overall, our results suggest that left frontal activation is augmented by ketamine when elaborative semantic processing is required at encoding. In addition, successful encoding on ketamine is supplemented by additional non-verbal processing that is incidental to task demands. The effects of ketamine at retrieval are consistent with impaired access to accompanying contextual features of studied items. Our findings show that, even when overt behaviour is unimpaired, ketamine has an impact upon the recruitment of key regions in episodic memory task performance.

We have used functional MRI to determine the effects of ketamine on brain systems activated in association with a working memory task. Healthy volunteers received intravenous infusions of placebo, ketamine at 50 ng/ml plasma concentration, and ketamine at 100 ng/ml. They were scanned while carrying out a verbal working memory task in which we varied the executive requirements (manipulation vs maintenance processes) and the mnemonic load (three vs five presented letters). We previously showed that ketamine produces a specific behavioral impairment in the manipulation task. In the current study, we modified tasks in order to match performance across drug and placebo conditions, and used an event-related fMRI design, allowing us to remove unsuccessful trials from the analysis. Our results suggest a task-specific effect of ketamine on working memory in a brain system comprising frontal cortex, parietal cortex, and putamen. When subjects are required to manipulate presented letters into alphabetical order, as opposed to maintaining them in the order in which they were presented, ketamine is associated with significantly greater activity in this system, even under these performance-matched conditions. No significant effect of ketamine was seen in association with increasing load. This suggests that our findings are not explicable in terms of a nonspecific effect of ketamine when task difficulty is increased. Rather, our findings provide evidence that the predominant effects of low, subdissociative doses of ketamine are upon the control processes engaged by the manipulation task. Furthermore, we have shown that ketamine's effects may be elucidated by fMRI even when overt behavioral measures show no evidence of impairment., (Copyright 2004 Nature Publishing Group)

Brain activation is adaptive to task difficulty and practice. We used functional MRI to map brain systems activated by an object-location learning task in 24 healthy elderly volunteers each scanned following placebo and two of four active drugs studied. We distinguished a fronto-striatal system adaptive to difficulty from a posterior system adaptive to practice. Fronto-striatal response to increased cognitive load was significantly attenuated by scopolamine, sulpiride and methylphenidate; practice effects were not modulated by these drugs but were enhanced by diazepam. We also found enhancement by methylphenidate, and attenuation by sulpiride, of load response in premotor, cingulate and parietal regions comprising a spatial attention network. Difficulty and practice evoke anatomically and pharmacologically dissociable brain activation dynamics, which are probably mediated by different neurotransmitter systems in humans.

We used multislice functional magnetic resonance imaging (fMRI) to investigate the association between behavioral and neurophysiological measures of working memory task performance in 20 right-handed male healthy volunteers. Images were acquired over a 5-min period at 1.5 Tesla. We used a periodic design, alternating 30-s blocks of the "n-back" working memory task with 30-s blocks of a sensorimotor control task to activate verbal working memory systems. The power of functional response to the task was estimated by sinusoidal regression at each voxel. The relationship between power of fMRI response and mean reaction time over all 11 working memory trials was explored by multiple regression, with age and mean reaction time to the control task as covariates, at voxel and regional levels of analysis. All subjects were able to perform the n-back task accurately. A spatially distributed network was activated, including dorsolateral prefrontal cortex, inferior frontal gyrus, lateral premotor cortex, and supplementary motor area (SMA) in the frontal lobes. More posteriorly, there were major foci of activation in parietal and occipitoparietal cortex, precuneus, lingual, and fusiform gyri of the ventral occipital lobe, inferior temporal gyrus, and cerebellum. The power of functional response was positively correlated with reaction time in bilateral posterior parietal cortex (Talairach coordinates in x, y, z (mm) 35, -44, 37 and -32, -56, 42), indicating that subjects who found the task difficult, and responded with a slower reaction time, tended to activate these regions more powerfully. One interpretation of this regionally specific relationship between prolonged reaction time and increased power of posterior parietal activation is consistent with prior studies identifying similar areas of parietal cortex as the site of the phonological storage function in verbal working memory.