Academic potential and cognitive functioning of long-term survivors after childhood liver transplantation

This cross-sectional study assessed intellect, cognition, academic function, behaviour, and emotional health of long-term survivors after childhood liver transplantation. Eligible children were >5 yr post-transplant, still attending school, and resident in Queensland. Hearing and neurocognitive testing were performed on 13 transplanted children and six siblings including two twin pairs where one was transplanted and the other not. Median age at testing was 13.08 (range 6.52-16.99) yr; time elapsed after transplant 10.89 (range 5.16-16.37) yr; and age at transplant 1.15 (range 0.38-10.00) yr. Mean full-scale IQ was 97 (81-117) for transplanted children and 105 (87-130) for siblings. No difficulties were identified in intellect, cognition, academic function, and memory and learning in transplanted children or their siblings, although both groups had reduced mathematical ability compared with normal. Transplanted patients had difficulties in executive functioning, particularly in self-regulation, planning and organization, problem-solving, and visual scanning. Thirty-one percent (4/13) of transplanted patients, and no siblings, scored in the clinical range for ADHD. Emotional difficulties were noted in transplanted patients but were not different from their siblings. Long-term liver transplant survivors exhibit difficulties in executive function and are more likely to have ADHD despite relatively intact intellect and cognition.

Improving the impact of luminance contrast on the window appearance in a conventional office room: Using supplementary lighting strategies

High contrast ratios between windows and surrounding surfaces could cause reduced visibility or discomfort for occupants. Consequently, building users may choose to intervene in lighting conditions through closing blinds and turning on the lamps in order to enhance indoor visual comfort. Such interventions increase projected electric lighting use in buildings. One simple method to prevent these problematic issues is increasing the luminance of the areas surrounding to the bright surface of windows through the use of energy-efficient supplementary lighting, such Light Emitting Diodes (LEDs). This paper reports on the results of a pilot study in conventional office in Brisbane, Australia. The outcomes of this study indicated that a supplementary LED system of approximately 18 W could reduce the luminance contrast on the window wall from values in the order of 117:1 to 33:1. In addition, the results of this experiment suggested that this supplementary strategy could increase the subjective scale appraisal of window appearance by approximately 33%, as well as reducing the likelihood of users’ intention to turn on the ceiling lights by about 27%. It could also diminish the likelihood of occupants’ intention to move the blind down by more than 90%.

Allergen capture by IgE and IgG enhanced cell-binding by allergen multimers: How complex is it?

Allergic diseases are the most common chronic disease of the western world, costing $7.8 billion per year in lost productivity and medical care in Australia alone.1 IgE is central to the immunopathogenesis of allergic diseases and important advances are now being made on multiple fronts of IgE research. In particular, two groups independently invested in the generation of IgE reporter mice to address the vexing question of the route of development of the elusive IgE+ B cell.2, 3 Two new anti-IgE mAb targeting membrane IgE and cell-bound IgE have the potential to deplete the cellular source of IgE.4, 5 These could be candidates for alternative anti-IgE treatment options with advantages over current anti-IgE therapy (OmalizumAb), which depletes free serum IgE. Researchers are still intrigued by the modes of interaction of IgE with allergen, and with both its receptors; the high affinity FcεR1 on mast cells and basophils, and the low affinity, C-type lectin, IgE receptor, CD23,6 on B cells and monocytes (Figure 1a and b). A new approach to the study of the complexity of these interactions was recently reported by Reginald et al.7 on page 167 of this issue.

Trialling a technopulp belt press filter at Pioneer Mill

Wilmar’s Pioneer Sugar mill has a need to replace some small rotary vacuum filters (RVFs) due to the condition of existing aged plant. A vacuum belt press filter (VBPF) manufactured by Technopulp of Brazil was purchased and installed at Pioneer Mill in September/October 2012 and commissioning trials undertaken over a five week period commencing in early November. There are no vacuum belt press filters currently in use in Australian sugar mills for mud processing. The Technopulp filter is a relatively common and well accepted technology with over 600 units installed. The main attractions for the VBPF to Pioneer Mill were…

Prehospital paediatric burn care: New priorities in paramedic reporting

OBJECTIVE: The present study evaluates the prehospital care of paediatric burn patients in Queensland (QLD). As first aid (FA) treatment has been shown to affect burn progression and outcome, the FA treatment and the risk of associated hypothermia in paediatric patients were specifically examined in the context of paramedic management of burn patients. METHODS: Data were retrospectively collected from electronic ambulance response forms (eARFs) for paediatric burn patients (0-5 years) who were attended by Queensland Ambulance Service (QAS) from 2008 to 2010. Data were collected from 117 eARFs of incidents occurring within the Brisbane, Townsville and Cairns regions. RESULTS: Initial FA measures were recorded in 77.8% of cases, with cool running water FA administered in 56.4% of cases. The duration of FA was recorded in 29.9% of reports. The duration of FA was significantly shorter for patients in Northern QLD (median = 10 min, n = 10) compared with Brisbane (median = 15 min, n = 18), P = 0.005. Patient temperatures were recorded significantly more often in Brisbane than in other regions (P = 0.041); however, in total, only 24.8% of all patients had documented temperature readings. Of these, six (5%) were recorded as having temperatures ≤ 36.0°C. Burnaid(TM) was the most commonly used dressing and was applied to 55.6% of all patients; however, it was applied with a variety of different outer dressings. Brisbane paramedics applied Burnaid significantly less often (44.3%) compared with paramedics from Northern QLD (72.7%) and Far Northern QLD (60.9%), P = 0.025. CONCLUSIONS: Despite FA and patient temperatures being important prognostic factors for burn patients, paramedic documentation of these was often incomplete, and there was no consistent use of burns dressings.

Countering disablism: An alternative universal income support system based on egalitarianism

The long-term vision of economic security and social participation for people with a disability held by disability activists and policy-makers has not been realised on a global scale. This is despite the implementation of various poverty alleviation initiatives by international and national governments. Indeed within advanced Western liberal democracies, the inequalities and poverty gaps have widened rather than closed. This article is based on findings from a historical-comparative policy and discourse analysis of disability income support system in Australia and the Basic Income model. The findings suggest that a model such as Basic Income, grounded in principles of social citizenship, goes some way to maintaining an adequate level of subsistence for people with a disability. The article concludes by presenting some challenges and a commitment to transforming income support policy.

Common variants near ATM are associated with glycemic response to metformin in type 2 diabetes

Metformin is the most commonly used pharmacological therapy for type 2 diabetes. We report a genome-wide association study for glycemic response to metformin in 1,024 Scottish individuals with type 2 diabetes with replication in two cohorts including 1,783 Scottish individuals and 1,113 individuals from the UK Prospective Diabetes Study. In a combined meta-analysis, we identified a SNP, rs11212617, associated with treatment success (n = 3,920, P = 2.9 P×-9, odds ratio = 1.35, 95% CI 1.22-1.49) at a locus containing ATM, the ataxia telangiectasia mutated gene. In a rat hepatoma cell line, inhibition of ATM with KU-55933 attenuated the phosphorylation and activation of AMP-activated protein kinase in response to metformin. We conclude that ATM, a gene known to be involved in DNA repair and cell cycle control, plays a role in the effect of metformin upstream of AMP-activated protein kinase, and variation in this gene alters glycemic response to metformin. © 2011 Nature America, Inc. All rights reserved.

Childhood-as-rescue in the emergence and spread of the U.S. public school

In this volume, the editors have brought together prominent international contributors to examine the relevance of Foucauldian thought on educational theory, practice and institutional life. The result is a diverse collection that offers broad and engaging analyses of how power and knowledge are configured in the practices and norms of schooling. This text not only provides a critical examination of the significance of Foucauldian thought for education, but also discusses how Foucault's theories are arrayed in the everyday life of schools.

Normalized wall index specific and MRI-based stress analysis of atherosclerotic carotid plaques: A study comparing acutely symptomatic and asymptomatic patients

Background: Biomechanical stresses play an important role in determining plaque stability. Quantification of these simulated stresses can be potentially used to assess plaque vulnerability and differentiate different patient groups. Methods and Results: 54 asymptomatic and 45 acutely symptomatic patients underwent in vivo multicontrast magnetic resonance imaging (MRI) of the carotid arteries. Plaque geometry used for finite element analysis was derived from in vivo MRI at the sites of maximum and minimum plaque burden. In total, 198 slices were used for the computational simulations. A pre-shrink technique was used to refine the simulation. Maximum principle stress at the vulnerable plaque sites (ie, critical stress) was extracted for the selected slices and a comparison was performed between the 2 groups. Critical stress in the slice with maximum plaque burden is significantly higher in acutely symptomatic patients as compared to asymptomatic patients (median, inter quartile range: 198.0 kPa (119.8-359.0 kPa) vs 138.4 kPa (83.8-242.6 kPa), P=0.04). No significant difference was found in the slice with minimum plaque burden between the 2 groups (196.7 kPa (133.3-282.7 kPa) vs 182.4 kPa (117.2-310.6 kPa), P=0.82). Conclusions: Acutely symptomatic carotid plaques have significantly high biomechanical stresses than asymptomatic plaques. This might be potentially useful for establishing a biomechanical risk stratification criteria based on plaque burden in future studies.

Stress analysis of carotid plaque based on in vivo MRI of acute symptomatic and asymptomatic patients

Stress analysis within carotid plaques based on in vivo MR imaging has shown to be useful for the identification of vulnerable atheroma. This study is to investigate whether magnetic resonance imaging (MRI) based-biomechanical stress analysis of carotid plaques can differentiate acute symptomatic and asymptomatic patients. 54 asymptomatic and 45 acute symptomatic patients underwent in vivo multi-contrast MRI of the carotid arteries. Plaque geometry used for finite element analysis was derived from in vivo MR images at the site of maximum and minimum plaque burden. In total 198 slices were used for the computational simulations. A pre shrink technique was used to refine the simulation. Maximum principle stress at the vulnerable plaque sites (i.e. critical stress) was extracted for the selected slices and a comparison was performed between the two groups. Critical stress at the site of maximum plaque burden is significantly higher in acute symptomatic patients as compared to asymptomatic patients [median: 198.0kPa (inter quartile range (IQR) = (119.8 - 359.0) vs. 138.4kPa (83.8, 242.6), p=0.04]. No significant difference was found at the minimum plaque burden site between the two groups [196.7kPa (133.3- 282.7) vs. 182.4kPa (117.2 - 310. 6), p=0.82). Stress analysis at the site of maximal plaque burden can be effectively used for differentiating acute symptomatic carotid plaques from asymptomatic plaques. This maybe potentially used for development of biomechanical risk stratification criteria based on plaque burden in future studies.

Subsampling multi-species trawl catches from tropical northern Australia: Does it matter which part of the catch is sampled?

Subsampling is a common method for estimating the abundance of species in trawl catches. However, the accuracy of subsampling in representing the total catch has not been assessed. To estimate one possible source of bias due to subsampling, we tested whether the position on trawler sorting trays from which subsamples were taken affected their ability to represent species in catches. This was done by sorting catches into 10 kg subsamples and comparing subsamples taken from different positions on the sorting tray. Comparisons were made after species were grouped into three categories of abundance, either 'rare', 'common' or 'abundant'. A generalised linear model analysis showed that taking subsamples from different positions on the sorting tray had no major effect on estimating the total numbers or weights of fish or invertebrates, or the total number of fish or invertebrate taxa, recorded in each position. Some individual taxa showed differences between positions on the sorting tray (11.5% of taxa ina three-position design; 25% in a five-position design). But consistent and meaningful patterns in the position of these taxa on the sorting tray could only be seen for the pony fish Leiognathus moretoniensis and the saucer scallop Amusium pleuronectes. Because most bycatch laxa are well mixed throughout the catch, subsamples can be taken from any position on trawler sorting trays without introducing bias.

Feasibility of an in-patient exercise intervention for children undergoing haematopoietic stem cell transplant

With improving survival rates following HSCT in children, QOL and management of short- and long-term effects need to be considered. Exercise may help mitigate fatigue and declines in fitness and strength. The aims of this study were to assess the feasibility of an inpatient exercise intervention for children undergoing HSCT and observe the changes in physical and psychological health. Fourteen patients were recruited, mean age 10 yr. A 6MWT, isometric upper and lower body strength, balance, fatigue, and QOL were assessed prior to Tx and six wk post-Tx. A supervised exercise program was offered five days per week during the inpatient period and feasibility assessed through uptake rate. The study had 100% program completion and 60% uptake rate of exercise sessions. The mean (±s.d.) weekly activity was 117.5 (±79.3) minutes. Younger children performed significantly more minutes of exercise than adolescents. At reassessment, strength and fatigue were stabilized while aerobic fitness and balance decreased. QOL revealed a non-statistical trend towards improvement. No exercise-related adverse events were reported. A supervised inpatient exercise program is safe and feasible, with potential physiological and psychosocial benefits.

Atmospheric polycyclic aromatic hydrocarbons in the urban environment: Occurrence, toxicity and source apportionment

Polycyclic Aromatic Hydrocarbons (PAHs) represent a major class of toxic pollutants because of their carcinogenic and mutagenic characteristics. People living in urban areas are regularly exposed to PAHs because of abundance of their emission sources. Within this context, this study aimed to: (i) identify and quantify the levels of ambient PAHs in an urban environment; (ii) evaluate their toxicity; and (iii) identify their sources as well as the contribution of specific sources to measured concentrations. Sixteen PAHs were identified and quantified in air samples collected from Brisbane. Principal Component Analysis – Absolute Principal Component Scores (PCA- APCS) was used in order to conduct source apportionment of the measured PAHs. Vehicular emissions, natural gas combustion, petrol emissions and evaporative/unburned fuel were the sources identified; contributing 56%, 21%, 15% and 8% of the total PAHs emissions, respectively, all of which need to be considered for any pollution control measures implemented in urban areas.