Folic acid use and major congenital malformations in offspring of women with epilepsy: a prospective study from the UK Epilepsy and Pregnancy Register

Objective: In the general population, folic acid supplementation during pregnancy has been demonstrated to reduce the frequency of neural tube defects (NTDs) and other major congenital malformations (MCMs). It is recommended that women with epilepsy contemplating pregnancy take supplemental folic acid because of the known antifolate effect of some antiepileptic drugs (AEDs). Here the aim was to determine the effectiveness of this practice.

Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register

Objective: To assess the relative risk of major congenital malformation (MCM) from in utero exposure to antiepileptic drug (AEDs).

Prospective Evaluation of Clinical and Ultrasound Findings in Ankle Disease in Juvenile Idiopathic Arthritis: Importance of Ankle Ultrasound

Objective. To prospectively compare clinical examination of the ankle structures with ultrasound (US) findings. Methods. In 42 children with juvenile idiopathic arthritis (JIA; 25 girls, 17 boys, mean age 11.3 yrs, range 2.3–22.3 yrs), a total of 61 swollen/painful ankles were assessed clinically and ultrasonographically. Accurate clinical examination of the entire ankle joint was performed, focusing especially on 3 regions — tibiotalar joint and medial and lateral tendons. Clinical and US findings were both scored 0–3 (normal-severe). Results. US demonstrated no signs of tibiotalar joint effusion in 14 out of 43 ankles considered clinically involved. For the medial tendons, US showed tenosynovitis in 13 ankles out of 31 thought to be clinically normal; and for the lateral tendons, of the 19 deemed to be clinically involved, less than 50% had involvement on US. Very poor agreement was observed comparing the clinical and US scores for the 3 regions: tibiotalar joint, kappa = 0.3; medial tendons, kappa = 0.24; lateral tendons, kappa = 0.25. With regard to other ankle structures, only 39% of the subtalar (talocalcaneal) joints considered clinically involved were deemed abnormal on US. Finally, of the 10 ankles with talonavicular US effusion, only 2 were considered clinically involved. Conclusion. Using US findings as the “gold standard,” clinical examination of the ankle in children with JIA was found to be inadequate in identifying the structures involved. US assessment prior to any glucocorticoid injection should be considered to improve the outcome. A prospective study comparing the outcome following clinical- versus US-guided ankle joint injection should be undertaken, to confirm our findings.

Memory-keeping effects and forgetfulness in the dynamics of a qubit coupled to a spin chain

Using recently proposed measures for non-Markovianity [H.-P. Breuer, E. M. Laine, and J. Piilo, Phys. Rev. Lett. 103, 210401 (2009)], we study the dynamics of a qubit coupled to a spin environment via an energy-exchange mechanism. We show the existence of a point, in the parameter space of the system, where the qubit dynamics is effectively Markovian and that such a point separates two regions with completely different dynamical behaviors. Indeed, our study demonstrates that the qubit evolution can in principle be tuned from a perfectly forgetful one to a deep non-Markovian regime where the qubit is strongly affected by the dynamical backaction of the environmental spins. By means of a theoretical quantum process tomography analysis, we provide a complete and intuitive characterization of the qubit channel.

The Battle of the Somme in Ulster memory and identity

One of the enduring illusions about Northern Ireland is that its society can be conceptualized through a binary distinction between protestant and catholic. unionist and nationalist. It is increasingly apparent that these broad domains are themselves fractured and diverse and that otherness is often conceived from within rather than without. Northern Ireland can also be viewed as a laboratory for identity formation as unionists and loyalists strive to reconcile themselves with the fundamental political changes that have followed in the wake of the Peace Process. This paper considers one aspect of the contestation of belonging that increasingly characterizes unionism. It examines the competition for the ownership of the mythology of the Battle of the Somme ( 1916), long a key event in the unionist narrative. In particular, the paper addresses the ways in which paramilitary organizations are using the Somme to legitimate their own activities but also to distance the loyalist working classes from the former hegemonic Britishness of official unionism and the sectarianism of the Orange Order. The analysis concludes that loyalist identity is being conceptualized thorough a narrative of betrayal from within and at an intensely localized scale.