A multicenter study on chronic cough in children : burden and etiologies based on a standardized management pathway

Background While the burden of chronic cough in children has been documented, etiologic factors across multiple settings and age have not been described. In children with chronic cough, we aimed (1) to evaluate the burden and etiologies using a standard management pathway in various settings, and (2) to determine the influence of age and setting on disease burden and etiologies and etiology on disease burden. We hypothesized that the etiology, but not the burden, of chronic cough in children is dependent on the clinical setting and age. Methods From five major hospitals and three rural-remote clinics, 346 children (mean age 4.5 years) newly referred with chronic cough (> 4 weeks) were prospectively managed in accordance with an evidence-based cough algorithm. We used a priori definitions, timeframes, and validated outcome measures (parent-proxy cough-specific quality of life [PC-QOL], a generic QOL [pediatric quality of life (PedsQL)], and cough diary). Results The burden of chronic cough (PC-QOL, cough duration) significantly differed between settings (P = .014, 0.021, respectively), but was not influenced by age or etiology. PC-QOL and PedsQL did not correlate with age. The frequency of etiologies was significantly different in dissimilar settings (P = .0001); 17.6% of children had a serious underlying diagnosis (bronchiectasis, aspiration, cystic fibrosis). Except for protracted bacterial bronchitis, the frequency of other common diagnoses (asthma, bronchiectasis, resolved without specific-diagnosis) was similar across age categories. Conclusions The high burden of cough is independent of children’s age and etiology but dependent on clinical setting. Irrespective of setting and age, children with chronic cough should be carefully evaluated and child-specific evidence-based algorithms used.

Sex differences in the human connectome: 4-Tesla high angular resolution diffusion imaging (HARDI) tractography in 234 young adult twins

Cortical connectivity is associated with cognitive and behavioral traits that are thought to vary between sexes. Using high-angular resolution diffusion imaging at 4 Tesla, we scanned 234 young adult twins and siblings (mean age: 23.4 2.0 SD years) with 94 diffusion-encoding directions. We applied a novel Hough transform method to extract fiber tracts throughout the entire brain, based on fields of constant solid angle orientation distribution functions (ODFs). Cortical surfaces were generated from each subject's 3D T1-weighted structural MRI scan, and tracts were aligned to the anatomy. Network analysis revealed the proportions of fibers interconnecting 5 key subregions of the frontal cortex, including connections between hemispheres. We found significant sex differences (147 women/87 men) in the proportions of fibers connecting contralateral superior frontal cortices. Interhemispheric connectivity was greater in women, in line with long-standing theories of hemispheric specialization. These findings may be relevant for ongoing studies of the human connectome.

Comparison of fractional and geodesic anisotropy in diffusion tensor images of 90 monozygotic and dizygotic twins

We used diffusion tensor magnetic resonance imaging (DTI) to reveal the extent of genetic effects on brain fiber microstructure, based on tensor-derived measures, in 22 pairs of monozygotic (MZ) twins and 23 pairs of dizygotic (DZ) twins (90 scans). After Log-Euclidean denoising to remove rank-deficient tensors, DTI volumes were fluidly registered by high-dimensional mapping of co-registered MP-RAGE scans to a geometrically-centered mean neuroanatomical template. After tensor reorientation using the strain of the 3D fluid transformation, we computed two widely used scalar measures of fiber integrity: fractional anisotropy (FA), and geodesic anisotropy (GA), which measures the geodesic distance between tensors in the symmetric positive-definite tensor manifold. Spatial maps of intraclass correlations (r) between MZ and DZ twins were compared to compute maps of Falconer's heritability statistics, i.e. the proportion of population variance explainable by genetic differences among individuals. Cumulative distribution plots (CDF) of effect sizes showed that the manifold measure, GA, comparably the Euclidean measure, FA, in detecting genetic correlations. While maps were relatively noisy, the CDFs showed promise for detecting genetic influences on brain fiber integrity as the current sample expands.

Novel risk loci for rheumatoid arthritis in Han Chinese and congruence with risk variants in Europeans

Objective To investigate differences in genetic risk factors for rheumatoid arthritis (RA) in Han Chinese as compared with Europeans. Methods A genome-wide association study was conducted in China with 952 patients and 943 controls, and 32 variants were followed up in 2,132 patients and 2,553 controls. A transpopulation meta-analysis with results from a large European RA study was also performed to compare the genetic architecture across the 2 ethnic remote populations. Results Three non-major histocompatibility complex (non-MHC) loci were identified at the genome-wide significance level, the effect sizes of which were larger in anti-citrullinated protein antibody (ACPA)-positive patients than in ACPA-negative patients. These included 2 novel variants, rs12617656, located in an intron of DPP4 (odds ratio [OR] 1.56, P = 1.6 × 10 -21), and rs12379034, located in the coding region of CDK5RAP2 (OR 1.49, P = 1.1 × 10-16), as well as a variant at the known CCR6 locus, rs1854853 (OR 0.71, P = 6.5 × 10-15). The analysis of ACPA-positive patients versus ACPA-negative patients revealed that rs12617656 at the DPP4 locus showed a strong interaction effect with ACPAs (P = 5.3 × 10-18), and such an interaction was also observed for rs7748270 at the MHC locus (P = 5.9 × 10-8). The transpopulation meta-analysis showed genome-wide overlap and enrichment in association signals across the 2 populations, as confirmed by prediction analysis. Conclusion This study has expanded the list of alleles that confer risk of RA, provided new insight into the pathogenesis of RA, and added empirical evidence to the emerging polygenic nature of complex trait variation driven by common genetic variants. Copyright © 2014 by the American College of Rheumatology.

Microstructural characterization of ultrafine-grain interstitial-free steel by X-ray diffraction line profile analysis

This paper highlights the microstructural features of commercially available interstitial free (IF) steel specimens deformed by equal channel angular pressing (ECAP) up to four passes following the route A. The microstructure of the samples was studied by different techniques of X-ray diffraction peak profile analysis as a function of strain (epsilon). It was found that the crystallite size is reduced substantially already at epsilon=2.3 and it does not change significantly during further deformation. At the same time, the dislocation density increases gradually up to epsilon=4.6. The dislocation densities estimated from X-ray diffraction study are found to correlate very well with the experimentally obtained yield strength of the samples.

Thermal Stability of Polystyrene Peroxide

It has been observed that poly(styrene peroxide) with a high molecular weight is thermally less stable than the same polymer with a low molecular weight. This has been explained as being due to the strain on the O-O bond due to the greater polymer chain length.

Direct and indirect effects of egg parasitism by Neopolycystus Girault sp. (Hymenoptera: Pteromalidae) on Paropsis atomaria Olivier (Coleoptera: Chrysomelidae).

Neopolycystus sp. is the only primary egg parasitoid associated with the pest beetle Paropsis atomaria in subtropical eucalypt plantations, but its impact on its host populations is unknown. The simplified ecosystem represented by the plantation habitat, lack of interspecific competition for host and parasitoid, and the multivoltinism of the host population makes this an ideal system for quantifying the direct and indirect effects of egg parasitism, and hence, effects on host population dynamics. Within-, between- and overall-egg-batch parasitism rates were determined at three field sites over two field seasons, and up to seven host generations. The effect of exposure time (egg batch age), host density proximity to native forest and water sources on egg parasitism rates was also tested. Neopolycystus sp. exerts a significant influence on P. atomaria populations in Eucalyptus cloeziana. plantations in south-eastern Queensland, causing the direct (13%) and indirect (15%) mortality of almost one-third of all eggs in the field. Across seasons and generations, 45% of egg batches were parasitised, with a within-batch parasitism rate of around 30%. Between-batch parasitism increased up to 5-6 days after oviposition in the field, although within-batch parasitism rates generally did not. However, there were few apparent patterns to egg parasitism, with rates often varying significantly between sites and seasons.

A spatial assessment of the risk to a mobile marine mammal from bycatch

Several species of marine mammals are at risk of extinction from being captured as bycatch in commercial fisheries. Various approaches have been developed and implemented to address this bycatch problem, including devices and gear changes, time and area closures and fisheries moratoria. Most of these solutions are difficult to implement effectively, especially for artisanal fisheries in developing countries and remote regions. Re-zoning of the Great Barrier Reef World Heritage Area (GBRWHA) in 2004 closed 33% of the region to extractive activities, including commercial fishing. However, the impact of re-zoning and the associated industry restructuring on a threatened marine mammal, the dugong (Dugong dugon), is difficult to quantify. Accurate information on dugong bycatch in commercial nets is unavailable because of the large geographic extent of the GBRWHA, the remoteness of the region adjacent to the Cape York Peninsula where most dugongs occur and the artisanal nature of the fishery. In the face of this uncertainty, a spatial risk-assessment approach was used to evaluate the re-zoning and associated industry restructuring for their ability to reduce the risk of dugong bycatch from commercial fisheries netting. The new zoning arrangements appreciably reduced the risk of dugong bycatch by reducing the total area where commercial netting is permitted. Netting is currently not permitted in 67% of dugong habitats of high conservation value, a 56% improvement over the former arrangements. Re-zoning and industry restructuring also contributed to a 22% decline in the spatial extent of conducted netting. Spatial risk assessment approaches that evaluate the risk of mobile marine mammals from bycatch are applicable to other situations where there is limited information on the location and intensity of bycatch, including remote regions and developing countries where resources are limited.

Binding of three molecules in the excited state

t is shown that three neutral molecules can form a stable trimer if one of them is in the excited state. The formation of termolecular electron donor-acceptor complexes of sequence DDA and DAA arises from charge-resonance interaction.

Use of biomass fuels in the brick-making industries of Sudan: Implications for deforestation and greenhouse gas emission

The study focuses on the potential roles of the brick making industries in Sudan in deforestation and greenhouse gas emission due to the consumption of biofuels. The results were based on the observation of 25 brick making industries from three administrative regions in Sudan namely, Khartoum, Kassala and Gezira. The methodological approach followed the procedures outlined by the Intergovernmental Panel on Climate Change (IPCC). For predicting a serious deforestation scenario, it was also assumed that all of wood use for this particular purpose is from unsustainable sources. The study revealed that the total annual quantity of fuelwood consumed by the surveyed brick making industries (25) was 2,381 t dm. Accordingly, the observed total potential deforested wood was 10,624 m3, in which the total deforested round wood was 3,664 m3 and deforested branches was 6,961 m3. The study observed that a total of 2,990 t biomass fuels (fuelwood and dung cake) consumed annually by the surveyed brick making industries for brick burning. Consequently, estimated total annual emissions of greenhouse gases were 4,832 t CO2, 21 t CH4, 184 t CO, 0.15 t N20, 5 t NOX and 3.5 t NO while the total carbon released in the atmosphere was 1,318 t. Altogether, the total annual greenhouse gases emissions from biomass fuels burning was 5,046 t; of which 4,104 t from fuelwood and 943 t from dung cake burning. According to the results, due to the consumption of fuelwood in the brick making industries (3,450 units) of Sudan, the amount of wood lost from the total growing stock of wood in forests and trees in Sudan annually would be 1,466,000 m3 encompassing 505,000 m3 round wood and 961,000 m3 branches annually. By considering all categories of biofuels (fuelwood and dung cake), it was estimated that, the total emissions from all the brick making industries of Sudan would be 663,000 t CO2, 2,900 t CH4, 25,300 t CO, 20 t N2O, 720 t NOX and 470 t NO per annum, while the total carbon released in the atmosphere would be 181,000 t annually.

Dynamic Space Warping Of Strokes For Recognition Of Online Handwritten Characters

This paper suggests a scheme for classifying online handwritten characters, based on dynamic space warping of strokes within the characters. A method for segmenting components into strokes using velocity profiles is proposed. Each stroke is a simple arbitrary shape and is encoded using three attributes. Correspondence between various strokes is established using Dynamic Space Warping. A distance measure which reliably differentiates between two corresponding simple shapes (strokes) has been formulated thus obtaining a perceptual distance measure between any two characters. Tests indicate an accuracy of over 85% on two different datasets of characters.

Interacting effects of vegetation, soils and management on the sensitivity of Australian savanna rangelands to climate change

There is an increasing need to understand what makes vegetation at some locations more sensitive to climate change than others. For savanna rangelands, this requires building knowledge of how forage production in different land types will respond to climate change, and identifying how location-specific land type characteristics, climate and land management control the magnitude and direction of its responses to change. Here, a simulation analysis is used to explore how forage production in 14 land types of the north-eastern Australian rangelands responds to three climate change scenarios of +3A degrees C, +17% rainfall; +2A degrees C, -7% rainfall; and +3A degrees C, -46% rainfall. Our results demonstrate that the controls on forage production responses are complex, with functional characteristics of land types interacting to determine the magnitude and direction of change. Forage production may increase by up to 60% or decrease by up to 90% in response to the extreme scenarios of change. The magnitude of these responses is dependent on whether forage production is water or nitrogen (N) limited, and how climate changes influence these limiting conditions. Forage production responds most to changes in temperature and moisture availability in land types that are water-limited, and shows the least amount of change when growth is restricted by N availability. The fertilisation effects of doubled atmospheric CO2 were found to offset declines in forage production under 2A degrees C warming and a 7% reduction in rainfall. However, rising tree densities and declining land condition are shown to reduce potential opportunities from increases in forage production and raise the sensitivity of pastures to climate-induced water stress. Knowledge of these interactions can be applied in engaging with stakeholders to identify adaptation options.

Effect of the antitumor antibiotic chromomycin A3 on the humoral immune response in rats

Chromomycin A3 (250 mug/kg) suppressed the humoral immune response in rats against sheep erythrocytes when administered 48 h or later after antigenic stimulus. The antibiotic at this dose enhanced immunity when given along with or before antigen administration. The natural heterohemagglutinin levels in rabbits and guinea pigs were not affected by the antibiotic (10 mug/kg per day x 7).