Does airways inflammation pre-exist before late onset wheeze in children?

Epidemiological studies show that some children develop wheezing after 3 yr of age which tends to persist. It is unknown how this starts or whether there is a period of asymptomatic inflammation. The aim of this study is to determine whether lower airway allergic inflammation pre-exists in late onset childhood wheeze (LOCW). Follow-up study of children below 5 yr who had a non-bronchoscopic bronchoalveolar lavage (BAL) performed during elective surgery. The children had acted as normal controls. A modified ISAAC questionnaire was sent out at least 7 yr following the initial BAL, and this was used to ascertain whether any children had subsequently developed wheezing or other atopic disease (eczema, allergic rhinitis). Cellular and cytokine data from the original BAL were compared between those who never wheezed (NW) and those who had developed LOCW. Eighty-one normal non-asthmatic children were recruited with a median age of 3.2 . Of the 65 children contactable, 9 (16.7%) had developed wheeze, 11 (18.5%) developed eczema and 14 (22.2%) developed hay fever. In five patients, wheeze symptoms developed mean 3.3- yr (range: 2–5 yr) post-BAL. Serum IgE and blood eosinophils were not different in the LOCW and NW, although the blood white cell count was lower in the LOCW group. The median BAL eosinophil % was significantly increased in the patients with LOCW (1.55%, IQR: 0.33 to 3.92) compared to the children who never wheezed, NW (0.1, IQR: 0.0 to 0.3, p = 0.01). No differences were detected for other cell types. There are no significant differences in BAL cytokine concentrations between children with LOCW and NW children. Before late onset childhood wheezing developed, we found evidence of elevated eosinophils in the airways. These data suggest pre-existent airways inflammation in childhood asthma some years before clinical presentation.

The last meal of the Late Ordovician mollusc ‘Helminthochiton’ thraivensis Reed, 1911, from the Lady Burn Starfish Beds, southwest Scotland.

An exceptional specimen of the Late Ordovician mollusc ‘Helminthochiton’ thraivensis Reed, from the Katian of the Lady Burn Starfish Beds, southwest Scotland, preserves gut contents that include nine pelmatozoan ossicles. These are interpreted as including two nodal and five intermodal columnals, and two radice ossicles from the attachment structure. The stem was cyclocyclic and heteromorphic, possibly N212. Radice ossicles were wider than the height of nodals, so radice scars must have encroached onto the latera of adjacent pluricolumnals. These features were compared with the 26 known pelmatozoan taxa from the Lady Burn Starfish Beds. Paracrinoids (one species) and glyptocystitid rhombiferans (six species) were discounted as prey because of their cemented attachment, and incorrect columnal morphology and lack of attachment, respectively. Of 19 species of crinoids, eight are discounted in which the column is pentagonal, tetragonal or unknown. Of the remaining eleven species, only the monobathrid camerate Macrostylocrinus cirrifer Ramsbottom satisfies all criteria for identification of the prey, including heteromorphy and radice scars encroaching adjacent internodals.

Dinoflagellate cyst-based reconstructions of mid to late Holocene winter sea-surface temperature and productivity from an anoxic fjord in the NE Pacific Ocean

Published contemporary dinoflagellate distributional data from the NE Pacific margin and estuarine environments (n = 136) were re-analyzed using Canonical Correspondence Analysis (CCA) and partial Canonical Correspondence Analysis (pCCA). These analyses illustrated the dominant controls of winter temperature and productivity on the distribution of dinoflagellate cysts in this region. Dinoflagellate cyst-based predictive models for winter temperature and productivity were developed from the contemporary distributional data using the modern analogue technique and applied to subfossil data from two mid to late Holocene (~5500 calendar years before present–present) cores; TUL99B03 and TUL99B11, collected from Effingham Inlet, a 15 km long anoxic fjord located on the southwest coast of Vancouver Island that directly opens to the Pacific Ocean through Barkley Sound. Sedimentation within these basins largely comprises annually deposited laminated couplets, each made up of a winter deposited terrigenous layer and spring to fall deposited diatomaceous layer. The Effingham Inlet dinoflagellate cyst record provides evidence of a mid-Holocene gradual decline in winter SST, ending with the initiation of neoglacial advances in the region by ~3500 cal BP. A reconstructed Late Holocene increase in winter SST was initiated by a weakening of the California Current, which would have resulted in a warmer central gyre and more El Niño-like conditions.

The RET mutation E768D confers a late-onset Familial medullary thyroid carcinoma - only phenotype with incomplete penetrance: Implications for screening and management of carrier status

Objective: We describe a 4-generation family with familial medullary thyroid carcinoma (FMTC) - a variant of multiple endocrine neoplasia type 2 (MEN 2) without extra-thyroid features. RET mutation analysis confirmed an E768D mutation in exon 13 in 8 family members, 3 affected with medullary thyroid cancer alone while the other 5 were detected to be mutation carriers. This mutation has been described in very few families worldwide and the spectrum of disease and natural history is unclear. Results: Three affected members had medullary thyroid cancer (MTC) confirmed histologically at ages 25, 50 and 56 years, respectively. The E768D mutation appears to have a less aggressive clinical course compared to other high risk RET mutations with no evidence of clinical recurrence up to I I years after initial therapy. Of five gene carriers identified, two are asymptomatic at the age of 70 and 61, and three had raised calcitonin levels at 46, 39, and 45 years. Following total thyroidectomy, one gene carrier had a histologically normal thyroid at age 46, following a mildly elevated calcitonin, one had C-cell hyperplasia at the age of 39, and one had a frank focus of carcinoma in the left thyroid lobe at the age of 45. No members had evidence of phaeochromocytoma or parathyroid disease on screening. Conclusion: The RET E768D mutation is associated with MTC with a later age at presentation, incomplete penetrance and less aggressive course compared with other high risk RET mutations. To date in this family the E768D mutation has not been associated with either phaeochromocytoma or hyperparathyroidism. The appropriate screening strategy for and management of E768D carriers is difficult reflecting the phenotypic heterogeneity.

Early Childhood Development of Late-Preterm Infants: A Systematic Review

CONTEXT: Late-preterm infants (LPIs) born at 34 to 36 weeks' gestation are increasingly regarded as being at risk for adverse developmental outcomes. To date, the early childhood development of LPIs has not been systematically considered.

OBJECTIVE: To undertake a broad examination of literature relating to early childhood development at the ages of 1 to 7 years of LPIs born at 34 to 36 weeks' gestation.

METHODS: We conducted a systematic review of early childhood outcomes in LPIs by using 9 electronic databases (January 1980 to March 2010). Bibliographies were reviewed. After examination of abstracts, ineligible studies were excluded. A specifically designed data-extraction form was used. The methodologic quality of included studies was assessed by using well-documented quality-appraisal guidelines.

RESULTS: Of 4581 studies, 10 (3 prospective and 7 retrospective cohort) were included. Studies were heterogeneous, and poorer outcomes were reported among LPIs in relation to neurodevelopmental disabilities, educational ability, early-intervention requirements, medical disabilities, and physical growth in comparison to term-born children. No identified study used healthy nonadmitted LPIs as a comparison group for admitted LPIs.

CONCLUSIONS: Evidence suggests that LPIs are at increased risk of adverse developmental outcomes and academic difficulties up to 7 years of age in comparison to term infants. An infant control group matched for gestational age has not been used; thus, for LPIs, the effect of neonatal admission on longer-term outcomes has not been fully explored. Systematic measurement of early childhood outcomes is lacking, and focused long-term follow-up studies are needed to investigate early childhood development after late-preterm birth. Pediatrics 2011;127:1111-1124

Phylogeographic analysis of North American populations of the parasitic herbaceous plant Monotropa hypopitys reveals a complex history of range expansion from multiple late glacial refugia

Aim We carried out a phylogeographic study across the range of the herbaceous plant species Monotropa hypopitys L. in North America to determine whether its current disjunct distribution is due to recolonization from separate eastern and western refugia after the Last Glacial Maximum (LGM). Location North America: Pacific Northwest and north-eastern USA/south-eastern Canada. Methods Palaeodistribution modelling was carried out to determine suitable climatic regions for M. hypopitys at the LGM. We analysed between 155 and 176 individuals from 39 locations spanning the species' entire range in North America. Sequence data were obtained for the chloroplast rps2 gene (n=168) and for the nuclear ITS region (n=158). Individuals were also genotyped for eight microsatellite loci (n=176). Interpolation of diversity values was used to visualize the range-wide distribution of genetic diversity for each of the three marker classes. Minimum spanning networks were constructed showing the relationships between the rps2 and ITS haplotypes, and the geographical distributions of these haplotypes were plotted. The numbers of genetic clusters based on the microsatellite data were estimated using Bayesian clustering approaches. Results The palaeodistribution modelling indicated suitable climate envelopes for M. hypopitys at the LGM in both the Pacific Northwest and south-eastern USA. High levels of genetic diversity and endemic haplotypes were found in Oregon, the Alexander Archipelago, Wisconsin, and in the south-eastern part of the species' distribution range. Main conclusions Our results suggest a complex recolonization history for M. hypopitys in North America, involving persistence in separate eastern and western refugia. A generally high degree of congruence between the different marker classes analysed indicated the presence of multiple refugia, with at least two refugia in each area. In the west, putative refugia were identified in Oregon and the Alexander Archipelago, whereas eastern refugia may have been located in the southern part of the species' current distribution, as well as in the 'Driftless Area'. These findings are in contrast to a previous study on the related species Orthilia secunda, which has a similar disjunct distribution to M. hypopitys, but which appears to have recolonized solely from western refugia. © 2011 Blackwell Publishing Ltd.

Late Holocene climate change in central Sweden inferred from lacustrine stable isotope data

Stable isotopes (delta O-18 and delta C-13) of lacustrine carbonates (Chara spp. algae and Pisidium spp. molluscs) from a lake sedimentary sequence in central Sweden were analysed to infer changes in lake hydrology and climate during the late Holocene. Results from analysis of lake water isotopes (delta O-18 and delta H-2) show that Lake Blektjarnen water isotope composition is responsive to the balance between evaporation and input water (E/l ratio). A high E/l ratio results from a dry and probably warmer climate, decreasing the relative importance of precipitation input. Under such conditions evaporation and atmospheric equilibration probably enrich lake water in O-18 and C-13, respectively, which is reflected in the isotopic composition of the carbonates in the lake. From the relatively positive Chara delta O-18 values we infer that conditions were dry and warm between 4400 and 4000 cal. a BP, whereas more negative values indicate that conditions were wetter and probably cooler between 4000 and 3000 cal. a BP. A drier climate is inferred from more positive values between 2500 and 1000 cal. a BP. However, a successive depletion after ca. 1750 cal. a BP, also detected in several other delta O-18 records (carbonate and diatom), suggest increasingly wetter conditions in Scandinavia after that time, which is probably related to increased strength of the zonal flow.

Incised palaeo-channels of the Late Middle Pleistocene Thames: age, origins and implications for fluvial palaeogeography and sea-level reconstruction in the southern North Sea Basin.

Multidisciplinary investigations of the infills of steeply-incised buried channels on the coast of Essex, England, provide important insights into late Middle Pleistocene climate and sea-level change and have a direct bearing on the differentiation of MIS 11 and MIS 9 in terrestrial records. New data are presented from Rochford and Burnham-on-Crouch where remnants of two substantial palaeo-channels filled with interglacial sediment can be directly related to the terrace stratigraphy of the Thames. The sediments in both channels accumulated in an estuarine environment early in an interglacial when mixed oak forest was becoming established. Lithological evidence suggests that the interglacial beds post-date the brackish-water infill of an older palaeo-channel ascribed to the Hoxnian and correlated with part of MIS 11, and pre-date terrace gravels (Barling Gravel) ascribed to MIS 8. An MIS 9 attribution is supported by molluscan biostratigraphy, palaeo-salinity and amino-acid racemization data. The relative sea-level record in this area thus includes evidence for two major marine transgressions during MIS 11 and MIS 9, with local maxima of >10 m O.D. Both are associated with sediments that show ‘Hoxnian’ palynological affinities. The wider significance of these findings, and of an intermediate phase of pronounced fluvial incision during MIS 10, is discussed.

Replication of EPHA1 and CD33 associations with late-onset Alzheimer’s disease: a multi-centre case-control study

A recently published genome-wide association study (GWAS) of late-onset Alzheimer's disease (LOAD) revealed genome-wide significant association of variants in or near MS4A4A, CD2AP, EPHA1 and CD33. Meta-analyses of this and a previously published GWAS revealed significant association at ABCA7 and MS4A, independent evidence for association of CD2AP, CD33 and EPHA1 and an opposing yet significant association of a variant near ARID5B. In this study, we genotyped five variants (in or near CD2AP, EPHA1, ARID5B, and CD33) in a large (2,634 LOAD, 4,201 controls), independent dataset comprising six case-control series from the USA and Europe. We performed meta-analyses of the association of these variants with LOAD and tested for association using logistic regression adjusted by age-at-diagnosis, gender, and APOE e4 dosage.

The Type Ic SN 2007gr: a census of the ejecta from late-time optical-infrared spectra

Nebular spectra of supernovae (SNe) offer an unimpeded view of the inner region of the ejecta, where most nucleosynthesis takes place. Optical spectra cover most, but not all, of the emitting elements and therefore offer only a partial view of the products of the explosion. Simultaneous optical-infrared spectra, on the other hand, contain emission lines of all important elements, from C and O through to the intermediate mass elements (IME) Mg, Si, S, Ca and to Fe and Ni. In particular, Si and S are best seen in the IR. The availability of IR data makes it possible to explore in greater detail the results of the explosion. SN 2007gr is the first Type Ic SN for which such data are available. Modelling the spectra with a non-local thermodynamic equilibrium (NLTE) code reveals that the inner ejecta contain similar to 1M(circle dot) of material within a velocity of approximate to 4500 km s(-1). The same mass of Ni-56 derived from the light-curve peak (0.076M(circle dot)) was used to power the spectrum, yielding consistent results. Oxygen is the dominant element, contributing similar to 0.8M(circle dot). The C/O ratio is