Ambulatory electroencephalogram in children:a prospective clinical audit of 100 cases

Ambulatory electroencephalogram has been used for differentiating epileptic from nonepileptic events, recording seizure frequency and classification of seizure type. We studied 100 consecutive children prospectively aged 11 days to 16 years that were referred for an ambulatory electroencephalogram to a regional children's hospital. Ambulatory electroencephalogram was clinically useful in contributing to a clinical diagnosis in 71% of children who were referred with a range of clinical questions. A diagnosis of epileptic disorder was confirmed by obtaining an ictal record in 26% and this included 11 children that had previously normal awake and or sleep electroencephalogram. We recommend making a telephone check of the current target event frequency and prioritising those with typical events on most days in order to improve the frequency of recording a typical attack.

Switched capacitor DC-DC converters for HVDC applications

DC distribution and transmission provides an efficient, cost effective and reliable alternative to traditional AC systems for offshore wind farm integration. High power DC-DC converters are key components to realise future offshore voltage DC grids and multi-terminal HVDC systems. Different DC-DC converter topologies have been proposed for this application. The aim of this paper is to investigate the viability of Switched Capacitor (SC) converters in high power application particularly the interconnection of offshore windfarms to a medium voltage DC grid. In addition, a comparison of alternative topologies that have been proposed will be presented. Simulation and experimental results are provided to verify the analysis.

Addition of PLA2 to CRP enhances sepsis diagnosis

Letter to the Editor refers to: Fredrikke Christie Knudtzen, Stig Lønberg Nielsen, Kim Oren Gradel, Annmarie Touborg Lassen, Hans Jørn Kolmos, Thøger Gorm Jensen, Pernille Just Vinholt, Court Pedersen, Characteristics of patients with community-acquired bacteremia who have low levels of C-reactive protein (≤20 mg/L), Journal of Infection, Volume 68, Issue 2, February 2014, Pages 149-155

Prevalência da síndrome metabólica e seus componentes nos estágios pubertários de escolares do sexo feminino norte-rio-grandenses

The diagnosis of nutritional status is extremely re levant in clinical practice and population assessment, due to the association betwe en body fat and metabolic alterations. The aim of this study is to analyze th e prevalence of metabolic syndrome (MS) and its components in the pubertal stages of f emale students in Rio Grande do Norte state, Brazil, in accordance with Internation al Diabetes Federation criteria. This is a cross-sectional study with 449 students aged betw een 8 and 19 years, stratified into pubertal stages systematized by Marshal and Tanner (1969), as follows: 27.6% prepubertal, 44.3% pubertal and 28.1% postpubertal, with mean ages of 9.4±1.27, 12.4±2.23 and 15.1±1.88 years, respectively. Preval ences were analyzed using distribution of frequencies and their respective 95 % confidence intervals, while the chi- square test and odds ratio were applied to analyze the associations between variables. The general prevalence of MS was 3.3% (CI: 2% - 5%) , without occurrences in the prepubertal stage, observing that it emerges from t he pubertal stage onwards with a prevalence of 2.5% (CI 95% 0.1% - 5%), 1% (CI 95% 0.4% - 2.3%) of cases with overweight and 1.5% (CI 95% -0.1% - 3.2%) with obes e individuals, while in the postpubertal stage the prevalence is 7.9% (CI 95% 3 .2% - 12.6%), 0.8% (CI 95% -0.8% - 2.3%) normal weight cases, 4% (CI 95% 0.6% - 7.4% ) overweight and 3.1% (CI 0.1% - 6.2%) obese individuals. There was an association (p<0.02) between pubertal stages and MS ( x 2 =5.2), with an OR of 3.3 (CI: 1.2 - 5), showing tha t postpubertal adolescents are more prone to SM than pubertals, while the OR i n obese individuals was 2.1 (CI: 2– 2.2) compared to the overweight. Body mass index (B MI) ( x 2 = 29.4; p<0.001) and age range ( x 2 = 13.1; p<0.001) showed a significant linear assoc iation with MS. Of the adolescents with MS, those aged ten years or younge r exhibited higher %G. The most prevalent components in all the stages were altered waist circumference (27.2% [CI 23% - 31%]) and low HDL cholesterol (39.6% [CI 35% – 44%]), which, coupled with hypertension, displayed significant differences in the postpubertal stage in relation to the other stages. The results show that MS emerges from the pubertal stage onwards in proportion to excess childhood body fat, a fact tha t calls for prevention strategies using an educational approach, reducing the large demand on the National Health System. Keywords: Metabolic syndrome, pubertal stages, risk factors.

(Table 2) Radiocarbon dates from lakes on Fildes Peninsula, King George Island

Precise relative sea level (RSL) data are important for inferring regional ice sheet histories, as well as helping to validate numerical models of ice sheet evolution and glacial isostatic adjustment. Here we develop a new RSL curve for Fildes Peninsula, South Shetland Islands (SSIs), a sub-Antarctic archipelago peripheral to the northern Antarctic Peninsula ice sheet, by integrating sedimentary evidence from isolation basins with geomorphological evidence from raised beaches. This combined approach yields not only a Holocene RSL curve, but also the spatial pattern of how RSL change varied across the archipelago. The curve shows a mid-Holocene RSL highstand on Fildes Peninsula at 15.5 m above mean sea level between 8000 and 7000 cal a BP. Subsequently RSL gradually fell as a consequence of isostatic uplift in response to regional deglaciation. We propose that isostatic uplift occurred at a non-steady rate, with a temporary pause in ice retreat ca. 7200 cal a BP, leading to a short-lived RSL rise of ~1 m and forming a second peak to the mid-Holocene highstand. Two independent approaches were taken to constrain the long-term tectonic uplift rate of the SSIs at 0.22-0.48 m/ka, placing the tectonic contribution to the reconstructed RSL highstand between 1.4 and 2.9 m. Finally, we make comparisons to predictions from three global sea level models.

Periodic Breathing and Behavioral Awakenings at High Altitude.

Objectives. To study the relationship between nocturnal periodic breathing episodes and behavioral awakenings at high altitude. Methods. Observational study. It is 6-day ascent of 4 healthy subjects from Besisahar (760 meters) to Manang (3540 meters) in Nepal in March 2012. A recording pulse oximeter was worn by each subject to measure their oxygen saturation and the presence of periodic breathing continuously through the night. An actigraph was simultaneously worn in order to determine nocturnal behavioral awakenings. There were no interventions. Results. 187-hour sleep at high altitude was analyzed, and of this, 145 hours (78%) had at least one PB event. At high altitude, 10.5% (95% CI 6.5-14.6%) of total sleep time was spent in PB while 15 out of 50 awakenings (30%, 95% CI: 18-45%) occurring at high altitudes were associated with PB (P < 0.001). Conclusions. Our data reveals a higher than expected number of behavioral awakenings associated with PB compared to what would be expected by chance. This suggests that PB likely plays a role in behavioral awakenings at high altitude.

Measuring the cost of resilience

Air traffic management research lacks a framework for modelling the cost of resilience during disturbance. There is no universally accepted metric for cost resilience. The design of such a framework is presented and the modelling to date is reported. The framework allows performance assessment as a function of differential stakeholder uptake of strategic mechanisms designed to mitigate disturbance. Advanced metrics, cost- and non-cost-based, disaggregated by stakeholder sub-types, are described. A new cost resilience metric is proposed and exemplified with early test data.

Revisiting the Late Jurassic-Early Cretaceous of the NW South Iberian Basin: new ages and sedimentary environments

The study of the Upper Jurassic-Lower Cretaceous deposits (Higueruelas, Villar del Arzobispo and Aldea de Cortés Formations) of the South Iberian Basin (NW Valencia, Spain) reveals new stratigraphic and sedimentological data, which have significant implications on the stratigraphic framework, depositional environments and age of these units. The Higueruelas Fm was deposited in a mid-inner carbonate platform where oncolitic bars migrated by the action of storms and where oncoid production progressively decreased towards the uppermost part of the unit. The overlying Villar del Arzobispo Fm has been traditionally interpreted as an inner platform-lagoon evolving into a tidal-flat. Here it is interpreted as an inner-carbonate platform affected by storms, where oolitic shoals protected a lagoon, which had siliciclastic inputs from the continent. The Aldea de Cortés Fm has been previously interpreted as a lagoon surrounded by tidal-flats and fluvial-deltaic plains. Here it is reinterpreted as a coastal wetland where siliciclastic muddy deposits interacted with shallow fresh to marine water bodies, aeolian dunes and continental siliciclastic inputs. The contact between the Higueruelas and Villar del Arzobispo Fms, classically defined as gradual, is also interpreted here as rapid. More importantly, the contact between the Villar del Arzobispo and Aldea de Cortés Fms, previously considered as unconformable, is here interpreted as gradual. The presence of Alveosepta in the Villar del Arzobispo Fm suggests that at least part of this unit is Kimmeridgian, unlike the previously assigned Late Tithonian-Middle Berriasian age. Consequently, the underlying Higueruelas Fm, previously considered Tithonian, should not be younger than Kimmeridgian. Accordingly, sedimentation of the Aldea de Cortés Fm, previously considered Valangian-Hauterivian, probably started during the Tithonian and it may be considered part of the regressive trend of the Late Jurassic-Early Cretaceous cycle. This is consistent with the dinosaur faunas, typically Jurassic, described in the Villar del Arzobispo and Aldea de Cortés Fms.

Ecophysiology of Adonis distorta, a high-mountain species endemic of the Central Apennines

Morphological, anatomical and physiological plant and leaf traits of A. distorta, an endemic species of the Central Apennines on the Majella Massif, growing at 2,675 m a.s.l, were analyzed. The length of the phenological cycle starts immediately after the snowmelt at the end of May, lasting 128 ± 10 days. The low A. distorta height  (Hmax= 64 ± 4 mm) and total leaf area (TLA= 38 ± 9 cm2) associated to a high leaf mass area (LMA =11.8±0.6 mg cm−2) and a relatively high leaf tissue density (LTD = 124.6±14.3 mg cm−3) seem to be adaptive traits to the stress factors of the environment where it grows. From a physiological point of view, the high A. distorta photosynthetic rates (PN =19.6 ± 2.3 µmol m−2 s−1) and total chlorophyll content (Chla+b = 0.88 ± 0.13 mg g−1) in July are justified by the favorable temperature. PN decreases by 87% in September at the beginning of plant senescence. Photosynthesis and leaf respiration (RD) variations allow A. distorta to maintain a positive carbon balance during the growing season becoming indicative of the efficiency of plant carbon use. The results could be an important tool for conservation programmes of the A. distorta wild populations.

The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

Narrative Deliberation? On Storytelling as a Necessary Component of Public Deliberation

This paper deals with the place of narrative, that is, storytelling, in public deliberation. A distinction is made between weak and strong conceptions of narrative. According to the weak one, storytelling is but one rhetorical device among others with which social actors produce and convey meaning. In contrast, the strong conception holds that narrative is necessary to communicate, and argue, about topics such as the human experience of time, collective identities and the moral and ethical validity of values. The upshot of this idea is that storytelling should be a necessary component of any ideal of public deliberation. Contrary to recent work by deliberative theorists, who tend to adopt the weak conception of narrative, the author argues for embracing the strong one. The main contention of this article is that stories not only have a legitimate place in deliberation, but are even necessary to formulate certain arguments in the fi rst place; for instance, arguments drawing on historical experience. This claim, namely that narrative is constitutive of certain arguments, in the sense that, without it, said reasons cannot be articulated, is illustrated by deliberative theory’s own narrative underpinnings. Finally, certain possible objections against the strong conception of narrative are dispelled.

Las edades de Hitler. De Satán a un ser de carne y hueso, y su representación en clave paródica

Adolf Hitler suscitó desde su entrada en la escena política alemana una fascinación perversa, un sentimiento que, con el tiempo, ha dado lugar a numerosas representaciones culturales sobre el Führer. La muestra, rica y variada tanto en el fondo como en la forma, nos permitirá trazar tres estadios en lo referente al proceso de construcción historiográfica del hitlerismo, iniciado con la caída del Tercer Reich. Estos responden en buena medida al devenir sociopolítico y cultural de la sociedad a escala global desde el final de la guerra y hasta nuestros días y pueden resumirse en tres: primero, la satanización; segundo, la humanización; tercero, el retrato caricaturesco. Proponemos un recorrido histórico por diversos productos culturales del dictador alemán cuyo propósito es desentrañar el retrato psicológico poliédrico que se ha construido en torno a la figura de Hitler.

El Cambio Climático en la Estrategia Global de Seguridad de la Unión Europea

El cambio climático es uno de los mayores desafíos de la actualidad. La UE ha abordado el tema de forma claramente insuficiente desde el punto de vista teórico, con unos planteamientos demasiado inmovilistas y hasta conformistas con su propia acción. Pero, al mismo tiempo, ha sido uno de los primeros y principales actores internacionales en actuar y posicionarse claramente en la lucha contra el cambio climático. La Estrategia Global de Seguridad de la UE no aborda adecuadamente ni el cambio climático como prioridad fundamental ni algunas de sus implicaciones en las políticas de los Estados Miembros de la UE.

The Weapons of Mass Destruction and the Global Security Strategy of the EU

The proliferation of weapons of mass destruction (WMD), nuclear, biological and chemical (NBC) is one of the main security challenges facing the international community today. However the new Global Security Strategy of 2016 raises the question of non-proliferation of WMD only as an incidental matter, not addressing directly the threat, a fundamental threat in the regional and global security. This is a clear step backwards for the European common security.

The Changing Face of Neolithic and Bronze Age Ireland: A Big Data Approach to the Settlement and Burial Records

This paper synthesizes and discusses the spatial and temporal patterns of archaeological sites in Ireland, spanning the Neolithic period and the Bronze Age transition (4300–1900 cal BC), in order to explore the timing and implications of the main changes that occurred in the archaeological record of that period. Large amounts of new data are sourced from unpublished developer-led excavations and combined with national archives, published excavations and online databases. Bayesian radiocarbon models and context- and sample-sensitive summed radiocarbon probabilities are used to examine the dataset. The study captures the scale and timing of the initial expansion of Early Neolithic settlement and the ensuing attenuation of all such activity—an apparent boom-and-bust cycle. The Late Neolithic and Chalcolithic periods are characterised by a resurgence and diversification of activity. Contextualisation and spatial analysis of radiocarbon data reveals finer-scale patterning than is usually possible with summed-probability approaches: the boom-and-bust models of prehistoric populations may, in fact, be a misinterpretation of more subtle demographic changes occurring at the same time as cultural change and attendant differences in the archaeological record.