Levels of Neonatal Thyroid Hormone in Preterm Infants and Neurodevelopmental Outcome at 51/2 Years: Millennium Cohort Study

Context: Transient hypothyroxinemia is the commonest thyroid dysfunction of premature infants, and recent studies have found adverse associations with neurodevelopment. The validity of these associations is unclear because the studies adjusted for a differing range of factors likely to influence neurodevelopment. Objective: The aim was to describe the association of transient hypothyroxinemia with neurodevelopment at 5.5 yr corrected age. Design: We conducted a follow-up study of a cohort of infants born in Scotland from 1999 to 2001 =34 wk gestation. Main Outcome Measures: We measured scores on the McCarthy scale adjusted for 26 influences of neurodevelopment including parental intellect, home environment, breast or formula fed, growth retardation, and use of postnatal drugs. Results: A total of 442 infants =34 wk gestation who had serum T4 measurements on postnatal d 7, 14, or 28 and 100 term infants who had serum T4 measured in cord blood were followed up at 5.5 yr. Infants with hypothyroxinemia (T4 level = 10th percentile on d 7, 14, or 28 corrected for gestational age) scored significantly lower than euthyroid infants (T4 level greater than the 10th percentile and less than the 90th percentile on all days) on all McCarthy scales, except the quantitative. After adjustment for confounders of neurodevelopment, hypothyroxinemic infants scored significantly lower than euthyroid infants on the general cognitive and verbal scales. Conclusions: Our findings do not support the view that the hypothyroxinemic state, in the context of this analysis, is harmless in preterm infants. Many factors contribute both to the etiology of hypothyroxinemia and neurodevelopment; strategies for correction of hypothyroxinemia should acknowledge its complex etiology and not rely solely on one approach.

A Search for Line Shape and Depth Variations in 51 Pegasi and tau Bootis

Spectroscopic observations of 51 Pegasi and tau Bootis show no periodic changes in the shapes of their line profiles; these results for 51 Peg are in significant conflict with those reported by Gray & Hatzes. Our detection limits are small enough to rule out nonradial pulsations as the cause of the variability in tau Boo, but not in 51 Peg. The absence of line shape changes is consistent with these stars' radial velocity variability arising from planetary mass companions.

Exoplanets or Dynamic Atmospheres? The Radial Velocity and Line Shape Variations of 51 Pegasi and tau Bootis

The stars 51 Pegasi and tau Bootis show radial velocity variations that have been interpreted as resulting from companions with roughly Jovian mass and orbital periods of a few days. Gray and Gray & Hatzes reported that the radial velocity signal of 51 Peg is synchronous with variations in the shape of the line lambda 6253 Fe I; thus, they argue that the velocity signal arises not from a companion of planetary mass but from dynamic processes in the atmosphere of the star, possibly nonradial pulsations. Here we seek confirming evidence for line shape or strength variations in both 51 Peg and tau Boo, using R = 50,000 observations taken with the Advanced Fiber Optic Echelle. Because of our relatively low spectral resolution, we compare our observations with Gray's line bisector data by fitting observed line profiles to an expansion in terms of orthogonal (Hermite) functions. To obtain an accurate comparison, we model the emergent line profiles from rotating and pulsating stars, taking the instrumental point-spread function into account. We describe this modeling process in detail. We find no evidence for line profile or strength variations at the radial velocity period in either 51 Peg or in tau Boo. For 51 Peg, our upper limit for line shape variations with 4.23 day periodicity is small enough to exclude with 10 sigma confidence the bisector curvature signal reported by Gray & Hatzes; the bisector span and relative line depth signals reported by Gray are also not seen, but in this case with marginal (2 sigma ) confidence. We cannot, however, exclude pulsations as the source of 51 Peg's radial velocity variation because our models imply that line shape variations associated with pulsations should be much smaller than those computed by Gray & Hatzes; these smaller signals are below the detection limits both for Gray & Hatzes's data and for our own. tau Boo's large radial velocity amplitude and v sin i make it easier to test for pulsations in this star. Again we find no evidence for periodic line shape changes, at a level that rules out pulsations as the source of the radial velocity variability. We conclude that the planet hypothesis remains the most likely explanation for the existing data.

Pan-retinal photocoagulation and other forms of laser treatment and drug therapies for non-proliferative diabetic retinopathy: systematic review and economic evaluation

BACKGROUND: Diabetic retinopathy is an important cause of visual loss. Laser photocoagulation preserves vision in diabetic retinopathy but is currently used at the stage of proliferative diabetic retinopathy (PDR).

OBJECTIVES: The primary aim was to assess the clinical effectiveness and cost-effectiveness of pan-retinal photocoagulation (PRP) given at the non-proliferative stage of diabetic retinopathy (NPDR) compared with waiting until the high-risk PDR (HR-PDR) stage was reached. There have been recent advances in laser photocoagulation techniques, and in the use of laser treatments combined with anti-vascular endothelial growth factor (VEGF) drugs or injected steroids. Our secondary questions were: (1) If PRP were to be used in NPDR, which form of laser treatment should be used? and (2) Is adjuvant therapy with intravitreal drugs clinically effective and cost-effective in PRP?

ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) for efficacy but other designs also used.

REVIEW METHODS: Systematic review and economic modelling.

RESULTS: The Early Treatment Diabetic Retinopathy Study (ETDRS), published in 1991, was the only trial designed to determine the best time to initiate PRP. It randomised one eye of 3711 patients with mild-to-severe NPDR or early PDR to early photocoagulation, and the other to deferral of PRP until HR-PDR developed. The risk of severe visual loss after 5 years for eyes assigned to PRP for NPDR or early PDR compared with deferral of PRP was reduced by 23% (relative risk 0.77, 99% confidence interval 0.56 to 1.06). However, the ETDRS did not provide results separately for NPDR and early PDR. In economic modelling, the base case found that early PRP could be more effective and less costly than deferred PRP. Sensitivity analyses gave similar results, with early PRP continuing to dominate or having low incremental cost-effectiveness ratio. However, there are substantial uncertainties. For our secondary aims we found 12 trials of lasers in DR, with 982 patients in total, ranging from 40 to 150. Most were in PDR but five included some patients with severe NPDR. Three compared multi-spot pattern lasers against argon laser. RCTs comparing laser applied in a lighter manner (less-intensive burns) with conventional methods (more intense burns) reported little difference in efficacy but fewer adverse effects. One RCT suggested that selective laser treatment targeting only ischaemic areas was effective. Observational studies showed that the most important adverse effect of PRP was macular oedema (MO), which can cause visual impairment, usually temporary. Ten trials of laser and anti-VEGF or steroid drug combinations were consistent in reporting a reduction in risk of PRP-induced MO.

LIMITATION: The current evidence is insufficient to recommend PRP for severe NPDR.

CONCLUSIONS: There is, as yet, no convincing evidence that modern laser systems are more effective than the argon laser used in ETDRS, but they appear to have fewer adverse effects. We recommend a trial of PRP for severe NPDR and early PDR compared with deferring PRP till the HR-PDR stage. The trial would use modern laser technologies, and investigate the value adjuvant prophylactic anti-VEGF or steroid drugs.

STUDY REGISTRATION: This study is registered as PROSPERO CRD42013005408.

FUNDING: The National Institute for Health Research Health Technology Assessment programme.

51 Pegasi - a planet-bearing Maunder minimum candidate

We observed 51 Peg, the first detected planet-bearing star, in a 55 ks XMM-Newton pointing and in 5 ks pointings each with Chandra HRC-I and ACIS-S. The star has a very low count rate in the XMM observation, but is clearly visible in the Chandra images due to the detectors' different sensitivity at low X-ray energies. This allows a temperature estimate for 51 Peg's corona of T⪉ 1 MK; the detected ACIS-S photons can be plausibly explained by emission lines of a very cool plasma near 200 eV. The constantly low X-ray surface flux and the flat-activity profile seen in optical Ca II data suggest that 51 Peg is a Maunder minimum star; an activity enhancement due to a Hot Jupiter, as proposed by recent studies, seems to be absent. The star's X-ray fluxes in different instruments are consistent with the exception of the HRC Imager, which might have a larger effective area below 200 eV than given in the calibration.

Compte rendu: Johann Wolfgang Unger (2013), The Discursive Construction of the Scots Language : Education, Politics and Everyday Life, Amsterdam, John Benjamins, coll. « Discourse Approaches to Politics, Society and Culture, 51 », 178 p. [ISBN : 978-9-027-20642-8]

Résumé non disponible

Unesp Ciência, 2014, ano 5, número 51

Revista elaborada pela Assessoria de Comunicação e Imprensa da Reitoria da UNESP

M. Tullius Cicero, Academica priora (1-13), De natura Deorum (13-46v), De fato (46v-50v), Epistolae ad familiares I-VIII, 8, 6 (51-91v). - Dares Phrygius, De excidio Troiae historia (92-97v).

Ce ms. forme un recueil de deux groupes de textes différents (Cicéron, ff. 1-91v et Darès, ff. 92-97v), mais contemporains et homogènes. Chacun possède son propre système de signatures.

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 47 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 50 et annexes / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1

Archives parlementaires de 1787 à 1860 ; 34-51. Assemblée nationale législative. Série 1 / Tome 44 / impr. par ordre du Sénat et de la Chambre des députés ; sous la dir. de M. J. Mavidal,... et de M. E. Laurent,... ; avec la collab. de MM. E. Tonnier et C. Pionnier

Collection : Les archives de la Révolution française ; 3.1