91 resultados para SIDS


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The importance of science and technology (S&T) in Small Island Developing States (SIDS) is clearly articulated in Chapter XI, paragraphs 57, 58, 61 and 62 of the Mauritius Strategy for the Further Implementation of the Programme of Action for Sustainable Development of Small Island Developing States (MSI). At the regional level, the Heads of Government of the Caribbean Community (CARICOM) noted the challenge that CARICOM member States face in competing in this new international economic environment in which the impact of scientific and technological change has created a knowledge-based global economy. Given the importance of S&T to development of Caribbean SIDS, the Economic Commission for Latin America and the Caribbean (ECLAC) Subregional Headquarters for the Caribbean embarked on a study to determine the causes and consequences of low rates of specialisation in S&T with a view to making recommendations for development of strategies for addressing these challenges. Data on postgraduate (Master of Science, Master of Philosophy and Doctor of Philosophy) enrolment and graduation in agriculture, engineering and the sciences from the three campuses of the University of the West Indies (UWI) as well as from the University of Technology in Jamaica and the University of Trinidad and Tobago (UTT) were examined and analysed. Face-to-face interviews were also held with key personnel from these institutions and a questionnaire was also served to individuals in key institutions. Results of the study revealed that although the number of students enrolled in higher degree programmes has increased in absolute terms, they are decreasing in relative terms. However, enrolment in agriculture has indeed declined while enrolment rates in engineering, although increasing, were not significantly high. Market forces have proved to be a main reason for this trend while facilities for the conduct and supervision of cutting-edge research, the disconnect between science and industry and societal labelling of scientists as “misfits” are also contributing to the situation. This has resulted in a reduced desire by students at all levels of the school system and faculty to be involved in S&T; lack of innovation; a better staffed private, as compared with public, sector; and poor remuneration in science-based employment. There also appears to be a gender bias in enrolment with more males than females being enrolled in engineering while the opposite is apparent in agriculture and the sciences. Recommendations for remedying this situation range from increasing investment in S&T, creating linkages between science and industry as well as with the international community, raising awareness of the value of S&T at all levels of the education system to informing policy to stimulate the science – innovation interface so as to promote intellectual property rights.

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The Caribbean sub-regional synthesis report, covering 12 countries, assesses progress towards the gender equality goals articulated in the 1995 World Conference on Women, which produced the Beijing Platform for Action (BPfA). The process leading to the preparation of the report has involved a series of national, regional and global consultations that will culminate in the Beijing + 20 Review. The process has also led to the formulation of the Caribbean Joint Statement on Gender Equality and the Post-2015, as well as the SIDS Agenda, both of which express Caribbean perspectives and expectations regarding gender equality.

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This paper will contend that the post-2015 development agenda presents a major opportunity for Caribbean countries to reverse decades of lagging economic performance and make the transition to balanced, holistic, and people-centred growth and development. The MDGs, while valuable in promoting gains in poverty reduction, health, education, nutrition, and maternal well-being were not tailored to the growth and development needs of the region. This can now be changed by a post-2015 development agenda which goes beyond improving the welfare of citizens by meeting basic needs and enhancing access to primary services. The necessary scaling-up of the MDG framework will require that the sustainable development goals, which will anchor the post- 2015 development agenda, are capable of promoting structural change, competitiveness and output gains while advancing social development and meeting environmental concerns. They must also address the unfinished business of the millennium development goals, primarily in the area of human development.

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The post-mortem use of modern imaging techniques such as multislice computed tomography (MSCT) is becoming increasingly important as an aid for conventional autopsy. This article presents a case of a 4-month-old boy who died from sudden infant death syndrome (SIDS) with intravascular gas after an intraosseus medication application documented by post-mortem MSCT. It is most likely that the gas entered the body during resuscitation. This case emphasises the advantage of post-mortem imaging as a complementary aid for the autopsy. We conclude that during emergency treatment, the medical staff should be aware of the possibility of causing a gas embolism following intraosseus medication. Resuscitation with an inserted, disconnected intraosseous needle should be avoided.

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The SNTA1-encoded α1-syntrophin (SNTA1) missense mutation, p.A257G, causes long QT syndrome (LQTS) by pathogenic accentuation of Nav1.5's sodium current (I Na). Subsequently, we found p.A257G in combination with the SNTA1 polymorphism, p.P74L in 4 victims of sudden infant death syndrome (SIDS) as well as in 3 adult controls. We hypothesized that p.P74L-SNTA1 could functionally modify the pathogenic phenotype of p.A257G-SNTA1, thus explaining its occurrence in non-LQTS populations. The SNTA1 variants p.P74L, p.A257G, and the combination variant p.P74L/p.A257G were engineered using PCR-based overlap-extension and were co-expressed heterologously with SCN5A in HEK293 cells. I Na was recorded using the whole-cell method. Compared to wild-type (WT), the significant increase in peak I Na and window current found with p.A257G was reversed by the intragenic variant p.P74L (p.P74L/p.A257G). These results report for the first time the intragenic rescue of an LQT-associated SNTA1 mutation when found in combination with the SNTA1 polymorphism p.P74L, suggesting an ever-increasing picture of complexity in terms of genetic risk stratification for arrhythmia.

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BACKGROUND Approximately 10% of sudden infant death syndrome (SIDS) may stem from cardiac channelopathies. The KCNJ8-encoded Kir6.1 (K(ATP)) channel critically regulates vascular tone and cardiac adaptive response to systemic metabolic stressors, including sepsis. KCNJ8-deficient mice are prone to premature sudden death, particularly with infection. We determined the spectrum, prevalence, and function of KCNJ8 mutations in a large SIDS cohort. METHODS AND RESULTS Using polymerase chain reaction, denaturing high-performance liquid chromatography, and DNA sequencing, comprehensive open reading frame/splice-site mutational analysis of KCNJ8 was performed on genomic DNA isolated from necropsy tissue on 292 unrelated SIDS cases (178 males, 204 white; age, 2.9±1.9 months). KCNJ8 mutations were coexpressed heterologously with SUR2A in COS-1 cells and characterized using whole-cell patch-clamp. Two novel KCNJ8 mutations were identified. A 5-month-old white male had an in-frame deletion (E332del) and a 2-month-old black female had a missense mutation (V346I). Both mutations localized to Kir6.1's C-terminus, involved conserved residues and were absent in 400 and 200 ethnic-matched reference alleles respectively. Both cases were negative for mutations in established channelopathic genes. Compared with WT, the pinacidil-activated K(ATP) current was decreased 45% to 68% for Kir6.1-E332del and 40% to 57% for V346I between -20 mV and 40 mV. CONCLUSIONS Molecular and functional evidence implicated loss-of-function KCNJ8 mutations as a novel pathogenic mechanism in SIDS, possibly by predisposition of a maladaptive cardiac response to systemic metabolic stressors akin to the mouse models of KCNJ8 deficiency.

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BACKGROUND Approximately 10% of sudden infant death syndrome (SIDS) cases may stem from potentially lethal cardiac channelopathies, with approximately half of channelopathic SIDS involving the Na(V)1.5 cardiac sodium channel. Recently, Na(V) beta subunits have been implicated in various cardiac arrhythmias. Thus, the 4 genes encoding Na(V) beta subunits represent plausible candidate genes for SIDS. OBJECTIVE This study sought to determine the spectrum, prevalence, and functional consequences of sodium channel beta-subunit mutations in a SIDS cohort. METHODS In this institutional review board-approved study, mutational analysis of the 4 beta-subunit genes, SCN1B to 4B, was performed using polymerase chain reaction, denaturing high-performance liquid chromatography, and direct DNA sequencing of DNA derived from 292 SIDS cases. Engineered mutations were coexpressed with SCN5A in HEK 293 cells and were whole-cell patch clamped. One of the putative SIDS-associated mutations was similarly studied in adenovirally transduced adult rat ventricular myocytes. RESULTS Three rare (absent in 200 to 800 reference alleles) missense mutations (beta3-V36M, beta3-V54G, and beta4-S206L) were identified in 3 of 292 SIDS cases. Compared with SCN5A+beta3-WT, beta3-V36M significantly decreased peak I(Na) and increased late I(Na), whereas beta3-V54G resulted in a marked loss of function. beta4-S206L accentuated late I(Na) and positively shifted the midpoint of inactivation compared with SCN5A+beta4-WT. In native cardiomyocytes, beta4-S206L accentuated late I(Na) and increased the ventricular action potential duration compared with beta4-WT. CONCLUSION This study provides the first molecular and functional evidence to implicate the Na(V) beta subunits in SIDS pathogenesis. Altered Na(V)1.5 sodium channel function due to beta-subunit mutations may account for the molecular pathogenic mechanism underlying approximately 1% of SIDS cases.

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BACKGROUND Sudden infant death syndrome (SIDS) is a leading cause of death during the first 6 months after birth. About 5% to 10% of SIDS may stem from cardiac channelopathies such as long-QT syndrome. We recently implicated mutations in alpha1-syntrophin (SNTA1) as a novel cause of long-QT syndrome, whereby mutant SNTA1 released inhibition of associated neuronal nitric oxide synthase by the plasma membrane Ca-ATPase PMCA4b, causing increased peak and late sodium current (I(Na)) via S-nitrosylation of the cardiac sodium channel. This study determined the prevalence and functional properties of SIDS-associated SNTA1 mutations. METHODS AND RESULTS Using polymerase chain reaction, denaturing high-performance liquid chromatography, and DNA sequencing of SNTA1's open reading frame, 6 rare (absent in 800 reference alleles) missense mutations (G54R, P56S, T262P, S287R, T372M, and G460S) were identified in 8 (approximately 3%) of 292 SIDS cases. These mutations were engineered using polymerase chain reaction-based overlap extension and were coexpressed heterologously with SCN5A, neuronal nitric oxide synthase, and PMCA4b in HEK293 cells. I(Na) was recorded using the whole-cell method. A significant 1.4- to 1.5-fold increase in peak I(Na) and 2.3- to 2.7-fold increase in late I(Na) compared with controls was evident for S287R-, T372M-, and G460S-SNTA1 and was reversed by a neuronal nitric oxide synthase inhibitor. These 3 mutations also caused a significant depolarizing shift in channel inactivation, thereby increasing the overlap of the activation and inactivation curves to increase window current. CONCLUSIONS Abnormal biophysical phenotypes implicate mutations in SNTA1 as a novel pathogenic mechanism for the subset of channelopathic SIDS. Functional studies are essential to distinguish pathogenic perturbations in channel interacting proteins such as alpha1-syntrophin from similarly rare but innocuous ones.

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Objective: To perform a systematic review of the literature on SIDS and SUID deaths concentrated in the African-American community, describe health education and policy recommendations and recommend a new approach that may aid in decreasing the disparity of infant mortality in the African-American community. ^ Methods: The PubMed database was systematically searched to identify relevant articles for final review and analysis. Using the CASP 2006 system to critique literature, twelve articles were found that met inclusion and exclusion criteria. ^ Results: Evidence in the literature confirmed there was a current disparity among African Americans' infant mortality rates in comparison to other US ethnic groups. The underlying reasons for these disparities included the following maternal and infant characteristics: mothers younger than eighteen, having more than one live infant, having a high school education or less, never been married, and have infants born preterm or with low birth weight. Maternal smoking, substance abuse, and breastfeeding did not have a significant impact on infant sleep environments among African Americans. ^ Conclusion: Tailored health education programs at the community level, better access to pre-pregnancy and prenatal care, and increased maternal perception of risk that is relevant to the infants sleeping environment are all possible solutions that may decrease African American infant mortality rates.^

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Este proyecto consiste en el diseño y construcción de un sintetizador basado en el chip 6581 Sound Interface Device (SID). Este chip era el encargado de la generación de sonido en el Commodore 64, ordenador personal comercializado en 1982, y fue el primer sintetizador complejo construido para ordenador. El chip en cuestión es un sintetizador de tres voces, cada una de ellas capaz de generar cuatro diferentes formas de onda. Cada voz tiene control independiente de varios parámetros, permitiendo una relativamente amplia variedad de sonidos y efectos, muy útil para su uso en videojuegos. Además está dotado de un filtro programable para conseguir distintos timbres mediante síntesis sustractiva. El sintetizador se ha construido sobre Arduino, una plataforma de electrónica abierta concebida para la creación de prototipos, consistente en una placa de circuito impreso con un microcontrolador, programable desde un PC para que realice múltiples funciones (desde encender LEDs hasta controlar servomecanismos en robótica, procesado y transmisión de datos, etc.). El sintetizador es controlable vía MIDI, por ejemplo, desde un teclado de piano. A través de MIDI recibe información tal como qué notas debe tocar, o los valores de los parámetros del SID que modifican las propiedades del sonido. Además, toda esa información también la puede recibir de un PC mediante una conexión USB. Se han construido dos versiones del sintetizador: una versión “hardware”, que utiliza el SID para la generación de sonido, y otra “software”, que reemplaza el SID por un emulador, es decir, un programa que se comporta (en la medida de lo posible) de la misma manera que el SID. El emulador se ha implementado en un microcontrolador Atmega 168 de Atmel, el mismo que utiliza Arduino. ABSTRACT. This project consists on design and construction of a synthesizer which is based on chip 6581 Sound Interface Device (SID). This chip was used for sound generation on the Commodore 64, a home computer presented in 1982, and it was the first complex synthesizer built for computers. The chip is a three-voice synthesizer, each voice capable of generating four different waveforms. Each voice has independent control of several parameters, allowing a relatively wide variety of sounds and effects, very useful for its use on videogames. It also includes a programmable filter, allowing more timbre control via subtractive synthesis. The synthesizer has been built on Arduino, an open-source electronics prototyping platform that consists on a printed circuit board with a microcontroller, which is programmable with a computer to do several functions (lighting LEDs, controlling servomechanisms on robotics, data processing or transmission, etc.). The synthesizer is controlled via MIDI, in example, from a piano-type keyboard. It receives from MIDI information such as the notes that should be played or SID’s parameter values that modify the sound. It also can receive that information from a PC via USB connection. Two versions of the synthesizer have been built: a hardware one that uses the SID chip for sound generation, and a software one that replaces SID by an emulator, it is, a program that behaves (as far as possible) in the same way the SID would. The emulator is implemented on an Atmel’s Atmega 168 microcontroller, the same one that is used on Arduino.

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ECLAC advocates that the Caribbean’s high debt dilemma was not principally driven by policy missteps, or the international financial crisis. Rather, it finds its roots in external shocks, compounded by the inherent structural weaknesses and vulnerabilities confronting Caribbean SIDS and their limited capacity to respond. A major factor has been the underperformance of the export sector, partly due to a decline in competitiveness and a slowdown in economic activity especially among the tourism-dependent economies. Caribbean countries have also accumulated debt as a consequence of increased expenditures to address the impact of extreme events and climate change attendant difficulties. Most Caribbean countries are located in the hurricane belt and are also prone to earthquakes and other hazards. Indeed, a disaster resulting in damage and losses in excess of 5 per cent of GDP can be expected to hit any Caribbean country every few years. Moreover, over the period 2000-2014, it is estimated that the economic cost of natural disasters in Caribbean countries was in excess of US$30.7 billion. The English Speaking Caribbean countries are extremely vulnerable to natural disasters.

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Provocative advertising is characterized by a deliberate attempt to gain attention through shock. This research investigates the reactions of individuals to a provocative appeal for a cause as opposed to a provocative advertisement for a standard consumer product, using mild erotica as the element of provocative imagery. An experiment using 391 adult subjects was conducted, and two analyses were performed. The first examined the effect of stimulus type (mildly erotic/nonerotic) by product category (cause appeal/consumer product) on attitude to the ad. The second examined the effect of stimulus type (mildly erotic/nonerotic) by cause (AIDS [acquired immunodeficiency syndrome]/SIDS [sudden infant death syndrome]) on corporate image. Both analyses also included gender as a third independent variable. The results suggest that people prefer mildly erotic ads generally, that an organization using mild erotica in appeals for a cause will be viewed more favorably where the erotica is congruent with the cause, and that women may be more responsive to mild erotica in cause appeals than are men.

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This work has, as its objective, the development of non-invasive and low-cost systems for monitoring and automatic diagnosing specific neonatal diseases by means of the analysis of suitable video signals. We focus on monitoring infants potentially at risk of diseases characterized by the presence or absence of rhythmic movements of one or more body parts. Seizures and respiratory diseases are specifically considered, but the approach is general. Seizures are defined as sudden neurological and behavioural alterations. They are age-dependent phenomena and the most common sign of central nervous system dysfunction. Neonatal seizures have onset within the 28th day of life in newborns at term and within the 44th week of conceptional age in preterm infants. Their main causes are hypoxic-ischaemic encephalopathy, intracranial haemorrhage, and sepsis. Studies indicate an incidence rate of neonatal seizures of 0.2% live births, 1.1% for preterm neonates, and 1.3% for infants weighing less than 2500 g at birth. Neonatal seizures can be classified into four main categories: clonic, tonic, myoclonic, and subtle. Seizures in newborns have to be promptly and accurately recognized in order to establish timely treatments that could avoid an increase of the underlying brain damage. Respiratory diseases related to the occurrence of apnoea episodes may be caused by cerebrovascular events. Among the wide range of causes of apnoea, besides seizures, a relevant one is Congenital Central Hypoventilation Syndrome (CCHS) \cite{Healy}. With a reported prevalence of 1 in 200,000 live births, CCHS, formerly known as Ondine's curse, is a rare life-threatening disorder characterized by a failure of the automatic control of breathing, caused by mutations in a gene classified as PHOX2B. CCHS manifests itself, in the neonatal period, with episodes of cyanosis or apnoea, especially during quiet sleep. The reported mortality rates range from 8% to 38% of newborn with genetically confirmed CCHS. Nowadays, CCHS is considered a disorder of autonomic regulation, with related risk of sudden infant death syndrome (SIDS). Currently, the standard method of diagnosis, for both diseases, is based on polysomnography, a set of sensors such as ElectroEncephaloGram (EEG) sensors, ElectroMyoGraphy (EMG) sensors, ElectroCardioGraphy (ECG) sensors, elastic belt sensors, pulse-oximeter and nasal flow-meters. This monitoring system is very expensive, time-consuming, moderately invasive and requires particularly skilled medical personnel, not always available in a Neonatal Intensive Care Unit (NICU). Therefore, automatic, real-time and non-invasive monitoring equipments able to reliably recognize these diseases would be of significant value in the NICU. A very appealing monitoring tool to automatically detect neonatal seizures or breathing disorders may be based on acquiring, through a network of sensors, e.g., a set of video cameras, the movements of the newborn's body (e.g., limbs, chest) and properly processing the relevant signals. An automatic multi-sensor system could be used to permanently monitor every patient in the NICU or specific patients at home. Furthermore, a wire-free technique may be more user-friendly and highly desirable when used with infants, in particular with newborns. This work has focused on a reliable method to estimate the periodicity in pathological movements based on the use of the Maximum Likelihood (ML) criterion. In particular, average differential luminance signals from multiple Red, Green and Blue (RGB) cameras or depth-sensor devices are extracted and the presence or absence of a significant periodicity is analysed in order to detect possible pathological conditions. The efficacy of this monitoring system has been measured on the basis of video recordings provided by the Department of Neurosciences of the University of Parma. Concerning clonic seizures, a kinematic analysis was performed to establish a relationship between neonatal seizures and human inborn pattern of quadrupedal locomotion. Moreover, we have decided to realize simulators able to replicate the symptomatic movements characteristic of the diseases under consideration. The reasons is, essentially, the opportunity to have, at any time, a 'subject' on which to test the continuously evolving detection algorithms. Finally, we have developed a smartphone App, called 'Smartphone based contactless epilepsy detector' (SmartCED), able to detect neonatal clonic seizures and warn the user about the occurrence in real-time.

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This paper examines the efficiency of public sector expenditures and foreign aid at achieving social sector outcomes in Small Island Developing States (SIDS). Efficiency is estimated using a Stochastic Production Function (SPF) approach and panel data since 1990. A second stage of the analysis examines the determinants of efficiency. Results indicate that the efficiency of aid and public sectors at improving life expectancy has deteriorated during the 1990s but efficiency at improving school enrolments has increased. Higher levels of governance are associated with higher efficiency. There is also evidence to suggest that efficiency is lower in SIDS, as well as in Sub-Saharan Africa.