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Background Although single-incision endoscopic splenectomy (SIES-Sp) has been shown to be feasible and safe, few have compared the SIES-Sp with multiport laparoscopic splenectomy (MPLS). The purpose of this study was to compare the two techniques in children undergoing total splenectomy. Materials and Methods We reviewed all children (age  .99). Severe complications included cardiac arrest in 1 SIES-Sp patient and bleeding requiring reoperation in 1 MPLS patient. Conclusion SIES-Sp is a safe alternative to the traditional MPLS for children. Additional procedures do not preclude a less invasive approach, but larger spleens may present a challenge.Rapid and seemingly effortless word recognition is a virtually unquestioned characteristic of skilled reading, yet the definition and operationalization of the concept of cognitive effort have proven elusive. We investigated the cognitive effort involved in oral and silent word reading using pupillometry among adults (Experiment 1, N = 30; Experiment 2, N = 20) and fourth through sixth graders (Experiment 3, N = 30; Experiment 4, N = 18). We compared multiple pupillary measures (mean, peak, and peak latency) for reading familiar words (real words) and unfamiliar letter strings (pseudowords) varying in length. Converging with the behavioral data for accuracy and response times, pupillary responses demonstrated a greater degree of cognitive effort for pseudowords compared with real words and stronger length effects for pseudowords than for real words. These findings open up new possibilities for studying the issue of effort and effortlessness in the field of word recognition and other fields of skill learning.Cardiovascular disease (CVD), including hypertensive disorders of pregnancy (HDP) and peripartum cardiomyopathy, is a leading cause of pregnancy-related death in the United States. Women who are African American or American Indian/Alaskan Native, have HDP, are medically underserved, are older, or are obese have a major risk for the onset and/or progression of CVD during and after pregnancy. [https://www.selleckchem.com/products/ZLN005.html ZLN005 research buy] Paradoxically, women with no preexisting chronic conditions or risk factors also experience significant pregnancy-related cardiovascular (CV) complications. The question remains whether substantial physiologic stress on the CV system during pregnancy reflected in hemodynamic, hematological, and metabolic changes uncovers subclinical prepregnancy CVD in these otherwise healthy women. Equally important and similarly understudied is the concept that women's long-term CV health could be detrimentally affected by adverse pregnancy outcomes, such as preeclampsia, gestational hypertension, and diabetes, and preterm birth. Thus, a critical life span perspective in the assessment of women's CV risk factors is needed to help women and health care providers recognize and appreciate not only optimal CV health but also risk factors present before, during, and after pregnancy. In this review article, we highlight new advancements in understanding adverse, pregnancy-related CV conditions and will discuss promising strategies or interventions for their prevention, diagnosis, and treatment.Purpose This exploratory study describes the emergent literacy skills of children with developmental language disorder (DLD) who speak Spanish, a language with a simple phonological structure and transparent orthography. We examine differences between children with DLD and their typically developing (TD) peers on a battery of emergent literacy measures. Method Participants included 15 monolingual Spanish-speaking children with DLD (who did not present with cognitive difficulties) and 15 TD controls matched for age, gender, and socioeconomic status, ranging in age from 3;10 to 6;6 (years;months; Mage = 4;11). All children completed a battery of comprehension-related emergent literacy tasks (narrative retell, print concept knowledge) and code-related emergent literacy tasks (beginning sound, rhyming awareness, alphabet knowledge, and name-writing ability). Results On average, children with DLD performed significantly worse than TD controls on a battery of comprehension- and code-related emergent literacy measures. On all code-related skills except rhyming, children with DLD were more likely than their TD peers to score "at risk." Conclusions The results suggest some universality in the effect of DLD on reading development. Difficulties with emergent literacy that are widely documented in English-speaking children with DLD were similarly observed in Spanish-speaking children with DLD. Future research should explore long-term reading outcomes in Spanish for children with DLD.Although pregnancy is rare in women with cirrhosis, it is increasingly prevalent in an era of modern assisted conception techniques and improved awareness, monitoring and management of underlying liver disease. After overcoming the difficulties of subfertility and becoming pregnant, women undergo a 'high-risk' pregnancy which can be complicated by variceal haemorrhage (≤50%) and hepatic decompensation (≤25%). Management of these complications are similar to non-pregnant individuals. However, there are a few caveats to consider. These pregnancies are associated with adverse maternal and foetal outcomes, such as mortality (0%-8%) and prematurity (19%-67%) in the newborn, and mortality (0%-14%), pregnancy-induced hypertension (5%-22%) and post-partum haemorrhage (5%-45%) in the mother. Pre-pregnancy counselling, use of predictive scores and appropriate variceal screening during pregnancy can stratify patients and improve outcomes. This review focusses on the complications that can occur during pregnancy in women with cirrhosis.Opportunistic infections are an ongoing concern in patients with autoimmune disease who are being treated with immunosuppressive agents. Nocardiosis is an uncommon opportunistic infection which has been reported in association with immunosuppressed patients and autoimmune disease. It is challenging to diagnose and can have multisystem manifestations. Failure to diagnose and appropriately treat can result in significant mortality. We present a 49 year old woman with systemic lupus erythematosus and neuromyelitis optica spectrum disorder who was treated with mycophenolate mofetil, prednisone and recent plasmapheresis. She developed acute onset of shortness of breath and fevers and was ultimately diagnosed with disseminated nocardiosis with lung, brain and muscle abscesses.