Gordonspivey7007
Children with Down syndrome are at risk for feeding difficulties due to medical comorbidities and associated developmental delays, yet there are no peer-reviewed published standards to guide families with feeding progression. This study explored family experiences introducing complementary foods (e.g., purees, table food) for children with Down syndrome. A secondary aim was to describe primary care provider (PCP) training on early progression of feeding for children with Down syndrome and investigate the recommendations they gave families.
Semi-structured interviews with twenty-two parents and eight primary care providers (PCPs) were conducted. Descriptive statistics were used to characterize the sample and to report on findings related to feeding milestones. Qualitative interview data were considered in an iterative and cyclical fashion.
Parental themes included differences in feeding for children with Down syndrome, limited guidance that was not always followed, feeding difficulties and related stress, and gross motor milestone acquisition related to feeding milestones. PCP themes included limited resources/training, providing similar recommendations for children with and without Down syndrome, and desire for training/resources.
Published guidelines on feeding progression for children with Down syndrome are needed, including considerations for determining when skill and interest converge to signal safe introduction of complementary foods.
Published guidelines on feeding progression for children with Down syndrome are needed, including considerations for determining when skill and interest converge to signal safe introduction of complementary foods.
To compare Netra smartphone-based and automated refraction with subjective refraction for screening of refractive errors.
Cross-sectional study at the University of Malaya Medical Centre, Kuala Lumpur. Subjects underwent subjective refraction, then automated refraction, and finally Netra smartphone-based refraction. All results were converted to power vectors (M, J0 and J45) and were analysed using repeated-measures ANOVA and Bland-Altman plots. Sensitivity and specificity were determined. The best cut-off points were determined from ROC curve analysis.
<.05 was considered statistically significant.
Data from the right eyes of 204 subjects were analysed. Mean age was 36.6±15.7years (range 16-78years). Spherical equivalent [mean (95% CI)] from Netra and automated refraction were similar, and both more myopic than subjective refraction; -2.87 (-3.23 to -2.51), -2.85 (-3.21 to -2.49) and -2.46 (-2.83 to -2.10) respectively (
<.001). Differences in J0 and J45 between Netra and subjective refraction were not statistically significant (0.10 vs 0.11 and 0.01 vs -0.02 respectively, both
>.05), but those between automated and subjective refraction were (0.06 vs 0.11 and 0.07 vs -0.02,
=.004 and
<.001 respectively). Bland Altman plots showed the 95% limits of agreement with Netra refraction were wider than with automated refraction (-2.21D to 1.42D vs. -1.90D to 1.16D respectively).
Netra smartphone-based refraction gives similar readings to automated refraction, and both show myopic overestimation when compared to subjective refraction. However, due to non-insignificant practical usage issues, its use as a screening tool for refractive errors is limited.
Netra smartphone-based refraction gives similar readings to automated refraction, and both show myopic overestimation when compared to subjective refraction. However, due to non-insignificant practical usage issues, its use as a screening tool for refractive errors is limited.
There is no authorized treatment for ataxia telangiectasia (AT). As cerebellar symptoms of storage diseases were improved by acetyl-DL-leucine (ADLL), the authors hypothesized a symptomatic and disease-modifying effect in AT upon supplementation with ADLL.
Six patients were treated with ADLL 3 g/day for 1 week followed by 5g/day for 3 weeks to 1 year. Cerebellar ataxia was evaluated by validated scales. Gaze-holding, saccades and smooth pursuit were examined by video-oculography. Measurements took place at baseline, at 1 month of therapy in 5 patients, and after 6 and 12 months in 1 patient.
The Scale for Assessment and Rating of Ataxia changed from the baseline, mean, (SD, min-max) of 22.1 (5.88, 11-28.5) to 18 points (5.39, 8.5-23.5) after 1 month on medication (
= .0028). All patients demonstrated gaze-holding deficits; 3 patients had central-position downbeat-nystagmus. Mean slow-phase velocity of this nystagmus with the gaze straight-ahead changed from 5.57°/s (1.8, 3.53-6.99) to 4.7°/s (0.79, 3.97-5.56) after 1 month on treatment (1.35, -2.56-4.17) (
= .046).
ADLL may improve ataxia and ocular stability in AT patients, while the molecular basis still remains to be elucidated. A multicentric, rater-blinded, phase II trial currently investigates the effects of acetyl-L-leucine in AT (NCT03759678).
ADLL may improve ataxia and ocular stability in AT patients, while the molecular basis still remains to be elucidated. A multicentric, rater-blinded, phase II trial currently investigates the effects of acetyl-L-leucine in AT (NCT03759678).
Considering the limitations of conventional risperidone (RSP) therapies, the present research characterizes the usefulness of multivesicular liposomes (MVLs) as an efficient controlled-release carrier for this widely used antipsychotic drug, to be employed for the treatment of schizophrenia.
A 2
full factorial design based on three independent variables was implemented to plan the experiments the molar ratios of lipid to the drug, triolein to phospholipid, and cholesterol to phospholipid. The impacts of these parameters on the risperidone encapsulation efficiency and its release pattern within the first 24 and 48 h were investigated as dependent variables. Then, the optimized liposomal system was further in-depth analyzed in terms of size, morphological and structural features, release profile over 15 days, biocompatibility, and stability.
Optimized formulation parameters gave rise to MVLs possessing a spherical morphology with a median diameter of about 8 μm, a relatively narrow size distribution (span value of 1.49), and an encapsulation efficiency of 57.6%. These carriers not only exhibited a sustained-release behavior
, lasting until the end of the 15 days but also underwent a negligible change in their size and RSP incorporation over two months at refrigerator condition. Furthermore,
cytotoxicity and hemolysis assessments revealed that the optimized MVL formulation is biocompatible.
This study revealed the potential of MVLs as a promising system for the delivery of RSP and could open a new vista for the successful management of schizophrenia.
This study revealed the potential of MVLs as a promising system for the delivery of RSP and could open a new vista for the successful management of schizophrenia.The molecular mechanism underlying modulation of metamorphosis of the bivalve Mytilus coruscus by bacteria remains unclear. Here, the functional role of the thioesterase gene tesA of the bacterium Pseudoalteromonas marina in larval metamorphosis was examined. The aim was to determine whether inactivation of the tesA gene altered the biofilm-inducing capacity, bacterial cell motility, biopolymers, or the intracellular c-di-GMP levels. Complete inactivation of tesA increased the c-di-GMP content in P. marina, accompanied by a reduced fatty acid content, weaker motility, upregulation of bacterial aggregation, and biofilm formation. The metamorphosis rate of mussel larvae on ΔtesA biofilms was reduced by ∼ 80% compared with those settling on wild-type P. marina. Exogenous addition of a mixture of extracted fatty acids from P. marina into the ΔtesA biofilms promoted the biofilm-inducing capacity. This study suggests that the bacterial thioesterase gene tesA altered the fatty acid composition of ΔtesA P. marina biofilms (BF) through regulation of its c-di-GMP, subsequently impacting mussel metamorphosis.
Recent observations showed that systemic immune changes are detectable in case of breast cancer (BC). In this preliminary study, we investigated routinely measured peripheral blood (PB) parameters for malignant BC cases in comparison to benign breast conditions. Complete blood count, circulating lymphoid subpopulation, and serological carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels were considered.
A total of 127 female patients affected by malignant (n = 77, mean age = 63years, min = 36, max = 90) BC at diagnosis (naïve patients) or benign breast conditions (n = 50, mean age = 33years, min = 18, max = 60) were included in this study. For each patient, complete blood count and lymphoid subpopulations (T-helper, T-cytotoxic, B-, NK-, and NKT-cells) analysis on PB samples were performed. Hormonal receptor status, Ki-67 expression, and serological CEA and CA15-3 levels were assessed in the case of patients with malignant BC via statistical analysis.
Women with malignant BC disclosed unophenotyping technologies, will provide additional insights for describing the relationship between tumor onset and peripheral alterations.
This preliminary study confirms the ability of malignant BC to determine systemic modifications. The stratification of malignant BC cases according to the Ki-67 proliferation marker highlighted increasing detectable alterations in the periphery of women with aggressive BC. The advent of novel and more sensitive biomarkers, as well as deep immunophenotyping technologies, will provide additional insights for describing the relationship between tumor onset and peripheral alterations.The Society of Toxicologic Pathology's Annual Virtual Symposium (2021) included a session on "Regulatory Perspectives on Juvenile Animal Toxicologic Pathology." The following narrative summarizes the key concepts from the four talks included in this symposium session chaired by Drs Deepa Rao and Alan Hoberman. These encompass an overview of various global regulations impacting the conduct of juvenile animal studies in pharmaceutical drug development and chemical toxicity assessments in a talk by Dr Alan Hoberman. Given the numerous regulatory guidances and legal statutes that have covered the conduct of juvenile animal studies and the recent harmonization of these guidances for pharmaceuticals, Dr Paul Brown provided an update on the harmonization of these guidances for pharmaceuticals, in the recently finalized version of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use S11 guidance document, "Nonclinical Safety Testing in Support of Development of Pediatric Medicines." The first two talks on regulations were followed by two talks focused on an evaluation of the postnatal development of two major organ systems relevant in juvenile animals. Dr Aurore Varela covered study design and endpoints impacting the skeletal system (bone), while Dr Brad Bolon presented a talk on the study design and conduct of neuropathology evaluations for the developing nervous system.
The infrafloccular approach in microvascular decompression (MVD) surgery for hemifacial spasm (HFS) was investigated for the prevention of hearing complications.
Retrospective analysis of 136 patients who underwent MVD for HFS in 2019. The infrafloccular approach for MVD was adopted to resolve the symptom and protect hearing function. Postoperative hearing function was evaluated subjectively and objectively within 30 postoperative days, and later mainly subjectively. Odanacatib order Postoperative condition of mastoid air cells based on the CT scan of the following day was also recorded.
No final postoperative subjective hearing impairment was found in all patients. Mastoid air cells were opened in 105 patients, and subjective hearing impairment was recorded in 57 patients within 30 postoperative days, but all improved later. Increases in thresholds of greater than 10 dB in air conduction were observed in 28 patients, including 26 of transient conductive hearing loss (increases in the threshold of less than or equal to 10 dB).
