Cognitive Profiles of Reading-Disabled Children: Comparison of Language Skills in Phonology, Morphology, and Syntax

A comprehensive cognitive appraisal of elementary school children with learning disabilities showed that within the language sphere, deficits associated with reading disability are selective Phonological deficits consistently accompany reading problems whether they occur in relatively pure form or in the presence of coexisting attention deficit or arithmetic disability Although reading-disabled children were also deficient in production of morphologically related forms, this difficulty stemmed in large part from the same weakness in the phonological component that underlies reading disability In contrast, tests of syntactic knowledge did not distinguish reading-disabled children from those with other cognitive disabilities, nor from normal children after covarying for intelligence

Observation versus late reintroduction of letrozole as adjuvant endocrine therapy for hormone receptor-positive breast cancer (ANZ0501 LATER): an open-label randomised, controlled trial

BACKGROUND

Despite the effectiveness of adjuvant endocrine therapy in preventing breast cancer recurrence, breast cancer events continue at a high rate for at least 10 years after completion of therapy.

PATIENTS AND METHODS

This randomised open label phase III trial recruited postmenopausal women from 29 Australian and New Zealand sites, with hormone receptor-positive early breast cancer, who had completed ≥4 years of endocrine therapy [aromatase inhibitor (AI), tamoxifen, ovarian suppression, or sequential combination] ≥1 year prior, to oral letrozole 2.5 mg daily for 5 years, or observation. Treatment allocation was by central computerised randomisation, stratified by institution, axillary node status and prior endocrine therapy. The primary outcome was invasive breast cancer events (new invasive primary, local, regional or distant recurrence, or contralateral breast cancer), analysed by intention to treat. The secondary outcomes were disease-free survival (DFS), overall survival, and safety.

RESULTS

Between 16 May 2007 and 14 March 2012, 181 patients were randomised to letrozole and 179 to observation (median age 64.3 years). Endocrine therapy was completed at a median of 2.6 years before randomisation, and 47.5% had tumours of >2 cm and/or node positive. At 3.9 years median follow-up (interquartile range 3.1-4.8), 2 patients assigned letrozole (1.1%) and 17 patients assigned observation (9.5%) had experienced an invasive breast cancer event (difference 8.4%, 95% confidence interval 3.8% to 13.0%, log-rank test P = 0.0004). Twenty-four patients (13.4%) in the observation and 14 (7.7%) in the letrozole arm experienced a DFS event (log-rank P = 0.067). Adverse events linked to oestrogen depletion, but not serious adverse events, were more common with letrozole.

CONCLUSION

These results should be considered exploratory, but lend weight to emerging data supporting longer duration endocrine therapy for hormone receptor-positive breast cancer, and offer insight into reintroduction of AI therapy.

CLINICAL TRIALS NUMBER

Australian New Zealand Clinical Trials Registry (www.anzctr.org.au), ACTRN12607000137493.

Sexual networks and social capital: multiple and concurrent sexual partnerships as a rational response to unstable social networks

Multiple and concurrent sexual partnerships (MCP) are prevalent in southern Africa and have been identified as a primary cause of high HIV prevalence in this region. Sexual liaisons with multiple partners serve to increase the size and diversity of an individual's sexual-and social-network and therefore to increase their social capital. This maximisation of social capital may minimise the risk to relationship(s) at the cost of maximising the biological risk of HIV infection. Many sexually active individuals appear to neglect their biological risk of HIV infection in order to maximise their 'social capital.' This would seem to be irrational from the perspective of any individual actor, but on a larger social scale, this may give individuals better access to some social and economic goods. The article argues that people who are in unstable and less-connected parts of the sexual network are those most active in building their sexual networks, even where they are not especially promiscuous. However, such strategies may increase exposure to HIV infection in particular populations, such as intravenous drug users, sex workers, and men having sex with men, as well as in the general population of heterosexual southern Africans. What these high HIV-prevalence populations have in common is their participation in sexual-social networks in which individuals try to maximise their social capital by extending the diversity and density of their sexual networks. The discussion shifts analytic attention away from the notion of higher-risk sexual practices of individuals towards consideration for the structure and dynamics of social and sexual networks at a societal level.

Evidence of lensing of the cosmic microwave background by dark matter halos

We present evidence of the gravitational lensing of the cosmic microwave background by 10(13) solar mass dark matter halos. Lensing convergence maps from the Atacama Cosmology Telescope Polarimeter (ACTPol) are stacked at the positions of around 12 000 optically selected CMASS galaxies from the SDSS-III/BOSS survey. The mean lensing signal is consistent with simulated dark matter halo profiles and is favored over a null signal at 3.2σ significance. This result demonstrates the potential of microwave background lensing to probe the dark matter distribution in galaxy group and galaxy cluster halos.

Large-aperture wide-bandwidth antireflection-coated silicon lenses for millimeter wavelengths

The increasing scale of cryogenic detector arrays for submillimeter and millimeter wavelength astrophysics has led to the need for large aperture, high index of refraction, low loss, cryogenic refracting optics. Silicon with n=3.4, low loss, and high thermal conductivity is a nearly optimal material for these purposes but requires an antireflection (AR) coating with broad bandwidth, low loss, low reflectance, and a matched coefficient of thermal expansion. We present an AR coating for curved silicon optics comprised of subwavelength features cut into the lens surface with a custom three-axis silicon dicing saw. These features constitute a metamaterial that behaves as a simple dielectric coating. We have fabricated silicon lenses as large as 33.4 cm in diameter with micromachined layers optimized for use between 125 and 165 GHz. Our design reduces average reflections to a few tenths of a percent for angles of incidence up to 30° with low cross polarization. We describe the design, tolerance, manufacture, and measurements of these coatings and present measurements of the optical properties of silicon at millimeter wavelengths at cryogenic and room temperatures. This coating and lens fabrication approach is applicable from centimeter to submillimeter wavelengths and can be used to fabricate coatings with greater than octave bandwidth.

Evidence for dark energy from the cosmic microwave background alone using the Atacama Cosmology Telescope lensing measurements

For the first time, measurements of the cosmic microwave background radiation (CMB) alone favor cosmologies with w = -1 dark energy over models without dark energy at a 3.2-sigma level. We demonstrate this by combining the CMB lensing deflection power spectrum from the Atacama Cosmology Telescope with temperature and polarization power spectra from the Wilkinson Microwave Anisotropy Probe. The lensing data break the geometric degeneracy of different cosmological models with similar CMB temperature power spectra. Our CMB-only measurement of the dark energy density Ω(Λ) confirms other measurements from supernovae, galaxy clusters, and baryon acoustic oscillations, and demonstrates the power of CMB lensing as a new cosmological tool.

Detection of the power spectrum of cosmic microwave background lensing by the Atacama Cosmology Telescope

We report the first detection of the gravitational lensing of the cosmic microwave background through a measurement of the four-point correlation function in the temperature maps made by the Atacama Cosmology Telescope. We verify our detection by calculating the levels of potential contaminants and performing a number of null tests. The resulting convergence power spectrum at 2° angular scales measures the amplitude of matter density fluctuations on comoving length scales of around 100 Mpc at redshifts around 0.5 to 3. The measured amplitude of the signal agrees with Lambda cold dark matter cosmology predictions. Since the amplitude of the convergence power spectrum scales as the square of the amplitude of the density fluctuations, the 4σ detection of the lensing signal measures the amplitude of density fluctuations to 12%.

Prospective study of outcomes after percutaneous biliary drainage for malignant biliary obstruction

BACKGROUND

Percutaneous biliary drainage (PBD) is used to relieve malignant bile duct obstruction (MBO) when endoscopic drainage is not feasible. Little is known about the effects of PBD on the quality of life (QoL) in patients with MBO. The aim of this study was to evaluate changes in QoL and pruritus after PBD and to explore the variables that impact these changes.

MATERIALS AND METHODS

Eligible patients reported their QoL and pruritus before and after PBD using the Functional Assessment of Cancer Therapy-Hepatobiliary instrument (FACT-HS) and the Visual Analog Scale for Pruritus (VASP). Instruments were completed preprocedure and at 1 and 4 weeks following PBD.

RESULTS

A total of 109 (60 male/49 female) patients enrolled; 102 (94%) had unresectable disease. PBD was technically successful (hepatic ducts cannulated at the conclusion of procedure) in all patients. There were 2 procedure-related deaths. All-cause mortality was 10% (N = 11) at 4 weeks and 28% (N = 31) at 8 weeks post-PBD with a median survival of 4.74 months. The mean FACT-HS scores declined significantly (P < .01) over time (101.3, 94.8, 94.7 at baseline, 1 week, 4 weeks, respectively). The VASP scores showed significant improvement at 1 week with continued improvement at 4 weeks (P < .01).

CONCLUSIONS

PBD improves pruritus but not QoL in patients with MBO and advanced malignancy. There is high early mortality in this population.

When language comprehension reflects production constraints: resolving ambiguities with the help of past experience

A key assumption in language comprehension is that biases in behavioral data, such as the tendency to interpret John said that Mary left yesterday to mean that yesterday modifies the syntactically local verb left, not the distant verb said, reflect inherent biases in the language comprehension system. In the present article, an alternative production-distribution-comprehension (PDC) account is pursued; this account states that comprehension biases emerge from different interpretation frequencies in the language, which themselves emerge from pressures on the language production system to produce some structures more than others. In two corpus analyses and two self-paced reading experiments, we investigated these claims for verb modification ambiguities, for which phrase length is hypothesized to shape production. The results support claims that tendencies to produce short phrases before long ones create distributional regularities for modification ambiguities in the language and that learning over these regularities shapes comprehenders' interpretations of modification ambiguities. Implications for the PDC and other accounts are discussed.

Experience and grammatical agreement: statistical learning shapes number agreement production

A robust result in research on the production of grammatical agreement is that speakers are more likely to produce an erroneous verb with phrases such as the key to the cabinets, with a singular noun followed by a plural one, than with phrases such as the keys to the cabinet, where a plural noun is followed by a singular. These asymmetries are thought to reflect core language production processes. Previous accounts have attributed error patterns to a syntactic number feature present on plurals but not singulars. An alternative approach is presented in which a process similar to structural priming contributes to the error asymmetry via speakers' past experiences with related agreement constructions. A corpus analysis and two agreement production studies test this account. The results suggest that agreement production is shaped by statistical learning from past language experience. Implications for accounts of agreement are discussed.

The spatio-temporal mapping of epileptic networks: combination of EEG-fMRI and EEG source imaging

Simultaneous EEG-fMRI acquisitions in patients with epilepsy often reveal distributed patterns of Blood Oxygen Level Dependant (BOLD) change correlated with epileptiform discharges. We investigated if electrical source imaging (ESI) performed on the interictal epileptiform discharges (IED) acquired during fMRI acquisition could be used to study the dynamics of the networks identified by the BOLD effect, thereby avoiding the limitations of combining results from separate recordings. Nine selected patients (13 IED types identified) with focal epilepsy underwent EEG-fMRI. Statistical analysis was performed using SPM5 to create BOLD maps. ESI was performed on the IED recorded during fMRI acquisition using a realistic head model (SMAC) and a distributed linear inverse solution (LAURA). ESI could not be performed in one case. In 10/12 remaining studies, ESI at IED onset (ESIo) was anatomically close to one BOLD cluster. Interestingly, ESIo was closest to the positive BOLD cluster with maximal statistical significance in only 4/12 cases and closest to negative BOLD responses in 4/12 cases. Very small BOLD clusters could also have clinical relevance in some cases. ESI at later time frame (ESIp) showed propagation to remote sources co-localised with other BOLD clusters in half of cases. In concordant cases, the distance between maxima of ESI and the closest EEG-fMRI cluster was less than 33 mm, in agreement with previous studies. We conclude that simultaneous ESI and EEG-fMRI analysis may be able to distinguish areas of BOLD response related to initiation of IED from propagation areas. This combination provides new opportunities for investigating epileptic networks.

Acceptance of repeat population-based voluntary counselling and testing for HIV in rural Malawi

OBJECTIVE

To examine the acceptance of repeat population-based voluntary counselling and testing (VCT) for HIV in rural Malawi.

METHODS

Behavioural and biomarker data were collected in 2004 and 2006 from approximately 3000 adult respondents. In 2004, oral swab specimens were collected and analysed using ELISA and confirmatory Western blot tests, while finger-prick rapid testing was done in 2006. We used cross-tabulations with chi(2) tests and significance tests of proportions to determine the statistical significance of differences in acceptance of VCT by year, individual characteristics and HIV risk.

RESULTS

First, over 90% of respondents in each round accepted the HIV test, despite variations in testing protocols. Second, the percentage of individuals who obtained their test results significantly increased from 67% in 2004, when the results were provided in randomly selected locations several weeks after the specimens were collected, to 98% in 2006 when they were made available immediately within the home. Third, whereas there were significant variations in the sociodemographic and behavioural profiles of those who were successfully contacted for a second HIV test, this was not the case for those who accepted repeat VCT. This suggests that variations in the success of repeat testing might come from contacting the individuals rather than from accepting the test or knowing the results.

CONCLUSIONS

Repeat HIV testing at home by trained healthcare workers from outside the local area, and with either saliva or blood, is almost universally acceptable in rural Malawi and, thus, likely to be acceptable in similar contexts.

Radiofrequency ablation in the management of liver metastases from breast cancer

OBJECTIVE

Systemic chemotherapy remains the standard treatment for patients with breast cancer hepatic metastases. Resection of metastases has survival advantages in a small percentage of selected patients. Radiofrequency ablation has been used in small numbers of selected patients. This small series was undertaken to review our experience with radiofrequency ablation in the management of patients with breast cancer hepatic metastases.

CONCLUSION

Radiofrequency ablation of breast cancer hepatic metastases is safe and may be used to control hepatic deposits in patients with stable or no extrahepatic disease.

Application of portfolio theory to risk-based allocation of surveillance resources in animal populations

Distribution of finite levels of resources between multiple competing tasks can be a challenging problem. Resources need to be distributed across time periods and geographic locations to increase the probability of detection of a disease incursion or significant change in disease pattern. Efforts should focus primarily on areas and populations where risk factors for a given disease reach relatively high levels. In order to target resources into these areas, the overall risk level can be evaluated periodically across locations to create a dynamic national risk landscape. Methods are described to integrate the levels of various risk factors into an overall risk score for each area, to account for the certainty or variability around those measures and then to allocate surveillance resources across this risk landscape. In addition to targeting resources into high risk areas, surveillance continues in lower risk areas where there is a small yet positive chance of disease occurrence. In this paper we describe the application of portfolio theory concepts, routinely used in finance, to design surveillance portfolios for a series of examples. The appropriate level of resource investment is chosen for each disease or geographical area and time period given the degree of disease risk and uncertainty present.

Clinical placements in residential aged care facilities: the impact on nursing students' perception of aged care and the effect on career plans

OBJECTIVES

Undergraduate nursing students have often found clinical placements in aged care unsatisfactory and/or unsettling, dissuading them from considering aged care as an employment option on graduation. This study asked which elements of the clinical placement experience produced that outcome; and what changes could yield more positive outcomes.

DESIGN

A descriptive qualitative pilot study was carried out in late 2003. A combination of nominal groups and semi-structured interviews was used with students and experienced nurses to identify commonalities and variations in issues nominated as important and in the views expressed on those issues. Transcripts were independently analysed by two experienced investigators. Themes identified were discussed among the researchers.

SUBJECTS

Fourteen volunteer undergraduate nursing students, all of whom had completed clinical placements in residential care and some of whom had prior experience in such facilities, participated in the nominal groups. Twelve registered nurses who had acted as clinical teachers in aged care facilities were interviewed.

RESULTS

Perceived issues included: unexamined assumptions about nursing's core skills; lack of pre-placement orientation to the residential care environment; the appeal of and apprehension aroused by autonomous practice; and status, income and career progression considerations.

CONCLUSIONS

Analysis of the sometimes ambivalent and conflicting views expressed pointed to possible changes, all within the domain of training and employing institutions, capable of bringing submerged issues to the surface for examination and resolution as part of raising student understanding of gerontology as a demanding specialty and residential care as a rewarding career.

Managing high-density commercial scale wine fermentations

AIMS

To investigate the effects of grape juice dilution and different temperature/nitrogen addition regimes on commercial-scale, high-density Shiraz and Chardonnay fermentations.

METHODS AND RESULTS

Duplicated fermentations (30 hl) were conducted at two temperatures for Shiraz and for Chardonnay. Two additional tanks of Chardonnay and Shiraz were diluted. Nitrogen was added once at inoculation or in aliquots over several days. Yeast concentration and viability was determined by flow cytometry. Fermentation chemistry was monitored by Fourier transform infrared spectroscopy. Fermentations arrested in both of the undiluted, higher temperature duplicate tanks of Shiraz. Different fermentation temperature resulted in sensorially different Shiraz, but not Chardonnay, wines made from undiluted musts. The converse was observed for wines made from diluted musts.

CONCLUSIONS

High-density musts can be fermented completely using reduced fermentation temperature coupled with incremental nitrogen addition.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first study in duplicated, commercial-scale, high-density grape juice fermentations to address temperature, nitrogen addition, and juice dilution effects on stuck fermentation potential and wine sensory properties.

Chemical, biological, radiological and nuclear terrorism: an introduction for occupational physicians

BACKGROUND

Chemical, biological, radiological and nuclear terrorism poses considerable threat throughout the world.

AIM

To provide occupational physicians with an understanding of this threat and its main forms and what action can be taken to counter this threat.

METHODS

Presenters at a conference on chemical, biological, radiological and nuclear terrorism were asked to contribute their evidence-based opinions in order to produce a review article.

RESULTS

This paper presents a summary of the different forms of chemical, biological, radiological and nuclear terrorism and the effective counter-measures and also provides a review of current scientific literature.

CONCLUSION

The threat of chemical, biological, radiological and nuclear terrorism is present throughout the world and is one that occupational physicians should be aware of, as well as the action that can be taken to counter it.

Innovations in aged care: study tours for Japanese health professionals

Australian health care management is of increasing interest to Asian organisations, and there have been many advances in the conduct of informative tours. Points to consider when conducting such tours for Japanese visitors are described under the mnemonic STUDY TOURS: Specifications, Translation, Understanding culture, Delivering education, Yen, Timing, Organisation, Unique needs, Residents' values and Safety.

Calorific restriction: can we extrapolate from animals to humans?

Dietary restriction in animals results in a dramatic reduction of cancer incidence. Several attempts have been made to extrapolate this observation to the human situation. Recent developments in our knowledge of gene-dietary interactions, particularly in relation to vitamins, have been taken into account in a new examination of the likely effects of dietary restriction in humans, but this is a relatively new area of research. Epidemiological studies in relation to diet have also been considered, but probably need to be refined further because of the subtle effects of dietary interactions. Until more detailed information is available the extrapolation can still only be made with the utmost caution.

Development and evaluation of a training program in peer support for former consumers

While mental health policy in Australia promotes the involvement of mental health consumers in service planning, implementation and evaluation, little has been reported on the training required for the new roles that consumers are being expected to undertake. In this study, 10 former consumers of mental health services participated in a 16-week training program in peer support. The impact of the program on the psychological well-being of the participants was assessed using a battery of self-evaluation questionnaires and focus group interviews. Findings suggest that exposure to people with acute mental health problems (i.e. inpatients), did not, in this instance, adversely impact on the psychological well-being of the participants. Barriers to consumer participation in the mental health field are discussed and recommendations for the content and structure of future consumer peer support training initiatives are proposed.

False positives in universal neonatal screening for permanent childhood hearing impairment

High rates of false-positive neonatal screens for permanent childhood hearing impairment (PCHI) associated with raised hearing thresholds lead to unnecessary assessments of the baby, which may worry parents. False-positive rates need to be reduced, especially in view of the UK government's announcement that national neonatal screening will be introduced. We report screening criteria that give a six-fold reduction in false-positive rates.

Molecular cloning and characterization of a lipid phosphohydrolase that degrades sphingosine-1- phosphate and induces cell death

Sphingosine and sphingosine-1-phosphate (SPP) are interconvertible sphingolipid metabolites with opposing effects on cell growth and apoptosis. Based on sequence homology with LBP1, a lipid phosphohydrolase that regulates the levels of phosphorylated sphingoid bases in yeast, we report here the cloning, identification, and characterization of a mammalian SPP phosphatase (mSPP1). This hydrophobic enzyme, which contains the type 2 lipid phosphohydrolase conserved sequence motif, shows substrate specificity for SPP. Partially purified Myc-tagged mSPP1 was also highly active at dephosphorylating SPP. When expressed in yeast, mSPP1 can partially substitute for the function of LBP1. Membrane fractions from human embryonic kidney HEK293 cells transfected with mSPP1 markedly degraded SPP but not lysophosphatidic acid, phosphatidic acid, or ceramide-1-phosphate. Enforced expression of mSPP1 in NIH 3T3 fibroblasts not only decreased SPP and enhanced ceramide levels, it also markedly diminished survival and induced the characteristic traits of apoptosis. Collectively, our results suggest that SPP phosphohydrolase may regulate the dynamic balance between sphingolipid metabolite levels in mammalian cells and consequently influence cell fate.

Student Voice in Curriculum Making

Undergraduate student nurses (n = 117) were asked to reflect critically on their psychiatric clinical learning experience and identify strengths and weaknesses not only in the actions and behaviors of others, but also in their own. A questionnaire was specifically constructed to encourage the voicing of issues, concerns, actions, and behaviors that centered around the concept of quality in relation to four predetermined categories: clinical practice, clinical nursing staff, clinical facilitators, and students. Themes, inductively derived from the collected information within each category, were organized into clusters and then into frequency distributions to facilitate interpretation. The study generated information that should be useful in planning and supervising effective and mutually satisfying clinical practicums in any psychiatric context. Moreover, the responses gave voice to matters that otherwise may have gone unrecognized in the curriculum. The study confirms that student voice must become an integral part of the alternatives from which curriculum-making choice is made.

The concomitant effects of phrase length and informational content in sentence comprehension

Recent evidence suggests that phrase length plays a crucial role in modification ambiguities. Using a self-paced reading task, we extended these results by examining the additional pragmatic effects that length manipulations may exert. The results demonstrate that length not only modulates modification preferences directly, but that it also necessarily changes the informational content of a sentence, which itself affects modification preferences. Our findings suggest that the same length manipulation affects multiple sources of constraints, both structural and pragmatic, which can each exert differing effects on processing.

Sphingoid base 1-phosphate phosphatase: a key regulator of sphingolipid metabolism and stress response

The sphingolipid metabolites ceramide and sphingosine-1-phosphate are second messengers with opposing roles in mammalian cell growth arrest and survival; their relative cellular level has been proposed to be a rheostat that determines the fate of cells. This report demonstrates that this rheostat is an evolutionarily conserved stress-regulatory mechanism that influences growth and survival of yeast. Although the role of sphingosine-1-phosphate in yeast was not previously examined, accumulation of ceramide has been shown to induce G1 arrest and cell death. We now have identified a gene in Saccharomyces cerevisiae, LBP1, that regulates the levels of phosphorylated sphingoid bases and ceramide. LBP1 was cloned from a yeast mutant that accumulated phosphorylated long-chain sphingoid bases and diverted sphingoid base intermediates from sphingolipid pathways to glycerophospholipid biosynthesis. LBP1 and its homolog, LBP2, encode very hydrophobic proteins that contain a novel-conserved sequence motif for lipid phosphatases, and both have long-chain sphingoid base phosphate phosphatase activity. In vitro characterization of Lbp1p shows that this phosphatase is Mg2+-independent with high specificity for phosphorylated long-chain bases, phytosphingosine and sphingosine. The deletion of LBP1 results in the accumulation of phosphorylated long-chain sphingoid bases and reduced ceramide levels. Moreover, deletion of LBP1 and LBP2 results in dramatically enhanced survival upon severe heat shock. Thus, these phosphatases play a previously unappreciated role in regulating ceramide and phosphorylated sphingoid base levels in yeast, and they modulate stress responses through sphingolipid metabolites in a manner that is reminiscent of their effects on mammalian cells.