Objective: Recent discussions of aetiological overlap between ADHD and Autism Spectrum Disorder (ASD) require comparative studying of these disorders. Method: We examined performance of ASD patients ...with (ASD+) and without (ASD–) comorbid ADHD, ADHD patients, and controls for selected putative endophenotypes of ADHD: Intrasubject Variability (ISV) of reaction times, working memory (WM), inhibition, and temporal processing. Results: We found that patients with ADHD or ASD+, but not ASD–, had elevated ISV across the entire task battery and temporal processing deficits, and that none of the groups were impaired in WM or inhibition. High levels of ISV and generally poor performance in ASD+ patients were only partially due to additive effects of the pure disorders. Conclusion: Overall, we conclude that, within our limited but heterogeneous task battery, ISV and temporal processing deficits are most sensitive to ADHD symptomatology and that controlling for ADHD comorbidity is mandatory when assessing ISV in autism.
Household Air Pollution (HAP) from biomass cooking fuels is a major cause of morbidity and mortality in low-income settings worldwide. In Nepal the use of open stoves with solid biomass fuels is the ...primary method of domestic cooking. To assess patterns of domestic air pollution we performed continuous measurement of carbon monoxide (CO) and particulate Matter (PM2.5) in 12 biomass fuel households in Janakpur, Nepal. We measured kitchen PM2.5 and CO concentrations at one-minute intervals for an approximately 48-h period using the TSI DustTrak II 8530/SidePak AM510 (TSI Inc, St. Paul MN, USA) or EL-USB-CO data logger (Lascar Electronics, Erie PA, USA) respectively. We also obtained information regarding fuel, stove and kitchen characteristics and cooking activity patterns. Household cooking was performed in two daily sessions (median total duration 4 h) with diurnal variability in pollutant concentrations reflecting morning and evening cooking sessions and peak concentrations associated with fire-lighting. We observed a strong linear relationship between PM2.5 measurements obtained by co-located photometric and gravimetric monitoring devices, providing local calibration factors of 4.9 (DustTrak) and 2.7 (SidePak). Overall 48-h average CO and PM2.5 concentrations were 5.4 (SD 4.3) ppm (12 households) and 417.6 (SD 686.4) μg/m3 (8 households), respectively, with higher average concentrations associated with cooking and heating activities. Overall average PM2.5 concentrations and peak 1-h CO concentrations exceeded WHO Indoor Air Quality Guidelines. Average hourly PM2.5 and CO concentrations were moderately correlated (r = 0.52), suggesting that CO has limited utility as a proxy measure for PM2.5 exposure assessment in this setting. Domestic indoor air quality levels associated with biomass fuel combustion in this region exceed WHO Indoor Air Quality standards and are in the hazardous range for human health.
•Intensive PM2.5 and CO monitoring was performed in 12 biomass fuel-using households in Janakpur.•Domestic cooking activity patterns and kitchen, stove and fuel characteristics were recorded.•Temporal PM2.5 and CO patterns demonstrated diurnal variability reflecting morning and evening cooking sessions.•Average PM2.5 and peak CO concentrations both exceeded World Health Organization (WHO) Indoor Air Quality Guidelines.•Concentrations of PM2.5 and CO were moderately correlated during cooking periods.
The exposure of children to air pollution in low resource settings is believed to be high because of the common use of biomass fuels for cooking. We used microenvironment sampling to estimate the ...respirable fraction of air pollution (particles with median diameter less than 4μm) to which 7–9year old children in southern Nepal were exposed. Sampling was conducted for a total 2649h in 55 households, 8 schools and 8 outdoor locations of rural Dhanusha. We conducted gravimetric and photometric sampling in a subsample of the children in our study in the locations in which they usually resided (bedroom/living room, kitchen, veranda, in school and outdoors), repeated three times over one year. Using time activity information, a 24-hour time weighted average was modeled for all the children in the study. Approximately two-thirds of homes used biomass fuels, with the remainder mostly using gas. The exposure of children to air pollution was very high. The 24-hour time weighted average over the whole year was 168μg/m3. The non-kitchen related samples tended to show approximately double the concentration in winter than spring/autumn, and four times that of the monsoon season. There was no difference between the exposure of boys and girls. Air pollution in rural households was much higher than the World Health Organization and the National Ambient Air Quality Standards for Nepal recommendations for particulate exposure.
•Air pollution exposure (respirable PM) was estimated for children in Nepal.•Gravimetric and photometric microenvironment sampling was conducted.•Total sampling was repeated three times over a year and totaled over 2500 hours.•The 24-hour time weighted average was 168µg/m3.•There was substantial variability from season to season and by fuel type.•There was no difference in exposure between boys and girls.
Background
Recent work demonstrated the value of antigen‐specific antibody indices (AI and C‐value) to detect intrathecal antibody production against Sarcocystis neurona for antemortem diagnosis of ...equine protozoal myeloencephalitis (EPM).
Objectives
The study was conducted to assess whether the antigen‐specific antibody indices can be reduced to a simple serum : cerebrospinal fluid (CSF) titer ratio to achieve accurate EPM diagnosis.
Animals
Paired serum and CSF samples from 128 horses diagnosed by postmortem examination. The sample set included 44 EPM cases, 35 cervical‐vertebral malformation (CVM) cases, 39 neurologic cases other than EPM or CVM, and 10 non‐neurologic cases.
Methods
Antibodies against S. neurona were measured in serum and CSF pairs using the SnSAG2 and SnSAG4/3 (SnSAG2, 4/3) ELISAs, and the ratio of each respective serum titer to CSF titer was determined. Likelihood ratios and diagnostic sensitivity and specificity were calculated based on serum titers, CSF titers, and serum : CSF titer ratios.
Results
Excellent diagnostic sensitivity and specificity was obtained from the SnSAG2, 4/3 serum : CSF titer ratio. Sensitivity and specificity of 93.2 and 81.1%, respectively, were achieved using a ratio cutoff of ≤100, whereas sensitivity and specificity were 86.4 and 95.9%, respectively, if a more rigorous cutoff of ≤50 was used. Antibody titers in CSF also provided good diagnostic accuracy. Serum antibody titers alone yielded much lower sensitivity and specificity.
Conclusions and Clinical Importance
The study confirms the value of detecting intrathecal antibody production for antemortem diagnosis of EPM, and they further show that the antigen‐specific antibody indices can be reduced in practice to a simple serum : CSF titer ratio.
Background: Endocrine dysregulation of hormones of energy metabolism is well documented in critically ill humans, but limited information exists in septic foals. The purpose of this study was to ...provide information on the hormonal response to energy metabolism in critically ill foals, focusing on insulin, glucagon, and leptin.
Hypothesis: Concentrations of insulin, glucagon, leptin, and triglycerides will be higher, whereas glucose concentration will be lower in septic foals than in healthy and sick nonseptic foals. The magnitude of these differences will be associated with severity of disease and nonsurvival.
Animals: Forty‐four septic, 62 sick nonseptic, and 19 healthy foals <7 days of age.
Methods: In this prospective multicenter cross‐sectional study, blood samples were collected at admission. Foals with positive blood culture or sepsis score ≥12 were considered septic.
Results: Septic foals had lower glucose and insulin and higher triglyceride and glucagon concentrations than did healthy foals. Glucagon concentrations were not different between septic foals that died (n = 14) or survived (n = 30). Higher insulin and lower leptin concentrations were associated with mortality. Quantitative insulin‐sensitivity check index was higher in septic foals.
Conclusions and Clinical Importance: Energy metabolism and the endocrine response of related hormones in septic foals are characterized by hypoglycemia, hypertriglyceridemia, low insulin concentration, and high glucagon concentration. Leptin and insulin may have prognostic value for nonsurvival in septic foals. The hormonal response related to energy metabolism in critical illness differs between foals and humans.
REASONS FOR PERFORMING STUDY: Resistance to the somatotropic axis and increases in ghrelin concentrations have been documented in critically ill human patients, but limited information exists in ...healthy or sick foals. OBJECTIVES: To investigate components of the somatotropic axis (ghrelin, growth hormone and insulin‐like growth factor‐1 IGF‐1) with regard to energy metabolism (glucose and triglycerides), severity of disease and survival in critically ill equine neonates. It was hypothesised that ghrelin and growth hormone would increase and IGF‐1 would decrease in proportion to severity of disease, supporting somatotropic axis resistance, which would be associated with severity of disease and mortality in sick foals. STUDY DESIGN: Prospective multicentre cross‐sectional study. METHODS: Blood samples were collected at admission from 44 septic, 62 sick nonseptic (SNS) and 19 healthy foals, all aged <7 days. Foals with positive blood cultures or sepsis scores ≥12 were considered septic, foals with sepsis scores of 5–11 were classified as SNS. Data were analysed by nonparametric methods and multivariate logistic regression. RESULTS: Septic foals had higher ghrelin, growth hormone and triglyceride and lower IGF‐1 and glucose concentrations than healthy foals (P<0.01). Sick nonseptic foals had higher growth hormone and triglycerides and lower IGF‐1 concentrations than healthy foals (P<0.05). Growth hormone:IGF‐1 ratio was higher in septic and SNS foals than healthy foals (P<0.05). Hormone concentrations were not different between septic nonsurvivors (n = 14) and survivors (n = 30), but the growth hormone:IGF‐1 ratio was lower in nonsurvivors (P = 0.043). CONCLUSIONS: Somatotropic axis resistance, characterised by a high growth hormone:IGF‐1 ratio, was frequent in sick foals, associated with the energy status (hypoglycaemia, hypertriglyceridaemia) and with mortality in septic foals. POTENTIAL RELEVANCE: A functional somatotropic axis appears to be important for foal survival during sepsis. Somatotropic resistance is likely to contribute to severity of disease, a catabolic state and likelihood of recovery.
Background: Disorders of calcium regulation are frequently found in humans with critical illness, yet limited information exists in foals with similar conditions including septicemia. The purpose of ...this study was to determine whether disorders of calcium exist in septic foals, and to determine any association with survival.
Hypothesis: Blood concentrations of ionized calcium (Ca2+) and magnesium (Mg2+) will be lower in septic foals with concomitant increases in parathyroid hormone (PTH), calcitonin (CT), and parathyroid‐related peptide (PTHrP) compared with healthy foals. The magnitude of these differences will be negatively associated with survival.
Animals: Eighty‐two septic, 40 sick nonseptic, and 24 healthy foals of ≤7 days were included.
Methods: Prospective, observational study. Blood was collected at initial examination for analysis. Foals with positive blood culture or sepsis score ≥14 were considered septic. Foals with disease other than sepsis and healthy foals were used as controls. Hormone concentrations were measured with validated immunoassays.
Results: Septic foals had decreased Ca2+ (5.6 versus 6.1 mg/dL, P < .01) and increased serum PTH (16.2 versus 3.2 pmol/L, P < .05), and phosphorus concentrations (7.1 versus 6.3 mg/dL, P < .01). No differences in serum Mg2+, PTHrP, and CT concentrations were found. Nonsurviving septic foals (n = 42/82) had higher PTH concentrations (41.1 versus 10.7 pmol/L, P < .01) than survivors (n = 40/82).
Conclusions and Clinical Importance: Septic foals were more likely to have disorders of calcium regulation compared with healthy foals, where hyperparathyroidemia was associated with nonsurvival.
Abstract
Background
Mobile technology is increasingly important for delivering public health interventions to remote populations. This research study developed, piloted, and assessed a serious game ...for mobile devices that teaches geohazard, maternal, and neonatal health messages. This unique mHealth intervention aimed at low-literacy audiences in low resource settings is part of the Maternal and Neonatal Technologies in Rural Areas (MANTRA) project: Increasing maternal and child health resilience before, during, and after disasters using mobile technology in Nepal. Specifically, we assess impact of the serious game to improve knowledge gain in our target audience.
Methods
Co-creation with the MANTRA team and local stakeholders in Nepal identified core needs, developed appropriate pictograms and mechanics, and tailored the pilot game to the local cultural context. Through picture matching with immediate audio and visual feedback, the game teaches 28 learning objectives in three modules: maternal health, neonatal health, and geohazards. To assess the game, 35 participants were recruited in Kathmandu and villages in Kavre district. Sessions consisted of pre-test assessment, playing the game, post-test assessment, and a focus group to elicit qualitative feedback.
Results
The knowledge assessment quantified knowledge gain. Overall, the group averaged a normalized 6.8 point improvement (p = 0.000022). Change in the geohazard module was 9.5 points (p = 0.001), followed by maternal health (7.4 points, p = 0.007), and neonatal health (4.3 points, p = 0.83). Four learning objectives had statistically significant change (p < 0.05). Feedback demonstrated high engagement, motivation, and usability of the game.
Conclusions
This MANTRA study is a unique mhealth intervention of a serious game to teach core health and hazards messages to low-literacy audiences in rural Nepal. The pilot intervention demonstrated statistically significant knowledge improvement among participants.
Key messages
The pilot MANTRA mobile serious game intervention is a novel idea, to bring public health knowledge to difficult to reach vulnerable populations, including often ignored illiterate audiences.
The pilot MANTRA mobile serious game intervention demonstrated a statistically significant knowledge improvement of geohazard, maternal, and neonatal health learning objectives among participants.
This paper presents the results of a bumblebee mark-reobservation study conducted in a fragmented agricultural landscape, where bumblebee resources (forage, and probably also nest sites) exist mainly ...on scattered remnants of semi-natural habitat. The results show that reobservations of bumblebees marked while foraging were numerous and in general at short distances (less than 50 m) from where they were marked. In contrast, when bumblebees were marked at the nest, the numbers of reobservations were very low, even though monitoring of nest traffic showed the nest to be very active during reobservation walks. The results indicate that bumblebees do not necessarily forage close to their nest, and that caution is needed if foraging area and nest location are based solely on the observation of foragers
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