Pre-académica: Batería Neurocognitiva Preescolar / Pre-academic: Neurocognitive Preschool Battery

Introducción. Pre-Académica está conformada por 8 tareas cognitivas para evaluar la atención, las capacidades numéricas básicas, la memoria de trabajo, el pensamiento y el lenguaje oral en la infancia preescolar. Método. Participaron 375 niños entre 4 y 6 años en la provincia de Cienfuegos, Cuba. Se realizaron varios análisis estadísticos para obtener la validez (asociación con otra variable, estructura interna y contenido) y la confiabilidad (método test - retest). Resultados. La validez de asociación indicó adecuadas correlaciones entre Pre-Académica y Luria Inicial (.42** y .67**). Igualmente, mostró valores de coincidencia entre 73% y 76%. El análisis de factores agrupó 3 factores: Magnitudes (24,26%), Pensamiento (22,46%) y Lenguaje (19,16%), indicando una apropiada estructura interna (65,89% de la varianza). El análisis de validez de contenido recomendó modificar un grupo de ítems con mala discriminación (28% de los ítems). En igual sentido, sugirió diseñar un grupo de ítems para mejorar la validez de contenido en las tareas con mala discriminación: Vocabulario, Rimas y Matrices. El método test ­ retest mostró indicadores apropiados de confiabilidad (valores entre .82 y .94). Conclusiones. En su fase de prueba, la Pre-Académica mostró puntos positivos y negativos. Positivos. (1) El 72% de los ítems mostraron buena discriminación y (2) Logró agrupar 6 tareas en dos factores explicativos (Lenguaje y Magnitudes). Negativos. (1) El 28% de los ítems tienen mala discriminación y (2) Se diseñaron pocos ítems para reorganizar la prueba después de este análisis. Se recomienda diseñar un grupo de ítems para mejorar la validez de la Pre-Académica.

Introduction. Pre-Academic consists of 8 cognitive tasks to assess attention, basic numerical abilities, working memory, thinking and oral language in preschool childhood. Method. 375 children between 4 and 6 years old participated in the province of Cienfuegos, Cuba. Several statistical analyzes were carried out to obtain validity (association with another variable, internal structure and content) and reliability (test - retest method). Results. The association validity indicated appropriate correlations between Pre-Academic and Luria Initial (.42** and .67**). Similarly, it showed coincidence values between 73% and 76%. The analysis of factors contained 3 factors: Magnitudes (24,26%), Thought (22,46%) and Language (19,16%), indicating an appropriate structure interns (65,89% of the variance). The analysis of content validity recommended to modify a group of articles with bad discrimination (28% of the items). Similarly, suggested to design a group of items to increase the content validity in the tasks with bad discrimination: Vocabulary, Rhymes and Matric. The test - retest method showed appropriate indicators of reliability (values between .82 and .94). Conclusions. In first phase test, Pre-Academic showed positive and negative points. Positive. (1) 72% of the items showed good discrimination, (2) 6 tasks were grouped into two explanatory factors (Language and Magnitudes). Negative. (1) 28% of the items have bad discrimination; (2) insufficient items were designed to reorganize the test after this analysis. It is recommended to design a group of items to increase the validity of the Pre-Academic.

Interventional Radiology service provision and practice for the management of traumatic splenic injury across the Regional Trauma Networks of England.

INTRODUCTION: The management of blunt splenic injuries (BSI) has evolved toward strategies that avoid splenectomy. There is growing adoption of interventional radiology (IR) techniques in non-operative management of BSI, with evidence suggesting a corresponding reduction in emergency laparotomy requirements and increased splenic preservation rates. Currently there are no UK national guidelines for the management of blunt splenic injury. This may lead to variations in management, despite the reorganisation of trauma services in England in 2012. MATERIALS AND METHODS: A survey was distributed through the British Society of Interventional Radiologists to all UK members aiming to identify availability of IR services in England, radiologists' practice, and attitudes toward management of BSI. RESULTS: 116 responses from respondents working in 23 of the 26 Regional Trauma Networks in England were received. 79% provide a single dedicated IR service but over 50% cover more than one hospital within the network. All offer arterial embolisation for BSI. Only 25% follow guidelines. In haemodynamically stable patients, an increasing trend for embolisation was seen as grade of splenic injury increased from 1 to 4 (12.5%-82.14%, p<0.01). In unstable patients or those with radiological evidence of bleeding, significantly more respondents offer embolisation for grade 1-3 injuries (p<0.01), compared to stable patients. Significantly fewer respondents offer embolisation for grade 5 versus 4 injuries in unstable patients or with evidence of bleeding. CONCLUSION: Splenic embolisation is offered for a variety of injury grades, providing the patient remains stable. Variation in interventional radiology services remain despite the introduction of regional trauma networks.

Predictive coding in autism spectrum disorder and attention deficit hyperactivity disorder.

Predictive coding has been proposed as a framework to understand neural processes in neuropsychiatric disorders. We used this approach to describe mechanisms responsible for attentional abnormalities in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). We monitored brain dynamics of 59 children (8-15 yr old) who had ASD or ADHD or who were control participants via high-density electroencephalography. We performed analysis at the scalp and source-space levels while participants listened to standard and deviant tone sequences. Through task instructions, we manipulated top-down expectation by presenting expected and unexpected deviant sequences. Children with ASD showed reduced superior frontal cortex (FC) responses to unexpected events but increased dorsolateral prefrontal cortex (PFC) activation to expected events. In contrast, children with ADHD exhibited reduced cortical responses in superior FC to expected events but strong PFC activation to unexpected events. Moreover, neural abnormalities were associated with specific control mechanisms, namely, inhibitory control in ASD and set-shifting in ADHD. Based on the predictive coding account, top-down expectation abnormalities could be attributed to a disproportionate reliance (precision) allocated to prior beliefs in ASD and to sensory input in ADHD.

Undergraduate radiology teaching from the student's perspective.

OBJECTIVES: To obtain medical students' evaluation of the quality of undergraduate radiology teaching received, preferred teaching methods and resources. This is a follow-up project to an earlier study of junior doctors who felt that radiology teaching left them ill prepared for medical practice. METHODS: A questionnaire to third and fifth year medical students undertaking clinical rotations at Newcastle University, UK. RESULTS: The questionnaire was completed by 57/60 (95 %) of third and 37/40 (93 %) of final year medical students. Students received minimal radiology teaching in pre-clinical years, feeling this was insufficient. The majority of students rated interactive case-based teaching as effective. Self-directed learning resources such as textbooks, journals and even online learning modules were perceived as less effective. Other types of web resources rated higher. Motivation for most students when studying radiology was to achieve learning objectives needed to pass their next exams and/or to improve as a doctor. CONCLUSIONS: Medical students criticise the lack of radiology teaching in pre-clinical undergraduate years. Radiology teaching should be represented in all undergraduate years, preferably delivered via interactive teaching sessions. Currently available e-learning modules do not meet the students' learning needs and there is a call for reliable, up-to-date open access electronic resources. MAIN MESSAGES: • Radiology teaching should be represented in all pre-clinical and clinical undergraduate years. • Medical students rate interactive case-based teaching sessions as very effective. • There is a call for reliable, up-to-date open access electronic resources for medical students.

Analysis of hazardous material releases due to natural hazards in the United States.

Natural hazards were the cause of approximately 16,600 hazardous material (hazmat) releases reported to the National Response Center (NRC) between 1990 and 2008-three per cent of all reported hazmat releases. Rain-induced releases were most numerous (26 per cent of the total), followed by those associated with hurricanes (20 per cent), many of which resulted from major episodes in 2005 and 2008. Winds, storms or other weather-related phenomena were responsible for another 25 per cent of hazmat releases. Large releases were most frequently due to major natural disasters. For instance, hurricane-induced releases of petroleum from storage tanks account for a large fraction of the total volume of petroleum released during 'natechs' (understood here as a natural hazard and the hazardous materials release that results). Among the most commonly released chemicals were nitrogen oxides, benzene, and polychlorinated biphenyls. Three deaths, 52 injuries, and the evacuation of at least 5,000 persons were recorded as a consequence of natech events. Overall, results suggest that the number of natechs increased over the study period (1990-2008) with potential for serious human and environmental impacts.

Empirical estimation of the conditional probability of natech events within the United States.

Natural disasters are the cause of a sizeable number of hazmat releases, referred to as "natechs." An enhanced understanding of natech probability, allowing for predictions of natech occurrence, is an important step in determining how industry and government should mitigate natech risk. This study quantifies the conditional probabilities of natechs at TRI/RMP and SICS 1311 facilities given the occurrence of hurricanes, earthquakes, tornadoes, and floods. During hurricanes, a higher probability of releases was observed due to storm surge (7.3 releases per 100 TRI/RMP facilities exposed vs. 6.2 for SIC 1311) compared to category 1-2 hurricane winds (5.6 TRI, 2.6 SIC 1311). Logistic regression confirms the statistical significance of the greater propensity for releases at RMP/TRI facilities, and during some hurricanes, when controlling for hazard zone. The probability of natechs at TRI/RMP facilities during earthquakes increased from 0.1 releases per 100 facilities at MMI V to 21.4 at MMI IX. The probability of a natech at TRI/RMP facilities within 25 miles of a tornado was small (∼0.025 per 100 facilities), reflecting the limited area directly affected by tornadoes. Areas inundated during flood events had a probability of 1.1 releases per 100 facilities but demonstrated widely varying natech occurrence during individual events, indicating that factors not quantified in this study such as flood depth and speed are important for predicting flood natechs. These results can inform natech risk analysis, aid government agencies responsible for planning response and remediation after natural disasters, and should be useful in raising awareness of natech risk within industry.

Accidental hazardous material releases with human impacts in the United States: exploration of geographical distribution and temporal trends.

OBJECTIVE: To investigate the circumstances and geographic and temporal distributions of hazardous material releases and resulting human impacts in the United States. METHOD: Releases with fatalities, injuries, and evacuations were identified from reports to the National Response Center between 1990 and 2008, correcting for data quality issues identified in previous studies. RESULTS: From more than 550,000 reports, 861 deaths, 16,348 injuries and 741,427 evacuations were identified. Injuries from releases of chemicals at fixed facilities and natural gas from pipelines have decreased whereas evacuations from petroleum releases at fixed facilities have increased. CONCLUSION: Results confirm recent advances in chemical and pipeline safety and suggest directions for further improvement including targeted training and inspections and adoption of inherently safer design principles.

Petroleum and hazardous material releases from industrial facilities associated with Hurricane Katrina.

Hurricane Katrina struck an area dense with industry, causing numerous releases of petroleum and hazardous materials. This study integrates information from a number of sources to describe the frequency, causes, and effects of these releases in order to inform analysis of risk from future hurricanes. Over 200 onshore releases of hazardous chemicals, petroleum, or natural gas were reported. Storm surge was responsible for the majority of petroleum releases and failure of storage tanks was the most common mechanism of release. Of the smaller number of hazardous chemical releases reported, many were associated with flaring from plant startup, shutdown, or process upset. In areas impacted by storm surge, 10% of the facilities within the Risk Management Plan (RMP) and Toxic Release Inventory (TRI) databases and 28% of SIC 1311 facilities experienced accidental releases. In areas subject only to hurricane strength winds, a lower fraction (1% of RMP and TRI and 10% of SIC 1311 facilities) experienced a release while 1% of all facility types reported a release in areas that experienced tropical storm strength winds. Of industrial facilities surveyed, more experienced indirect disruptions such as displacement of workers, loss of electricity and communication systems, and difficulty acquiring supplies and contractors for operations or reconstruction (55%), than experienced releases. To reduce the risk of hazardous material releases and speed the return to normal operations under these difficult conditions, greater attention should be devoted to risk-based facility design and improved prevention and response planning.

GvHD-associated cytokine polymorphisms do not associate with Omenn syndrome rather than T-B- SCID in patients with defects in RAG genes.

Recombinase activating genes 1/2 (RAG1/2) deficiency, critical to initiate gene rearrangement encoding lymphocyte receptors, causes T-B- severe combined immunodeficiency (SCID) and Omenn syndrome (OS), characterised by erythroderma, hepatosplenomegaly, lymphadenopathy, activated, clonal T cell expansions with restricted TCRVbeta family usage, and opportunistic infection. Many features of OS resemble graft-versus-host disease (GvHD). Frequency of GvHD-associated cytokine gene polymorphisms (CGPs) with OS was investigated to explain phenotypic differences between T-B- SCID and OS. Allele frequencies of IFNgamma T874A, IFNgamma-R1, TNFalphad microsatellites, IL-10 promoter region C592A and A1082G, IL-4 C-590T, IL-6 G-174C, IL-4R Q+576R, IFNgamma-R1 T-56C, TNFalphaRII 196 M/R single-nucleotide polymorphisms and IL-1Ra intron 1 VNTR were examined in 33 OS and 23 SCID patients. No significant differences in allele frequencies were found between the groups, and no trends identified. The mechanisms determining the OS or T-B-NK+ SCID phenotype remain to be determined.

A geographic sampling strategy for studying relationships between human activity and malaria vectors in urban Africa.

This paper describes a geographic sampling strategy for ecologic studies and describes the relationship between human activities and anopheline larval ecology in urban areas. Kisumu and Malindi, Kenya were mapped using global positioning systems, and a geographic information system was used to overlay a measured grid, which served as a sampling frame. Grid cells were stratified and randomly selected according to levels of planning and drainage. A cross-sectional survey was conducted in April and May 2001 to collect entomologic and human ecologic data. Multivariate regression analysis was used to test the relationship between the abundance of potential larval habitats, and house density, socioeconomic status, and planning and drainage. In Kisumu, 98 aquatic habitats were identified, 65% of which were human made and 39% were positive for anopheline larvae. In Malindi, 91 aquatic habitats were identified, of which, 93% were human made and 65% were harboring anopheline larvae. The regression model explains 82% of the variance associated with the abundance of potential larval habitats in Kisumu. In Malindi, 59% of the variance was explained. As the number of households increased, the number of larval habitats increased correspondingly to a point. Beyond a critical threshold, the density of households appeared to suppress the development of aquatic habitats. The proportion of high-income households and the planning and drainage variables tested insignificant in both locations. The integration of social and biologic sciences will allow local mosquito and malaria control groups an opportunity to assess the risk of encountering potentially infectious mosquitoes in a given area, and concentrate resources accordingly.