The Relationship of Preterm and Small for Gestational Age with Child Cognition During School-Age Years.

BACKGROUND: Children born preterm and/or small for gestational age (SGA) are at increased risk of poor cognitive outcomes, particularly in low and middle-income countries (LMICs). OBJECTIVES: This study aimed to examine the cognitive and academic deficits during the school-age years in children born preterm or SGA compared with those in children born term adequate for gestational age (AGA) in rural Vietnam. METHODS: Children born to women in a preconception micronutrient supplementation trial in Vietnam were classified into 3 groups: preterm AGA (n =138), term SGA (n =169), and term AGA (n = 1134). Cognitive abilities were assessed using the Wechsler Intelligence Scale for Children, measuring 4 domains [verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), and processing speed index (PSI) scores] and full-scale intelligence quotient (FSIQ) at 6-7 and 10-11 y. Academic achievement was assessed with mathematic and language tests. Analysis of variance and multiple regression models were used to analyze differences in cognitive function and academic achievement at 6-7 and 10-11 y by birth phenotypes. RESULTS: Compared with term AGA children, those born SGA had lower cognitive scores at both 6-7 y (VCI, -2.3; PRI, -3.7; PSI -2.1; and FSIQ, -2.9) and 10-11 y (VCI, -3.7; PRI, -3.5; WMI, -2.7; PSI, -1.9; and FSIQ, -3.9). Children born SGA also had poorer academic achievement with lower language (5.3) and mathematic (2.5) scores. Adjustments for maternal factors and home environment attenuated the associations, but the differences in VCI, PRI, FSIQ, and language at 10-11 y remained significant. There were no differences in cognitive function and academic achievement between children born preterm and AGA. CONCLUSIONS: Our findings highlight the enduring association of birth phenotype on cognitive functioning and academic achievement during the school years, despite adjustments for maternal education and family environment. Further research is needed to implement effective interventions to improve birth outcomes and optimize child health and development in LMICs. The trial was registered at clinicaltrials.gov as NCT01665378 (URL: https://clinicaltrials.gov/ct2/show/NCT01665378).

Investigating rater-student interaction, gender bias, and major bias in the assessment of research seminar presentation.

The study aims to investigate the severity of raters toward examinees' performances and to analyze biases subject to genders and academic majors based on the rater-examinee interactions. Data were collected across a 13-week research seminar course in English. Six raters were selected to rate 33 examinees using 18-item criteria. The many-facet Rasch measurement was utilized to analyze rater-examinee interactions and bias factors. The results confirmed that the instrument is reliable and valid. This study depicted the interaction between raters and other facets using a variable map, where the raters exhibited different levels of severity/leniency in scoring students' performances in oral presentations at the research seminar course. The result based on the Rasch analysis also confirmed that gender and academic majors contaminated rater assessment. Bias interaction between raters and student gender was detected, and Rater 6 displayed bias based on gender due to the tendency to give higher scores to female than male participants with a target contrast of 2.05 logits. Bias interaction between rater academic majors and student academic majors was also identified among raters with linguistics and psychology majors.

Polyvinyl alcohol/cellulose nanocrystals/alkyl ketene dimer nanocomposite as a novel biodegradable food packing material.

Polyvinyl alcohol (PVA) is used in many applications because of its excellent physicochemical properties, non-toxicity, and biodegradability. However, its relatively low water resistance, poor water vapor/ultraviolet (UV) barrier properties, and poor mechanical properties compared with conventional polymers limit its applications in food packaging. In this study, cellulose nanocrystals (CNCs) and alkyl ketene dimer (AKD) were used to overcome these issues. The mechanical properties, water resistance, and barrier properties of the developed PVA/CNC/AKD films were significantly improved relative to those of a neat PVA film. The mechanical strength of a PVA/CNC/AKD 15% film (15 wt% AKD in a PVA/CNC matrix of 5 wt% CNCs) was 64.6% and 37% higher than those of PVA and PVA/CNC films, respectively. The water vapor transmission rate, water absorption, and solubility of PVA/CNC/AKD 15% were 41.2%, 61.1%, and 92.9%, respectively (lower than those of the neat PVA film). In addition, the UV barrier properties and soil degradation of the PVA/CNC/AKD films were significantly improved.

Reassessment of the positive predictive value and specificity of Xpert MTB/RIF: a diagnostic accuracy study in the context of community-wide screening for tuberculosis.

BACKGROUND: Community-wide screening for tuberculosis with Xpert MTB/RIF as a primary screening tool overcomes some of the limitations of conventional screening. However, concerns exist about the low positive predictive value of this test in screening settings. We did a cross-sectional assessment of this diagnostic test to directly estimate the actual positive predictive value of Xpert MTB/RIF when used in the setting of community-wide screening for tuberculosis, and to draw an inference about the specificity of the test for tuberculosis detection. METHODS: Field staff visited households in 60 randomly selected villages in Ca Mau province, Vietnam. We included people aged 15 years or older who provided written informed consent and were able to produce 0·5 mL or more of sputum, irrespective of reported symptoms. Participants were tested with Xpert MTB/RIF, then those with positive results had two further sputum samples tested for smear microscopy and culture, and underwent chest radiography at the provincial TB Health Center. The positive predictive value of Xpert MTB/RIF was compared against two reference standards for tuberculosis diagnosis-a positive sputum culture for Mycobacterium tuberculosis, and a positive sputum culture or a chest radiograph consistent with active pulmonary tuberculosis. We then calculated the specificity of Xpert MTB/RIF for tuberculosis detection on the basis of these positive predictive values and disease prevalence in this setting. FINDINGS: 43 435 adults consented to screening with Xpert MTB/RIF. Sputum samples of 0·5 mL or greater were collected from 23 202 participants, producing 22 673 valid results. 169 participants had positive Xpert MTB/RIF results (0·39% of those screened and 0·75% of those with valid sputum results). The positive predictive value of Xpert MTB/RIF was 61·0% (95% CI 52·8-68·7) when compared against a positive sputum culture and 83·9% (76·8-89·2) when compared against a positive sputum culture or chest radiograph consistent with active tuberculosis. On the basis of these positive predictive values, the specificity of Xpert MTB/RIF was determined to be between 99·78% (95% CI 99·71-99·84) and 99·93% (99·88-99·96). INTERPRETATION: The positive predictive value and specificity of Xpert MTB/RIF in the context of community-wide screening for tuberculosis is substantially higher than that predicted in previous studies. Our findings support the potential role of Xpert MTB/RIF as a primary screening tool to detect prevalent cases of tuberculosis in the community. FUNDING: Australian National Health and Medical Research Council.