Seizure burden and neurodevelopmental outcome in neonates with hypoxic-ischemic encephalopathy.

Aim: To examine the relationship between electrographic seizures and long-term outcome in neonates with hypoxic-ischemic encephalopathy (HIE). Method: Full-term neonates with HIE born in Cork University Maternity Hospital from 2003 to 2006 (pre-hypothermia era) and 2009 to 2012 (hypothermia era) were included in this observational study. All had early continuous electroencephalography monitoring. All electrographic seizures were annotated. The total seizure burden and hourly seizure burden were calculated. Outcome (normal/abnormal) was assessed at 24 to 48 months in surviving neonates using either the Bayley Scales of Infant and Toddler Development, Third Edition or the Griffiths Mental Development Scales; a diagnosis of cerebral palsy or epilepsy was also considered an abnormal outcome. Results: Continuous electroencephalography was recorded for a median of 57.1 hours (interquartile range 33.5-80.5h) in 47 neonates (31 males, 16 females); 29 out of 47 (62%) had electrographic seizures and 25 out of 47 (53%) had an abnormal outcome. The presence of seizures per se was not associated with abnormal outcome (p=0.126); however, the odds of an abnormal outcome increased over ninefold (odds ratio [OR] 9.56; 95% confidence interval [95% CI] 2.43-37.67) if a neonate had a total seizure burden of more than 40 minutes (p=0.001), and eightfold (OR: 8.00; 95% CI: 2.06-31.07) if a neonate had a maximum hourly seizure burden of more than 13 minutes per hour (p=0.003). Controlling for electrographic HIE grade or treatment with hypothermia did not change the direction of the relationship between seizure burden and outcome. Interpretation: In HIE, a high electrographic seizure burden is significantly associated with abnormal outcome, independent of HIE severity or treatment with hypothermia

On religion and cultural policy: notes on the Roman Catholic Church

This paper argues that religious institutions have largely been neglected within the study of cultural policy. This is attributed to the inherently secular tendency of most modern social sciences. Despite the predominance of the ‘secularisation paradigm’, the paper notes that religion continues to promote powerful attachments and denunciations. Arguments between the ‘new atheists’, in particular, Richard Dawkins, and their opponents are discussed, as is Habermas’s conciliatory encounter with Joseph Ratzinger (later Pope Benedict XVI). The paper then moves to a consideration of the Roman Catholic Church as an agent of cultural policy, whose overriding aim is the promotion of ‘Christian consciousness’. Discussion focuses on the contested meanings of this, with reference to (1) the deliberations of Vatican II and (2) the exercise of theological and cultural authority by the Pope and the Congregation for the Doctrine of the Faith (CDF). It is argued that these doctrinal disputes intersect with secular notions of social and cultural policy and warrant attention outside the specialist realm of theological discourse

Stable U(IV) Complexes Form at High-Affinity Mineral Surface Sites

Uranium (U) poses a significant contamination hazard to soils, sediments, and groundwater due to its extensive use for energy production. Despite advances in modeling the risks of this toxic and radioactive element, lack of information about the mechanisms controlling U transport hinders further improvements, particularly in reducing environments where UIV predominates. Here we establish that mineral surfaces can stabilize the majority of U as adsorbed UIV species following reduction of UVI. Using X-ray absorption spectroscopy and electron imaging analysis, we find that at low surface loading, UIV forms inner-sphere complexes with two metal oxides, TiO2 (rutile) and Fe3O4 (magnetite) (at <1.3 U nm–2 and <0.037 U nm–2, respectively). The uraninite (UO2) form of UIV predominates only at higher surface loading. UIV–TiO2 complexes remain stable for at least 12 months, and UIV–Fe3O4 complexes remain stable for at least 4 months, under anoxic conditions. Adsorbed UIV results from UVI reduction by FeII or by the reduced electron shuttle AH2QDS, suggesting that both abiotic and biotic reduction pathways can produce stable UIV–mineral complexes in the subsurface. The observed control of high-affinity mineral surface sites on UIV speciation helps explain the presence of nonuraninite UIV in sediments and has important implications for U transport modeling

Concurrent validity of a touchscreen application to detect early cognitive delay

OBJECTIVE: To explore the ability of an interactive screening tool to identify cognitive delay in children aged 18 to 24 months. DESIGN: Children were assessed using the Bayley Scale of Infant and Toddler Development-third edition (BSID-III) and a touchscreen measure of problem-solving (Babyscreen V.1.5). We examined the internal consistency and concurrent validity between the two measures. A BSID-III cognitive composite score (BSID-IIIcc) ≤1 SD below population mean was used to indicate a low average cognitive ability. RESULTS: 87 children with a mean (SD) age of 20.4 (1.3) months who experienced complications at delivery (n=53) and healthy age-matched controls (n=34) were included in the study. A moderate positive correlation between the BSID-IIIcc and the total number of tasks completed on the Babyscreen suggested reasonable concurrent validity (r=0.414, p90 (-1.08 (-1.5 to -0.46) vs 0.31 (-0.46 to 0.76); p=0.001). The area under the receiver operating characteristic curve for the prediction of a low normal BSID-IIIcc was 0.787 (CI 0.64 to 0.93). A BST z-score of <-0.44 yielded 82.4% sensitivity and 71.4% specificity in identifying children with cognitive delay. CONCLUSIONS: A touchscreen-based application has concurrent validity with the BSID-IIIcc and could be used to screen for cognitive delay at 18-24 months of age

A two-component pre-seeded dermal-epidermal scaffold

We have developed a bilayered dermal-epidermal scaffold for application in the treatment of full-thickness skin defects. The dermal component gels in situ and adapts to the lesion shape, delivering human dermal fibroblasts in a matrix of fibrin and cross-linked hyaluronic acid modified with a cell adhesion-promoting peptide. Fibroblasts were able to form a tridimensional matrix due to material features such as tailored mechanical properties, presence of protease-degradable elements and cell-binding ligands. The epidermal component is a robust membrane containing cross-linked hyaluronic acid and poly-l-lysine, on which keratinocytes were able to attach and to form a monolayer. Amine-aldehyde bonding at the interface between the two components allows the formation of a tightly bound composite scaffold. Both parts of the scaffold were designed to provide cell-type-specific cues to allow for cell proliferation and form a construct that mimics the skin environment.D.S.K. acknowledges funding from the Biotechnology Research Endowment from the Department of Anesthesiology at Boston Children's Hospital. I.P.M. acknowledges the Portuguese Foundation for Science and Technology for the grant BD/39396/2007 and the MIT-Portugal Program. D.G. acknowledges the Swiss National Science Foundation for a post-doctoral fellowship (PBGEP3-129111). B.P.T. acknowledges an NIR Ruth L. Kirschstein National Research Service Award (F32GM096546)

Exploring CRM effectiveness: an institutional theory perspective

This study identifies the potential contribution that institutional theory can make to understanding the success of marketing practices. Based on institutional theory, we argue that the effectiveness of marketing practices decreases when firms are motivated to adopt such practices under the influence of institutional pressures originating in firms' environments. However, alignment between a practice and a firm's marketing strategy may buffer against these negative effects. We apply these insights to the case of customer relationship management (CRM). CRM is considered an important way to enhance customer loyalty and firm performance, but it has also been criticized for being expensive and for not living up to expectations. Empirical data from 107 organizations confirm that, in general, adopting CRM for mimetic motives is likely to result in fewer customer insights as a result of using this practice. Our study suggests that institutional theory has much to offer to the investigation of the effectiveness of marketing practices

Reconfigurable Intelligent Surfaces for THz: Hardware Design and Signal Processing Challenges

Wireless communications in the THz frequency band is an envisioned revolutionary technology for sixth Generation (6G) networks. However, such frequencies impose certain coverage and device design challenges that need to be efficiently overcome. To this end, the development of cost- and energy-efficient approaches for scaling these networks to realistic scenarios constitute a necessity. Among the recent research trends contributing to these objectives belongs the technology of Reconfigurable Intelligent Surfaces (RISs). In fact, several high-level descriptions of THz systems based on RISs have been populating the literature. Nevertheless, hardware implementations of those systems are still very scarce, and not at the scale intended for most envisioned THz scenarios. In this paper, we overview some of the most significant hardware design and signal processing challenges with THz RISs, and present a preliminary analysis of their impact on the overall link budget and system performance, conducted in the framework of the ongoing TERRAMETA project.Comment: 5 pages, 7 figures, EuCAP 202

Consumer–brand identification revisited: An integrative framework of brand identification, customer satisfaction, and price image and their role for brand loyalty and word of mouth

Consumer–brand identification has received considerable attraction among scholars and practitioners in recent years. We contribute to previous research by proposing an integrative model that includes consumer–brand identification, customer satisfaction, and price image to investigate the interrelationships among these constructs as well as their effects on brand loyalty and positive word of mouth. To provide general results, we empirically test the model using a sample of 1443 respondents from a representative consumer panel and 10 service/product brands. The results demonstrate that identification, satisfaction, and price image significantly influence both loyalty and word of mouth. Moreover, we find significant interrelationships among the constructs: Identification positively influences both satisfaction and price image, which also increases satisfaction. By disclosing the relative importance of three separate ways of gaining and retaining customers, this study helps managers more appropriately choose the right mix of branding, pricing, and relationship marketing. From an academic point of view, our research is the first to explicitly examine the effects of the concept of identification for price management and to integrate variables from the fields of branding, relationship marketing, and behavioral pricing, which have separately been identified as particularly important determinants of marketing outcomes

Corporate reputation past and future: a review and integration of existing literature and a framework for future research

The concept of corporate reputation is steadily growing in interest among management researchers and practitioners. In this article, we trace key milestones in the development of reputation literature over the past six decades to suggest important research gaps as well as to provide contextual background for a subsequent integration of approaches and future outlook. In particular we explore the need for better categorised outcomes; a wider range of causes; and a deeper understanding of contingencies and moderators to advance the field beyond its current state while also taking account of developments in the macro business environment. The article concludes by presenting a novel reputation framework that integrates insights from reputation theory and studies, outlines gaps in knowledge and offers directions for future research