Nutritional management of children with cerebral palsy: a practical guide

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Host Suitability of a Gregarious Parasitoid on Beetle Hosts: Flexibility between Fitness of Adult and Offspring

Behavioral tactics play a crucial role in the evolution of species and are likely to be found in host-parasitoid interactions where host quality may differ between host developmental stages. We investigated foraging decisions, parasitism and related fitness in a gregarious ectoparasitoid, Sclerodermus harmandi in relation to two distinct host developmental stages: larvae and pupae. Two colonies of parasitoids were reared on larvae of Monochamus alternatus and Saperda populnea (Cerambycidae: Lamiinae). Paired-choice and non-choice experiments were used to evaluate the preference and performance of S. harmandi on larvae and pupae of the two species. Foraging decisions and offspring fitness-related consequences of S. harmandi led to the selection of the most profitable host stage for parasitoid development. Adult females from the two colonies oviposited more quickly on pupae as compared to larvae of M. alternatus. Subsequently, their offspring development time was faster and they gained higher body weight on the pupal hosts. This study demonstrates optimal foraging of intraspecific détente that can occur during host-parasitoid interactions, of which the quality of the parasitism (highest fitness benefit and profitability) is related to the host developmental stage utilized. We conclude that S. harmandi is able to perfectly discriminate among host species or stages in a manner that maximizes its offspring fitness. The results indicated that foraging potential of adults may not be driven by its maternal effects, also induced flexibly with encountering prior host quality

Search for long-lived particles decaying to jet pairs

A search is presented for long-lived particles with a mass between 25 and 50 GeV$/c^2$ and a lifetime between 1 and 200 ps in a sample of proton-proton collisions at a centre-of-mass energy of $\sqrt{s}=7$ TeV, corresponding to an integrated luminosity of 0.62 fb$^{-1}$, collected by the LHCb detector. The particles are assumed to be pair-produced by the decay of a Standard Model-like Higgs boson. The experimental signature of the long-lived particle is a displaced vertex with two associated jets. No excess above the background is observed and limits are set on the production cross-section as a function of the long-lived particle mass and lifetime

Screening for Non-invasive Ventilatory Requirements in Children With Spinal Muscular Atrophy

Introduction: Despite disease modifying treatments (DMT) in Spinal Muscular Atrophy (SMA), ongoing ventilatory requirements are common. Current guidelines suggest screening with oximetry with transcutaneous carbon dioxide (TcCO2). Aim: To determine the utility of pulse oximetry with TcCO2 as a screening tool for sleep disordered breathing (SDB) and need for Polysomnography(PSG)/Non-invasive ventilation (NIV) in children with SMA. Methods: A prospective cohort study was conducted in Queensland, Australia with diagnostic PSG completed in DMT naïve children. Transcutaneous carbon dioxide and pulse oximetry were recorded and extracted. Apnoea-hypopnoea indices (AHI) criteria, stratified by age, were applied to define normalcy and indication for non-invasive ventilation (NIV). Abnormal was defined as: ≤3 months of age [mo] AHI≥10 events/hour; > 3mo AHI ≥ 5events/hour. Receiver operating characteristic (ROC) curves and clinically meaningful cut-points were calculated for abnormal PSG and a variety of pulse oximetry/TcCO2 variables. Sensitivity, specificity, and predictive values are reported. Results: Total of45 children recruited (see table 1). The odds ratio of an abnormal PSG if the ODI4≥20 events/hour and a McGill score ≥ 2 was10.1 (95% CI 1.1-89.9; p=0.04). Conclusion: This is the first study to assess utility of pulse oximetry/TcCO2 to screen for need for NIV in children with SMA; particularly important where access to gold standard full diagnostic PSG is limited. TcCO2 adds limited information. Advantages of pulse oximetry: tolerated by children; versatile (e.g. ward/home); may avoid need for a diagnostic PSG(positive screen directed to NIV titration PSG) for some children. Findings need to be validated prospectively. Grant Support: Nil. This abstract is funded by: Nil.No Full Tex

Effect of nusinersen on respiratory function in paediatric spinal muscular atrophy types 1-3

Introduction: Nusinersen is used in spinal muscular atrophy (SMA) to improve peripheral muscle function; however, respiratory effects are largely unknown. Aim: To assess the effects of nusinersen on respiratory function in paediatric SMA during first year of treatment. Methods: A prospective observational study in paediatric patients with SMA who began receiving nusinersen in Queensland, Australia, from June 2018 to December 2019. Outcomes assessed were the age-appropriate respiratory investigations: spirometry, oscillometry, sniff nasal inspiratory pressure, mean inspiratory pressure, mean expiratory pressure, lung clearance index, as well as polysomnography (PSG) and muscle function testing. Lung function was collected retrospectively for up to 2 years prior to nusinersen initiation. Change in lung function was assessed using mixed effects linear regression models, while PSG and muscle function were compared using the Wilcoxon signed-rank test. Results: Twenty-eight patients (15 male, aged 0.08-18.58 years) were enrolled: type 1 (n=7); type 2 (n=12); type 3 (n=9). The annual rate of decline in FVC z-score prior to nusinersen initiation was -0.58 (95% CI -0.75 to -0.41), and post initiation was -0.25 (95% CI -0.46 to -0.03), with a significant difference in rate of decline (0.33 (95% CI 0.02 to 0.66) (p=0.04)). Most lung function measures were largely unchanged in the year post nusinersen initiation. The total Apnoea-Hypopnoea Index (AHI) was reduced from a median of 5.5 events/hour (IQR 2.1-10.1) at initiation to 2.7 events/hour (IQR 0.7-5.3) after 1 year (p=0.02). All SMA type 1% and 75% of SMA types 2 and 3 had pre-defined peripheral muscle response to nusinersen. Conclusion: The first year of nusinersen treatment saw reduced lung function decline (especially in type 2) and improvement in AHI.Full Tex

Dysphagia and Lung Disease in Children With Spinal Muscular Atrophy Treated With Disease-Modifying Agents

Dysphagia and Lung Disease in Children With Spinal Muscular Atrophy Treated With Disease-Modifying Agent