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Overexposure to solar ultraviolet radiation (UVR) in childhood is considered to be a critical factor for developing skin cancer in later life. Clothing may offer a simple and effective means of protection against overexposure to the sun, but its use has often been underrated in public opinion. The Health Protection Agency, in close collaboration with a number of UK retailers, conducted a study to evaluate the UVR protection characteristics of the summer 2005 collection of children's clothing for outdoor activity. The current paper presents a summary of the assessment and the effects of stretching and wetting on the Ultraviolet Protection Factor (UPF) rating of children's clothing. The results demonstrate the need for better public guidance in sun protection of children and more comprehensive evaluation procedures for sun protection provided by clothing. [ABSTRACT FROM AUTHOR]

Delay in diagnosis can be serious in amoebic hepatic abscess, which is readily treatable. Two cases are presented to illustrate potential causes of delay. The first case had never been to an endemic area, apparently contracting the infection from his wife. The second case had negative serological tests. [ABSTRACT FROM PUBLISHER]

Identifying linked cases of infection is a critical component of the public health response to viral infectious diseases. In a clinical context, there is a need to make rapid assessments of whether cases of infection have arrived independently onto a ward, or are potentially linked via direct transmission. Viral genome sequence data are of great value in making these assessments, but are often not the only form of data available. Here, we describe A2B-COVID, a method for the rapid identification of potentially linked cases of COVID-19 infection designed for clinical settings. Our method combines knowledge about infection dynamics, data describing the movements of individuals, and evolutionary analysis of genome sequences to assess whether data collected from cases of infection are consistent or inconsistent with linkage via direct transmission. A retrospective analysis of data from two wards at Cambridge University Hospitals NHS Foundation Trust during the first wave of the pandemic showed qualitatively different patterns of linkage between cases on designated COVID-19 and non-COVID-19 wards. The subsequent real-time application of our method to data from the second epidemic wave highlights its value for monitoring cases of infection in a clinical context., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.)

SARS-CoV-2 is notable both for its rapid spread, and for the heterogeneity of its patterns of transmission, with multiple published incidences of superspreading behaviour. Here, we applied a novel network reconstruction algorithm to infer patterns of viral transmission occurring between patients and health care workers (HCWs) in the largest clusters of COVID-19 infection identified during the first wave of the epidemic at Cambridge University Hospitals NHS Foundation Trust, UK. Based upon dates of individuals reporting symptoms, recorded individual locations, and viral genome sequence data, we show an uneven pattern of transmission between individuals, with patients being much more likely to be infected by other patients than by HCWs. Further, the data were consistent with a pattern of superspreading, whereby 21% of individuals caused 80% of transmission events. Our study provides a detailed retrospective analysis of nosocomial SARS-CoV-2 transmission, and sheds light on the need for intensive and pervasive infection control procedures., Competing Interests: CI, WH, BW, MR, AP, CJ, TF, LM, CH, MH, AJ, LC, SC, AY, GH, FK, TF, MP, IG, YC, MC, SP, DS, LR, NJ, SS, SF, TD, KG, CW, MF, EG, NB, MW, SB, SP, IG, TG, Dd, MT No competing interests declared, (© 2021, Illingworth et al.)

Background: Interpretation of pediatric bone mineral density by dual energy absorptiometry (DXA) requires adjustment for height (Ht). This is often not easily obtainable in nonambulant subjects., Aims: To investigate the feasibility of using DXA images to evaluate measurements of Ht, sitting height (SH), and leg length (LL)., Methodology: A total of 2 observers performed measurements of Ht, SH, and LL on 3 separate occasion using DXA digital images in 125 children. Intraclass correlation and relative technical error of measurement (rTEM) were performed to assess reliability of repeated measurements. In 25 children, Ht and SH were measured in clinic on the same day and Bland-Altman analysis was performed to compare DXA measured Ht, SH, LL with clinic measurements for these 25 children., Results: Intraclass correlation for DXA based Ht, SH, and LL measurements ranged from 0.996 to 0.998 (p < 0.0001). rTEM of Ht, SH, and LL for observer 1 was 0.0016%, 0.002%, and 0.0034%, respectively. rTEM of Ht, SH, and LL between observer 1 and 2 was 0.0047%, 0.0049%, and 0.0087%, respectively. Mean difference between clinic and DXA measurements from Bland-Altman plots were +0.57 cm (95% confidence interval [CI] -0.54 to +1.68) for Ht, +1.33cm (-1.60 to +4.24) for SH, and -0.76cm (-3.88 to +2.37) for LL., Conclusions: Our study demonstrated for the first time that Ht, SH, and LL in children can be measured very precisely using DXA images. Ht can be measured accurately. We believe this may be a convenient method to obtain Ht measurements to allow size adjustment of DXA bone mineral density in immobile children with chronic conditions., (Copyright © 2018 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.)

Bicycling is a popular activity for children. In order for children to enjoy cycling and to minimize injury, it is important that they are positioned appropriately on the bicycle. The purpose of this study was therefore to identify a suitable bicycle setup for children aged between 7 and 16 years which accommodates developmental differences in anthropometrics, flexibility and perceptions of comfort. Using an adjustable bicycle fitting rig, we found the most comfortable position of 142 children aged 7 to 16. In addition, a number of anthropometric measures were recorded. Seat height and the horizontal distance between seat and handlebars were strongly predictable (R 2  > 0.999, p < 0.001 and R 2  = 0.649, p < 0.001 respectively), whilst the predictability of the vertical distance between seat and handlebars was weaker (R 2  = 0.231, p < 0.001). These results have practical implications for children and parents, paediatric researchers and clinicians as well as bicycle manufacturers., (Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.)

Objective: The aim is to identify the role and scope of Accredited Exercise Physiologist (AEP) services in the mental health sector and to provide insight as to how AEPs can contribute to the multidisciplinary mental health team., Methods: A modified Delphi approach was utilised. Thirteen AEPs with experience in mental health contributed to the iterative development of a national consensus statement. Six mental health professionals with expertise in psychiatry, mental health nursing, general practice and mental health research participated in the review process. Reviewers were provided with a template to systematically provide feedback on the language, content, structure and relevance to their professional group., Results: This consensus statement outlines how AEPs can contribute to the multidisciplinary mental health team, the aims and scope of AEP-led interventions in mental health services and examples of such interventions, the range of physical and mental health outcomes possible through AEP-led interventions and common referral pathways to community AEP services., Outcome: AEPs can play a key role in the treatment of individuals experiencing mental illness. The diversity of AEP interventions allows for a holistic approach to care, enhancing both physical and mental health outcomes., (© The Royal Australian and New Zealand College of Psychiatrists 2016.)

Background: Ginseng (Panax ginseng Meyer) is an important medicinal herbs in Asia. However, ginseng varieties are less developed., Method: To developed ginseng varieties, a pure line selection method was applied in this study., Results: Gumpoong was testing of 4-yr-old specimens in 2002, the proportions of the below-ground roots that were rusty colored for Gumpoong was 1.29 in Daejeon and 1.45 in Eumseong, whereas the proportions for its yellow berry variant were 2.60 and 2.45 in the two regions, respectively. Thus the Gumpoong was resistant to root rust. Sunpoong has a high yielding property. Its average root weight is 70.6 g for 6-yr-old roots. Its yield is 2.9 kg/1.62m(2) and the rate of heaven- and earth-grade product is 20.9%, which is very high compared to 9.4% for Yunpoong. Sunone is resistance to root rot and the survival rate of 4-yr-old roots was 44.4% in 1997, whereas that of the violet-stem variant landrace was 21.7%. Sunhyang has content of arginyl-fructosyl-glucose (AFG), which produces the unique scent of red ginseng, is 95.1 μmol/g and greater than the 30.8 μmol/g of Chunpoong in 6-yr-old plants. Sunun and Cheongsun are being nurtured to protect genetic resources., Conclusion: Developed ginsneg varieties will be used as the basis for the protection of genetic resources and breeding.

Background: Intervention studies for children at risk of dyslexia have typically been delivered preschool, and show short-term effects on letter knowledge and phoneme awareness, with little transfer to literacy., Methods: This randomised controlled trial evaluated the effectiveness of a reading and language intervention for 6-year-old children identified by research criteria as being at risk of dyslexia (n = 56), and their school-identified peers (n = 89). An Experimental group received two 9-week blocks of daily intervention delivered by trained teaching assistants; the Control group received 9 weeks of typical classroom instruction, followed by 9 weeks of intervention., Results: Following mixed effects regression models and path analyses, small-to-moderate effects were shown on letter knowledge, phoneme awareness and taught vocabulary. However, these were fragile and short lived, and there was no reliable effect on the primary outcome of word-level reading., Conclusions: This new intervention was theoretically motivated and based on previous successful interventions, yet failed to show reliable effects on language and literacy measures following a rigorous evaluation. We suggest that the intervention may have been too short to yield improvements in oral language; and that literacy instruction in and beyond the classroom may have weakened training effects. We argue that reporting of null results makes an important contribution in terms of raising standards both of trial reporting and educational practice., (© 2014 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

Objectives: To investigate the incidence of bilateral cranial cruciate ligament (CrCL) rupture and determine any associated risk factors., Methods: The patient information system and surgical database at the Queen Mother Hospital for Animals, Royal Veterinary College, were searched from March 1998 to March 2007. Patient files were reviewed and data recorded. The risk factors considered included: gender, neuter status, breed, body mass, age and concurrent orthopaedic disease., Results: In total, 511 dogs were identified as having cruciate rupture and included for analysis. Bilateral rupture of the CrCl was present in 38.7% (198/511) of the dogs. The mean (± SD) time that passed until the contralateral CrCL ruptured was 57.9 weeks (± 54.1; range 3 to 260 weeks). Dogs with bilateral cruciate rupture were younger (mean ± SD; 4.3 ± 2.7 years) than dogs with unilateral cruciate rupture (mean ± SD; 5.3 ± 2.8 years). In dogs with CrCL rupture, male dogs were more likely to have bilateral rupture than female dogs, overweight dogs were more likely to have bilateral rupture, Golden Retrievers were less likely to have bilateral rupture, and Rottweilers had the highest odds of bilateral rupture., Clinical Significance: In dogs with CrCL rupture, this study suggests possible relationships towards the incidence of a bilateral rupture also occurring as more likely in male dogs, young dogs with a mean age of four years (4.3 ± 2.7 years), Rottweiler dogs, and with an average elapsed time between ruptures of 57.9 weeks.

Lantibiotics are antimicrobial peptides that possess great potential as clinical therapeutic agents. These peptides exhibit many beneficial traits and in many cases the emergence of resistance is extremely rare. In contrast, producers of lantibiotics synthesize dedicated immunity proteins to provide self-protection. These proteins have very specific activities and cross-immunity is rare. However, producers of two peptide lantibiotics, such as lacticin 3147, face the unusual challenge of exposure to two active peptides (alpha and beta). Here, in addition to establishing the contribution of LtnI and LtnFE to lacticin 3147 immunity, investigations were carried out to determine if production of a closely related lantibiotic (i.e. staphylococcin C55) or possession of LtnI/LtnFE homologues could provide protection. Here we establish that not only are staphylococcin C55 producers cross-immune to lacticin 3147, and therefore represent a natural repository of Staphylococcus aureus strains that are protected against lacticin 3147, but that functional immunity homologues are also produced by strains of Bacillus licheniformis and Enterococcus faecium. This result raises the spectre of resistance through immune mimicry, i.e. the emergence of lantibiotic-resistant strains from the environment resulting from the possession/acquisition of immunity gene homologues. These phenomena will have to be considered carefully when developing lantibiotics for clinical application.

Purpose: To evaluate the safety, tolerability, efficacy, and impact on quality of life of gabapentin (Neurontin; GBP) as adjunctive therapy in patients with refractory partial seizures., Methods: AUS-STEPS was an open-label, multicenter, prospective study in patients experiencing partial seizures who were inadequately controlled with one to three concurrent antiepileptic drugs (AEDs). GBP treatment was titrated to a maximum of 4,800 mg/day, over a treatment period of 24 weeks, to achieve an efficacious and tolerable dosage. Efficacy was assessed by seizure-frequency data. Quality of life was evaluated by using the QOLIE-10 questionnaire, and safety was assessed by adverse-event reports and clinical laboratory findings., Results: A total of 176 patients received treatment with GBP, with 174 evaluable for intention-to-treat (ITT) efficacy analysis. A reduction of >50% in overall seizure frequency was observed in 93 patients (53%). There was a small (4.6%) overall improvement in QOLIE-10 score. The most frequent adverse events were dizziness (31%), fatigue (29%), somnolence (27%), headache (21%), and ataxia (20%), with no major increase seen in adverse events necessitating discontinuation as the dose of GBP was titrated upward., Conclusions: This study indicates that patients with partial epilepsy may be effectively treated with GBP at dosages of < or =4,800 mg/day, without altering the safety profile of the drug.

The inflammatory demyelinating polyneuropathies are presumed to be autoimmune diseases and as such have been treated in the past with corticosteroids, plasmapheresis and immunosuppressants. Immunoglobulin infusions represent a fourth treatment with the potential to modify the activity of the immune system in disease states. Limited past experience suggests that both acute inflammatory polyneuropathy and chronic inflammatory demyelinating polyneuropathy may respond to immunoglobulin infusions with minimal morbidity. We here outline our successful experience of this treatment in 5 of 6 patients with inflammatory demyelinating polyneuropathies and review the literature describing its use.

Two patients are described, both of whom demonstrate a temporal association between the clinical manifestations of cerebral ischaemia and smoking. A number of mechanisms through which smoking may influence cerebral blood flow and platelet function are discussed, and their relevance to the present cases is considered.

A blind controlled trial of dextran 40 in ischaemic stroke is reported. In the treated group mortality in the acute stage in patients with severe strokes was significantly reduced but survivors were severely disabled and six months later no significant benefit could be detected. In less severe strokes no effect of treatment was found. It is concluded that the action of dextran 40 in reducing acute mortality probably lay in preventing or reversing cerebral swelling but no evidence of the expected action in reducing the area of infarction following improved blood flow was found. The importance of extending assessment beyond the two weeks customary in therapeutic trials in stroke is emphasized.

Internuclear ophthalmoplegia has not previously been described in progressive supranuclear palsy. The present report draws attention to the occurrence of varying degrees of anterior internuclear ophthalmoplegia in 4 out of 13 cases of this condition studied over a 4-yr period. This finding suggests that the medial longitudinal fasciculus may be involved in the degenerative process in some cases of progressive supranuclear palsy.

Two sisters developed motor neurone disease (MND), which was associated with progressive intellectual impairment in one; they survived for 18 and 24 months, respectively. At necropsy, the features of MND were confirmed, and the demented patient had severe non-specific cerebral atrophy. No evidence of Alzheimer's disease was found. Organic dementia of non-specific type can be associated with up to 15% of the familial cases of MND and with about 2% of the sporadic cases of MND in the Western world.