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Classification of arithmetic disorders is predicated on neuropsychological features and associated learning disabilities. Assesses the compatibility of these classifications on a nonreferred, population-based cohort of children (N=139) with developmental dyscalculia. Concludes that children with dyscalculia and disabilities in reading and/or writing are more profoundly impaired in arithmetic than children with dyscalculia alone or attention deficit hyperactivity disorder. Contains 36 references. (Author/ASK)

BACKGROUND : Previously, sponsored publications have shown that either terbinafine or itraconazole (pulse regimen) are effective for patients with toenail onychomycosis. However, independent comparative studies are lacking. OBJECTIVES : To objectively compare treatment with terbinafine and itraconazole in patients with toenail onychomycosis. METHODS : The effectiveness of terbinafine (250 mg/day 3 months) versus itraconazole pulse regimen (400 mg/day for the first week of each month, for three cycles) was retrospectively evaluated in patients with toenail onychomycosis using mycological tests and subjective outcome measures. Statistical analyses were performed using one-way analyses of variance (ANOVA) for continuous variables and Fisher exact tests for categorical variables. RESULTS : Included in the study were 117 patients (74 patients treated by terbinafine and 43 patients treated with itraconazole). Patients were examined at an average period of 20 months after the end of therapy. Mycological cure was observed in 70.6% and 62.8% of the patients who were treated by terbinafine or itraconazole, respectively (not statistically significant). Mean visual analogue scale assessment of treatment outcome was 79.9 mm (SD 24.7 mm) and 65.2 mm (SD 34.6 mm) for patients treated by terbinafine or itraconazole, respectively ( p =0.008). When the results were stratified according to age and gender, it was observed that the advantage of terbinafine versus itraconazole retained statistical significance only for patients who were 55 years old and above, or females. CONCLUSIONS : Mycological cure proportions were not statistically significant between patients treated by terbinafine or itraconazole for toenail onychomycosis. However, better subjective outcome measures indicated an advantage for terbinafine over itraconazole, noticeable in females and patients 55 years old and above. [ABSTRACT FROM AUTHOR]

Chronic schizophrenics as a group were inferior to controls on tests of neuropsychological function. When divided into groups according to length of illness they differed from each other primarily in tests of language. No other deficits in cognitive function progressed; the performance of the patients on memory, visuo-spatial tasks, rate of information processing and abstract thinking did not decline according to length of illness. The results indicate that chronic schizophrenia is characterised by a selective deterioration of language, which correlates with the notion that schizophrenia may be associated with left hemisphere dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: We assessed the efficacy of taurolidine lock (TL) in preventing catheter-related bloodstream infections (CRBSIs) and related hospitalizations in children with parenteral nutrition (PN) in the home setting., Methods: This study is a retrospective case series study. All children with intestinal failure in a single center in southern Israel who were administered PN and treated with TL between 2017 and 2024 were included. The rates of CRBSI episodes, related hospitalizations and pathogen distribution in the pre-TL and post-TL periods were compared., Results: Overall, 14 patients were included. The median pre-TL and post-TL periods were 990 and 1260 days, respectively. The rate of CRBSI episodes due to bacterial infection per 1000 days declined by 45%, from 6.2 to 3.7, with p = 0.0008, while fungal CRBSI rates were low (<10% of all positive cultures) and did not decline significantly. Similarly, the hospitalization episode rate per 1000 days declined by 41%, from 7.6 to 4.5, with p = 0.001., Conclusions: Taurolidine lock treatment for children with central-line PN resulted in a substantial decrease in CRBSI episodes and related hospitalizations.

The educational staff that meets the children at school struggles to cope with the death of a child, and often avoids talking with them about the death and their sense of loss. This way of coping is complicated in the case of grief among children with special needs, called "disenfranchised grief ". The aim of this qualitative study was to examine the experience and the perceptions of the educational staff in schools for special education and to assess their way of coping, support and care they employ following the death of a student. 15 staff members from different schools in Israel, interviewed. The findings reveal that schools are a significant source of support for students, staff and parents, alike, in the processing of the loss. The special education frameworks generally maintained a special and close connection with students and families. procedures and guidelines are required following death of a student., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study aimed to examine attachment and adult separation anxiety (ASA) among women who lost a parent in their youth. We hypothesized that insecure attachment and increased ASA from a romantic partner would be found among women who have lost a parent in youth, compared to women whose parents were both alive. Sixty women who lost one or both parents in their youth and 60 who had living parents participated in the study (mean age: 32.3, range: 18-62 years). Participants filled out the ASA and Short Attachment questionnaires. Women who lost a parent reported higher levels of anxious attachment and ASA from partner; the two groups did not differ, however, in terms of avoidant attachment. Additionally, similar effects on ASA and attachment were found among adult women who lost a father or a mother in their youth. In conclusion, the loss of a parent early in life may be associated with an insecure attachment style and increased ASA., (© 2023 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

A parent's death shakes the child's world and unbalances the family structure. School can be a source of support, yet there is scarce research on the experience of bereaved children in school a few years after the loss and from their own perspective. In this qualitative-phenomenological study we set out to identify the subjective experience of parentally bereaved children and adolescents in school, at least one year after the death. Twenty parentally bereaved children and adolescents were interviewed. Findings indicated that most felt they were regarded differently by staff at school. For some, this felt right, while others were uncomfortable. Most needed consideration and flexibility and wished the staff would discuss their needs with them. We conclude that it is important to directly inquire about and address each student's needs. School personnel should be better informed about how to deal with students' loss to help them in the long term.

Lay Abstract: We tested the ability of a short, recently developed parent interview and two widely used parent-report questionnaires to discriminate school-age verbal children with autism spectrum disorder from those with attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHD w/oASD ). These measures included the Autism Symptom Interview - School-Age, the Social Responsiveness Scale - 2nd Edition, and the Social Communication Questionnaire - Lifetime. The classification accuracy of all three parent screeners fell in the moderate range. Accuracy varied by instrument, and the Social Communication Questionnaire - Lifetime questionniare showed the highest accuracy. Children with autism spectrum disorder who were incorrectly classified by all parent screeners did not differ from those correctly classified in regard to demographics, intellectual abilities, nor in any specific clinical area beyond general parent concerns. These findings showed that there are valid screening options for assessing school-age verbal children with autism spectrum disorder versus ADHD w/oASD . They also underscore the need to assess multiple sources of information for increased accuracy.

Losing a loved one as a result of murder is a profoundly traumatic experience. This is even more precise with regard to children who have lost an immediate family member, such as a parent or a sibling. This experience may severely impact the children's social and emotional lives, their functioning, adaptability, and psychological and physical development. In the last few years, public and therapeutic awareness in Israel has been raised with regard to the effect of murder cases on the families of the victims. In 2009, the Israeli government approved an assistance program for families bereaved by homicide in Israel. This article focuses on the treatment of grieving children in the Arab community, which touches upon the violent nature of the murder, requires awareness, and broadens the knowledge of children's grieving processes, as well as religious, cultural, and social perceptions regarding death and treatment-seeking.

Early diagnosis of autism spectrum disorder (ASD) in children enables earlier access to services and better ability to predict subsequent development. A vast body of literature consistently shows discrepancies in the age of diagnosis between children from varying socio-economic levels, cultural and ethnic backgrounds. The present study examines the effect of sociodemographic factors on age of ASD diagnosis among the three primary ethnic sectors in Jerusalem region: secular and modern religious Jews, ultra-Orthodox Jews and Arabs. Findings indicate minimal differences in age of diagnosis prior to the age of six, although Arab children of this age were largely minimally verbal. After age six, no Arab children were referred for an evaluation.

Purpose: Pathogenic variants in the X-linked gene NEXMIF (previously KIAA2022) are associated with intellectual disability (ID), autism spectrum disorder, and epilepsy. We aimed to delineate the female and male phenotypic spectrum of NEXMIF encephalopathy., Methods: Through an international collaboration, we analyzed the phenotypes and genotypes of 87 patients with NEXMIF encephalopathy., Results: Sixty-three females and 24 males (46 new patients) with NEXMIF encephalopathy were studied, with 30 novel variants. Phenotypic features included developmental delay/ID in 86/87 (99%), seizures in 71/86 (83%) and multiple comorbidities. Generalized seizures predominated including myoclonic seizures and absence seizures (both 46/70, 66%), absence with eyelid myoclonia (17/70, 24%), and atonic seizures (30/70, 43%). Males had more severe developmental impairment; females had epilepsy more frequently, and varied from unaffected to severely affected. All NEXMIF pathogenic variants led to a premature stop codon or were deleterious structural variants. Most arose de novo, although X-linked segregation occurred for both sexes. Somatic mosaicism occurred in two males and a family with suspected parental mosaicism., Conclusion: NEXMIF encephalopathy is an X-linked, generalized developmental and epileptic encephalopathy characterized by myoclonic-atonic epilepsy overlapping with eyelid myoclonia with absence. Some patients have developmental encephalopathy without epilepsy. Males have more severe developmental impairment. NEXMIF encephalopathy arises due to loss-of-function variants.

Aim: We describe the clinical, microbiologic, therapeutic, and outcome characteristics of infants under three months of age with a positive urine culture reported after discharge from emergency department with normal urinalysis., Methods: We enrolled all infants with a urine culture obtained during an emergency room visit during 2004-2012, discharged without antibiotic therapy and subsequently reported with a positive urine culture., Results: Three hundred and ninety-three positive urine cultures were reported; 46/393 (11.7%, 42 in patients under two months of age) had positive urine cultures following normal urinalysis at first visit. Fifteen (33%) had positive urine cultures at second visit; 11/15 (73%) infants with second positive urine culture were under one month of age, eight were asymptomatic and seven had mild symptoms at second visit. Pathogens isolated in all 15 infants were identical between first and second visit. All 27 infants re-examined at second visit at the emergency room were hospitalised, completed sepsis work/up and received antibiotic treatment. None developed serious bacterial infections., Conclusion: We propose a new management approach for young infants with normal urinalysis and positive urine culture and suggest restricting the management option including hospitalisation, sepsis work/up and antibiotic treatment at second visit only to infants under one month of age., (©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Objective: To assess whether prenatal treatment with betamethasone has a significant influence on cerebral maturation indices as measured by electroencephalographic (EEG) indices., Study Design: Infants born less than 35 weeks postmenstrual age (PMA) were prospectively enrolled if their mother received a full course of bethametasone prior to delivery (study group) or not (control group); infants with major intracranial abnormalities were excluded as well as those who were sedated or needed assisted ventilation. EEG was recorded during the first 10 days of life. Interburst intervals and maximal amplitudes of theta and delta bandwidths were calculated by a signal processing software. A multivariate general linear model was used to analyze the relationship between the 2 groups and the different electrophysiologic parameters, adjusting for PMA and mode of delivery., Results: Thirty-eight infants were included in the study group and 36 in the control group. Univariate analysis demonstrated a negative correlation between PMA at test and EEG indices (interburst interval and delta and theta frequencies). Multivariate analysis demonstrated a less robust correlation of PMA and EEG indices and a positive correlation of prenatal betamethasone treatment with Theta frequencies. Repeating the data analysis separately for each study group, the above results remained significant mainly in the study group., Conclusions: Our findings suggest a possible stabilization effect of corticosteroids on the central nervous system and a possible delay of the maturation of cerebral activity related to prenatal corticosteroids use. These findings may relate to a better neurodevelopmental outcome of infants treated prenatally with corticosteroids.

Analysis of intravascular optical coherence tomography (IVOCT) data has potential for real-time in vivo plaque classification. We developed a processing pipeline on a three-dimensional local region of support for estimation of optical properties of atherosclerotic plaques from coronary artery, IVOCT pullbacks. Using realistic coronary artery disease phantoms, we determined insignificant differences in mean and standard deviation estimates between our pullback analyses and more conventional processing of stationary acquisitions with frame averaging. There was no effect of tissue depth or oblique imaging on pullback parameter estimates. The method's performance was assessed in comparison with observer-defined standards using clinical pullback data. Values (calcium [Formula: see text], lipid [Formula: see text], and fibrous [Formula: see text]) were consistent with previous measurements obtained by other means. Using optical parameters ([Formula: see text], [Formula: see text], [Formula: see text]), we achieved feature space separation of plaque types and classification accuracy of [Formula: see text]. Despite the rapid [Formula: see text] motion and varying incidence angle in pullbacks, the proposed computational pipeline appears to work as well as a more standard "stationary" approach.

The presence of extensive calcification is a primary concern when planning and implementing a vascular percutaneous intervention such as stenting. If the balloon does not expand, the interventionalist must blindly apply high balloon pressure, use an atherectomy device, or abort the procedure. As part of a project to determine the ability of Intravascular Optical Coherence Tomography (IVOCT) to aid intervention planning, we developed a method for automatic classification of calcium in coronary IVOCT images. We developed an approach where plaque texture is modeled by the joint probability distribution of a bank of filter responses where the filter bank was chosen to reflect the qualitative characteristics of the calcium. This distribution is represented by the frequency histogram of filter response cluster centers. The trained algorithm was evaluated on independent ex-vivo image data accurately labeled using registered 3D microscopic cryo-image data which was used as ground truth. In this study, regions for extraction of sub-images (SI's) were selected by experts to include calcium, fibrous, or lipid tissues. We manually optimized algorithm parameters such as choice of filter bank, size of the dictionary, etc. Splitting samples into training and testing data, we achieved 5-fold cross validation calcium classification with F 1 score of 93.7±2.7% with recall of ≥89% and a precision of ≥97% in this scenario with admittedly selective data. The automated algorithm performed in close-to-real-time (2.6 seconds per frame) suggesting possible on-line use. This promising preliminary study indicates that computational IVOCT might automatically identify calcium in IVOCT coronary artery images.

Background: Tuberculous pleurisy is the most common form of extrapulmonary tuberculosis, and a common cause of exudative pleural effusion. Closed pleural biopsy can be used for diagnosis. In recent years, more invasive methods are used for the diagnostic process in the western world. Contrary to the global trend, physicians at the Pulmonary Institute of the Soroka University Medical Center still perform a closed pleural biopsy as the first diagnostic step. In this article, we report our experience in the diagnosis of tuberculous pleurisy by closed pleural biopsy., Methods: A retrospective cohort analysis, conducted among patients, who were admitted for investigation of pleural effusion between 2008 and 2013, and underwent closed pleural biopsy with an Abrams needle in the evaluation of tuberculous pleurisy (n=25). Histopathological evidence of tuberculosis bacterium infection included a positive staining for acid-fast bacteria, identification of Langerhans giant cells, demonstration of chronic granulomatous inflammation or demonstration of granulomas with central necrosis in samples of pleural fluid or pleural biopsy., Results: Closed pleural biopsy was performed in 22/25 (88%) of patients. In 15/22 subjects (68%) histopathotogical evidence of tuberculous pleurisy was found. No significant complications were evident after the procedure. In addition, it was found that acid-fast bacteria in sputum samples, gastric fluid and pleural fluid is of very low diagnostic yield for the diagnosis of tuberculous pleurisy, while in cultures of sputum, gastric fluid or pleural fluid infection it was diagnosed in 27, 28 and 28% of subjects respectively., Conclusions: In subjects with a high probability for tuberculous pleurisy, closed pleural biopsy using Abrams needle is available, inexpensive and has a good diagnostic yield and low complication rate. We believe that there is great importance in preserving the ability to perform a closed pleural biopsy in all. medical centers in Israel.