Genetic, environmental, and gender effects on individual differences in toddler expressive language.

In this article, the authors examined the genetic and environmental factors influencing expressive language development in a sample of 386 toddler twin pairs participating in the Wisconsin Twin Project. Expressive language was assessed using 2 measures from the MacArthur Communicative Development Inventories-Short Form: Total Vocabulary and Two-Word Combination Use (L. Fenson et al., 2000). A sex-limitation structural equation model estimated the contribution of genetics, shared environment, and nonshared environment to individual variation. For vocabulary, heritability was higher for boys than for girls (20% vs. 8%). For word combination use, heritability was higher for girls (28% vs. 10%). However, the majority of individual variation in both boys and girls could be attributed to shared environment (54%-78%).     

Effects of home parenteral nutrition on resting metabolic rate: a case study.

Resting metabolic rate (RMR) measurement by indirect calorimetry is often used in acute care; however, indirect calorimetry is rarely performed on patients treated at home with complex therapies such as home parenteral nutrition (HPN). A new hand-held indirect calorimeter is now available to measure RMR and oxygen consumption (VO2). This is a case study of a 35-year-old female who had her RMR and VO2 measured at rest while receiving cyclic HPN and while off of HPN over a period of 8 days. Results indicate that her RMR was higher while receiving HPN. Measuring RMR in patients receiving HPN may be very beneficial to avoid underfeeding and overfeeding. It will be important for the clinician to note if the patient is receiving HPN at the time of the measurement because RMR may be affected by HPN infusion.     

Ocular component measurement using the Zeiss IOLMaster.

PURPOSE: Axial length is traditionally measured using A-scan ultrasound. The IOLMaster is a new instrument that uses partial coherence interferometry to measure axial length. We compared the repeatability of these techniques for both an experienced and an inexperienced observer, the agreement between the two techniques, and the effect of cycloplegia on IOLMaster measurements. METHODS: Five measurements of axial length and three measurements of anterior chamber depth were taken with the IOLMaster in two sessions separated by 1 to 12 days in 20 young adults. The two examiners each took measurements, and the subject was then cyclopleged with 1% tropicamide. The IOLMaster readings were then repeated by both examiners, followed by five ultrasound readings. Repeatability was evaluated by calculating the difference between measurements from the two sessions. The mean and standard deviation of these differences was then used to determine the 95% limits of agreement (LoA) for each technique. In addition, the agreement between the IOLMaster and ultrasound was assessed, along with the effect of cycloplegia on IOLMaster readings. RESULTS: The IOLMaster was more repeatable than ultrasound. For axial length, the 95% LoA were -0.11 to +0.07 mm, -0.06 to +0.05 mm, and -0.25 to +0.35 mm, for noncycloplegic IOLMaster, cycloplegic IOLMaster, and ultrasound, respectively. The two instruments showed modest agreement with each other (mean difference, +0.12 mm; 95% LoA, -0.39 to +0.64 mm; p > 0.0125). Cycloplegia had no significant effect on IOLMaster axial length measurements. The 95% LoA for anterior chamber depth measurement were -0.11 to +0.18 mm, -0.06 to +0.04 mm, and -0.19 to +0.21 mm, for noncycloplegic IOLMaster, cycloplegic IOLMaster, and ultrasound, respectively. The IOLMaster gave significantly longer anterior chamber depths than ultrasound (mean, +0.18 mm; 95% LoA, -0.02 to +0.37 mm; p < 0.0125), and cycloplegia produced significantly deeper anterior chamber depths using the IOLMaster (mean, +0.12 +/- 0.09 mm; 95% LoA, -0.05 to +0.29 mm; t = 6.17; p < 0.001). The experienced observer's measurements were more repeatable than the inexperienced observer's for ultrasound, but not for the IOLMaster. CONCLUSIONS: The superior repeatability of the IOLMaster suggests that it should become the standard for axial length measurement. The 95% limits of agreement for the cycloplegic measurements correspond to a change in refractive error of +/-0.12 D.     

Predictive factors of local-regional recurrences following parotid sparing intensity modulated or 3D conformal radiotherapy for head and neck cancer.

BACKGROUND AND PURPOSE: Predictive factors for local-regional (LR) failures after parotid-sparing, Intensity modulated (IMRT) or 3D conformal radiotherapy for head and neck (HN) cancers were assessed. PATIENTS AND METHODS: One hundred and fifty-eight patients with mostly stages III-IV HN squamous cell carcinoma underwent curative bilateral neck irradiation aimed at sparing the parotid glands. Patient, tumor, and treatment factors were analyzed as predictive factors for LR failure. RESULTS: Twenty-three patients had LR recurrence (19 in-field and four marginal). No differences were found in the doses delivered to the PTVs of patients with or without in-field recurrences. In univariate analysis, tumor site was highly predictive for LR failure in both postoperative and definitive RT patients. In postoperative RT patients, pathologic tumor size, margin status, extracapsular extension (ECE) and number of lymph node metastases, were also significantly predictive. Multivariate analysis showed tumor site (oropharynx vs. other sites) to be a significant predictor in all patients, and involved margins and number of involved lymph nodes in postoperative patients. CONCLUSIONS: Clinical rather than dosimetric factors predicted for LR failures in this series, and were similar to those reported following standard RT. These factors may aid in the selection of patients for studies of treatment intensification using IMRT.     

Development and Characterizations of Pullulan and Maltodextrin-Based Oral Fast-Dissolving Films Employing a Box–Behnken Experimental Design

Migraine is a neurological disorder characterized by severe headaches, visual aversions, auditory, and olfactory disorders, accompanied by nausea and vomiting. Zolmitriptan (ZMT^®) is a potent 5HT1B/1D serotonin receptor agonist frequently used for the treatment of migraine. It has erratic absorption from the gastrointestinal tract (GIT), but its oral bioavailability is low (40–45%) due to the hepatic metabolism. This makes it an ideal candidate for oral fast dissolving formulations. Hence, the current study was undertaken to design and develop oral fast-dissolving films (OFDFs) containing ZMT for migraine treatment. The OFDFs were formulated by the solvent casting method (SCM) using Pullulan (PU) and maltodextrin (MDX) as film-forming agents and propylene glycol (PG) as a plasticizer. The strategy was designed using Box–Behnken experimental design considering the proportion of PU:MDX and percentage of PG as independent variables. The effectiveness of the OFDF’s was measured based on the following responses: drug release at five min, disintegration time (D-time), and tensile strength (TS). The influence of formulation factors, including percent elongation (%E), thickness, water content, moisture absorption, and folding endurance on ZMT-OFDFs, were also studied. The results showed a successful fabrication of stable ZMT-OFDFs, with surface uniformity and amorphous shape of ZMT in fabricated films. The optimized formulation showed a remarkable rapid dissolution, over 90% within the first 5 min, a fast D-time of 18 s, and excellent mechanical characteristics. Improved maximum plasma concentration (C max) and area under the curve (AUC 0–t) in animals (rats) treated with ZMT-OFDFs compared to those treated with an intra-gastric (i-g) suspension of ZMT were also observed. Copolymer OFDFs with ZMT is an exciting proposition with great potential for the treatment of migraine headache. This study offers a promising strategy for developing ZMT-OFDFs using SCM. ZMT-OFDFs showed remarkable rapid dissolution and fast D-time, which might endeavor ZMT-OFDFs as an auspicious alternative approach to improve patient compliance and shorten the onset time of ZMT in migraine treatment.     

Diet Modification before or during Pregnancy on Maternal and Foetal Outcomes in Rodent Models of Maternal Obesity

The obesity epidemic has serious implications for women of reproductive age; its rising incidence is associated not just with health implications for the mother but also has transgenerational ramifications for the offspring. Increased incidence of diabetes, cardiovascular disease, obesity, and kidney disease are seen in both the mothers and the offspring. Animal models, such as rodent studies, are fundamental to studying maternal obesity and its impact on maternal and offspring health, as human studies lack rigorous controlled experimental design. Furthermore, the short and prolific reproductive potential of rodents enables examination across multiple generations and facilitates the exploration of interventional strategies to mitigate the impact of maternal obesity, both before and during pregnancy. Given that obesity is a major public health concern, it is important to obtain a greater understanding of its pathophysiology and interaction with reproductive health, placental physiology, and foetal development. This narrative review focuses on the known effects of maternal obesity on the mother and the offspring, and the benefits of interventional strategies, including dietary intervention, before or during pregnancy on maternal and foetal outcomes. It further examines the contribution of rodent models of maternal obesity to elucidating pathophysiological pathways of disease development, as well as methods to reduce the impact of obesity on the mothers and the developing foetus. The translation of these findings into the human experience will also be discussed.