Purpose: To establish normative data for children and to characterize developmental differences in performance with the free recall version of the Randomized Dichotic Digits Test. Research Design: Group comparison of behavioral data derived from administration of the Randomized Dichotic Digits Test. Study Sample: Children from 10 to 18 years of age (167) and young adults from 19 to 28 years of age (50). Results: Performance improved with age across all types of digit pairs, especially in the left ear, leading to smaller interaural asymmetries among older participants. A left-ear advantage was produced by 39 subjects (18%), only two of whom were left-handed. Normative data are reported for right and left ear scores and for interaural asymmetry (percent correct difference between the two ears) under one-, two-, and three-pair conditions of the test and for interaural asymmetry across the entire test. A unilateral deficit was identified in children (15.5%) and young adults (12%) for the left ear and in children (11.3%) and young adults (6%) for the right ear. A bilateral deficit was also identified in children (6.5%) and young adults (6%). Conclusions: This test may be useful as part of the clinical battery for identifying binaural integration weaknesses and referring individuals for auditory rehabilitation for interaural asymmetry (ARIA).

An 82-year-old woman presented to the emergency department with chest pain after sustaining a transient ischemic attack 1 week prior to presentation. Electrocardiography revealed ST-segment elevation in leads I, II, aVF, and V3 through V6. Coronary angiography demonstrated nearly normal coronaries but left ventriculography showed apical akinesis and basal hyperkinesis. One month later her follow-up echocardiography showed no wall motion abnormalities. Several reports of tako-tsubo syndrome or transient left ventricular apical ballooning have been described, especially in Japan. We present a case with the typical features of the syndrome after a cerebrovascular accident.

Purpose of Review: This article reviews the latest data on unprotected left main (ULM) percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery, with a focus on the NOBLE and EXCEL trials. Recent Findings: In EXCEL trial, the primary endpoint at 3 years was 15.4% in the PCI group and 14.7% in the CABG group (p = 0.02 for non-inferiority of PCI versus CABG). In NOBLE, the primary endpoint at 5 years was 28% and 18% for PCI and CABG, respectively (HR 1.51, CI 1.13–2.0, which did not meet the criteria for non-inferiority of PCI to CABG; p for superiority of CABG was 0.0044). Higher repeat revascularization and non-procedural myocardial infarction were noted in PCI group but there was no difference in all-cause or cardiac mortality between the two groups. Summary: A heart team approach with appropriate patient selection, careful assessment of LM lesions, and meticulous procedural technique makes PCI a valid alternative to CABG for ULM stenosis.

Background: Left/right judgment (LRJ) measurement is a potential way to identify dysfunction in cortical body maps, and to measure improvement related to corresponding treatments. Few studies have explored the reliability of various methods for LRJ measurement. Objectives: To determine measurement reliability of LRJ utilizing two methods: card-based (CB) and tablet-based (TB). Establish minimal detectable difference (MDD) for accuracy and reaction time for both assessments. Methods: Testing was done over two different days. Session 1 consisted of testing LRJ utilizing CB assessment with photos of left and right hands over two trial periods. The TB format was also tested over two trial periods. Session 2 tested with the CB assessment for two trial periods. 40 images were used in the basic upright position for both CB and TB formats. Results: Fifty participants (N = 50; female = 35) with an average age of 24.3 (range 19–35) were studied. ICC (2,k) for reaction time for both methods were >0.84. The MDD for reaction time was between 0.19 and 0.49 s for various test points for both methods. Combined left and right accuracy ICC (2,k) for both methods were >0.51, with MDD between 5 and 14%. Conclusions: This study examined the reliability and MDD for the LRJ measurement for card and tablet-based assessments. Generally, LRJ reaction time had good reliability, while accuracy had moderate reliability and varied between testing methods.

Background Obesity and hypertension are two risk factors of left ventricular hypertrophy (LVH) in adults. We aimed to examine the impacts of body weight and blood pressure (BP) from childhood on adult LV geometric remodeling. Methods The study cohort consisted of 1256 adults aged 27–42 years who had 2–10 measurements of body mass index (BMI) and BP from childhood in 1987 to adulthood in 2010. We calculated the cumulative and incremental values of BMI and BP from childhood to adulthood. In adulthood, four LV geometric patterns were defined based on the values of left ventricular mass index (g/m2.7) and relative wall thickness: normal geometry, concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH). Results The prevalence of abnormal LV geometric patterns in adults was 26.4% for CR, 2.0% for EH and 2.5% for CH. For childhood values, systolic BP (Odds Ratio [OR] = 1.26, 95% confidence interval [CI] = 1.08–1.47) but not BMI (OR = 1.06, 95%CI = 0.93-1.18) was associated with adult CR, whereas BMI (OR = 3.53, 95%CI = 2.09–5.98) but not systolic BP (OR = 1.04, 95%CI = 0.65–1.66) was associated with adult EH. Both childhood BMI (OR = 2.69, 95%CI = 1.77–4.09) and systolic BP (OR = 1.64, 95%CI = 1.07–2.51) were independently associated with adult CH. For adulthood, cumulative and incremental values, BMI and systolic BP were independently associated with adult CR, EH and CH. Conclusion Excessive body weight and elevated BP from childhood have independent influences on the development of adult LV geometric remodeling.

Understanding the hemodynamics of the cardiovascular system and associated diseases is important for mitigating health risks. We applied flow diagnostic techniques to investigate pulsatile flow characteristics past sidewall cavities, which have implications to two biomedical problems in the cardiovascular system: sidewall aneurysms and the left atrial appendage. Superhydrophobically-coated mesh diverters and synthetic slippery surfaces were studied for their effects on flow diversion and cavity flow enhancements. The study of pulsatile flow over a coated mesh diverter showed that the formation of the primary vortex was prevented which prevents flow stagnation and downwash flow in the cavity. The second study indicates that the healthy heart cycle is essential to reducing flow stasis inside the left atrial appendage. After applying a synthetic slippery surface to the interior of a side wall cavity model, this surface reduced the wall shear stress and allowed vortical flow to reach deeper into the cavity.

A semi-systematic literature review of research carried out on the evolution of the concept of Euroscepticism since the term first was reportedly used in 1986 with special focus on articles published around the year before the 2019 European Parliament elections and to this date. The thesis was conducted with a particular interest in gathering more knowledge on using an evidence-based method in political science. The purpose was twofold, therefore: one to see how the concept itself has evolved in research, in terms of definition and salience as well as in terms of measuring and explanatory factors, and the other to see if the method used is appropriate to this purpose. From the data gathered, it can be said that the method is pertinent and relevant when assembling research from a widespread and multifaceted area in terms of geography and content, since it is meant to avoid the pitfalls of ‘picking and choosing’ data. The articles thus uncovered have shown that there is a red thread in research on Euroscepticism, that its context has changed and therefore its content, and that Euroscepticism 2020 is a salient issue.

Background: Resistant hypertension (RH) is defined as blood pressure (BP) that remains elevated (>140/90mmHg) despite being treated with an antihypertensive regimen of 3 or more medications from different classes, including a long-acting calcium channel blocker, an angiotensin converting enzyme inhibitor or angiotension receptor blocker and a diuretic. The prevalence of RH in South Africa is currently unknown, however, clinical reports suggest that it is not rare. Patients with RH are significantly predisposed to cardiovascular (CV) diseases compared to patients with controlled BP. Consequences of RH include left ventricular hypertrophy, heart failure, ischaemic heart disease, chronic kidney disease leading to end-stage renal disease, stroke, vascular dementia, CV death and peripheral arterial disease. A proportion of patients with RH who never achieve BP control despite maximal medical treatment, represent a potentially novel and distinctive phenotype which is different from RH patients whose BP canbe controlled. Recognising and categorising such patients becomes the initial and crucial step in stratifying phenotypes and defining mechanisms of treatment resistance. Objectives: The aim of this study was to identify patients with resistant uncontrolled hypertension (RUH) and compare phenotypes in these patients to resistant controlled hypertensives (RCH). Methods: We enrolled 50 patients from the Groote Schuur Hospital Hypertension Clinic: a teriary referral hospital for RH. Patients on 4 or more antihypertensive medication including a diuretic, with BP< 140/90mmHg were considered RCH, and those with BP ≥ 140/90 considered RUH. Assessments included clinical examination, electrocardiography, echocardiography, applanation tonometry, serum biomarkers and cardiovascular magnetic resonance (CMR - which included biventricular volumes and function, myocardial strain, tissue characteristics and late gadolinium enhancement - LGE). Results: Thirty were diagnosed with RUH and twenty with RCH. Patients with RUH were more likely to have a longer duration since diagnosis of hypertension (10.5±10.7 vs. 3.6±3.4, p=0.02) and more likely to be on treatment that included an ACE-inhibitor (90% vs. 58%, p=0.01). As expected, patients with RUH had significantly higher systolic BP (155.6±21.6 vs. 137.8±16.5 mmHg, p< 0.001), diastolic BP (88.4±14.5 vs. 77.5±13.6 mmHg, p= 0.03), mean arterial BP (115.4±17.2 vs 101±15.3 mmHg, p= 0.004) and pulse pressure (67.3±14.2 vs. 60.1±12.4 mmHg, p=0.001). Further, RUH patients had significantly lower large artery elasticity (12.5±4 vs 14.7±3.8ml/mmHgx100, p=0.08) and lower small artery elasticity (4.1±2.1 vs. 6.9±3.6ml/mmHgx100, p< 0.001). RUH patients also had a higher systemic vascular resistance (1754±418.4 vs. 1363±371.5dyneXsecXcm-5, p=0.002). On CMR, RUH patients had lower right ventricular (RV) end-systolic and end-diastolic volumes (p=0.02), as well as higher indexed left ventricular mass (LVMI) (61.6±17.6 vs 52.9±13.9 g/m2 , p= 0.06). There were no differences in native T1, extracellular volume quantification and LGE volume fraction between RUH and RCH patients. Conclusions: Patients with RUH have a greater involvement and more severe CV phenotype, that is likely to result in increased CV morbidity and mortality, including greater target end organ damage as a result of vascular adaptations and concentric remodeling.

This study examined teachers' perceptions and attitudes of Title I students at an urban elementary school in which over 90% of the student population receives free or reduced-priced lunch. Using participant observation and in-depth interviews, this research analyzed three avenues for Title I students to acquire cultural and social capital at school: material and non-material resources, language acquisition, and the building of positive teacher-student relationships. In order to analyze these avenues, this study explored the following questions: How do teachers talk about and perceive Title I students? Do their attitudes and the images constructed from these perceptions impact students' ability to build positive teacher-student relationships? Do these perceptions and attitudes impact students' opportunities to build social and cultural capital? Do the resources afforded to students aide the acquisition of cultural capital? What expectations do teachers have for students' language usage and do these expectations hinder the acquisition of cultural capital? These questions guided my data collection process and analysis on how social and cultural capital operates within a Title I school. This study found that students attending Sherwood did not have access to quality material resources such as books and computers. However, they did have exposure to non-material resources such as nutritional programs that provided students' avenues to acquire cultural capital through dominant cultural experiences. Students' acquisition of Standard English was another avenue for students to acquire cultural capital. Teachers at Sherwood held different expectations for African American students and Spanish speaking students. African American students were constantly corrected when they did not speak Standard English by white teachers. In contrast, Spanish-speaking students were not corrected because teachers did not view their language as a disruption to the class. My findings suggest that African American students did not know why Standard English was important. Thus, it is likely that they did not learn how to activate this form of capital to their social benefit. In contrast, the cultural codes Spanish-speaking students were perceived as of higher value and incorporated in the school. Last, this study found teachers' perceptions of Title I students did not always hinder their ability to form positive teacher-student relationships, but may have helped these relationships to form because of teachers' perceptions of students' home life. Throughout this study, I explored the strategies and obstacles faced by Title I teachers and students as well as how these affect the acquisition of cultural and social capital.

The present research is based on the theory that there are two major modes of consciousness, verbal and imaginal, which are controlled by the left and right hemispheres, respectively. This project was concerned with the relationship between these modes of consciousness and the measures employed in this study. The measures employed were an ongoing mentation report (OMR), a paired-associate learning (PAL) task, the Betts vividness of imagery questionnaire, the Gordon test of imagery control, and the visual imagery scale of Imaginal Processes Inventory (IPI). EEG and EOG measures were recorded during the OMR, and lateral eye movement was taken as an indication of activation in the cerebral hemisphere contralateral to the direction of eye movement.