Objective To investigate the association between low functional health literacy ability to read and understand basic health related information and mortality in. The online version of Renewable Energy at ScienceDirect. Median barriers separate lanes of traffic moving in opposite directions on multilane highways. Such traffic safety devices can reduce headon collisions but also have. Objective To compare the intelligence and grip strength of orthopaedic surgeons and anaesthetists. Design Multicentre prospective comparative study. Setting Three UK. The online version of Pattern Recognition Letters at ScienceDirect. This cohort study investigates the association between neurodevelopment at 4. Neonatal Glycemia and Neurodevelopmental Outcomes at 4. Years Neonatology JAMA Pediatrics. Key Points. Question. What is the relationship between neonatal hypoglycemia, including the severity and frequency, and neurodevelopmental outcomes Findings. In this prospective cohort study of 4. L was not associated with combined neurosensory impairment at 4. Severe, recurrent, and clinically undetected episodes increased this risk. Meaning. Neonatal hypoglycemia may increase the risk of impaired executive function and visual motor function in a dose dependent fashion, even if not detected clinically, and may thus influence later learning randomized trials to determine optimal intervention thresholds need to assess neurodevelopment at least to school age. Content_public/Journal/bioinformatics/30/8/10.1093_bioinformatics_btt760/3/btt760f5p.gif?Expires=1499085519&Signature=WqWaPFWliNTFFvxkmf5q-mkWzd1hugH2J5~~XZt5X1rH6xgB2cjav7XC~GMUryhyLMNb2vUcRKBi3JIpTTLxNbjTfg-q~qNqXPeJVpfMb6h1syA5tC4MZKxvwCf~PH~QHAZz4ZrBvoIf7lPrytWjqhNbydJv--G3T8xeatlnZJE2z~cIwDZJfZmYDks2btReT5ed-ln4NbVToddhMfg7mq4IHfRUAyv07OWib4pPw8Q414ZNqAmHupVaAdS52Jb7xnnZfv38BNK8uUbne545OfeB9xzHNh8AUdhmBAv2DdxtPUqsxxj0kYrGfpoFNXflktzQY~u0uUY~eplfcgJINg__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q' alt='Procite 5 0 Download Speed' title='Procite 5 0 Download Speed' />Abstract. Importance. Hypoglycemia is common during neonatal transition and may cause permanent neurological impairment, but optimal intervention thresholds are unknown. Objective. To test the hypothesis that neurodevelopment at 4. Design, Setting, and Participants. The Children With Hypoglycemia and Their Later Development CHYLD Study is a prospective cohort investigation of moderate to late preterm and term infants born at risk of hypoglycemia. Clinicians were masked to neonatal interstitial glucose concentrations outcome assessors were masked to neonatal glycemic status. The setting was a regional perinatal center in Hamilton, New Zealand. The study was conducted from December 2. November 2. 01. 0. The dates of the follow up were September 2. June 2. 01. 5. Participants were 6. Blood and masked interstitial glucose concentrations were measured for up to 7 days after birth. Infants with hypoglycemia whole blood glucose concentration lt 4. L were treated to maintain blood glucose concentration of at least 4. L. Exposures. Neonatal hypoglycemic episode, defined as at least 1 consecutive blood glucose concentration less than 4. L, a severe episode lt 3. L, or recurrent 3 episodes. An interstitial episode was defined as an interstitial glucose concentration less than 4. L for at least 1. Main Outcomes and Measures. Cognitive function, executive function, visual function, and motor function were assessed at 4. The primary outcome was neurosensory impairment, defined as poor performance in one or more domains. Results. In total, 4. Their mean SD age at the time of assessment was 4. Those exposed to neonatal hypoglycemia 2. RD, 0. 0. 1 9. 5 CI, 0. Microsoft Access Utility Add In Download. RR, 0. 9. 6 9. 5 CI, 0. However, hypoglycemia was associated with increased risk of low executive function RD, 0. CI, 0. 0. 1 to 0. RR, 2. 3. 2 9. 5 CI, 1. RD, 0. 0. 3 9. 5 CI, 0. RR, 3. 6. 7 9. 5 CI, 1. Conclusions and Relevance. Neonatal hypoglycemia was not associated with increased risk of combined neurosensory impairment at 4. Randomized trials are needed to determine optimal screening and intervention thresholds based on assessment of neurodevelopment at least to school age. Orthopaedic surgeons as strong as an ox and almost twice as clever Multicentre prospective comparative study. P Subramanian, trauma and orthopaedic specialist regist S Kantharuban, core surgical trainee, Oxford Deanery. V Subramanian, foundation year trainee, Mersey Deanery. S A G Willis Owen, postdoctoral research scientist. C A Willis Owen, consultant trauma and orthopaedic surgeon. North East Thames London Orthopaedic Rotation, Whipps Cross Hospital, Leytonstone, London W1. NR, UK2. Milton Keynes Hospital, Eaglestone, Milton Keynes MK6 5. LD, UK3. Southport General Hospital, Southport PR8 6. PN, UK4. National Heart and Lung Institute, London SW3 6. LY5. Queen Marys Hospital, Kent DA1. LT, UKCorrespondence to P Subramanian drpadathotmail. Abstract. Objective To compare the intelligence and grip strength of orthopaedic surgeons and anaesthetists. Design Multicentre prospective comparative study. Setting Three UK district general hospitals in 2. Participants 3. 6 male orthopaedic surgeons and 4. Main outcome measures Intelligence test score and dominant hand grip strength. Results Orthopaedic surgeons had a statistically significantly greater mean grip strength 4. SD 6. 9. 5 kg than anaesthetists 4. The mean intelligence test score of orthopaedic surgeons was also statistically significantly greater at 1. Conclusions Male orthopaedic surgeons have greater intelligence and grip strength than their male anaesthetic colleagues, who should find new ways to make fun of their orthopaedic friends. Introduction. A humorous anaesthetic colleague recently repeated the following popular saying while an operating table was being repaired with a mallet typical orthopaedic surgeonas strong as an ox but half as bright. Making fun of orthopaedic surgeons is a popular pastime in operating theatres throughout the country. This pursuit has recently spread to the internet a humorous animation entitled orthopedia vs anesthesia had received more than half a million hits at the time of writing. Several comparisons of orthopaedic surgeons to primates have been published, and the medical literature contains suggestions that orthopaedic surgery requires brute force and ignorance. The stereotypical image of the strong but stupid orthopaedic surgeon has not been subject to scientific scrutiny. Previous studies have shown that the average hand size of orthopaedic surgeons is larger than that of general surgeons. However, a search of the worldwide scientific literature found no studies assessing the strength or intelligence of orthopaedic surgeons. In the absence of a cohort of willing oxen as a control group, and given that the phrase is popular with anaesthetists, we designed this study to compare the mean grip strength of the dominant hand and the intelligence test score of orthopaedic surgeons and anaesthetists. Methods. We compared the strength and intelligence of orthopaedic surgeons and anaesthetists in three district general hospitals during a two week period in 2. We included consultant and registrar grades, as these grades indicate commitment to the chosen specialty. We invited all doctors who were present in the hospital during any day of the two week period to participate. We excluded doctors on leave for the whole period and those who chose not to take part. Because of a lack of female orthopaedic surgeons in all three hospitals, we restricted the study to men. We measured intelligence by using a surrogate for the widely accepted intelligence quotient IQ. By definition, the median IQ of the general population is 1. We used the Mensa Brain Test version 1. Barnstorm Entertainment Group to measure intelligence. This is a standardised test that uses questions taken from official Mensa IQ tests and is endorsed by Mensa a worldwide organisation for people with an IQ in the top 2. The test consisted of 2. Participants used a hand held touch screen computer i. Phone 4 to complete the test. Five trial questions allowed participants to become familiar with the question format and test apparatus. Help was available as needed, so that difficulty understanding the test apparatus did not influence participants results. Participants completed the test in a distraction free environment. The test yielded scores in a similar format to a formal IQ test, designed to have a median value of 1. We measured strength by using the surrogate of grip strength of the dominant hand. We chose this on grounds of acceptance for participants, portability, and validity. We used a calibrated Jamar hydraulic hand dynamometer Sammons Preston Rolyan, Chicago, IL, USA. Participants sat in a straight backed chair with the shoulder adducted and neutrally rotated, elbows flexed at 9. We recorded the best of three attempts from the dominant hand. We collected data in an Excel spreadsheet version 1. StataSE 1. 0. 0 for Unix. We examined strength and IQ for normality by testing for skewness and kurtosis. Variables that deviated significantly from a normal distribution were subject to a transformation before further analysis. We formally tested the association between specialty and IQ and between specialty and grip strength by using linear regression models with robust sandwich estimation of the variance allowing for clustering by hospital. These models incorporated multiple predictors including specialty, age, handedness, and grade. We then used Wald tests to assess the significance of individual parameters of the model. We based sample size calculations on a type I error of 0. II error of 0. 2, a mean of 1. For an effect size of a 1. IQ, we needed 3. 6 participants in each group. Results. Thirty six male orthopaedic surgeons were available to take part. Forty male and six female anaesthetists took part. Sex is a significant confounding factor of grip strength. The paucity of female orthopaedic surgeons meant that we could make no meaningful comparison of women, so we excluded these data from analysis, leaving 3. Table 1 shows the demographics and measured parameters of each group. Figure 1 shows the results of measured parameters graphically in the form of a scatter plot. Table 1 Participants demographics, intelligence, and grip strength. Fig 1 Scatter plot of grip strength against intelligence score, by specialty. Intelligence did not deviate significantly from a normal distribution P0. Strength, however, did deviate P0. P0. 0. 07 as opposed to kurtosis P0. We therefore log transformed grip strength data before regression analysis. We examined the association between specialty and IQ and between specialty and grip strength by using linear regression models with robust sandwich estimation of the variance allowing for clustering by hospital. These models incorporated various putative predictors available at the time of analysis specialty, age, handedness, and grade. Specialty showed a significant relation with both intelligence F1. P0. 0. 48. 9 and loggrip strength F3. P0. 0. 27. 4 table 2. Specifically, orthopaedic surgeons had a higher mean intelligence score 1. Table 2 Statistical relation between speciality and both strength and intelligence, as tested by linear regression. Fig 2 Box plot of grip strength kg by specialty data shown before transformation for ease of interpretation. Upper and lower whiskers represent 1. Fig 3 Box plot of intelligence test score by specialty. Upper and lower whiskers represent 1. Discussion. This study is the first of its kind to provide evidence for the perpetual banter between orthopaedic surgeons and anaesthetists. We have shown a small but statistically significant difference in both grip strength and intelligence score between the two groups, with higher results for orthopaedic surgeons. The intelligence scores were lower than anticipated for IQ in the medical profession. This is likely to be a reflection of the way in which intelligence was tested, and the scores derived from the rather difficult Mensa brain test may not be directly comparable to IQ scores.