BACKGROUND Lyme neuroborreliosis (LNB) is characterized by cerebrospinal fluid (CSF) inflammation with several cytokines/chemokines and B-lymphocytes. Clinically, LNB in children may be difficult to discriminate from non-Lyme aseptic meningitis (NLAM). We aimed to identify CSF cytokine/chemokine patterns in children with LNB, NLAM and controls and elucidate the diagnostic value of these cytokines/chemokines alone or in combination to discriminate between LNB and NLAM. METHODS Children with symptoms suggestive of LNB were included prospectively and categorized as LNB, NLAM or controls (no pleocytosis). Cytokines/chemokines in CSF were measured by multiplex bead assays and levels were compared between the three groups by nonparametric statistical tests. Previous results from the same children on the established biomarker, CXCL13, were included in the statistical analyses. The diagnostic properties of cytokines/chemokines to discriminate between LNB and NLAM were determined by receiver operating characteristic curve analyses with estimates of area under curve (AUC). To explore diagnostic properties of combinations of cytokines/chemokines, prediction models based on logistic regression were used. RESULTS We included 195 children with LNB (n = 77), NLAM (n = 12) and controls (n = 106). Children with LNB had higher CSF levels of CCL19, CCL22 and CXCL13 compared to NLAM and controls, whereas INFγ was higher in NLAM than in LNB and controls. CXCL13 was the superior single cytokine/chemokine to discriminate LNB from NLAM (AUC 0.978). The combination CXCL13/CCL19 (AUC 0.992) may possibly improve the specificity for LNB, especially for children with moderate CXCL13 levels. CONCLUSIONS The intrathecal immune reaction in LNB is characterized by B cell associated chemokines. Whether the combination CXCL13/CCL19 further improves discrimination between LNB and NLAM beyond the diagnostic improvements by CXCL13 alone needs to be tested in new studies. Selleckchem Fluzoparib In this study we evaluate how cognitive load affects susceptibility to auditory signals. Previous research has used the frontal P3 (fP3) event related potential response to auditory novel stimuli as an index for susceptibility to auditory signals. This work demonstrated that tasks that induce cognitive load such as visual and manual tasks, reduced susceptibility. It is however unknown whether cognitive load without visual or manual components also reduces susceptibility. To investigate this, we induced cognitive load by means of the verb generation task, in which participants need to think about a verb that matches a noun. The susceptibility to auditory signals was measured by recording the event related potential in response to a successively presented oddball probe stimulus at 3 different inter-stimulus intervals, 0 ms, 200 ms or 400 ms after the offset of the noun from the verb generation task. An additional control baseline condition, in which oddball response was probed without a verb generation task, was also included. Results show that the cognitive load associated with the verb task reduces fP3 response (and associated auditory signal susceptibility) compared to baseline, independent of presentation interval. This suggests that not only visual and motor processing, but also cognitive load without visual or manual components, can reduce susceptibility to auditory signals and alerts. Passive sentences have been shown to be more difficult than active sentences for young children in English, German, Italian, Turkish, as well as Japanese, Korean. Many factors, such as syntactic structure, lexical-semantic, language experience, have been proved to affect passive sentence processing. In this paper, two experiments were carried out to investigate the role of perspective-shifting and animacy characteristics of agents and patients in processing passive sentences by 5~6 year-old Chinese children, using a sentence-picture matching task. The results were as follows (1) Passive sentences were more difficult to comprehend than active sentences in Mandarin Chinese; (2) The ability of perspective-shifting played an important role in processing passive sentences. In sum, addressing sentences involving syntactic transformation is a complex cognitive activity for young children. Many factors, such as syntactic structure, lexical-semantic, language experience, and cognitive flexibility should be given full consideration. Fetal growth restriction is a major complication of pregnancy and increases the risk of stillbirth. Midwives screen for fetal wellbeing by measuring the symphysis fundal height to detect growth restriction, which can present in a low risk pregnancy or occur late in gestational age. The detection, surveillance and onward referral of these pregnancies are the responsibility of all midwives. To prevent avoidable stillbirth due to restricted fetal growth and to ensure safe, evidence based practice, the Perinatal Institute developed the Growth Assessment Protocol (GAP). A qualitative study using semi-structured interviews was conducted to explore 2nd year student midwives' perception of the GAP training and its impact on their clinical practice. Data was analysed and four main themes were identified using interpretative phenomenological analysis. The findings from the study show that the participants viewed the GAP training as 'authentic' and commented on the alignment with contemporary practice for the detection and surveillance of at risk pregnancies. The findings suggest that GAP training for pre-registration student midwives has the potential to provide a sustainable workforce, prepared to meet the World Health Organisation's global strategy for eliminating avoidable stillbirth by 2030. The use of digital environments in nursing education offers new opportunities for nursing students' medical mathematics learning. The aim of this study was to investigate the effects of Digital Learning Materials (DLMs) on nursing students' mathematics learning, self-efficacy, and task value. A pre-test/post-test control group design was used. Students were assigned to the DLMs group (experimental condition) or the face-to-face group (control condition). Students in both conditions completed the same assignments and discussed these with their peers and the (online) teacher via the discussion board or in the classroom setting. The results showed that the mathematics learning of students undergoing DLMs training and of those undergoing face-to-face training improved from the pretest to the post-test, but no significant differences were found between the two conditions. A significant interaction effect between condition and self-efficacy was reported, producing a large reduction in the self-efficacy of students in the DLMs condition and a small reduction in the self-efficacy of students in the face-to-face condition.