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R J Simonds

Publications and source records attributed to R J Simonds.

57 records · Page 4Linked to original sources

The postnatal development of the motor speech area: a preliminary study.

This preliminary study follows the maturation of motor speech areas and their adjacent orofacial motor zones in the right and left hemispheres of the human infant from 3 months to 72 months of age. Quantitative studies of basilar dendrite patterns of layer 5 cortical pyramids are reported in 17 age-graded subjects. The sequence of developmental changes is characterized by early (3 month) prominence of orofacial motor zones over motor speech areas and of the right hemisphere over the left as expressed in total basilar dendritic length and the length of proximal order dendritic segments. The complex series of changes which follow appear to involve increase in number and marked increase in length of the developing distal order segments and possible shortening of the proximal segments. During a variable sequence of apparent growth spurts and resorptions, dendrite arborizations of the motor speech areas overtake and exceed those of orofacial musculature and the total length of dendrite systems on the left finally exceeds those on the right, although even in the most mature group, (42-72 months), distal segment length in the right motor speech area still exceeds that of the left. The early structural primacy of right-sided dendrite systems and the progressive shift to left-sided primacy is considered in the light of the presence of a long phylogenetic and ontogenetic history of gross anatomical asymmetry favoring the left side. The possibility that developmental patterns of the cortical macroenvironment and microenvironment may be dissociated with the microenvironment depending heavily on epigenetic factors receives support from recent data suggesting the existence of a time window or critical period during which primary language proficiency must be attained if normal lateralization of language function is to occur.

Child↗

Preventing perinatal transmission of HIV--costs and effectiveness of a recommended intervention.

OBJECTIVE: To calculate the national costs of reducing perinatal transmission of human immunodeficiency virus through counseling and voluntary testing of pregnant women and zidovudine treatment of infected women and their infants, as recommended by the Public Health Service, and to compare these costs with the savings from reducing the number of pediatric infections. METHOD: The authors analyzed the estimated costs of the intervention and the estimated cost savings from reducing the number of pediatric infections. The outcome measures are the number of infections prevented by the intervention and the net cost (cost of intervention minus the savings from a reduced number of pediatric HIV infections). The base model assumed that intervention participation and outcomes would resemble those found in the AIDS Clinical Trials Group Protocol 076. Assumptions were varied regarding maternal seroprevalence, participation by HIV-infected women, the proportion of infected women who accepted and completed the treatment, and the efficacy of zidovudine to illustrate the effect of these assumptions on infections prevented and net cost. RESULTS: Without the intervention, a perinatal HIV transmission rate of 25% would result in 1750 HIV-infected infants born annually in the United States, with lifetime medical-care costs estimated at $282 million. The cost of the intervention (counseling, testing, and zidovudine treatment) was estimated to be $ 67.6 million. In the base model, the intervention would prevent 656 pediatric HIV infections with a medical care cost saving of $105.6 million. The net cost saving of the intervention was $38.1 million. CONCLUSION: Voluntary HIV screening of pregnant women and ziovudine treatment for infected women and their infants resulted in cost savings under most of the assumptions used in this analysis. These results strongly support implementation of the Public Health Service recommendations for this intervention.

AIDS Serodiagnosis↗