bluuebunny/crossref_metadata_2025 huggingface dataset:
Co‐ocurrence of developmental delays in a screening study of 4‐year‐old Finnish children
Authors: Valtonen Riitta , Ahonen Timo , Lyytinen Paula , Lyytinen Heikki
Published: July 2010

The aim of this population study was to examine the severity and prevalence of co‐occurring developmental delays in 4‐year‐old children, the rate of overlapping problems, and sex differences. A sample of 434 children (196 males, 238 females; mean age 4 years 3 months, SD 1 month) were administered the‘Lene’test: a comprehensive neuro‐developmental screening test. Results suggest that co‐occurrence of attention‐behavioural, motor‐perceptual, and language delays occurring in school‐aged children could already be detected at the age of 4 years. Isolated delays were usually mild, but co‐occurring difficulties were mostly moderate or severe. Overlap between developmental delays depended on the severity of the problems. It emerged that males had more severe and more often co‐occurring problems than females. Co‐occurrence of developmental delays as a risk factor at the early stage of development is discussed.
Limb distribution, motor impairment, and functional classification of cerebral palsy
Authors: Gorter Jan Willem , Rosenbaum Peter L , Hanna Steven E , Palisano Robert J , Bartlett Doreen J , Russell Dianne J , Walter Stephen D , Raina Parminder , Galuppi Barbara E , Wood MD Ellen
Published: July 2010

This study explored the relationships between the Gross Motor Function Classification System (GMFCS), limb distribution, and type of motor impairment. Data used were collected in the Ontario Motor Growth study, a longitudinal cohort study with a population‐based sample of children with cerebral palsy (CP) in Canada (n=657; age 1 to 13 years at study onset). The majority (87.8%) of children with hemiplegia were classified as level I. Children with a bilateral syndrome were represented in all GMFCS levels, with most in levels III, IV, and V. Classifications by GMFCS and‘limb distribution’or by GMFCS and‘type of motor impairment’were statistically significantly associated (Pearson's χ2p < 0.001), though the correlation for limb distribution (two categories) by GMFCS was low (tau‐b=0.43). An analysis of function (GMFCS) by impairment (limb distribution) indicates that the latter clinical characteristic does not add prognostic value over GMFCS. Although classification of CP by impairment level is useful for clinical and epidemiological purposes, the value of these subgroups as an indicator of mobility is limited in comparison with the classification of severity with the GMFCS.
Periodic leg movements in prepubertal children with sleep disturbance
Authors: Martinez Sandra , Guilleminault Christian
Published: July 2010

This study's aims were to determine: (1) prevalence of periodic leg movements (PLMs) in walking prepubertal children consulting a sleep clinic for any sleep disorder; (2) associations between PLMs and other sleep and medical disorders; and (3) the response of other sleep disorders to treatment with the dopamine agonist pramipexol. Clinical evaluation and polysomnography were carried out for a period of 12 months on 252 consecutively seen, prepubertal children with sleep disorders (156 males, 96 females; aged 15mo to 11y, mean 7y 1mo, SD3y 10mo). Sleep disorders unrelated to PLMs were treated, and six children received pramipexol for PLMs. Follow‐up included clinical evaluation and polysomnography. Twenty‐three per cent of children were diagnosed with PLMs on the basis of polysomnography. The presence of PLMs had usually been unrecognized clinically. The only clinical symptom that could be related to periodic limb movement disorder was a report of leg pains at morning awakening. Only two of 58 children had PLMs without other clinical or polysomnographic findings. Comorbidity seen with PLMs included neuropsychiatric syndromes (n=20), isolated sleep disordered breathing (SDB; n=29), and several other comorbid conditions (n=7). Seven of 11 children seen with attention‐deficit‐hyperactivity disorder also had PLMs. Surgery for SDB was associated with subsequent cessation of PLMs in 15 of 29 children. Five out of six children with PLMs who received pramipexol were able to tolerate the drug and experienced a complete disappearance of their PLMs. Presence of chronic fatigue, sleepiness, disrupted nocturnal sleep, and difficulties in falling asleep should lead to a systematic search for PLMs that is independent of associated syndromes. Isolated treatment of SDB might help eliminate some, but not all, PLMs.
Sturge–Weber syndrome and paroxysmal hemiparesis: epilepsy or ischaemia?
Authors: Jansen Floor E , Van Der Worp H Bart , Van Huffelen Alexander , Van Nieuwenhuizen Onno
Published: July 2010

Transient neurological deficits experienced by patients with Sturge–Weber syndrome can be caused by epilepsy, or may result from temporary ischaemia of the cortex underlying the vascular malformation. To show the difficulty in distinguishing seizures from ischaemic symptoms, two male children with episodes of acute unilateral weakness are presented here as well as a review of the literature. The first child presented at 2 years of age with a sudden increase in his pre‐existing right hemiparesis accompanied by screaming. Ictal epileptiform activity was recorded at the moment of the attack, and subsequent seizures were controlled by adjustment of antiepileptic drug treatment. The second child presented at 4 years of age with attacks of vomiting and a coinciding increase in the pre‐existing paresis of the left leg. Electroencephalogram (EEG) recording did not show ictal epileptiform activity. The origin was presumed to be vascular. Treatment with aspirin led to control of these transient ischaemic attacks. Ictal EEG is needed to differentiate between an epileptic and an ischaemic origin of transient focal deficit. Treatment with aspirin should be considered if an ischaemic origin cannot be excluded.
Vernier acuity is selectively affected in infants and children with cortical visual impairment
Authors: Skoczenski Ann M , Good William V
Published: July 2010

Cortical visual impairment (CVI) refers to bilateral impairment of vision that is usually due to damage occurring perinatally in the visual cortex and/or optic radiations. The most common cause of this damage is hypoxia, and other causes include encephalitis, meningitis, and trauma. Relatively little research has been done to quantify visual abilities in children with CVI. In the present study, we used an electrophysiological technique (visual evoked potentials) to measure two aspects of spatial vision in 35 infants and children with CVI (15 females, 20 males; mean age 3 years 6 months, SD 3 years 5 months; age range 4 months to 16 years). We measured each child's grating acuity (resolution for detecting high‐contrast stripe patterns) and vernier acuity (resolution for localizing pattern elements). Performance on grating acuity and vernier acuity in individuals with CVI was compared with that of age‐matched individuals with normal vision, and it was found that vernier acuity was relatively lower than grating acuity in children with CVI. Results support the theory that vernier acuity is cortically mediated, and suggest that vernier acuity is a more sensitive measure than grating acuity for quantifying vision deficits in patients with CVI.
Development of displacement of centre of mass during independent walking in children
Authors: MSc Frédéric Dierick , PT Caroline Lefebvre , Van Den Hecke Adélaïde , Detrembleur Christine
Published: July 2010

The aims of this study were to assess the characteristics of three‐dimensional displacement of the centre of mass of the body (CMb) during walking in healthy children and to compare it with those of young adults. Twenty‐one children (11 males, 10 females; age range 1 to 9 years) were recruited from the nursery and school attached to the Université catholique de Louvain, Brussels, Belgium; and three young adults (one male, two females; mean age 26 years 4 months) were recruited from the Rehabilitation and Physical Medicine Unit of the same university. Displacement of CMb was assessed at different walking velocities in the children and adults by two successive mathematical integrations of ground reaction forces, measured by a large strain‐gauge force platform. Displacement of CMb was controlled for leg length of the participant to eliminate the scaling effect that is dependent on growth. Results showed that vertical and lateral amplitudes of the CMb when controlled for leg length were greater for children before 4 years of age and that the forward amplitude when controlled for leg length was greater for children before 7 years of age. We conclude that the development of mature human CMb displacement during independent walking is a gradual neural process, evolving until the age of 7 years.
Care provider assessment of intrathecal baclofen in children
Authors: Gooch Judith L , Oberg Wende A , PT Barbara Grams , Ward Lorrie A , Walker Marion L
Published: July 2010

Intrathecal baclofen is used increasingly to manage severe spasticity in children. Before implanting the baclofen pump, care providers typically ask how it will benefit their child. The purpose of this study was to describe the perceptions of care providers about intrathecal baclofen for management of spasticity in 80 individuals (52 males, 28 females). The individuals were younger than 22 years at the time of implantation (mean age 11 years, SD 5 years; range 3 to 21 years). Participants had been implanted with the pump for a minimum of one year at the time of evaluation. The most common diagnoses were quadriplegic and diplegic cerebral palsy and traumatic brain injury. Most participants were at level IV and V on the Gross Motor Function Classification System. After pump implantation most participants had tone reduction on the Ash worth scale of 1 to 1.9 in the lower extremities and 0 to 0.9 in the upper extremities. Lower extremity range of motion was maintained in 43 of 51 individuals (84%) and lost in 8 participants (16%). Complications requiring surgery occurred in 63 of a larger group of 152 patients (incidence per patient‐year of follow‐up was 0.19). Thirty‐one of the 80 children had orthopedic procedures after pump placement. Only one of these was unexpected and none had rapid progression of scoliosis. Most treatment goals were achieved. Goals most commonly chosen (decreased pain, prevention of worsening of deformity, and improved ease of care) were improved in 91%, 91%, and 88% of participants respectively. Ninety‐five per cent of care providers agreed that they would have this procedure performed again (81% strongly agreed, 14% slightly agreed). All care providers reported improvement in scores on the Caregiver Questionnaire. This information has been helpful to families considering intrathecal baclofen therapy.
Comparison of three ankle—foot orthosis configurations for children with spastic diplegia
Authors: Buckon Cathleen E , Thomas Susan Sienko , Jakobson‐Huston Sabrina , Moor Michael , Sussman Michael , Aiona Michael
Published: July 2010

This study compared the functional efficacy of three commonly prescribed ankle–foot orthosis (AFO) configurations (solid [SAFO], hinged [HAFO], and posterior leaf spring [PLS]). Sixteen independently ambulatory children (10 males, six females; mean age 8 years 4 months, SD 2 years 4 months; range 4 years 4 months to 11 years 6 months) with spastic diplegia participated in this study. Four children were classified at level I of the Gross Motor Function Classification System (GMFCS; Palisano et al. 1997); the remaining 12 were at level II. Children were assessed barefoot (BF) at baseline (baseline assessment of energy consumption was performed with shoes on, no AFO) and in each orthotic configuration after three months of use, using gait analysis, oxygen consumption, and functional outcome measures. AFO use did not markedly alter joint kinematics or kinetics at the pelvis, hip, or knee. All AFO configurations normalized ankle kinematics in stance, increased step/stride length, decreased cadence, and decreased energy cost of walking. Functionally, all AFO configurations improved the execution of walking/running/jumping skills, upper extremity coordination, and fine motor speed/dexterity. However, the quality of gross motor skill performance and independence in mobility were unchanged. These results suggest that most children with spastic diplegia benefit functionally from AFO use. However, some children at GMFCS level II demonstrated a subtle but detrimental effect on function with HAFO use, shown by an increase in peak knee extensor moment in early stance, excessive ankle dorsiflexion, decreased walking velocity, and greater energy cost. Therefore, constraining ankle motion by using a PLS or SAFO should be considered for most, but not all, children with spastic diplegia.
Sleep disturbances in children with epilepsy compared with their nearest‐aged siblings
Authors: Wirrell Elaine , RN Marlene Blackman , Barlow Karen , Mah Jean , Hamiwka Lorie
Published: July 2010

The aim of the study was to compare sleep patterns in children with epilepsy with those of their non‐epileptic siblings and to determine which epilepsy‐specific factors predict greater sleep disturbance. We conducted a case‐control study of 55 children with epilepsy (mean age 10y, range 4 to 16y; 27 males, 28 females) and their nearest‐aged non‐epileptic sibling (mean age 10y, range 4 to 18y; 26 males, 29 females). Epilepsy was idiopathic generalized in eight children (15%), symptomatic generalized in seven (13%), and focal in 40 (73%); the mean duration was 5 years 8 months. Parents or caregivers completed the Sleep Behavior Questionnaire (SBQ) and Child Behavior Checklist (CBCL) for patients and controls, and the Quality of Life in Childhood Epilepsy (QOLCE) for patients. Patients had a higher (more adverse) Total Sleep score (p<0.001) and scored worse than controls on nearly all subscales of the SBQ. In patients, higher Total Sleep scores were correlated with higher scores on the Withdrawn, Somatic complaints, Social problems, and Attention subscales of the CBCL, and significantly lower Total Quality of Life Scores. Refractory epilepsy, mental retardation, * and remote symptomatic etiology predicted greater sleep problems in those with epilepsy. We conclude that children with epilepsy in this current study had significantly greater sleep problems than their non‐epileptic siblings.
Neuropsychiatric movement disorders following streptococcal infection
Authors: Walker K G , Lawrenson J , Wilmshurst J M
Published: July 2010

The aim of this study was to describe post‐streptococcal movement disorders that form part of the acute rheumatic fever complex. The clinical records of patients diagnosed with Sydenham's chorea were analyzed retrospectively to investigate epidemiology, the significance of socioeconomic deprivation, clinical manifestations, treatments, outcomes, long‐term morbidity, and disease evolution. Forty‐two patients (21 males, 21 females) were diagnosed with Sydenham's chorea. The median presentation age was 9 years 8 months (range 3y 5mo to 13y 2mo). Nineteen patients were of indigenous African ancestry; 23 were of mixed ancestry. All patients lived in poverty and had poor access to medical care. Twelve of the total group had disabling symptoms for longer than 2 years; six of these patients developed paediatric autoimmune neuropsychiatric disorder associated with Streptococcus (Paediatric autoimmune neuropsychiatric disorder associated with Streptococcus [PANDAS]), five Tourette syndrome (TS), and one learning difficulties. Poor outcome was significantly more prevalent in patients of mixed ancestry, in those with a positive family history, previous behavioural problems, or a failure to complete 10 days of penicillin and ‘bed‐rest’/hospitalization. Sydenham's chorea is one manifestation of post‐streptococcal neuropsychiatric movement disorders. This study demonstrates that patients can present with one diagnosis and evolve other neuropsychiatric conditions such as TS and PANDAS. In the South African context, it is important to delineate neuropsychiatric movement disorders associated with streptococcal infections. The potential genetic susceptibility should be explored.
Immediate effects of methylphenidate on cognitive attention skills of children with attention‐deficit‐hyperactivity disorder
Authors: Hood Jane , Baird Gillian , Rankin Peter M , Isaacs Elizabeth
Published: July 2010

This study investigated the immediate effects of stimulant medication (methylphenidate) on cognitive attention processes in children with attention‐deficit‐hyperactivity disorder (ADHD). Thirteen males and two females (mean age 9y 5mo, SD 18.3mo) with a diagnosis of ADHD and who were to be prescribed methylphenidate were assessed twice on one day with the Test of Everyday Attention for Children, a neuropsychological battery designed to tap different aspects of cognitive attention. Between assessments, the children were administered methylphenidate (10mg). Each child had at least average intelligence (IQ 80 or over, as measured by the Wechsler Intelligence Scale for Children ‐ III UK) and was on no other medication. A group of 16 children, who were matched for age, sex, and intelligence, also performed the cognitive tests twice on the same day to control for practice effects of testing. At the first assessment, children with ADHD demonstrated significant impairments in several aspects of cognitive attention in comparison with the control group, particularly sustained attention. After administration of methylphenidate for the children with ADHD, they showed significant improvements in their performance on measures of cognitive attention compared to controls. The immediate effects of methylphenidate and the significance of measuring cognitive aspects of attention as well as behavioural measures are discussed.
Health‐related quality of life of children and adolescents with cerebral palsy: hearing the voices of the children
Authors: Varni James W , Burwinkle Tasha M , Sherman Sandra A , Hanna Kanela , Berrin Susan J , Malcarne Vanessa L , Chambers Henry G
Published: July 2010

The aim of the study was to determine whether pediatric patients with cerebral palsy (CP; 24.3% hemiplegic, 30.4% diplegic, 38.5% quadriplegic) can self‐report their health‐related quality of life (HRQOL) with the Pediatric Quality of Life Inventory Version 4.0 (PedsQL 4.0) Generic Core Scales. The PedsQL was administered to 148 families (84 males, 64 females; mean 10y, SD 3y 9mo, range 5 to 18y) recruited from a children's hospital clinic and state medical therapy clinics. Sixty‐nine children (47%) were able to self‐report. Children with CP self‐reported a significantly lower HRQOL (mean 65.9) than healthy children (mean 83.8). Children with CP self‐reported a similar HRQOL to pediatric cancer patients receiving treatment (mean 68.9). Children diagnosed with quadriplegia (mean 49.4) self‐reported more impaired HRQOL than children with diplegia (mean 69.1) and hemiplegia (mean 72.4). Parent‐child concordance was lowest for emotional functioning. Providers and parents should obtain the children's HRQOL perceptions whenever possible.
Cortical reorganization induced by virtual reality therapy in a child with hemiparetic cerebral palsy
Authors: You Sung H , Jang Sung Ho , Kim Yun‐Hee , Kwon Yong‐Hyun , Barrow Irene , Hallett Mark
Published: July 2010

Virtual reality (VR) therapy is a new, neurorehabilitation intervention aimed at enhancing motor performance in children with hemiparetic cerebral palsy (CP). This case report investigated the effects of VR therapy on cortical reorganization and associated motor function in an 8‐year‐old male with hemiparetic CP. Cortical activation and associated motor development were measured before and after VR therapy using functional magnetic resonance imaging (fMRI) and standardized motor tests. Before VR therapy, the bilateral primary sensorimotor cortices (SMCs) and ipsilateral supplementary motor area (SMA) were predominantly activated during affected elbow movement. After VR therapy, the altered activations disappeared and the contralateral SMC was activated. This neuroplastic change was associated with enhanced functional motor skills including reaching, self‐feeding, and dressing. These functions were not possible before the intervention. To our knowledge, this is the first fMRI study in the literature that provides evidence for neuroplasticity after VR therapy in a child with hemiparetic CP.
Gastrostomy feeding in cerebral palsy: too much of a good thing?
Authors: Sullivan Peter B , Alder Nicola , E Allison M , Grant Hugh , Juszczak Edmund , Henry Jeya , Warner Justin , Wells Jonathan
Published: July 2010

Gastrostomy tube (GT) feeding in children with cerebral palsy (CP) is associated with significant increases in weight gain and, potentially, with overfeeding. This study aimed to measure energy balance and body composition in children with CP who were fed either orally or by GT. Forty children (27 males, 13 females; median age 8y 6mo; range 1y 4mo‐18y 11mo) with spastic quadriplegic C P, of whom 22 were gastrostomy‐fed and 18 orally‐fed, underwent anthropometry, indirect calorimetry, and total energy expenditure determination (doubly‐labelled water method). Total body water content (estimated by the 180 dilution method) was used to determine body composition. The Gross Motor Function Classification System (GMFCS) was used to determine the degree of motor impairment. GMFCS levels ranged from I to V; in the gastrostomy group 19 out of 22 were Level V and two out of 22 were Level I V. Within the orally‐fed group, 11 out of 18 were Level V and four out of 18 were Level I V. Resting metabolic rate and total energy expenditure of the gastrostomy‐fed children were lower but they had a significantly larger triceps skin fold thickness (p=0.01) and fat mass index (p=0.02) than the orally‐fed children. Both groups had consistently higher body‐fat content and lower fat‐free (i.e. muscle and bone) content than the reference population of age‐and sex‐matched children without disabilities. This study has demonstrated the relatively low energy expenditure and high body‐fat content of children with severe CP and highlighted the potential risk of overfeeding with available enteral feeds administered via GT.
Parotid and submandibular botulinum toxin A injections for sialorrhoea in children with cerebral palsy
Authors: Banerjee KJ , Glasson C , O'Flaherty SJ
Published: July 2010

The aim of this study was to determine whether botulinum toxin A (BTX‐A) injected into the parotid and submandibular salivary glands of children aged 6 to 16 years with cerebral palsy (CP) and relative sialorrhoea significantly decreases their drooling and improves their quality of life. Twenty children (10 males, 10 females; mean age 10y 1mo [SD 3y 8mo]; range 6y 1mo‐16y 7mo) with CP, identified as having significant daily drooling (scoring at least 6 on drooling frequency/severity scales) were recruited. BTX‐A (2U/kg; maximum 70U) was injected under sedation, using ultrasound guidance (1.4U/kg and 0.6U/kg divided between parotid and submandibular glands respectively). Nineteen children completed the study: 15 with spastic quadriplegia (Gross Motor Function Classification System [GMFCS] Level V); one with dystonia (GMFCS Level V); one with hemiplegia (GMFCS Level II); and two with a mixed pattern of CP (GMFCS Levels III and V). Drooling was assessed by five methods at baseline, and 4 and 12 weeks after injection. Qualitative assessment of drooling frequency and severity scores showed statistically significant reductions at 4 weeks (p≤0.001) and 12 weeks (p=0.006). Qualitative assessment of quality of life scores (rated by parents and teachers separately) also significantly improved (p≤0.001 and P=0.023 respectively). Quantitative assessments showed that the number of bibs/scarves changed per day was significantly reduced at 4 weeks (p≤0.001). There was no side effect from the injections themselves; 89% of parents and children wished for further intrasalivary BTX‐A injections in the future. We conclude that percutaneous intrasalivary BTX‐A injections into the parotid and submandibular salivary glands can reduce drooling in children with CP and relative sialorrhoea, leading to an improvement in their quality of life.
Prevalence of cerebral palsy in the West of Ireland 1990–1999
Authors: Mongan Deirdre , MRCPI Kevin Dunne , MRCP Sinead O'Nuallain , Gaffney Geraldine
Published: July 2010

An ongoing population‐based register of cerebral palsy (CP) in the West of Ireland was established in 2002 to calculate the prevalence of CP and to monitor CP epidemiological trends in the area. Children were only included if they were at least 5 years of age; children with postneonatal CP were also included. Eighty‐five children were identified, giving an overall prevalence for the period 1990 to 1999 of 1.88 per 1000 neonatal survivors (95% confidence interval 1.5–2.4). Males accounted for 68% (n=51) and females for 32% (n=24) of all cases. Among infants weighing less than 1500g at birth, the rate of CP was 39/1000 neonatal survivors compared with 1.3/1000 for infants weighing more than 2500g. The most common CP subtype was bilateral spastic CP (51%), followed by hemiplegia (32%), dyskinesia (9%), and ataxia (7%). Eighteen per cent of all children were unable to walk, 21% had a sensory impairment, and 56% had an intellectual impairment.
Differences between European birthweight standards: impact on classification of ‘small for gestational age’
Authors: Hemming K , Hutton J L , Glinianaia S V , Jarvis S N , Platt M J
Published: July 2010

We describe a quantitative and comparative review of a selection of European birthweight standards for gestational age for singletons, to enable appropriate choices to be made for clinical and research use. Differences between median values at term across standards in 10 regions and misclassification of 'small for gestational age’(SGA), were studied. Sex and parity differences, exclusion criteria, and methods of construction were considered. There was wide variation between countries in exclusion criteria, methods of calculating standards, and median birthweight at term. The lightest standards (e.g. France's medians are 255g lower than Norway's medians) were associated with fewer exclusion criteria. Up to 20% of the population used in the construction of the Scottish standard would be classified as SGA using the Norwegian standard. Substantial misclassification of SGA is possible. Assumptions about variation used in the construction of some standards were not justified. It is not possible to conclude that there are real differences in birthweight standards between European countries. Country‐based standards control for some population features but add misclassification due to the differing ways in which standards are derived. Standards should be chosen to reflect clinical or research need. If standards stratified by sex or parity are not available, adjustments should be made. In multinational studies, comparisons should be made between results using both a common standard and country‐based standards.
Clinical use of the Mayo‐Portland Adaptability Inventory in rehabilitation after paediatric acquired brain injury
Authors: Kostadinov Neychev Bruce Oddson , Rumney Peter , Johnson Patricia , Thomas‐Stonell Nancy
Published: July 2010

The Mayo‐Portland Adaptability Inventory (MPAI; designed to be administered by clinicians) is a popular measure of disability following head injury in adults. Its acceptability, validity, and reliability were assessed for use with children. There were 335 children and adolescents (215 males, 120 females) aged between 1 and 19 years at injury (median age 9y 8mo [SD 5y]) in our sample. The test was acceptable to respondents, rapidly and easily administered, and required only small modifications. It demonstrated validity against client and parent reports of major symptoms. It demonstrated test‐retest reliability within the limitations of our data and excellent interrater accord. Consequently, the MPAI is recommended for paediatric use for evaluating rehabilitation needs and therapy outcome.
Comparing functional profiles of children with hemiplegic and diplegic cerebral palsy in GMFCS Levels I and II: are separate classifications needed?
Authors: Damiano Diane , Abel Mark , Romness Mark , Oeffinger Donna , Tylkowski Chester , Gorton George , Bagley Anita , Nicholson Diane , Barnes Douglas , Calmes Janine , Kryscio Richard , Rogers Sarah
Published: July 2010

The goal was to compare children with hemiplegia with those with diplegia within Gross Motor Functional Classification System (GMFCS) levels using multiple validated outcome tools. Specifically, we proposed that children with hemiplegia would have better gait and gross motor function within levels while upper extremity function would be poorer. Data were collected on 422 ambulatory children with cerebral palsy: 261 with diplegia and 161 with hemiplegia, across seven centers. Those with hemiplegia in each level performed significantly and consistently better on gait or lower extremity function and poorer on upper extremity and school function than those with diplegia. In GMFCS Level II, the group with hemiplegia walked faster (p=0.017), scored 6.6 points higher on Dimension E of the Gross Motor Function Measure (p=0.017), 6.7 points lower on Upper Extremity subscale of the Pediatric Outcomes Data Collection Instrument, and 9.1 points lower on WeeFIM self‐care (p=0.002). Basing motor prognosis on GMFCS level alone may underestimate lower extremity skills of children with hemiplegia, and overestimate those of children with diplegia.
Spatial layout of letters in nonwords affects visual short‐term memory load: Evidence from human electrophysiology
Authors: Prime David , Dell'acqua Roberto , Arguin Martin , Gosselin Frédéric , Jolicœur Pierre
Published: July 2010

The sustained posterior contralateral negativity (SPCN) was used to investigate the effect of spatial layout on the maintenance of letters in VSTM. SPCN amplitude was measured for words, nonwords, and scrambled nonwords. We reexamined the effects of spatial layout of letters on SPCN amplitude in a design that equated the mean frequency of use of each position. Scrambled letters that did not form words elicited a larger SPCN than either words or nonwords, indicating lower VSTM load for nonwords presented in a typical horizontal array than the load observed for the same letters presented in spatially scrambled locations. In contrast, prior research has shown that the spatial extent of arrays of simple stimuli did not influence the amplitude of the SPCN. Thus, the present results indicate the existence of encoding and VSTM maintenance mechanisms specific to letter and word processing.
Activity screening and structure–activity relationship of the hit compounds targeting APN/CD13
Authors: Wang Xuejian , Jing Fanbo , Zhu Huawei , Fang Hao , Zhang Jian , Xu Wenfang
Published: July 2010

Aminopeptidase N (APN) plays an important role in tumor progression, which participates in the progress such as proliferation, attachment, angiogenesis, and tumor invasion. All of this makes APN as a good chemical therapeutic anti‐tumor target. In this study, a series of chemically synthesized APN inhibitors were tested for the anti‐tumor activities, and three most effective compounds were chosen according to the MTT assay. Then, the enzyme inhibitory, anti‐tumor, specificity, angiogenesis, and invasion were determined to evaluate the activity of these three compounds. All compounds can markedly inhibit the enzyme activity of APN, angiogenesis of endothelial cells, and the invasion of ES‐2 cells. And it had little effect on the viability of K562 which express low level of APN. This data indicated that the tested compounds were APN hit compounds. We also did kinetic assay to determine the inhibition constant and constructed a three‐dimensional quantitative structure–activity relationship model to analyze the structure–activity relationship to direct the further design of novel APN inhibitors as anti‐tumor agents. These data demonstrate that the tested compounds can be developed as novel candidates of anticancer agent.
‘La zecca vecchia’: myth, archeology and architectural design in the high Renaissance concept of rustication
Authors: Kantor‐Kazovsky Lola
Published: July 2010

The article discusses rustication in Renaissance architecture using the analysis of the Mint in Venice as a case study. Its rustication is usually seen as a result of Sansovino's implementing Serlio's theory, while in fact it is better to speak of intellectual cooperation between the architect and the theoretician during the simultaneous growth of their projects. Both of them took inspiration from the building then believed to be the Temple of Saturn or the Aerarium (treasury) of the Romans. I argue that the rustication of this and other classical structures was thought to be an archaic feature, while the Aerarium had the additional connotation of the Saturnian Golden Age. The term rustico introduced by Serlio circumscribes precisely the range of significations implied in the idea of the Aerarium: it invokes the aesthetic roughness of the archaic epoch and the agricultural connotations of Saturn's rule. Serlio's introduction of the ornamento rustico in the canon is thus an architectural expression of Golden Age mythology so popular with the High Renaissance. To this level of meaning, which Serlio shared with his milieu, he added new approaches (such as nature versus art) that became more popular with his followers.
Differential Effect of Helicobacter pylori Eradication on Time‐Trends in Brady/Hypokinesia and Rigidity in Idiopathic Parkinsonism
Authors: Dobbs Sylvia M. , Dobbs R. John , Weller Clive , Charlett André , Bjarnason Ingvar T. , Lawson Andrew J. , Letley Darren , Harbin Lucy , Price Ashley B. , Ibrahim Mohammad A. A. , Oxlade Norman L. , Bowthorpe James , Leckstroem Daniel , Smee Cori , Plant J. Malcolm , Peterson Dale W.
Published: July 2010

Background:  We examine the effect of eradicating Helicobacter in idiopathic parkinsonism (IP). Marked deterioration, where eradication‐therapy failed, prompted an interim report in the first 20 probands to reach de‐blinding. The null‐hypothesis, “eradication has no effect on principal outcome, mean stride length at free‐walking speed,” was rejected. We report on study completion in all 30 who had commenced post‐treatment assessments.

Methods:  This is a randomized, placebo‐controlled, parallel‐group efficacy study of eradicating biopsy‐proven (culture and/or organism on histopathology) Helicobacter pylori infection on the time course of facets of IP, in probands taking no, or stable long‐t½, anti‐parkinsonian medication. Persistent infection at de‐blinding (scheduled 1‐year post‐treatment) led to open active eradication‐treatment.

Results:  Stride length improved (73 (95% CI 14–131) mm/year, p = .01) in favor of “successful” blinded active over placebo, irrespective of anti‐parkinsonian medication, and despite worsening upper limb flexor rigidity (237 (57–416) Nm × 10−3/year, p = .01). This differential effect was echoed following open active, post‐placebo. Gait did not deteriorate in year 2 and 3 post‐eradication. Anti‐nuclear antibody was present in all four proven (two by molecular microbiology only) eradication failures. In the remainder, it marked poorer response during the year after eradication therapy, possibly indicating residual “low‐density” infection.

We illustrate the importance of eradicating low‐density infection, detected only by molecular microbiology, in a proband not receiving anti‐parkinsonian medication. Stride length improved (424 (379–468) mm for 15 months post‐eradication, p = .001), correction of deficit continuing to 3.4 years. Flexor rigidity increased before hydrogen‐breath‐test positivity for small intestinal bacterial overgrowth (208 (28–388) Nm × 10−3, p = .02), increased further during (171 (67–274), p = .001) (15–31 months), and decreased (136 (6–267), p = .04) after restoration of negativity (32–41 months).

Conclusion:  Helicobacter is an arbiter of progression, independent of infection‐load.
Metamorphic evolution of the Susunai metabasites in southern Sakhalin, Russian Republic
Authors: SAKAKIBARA M. , OFUKA H. , KIMURA C. , ISHIZUKA H. , MIYASHITA S. , OKAMURA M. , MELINIKOV O. A.
Published: July 2010

ABSTRACT The Susunai Complex of southeast Sakhalin represents a subduction‐related accretionary complex of pelitic and basic rocks. Two stages of metamorphism are recognized: (1) a local, low‐P/T event characterized by Si‐poor calcic amphiboles; (2) a regional, high‐P/T event characterized by pumpellyite, actinolite, epidote, sodic amphibole, sodic pyroxene, stilpnomelane and aragonite. The major mineral assemblages of the high‐P/T Susunai metabasites contain pumpellyite + epidote + actinolite + chlorite, epidote + actinolite + chlorite, epidote + Na‐amphibole + Na‐pyroxene + chlorite‐(‐haematite. The Na‐amphibole is commonly magnesioriebeckite. The Na‐pyroxene is jadeite‐poor aegirine to aegirine‐augite. Application of empirically and experimentally based thermobarometers suggests peak conditions of T= 250–300C, P= 4.7–6 kbar. Textural relationships in Susunai metabasite samples and a petrogenetic grid calculated for the Fe3+‐rich basaltic system suggest that pressure and temperature increased during prograde metamorphism.
Long‐term efficacy and safety of eslicarbazepine acetate: Results of a 1‐year open‐label extension study in partial‐onset seizures in adults with epilepsy
Authors: Halász Peter , Cramer Joyce A. , Hodoba Danilo , Członkowska Anna , Guekht Alla , Maia Joana , Elger Christian , Almeida Luis , Soares‐da‐Silva Patricio ,   on behalf of the BIA‐2093‐301 Study Group
Published: July 2010

Purpose:  To evaluate the long‐term efficacy and safety of once daily eslicarbazepine acetate (ESL) as adjunctive therapy for partial‐onset seizures in adults with epilepsy.

Methods:  One‐year open‐label treatment extension with ESL in patients who completed a placebo‐controlled pivotal study (Epilepsia 2009; 50: 454–463). Starting dose was 800 mg once daily, for 4 weeks; thereafter, dose could be titrated up or down. Doses of concomitant antiepileptic drugs were to be kept stable.

Results:  Overall, 314 patients were enrolled. The intent‐to‐treat population consisted of 312 patients, and 239 (76.6%) completed 1 year of treatment. ESL median dose was 800 mg once daily. Compared to baseline, median seizure frequency decreased by 39% during the first 4 weeks and between 48% and 56% thereafter. The responder rate (≥50% seizure reduction) was 41% during weeks 1–4 and, thereafter ranged between 48% and 53%. The proportion of seizure‐free patients per 12‐week interval ranged between 8.7% and 12.5%. Quality of life, as measured by the Quality of Life in Epilepsy Inventory‐31 (QOLIE‐31), and depressive symptoms, as measured by the Montgomery Asberg Depression Rating Scale (MADRS), improved significantly compared to baseline. Treatment‐emergent adverse events (TEAEs) were reported by 51% of patients. The most frequent TEAEs were headache (10%), dizziness (10%), diplopia (5%), and nasopharyngitis (5%). TEAEs were mostly (97%) of mild to moderate intensity. Eleven patients (3.5%) discontinued due to TEAEs. There were no results of laboratory tests raising safety concerns.

Discussion:  Sustained therapeutic effect, favorable tolerability and safety, and an improvement in quality of life and depressive symptoms were observed during long‐term add‐on treatment of partial‐onset seizures in adults with once daily ESL.
Therapeutic time window of low‐frequency stimulation at entorhinal cortex for amygdaloid‐kindling seizures in rats
Authors: Xu Zheng‐Hao , Wu Deng‐Chang , Fang Qi , Zhong Kai , Wang Shuang , Sun Hong‐Liu , Zhang Shi‐Hong , Chen Zhong
Published: July 2010

The present study was designed to determine whether low‐frequency stimulation (LFS) of the entorhinal cortex (EC) has an anticonvulsive effect, and whether LFS delivered at different times plays different roles. We found that LFS of the EC immediately or 4 s after kindling stimulation had an anticonvulsive effect, and that the latter had a better effect on both kindling and kindled seizures. However, LFS delivered after the cessation of afterdischarge or 10 s after the kindling stimulation, augmented the epileptic activity. So the EC is a potential target for LFS to interfere with epilepsy. Our findings suggest that even in the duration of afterdischarge, there exists a “time window” for LFS treatment, indicating that the time delay of closed‐loop stimulation is crucial for LFS treatment.
Imperfectly Credible Disinflation under Endogenous Time‐Dependent Pricing
Authors: BONOMO MARCO , CARVALHO CARLOS
Published: July 2010

The real effects of an imperfectly credible disinflation depend critically on the extent of price rigidity. We examine this interaction in a model with endogenous time‐dependent pricing. Both the endogenous initial degree of price rigidity and changes in the duration of price spells during disinflation are important in explaining the effects of imperfect credibility. We initially consider a setup where the degree of credibility is fixed and then allow agents to update beliefs about the “type” of monetary authority that they face. In both cases, the interaction between endogeneity of pricing behavior and imperfect credibility increases the output costs of disinflation.
The Effects of National and Local Funding on Judicial Performance: Perceptions of Russia's Lawyers
Authors: Baird Vanessa A. , Javeline Debra
Published: July 2010

Courts that perform well are the cornerstone of the rule of law and democratic development. When courts are perceived as legalistic, fair, impartial, and independent of the influence of extrajudicial actors, aggrieved individuals are more likely to pursue litigation over other, potentially unlawful, alternatives. Using original data from surveys of more than 1,800 randomly sampled lawyers in 12 Russian cities, we investigate the effects of perceived government funding and power diversification on a variety of indicators of perceived judicial performance. We find that, according to lawyers, financial dependence on the national government has no independent effect on judicial performance, but financial dependence on local governments has consistently significant negative effects. We also find that diversified political power has consistently significant positive effects on perceived judicial performance, probably because the diversification makes courts seem less vulnerable to unified pressure from political actors.
Perceiving Discrimination on the Job: Legal Consciousness, Workplace Context, and the Construction of Race Discrimination
Authors: Hirsh Elizabeth , Lyons Christopher J.
Published: July 2010

Despite the continued importance of discrimination for racial labor market inequality, little research explores the process by which workers name potentially negative experiences as race discrimination. Drawing on the legal consciousness literature and organizational approaches to employment discrimination, we assess the effect of social status, job characteristics, and workplace context on the likelihood that workers perceive race discrimination at work. Analyzing data from the Multi-City Study of Urban Inequality, we find that ascriptive status is associated with perceptions of discrimination, with African Americans, Hispanics, and women more likely to perceive racial discrimination, net of job and organizational controls. Results also suggest that workers with a greater sense of entitlement (as indicated by job authority, promotion experience, and union membership) and knowledge of legal entitlements (as indicated by education level and age) are more likely to perceive workplace racial discrimination. Other workplace conditions can signal fairness and decrease perceptions of racial bias, such as formalized screening practices and having nonwhite supervisors, whereas working among predominantly nonwhite coworkers increases the likelihood of perceiving discrimination. These findings suggest that personal attributions of discrimination vary across social groups and their environments, and demonstrate the importance of workplace context for understanding how individuals apply legal concepts, such as discrimination, to their experiences.
Robotic Catheter Navigation within the Left Ventricle
Authors: DUNCAN EDWARD , JOHNS NEVILLE , SCHILLING RICHARD J. , SPORTON SIMON
Published: July 2010

Robotic navigation systems aim to improve ablation catheter maneuverability, tissue contact, and stability. These attributes suggest that such systems could enhance outcomes in the ablation of ventricular tachycardia (VT). To date, however, ablation has been confined to the atria. We present a case in which robotic catheter navigation alongside three‐dimensional anatomical mapping enabled successful ablation of VT within the left ventricle. (PACE 2011; 34:e102–e104)
Catheter Ablation of Electrical Storm Due to Monomorphic Ventricular Tachycardia in Patients with Nonischemic Cardiomyopathy: Acute Results and Its Effect on Long‐Term Survival
Authors: ARYA ARASH , BODE KERSTIN , PIORKOWSKI CHRISTOPHER , BOLLMANN ANDREAS , SOMMER PHILIPP , GASPAR THOMAS , WETZEL ULRIKE , HUSSER DANIELA , KOTTKAMP HANS , HINDRICKS GERHARD
Published: July 2010

Background: Electrical storm due to recurrent ventricular tachycardia (VT) in patients with implantable cardioverter defibrillator (ICD) can adversely affect their long‐term survival. This study evaluates the efficiency of the radiofrequency catheter ablation of electrical storm due to monomorphic VT in patients with idiopathic dilated cardiomyopathy (DCM) and assesses its long‐term effects on survival.

Methods and Results: Between April 2004 and October 2008, 13 consecutive patients (nine men, mean age 56.8 ± 17.8 years) with DCM and electrical storm due to monomorphic VT who had ICD underwent 17 catheter ablation procedures, including four epicardial, at our center. Acute complete success was defined as the lack of inducibility of any VT at the end of procedure during programmed right ventricular stimulation and was achieved in eight patients (61.5%). During a median follow‐up of 23 months (range 3–63 months) nine patients (69%) were alive and eight patients (61.5%) were free from VT recurrence. Among those with acute complete (n = 8) and partial (n = 5) success, seven patients (87.5%) and one patient (20%) were free from any VT recurrence and ICD therapy, respectively (P = 0.025). Among those with acute complete and partial success, seven patients (87.5%) and two patients (40%) were alive, respectively (Mantel‐Cox test P = 0.082). Among those who had an initially failed endocardial ablation (n = 8), four underwent further epicardial ablation that was completely successful in three patients (75%).

Conclusion: Catheter ablation in patients with DCM and electrical storm due to monomorphic VT who had an ICD prevents further VT recurrence in 61.5% of the patients. Complete successful catheter ablation may play a protective role and was associated with reduced mortality during the follow‐up period. More aggressive ablation strategies in patients with initially failed endocardial ablation might improve the long‐term survival of these patients; however, further studies are needed to clarify this issue. (PACE 2010; 33:1504–1509)