bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of curcuminoids hydrogel patch using chitosan from various sources as controlled‐release matrix
Authors: Boriwanwattanarak P. , Ingkaninan K. , Khorana N. , Viyoch J.
Published: April 2008

Synopsis

In this study, we developed the hydogel patch containing curcuminoids for application in cosmetic purpose. The powder of curcuminoids extracted from rhizome of Curcuma longa Linn. was first formulated into o/w microemulsions before incorporating into the polymer solution. The polymer solutions consisted of chitosan derived from various sources or the blended chitosan starch. We found that chitosan from squid pen gave the patch with highest strength and flexibility. After incorporation of curcuminoids microemulsion into the polymer solution of squid chitosan in ratio of 1 : 1 by weight, values of tensile strength and per cent elongation at break of the obtained patch decreased (from 4.55 ± 0.41 N mm−2 to 2.26 ± 0.01 N mm−2 for tensile strength and from 40.27 ± 1.46% to 29.65 ± 2.77% for elongation at break). The DSC thermogram of the squid patch containing curcuminoids implied non‐crystalline structure of polymeric network, corresponding to porous characteristics of the patch surface. The results showed that the curcumin content remained at a concentration of 96% and 40% of the initial content after being kept at 4°C and room temperature, respectively. When the patch was kept at 50°C, the remaining curcumin could not be detected. According to vertical diffusion cell method, we found a rapid rate of curcumin release from the patch. The curcumin release pattern, which fitted well to the Higuchi’s model, exhibited two distinct phases: the rapid phase (0–15 min), where the release rate of the curcumin averaged 0.74 μg min−1 mm−2, and the slow phase (15–120 min), where the release rate averaged 0.13 μg min−1 mm−2. Any sign of skin irritation was not observed in volunteers after single application of the curcuminoids patch in the under‐eye area for 30 min. This finding indicates mildness to skin of the developed patch.
Combined retinol–lactose–glycolic acid effects on photoaged skin: a double‐blind placebo‐controlled study
Authors: Bertin C. , Zunino H. , Lanctin M. , Stamatas G.N. , Camel E. , Robert C. , Issachar N.
Published: April 2008

Synopsis

The objective of this study was to assess the efficacy of the combination of retinol, lactose and glycolic acid applied topically on photodamaged skin. Forty female volunteers were enrolled in a double‐blind, randomized placebo‐controlled clinical study. A cream containing retinol, lactose and glycolic acid was applied on one side of the face and a placebo cream on the other side, twice daily for 12 weeks. Skin photoageing signs were assessed clinically, whereas skin microrelief and moisturization were measured instrumentally. Both the clinical assessment and the objective instrumental measurements revealed that the active‐treated side was significantly improved at the end of the study compared with baseline and control‐treated side. In conclusion, our results demonstrate that topical application of a combination of retinol, lactose and glycolic acid has significantly improved the appearance of photodamaged skin.
Cortical actin filaments at the division site of mitotic plant cells: a reconsideration of the ‘actin‐depleted zone’
Authors: Panteris Emmanuel
Published: April 2008

The preprophase bands of microtubules and F‐actin are primary markers of the division site for most plant cells. After preprophase band breakdown, the division site has been considered to be ‘negatively’ memorized by the local absence of cortical actin filaments. However, there have been reports of cortical F‐actin at the division site of mitotic plant cells, calling into question its distribution and possible role there. In this article, previous and recent data on this issue are reviewed. It is proposed that the division site of mitotic plant cells is not devoid of F‐actin but is traversed by scarce cortical actin filaments. The description of the division site as an ‘actin exclusion zone’ might therefore be attributed to a failure to preserve and/or image the notoriously sensitive actin filaments. Accordingly, the ‘actin‐depleted zone’ should be considered as a site with fewer actin filaments than the rest of the cortical cytoplasm. Taking into account recent molecular data on division site components, a possible role for the scarcity of cortical actin filaments in establishing a zone of minimum mobility is also proposed.
Governance and sustainability in Glasgow: connecting symbolic capital and housing consumption to regeneration
Authors: McIntyre Zhan , McKee Kim
Published: April 2008

To transcend a legacy of slum‐living, paternalistic provision and urban decline, Glasgow City Council has endeavoured to transform the city's fortunes by a plethora of mechanisms that have at their core the establishment of sustainable communities. Framed within a policy discourse which emphasises ‘cultural and social’ as well as ‘physical and economic’ renaissance, the crux of the Council's strategy has been to stem the migratory tide of affluent households and to empower public sector housing tenants. Drawing on

Rose's (2001

Community, citizenship and the third way in Meredyth D and Minson J P eds Citizenship and cultural policy Sage) ‘ethopolitics’ we argue these developments in Glasgow reflect the wider emergence of technologies of governance in UK housing policy that seek to realign citizens’ identities with norms of active, entrepreneurial consumption.
Global Phosphorus Flows and Environmental Impacts from a Consumption Perspective
Authors: Liu Yi , Villalba Gara , Ayres Robert U. , Schroder Hans
Published: April 2008

Human activities have significantly intensified natural phosphorus cycles, which has resulted in some serious environmental problems that modern societies face today. This article attempts to quantify the global phosphorus flows associated with present day mining, farming, animal feeding, and household consumption. Various physical characteristics of the related phosphorus fluxes as well as their environmental impacts in different economies, including the United States, European countries, and China, are examined. Particular attention is given to the global phosphorus budget in cropland and the movement and transformation of phosphorus in soil, because these phosphorus flows, in association with the farming sector, constitute major fluxes that dominate the anthropogenic phosphorus cycle. The results show that the global input of phosphorus to cropland, in both inorganic and organic forms from various sources, cannot compensate for the removal in harvests and in the losses by erosion and runoff. A net loss of phosphorus from the world's cropland is estimated at about 10.5 million metric tons (MMT) phosphorus each year, nearly one half of the phosphorus extracted yearly.
Extensive Left Ventricular to Coronary Artery Connections in Hypoplastic Left Heart Syndrome
Authors: Roberson David A , Cui Wei , Cuneo Bettina F , Van Bergen Andrew H. , Javois Alex J , Bharati Saroja
Published: April 2008

We demonstrate the echocardiographic features of a rare case of very extensive left ventricular to coronary arterial connections (VCC) to both the right and left coronary arteries in a fetus and subsequent neonate with hypoplastic left heart syndrome (HLH). The right coronary artery, after receiving multiple VCC supplied the only antegrade ascending aortic flow. The left main coronary artery was very hypoplastic and the left anterior descending coronary artery was dilated and tortuous with multiple large VCC. The left circumflex coronary artery arose exclusively from its own VCC. To our knowledge this is the first such echocardiographic demonstration of HLH with extensive bilateral VCC and coronary artery stenosis and interruption.
“Tardus and Parvus” Phenomenon in Upper Limb Arteries for Identifying Subclavian Arterial Stenosis
Authors: Duan Yun‐You , Yuan Li‐Jun , Ding Kang , Liu Xi , Lv Fa‐Qin , Cao Tie‐Sheng
Published: April 2008

Background: The detection of subclavian artery (SCA) stenosis or occlusion is important, and an easy and accurate noninvasive screening method is needed. Methods: Pulsed Doppler spectra of bilateral SCA, vertebral arteries, axillary arteries, and brachial arteries were recorded and analyzed both in patients with SCA stenosis and healthy subjects. Results: Thirty‐five patients showed SCA stenosis less than 80% (mean: 72 ± 14%; Vmax: 450.1 ± 101.5 cm/sec) and seven patients demonstrated one‐side SCA occlusion. The Vmax, systolic acceleration (SA) and resistance index (RI) were much lower (parvus) while the acceleration time (AT) was much longer (tardus) in axillary and brachial arteries on the ipsilateral than those both on the contralateral and the control group (Axillary artery: Vmax: 31.3 ± 11.8 vs. 62.0 ± 24.1 and 85.8 ± 14.3 cm/sec, P < 0.01; SA: 2.0 ± 1.0 vs. 6.8 ± 4.9 and 9.6 ± 2.0 m/sec2, P < 0.05; RI: 0.8 ± 0.1 vs. 1.1 ± 0.4 and 1.1 ± 0.3, P < 0.01; AT: 141 ± 34 vs. 86 ± 26 and 76 ± 9 ms, P < 0.01. Brachial artery: Vmax: 47.5 ± 25.2 vs. 76.7 ± 37.6 and 84.6 ± 14.2 cm/sec, P < 0.05; SA: 3.1 ± 2.1 vs. 9.1 ± 5.2 and 10.1 ± 3.5 m/sec2, P < 0.01; RI: 1.0 ± 0.1 vs. 1.2 ± 0.1 and 1.2 ± 0.1, P < 0.01; AT: 155 ± 31 vs. 86 ± 19 and 78 ± 12ms, P < 0.01). Conclusions: The “tardus and parvus” phenomenon in ipsilateral axillary and brachial arteries could be employed as an alternative method and a shortcut for detection of the SCA stenosis or occlusion.
The Sociological Study of Values
Authors: Wuthnow Robert
Published: April 2008

Fifty years ago, Robin M. Williams Jr. described eight notable changes in U.S. sociology, one of which was the “widespread diffusion of a relatively clear and sophisticated conception of the place of values in sociological study, as an object of research, as a factor in behavior, and as an element to be controlled in the prosecution of research” (Williams, 1958:621). In this essay, I ask what has become of that rising interest in the sociological study of values? I follow three distinct trajectories of sociological research on values, briefly describing the contributions of each, and identifying several lines of inquiry that strike me as particularly important and promising for the future.
Social Relations, Core Values, and the Polyphony of the American Experience
Authors: Cerulo Karen A.
Published: April 2008

This essay examines social relations and cultural values in the United States, paying special attention to recent characterizations of Americans as increasingly isolated, disconnected, and dangerously individualistic. In this essay, I refute such claims. And building on earlier work (Cerulo, 2002), I show that U.S. social relations and cultural values are more multifaceted than such “new individualism” arguments suggest. Indeed, as Robin M. Williams Jr. discovered 50 years ago, when studied in a systematic way, U.S. values and beliefs present us with a multiplex system—a system in which individualism plays only a supporting role. This is true, I suggest, because Americans’“value focus”—that is, the prioritization of one value over another—shifts in concert with certain social events and structural conditions. In this way, we can think of U.S. values as part of a “cultural toolkit,” with actors selecting or foregrounding the values needed to support certain strategies of action.
The Pseudomonas aeruginosa autoinducer dodecanoyl‐homoserine lactone inhibits the putrescine synthesis in human cells
Authors: KRISTIANSEN SØREN , BJARNSHOLT THOMAS , ADELTOFT DINAH , IFVERSEN PETER , GIVSKOV MICHAEL
Published: April 2008

Pseudomonas aeruginosa uses acyl‐homoserine lactones to coordinate gene transcription in a process called quorum sensing (QS). The QS molecules C4‐HSL and C12‐oxo‐HSL are synthesized from the universal precursor S‐adenosyl methionine, which is also a precursor of polyamines in human cells. Polyamines are required for mitotic cell division and peak during this phase. The polyamine putrescine is synthesized by ornithine decarboxylase (ODC) as a rate‐limiting step. The ODC enzyme concentration also peaks during the mitotic phase. This peak is mediated by translation of ODC mRNA by the ITAF45 protein, which translocates from the nuclear compartment to the cytoplasm in a phosphorylation‐dependent manner. We observed that C12‐HSL‐treated human epidermal cells had a higher cytoplasm‐to‐nuclear ITAF45 protein concentration and this translocation was dependent on the dephosphorylation of ITAF45. Finally, C12‐HSL‐treated cells also had a time‐course‐dependent higher concentration of ODC mRNA. Based on these mitotic markers, more human cells were apparently trapped in the mitotic phase when treated with C12‐HSL. This should normally imply higher levels of putrescine. However, C12‐HSL‐treated human cells had a significantly lower concentration of putrescine and displayed a lower cell proliferation rate. In conclusion, the P. aeruginosa autoinducer C12‐oxo‐HSL apparently arrests human cells in the mitotic phase by lowering the concentration of putrescine.
Prokaryotic expression and monoclonal antibody preparation of Mycobacterium tuberculosis ferric uptake regulator B
Authors: JIANG HONG , GAO XUE , LI YUAN , XU ZHI‐KAI , WANG LI‐MEI , BAI XUE‐FAN , XUE YING
Published: April 2008

Ferric uptake regulator B (FurB) of Mycobacterium tuberculosis, which belongs to the Fur superfamily, is principally responsible for maintaining iron and zinc homeostasis in prokaryotes. This common feature of FurB and the role of FurB in iron and zinc metabolism contribute to research on the pathogenesis of mycobacteria. In this study, three novel mouse monoclonal antibodies were generated using the prokaryotically expressed FurB protein as immunogen. The FurB gene of M. tuberculosis H37Rv was inserted into a bacterial expression vector of pQE‐80L and was effectively expressed in Escherichia coli DH5α. The expressed fusion protein existed as the insoluble form (inclusion bodies) in cell lysate and was purified on an Ni‐NTA column. Using the fusion protein to immunize BALB/c mice, three monoclonal antibodies (DD12, BH1, and DH8) were produced. As shown by Western blot analysis and indirect immunofluorescence assay, the three respective antibodies could recognize the FurB protein. These results suggest that the antibodies against FurB may provide a powerful tool for investigating the function of FurB in the pathogenesis of tuberculosis.
Distribution and richness of diadromous fish assemblages in Western Europe: large‐scale explanatory factors
Authors: Béguer M. , Beaulaton L. , Rochard E.
Published: April 2008

Abstract –  The aim of this study was to analyse the distribution of 14 diadromous fish at the beginning of the 20th century in western Europe. This study was conducted on a set of 41 water basins. Five environmental variables were selected and we used generalised additive models for explaining the presence–absence of species. The richest basins were located in the centre of the study area. Six main assemblage types were identified along a latitudinal gradient; they were constituted of a common species basis but differed by the absence or presence of other species. The 10 single species models produced have moderate to very good discrimination level and they can correctly predict both absence and presence. Temperature is included in all but one model, response curves vary according to the species; surface area is included in six models.
Increased population density of pike Esox lucius– a result of selective harvest of large individuals
Authors: Sharma C. M. , Borgstrøm R.
Published: April 2008

Abstract –  The effect of selective harvest of large pike on number of middle‐sized pike was tested in a small, eutrophic lake in SE Norway. The pike population was estimated using a mark–recapture method in two different periods: before (1980–1983) and during the manipulation of the pike population (2004–2006). After an extensive size selective harvest of large pike (≥65 cm) in 2004, the number of pike in length‐class 45–65 cm, mainly 3+ pike, increased significantly from 2004 to 2005. The number in this length‐class was even higher in 2006. Since 2+ pike was part of the diet of large pike, the increase in number of 3+ pike in 2005 and 2006 is probably due to reduced consumption of 2+ pike, following the substantial selective removal of large pike in 2004 and 2005. To maintain a high annual survival of young pike, a selective exploitation of large pike has to be carried out annually.
Eosinophil activation in preterm infants with lung disease
Authors: Broström E Berggren , Katz‐Salamon M , Lundahl J , Halldén G , Winbladh B
Published: April 2008

Aim: We investigated the role of eosinophils in the pathogenesis of bronchopulmonary dysplasia (BPD) in preterm infants.

Methods: Fifteen preterm infants with BPD were compared to 13 preterms with respiratory distress syndrome (RDS) and to 16 healthy preterms. We assessed total eosinophil and neutrophil counts in venous blood samples and the levels of the eosinophilic activity markers eosinophilic cationic protein (ECP) and the cellular surface antigen (CD9).

Results: The eosinophil count was greater in BPD compared with RDS and healthy infants (1414 vs. 797 and 471 cells per microlitre, respectiveley, p = 0.03). ECP levels were elevated (34 vs. 12.8 and 9.8 μg/L, respectively, p = 0.002) and CD9 levels reduced (75 vs. 94 and 86 mean fluorescence intensity units, respectively, p = 0.01) in BPD compared with RDS and healthy infants, suggesting eosinophilic activation in BPD. These findings were not solely explained by differences between gestational age or birth weight of the different groups. ECP levels were positively correlated with the duration of oxygen supplementation in the BPD group. The eosinophil count fell promptly after steroid treatment was commenced in the BPD group.

Conclusion: The findings suggest that BPD is linked to eosinophil activation, which might contribute to the pathogenesis.
Recurrent gastroesophageal reflux in neurologically impaired patients after fundoplication
Authors: Goessler A , Huber‐Zeyringer A , Hoellwarth ME
Published: April 2008

Goessler A, Huber‐Zeyringer A, Hoellwarth M.E. “Recurrent gastroesophageal reflux in neurologically impaired patients after fundoplication.” Acta Paediatr 00, Stockholm. ISSN 0803‐5253.

Aim: To evaluate the outcome and analyse the main causes of complications and failures of antireflux surgery for gastroesophageal reflux disease (GERD) in neurologically impaired patients (NIP).

Methods: From 1985 to 1999 44 NIP (mean age 12 years) underwent surgery for GERD. Type of surgery, complications and recurrent reflux were analysed.

Results: Twenty‐seven patients (61%) showed preoperatively severe failure to thrive. All patients showed pathologic results in 24‐h pH monitoring. Surgical treatment consisted of ventral (n = 25, Thal) or dorsal (n = 4, Toupet) semifundoplication or a Nissen fundoplication (n = 15). Postoperatively, all patients showed an impressive growth, regress of symptoms and improvement of results of diagnostic investigations. Late complications and recurrence of reflux were significantly related to preoperative extreme dystrophy (p < 0.0025). In six patients (15%) severity of symptoms related to recurrent reflux required a reoperation 17.8 month postoperatively (range 8–35 month). Recurrent reflux was found in 40% after ventral semifundoplication and in 46% after Nissen fundoplication (8 and 47 months postoperatively, respectively).

Conclusion: Symptoms improved impressively after fundoplication in mentally retarded children. The incidence of recurrent reflux is not related to the type of surgery, however, it occurs significantly earlier with ventral semifundoplication when compared with Nissen fundoplication. Both late complications as well as recurrent reflux are related significantly to preoperative dystrophy.
Psychosocial problems in children with cystic fibrosis
Authors: Bregnballe V , Thastum M , Schiøtz PO
Published: April 2008

Aim: To compare the well‐being of children (7–14 years) with cystic fibrosis (CF) (n = 43) with the well‐being of healthy controls (n = 1121).

Methods: The self‐report questionnaire Beck Youth Inventories (BYI) was used to study depression, anxiety, anger, disruptive behaviour and self‐concept in children with CF. A measure of social desirability was included as well as body mass index (BMI) and percentage of predicted forced expiratory volume in one second (FEV1) as measures of health status.

Results: The children with CF did not differ from the norm group concerning depression, disruptive behaviour and self‐concept. Young children with CF (7–10 years) and boys with CF scored significantly higher on anxiety. Girls with CF scored significantly lower on anger than controls. BMI was not associated with any of the BYI subscales. In patients aged 11–14 years, there was a significant correlation between FEV1 and self‐concept as well as a significant inverse correlation between FEV1 and anxiety.

Conclusions: Younger children with CF and boys with CF were more anxious than the healthy controls, and girls with CF expressed less anger than their healthy peers. Effects sizes however were small. Low FEV1 was associated with low self‐concept and high anxiety in adolescent patients.
Validating and updating a prediction rule for serious bacterial infection in patients with fever without source
Authors: Bleeker SE , Derksen‐Lubsen G , Grobbee DE , Donders ART , Moons KGM , Moll HA
Published: April 2008

Aim: To externally validate and update a previously developed rule for predicting the presence of serious bacterial infections in children with fever without apparent source.

Methods: Patients, 1–36 mo, presenting with fever without source, were prospectively enrolled. Serious bacterial infection included bacterial meningitis, sepsis, bacteraemia, pneumonia, urinary tract infection, bacterial gastroenteritis, osteomyelitis/ethmoiditis. The generalizability of the original rule was determined. Subsequently, the prediction rule was updated using all available data of the patients with fever without source (1996–1998 and 2000–2001, n = 381) using multivariable logistic regression.

Results: the generalizability of the rule appeared insufficient in the new patients (n = 150). In the updated rule, independent predictors from history and examination were duration of fever, vomiting, ill clinical appearance, chest‐wall retractions and poor peripheral circulation (ROC area (95%CI): 0.69 (0.63–0.75)). Additional independent predictors from laboratory were serum white blood cell count and C‐reactive protein, and in urinalysis ≥70 white bloods (ROC area (95%CI): 0.83 (0.78–0.88).

Conclusions: A previously developed prediction rule for predicting the presence of serious bacterial infection in children with fever without apparent source was updated. Its clinical score can be used as a first screening tool. Additional laboratory testing may specify the individual risk estimate (range: 4–54%) further.
Developing a social brain
Authors: Johnson Mark H
Published: April 2008

A new account of human postnatal functional brain development, interactive specialization (IS), is introduced and applied to one important domain of human development: the social brain. Behavioural, ERP and fMRI evidence from newborns, infants and children in face processing tasks is briefly reviewed, and is shown to be consistent with predictions from the IS account.

Conclusion: It is suggested that this new view of functional brain development can also be applied to other domains of typical and atypical human development.
Preliminary evidence of a sensitive period for olfactory learning by human newborns
Authors: Romantshik O , Porter RH , Tillmann V , Varendi H
Published: April 2008

Aim: To test the hypothesis that a brief window of time immediately after delivery may be a particularly sensitive period for olfactory learning by human neonates.

Methods: Fifty‐five vaginally delivered newborns were exposed to an odorant for 30 min beginning 4–37 min after birth (Early exposure) or 12‐h post‐partum (Late exposure). Several days later, newborns' head orientation responses to the exposure odour versus an unfamiliar odour or an odourless control stimulus were tested.

Results: Infants in the Early exposure group spent significantly more time oriented towards the familiar scent rather than a novel odour (Z = 2.869; n = 28; p < 0.01), or an odourless stimulus (Z = 2.550; n = 28; p < 0.01). Infants in the Late exposure condition did not respond differentially to the exposure odour versus a novel odour (Z = 1.105; n = 27, p = 0.27), and spent more time oriented towards an odourless stimulus than to the exposure odour (Z = 2.042; n = 27, p < 0.05).

Conclusion: Infants in the Early exposure group, but not in the Late exposure group, became familiar with the exposure odour and retained a memory trace of it during the test trials.
Females born large for gestational age have a doubled risk of giving birth to large for gestational age infants
Authors: Ahlsson F , Gustafsson J , Tuvemo T , Lundgren M
Published: April 2008

Aim: To analyse if females born large for gestational age (LGA) have an increased risk to give birth to LGA infants and to study anthropometric characteristics in macrosomic infants of females born LGA.

Methods: The investigation was performed as an intergenerational retrospective study of women born between 1973 and 1983, who delivered their first infant between 1989 and 1999. Birth characteristics of 47 783 females, included in the Swedish Birth Register both as newborns and mothers were analysed. LGA was defined as >2 SD in either birth weight or length for gestational age. The infants were divided into three subgroups: born tall only, born heavy only and born both tall and heavy for gestational age. Multiple logistic and linear regression analyses were performed.

Results: Females, born LGA with regard to length or weight, had a two‐fold (adjusted OR 1.96, 95% Cl 1.54–2.48) increased risk to give birth to an LGA infant. Females, born LGA concerning weight only, had a 2.6 (adjusted OR 2.63, 95%, 1.85–3.75) fold increased risk of having an LGA offspring heavy only and no elevated risk of giving birth to an offspring that was tall only, compared to females born not LGA. In addition, maternal obesity was associated with a 2.5 (adjusted OR 2.56, 95%, 2.20–2.98) fold increased risk of having an LGA newborn, compared to mothers with normal weight.

Conclusion: Females, born LGA, have an increased risk to give birth to LGA infants, compared to mothers born not LGA. Maternal overweight increases this risk even further.
Early cardiac involvement in children carrying the A3243G mtDNA mutation
Authors: Wortmann S B , Rodenburg R J , Backx A P , Schmitt E , Smeitink J A M , Morava E
Published: April 2008

The phenotypic spectrum of the mitochondrial A3243G DKA mutation is highly variable, particularly when occuring in childhood. In contrast to the classical presentation in adulthood (MELAS syndrome; mitochondria! myopathy, encephalopathy, lactic acidosis and stroke‐like episodes) children show a different pattern of symptoms, often without the typical encephalopathy or psychomotor regression. We present six children carrying the A3243G mtDNA mutation with a heteroplasmy above 50 % in muscle tissue. The age of diagnosis ranged from 2 weeks up to 14.5 years. The clinical presentation was rather non‐specific including muscle weakness, developmental delay and epilepsy. In this small pediatric group we detected presymptomatic cardiac involvement in five out of six children already at an early stage of disease. The cardiac pathology included cardiomyopathy and biventricular hypertrophy with rhythm disturbances (for example long QT‐syndrome). The observed cardiac changes do not always increase the risk of cardiac deterioration; however, two of our patients died early on.

Conclusion: We hypothesize that the A3243G mutation might be underdiagnosed, as patients could suffer from an unexplained cardiac death before the diagnosis is made. We advise performing regular repeated ECGs and echocardiography in all children carrying a A3243G mtDNA mutation independently from the presence of cardiac symptoms.
New guidelines for newborn resuscitation
Authors: Saugstad Ola Didrik
Published: April 2008

The new guidelines from the International Liaison Committee on Resuscitation and American Heart Association/American Academy of Pediatrics for newborn resuscitation underline that efficient ventilation is the key to a successful resuscitation of the newly born infant. Compared with the former guidelines published in 1999, the major changes are (i) less emphasis on using supplemental oxygen when initiating resuscitation, (ii) no need for routine intrapartum oropharyngeal and nasopharyngeal suctioning for vigorous infants born to mothers with meconium staining of amniotic fluid, (iii) occlusive wrapping of very low birth weight infants <28 weeks to reduce heat loss is recommended, (iv) preference for the intravenous versus endotracheal route for adrenaline and (v) more emphasis on parental autonomy at the threshold of viability. A number of gaps in newborn resuscitation have been identified and discussed.

Conclusion: The new guidelines for newborn resuscitation are more evidence‐based than previously ones. However, still there is a need for further research and modifications.
Working mothers breastfeed babies more than housewives
Authors: Bakoula Chryssa , Veltsista Alexandra , Prezerakou Anargyroula , Moustaki Maria , Fretzayas Andreas , Nicolaidou Polyxeni
Published: April 2008

Aim: To examine the prevalence and determinants of breastfeeding and to identify perinatal, sociodemographic, psychosocial and environmental factors associated with maternal infant feeding intention.

Methods: A sample of 3734 Greek mothers that delivered their infants in 2000 was recruited in a longitudinal cohort study. Data on duration of breastfeeding was based on a questionnaire answered by 76.6% of the participants at 8–12 months postpartum.

Results: The rates of any breastfeeding at 3 and 6 months were 52% and 24%, respectively. The corresponding rates of exclusive breastfeeding were 37% and 17%. From Cox regression analysis mother's intention to breastfeed for a short time and upbringing in the area of Athens were significantly associated with early termination of any breastfeeding and exclusive breastfeeding. A positive intention to breastfeed was influenced by maternal entitlement more than 6 months, delivery in autumn or winter, mother's upbringing abroad and previous breastfeeding experience.

Conclusions: The rates of any breastfeeding and exclusive breastfeeding during the first year of life were fairly satisfactory. Programs to support breastfeeding are necessary and should encourage women to feel positive to breastfeed, focusing particularly on non‐working mothers, mothers with a maternity entitlement less than 6 months and mothers who lack previous breastfeeding experience.
A major deletion in the surfactant protein‐B gene causing lethal respiratory distress
Authors: Wegner Daniel J , Hertzberg Torbjörn , Heins Hillary B , Elmberger Göran , MacCoss Michael J , Carlson Christopher S , Nogee Lawrence M , Cole F Sessions , Hamvas Aaron
Published: April 2008

Background: Loss of function mutations in the surfactant protein‐B gene (SFTPB) cause lethal neonatal respiratory distress due to reduced or absent expression of mature surfactant protein B (SP‐B, encoded in exons 6 and 7). No large deletions in SFTPB have been previously identified.

Aim: Genomic, proteomic and immunohistochemical characterization of a 3 kb deletion in SFTPB.

Methods: A full‐term newborn presented with refractory respiratory failure. We amplified and sequenced SFTPB from the infant and both parents, determined SP‐B protein expression in tracheal aspirate samples using Western‐blot analysis, and performed immunohistochemical staining and electron microscopy of lung biopsy tissue.

Results: The infant was homozygous for a 2958 bp deletion in SFTPB that included exons 7 and 8. Both asymptomatic parents were heterozygous for the deletion. A truncated mature SP‐B peptide was detected on Western blotting of tracheal aspirate. Amino acid sequence specific to that encoded in exon 5 was present, but that encoded by exon 7 was absent. ProSP‐B expression was robust within alveolar type II cells and lamellar body structure was disrupted.

Conclusions: This deletion in SFTPB resulted in SP‐B deficiency due to absence of elements in mature SP‐B that are critical for appropriate peptide folding, trafficking and processing.
Rapunzel syndrome: a diagnosis overlooked
Authors: Mathai John , Chacko Jacob , Kumar T. Sathish , Scott Julius Xavier , Agarwal Indira , Varkki Sneha
Published: April 2008

We report two children who presented with a painless abdominal mass masquerading as a splenic enlargement. The paucity of symptoms resulted in delayed diagnosis. At laparotomy the trichobezoars were found to have a tail extending into the small intestine.

Conclusion: This condition eludes diagnosis unless sought for particularly in the paediatric age group. Hence we present our experience of two consecutive cases of paediatric Rapunzel syndrome, along with the relevant literature and in retrospect, how an early diagnosis could have been made.
Parental stress and toddler behaviour at age 18 months after pre‐term birth
Authors: Jackson Karin , Ternestedt Britt‐Marie , Magnuson Anders , Schollin Jens
Published: April 2008

Aim: To describe the parent's judgement of their own stress and the child's behaviour at 18 months after pre‐term birth and if there are any correlations between these assessments, the morbidity in the neonatal period, the gestational age at birth and the occurrence of twin/triplet births.

Method: Twenty‐one mothers and 19 fathers of pre‐term infants answered two questionnaires, The Swedish Parenthood Stress Questionnaire (SPSQ) and The Toddler Behaviour Questionnaire (TBQ).

Results: Mothers scored somewhat higher than fathers concerning parental stress. Parents with twins/triplets and of children born in gestational week 25–30 felt more stress, though the differences were not statistically significant. High‐risk diagnoses did not correlate to any of the dimensions. The parents judged the behaviour of the children similar except that parents of children born in gestational week 25–30 scored significantly higher for intensity/activity (p = 0.002). The correlation between parental stress and judgement of their children's behaviour did not show any significant association except for the dimension regularity in TBQ (p = 0.016).

Conclusions: The mothers' and fathers' assessments of their own stress and of the children's behaviour were similar. Parents of very pre‐term children felt more stress and judged the children somewhat delayed in their social behaviours, probably due to their low gestational age.
Novel mutations in the gene encoding ATP binding cassette protein member A3 (ABCA3) resulting in fatal neonatal lung disease
Authors: Saugstad Ola D. , Hansen Thor Willy Ruud , Rønnestad Arild , Nakstad Britt , Tølløfsrud Per Arne , Reinholt Finn , Hamvas Aaron , Cole F. Sessions , Dean Michael , Wert Susan E. , Whitsett Jeffrey A. , Nogee Lawrence M.
Published: April 2008

Aim: To investigate whether intractable respiratory distress syndrome in three Norwegian term infants was due to mutations in the ABCA3 gene.

Methods: The genes encoding SP‐B (SFTPB), SP‐C (SFTPC), and ABCA3 (ABCA3) were sequenced from the parents of one infant and two unrelated infants with fatal neonatal lung disease. Lung tissue was examined by histology, immunohistochemistry and electron microscopy.

Results: Novel ABCA3 mutations were identified in each family. One patient had a phenotype differing from previous descriptions of this disease with an initial uneventful period. The diagnosis was established 19 years after death by analysing DNA material from the parents, with an ABCA3 mutation identified on one allele in each parent. The other two infants had more typical clinical courses with the onset of respiratory symptoms immediately after birth. ABCA3 mutations were identified on both alleles from these two infants, and electron microscopy of alveolar type 2 cells demonstrated abnormal lamellar body formation characteristic of this disorder.

Conclusion: ABCA3 mutations were the basis for lung disease in all three patients. Children with lung disease due to ABCA3 deficiency may not have symptoms at birth. The finding of five novel mutations indicates allelic heterogeneity for ABCA3 mutations within the Norwegian population.
Lack of recognition and complexity of foetal alcohol neuroimpairments
Authors: Elgen I , Bruaroy S , Laegreid L M
Published: April 2008

Aims: To obtain the recorded prevalence of foetal alcohol syndrome (FAS) and foetal alcohol spectrum disorders (FASD) in Norway, and evaluate the effect of a general information program to increase the recognition of FAS/FASD for health care and social workers.

Methods: A questionnaire regarding prevalence of FAS/FASD was sent to all Norwegian paediatric and child psychiatry departments. In the region Hordaland county, an information program was carried out to educate health‐care and social workers on symptoms and signs of FAS/FASD, and referral was encouraged for suspected cases. Referred children received a neuropaediatric evaluation, and the effect of the information program on recorded FAS/FASD was recorded.

Results: Based on the national survey, a prevalence of 0.3 per 1000 was calculated. After the information program, the estimated prevalence in Hordaland County increased to 1.5 per 1000. In 5 years, 25 children were diagnosed with FAS and 22 with FASD. One‐third of all children were mentally retarded. Microcephaly and neuroimpairments were more common among FAS children. Almost all children met the criteria of ADHD.

Conclusion: The rate of FAS/FASD may be greatly underestimated because of lack of knowledge. An information program aimed at health‐care and social workers is effective.
Is there a connection between severe cerebral palsy and increased gluten sensitivity?
Authors: Stenberg R , Schollin J
Published: April 2008

In nine children with severe cerebral palsy (CP), feeding difficulties and poor development of weight and height, laboratory markers for metabolic and enteral dysfunction were studied.

Conclusion: Four of the nine patients with CP had increased levels of antigliadin antibodies AGA (IgA), a finding which calls for further studies concerning the possible connection between increased celiac markers and CP.
Enzyme replacement therapy with agalsidase alfa in children with Fabry disease
Authors: Ramaswami U , Wendt S , Pintos‐Morell G , Parini R , Whybra C , Leon Leal J A , Santus F , Beck M
Published: April 2008

Aim: To assess the effects of enzyme replacement therapy (ERT) in children with Fabry disease.

Methods: Safety and efficacy of ERT with agalsidase alfa, 0.2 mg/kg infused over 40 minutes every 2 weeks for 23 weeks, were studied in a multicentre open‐label trial in nine boys and four girls. Median age at the start of the study was 11.0 years (range 3.5–18 years).

Results: Fifty‐four adverse events were reported in 11 patients. No serious adverse events related to ERT were reported. Twelve of the 54 adverse events were considered possibly or probably related to ERT. Infusion reactions (8 mild, 3 moderate) occurred in four boys, in seven infusions. One boy developed IgG antibodies, although he continued to make good clinical progress. At the end of the study, two of the four boys and the one girl on regular pain medication at baseline had stopped taking analgesics. Brief Pain Inventory (BPI) scores decreased in most patients by week 12 and were sustained until the end of the study. This change was greater in the boys, who had higher (worse) BPI scores at baseline. Pain‐related quality of life (QoL) scores also decreased during the study. Plasma globotriaosylceramide concentrations and urinary globotriaosylceramide:sphingomyelin ratios decreased after 12 and 23 weeks of therapy, particularly in the boys. Increases in sweat volume were recorded in three out of five of the boys and in one of two girls tested after 23 weeks of treatment.

Conclusion: ERT with agalsidase alfa in children with Fabry disease is well tolerated and, in the short term, appears to decrease pain and to improve pain‐related QoL.
Preoperative lung function in newborn infants with univentricular hearts compared with healthy controls
Authors: Matthews Iren Lindbak , Kaldestad Runa Helen , Bjørnstad Per G. , Thaulow Erik , Grønn Morten
Published: April 2008

Aim: To measure the difference in lung function between newborns with univentricular hearts and healthy controls and study associations between lung function and pulmonary blood flow and pulmonary vasculature markings.

Method: Tidal flow‐volume measurements and single occlusion tests were performed before surgery on 25 unsedated spontaneously breathing newborns with univentricular hearts recruited over a 3‐year period. Seventy‐five healthy control infants were measured. Pulmonary blood flow was graded according to the haemodynamic effect of the echocardiographically defined anatomy of the heart defect. Pulmonary vasculature was graded according to radiological markings.

Results: The infants with univentricular hearts had a lower mean tidal volume of 4.7 ml (CI 2.3, 7.2, p < 0.001) (n = 24) and a lower mean compliance of the respiratory system of 12.7 ml/kPa (CI 4.6, 20.8, p = 0.004) (n = 14). Pulmonary blood flow grading was associated with respiratory rate (r = 0.53, p < 0.001), tidal volume (r =–0.48, p < 0.001), compliance (r =–0.55, p < 0.001) and resistance (r =–0.31, p = 0.043). Pulmonary vasculature grading was associated with compliance (r =–0.68, p = 0.006), resistance (r =–0.69, p = 0.007) and the time constant (r =–0.62, p = 0.042).

Conclusion: Newborns with univentricular hearts have reduced tidal volumes and reduced compliance of the respiratory system. The lung function abnormalities are associated with the degree of pulmonary blood flow and pulmonary vasculature markings.
Quality of life in children with hypoplastic left heart syndrome
Authors: Mellander M. , Berntsson L. , Nilsson B.
Published: April 2008

Aim: To measure quality of life in children with hypoplastic left heart syndrome and their families.

Methods: A questionnaire exploring socioeconomic status, structure and function of networks and psychological well‐being was completed by the families of all 18 patients older than 2 years (age range 2.7–10.6). The results were compared with those of 180 healthy Swedish children matched for age and sex.

Results: There were no significant differences between the groups in any of the aspects of socioeconomic status. Study group parents had not more available time for their child (p < 0.05) and more separations/divorces (p < 0.01). The patients had lower self‐esteem (p < 0.05), more psychosomatic symptoms (p < 0.001) and lower peer acceptance (p < 0.01) than control children.

Conclusion: With regard to psychological well‐being, quality of life was significantly lower in children with hypoplastic left heart syndrome than in healthy controls.
Energy substrate production in infants born small for gestational age
Authors: Diderholm Barbro , Ewald Uwe , Ahlsson Fredrik , Gustafsson Jan
Published: April 2008

Aim: To investigate energy substrate production and its hormonal regulation in infants born small for gestational age.

Methods: Eleven infants, aged 24.4 ± 5.3 hour, were studied following a fast of 4.0 ± 0.6 hour. Gestational age was 35.4 ± 2.8 weeks and birth weight 1804 ± 472 g (<−2 SD). Rates of glucose production and lipolysis were analyzed using [6,6‐2H2]‐glucose and [2‐13C]‐glycerol.

Results: Plasma levels of glucose and glycerol were 4.1 ± 1.1 mmol . L−1 and 224 ± 79 μmol . L−1, respectively. Glucose appearance averaged 30.3 ± 8.2 and glucose production rate 21.1 ± 6.1 μmol . kg−1 . minutes−1. Glycerol production rate was 5.6 ± 1.6 μmol . kg−1 . minutes−1, correlating strongly to birth weight (r = 0.904, p < 0.001). Of the glycerol produced, 55 ± 22% was converted to glucose, corresponding to 8 ± 3% of the glucose production.

Conclusions: Even though the infants could produce energy substrates, lipolysis was reduced and the glucose production was in the low end of the normal range compared with infants born appropriate for gestational age. The correlation between glycerol production and birth weight indicates that lipolysis depends on the amount of stored fat. Data on insulin and insulin‐like growth factor binding protein 1 support the view that insulin sensitivity in these infants is reduced in the liver but increased peripherally.
Severe adverse reactions to Infliximab therapy are common in young children with inflammatory bowel disease
Authors: Kolho K‐L , Ruuska T , Savilahti E
Published: April 2008

Since 2000 we have introduced 141 Infliximab infusions to 23 children with severe inflammatory bowel disease. A total of seven severe adverse reactions occurred in 26% (6 of 23) of the children. Four reactions were acute (anaphylaxis n = 2; allergic reaction n = 2) and 3/4 of these children were younger than 10 years of age. Two children developed an abscess and one child had septicaemia and brain lesions related to progressive multifocal leucoencephalopathy.

Conclusion: adverse reactions to Infliximab infusions are common. Young children seem to be prone to severe allergic reactions although they are on azathioprine and conventional glucocorticoid therapy.
Visits by the family to the neonatal intensive care unit
Authors: Latva R , Lehtonen L , Salmelin R K , Tamminen T
Published: April 2008

Aim: To investigate visiting frequency of family members, including mother, father, siblings and grandparents and associated factors during hospitalisation of preterm infants.

Methods: The study included all premature (< 37 weeks) infants born in Tampere University Hospital in 1997–1998 admitted to the neonatal intensive care unit (NICU) with a birth weight less than 2500 g (n = 210). Maternal and infant data and visits made by family members were compiled from the infants' hospital records.

Results: The length of the infants' hospitalisation varied from 2 to 133 days (median 26, quartiles 19, 45). Mothers visited the NICU on average 6.7 days/week; fathers 4.8 days/week. Mothers visited less frequently the lower the gestational age and the longer the distance between home and hospital. Fathers visited less frequently if distance from home to hospital was longer and if the infant had siblings. A total of 92% of siblings and 80% of grandparents visited the hospital.

Conclusions: The results showed active visiting by the parents in the NICU. A lower gestational age was associated with lower visiting frequency for mothers. In contrast, more practical limitations such as geographical distance and other children to be taken care of had greater effect on the visiting frequency for fathers.
Phenotype of acute respiratory syncytial virus induced lower respiratory tract illness in infancy and subsequent morbidity
Authors: Elphick H E , Ritson S , Rigby A S , Everard M L
Published: April 2008

The objective of this study was to investigate the association hypothesis that outcome following respiratory syncytial virus (RSV) induced bronchiolitis (RSVB) and RSV induced wheeze (RSVW) are different. At 3 years respiratory symptoms were more common in those with RSV infection than the control group but there was no increase in allergic sensitisation (11%vs 10%). Those with RSVW were more likely to have evidence of allergic sensitisation when compared with RSVB subjects (22%vs 7%), and have increased symptoms and increased use of inhaled steroids.

Conclusion: The data argue that RSV infection during infancy does not induce allergic asthma and that host factors rather than the virus determine long‐term outcomes.