bluuebunny/crossref_metadata_2025 huggingface dataset:
Co‐occurring development of early childhood communication and motor skills: results from a population‐based longitudinal study
Authors: Wang M. V. , Lekhal R. , Aarø L. E. , Schjølberg S.
Published: September 2012

Background

Communicative and motor development is frequently found to be associated. In the current study we investigate to what extent communication and motor skills at 1½ years predict skills in the same domains at 3 years of age.

Methods

This study is based on theNorwegianMother andChildCohortStudy (MoBa) conducted by theNorwegianInstitute ofPublicHeath. Data stem from 62 944 children and their mothers. Mothers completed questionnaires on their child's communication and motor skills at ages 1½ and 3. Associations between communication and motor skills were estimated in a cross‐lagged model with latent variables.

Results

Early communication skills were correlated with early motor skills (0.72). Stability was high (0.81) across time points for motor skills and somewhat lower (0.40) for communication skills. Early motor skills predicted later communication skills (0.38) whereas early communication skills negatively predicted later motor skills (−0.14).

Conclusion

Our findings provide support for the hypothesis that these two difficulties are not symptoms of separate disorders, but might rather be different manifestations of a common underlying neurodevelopmental weakness. However, there also seem to be specific developmental pathways for each domain. Besides theoretical interest, more knowledge about the relationship between these early skills might shed light upon early intervention strategies and preventive efforts commonly used with children with problems in these areas. Our findings suggest that the relationship between language and motor skills is not likely to be simple and directional but rather to be complex and multifaceted.
Children's Emotional Responses to a Paediatric Hospital Atrium
Authors: Koller Donna , McLaren Coralee
Published: September 2012

This paper illuminates children's emotional responses to an atrium in a contemporary Canadian paediatric hospital. It draws on a focused analysis of data elicited in a qualitative study that explored patients' perspectives on the design and architecture of the atrium. Children were involved in all phases of the project either as consultants on the research methods or participating in interviews and taking photographs of the space. The atrium consists of a main lobby with a high windowed ceiling, brightly coloured elevators with exposed mechanisms, information desks, a large fountain and food venues. Children expressed a range of emotions associated with the space. The findings demonstrate children's ability to identify multi‐faceted issues related to hospital design and affirm their rights to participate in decisions regarding spaces that purportedly are designed for them.
The complexity of elastic fibre biogenesis in the skin – a perspective to the clinical heterogeneity of cutis laxa
Authors: Uitto Jouni , Li Qiaoli , Urban Zsolt
Published: September 2012

Elastic fibres are critical connective tissue components providing elasticity and resilience to skin and other tissues. These fibres are composed of elastin and a number of elastin‐associated microfibrillar proteins that assemble in a complex fibre network in a multi‐step process. Multiple cellular processes, including mitochondrial function, specific molecules in the secretory pathways and temporally and spatially ordered production of elastic fibre components, are required for the biogenesis of functional elastic fibres. Abnormalities in these processes can lead to loss of functional elastic fibres manifesting phenotypically as a skin disease. The paradigm of elastic fibre diseases affecting the skin is cutis laxa, a clinically and genetically heterogeneous group of disorders characterized by loose and sagging skin, frequently associated with extracutaneous manifestations in the lungs and the arterial blood vessels. The complexity of cutis laxa is emphasized by the fact that as many as 10 distinct genes can harbour mutations in this and related disorders. Understanding of the pathomechanistic pathways involved in perturbed elastic fibre assembly in cutis laxa provides information potentially helpful for the development of molecular strategies towards treatment of these, currently intractable, diseases.
IL‐33 is secreted by psoriatic keratinocytes and induces pro‐inflammatory cytokines via keratinocyte and mast cell activation
Authors: Balato Anna , Lembo Serena , Mattii Martina , Schiattarella Maria , Marino Rita , De Paulis Amato , Balato Nicola , Ayala Fabio
Published: September 2012

IL‐33 is a novel pro‐inflammatory cytokine and ligand for the orphan receptor ST2. Although originally defined as an inducer of Th2‐mediated responses, IL‐33 was recently found to be involved in arthritis, a Th1/Th17‐mediated disease. Here, we assessed the ability of IL‐33 to promote inflammation via mast cells (MCs) and keratinocytes (KCs) activation in psoriasis. IL‐33 resulted elevated in the skin but not in the serum of psoriasis patients. IL‐33 was secreted by psoriasis KCs and HaCaT cells after TNF‐α stimulation. In HMC‐1, TNF‐α, but not IL‐17, could induce a robust increase in IL‐33 expression. In HaCaT cells, TNF‐α was able to induce IL‐6, MCP‐1 and VEGF, and the addition of IL‐33 reinforced these increases. TNF‐α + IL‐33 combination showed similar results in primary KCs and ex vivo skin organ culture. In conclusion, our study suggests that IL‐33 may be involved in psoriasis biology via MCs and KCs.
Behaviour and physiology are linked in the responses of freshwater mussels to drought
Authors: GOUGH HARLAN M. , GASCHO LANDIS ANDREW M. , STOECKEL JAMES A.
Published: September 2012

1. Droughts have become prevalent in the south‐eastern U.S.A. and are predicted to become more common in the future. Drought conditions have particularly strong negative effects on sessile aquatic organisms with limited dispersal ability. This study explored the linkages between physiological tolerance, behavioural response and survival of three species of freshwater mussels subjected to drought.

2. To assess physiological tolerance, we measured survival under desiccation at 25, 35 and 45 °C in the laboratory. To assess behavioural responses, we tracked horizontal and vertical movement of mussels in a drying stream reach.

3. Uniomerus tetralasmus showed the greatest desiccation tolerance, Lampsilis straminea was intermediate, and Pyganodon grandis had the lowest tolerance at all temperatures.

4. In the drying stream reach, U. tetralasmus showed little horizontal movement and quickly became stranded. The other two species tracked the receding water. It was not until the pool had been reduced to c. 10% of its original size that ≥50% of P. grandis and L. straminea became stranded.

5. Uniomerus tetralasmus and L. straminea burrowed in response to becoming stranded; however, both species burrowed only shallowly (3–4 cm), presumably because burrowing to greater depths did not convey increasing thermal refuge. Pyganodon grandis rarely burrowed. No P. grandis survived the 15‐week drought, while 45% of L. straminea and 77% of U. tetralasmus survived.

6. Three strategies emerged for freshwater mussels to cope with drought conditions: tracking (intolerant), track then burrow (semi‐tolerant) and burrowing (tolerant). Results suggest that drought poses the greatest threat to intolerant trackers, while tolerant burrowers are the most resistant to drought conditions.
Dental health and oral health‐related quality of life in children with congenital bleeding disorders
Authors: Salem K. , Eshghi P.
Published: September 2012

The purpose of this study was to investigate the dental and some other aspects of oral health status of young patients with congenital bleeding disorders (CBD) and the impact of these on their quality of life (OHR‐QoL) compared with controls. DMFS‐dmfs (Decayed, Missed, Filled Tooth surfaces in permanent and primary teeth) scores, Simplified oral hygiene index, occurance of hypoplasia of first permanent molars, Temporomandibular joint dysfunction and occlusion of 46 CBD patients at the age range of 2–15 years and 46 of other children as control were compared, and the impact of their oral health situation on quality of life was also investigated. Data were analysed by chi–square, t‐test and Pearson correlation. Patients were significantly more caries‐free with less decayed teeth in primary‐permanent dentition (P = 0.03, t = −2.17).The mean scores of OHR‐QoL of CBD patients and controls were not significantly different. Oral Bleeding was the significant variable in relation to ‘oral health‐related quality of life’ in CBD groups (Pearson correlation, r = −0.56, P = 0.000). OHR‐QoL in the control group was related to dmfs score (r = −0.392, P = 0.011) and male gender (r = −0.329, P = 0.026). Congenital bleeding disorder CBD patients were found to have a better dental health situation in primary dentition compared with controls; however, their ‘oral health‐related quality of life’ was similar. Oral bleeding was the only significant factor related to OHR‐QoL in CBD. It shows an overall importance of development of comprehensive care centres for CBD as the main cause of this achievement.
Fracture resistance of bone samples filled with fibre‐reinforced composite posts: an ex vivo model
Authors: Cauwels R. G. E. C. , Martens L. C. , Verbeeck R. M. H.
Published: September 2012

Aim

To evaluate the strengthening effect of two different types of fibre‐reinforced composite (FRC) posts in an ex vivo experimental model.

Methodology

Compact and hollow bone samples from bovine femurs were used as standardized samples. A total of 80 hollow samples were divided into two groups and filled either with a prefabricated FRC post or with individually adapted FRC posts. For each group, half of the samples were subjected to thermocycling (5–55 °C, 5000×). The remaining samples were kept for 24 h at 37 °C at 100% relative humidity. All samples were loaded diametrically until fracture. The null hypothesis tested was that the fracture resistance of standardized bone samples is not influenced by the type of FRC post, independently of the exposure to thermocycling. Results were evaluated by anova, and subsequent multiple comparisons were performed.

Results

The samples filled with the individually adapted FRC posts were more resistant to fracture than the prefabricated ones (P < 0.001), but this difference was not apparent in the thermocycled groups. Detachment of the posts upon fracture was highest after thermocycling for both groups, amounting to 55% and 95% for the individual adapted posts and the prefabricated posts, respectively.

Conclusions

Initially, the samples filled with the individually adapted FRC posts were more resistant to fracture than those filled with the prefabricated ones. However, after ageing of the samples, both types of posts had similar strengthening effects.
Leptin expression in healthy and inflamed human dental pulp
Authors: Martín‐González J. , Sánchez‐Jiménez F. , Pérez‐Pérez A. , Carmona‐Fernández A. , Sánchez‐Margalet V. , Segura‐Egea J. J.
Published: September 2012

Aim

To investigate the expression of leptin in healthy and inflamed human dental pulp.

Methodology

Twenty‐one pulp samples were obtained from freshly caries‐ and restoration‐free extracted human third molars. In seven‐third molars (inflamed pulp group), inflammation was induced prior to extraction. Pulp samples were processed, and leptin expression was determined by quantitative real‐time PCR (qRT‐PCR) and the amount of leptin by immunoblot.

Results

All healthy and inflamed dental pulp samples expressed leptin. Western blot analysis revealed the presence of a protein with an apparent molecular weight of ~16 kDa in human dental pulp, which corresponds to the estimated molecular weight of leptin. The expression of leptin mRNA in dental pulp was confirmed by qRT‐PCR analysis, and the size of the amplified fragments (296 bp for leptin and 194 bp for cyclophilin) was confirmed by agarose gel electrophoresis. The expression of leptin in the inflamed pulp group was significantly greater (P < 0.05) than in healthy teeth. The relative amount of leptin in inflamed pulps was almost twice than in healthy pulps.

Conclusions

For the first time, the presence of leptin in human dental pulp tissues has been demonstrated. The upregulation of leptin expression in inflamed pulp samples suggests that leptin can play a role in pulpal inflammatory and immune responses.
Social Research and the Privacy and Participation of Children: Reflections on Researching Australian Children's Playlore
Authors: Darian‐Smith Kate , Henningham Nikki
Published: September 2012

Social research into the daily activities of children is important if we are to understand how children perceive themselves in relationship to their world. Ethically managed social research that allows children to speak as informed and competent subjects is thus vital. However, research regulatory bodies may be more concerned with protecting the privacy of children than facilitating their participation in research projects. In a context where publicly funded researchers are encouraged to make their data available for reuse, the bureaucratisation of the consent and ethics processes may impinge on the conduct and benefits, and the future accessibility, of the research itself. Reflecting on the findings of the Childhood, Tradition and Change research on playlore in Australian primary schools, we argue for a more balanced approach from regulatory authorities between protection and participation in relation to low‐risk social research with children.
Acute toxicity due to the confirmed consumption of synthetic cannabinoids: clinical and laboratory findings
Authors: Hermanns‐Clausen Maren , Kneisel Stefan , Szabo Bela , Auwärter Volker
Published: September 2012

Aims

Recently, several synthetic cannabinoids were identified in herbal mixtures consumed as recreational drugs alternative to cannabis products. The aim was to characterize the acute toxicity of synthetic cannabinoids as experienced by emergency patients.

Design

This was a retrospective study targeting patients seeking emergency treatment after recreational use of synthetic cannabinoids.

Setting and participants

Patients were selected from the database of the Poisons Information Center Freiburg between September 2008 and February 2011. The inclusion criteria were: hospitalization, available clinical reports and analytical verification of synthetic cannabinoid uptake. In total, 29 patients were included (age 14–30 years, median 19; 25 males, four females).

Measurements

Clinical reports were evaluated and synthetic cannabinoids and other drugs were determined analytically.

Findings

CP‐47,497‐C8 (one), JWH‐015 (one), JWH‐018 (eight), JWH‐073 (one), JWH‐081 (seven), JWH‐122 (11), JWH‐210 (11), JWH‐250 (four) and AM 694 (one) were quantified in blood samples. JWH‐018 was most common in 2008–9, JWH‐122 in 2010, and JWH‐210 in 2011. Tachycardia, agitation, hallucination, hypertension, minor elevation of blood glucose, hypokalaemia and vomiting were reported most frequently. Chest pain, seizures, myoclonia and acute psychosis were also noted.

Conclusions

There appears to have been an increase in use of the extremely potent synthetic cannabinoids JWH‐122 and JWH‐210. Acute toxic symptoms associated with their use are also reported after intake of high doses of cannabis, but agitation, seizures, hypertension, emesis and hypokalaemia seem to be characteristic to the synthetic cannabinoids, which are high‐affinity and high‐efficacy agonists of the CB1 receptor. Thus, these effects are due probably to a strong CB1 receptor stimulation.
Psychotropic drugs and risk of motor vehicle accidents: a population‐based case‐control study
Authors: Chang Chia‐Ming , Wu Erin Chia‐Hsuan , Chen Chuan‐Yu , Wu Kuan‐Yi , Liang Hsin‐Yi , Chau Yeuk‐Lun , Wu Chi‐Shin , Lin Keh‐Ming , Tsai Hui‐Ju
Published: September 2012

Aim

To examine comprehensively the relationship between exposure to four classes of psychotropic drugs including antipsychotics, antidepressants, benzodiazepines (BZDs) and Z‐drugs, and motor vehicle accidents (MVAs).

Method

The authors conducted a matched case‐control study of 5183 subjects with MVAs and 31 093 matched controls, identified from the claims records of outpatient service visits during the period from 2000 to 2009. Inclusion criteria were defined as subjects aged equal to or more than 18 years and involved in MVAs. Conditional logistic regressions with covariates adjustment (including urbanity, psychiatric and non‐psychiatric outpatient visits and Charlson comorbidity score) were applied to examine the effect of four classes of psychotropic drugs on MVAs.

Results

Significant increased risk of MVAs was found in subjects taking antidepressants within 1 month (adjusted odds ratio (AOR) 1.73, 95% confidence interval (CI) 1.34, 2.22), 1 week (AOR 1.71, 95% CI 1.29, 2.26), and 1 day (AOR 1.70, 95% CI 1.26, 2.29) before MVAs occurred. Similar results were observed in subjects taking benzodiazepines (BZDs) (AOR 1.56, 95% CI 1.38, 1.75 for 1 month; AOR 1.64, 95% CI 1.43, 1.88 for 1 week, and AOR 1.62, 95% CI 1.39, 1.88 for 1 day) and Z‐drugs (AOR 1.42, 95% CI 1.14, 1.76 for 1 month, AOR 1.37, 95% CI 1.06, 1.75 for 1 week, AOR 1.34, 95% CI 1.03, 1.75 for 1 day), but not antipsychotics. Moreover, significant dose effects of antidepressants (equal to or more than 0.6–1.0 DDD), BZDs (equal to or more than 0.1–0.5 DDD) and Z‐drugs (more than 1 DDD) were observed, respectively, on the risk of experiencing an MVA.

Conclusion

Taken together, subjects taking antidepressants, BZDs and Z‐drugs, separately, should be particularly cautioned for their increasing risk of MVAs.
Parameter and uncertainty estimation for process‐oriented population and distribution models: data, statistics and the niche
Authors: Marion Glenn , McInerny Greg J. , Pagel Jörn , Catterall Stephen , Cook Alex R. , Hartig Florian , O'Hara Robert B.
Published: September 2012

The spatial distribution of a species is determined by dynamic processes such as reproduction, mortality and dispersal. Conventional static species distribution models (SDMs) do not incorporate these processes explicitly. This limits their applicability, particularly for non‐equilibrium situations such as invasions or climate change. In this paper we show how dynamic SDMs can be formulated and fitted to data within a Bayesian framework. Our focus is on discrete state‐space Markov process models which provide a flexible framework to account for stochasticity in key demographic processes, including dispersal, growth and competition. We show how to construct likelihood functions for such models (both discrete and continuous time versions) and how these can be combined with suitable observation models to conduct Bayesian parameter inference using computational techniques such as Markov chain Monte Carlo. We illustrate the current state‐of‐the‐art with three contrasting examples using both simulated and empirical data. The use of simulated data allows the robustness of the methods to be tested with respect to deficiencies in both data and model. These examples show how mechanistic understanding of the processes that determine distribution and abundance can be combined with different sources of information at a range of spatial and temporal scales. Application of such techniques will enable more reliable inference and projections, e.g. under future climate change scenarios than is possible with purely correlative approaches. Conversely, confronting such process‐oriented niche models with abundance and distribution data will test current understanding and may ultimately feedback to improve underlying ecological theory.
Modelling salmon lice, Lepeophtheirus salmonis, reproduction on farmed Atlantic salmon, Salmo salar L
Authors: Stormoen M , Skjerve E , Aunsmo A
Published: September 2012

The aim of this study was to model sea lice levels and the effect on reproduction by a stochastic simulation model and to evaluate the uncertainty of lice estimates based upon counts. Two empirical data sets were examined to parameterize the models. An overall fit of the data to the Poisson distribution was found and thus was used as the base of the stochastic models. In the model, salmon lice reproduction is not linear with the number of adult females and at low lice loads a smaller proportion of the adult female lice will reproduce. Depending on the variance structure, it was estimated that between 40% and 60% of the adult female lice will reproduce at an abundance of 0.5 adult females per fish. Lice counts, especially when examining few fish at low lice loads, are uncertain and at a true abundance of 0.1 one may count between 0 and 5 lice when examining 10 fish. Understanding the dynamics of sea lice reproduction is a key factor in the development of sustainable control strategies.
Effect of chloride on nitrite‐induced methaemoglobinemia in Atlantic sturgeon,Acipenser oxyrinchus oxyrinchus(Mitchill)
Authors: Matsche M A , Markin E , Donaldson E , Hengst A , Lazur A
Published: September 2012

We evaluated the effects of chloride concentration on the clinical pathology in juvenile Atlantic sturgeon,Acipenser oxyrinchus oxyrinchus(Mitchill),following semi‐static exposures to 1 mg L−1nitrite for 96 h. In spring water naturally low in chloride (5 mg L−1), plasma nitrite concentrated to more than 40× environmental levels resulting in a severe methaemoglobinemia characterized by torpid behaviour, 30‐fold increase in methaemoglobin fraction, anaemia, leucopenia and hyperkalaemia. Loss of intracellular water and potassium to extracellular space may have resulted in hyperkalaemia and haemodilution. Fish survived nitrite exposure, but 60% of torpid fish died following capture and tissue sampling. Fish acclimated to 10‐fold higher chloride content (55 mg L−1) did not concentrate nitrite in the plasma above environmental levels or develop methaemoglobinemia, but did exhibit similar haematology and plasma chemistry changes. Plasma nitrite returned to preexposure levels by 14 days following nitrite exposures, but severity of clinical pathology changes persisted or increased, suggesting that Atlantic sturgeon have reduced capacity to recover from methaemoglobinemia. Fish that survive methaemoglobinemia may be susceptible to mortality from the cumulative effects of intoxication, handling and other stresses for two or more weeks following nitrite remediation. Chloride buffering in aquaculture systems reduces the toxic effects of nitrite accumulation.
Risk‐spreading larviposition behaviour of female nose bot flies (Cephenemyia) attacking black‐tailed deer
Authors: ANDERSON J. R.
Published: September 2012

While baited deer models were under observation nine Cephenemyia jellisoni Townsend (Diptera: Oestridae) females and seven C. apicata Bennett & Sabrosky engaged in a risk‐spreading larviposition behaviour by larvipositing on models only once and then flying away. Additionally, analysis of 225 unobserved larvipostions in which larvae were trapped in adhesive on the muzzles of deer models showed that 94% of C. apicata and 95% of C. jellisoni larviposited on a model only once. The number of single larvipositions was highly significant for both species. The principal adaptive significance of such risk‐spreading larviposition behaviour is that it spreads the reproductive output of a female among many hosts, and in years when adult eclosion and survival rates are low, it ensures that the larvae of the few surviving females will be distributed among a maximum number of hosts. Several other benefits of such behaviour also are discussed.
Biocontrol and population dynamics of Fusarium spp. on wheat stubble in Argentina
Authors: Palazzini J. M. , Groenenboom‐de Haas B. H. , Torres A. M. , Köhl J. , Chulze S. N.
Published: September 2012

The biocontrol effect of Clonostachys rosea (strains 016 and 1457) on Fusarium graminearum, F. avenaceum, F. verticillioides, F. langsethiae, F. poae, F. sporotrichioides, F. culmorum and Microdochium nivale was evaluated on naturally infected wheat stalks exposed to field conditions for 180 days. Experiments were conducted at two locations in Argentina, Marcos Juarez and Río Cuarto. Antagonists were applied as conidial suspensions at two inoculum levels. Pathogens were quantified by TaqMan real‐time qPCR. During the first year at Marcos Juarez, biocontrol was observed in one antagonist treatment for F. graminearum after 90 days (73% reduction) but after 180 days, the pathogen decreased to undetectable levels. During the second year, biocontrol was observed in three antagonist treatments for F. graminearum and F. avenaceum (68·3% and 98·9% DNA reduction, respectively, after 90 days). Fusarium verticillioides was not controlled at Marcos Juarez. At Río Cuarto, biocontrol effects were observed in several treatments at different intervals, with a mean DNA reduction of 88·7% for F. graminearum and F. avenaceum, and 100% reduction for F. verticillioides in two treatments after 180 days. Populations of F. avenaceum and F. verticillioides were stable; meanwhile, F. graminearum population levels varied during the first 90 days, and low levels were observed after 180 days. The other pathogens were not detected. The study showed that wheat stalks were important reservoirs for F. avenaceum and F. verticillioides populations but less favourable for F. graminearum survival. Clonostachys rosea (strain 1457) showed potential to reduce the Fusarium spp. on wheat stalks.
The association between DRD2/ANKK1 and genetically informed measures of alcohol use and problems
Authors: Meyers Jacquelyn L. , Nyman Emma , Loukola Anu , Rose Richard J. , Kaprio Jaakko , Dick Danielle M.
Published: September 2012

In 1990, Blum and colleagues first reported an association between DRD2 and alcoholism. While there have been subsequent replications of this genetic association, there have also been numerous studies that failed to detect an association between DRD2 and alcohol dependence. We propose that one aspect contributing to this inconsistency is the variation in alcohol phenotype used across studies. Within the population‐based Finnish twin sample, FinnTwin16, we previously performed multivariate twin analyses to extract latent genetic factors, which account for the variation across seven measures of alcohol consumption (frequency of drinking, frequency × quantity, frequency of heavy drinking, frequency of intoxication and maximum drinks in a 24‐hour period) and problems (the Rutgers Alcohol Problem Index—RAPI and the Mälmö‐modified Michigan Alcohol Screen Test—MmMAST) in 3065 twins. In the present study, we examined the association between 31 DRD2/ANKK1 single‐nucleotide polymorphisms (SNPs) and the genetic factor scores generated by twin analyses in a subset of FinnTwin16 (n = 602). We focus on two of the genetic factors: a general alcohol consumption and problems factor score, which represents shared genetic variance across alcohol measures, and a alcohol problems genetic factor score, which loads onto the two indices of problematic drinking (MAST and RAPI). After correction for multiple testing across SNPs and phenotypes, of the 31 SNPs genotyped across DRD2/ANKK1, one SNP (rs10891549) showed significant association with the general alcohol consumption and problems factor score (P = 0.004), and four SNPs (rs10891549, rs1554929, rs6275, rs6279), representing two independent signals after accounting for linkage disequilibrium, showed significant association with the alcohol problems genetic factor score (P = 0.005, P = 0.005, P = 0.003, P = 0.003). In this study, we provide additional positive evidence for the association between DRD2/ANKK1 and alcohol outcomes, including frequency of drinking and drinking problems. Additionally, post hoc analyses indicate stronger association signals using genetic factor scores than individual measures, which suggest that accounting for the genetic architecture of the alcohol measures reduces genetic heterogeneity in alcohol dependence outcomes in this sample and enhances the ability to detect association.
Time course of cocaine‐induced behavioral and neurochemical plasticity
Authors: Lutgen Victoria , Kong Linghai , Kau Kristen S. , Madayag Aric , Mantsch John R. , Baker David A.
Published: September 2012

Factors that result in augmented reinstatement, including increased withdrawal period duration and high levels of cocaine consumption, may provide insight into relapse vulnerability. The neural basis of augmented reinstatement may arise from more pronounced changes in plasticity required for reinstatement and/or the emergence of plasticity expressed only during a specific withdrawal period or under specific intake conditions. In this study, we examined the impact of withdrawal period duration and cocaine intake on the magnitude of cocaine‐primed reinstatement and extracellular glutamate in the nucleus accumbens, which has been shown to be required for cocaine‐primed reinstatement. Rats were assigned to self‐administer under conditions resulting in low (2 hours/day; 0.5 mg/kg/infusion, IV) or high (6 hours/day; 1.0 mg/kg/infusion, IV) levels of cocaine intake. After 1, 21 or 60 days of withdrawal, drug seeking and extracellular glutamate levels in the nucleus accumbens were measured before and after a cocaine injection. Cocaine‐reinstated lever pressing and elevated extracellular glutamate at every withdrawal time point tested, which is consistent with the conclusion that increased glutamatergic signaling in the nucleus accumbens, is required for cocaine‐induced reinstatement. Interestingly, high‐intake rats exhibited augmented reinstatement at every time point tested, yet failed to exhibit higher levels of cocaine‐induced increases in extracellular glutamate relative to low‐intake rats. Our current data indicate that augmented reinstatement in high‐intake rats is not due to relative differences in extracellular levels of glutamate in the nucleus accumbens, but rather may stem from intake‐dependent plasticity.
Turn and face the strange – ch..ch..ch..changes to neonatal resuscitation guidelines in the past decade
Authors: O'Donnell Colm PF
Published: September 2012

Resuscitation of newborns has been described since ancient times and is among the most commonly performed emergency medical interventions. The International Liaison Committee on Resuscitation first made recommendations on resuscitation in newborns in 1999. Over the last decade, new research and careful review of the available evidence have resulted in substantial changes to these recommendations – in particular, regarding the assessment of colour, giving supplemental oxygen, suctioning infants born through meconium‐stained liquor, confirming endotracheal tube position, the use of pulse oximetry, giving CPAP to premature infants, keeping preterm infants warm using polyethylene wrapping and cooling term infants with encephalopathy. This process has also highlighted the paucity of evidence to support much of the care given to infants in the delivery room and the need for research to refine our techniques.
Increasing rates of prematurity and epidemiology of late preterm birth
Authors: Cheong Jeanie LY , Doyle Lex W
Published: September 2012

Preterm birth rates in Australia have risen in the last two decades, mostly accounted for by the rise in late preterm births. Late preterm births (34–36 weeks) comprise 70% of all preterm births, which translates to approximately 16 000 births annually in Australia. The precise causes for this trend are unclear; however, possible aetiologies include increasing maternal age, increased use of artificial reproductive technologies and increased multiple births. Compared with term‐born children, late preterm children not only have increased mortality and in‐hospital morbidity including respiratory difficulties, but also long‐term cognitive, school performance, behaviour and psychiatric problems. The potential public health and educational burden of late preterm birth is considerable. More research is required in this area to understand the risk factors for late preterm birth and to help identify those children at highest risk of developmental deficits.
Nasal continuous positive airway pressure for respiratory distress in non‐tertiary care centres: What is needed and where to from here?
Authors: Buckmaster Adam
Published: September 2012

Respiratory distress is one of the commonest reasons for admission to a special care nursery (SCN) affecting between 2.5 and 5.0% of all babies born per year. While most recover with supplemental oxygen, some require transfer to a neonatal intensive care leading to significant family disruption, and financial cost. Does nasal continuous positive airway pressure (nCPAP) improve outcomes in babies with respiratory distress? What are the risks of its use? Should it be used in SCNs, and, if so, what is required in order to undertake nCPAP safely? There is strong evidence to support the use of nCPAP in the treatment of babies with respiratory distress. The risk benefit ratio of providing nCPAP in SCNs depends upon many factors including the ability to maintain the skills required and the distance/time to the nearest tertiary centre. Appropriate nurseries should be identified with the aim of supporting them in the provision of nCPAP in a safe manner.
Do antenatal classes do enough to prepare parents for when things go wrong?
Authors: Gregory Eleanor
Published: September 2012

Antenatal classes play an important role in educating expectant parents about pregnancy, labour and delivery. They cover a range of topics, but they are failing parents because they do not provide sufficient information to prepare them for abnormal labours and deliveries. They do not do enough to educate parents about what to expect when problems arise and what happens afterwards. This paper looks at whether classes do enough to make parents aware of problems and whether they should be doing more. It examines the arguments both for and against including this information in antenatal classes.
Which high‐risk infants should we follow‐up and how should we do it?
Authors: Walker Karen , Holland Andrew JA , Halliday Robert , Badawi Nadia
Published: September 2012

Early detection of neurodevelopmental delay and appropriate intervention has been associated with improved academic and social outcomes. Identifying those who are at high risk and might benefit is not straightforward. Approximately 2% of infants are admitted to a neonatal intensive care unit after birth and these babies are known to be at high risk of developmental impairment. While it is well recognised that the extreme preterm infant is at high risk of developmental impairment, there is increasing evidence of a risk in late preterm infants as well as those undergoing major cardiac and non‐cardiac surgery. Not all infants are enrolled in multidisciplinary follow‐up clinics with easy access to early intervention. These clinics are expensive to run with both limited and conflicting data on their long‐term value. This review will concentrate on identifying which infants are at risk, reviewing the aetiology of the risk factors and the efficacy of follow‐up clinics.
Developmental origins of health and adult disease: What should neonatologists/paediatricians be considering about the long‐term health of their patients?
Authors: Kent Alison L
Published: September 2012

The developmental origins of health and disease hypothesis is now strongly supported by both animal and human evidence, and as a consequence, obstetricians, neonatologists and paediatricians need to consider the impact that the in utero and early post‐natal environment can have on later renal, cardiovascular and metabolic health. Four common clinical scenarios were provided along with animal and human evidence identifying long‐term health implications. Suggestions as to how we should translate this growing body of evidence into practice are provided.
Chemoprophylaxis of neonatal fungal infections in very low birthweight infants: efficacy and safety of fluconazole and nystatin
Authors: Blyth Christopher C , Barzi Federica , Hale Katherine , Isaacs David
Published: September 2012

Aim:  To review the use of antifungal chemoprophylaxis to prevent neonatal invasive fungal infections (IFI) in very low birthweight infants (VLBW <1500 g).

Method:  Systematic review of randomised controlled trials.

Results:  Nine trials were identified (2029 infants), with six comparing fluconazole with placebo/no treatment (840 infants), three comparing nystatin with placebo/no treatment (1200 infants) and two comparing fluconazole and nystatin (257 infants).

Prophylactic fluconazole reduced the incidence of IFI in VLBW infants <1500 g to 5.1% compared with 16.0% in infants receiving placebo, relative risk (RR) = 0.36 (95% confidence interval 0.15–0.89). The mortality was 10.9% and 16.7%, respectively (RR 0.76, 0.54–1.08). Oral nystatin reduced the incidence of IFI in VLBW infants to 5.3% compared with 28.0% in infants receiving placebo (RR 0.16, 0.11–0.23). Mortality was 7.5% with nystatin and 10.9% with placebo (RR 0.86, 0.59–1.26). The incidence of IFI in studies comparing fluconazole and nystatin was 3.6% and 8.0%, respectively (RR 0.54, 0.19–1.56), and mortality was not significantly different: 4.6% versus 9.8% (RR 0.43, 0–4.31)

Conclusions:  Prophylactic fluconazole and oral nystatin are both highly effective in preventing IFI in VLBW infants. Both agents are safe without significant toxicities. Antifungal prophylaxis should therefore be used in all VLBW infants. Given the paucity of data comparing fluconazole with nystatin, the choice of antifungal agent should be influenced by the incidence of IFI, local epidemiology and relative cost.
Barriers to neonatal care in developing countries: Parents' and providers' perceptions
Authors: Martinez Alma M , Khu Dung Thi Khanh , Boo Nem Yun , Neou Leakhena , Saysanasongkham Bounnack , Partridge John Colin
Published: September 2012

Aim:  Hospital care and advanced medical technologies for sick neonates are increasingly available, but not always readily accessible, in many countries. We characterised parents' and providers' perceptions of barriers to neonatal care in developing countries.

Methods:  We interviewed parents whose infant was hospitalised within the first month of life in Cambodia, Malaysia, Laos and Vietnam, asking about perceived barriers to obtaining newborn care. We also surveyed health‐care providers about perceived barriers to providing care.

Results:  We interviewed 198 parents and 212 newborn care providers (physicians, nurses, midwives, paediatric and nursing trainees). Most families paid all costs of newborn care, which they reported as a hardship. Although newborn care is accessible, 39% reported that hospitals are too distant; almost 20% did not know where to obtain care. Parents cited lack of cleanliness (46%), poor availability of medications (42%) or services (36%), staff friendliness (42%), poor infant outcome (45%), poor communications with staff (44%) and costs of care (34%) as significant problems during prior newborn care. Providers cited lack of equipment (74%), lack of staff training (61%) and poor infrastructure (51%) as barriers to providing neonatal care. Providers identified distance to hospital, lack of transportation, care costs and low parental education as barriers for families.

Conclusions:  Improving cleanliness, staff friendliness and communication with parents may diminish some barriers to neonatal care in developing countries. Costs of newborn care, hospital infrastructure, distance to hospital, staffing shortages, limited staff training and limited access to medications pose more difficult barriers to remedy.
Incorporating speech‐language pathology within Australian neonatal intensive care units
Authors: Mathisen Bernice A , Carey Lindsay B , O'Brien Annette
Published: September 2012

Working in neonatal intensive care units (NICU) is considered to be advanced practice for speech‐language pathologists (SLPs) requiring post‐graduate specialised education and ongoing clinical mentoring, not easily accessible within some countries such as Australia. This review investigated whether there was evidence to support SLPs as core NICU team members, rather than fleeting therapists. The review found that the roles and responsibilities of SLPs in NICUs included assessment and intervention of preterm infant communication, feeding and swallowing using a family‐centred approach. This approach was respectful of the cultural and linguistic diversity of the parents and the particular expertise of other NICU team members. Whilst there has been a significant and promising increase in research with regard to SLP involvement with preterm infants (especially around feeding and swallowing assessment and specific treatments), the need for high‐quality well‐designed research is essential.
Can asthma education improve the treatment of acute asthma exacerbation in young children?
Authors: Soo Yien Yien , Saini Bandana , Moles Rebekah Jane
Published: September 2012

Acute exacerbation of asthma requires timely and appropriate treatment. Young children are completely reliant on others in this respect. This paper aims to evaluate the effectiveness of staff asthma education programs in ensuring correct treatment for young children experiencing asthma exacerbations in formal care. A systematic review was undertaken of studies focusing on staff asthma education in relation to pharmacological treatment of acute asthma exacerbation. Three randomised controlled trials and seven uncontrolled pre‐ and post‐test intervention studies were included for review. Asthma education was found to increase staff knowledge and confidence in managing asthma. There was a distinct lack of staff performance testing and studies undertaken in the pre‐school setting. Staff asthma education appears effective in increasing asthma knowledge; however, utility of this measure is limited with respect to staff performance in treating acute asthma exacerbation. Further studies evaluating asthma education through performance are needed.
Persistent unilateral white‐out in preterm infant
Authors: Pahuja Anoop , Lee Silke
Published: September 2012

We would like to present a case of persistent right sided collapse in a preterm baby with an unexpected diagnosis. Baby X was born floppy requiring resuscitation and was intubated, ventilated and was transferred to NICU. There was decreased air entry on auscultation of right side of the chest, while the rest of the examination was normal. The chest X‐ray showed right side white‐out suggestive of collapse consolidation. She required significantly high ventilatory pressures to maintain saturations and chest X‐ray performed on day 4 remained unchanged with persistent right sided white‐out. The CT scan of the chest showed no definable right lung, right pulmonary artery or right main bronchus. The diagnosis of right lung agenesis with single pulmonary artery was made and baby was found to have more congenital malformations on further investigations, and later developed complications leading to palliative care.
Respiratory distress in a one‐month‐old child suffering brachial plexus palsy
Authors: Héritier Odile , Vasseur Maurer Sabine , Reinberg Olivier , Cotting Jacques , Perez Marie‐Hélène
Published: September 2012

This paper describes a one‐month‐old girl presenting with respiratory and growth failure due to diaphragmatic paralysis associated with left brachial plexus palsy after forceps delivery. Despite continuous positive pressure ventilation and nasogastric feeding, the situation did not improve and a laparoscopic diaphragmatic plication had to be performed. When dealing with a child born with brachial plexus palsy, one must think of this possible association and if necessary proceed to the complementary radiological examinations. The treatment must avoid complications like feeding difficulties and failure to thrive, respiratory infections or atelectasis. It includes intensive support and a good evaluation of the prognosis of the lesion to decide the best moment for a surgical therapy.
Rare presentation of shock and acute mesenteric ischaemia secondary to acute adrenal insufficiency in an 11‐year‐old male
Authors: Roldan‐Martin Maria B , Rodriguez‐Ogando Alejandro , Sanchez‐Galindo Amelia C , Parente‐Hernandez Alberto , Luengo‐Herrero Vanessa , Sanchez‐Sanchez Cesar
Published: September 2012

An 11‐year‐old Caucasian male with history of abdominal pain, diarrhoea, fatigue, emesis and fever on the previous days presented with dehydratation, shock and acute mesenteric ischaemia. Final diagnosis of Addison's disease was made.
Use of digital retinal imaging in screening for retinopathy of prematurity
Authors: Kandasamy Yogavijayan , Smith Roger , Wright Ian , Hartley Leo
Published: September 2012

The frequency of premature births is increasing world‐wide. This factor, combined with improved survival and revised screening criteria, is resulting in an increased workload in screening for retinopathy of prematurity. Digital retinal imaging is emerging as an important alternative tool for diagnosing retinopathy of prematurity, and its use has even been extended to developing countries. Neonatal nurses and technicians can be trained to use digital imaging devices effectively. This is important in areas that do not have ready access to paediatric ophthalmologists. The ability to transfer images electronically makes it a valuable tool in telemedicine, while the ability to store and retrieve images is also advantageous from a medico‐legal perspective. Image analysis software can further improve the accuracy of diagnosis. The main limitation of this technology is its high capital cost.
Extracorporeal shock wave lithotripsy for distal ureteral calculi: Improved efficacy using low frequency
Authors: Anglada‐Curado Francisco Jose , Campos‐Hernández Pablo , Carrasco‐Valiente Julia , Anaya‐Henares Fernando , Carazo‐Carazo Jose Luis , Alvarez‐Kindelán Jose , Regueiro‐López Juan Carlos , Requena‐Tapia Maria Jose
Published: September 2012

Objectives

To compare low versus high frequency for lithotripsy in the management of distal ureteral calculi.

Methods

A total of 154 patients with radio‐opaque calculi (0.5–1 cm diameter) in the distal ureter were randomized to be given either lithotripsy at 80 or 60 pulses per min (high frequency or low frequency groups, respectively). The number of waves and sessions received, and time to total resolution were measured. A Dornier Compact Delta lithotripter was used.

Results

A total of 72 patients were assigned to the high frequency group and 78 to the low frequency group. Four patients were excluded from the study because of intolerance of the procedure. The size was slightly lower in low frequency group, whereby an analysis of covariance was carried out to eliminate the size factor, with the limit established as 0.7 cm. The low frequency group received 2980 ± 1211 waves, and the high frequency group received 5752 ± 3121 (P < 0.001). The success rate was higher in the low frequency group (100%) than in the high frequency group (92.9%; P = 0.02). If adjusted to the size of the calculus with a threshold of 0.7 cm, there was a difference, although it was not statistically significant. The time to elimination of the fragments was higher in the high frequency group (17.68 days) than in the low frequency group (7.15 days; P < 0.001). The number of sessions necessary for resolution was higher in the high frequency group (1.56) than in the low frequency group (1.14; P < 0.001).

Conclusions

Lithotripsy at 60 pulses provides better outcomes than lithotripsy at 80 pulses for the treatment of distal ureteral calculi.
Survival of Tradescantia fluminensis in sea water
Authors: Hurrell Geoffrey A. , Lusk Carolyn S.
Published: September 2012

Tradescantia fluminensis stem fragments that had been immersed in sea water for periods of 0, 1, 3, 6, 12 and 24 hours and 2, 4 and 7 days were planted into growing media and observed for regrowth for 39 days after immersion. At the end of this time, 93% of untreated fragments had produced new shoots at the nodes but only 43% of fragments produced new shoots after 24 hours immersion, and none survived longer than 2 days of immersion. Because 2 days is sufficient for dispersal to nearby coastlines, there is a real risk of Tradescantia stems being washed by floodwaters into the ocean and being carried by currents and tides into nearby estuaries and onto beaches where they could start new infestations.