Developmental Changes in Measures of Hierarchical Stimulus Recognition in Conditions of Directed Attention in Children Aged 5–10 Years

Reaction times and the accuracy of recognition of hierarchical letter stimuli at the local and global levels were studied in 95 children of four age groups (5–6, 6–7, 7–8, and 9–10 years) and 10 adults. Overall, children of all age groups and adults recognized hierarchical stimuli at the global level more accurately and rapidly than at the local level (the global advantage effect) and showed slowing of reactions on recognition of incongruent stimuli at the local level (the global interference effect). At younger ages (5–6 years), there were significant individual differences in measures of recognition of hierarchical letters – in some children of this age (seven of 37), the global advantage effect on recognition of incongruent stimuli was absent. Significant progressive changes in the accuracy of recognition of hierarchical stimuli at both the local and global levels were seen on development from 6–7 to 7–8 years, as well as in adults a compared with children aged 9–10 years. Different developmental dynamics in the speed of recognition of hierarchical stimuli were seen at the local and global levels: the speed of recognition of small letters increased significantly in each sequential age group, starting from 6–7 years, while recognition of large letters showed no significant decrease in reaction times in children aged 9–10 years as compared with those aged 7–8 years. In the two youngest age groups (5–6 and 6–7 years), the type of hierarchical stimulus was found to influence recognition speed: reaction times increased significantly, independently of the level of recognition, using both target (incongruent stimuli) and neutral elements at the irrelevant level. It is suggested that the nonlinear developmental dynamics of measures of the recognition of hierarchical stimuli at preschool and early school age are determined by the maturation of the mechanisms processing sense-specific information and by the formation of executive functions, especially those associated with selective extraction of significant signals.     

Causes of Hospitalization among Children Ages Zero to Nine Years Old in the City of São Paulo,Brazil

INTRODUCTION:

The profile of child morbidity is an important parameter for defining and altering health policies. Studies about infant mortality are more numerous than those on morbidity, especially related to hospital admissions. The objective of this study is to describe the causes of admission in the public health system for children from zero to nine years of age in the city of São Paulo during the years 2002 to 2006 and compare these results to those from the national data.

METHOD:

Through a cross-sectional study, data were obtained from the Hospital Information System, which is available in the Information System of the Unified Health System - DATASUS.

RESULTS:

Within the period, 16% of the total admissions corresponded to children from zero to nine years of age, with most of the children being younger than one year of age. In the city of São Paulo, the admission coefficient increased 11%, and in Brazil, it decreased 14%. Respiratory diseases were the main causes of hospitalization. In São Paulo, the second most frequent causes of admission were diseases that originated during the perinatal period (15.9%), and in Brazil, the second most frequent cause of admission was infectious-parasitic diseases (21.7%). Admissions for perinatal diseases increased 32% in São Paulo and 6% in Brazil. While hospitalizations for diarrhea decreased in Brazil, an increase was recorded in the city of São Paulo for children under five years old.

CONCLUSIONS:

The findings of this study show a paradoxical increase in the number of hospitalizations during an expansion of primary attention, indicating that the rise was not associated with a significant improvement in the quality of service.     

Evaluation of a Deformable Musculoskeletal Model for Estimating Muscle–Tendon Lengths During Crouch Gait

The hamstrings and psoas muscles are often lengthened surgically in an attempt to correct crouch gait in persons with cerebral palsy. The purpose of this study was to determine if, and under what conditions, medial hamstrings and psoas lengths estimated with a deformable musculoskeletal model accurately characterize the lengths of the muscles during walking in individuals with crouch gait. Computer models of four subjects with crouch gait were developed from magnetic resonance (MR) images. These models were used in conjunction with the subjects' measured gait kinematics to calculate the muscle–tendon lengths at the body positions corresponding to walking. The lengths calculated with the MR-based models were normalized and were compared to the lengths estimated using a deformable generic model. The deformable model was either left undeformed and unscaled, or was deformed or scaled to more closely approximate the femoral geometry or bone dimensions of each subject. In most cases, differences between the normalized lengths of the medial hamstrings computed with the deformable and MR-based models were less than 5 mm. Differences in the psoas lengths computed with the deformable and MR-based models were also small (<3 mm) when the deformable model was adjusted to represent the femoral geometry of each subject. This work demonstrates that a deformable musculoskeletal model, in combination with a few subject-specific parameters and simple normalization techniques, can provide rapid and accurate estimates of medial hamstrings and psoas lengths in persons with neuromuscular disorders. © 2001 Biomedical Engineering Society. PAC01: 8719St, 8761-c     

Lupus and Pregnancy—15 Years of Experience in a Tertiary Center

This retrospective study was designed to evaluate the outcome of pregnancies in women diagnosed with systemic lupus erythematosus (SLE) followed in a tertiary fetal–maternal center. Data were collected from clinical charts between January 1993 and December 2007, with a total of 136 pregnancies (107 patients). Mean maternal age was 29 years, with the vast majority of patients being Caucasian. Most patients were in remission 6 months prior to pregnancy (93%) and the most frequently affected organs were the skin and joints. Renal lupus accounted for 14% of all cases. Twenty-nine percent of patients were positive for at least one antiphospholid antibody (aPL) and nearly 50% had positive SSa/SSb antibodies. All patients with positive aPL received low-dosage aspirin and low-molecular-weight heparin (LMWH). There were no pregnancy complications in more than 50% of cases and hypertensive disease and intrauterine growth restriction were the most common adverse events. There were 125 live births, one neonatal death, eight miscarriages, and three medical terminations of pregnancy. Preterm delivery occurred in 25% of pregnancies. Our results are probably the conjoined result of a multidisciplinary approach together with a systematic management of SLE pregnancies, with most patients keeping their prior SLE medication combined with low-dosage aspirin and LMWH in the presence of aPL.     

Intracranial Recording and Source Localization of Auditory Brain Responses Elicited at the 50 ms Latency in Three Children Aged from 3 to 16 Years

Maturational studies of the auditory-evoked brain response at the 50 ms latency provide an insight into why this response is aberrant in a number of psychiatric disorders that have developmental origin. Here, using intracranial recordings we found that neuronal activity of the primary contributors to this response can be localised at the lateral part of Heschl’s gyrus already at the age of 3.5 years. This study provides results to support the notion that deviations in cognitive function(s) attributed to the auditory P50 in adults might involve abnormalities in neuronal activity of the frontal lobe or in the interaction between the frontal and temporal lobes. Validation and localisation of progenitors of the adults’ P50 in young children is a much-needed step in the understanding of the biological significance of different subcomponents that comprise the auditory P50 in the adult brain. In combination with other approaches investigating neuronal mechanisms of auditory P50, the present results contribute to the greater understanding of what and why neuronal activity underlying this response is aberrant in a number of brain dysfunctions. Moreover, the present source localisation results of auditory response at the 50 ms latency might be useful in paediatric neurosurgery practice.     

Construction of human–rodent hybrid cells containing single transferable fragments of human chromosome 10p

The introduction of chromosome 10p into human glioblastoma or prostate cancer cells has been demonstrated to suppress their malignant phenotype, suggesting the presence of glioma or prostate tumor suppressor genes on 10p. As a resource for the fine mapping of these genes, a series of human-rodent hybrid cell lines containing single transferable fragments (STFs) of 10p were constructed. Normal chromosome 10 tagged with a neomycin-resistance gene on its short arm was fragmented by gamma-irradiation of 5–10 krad, transferred into mouse L cells or Chinese hamster ovary cells by microcell-mediated chromosome transfer (MMCT), and then selected against G418. Thirty-three independent rodent-human hybrids carrying various-sized STFs were obtained. Polymerase chain reaction (PCR)-based genotyping revealed that these STFs contained the whole, or portions, of a 43-cM region on 10p14-pter and could be defined by 19 sequence-tagged-site (STS) markers. Using this panel of hybrids as donors for further MMCT, genes on the refined fragments could be transferred into other cells. This hybrid panel would therefore be a useful resource for the fine mapping of the genes on 10p14-pter to segments of about 2.4 cM by functional complementation. Received: July 28, 2000 / Accepted: September 6, 2000     

Utilization of a sol–gel method for encapsulation of doxorubicin

The sol-gel pre-doping method was used to encapsulate doxorubicin in silica gels and optimum conditions of preparation of drug-loaded gel were established, ensuring both reproducible and effective results of quantitative encapsulation of doxorubicin and its gradual but complete release. Doxorubicin was encapsulated in polysiloxane polymers using the method based on sol-gel encapsulation without a catalyst, with an acid catalyst (HCl) and a base catalyst (NH₃). The time of gelation of the gel loaded with doxorubicin, encapsulation efficiency of the drug and the degree of release of the drug from the gel are all affected by the kind of catalyst (acidic or basic) or its absence at the gel preparation stage, and the temperature of the gelation process. The time of sol gelation when using the NH₃ or HCl catalyst was 9 days at 21°C, 2 days at 30°C and 1.5 days at 37°C, while for the gel prepared without a catalyst it was 90 days at 21°C, 75 days at 30°C and 70 days at 37°C. The efficiency of doxorubicin encapsulation was 99.5 ± 0.5% (w/w) for acid-catalyzed gel, 98.9 ± 1.01% (w/w) for base-catalyzed gel and 86.4 ± 11.6% (w/w) for non-catalyzed gel. A 100% (w/w) release of doxorubicin by diffusion through pores was found only in the case of base-catalyzed gel after a 140-h incubation time. For acid-catalyzed gel and non-catalyzed gel, the total amounts of released doxorubicin after 140 h of incubation were 3-5% (w/w) and 9-11% (w/w), respectively. The stability of doxorubicin encapsulated in the three kinds of gel matrices was found to be improved compared to the stability of a free form of the drug in solution.     

High Heritability for a Composite Index of Children’s Activity Level Measures

Despite the high heritability of children’s activity level, which forms part of the core symptom domain of hyperactivity-impulsivity within attention deficit hyperactivity disorder (ADHD), there has only been a limited success with identifying candidate genes involved in its etiology. This may reflect a lack of understanding about the different measures used to define activity level across studies. We aimed to study the genetic and environmental etiology across three measures of activity level: parent and teacher ratings of hyperactivity-impulsivity and actigraph measurements, within a population-based sample of 463 7–9 year old twin pairs. We further examined ways in which the three measures could be combined for future molecular studies. Phenotypic correlations across measures were modest, but a common underlying phenotypic factor was highly heritable (92%); as was a simple aggregation of all three measurements (77%). This suggests that distilling what is common to all three measures may be a good method for generating a quantitative trait suitable for molecular studies of activity level in children. The high heritabilities found are encouraging in this respect. Edited by Danielle Posthuma.     

Significance of cyclin E, p16ink4a and ki67 Overexpression in Cervical Exfoliated-cell Specimens for Primary Screening of HPV-related Cervical Carcinoma

Cervical carcinoma is one of the worldwide diseases in de-veloping countries. Cancer of the uterine, with a relativefrequency of 15% of all cancer of women, is ranked sec-ond [ 1 ] . Moreover, recent study has revealed that themorbid age of cervical neopl…     

Pathology of the Adrenal Cortex: a Reappraisal of the Past 25 Years Focusing on Adrenal Cortical Tumors

A reappraisal of the major advances in the diagnostic pathology of adrenal cortical lesions and tumors in the last 25 years is presented, with special reference to the definition of malignancy in primary adrenal cancer and its variants. Slightly more than 25 years ago, Weiss proposed his diagnostic scoring system for adrenal cortical carcinoma. This represented a milestone for adrenal pathologists and the starting point for further modifications of the system, either through minor changes in the scoring procedure itself or concentrating on some particular Weiss criterion such as mitotic index, integrated into alternative scoring schemes or algorithms that are currently under validation. Improvements in diagnostic immunohistochemistry have led to the identification of markers of cortical origin, such as Melan-A, alpha-inhibin, and SF-1 and of prognostic factors in carcinoma, such as the Ki-67 proliferation index and SF-1 itself. With regard to hyperplastic conditions, genetic investigations have allowed the association of the majority of cases of primary pigmented nodular adrenocortical disease (PPNAD) in Carney complex to mutations in the gene encoding the regulatory subunit 1A of protein kinase A (PRKAR1A). Other hereditary conditions are also associated with adrenal cortical tumors, including the Li–Fraumeni, Beckwith–Wiedemann, Gardner, multiple endocrine neoplasia type 1, and neurofibromatosis type 1 syndromes. Moreover, several advances have been made in the knowledge of the molecular background of sporadic tumors, and a number of molecules/genes are of particular interest as potential diagnostic and prognostic biomarkers.     

A Developmental Study of the Feedback-Related Negativity From 10–17 Years: Age and Sex Effects for Reward Versus Non-Reward

We employed event-related potentials to examine the feedback-related negativity (FRN), during a non-learning reward versus non-reward task. We compared 10–12-year-old, 13–14-year-old, and 15–17-year-old youth (n?=?91). Age effects included a larger FRN for younger age groups, regardless of feedback type, and a decrease in peak latency for feedback, across age groups as a linear trend. Males showed larger responses irrespective of feedback type and longer latency for rewarded feedback. Source modeling revealed reward/non-reward differences in the anterior cingulate cortex (ACC) and orbitofrontal cortex, most strongly in the subgenual ACC. Males showed more subgenual ACC activity for feedback overall.     

Evaluation of a Cognitive–Behavioral Pain Management Program for Children with Chronic Abdominal Pain: A Randomized Controlled Study

Background

Chronic abdominal pain (CAP) in childhood is widely prevalent and has adverse effects on mental health and quality of life. Earlier research emphasized the positive effects of psychological intervention on pain symptoms. This study describes the results of a cognitive–behavioral pain management program for children with CAP. The newly developed cognitive–behavioral group program, “Stop the pain with Happy-Pingu,” includes six sessions for the children and one meeting for the parents.

Purpose

We hypothesized that the training would significantly reduce pain symptoms (frequency, duration, intensity, and pain-related impairment) and increase health-related quality of life compared to wait-list controls, with improvement seen both at the end of treatment and at a 3-month follow-up.

Method

In all, 29 children were randomized into two groups: 15 in the intervention group (IG) and 14 as the wait-list controls (WLC). An intent-to-treat analysis was performed using two-factorial multivariate analyses of variance with repeated measures.

Results

Children in the IG experienced both a reduction in pain (primary outcome) and an improvement in health-related quality of life (secondary outcome) as compared to the WLC. The effect sizes ranged from medium to high.

Conclusion

Cognitive–behavioral methods seem to be appropriate for treating children with CAP.     

Effects of a Cognitive–Behaviorally Based Physical Activity Treatment for 4- and 5-Year-Old Children Attending US Preschools

Background

Inadequate volumes of physical activity may be associated with the increases in inappropriately high weight in children of 5 years of age and younger. Preschools have typically lacked sufficient time in daily physical activity.

Purpose

A preschool-administered physical activity treatment based on social cognitive and self-efficacy theory (Start For Life) was tested for its association with increased physical activity and reduced body mass index (BMI).

Methods

Data from accelerometer and BMI assessments over a 9-month preschool year (18 treatment and 8 control classes of 17 to 20 children each; mean age?=?4.4 years) were used to contrast the behaviorally based treatment of 30 min per day with a usual care condition of the same duration. The sample was primarily African-American. Preschool teachers administered all processes.

Results

The Start For Life treatment was associated with a significantly greater percentage of the preschool day in moderate-to-vigorous and vigorous physical activity (approximately 30 min per week more), with sedentary time unaffected. The treatment was also associated with a significant reduction in BMI, with effect sizes greatest in overweight and obese children.

Conclusions

Although results were positive in contrast to usual care and other related interventions, the specific sample requires that the Start For Life treatment undergo sufficient replication to increase confidence in generalizability of the findings to others. Although reduction in sedentary time may require a different strategy, the practical application of the present treatment suggests possibilities for addressing overweight through increasing moderate-to-vigorous physical activity in preschool settings.     

First Report on the Moroccan Registry of Primary Immunodeficiencies: 15 Years of Experience (1998–2012)

Purpose

Primary immunodeficiencies (PIDs) are a large group of diseases characterized by susceptibility to infections. We provide the first comprehensive report on PIDs in Morocco, the epidemiological, clinical, etiological and outcome features which have never before been described.

Methods

A national registry was established in 2008, grouping together data for PID patients diagnosed since 1998.

Results

In total, 421 patients were diagnosed between 1998 and 2012. Parental consanguinity was common (recorded for 43.2 % of patients) and the median time to diagnosis was 2.0 years. Overall, 27.4 % of patients were considered to have well defined syndromes with immunodeficiency (48 cases of hyper-IgE syndrome and 40 of ataxia-telangiectasia); 22.7 % had predominantly antibody deficiencies (29 cases of agammaglobulinemia and 24 of CVID); 20.6 % had combined immunodeficiencies (37 cases of SCID and 26 of MHC II deficiencies) and 17.5 % had phagocyte disorders (14 cases of SCN and 10 of CGD). The principal clinical signs were lower respiratory tract infections (60.8 %), skin infections (33.5 %) and candidiasis (26.1 %). Mortality reached 28.8 %, and only ten patients underwent bone marrow transplantation. We analyzed the impact on mortality of residence, family history, parental consanguinity, date of diagnosis and time to diagnosis, but only date of diagnosis had a significant effect.

Conclusions

The observed prevalence of PID was 0.81/100,000 inhabitants, suggesting considerable underdiagnosis and a need to increase awareness of these conditions in Morocco. The distribution of PIDs was different from that reported in Western countries, with a particularly high proportion of SCID, MHC II deficiencies, hyper-IgE syndrome and autosomal recessive agammaglobulinemia. However, we have now organized a national network, which should improve diagnosis rates in remote regions.