Sex determination of infant and juvenile skeletons: I. Morphognostic features

Ancient cemeteries are often characterized by a considerable number of infants and young children. Sex differences in childhood mortality, however, could rarely be studied up to now, mainly because there were only few proven traits for sexual determination of immature skeletons. Based on a historic sample of sixty-one children of known sex and age from Spitalfields, London (37 boys, 24 girls), sexually distinctive traits in the mandible and ilium are presented for morphognostic diagnosis. Besides other features, boys typically show a more prominent chin, an anteriorly wider dental arcade, and a narrower and deeper sciatic notch than girls. Most of the traits presented in this study allow individuals between birth and five years of age to be successfully allocated to either sex in 70–90% of the cases. © 1993 Wiley-Liss, Inc.     

Age and sex biases in the preservation of human skeletal remains

Inaccuracies introduced through biases in preservation are a major source of error in paleodemographic reconstructions. Although it is generally assumed that such biases exist, little is known about their magnitude. To investigate this problem, we studied age and sex differences in the preservation of skeletal remains from Mission La Purisima and a prehistoric cemetery (Ca-Ven-110). Comparison of mortality profiles obtained through analysis of skeletal remains and burial records from the mission indicates that biases in preservation can be very significant in poorly preserved skeletal collections. The Purisima burial records show that most of the people interred in the cemetery were either infants or elderly adults. The skeletal remains, in contrast, are predominantly those of young adults. The burial records and skeletal collection produced comparable sex ratios. These results show that age biases in preservation are much more important than sex biases. This conclusion is supported by data on the completeness of the skeletons from La Purisima and Ca-Ven-110. At both sites, the remains of young adults were better preserved than those of children or elderly adults, and the completeness of male and female skeletons was comparable.     

Newer anticonvulsants: Lamotrigine, topiramate and gabapentin

BACKGROUND The second generation antiepileptic drugs (AEDs), which include lamotrigine, topiramate, and gabapentin, have been introduced during the past 20 years. Because the newer AEDs differ in their pharmacokinetics from the first generation AEDs, it is hoped that the second generation AEDs will be less teratogenic. METHODS The findings in pregnancy cohorts and case-control studies concerning lamotrigine, topiramate and gabapentin-exposed pregnancies have been analyzed. RESULTS The rate of all malformations in lamotrigine monotherapy-exposed pregnancies has been between 2.0 and 5.6%, in comparison to baseline rates of 1.1 to 3.6% in two unexposed comparison groups. Compared to reference populations, a higher risk (0.4%) of isolated oral clefts has been observed in one cohort of 1562 lamotrigine-exposed pregnancies, but the risk was lower (0.1%) in other studies. In topiramate-exposed pregnancies, the rate of all malformations has been 4.2 to 4.9%, with an increase in oral clefts with and without other anomalies. The limited information available now for gabapentin has shown no evidence of teratogenicity. Concerning other developmental effects of these drugs, young children exposed to lamotrigine in utero have shown no deficits in cognitive function. Prenatal exposure to topiramate has been associated with an elevated frequency of small size for gestational age newborns. CONCLUSIONS The information available suggests an increased risk of oral clefts in infants exposed to topiramate, and perhaps lamotrigine, early in pregnancy, and of growth retardation for topiramate-exposed infants. Larger sample sizes are needed to clarify the questions that have been raised. Birth Defects Research (Part A) 94:599-606, 2012. ? 2012 Wiley Periodicals, Inc.     

Early childhood stress and adult age mortality--a study of dental enamel hypoplasia in the medieval Danish village of Tirup

This study explores how linear enamel hypoplasia (LEH) affects mortality in the village of Tirup (A.D. 1150-1350), Denmark. Data consist of information on 583 skeletons aged 1 year or more. Three partly overlapping subsamples were defined. (1) 104 skeletons of young children aged 1-6 years and 120 skeletons of adults giving information on LEH. (2) 458 skeletons aged 6 years or more. (3) 109 adult skeletons (aged 20 years or more) that provided transition analysis age estimates, sex assessments, and LEH information. Of the 109 skeletons in Subsample 3, 60 had no and 49 had at least one LEH. In Subsample 1, it was found that the case fatality rate for episodes potentially leading to LEH dropped from over 0.5 in 1-year olds to around 0.1 in 3-5-year olds. Only models with heterogeneity of frailty could describe late childhood and adolescent mortality. Further, it was shown that only a model with continuously varying frailty preserved heterogeneity to adulthood. Among young adult females and males in all adult ages, people with LEH experienced a higher mortality than people without it. Among males, the mortality rate ratio (MRR) was 2.28. The analyses indicate that the MRR gives an unbiased estimate for the extra risk of dying for adult males with LEH. The values of the case fatality rates for young children might be slightly biased upward because of a higher than average number of older children and adolescents dying with LEH.     

An assessment of the health status and physical characteristics of an early 20th century community a + Maroelabult in the north west province, South Africa.

As a result of mining activities, two related graveyards dating from the last decade of the 19th century and first half of the 20th century had to be relocated. This provided the opportunity to study 47 skeletons of black South Africans, with the aim of obtaining information on the health status and life style of people from a rural area in a mostly pre-antibiotic era. Although the sample is too small to do a proper palaeodemographic analysis, the age spread of the individuals indicates a high infant mortality rate and generally low life expectancy. Medical services were available, as could be seen from the surgically treated forearm fracture of one individual. One individual had signs of a possible treponemal infection, while subperiosteal bone growth on the ribs of another may indicate tuberculosis. High incidences of arthritic disease and joint degeneration probably indicate a high work load. Enlarged fontanelles with delayed closure were noted in some of the infants. Data on long bone lengths also indicate that the growth of the children may have been retarded in comparison to other similarly aged children. It thus seems as though this was a community under considerable stress. A surprising find was the unusually high incidence of individuals with dental abnormalities and variations.     

Testing the quality of nonadult Bayesian dental age assessment methods to juvenile skeletal remains: the Lisbon collection children and secular trend effects

Age estimation of nonadult skeletons from archaeological or forensic contexts has relied heavily on modern schedules of dental formation developed on samples of children of affluent populations. Although genetic factors have been considered to have had the greatest influence on population differences in dental development, increased interest has been placed on the role of environmental influences, such as differences in socioeconomic status and secular trends. This study evaluates the quality (i.e., accuracy and reliability) of two Bayesian dental age estimation methods to a sample of identified child skeletons from the Lisbon collection (20th century Portugal). The two Bayesian methods are developed on a reference sample of modern children from France, Ivory Coast, Iran, and Morocco. The test sample from Lisbon, compared to the reference sample, is separated by over 50 years of secular trends and comprises a lower socioeconomic segment. The two Bayesian methods show that the Lisbon children are consistently 1-year behind in dental age compared to the modern children of the reference sample. Environmental factors largely explain the differences between dental and chronological age in historic samples of nonadults.     

儿童支原体肺炎482例的临床症状及诊治分析

目的：分析儿童支原体肺炎的临床特点、影像学表现与治疗手段。方法：回顾性分析2001年1月-2012年1月在我院住院的482例被确诊为支原体肺炎患儿的临床病历资料,包括各种检测结果、临床表现及治疗转归。结果：儿童支原体肺炎主要的临床症状为咳嗽及发热等;婴幼儿通常还伴有气短喘憋,听诊可闻及痰呜音。影像学特征呈现多样性,斑片状阴影多见于婴幼儿,节段性、大片状阴影多见于学龄儿童。应用阿奇霉素联合激素治疗可获得很好的临床疗效。结论：儿童支原体肺炎具有临床表现和影像学表现不相符的特点,其影像学表现缺乏特异性。早期规范应用大环内酯类药物治疗,可有效缓解临床症状,对防止复发具有非常重要的临床意义。     

沈阳地区婴幼儿RSV感染的病原学调查研究

查明冬春季沈阳地区婴幼儿RSV感染流行情况.采用APAAP法和IFA法对65例临床诊断为急性病毒性下呼吸道感染的婴幼儿进行了检查.在RSV感染的高发季节由RSV引起婴幼儿的急性下呼吸道感染的阳性率为44.60%(29/65),0～6个月婴幼儿感染率最高,为74.07%(20/27),并有明显的喘息倾向.以上结果表明RSV仍是引起婴幼儿急性下呼吸道感染,特别是肺炎和毛细支气管炎的重要病原体,沈阳地区仍有流行.为防止和控制RSV的流行及为RSV的防治提供了依据.     

Focus: Vaccines: Challenges in Maximizing Impacts of Preventive Strategies against Respiratory Syncytial Virus (RSV) Disease in Young Children

Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract illness in infants and young children. It causes substantial morbidity and mortality in young children and older adults. As few therapeutic and prophylaxis options against RSV illness are currently available, there is a great need for effective RSV vaccines and immune-prophylaxis. Encouragingly, multiple vaccines and immuno-prophylaxis aiming to protect pediatric populations have shown promising progress in clinical trials. The three major preventive strategies include RSV F-protein-based vaccines for pregnant women, extended half-life monoclonal antibodies for neonates, and live-attenuated vaccines for infants. Each preventive strategy has its own merits and challenges yet to be overcome. Challenges also exist in maximizing vaccine impacts in the post-implementation era. This perspectives piece focuses on RSV preventive strategies in young children and highlights the remaining questions in current development of RSV immunization products and design of immunization programs.     

Infants,Children, and Informed Consent

Obtaining informed consent for non-therapeutic experimentation on infants and children has ethical and legal implications that cause great controversy. There is some danger that worthy research will be inhibited if current ethical codes are interpreted too strictly, yet infants, children, and other vulnerable groups clearly must be protected from exploitation as research subjects. It is suggested that permission from parents coupled with integrity of the investigator will remain the child''s best protection, but several additional protective mechanisms are available and should be used. Some guidelines for non-therapeutic research are suggested which should not only provide adequate protection for infants and young children involved in research projects, but allow investigators reasonable freedom to prosecute worthy research vital to continued improvements in child care.     

Probiotic Supplement Use among Young Children in Taiwan: A Prospective Cohort Study

Objectives

The objective of this study is to provide details on probiotic supplement use among young children in Taiwan.

Participants and Methods

This study is based on the Taiwan Birth Cohort Study database. We used questionnaires to collect information on probiotic supplement use among young children from birth to 18 months of age, while also considering their demographic characteristics and other covariates. Low-birth-weight infants, preterm infants, those with birth defects, and those with caregivers who returned incomplete questionnaires were excluded. The final valid sample comprised 16,991 cases.

Results

Approximately half the children received probiotic supplements before the age of 18 months. Only 6.3% of the children received probiotic supplements during the two periods of birth to 6 months and 7 to 18 months. Firstborn children, native mothers, mothers with higher educational levels, higher family income, and parents who lead healthy lifestyles were positively related to probiotic supplement use among children. Young children who were breastfed, with eczema, or with gastrointestinal tract problems were significantly positively associated with probiotic supplement use.

Conclusion

The findings show that probiotic supplement usage among young children is associated with a more socially advantaged circumstance and certain child health factors, such as eczema, diarrhea, and constipation. Parents might use probiotic supplements for prevention or treatment of child diseases. The findings of this research could serve as a baseline for future studies, and provide insight into probiotic supplement use behavior for health professionals caring for infants and young children.     

不同时间段睡眠剥夺配合改良式水合氯醛保留灌肠法在婴幼儿肺功能检查中的效果分析

摘要 目的：探讨不同时间段睡眠剥夺配合改良式水合氯醛保留灌肠法在婴幼儿肺功能检查中的镇静效果。方法：前瞻性选取2018年2月~2020年8月本院收治并需行肺功能检查的婴幼儿临床资料,纳入194例婴幼儿作为研究对象,根据随机数字表法简单随机分为四组。对照组（n=48）不进行睡眠剥夺,短时段组（n=48）行短时段睡眠剥夺,中时段组（n=49）行中时段睡眠剥夺,长时段组（n=49）行长时段睡眠剥夺。对比四组婴幼儿的入睡时间、镇静效果及不良反应。结果：四组婴幼儿入睡时间的组间差异具有统计学意义（P＜0.05）。与对照组相比,联合睡眠剥夺干预的三组婴幼儿在10 min内进入睡眠的例数明显增多;随着睡眠剥夺时间增加,睡眠剥夺的三组婴幼儿超过30 min才进入睡眠的例数明显少于对照组。四组婴幼儿镇静效果的组间比较差异具有统计学意义（P＜0.05）;与对照组相比,联合睡眠剥夺干预的三组婴幼儿镇静效果明显升高,镇静总有效率均高于对照组（P＜0.05）。在实验期间,四组婴幼儿均出现不同类型的不良反应,各类型不良反应发生率及总发生率的组间比较,差异均无统计学意义（P>0.05）,但长时段组出现情绪烦躁的比例略高。结论：睡眠剥夺配合改良式水合氯醛灌肠法对婴幼儿具有良好的镇静效果,但长时段睡眠剥夺可能会使其情绪烦躁,需在检查完成后悉心安抚婴幼儿情绪。     

Brief communication: Testing the usefulness of the basilar suture as a means to determine age in great ape skeletons

A fused/closed basilar suture is usually treated as an indication of old age in great apes. A sample, drawn from a variety of sources, of known-aged captive great ape skeletons was analyzed to test the usefulness of using the basilar suture to categorize adult skeletons as either "adult" or "old adult". The state of closure of the basilar suture was examined in 30 chimpanzees, 19 gorillas, and 15 orangutans, all of known age. The results show that the basilar suture demonstrates a high level of uniformity in rate of closure and is closed at an early age in virtually all known-aged individuals. Thus, an old adult category most likely includes individuals who are, in fact, relatively young. This indicates that using the basilar suture as a means to classify individual skeletons as adult or old adult is very imprecise. The homogenous nature of basilar suture closure appears to prevent meaningful application of suture status for categorizing adult ape skeletons by age groups.     

婴幼儿皮肤微生态特点及其在特应性皮炎发病中的作用

特应性皮炎(atopic dermatitis, AD)是一种常见的慢性炎症性皮肤病, 可发生于各个年龄段, 婴幼儿尤为高发。AD病因复杂, 既往认为遗传背景、皮肤屏障功能障碍和免疫紊乱是其主要发病机制。近年来皮肤微生态在AD发病中的作用被逐渐揭示, 成人AD常伴有以金黄色葡萄球菌定植增加和菌群多样性下降为主要特征的皮肤菌群失调。婴幼儿皮肤屏障功能与免疫功能随着年龄增长发生显著变化, 其皮肤菌群特点也不同于成人, 国内对此领域关注较少, 因此本文就婴幼儿皮肤微生态的特点及其在AD发病中的作用作一综述。

     

建湖县城区2008—2011年轮状病毒减毒活疫苗接种副反应监测分析

目的了解轮状病毒活疫苗接种后副反应发生的情况,为该疫苗安全接种提供依据。方法对2008—2011年间每年的6月1日到8月31日在建湖县城区免疫规划门诊接种的婴幼儿登记数据进行分析。结果接种5 139人,报告副反应114人,报告率2.218%。报告发生率,一般副反应109例,发生率为2.121%;异常副反应5例,发生率为0.097%。结论接种轮状病毒活疫苗异常副反应发生率低,接种疫苗安全。     

Sex differences in concentrations of HMGB1 and numbers of pigmented monocytes in infants and young children with malaria

Sex remains a key biological variable affecting human innate and adaptive immune responses to infection and in pathogenesis of diseases. In malaria, females demonstrate higher concentrations of antibodies and rates of severe adverse events and mortality following malaria vaccination. Although monocytes/macrophages play a crucial role in disease and protection in malaria, no studies have investigated sex differences in their functions in production of proinflammatory cytokines and chemokines in malaria-infected subjects. Here, we show significant sex differences in serum concentrations of HMGB1, a non-histone chromatin-associated protein, and numbers of pigmented monocytes, which are both markers of severe malaria, in infants and young children <5 years old from a malaria endemic region in Northern Uganda. Female infants and young children with clinical malaria had significantly higher HMGB1 concentrations than males, and female infants and young children with asymptomatic malaria had significantly lower numbers of pigmented monocytes than males with asymptomatic malaria. There was (1) a significant correlation between HMGB1 concentrations and pigmented monocyte numbers in female but not male infants; and (2) a significant correlation between HMGB1 concentrations and parasite densities in female but not male infants. These findings suggest that female infants and young children with clinical malaria might be at a greater risk of morbidity characterized by higher serum HMGB1 levels.     

Age structure and selected pathological aspects of a series of skeletons of late medieval Bernau (Brandenburg,Germany)

The age distribution of an excavation site from the late Middle Ages (beginning of the 13th century until 1598) in Bernau (Brandenburg, Germany) that contained 252 skeletons shows a mortality maximum at the age classes infants I and mature. The lowest mortality was calculated for the adult age class. 51.6% of the individuals died before the age of 20 years. The mortality rate of young women was higher than that of young men. The life expectancy of the total population was 25 years. Altogether, 87 adult skeletons were examined for degenerative joint diseases. Many of the examined joints showed indications of beginning osteoarthritis; the intensity of the disease was low or medium severe. The highest values were found for the hip joint, followed by the elbow and the knee. For all joints examined, women were less often and to a lesser extent affected than men, which was noticeable best in the upper extremity. Harris lines were found in 75% of the children, 4.7 per average individual. No such lines were found by the age of one year, the peak value of the frequency being recorded at the age between 2 and 3 years. This can be correlated to the weaning period. The comparison to a rural population yielded a higher load with Harris lines in the small village, which, however, was not correlated to a higher mortality. Altogether, the population of Bernau is characterised by good living conditions and a considerable chance of survival for the children, as well as by a labour system, dominated by crafts and farming.     

Urinary Screening Tests in the Prevention of Mental Deficiency

A substantial number of genetically determined biochemical disorders in infants and young children produce mental deficiency and serious ill health in early life. If these diseases are detected promptly, effective therapy can be instituted to prevent the development of mental defect, or, where no treatment is presently available, the parents can be given appropriate genetic counselling so that the birth of further affected children can be prevented.Eight simple urine screening tests are described which have proved useful in the early detection of metabolic disorders in apparently healthy infants. These tests can easily be performed by a physician or nurse without special training or elaborate equipment. The attention of general practitioners, pediatricians and public health physicians is directed to the real possibilities for preventing some forms of mental deficiency through the routine use of screening tests on urine and on blood.     

Vaccine Induced Herd Immunity for Control of Respiratory Syncytial Virus Disease in a Low-Income Country Setting

Background

Respiratory syncytial virus (RSV) is globally ubiquitous, and infection during the first six months of life is a major risk for severe disease and hospital admission; consequently RSV is the most important viral cause of respiratory morbidity and mortality in young children. Development of vaccines for young infants is complicated by the presence of maternal antibodies and immunological immaturity, but vaccines targeted at older children avoid these problems. Vaccine development for young infants has been unsuccessful, but this is not the case for older children (> 6m). Would vaccinating older children have a significant public health impact? We developed a mathematical model to explore the benefits of a vaccine against RSV.

Methods and Findings

We have used a deterministic age structured model capturing the key epidemiological characteristics of RSV and performed a statistical maximum-likelihood fit to age-specific hospitalization data from a developing country setting. To explore the effects of vaccination under different mixing assumptions, we included two versions of contact matrices: one from a social contact diary study, and the second a synthesised construction based on demographic data. Vaccination is assumed to elicit an immune response equivalent to primary infection. Our results show that immunisation of young children (5–10m) is likely to be a highly effective method of protection of infants (<6m) against hospitalisation. The majority benefit is derived from indirect protection (herd immunity). A full sensitivity and uncertainty analysis using Latin Hypercube Sampling of the parameter space shows that our results are robust to model structure and model parameters.

Conclusions

This result suggests that vaccinating older infants and children against RSV can have a major public health benefit.     

Systems vaccinology: a promise for the young and the poor

As a child, the risk of suffering and dying from infection is higher the younger you are; and higher, the less developed a region you are born in. Childhood vaccination programmes have greatly reduced mortality around the world, but least so for the very young among the very poor of the world. This appears partly owing to suboptimal vaccine effectiveness. Unfortunately, although most vaccines are administered to the newborn and very young infant (less than or equal to two months), we know the least about their host response to vaccination. We thus currently lack the knowledge to guide efforts aimed at improving vaccine effectiveness in this vulnerable population. Systems vaccinology, the study of molecular networks activated by immunization, has begun to provide unprecedented insights into mechanisms leading to vaccine-induced protection from infection or disease. However, all published reports of systems vaccinology have focused on either adults or at most children and older infants, not those most in need, i.e. newborns and very young infants. Given that the tools of systems vaccinology work perfectly well with very small sample volumes, it is time we deliver the promise that systems vaccinology holds for those most in need of vaccine-mediated protection from infection.