Parenting Practices at 24 to 47 Months and IQ at Age 8: Effect-Measure Modification by Infant Temperament

Cognitive development might be influenced by parenting practices and child temperament. We examined whether the associations between parental warmth, control and intelligence quotient (IQ) may be heightened among children in difficult temperament. Participants were from the Avon Longitudinal Study of Parents and Children (n = 7,044). Temperament at 6 months was measured using the Revised Infant Temperament Questionnaire and classified into ‘easy’ and ‘difficult’. Parental warmth and control was measured at 24 to 47 months and both were classified into 2 groups using latent class analyses. IQ was measured at 8 years using the Wechsler Intelligence Scale for Children and dichotomized (<85 and ≥85) for analyzing effect-measure modification by temperament. Linear regression adjusted for multiple confounders and temperament showed lower parental warmth was weakly associated with lower IQ score [β = -0.52 (95% CI 1.26, 0.21)], and higher parental control was associated with lower IQ score [β = -2.21 (-2.95, -1.48)]. Stratification by temperament showed no increased risk of having low IQ in temperamentally difficult children [risk ratio (RR) = 0.97 95% CI 0.65, 1.45)] but an increased risk among temperamentally easy children (RR = 1.12 95% CI 0.95, 1.32) when parental warmth was low. There was also no increased risk of having low IQ in temperamentally difficult children (RR = 1.02 95% CI 0.69, 1.53) but there was an increased risk among temperamentally easy children (RR = 1.30 95% CI 1.11, 1.53) when parental control was high. For both parental warmth and control, there was some evidence of negative effect-measure modification by temperament on the risk-difference scale and the risk-ratio scale. It may be more appropriate to provide parenting interventions as a universal program rather than targeting children with difficult temperament.     

不同月龄婴儿接种DTP后血清中百日咳抗体水平的观测

本文对比观察了２１３例２月龄、３月龄婴儿接种ＤＴＰ后百日咳抗体水平的变化,探讨了母传抗体对免后抗体增长的影响。结果表明２月龄、３月龄婴儿ＤＴＰ免疫后１个月和３个月血清中百日咳抗体达保护水平的百分率无显著性差异（ｘ￣２＝０．０３６,ｐ＞０．９;ｘ￣２＝０．３２７,ｐ＞０．５）,免后１个月抗体ＧＭＴ无显著性差异（ｔ＝０．１７,ｐ＞０．５）,免后３个月抗体ＧＭＴ３月龄组高于２月龄组（ｔ＝２．２２,ｐ＜０．０５）。我们还发现免前抗体水平与免后１个月ＧＭＴ虽有负相关（ｒ＝—０,７５４）的倾向,但总体上对抑制免后抗体应答不明显,因而建议将儿童ＤＴＰ基础免疫的起始月龄提前至２月龄进行。     

Long-Term Neurodevelopmental Outcome of Monochorionic and Matched Dichorionic Twins

Background

Monochorionic (MC) twins are at increased risk for perinatal mortality and serious morbidity due to the presence of placental vascular anastomoses. Cerebral injury can be secondary to haemodynamic and hematological disorders during pregnancy (especially twin-to-twin transfusion syndrome (TTTS) or intrauterine co-twin death) or from postnatal injury associated with prematurity and low birth weight, common complications in twin pregnancies. We investigated neurodevelopmental outcome in MC and dichorionic (DC) twins at the age of two years.

Methods

This was a prospective cohort study. Cerebral palsy (CP) was studied in 182 MC infants and 189 DC infants matched for weight and age at delivery, gender, ethnicity of the mother and study center. After losses to follow-up, 282 of the 366 infants without CP were available to be tested with the Griffiths Mental Developmental Scales at 22 months corrected age, all born between January 2005 and January 2006 in nine perinatal centers in The Netherlands. Due to phenotypic (un)alikeness in mono-or dizygosity, the principal investigator was not blinded to chorionic status; perinatal outcome, with exception of co-twin death, was not known to the examiner.

Findings

Four out of 182 MC infants had CP (2.2%) - two of the four CP-cases were due to complications specific to MC twin pregnancies (TTTS and co-twin death) and the other two cases of CP were the result of cystic PVL after preterm birth - compared to one sibling of a DC twin (0.5%; OR 4.2, 95% CI 0.5–38.2) of unknown origin. Follow-up rate of neurodevelopmental outcome by Griffith''s test was 76%. The majority of 2-year-old twins had normal developmental status. There were no significant differences between MC and DC twins. One MC infant (0.7%) had a developmental delay compared to 6 DC infants (4.2%; OR 0.2, 95% 0.0–1.4). Birth weight discordancy did not influence long-term outcome, though the smaller twin had slightly lower developmental scores than its larger co-twin.

Conclusions

There were no significant differences in occurrence of cerebral palsy as well as neurodevelopmental outcome between MC and DC twins. Outcome of MC twins seems favourable in the absence of TTTS or co-twin death.     

Relationship between Age/Gender-Induced Survival Changes and the Magnitude of Inflammatory Activation and Organ Dysfunction in Post-Traumatic Sepsis

Age/gender may likely influence the course of septic complications after trauma. We aimed to characterize the influence of age/gender on the response of circulating cytokines, cells and organ function in post-traumatic sepsis. We additionally tested whether post-traumatic responses alone can accurately predict outcomes in subsequent post-traumatic sepsis. A mouse 2-hit model of trauma/hemorrhage (TH, 1^st hit) and cecal ligation and puncture (CLP, 2^nd hit) was employed. 3, 15 and 20 month (m) old female (♀) and male (♂) CD-1 mice underwent sublethal TH followed by CLP 2 days later. Blood was sampled daily until day 6 post-TH and survival was followed for 16 days. To compare general response patterns among groups, we calculated two scores: the inflammatory response (including KC, MIP-1α, TNFα, MCP-1, IFNγ, IL-1β,-5,-6,-10) and the organ dysfunction score (Urea, ALT, AST and LDH). Moreover, mice were retrospectively divided into survivors (SUR) and dying (DIE) based on post-CLP outcome. In general, females survived better than males and their survival did not correspond to any specific estrus cycle phase. Pre-CLP phase: the post-TH inflammatory score was weakest in 3 m♂ but there were no changes among remaining groups (similar lack of differences in the organ dysfunction score). TH induced a 40% increase of IFNγ, MIP-1α and IL-5 in 15 m♂ SUR (vs. DIE) but predictive accuracy for post-CLP outcomes was moderate. Post-CLP phase: while stable in males, inflammatory response score in 15 m and 20 m females decreased with age at day 1 and 2 post-CLP. SUR vs. DIE differences in inflammatory and organ dysfunction score were evident but their magnitude was comparable across age/gender. Nearly identical activation of the humoral inflammatory and organ function compartments, both across groups and according to sepsis severity, suggests that they are not directly responsible for the age/gender-dependent disparity in TH-CLP survival in the studied young-to-mature population.     

Actigraphic Monitoring of the Activity-Rest Behavior of Preterm and Full-Term Infants at 20 Months of Age

Differences in the activity-rest behavior of preterm and full-term infants provide an important contribution to the analysis of the ontogeny of circadian rhythms. In this study, we recorded the activity-rest behavior of 17 preterm and 8 full-term infants at the approximate age of 20 months over an average of 10 days by means of actigraphic monitoring (Actiwatch®, Cambridge Neurotechnology Ltd.). At the same time, the parents of the infants kept a daily diary. The activity-rest rhythm, the nighttime sleep duration, the daytime rest duration, as well as the sleep quality of the infants were analyzed. Preterm and full-term infants at the age of 20 months show a circadian rhythm with a period length between 23 h 32 min (23:32 h) and 24 h 23 min (24:23 h). It can be concluded that the preterm and full-term infants all reached a vital developmental step by showing the dominant circadian rhythm in the spectrum. The daytime rest duration of preterm infants is significantly shorter than that of full-term infants. The sleep quality of preterm infants is significantly lower than that of full-term infants, which means that the preterm infants have a larger percentage of less restful nighttime sleep. In other studies preterm infants show an over-proportional frequency of attention deficit hyperactivity disorder (ADHD). For this reason, future analyses should reveal whether or not actigraphic monitoring is a suitable means for an early identification of activity-rest behavior in children who may develop ADHD.     

Actigraphic Monitoring of the Activity-Rest Behavior of Preterm and Full-Term Infants at 20 Months of Age

Differences in the activity-rest behavior of preterm and full-term infants provide an important contribution to the analysis of the ontogeny of circadian rhythms. In this study, we recorded the activity-rest behavior of 17 preterm and 8 full-term infants at the approximate age of 20 months over an average of 10 days by means of actigraphic monitoring (Actiwatch®, Cambridge Neurotechnology Ltd.). At the same time, the parents of the infants kept a daily diary. The activity-rest rhythm, the nighttime sleep duration, the daytime rest duration, as well as the sleep quality of the infants were analyzed. Preterm and full-term infants at the age of 20 months show a circadian rhythm with a period length between 23 h 32 min (23:32 h) and 24 h 23 min (24:23 h). It can be concluded that the preterm and full-term infants all reached a vital developmental step by showing the dominant circadian rhythm in the spectrum. The daytime rest duration of preterm infants is significantly shorter than that of full-term infants. The sleep quality of preterm infants is significantly lower than that of full-term infants, which means that the preterm infants have a larger percentage of less restful nighttime sleep. In other studies preterm infants show an over-proportional frequency of attention deficit hyperactivity disorder (ADHD). For this reason, future analyses should reveal whether or not actigraphic monitoring is a suitable means for an early identification of activity-rest behavior in children who may develop ADHD.     

Safety and Immunogenicity of a Live Attenuated RSV Vaccine in Healthy RSV-Seronegative Children 5 to 24 Months of Age

Despite substantial morbidity associated with respiratory syncytial virus (RSV) infection, there is no licensed vaccine. MEDI-559 is a live attenuated intranasal vaccine candidate being developed for prevention of lower respiratory illness due to RSV in young children. This randomized, placebo-controlled study evaluated safety of MEDI-559 in healthy, RSV-seronegative children. MEDI-559 or placebo was administered on 3 occasions, 2 months apart. Primary safety was based on solicited symptoms (SSs) and adverse events (AEs) collected for 28 days after each dose. Nasal wash samples were collected 3 times after each dose (days 7-10, 12-18, 28-34) and at sick visits. Serum was collected for measuring antibody immune responses to RSV prior to first vaccination and 28 days post final dose. Long-term safety was monitored for 365 days from first dose. SSs were mild and frequent (MEDI-559 84%; placebo 91%); most common SSs were runny/stuffy nose, cough, and irritability/fussiness. AEs occurred in 67% MEDI-559 and 57% placebo recipients: most common AE was upper respiratory tract infection (MEDI-559 35%; placebo 23%). Higher incidence of medically attended lower respiratory illness within 28 days after dosing occurred in the MEDI-559 arm compared to placebo (none associated with vaccine virus shedding). There was no evidence of enhanced RSV disease. Vaccine virus was detected only in MEDI-559 recipients; shedding occurred in 56%subjects, primarily post dose 1. A functional immune response was observed in 59% and 9% MEDI-559 and placebo recipients, respectively, by an RSV microneutralization assay. Vaccine take, assessed by proportion that shed vaccine-type virus or had a seroresponse against RSV, was seen in 95% MEDI-559 subjects. MEDI-559 is therefore biologically active and immunogenic in this seronegative pediatric population. Although the frequency of SSs and AEs was not considered clinically significant, the increase in medically attended lower respiratory illnesses in the vaccine group warrants expanded safety studies.

Trial Registration

ClinicalTrials.gov NCT00767416     

Differentiation of Gram Positive and Gram Negative Bacteria in Transparent Acrylic Resin Emulsion Replicas of Surfaces of Plants

When acrylic resin emulsion (Rohm & Haas Primal AC-33) is allowed to dry on a leaf surface, it can be peeled off to give a transparent replica of the surface with bacteria and fungi embedded in it. The distribution of micro-organisms in the replica appears to reflect the patterns in which they occur naturally on the surface. The resin replicas may be stained by a variety of microscopical stains, the best of which is phenol-acetic-aniline blue, and are suitable for high power light microscopy.
Acrylic resin emulsion differs from widely used cellulose-based materials in that permanent differentiated preparations of Gram positive and Gram negative stained bacteria may be produced from a wide variety of types of surface.     

Usefulness of Parent-Completed ASQ for Neurodevelopmental Screening of Preterm Children at Five Years of Age

Introduction

Preterm children are at greater risk of developmental impairment and require close follow-up for early and optimal medical care. Our goal was to examine use of the parent-completed Ages and Stages Questionnaire (ASQ) as a screening tool for neurodevelopmental disabilities in preterm infants at five years of age.

Patients and Methods

A total of 648 preterm children (<35 weeks gestational age) born between 2003 and 2004 and included in the regional Loire Infant Follow-up network were evaluated at five years of age. ASQ was compared with two validated tools (Intelligence Quotient and Global School Adaptation Score) and the impact of maternal education on the accuracy of this questionnaire was assessed.

Results

Overall ASQ scores for predicting full-scale IQ<85 and GSA score produced an area under the receiver operating characteristic curve of 0.73±0.03 and 0.77±0.03, respectively. An ASQ cut-off value of 285 had optimal discriminatory power for identifying children with IQ scores<85 and GSA scores in the first quintile. ASQ values<285 were significantly associated with a higher risk of non-optimal neurologic outcomes (sensitivity of 0.80, specificity of 0.54 for IQ<85). ASQ values>285 were not distinctive for mild delay or normal development. In children with developmental delay, no difference was found when ASQ scores according to maternal education levels were analyzed.

Conclusions

ASQ at five years is a simple and cost-effective tool that can detect severe developmental delay in preterm children regardless of maternal education level, while its capacity to identify children with mild delay appears to be more limited.     

碱性纤维素酶革兰氏阴性菌株筛选及酶学性质研究

用CMC平板筛选方法,从造纸厂碱性淤泥中获得透明圈直径大于30mm的产碱性纤维素酶革兰氏阴性菌H8005。液体摇瓶培养产生碱性CMC酶活力高达4．2IU／mL。酶学性质初步研究显示,H8005产生的CMC酶反应的pH值以8．0左右为适;在碱性条件下具有较高的酶活和一定的稳定性;反应温度以55℃左右为宜;且具有较好的温度稳定性。Mn^2＋与Fe^3＋对酶反应有促进作用,Cu^2＋和Pb^2＋对酶反应有抑制作用。该菌产生的纤维素酶在棉织品的水洗整理及洗涤剂工业中具有非常良好的应用前景。     

Longevity of Breeding Sows in Relation to Leg Weakness Symptoms at Six Months of Age

The objective of this study was to evaluate the influence of leg weakness symptoms measured early in life (at 6 months of age) on the longevity of the sows, i.e. the age at culling due to locomotory problems in a Danish pig herd. One hundred and eighty-seven gilts at 6 months of age were selected according to different leg weakness symptoms and were followed until culling and judged for leg weakness once in every gestation using a scale from 1 (normal) to 4 (severe changes). Age at culling, and the main and secondary reasons for culling were recorded. The influence of leg weakness symptoms on longevity was evaluated by survival analysis. Though only 12% of the gilts showed a stiff locomotion half of the sows had suffered from this and nearly one third had been distinctly lame at some time in their life. Buck-kneed forelegs, upright pasterns, legs turned out, standing under position and swaying hindquarters were associated with stiff locomotion or lameness, whereas weak pasterns on hind legs and splayed digits on forelegs were associated with brisk movement (freedom from locomotor problems). The following leg weakness symptoms at the gilt stage were found to have significant negative effects on longevity: buck-kneed forelegs, swaying hindquarters, and standing under position on hind legs.     

A Taxonomic Study of Flavobacteria and Related Gram Negative Yellow Pigmented Rods

One hundred and seventy-nine yellow pigmented Gram negative rods, including 170 new isolates obtained from a variety of habitats, were investigated and the results analysed by computer. Nine phena, embracing 146 strains, were distinguished. Five of these comprised 88 of the 109 non-motile, aflagellate strains (i.e. 'atypical cytophagas') and they should be assigned to a re-defined genus Flavobacterium . A separate phenon containing 41 of the gliding isolates was delineated which should be ascribed provisionally to the genus Flexibacter . Only low G + C contents have been recorded for representative strains from these six phena but one strain (which would have been ascribed to Flavobacterium ) had a high G + C content; such organisms (both peritrichous and non-motile) should comprise a separate genus Empedobacter (Brisou). The remaining three phena respectively comprised strains of Erwinia herbicola , pseudomonads and unclassified aflagellate isolates; their taxonomic position is discussed.     

An Initial Approach to the Taxonomy of Some Gram Negative Yellow Pigmented Rods

SUMMARY: The responses of various groups of Gram negative, yellow pigmented rods constructed on the basis of classical criteria to a wide range of cultural and biochemical features were examined. The occurrence of a wide area of slime surrounding true growth with isolates which may spread but did not glide is described. The correlation between the classical groups and divisions suggested on the basis of pigment absorption curves was examined.     

Effect of Age on Survival Outcome in Operated and Non-Operated Patients with Colon Cancer: A Population-Based Study

Objective

To know the effect of age on survival outcome in operated and non-operated patients with colon cancer.

Methods

From the Surveillance, Epidemiology, and End Results database, we identified 123,356 patients with colon cancer who were diagnosed between 1996 and 2005, grouped them as older or younger than 40 years and analyzed their 5-year cancer-specific survival (CSS) data, along with some risk factors, using Kaplan–Meier methods and multivariable Cox regression models.

Results

The younger group had significantly higher pathological grades (P<0.001), more mucinous and signet-ring histology (P<0.001), advanced AJCC stage (P<0.001), and were more likely to undergo surgery (P<0.001). For surgically treated patients, age did not significantly affect 5-year CSS (younger: 66.7%; older: 67.3%; P = 0.86). Further analysis showed that age was an independent prognostic factor in stage I–IV disease (stage I: P = 0.001; P<0.001 for stages II–IV, in both uni- and multivariate analyses), but not for patients with unknown disease stage (P = 0.52). For non-surgically treated patients, age significantly affected 5-year CSS (younger: 16.2%; older: 12.9%; P<0.001) in univariate analysis; and was an independent prognostic factor (P<0.001) in multivariate analysis.

Conclusion

The CSS rate for younger CC patients was at least as high as for older patients, although they presented with higher proportions of unfavorable factors and more advanced disease.     

The Interaction of Child Care and Family Risk in Relation to Child Development at 24 and 36 Months

Family risk factors (psychosocial, socioeconomic, and sociocultural), child care characteristics (quality and hours in care), and the interactions of these variables were examined as predictors of behavior problems, prosocial behavior, and language skills in a longitudinal sample of 943 children (assessed at 24 and 36 months) enrolled in child care as infants. Family risk variables were the strongest predictors of all outcomes. Child care quality was a significant predictor of 36-month caregiver-reported social skills and 36-month language skills. Contrary to expectations, limited evidence was found to suggest child care experiences moderate the negative associations between family risk and child outcomes. Family risk interacted with child care quality in only 1 of the 5 analyses, and did not interact with child care quantity in any of the analyses. One interaction between family risk and child care was significant. Children from minority and single-parent families were rated as less prosocial by their mothers when in low-quality child care.