Emotional expressiveness of 5–6 month-old infants born very premature versus full-term at initial exposure to weaning foods

Facial expressions of 5–6 month-old infants born preterm and at term were compared while tasting for the first time solid foods (two fruit and two vegetable purées) given by the mother. Videotapes of facial reactions to these foods were objectively coded during the first six successive spoons of each test food using Baby FACS and subjectively rated by naïve judges. Infant temperament was also assessed by the parents using the Infant Behaviour Questionnaire. Contrary to our expectations, infants born preterm expressed fewer negative emotions than infants born full-term. Naïve judges rated infants born preterm as displaying more liking than their full-term counterparts when tasting the novel foods. The analysis of facial expressions during the six spoonfuls of four successive meals (at 1-week intervals) suggested a familiarization effect with the frequency of negative expressions decreasing after tasting the second spoon, regardless of infant age, type of food and order of presentation. Finally, positive and negative dimensions of temperament reported by the parents were related with objective and subjective coding of affective reactions toward foods in infants born preterm or full-term. Our research indicates that premature infants are more accepting of novel foods than term infants and this could be used for supporting the development of healthy eating patterns in premature infants. Further research is needed to clarify whether reduced negativity by infants born prematurely to the exposure to novel solid foods reflects a reduction of an adaptive avoidant behaviour during the introduction of novel foods

A double blind randomized trial of wound infiltration with ropivacaine after breast cancer surgery with axillary nodes dissection

<p>Abstract</p> <p>Background</p> <p>The effect of local infiltration after breast surgery is controversial. This prospective double blind randomized study sought to document the analgesic effect of local anaesthetic infiltration after breast cancer surgery.</p> <p>Methods</p> <p>Patients scheduled for mastectomy or tumorectomy and axillary nodes dissection had immediate postoperative infiltration of the surgical wound with 20 ml of ropivacaine 7.5 mg.ml^-1or isotonic saline. Pain was assessed on a visual analogue scale at H2, H4, H6, H12, H24, H72, and at 2 month, at rest and on mobilization of the arm. Patient'comfort was evaluated with numerical 0-3 scales for fatigue, quality of sleep, state of mood, social function and activity.</p> <p>Results</p> <p>Twenty-two and 24 patients were included in the ropivacaine and saline groups respectively. Postoperative pain was lower at rest and on mobilization at 2, 4 and 6 hour after surgery in the ropivacaine group. No other difference in pain intensity and patient 'comfort scoring was documented during the first 3 postoperative days. Patients did not differ at 2 month for pain and comfort scores.</p> <p>Conclusion</p> <p>Single shot infiltration with ropivacaine transiently improves postoperative pain control after breast cancer surgery.</p> <p>Trial registration number</p> <p><a href="http://www.clinicaltrials.gov/ct2/show/NCT01404377">NCT01404377</a></p

The Making of a Mobile Caliphate State in the African Sahel

The goal of this chapter is to thoroughly understand the context of the dominant jihadist narratives and the nature of their appeal in the Sahelian region. All these jihadist ideologies are based on a peculiar Salafi Radicalism that aimed to transform the state and society by methods of preaching and violence. Therefore, studying and analyzing the principles of the Salafist discourse as a political project helps us to understand its points of strengths and weaknesses. In addition, we can be better look at the future trends and prospects of violent jihadist groups in the African Sahel. The roots of this Islamic discourse as a political project may be attributed to what Lunay and Suarez call the “Islamic domain.” The rise of violent radical Islamism represents drive from the internal political and socioeconomic dynamics evolving in each Sahelian state. However, the struggle and rivalry of jihadist ideologies after the military defeat of Daesh in Mosul is important at a time when thousands of fighters who have survived the civil wars in Iraq, Syria, and Libya are looking for new jihadist fields

Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review

Background: Urinary tract infection (UTI) is one of the most common sources of infection in children under five. Prompt diagnosis and treatment is important to reduce the risk of renal scarring. Rapid, cost-effective, methods of UTI diagnosis are required as an alternative to culture. Methods: We conducted a systematic review to determine the diagnostic accuracy of rapid tests for detecting UTI in children under five years of age. Results: The evidence supports the use of dipstick positive for both leukocyte esterase and nitrite (pooled LR+ = 28.2, 95% CI: 17.3, 46.0) or microscopy positive for both pyuria and bacteriuria (pooled LR+ = 37.0, 95% CI: 11.0, 125.9) to rule in UTI. Similarly dipstick negative for both LE and nitrite (Pooled LR- = 0.20, 95% CI: 0.16, 0.26) or microscopy negative for both pyuria and bacteriuria (Pooled LR- = 0.11, 95% CI: 0.05, 0.23) can be used to rule out UTI. A test for glucose showed promise in potty-trained children. However, all studies were over 30 years old. Further evaluation of this test may be useful. Conclusion: Dipstick negative for both LE and nitrite or microscopic analysis negative for both pyuria and bacteriuria of a clean voided urine, bag, or nappy/pad specimen may reasonably be used to rule out UTI. These patients can then reasonably be excluded from further investigation, without the need for confirmatory culture. Similarly, combinations of positive tests could be used to rule in UTI, and trigger further investigation

A randomised controlled trial for the effectiveness of intra-articular Ropivacaine and Bupivacaine on pain after knee arthroscopy: the DUPRA (DUtch Pain Relief after Arthroscopy)-trial

In this double-blinded, randomised clinical trial, the aim was to compare the analgesic effects of low doses of intra-articular Bupivacaine and Ropivacaine against placebo after knee arthroscopy performed under general anaesthesia. A total of 282 patients were randomised to 10 cc NaCl 0.9%, 10 cc Bupivacaine 0.5% or 10 cc Ropivacaine 0.75%. Patients received the assigned therapy by intra-articular injection after closure of the portal. Pain and satisfaction were measured at one, 4 h and 5-7 days after arthroscopy with Numerical Rating Scale (NRS) -scores. NSAID consumption was also recorded. One-h NRS-scores at rest were higher in the NaCl group compared with the Bupivacaine group (P <0.01), 1 h NRS-scores in flexion were higher in the NaCl group compared with the Bupivacaine (P <0.01) and Ropivacaine (P <0.01) groups. NRS-satisfaction at 4 h was higher for the Bupivacaine group compared with the NaCl group (P = 0.01). Differences in NRS-scores were significant but low in magnitude. NSAID consumption was lower in the Bupivacaine group compared with the NaCl group (P <0.01). The results of this randomised clinical trial demonstrate improved analgesia after administration of low doses of intra-articular Bupivacaine and Ropivacaine after arthroscopy of the knee. Considering reports of Bupivacaine and Ropivacaine being chondrotoxic agents and the relatively small improvement on patient comfort found in this trial, it is advised to use systemic anaesthetic instead of intra-articular Bupivacaine or Ropivacaine for pain relief after knee arthroscopy.

How does study quality affect the results of a diagnostic meta-analysis?

Background: The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods: This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results: Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three clinical stages assessed by the review. The results of regression analyses were also affected by whether or not a weighting (by sample size) was applied. Our analysis was severely limited by the completeness of reporting and the differences between the index tests evaluated and the reference standards used to confirm diagnoses in the primary studies. Few tests were evaluated by sufficient studies to allow meaningful use of meta-analytic pooling and investigation of heterogeneity. This meant that further analysis to investigate heterogeneity could only be undertaken using a subset of studies, and that the findings are open to various interpretations. Conclusion: Further work is needed to investigate the influence of methodological quality on the results of diagnostic meta-analyses. Large data sets of well-reported primary studies are needed to address this question. Without significant improvements in the completeness of reporting of primary studies, progress in this area will be limited

An expanded database of Southern Hemisphere surface sediment dinoflagellate cyst assemblages and their oceanographic affinities

Dinoflagellate cyst assemblages present a valuable proxy to infer paleoceanographic conditions, yet factors influencing geographic distributions of species remain largely unknown, especially in the Southern Ocean. Strong lateral transport, sea-ice dynamics, and a sparse and uneven geographic distribution of surface sediment samples have limited the use of dinocyst assemblages as a quantitative proxy for paleo-environmental conditions such as sea surface temperature (SST), nutrient concentrations, salinity, and sea ice (presence). In this study we present a new set of surface sediment samples (n=66) from around Antarctica, doubling the number of Antarctic-proximal samples to 100 (dataset wsi_100) and increasing the total number of Southern Hemisphere samples to 655 (dataset sh_655). Additionally, we use modelled ocean conditions and apply Lagrangian techniques to all Southern Hemisphere sample stations to quantify and evaluate the influence of lateral transport on the sinking trajectory of microplankton and, with that, to the inferred ocean conditions. k-means cluster analysis on the wsi_100 dataset demonstrates the strong affinity of Selenopemphix antarctica with sea-ice presence and of Islandinium spp. with low-salinity conditions. For the entire Southern Hemisphere, the k-means cluster analysis identifies nine clusters with a characteristic assemblage. In most clusters a single dinocyst species dominates the assemblage. These clusters correspond to well-defined oceanic conditions in specific Southern Ocean zones or along the ocean fronts. We find that, when lateral transport is predominantly zonal, the environmental parameters inferred from the sea floor assemblages mostly correspond to those of the overlying ocean surface. In this case, the transport factor can thus be neglected and will not represent a bias in the reconstructions. Yet, for some individual sites, e.g. deep-water sites or sites under strong-current regimes, lateral transport can play a large role. The results of our study further constrain environmental conditions represented by dinocyst assemblages and the location of Southern Ocean frontal systems.</p

The Holocene Black Sea reconnection to the Mediterranean Sea: New insights from the northeastern Caucasian shelf

Recent findings about the evolution of palaeogeographic conditions of the Black Sea during the Holocene have significantly improved our understanding of the profound environmental changes that took place around 9 ka ago, when the Neoeuxinian Lake reconnected to the global ocean. In contrast to the western and southeastern regions where numerous studies have been recently performed, the northeast region remains relatively under investigated. We carried out the first multi-proxy continuous study of a sediment core (Ak-2575) from the northeastern Black Sea shelf that includes benthic calcareous fossils (ostracods, molluscs and foraminifers), dinoflagellate cysts (dinocysts) and sedimentology, thus providing reconstructions of surface and bottom-water conditions. The age model of the core is based on 10 AMS-14C dates. Calibrated ages are used throughout the manuscript. The first appearance of Mediterranean elements is documented at 9.6 cal. ka BP. Our data provide evidence of sustained cohabitation of benthic species of Caspian and Mediterranean origins, represented by different ontogenetic stages, from at least ~ 7.8 (or even 8.8) to 6.7 cal. ka BP with the gradual disappearance of brackish species suggesting a gradual increase in salinity and most likely a change in the salt composition. Dinocyst assemblages show species succession that is coherent across the Black Sea basin, with brackish taxa dominating until ~ 8.5 cal. ka BP and being slowly replaced by euryhaline species. The occurrences of authigenic gypsum crystals, especially abundant at ~ 7.4 and 6.5 cal. ka BP, suggest the temporal appearance of hydrogen sulphide at the shelf edge which during certain periods appears to reduce the abundance of benthic fauna

The Cyst-Theca Relationship Of The Dinoflagellate Cyst Trinovantedinium Pallidifulvum, With Erection Of Protoperidinium Lousianensis Sp Nov And Their Phylogenetic Position Within The Conica Group

We establish the cyst-theca relationship of the dinoflagellate cyst species Trinovantedinium pallidifulvum Matsuoka 1987 based on germination experiments of specimens isolated from the Gulf of Mexico. We show that the motile stage is a new species, designated as Protoperidinium louisianensis. We also determine its phylogenetic position based on single-cell polymerase chain reaction (PCR) of a single cell germinated from the Gulf of Mexico cysts. To further refine the phylogeny, we determined the large subunit (LSU) sequence through single-cell PCR of the cyst Selenopemphix undulata isolated from Brentwood Bay (Saanich Inlet, BC, Canada). The phylogeny shows that P. louisianensis is closest to P. shanghaiense, the motile stage of T. applanatum, and is consistent with the monophyly of the genus Trinovantedinium. Selenopemphix undulata belongs to a different clade than Selenopemphix quanta (alleged cyst of P. conicum), suggesting that the genus Selenopemphix is polyphyletic. Trinovantedinium pallidifulvum is widely distributed with occurrences in the Gulf of Mexico, the North Atlantic, the northeast Pacific and southeast Asia. In addition, we illustrate the two other extant species, Trinovantedinium applanatum and Trinovantedinium variabile, and two morphotypes of Trinovantedinium. Geochemical analyses of the cyst wall of T. pallidifulvum indicate the presence of amide groups in agreement with other heterotrophic dinoflagellate species, although the cyst wall of T. pallidifulvum also includes some unique features