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Three dinuclear complexes of composition [NiII2(L)2][ClO4]2 and [CuII2(L)2(OClO3)2].3H2O have been synthesized using a new tripodal ligand [(2-pyridyl)methyl](2-benzyl)-aminomethyl}-phenol (HL)], in its deprotonated form, providing a N2O donor set. Crystallographic analyses reveal that [CuII2(L)2(OClO3)2].3H2O has a diphenoxo-bridged structure. In [CuII2(L)2(OClO3)2].3H2O, each metal center is MIIN2O3-coordinated with a square-pyramidal environment for each copper(II) center. In this work, the molecular structure, harmonic vibrational frequencies and UV-Vis of [NiII2(L)2]2+ and [CuII2(L)2]2+ has been explored. With the help of density functional theory (DFT)/B3LYP techniques and LANL2DZ as a basis set, the ground-state molecule shape and vibrational frequencies were computed. The basic vibrations were allocated using the VEDA program to compute the potential energy distribution (PED) of the vibrational modes. The band gap energies of the title complexes ([NiII2(L)2]2+ and [CuII2(L)2]2+) are 3.21 eV and 1.59 eV, respectively, according to HOMO-LUMO energies. The maximal absorption wavelength and band gap energy of the title complexes were calculated theoretically using the UV absorption spectra. MEP analysis identifies electrophilic and nucleophilic sites. Hirshfeld surface analysis was used to characterize the 3D intermolecular interactions in ([NiII2(L)2]2+ and [CuII2(L)2]2+) of the crystal surface, whereas fingerprint plots were used to explain the 2D interactions. The biological activity of the complexes was investigated using molecular docking. [ABSTRACT FROM AUTHOR]

Nursery cultivation is recognized globally as an intensive production system to support quality seedlings as well as to manage resources efficiently. Apart from other factors, potting media (PM) play a crucial role in determining the success of nursery cultivation. Worldwide, peat is the most commonly used substrate in PM because of its favorable physicochemical properties. However, due to ascending environmental and ecological concerns regarding the use of peat, a variety of new substrates have been used/tested by researchers/practitioners/growers as PM. Bark, coir pith, wood fiber, compost derived from various agro-residues, and vermicompost either alone or in combination are some of the commonly explored substrates and found to have the potential to replace peat to a greater extent. In lieu of availability, abundance, low cost, and no/low processing requirement, the use of agro-industrial residue (AIR) in the PM is the current trend. However, challenges associated with their adoption cannot be ignored. The present review is focused on providing collective information, scientific knowledge and detailed analysis of various AIR used in PM. The critical evidence-based review would help in developing a consistent approach for the identification, selection and characterization of a new renewable substrate. In addition, it would help in developing a rationale understanding of the practical and economic realities involved in the adoption of the same in PM. [ABSTRACT FROM AUTHOR]

Using protonated forms of tridentate phenol amine ligand 2-((benzyl(pyridine-2-ylmethyl)amino)methyl)phenol (HL) mononuclear copper(II) complex was synthesized. This ligand yielded mononuclear complex of composition [Cu(HL)Cl2] (1) which has been characterized by X-ray crystallography, UV–vis, and EPR measurements. Complex 1 shows axial spectra typical of d9 (dx2-y2 as ground state) configuration. Using DFT/B3LYP/LANL2DZ and 6-311++G(d,p) level of theory, structural optimization, electronic and vibrational characteristics of the ligand and complex were examined. The experimental and theoretical parameters are quite well aligned. The assignments of the vibrational frequencies were performed by potential energy distribution analysis by using VEDA program. Molecular electrostatic potential and frontier molecular orbitals analysis have been carried out to understand the molecule reactivity. A TD-DFT computation is also started to replicate the UV–vis absorption spectrum and to determine various essential electronic parameters such as the HOMO–LUMO gap energy and electronic transitions. [ABSTRACT FROM AUTHOR]

Introduction: Glucose 6-phosphate dehydrogenase (G6PD) deficiency increases the risk of severe neonatal hyperbilirubinemia. This study evaluates the risk factors predicting the need for phototherapy in G6PD-deficient neonates after 72 h of age and assesses the safety of early discharge. Methods: A retrospective cohort study of 681 full-term G6PD-deficient infants with a birth weight ≥2,500 g over 4 years was conducted. We compared the baseline characteristics, bilirubin level on day 4 (after 72 h of life), day of peak bilirubin, G6PD levels, and concomitant ABO incompatibility between the group that required phototherapy (Group A) and those who did not (Group B). Results: 396 infants (58%), predominantly males, required phototherapy in the first week of life. The infants who required phototherapy had a lower median gestational age (38.3 vs. 38.7 weeks, p < 0.01) and had lower G6PD levels (2.3 ± 2.5 vs. 3 ± 3.4 IU, p < 0.05) compared to the controls. The mean day-four total serum bilirubin (TSB) levels were higher (213 ± 32 vs. 151 ± 37 µmol/L, p < 0.01), with bilirubin level peaking earlier (3 vs. 4 days of life, p < 0.01) in group A. Regression analysis identified TSB levels on day 4, Chinese race, lower gestation, and concomitant ABO incompatibility as the significant predictors for the need for phototherapy in the study population. In particular, coexisting ABO blood group incompatibility increased the risk of jaundice requiring phototherapy (OR 4.27, 95% CI: 1.98–121, p < 0.01). Day four TSB values above 180 µmol/L predicted the need for phototherapy with 86% sensitivity and 80% specificity. The findings were similar across both male and female infants with G6PD deficiency. Conclusion: G6PD-deficient infants with day four TSB levels of >180 µmol/L (10.5 mg/dL) and associated ABO blood group incompatibility have a higher risk of requiring phototherapy in the first week of life and should be closely monitored. [ABSTRACT FROM AUTHOR]

Objective  The aim of this study is to compare neonatal mortality and morbidity in multiple and singleton preterm/very low birthweight (PT/VLBW) multiethnic Asian infants. Study Design  Cohort study of 676 singleton and 299 multiple PT/VLBW infants born between 2008 and 2012 at KK Women's and Children's Hospital, the largest tertiary perinatal center in Singapore with further stratification by gestational ages 23 to 25 (Group 1), 26 to 28 (Group 2), and ≥29 (Group 3) weeks. Outcome measures included predischarge mortality and major neonatal morbidity. Results  Overall survival to discharge was comparable for singletons 611/676 (90%) and multiples 273/299 (91%). Use of assisted reproductive technologies (47 vs. 4%), antenatal steroids (80 vs. 68%), and delivery by cesarean section (84 vs. 62%) were significantly higher (p  < 0.001) in multiples while pregnancy induced hypertension (8.7 vs. 31.6%, p  < 0.001) and maternal chorioamnionitis (31 vs. 41%, p  < 0.01) were seen less commonly compared with singleton pregnancies. Survival was comparable between singletons and multiples except for a lower survival in multiples in Group 2 (81.7 vs. 92.4%, p  = 0.007). Major neonatal morbidities were comparable for multiples and singletons in the overall cohort. Presence of hemodynamically significant patent ductus arteriosus (HsPDA) requiring treatment (88.9 vs. 72.5%), air leaks (33 vs. 14.6%, p  = 0.02), NEC (30 vs. 14.6%, p  = 0.04), and composite morbidity (86 vs. 66%, p  = 0.031) were significantly higher in multiples in Group 1. A significantly higher incidence of HsPDA (68.1 vs. 52.4%, p  = 0.008) was also observed in multiples in Group 2. Multiple pregnancy was not an independent predictor of an adverse outcome on regression analysis (OR: 0.685, 95% confidence interval: 0.629–2.02) even in GA ≤25 weeks. Conclusion  Neonatal mortality and morbidity were comparable in our cohort of PT/VLBW singletons and multiple births, but preterm multiple births ≤25 weeks had a higher incidence of neonatal morbidity. Key Points Use of assisted reproductive technologies was significantly higher in multiples as compared to singletons. Major neonatal morbidities and mortality were similar between singletons and multiples in our cohort. In gestations less than 25 weeks multiples had higher neonatal morbidities than their singleton counterparts. [ABSTRACT FROM AUTHOR]

Using the deprotonated forms of the tetradentate phenol amine ligands 2-((((1-methylbenzimidazol-2-yl)methyl)(pyridin-2-ylmethyl)amino)methyl)phenol (HL1) and 2-(((pyridin-2-ylmethyl)(quinolin-2-ylmethyl)amino)methyl)phenol (HL2), dinuclear copper(II) complexes were synthesized. These ligands yielded two binuclear complexes with the composition [Cu2(Ln)2](ClO4)2 [n = 1, (1) and n = 2, (2)] and two mononuclear complexes with the compositions [Cu(HL1)(CH3CN)](ClO4)2 (3) and [Cu(HL2) (CH3CN)(OClO3)](ClO4) (4), which have been characterized using X-ray crystallography, UV-Vis, and magnetic susceptibility measurements. The magnetic susceptibility studies of 1 and 2 indicate moderate antiferromagnetic coupling between the CuII ions through the μ-phenoxo bridges [J = −38(2) and −145(1) cm−1, respectively], which is described by the Bleaney–Bowers dinuclear model. In contrast, 3 and 4 are devoid of any significant magnetic interactions between the mononuclear units. 3 and 4 show axial spectra typical of the d9 (dx2–y2 as the ground state) configuration. The dimer complexes 1 and 2 can be converted into the corresponding monomeric Cu(II) complexes 3 and 4via adding two equivalents of an acid, such as perchloric acid (HClO4), to a CH3CN solution of the dimer. The dimeric core can be regenerated via adding an equivalent of a base, such as triethylamine (Et3N). Time-dependent density functional theory (TD-DFT) calculations using the M06 functional were performed in order to rationalize the electronic structures of the complexes and to shed light on the origin of the observed electronic transitions. Additionally, DFT/B3LYP calculations helped us to unambiguously state the sign and magnitude of the magnetic coupling constants along with an approximation of the spin density distribution. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to evaluate the efficacy of the developmental paediatrics teaching programme for undergraduate medical students posted to the Department of Child Development (DCD), in a tertiary children's hospital in Singapore. Methods: Efficacy of the teaching program was evaluated objectively using multiple-choice questions (MCQs) and subjectively using a self-assessment evaluation form developed in-house. Feedback was obtained from the students and tutors at the end of the posting. Results: 36 students participated in this evaluation. There was a significant positive difference in the pre and end of posting MCQ scores (p < 0.001). The difference in the student's self-assessment of their knowledge and skills of child development before and at the end of their DCD posting was similarly positively significant (p < 0.001). Feedback from the students using a series of open-ended questions indicated that they had a very positive learning experience and this included learning beyond their stated learning objectives. Feedback from the tutors was reflective of some of the challenges they faced while teaching. Conclusion: The integrated approach to teaching developmental paediatrics that includes didactic, reflective, interactive and problem-based learning results in a highly positive learning experience and enhances both the knowledge and skills in child development. This enables delivery of a holistic curriculum that goes beyond teaching mainly routine developmental assessment. [ABSTRACT FROM AUTHOR]

Developmental delays are common in childhood, occurring in 10%-15% of preschool children. Global developmental delays are less common, occurring in 1%-3% of preschool children. Developmental delays are identified during routine checks by the primary care physician or when the parent or preschool raises concerns. Assessment for developmental delay in primary care settings should include a general and systemic examination, including plotting growth centiles, hearing and vision assessment, baseline blood tests if deemed necessary, referral to a developmental paediatrician, and counselling the parents. It is important to follow up with the parents at the earliest opportunity to ensure that the referral has been activated. For children with mild developmental delays, in the absence of any red flags for development and no abnormal findings on clinical examination, advice on appropriate stimulation activities can be provided and a review conducted in three months' time. [ABSTRACT FROM AUTHOR]

Child development refers to the continuous but predictably sequential biological, psychological and emotional changes that occur in human beings between birth and the end of adolescence. Developmental surveillance should be incorporated into every child visit. Parents play an important role in the child's developmental assessment. The primary care physician should educate and encourage parents to use the developmental checklist in the health booklet to monitor their child's development. Further evaluation is necessary when developmental delay is identified. This article aimed to highlight the normal child developmental assessment as well as to provide suggestions for screening tools and questions to be used within the primary care setting. [ABSTRACT FROM AUTHOR]

East Tennessee and Middle Appalachia is the epicenter of the prescription drug epidemic, with approximately 15% of women giving birth at our institution documented as suffering from drug addiction. Objective: The objective of this study was to describe our sample of women giving birth to infants who were drug exposed and experienced Neonatal Abstinence Syndrome (NAS) and to determine the maternal and neonatal factors associated with the severity of NAS as measured by the length of stay (LOS) in the Neonatal Intensive Care Unit (NICU). Methodology: This was a retrospective chart review of 73 infants diagnosed with NAS and treated in the NICU. We conducted bivariate analyses and multivariate modeling (least squares regression with backward elimination) of the significant variables (p < .10) against the infant's LOS. Results: The mean LOS for infants with NAS was 17.7 days (sd = 11.6); 75.3% received nonpharmacological and 86.3% received pharmacologic (morphine) treatment. Of 73 women, 53.4% had a history of mental illness; 53.4% smoked >5 cigarettes per day in last trimester; 89% were taking buprenorphine, 9.6% had cord tissue positive for benzodiazepine. Term infants had 2.3 day longer LOS on average (p = 0.027) compared to preterm infants; infants exposed to benzodiazepines had 12.7 day longer LOS on average (p = 0.07) and prenatal exposure to >5 cigarettes per day in last trimester increased the hospital stay by 6.4 days (p = 0.022). Conclusion: We found that exposure to benzodiazepines and cigarette smoking were associated with an increased LOS. [ABSTRACT FROM AUTHOR]

East Tennessee and Middle Appalachia is the epicenter of the prescription drug epidemic, with approximately 15% of women giving birth at our institution documented as suffering from drug addiction. Objective: The objective of this study was to describe our sample of women giving birth to infants who were drug exposed and experienced Neonatal Abstinence Syndrome (NAS) and to determine the maternal and neonatal factors associated with the severity of NAS as measured by the length of stay (LOS) in the Neonatal Intensive Care Unit (NICU). Methodology: This was a retrospective chart review of 73 infants diagnosed with NAS and treated in the NICU. We conducted bivariate analyses and multivariate modeling (least squares regression with backward elimination) of the significant variables (p < .10) against the infant's LOS. Results: The mean LOS for infants with NAS was 17.7 days (sd = 11.6); 75.3% received nonpharmacological and 86.3% received pharmacologic (morphine) treatment. Of 73 women, 53.4% had a history of mental illness; 53.4% smoked >5 cigarettes per day in last trimester; 89% were taking buprenorphine, 9.6% had cord tissue positive for benzodiazepine. Term infants had 2.3 day longer LOS on average (p = 0.027) compared to preterm infants; infants exposed to benzodiazepines had 12.7 day longer LOS on average (p = 0.07) and prenatal exposure to >5 cigarettes per day in last trimester increased the hospital stay by 6.4 days (p = 0.022). Conclusion: We found that exposure to benzodiazepines and cigarette smoking were associated with an increased LOS. [ABSTRACT FROM AUTHOR]

Aim: To describe nutritional practices among preterm extremely low-birthweight (ELBW) infants and their impact on growth and to compare differences in nutritional intervention and comorbidities between those with limited growth velocity (GV < 25th percentile) and those with GV > 25th percentile.Methods: A prospective cohort study was conducted to assess total protein and energy intake for week 1, days 14, 21 and 28 of life. Post-natal growth was calculated by measuring GV using an exponential model. Univariable analysis was applied to identify the potential risk factors associated with poor GV at day 28 and at discharge from hospital.Results: The median GV from birth to day 28 was 9.84 g/kg/day and 11.87 g/kg/day for GV from birth to discharge. Increased protein and energy intake was associated with higher GV at discharge. Hypotension needing inotropes, necrotising enterocolitis (NEC), patent ductus arteriosus and chronic lung disease were significantly associated with reduced GV at discharge. Infants with NEC, hypotension needing inotropes and sepsis took a significantly longer time to achieve full enteral nutrition. A longer time to attain full enteral feeds was associated with slower GV at discharge. Small-for-gestational-age babies increased from 22% at birth to 66.6% at discharge.Conclusions: GV at discharge was positively correlated with increasing protein and energy intake in the first 28 days and adversely affected by the presence of neonatal morbidities. There was strong evidence of extra-uterine growth restriction, with the majority of preterm ELBW infants having lower z scores at discharge compared to at birth. [ABSTRACT FROM AUTHOR]

Objective: To study effectiveness of quality improvement interventions in reducing hypothermia in preterm infants on admission to neonatal intensive care unit.Design: Quality improvement methodologies including multidisciplinary planning and implementation of evidence-based interventions. Data during and post-implementation were collected.Setting and Participants: In total, 84 preterm infants with birth weights ≤ 1500 g delivered during implementation period (October 2008-April 2009) were compared with 168 historical controls and 947 infants in the subsequent 4 years.Intervention(s): In addition to routine interventions, delivery room temperatures were increased, and use of full-body polyethylene wraps and woollen caps were implemented during initial stabilization. Education and training were provided to reinforce the new interventions.Main Outcome Measure(s): Primary outcome was incidence of hypothermia and mean admission temperature. Secondary outcomes were rates of intraventricular haemorrhage and mortality.Results: Incidence of admission hypothermia decreased from 79.4 to 40.5% (P < 0.001), constituting a 49% improvement (OR = 0.177, 95% CI: 0.099-0.316). Mean admission temperature increased from 35.8 ± 0.8°C to 36.5 ± 0.7°C (P < 0.001). Hyperthermia incidence was higher at 6% compared to baseline of 1.3% (P = 0.049). The incidence of admission hypothermia remained stable at 47.4% in the 4 years post-implementation. Rates of intraventricular haemorrhage and mortality remained unchanged. Small for gestation, low 5-min Apgar score and singleton delivery were factors found to be associated with admission hypothermia.Conclusion: The implementation of evidence-based best practices resulted in significant reduction in admission hypothermia in preterm infants, which persisted for 4 years post-implementation. The practices have since become standard of care in our institution. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the predictive and concurrent diagnostic agreement of the Ages and Stages Questionnaire 3rd Edition (ASQ-3) with the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) in infants born preterm and very-low-birthweight (PT/VLBW; ≤1250g).Method: We evaluated 141 PT/VLBW infants (68 males, 73 females) born at the KK Women's and Children's Hospital between January 2010 and December 2011, to determine predictive and concurrent diagnostic agreement between the ASQ-3 at 9, 12, 18, and 24 months corrected age and Bayley-III at 24 months. Cut-offs on the ASQ-3 at 24 months were estimated by receiver operating characteristic curves.Results: Sixty (43%) and 25 (18%) failed in any domain of the ASQ-3 and Bayley-III (<70) respectively. A negative predictive value (NPV) >98% was achieved for the motor domain from 9 months, and >90% for the communication domain and the overall results at 24 months. Optimal referral ASQ-3 score at 24 months to achieve 100% NPV was 243.Interpretation: In PT/VLBW infants, ASQ-3 screening at 24 months can reduce the need for costly psychometric assessments in children with normal results. Clinicians can be assured of normal motor development at 9 months using the ASQ-3, but should continue to screen children on other domains. [ABSTRACT FROM AUTHOR]

Background: The aim was to evaluate the ability of customized and cohort birthweight standards in discriminating intrauterine growth retardation (IUGR).Methods: Birthweights (BWs) of GUSTO singleton infants born at gestational age (GA) 35-41 weeks were converted using two standards: (a) GUSTO cohort-based BW centile adjusted for GA and baby gender; (b) customized BW percentile calculator adjusted for maternal height and weight, race, parity, GA and gender. Infants were classified into three groups: (1) < 10th BW centile by customization- customized-SGA, (2) < 10th BW centile by GUSTO- GUSTO-SGA; and (3) > 10th BW centile by both standards - BOTH-non-SGA.Results: Of the 1011 infant-mother dyads, 68 were customized-SGA and 104 were GUSTO-SGA, with concordance of 61% (n = 63) for SGA. While 5 (7%) of customized-SGA were not SGA by GUSTO-charts, 41 (39%) of GUSTO-SGA were not SGA by customized-charts. Customized-SGA had significantly the least growth in abdominal circumference (AC) and highest head circumference (HC): AC growth ratio between second and third trimester; and the lowest mean BW, ponderal index and placental weight than other groups.Conclusion: Customized-SGA standard was a better discriminator of pathologic fetal growth based on AC growth. It improved strength of association with pathology and in our population reduced false positives (41/104 = 39%) in the assessment of SGA. [ABSTRACT FROM AUTHOR]

Background: A susceptibility to metabolic diseases is associated with abdominal adipose tissue distribution and varies between ethnic groups. The distribution of abdominal adipose tissue at birth may give insights into whether ethnicity-associated variations in metabolic risk originate partly in utero. Objective: We assessed the influence of ethnicity on abdominal adipose tissue compartments in Asian neonates in the Growing Up in Singapore Toward Healthy Outcomes mother-offspring cohort. Design: MRI was performed at ≤2 wk after birth in 333 neonates born at ≥34 wk of gestation and with birth weights ≥2000 g. Abdominal superficial subcutaneous tissue (sSAT), deep subcutaneous tissue (dSAT), and internal adipose tissue (IAT) compartment volumes (absolute and as a percentage of the total abdominal volume) were quantified. Results: In multivariate analyses that were controlled for sex, age, and parity, the absolute and percentage of dSATand the percentage of sSAT (but not absolute sSAT) were greater, whereas absolute IAT (but not the percentage of IAT) was lower, in Indian neonates than in Chinese neonates. Compared with Chinese neonates, Malay neonates had greater percentages of sSAT and dSAT but similar percentages of IAT. Marginal structural model analyses largely confirmed the results on the basis of volume percentages with controlled direct effects of ethnicity on abdominal adipose tissue; dSAT was significantly greater (1.45 mL; 95% CI: 0.49, 2.41 mL, P = 0.003) in non-Chinese (Indian or Malay) neonates than in Chinese neonates. However, ethnic differences in sSAT and IAT were NS [3.06 mL (95% CI:–0.27, 6.39 mL; P = 0.0712) for sSAT and –1.30 mL (95% CI: –2.64, 0.04 mL; P = 0.057) for IAT in non-Chinese compared with Chinese neonates, respectively]. Conclusions: Indian and Malay neonates have a greater dSAT volume than do Chinese neonates. This finding supports the notion that in utero influences may contribute to higher cardiometabolic risk observed in Indian and Malay persons in our population. If such differences persist in the longitudinal tracking of adipose tissue growth, these differences may contribute to the ethnic disparities in risks of cardiometabolic diseases. This trial was registered at clinicaltrials.gov as NCT01174875. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding has been shown to enhance global measures of intelligence in children. However, few studies have examined associations between breastfeeding and specific cognitive task performance in the first 2 y of life, particularly in an Asian population. Objective: We assessed associations between early infant feeding and detailed measures of cognitive development in the first 2 y of life in healthy Asian children born at term. Design: In a prospective cohort study, neurocognitive testing was performed in 408 healthy children (aged 6, 18, and 24 mo) from uncomplicated pregnancies (i.e., birth weight >2500 and <4000 g, gestational age ≥37 wk, and 5-min Apgar score ≥9). Tests included memory (deferred imitation, relational binding, habituation) and attention tasks (visual expectation, auditory oddball) as well as the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Children were stratified into 3 groups (low, intermediate, and high) on the basis of breastfeeding duration and exclusivity. Results: After potential confounding variables were controlled for, significant associations and dose-response relations were observed for 4 of the 15 tests. Higher breastfeeding exposure was associated with better memory at 6 mo, demonstrated by greater preferential looking toward correctly matched items during early portions of a relational memory task (i.e., relational binding task: P-trend = 0.015 and 0.050 for the first two 1000-ms time bins, respectively). No effects of breastfeeding were observed at 18 mo. At 24 mo, breastfed children were more likely to display sequential memory during a deferred imitation memory task (P-trend = 0.048), and toddlers with more exposure to breastfeeding scored higher in receptive language [+0.93 (0.23, 1.63) and +1.08 (0.10, 2.07) for intermediate- and high-breastfeeding groups, respectively, compared with the low-breastfeeding group], as well as expressive language [+0.58 (-0.06, 1.23) and +1.22 (0.32, 2.12) for intermediate- and high-breastfeeding groups, respectively] assessed via the BSID-III. Conclusions: Our findings suggest small but significant benefits of breastfeeding for some aspects of memory and language development in the first 2 y of life, with significant improvements in only 4 of 15 indicators. Whether the implicated processes confer developmental advantages is unknown and represents an important area for future research. This trial was registered at www.clinicaltrials.gov as NCT01174875. [ABSTRACT FROM AUTHOR]

Comparisons of cognitive processing in monolinguals and bilinguals have revealed a bilingual advantage in inhibitory control. Recent studies have demonstrated advantages associated with exposure to two languages in infancy. However, the domain specificity and scope of the infant bilingual advantage in infancy remains unclear. In the present study, 114 monolingual and bilingual infants were compared in a very basic task of information processing-visual habituation-at 6 months of age. Bilingual infants demonstrated greater efficiency in stimulus encoding as well as in improved recognition memory for familiar stimuli as compared to monolinguals. Findings reveal a generalized cognitive advantage in bilingual infants that is broad in scope, early to emerge, and not specific to language. [ABSTRACT FROM AUTHOR]

The world population is becoming older now. The boom of the elderly population comes from public health efforts to improve living conditions and prevent disease, and from improved medical interventions. People more than 65-year-old who are representing 12.9% of the population now is expected to grow to be 19% of the population by 2030. Very few numbers of diseases will have such socioeconomic burden on society in the newer world. Although Alzheimer's disease (AD) has been studied very well recently, still its exact etiopathogenesis is unknown. Currently there are no available tests for the definitive diagnosis of AD. So the clinical diagnosis of AD remains a diagnosis of exclusion. This limits the potential for early intervention. The difference between normal degenerative processes of brain and preclinical changes of AD is a gray zone and there is no particular way to distinguish between the two. Now several modalities like functional magnetic resonance imaging (fMRI), positron emission tomography (PET) scan, electrophysiological tests and cerebrospinal fluid (CSF) biomarkers for tauopathy and Ab have shown to be promising in the development of early diagnostic tools for neurodegenerative changes and help us to differentiate between healthy aging and pathological aging. In this article we tried to discuss about the differences between pathological and physiological aging process from radiological, pathological, biochemical, and electrophysiological point of view. However, differentiating between physiological and pathological dementia still remains a challenge. [ABSTRACT FROM AUTHOR]

Objective Primary outcome was to compare neurodevelopmental outcome at two years in intracytoplasmic sperm injection (ICSI) conceived children versus matched controls. Secondary outcome was to determine incidence of major congenital malformations and study perinatal outcome. Design Prospective cohort study. Setting Tertiary care perinatal centre over a period of 13 months. Population Seventy-six ICSI conceived children and 261 matched controls selected by matching for maternal age, sex, date of delivery, race, plurality and parity. Methods Mental Development Index (MDI) and Psychometric Development Index (PDI) of the Bayley's Scale of Development (BSID-II) and Vineland Adaptive Behaviour Scale (VABS) were used to assess the neurodevelopmental and functional outcome. The congenital malformations were classified according to ICD-9 code. Main outcome measures Primary outcome measure—neurodevelopmental and functional outcomes. Secondary outcome measure—congenital malformations and perinatal outcomes. Results Neurodevelopmental and functional outcome were comparable in both groups. The mean MDI score was 92 [16] versus 90 [14] in the study and control groups respectively. Fourteen (18.4%) in the ICSI group had MDI <85 compared with 87 (33%) controls ( P= 0.002). On linear regression the MDI was independently affected by plurality ( P= 0.001), maternal education and socio-economic status ( P= 0.01). The study group had a lower gestation (36 [3] vs 37.1 [2] weeks; P= 0.005) and a higher incidence of prematurity <34 weeks [19 (25%)] vs [31 (12%)] P= 0.012]. Six (7.9%) of the ICSI babies and seven (2.7%) of the controls had a major congenital malformation ( P= 0.05). Conclusions Children born by ICSI pregnancies did not have an adverse neurodevelopmental outcome. The incidence of major congenital malformations in ICSI needs further evaluation. [ABSTRACT FROM AUTHOR]

Acute lingual swelling is a potentially life threatening clinical condition which is encountered very rarely, the differential diagnosis of which includes hemorrhage, infarction, abscess, tumor and edema. Herein we report a case of lingual abscess that presented with acute tongue swelling and respiratory distress after extraction of lower two incisor teeth. [ABSTRACT FROM AUTHOR]