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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]

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]

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]

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]