Texture Consumption Patterns of 8- to 12-Month-Old Infants: A Reflection of Typical Feeding Development.

Purpose The lack of age-appropriate expectations for the acquisition of feeding skills and consumption of textured food in early childhood inhibits early and accurate identification of developmental delay in feeding and pediatric feeding disorder. The objective of this study was to describe texture intake patterns in a cohort of typically developing infants between 8 and 12 months of age, with the aim of informing future research to establish targets for feeding skill acquisition. Method Using cross-sectional methodology, we studied the presence of liquid and solid textures and drinking methods in the diet, consumption patterns by texture and drinking methods, and caloric intake by texture via caregiver questionnaire and 3-day dietary intake record in 63 healthy infants between 8 and 12 months of age. Descriptive statistics and a one-way analysis of variance were conducted to compare the effect of age on texture intake patterns. Results Findings reveal rapid advancement of intake patterns for texture overall and for energy intake by texture between 8 and 12 months of age. Whereas liquids continue to provide a large proportion of total energy through this time, solids contribute an equal proportion of energy by 12 months of age. Conclusions This study describes texture intake patterns in a cohort of typically developing infants between 8 and 12 months of age by examining the presence of texture and drinking methods, liquid and solid consumption patterns, and energy intake by texture. When applied to data from a future population sample, findings will provide a threshold for age expectations for typical and disordered feeding development to aid in the detection of developmental delay in feeding and pediatric feeding disorder. What Is Known: Expectations regarding early feeding development have been focused on nutrition parameters. Lack of standardized, age-appropriate expectations for texture progression in infancy and early childhood inhibits early and accurate identification and treatment of pediatric feeding disorder. What Is New: We have described changes in dietary composition by texture and drinking method in healthy infants. Together with nutritional composition, this study describes a more comprehensive assessment of infant feeding, particularly to clinicians who need to diagnose feeding skill deficits. Supplemental Material https://doi.org/10.23641/asha.16879615.

Prevalence of molar-incisor hypomineralization in Milwaukee, Wisconsin, USA: a pilot study.

Purpose: This pilot study investigated the prevalence of Molar-Incisor Hypomineralization (MIH) in third-grade school children in Milwaukee Wisconsin, USA. Methods: A convenience sample of third-grade school children in the Milwaukee Public School System (MPS) participated in the study. Calibrated examiners trained on the European Academy of Paediatric Dentistry (EAPD) MIH recommendations examined the children between December 1, 2014 and June 30, 2015. Children were examined at their schools using a flashlight and mirror after receiving consent from parents/caregivers and assent from each child. Findings were recorded onto a standardized form by one of five trained examiners. Summary statistics were calculated, and bivariate analysis were done to identify factors associated with MIH. Results: A total of 375 children (average age =8.66 years, range 7-12) were examined, 60% females and 41% Hispanics. Overall, 36 (9.6%) of the children demonstrated findings consistent with the diagnosis of MIH. Among the teeth with MIH defects, severe defects were higher in lower molars. There were no statistically significant differences between those with and without MIH by sex, race/ethnicity, and socioeconomic status in this study. Conclusion: The study revealed that 9.6% of the children examined were affected by MIH. Future studies should focus on statewide and/or nationwide surveys in the United States to ascertain the extent and severity of the condition.

Interproximal distance analysis of stereolithographic casts made by CAD-CAM technology: An in vitro study.

STATEMENT OF PROBLEM: The accuracy of interproximal distances of the definitive casts made by computer-aided design and computer-aided manufacturing (CAD-CAM) technology is not yet known. PURPOSE: The purpose of this in vitro study was to compare the interproximal distances of stereolithographic casts made by CAD-CAM technology with those of stone casts made by the conventional method. MATERIAL AND METHODS: Dentoform teeth were prepared for a single ceramic crown on the maxillary left central incisor, a 3-unit fixed dental prosthesis (FDP) on the second premolar for a metal-ceramic crown, and a maxillary right first molar for a metal crown. Twenty digital intraoral impressions were made on the dentoform with an intraoral digital impression scanner. The digital impression files were used to fabricate 20 sets of stereolithographic casts, 10 definitive casts for the single ceramic crown, and 10 definitive casts for the FDP. Furthermore, 20 stone casts were made by the conventional method using polyvinyl siloxane impression material with a custom tray. Each definitive cast for stereolithographic cast and stone cast consisted of removable die-sectioned casts (DC) and nonsectioned solid casts (SC). Measurements of interproximal distance of each cast were made using CAD software to provide mean ±standard deviation (SD) values. Data were first analyzed by repeated measures analysis of variance (ANOVA), using different methods of cast fabrication (stone and stereolithography) as one within subject factor and different cast types (DC and SC) as another within subject factor. Post hoc analyses were performed to investigate the differences between stone and stereolithographic casts depending upon the results from the repeated measures ANOVA (α=.05). RESULTS: Analysis of interproximal distances showed the mean ±SD value of the single ceramic crown group was 31.2 ±24.5 µm for stone casts and 261.0 ±116.1 µm for stereolithographic casts, whereas the mean ±SD value for the FDP group was 46.0 ±35.0 µm for stone casts and 292.8 ±216.6 µm for stereolithographic casts. For both the single ceramic crown and the FDP groups, there were significant differences in interproximal distances between stereolithographic casts and stone casts (P<.001). In addition, the comparisons of DC with SC of stone and stereolithographic casts for the single ceramic crown and FDP groups demonstrated there was statistically significant differences among interproximal distances between DC stereolithographic casts and SC stereolithographic casts only for the FDP group (P<.001). CONCLUSIONS: For both the single ceramic crown and the FDP groups, the stereolithographic cast group showed significantly larger interproximal distances than the stone cast group. In terms of the comparison between DC and SC, DC stereolithographic casts for the FDP group only showed significantly larger interproximal values than those of the SC stereolithographic casts for the FDP group.

An Online Educational Program Improves Pediatric Oncology Nurses' Knowledge, Attitudes, and Spiritual Care Competence.

This study evaluated the potential impact of an online spiritual care educational program on pediatric nurses' attitudes toward and knowledge of spiritual care and their competence to provide spiritual care to children with cancer at the end of life. It was hypothesized that the intervention would increase nurses' positive attitudes toward and knowledge of spiritual care and increase nurses' level of perceived spiritual care competence. A positive correlation was expected between change in nurses' perceived attitudes toward and knowledge of spiritual care and change in nurses' perceived spiritual care competence. A prospective, longitudinal design was employed, and analyses included one-way repeated-measures analysis of variance, linear regression, and partial correlation. Statistically significant differences were found in nurses' attitudes toward and knowledge of spiritual care and nurses' perceived spiritual care competence. There was a positive relationship between change scores in nurses' attitudes toward and knowledge of spiritual care and nurses' spiritual care competence. Online spiritual care educational programs may exert a lasting impact on nurses' attitudes toward and knowledge of spiritual care and their competence to provide spiritual care to children with cancer at the end of life. Additional studies are required to evaluate the direct effects of educational interventions patient outcomes.

The Decay of Disease Association with Declining Linkage Disequilibrium: A Fine Mapping Theorem.

Several important and fundamental aspects of disease genetics models have yet to be described. One such property is the relationship of disease association statistics at a marker site closely linked to a disease causing site. A complete description of this two-locus system is of particular importance to experimental efforts to fine map association signals for complex diseases. Here, we present a simple relationship between disease association statistics and the decline of linkage disequilibrium from a causal site. Specifically, the ratio of Chi-square disease association statistics at a marker site and causal site is equivalent to the standard measure of pairwise linkage disequilibrium, r2. A complete derivation of this relationship from a general disease model is shown. Quite interestingly, this relationship holds across all modes of inheritance. Extensive Monte Carlo simulations using a disease genetics model applied to chromosomes subjected to a standard model of recombination are employed to better understand the variation around this fine mapping theorem due to sampling effects. We also use this relationship to provide a framework for estimating properties of a non-interrogated causal site using data at closely linked markers. Lastly, we apply this way of examining association data from high-density genotyping in a large, publicly-available data set investigating extreme BMI. We anticipate that understanding the patterns of disease association decay with declining linkage disequilibrium from a causal site will enable more powerful fine mapping methods and provide new avenues for identifying causal sites/genes from fine-mapping studies.

Accuracy and precision of occlusal contacts of stereolithographic casts mounted by digital interocclusal registrations.

STATEMENT OF PROBLEM: Little peer-reviewed information is available regarding the accuracy and precision of the occlusal contact reproduction of digitally mounted stereolithographic casts. PURPOSE: The purpose of this in vitro study was to evaluate the accuracy and precision of occlusal contacts among stereolithographic casts mounted by digital occlusal registrations. MATERIAL AND METHODS: Four complete anatomic dentoforms were arbitrarily mounted on a semi-adjustable articulator in maximal intercuspal position and served as the 4 different simulated patients (SP). A total of 60 digital impressions and digital interocclusal registrations were made with a digital intraoral scanner to fabricate 15 sets of mounted stereolithographic (SLA) definitive casts for each dentoform. After receiving a total of 60 SLA casts, polyvinyl siloxane (PVS) interocclusal records were made for each set. The occlusal contacts for each set of SLA casts were measured by recording the amount of light transmitted through the interocclusal records. To evaluate the accuracy between the SP and their respective SLA casts, the areas of actual contact (AC) and near contact (NC) were calculated. For precision analysis, the coefficient of variation (CoV) was used. The data was analyzed with t tests for accuracy and the McKay and Vangel test for precision (α=.05). RESULTS: The accuracy analysis showed a statistically significant difference between the SP and the SLA cast of each dentoform (P<.05). For the AC in all dentoforms, a significant increase was found in the areas of actual contact of SLA casts compared with the contacts present in the SP (P<.05). Conversely, for the NC in all dentoforms, a significant decrease was found in the occlusal contact areas of the SLA casts compared with the contacts in the SP (P<.05). The precision analysis demonstrated the different CoV values between AC (5.8 to 8.8%) and NC (21.4 to 44.6%) of digitally mounted SLA casts, indicating that the overall precision of the SLA cast was low. CONCLUSIONS: For the accuracy evaluation, statistically significant differences were found between the occlusal contacts of all digitally mounted SLA casts groups, with an increase in AC values and a decrease in NC values. For the precision assessment, the CoV values of the AC and NC showed the digitally articulated cast's inability to reproduce the uniform occlusal contacts.

Testing multiple hypotheses with skewed alternatives.

In many practical cases of multiple hypothesis problems, it can be expected that the alternatives are not symmetrically distributed. If it is known a priori that the distributions of the alternatives are skewed, we show that this information yields high power procedures as compared to the procedures based on symmetric alternatives when testing multiple hypotheses. We propose a Bayesian decision theoretic rule for multiple directional hypothesis testing, when the alternatives are distributed as skewed, under a constraint on a mixed directional false discovery rate. We compare the proposed rule with a frequentist's rule of Benjamini and Yekutieli (2005) using simulations. We apply our method to a well-studied HIV dataset.

A Bayesian methodology for detecting targeted genes under two related experiments.

Many gene expression data are based on two experiments where the gene expressions of the targeted genes under both experiments are correlated. We consider problems in which objectives are to find genes that are simultaneously upregulated/downregulated under both experiments. A Bayesian methodology is proposed based on directional multiple hypotheses testing. We propose a false discovery rate specific to the problem under consideration, and construct a Bayes rule satisfying a false discovery rate criterion. The proposed method is compared with a traditional rule through simulation studies. We apply our methodology to two real examples involving microRNAs; where in one example the targeted genes are simultaneously downregulated under both experiments, and in the other the targeted genes are downregulated in one experiment and upregulated in the other experiment. We also discuss how the proposed methodology can be extended to more than two experiments.

Specific antibodies to recombinant allergens of Aspergillus fumigatus in cystic fibrosis patients with ABPA.

BACKGROUND: Aspergillus fumigatus, a widely distributed fungus, has been implicated in causing life threatening infections as well as severe asthma and allergic diseases in man. Allergic affliction like allergic bronchopulmonary aspergillosis (ABPA) is a disabling lung disease frequently seen in patients with asthma and cystic fibrosis. Immunodiagnosis of the former is comparatively easier due to the availability of purified antigens and sensitive methods. However, this is not true with cystic fibrosis patients where the prevalence of ABPA is fairly high and the morbidity and mortality are significant. METHODS: In the present study, we have evaluated purified recombinant allergens from A. fumigatus, namely Asp f 1, f 2, f 3, f 4, and f 6 using ELISA and a semi-automated method (ImmunoCAP). We studied 17 patients each from cystic fibrosis with ABPA, and cystic fibrosis with asthma, 22 cystic fibrosis with no ABPA or asthma, and 11 age matched controls. RESULTS: The results indicate that no antigen, antibody or method is capable of differentiating cystic fibrosis (CF) with ABPA from other CF patients, although some allergens showed strong reaction or showed more prevalence among the patients studied. CONCLUSION: When results of several allergens such as Asp f 1, f 2, f 3, f 4, and f 6 in their binding to IgA, IgG, and IgE antibodies were analyzed, a more strong discrimination of CF patients with ABPA was possible from the other groups studied.

Specific IgE response to purified and recombinant allergens in latex allergy.

BACKGROUND: In recent years, allergy to natural rubber latex has emerged as a major allergy among certain occupational groups and patients with underlying diseases. The sensitization and development of latex allergy has been attributed to exposure to products containing residual latex proteins. Although improved manufacturing procedures resulted in a considerable reduction of new cases, the potential risk for some patient groups is still great. In addition the prevalent cross-reactivity of latex proteins with other food allergens poses a major concern. A number of purified allergens and a few commercial kits are currently available, but no concerted effort was undertaken to evaluate them. METHODS: We studied 11 purified latex allergens, Hev b 1 to Hev b 10, and Hev b 13 along with several crude allergen extracts and two commercial ImmunoCAP assays to evaluate specific IgE antibody in the sera from latex allergic patients and controls. Health care workers and spina bifida patients with clinical symptoms of latex allergy, spina bifida patients without latex allergy, and non-atopic health care workers have been studied. RESULTS: The results suggest that Hev b 2, 5, 6, and 13 together identified over 80 percent health care workers with latex allergy, while Hev b 6 along with Hev b 1 or 3 detected specific IgE antibody in all sera studied from patients with spina bifida and latex allergy. The ImmunoCAP results using both Hev b 5 amplified and non-amplified closely agreed with the clinical diagnosis of latex allergy in health care workers and in spina bifida. CONCLUSION: Although the purified allergens and crude extracts reacted diversely with IgE from different patient groups, the results indicated that use of certain combinations of purified recombinant antigens will be useful in commercial kits or in in-house assays for detecting specific IgE antibody in the sera. The results suggest that a combination of Hev b 2, 3, 5, 6, and 13 together detected specific IgE in 80% of the sera from latex allergic patients. Both ImmunoCAPs correctly identified over 95% of latex allergic patients, however, showed reactivity with a few normal control subjects.

Modulation of airway inflammation by immunostimulatory CpG oligodeoxynucleotides in a murine model of allergic aspergillosis.

Allergic aspergillosis is a Th2 T-lymphocyte-mediated pulmonary complication in patients with atopic asthma and cystic fibrosis. Therefore, any therapeutic strategy that selectively inhibits Th2 T-cell activation may be useful in downregulating allergic lung inflammation in asthma. In the present study, we developed a CpG oligodeoxynucleotide (ODN)-based immune intervention of allergic inflammation in a mouse model of allergic aspergillosis. Four different groups of mice were used in a short-term immunization protocol. Three experimental groups of animals (groups 1 to 3) were sensitized with Aspergillus fumigatus antigens. Animals in group 1 were immunized with A. fumigatus antigen alone, while those in group 2 were treated with CpG-ODN 1 day before the first antigen immunization, and the animals in group 3 received the first CpG-ODN administration between the antigen treatments. The animals in group 4 served as controls and were given phosphate-buffered saline. Allergen-specific serum immunoglobulins and total immunoglobulin E in different groups of animals were measured by enzyme-linked immunosorbent assay, while airway remodeling and cytokine production were studied by immunohistochemistry. The results demonstrated that CpG-ODN administration either before (group 2) or between (group 3) antigen treatments resulted in reduced total immunoglobulin E levels and peripheral blood eosinophil numbers compared to A. fumigatus allergen-sensitized group 1 animals. Similarly, treatment with CpG-ODN also downregulated inflammatory cell infiltration, goblet cell hyperplasia, and basement membrane thickening compared to A. fumigatus-sensitized mice. The distinct reduction in peripheral blood eosinophilia and airway remodeling in CpG-ODN-treated mice emphasized its usefulness as an immunomodulating agent for allergic fungal diseases.

Stage-based interventions for low-fat diet with middle school students.

Preventing obesity and cardiovascular disease at early ages is important; however, few effective interventions for early adolescents have been reported. In this study, low-income, culturally diverse students from an urban middle school (n = 60) received four classroom interventions with the use of a combined Health Promotion/Transtheoretical Model to control fat in diet and increase physical activity. A control group (n = 57) received the usual classroom education. Pretest percentage fat in diet was regressed on demographics, access to low-fat foods, perceived self-efficacy, benefits/barriers, and stage of change with results as proposed by the model [F(9,64) = 5.77; p =.000; adjusted R(2) = 0.35]. Posttest percentage fat in food was significantly less for the intervention group as compared with the control group (t = 2.06; df, 115; p =.04).

Aphasia type and aging in Hindi-speaking stroke patients.

In this study, the clinical profile of Hindi-speaking stroke patients with aphasia from northern India has been investigated. We examined the interactional effect between age and gender with aphasia type in 97 Hindi-speaking right-handed individuals, the majority of them with a confirmed diagnosis of a cerebrovascular accident. The subjects included in the study ranged from 3 weeks to two years post-onset with a diagnosis of a common classical aphasia (Broca's, Wernicke's, anomic, global, conduction, and transcortical) types involving both males and females. Also examined was the interaction between literacy and aphasia type since the subjects had varied exposures to education (total illiteracy to professional/university education). While the data reported here about Hindi-speaking aphasics are relatively in agreement with the age-aphasia type patterns discussed in western countries, nonetheless some differences were also observed. The mean age of Indian patients with aphasia was significantly lower. Also, in addition to some gender and literacy related differences, an outstanding difference was that many clinical symptoms that are known to co-occur with aphasia were not readily reported by subjects with stroke.