[Sleep quality, emotional and behavioral disturbances, and eating behavior in adolescents with obesity: a network analysis-based model]. / Kachestvo sna, emotsional'no-povedencheskie narusheniya i pishchevoe povedenie u podrostkov s ozhireniem: model', osnovannaya na analize seti.

OBJECTIVE: To attempt to identify persistent associations between sleep quality, symptoms of emotional and behavioral disturbances, and characteristics of eating behavior in obese adolescents based on a network analysis. MATERIAL AND METHODS: The study included 194 adolescents, aged 12-17 years (76 girls, 118 boys), with a confirmed diagnosis of obesity due to excess calories (ICD-10 code E66.0). Sleep quality was studied on the basis of the Adolescent Sleep Wake Scale (ASWS), emotional and behavioral disturbances were assessed with the Achenbach Youth Self-Report for Ages 11-18 (YSR), eating behavior - with the Dutch Eating Behavior Questionnaire (DEBQ). Network analysis was used to identify the most significant and stable associations between the studied indicators. RESULTS: The association of poor sleep quality with manifestations of disinhibited behavior in the form of violations of the rules of behavior, aggressiveness, and impaired attention was revealed. Positive correlations between the manifestations of disinhibited behavior (primarily, rule-breaking behavior) and emotional eating behavior, which, in turn, had a positive relationship with external and a negative relationship with restrictive eating behavior, were noted. The disinhibited adolescent behavior is linked with uncontrolled food intake, which can contribute to the development of obesity. CONCLUSION: Impaired sleep quality, symptoms of emotional and behavioral disorders, and eating disorders in obese adolescents present a stable and specific clinical pattern that should be taken into account when justifying therapy.

[Electroencephalogram features in children with congenital hyperinsulinism treated according to the international protocol in Russian Federation].

BACKGROUND: Congenital hyperinsulinism (CHI) is a rare life-threatening disease characterised by persistent hypoglycaemia as a result of inappropriate insulin secretion, which can lead to irreversible neurological defects in infants. AIM: To evaluate neurophysiological characteristics of central nervous system in children with congenital hyperinsulinism treated according to the international protocol in Russian Federation. MATERIALS AND METHODS: Our retrospective, prospective cohort study included 73 patients who received treatment for CHI according to the current international protocol at different departments of the Almazov National Medical Research Centre from 2017 to 2022. All patients underwent a comprehensive examination, including electroencephalography (EEG). RESULTS: Among 73 patients with CHI, 35% (23) had focal form of the disease, 65% had non-focal form (49% (39) - diffuse form, 16% (11) - atypical form). All patients with focal form of CHI had a recovery as an outcome.Analysing the EEG data we found that paroxysmal activity was recorded in 23 patients (32%), 50 patients did not have paroxysmal activity (68%). Diffuse changes were observed in 47 patients (64%), whereas 26 patients (36%) were absent of it. By constructing Kaplan-Meier curves we found that the alpha rhythm is formed significantly (p=0.026) earlier in patients with a focal form of CHI. CONCLUSION: CHI patients treated according to the international guidelines in Russian Federation show rather positive neurological outcome. We established that alpha rhythm earliest formation is associated with focal form of CHI.

[Sleep disturbances and their associations with disorders in emotional sphere and behavior in children]. / Rasstroistva sna i ikh svyaz' s narusheniyami v emotsional'noi sfere i povedenii u detei.

The paper addresses associations between sleep disorders and emotional and behavioral disturbances in children. These associations are considered in a view of commonly found co-occurrences of sleep problems, signs of anxiety and depression, oppositional-defiant behavior, and increased aggressiveness. The authors put forward a conception of reciprocal influences of these disturbances and provide information on potential physiological mechanisms responsible for associations between sleep problems and emotional and behavioral disturbances in children. Attention is drawn to hypothalamus-hypophysis-adrenal axis activation, serotonergic and aminergic systems imbalance, impaired melatonin and orexins production. Possibility of an existing pattern encompassing sleep problems, emotional and behavioral disturbances is discussed. Practical recommendations aimed at timely identification and treatment of the mentioned disorders are suggested.

Multimodal nonlinear-optical imaging of nucleoli.

Multimodal nonlinear microscopy combining third-harmonic generation (THG) with two- and three-photon-excited fluorescence (2PEF and 3PEF) is shown to provide a powerful resource for high-fidelity imaging of nucleoli and nucleolar proteins. We demonstrate that, with a suitably tailored genetically encoded fluorescent stain, the 2PEF/3PEF readout from specific nucleolar proteins can be reliably detected against the extranucleolar 2PEF/3PEF signal, enabling high-contrast imaging of the key nucleolar ribosome biogenesis components, such as fibrillarin. THG is shown to provide a versatile readout for unstained nucleolus imaging in a vast class of biological systems as different as neurons in brain slices and cultured HeLa cells.

[Pharmacotherapy of sleep disturbances in pre-school and elementary school children]. / Farmakoterapiya rasstroistv sna v doshkol'nom i mladshem shkol'nom vozraste.

Sleep disturbance in pre-school and elementary school children is a common clinical situation. These disturbances may require pharmacotherapeutic approaches in certain cases. Major forms of sleep disturbances in children and data on known pharmacotherapeutic means of their treatment are considered.

[Pharmacotherapy of sleep disturbances in pre-school and elementary school children]. / Farmakoterapiya rasstroistv sna v doshkol'nom i mladshem shkol'nom vozraste.

Sleep disturbance in pre-school and elementary school children is a common clinical situation. These disturbances may require pharmacotherapeutic approaches in certain cases. Major forms of sleep disturbances in children and data on known pharmacotherapeutic means of their corrections are considered.

Cell-specific three-photon-fluorescence brain imaging: neurons, astrocytes, and gliovascular interfaces.

We present brain imaging experiments on rat cortical areas, demonstrating that, when combined with a suitable high-brightness, cell-specific genetically encoded fluorescent marker, three-photon-excited fluorescence (3PEF), enables subcellular-resolution, cell-specific 3D brain imaging that is fully compatible and readily integrable with other nonlinear-optical imaging modalities, including two-photon-fluorescence and harmonic-generation microscopy. With laser excitation provided by sub-100-fs, 1.25-µm laser pulses, cell-specific 3PEF from astrocytes and their processes detected in parallel with a three-photon-resonance-enhanced third harmonic from blood vessels is shown to enable a high-contrast 3D imaging of gliovascular interfaces.

Stain-free subcellular-resolution astrocyte imaging using third-harmonic generation.

We demonstrate stain-free, high-contrast, subcellular-resolution imaging of astroglial cells using epi-detected third-harmonic generation (THG). The astrocyte-imaging capability of THG is verified by colocalizing THG images with fluorescence images of astrocytes expressing a genetically encodable fluorescent reporter. We show that THG imaging with an optimized point-spread function can reliably detect significant subcellular features of astrocytes, including cell nuclei, as well as the soma shape and boundaries.

[Sleep disturbances in children with autistic spectrum disorders].

An association between sleep disorders and autistic spectrum disorders in children is considered. Characteristic variants of sleep disorders, including resistance to going to bed, frequent night awakenings, parasomnias, changes in sleep structure, primarily, the decrease in the percentage of rapid eye movement sleep, are presented. Attention is focused on the possibility of the direct relationship between sleep disturbance and the pathogenesis of autistic spectrum disorders. A role of pathological alterations in the production of neuromediators and morphological changes in the brain structures characteristic of autistic spectrum disorders in the genesis of sleep disorders in children is discussed. Possible non-pharmacological and pharmacological approaches are suggested.

Sleep disturbances in two-month-old infants sharing the bed with parent(s).

AIM: The aim of this study was to evaluate possible relationship between infant-parent(s) bed sharing during night sleep and sleep characteristics in two-month-old infants. METHODS: One hundred and twelve healthy infants from the community setting (48 males, 64 females) who were singletons born in St. Petersburg, Russia in 2007, at term, with normal weight entered the study. Infants did not have signs of inborn malformations, intrauterine infections, inherited or progressive diseases. Information about major infant, maternal, and demographic characteristics was collected from available medical documents. The mothers were approached by trained interviewer. As a part of interview, the mothers were requested to answer whether the baby was a regularly solitary sleeper or regularly shared the bed with parent(s) during night sleep and to fill in the questionnaire addressing infant's behaviour during sleep. RESULTS: Of 112 infants, 83 (74%) were solitary sleepers, 29 (26%) shared the bed with parent(s). No statistically significant difference was found for major infant, parental and demographic characteristics between two groups. Bed sharing babies had significantly higher values (more problems) on sleep duration and night wakening scores. It was more common with them to sleep too little, wake more than twice during the night, less often return to sleep without help after waking. Significantly higher values were found on sleep disordered breathing and parasomnia scores; noisy breathing during sleep was more commonly reported in them. CONCLUSION: Maternal reports on disturbed sleep in two-month-old babies were more common in the cases of infant-parent(s) bed sharing.

Environmental characteristics and sleep in two-month-old infants.

The study aimed at assessing possible relationship between the quality of infant environment and maternal reported behavioural features during sleep in 2-month-old infants. It comprised 115 randomly selected, apparently healthy infants (50 boys, 65 girls) from community setting who were singletons born at term with normal birth weight in St. Petersburg in 2001-2002. Quality of infant care was estimated using the "PROCESS" (Paediatric Review of Children's Environment Support and Stimulation) inventory enabling to measure infant's developmental stimulation and organisation. Infant's behaviour during sleep was assessed using an adapted version of the Children's Sleep Habits Questionnaire (CSHQ). The babies facing more developmental stimulation and from more organised environment less often fell asleep in parents bed (P = 0.036). Infants from more organised environment were more often put to sleep at the same time at night, more often were ready to go to sleep at bedtime and less often struggled at bed; it was more common with them to have right amount of sleep and to have about a same amount of sleep each day; less often they moved a lot during sleep and woke up in sleep. These associations remained significant after adjustment has been made for each of such potential confounders as infant's gender, weight at birth and at study, gestational age, Apgar score at 1 and 5 minutes, birth order, maternal age and education, maternal marital status, infant's feeding at birth and at study, as well as to their simultaneous effects. Lower environmental organisation and developmental stimulation may be associated with specific disadvantageous infant behavioural features during sleep. Infants with parentally reported sleep problems should be carefully considered for possible flaws in the quality of environment.

Sudden infant deaths: stress, arousal and SIDS.

The prevalence of the Sudden Infant Death Syndrome (SIDS) has dropped in most countries following the development of education campaigns on the avoidance of preventable risk factors for SIDS. These include factors in the infant's micro environment, such as prenatal passive smoking, administration of sedative drugs, prone sleep, high ambient temperature or sleeping with the face covered. Sleep laboratory studies have shown that these risk conditions contribute to the development of respiratory and autonomic disorders and reduce the child's arousability. The opposite effects were seen when studying factors protective from SIDS, such as breastfeeding or the use of a pacifier. In victims of SIDS, similar breathing, autonomic and arousal characteristics were recorded days or weeks before their death. It is concluded that in some infants, already immature control mechanisms can be aggravated by environmental factors.

Maternal smoking during pregnancy and behavioural characteristics in 2 - 4-month-old infants.

The study aimed to assess potential relationship between maternal smoking during pregnancy and behavioural characteristics in 2 - 4-month-old infants. It covered period from 1999 to 2000 and comprised 250 randomly selected, apparently healthy singleton born infants from community setting (129 boys, 121 girls). The mothers were asked to complete the questionnaires addressing infant, maternal, demographic major characteristics with particular emphasis on maternal smoking during pregnancy. To objectively assess behavioural peculiarities of the infants, the mothers were requested to complete the Early Infancy Temperament Questionnaire. Of 250 mothers, 64. women (25.6 %) smoked during pregnancy. The infants of smoking mothers were more often born low birth weight and were also lighter at study; more frequently they were born at earlier gestational age, had lower Apgar score at 5 th minute, were less frequently breast fed at birth and at the time of study. Mothers who smoked during pregnancy were younger, had lower educational level, and less frequently were married. The infants born to smoking mothers had more frequent fussy periods occurring at about the same time of the day, protesting behaviour at face washing and washing in bath, indifferent attitude to the mother when held by new person, extreme reactions (either indifference or much feeling) during diapering and bowel movement, less attention to the parents during parent-infant play activity, and more sensitivity to the wet diaper. They were also characterised by more intensive reactions (displayed more amount of energy regardless of positive or negative behaviour) compared with the babies from the non-smoking group. This association remained after adjustment has been made for major potential confounders, and had a significant "dose-response" effect. Maternal smoking during pregnancy may serve as a risk factor for infant's behavioural deviations.

Sudden infant deaths: from epidemiology to physiology.

The incidence of sudden infant death syndrome (SIDS) has dropped significantly in most countries following the development of education campaigns on the avoidance of risk factors for SIDS. However, questions have been raised about the physiological mechanism responsible for the effects of these environmental risk factors. Since 1985, a series of prospective, multicentric studies have been developed to address these questions; over 20,000 infants were recorded during one night in a sleep laboratory and among these, 40 infants eventually died of SIDS. In this review, the following methods were employed: sleep recordings and analysis, monitoring procedure, data analysis of sleep stages, cardiorespiratory and oxygen saturation, scoring of arousals, spectral analysis of the heart rate and the determination of arousal thresholds, and statistical analysis and the results including sleep apneas, arousals and heart rate and autonomic controls in both future SIDS victims and normal infants were introduced separately. In addition, the physiological effect of prenatal risk factors (maternal smoking during gestation) and postnatal risk factors (administration of sedative drugs, prone sleeping position, ambient temperature, sleeping with the face covered by a bed sheet, pacifiers and breastfeeding) in normal infants were analyzed. In conclusion, the physiological studies undertaken on the basis of epidemiological findings provide some clues about the physiological mechanisms linked with SIDS. Although the description of the mechanisms responsible for SIDS is still far from complete, it appears to involve both arousal responses and cardiac autonomic controls during sleep-wake processes.

Developmental characteristics of apnea in infants who succumb to sudden infant death syndrome.

We compared the breathing characteristics of 40 infants who subsequently died of sudden infant death syndrome (SIDS) with those of 607 healthy infants matched for sex and age. The infants were between 2 and 19 wk old at the time of recording. Compared with the control group, the infants who died of SIDS experienced significantly more frequent episodes of obstructive and mixed sleep apnea. The duration of the apneic episodes did not exceed 15 s. Moreover, the SIDS group had a greater proportion of infants with obstructive and mixed apneic episodes than did the control group. In both groups, the frequency of episodes among male infants with apnea was greater than that among female infants. After the age of 9 wk, the proportion of male infants with episodes of obstructive apnea was greater in the SIDS group than in the control group. The frequency of apneic episodes decreased with age. The rate of decrease was significantly greater in the control subjects than in the SIDS group. This finding was made mainly in male infants. The present study provides further indirect evidence for a slower maturation of respiratory control in some infants who ultimately die of SIDS.

Snoring, noisy breathing in sleep and daytime behaviour in 2-4-month-old infants.

UNLABELLED: The study aimed at evaluating possible associations between snoring and/or noisy breathing in sleep and daytime behaviour in 2-4-month-old infants using the Early Infancy Temperament Questionnaire (EITQ) as a tool. It covered the period from 1997 to 1998 and comprised 200 randomly selected clinically healthy infants aged 2-4 months from the community who were singletons and born in St. Petersburg within the chosen period. The mothers were asked to complete the questionnaires addressing infant, maternal, and major demographic characteristics, some infant care practices as well as the infant's habitual breathing symptoms during sleep. As a part of interview, the mothers answered the EITQ consisting of 76 items which describe different aspects of infant behaviour. Groups of questions were added according to a scoring sheet to produce total scores describing nine different aspects of infant temperament: activity, rhythm, approach, adaptability, intensity, mood, persistence, distractibility and threshold. In 129 cases (64.5%), mothers reported no respiratory disturbances during sleep in their infants. Mothers of ten infants (5.0%) described their babies as habitual snorers; 48 babies (24.0%) were characterised as having other than snoring noisy breathing during sleep, and 13 (6.5%) habitually had both snoring and noisy breathing. Symptomatic infants were rated as being moodier when awake compared with asymptomatic ones and most moodiness was the feature of those infants who had both snoring and noisy breathing during sleep. These associations remained after adjustment had been made for major potential confounders. CONCLUSION: Snoring and noisy breathing during sleep, rather common symptoms in young infants, may be associated with specific behavioural disturbances, and moody infants should be investigated carefully for possible obscure respiratory problems.

Pacifier use and sleep position in 2 to 4 month old infants.

UNLABELLED: Much interest has been raised in optimal infant care practices which can be preventive against sudden infant death syndrome (SIDS). In particular, avoiding prone sleep and the use of a pacifier were reported to be associated with a reduced risk for SIDS. It was suggested that potential beneficial effect resulted from the use of a pacifier might be ascribed at least in part to the prevention of an infant to be put prone to sleep and/or to turn down prone in sleep. To explore this hypothesis, the study aimed to analyse potential interaction between the habitual sleep position and the regular use of a pacifier in 2-4-month-old infants, age known for the peak incidence of SIDS. 192 randomly selected clinically healthy infants born in St. Petersburg in 1997-1998 entered the survey. The mothers were asked to complete the questionnaires addressing infant, maternal, and demographic major characteristics as well as sleep routine and other child care practices with particular emphasis on the use of a pacifier. Of 181 infants for whom the mothers were able to define typical position the baby was put to sleep and/or found, 174 (96.1%) were usually put to sleep non-prone: 103 on the back, and 71 on the side. In 51 of 181 cases (28.2%) the babies habitually changed their position in sleep. Of 174 babies usually put to sleep non-prone, 6 (3.5%) usually turned to front. Putting baby to sleep on the side compared with on the back bore the risk to turn to front equal to 3.01 (95% CI: 0.42-34.0). There was no difference in any infant, maternal, and demographic characteristic between the groups of the babies usually put to sleep prone and non-prone. Of 192 infants, 117 (60.9%) were usually left to sleep with a pacifier, and there was no significant association between the use of a pacifier and optional prone or non-prone position the baby was usually put to sleep. Likewise, the use of a pacifier did not significantly influence infant's position when found. CONCLUSION: In clinically healthy 2-to-4-month-old babies, the use of a pacifier does not have major influence on the choice of sleep position and infant's propensity to spontaneously modify it during sleep.

Factors influencing the determination of arousal thresholds in infants - a review.

Objective: To review the major confounding factors that influence the determination of arousal thresholds in infants.Review of confounding factors: The determination of arousal thresholds in infants measures their arousability from sleep. The evaluation is influenced by various conditions. The infant's arousability is decreased by maternal factors, such as exposure to cigarette smoke, alcohol, illegal drugs or medications during gestation or breastfeeding. The levels of arousal thresholds also depend on the age of the infant and on experimental conditions, such as previous sleep deprivation, type of arousal challenges, time of administration of the arousal challenge, sleep stage, body position, room temperature, use of a pacifier, bed sharing, or type of feeding. In addition, spontaneous arousals can occur and modify the infant's response to external arousal challenges.Conclusions: Factors known to modify infants' arousability from sleep should be controlled during studies designed to determine arousal thresholds.

Frequency of obstructive and mixed sleep apneas in 1,023 infants.

STUDY OBJECTIVES: To collect normative data on the frequency of obstructive and mixed sleep apneas in healthy infants. STUDY DESIGN: 1100 infants were recorded during one night in a sleep laboratory. SETTING: the recordings were performed in an infant sleep laboratory. PATIENTS: The recordings of 1023 infants were used for analysis, the data of 77 infants being excluded because of poor recording quality. The infants were born full-term, were healthy at the time of study, had no history of apnea and were aged between 2 and 28 weeks. The polysomnographic recordings were analyzed visually and were subdivided according to the age of the subjects into 2-7 weeks, 8-11 weeks, 12-15 weeks, 16-19 weeks and 20-27 weeks of life. INTERVENTIONS: NA. MEASUREMENTS AND RESULTS: At 2-7 weeks of life, obstructive apneas (p=.013) and mixed apneas (p=.004) were significantly more frequent than at any other age group. At 8 to 11 weeks of life, obstructive apneas were significantly more frequent in boys than girls (p=.016). CONCLUSIONS: The present findings add to our knowledge of infants' respiratory characteristics during sleep.