Children’s participation in /u/-fronting in Ontario English

Choices abound for 2013–14 influenza season

Εισαγωγή: Η παιδική παχυσαρκία αποτελεί μία επιδημία του σύγχρονου δυτικού κόσμου και ορίζεται λειτουργικά ως η υπέρμετρη αύξηση του λιπώδους ιστού. Η παχυσαρκία αποτελεί ανεξάρτητο παράγοντα κινδύνου για την ανάπτυξη μίας πληθώρας συνοσηροτήτων όπως την αντίσταση στην ινσουλίνη, το σακχαρώδη διαβήτη τύπου 2, καρδιοαγγειακά νοσήματα και μεταβολικό σύνδρομο. Ο λιπώδης ιστός είναι ένα παρακρινές και ενδοκρινές όργανο, το οποίο μέσω της έκκρισης κυτταροκινών και φλεγμονογόνων παραγόντων έχει την ικανότητα να ρυθμίσει το ενεργειακό ισοζύγιο του οργανισμού. Η αντιπονεκτίνη μία από τις πιο σημαντικές κυτταροκίνες του λιπώδους ιστού, μέσω των υποδοχέων της AdipoR1 και AdipoR2, ενεργοποιεί την ινσουλινοεπαγώμενη πρόσληψη της γλυκόζης από το λιποκύτταρο, ενώ έχει αντι-φλεγμονώδης και αντι-αθηρωματική δράση σε άλλους ιστούς του οργανισμού. Ο PPAR-γ, ανήκει στην υπερ-οικογένεια των πυρηνικών υποδοχέων PPARs (peroxisome proliferative-activated receptors) και είναι ένας μεταγραφικός παράγοντας, ο οποίος σε ανταπόκριση στα κυκλοφορούντα ελεύθερα λιπαρά οξέα, ενεργοποιεί τη διαφοροποίηση των προλιποκυττάρων σε ώριμα λιποκύτταρα μικρού μεγέθους με πολλά λιποσταγονίδια. Το PPAR-γ μέσω της ενεργοποίησης του από τους ενδογενείς υποκαταστάτες του, τις θειαζολιδινεδιόνες, επάγει την ινσουλινοευαισθησία και αυξάνει την έκφραση της αντιπονεκτίνης. Τα ενδοκανναβινοειδή, μέσω των υποδοχέων τους CB1 και CB2, ρυθμίζουν την όρεξη στο κεντρικό νευρικό σύστημα, ενώ μπορούν να ενεργοποιήσουν περιφερικά τη λιπογένεση και να μειώσουν τη γονιδιακή έκφραση της αντιπονεκτίνης. Τα ενδοκανναβινοειδή βρίσκονται υπερενεργοποιημένα σε ενήλικες παχύσαρκους, ενώ τα επίπεδα της αντιπονεκτίνης μειώνονται σημαντικά. Σκοπός: Να μελετηθούν τα επίπεδα έκφρασης του AdipoR1, του PPAR-γ, του CB1 και των ενζύμων των ενδοκανναβινοειδών FAAH και DAGL-α, σε λεπτόσωμα και παχύσαρκα προεφηβικά παιδιά και να συσχετιστούν με τα κυκλοφορούντα επίπεδα της αντιπονεκτίνης και της ινσουλίνης. Μεθοδολογία: Για το σκοπό αυτό αναπτύχθηκαν πρωτογενείς καλλιέργειες προλιποκυττάρων και ώριμων λιποκυττάρων από βιοψίες κοιλιακού υποδόριου λιπώδους ιστού 17 παχύσαρκων (BMI>95%) και 36 λεπτόσωμων (BMI<85%) προεφηβικών παιδιών. Τα παιδιά χωρίστηκαν σε δύο ηλικιακές ομάδες, ομάδα Α: 2 μηνών-7 ετών και ομάδα Β: 9-12 ετών. Η γονιδιακή και πρωτεϊνική έκφραση του AdipoR1, PPAR-γ και CB1 μελετήθηκαν με τη μέθοδο RT-PCR και Western Immunoblotting. Επίσης, η γονιδιακή έκφραση των ενζύμων των ενδοκανναβινοειδών FAAH και DAGL-α, μελετήθηκαν με Real-Time PCR. Τα κυκλοφορούντα επίπεδα της ολικής και HMW αντιπονεκτίνης όπως και της ινσουλίνης μετρήθηκαν με ELISA, ενώ υπολογίστηκε ο δείκτης ινσουλινοαντίστασης HOMA-IR και μετρήθηκε η περίμετρος κοιλίας σε κάθε παιδί. Αποτελέσματα: Η πρωτεϊνική έκφραση του AdipoR1 βρέθηκε μειωμένη στα προλιποκύτταρα και ώριμα λιποκύτταρα των μικρότερων παχύσαρκων παιδιών της ομάδας Α, σε σύγκριση με τα αντίστοιχα λεπτόσωμά τους. To PPAR-γ βρέθηκε αυξημένο στα ώριμα λιποκύτταρα των λεπτόσωμων και παχύσαρκων παιδιών, σε σύγκριση με τα προλιποκύτταρά τους, ενώ ήταν και σημαντικά αυξημένο στα ώριμα λιποκύτταρα των μικρότερων παχύσαρκων παιδιών, σε σύγκριση με τα αντίστοιχα λεπτόσωμά τους. Ο υποδοχέας των ενδοκανναβινοειδών, CB1, ήταν σημαντικά μειωμένος στα ώριμα λιποκύτταρα των παχύσαρκων παιδιών και των δύο ηλικιακών ομάδων, σε σύγκριση με τα αντίστοιχα λεπτόσωμά τους, ενώ παρουσίασε μία σημαντική αύξηση με την ηλικία. Επιπρόσθετα, το ένζυμο αποδόμησης FAAH (για την ανανδαμίδη) μειώθηκε με την ηλικία στα μεγαλύτερα λεπτόσωμα παιδιά της ομάδας Β, ενώ στα μεγαλύτερα παχύσαρκα παιδιά ήταν αυξημένο σε σύγκριση με τα αντίστοιχα λεπτόσωμά τους. Το ένζυμο βιοσύνθεσης DAGL-α (για το 2-AG) βρέθηκε αυξημένο στα μεγαλύτερα λεπτόσωμα και παχύσαρκα παιδιά της ομάδας Β σε σύγκριση με τα λεπτόσωμα και παχύσαρκα παιδιά της ομάδας Α. Η ινσουλίνη και το HOMA-IR ήταν σημαντικά αυξημένα στα μεγαλύτερα παιδιά, λεπτόσωμα και παχύσαρκα, σε σύγκριση με τα μικρότερα παιδιά. Η HMW αντιπονεκτίνη βρέθηκε μειωμένη στα λεπτόσωμα και παχύσαρκα παιδιά της ομάδας Β σε σύγκριση με τα αντίστοιχα παιδιά της ομάδας Α, ενώ ήταν σημαντικά αυξημένη στα μικρότερα παχύσαρκα παιδιά σε σύγκριση με τα αντίστοιχα λεπτόσωμά τους. Η περίμετρος κοιλίας ήταν σημαντικά αυξημένη στα μεγαλύτερα παχύσαρκα αγόρια σε σύγκριση με τα αντίστοιχα λεπτόσωμά τους. Συμπεράσματα: Η μειωμένη έκφραση του CB1 και η αυξημένη έκφραση του PPAR-γ στα μικρότερα παχύσαρκα προεφηβικά παιδιά της ομάδας Α, σε συνάφεια με τα αυξημένα επίπεδα της HMW αντιπονεκτίνης, πιθανόν να αντικατοπτρίζουν έναν προστατευτικό μηχανισμό ελεγχόμενης λιπογένεσης και διατήρησης της ινσουλινοευαισθησίας στα παιδιά αυτά που ήδη παρουσιάζουν μειωμένα επίπεδα έκφρασης του υποδοχέα της αντιπονεκτίνης, AdipoR1. Επιπλέον, τα μειωμένα επίπεδα της HMW αντιπονεκτίνης και τα αυξημένα επίπεδα της ινσουλίνης στα μεγαλύτερα παιδιά πιθανόν απεικονίζει την προετοιμασία των παιδιών αυτών για την «φυσιολογική» ινσουλινοαντίσταση της εφηβείας. Η αύξηση των ενζύμων FAAH και DAGL-α στα μεγαλύτερα παχύσαρκα παιδιά της ομάδας Β, μπορεί έμμεσα να μας δείχνει ότι τα επίπεδα της ανανδαμίδης στα παιδιά αυτά είναι μειωμένα, ενώ τα επίπεδα του ενδοκανναβινοειδούς 2-AG αυξάνονται, θέτοντας πιθανόν τα παχύσαρκα παιδιά σε μεγαλύτερο κίνδυνο για λιπογένεση. Η μειωμένη έκφραση του CB1 στα μεγαλύτερα παχύσαρκα παιδιά όμως, μπορεί να απεικονίζει είτε την προσπάθεια του οργανισμού να περιορίσει την λιπογένεση στα παιδιά αυτά, που ήδη βρίσκονται σε κίνδυνο λόγω της παχυσαρκίας τους, είτε αντικατοπτρίζει τη μειωμένη ικανότητα του υποδόριου λιπώδους ιστού να αποθηκεύσει λίπος αυξάνοντας τον κίνδυνο εναπόθεσης λίπους ενδοκοιλιακά, το οποίο μπορεί να διαταράξει την ενεργειακή ισορροπία του οργανισμού τους προκαλώντας διαταραγμένη ανοχή στη γλυκόζη.

phonological disorder. to verify the association between the phonological performance in picture naming and imitation tasks, assessing the occurrence of phonological processes and using the severity indexes of Percentage of Correct Consonants and Phonological Density Index. participants of this research were 50 phonologically disordered children, with no history of prior speech-language therapy and with ages between 4:0 and 12 years. The analysis of the phonological processes indicated that the non-productive processes were more frequent than the productive ones, not only in the imitation task but also in the picture naming task. It was observed that in both tasks, most participants presented the phonological processes of cluster reduction, liquid simplification and final consonant deletion, independently of their productivity. When comparing both tasks, there was an association and agreement regarding the number of participants who presented phonological processes as well as a correlation regarding the total number of phonological processes; there was no evidence of differences concerning the averages of the phonological processes observed in the imitation and picture naming tasks; a negative correlation was observed between the severity indexes Percentage of Correct Consonants and Phonological Density Index; moreover, these values presented a strong correlation in both tests, indicating that they detect similar severity levels. the study verified an association and agreement between the picture naming and imitation tasks, not only for the number of participants who presented phonological processes, but also for the number of phonological processes, thus indicating the importance of using structured tests for the diagnosis of phonological disorder. Furthermore, for the severity indexes, Percentage of Correct Consonants and Phonological Density Index, a high correlation was observed between the tasks, indicating that both tasks are useful instruments in detecting phonological disorder.

Past research shows that the bilingual experience may enhance cognitive executive function. In this experiment, we evaluated cognitive control in bilinguals relative to monolinguals by using a dimensional overlap model to predict performance in a task composed of Stroop and Simon stimuli. A group of 24 Spanish monolinguals and 24 bilinguals with differing first languages and all having Spanish as a second language (L2) did a picture naming task and a task composed of Stroop and Simon stimuli, where the effect of different overlap conditions (spatial/color) between stimuli and responses were examined. The tasks were performed in Spanish for both groups and performance was indexed with behavioral and electrophysiological measures. We hypothesized that the bilinguals’ daily language practice in L2 reflected overlap conditions similar to the Simon task. Both naming a picture in L2 and the Simon task would involve conflict at the response level. L2 picture naming entails interference between two potential oral responses, to name in L2 vs. L1 (correct vs. incorrect responses, respectively). Similarly, incongruent stimuli in the Simon task produce interference because the irrelevant dimension (spatial location) overlap with an incorrect response. In contrast, the manual Stroop task involves a different type of conflict between two overlapping stimulus dimensions (the ink color and the color meaning). We predicted for these reasons a superior performance in Simon tasks over Stroop tasks for bilinguals, while monolinguals were expected to have a similar performance in both tasks. We also expected to see a correlation between the performance on the picture naming task and the Simon task in bilinguals. However, the behavioral results did not confirm these hypotheses. In fact, both groups had similar congruency effects as measured by reaction times and error rates, and there was no correlation between the picture naming and Simon task in bilinguals. Despite this, the electrophysiological data suggested a relationship between the picture naming task and the P300 congruency effect in bilinguals. Our findings provide insights into the neurocognitive bases of language and serve as a research avenue for language behaviors in bilinguals.

During the fourth age (80+ years), cognitive difficulties increase. Although language seems to resist the advancement of age, an older person without pathological developments in cognition may exhibit deficits in lexical access. This study examines the restrictions on lexical access in people aged 80 and older in word recognition and retrieval modalities through four lexical tasks. The effect of aging on response time and accuracy was measured using recognition (lexical decision/naming/priming) and retrieval (picture naming) tasks. A fourth age group (>80) and two third age groups (60-69/70-79) were compared according to lexical access modality and type of task employed through linear regression models. People aged 80 and older exhibit a strong lexical access constraint, as they are slower and less accurate in recognizing and retrieving words than both third age groups. These restrictions are more profound for the word retrieval modality, especially in the picture naming task. Impaired fluid intelligence and internode transmission deficits during advanced aging could further reduce the ability to recognize and/or retrieve words, having an impact on access speed and accuracy. Furthermore, the idea that crystallized intelligence could strengthen the accuracy of lexical access during aging is supported, specifically in word recognition modality.

For over 30 years, parental reports have been used to study the vocabulary of children under 4 years of age. Research exploring parental checklists as a measure of vocabulary in older children is very limited. Typically, authors of parental checklists report the reliability of the developed tools but do not explore validity in terms of the agreement between parental assessments and the children's actual word knowledge. We aimed to explore the reliability and validity of a parental checklist for assessing vocabulary in children aged between 3 and 6 years. Furthermore, we aimed to evaluate the agreement between indirect (parental checklist) and direct (picture naming and picture recognition tasks) assessments of children's vocabulary. A group of 94 typically developing monolingual Polish-speaking children aged between 3 and 6 years were first directly tested onsite with picture naming and picture recognition tasks (Cross-Linguistic Lexical Tasks). Subsequently, the participants' parents completed an online checklist containing the same set of 128 items and marked all the words that they had ever heard in their child's spontaneous speech. The parental checklist demonstrated very high internal consistency. The scores of the parental checklist and vocabulary tasks were moderately correlated. We compared the total number of words marked by parents and the number of items correctly identified by children in the picture naming and picture recognition tasks. In picture naming, we found no difference between the children's scores and the number of words selected by parents. However, parents selected significantly fewer words than children correctly recognised in the picture recognition task. When data were analysed at the level of individual items (i.e., whether parents selected exactly the same items that children answered correctly), we found that the level of agreement was low. The level of agreement correlated negatively with the children's vocabulary; that is, the more words a child knew, the lower the agreement between the direct measure and the parental checklist. Parental checklists should be used with caution in children aged between 3 and 6 years, especially if the assessed children have a large vocabulary and if item analysis is planned. Such checklists may be of more use in younger children or in children with limited vocabulary. What is already known on the subject Parental checklists are commonly used to assess the vocabulary of children younger than 4 years of age. Previous research has indicated that parental checklists are reliable in terms of internal consistency and valid in terms of predictive and convergent validity. What this paper adds to the existing knowledge This study introduces a parental checklist designed for assessing the vocabulary of monolingual Polish-speaking children aged between 3 and 6 years. Statistical analyses reveal that while the parental checklist exhibits high reliability, and the scores on the checklist correlate with direct measures of vocabulary, the agreement between parental reports and direct vocabulary measures (i.e., validity) is notably low, particularly when examining individual test items. What are the clinical implications of this work? These findings underscore the importance of exercising caution when using parental vocabulary checklists with children aged between 3 and 6 years. These checklists can serve as a replacement for direct vocabulary tests only when the general/overall score is needed. However, when specific words are the subject of interest, parental reports may not be a valid measure.

Acute Appendicitis in Infants: Still a Diagnostic Dilemma

Differences between a clinical sample of younger (ages 5 to 11) and older (ages 12 to 19) children meeting DSM-III criteria for overanxious disorder (OAD) were examined. Younger and older children were compared in terms of (1) the rates of OAD diagnoses occurring in the two age groups, (2) sociodemographic characteristics, (3) symptom expression, (4) association with other forms of maladjustment, and (5) self-reported anxiety and depression. The prevalence of OAD diagnoses and sociodemographic characteristics did not differ. Although younger and older OAD children showed similar rates of most specific DSM-III OAD symptoms, older children presented with a higher total number of overanxious symptoms than younger children. Older children more frequently exhibited a concurrent major depression or simple phobia, whereas younger OAD children more commonly had coexisting separation anxiety or attention deficit disorders. Older OAD children reported significantly higher levels of anxiety and depression on self-report measures. Findings indicated that the expression of OAD varies by developmental level.

Word knowledge and the speed of word processing in monolingual children and adults are influenced by word properties, such as the age of acquisition (AoA), imageability, and frequency. Understanding how different properties of words contribute to the ease of processing by bilingual children is a critical step for establishing models of childhood bilingualism. However, a joint impact of these properties has not been so far assessed in bilingual children. Here, we compared the impact of AoA, imageability, and frequency on accuracy and response times in picture naming and picture recognition tasks in monolingual and bilingual children. We used Cross-Linguistic Lexical Tasks to test 45 monolingual children (aged 4 to 7 years) and 45 migrant bilingual children in their L1 (Polish). Word AoA, imageability, and frequency independently affected the accuracy and response times in both picture naming and picture recognition tasks. Crucially, bilingual children were more sensitive to word characteristics than their monolingual peers: Bilingual children’s accuracy was particularly low for words of high AoA (in the picture recognition task) and for words of low frequency (in the picture naming task). Also, the increase in response times for low-imageable and low-frequent words was particularly salient in bilingual children. The results suggest a new area of interest for further studies: the question of whether bilinguals and monolinguals show different sensitivity to psycholinguistic factors, and if so, does that sensitivity change with age or language exposure?

Prevention and Control of Influenza With Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2015–16 Influenza Season

COMMENTARY

Purpose The purpose of this study was to compare masked English speech recognition thresholds between Spanish-English bilingual and English monolingual children and to evaluate effects of age, maternal education, and English receptive language abilities on individual differences in masked speech recognition. Method Forty-three Spanish-English bilingual children and 42 English monolingual children completed an English sentence recognition task in 2 masker conditions: (a) speech-shaped noise and (b) 2-talker English speech. Two age groups of children, younger (5-6 years) and older (9-10 years), were tested. The predictors of masked speech recognition performance were evaluated using 2 mixed-effects regression models. In the 1st model, fixed effects were age group (younger children vs. older children), language group (bilingual vs. monolingual), and masker type (speech-shaped noise vs. 2-talker speech). In the 2nd model, the fixed effects of receptive English vocabulary scores and maternal education level were also included. Results Younger children performed more poorly than older children, but no significant difference in masked speech recognition was observed between bilingual and monolingual children for either age group when English proficiency and maternal education were also included in the model. English language abilities fell within age-appropriate norms for both groups, but individual children with larger receptive vocabularies in English tended to show better recognition; this effect was stronger for younger children than for older children. Speech reception thresholds for all children were lower in the speech-shaped noise masker than in the 2-talker speech masker. Conclusions Regardless of age, similar masked speech recognition was observed for Spanish-English bilingual and English monolingual children tested in this study when receptive English language abilities were accounted for. Receptive English vocabulary scores were associated with better masked speech recognition performance for both bilinguals and monolinguals, with a stronger relationship observed for younger children than older children. Further investigation involving a Spanish-dominant bilingual sample is warranted given the high English language proficiency of children included in this study.

Liver transplantation in infants younger than 90 days is increasingly common. These infants typically arrive for transplantation in fragile medical condition. It is commonly assumed that they may experience high complication rates, difficult postoperative courses, and poor graft and patient survival. We sought to understand whether graft and patient survival rates in these young infants were lower than in older children, these patients experienced more complications than older children, and health care resource utilization was higher in this population. Data queried from the Study of Pediatric Liver Transplantation (SPLIT) database were limited to infants ages 0 to 90 days who had received their primary liver transplant between February 1996 and May 2004. Patients older than 90 days registered in the SPLIT database were used for comparison. Thirty-eight patients, ages 0 to 90 days, were included in the analysis. Their severity of illness was reflected by a median calculated Pediatric Endstage Liver Disease score of 34.8 at transplant. A majority (89.5%) of infants received cadaveric liver grafts, of which 47% were reduced organs. The infants experienced prolonged hospitalizations, spending an average of 50.9 +/- 7.6 days in the hospital after transplant. Long stays in the intensive care unit (average 22.1 +/- 1.5 days) and need for mechanical ventilation (average 16.2 +/- 2.7 days) also occurred. Length of hospitalization, intensive care, and mechanical ventilation were significantly higher than in older children (P < 0.0001). The reoperation rate (60.5%) was high and significantly greater than in older children (P = 0.007), with 10 patients (26.3%) needing 3 or more early reoperations. Reoperations occurred for bleeding, wound complications, biliary complications, and sepsis. There was no difference in vascular or biliary tract complications compared with older children. Bacterial infections were also common (52.6%) and were seen with greater frequency than in older children (P < 0.04). This infant cohort had an overall graft survival of 76.1% and overall patient survival of 87.8% at 1 year, with median follow-up of 12.5 months (range 0.6-84.0 months). Graft and patient survival in infants younger than 90 days was similar to that in older infants and children (P = NS). Young infants experience graft and patient survival similar to that in older cohorts of liver transplant recipients. Posttransplant complication rates, including the reoperation rate, were higher in this younger group, and the duration of hospitalization and intensive support were significantly longer. Future studies to better examine the factors, including age, that may contribute to the need for reoperation in children are warranted. Recognition and further analysis of the cost of care in this age group is also needed.

In adults, the lower limit of cerebral autoregulation (LLA) is generally considered to be a mean arterial pressure (MAP) of 60 mmHg. The LLA in healthy children has not been identified. The aim of this report is to describe the LLA in anesthetized children and relate it to age. Static cerebral autoregulation testing was performed in children 6 months to 14 years of age during <1 MAC sevoflurane anesthesia. Mean middle cerebral artery flow velocities (Vmca) were continuously measured using transcranial Doppler ultrasonography. MAP was increased with infusion of intravenous phenylephrine incrementally titrated to the greater of either: 1) 20% above baseline MAP or 2) 80 mmHg (<9 years), 90 mmHg (9-14 years). The LLA was defined by the point where the two linear regression lines fitting the Vmca/MAP crossed. The lower limit reserve (LLR) and autoregulatory reserve (ARR%) were defined as follows: LLR=Baseline MAP-LLA; ARR (%)=(LLR/Baseline MAP)x100. There were 13 subjects <2 years of age (group 1), 13 subjects 2 to 5 years of age (group 2), 14 subjects 6 to 9 years of age (group 3), and 13 subjects 10 to 14 years of age (group 4). Older children (groups 3 and 4) had a higher baseline MAP compared with younger children (groups 1 and 2) (82 +/- 10 mmHg vs. 70 +/- 10 mmHg, respectively; P=0.0001). However, there was no difference in LLA (59 +/- 17 mmHg vs. 60 +/- 8 mmHg; P=0.6) between older and younger children. Consequently, the LLR was greater in older children compared with younger children (25 +/- 12 mmHg vs. 12 +/- 10 mmHg, respectively; P=0.0007). Similarly, the ARR was significantly higher in older children compared with younger children (30% +/- 16% vs. 16% +/- 12%; P=0.002). In this study, we found no age-related differences in the LLA. Older children had a greater LLR and ARR compared with young children. The baseline MAP in young children may rest close to the LLA. These findings may have implications for managing hemodynamics in anesthetized children at risk for secondary brain injury.

Gamma-oscillations modulated by picture naming and word reading: Intracranial recording in epileptic patients