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An experiment was conducted to evaluate the reproductive performance and offspring quality of Macrobrachium vollenhovenii broodstock fed four diets: commercial maturation feed (control, T0), maggot (T1), fresh mackerel (T2) and locally formulated feed (T3). Spent broodstock of M. vollenhovenii fed experimental diets and their reproductive performances were evaluated in phase one experimentation. In phase two their offspring quality in a recirculation system with three replicates per treatment (TL0, TL1, TL2 and TL3) were evaluated for 30 days. The duration of gonadal development was significantly different among all the treatments, 28.67 ± 0.58 days and 16.33 ± 1.15 days for T0 and T1, respectively. T1 recorded the best GSI (16.08 ± 0.2%). Larval development in TL1 and TL3 were significantly faster than TL0 and TL2. However, survival rate was the best in TL3 (32.17 ± 0.57%) followed by TL0 (29.63 ± 0.33%). The results of this study are evidence of the possibility of successfully re-maturing and breeding this prawn in captivity. [ABSTRACT FROM AUTHOR]

Macrobrachium vollenhovenii (Herklots, 1857), the largest of the indigenous West African Palaemonidae prawns, has a high potential for aquaculture. This work was carried out to assess the effect of temperature on embryonic development and offspring quality of this species. In the phase one experiment, females at stage V of gonadal development incubated their eggs at three experimental temperatures and their embryonic development was evaluated. Seven embryonic developmental stages were observed: fertilisation, mitosis, morula, blastula, gastrula, nauplius and larvae. The incubation periods were 19, 14 and 13 days at 26 °C, 28 °C and 30 °C, respectively. A temperature of 30 °C resulted in higher broodstock mortality (33.33%). In phase two, larvae were reared at the respective temperatures for 30 days at a stocking density of 30 larvae per litre of water. Offspring quality was significantly different between treatments from day five onwards, with the fastest development at 30 °C followed by 28 °C. However, larval survival rate was significantly higher at 26 °C (31.7%) followed by 28 °C (27.6%). A temperature of 28 °C could therefore be recommended as the most favourable for embryonic development and larviculture of M. vollenhovenii. These findings will help bridge the knowledge gap with respect to captive breeding and hatchery technology for M. vollenhovenii. [ABSTRACT FROM AUTHOR]

Net community production (NCP), an analog of carbon export out of the surface ocean, is often estimated using budgets of dissolved oxygen. Accurate estimates of oxygen‐based NCP, especially in dynamic coastal regions, require constraints on vertical transport of water with O2 out of equilibrium with the atmosphere, nonsteady state change in the oxygen inventory, heating/cooling‐driven O2 disequilibrium, and the rate of bubble injection from wave activity. The latter two are typically evaluated by using discrete measurements of the O2/Ar ratio in lieu of O2 only. Because sophisticated sampling and measurement techniques are required to make these measurements, they are often limited in spatiotemporal resolution. However, high‐resolution estimates of NCP may be useful in determining small‐scale patchiness in export. In this study, we calculated high‐resolution NCP in coastal Southern California using dissolved oxygen measurements made by an autonomous buoyancy‐driven Slocum glider and an empirical relationship derived using discrete measurements of O2/Ar in the surface mixed layer to remove the influence of bubble injection, which accounted for approximately one fourth of the O2 supersaturation observed. Using estimates of vertical transport from wind speed‐based parameterizations, previously validated using a 7Be budget, we were able to correct for the physical biases to the signal, which are known to significantly influence dissolved oxygen budgets in this region. Our results agree well with previously published NCP estimates for the study area but also reveal higher‐frequency variability that discrete sampling was unable to resolve, suggesting that this approach may be useful in other regions with well‐constrained vertical transport rates. Plain Language Summary: The ocean takes up carbon dioxide from the atmosphere through a process referred to as "the biological pump." "Carbon export" refers to the amount of carbon removed by this process and is therefore an important quantity in determining the ocean's role as a sink for atmospheric carbon dioxide and significantly influences ocean chemistry. Carbon export is often estimated using budgets of oxygen in the surface ocean because oxygen is affected by the same processes. However, bubbles introduced through wave activity can bias oxygen budgets if not accounted for using precise measurements, which are often made in low spatiotemporal resolution and thus can miss patchy, high‐productivity events believed to contribute significantly to carbon export. In this study, we use an autonomous underwater vehicle to estimate carbon export with high resolution in coastal California. The results agree with more precise but lower‐resolution measurements, implying that the vehicle‐based approach may be useful for estimating carbon export in similar regions that may be dominated by undersampled, high‐productivity events. Key Points: A glider‐mounted oxygen sensor shows the oxygen inventory varies across the San Pedro Channel and is not reflected in surface concentrationUsing an empirical relationship between oxygen supersaturation and {Delta}O2/Ar, we make high‐resolution estimates of NCP, an analog of carbon exportThis approach removes the effect of bubble injection and may be useful for detecting patchy, high‐productivity events in similar regions [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety and efficacy of orally administered perflubron for bowel recognition on MR imaging in a pediatric population.Materials and Methods: A multicenter trial evaluated 39 pediatric subjects before and after ingestion of perflubron with T1-, proton-density, and T2-weighted sequences through the abdomen and/or pelvis. Post-contrast images were compared with pre-contrast images. Safety was evaluated through assessment of adverse events, clinical laboratory parameters, and vital signs.Results: With regard to efficacy analysis, improvement in the percent of bowel darkened was observed for 85 % of the subjects on T1-weighted images and for 95 % of the subjects on proton-density and T2-weighted images. For images of the abdominal region, the percent of bowel darkened was improved for 90-92 % of the subjects across pulse sequences. Improvement rates for the images of the pelvic region ranged from 71 % to 100 %. For at least 75 % of the subjects, proton-density and T2-weighted images of the body and tail of the pancreas, left lobe of the liver, mesenteric fat, and pathological tissue were improved relative to predosing images. Twenty-three percent of the subjects experienced some adverse effects, most of which were minor and related to the digestive system. Clinical laboratory and vital sign evaluations revealed no trends associated with the administration of perflubron.Conclusion: Perflubron is a relatively safe and effective gastrointestinal MR contrast agent in the pediatric population. [ABSTRACT FROM AUTHOR]

Objective:Bayley-III scales are currently used to evaluate outcomes of term infants following hypothermia therapy, while all before reported outcomes in this population have used Bayley-II. Our objectives were to determine the incidence of abnormal neurodevelopmental outcomes using Bayley III and the predictive value of Magnetic resonance imaging (MRI) in infants who received systemic hypothermia.Study Design:We conducted a prospective cohort study of inborn infants who underwent hypothermia for moderate/severe neonatal encephalopathy from October 2005-November 2011.Result:Eighty newborns underwent hypothermia (incidence of 1/1000). Of the survivors, 89% had Bayley-III performed around 24 months of age. An abnormal outcome using Bayley-III <85 occurred in 50%, while Bayley III <70 occurred in 13%. MRI predicted Bayley III<85 with sensitivity of 73%, specificity of 84%, positive-predictive value of 84% and negative-predictive value of 74%.Conclusion:A Bayley-III 85 cutoff identifies a disability rate of 50%, and MRI was predictive of abnormal outcomes. Findings can be useful for counseling of families and planning of future studies using Bayley III. [ABSTRACT FROM AUTHOR]

The article discusses the Africa Centre Vertical Transmission Study which aims to identify the impact of infant feeding practices on HIV infection rates of infants at 6 and 22 weeks of age. Conducted in the rural Umkhanyakude district of northern KwaZulu Natal in August 2001, the study analyzed a group of 3,445 pregnant women. Researchers found that HIV positive women are at a significantly increased risk of pregnancy complications.

Objective : To assess the infant feeding components of prevention of mother to child HIV transmission (PMTCT) programmes. Methods: Assessments were performed across Botswana, Kenya, Malawi and Uganda. 29 districts offering PMTCT were selected by stratified random sampling with rural and urban strata. All health facilities in the selected PMTCT district were assessed. The facility level manager and the senior nurse in charge of maternal care were interviewed. 334 randomly selected health workers involved in the PMTCT programme completed self-administered questionnaires. 640 PMTCT counselling observations were carried out and 34 focus groups were conducted amongst men and women. Results: Most health workers (234∕334, 70%) were unable to correctly estimate the transmission risks of breastfeeding irrespective of exposure to PMTCT training. Infant feeding options were mentioned in 307 of 640 (48%) observations of PMTCT counselling sessions, and in only 35 (5.5%) were infant feeding issues discussed in any depth; of these 19 (54.3%) were rated as poor. Several health workers also reported receiving free samples of infant formula in contravention of the International Code on Breastmilk Substitutes. National HIV managers stated they were unsure about infant feeding policy in the context of HIV. Finally, there was an almost universal belief that an HIV positive mother who breastfeeds her child will always infect the child and intentional avoidance of breastfeeding by the mother indicates that she is HIV positive. Conclusions: These findings underline the need to implement and support systematic infant feeding policies and programme responses in the context of HIV programmes. [ABSTRACT FROM AUTHOR]

Background. Breast problems, including mastitis, can interfere with the duration and exclusivity of breast-feeding. However, there are no large prospective studies documenting the prevalence, duration, and timing of such problems in breast-feeding women, particularly those who are infected with human immunodeficiency virus (HIV). Methods. Women enrolled prenatally underwent a breast-feeding counseling intervention until 6 months after delivery. Breast health problems were documented per breast for 180 days after delivery, with 14-day recall histories. Results. Breast health problems were rare, and there were no significant differences between HIV-infected and HIV-uninfected women for any of the following conditions: engorgement, 39 HIV-infected women (3.5%) versus 33 HIV-uninfected women (2.7%; P = .30); breast thrush, 17 (1.5%) versus 12 (1.0%; P = .25); bleeding nipple, 6 (0.5%) versus 4 (0.3%; P = .45); and mastitis/abscess, 11 (1.0%) versus 6 (0.5%; P = .17). Most problems occurred during the first month after birth, with few additional mothers experiencing problems after this point: at 1 and 6 months, 13% and 17% of all mothers, respectively, had experienced a minor or major breast health problem, including sore nipples. Women who had not exclusively breast-fed their infants were more likely to experience any of the breast health problems than were women who had exclusively breast-fed their infants (time-dependent variable; adjusted odds ratio, 1.46; 95% confidence interval, 1.13-1.87; P = .003). HIV-infected women who experienced any serious breast health problem (i.e., bleeding nipple, pus oozing from a nipple or breast, or mastitis/abscess) were 3.55 times (95% confidence interval, 0.86-14.78 times; P = .08) more likely to transmit HIV postnatally to their infant. Conclusions. With encouragement to exclusively breast-feed, women experienced few breast health problems. When those problems did occur, HIV-infected women with bleeding nipple, pus oozing from a nipple or breast, or mastitis/abscess were more likely to transmit HIV to their infants. [ABSTRACT FROM AUTHOR]

Unlabelled: Exclusive breastfeeding (EBF) from 0 to 6 mo of age is recommended by the World Health Organization as the optimal feeding method for infants, including infants of human immunodeficiency virus (HIV)-infected women from developing countries who choose to breastfeed. EBF may be associated with less risk of postnatal HIV transmission than mixed feeding, but is still uncommonly practised for reasons that are poorly understood. This study aimed to assess EBF rates and the impediments to EBF in a South African rural area of high HIV prevalence where most mothers are unaware of their status. In a longitudinal study, 130 women attending 3 clinics, chosen for their disparate socioeconomic characteristics, were interviewed at weekly postnatal intervals. Follow-up to 16 wk was completed on 119 infants. In an additional cross-sectional survey mothers of 445 infants, aged 0-12 mo, attending immunization clinics were interviewed. In the longitudinal study 46% of infants received non-breast-milk fluids or feeds within 48 h of birth; only 10% were exclusively breastfed for 6 wk and 6% for 16 wk. Supplements, most commonly formula milk, were introduced for perceived milk insufficiency. Feeding choices were mainly self-determined (43% of women), but health staff (22%) and grandmothers (16%) were cited as sources of advice. In the cross-sectional survey caregivers reported that 47% of infants aged 2 wk, 40% aged 6 wk and 33% aged 12 wk had been exclusively breastfed since birth.Conclusion: EBF is uncommon in this area in spite of a baby-friendly hospital initiative in the district. Strategies to promote exclusive breastfeeding in developing countries where HIV and infant feeding policies are being formulated must strongly address local perceptions on the need for supplements and sources of feeding advice. [ABSTRACT FROM AUTHOR]

There is vigorous controversy around whether HIV-infected women in developing countries should choose formula or breastfeeding for their infants. Formula eliminates HIV transmission but incurs risk of increased mortality, whereas breastfeeding has multiple benefits but entails risk of HIV transmission. International guidelines are available but need to be strengthened. This commentary summarizes data on the scale and rate of mother-to-child transmission (MTCT) of HIV through breastfeeding, and the hazards and benefits of breast- and formula-feeding. The case against providing free or subsidized formula to HIV-infected mothers is based on the following: it exacerbates disadvantages of formula feeding; compromises free choice; targets beneficiaries erroneously; creates a false perception of endorsement by health workers; compromises breastfeeding; results in disclosure of HIV status; ignores hidden costs of preparation of formula; increases mixed breastfeeding, which is an unsatisfactory method for all women; requires organization and management of programmes that are complicated and costly; and finally increases the 'spill-over' effect into the normal breastfeeding population. Recommendations to minimize these drawbacks include use of affordable antiretrovirals to reduce MTCT; investments in high-quality, widely available HIV counselling; support for choice of feeding; and exclusive breastfeeding for those who choose to breastfeed. [ABSTRACT FROM AUTHOR]

There is vigorous controversy around whether HIV-infected women in developing countries should choose formula or breastfeeding for their infants. Formula eliminates HIV transmission but incurs risk of increased mortality, whereas breastfeeding has multiple benefits but entails risk of HIV transmission. International guidelines are available but need to be strengthened. This commentary summarizes data on the scale and rate of mother-to-child transmission (MTCT) of HIV through breastfeeding, and the hazards and benefits of breast- and formula-feeding. The case against providing free or subsidized formula to HIV-infected mothers is based on the following: it exacerbates disadvantages of formula feeding; compromises free choice; targets beneficiaries erroneously; creates a false perception of endorsement by health workers; compromises breastfeeding; results in disclosure of HIV status; ignores hidden costs of preparation of formula; increases mixed breastfeeding, which is an unsatisfactory method for all women; requires organization and management of programmes that are complicated and costly; and finally increases the ‘spill-over’ effect into the normal breastfeeding population. [ABSTRACT FROM PUBLISHER]

Objects: Foramen magnum and jugular foramen stenosis, well-known problems in achondroplasia, may result in brain stem compression and venous outflow obstruction, respectively. We studied a series of children with achondroplasia using gated cine phase contrast (PC) CSF flow studies to evaluate CSF dynamics across the foramen magnum and MR venography (MRV) to depict obstructed venous drainage. Methods: Ten patients (9 months to 11 years, mean 2.85 years) were referred for possible brain stem compression. MRI included routine sequences, cine PC with velocity encoding (VENC) = 5 cm/s, and MRV. Six patients, including the asymptomatic patient, had brain stem compression without tonsillar herniation; two had tonsillar herniation; and two had neither brain stem compression nor tonsillar herniation. Abnormal tonsillar movement was seen only with tonsillar herniation. MRV showed steno-occlusive disease of the internal jugular vein (IJV) in nine patients, sigmoid sinus in four, and absent or hypoplastic transverse sinus in seven. Veno-occlusive disease was not progressive. No patient had massive hydrocephalus, although larger ventricles were associated with more profuse venous collateral formation and more severe degrees of IJV stenosis. Three patients have undergone CSF diversion. Conclusions: MR imaging may be useful in defining the pathophysiology of brain stem compression and hydrocephalus in achondroplasia. [ABSTRACT FROM AUTHOR]

Purpose: To report our experience with inferior vena cava (IVC) filters in pediatric patients.Methods: Over a 19-month period, eight low-profile percutaneously introducible IVC filters were placed in four male and four female patients aged 6-16 years (mean 11 years). Indications were contraindication to heparin in six patients, anticoagulation failure in one, and idiopathic infrarenal IVC thrombosis in one. Six of the eight devices placed were titanium Greenfield filters. One LGM and one Bird's Nest filter were also placed. Two of the filters were introduced via the right internal jugular vein by cutdown, and the remainder were placed percutaneously via the right internal jugular vein or the right common femoral vein. Patients received follow-up abdominal radiographs from 2 to 13 months after IVC filter placement.Results: All filters were inserted successfully without complication. Three of the patients died during the follow-up period: two due to underlying brain tumors at 2 and 12 months and a third at 6 weeks due to progressive idiopathic renal vein and IVC thrombosis. The remaining five patients were all alive and well at follow-up without evidence of IVC thrombosis, pulmonary emboli, or filter migration.Conclusion: IVC filter placement using available devices for percutaneous delivery is technically feasible, safe, and effective in children. [ABSTRACT FROM AUTHOR]

We present a case of extracranial craniopharyngioma simulating a sphenoid sinus mucocele in a 12‐year‐old female who presented with progressive subacute left‐sided visual disturbance. Although infrasellar craniopharyngioma is a rare entity, the presence of foci of calcification within the lesion is a useful finding for diagnosis. [ABSTRACT FROM AUTHOR]

Reports on the surgical problems and lessons encountered with an epidemic of Shigella dysenteriae type I in Africa. Signs and symptoms of the disease; Similarities with other endemic diseases; Difficulties in diagnosing the disease; Referral of patients to surgeons due to abdominal tenderness, distension, peritonitis or perforation; Performance of laparotomy due to evidence of perforation.

We report a patient with occipital flattening attributed to lambdoid synostosis on the basis of perisutural sclerosis. The lambdoid suture was patent at surgery and by histology. Specimen radiography showed no perisutural sclerosis. This case questions the validity of peri- sutural sclerosis as a radiographic indicator of impending lambdoid synostosis. [ABSTRACT FROM AUTHOR]

Two cases of smooth muscle tumor developing in immunocompromised children are described. Both children presented after transplant surgery, one with a hepatic leiomyoma and the other with a hepatic leiomyosarcoma. [ABSTRACT FROM AUTHOR]

Background: Integrated Management of Childhood Illness (IMCI) is a strategy to reduce mortality and morbidity in children under-5 years by improving management of common illnesses at primary level. IMCI has been shown to improve health worker performance, but constraints have been identified in achieving sufficient coverage to improve child survival, and implementation remains sub-optimal. At the core of the IMCI strategy is a clinical guideline whereby health workers use a series of algorithms to assess and manage a sick child, and give counselling to carers. IMCI is taught using a structured 11-day training course that combines classroom work with clinical practise; a variety of training techniques are used, supported by comprehensive training materials and detailed instructions for facilitators.Methods: We conducted focus group discussions with IMCI trained health workers to explore their experiences of the methodology and content of the IMCI training course, whether they thought they gained the skills required for implementation, and their experiences of follow-up visits.Results: Health workers found the training interesting, informative and empowering, and there was consensus that it improved their skills in managing sick children. They appreciated the variety of learning methods employed, and felt that repetition was important to reinforce knowledge and skills. Facilitators were rated highly for their knowledge and commitment, as well as their ability to identify problems and help participants as required. However, health workers felt strongly that the training time was too short to acquire skills in all areas of IMCI. Their increased confidence in managing sick children was identified by health workers as an enabling factor for IMCI implementation in the workplace, but additional time required for IMCI consultations was expressed as a major barrier. Although follow-up visits were described as very helpful, these were often delayed and there was no ongoing clinical supervision.Conclusion: The IMCI training course was reported to be an effective method of acquiring skills, but more time is required, either during the course, or with follow-up, to improve IMCI implementation. Innovative solutions may be required to ensure that adequate skills are acquired and maintained. [ABSTRACT FROM AUTHOR]

BACKGROUND: Both the pattern and duration of breast feeding are important determinants of health outcomes. In vertical HIV transmission research, reliable documentation of early breast feeding practices is important in order to correctly attribute postnatal transmission to feeding pattern. AIMS: To validate methods of collecting data on the duration of exclusive breast feeding (EBF) in an area of South Africa with a high HIV prevalence rate. METHODS: A total of 130 mothers were interviewed weekly, postnatally. At every interview a 48 hour and a seven day recall breast feeding history were taken. A subset of 70 mothers also received two intermediate visits per week during which additional 48 hour, non-overlapping, recall interviews were conducted. Ninety three infants were revisited at 6-9 months of age when mothers' recall of EBF duration from birth was documented. The different methods of recalling EBF status were compared against an a priori "best comparison" in each case. RESULTS: Reported breast feeding practices over the previous 48 hours did not reflect EBF practices since birth (specificity 65-89%; positive predictive value 31-48%). Six month EBF duration recall was equally poor (sensitivity at 2 weeks 79%; specificity 40%). Seven day recall accurately reflected EBF practices compared with thrice weekly recall over the same time period (sensitivity 96%, specificity 94%). CONCLUSIONS: 48 hour EBF status does not accurately reflect feeding practices since birth. Long term recall data on EBF are even more inaccurate. We recommend that data on duration of EBF be collected prospectively at intervals of no longer than one week. [ABSTRACT FROM AUTHOR]