Experimental review of PEI electrodeposition onto copper substrates for insulation of complex geometries.

Polyetherimide (PEI) was used for coating copper substrates via electrophoretic deposition (EPD) for electrical insulation. Different substrate preparation and electrical field application techniques were compared, demonstrating that the use of a pulsed voltage of 20 V allowed for the best formation of insulating coatings in the 2-6 µm thickness range. The results indicate that pulsed EPD is the best technique to effectively coat conductive substrates with superior surface finish coatings that could pass a dielectric withstand test at 10 kV mm-1, which is of importance within the EV automotive industry.

Type 2 diabetes mellitus in women with polycystic ovary syndrome during a 24-year period: importance of obesity and abdominal fat distribution.

STUDY QUESTION: What are the predictive factors for later development of type 2 diabetes (T2DM) in women with polycystic ovary syndrome (PCOS)? SUMMARY ANSWER: Obesity and abdominal fat distribution in women with PCOS in the mid-fertile years were the major risk factors for T2DM development 24 years later when lifestyle factors were similar to controls. WHAT IS KNOWN ALREADY: Women with PCOS have an increased prevalence of T2DM. STUDY DESIGN SIZE DURATION: A longitudinal and cross-sectional study was performed. Women with PCOS were examined in 1992 and in 2016. Randomly selected, age-matched women from the general population served as controls. PARTICIPANTS/MATERIALS SETTING METHODS: Women with PCOS (n = 27), attending an outpatient clinical at a tertiary care centre for infertility or hirsutism were diagnosed in 1992 (mean age 30 years) and re-examined in 2016 (mean age 52 years). Women from the World Health Organization MONItoring of trends and determinants for CArdiovascular disease (WHO MONICA-GOT) 2008, aged 38-68 years, served as controls (n = 94), and they were previously examined in 1995. At both at baseline and at follow-up, women had blood samples taken, underwent a clinical examination and completed structured questionnaires, and the women with PCOS also underwent a glucose clamp test at baseline. MAIN RESULTS AND THE ROLE OF CHANCE: None of women with PCOS had T2DM at baseline. At the 24-year follow-up, 19% of women with PCOS had T2DM versus 1% of controls (P < 0.01). All women with PCOS who developed T2DM were obese and had waist-hip ratio (WHR) >0.85 at baseline. No difference was seen between women with PCOS and controls regarding use of high-fat diet, Mediterranean diet or amount of physical activity at follow-up at peri/postmenopausal age. However, women with PCOS had a lower usage of a high-sugar diet as compared to controls (P = 0.01). The mean increases in BMI and WHR per year were similar in women with PCOS and controls during the follow-up period. LIMITATIONS REASONS FOR CAUTION: The small sample size of women with PCOS and the fact that they were recruited due to infertility or hirsutism make generalization to women with milder forms of PCOS uncertain. WIDER IMPLICATIONS OF THE FINDINGS: Obesity and abdominal fat distribution, but not hyperandrogenism per se, in women with PCOS in the mid-fertile years were the major risk factors for T2DM development 24 years later when peri/postmenopausal. Lifestyle factors were similar to controls at that time. STUDY FUNDING/COMPETING INTERESTS: The study was financed by grants from the Swedish state under the agreement between the Swedish government and the country councils, the ALF-agreement (ALFGBG-718611), the Gothenburg Medical Association GLS 694291 and 780821, the Swedish Heart Lung Foundation and Hjalmar Svensson Foundation. The authors have no conflict of interest.

Health disparities based on neighbourhood and social conditions: Open Comparisons-an indicator-based comparative study in Sweden.

OBJECTIVE: The overarching goal of the Swedish public health policy is to create the right societal conditions for good and equitable health throughout the population and to reduce avoidable health inequalities within a generation. The objective of this article is to highlight the main findings of the Open Comparisons in Public Health (OCPH) 2019 study. STUDY DESIGN: The OCPH is a longitudinal indicator-based comparative study, encompassing 39 public health indicators with results from Sweden's 21 regions and 290 municipalities. METHODS: Descriptive statistics and 95% confidence intervals were used to compare results between municipalities, regions and time points. Correlation analysis was used to study the strength of the relationship between the results of municipalities and their socio-economic conditions. RESULTS: Across the population, levels of health are good and have, in some areas, improved over recent decades. However, some significant health disparities remain according to neighbourhood, sex, age and educational background. Health disparities related to the level of education are often larger than those between women and men, and there are larger differences within a region than between regions. Health disparities have, in some cases, increased, such as for life expectancy. CONCLUSION: If health equity is to be achieved, leaders at all levels must collaborate and advocate for political action and local efficient public health interventions to eliminate health disparities as a result of neighbourhood and social conditions.

Predicting health-related quality of life 2 years after moderate-to-severe traumatic brain injury.

AIMS: To describe health-related quality of life (HRQL) 2 years after moderate-to-severe traumatic brain injury (TBI) and to assess predictors of HRQL. MATERIALS AND METHODS: A prospective cohort study of 91 patients, aged 16-55 years, admitted with moderate-to-severe TBI to a trauma referral centre between 2005 and 2007, with follow-up at 1 and 2 years. Mean age was 31.1 (SD = 11.3) years, and 77% were men. Injury severity was evaluated by the Glasgow Coma Scale (GCS), head CT scan (using a modified Marshall Classification), Injury Severity Score (ISS) and post-traumatic amnesia (PTA). The Functional Independence Measure (FIM), Community Integration Questionnaire (CIQ), Beck Depression Inventory (BDI) and Medical Outcomes 36-item Short Form Health Survey (SF-36) were administered at follow-up visits. The main outcome measures were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the SF-36. RESULTS: HRQL appears to be relatively stable between 1 and 2 years after injury. In the multivariate linear regression, younger age (ß = -0.20, P = 0.032), more severe TBI (ß = 0.28, P = 0.016), more severe overall trauma (ß = 0.22, P = 0.026), higher levels of community integration (ß = 0.36, P = 0.019) and higher positive change in PCS scores from 1 to 2 years (ß = 0.41, P < 0.001) predicted better self-reported physical health 2 years post-TBI. Lower scores for depression (ß = -0.70, P < 0.001) and a higher positive change in MCS scores (ß = 0.62, P < 0.001) predicted better self-reported mental health. CONCLUSIONS: Future interventions should focus on aspects related to HRQL that are more easily modified, such as physical functioning, home and social integration, productivity, and mental and emotional status.

Longitudinal follow-up of children born preterm: somatic and mental health, self-esteem and quality of life at age 19.

In a long-term prospective study, 39 preterm children born before 35 completed weeks of gestation and 23 full-term children were followed up at 19 years of age. Information about somatic and mental health was obtained through interviews and confirmed by medical records. Self-esteem and quality of life were assessed from the subjects' perspective. Significantly more preterms than full-terms had somatic health problems, both during childhood and adolescence and also at age 19. A wide spectrum of diagnoses was represented. Preterms with moderately severe somatic problems also showed signs of psychological distress. The frequency of mental health problems did not differ between the groups. Preterms and full-terms had similarly positive scores regarding self-esteem and quality of life. Altogether, the results indicate that apart from some vulnerability regarding physical health, this group of moderately immature subjects born preterm seems to function as well as young adults in general in important domains of life.

Prevalence of IgA-antigliadin antibodies and IgA-antiendomysium antibodies related to celiac disease in children with Down syndrome.

OBJECTIVE: This study was undertaken to investigate the prevalence of celiac disease in children and adolescents with Down syndrome. MATERIAL AND METHODS: Forty-three children and adolescents with Down syndrome were screened for IgA-antigliadin antibodies (AGA) and IgA-antiendomysium antibodies (EMA). Patients found to be either AGA- or EMA-positive were investigated further with intestinal biopsy. RESULTS: None of the 43 patients had known celiac disease at entry into the study; 37% (16/43) were found to have AGA levels above normal, and 16% (7/43) to be EMA-positive. Of the 15 patients who underwent biopsy, 8 manifested villous atrophy. Villous atrophy was present in all 7 of the EMA-positive patients, whereas the villi were normal in 7 of the 13 AGA-positive patients who underwent biopsy. CONCLUSIONS: EMA is a good immunologic marker for use in screening for celiac disease, and screening is justified in patients with Down syndrome.

The impact of thyroid autoimmunity in children and adolescents with Down syndrome.

The extent to which autoimmunity contributes to thyroid dysfunction in individuals with Down syndrome (DS) has not been clarified. In this study, we used the same highly sensitive method to detect both thyroid autoantibodies (thyroglobulin and thyroid peroxidase autoantibodies) in 70 children (32 M and 38 F) with DS, mean age 10.5 y (range 1-19 y). Twenty-seven (39%) of the patients were found to have thyroid autoantibodies, the prevalence of antibody positivity increasing with age. Of the 17 (24%) of the series who were hypothyroid (i.e. high basal TSH level and a low total- or free-T4 level), 11 had thyroid autoantibodies, and another 6 with thyroid autoantibodies became hypothyroid during 13-35 months of follow-up. Thus, the findings suggest that the majority of hypothyroid children with DS suffer from autoimmune thyroid disease.

Growth and motor performance in preterm children at 8 years of age.

At 8 years of age 41 preterm and 24 term children were followed up in a long-term prospective study of 46 unselected infants born before 35 completed weeks of gestation and of 26 term infants. The two groups were comparable in physical growth and there was no significant difference between them in motor performance, as evaluated with the Test of Motor Impairment. Only minor motor problems were found (in 22% of the preterm and 17% of the term group). In the preterm group, motor impairment was correlated to birthweight. The preterm children had less developed postural control and manifested more compensatory movements during the balance tasks than the term children.

Gender differences in drinking motivations and outcomes.

To investigate gender differences in the dynamics of alcohol use, we gathered self-reported data from male and female college students. Results of our experiment showed that dominance power motivations were correlated with negative drinking outcomes for both men and women; assertiveness power motivations were associated with negative outcomes only for women. For both sexes, a higher proportion of positive social motivations was associated with fewer negative drinking outcomes. We expect that, in addition to the more traditionally defined needs for dominance power shown to be important for drinking among men, women may use alcohol in relation to needs for assertiveness and self-expression.

Follow-up of preterm children: II. Growth and development at four years of age.

In a long-term prospective study, 46 unselected infants born before 35 completed weeks of gestation were compared with 26 full-term infants. At four years of age, 44 preterms and 25 full-terms were available to follow-up. The preterms were somewhat shorter in stature and lighter in weight than the full-terms but fell well within the normal range for Swedish children. Head circumference in the preterm group was significantly correlated to neurological development. Psychometric evaluation with Griffiths' mental developmental scale showed the preterms to fall within the normal range, though their performance was inferior to that of the full-terms. The greatest differences between the groups were in scores for the subscales eye and hand coordination, performance, and practical reasoning. There was no correlation within the preterm group between the test results and birthweight, gestational age, prenatal score, perinatal score, or parental social status or education. Language development was delayed among the preterms, more of whom required speech therapy. Visual and hearing disorders were more common among preterms than expected. Although they were all in good health, more preterms than full-terms needed hospital care during the first four years of life.

Follow-up of preterm children. I. Neurological assessment at 4 years of age.

In a long-term prospective study, 46 unselected infants born before 35 completed weeks of gestational age were compared with 26 full-term infants. At 4 years of age, 44 preterms and 25 full-terms were available to follow-up. Two preterm children manifested abnormal neurological development, slight spastic diplegia in one case, and psychomotor retardation in the other. Both these cases had already been identified at 18 months of age. Thorough neurological assessment revealed a number of differences between the two groups indicating both delayed neurological maturation and mild dysfunction in the preterms. We drew up a neurological profile to describe these minor neurological signs. The preterms had poorer muscle tone, more spontaneous movements, and were less skilled in certain gross motor functions. They also showed less developed balance reactions, had difficulties in some coordination tests, and asymmetry was more common in neurological functions. In the different subsystems of the neurological profile we also found a greater variation in the preterm group than in the full-term group. There were no significant correlations within the preterm group between the neurological findings at 4 years of age and gestational age, birthweight, and prenatal or perinatal factors.

Tandem duplication (1) (q11----q22) in a male infant with multiple congenital malformations.

An inverted tandem duplication of 1q11-q22 was found in a male infant with severely retarded psychomotor development, growth retardation, and multiple congenital malformations. Trisomy for this segment of chromosome 1 has not been previously reported.

Growth and development in preterm infants during the first 18 months.

In a long-term prospective study 46 unselected infants born before 35 completed weeks of gestational age were followed up, and compared to 26 fullterm infants. At 9 and 18 months of chronological age their height and weight were still lower than that of fullterms, but the difference disappeared when age was corrected for gestational age at birth. The motor and neurological maturity and language development was delayed in the preterms still at 18 months, which could possibly also be explained by their lower biological age. Ten of the preterm infants showed, at one or several occasions during follow up, definite neurological abnormality. At 18 months of age two of them were handicapped, one with retrolental fibroplasia, nearly blind, and another with cerebral palsy (slight spastic diplegia). Five of them had late psychomotor development, while two were borderline and one normal. We defined pre- and perinatal risk groups, but found that development at 18 months was not correlated to degree of risk. Neither was there any correlation between neurological examination at term and later handicap or psychomotor retardation. We found more illness, mostly due to common infections, during the first 18 months in the preterm group, as measured by the number of visits to a doctor and days spent in hospital.

Neurological assessment of preterm infants at term conceptional age in comparison with normal full-term infants.

In a long-term prospective study 46 unselected infants born before 35 weeks of gestational age were followed up, which included repeated neurological and psychological examination. 40 of them were neurologically evaluated at term conceptional age and compared with 26 full-term newborns, all the infants being considered healthy. There was no difference in mean weight or length between the two groups, but mean head circumference was greater in the preterm group. The preterm infants had lower muscle tone as judged by spontaneous posture of arms and legs, and poor resistance to passive movements and slow arm recoil. In the traction test they had more head lag. The withdrawal and Moro reflexes were weaker, while asymmetric tonic neck reflex (ATNR) was easier to elicit. Head control in the sitting position was better. All infants were evaluated with a prenatal and perinatal optimality score, which was not however significantly correlated with the neurological findings. The preterm infants with only slightly reduced optimality score (low risk group) had approximately the same birth weight and gestational age as the other preterms. They more resembled the full-term infants with good resistance to passive movements, fast arm recoil and good responses concerning the withdrawal and Moro reflexes. However, they had a semiflexed position in supine and thus in this respect were more like the other preterms.

Epilepsy and myopathy in a patient with Rothmund-Thomson's syndrome.

A report of a 21-year-old female, who has had Rothmund-Thomson's syndrome since early childhood, is given. In addition to the original disease with skin and tendon manifestations, she has also developed myopathy and epilepsy. It is discussed whether these two recent manifestations are part of her original syndrome or of different pathogenesis.

Child abuse in Malmö. A comparison between the periods 1967--1974 and 1975--1978.

In 1976 a survey was made of all children with a diagnosis of suspected or verified child abuse registered at the Department of Paediatrics in Malmö from 1967 through 1974. Some of the results have been compared with more recent data collected during the years 1975 through 1978. Registered incidents of child abuse were found to have increased markedly during the later period, to a great extent due to the increased number of older children being registered in 1975--1978. A steep increase in cases was observed in 1976 coinciding with intensified efforts to inform and educate personnel responsible for the care or welfare of children. The larger number of incidents registered during the later period is thus considered to most likely have been caused by greater vigilance on the part of personnel responsible for children and not due to an increase in the real incidence of child abuse. A comparison between the two periods regarding the type of injuries recorded shows a five-fold increase in the yearly rate of less severe lesions, as contrasted with a two-fold increase in more severe lesions. During both periods, slight injuries represented a majority of all cases.

Alcoholics Anonymous in a Western U.S. city.

Description of two groups of Alcoholics Anonymous includes data on the relationship between attendance during a 4-month period and abstinence at 6-month and 30-month follow-up studies.

Functions of drinking for Native American and White youth.

Despite long concern in the United States over alcohol consumption by adolescents and problems associated with drinking among Native Americans, few studies have dealt with the functions of drinking for Native American and White youth. The findings presented here are based on responses to a self-report questionnaire administered to ninth- through twelfth-grade students at two high schools in Fremont County, Wyoming - the county where the great majority of Wyoming's Native American population resides. Based on work by Jessor, Carman and Grossman, 30 items concerning positive-social, personal-effect, and experiential reasons for drinking were examined. Although there are some statistically significant differences in responses to individual items and statistically significant differences between Indian and White males and females on the Personal-Effect and Positive-Social categories of items, the functions of drinking appear to be quite similar for these Indian and White youth.