Maternal Serotonergic Antidepressant Use in Pregnancy and Risk of Seizures in Children.

OBJECTIVE: To evaluate whether children born to women who use serotonergic antidepressants during pregnancy have higher risk of neonatal seizures and epilepsy. METHODS: We used Swedish register-based data to examine associations between maternal-reported use of selective-serotonin reuptake inhibitor (SSRI) and selective serotonin-norepinephrine reuptake inhibitors (SNRI) in pregnancy and diagnosis of neonatal seizures and/or epilepsy in over 1.2 million children. To account for systematic differences between exposed and unexposed children we adjusted for a wide range of measured confounders. After first evaluating the role of maternal indication for SSRI/SNRI use (i.e., depression and anxiety) and parental epilepsy, we adjusted for remaining parental background factors (e.g., age, co-morbidities, education, and family socioeconomic indices) and pregnancy-specific characteristics (e.g., maternal use of other psychotropic medications and tobacco smoking in early pregnancy). RESULTS: Compared with all other children, children of women that reported use of SSRI/SNRI in pregnancy had an elevated risk of neonatal seizures and epilepsy (risk ratio [RR]=1.41, 95% confidence interval [CI]=1.03-1.94; hazard ratio [HR]=1.21, 95% CI=1.03-1.43 respectively). The estimates of association were attenuated by adjustment for maternal indications for SSRI/SNRI use (RR=1.30, 95% CI=0.94-1.79; HR = 1.13, 95% CI = 0.95-1.33), but not by additional adjustment for parental history of epilepsy. Full adjustment for all measured parental and pregnancy-specific factors resulted in substantial attenuation of the remaining associations (RR = 1.10, 95% CI = 0.79-1.53; HR = 0.96, 95% CI = 0.81-1.14). CONCLUSIONS: The present study found no support for the concern that maternal SSRI/SNRI use in pregnancy increases children's risk for neonatal seizures or epilepsy. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that exposure to SSRI/SNRI's in the first trimester of pregnancy is not associated with an increased incidence of neo-natal seizures/epilepsy.

Fifteen-year surveillance of pathological findings associated with death or euthanasia in search-and-rescue dogs deployed to the September 11, 2001, terrorist attack sites.

OBJECTIVE: To compare the cause of death (COD; whether by natural death or euthanasia for poor quality of life caused by a primary pathological condition) between search-and-rescue (SAR) dogs deployed to the World Trade Center, Pentagon, or Fresh Kills Landfill on Staten Island following the 9/11 terrorist attacks and SAR dogs that were not deployed to these sites. ANIMALS: 95 deployed SAR dogs (exposed dogs) and 55 nondeployed SAR dogs (unexposed dogs). PROCEDURES: Following natural death or euthanasia, 63 dogs (44 exposed and 19 unexposed) underwent a necropsy examination. For the remaining 87 dogs, the COD was categorized on the basis of information obtained from medical records or personal communications. RESULTS: The median age of death was 12.8 years for exposed dogs and 12.7 years for unexposed dogs. The COD was not impacted by deployment status. In the 150 exposed and unexposed dogs, degenerative conditions were the most common COD followed by neoplasia. Respiratory disease was infrequent (overall, 7 [4.7%] dogs); 4 of 5 cases of pulmonary neoplasia occurred in unexposed dogs. However, in dogs that underwent necropsy, pulmonary particulates were reported significantly more often in exposed dogs (42/44 [95%]), compared with unexposed dogs (12/19 [63.2%]). CONCLUSIONS AND CLINICAL RELEVANCE: No difference was found in the COD on the basis of disease category and organ system involved between exposed and unexposed SAR dogs. The long life spans and frequency of death attributed to degenerative causes (ie, age-related causes) suggested that the risk of long-term adverse health effects in this population of SAR dogs was low.

A Randomized Cross-Over Field Study of Pre-Hydration Strategies in Dogs Tracking in Hot Environments.

The objective of this study was to evaluate 4 pre-exercise hydration strategies (oral water, chicken-flavored water, chicken-flavored oral electrolyte solution, and subcutaneous electrolyte solution) in working dogs conducting rigorous tracking operations in hot and arid conditions. In a randomized cross-over field study, 7 Border Patrol Search, Trauma, and Rescue (BORSTAR) Unit dogs working/training out of Fort Bliss in El Paso, Texas were randomly assigned to one of 4 different hydration strategy treatments each day for 4 days of study participation. Dogs were provided hydration treatment prior to running 2 separate one-mile tracks and were offered water while tracking. Body weight, blood, and urine were collected at the beginning of the study day and at the completion of each track. Core body temperatures were recorded using internal temperature sensing capsules. The impact of hydration strategy on change in weight, peak temperature, and serum chemical, hematological, and urinary parameters were analyzed using the COIN procedure in Ra. Compared to the other 3 hydration strategies, dogs receiving chicken-flavored water had higher blood creatine kinase values at the end of the second track (p = 0.0361). Otherwise, hydration strategy had minimal effects on blood or urine parameters. Total fluid intake was lower with water only compared to the other three hydration strategies. Dogs developed elevated core body temperatures (median 41°C; 106°F) without signs of heat exhaustion or heat stroke. Alternate hydration strategies increased total fluid intake compared to water alone; however, chicken-flavored water resulted in increased markers of muscle injury suggesting electrolyte-enriched strategies may have an advantage as a hydration strategy. Additionally, electrolyte-enriched fluids before exercise may help these dogs maintain lower peak temperatures.

Body Temperature Responses During Phases of Work in Human Remains Detection Dogs Undergoing a Simulated Deployment.

Body temperature responses were recorded during phases of work (waiting-to-work in close proximity to search site, active work in a search site, and post-work recovery crated in vehicle) in human remains detection dogs during search training. State or federally certified human remains detection dogs (n = 8) completed eight iterations of searching across multiple novel search environments to detect numerous scent sources including partial and complete, buried, hidden, or fully visible human remains. Internal temperature (Tgi) of the body was measured continuously using an ingestible thermistor in the gastrointestinal tract. Mean total phase times were: waiting-to-work: 9.17 min (±2.27); active work: 8:58 min (±2:49); and post-work recovery: 24:04 min (±10.59). Tgi was impacted by phase of work (p < 0.001) with a small increase during active work, with mean peak temperature 39.4 °C (±0.34 °C) during that period. Tgi continued to increase for a mean of 6:37 (±6:04) min into the post-work recovery phase in the handler's vehicle with a mean peak Tgi of 39.66 °C (±0.41 °C). No significant increase in temperature was measured during the waiting-to-work phase, suggesting behaviors typical of anticipation of work did not appear to contribute to overall body temperature increase during the waiting-to-work recovery cycle. Continued increase of gastrointestinal body temperature several minutes after cessation of exercise indicates that risk of heat injury does not immediately stop when the dog stops exercising, although none of the dogs in this study reached clinically concerning body temperatures or displayed any behavioral signs suggestive of pending heat injury. More work is needed to better understand the impact of vehicle crating on post-work recovery temperatures in dogs.

Reciprocal surface expression of arylsulfatase A and ubiquitin in normal and defective mammalian spermatozoa.

Defective mammalian spermatozoa are marked on their surface by proteolytic chaperone ubiquitin. To identify potential ubiquitinated substrates in the defective spermatozoa, we resolved bull sperm protein extracts on a two-dimensional gel and isolated a 64-65-kDa spot (p64) corresponding to one of the major ubiquitin-immunoreactive bands observed in the one-dimensional Western blots. Immune serum raised against this protein recognized a prominent, possibly glycosylated band/spot in the range of 55-68 kDa, consistent with the original spot used for immunization. Internal sequences obtained by Edman degradation of this spot matched the sequence of arylsulfatase A (ARSA), the sperm acrosomal enzyme thought to be important for fertility. By immunofluorescence, a prominent signal was detected on the acrosomal surface (boar and bull) and on the sperm tail principal piece (bull). A second immune serum raised against a synthetic peptide corresponding to an immunogenic internal sequence (GTGKSPRRTL) of the porcine ARSA also labeled sperm acrosome and principal piece. Both sera showed diminished immunoreactivity in the defective bull spermatozoa co-labeled with an anti-ubiquitin antibody. Western blotting and image-based flow cytometry (IBFC) confirmed a reduced ARSA immunoreactivity in the immotile sperm fraction rich in ubiquitinated spermatozoa. Larger than expected ARSA-immunoreactive bands were found in sperm protein extracts immunoprecipitated with anti-ubiquitin antibodies and affinity purified with matrix-bound, recombinant ubiquitin-binding UBA domain. These bands did not show the typical pattern of ARSA glycosylation but overlapped with bands preferentially binding the Lens culinaris agglutinin (LCA) lectin. By both epifluorescence microscopy and IBFC, the LCA binding was increased in the ubiquitinated spermatozoa with diminished ARSA immunoreactivity. ARSA was also found in the epididymal fluid suggesting that in addition to intrinsic ARSA expression in the testis, epididymal spermatozoa take up ARSA on their surface during the epididymal passage. We conclude that sperm surface ARSA is one of the ubiquitinated sperm surface glycoproteins in defective bull spermatozoa. Defective sperm surface thus differs from normal sperm surface by increased ubiquitination, reduced ARSA binding, and altered glycosylation.

Behavior Differences Between Search-and-Rescue and Pet Dogs.

Behavioral traits such as trainability, fearlessness, and energy are required for dogs to succeed as search-and-rescue (SAR) dogs. Certification by the Federal Emergency Management Agency (FEMA) ensures that dogs and handlers have extensive training and have demonstrated specific skills in the field. To determine whether behavioral differences exist between SAR and pet dogs, and between FEMA-certified USAR and non-FEMA-certified SAR dogs, the Canine Behavioral Assessment and Research Questionnaire (C-BARQ) was administered to 129 SAR dogs participating in the post-9/11 medical surveillance study and a breed-matched sample of 2,131 pet dogs. Non-parametric mixed models were fit for each C-BARQ subscale with explanatory variables SAR/non-SAR status, FEMA certification status, breed, sex, neuter status, and age. SAR dogs had higher scores for trainability (P < 0.001) and energy (P < 0.001), and lower scores for aggression toward strangers (P < 0.01), aggression and fear toward dogs (P < 0.01), fear of dogs (P < 0.001), chasing (P < 0.001), fear of strangers (P < 0.001), and non-social fear (P < 0.001) than pet dogs. FEMA-certification was associated with lower fear of dogs (P < 0.05) and separation-related issues (P < 0.01) than non-FEMA certified SAR dogs. The traits identified in this study could provide guidance for more efficient selection of candidate SAR dogs and breeding stock.

Evaluation of Three Hydration Strategies in Detection Dogs Working in a Hot Environment.

Physical activity in hot environments can increase the risk of heat stress or heat stroke in dogs. Heat tolerance is influenced by acclimatization to the environment, physical fitness, and hydration state. Three common strategies to promote hydration in working dogs are free access to water (W), oral electrolyte solutions (OESs), and administration of subcutaneous fluids (SQs). None of these methods have been compared for safety or efficacy in a working environment. In a cross-over design, seven vehicle-screening canines were randomly assigned to each of the three hydration strategies during working shifts at the Sarita, TX checkpoint. Physical, behavioral, and biochemical parameters were collected before, during, and after a work shift (mean 5.7 ± 0.8 h). Dogs were given 10 mL/kg oral W, 10 mL/kg chicken flavored OES, or 15 mL/kg of SQs initially followed by controlled access to W or OES. The dogs drank 15.61 ± 4.47 mL/kg/h of W and OES when in the OES group, compared to 7.04 ± 3.42 and 5.56 ± 4.40 mL of W, for the W and SQ groups, respectively. The median environmental temperature was 84.8°F (29.3°C). The median humidity was 70%. Based on mixed effects linear modeling, dogs in the OES and SQ groups had significantly higher total CO2, and lower packed cell volume and total plasma protein at the end of the day. Creatinine increased a small but significant amount in the SQ group and decreased in the OES group. Searching behaviors were independent of hydration strategy but highly related to the dog specific factors of sex, breed, and activity level. Under conditions of controlled activity in moderate heat and humidity, dogs accustomed to the work and the environment were more likely to increase fluid consumption and hydration when provided a flavored OES. Potential benefits of OES and SQ were indirect and no adverse effects were documented for any of the hydration strategies tested.

The temporal dynamic of response inhibition in early childhood: an ERP study of partial and successful inhibition.

Event-related potentials were recorded while five-year-old children completed a Go/No-Go task that distinguished between partial inhibition (i.e., response is initiated but cancelled before completion) and successful inhibition (i.e., response is inhibited before it is initiated). Partial inhibition trials were characterized by faster response initiation and later latency of the lateral frontal negativity than successful Go and successful inhibition trials. The speed of response initiation was influenced by the response speed on previous trials and influenced the response speed on subsequent trials. Response initiation and action decision dynamically influenced each other, and their temporal interplay determined response inhibition success.

Camper learning and friendship at pediatric oncology camps in North America.

Children with cancer and their families often attend specialized camps (therapeutic recreation) through their cancer treatment journey, yet little is known about the effects of these camps. A qualitative cohort study was used to assess learning and friendship development by campers attending one of four pediatric oncology summer camps during 2010 in North America. Standardized perceived change questionnaires developed by the American Camp Association were administered following camp attendance. Five-hundred and eighteen campers were enrolled: 120 (age 6-9 years) and 398 (age 10 and older). The largest positive response from the younger campers was observed for the question, "At camp did you learn to look forward to trying new activities?" For the older campers' survey, the items "Becoming better at enjoying being with my friends," "Becoming better at helping my friends have a good time when they are with me," and "Becoming better at getting to know more things about my friends" were perceived to increase the most for the majority of campers compared to other questions. Items for which older campers most often perceived little change were "Becoming better at choosing people who would be good friends to be with" and "Becoming better at understanding friends' emotions." Camp helps children learn new activities as well as enjoy good times with friends. Dealing with one's own mistakes and understanding others' emotions are areas for improvement. Ultimately it is hoped that these skills gained at camp will help build coping and resiliency for children/siblings affected by pediatric cancers.

Feasibility of using event-related potentials as a sideline measure of neurocognitive dysfunction during sporting events.

This study recorded brain event-related potentials (ERPs) during an attention task under two conditions: (a) immediately after strenuous exercise and (b) immediately after an extended rest period. The goal was to examine the effect of different physiological states on the electrophysiological data. As expected, a larger P3b ERP component was observed in response to attended infrequent events. Strenuous exercise did not differentially alter the amplitude or latency of the brain response during an attention task. This study reports a novel application of ERPs as a potential additional measure of the neurocognitive state that can be assessed on the sideline of a sporting event.