Environmental effects on language development in normal and high-risk child populations

This report describes language development from infancy through 8 years of life for a large sample of very low birth weight (VLBW) (high medical risk, n = 94; low medical risk, n = 132) and term (n = 134) children. Children of high and low medical risk status showed lower levels and slower rates of development compared with term children. Although these children also showed nonverbal cognitive deficits, their language difficulties appeared to be independent of these general cognitive problems. Although lower socioeconomic status (SES) showed strong negative effects on rate of language development, this was comparable across the three risk groups. Within this generally lower SES sample of children, the type of interactive behaviors caregivers used in early childhood showed significant relations to skill growth. Children with faster rates of language growth had mothers who maintained their interests more often and were less likely to use highly directive behaviors.

Stented versus nonstented pediatric pyeloplasty: a modern series and review of the literature

PURPOSE

Dismembered pyeloplasty remains the principal surgical therapy for pediatric ureteropelvic junction obstruction, although the method of postoperative drainage continues to be debated. We compared stented versus nonstented repairs in a modern series.

MATERIALS AND METHODS

We evaluated 117 pediatric dismembered pyeloplasties performed by 3 pediatric urologists at 2 institutions from 1991 to 2000. Hospital stay, success rate and complication rate were reviewed. Results were compared with 833 evaluable cases in the literature.

RESULTS

Of the 52 stented repairs urological complications developed in 6 (12%), including symptomatic urinary tract infection in 3 and temporary obstruction in 3. Of the 65 nonstented repairs urological complications developed in 10 (15%), including prolonged leakage in 3, urinoma in 3, obstruction in 3 and urinary tract infection in 1. Mean hospitalization plus or minus standard error was shorter in the stented group (2.1 +/- 0.89 versus 2.6 +/- 1.1 days, p <0.02). We identified 9 previous studies comparing a total of 339 stented with 494 nonstented repairs. Overall the number of complications was almost equal (12% versus 14%) but the stented group had more infections, whereas more leaks occurred in the nonstented group. The nonstented group required more secondary procedures (12 of 339 versus 45 of 494, p = 0.003). Hospital stay was 12 days for stented and 5 days for nonstented repair in these earlier series.

CONCLUSIONS

In children the outcome of stented pyeloplasty is similar to that of nonstented repair. In contrast to previous reports, using a stent for drainage should not necessitate a longer hospital stay.

Residence of adenylyl cyclase type 8 in caveolae is necessary but not sufficient for regulation by capacitative Ca(2+) entry

Ca(2+)-sensitive adenylyl cyclases (ACs) depend on capacitative Ca(2+) entry (CCE) for their regulation. Residence of the endogenous Ca(2+)-inhibitable adenylyl cyclase of C6-2B glioma cells in cholesterol-enriched caveolae is essential for its regulation by CCE (Fagan, K. A., Smith, K. E., and Cooper, D. M. F. (2000) J. Biol. Chem. 275, 26530-26537). In the present study, we established that depletion of cellular cholesterol ablated the regulation by CCE of a Ca(2+)-stimulable adenylyl cyclase, AC8, heterologously expressed in HEK293 cells. We considered the possibility that a calmodulin-binding domain in the N terminus of AC8, which is not required for in vitro regulation by Ca(2+), might play a targeting role. Deletion and mutation of the N terminus did attenuate the enzyme's sensitivity to CCE without altering its in vitro responsiveness to Ca(2+)/calmodulin. Both N terminus-deleted AC8 and wild type AC8 were expressed at the plasma membrane, as shown by imaging analysis of green fluorescence protein-tagged constructs. However, not only wild type AC8 but also the CCE-insensitive mutants occurred in caveolar fractions of the plasma membranes, even though a Ca(2+)-insensitive adenylyl cyclase, AC7, was excluded from caveolae. Finally, the AC8 mutants were no more responsive to nonphysiological elevation of Ca(2+) than the wild type. We conclude that (i) not all adenylyl cyclases reside in caveolae, (ii) the calmodulin-binding domain in the N terminus of AC8 does not play a role in caveolar targeting, (iii) the N terminus does play a role in associating AC8 with factors that confer sensitivity to CCE, and (iv) residence of Ca(2+)-sensitive adenylyl cyclases in caveolae is essential but not sufficient for regulation by CCE.

Patterns of physical and neurologic development in preterm children

OBJECTIVE

To evaluate the influence of medical complications, gestational age, gender, ethnicity, and socioeconomic status on the changes in anthropometric measures and severity of neurologic impairment from 6 to 54 months of age in premature and term infants.

STUDY DESIGN

This study was a prospective longitudinal study to determine predictors of patterns of growth and neurologic outcome in low-risk (n=137) and high-risk (n=96) preterm infants compared to full-term infants (n=136). Growth modeling analyses were used to evaluate factors that might influence patterns of physical growth and changes in neurologic status.

RESULTS

Medical risk level was a predictor of height and head circumference at 30 months and neurologic outcome. Gender was a predictor of weight gain. Medical risk level and gender predicted 13.8% and 32% of the variance in head circumference and neurologic scores, respectively.

CONCLUSION

Medical complications after birth and gender are stronger influences than gestational age on patterns of growth and neurologic outcome.

Does early responsive parenting have a special importance for children's development or is consistency across early childhood necessary?

The role of early versus ongoing maternal responsiveness in predicting cognitive and social development was examined in home visits for mothers, full-term children (n = 103), and medically low-risk (n = 102) and high-risk (n = 77) preterm children at 5 ages. There were 4 maternal clusters based on warm and contingent responsiveness behaviors observed early (at 6, 12, and 24 months) and late (at 3 and 4 years): high early, high late; high early, low late; low early, moderate late; and low early, low late. Children, especially preterm children, showed faster cognitive growth when mothers were consistently responsive. Social growth was similar in the consistently responsive (high-high) and the early-responsive inconsistent (high-low) clusters, but greater deceleration at 4 years among children with mothers in the inconsistent cluster refuted the notion of a unique role for early responsiveness. The importance of consistent responsiveness, defined by an affective-emotional construct, was evident even when a broader constellation of parenting behaviors was considered.

Epidemiology and clonality of community-acquired methicillin-resistant Staphylococcus aureus in Minnesota, 1996-1998

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged among patients in the general population who do not have established risk factors for MRSA. Records from 10 Minnesota health facilities were reviewed to identify cases of MRSA infection that occurred during 1996-1998 and to identify which cases were community acquired. Susceptibility testing and pulsed-field gel electrophoresis (PFGE) subtyping were performed on available isolates. A total of 354 patients (median age, 16 years) with community-acquired MRSA (CAMRSA) infection were identified. Most case patients (299 [84%]) had skin infections, and 103 (29%) were hospitalized. More than 90% of isolates were susceptible to all antimicrobial agents tested, with the exception of beta-lactams and erythromycin. Of 334 patients treated with antimicrobial agents, 282 (84%) initially were treated with agents to which their isolates were nonsusceptible. Of 174 Minnesota isolates tested, 150 (86%) belonged to 1 PFGE clonal group. CAMRSA infections were identified throughout Minnesota; although most isolates were genetically related and susceptible to multiple antimicrobials, they were generally nonsusceptible to initial empirical therapy.

Pre-adult mortality in the blowfly Lucilia sericata

Populations of the blowfly, Lucilia sericata (Meigen) (Diptera: Calliphoridae), have a considerable potential for rapid increase; the lifetime reproductive output of each adult female has been estimated to be between 130 and 172 eggs. Nevertheless, in the field, absolute population densities of this species are relatively low. To account for this difference, the levels of mortality affecting the eggs, feeding and wandering larvae and pupae of L. sericata were assessed in the field and laboratory. Percentage egg hatch was dependent on relative humidity with no egg eclosion at humidities below 50%; there was no significant effect of temperature on egg hatch. On infested sheep, the mean mortality of feeding larvae was 53%, but this ranged widely from 0% to 96%. There was no effect of atmospheric temperature or humidity on the mortality of feeding larvae in vivo. In the laboratory, only 10% of wandering larvae pupariated at 10 degrees C. At above 20 degrees C pupariation was consistently almost 100%. Percentage emergence increased from 0% at 10 degrees C to about 80% between 20 and 30 degrees C. The upper lethal temperature for pupae was approached at 35 degrees C. Analysis of the predation of pupae in the field revealed a weak, but significant curvilinear relationship between temperature and proportionate mortality and a median mortality of 0.49% per 24 h exposure (interquartile range = 5.2%). There was no evidence of density dependence in pupal predation. Overall, it is estimated that pre-adult mortality accounts for losses of approximately 97% of each generation, but this figure is subject to considerable variation depending on factors such as climate, time of year and host susceptibility.

Precision and accuracy of computed tomography foot measurements

OBJECTIVE

To test the accuracy and precision of computed tomography (CT) imaging for describing the 3-dimensional structure of the foot in patients with diabetes mellitus and peripheral neuropathy.

DESIGN

Experimental, test-retest.

SETTING

Clinical CT scanner at a local hospital.

SPECIMENS

Two tissue-equivalent phantoms and 6 cadaver feet.

MAIN OUTCOME MEASURES

Measurements taken from CT data of phantoms and cadaver feet were compared with physical (caliper) measurements. The feasibility of creating a computer-aided design/rapid prototyping 3-dimensional model from CT data was assessed by using 1 cadaver foot.

RESULTS

No bias was found for phantom or cadaver CT measurements compared with caliper measurements. The mean difference between repeat scans of cadaver feet (1 observer) was 0.1 +/- 0.8 mm and between observers, 0.4 +/- 0.8 mm. Comparing caliper measurements of the rapid prototype model and actual foot measurements revealed an error of 0.3 +/- 0.4 mm.

CONCLUSION

CT-based 3-dimensional imaging produced accurate and precise foot measurements, enabling description of internal and external structures. This capability will be coupled with plantar pressure measurements to improve our understanding and treatment of foot ulcers in people with diabetes.

Behavior of sewage sludge-derived PAHs on pasture

A field experiment was set up to investigate the retention of PAHs by pasture grass following sludge application. In addition to information on compound-specific loss rates, the influence of meteorological variables and sludge-pasture contact time on the weathering process were investigated. The rates of loss were compound specific with half-lives ranging from < 1 to 10 d. The lighter PAHs were rapidly lost from the grass surface primarily by volatilization. For the intermediate and heavier PAHs, loss was slower with rain playing an important role in the weathering process. Growth dilution was also important in reducing the contaminant levels in the grass. The effect of sludge-pasture contact time prior to weathering by rain on the residual levels remains unclear. In terms of risk of exposure, there is the potential for persistent organic contaminants to be introduced into the grazing animal food chain if sewage sludge is applied to pasture land.

Seasonal and species differences in the air--pasture transfer of PAHs

A field plot was established at a semirural site in the U.K. to investigate the atmospheric transfer of PAHs to different pasture species over the whole growing season. The PAHs displayed a range of partitioning behaviors in the atmosphere from exclusively gas phase to exclusively particle bound, resulting in different modes of deposition to the plant surface. The different pasture species had different plant and sward characteristics, e.g., leaf morphologies, yields, etc. For the majority of PAHs, the plant species displayed a seasonality in concentrations, with concentrations being higher in the winter than in the summer. For the lighter PAHs, this seasonality was absent with soil outgassing and/or summer sources of PAHs being implicated. Air-plant transfer factors (scavenging coefficients, with units m3/g dw) typically ranged between 4 and 52 during the summer, increasing to 8-88 during winter. Despite different plant and sward characteristics, the mixtures and concentrations of PAHs were similar for all the plant species. This indicates that there was little difference in the interception and retention behavior of the gas- and particle-phase PAHs. The implications of this for food chain transfer and air-vegetation modeling are discussed.

Microbial transformations of steroids--XII. Progesterone hydroxylation profiles are modulated by post-translational modification of an electron transfer protein in Streptomyces roseochromogenes

When Streptomyces roseochromogenes strain 10984 was incubated with exogenous progesterone for 25 h the major monohydroxylated metabolite, 16alpha-hydroxyprogesterone was produced in 3.6 fold excess to the minor metabolite 2beta,16alpha-dihydroxyprogesterone. In a reconstituted system containing highly purified progesterone 16alpha-hydroxylase cytochrome P-450, and electron transfer proteins ferredoxin-like redoxin (roseoredoxin) and redoxin reductase (roseoredoxin reductase), both metabolites were produced but in a 10:1 ratio. When S. roseochromogenes was pre-incubated for 8 h with 0.32 mM progesterone and the purified components of the hydroxylase system incubated as before, the ratio of 16alpha-hydroxyprogesterone to 2beta,16alpha-dihydroxyprogesterone produced decreased to 2.8:1, virtually identical to the ratio in whole cell transformations. Reconstitution assays containing all combinations of hydroxylase proteins purified from progesterone pre-incubated and control cells showed that the roseoredoxin was solely responsible for the observed changes in in vitro metabolite ratios. The fact that the lower 16alpha-hydroxyprogesterone to 2beta,16alpha-dihydroxyprogesterone ratio was also obtained when S. roseochromogenes was exposed to 0.335 mM cycloheximide for 8 h prior to the progesterone pre-incubation, pointed to post-translation modification of the roseoredoxin. Separation of two isoforms of roseoredoxin by isoelectric focusing supported this proposition.

Use of molecular subtyping in surveillance for Salmonella enterica serotype typhimurium

BACKGROUND

Because Salmonella enterica serotype typhimurium is the most common serotype isolated from persons with salmonellosis in the United States, it is difficult to detect unusual clusters or outbreaks. To determine whether molecular subtyping could be useful in public health surveillance for S. enterica serotype typhimurium, the Minnesota Department of Health initiated the routine use of pulsed-field gel electrophoresis (PFGE) of isolates.

METHODS

Beginning in 1994, all S. enterica serotype typhimurium isolates submitted by clinical laboratories to the Department of Health were subtyped by PFGE. A standard questionnaire was used to interview patients about possible sources of infection.

RESULTS

From 1994 through 1998, 998 cases of infection with S. enterica serotype typhimurium were reported to the Minnesota Department of Health (4.4 cases per 100,000 person-years). PFGE was performed on 958 of the isolates (96 percent), and 174 different patterns were identified. Sixteen outbreaks with a common source were identified, accounting for 154 cases. PFGE subtyping made it possible to confirm 10 outbreaks that involved small numbers of cases in institutional settings. Of six larger, community-based outbreaks, four would probably not have been recognized without PFGE subtyping. These four outbreaks accounted for 96 of the 154 culture-confirmed outbreak cases (62 percent). Fifty-six of 209 isolates tested for antimicrobial susceptibility (27 percent) were resistant to at least five antimicrobial agents. The multidrug-resistant isolates identified had unique PFGE patterns.

CONCLUSIONS

Routine molecular subtyping of S. enterica serotype typhimurium by PFGE can improve the detection of outbreaks and aid in the identification of multidrug-resistant strains. Combining routine molecular subtyping with a method of rapid communication among public health authorities can improve surveillance for S. enterica serotype typhimurium infections.

Does early responsive parenting have a special importance for children's development or is consistency across early childhood necessary?

The role of early versus ongoing maternal responsiveness in predicting cognitive and social development was examined in home visits for mothers, full-term children (n = 103), and medically low-risk (n = 102) and high-risk (n = 77) preterm children at 5 ages. There were 4 maternal clusters based on warm and contingent responsiveness behaviors observed early (at 6, 12, and 24 months) and late (at 3 and 4 years): high early, high late; high early, low late; low early, moderate late; and low early, low late. Children, especially preterm children, showed faster cognitive growth when mothers were consistently responsive. Social growth was similar in the consistently responsive (high-high) and the early-responsive inconsistent (high-low) clusters, but greater deceleration at 4 years among children with mothers in the inconsistent cluster refuted the notion of a unique role for early responsiveness. The importance of consistent responsiveness, defined by an affective-emotional construct, was evident even when a broader constellation of parenting behaviors was considered.

Identification and characterization of two G protein-coupled receptors for neuropeptide FF

The central nervous system octapeptide, neuropeptide FF (NPFF), is believed to play a role in pain modulation and opiate tolerance. Two G protein-coupled receptors, NPFF1 and NPFF2, were isolated from human and rat central nervous system tissues. NPFF specifically bound to NPFF1 (K(d) = 1.13 nm) and NPFF2 (K(d) = 0.37 nm), and both receptors were activated by NPFF in a variety of heterologous expression systems. The localization of mRNA and binding sites of these receptors in the dorsal horn of the spinal cord, the lateral hypothalamus, the spinal trigeminal nuclei, and the thalamic nuclei supports a role for NPFF in pain modulation. Among the receptors with the highest amino acid sequence homology to NPFF1 and NPFF2 are members of the orexin, NPY, and cholecystokinin families, which have been implicated in feeding. These similarities together with the finding that BIBP3226, an anorexigenic Y1 receptor ligand, also binds to NPFF1 suggest a potential role for NPFF1 in feeding. The identification of NPFF1 and NPFF2 will help delineate their roles in these and other physiological functions.

Charge-density-wave-induced modifications to the quasiparticle self-energy in 2H- TaSe2

The self-energy of the photohole in 2H-TaSe2 is measured by angle-resolved photoemission spectroscopy as a function of binding energy and temperature. In the charge-density wave (CDW) state, a structure in the self-energy is detected at approximately 65 meV that cannot be explained by electron-phonon scattering. A reduction in the scattering rates below this energy indicates the collapse of a major scattering channel with the formation of the CDW state accompanying the appearance of a bosonic "mode" in the excitation spectrum of the system.

Progesterone side-chain cleavage by Bacillus sphaericus

The side-chain of progesterone was cleaved by Bacillus sphaericus to produce two C-19 keto androstene steroids. The structures of these metabolites were androstenedione and 1-dehydroandrostenedione. High concentrations of glucose in the culture medium inhibited conversion of progesterone to these two metabolites.

The use of entomopathogenic fungi for the control of parasitic mites, Psoroptes spp

In vitro trials were carried out to evaluate the potential of fungal pathogens as biological control agents of parasitic mites, Psoroptes ovis (Hering) (Acari: Psoroptidae) from rabbit hosts (synonym: Psoroptes cuniculi). The fungus Hirsutella thompsonii Fisher showed no pathogenicity. Metarhizium anisopoliae (Metschinkoff), however, showed a high level of pathogenicity; 3 days after exposure to fungal conidia all mites were dead and 6 days after exposure 60% of the dead adult females, 10% of the dead adult males and 30% of the dead female nymphs had fungal hyphae protruding from their cuticular surface. There was a significant effect of conidial concentration on the number of mite cadavers that displayed fungal infection. Exposure to between 1x10(4) and 1x10(6) conidiaml(-1) resulted in 2-25% of the mites being infected. Mean infection levels were highest, 71%, when the mites were exposed to 1x10(7) conidiaml(-1). Similarly, there was a significant effect of conidial concentration on the time taken for the mites to reach 50% levels of mortality (LT(50)) The mean LT(50) value was approximately 2.7 days, when the mites were exposed to a solution of 1x10(7) and 1x10(8) conidiaml(-1) which was significantly shorter than controls exposed to 0.03% Tween-80 solution only. There was no significant effect of passaging the fungus, either once or twice, through the host on the subsequent infectivity of M. anisopliae. The potential for use of entornopathogenic fungi for the control of parasitic mites, particularly in relation to sheep, is discussed.

Expression of a novel neuropeptide Y receptor subtype involved in food intake: an in situ hybridization study of Y5 mRNA distribution in rat brain

Our group has reported on the cloning of a novel rat neuropeptide Y (NPY) receptor involved in NPY-induced food intake, the Y5 receptor. The distribution in rat brain of the mRNA encoding this receptor has been determined by in situ hybridization histochemistry, using radiolabeled oligonucleotide probes. Control experiments were carried out in cell lines transfected with either rat Y1 or rat Y5 cDNAs. With the exception of the cerebellum, only the antisense probes yielded hybridization signal in rat brain tissue sections. A number of brain regions contained hybridization signals indicative of Y5 mRNA localization. Chief among these were various hypothalamic nuclei, including the medial preoptic nucleus, the supraoptic nucleus, the paraventricular nucleus, and the lateral hypothalamus. Other regions with substantial hybridization signals included the midline thalamus, parts of the amygdala and hippocampus, and some midbrain and brain-stem nuclei. In general a low density of Y5 mRNA was observed in most cortical structures, with the exception of the cingulate and retrosplenial cortices, each of which contained a moderate abundance of Y5 hybridization signal. The distribution of this receptor mRNA is consistent with a role for the Y5 receptor in food intake and also suggests involvement in other processes mediated by NPY.

Regulation of the Ca2+-inhibitable adenylyl cyclase type VI by capacitative Ca2+ entry requires localization in cholesterol-rich domains

The endogenous Ca(2+)-inhibitable adenylyl cyclase type VI of C6-2B glioma cells is regulated only by capacitative Ca(2+) entry and not by a substantial elevation of [Ca(2+)](i) from either intracellular stores or via ionophore-mediated Ca(2+) entry (Chiono, M., Mahey, R., Tate, G., and Cooper, D. M. F. (1995) J. Biol. Chem. 270, 1149-1155; Fagan, K. A., Mons, N., and Cooper, D. M. F. (1998) J. Biol. Chem. 273, 9297-9305). The present studies explored the role of cholesterol-rich domains in maintaining this functional association. The cholesterol-binding agent, filipin, profoundly inhibited adenylyl cyclase activity. Depletion of plasma membrane cholesterol with methyl-beta-cyclodextrin did not affect forskolin-stimulated adenylyl cyclase activity and did not affect capacitative Ca(2+) entry. However, cholesterol depletion completely ablated the regulation of adenylyl cyclase by capacitative Ca(2+) entry. Repletion of cholesterol restored the sensitivity of adenylyl cyclase to capacitative Ca(2+) entry. Adenylyl cyclase catalytic activity and immunoreactivity were extracted into buoyant caveolar fractions with Triton X-100. The presence of adenylyl cyclase in such structures was eliminated by depletion of plasma membrane cholesterol. Altogether, these data lead us to conclude that adenylyl cyclase must occur in cholesterol-rich domains to be susceptible to regulation by capacitative Ca(2+) entry. These findings are the first indication of regulatory significance for the localization of adenylyl cyclase in caveolae.

Cutaneous manifestations of alcohol abuse

Alcohol consumption and abuse can have a variety of cutaneous manifestations. In addition to the well-recognized stigmata of the chronic alcoholic patient, even early abuse can result in distinctive skin changes or exacerbate existing cutaneous disorders. An accurate history of alcohol intake will facilitate recognition of these alcohol-induced cutaneous disorders and treatment resistance of dermatoses such as psoriasis as well as help decrease morbidity in surgical procedures. Familiarization with the spectrum of cutaneous manifestations of alcohol abuse and alcoholic liver disease can also allow for early detection and treatment in an attempt to minimize the medical consequences. We review the medical literature and discuss the spectrum of dermatologic disease associated with the use and abuse of alcohol.

Incidence of foodborne illnesses reported by the foodborne diseases active surveillance network (FoodNet)-1997. FoodNet Working Group

In 1997, the Foodborne Diseases Active Surveillance Program (FoodNet) conducted active surveillance for culture-confirmed cases of Campylobacter, Escherichia coli O157, Listeria, Salmonella, Shigella, Vibrio, Yersinia, Cyclospora, and Cryptosporidium in five Emerging Infections Program sites. FoodNet is a collaborative effort of the Centers for Disease Control and Prevention's National Center for Infectious Diseases, the United States Department of Agriculture's Food Safety and Inspection Service, the Food and Drug Administration's Center for Food Safety and Applied Nutrition, and state health departments in California, Connecticut, Georgia, Minnesota, and Oregon. The population under active surveillance for foodborne infections was approximately 16.1 million persons or roughly 6% of the United States Population. Through weekly or monthly contact with all clinical laboratories in these sites, 8,576 total isolations were recorded: 2,205 cases of salmonellosis, 1,273 cases of shigellosis, 468 cases of cryptosporidiosis, 340 of E. coli O157:H7 infections, 139 of yersiniosis, 77 of listeriosis, 51 of Vibrio infections, and 49 of cyclosporiasis. Results from 1997 demonstrate that while there are regional and seasonal differences in reported incidence rates of certain bacterial and parasitic diseases, and that some pathogens showed a change in incidence from 1996, the overall incidence of illness caused by pathogens under surveillance was stable. More data over more years are needed to assess if observed variations in incidence reflect yearly fluctuations or true changes in the burden of foodborne illness.

Life-cycle stage morphology of Psoroptes mange mites

Detailed life-cycle stage descriptions for the ectoparasitic mite Psoroptes ovis (Hering) (Acari: Psoroptidae) from rabbit hosts (syn. Psoroptes cuniculi) are presented. The results resolve a number of contradictions in the literature relating to the recognition of the life cycle stages of these mites. This study supports the view that there are two distinct male nymphal stages, both lacking dorsoposterior tubercles. The male tritonymph is significantly larger than the protonymph and has five pairs of metapodosomal setae rather than three. In addition, male tritonymphs have two pairs of cuticular pits on the central metapodosoma rather than the single pair of the protonymph. The results also show that the female protonymph can be distinguished from the male nymphal stages and the female tritonymph. Both female nymphal stages possess dorsoposterior tubercles, but the protonymph is significantly smaller than the tritonymph. In addition, the protonymph possesses three pairs of metapodosomal setae rather than five, one pair of cuticular pits rather than two, and a pulvillus on leg IV which is absent in the female tritonymph. The presence of dorsoposterior tubercles enables the female nymphs to be distinguished easily from the males. By contrast, distinguishing between the nymphal stages of the same sex relies on the identification of both the number of metapodosomal setae and cuticular pits. These descriptions are used to produce a key, which allows the various stages of both sexes to be distinguished.