Health: SIDs Link

By Jonathan On Jul 5, 2017

SIDS Update

Nearly 55 percent of U.S. infants sleep with potentially unsafe bedding
NIH, CDC study shows unsafe infant bedding use still common, despite warnings
December 1, 2014
Nearly 55 percent of U.S. infants are placed to sleep with bedding that increases the risk of sudden infant death syndrome, or SIDS, despite recommendations against the practice, report researchers at the National Institutes of Health, the Centers for Disease Control and Prevention, and other institutions.
Soft objects and loose bedding — such as thick blankets, quilts, and pillows — can obstruct an infant’s airway and pose a suffocation risk, according to the NIH’s Safe to Sleep campaign. Soft bedding has also been shown to increase the risk of SIDS Infants should be placed to sleep alone, on their backs, on a firm sleep surface, such as in a mattress in a safety-approved crib External Web Site Policy, covered by a fitted sheet. Soft objects, toys, crib bumpers, quilts, comforters and loose bedding should be kept out of the baby’s sleep area.
Based on responses from nearly 20,000 caregivers, the researchers reported that, although such potentially unsafe bedding use declined from 85.9 percent in 1993-1995, it still remained high, at 54.7 percent, in 2008-2010.
“Parents have good intentions but may not understand that blankets, quilts and pillows increase a baby’s risk of SIDS and accidental suffocation,” said the study’s first author, Carrie K. Shapiro-Mendoza, Ph.D., M.P.H., senior scientist in the CDC’s Division of Reproductive Health in Atlanta.
The current study is an analysis of data from the National Infant Sleep Position Study (NISP), which collected information on the influence of infant sleep position and other safe sleep recommendations on infant care practices. Funded by the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the survey collected information by telephone from a random sample of more than 1,000 caregivers in U.S. households from 1992-2010.
“Parents receive a lot of mixed messages,” said study author Marian Willinger, Ph.D., special assistant for SIDS at the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. “Relatives may give them quilts or fluffy blankets as presents for the new baby, and they feel obligated to use them. Or they see magazine photos of babies with potentially unsafe bedding items. But babies should be placed for sleep on a firm, safety approved mattress and fitted sheet, without any other bedding.”
Drs. Shapiro-Mendoza and Willinger conducted the analysis with colleagues at CDC, the Yale School of Medicine in New Haven, Connecticut, the Boston University School of Public Health and the Boston University School of Medicine. The study was published online in Pediatrics.
SIDS is the unexplained death of a child within the first year of life. In 1992, the AAP issued its recommendation that infants be put to sleep on their backs. Two years later, the NICHD and its partners launched the Back to Sleep campaign, later renamed Safe to Sleep. The rate of SIDS in the United States has fallen 50 percent since 1992. However, since 2000, the SIDS rate has declined slowly, and researchers have reported an increase in other unexpected infant deaths, resulting from such causes as accidental suffocation, entrapment in bedding material or other causes. These accidental suffocation deaths have increased from 7.0 per every 100,000 live births in 2000 to 15.9 in 2010.
As part of the survey, caregivers were asked whether infants were placed to sleep on such items as blankets, bean bag chairs, rugs, sheepskin, cushions, or pillows. Caregivers were also asked about whether the infant was covered with such bedding materials as a blanket, quilt or comforter, sheepskin, or a pillow. The Safe to Sleep campaign advises against blankets or other coverings, and recommends sleep clothing, such as a one-piece sleeper, and keeping the room at a comfortable temperature.
“Bedding use for infant sleep remains common despite recommendations against this practice,” the study authors wrote.
By 2007-2010, most respondents reported following these Safe to Sleep recommendations: placing the infant to sleep in a crib or bassinet, placing the infant on his or her back, and not sharing a sleep surface with the infant. However, use of bedding was consistently 50 percent or higher for each of these years.
From 1993-1995 to 2008-2010, covering with thick blankets declined from 56 percent to 27.4 percent and covering with quilts or comforters declined from 39.2 percent to 7.9 percent. However, the authors did not see significant declines such bedding materials placed under infants, with 25.5 percent-31.9 percent reporting placing blankets under infants and 3.1 percent-4.6 percent placing cushions under infants.
“Interestingly, we also observed a greater decline in bedding use over the infants (quilts/comforters and thick blankets) compared with bedding (blankets) under infants,” the study authors wrote. “This finding raises a concern that parents may incorrectly perceive the recommendations as only pertaining to items covering or around the infant, and not include items under the infant.”
The researchers speculate that among the reasons mothers used bedding were to provide warmth and comfort or to prevent falls from an adult bed or sofa by using pillows as a barricade. They noted that a study of images from popular magazines targeting women of childbearing age found that more than two thirds of these images showed infants sleeping with potentially hazardous bedding such as blankets and pillows.
“Seeing images such as these may reinforce beliefs and perceptions that having these items in the infant sleep area is not only a favorable practice, but also the norm,” the researchers wrote.
The authors also found that caregivers of Hispanic and African-American infants were more likely to use potentially hazardous bedding compared to caregivers of white infants. In addition, younger mothers were more likely to use this bedding than were older mothers, as were non-college educated mothers compared to college-educated mothers.
About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s website at http://www.nichd.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

More SIDS articles

Click here to read news articles regarding the UCSF Report.

Unexplained SIDS deaths linked to microbes
PAUL TAYLOR
May 30, 2008

British researchers may be a step closer to solving the mystery of sudden infant death syndrome, in which apparently healthy infants die in their sleep.

They found significantly higher levels of two types of bacteria – Staphylococcus aureus and Escherichia coli – in autopsy samples from SIDS cases, compared with those from baby deaths attributed to known causes.

Infections have long been suspected in the unexplained deaths. But the new study, being published today in The Lancet, represents one of the most thorough assessments yet of this potential reason behind the fatalities.

Researchers conducted a systematic review of more than 500 autopsies performed between 1996 and 2005 at the Great Ormond Street Hospital for Children in London.

“Our findings suggest that microbes or microbial products could be related … to a proportion of unexplained sudden unexpected deaths in infancy,” they write.

The risk of SIDS tends to peak at eight to 10 weeks of age – a time when infants have immature immune systems that could leave them vulnerable to foreign organisms.

Even so, researchers are careful to point out “the mere detection of pathogens does not necessarily indicate the cause of death.” They say more study is needed.

Many factors could play a role. For instance, previous studies have linked the child’s position (face down), a smoker in the household and sleeping in the parents’ bed to an elevated rate of crib death.

“It’s possible that known risk factors for SIDS, such as overheating, co-sleeping, smoking may influence the growth of bacteria in these infants,” Nigel Klein, one of the researchers, said in an e-mail interview.

In the meantime, he added, parents should stick to established safety precautions, which can be found at http://www.sids.org.uk.

YOUNG BLOOD

Teenagers are much more likely than adults to suffer from fainting spells and other adverse effects when they donate blood, according to a study published in the Journal of the American Medical Association. “Most reactions are mild, but a handful experience more significant complications resulting from fainting and falling,” said Anne Eder, lead author of the study and executive medical officer of the American Red Cross in Washington, D.C.

Some teens have suffered concussions, received cuts deep enough to require stitches or broken bones because they collapsed in an unconscious state.

Those who had adverse reactions, including a dizzy spell or a slight bruise from the needle, were less inclined to donate blood again, the study revealed. The loss of potential donors is a big concern for the medical system, which occasionally faces blood shortages, Dr. Eder said.

Over all, the study found 10.7 per cent of teens aged 16 or 17 experience side effects within an hour of giving blood. In the 18-to-19 age group, 8.3 per cent suffer from reactions. Those 20 and older have a complication rate of 2.8 per cent. (In Canada, blood donors must be at least 17 years of age and no older than 71.)

Dr. Eder noted that earlier research has shown “the way the young respond to stress differs” from how adults respond, and the withdrawal of blood could be considered a stress on the body. Teens are also more likely to faint if they see others do so – a condition known as “epidemic fainting.”

To reduce the risk of serious complications, donors should get adequate sleep, nutrition and extra fluids the previous day, she said. They should also be closely observed in the period after blood is withdrawn.

VITAMIN D NO CURE-ALL

Vitamin D may help guard against many diseases, but prostate cancer doesn’t appear to be one of them.

Previous laboratory studies, in which prostate cancer cells were treated with high doses of vitamin D, suggested the nutrient might reduce the risk of developing this type of tumour. Studies in humans have produced inconsistent results.

However, a new and relatively large trial involving more than 1,500 male volunteers shows “no statistically significant difference in the risk of prostate cancer with increasing vitamin D,” according to findings published this week in the U.S.-based Journal of the National Cancer Institute.

The team, led by U.S. government researcher Jiyoung Ahn, compared vitamin D levels in blood samples from 749 men diagnosed with prostate cancer, with samples from 781 men free of the disease.

An editorial accompanying the study cautions “the absence of a link between vitamin D and prostate cancer risk, even if ultimately confirmed, should not be misrepresented as evidence against other well-documented benefits of vitamin D.”

Dr. Ahn readily agrees. “Population-based studies consistently provide evidence that greater vitamin D concentration is associated with decreased risk of colon cancer and higher bone density,” she said in an e-mail.

The vitamin, which is produced naturally in skin as a result of exposure to sunlight, may also protect against breast cancer and multiple sclerosis, other studies suggest.

‘Infections could be major cause of cot death’
By Rebecca Smith, Medical Editor
30/05/2008
Common infections could be a major cause of cot death, doctors at Great Ormond Street Hospital have discovered.
Doctors there investigated 546 sudden infant deaths and found that in half of the cases that had been classed as “unexplained”, potentially dangerous bacteria were found in the baby’s body.
Cot death can include cases in which a cause of death is found on examination but it cannot be determined why the baby died.
The bugs included staphylococcus aureus and E.coli which can cause serious problems without any outward signs.
And the bacteria were in almost the same concentrations as in cases where the cause of death was determined as infection.
The bugs were found in 16 per cent of the cot death cases where the cause of death had been unexplained compared with just six per cent where the death was due to non-infectious causes such as heart problems or accidents.
The authors of the research, which is published in The Lancet medical journal today, said these differences suggested that the infection with S.aureus and E.coli could be linked to the unexplained cot deaths.

SIDS May Be Linked to Bacteria
June, 2008
A baffling phenomenon known as sudden infant death syndrome is one of the leading causes of death for children under 1. Now, British researchers say they may have found a contributing factor: bacteria.
They found potentially dangerous bacteria such as Staphylococcus aureus and E. coli in nearly half of all babies who died suddenly and without explanation over a decade at a London hospital. Their findings are in Friday’s Lancet medical journal.
The researchers cautioned, however, that while the bacteria were found in the SIDS babies, that does not necessarily mean the bugs were responsible. Bacterial infections have long been suspected by some doctors to play a role in SIDS.
“We don’t know whether it’s a cause or if it’s identifying another potential risk factor,” said Dr. Nigel Klein, a professor at the Great Ormond Street Hospital for Children, where the study was conducted, and one of the paper’s authors.
He said that the higher level of bacteria might be evidence of another condition that killed the baby, such as a room that was too hot or had poor ventilation. Or it may have been coincidental.
The researchers used autopsy samples from 470 infants who died suddenly and unexpectedly between 1996 and 2005. They found dangerous bacteria in 181 babies, or nearly half of the 365 whose deaths were unexplained. There were similar bacteria in about a quarter (14 of 53) of the babies who died of known causes, excluding those who died of bacterial infections.
Most of the bacteria were detected in the babies’ lungs and spleens.
At birth, mothers transfer some of their antibodies against infection to their babies. But when babies are from 8 to 10 weeks old, the maternal antibodies have nearly run out and the babies typically have not started producing enough of their own.
That could make them particularly vulnerable to bacterial infections, said James Morris, a pathologist at the Royal Infirmary in Lancaster, who co-authored an accompanying commentary in the journal.
SIDS typically strikes when babies are between 8 and 10 weeks old.
“The study is a good indicator that certain bacteria might be involved in causing sudden infant deaths,” he said.
– Associated Press

Scripps study on SIDS focuses on accidental suffocation
THOMAS HARGROVE and LEE BOWMAN Scripps Howard News Service
December 22, 2007

The mystery of sudden infant death has been solved in a growing number of communities in America.

But the answer is seldom Sudden Infant Death Syndrome.

Coroners who carefully follow federal guidelines while probing the 4,000 unexpected infant deaths nationally each year are discovering a hard truth – most of these babies are suffocating in completely avoidable accidents, a nine-month investigation by Scripps Howard News Service has found.

These infants die because they are accidentally smothered by their parents or other children who sleep with them or because they are placed on dangerous overstuffed sofas or heavily blanketed adult beds.

Babies rarely die while sleeping alone in a crib.

The Scripps study also found that most coroners are not following the methods of investigation recommended by the Centers for Disease Control and Prevention, prompting them instead to rely on often-incorrect diagnoses of SIDS, still the officially listed cause for 57 percent of all infant deaths.

“It is far more common for a child to die of asphyxiation than to die of SIDS,” says Dr. Andrea Minyard, the state medical examiner in Pensacola, Fla. “We say this with a heavy heart. But it is an accurate portrayal of what really is happening. Most of the time, it’s either a parental overlay or unsafe and excessive bedding.”

Minyard ruled that two-thirds of the 41 sudden infant deaths in her area during a five-year period were accidental asphyxiations. She’s one of a growing number of medical examiners who blame suffocation, not SIDS, for most unexpected infant deaths, according to the Scripps study of 40,000 infant fatalities over 15 years.

These men and women believe they are in the vanguard of a new and revolutionary understanding about infant death, an emotionally difficult revelation that’s critical to saving babies.

“I think we have a clearer picture than many others out there,” said Chief Medical Examiner Dr. Dean Sienko of Lansing, Mich. “The benefits of looking carefully at these deaths have helped us to make recommendations that can save infants. Almost every time, we are finding multiple violations of the safe sleep guidelines.”

The study found that 11 coroners using federally recommended best practices when examining the deaths of babies discovered, on average, that 72 percent of the 354 infant fatalities in their communities actually were accidental suffocations.

The 11 coroners cover Calhoun, Ingham, Oakland and Saginaw counties in Michigan, Lake and Marion counties in Indiana, Escambia County, Fla., Ouachita Parish, La., Hennepin County, Minn., St. Charles County, Mo., and Dane County, Wis.

The Scripps study found that these 11 counties have three things in common:

n Coroner’s investigators with training in forensic methods are dispatched to the death scene immediately to re-create the conditions in which children die. They do not rely solely on police.

n The investigators carry a special checklist – most often the CDC’s Sudden Unexplained Infant Death Investigation protocol – to guide them on what steps to take when an infant dies.

n These coroners all report their findings to a local Child Death Review team that considers whether each fatality was adequately investigated.

The Scripps study found Child Death Review boards have a profound impact on whether accidents are detected. States with both local and statewide review boards are detecting more than twice as many suffocations than are states with little or no review.

Coroners who do not take all three of these steps usually report that most infants in their counties are dying of SIDS, the Scripps study found. According to standards set by the CDC and World Health Organization, a coroner should issue a diagnosis of SIDS when the cause of death is still unknown even after a complete autopsy, investigation of the death scene and detailed review of a child’s medical history.

But the top 11 coroners in the Scripps study said they are confident that the SIDS diagnosis is grossly overused in America because their own investigations overwhelmingly lead to different conclusions.

“I think this epidemic of (adult) overlays and asphyxia cases that has been reported is largely showing up now because of increasing consistency in death-scene investigations. It is bringing about a new understanding,” said Dr. Ljubisa Dragovic, medical examiner in Pontiac, Mich.

Nearly 90 percent of the 58 sudden infant deaths reported from 2000 to 2004 in Dragovic’s Oakland County were classified as accidental suffocations. It’s the nation’s highest rate of reported infant asphyxiation.

“They are rarely found in cribs, but in big beds or other places where they may be sharing a sleep space with four or five other family members,” Dragovic said. “Looking at the adults, we find a lot of instances where alcohol or drugs are involved. The sheer tiredness of new mothers on several occasions has been a factor.”

At the opposite end of the spectrum, the Scripps study found, at least 157 counties with populations of 100,000 or more reported zero cases of infant asphyxiation during the five years of the study.

The study found that nearly two-thirds of all sudden infant deaths in these counties were attributed to SIDS, a rate well above the national average. These counties were also nearly 20 percent more likely than the rest of the nation to report that infants die of “cause or causes unknown.”

In addition, these 157 counties reported that only 6.6 percent of all infant deaths were homicides, a detection rate one-fifth below the national average of 8.2 percent for infanticide. The study generally found that counties with below-average detection of homicides were also likely to have below-average rates of reported accidental asphyxiation.

The most populous area to report zero cases of accidental infant strangulation was Omaha, Neb., where 60 infants died unexpectedly during the five-year period of the study. More than 90 percent of those were labeled SIDS deaths.

“We aren’t doing this for humanitarian reasons,” said Omaha’s acting coroner, Tom Haynes. “If the family doesn’t admit to lying on top of the child during sleep – something I’ve never known to happen – then we have no choice but to call it SIDS.”

Unlike most of the 11 medical examiners leading their colleagues in detecting suffocation deaths in the Scripps study, Haynes is not a medical doctor or a pathologist. He’s a deputy county attorney who contracts with physicians to perform autopsies. Omaha police officers conduct infant death scene investigations rather than coroner’s investigators trained in forensic medicine.

“Unless the police department gets a specific indication that the child was suffocated, we can’t prove that the death wasn’t SIDS,” Haynes said.

The top coroners in the Scripps study agree it’s difficult to tell grieving families the truth.

“As a coroner, you don’t want to look into the face of a grandmother or father or mother who rolled over and smothered their child. There’s no way to console them,” said Dr. John McGoff, coroner for Indianapolis through 2004. “But without that knowledge, there’s no prevention.”

Under McGoff’s administration, accidental suffocation was the diagnosed cause of death for two-thirds of the 74 infants who died suddenly during the five-year period of the Scripps study.

What is needed, these top coroners say, is the courage to speak a difficult truth.

“Look, I go to the national meetings” of medical examiners and pathologists, said Dr. Kanu Virani of Saginaw, Mich. “They don’t want to stick their neck out because they think they are blaming the parents or the caregivers. But these are all preventable deaths.”

Virani has the nation’s second-highest detection rate of accidental suffocation, according to the Scripps study. He said the fact that four of the 11 coroners are from Michigan is a testament to intense training efforts in that state.

“A huge percentage of sudden infant deaths will be found to be asphyxia if a proper death scene investigation is done,” said Theresa Covington, director of the Michigan-based National Center for Child Death Review Policy. “This is what the national evidence is leading us to. They are not homicides or anything else. They are accidental suffocations.”

She predicted recognition of that truth will lead to a new infant safety campaign in America.

“If we can get to the truth, then we can craft the right intervention strategies so that we can actually make a dent in the number of sudden and unexplained infant deaths. We are doing a disservice to the parents if we don’t tell them the truth,” Covington said.

Tobacco industry pays scientists to challenge secondhand smoke’s link to infant death risk

The link between secondhand smoke and sudden infant death has been discredited in the last few years in scientific articles paid for and influenced by cigarette manufacturers, according to a new study of once-secret industry documents.

The key article, commissioned by Philip Morris and published in a respected pediatric epidemiology journal in 2001, discounts the significance of research showing a link between exposure to secondhand cigarette smoke and sudden infant death syndrome (SIDS). The article has been cited in at least 19 other scientific papers, misleading physicians, their patients and researchers about the risk of secondhand smoke exposure.

“Undermining people’s understanding of the link between secondhand smoke and SIDS places infants everywhere at increased risk,” according to Stanton Glantz, PhD, director of the Center for Tobacco Control Research and Education at UCSF and senior author of the new study analyzing the tobacco company documents.

Analysis of the Philip Morris documents shows that the company sought and paid an author to write an article for publication in a scientific journal, guided his writing and suggested changes in his conclusions in order to call into question the published studies showing links between secondhand cigarette smoke and SIDS.

The new report was prepared by researchers at UCSF and the U.S. Centers for Disease Control and Prevention (CDC) and appears in the March issue of the journal Pediatrics.

The article Philip Morris commissioned was part of the company’s overall scientific strategic plan for addressing secondhand smoke (SHS) and childhood health issues, the documents show. One document summarized the “impact assessment” for this project as follows: “Should provide the necessary scientific background for a policy on the acceptability of smoking around children.”

The key article acknowledges that smoking during pregnancy can endanger the fetus, but casts doubt on the published scientific finding that secondhand smoke increases the risk of sudden infant death — a finding highlighted in 1992 by the U.S. Environmental Protection Agency and reinforced by the California Environmental Protection Agency in 1997.

The tobacco company carried out this disinformation campaign even after the landmark 1998 settlement between all of the major U.S. tobacco manufacturers and 46 states. In the settlement, the tobacco firms agreed to pay the states $206 billion over the first 25 years and continuing amounts after that, and agreed to stop creating controversy about the evidence linking smoking and disease.

The tobacco industry’s disinformation campaign regarding secondhand smoke and maternal and child health can be counteracted, the UCSF and CDC researchers write in their analysis.

“Secondhand smoke must be recognized as an established, controllable risk factor for SIDS, like prone sleep positioning,” they conclude. “Clinicians and public health officials should intensify their efforts to promote reducing infant exposure to secondhand smoke as an effective strategy for reducing SIDS.”

The documents show that the tobacco industry hired scientists on at least two different occasions to prepare articles challenging the SHS/SIDS connection. The first one failed to attract an influential journal. But then Philip Morris retained a consultant to write a comprehensive review of all known risk factors for SIDS. Philip Morris was to provide the literature review, and the hired scientist was to write the paper. The company’s documents show that Philip Morris budgeted $50,000 to $100,000 for this project.

The company’s papers reveal a concerted effort by Philip Morris to influence the paper’s content and conclusions. When the author completed his first draft, he sent it to the company for review. The original conclusion stated that secondhand smoke increased the risk of SIDS. But a Philip Morris scientific affairs executive questioned this conclusion. The author accommodated many of Philip Morris’ suggested changes, and when he submitted his final draft to them, he had removed his original conclusion about the effect of secondhand smoke on infants. Instead, he wrote that “the majority of the effects of smoking can be explained by prenatal smoking by the mother,” and that postnatal (infant) secondhand smoke effects were “less well established” than prenatal smoking.

As published, the article mentions the financial support of Philip Morris, but does not acknowledge that the article was initiated, reviewed and influenced by the tobacco company. Not only does the limited acknowledgement mask the extent of the tobacco company’s influence on the conclusion, but totally hidden from view is the fact that the article was essentially conceived by the tobacco company in the first place, UCSF’s Glantz points out.

“This study of Philip Morris activity since the tobacco industry signed the Master Settlement Agreement in 1998 shows that the industry continues to use its 50-year old strategies to sow confusion about the real dangers of secondhand smoke and to distort the entire scientific process,” says Glantz.

The tobacco industry documents were made available as part of the Master Settlement Agreement, in which among other things, tobacco companies pledged to cease their efforts to discredit research on smoking and health. To this end, the current Philip Morris web site includes this statement:

“Public health officials have concluded that secondhand smoke from cigarettes causes disease, including lung cancer and heart disease, in non-smoking adults, as well as causes conditions in children such as asthma, respiratory infections, cough, wheeze, otitis media (middle ear infection) and sudden infant death syndrome. In addition, public health officials have concluded that secondhand smoke can exacerbate adult asthma and cause eye, throat and nasal irritation.”

“The new study shows clearly that Philip Morris continues to orchestrate a behind-the scenes effort to undermine the credibility of the health warnings their web site acknowledges,” Glantz says.

In their paper, he and his co-authors call into question the practice of accepting tobacco industry funds to support research.

“The tobacco industry’s long and consistent history of manipulating the content and presentation of scientific results raises questions about publishing work funded by the tobacco industry,” they write.

First author on the study is Elisa K. Tong, MD, a postdoctoral fellow in the UCSF Division of General Internal Medicine. Co-author is Lucinda England, MD, a medical epidemiologist in the Division of Reproductive Health at the CDC.

Contact: Wallace Ravven
wravven@pubaff.ucsf.edu
415-476-2557
University of California – San Francisco
The research was funded by the National Cancer Institute.
http://www.eurekalert.org/