Early emotional and behavioral difficulties and adult educational attainment: an 18-year follow-up of the TEMPO study.

Children who experience behavioral difficulties often have short and long-term school problems. However, the relationship between emotional difficulties and later academic achievement has not been thoroughly examined. Using data from the French TEMPO study (n = 666, follow-up 1991, 1999, 2009, mean age = 10.5, sd = 4.9 at baseline), we studied associations between internalizing and externalizing symptoms in: (a) childhood and (b) adolescence and educational attainment by young adulthood (< vs. ≥ high school degree), accounting for participants' age, sex, juvenile academic difficulties, and family income. High levels of childhood (but not adolescent) internalizing and externalizing symptoms were associated with low educational attainment; however, in multivariate models only the association with childhood internalizing symptoms remained statistically significant (OR = 1.75, 95 % CI 1.00-3.02). Supporting children with internalizing problems early on could help improve their long-term educational attainment.

Transmission dynamics of SARS-CoV-2 in British Columbia's largest school district during the second half of the 2020-2021 school year.

OBJECTIVES: To determine the extent and characteristics of in-school transmission of SARS-CoV-2 and determine risk factors for in-school acquisition of COVID-19 in one of Canada's largest school districts. METHODS: We conducted a retrospective chart review of all reportable cases of COVID-19 who attended a kindergarten-Grade 12 (K-12) school within the study area between January and June of the 2020-2021 school year. The acquisition source was inferred based on epidemiological data and, when available, whole genome sequencing results. Mixed effects logistic regression was performed to identify risk factors independently associated with in-school acquisition of COVID-19. RESULTS: Overall, 2877 cases of COVID-19 among staff and students were included in the analysis; of those, 9.1% had evidence of in-school acquisition. The median cluster size was two cases (interquartile range: 1). Risk factors for in-school acquisition included being male (adjusted odds ratio [aOR]: 1.59, 95% confidence interval [CI]: 1.17-2.17), being a staff member (aOR: 2.62, 95% CI: 1.64-4.21) and attending or working in an independent school (aOR: 2.28, 95% CI: 1.13-4.62). CONCLUSION: In-school acquisition of COVID-19 was uncommon during the study period. Risk factors were identified in order to support the implementation of mitigation strategies that can reduce transmission further.

RéSUMé: OBJECTIFS: Déterminer l'étendue et les caractéristiques de la transmission de la SRAS-CoV-2 en milieu scolaire, et déterminer les facteurs de risque de l'acquisition de la COVID-19 dans l'un des plus larges arrondissements scolaires du Canada. MéTHODES: Nous avons mené un examen rétrospectif des dossiers de tous les cas signalés de COVID-19 ayant fréquenté une école de niveau élémentaire, primaire ou secondaire dans la zone à l'étude entre janvier et juin de l'année scolaire 2020-2021. La source d'acquisition était inférée sur la base des données épidémiologiques et, lorsque disponibles, les résultats de séquençage du génome entier. Nous avons eu recours à des régressions logistiques multiniveaux pour identifier les facteurs indépendamment associés avec l'acquisition de la COVID-19 en milieu scolaire. RéSULTATS: Au total, 2 877 cas de COVID-19 parmi les employés et les élèves ont été inclus dans l'analyse; de ceux-ci, 9,1 % avaient acquis l'infection en milieu scolaire. La grosseur médiane des agrégats était de deux cas (écart interquartile : 1). Les risques facteurs de l'acquisition en milieu scolaire incluaient le fait d'être de sexe masculin (rapport de cotes ajusté [RCa] : 1,59, intervalle de confiance [IC] de 95% : 1,17-2,17), être un membre du personnel (RCa : 2,62, IC de 95% : 1,64-4,21) et fréquenter ou travailler dans une école indépendante (RCa : 2,28, IC de 95% : 1,13-4,62). CONCLUSION: Nos résultats suggèrent que l'acquisition de la COVID-19 en milieu scolaire était peu commune pendant la période d'étude. Des facteurs de risque ont été identifiés afin de supporter l'implémentation de mesures de contrôle pouvant réduire davantage la transmission.

Distinct bacterial colonization patterns of Escherichia coli subtypes associate with rheumatoid factor status in early inflammatory arthritis.

OBJECTIVES: The aetiology of RA is unknown; however, bacterial exposure, particularly to Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae, has been linked to disease pathogenesis. The strongest association was observed for RF(+) RA. We compare colonization patterns of these bacteria, and the anti-bacterial antibody levels in early onset RF(+) and RF(-) inflammatory arthritis. METHODS: Bacteria isolated from stool and urine of early-stage RF(+) and RF(-) patients recruited to the Early Arthritis Registry were biochemically identified and genotyped. IgM and IgA anti-bacterial and RF antibodies were assessed by ELISA. RESULTS: Differences in the types of colonizing pathogenic E. coli were identified. RF(+) patients were more commonly colonized with phylogenetic Group D E. coli, whereas RF(-) patients were more commonly colonized with phylogenetic Group B2 E. coli and these individuals also had lower joint scores and inflammatory markers yet higher IgA anti-E. coli antibody responses. CONCLUSIONS: These studies link the type of colonizing bacteria in the gut and urine with the immune response (anti-bacterial and RF) in early-onset inflammatory arthritis and provide evidence for a role of the host-pathogen response in the aetiology of RF.

Pyoderma Gangrenosum in Revision Total Hip Arthroplasty: Clinical and Histopathological Findings with a Seven-Year Follow-up: A Case Report.

CASE: We describe the clinical and histopathological findings associated with a case of pyoderma gangrenosum (PG) after revision total hip arthroplasty. The patient developed an expanding purple-red, necrotic, ulcerative lesion at the surgical site, which was initially suspected to be either a surgical-site infection or warfarin-induced skin necrosis. After treatment with empiric intravenous antibiotics, surgical debridement, and vacuum-assisted closure of the wound, the patient had a painless hip with a remodeled scar and was asymptomatic at the seven-year follow-up. CONCLUSION: Confirmation of the diagnosis of surgical-site PG requires clinical-pathological correlation and familiarity with the PG skin lesion. Treatment of PG differs from treatment of infection; therefore, misdiagnosis and surgical treatment may exacerbate the clinical findings in PG.

Significance of authorship position: an open-ended international assessment.

INTRODUCTION: The International Committee of Medical Journal Editors (ICMJE) does not recommend guidelines on authorship position, despite its important role in academic promotion. To identify perceptions of authorship position, the authors performed the first study of authorship position using only open-ended questioning. METHODS: Articles with at least 3 authors were selected from the top 10 cited and 20 other medical journals. The first, last, and 1 author in-between were selected and asked to identify contributions of first and last authors listed in medical journal articles. The responses were analyzed for differences between perceptions of first versus last authorship. RESULTS: Respondents were more likely to report ICMJE criteria being fulfilled by first authors; however, only 1.1% identified all 3 ICMJE conditions of authorship for either author. ICMJE criteria were no more likely identified by authors of high-impact versus low-impact journals. Significant differences existed between the understandings of appropriate roles for first- versus last-listed authors. First-listed authors were viewed at least 7 times more likely to be involved in study conduct, manuscript writing, have a major study contribution and perform the majority of the work involved. Last-listed authors were at least 7 times more likely to be viewed as having a minor or no contribution to the study, provide funding, be a laboratory head/mentor, hold a senior position and supervise/oversee the study. CONCLUSIONS: ICMJE authorship criteria were poorly identified by respondents in this open-ended, international sampling of medical journal authors. Although ICMJE criteria are ideally met by all authors, this does not seem to be well understood or accepted.