National Trends in Inpatient Hospital Outcomes of Children with Osteogenesis Imperfecta and the Importance of Extraskeletal Manifestations: A Kids' Inpatient Database Study.

OBJECTIVE: To investigate the extent of extraskeletal manifestations along with inpatient outcomes and complications associated with osteogenesis imperfecta (OI). STUDY DESIGN: This cross-sectional study utilized the Kids' Inpatient Database as a part of the Healthcare Cost and Utilization Project to investigate inpatient hospital outcomes and management in patients with OI from 1997 through 2016. Data regarding hospital characteristics, cost of treatment, inpatient outcomes, and procedures were collected and analyzed. RESULTS: There were 7291 admissions that listed OI as a diagnosis in the Kids' Inpatient Database from 1997 through 2016. Unexpectedly, more than one-third of all admissions in these children with OI presented with an extraskeletal manifestation. The rate of major complications was 3.85%. The rate of minor complications was 19.4%, most commonly respiratory problems. The mortality rate was 18.2% in the neonatal period and 1.0% in all other admissions. Total charges of hospital stay increased over the years. CONCLUSIONS: We identified a striking prevalence of extraskeletal manifestations in OI along with inpatient outcomes and complications associated with OI, of which respiratory complications were predominant. We observed a significant financial burden for patients with OI and identified additional risks for financial crisis, in addition to disparities in care identified among socioeconomic groups. These data contribute to a more holistic understanding of OI from diagnosis to management.

Dairy goat doe-kid rearing systems: Farmers' motivations and a description of practices, benefits, and drawbacks.

In French dairy goat systems, kids are generally separated from their mother does shortly after birth. The main drivers of this practice are related to health-especially the prevention of the caprine arthritis encephalitis virus (CAEV) transmission-and economics. However, the separation of young ruminants from their does is being increasingly questioned by society and has raised concerns about the satisfaction of their behavioral needs. Some farmers choose to leave their female kids with their does. The aims of this study were to understand their motivations for leaving kids with their does, to describe how kids are reared in this case and how farmers perceive different aspects of the effects of this practice. Individual semi-structured interviews were carried out with 40 farmers who had implemented the kids-with-does practice for at least 1 yr. Compared with the national database describing the French population of dairy goat farmers, the characteristics of the interviewed farmers differed from those of the general population. They were younger and had done longer studies. Their farms were smaller, mainly with rare breeds, and milk was mainly processed on-farm under an organic certification system. They chose to implement this practice for different reasons: ethical considerations, improving integration of kids within the herd, saving time, and increasing comfort at work or improving the kids' growth, welfare, and health. The doe-kid rearing contact practices varied greatly between farms, with some kids staying with their does from a period of 45 d to never being separated; furthermore, some kids remained with their does all day, whereas others remained together part of the day or for a limited time, and daily contact evolved over time. Overall, farmers were satisfied as the benefits quoted were coherent with their motivations to implement this rearing practice. Most have decided to continue the practice, though usually with changes. However, as 40% of them had only 3 yr or less of experience of doe-kid rearing, some had not sufficient hindsight into long-term issues such as the transmission of CAEV. It is crucial to tackle challenges associated with this practice (i.e., potentially wild kids, health issues, and economic consequences stemming from a reduction in marketable milk).

Understanding pediatric inpatient conductive hearing loss: An analysis of patient demographics.

OBJECTIVE: Hearing loss is a common sensory impairment in children that affects quality of life and development. Early intervention, such as hearing aids and communication therapies, can help children overcome these challenges and lessen the impact on their development. The objective of this study was to identify specific patient demographic factors correlated with the prevalence of pediatric conductive hearing loss. STUDY DESIGN: The study utilized the Kids' Inpatient Database (KID) by the Agency for Healthcare Research and Quality which collects inpatient information from hospitals for patients under 21 years old. We included all patients discharged in 2016 diagnosed with conductive hearing loss, and excluded neonatal patients discharged within 28 days of birth. METHODS: Statistical analyses were performed using R Studio and IBM SPSS Statistics. Weighted odds ratios were calculated for conductive hearing loss in relation to race and income, and a multivariate regression analysis examined associations between demographic variables and race categories in conductive hearing loss. RESULTS: The prevalence of conductive hearing loss (CHL) in pediatric patients in 2016 was 51.62 cases per 100,000 patients. Non-Hispanic White patients had the highest prevalence, while Black patients had the highest likelihood of CHL compared to the overall population. Lower income levels were associated with a decreased probability of CHL diagnosis. After adjusting for age, sex, hospital region, insurance, and income on multivariate analysis, White and Black patients were less likely to be diagnosed with CHL. Furthermore, patients in specific income quartiles also had lower CHL likelihood compared to the general population. CONCLUSION: While Black patients had a higher likelihood of being diagnosed with CHL than the general population, socioeconomic factors such as income greatly influenced the likelihood of CHL diagnosis. Other significant factors included income, region of the country, sex, and age. Further research is needed to better understand and address healthcare disparities related to pediatric hearing loss.

Cryptosporidium parvum gp60 subtypes in diarrheic lambs and goat kids from Israel.

Cryptosporidium parvum is the second-most prevalent Cryptosporidium species that infects humans worldwide. In European countries, it is the most prevalent species in sheep, suggesting that these animals are a source of zoonotic infection. Preweaned lambs and goats are particularly susceptible to infection by the parasite and may suffer from severe diarrhea whilst excreting large quantities of infectious oocysts. Fifty fecal samples from preweaned lambs and goats with diarrhea from 35 farms across Israel, found to be Cryptosporidium-positive by microscopy, were tested by PCR and sequence analyses to determine the infective species and subtypes. Cryptosporidium parvum DNA was detected in most samples from both lambs and goats (46/50). Cryptosporidium xiaoi DNA was detected in three samples from kids, with co-infection detected in a single sample. Eleven different C. parvum subtypes were found, 10 in lambs and 5 in goats. All subtypes were from the IIa and IId subtype families, with subtypes IIdA20G1 and IIaA15G2R1 being the most prevalent and widespread. These subtypes were previously found in calves and humans in Israel and are considered the most prevalent C. parvum subtypes in small ruminants globally. These results underline the zoonotic potential of C. parvum from small ruminants and the high subtype diversity compared to previous reports from other Middle Eastern countries. In addition, this is the first report of C. xiaoi in Israel.

Talarolide A and Talaropeptides A-D: Potential Marine-Derived Therapeutic Peptides with Interesting Chemistry and Biological Activity Studied through Density Functional Theory (DFT) and Conceptual DFT.

Molecules sourced from marine environments hold immense promise for the development of novel therapeutic drugs, owing to their distinctive chemical compositions and valuable medicinal attributes. Notably, Talarolide A and Talaropeptides A-D have gained recent attention as potential candidates for pharmaceutical applications. This study aims to explore the chemical reactivity of Talarolide A and Talaropeptides A-D through the application of molecular modeling and computational chemistry techniques, specifically employing Conceptual Density Functional Theory (CDFT). By investigating their chemical behaviors, the study seeks to contribute to the understanding of the potential pharmacological uses of these marine-derived compounds. The molecular geometry optimizations and frequency calculations were conducted using the Density Functional Tight Binding (DFTBA) method. This was followed by a subsequent round of geometry optimization, frequency analysis, and computation of electronic properties and chemical reactivity descriptors. We employed the MN12SX/Def2TZVP/H2O model chemistry, utilizing the Gaussian 16 program and the SMD solvation model. The analysis of the global reactivity descriptors arising from CDFT was achieved as well as the graphical comparison of the dual descriptor DD revealing the areas of the molecules with more propensity to suffer a nucleophilic or electrophilic attack. Additionally, Molinspiration and SwissTargetPrediction were considered for the calculation of molecular characteristics and predicted biological targets. These include enzymes, nuclear receptors, kinase inhibitors, GPCR ligands, and ion channel modulators. The graphical results show that Talarolide A and the Talaropeptides A-D are likely to behave as protease inhibitors.

Fish oil supplementation as an omega-3 fatty acid source during gestation: effects on the performance of weaned male goat kids.

The aim of this study was to evaluate the effects of fish oil supplementation, as an omega-3 fatty acids source, to ration of does in the different periods of pregnancy on the fattening performance of kids after weaning. Eighty German Fawn × Hair crossbred does were randomly divided into two groups; half were given fish oil in the first half of pregnancy (FO group), while the other half were given saturated fat (PF (control) group). Then, the goats in the FO and PF groups were randomly divided into two subgroups, and half of the goats were fed fish oil during the second half of pregnancy (FO-FO and FO-PF groups), while the other half was fed saturated fat (PF-FO and PF-PF groups). Thus, study groups of kids were formed according to the nutrition program of the does described above. Forty-seven male kids (84.6 ± 2.44 days old; 14.5 ± 3.09 kg live weight, mean ± standard deviation) were fed for 56 days after weaning, and their weight, feed consumption, serum biochemical parameters, carcass performance, and meat quality characteristics were evaluated. Maternal nutrition significantly affected live weight gain and serum AST, glucose, total protein, and globulin concentrations (P ≤ 0.050). The live weight gain of kids in the PF-PF and PF-FO groups was higher than that in the FO-FO and FO-PF groups. Maternal nutrition tended to affect the hot and cold carcass weights of male kids (P = 0.078 and P = 0.084, respectively). In conclusion, fish oil supplementation during gestation could negatively affect the fattening performance of kids after weaning, especially the daily live weight gain, although it tended to positively affect hot and cold carcass weights.

[When pediatric resuscitation and anesthesia teams simulate together]. / Quand des équipes de réanimation et d'anesthésie pédiatrique simulent ensemble.

At the Grenoble-Alpes University Hospital Center, a high-fidelity simulation training project was born from the collaboration of the intensive care and pediatric anesthesia teams. The objective of these sessions was to improve practices by developing the technical and non-technical skills of the teams. Fifteen days were organized from 2018 to 2022, training 170 healthcare professionals. The results highlighted excellent satisfaction and helped improve professional practices.

A Short Knowledge Assessment Tool Is Valid and Acceptable for Adults with Inflammatory Bowel Disease.

BACKGROUND: For people with inflammatory bowel disease, validated knowledge questionnaires are valuable to identify gaps in understanding and explore the impact on disease variables. AIMS: The aim of this study was to validate the short knowledge questionnaire Inflammatory Bowel Disease Knowledge Inventory Device 2, known as IBD-KID2, for use with adults with inflammatory bowel disease. METHODS: Concurrent validity of IBD-KID2 was assessed by comparing scores with those achieved on the Crohn's and Colitis Knowledge Score (CCKNOW). IBD-KID2 reliability was assessed with test-retest completion at two time points, generalizability assessed by comparing IBD-KID2 cohort scores at different recruitment centres, and acceptability assessed using participant survey. RESULTS: Seventy-five adults with inflammatory bowel disease completed the study. The mean percentage scores achieved on the IBD-KID2 and CCKNOW were 72.8% (SD 16.0) and 49.7% (SD 18.2), respectively. There was a significant correlation between IBD-KID2 and CCKNOW scores (R 0.573, P < 0.005), confirming concurrent validity. IBD-KID2 reliability was confirmed as no significant difference was seen between scores at test and retest (mean difference -0.2, P = 0.92). Generalizability was established as no significant score difference was seen between recruitment centres after controlling for population differences. The acceptability survey showed that 49 (69%) participants preferred IBD-KID2 to the CCKNOW, 60 (85%) found the IBD-KID2 easier to complete, and 38 (53%) considered the CCKNOW as most suitable for adults. CONCLUSIONS: IBD-KID2 is a valid, reliable, and generalizable tool for measuring knowledge in adults with inflammatory bowel disease with good acceptability. IBD-KID2 is easy and quick to complete, hence limiting respondent burden.

Conceptual DFT-Based Computational Peptidology, Pharmacokinetics Study and ADMET Report of the Veraguamides A-G Family of Marine Natural Drugs.

As a continuation of our research on the chemical reactivity, pharmacokinetics and ADMET properties of cyclopeptides of marine origin with potential therapeutic abilities, in this work our already presented integrated molecular modeling protocol has been used for the study of the chemical reactivity and bioactivity properties of the Veraguamides A-G family of marine natural drugs. This protocol results from the estimation of the conceptual density functional theory (CDFT) chemical reactivity descriptors together with several chemoinformatics tools commonly considered within the process of development of new therapeutic drugs. CP-CDFT is a branch of computational chemistry and molecular modeling dedicated to the study of peptides, and it is a protocol that allows the estimation with great accuracy of the CDFT-based reactivity descriptors and the associated physical and chemical properties, which can aid in determining the ability of the studied peptides to behave as potential useful drugs. Moreover, the superiority of the MN12SX density functional over other long-range corrected density functionals for the prediction of chemical and physical properties in the presence of water as the solvent is clearly demonstrated. The research was supplemented with an investigation of the bioactivity of the molecular systems and their ADMET (absorption, distribution, metabolism, excretion, and toxicity) parameters, as is customary in medicinal chemistry. Some instances of the CDFT-based chemical reactivity descriptors' capacity to predict the pKas of peptides as well as their potential as AGE inhibitors are also shown.

Racial and socioeconomic disparities in the advanced treatment of medically intractable pediatric epilepsy.

OBJECTIVE: Racial and ethnic disparities in healthcare have gained significant importance since the Institute of Medicine published its report on disparities in healthcare. There is a lack of evidence on how race and ethnicity affect access to advanced treatment of pediatric medically intractable epilepsy. In this context, the authors analyzed the latest Kids' Inpatient Database (KID) for racial/ethnic disparities in access to surgical treatment of epilepsy. METHODS: The authors queried the KID for the years 2016 and 2019 for the diagnosis of medically intractable epilepsy. RESULTS: A total of 29,292 patients were included in the sample. Of these patients, 8.9% (n = 2610) underwent surgical treatment/invasive monitoring. The mean ages in the surgical treatment and nonsurgical treatment groups were 11.73 years (SD 5.75 years) and 9.5 years (SD 6.16 years), respectively. The most common insurance in the surgical group was private/commercial (55.9%) and Medicaid in the nonsurgical group (47.7%) (p < 0.001). White patients accounted for the most common population in both groups, followed by Hispanic patients. African American patients made up 7.9% in the surgical treatment group compared with 12.9% in the nonsurgical group. African American (41.1%) and Hispanic (29.9%) patients had higher rates of emergency department (ED) utilization compared with the White population (24.6%). After adjusting for all covariates, the odds of surgical treatment increased with increasing age (OR 1.06, 95% CI 1.053-1.067; p < 0.001). African American race (OR 0.513, 95% CI 0.443-0.605; p < 0.001), Hispanic ethnicity (OR 0.681, 95% CI 0.612-0.758; p < 0.001), and other races (OR 0.789, 95% CI 0.689-0.903; p = 0.006) had lower surgical treatment odds compared with the White population. Medicaid/Medicare was associated with lower surgical treatment odds than private/commercial insurance (OR 0.603, 0.554-0.657; p < 0.001). Interaction analysis revealed that African American (OR 0.708, 95% CI 0.569-0.880; p = 0.001) and Hispanic (OR 0.671, 95% CI 0.556-0.809; p < 0.001) populations with private insurance had lower surgical treatment odds than White populations with private insurance. Similarly, African American patients, Hispanic patients, and patients of other races with nonprivate insurance also had lower surgical treatment odds than their White counterparts after adjusting for all other covariates. CONCLUSIONS: Based on the KID, African American and Hispanic populations had lower surgical treatment rates than their White counterparts, with higher utilization of the ED for pediatric medically intractable epilepsy.

Impact of specific essential oils blend on milk production, serum biochemical parameters and kid performance of goats.

Effects of cinnamon, thyme, and peppermint essential oils blend (EOB) on milk production, serum constituents, and energy balance of early lactating does and performance of their kids were investigated. Twenty-seven late pregnant Damascus goats were grouped into two treatments: EOB (n = 14) received orally 1.5 ml EOB/d and control (n = 13) received orally 1.5 ml water/d. The trail started 15 days before the expected kidding date and lasted for 30 days postpartum while sample collection continued until the eighth week of lactation. Milk yield and composition, maternal metabolic profile, immunoglobulin (IgG), and weights of kids were monitored throughout 8 consecutive weeks postpartum. Energy corrected milk (ECM), milk energy value (MEV), net energy for lactation (NEL), and energy balance were estimated. Does treated with EOB had higher (p < 0.05) milk yield, ECM, and NEL than control. Treated does had higher (p = 0.02) energy balance than control does. The EOB increased (p < 0.05) concentrations of serum albumin, cholesterol, triglycerides, and IgG. Treatment with EOB improved (p < 0.05) weaning weight and total weight gain of single kids. Administration of EOB for 45 days during the transition period could improve milk production, metabolic status and energy balance of goats and performance of kids.

Does Generic Cyclic Kinase Insert Domain of Receptor Tyrosine Kinase KIT Clone Its Native Homologue?

Receptor tyrosine kinases (RTKs) are modular membrane proteins possessing both well-folded and disordered domains acting together in ligand-induced activation and regulation of post-transduction processes that tightly couple extracellular and cytoplasmic events. They ensure the fine-turning control of signal transmission by signal transduction. Deregulation of RTK KIT, including overexpression and gain of function mutations, has been detected in several human cancers. In this paper, we analysed by in silico techniques the Kinase Insert Domain (KID), a key platform of KIT transduction processes, as a generic macrocycle (KIDGC), a cleaved isolated polypeptide (KIDC), and a natively fused TKD domain (KIDD). We assumed that these KID species have similar structural and dynamic characteristics indicating the intrinsically disordered nature of this domain. This finding means that both polypeptides, cyclic KIDGC and linear KIDC, are valid models of KID integrated into the RTK KIT and will be helpful for further computational and empirical studies of post-transduction KIT events.

Risk factors for increased length of hospital stay among young pediatric patients who suffer facial fractures.

BACKGROUND/AIM: It is not known whether the mechanism of facial trauma influences the associated length of hospitalization. The aim of this study was to determine whether the mechanism of injury influenced the length of hospital stay (LOS) among pediatric patients who sustained facial fractures. MATERIALS AND METHODS: This retrospective cohort study was completed using the Kids' Inpatient Database (KID). The primary predictor variable was the mechanism of injury. The primary outcome variable was LOS. Linear regression was used to determine independent predictors of increased/decreased length of stay. A p-value of less than .05 was considered statistically significant. RESULTS: The final sample consisted of 2865 subjects aged 12 years or younger who had suffered facial fractures. The most common mechanism of injury was motor vehicle accidents (MVA) (58.6%). Facial fractures due to MVA added 1.20 days (95% CI, 0.02, 2.38; p < .05) when compared to those due to a fall. CONCLUSIONS: MVA significantly prolonged the LOS among young pediatric patients who sustained facial fractures, reflecting the exceptional amount of force involved. Having a chronic condition was also a significant factor for longer LOS. Four or more fractures also led to a longer LOS.

Morphometric features and performances of Black Bengal goat in Bangladesh.

Black Bengal goat (BBG) is the most adaptable, widely distributed, and prominent goat breed in Bangladesh, well known in the world for its high prolificacy, low demand of feed, tolerance to harsh weather conditions, and disease resistance with remarkably good quality red meat and skin. A large number of indiscriminate research reports on BBG have been published; however, the review on the productive and reproductive performances with different physiological features of BBG in Bangladesh is scarce. This review was conducted to investigate and summarize the available research reports on BBGs to highlight the gaps and provide coherent recommendations for the future research plan for sustainable BBG production in Bangladesh. It covers research works in morphometric features, feeding and nutrition, reproduction, diseases and health management, husbandry practices, and production performances of BBG under local conditions. Due to the contemporary increased demand for animal protein (meat and milk), the scope of small ruminants, especially goat farming, increases with other large ruminants farming. The key constraints of BBG production in Bangladesh include higher disease prevalence with low or no management practices, kid mortality, inadequate feeds and fodder supply, and poor marketing channel with some other stumpy genetic potentialities (slower body weight gain, low milk production) of this goat. Future research would be required to assess the contribution of BBG to household economies and food securities throughout the year and evaluate the constraints, adaptation and extension of artificial insemination (AI), and genetic improvement of economically important traits using molecular techniques and the selective breeding program.

The Italian Cilentana goat breed: productive performances and economic perspectives of goat farming in marginal areas.

In the internal areas of Cilento, province of Salerno (Campania), the Cilentana, a small native goat breed population, is reared quite widespread, due to its dual-purpose attitude and to its typical productions. The extensive livestock system adopted for this breed allows the use of otherwise abandoned territories and a sustainable farming capable of ensuring high-quality levels. In addition, Cilentana goat farming represents an important source of income for the local communities and also preserves the territory itself guaranteeing the protection of biodiversity and the conservation of local activities that have a historical tradition. The aim of this study is twofold: give an overview of Cilentana breed morphological and productive traits linked to the historical and gastronomic tradition of the area and emphasize the economic role of this breed in the perspective of the ongoing new Common Agricultural Policy (CAP) rules.

Keratitis-ichthyosis-deafness Syndrome with Heterozygous p.D50N in the GJB2 Gene in Two Serbian Adult Patients.

Purpose: Keratitis-ichthyosis-deafness (KID) syndrome is a rare congenital ectodermal dysplastic syndrome presenting with keratitis, ichthyosis and sensorineural hearing loss. The most common causes of KID syndrome are heterozygous missense mutations in the GJB2 gene that codes for connexin 26. Case report: During the ophthalmological examination, two adult females complained of recent worsening of visual acuity in both eyes. Anamnesis revealed that their eyes were red and irritated from early childhood onwards. Both of them had thickening and keratinisation of eyelid margins, lash loss, diffuse opacification of cornea and conjunctiva caused by keratinisation of eye surface, superficial and deep corneal vascularisation and corneal oedema. Partial sensorineural hearing loss and difficulties in speech were also noted along with typical ichthyosiform erythroderma. Genetic testing of the GJB2 gene revealed a heterozygous p.D50N mutation in both patients.Patients were treated with a combined topical corticosteroid and artificial tears therapy, with steroid therapy being intensified during the last month. The therapy increased the visual acuity by decreasing corneal oedema and by forming a more regular air-tear interface during the six months follow up. Subsequently, the disease progressed despite the continuation of the therapy. Conclusion: This is the first report of Serbian patients with KID syndrome. Despite the administration of the combined topical corticosteroid and artificial tears therapy the disease is relentlessly progressive and therapeutic success of ophthalmological signs with local therapeutic modalities used so far had been disappointing.

Mini international neuropsychiatry interview kid or child posttraumatic stress disorder symptom scale 5I for posttraumatic stress disorder among adolescent girls infected with COVID-19.

Background: Posttraumatic stress disorder (PTSD) is a mental disorder that may develop after exposure to exceptionally life threatening or horrifying events. People suffering from PTSD are vulnerable for both physical and mental health. Objectives: To find out sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and to plot receiver operating characteristic curve taking Mini International Neuropsychiatry Interview-Kid (MINIKID) as the gold standard and Child PTSD Symptom Scale 5I (CPSS-5I) as the newer diagnostic tool for diagnosing PTSD. Materials and Methods: The cross-sectional study was carried out for a period of 6 months from January 2021 to June 2021 at R. L. Jalappa Hospital and Research Center, Kolar, Karnataka through telephonic interviews. All the data entered in Microsoft office Excel sheet, analyzed using the SPSSv22 (IBM Corp). Results: Sensitivity of the CPSS-5I was 56% and specificity was 96% compared with MINIKID. 83% and 85%, respectively, was PPV and NPV of the CPSS-5I compared with MINIKID. Area under the curve is 83.9% with P < 0.001 (72.5-95.2) indicating CPSS-5I is 84% sensitive proving to be a very good diagnostic tool for diagnosing PTSD. Furthermore, scores of 9.5 or 10.5 from CPSS-5I can be used as cutoff in diagnosing PTSD using CPSS 51. Conclusion: CPSS-5I is extremely well designed, helpful and functional tool used in diagnosing PTSD. With the current study showing CPSS-5I can be used in post-COVID PTSD diagnosis, it also provides cutoff which can be helpful in mass screening.

Phenotypic differences of mutation-negative cases in Gitelman syndrome clinically diagnosed in adulthood.

Gitelman syndrome (GS), an autosomal recessive kidney disorder, is characterized by hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis. Generally, diagnosis is made in school-aged children but multiple cases have been diagnosed in adulthood. This study examines the phenotypic differences between genetically confirmed cases and mutation-negative cases in adults. A comprehensive screening of 168 genes, including GS-related genes, was performed for 84 independent individuals who were referred to our institute with a clinical diagnosis of GS. The cases of pseudo-Bartter syndrome (BS)/GS because of diuretic abuse or other causes, which was determined based on patients' medical records, were excluded during registration. Of these 70 eligible cases for analysis, 27 (38.6%) had genetic confirmation of GS, while 37 (52.8%) had no known variants associated with GS and were considered to be unsolved cases. Note that unsolved cases comprised older, mostly female, individuals with decreased kidney function and multiple basic features of GS. The phenotype of unsolved cases is similar to that of pseudo BS/GS cases, although these cases were excluded in advance. However, the genetic and autoimmune profiles of these unsolved cases have not yet been investigated to date. Therefore, these cases may be categorized into new disease groups.

Pre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation.

PURPOSE: For young children and adolescents with Chiari malformation type I (CM-I), the determinants of extended length of hospital stay (LOS) after neurosurgical suboccipital decompression are obscure. Here, we investigate the impact of patient- and hospital-level risk factors on extended LOS following surgical decompression for CM-I in young children to adolescents. METHODS: The Kids' Inpatient Database year 2012 was queried. Pediatric CM-I patients (6-18 years) undergoing surgical decompression were identified. Weighted patient demographics, comorbidities, complications, LOS, disposition, and total cost were recorded. A multivariate logistic regression was used to determine the odds ratio for risk-adjusted LOS. The primary outcome was the degree patient comorbidities or post-operative complications correlated with extended LOS. RESULTS: A total of 1592 pediatric CM-I patients were identified for which 328 (20.6%) patients had extended LOS (normal LOS, 1264; extended LOS, 328). Age, gender, race, median household income quartile, and healthcare coverage distributions were similar between the two cohorts. Patients with extended LOS had significantly greater admission comorbidities including headache symptoms, nausea and vomiting, obstructive hydrocephalus, lack of coordination, deficiency anemias, and fluid and electrolyte disorders. On multivariate logistic regression, several risk factors were associated with extended LOS, including headache symptoms, obstructive hydrocephalus, and fluid and electrolyte disorders. CONCLUSIONS: Our study using the Kids' Inpatient Database demonstrates that presenting symptoms and signs, including headaches and obstructive hydrocephalus, respectively, are significantly associated with extended LOS following decompression for pediatric CM-I.

Graduate Student Literature Review: Current recommendations and scientific knowledge on dairy goat kid rearing practices in intensive production systems in Canada, the United States, and France.

Dairy goat kid rearing is the foundation of future milk production, yet little is known on this topic. References available to producers are limited, making it more difficult for dairy goat farms to reach their full production potential. This review paper aimed to identify the current recommendations on dairy goat kid rearing practices for intensive production systems and to assess whether the different recommendations were based on scientific literature. Recommendations on dairy goat kid rearing practices, from birth to weaning inclusively, were presented and compared between countries under similar intensive production systems, including Canada, the United States, and France. The different areas of rearing investigated included kidding management, colostrum management, liquid and solid feeding, health management, disbudding, housing, weaning, and growth monitoring. Gaps in the literature were identified in all areas except for disbudding. More research on the topic of goat kid raising practices would be beneficial to refine and validate current recommendations.