Shorter Telomere Length Is Associated With Older Age, Poor Sleep Hygiene, and Orthopedic Injury, but Not Mild Traumatic Brain Injury, in a Cohort of Canadian Children.

BACKGROUND: Predicting recovery following pediatric mild traumatic brain injury (mTBI) remains challenging. The identification of objective biomarkers for prognostic purposes could improve clinical outcomes. Telomere length (TL) has previously been used as a prognostic marker of cellular health in the context of mTBI and other neurobiological conditions. While psychosocial and environmental factors are associated with recovery outcomes following pediatric mTBI, the relationship between these factors and TL has not been investigated. This study sought to examine the relationships between TL and psychosocial and environmental factors, in a cohort of Canadian children with mTBI or orthopedic injury (OI). METHODS: Saliva was collected at a postacute (median 7 days) timepoint following injury to assess TL from a prospective longitudinal cohort of children aged 8 to 17 years with either mTBI (n = 202) or OI (n = 90), recruited from 3 Canadian sites. Questionnaires regarding psychosocial and environmental factors were obtained at a postacute follow-up visit and injury outcomes were assessed at a 3-month visit. Univariable associations between TL and psychosocial, environmental, and outcome variables were assessed using Spearman's correlation. Further adjusted analyses of these associations were performed by including injury group, age, sex, and site as covariates in multivariable generalized linear models with a Poisson family, log link function, and robust variance estimates. RESULTS: After adjusting for age, sex, and site, TL in participants with OI was 7% shorter than those with mTBI (adjusted mean ratio = 0.93; 95% confidence interval, 0.89-0.98; P = .003). As expected, increasing age was negatively associated with TL (Spearman's r = -0.14, P = .016). Sleep hygiene at 3 months was positively associated with TL (adjusted mean ratio = 1.010; 95% confidence interval, 1.001-1.020; P = .039). CONCLUSION: The relationships between TL and psychosocial and environmental factors in pediatric mTBI and OI are complex. TL may provide information regarding sleep quality in children recovering from mTBI or OI; however, further investigation into TL biomarker validity should employ a noninjured comparison group.

Lightweight Biobased Polyurethane Composites Derived from Liquefied Polyol Reinforced by Biomass Sources with High Mechanical Property and Enhanced Fire-Resistance Performance.

Lightweight biobased insulation polyurethane (BPU) composite foams with high fire-resistance efficiency are interested in building effective energy and low environmental impact today. This study focuses on manufacturing lightweight BPU from liquefied bamboo polyols and biomass resources, including rice husk and wood flour. Then, they are combined with three flame retardant (FR) additives, such as aluminum diethyl phosphinate, aluminum trihydroxide, and diammonium phosphate, to improve their fire resistance performance. The physicochemical properties, microstructure, thermal stability, mechanical properties, and flame-retardant properties of the BPU composites are characterized to optimize their compromise properties. The results showed that composites with optimized FRs achieved UL94 V-0 and those with nonoptimized FRs reached UL94 HB. The limiting oxygen index exhibited that the fire resistance of BPU composites could increase up to 21-37% within FR additives. In addition, the thermal stability of BPU composites was significantly improved in a temperature range of 300-700 °C and the compressive strength of the BPU composites was also enhanced with the presence of FRs. The scanning electron microscopy observation showed an influence of FRs on the morphology and cell size of the BPU composites. The bio-PU-derived samples in this study showed significantly low thermal conductivity values, demonstrating their remarkable thermal insulation effectiveness.

A novel modification of frozen elephant trunk technique: unique protocol from one institution.

OBJECTIVE: We aim to present a novel surgical technique of Frozen Elephant Trunk (FET) to treat complex thoracic aortic diseases in one stage and report its short-term outcomes. PATIENTS AND METHODS: Between December 2019 and 30 April 2021, twenty-five patients underwent FET operation at Viet Duc University Hospital. The mean age of the patients was 55.9 (±9.9, range 33-72) years. Eighteen (72%) of the patients were men. Thoracic aortic aneurysm was presented in three (12%) patients. Among seventeen (68%) of the patients undergoing the aortic dissection, eleven (44%) were treated acute type A aortic dissection. Type A intramural hematoma was presented in three (12%) patients. Four (16%) of the patients had undergone previous aortic operations, four (16%) of them had Marphan syndrome and two (11.1%) of them had stage 3 chronic kidney disease. All patients underwent FET procedure by unique protocol. Brain protection was achieved by antegrade bilateral selective cerebral perfusion and moderate hypothermia (28°C) in all cases; besides cerebral tissue oximetry monitoring was used to control brain oxygenation. RESULTS: There were no perioperative deaths, and all patients are still alive during mild-term follow-up period. Sixteen (88.9%) patients received isolated FET, while a Bentall procedure during FET was performed in two (8%) patients and right coronary artery bypass was in one (4%) case. The duration of cardiopulmonary bypass, cross-clamping, circulatory arrest, and total operation were 176.7 (±48.1, range 102-330), 106 (±39.8, range 63-205), 32.7 (±9.6, range 20-58), and 365.6 (±53.6, range 270-480) min, respectively. There was no bleeding following surgery. Prolonged ventilation required tracheotomy was documented in two (8%) patients, hemodialysis caused acute renal failure was in five (20%) patients, cerebral shock was in one (4%) patient, and type 1A endoleak in 2 (8%) patients. CONCLUSIONS: Our modification of FET technique was feasible, effective, and safe, with good postoperative outcomes.

Electric field and charged impurity doping effects on the Schottky anomaly of ß12-borophene.

Due to the coexistence of Dirac and triplet fermions, monolayer ß12-borophene has recently attracted both experimental and theoretical researchers. In particular, various phase transitions have been recently reported in the structure, in the presence of dilute charged impurity and a perpendicular electric field, leading to interesting electronic heat capacity (HC). In this paper, we systematically examine the effects of charged impurity doping and electric field on the HC of monolayer ß12-borophene. To do this, we utilize the five-band tight-binding Hamiltonian model, the Green's function, T-matrix, and the Born approximation for different models considering the substrate effects. Numerical analysis reveals that the inversion symmetric model is the proper model in the pristine and perturbed metallic ß12-borophene, leading to a regular reduction of HC with both charged impurity and electric field. Moreover, the pristine and perturbed Schottky anomaly alterations are fully addressed. Unforeseeably, HC irregularly fluctuates with impurity in the homogeneous model. We believe that our results provide new physical insights into the thermal properties of monolayer ß12-borophene.

Schottky anomaly and Néel temperature treatment of possible perturbed hydrogenated AA-stacked graphene, SiC, and h-BN bilayers.

In this paper, the potential of engineering and manipulating the electronic heat capacity and Pauli susceptibility of pristine and perturbed hydrogenated AA-stacked graphene, SiC (silicon carbide), and h-BN (hexagonal boron nitride) bilayers is studied using a designed transverse Zeeman magnetic field and the dilute charged impurity. The tight-binding Hamiltonian model, the Born approximation and the Green's function method describe the carrier dynamics up to a certain degree. The unperturbed results show that the heat capacity and susceptibility of all bilayers increase with different hydrogenation doping configurations. We also found that the maximum heat capacity and susceptibility relates to the chair-like and table-like configurations. Also, the graphene possesses the highest activity compared to SiC and h-BN lattices due to its zero on-site energies. For the Zeeman magnetic field-induced Schottky anomaly and the Néel temperature corresponding to the maximum electronic heat capacity, EHCMax., and Pauli spin paramagnetic susceptibility, PSPSMax., respectively, the pristine EHCMax. (PSPSMax.) decreases (increases) with the Zeeman field. On the other hand, the corresponding results for reduced table-like and reduced chair-like lattices illustrate that both EHCMax. and PSPSMax. decrease with the Zeeman field, on average. However, under the influence of the dilute charged impurity, the pristine EHCMax. of graphene (SiC and h-BN) decreases (increases) with impurity concentration for all configurations while the corresponding PSPSMax. fluctuates (decreases) for the pristine (reduced table-like and reduced chair-like) case. These findings introduce hydrogenated AA-stacked bilayers as versatile candidates for real applications.

Viral encephalopathy and retinopathy in aquaculture: a review.

Viral encephalopathy and retinopathy (VER), otherwise known as viral nervous necrosis (VNN), is a major devastating threat for aquatic animals. Betanodaviruses have been isolated in at least 70 aquatic animal species in marine and in freshwater environments throughout the world, with the notable exception of South America. In this review, the main features of betanodavirus, including its diversity, its distribution and its transmission modes in fish, are firstly presented. Then, the existing diagnosis and detection methods, as well as the different control procedures of this disease, are reviewed. Finally, the potential of selective breeding, including both conventional and genomic selection, as an opportunity to obtain resistant commercial populations, is examined.

Cost-effectiveness of onabotulinumtoxinA for the treatment of wrist and hand disability due to upper-limb post-stroke spasticity in Scotland.

BACKGROUND AND PURPOSE: The objective was to evaluate the cost-effectiveness of treating upper-limb post-stroke spasticity (ULPSS) with usual care (UC) plus onabotulinumtoxinA versus UC alone in Scotland. METHODS: We developed a model to simulate costs and quality-adjusted life years (QALYs) gained from treating ULPSS. Efficacy data and health utilities were taken from clinical trials. Unit costs were taken from published Scottish sources. We compared UC plus onabotulinumtoxinA and UC alone in three scenarios: (i) a scenario from the National Health Service perspective, which included differences in onabotulinumtoxinA use, specialist visits and day-hospital visits; (ii) a scenario that only included differences in onabotulinumtoxinA use and specialist visits; and (iii) a scenario from a societal perspective that included differences in onabotulinumtoxinA use, specialist visits and caregiver burden. RESULTS: In the first scenario, the model predicted that UC plus onabotulinumtoxinA produced 0.107 QALYs at an additional cost of £1099 compared with UC alone over 5 years, resulting in an incremental cost-effectiveness ratio (ICER) of £10,271/QALY. In the second scenario, the ICER increased to £27,134/QALY. In the third scenario (societal perspective), UC plus onabotulinumtoxinA produced lower total cost and higher QALYs, and therefore was superior to UC alone. CONCLUSIONS: Based on a model, UC plus onabotulinumtoxinA improved disability, which translated into greater QALYs but also increased direct medical costs compared with UC alone; however, the resulting ICER can be considered cost-effective. Moreover, UC plus onabotulinumtoxinA can be cost-saving if reduction in caregiver burden was included. OnabotulinumtoxinA offers value for money in the management of ULPSS in Scotland.

Low-pass genome-wide sequencing and variant inference using identity-by-descent in an isolated human population.

Whole-genome sequencing in an isolated population with few founders directly ascertains variants from the population bottleneck that may be rare elsewhere. In such populations, shared haplotypes allow imputation of variants in unsequenced samples without resorting to complex statistical methods as in studies of outbred cohorts. We focus on an isolated population cohort from the Pacific Island of Kosrae, Micronesia, where we previously collected SNP array and rich phenotype data for the majority of the population. We report identification of long regions with haplotypes co-inherited between pairs of individuals and methodology to leverage such shared genetic content for imputation. Our estimates show that sequencing as few as 40 personal genomes allows for inference in up to 60% of the 3000-person cohort at the average locus. We ascertained a pilot data set of whole-genome sequences from seven Kosraean individuals, with average 5× coverage. This assay identified 5,735,306 unique sites of which 1,212,831 were previously unknown. Additionally, these variants are unusually enriched for alleles that are rare in other populations when compared to geographic neighbors (published Korean genome SJK). We used the presence of shared haplotypes between the seven Kosraen individuals to estimate expected imputation accuracy of known and novel homozygous variants at 99.6% and 97.3%, respectively. This study presents whole-genome analysis of a homogenous isolate population with emphasis on optimal rare variant inference.

Estudio comparativo de toracoscopia versus toracotomía en atresia esofágica / Comparative study of thoracoscopy versus thoracotomy in esophageal atresia

Introducción. El abordaje toracoscópico de la atresia de esófago ha sido descrito, pero no existen estudios que muestren sus beneficios con respecto a la técnica abierta tradicional. El objetivo de este estudio es comparar el resultado de la atresia esofágica con fístula traqueoesofágica distal (tipo III) en función del tipo de abordaje. Material y métodos. Entre enero de 2000 y diciembre de 2006 se operó a 31 niños, 17 por toracotomía (peso entre 1.750 y 4.020 g) y14 por toracoscopia (peso entre 1.600 y 4.160 g). Se excluyeron los pacientes que fallecieron por otras patologías (3 casos en el grupo detoracotomía), así que se analizaron 14 pacientes en cada grupo. Las variables estudiadas incluyen: duración del procedimiento quirúrgico, tiempo bajo ventilación mecánica, tiempo con drenaje torácico, tiempo de estancia en cuidados intensivos, momento de inicio de la alimentación oral, duración de analgesia con morfina, tiempo de estancia hospitalaria y porcentaje de complicaciones. Resultados. La necesidad de opiáceos fue superior en el grupo detoracotomía que en el grupo de toracoscopia (media 6,6 días frente a5,3 días, respectivamente, p=0,16). La duración de la hospitalización fue también superior en el grupo de toracotomía (media 22,6 días frente a 19,1 días, p=0,3). No se encontraron diferencias estadísticamente significativas entre ambos grupos respecto a la estenosis de la anastomosis que precisó dilatación (21% en el grupo de toracotomía frente a21% en el grupo de toracoscopia) ni respecto a la indicación de funduplicatura tipo Nissen (28% en el grupo de toracotomía frente a 14%en el grupo de toracoscopia). Conclusiones. El abordaje toracoscópico de la atresia esofágica tipo III reduce tanto la necesidad de analgesia como la duración de la estancia hospitalaria, sin incrementar el riesgo de complicaciones postoperatorias (AU)

Introduction. Thoracoscopic treatment of esophageal atresia type3 has been previously reported to be feasible but no study clearly showed the benefits of thoracoscopy compared to open procedure. The aim of this study was to compare the outcome of esophageal atresia type IIItreated by thoracoscopic or open procedure. Material and method. From january 2000 to december 2006, 31children were operated, 17 by thoracotomy (weight range from 1,750to 4,020 g) and 14 by thoracoscopy (weight range from 2,110 to 4,160g). Neonatal deaths from an independent condition (3 cases in thoracotomy group) were excluded from the study and we analyzed 14 children in each group. Analyzed data included length of surgery, length of postoperative assisted ventilation, length of pleural drainage, length of stay in ICU, delay before oral feeding, length of morphine analgesia, length of hospitalization and rate of complication. Results. Length of morphine analgesia was higher in thoracotomy group than in thoracoscopic group (mean 6, 6 days versus 5,3 days,p= 0,16). Length of hospitalization was also higher in thoracotomy group(mean 22,6 days versus 19,1 days, p= 0,3). The rate of complication with thoracoscopy was not higher need of oesophageal dilatation (21%in thoracoscopic group versus 14 % in thoracotomy group), need of Nissen fundoplication (21 % in thoracoscopic group versus 28% in thoracotomy group).Conclusion. Thoracoscopic treatment of esophageal atresia type III reduces the need of morphine analgesia and the length of stay without increasing the risk of postoperative complications (AU)

[Comparative study of thoracoscopy versus thoracotomy in esophageal atresia]. / Estudio comparativo de toracoscopia versus toracotomía en atresia esofágica.

INTRODUCTION: Thoracoscopic treatment of esophageal atresia type 3 has been previously reported to be feasible but no study clearly showed the benefits of thoracoscopy compared to open procedure. The aim of this study was to compare the outcome of esophageal atresia type III treated by thoracoscopic or open procedure. MATERIAL AND METHOD: From january 2000 to december 2006, 31 children were operated, 17 by thoracotomy (weight range from 1750 to 4020 g) and 14 by thoracoscopy (weight range from 2110 to 4160 g). Neonatal deaths from an independent condition (3 cases in thoracotomy group) were excluded from the study and we analyzed 14 children in each group. Analyzed data included length of surgery, length of post operative assisted ventilation, length of pleural drainage, length of stay in ICU, delay before oral feeding, length of morphine analgesia, length of hospitalization and rate of complication. RESULTS: Length of morphine analgesia was higher in thoracotomy group than in thoracoscopic group (mean 6.6 days versus 5.3 days, p = 0.16). Length of hospitalization was also higher in thoracotomy group (mean 22.6 days versus 19.1 days, p = 0.3). The rate of complication with thoracoscopy was not higher need of oesophageal dilatation (21% in thoracoscopic group versus 14% in thoracotomy group), need of Nissen fundoplication (21% in thoracoscopic group versus 28% in thoracotomy group). CONCLUSION: Thoracoscopic treatment of esophageal atresia type III reduces the need of morphine analgesia and the length of stay without increasing the risk of postoperative complications.

Effects of caffeine on sensorimotor gating of the startle reflex in normal control subjects: impact of caffeine intake and withdrawal.

RATIONALE: Prepulse inhibition (PPI), a cross-species measure of sensorimotor gating, is impaired in certain neuropsychiatric disorders. This study was designed to assess caffeine effects on PPI in normal humans, as part of an effort to understand cross-species differences and similarities in the neurochemical regulation of PPI. METHODS: Startle was measured during a screening session; 7 days later, subjects were retested after placebo or caffeine (200 mg; double-blind design). Subjects were characterized as low versus high caffeine drinkers based on established scales (range 11-628 mg/day), and either maintained ad libitum caffeine intake (Ad lib study; n=18) or refrained from caffeine consumption for > or =15 h prior to testing (Withdrawal study; n=12). Autonomic and self-rating measures, acoustic and tactile startle, and unimodal and cross-modal PPI, were measured in divided sessions for 3 h post-treatment. RESULTS: There were significant effects of caffeine and/or caffeine withdrawal on several self-rating and autonomic measures, and on startle reflex habituation, but not on acoustic or tactile startle magnitude or PPI. Difference scores of startle data from screening versus test days revealed no group effects on startle magnitude, but PPI difference scores revealed that caffeine had opposite effects on low versus high caffeine drinkers (means=57 versus 258 mg/day) in the two withdrawal states. In the absence of withdrawal, caffeine reduced PPI in heavy caffeine drinkers; during withdrawal, caffeine increased PPI in heavy caffeine drinkers. The opposite pattern was evident in low caffeine drinkers. CONCLUSIONS: While a physiologically active dose of caffeine has no simple effects on PPI in normal humans, both withdrawal states and normal levels of caffeine consumption may be important factors in understanding this drug's effects on sensorimotor gating.

Preliminary findings with a new Vietnamese Stroop test.

Stroop performance was compared in primary Vietnamese- vs English-speaking individuals (age range 19-68 years), currently living in the USA. A modified Vietnamese Stroop task mimicked word, color, and interference effects of an English-language Stroop test. Stroop performance (items correctly completed and interference "cost") did not differ significantly between 30 Vietnamese Americans whose first language was Vietnamese (M age 34.3 yr.) vs 30 American-born individuals whose first language was English (M age 31.2 yr.). Expected performance decrements with aging were observed in English-language Stroop performance but not in Vietnamese-language Stroop performance, which instead exhibited a trend towards the opposite pattern. Unexpected group differences associated with age in Stroop performance may reflect subtle differences in task demands, not evident in simple category performance scores, or alternatively, cultural or neuropsychological differences in the study groups.

Detection and characterisation of transforming growth factor-beta in porcine colostrum.

Porcine colostrum and milk collected at different stages of lactation were assessed for transforming growth factor-beta (TGF-beta) activity using an epithelial cell bio-assay. A high level of TGF-beta activity was recorded in all colostrum samples after transient acidification treatment, ranging between 126 and 260 ng/ml for samples collected at the time of parturition and 73 ng/ml for the sample collected 12 h after parturition. Without transient acidification treatment TGF-beta activity was detected only in 2 samples collected at the time of parturition (12 ng/ml) and 12 h after parturition (9 ng/ml), respectively. TGF-beta activity was undetectable in milk collected 5 days after parturition. These results suggest that TGF-beta exists mainly in latent form in porcine colostrum and the concentration declines rapidly as lactation proceeds. After enrichment with cation exchange chromatography a low level of TGF-beta activity was detected in porcine milk. Further separation by size exclusion chromatography revealed two molecular mass forms of TGF-beta in both colostrum and milk samples, a major peak of about 80 kD and a minor peak of about 25 kD representing latent and active forms of TGF-beta, respectively. A further experiment showed that the latent form of TGF-beta in colostrum can be activated at pH 3.5 or less. It is speculated that TGF-beta found in the colostrum may play a physiological role in regulating postnatal adaptation of the gastro-intestinal tract in newborns.

Strategies for reaching Asian Americans with health information.

INTRODUCTION: Cultural, linguistic, and economic barriers place many Asian Americans in jeopardy of missing opportunities for disease prevention, early diagnosis, prompt treatment, and participation in clinical trials. One way to learn how to address these barriers is through the development of a demonstration health education and prevention program focused on an indicator disease such as cancer. METHODS: In 1994, the University of California, San Diego (UCSD) Cancer Center began a highly focused cancer education program. Staffing was done with a variety of bicultural and bilingual undergraduates recruited from local colleges and trained to work as community health educators. Asian grocery stores were selected as optimal educational sites. Adaptation of sheltered English teaching techniques and hands-on teaching aids helped to overcome language and educational barriers. The educational intervention was evaluated using unobtrusive measures. RESULTS: With the volunteers' help, culturally sensitive means to disseminate information on cancer were evaluated. A variety of approaches evolved that effectively bridged many communication barriers. Fear of cancer itself, belief that thinking about cancer could provoke the onset of the disease, and financial barriers to care proved to be just as formidable barriers to cancer education in this ethnic group as they are in others. Using student volunteers and donated store space, this educational program was conducted with minimal expense. CONCLUSION: Reaching this population with the help of ethnically and linguistically compatible students was effective, but the barriers they faced when trying to connect with their potential audience were still considerable. Rigorous evaluation of the strategies used in this intervention is warranted.

Radiographic identification of unknown human remains and interpreter experience level.

The use of radiographs as a means of identification of unknown remains is a well-established method as performed by radiologists, forensic anthropologists, or pathologists. We devised a test to determine whether the degree of radiographic and medical knowledge of a film interpreter correlates with the degree of accuracy in making comparisons of radiographic unknowns. Three groups considered to be distinctly different in their level of medical knowledge and radiographic interpretive skills were chosen to evaluate forensic identification cases. Although all three groups identified a majority of cases correctly, none were completely accurate. The group with training in radiographic interpretation performed significantly better. Our study supports the need for trained interpreters in cases of forensic identification.