Autonomic dysregulation and self-injurious thoughts and behaviours in children and young people: A systematic review and meta-analysis.

Background: Self-injurious thoughts and behaviours (SITBs) have been associated with dysfunction of the Autonomic Nervous System (ANS) in children and young people, suggesting that objective ANS measures may aid assessment of suicide risk, but a systematic synthesis of this literature is currently lacking. Methods: Following a pre-registered protocol (PROSPERO CRD42022327605), we conducted a systematic search of PubMed, Medline, Embase, PsycINFO, and Web of Science, for empirical studies published until 10th May 2022 that compared indices of ANS functioning in individuals aged 0-25 years with versus without SITBs, or reported continuous associations between ANS measures and SITBs. Study quality was assessed with the Newcastle-Ottawa Scales. Pooled effect sizes (Hedge's g) were estimated with random-effects meta-analytic models. Results: Twenty studies (1979 participants) were included in our systematic review, with 16 included in meta-analyses. Results suggested that SITBs were associated with altered cardiac indices of arousal (g = -0.328, p < 0.001), which was driven by lower heart rate variability in individuals with SITBs (g = -0.375, p = 0.025). Overall results for electrodermal activity were not significant (g = 0.026, p = 0.857), but subgroup analyses showed increased activity in studies of individuals who engaged specifically in non-suicidal self-harm (g = 0.249, p = 0.014) but decreased activity in the remaining studies (g = -0.567, p = 0.004). Conclusions: Our systematic review and meta-analysis found evidence of reduced parasympathetic regulation as well as more tentative evidence of altered electrodermal activity in children and young people displaying SITBs. Future longitudinal studies should test the clinical utility of these markers for detecting and monitoring suicide risk.

Influence of weaning management at 30, 75 and 180 days of age on non-esterified fatty acids and reproductive performance in beef cows.

This study aimed to investigate the effect of age at weaning of calves on non-esterified fatty acids (NEFA) and reproductive parameters of beef cows. Animals (n = 65) were randomly assigned to three treatments after calving: hyper-early weaning (W30) at 32 ± 0.89 days, early weaning (W75) at 77 ± 0.95 days, and conventional weaning (W180) at 183 ± 0.82 days. Body weight (BW) and body condition score (BCS) were evaluated at parturition (AP) and at 30, 45, 64, 81, 100 and 115 days postpartum (dPP). Blood samples were collected to analyze NEFA levels and progesterone (P4) at 30, 45, 64 and 81 dPP. Higher BW and BCS were observed from 64 to 115 dPP in W30 cows than W180 ones (p < 0.05). Cows subjected to W30 condition had higher levels of NEFA at 30 dPP compared to 64 and 81 dPP (p < 0.05). We also observed that cows from W180 group showed decreased levels of NEFA at 30 dPP compared to 45 (p < 0.01) and 64 dPP (p < 0.05). The highest P4 level was observed at 64 dPP in W30 cows compared to W75 and W180 (p < 0.05). We also observed higher CR of W30 (86%) compared to W180 (47%) at 45 dPP (p < 0.05). The overall pregnancy rate (PR) was higher for W30 (95.5%) than W180 (73.9%). In addition, higher BW at calving and P4 levels at 30 dPP were positively correlated with the possibility of pregnancy (p < 0.05). Improvement in BW and BCS were observed in cows subjected to hyper-early weaning management. However, levels of NEFA decreased as the postpartum period progressed. We concluded that cows who weaned calves hyper-early have greater chances of increasing cyclicity and PRs.

Weaning at 30, 75 and 180 days: Comparison between immune responses of beef calves.

The interruption of the maternal-filial bond in young calves can alter the physiological responses due to increased stress at this moment. Therefore, we aimed to analyze the association between age at weaning and the immune responses of 64 beef calves weaned abruptly. The animals were distributed in three weaning (W) treatments: hyper-early (W30), early (W75) and conventional (W180). The treatments agree with the weaning ages used in cow-calf systems in South America. Blood samples were collected of all experimental animals on the day of weaning and days 1, 2 and 7 post-weaning day of the three treatments. Blood samples were used to analyze hematological variables, total plasma proteins (TPP), fibrinogen, serum amyloid A protein (SAA) and cortisol. The variables analyzed were influenced by the sampling day (P < 0.001) and the calf gender (P < 0.05), and an interaction between treatment x sampling day was observed. Over the study period, high serum cortisol levels were observed for W30 calves. The serum amyloid A protein was significantly influenced by sampling day. When compared to W180 calves, W30 and W75 animals showed prolonged concentrations in plasma fibrinogen. In addition, they presented neutrophilia and lymphopenia during the 180-187 days period, which resulted in a greater neutrophil:lymphocyte ratio (N:L ratio). Calf gender resulted in changes in the number of blood leukocytes (P < 0.05). This result provides an alert for weaning at an early age, indicating that different management strategies must be tested to minimize physiological instabilities in critical periods of the life of animals.

Durometry as an alternative tool to the modified Rodnan's skin score in the assessment of diffuse systemic sclerosis patients: a cross-sectional study.

BACKGROUND: The reproducibility and reliability of the modified Rodnan's Skin Score (mRSS) are debated due to investigator-related subjectivity. Here, we evaluate if durometry correlates with mRSS in patients with diffuse systemic sclerosis (SSc). METHODS: This cross-sectional study was conducted from December 2018 to June 2019, including 58 diffuse SSc patients. Two certified researchers, blind to each other's scores, performed the mRSS, followed by durometry at 17 predefined skin sites. For durometry and mRSS, individual scores per skin site were registered. Durometry and mRSS results measured by each researcher, as well as scores from different researchers, were compared. Skin thickness measurements from forearm skin biopsies were available in a subset of the patients, for comparisons. Statistical analyses included Cohen's Kappa Coefficient, Intraclass Correlation Coefficient, Kendall's Coefficient and Spearman's test. RESULTS: Mean (standard deviation, SD) patient age was 44.8 (12.9) years, and 88% were female. Inter-rater agreement varied from 0.88 to 0.99 (Intraclass correlation coefficient) for durometry, and 0.54 to 0.79 (Cohen's Kappa coefficient) for mRSS, according to the specific evaluated sites. When data were compared with skin thickness assessed in forearm biopsies, durometry correlated better with skin thickness than mRSS. CONCLUSION: Durometry may be considered as an alternative method to quantify skin involvement in patients with diffuse SSc. The strong inter-rater agreement suggests that the method may be useful for the assessment of patients by multiple researchers, as in clinical trials.

Quality of life of asthmatic children and adolescents: relation to maternal coping.

OBJECTIVE: To evaluate the quality of life of asthmatic children and adolescents, its relation with sociodemographic and clinical variables, and maternal coping strategies. METHODS: Cross-sectional study in which children and adolescents with asthma answered a quality of life questionnaire, and their mothers did the same with a coping scale. RESULTS: Out of the 42 children and adolescents investigated, 74% were classified as having mild/severe persistent asthma; 19%, mild persistent asthma; and 7%, intermittent asthma. A total of 69% of the participants showed impaired quality of life with mean scores ranging between 4.7 and 3.5, with greater harm in the domain of symptoms (score=3.6). There was a significant association between maternal schooling and the general index of quality of life, whereas maternal coping strategies were not associated with the severity of asthma. A large number of strategies used by mothers to cope with their children's crises were related to the management of stressors or to religious practices, and the latter presented negative correlation with the children's quality of life general index, showing that mothers whose children had worse quality of life used more religious coping. CONCLUSIONS: Asthmatic children, particularly those with moderate/severe persistent asthma, showed significant alterations as to quality of life. The high percentage of mothers using religious strategies, particularly in face of more severe clinical conditions, seem to indicate that they feel powerless to act, thus requiring concrete and useful orientation to low income families.

Risks, benefits, and therapeutic potential of hematopoietic stem cell transplantation for autoimmune diabetes.

Type 1 diabetes mellitus is a chronic disease that results from the autoimmune response against pancreatic insulin producing ß cells. Apart of several insulin regimens, since the decade of 80s various immunomodulatory regimens were tested aiming at blocking some steps of the autoimmune process against ß cell mass and at promoting ß cell preservation. In the last years, some independent research groups tried to cure type 1 diabetes with an "immunologic reset" provided by autologous hematopoietic stem cell transplantation in newly diagnosed patients, and the majority of patients became free form insulin with increasing levels of C-peptide along the time. In this review, we discuss the biology of hematopoietic stem cells and the possible advantages and disadvantages related to the high dose immunosuppression followed by autologous hematopoietic stem cell transplantation.

[Relationship between waist circumference and nutritional status, lipid profile and blood pressure in low socioeconomic level pre-school children]. / Relação da cintura abdominal com a condição nutricional, perfil lipídico e pressão arterial em pré-escolares de baixo estrato socioeconômico.

OBJECTIVE: To evaluate anthropometric data, blood lipid levels, blood pressure (BP) and waist circumference (WC) in preschool children. To relate WC with blood lipid levels and BP in obese and non-obese children. METHODS: In a transversal study we investigated 65 preschool children of low socioeconomic level in Santo André, São Paulo. The evaluation consisted of BP measurement (Task Force, 1996), weight (W), height (H) expressed as z score (WHO, 1995) and body mass index (BMI), triglycerides, total and fractions of cholesterol blood levels (Kwiterovich and AHA). STATISTICAL ANALYSIS: Fisher test and correlations. RESULTS: We observed high BP and lipid levels unrelated to nutritional status. WC was significantly and positively correlated to BMI and ZWH (r = 0.87 and r = 0.83, respectively). Using as a cut-off 75 percentile of WC we found an accuracy of 89.1% with 87.2% specificity and 70.6% sensitivity and predictive value (+) 66.7% and (-) 66.7%. There was no relationship between WC and lipid and BP levels. CONCLUSIONS: WC showed direct correlation with anthropometric indexes commonly used and in preschool children wasn't predictor of cardiovascular risk.