Optimality of Group Testing with Differential Misclassification

Group testing is a method that can be used to estimate the prevalence of rare infectious diseases,which can effectively save time and reduce costs compared to the method of random sampling.However,previous literature only demonstrated the optimality of group testing strategy while estimating prevalence under some strong assumptions.This article weakens the assumption of misclassification rate in the previous literature,considers the misclassification rate of the infected samples as a differentiable function of the pool size,and explores some optimal properties of group testing for estimating prevalence in the presence of differential misclassification conforming to this assumption.This article theoretically demonstrates that the group testing strategy performs better than the sample by sample procedure in estimating disease prevalence when the total number of sample pools is given or the size of the test population is determined.Numerical simulation experiments were conducted to evaluate the performance of group tests in estimating prevalence in the presence of dilution effect.

Mental Health and Quality of Life of Disable Palestinian Children in the Gaza Strip

The aim of the study was to investigate the prevalence of mental health problems and quality of life among Palestinian disable children. The sample consisted of 391 disable Palestinian children in the Gaza Strip which was selected randomly from the data base of two NGOs working with such group of children. The age of children ranged from 6 - 18 years with mean age (11.73). Instruments: The children and adolescents demographic data were collected by questionnaire include sex, age, class, and place of residence, Gaza Child Health Study Scales (parents and children forms), and The Pediatric Quality of Life Inventory generic core (version 4.0) scale. The results showed that children reported mean conduct disorder was 1.33;oppositional disorder was 5;mean overanxious was 6.75;separation anxiety mean was 6.36;and depression was 7.57. There were statistically significant differences toward boys in depression. According to parents, mean conduct disorder mean was 1.94;mean oppositional disorder was 6.09;mean overanxious was 7.47;separation anxiety mean was 6.48;and mean depression was 9.6. The study showed that mean depression in boys was 10.4 compared to 8.9 in girls. There were statistically significant differences toward boys in depression. Parents of children with physical disabilities reported more overanxious problems in their children compared to other parents with other types of disabilities (vision, mental, and multiple). Also, parents of children with physical disability had more separation anxiety than other groups (mental and multiple disabilities). Quality of life of children was scored by children themselves;mean emotional functioning was 8.24;mean social functioning was 6.65;school functioning mean was 9.17;and cognitive functioning was 8.57. The study showed that mental health problems rated by children such as conduct disorder was positively correlated with emotional and cognitive functioning;oppositional disorder was correlated with emotional, social, and cognitive function;overanxious disorder was correlated emotional, school, and cognitive functioning;separation anxiety was correlated emotional functioning;and depression was correlated emotional, social, and cognitive functioning.

Effect of angiotensin converting enzyme gene I/D polymorphism in South Indian children with nephrotic syndrome

Nephrotic syndrome is one of the most common childhood kidney diseases. It is mostly found in the age group of 2 to 8 years. Around 10%-15% of nephrotic syndrome cases are non-responders of steroid treatment(SRNS).Angiotensin converting enzyme(ACE)(I/D) gene association studies are important for detecting kidney disease and herein we assessed the association of ACE(I/D) polymorphism with nephrotic syndrome in South Indian children. We recruited 260 nephrotic syndrome(162 boys and 98 girls) and 218(140 boys and 78 girls) control subjects. ACE I/D polymorphism was analyzed by PCR using genotype allele specific primers. In ACE(I/D), we did not find significant association for the ungrouped data of nephrotic syndrome children and the control subjects. Kidney biopsies were done in 86 nephrotic syndrome cases(minimal change disease, n = 51;focal segmental glomerulosclerosis, n = 27;diffuse mesangial proliferation, n = 8). We segregated them into the minimal change disease/focal segmental glomerulosclerosis groups and observed that the ACE’D’ allele was identified with borderline significance in cases of focal segmental glomerulosclerosis and the ’Ⅰ’ allele was assessed as having very weak association in cases of minimal change disease. ’Ⅱ’ genotype was weakly associated with minimal change disease. Gender specific analysis revealed weak association of’ID’ genotype with female nephrotic syndrome in females. Dominant expression of DD genotype was observed in males with nephrotic syndrome. Our finding indicated that ACE(I/D) has moderate association with focal segmental glomerulosclerosis. However, due to the limited number of biopsy proven focal segmental glomerulosclerosis subjects enrolled, further studies are required to confirm these results.

Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria

Background: Assessment of the safety profile of the new rotavirus vaccines in Africa requires base-line epidemiological data on intussusception. Hence, this study was aimed at describing the prevalence and associated factors of intussusception in under-five children in Enugu, Southeast, Nigeria. Methods: This was a retrospective descriptive study involving the sixty reported cases of intussusception in under-five children admitted in a hospital in Enugu between 2007 and 2012. Cases of intussusception were selected using the Brighton collaboration intussusception working group level I diagnostic criteria. Information sought from the patients’ folders included demographic characteristics and clinical manifestations including history of previous rotavirus vaccination, duration of illness prior to presentation, diarrhoea, vomiting, passage of red currant jelly-like stool, abdominal mass and distension, method of diagnosis, treatment option(s) employed and their outcomes. The data was analyzed using SPSS version 17.0. Results: The majority of the cases were aged less than one year (53;88.3%) while the average incidence of intussusception was 0.1 per 1000. None of the cases had received rotavirus vaccinations. The common clinical presentations were vomiting, 55 (17.2%), passage of red currant stool 50 (15.6%), fever 50 (15.6%) and abnormal/absent bowel sound 43 (15.9%). Diagnosis was essentially with the aid of abdominal ultrasonography, 38 (63.3%) while surgery (laparotomy) was the treatment of choice in most cases 48 (80.0%). The case fatality rate was 3 (5.0%). Conclusion: None of the cases studied could be directly linked to rotavirus vaccinations. But seasonal peak incidence coincided with rotavirus diarrhea peak incidence. Efforts should be made to institute post-rotavirus vaccine licensure prospective surveillance study in order to fully determine any relationship between rotavirus vaccination and intussusception in Enugu, South east, Nigeria.

Erratum to “Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria” [World Journal of Vaccines Vol.4 No.3 (August 2014) 123-132]

The original online version of this article (Tagbo, B. N., et al. 2014 “Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria”, 2014, 4, 123-132, http://dx.doi.org/10.4236/wjv.2014.43015) was published in August 2014. The author wishes to correct the author’s name and the Table 3 in the text.

Role of the histone methyltransferases Ezh2 and Suv4-20h1/Suv4-20h2 in neurogenesis

Mechanisms regulating neurogenesis involve broad and complex processes that represent intriguing therapeutic targets in the field of regenerative medicine.One influential factor guiding neural stem cell proliferation and cellular differentiation during neurogenesis are epigenetic mechanisms.We present an overview of epigenetic mechanisms including chromatin structure and histone modifications;and discuss novel roles of two histone modifiers,Ezh2 and Suv4-20h1/Suv4-20h2(collectively referred to as Suv4-20h),in neurodevelopment and neurogenesis.This review will focus on broadly reviewing epigenetic regulatory components,the roles of epigenetic components during neurogenesis,and potential applications in regenerative medicine.

The Yoruba version of LittlEARS Auditory Questionnaire: Evaluation of auditory development in children with normal hearing

The goal of this study was to translate the LittlEARS Auditory Questionnaire into Yoruba language for use with Yoruba-speaking parents and to evaluate the psychometric properties of the Yoruba version of questionnaire. Translation of the LittlEARS Auditory Questionnaire into Yoruba language was done using a back-translation method. The study participants included 423 parents of normal hearing children aged6 e24 months. Psychometric analyses(scale analysis and item analysis) of the translated questionnaire was done. The scale characteristics in the dataset are: Internal consistency: Cronbach's alpha?0.907;reliability; Split-half?0.701; predictive accuracy; Guttman's lambda?0.583; correlation between total score and children's age?0.783. The regression analysis showed that 75.3% of the variance in the total scores can be explained by age. The Yoruba version of the LittlEARS Auditory Questionnaire is a dependable and valid tool as evidenced by the results of psychometric analyses. The tool is useful for assessing auditory development in children between 6 and 24 months of age.

Comorbidity of post traumatic stress disorder, attention deficit with hyperactivity, conduct, and oppositional defiant disorder in Palestinian children affected by war on Gaza

Aim: The aim of this study was to investigate the impact of war on children and comorbidity of post traumatic stress disorder, attention deficit with hyperactivity, conduct, and oppositional defiant disorder in Palestinian children. Methods: The study was conducted in the entire Gaza Strip 6 months after the end of the war on Gaza that lasted for 23 days. The study sample included 410 children aged 6 to 17 years. Children completed measures of experience of traumatic events (Gaza Traumatic Checklist-War on Gaza), post traumatic stress disorder index, attention deficit with hyperactivity scale for parents and self, conduct disorder scale, and oppositional defiant disorder. Results: Palestinians children investigated 6 months after the war on Gaza still reported traumatic experiences: 94.6% heard the sonic sounds of the jet fighters, 91.7% heard shelling of the area by artillery, 92% watched mutilated bodies on television, 80% were deprived from water or electricity during the war, 50.7% said they left home for safer place. Using Diagnostic Manual of Mental Disorders-IV (DSM-IV) criteria for post traumatic stress disorder, 25.1% of children reported no psychological reactions, 25.9% of children reported one criteria, 39.3% of children reported partial post traumatic stress disorder and 9.8% of children reported full criteria for post traumatic stress disorder. According to the parents’ report, the results showed 31.3% of children met the criteria for inattentive type, 36.3% of children were impulsive and 29% met criteria for combined type. According to the children’s report, the results showed 28.8% of children met the criteria for inattentive type, 37.3% of children were impulsive and 28.3% met criteria for combined type. Using DSM-IV diagnostic criteria of conduct disorder and oppositional defiant disorder, the study showed that 38.1% of parents reported conduct disorder in their children and 46.3% reported oppositional defiant disorder. While 39.3% of children themselves reported conduct disorder and 44% of them reported oppositional defiant disorder. The study showed that 5.1% of children had comorbidity of post traumatic stress disorder and attention deficit disorder, 4.4% had comorbidity of post traumatic stress disorder and impulsivity-hyperactivity disorder, and 4.4% had comorbidity of post traumatic stress disorder and attention deficit with hyperactivity combined type. Also, 4.6% of children had comorbidity of conduct and post traumatic stress disorder and 6.1% had comorbidity of oppositional defiant disorder and post traumatic stress disorder. Conclusions: This study revealed that children living in areas of conflict and war are the main group at risk of developing post traumatic stress disorder and other behavioral problems including attention deficit with hyperactivity, conduct, and oppositional defiant disorder, and the internationallaws must protect the civilians during the conflict, establishing safe havens for children and their families to decrease the effect of war on children.

Psychiatric Morbidity of Chikungunya among Children in Bangladesh

Chikungunya occurred as a major epidemic form in Bangladesh in 2017 after a gap of 6 years. The first outbreak of Chikungunya was identified in Bangladesh in 2008. Another outbreak occurred at Dhaka in 2011. But the current outbreak is huge and effecting almost two third of the population. Methods: This was a retrospective case series study, consisted of 60 children, among which 35 were male and 25 female, ages ranging from 5 to 15 years. Those children were recruited from child health care clinic with a history of two to five days’ high grade fever. All patients recruited were IgM antibody for Chikungunya positive (after 5th day of onset of fever) and on the other hand antibody for Dengue was negative. Two patients were excluded from the study due to Cerebral Palsy and Claustrophobia. Finally 58 patients were assessed. Informed written consent was obtained from all the legal guardians before data collection. Results: All patients presented with a history of two to five days’ high grade fever. The fever was preceded by a maculopapular rash over the trunk and extremities, headache, myalgia and arthralgia. Delirium (non-specified) was most prevalent psychiatric symptoms 45 (77%). Other psychiatric symptoms were Panic Disorder (56%), Phobic Disorder (36%), Neurasthenia or Fatigue syndrome (27%), Hypersomnia (13%) and Claustrophobia (5%). Conclusion: This study suggested that psychiatric morbidity among pediatric Chikungunya patients is very common. Knowledge of the pathogenesis is required to reduce the psychiatric complications and to prevent the morbidity. There is an emergence to invent the prophylactic vaccination, proper and early diagnosis of Chikungunya.

Low-field, high-gradient NMR shows diffusion contrast consistent with localization or motional averaging of water near surfaces

Nuclear magnetic resonance(NMR)measurements of water diffusion have been extensively used to probe microstructure in porous materials,such as biological tissue,however primarily using pulsed gradient spin echo(PGSE)methods.Low-field single-sided NMR systems have built-in static gradients(SG)much stronger than typical PGSE maximum gradient strengths,which allows for the signal attenuation at extremely high b-values to be explored.Here,we perform SG spin echo(SGSE)and SG stimulated echo(SGSTE)diffusion measurements on biological cells,tissues,and gels.Measurements on fixed and live neonatal mouse spinal cord,lobster ventral nerve cord,and starved yeast cells all show multiexponential signal attenuation on a scale of b with significant signal fractions observed at b×Do>1 with b as high as 400 ms/um2.These persistent signal fractions trend with surface-to-volume ratios for these systems,as expected from porous media theory.An exception found for the case of fixed vs.live spinal cords was attributed to faster exchange or permeability in live spinal cords than in fixed spinal cords on the millisecond timescale.Data suggests the existence of multiple exchange processes in neural tissue,which may be relevant to the modeling of time-dependent diffusion in gray matter.The observed multi-exponential attenuation is from protons on water and not macromolecules because it remains proportional to the normalized signal when a specimen is washed with D20.The signal that persists to b×Do>1 is also drastically reduced after delipidation,indicating that it originates from lipid membranes that restrict water diffusion.The multiexponential or stretched exponential character of the signal attenuation at b×Do>1 appears mono-exponential when viewed on a scale of(b×Do)/3,suggesting it may originate from localization or motional averaging of water near membranes on sub-micron length scales.To try to disambiguate these two contributions,signal attenuation curves were compared at varying temperatures.While the curves align when normalizing them using the localization length scale,they separate on a motional averaging length scale.This supports localization as the source of non-Gaussian displacements,but this interpretation is still provisional due to the possible confounds of heterogeneity,exchange,and relaxation.Measurements on two types of gel phantoms designed to mimic extracellular matrix.one with charged functional groups synthesized from polyacrylic acid(PAC)and another with uncharged functional groups synthesized from polyacrylamide(PAM),both exhibit signal at b×Do>1,potentially due to water interacting with macromolecules.These preliminary finding motivate future research into contrast and attenuation mechanisms in tissue with low-field,high-gradient NMR。

Assessing Chemical Mixtures and Human Health: Use of Bayesian Belief Net Analysis

Background: Despite humans being exposed to complex chemical mixtures, much of the available research continues to focus on a single compound or metabolite or a select subgroup of compounds inconsistent with the nature of human exposure. Uncertainty regarding how best to model chemical mixtures coupled with few analytic approaches remains a formidable challenge and served as the impetus for the study. Objectives: To identify the polychlorinated biphenyl (PCB) congener(s) within a chemical mixture that was most associated with an endometriosis diagnosis using novel graphical modeling techniques. Methods: Bayesian Belief Network (BBN) models were developed and empirically assessed in a cohort comprising 84 women aged 18 - 40 years who underwent a laparoscopy or laparotomy between 1999 and 2000;79 (94%) women had serum concentrations for 68 PCB congeners quantified. Adjusted odds ratios (AOR) for endometriosis were estimated for individual PCB congeners using BBN models. Results: PCB congeners #114 (AOR = 3.01;95% CI = 2.25, 3.77) and #136 (AOR = 1.79;95% CI = 1.03, 2.55) were associated with an endometriosis diagnosis. Combinations of mixtures inclusive of PCB #114 were all associated with higher odds of endometriosis, underscoring its potential relation with endometriosis. Conclusions: BBN models identified PCB congener 114 as the most influential congener for the odds of an endometriosis diagnosis in the context of a 68 congener chemical mixture. BBN models offer investigators the opportunity to assess which compounds within a mixture may drive a human health effect.

The Effect of Antiretroviral Therapy (ART) on Body Composition and Clinical Markers of Lipodystrophy in HIV-Infected Children Assessed in Follow-Up Study

Objectives: Antiretroviral therapy (ART) has been associated with lipodystrophy in children. We evaluated changes in various anthropometric measurements for the assessment of lipodystrophy and assessed whether there was an association with use of protease inhibitors (PI), non-PI containing ART and/or stavudine (d4T). Methods: Eighty-five HIV-infected children attending the HIV clinic at Great Ormond Street Hospital (GOSH) were included. The average follow-up was 8.4 months (range 3 - 12 months). Body fat redistribution was assessed by anthropometric measurements including skinfold thickness and circumferences of upper and lower limbs. Measurements were converted to age- and sex-adjusted z-scores through development stages including puberty. Results: Sixty children had taken ART;37 received PI-containing;38 received d4T;25 had never been treated. In the studied population, clinically important changes with decreases in biceps (BSF), subscapular skinfolds and total body fat (4SFT) over period of 12 months were observed. Some increase was noticed in triceps skinfolds (TSF). Limbs circumferences remained at the same level. Further we looked at 4 months basis changes in anthropometric measurements stratified by baseline ART. Generally z-scores of anthropometric measurements were lower in therapy naive children when compared to ART groups. PI-based ART regimens resulted in significant increases in BSF with a trend towards increases in TSF, suprailiac and 4SFT. Mid-arm and thigh circumferences were higher in PI compared to naive group. Similarly, significant changes in BSF z-scores were associated with d4T use. Increases were seen in TSF and mid-arm circumference and decreases were observed in subscapular skinfolds and calf circumference z-scores. Conclusions: Body fat redistribution in HIV-infected children with sub-clinical lipodystrophy could be detected by anthropometric measurements, particularly when PI or d4T is included in ART. Over time, changes with increase in arm and trunk fat, and no change or decrease in leg fat were more pronounced among ART-receiving children.

Vaccination Coverage and Its Determinants in Children Aged 11 - 23 Months in an Urban District of Nigeria

Background/Objectives: Performance of the vaccination programme in Nigeria is lower than the regional average as well the 95% target necessary for sustained control of vaccine preventable diseases. This study is aimed at assessing the vaccination coverage and its associated factors in children aged 11 - 23 months in Enugu Metropolis. Methods: A cross sectional study in which caregivers and their children pair, aged 11 - 23 months attending children’s outpatient clinics in Enugu metropolis was undertaken. Respondents were selected consecutively while data were collected using pretested interviewer administered semi-structured questionnaire. Data were analyzed using SPSS version 20.0 while level of significance was set at p < 0.05. Logistic regression analysis was used to identify independent predictors of full vaccination. Results: Of 351 subjects studied, 84.9% (298) were fully immunized according to the national programme on immunization schedule using both vaccination cards and history. The OPV0, OPV3, pentavalent-1, pentavalent-3 and measles coverage at the time of survey were 100.0%, 97.2%, 98.0%, 98.6%, 96.9% and 95.4%, respectively. On logistic regression: maternal occupation (government employees), children born in government hospitals and knowledge of when to start and complete vaccinations in a child were the likely predictors for completion of full vaccination in the children. Conclusion: The vaccination coverage among the study group was adjudged to be relatively high. Delivery of a child in a government hospital and the knowledge of the age when routine vaccinations should begin and end in a child were the independent predictors of the high vaccination coverage rate observed. Awareness and health education efforts in government tertiary hospitals should be extended to private and other hospitals to improve and sustain national vaccination coverage in Nigeria.

Seroconversion of Hepatitis B Vaccine in Young Bangladeshi Children: A Tertiary Centre Experience

Background: Hepatitis B virus (HBV) infection is one of the most important global health problems and active immunization is the single most important and effective preventive measure against HBV infection. Several studied show that HBV carrier rate is between 2% - 7% in Bangladesh. Bangladesh introduced hepatitis B vaccination in children through Expanded Program on Immunization (EPI) in 2005 that includes 3 doses which starts from six weeks after birth. Currently booster vaccination is not recommended any more. However, many studies on different countries observed a declined level of HBs-antibody over a period of 3 - 6 years that may even reach to non-protective levels. Objective: To evaluate the status of seroconversion and seroprotection along with non-responders of EPI vaccinated children against HBV and to measure their antibody levels in different age groups. Methods: A cross sectional descriptive study was done in the department of Pediatric Gastroenterology, Hepatology & Nutrition, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh on 120 cases of EPI vaccinated children enrolled from January-December 2019 while attending the inpatient department without any liver problem. The development of Anti-HBs titre greater than or equal to 10 mIU/mL is considered as protective immunity and any titre less than 10 mIU/mL as non-protective following HBV vaccination. Results: Age of the children was 1 - 12 years with mean age of 5.6 ± 1.7 years and male: female ratio was 1.1:1. Among the children, 56 (46.6%) were from 1 - 5 years age, 36 (30.1%) children from 6 - 10 years age group and 27 (23.3%) children from 11 - 12 years age group. Out of 120 children, presence of Anti-HBs protective titre was in 63 (52.5%) children and non-protective level in 57 (47.5%) children. Among protective level, 34 (60.7%) children were in 1 - 5 years age group, 18 (50.0%) children in 6 - 10 years age group and 11 (39.3%) children in 11 - 12 years age group. Total 24 (20%) children were completely non-responder (antibody titre 0.00 mIU/mL). Out of 120 mother, 06 (5%) were HBV positive. Among them 05 (83.33%) children had Anti-HBs less than 10 mIU/mL. Conclusion: After primary vaccination, a good immune response was detected against hepatitis B virus but it goes below even up to non-protective level with the increase of age. Half of the studied children had non-protective titre after 5 years and one-fifth children totally non-responder after primary hepatitis B vaccination. A booster dose may be recommended after 5 years for optimum seroprotection.

Predictors of Exclusive Breastfeeding Duration among Mothers Attending Immunization Clinic in a Tertiary Health Facility in Enugu, Nigeria

Background: Breastfeeding is cost effective means towards the realization of some key United Nations Sustainable Development Goals by the year 2030 particularly in resource limited settings. The objectives of the study were to evaluate the predictors of exclusive breastfeeding duration among mother and child pairs utilizing a tertiary immunization clinic facility. Methods: This was a cross-sectional descriptive study. Respondents were mother-and-child pairs who were recruited consecutively. Relevant maternal and child characteristics were collected using a semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences version 20.0 (p Results: Four hundred and twenty seven mother-child pairs were studied. Majority of the mothers have at least secondary education, 383 (80.7%). 407 (95.3%) of the mothers fully understood the actual meaning of EBF. 189 (42.7%) reported practicing EBF in their index child for six months. Maternal perception of insufficient milk production, 52/99 (52.5%) was the most common reason for practicing EBF for Maternal education and occupation and gender of the child were significantly associated with completion of EBF for 6 months among respondents. Conclusion: EBF duration in the current study is low and is significantly associated with maternal education, maternal occupation and gender of the child. Improving girl child education, complementing baby friendly hospital initiative with baby friendly community initiative should be adopted to improve EBF duration in our setting.

ROLE OF ACULASER THERAPY IN CEREBRAL PALSY CHILDERN (INITIAL DATA & RESULTS)

A single, open and non-comparative study was conducted at Anwar Shah’s First C.P. & Paralysis Clinic and Research Center to evaluate the effects of Aculaser (acupoint-laser) Therapy for children suffering from cerebral palsy (CP) of various types. These children were further classified according to their major complaints. Analysis of the data indicated that 11 children with severe spasticity and stiffness all showed marked improvement (100% success rate); of the 8 children with epileptic fits, 6 patients had a significant reduction in the intensity, frequency and duration of epileptic fits, while the rest 2 cases showed no any improvement or aggravation (75% success rate); out of 5 children with cortical blindness, 2 cases showed complete recovery of vision and 3 had marked improvement (40% cure rate); out of 4 children with hearing difficulties, 2 showed marked improvement (50% success rate); out of 14 children with aphasis, 8 showed improvement (57% improvement rate). Results of this study show that Aculaser Therapy has a high improvement rate of CP children, not only improving the spasticity and stiffness but also the cortical blindness, epilepsy, deafness and speech.

Outcomes of Transcatheter Closure in Outlet-Type Ventricular Septal Defect after 1 Year

Background:Ventricular septal defect(VSD)is the most common congenital heart disease.Transcatheter VSD closure is an effective treatment for patients with muscular and perimembranous VSD.However,there is a limit data for outlet VSD,especially impact to the aortic valve leaflet after transcatheter closure.This study aims to assess the outcomes of transcatheter closure of the outlet-type ventricular septal defect(OVSD)after 1 postoperative year.Methods:A retrospective study was performed including 50 patients who underwent transcatheter(n=25)and surgical(n=25)OVSD closure during the exact time frame at two medical centres.Results:The median age and body weight of patients in the transcatheter group were significantly higher than those of patients in the surgical group(7.0 vs.2.8 years;27.0 vs.11.4 kg;p<0.01).The defect size in the surgical group was significantly larger than that in the transcatheter group(5.0 vs.3.0 mm;p<0.01).All OVSD patients have successful transcatheter closure(100%)as effective as surgical closure.Less than small residual shunt was present 20%and 8%immediately after the procedure in the transcatheter and surgical groups(p=0.50),which decreased to 12%and 4%at the 1-year follow-up(p=0.61),respectively.No incidence of complete atrioventricular block and other complications was observed in both groups,and no significant differences were noted in the new onset or worsening of the aortic regurgitation in both groups(p=1.0).Conclusions:Transcatheter treatment could be effectively and safely achieved for OVSD closure at 1-year follow-up.

Global trends and knowledge-relationship of symptom clusters in cancer research:a bibliometric analysis over the past 20 years

Objective:To use Cite Space and VOSviewer to investigate the scientific production in the field of symptom clusters in cancer research.Methods:The search was performed using the terms“symptom clusters,”“cancer,”and“oncology”on the Web of Science Core Collection database.The retrieval time was from 2001 to 2021,which covers the last 2 decades.Based on the production theory of scientific knowledge and the data mining of citations,data pertaining to the annual publications,journals,countries,organizations,authors,and keywords that produce symptom clusters in cancer research,as well as their cooperation(collaboration network),were extracted,and then both were clarified by the software tools VOSviewer(version 1.6.16)and Cite Space(version 6.1.R2).Results:A total of 1796 publications were retrieved between 2001 and 2021,and 473 relevant publications were included after screening.The results showed an increasing trend in published articles.The United States had the largest number of publications(261/473,55.18%),followed by China and Canada.The University of California,San Francisco,was the most productive institution.Current research hotspots included the analysis of symptom clusters and symptom management in patients with breast cancer and lung cancer,as well as any advanced cancer and cancer cachexia;fatigue-related symptom clusters and depression-anxiety symptom cluster;and the impacts of symptom clusters on quality of life.The research frontiers included analysis between health-related quality of life and symptom clusters,data mining in symptom clusters,research on the mental health status of cancer patients,and study of the mechanism and biological pathways of symptom clusters.Conclusions:The study provides insight into the global research perspective for the scientific progress on cancer symptom clusters,which suggests a growing scientific interest in this field,and more studies are warranted to guide symptom management.

The COVID-19 Pandemic: Present or Gone, Where Do Adolescents Stand?

Introduction: The initial global response to the SARS-CoV-2 pandemic focused on adults as adolescents mainly had subclinical infections. Adolescents, however, could transmit the virus and hence be a risk to the elderly, young children and immunocompromised. Adolescents are also at risk of long-term complications. This study sought to determine the prevalence of antibodies to SARS-CoV-2 among adolescents in Southern Nigeria, and to determine the association between SARS-CoV-2 seropositivity and age, gender, socioeconomic class, school type and nutritional status. Methods: This descriptive cross-sectional study was carried out in Edo state of southern Nigeria. We recruited 270 in-school adolescents aged 10 - 19 years. A WHO-adapted, pre-tested questionnaire was used to obtain data on participant history and risk factors. The questionnaire was interviewer-administered. Adolescents whose parents gave consent were recruited through a multi-stage randomized sampling method. Capillary blood for the assay was collected and analysed using a lateral-flow immunoassay device. The primary outcome was serostatus of the study. The positive predictors of serostatus were finally determined using a multiple logistics regression model. Statistical significance was set at p Results: The seroprevalence of SARS-CoV-2 was 45.9%. IgM antibodies were found in 5.6% of participants. Older adolescents had higher seropositivity rates than younger adolescents (2 = 8.101, p = 0.017). There was no association between gender and seropositivity. Adolescents in public schools were more likely to be seropositive than those in private schools (2 = 25.242, p = 0.001). A higher seroprevalence was noticed among study participants in the lower socioeconomic class (x2 = 6.928, p = 0.031), and those in overcrowded classes. (2 = 79.303, p = 0.001). Conclusion: This study showed a high seroprevalence of SARS-CoV-2 among in-school adolescents. Behavioural change communication on SARS-CoV-2, vaccination of adolescents, and standardization of classrooms are recommended.

RANKL inhibition reduces lesional cellularity and Gαs variant expression and enables osteogenic maturation in fibrous dysplasia

Fibrous dysplasia(FD)is a rare,disabling skeletal disease for which there are no established treatments.Growing evidence supports inhibiting the osteoclastogenic factor receptor activator of nuclear kappa-B ligand(RANKL)as a potential treatment strategy.In this study,we investigated the mechanisms underlying RANKL inhibition in FD tissue and its likely indirect effects on osteoprogenitors by evaluating human FD tissue pre-and post-treatment in a phase 2 clinical trial of denosumab(NCT03571191)and in murine in vivo and ex vivo preclinical models.Histological analysis of human and mouse tissue demonstrated increased osteogenic maturation,reduced cellularity,and reduced expression of the pathogenic Gαs variant in FD lesions after RANKL inhibition.RNA sequencing of human and mouse tissue supported these findings.The interaction between osteoclasts and mutant osteoprogenitors was further assessed in an ex vivo lesion model,which indicated that the proliferation of abnormal FD osteoprogenitors was dependent on osteoclasts.The results from this study demonstrated that,in addition to its expected antiosteoclastic effect,denosumab reduces FD lesion activity by decreasing FD cell proliferation and increasing osteogenic maturation,leading to increased bone formation within lesions.These findings highlight the unappreciated role of cellular crosstalk between osteoclasts and preosteoblasts/osteoblasts as a driver of FD pathology and demonstrate a novel mechanism of action of denosumab in the treatment of bone disease.