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Pediatrics Sep 2023Neurodevelopmental evaluation of toddlers with complex congenital heart disease is recommended but reported frequency is low. Data on barriers to attending...
BACKGROUND AND OBJECTIVES
Neurodevelopmental evaluation of toddlers with complex congenital heart disease is recommended but reported frequency is low. Data on barriers to attending neurodevelopmental follow-up are limited. This study aims to estimate the attendance rate for a toddler neurodevelopmental evaluation in a contemporary multicenter cohort and to assess patient and center level factors associated with attending this evaluation.
METHODS
This is a retrospective cohort study of children born between September 2017 and September 2018 who underwent cardiopulmonary bypass in their first year of life at a center contributing data to the Cardiac Neurodevelopmental Outcome Collaborative and Pediatric Cardiac Critical Care Consortium clinical registries. The primary outcome was attendance for a neurodevelopmental evaluation between 11 and 30 months of age. Sociodemographic and medical characteristics and center factors specific to neurodevelopmental program design were considered as predictors for attendance.
RESULTS
Among 2385 patients eligible from 16 cardiac centers, the attendance rate was 29.0% (692 of 2385), with a range of 7.8% to 54.3% across individual centers. In multivariable logistic regression models, hospital-initiated (versus family-initiated) scheduling for neurodevelopmental evaluation had the largest odds ratio in predicting attendance (odds ratio = 4.24, 95% confidence interval, 2.74-6.55). Other predictors of attendance included antenatal diagnosis, absence of Trisomy 21, higher Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery mortality category, longer postoperative length of stay, private insurance, and residing a shorter distance from the hospital.
CONCLUSIONS
Attendance rates reflect some improvement but remain low. Changes to program infrastructure and design and minimizing barriers affecting access to care are essential components for improving neurodevelopmental care and outcomes for children with congenital heart disease.
Topics: Pregnancy; Humans; Female; Child; Retrospective Studies; Heart; Cardiopulmonary Bypass; Critical Care; Down Syndrome
PubMed: 37593818
DOI: 10.1542/peds.2022-060995 -
Biostatistics (Oxford, England) Dec 2023Many scientific questions can be formulated as hypotheses about conditional correlations. For instance, in tests of cognitive and physical performance, the trade-off...
Many scientific questions can be formulated as hypotheses about conditional correlations. For instance, in tests of cognitive and physical performance, the trade-off between speed and accuracy motivates study of the two variables together. A natural question is whether speed-accuracy coupling depends on other variables, such as sustained attention. Classical regression techniques, which posit models in terms of covariates and outcomes, are insufficient to investigate the effect of a third variable on the symmetric relationship between speed and accuracy. In response, we propose a conditional correlation model with association size, a likelihood-based statistical framework to estimate the conditional correlation between speed and accuracy as a function of additional variables. We propose novel measures of the association size, which are analogous to effect sizes on the correlation scale while adjusting for confound variables. In simulation studies, we compare likelihood-based estimators of conditional correlation to semiparametric estimators adapted from genomic studies and find that the former achieves lower bias and variance under both ideal settings and model assumption misspecification. Using neurocognitive data from the Philadelphia Neurodevelopmental Cohort, we demonstrate that greater sustained attention is associated with stronger speed-accuracy coupling in a complex reasoning task while controlling for age. By highlighting conditional correlations as the outcome of interest, our model provides complementary insights to traditional regression modeling and partitioned correlation analyses.
Topics: Humans; Likelihood Functions; Computer Simulation; Regression Analysis; Bias; Models, Statistical
PubMed: 35939558
DOI: 10.1093/biostatistics/kxac032 -
The Chronicle of Mentoring & Coaching Nov 2023Scholars have long recognized gender variation in social relationship dynamics. However, how gender shapes developmental networking relationships for career advancement,...
Scholars have long recognized gender variation in social relationship dynamics. However, how gender shapes developmental networking relationships for career advancement, particularly among university faculty members, is understudied. This area of research is important since women comprise an increasing proportion of faculty and yet report receiving less mentoring and lower career satisfaction, productivity, and advancement than their male counterparts. This cross-sectional study assessed gender differences in self-reported dimensions of faculty participants' developmental networks by collecting information on relationships with , who are people who have taken concerted action and offered professional and personal guidance to help participants advance in their careers over the past year. The investigators used egocentric network data from an electronically administered Mentoring Network Questionnaire collected from 159 faculty involved in a mentoring intervention during the pandemic. Faculty were from multiple Southwest and Mountain West institutions. Statistical analyses were performed using the Chi-squared test, Wilcoxon rank-sum test, and unadjusted multilevel regression. Female faculty chose developers of lower gender diversity than male faculty (p=0.01). Compared to male faculty, female faculty reported receiving more psychosocial support from individual developers (p=0.03). Female faculty members' developers were more often characterized as and less often described as and than male faculty, based on relative levels of career and psychosocial support that individual developers provided (p<0.001). No gender differences were found in other network characteristics. Female faculty build developmental networks that have different factors compared to male faculty. Greater levels of psychosocial support and fewer allies and sponsors for female faculty may have long-term implications for differential career advancement for women vs. men in academic careers. Strategies to enhance networking should address gender differences and include a structured framework for assessing network gaps.
PubMed: 38187464
DOI: No ID Found -
Journal of Affective Disorders Dec 2023Associations between inflammatory markers and depression are reported among adults; however, less is known in adolescent depression in particular whether these...
BACKGROUND
Associations between inflammatory markers and depression are reported among adults; however, less is known in adolescent depression in particular whether these associations are sex-specific. We aimed to identify inflammatory markers of increased risk and presence of depression in adolescence and their association with severity of depressive symptoms in the entire cohort and separately in boys and girls.
METHODS
We measured serum cytokines using a Meso Scale Discovery electrochemiluminescence V-PLEX assay in a cohort of 150 adolescents stratified for risk/presence of depression. Risk group and sex-specific differences in inflammatory markers were assessed with 2-way mixed ANOVA, and sex-moderated associations between inflammatory markers and the severity of depressive symptoms were assessed with moderated multiple hierarchical regression analyses.
RESULTS
We found a significant interaction between biological sex and the risk group, where boys showed higher interleukin (IL)-2 levels among the depressed group compared with the low-risk group. The severity of depressive symptoms was associated with elevated levels of IL-2 in boys, and of IL-6 in girls. There was a significant moderating effect of sex on the relationship between IL-2 and the severity of depressive symptoms but not for IL-6.
LIMITATIONS
The cross-sectional design means that we cannot be certain about the direction of the associations.
CONCLUSIONS
Our findings suggest sex-specific associations between inflammatory markers and the development of adolescent depression, where IL-2 may increase risk for depression and severity of depressive symptoms in boys, but not in girls. However, IL-6 may increase risk for more severe depressive symptoms in girls.
Topics: Male; Adult; Female; Humans; Adolescent; Depression; Interleukin-2; Interleukin-6; Cross-Sectional Studies; Risk Factors
PubMed: 37437730
DOI: 10.1016/j.jad.2023.07.055 -
BMJ Paediatrics Open Oct 2023To estimate the prevalence of developmental dysplasia of the hip (DDH) in infants with a systematic review and meta-analysis. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To estimate the prevalence of developmental dysplasia of the hip (DDH) in infants with a systematic review and meta-analysis.
METHOD
A literature search was conducted in April 2023, using databases such as Cochrane Library, PubMed, MEDLINE, CNKI, and SinoMed, without language restrictions. Eligible studies included cross-sectional studies reporting the prevalence of DDH among infants aged 0-12 months. Two independent reviewers manually selected and coded the studies, with any disagreements resolved by a third reviewer. Meta-analysis was performed using a random-effects model to calculate the prevalence of DDH. Regression analysis examined the trend of DDH prevalence, and stratification analysis explored heterogeneity between studies.
RESULTS
A total of 65 studies involving 3 451 682 infants were included in the meta-analysis. None of the studies were classified as high quality, four were medium-to-high quality, 50 were low-to-medium quality, and eight were low quality. The pooled prevalence of DDH was 1.40% (95% CI: 0.86 to 2.28, I=100%), and prevalence of dysplasia, subluxation, and dislocation was 1.45% (95% CI: 0.93 to 2.24, I=97%), 0.37% (95% CI: 0.22 to 0.60, I=94%), and 0.21% (95% CI: 0.13 to 0.34, I=92%), respectively. Notably, the overall prevalence has a slight upward trend in the last three decades (β=0.24, p=0.35), but the dysplasia was downward trend (β=-0.48, p<0.01). Girls have higher risk of DDH than boys (1.46% vs 0.66%; Q=5.83, df=1, p=0.02). There were no significant differences based on gender, country, setting, or screening technique.
CONCLUSION
The prevalence of DDH among infants is approximately one in a 100, with girls being at higher risk. Though the prevalence of dysplasia has decreased, there is a slight upward trend in overall DDH. Therefore, routine screening for DDH in infants is recommended to prevent more serious developmental problems.
Topics: Male; Female; Humans; Infant; Prevalence; Cross-Sectional Studies; Developmental Dysplasia of the Hip; Hip Dislocation, Congenital; Mass Screening
PubMed: 37879719
DOI: 10.1136/bmjpo-2023-002080 -
Biomedicine & Pharmacotherapy =... Jan 2024Recent studies have described the importance of lymphatics in numerous organ-specific physiological and pathological processes. The role of meningeal lymphatics in...
Recent studies have described the importance of lymphatics in numerous organ-specific physiological and pathological processes. The role of meningeal lymphatics in various neurological and cerebrovascular diseases has been suggested. It has also been shown that these structures develop postnatally and are altered by aging and that the vascular endothelial growth factor C (VEGFC)/ vascular endothelial growth factor receptor 3 (VEGFR3) signaling plays an essential role in the development and maintenance of them. However, the molecular mechanisms governing the development and maintenance of meningeal lymphatics are still poorly characterized. Recent in vitro cell culture-based experiments, and in vivo studies in zebrafish and mouse skin suggest that collagen and calcium binding EGF domains 1 (CCBE1) is involved in the processing of VEGFC. However, the organ-specific role of CCBE1 in developmental lymphangiogenesis and maintenance of lymphatics remains unclear. Here, we aimed to investigate the organ-specific functions of CCBE1 in developmental lymphangiogenesis and maintenance of meningeal lymphatics during aging. We demonstrate that inducible deletion of CCBE1 leads to impaired postnatal development of the meningeal lymphatics and decreased macromolecule drainage to deep cervical lymph nodes. The structural integrity and density of meningeal lymphatics are gradually altered during aging. Furthermore, the meningeal lymphatic structures in adults showed regression after inducible CCBE1 deletion. Collectively, our results indicate the importance of CCBE1-dependent mechanisms not only in the development, but also in the prevention of the age-related regression of meningeal lymphatics. Therefore, targeting CCBE1 may be a good therapeutic strategy to prevent age-related degeneration of meningeal lymphatics.
Topics: Animals; Mice; Collagen Type I; Lymphangiogenesis; Lymphatic Vessels; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factor C; Zebrafish
PubMed: 38141283
DOI: 10.1016/j.biopha.2023.116032 -
Neuroscience and Biobehavioral Reviews Jul 2023Exposure to stress during early development may lead to altered neurobiological functions, thus increasing the risk for psychiatric illnesses later in life. One... (Meta-Analysis)
Meta-Analysis Review
Exposure to stress during early development may lead to altered neurobiological functions, thus increasing the risk for psychiatric illnesses later in life. One potential mechanism associated with those outcomes is the disruption of glial density and morphology, despite results from rodent studies have been conflicting. To address that we performed a systematic review and meta-analysis of rodent studies that investigated the effects of prenatal stress (PNS) and early life stress (ELS) on microglia, astrocyte, and oligodendrocyte density and morphology within the offspring. Our meta-analysis demonstrates that animals exposed to PNS or ELS showed significant increase in microglia density, as well as decreased oligodendrocyte density. Moreover, ELS exposure induced an increase in microglia soma size. However, we were unable to identify significant effects on astrocytes. Meta-regression indicated that experimental stress protocol, sex, age, and type of tissue analyzed are important covariates that impact those results. Importantly, PNS microglia showed higher estimates in young animals, while the ELS effects were stronger in adult animals. This set of data reinforces that alterations in glial cells could play a role in stress-induced dysfunctions throughout development.
Topics: Animals; Female; Pregnancy; Astrocytes; Microglia; Oligodendroglia; Rodentia; Stress, Psychological
PubMed: 37116770
DOI: 10.1016/j.neubiorev.2023.105202 -
Immunotherapy that leverages HPV-specific immune responses for precancer lesions of cervical cancer.Taiwanese Journal of Obstetrics &... Jan 2024Cervical cancer and its precursor lesion, cervical intraepithelial neoplasia (CIN), are caused by high-risk human papillomavirus (HPV) viral infection and are highly... (Review)
Review
Cervical cancer and its precursor lesion, cervical intraepithelial neoplasia (CIN), are caused by high-risk human papillomavirus (HPV) viral infection and are highly susceptible to host immunity targeting of HPV viral proteins, which include both foreign antigens and cancer antigens expressed by tumors. Immunotherapy that induces Th1 immunoreactivity against viral proteins is expected to take advantage of this immunological regression mechanism. However, although cancer immunotherapies for cervical cancer and CIN have been developed over the past several decades, none have been commercialized. Most of these immunotherapies target the viral cancer proteins E6 and E7, which are generally the same. The reasons for the underdevelopment of HPV-targeted immunotherapy differ depending on whether the target is invasive cancer or CIN. We here summarize the developmental history of cancer immunotherapy for CIN and discuss strategies for solving the problems that led to this underdevelopment. We note that CIN is a mucosal lesion and propose that inducing mucosal immunity may be the key.
Topics: Female; Humans; Uterine Cervical Neoplasms; Human Papillomavirus Viruses; Papillomavirus Infections; Papillomavirus E7 Proteins; Papillomaviridae; Uterine Cervical Dysplasia; Oncogene Proteins, Viral; Immunotherapy; Immunity
PubMed: 38216264
DOI: 10.1016/j.tjog.2023.10.002 -
Human Nature (Hawthorne, N.Y.) Mar 2024Receiving social support from community and extended family has been typical for mothers with infants in human societies past and present. In non-industrialised...
Receiving social support from community and extended family has been typical for mothers with infants in human societies past and present. In non-industrialised contexts, infants of mothers with extended family support often have better health and higher survival through the vulnerable infant period, and hence shared infant care has a clear fitness benefit. However, there is scant evidence that these benefits continue in industrialised contexts. Better infant health and development with allocare support would indicate continued evolutionary selection for allocare. The research reported here used multiple logistic regression analysis to test whether a lack of family and other social support for mothers was associated with an increased risk of developmental delay in 9-month-old infants in the UK Millennium Cohort (analysis sample size, 15,696 infants). Extended family-based childcare during work hours and more maternal time spent with friends were the most influential kin and social support variables: infants of mothers with kin-based childcare versus all other childcare arrangements had a lower risk of developmental delay (OR = 0.61, 95% CIs: 0.46-0.82). Infants of mothers who spent no time with friends when compared with those who saw friends every day had double the odds of delay. Greater paternal involvement in infant care was associated with a lower odds of developmental delay. In conclusion, shared care of infants and social support for mothers may influence fitness-related traits in industrialised societies rather than being factors that influenced selection only in the past and in societies which retain close kin networks and a strong local community focus.
Topics: Humans; Infant; Developmental Disabilities; Female; Social Support; Male; United Kingdom; Mothers; Child Development; Adult; Infant Care
PubMed: 38353866
DOI: 10.1007/s12110-024-09468-4 -
Journal of Dental Sciences Oct 2023Radiographs provide critical information on developmental and eruption problems, detection of interface caries, pulpal and periapical pathologies in clinical...
BACKGROUND/PURPOSE
Radiographs provide critical information on developmental and eruption problems, detection of interface caries, pulpal and periapical pathologies in clinical examination. This study aimed to evaluate parents' knowledge, attitudes and behaviors towards dental radiographs.
MATERIALS AND METHODS
A cross-sectional study was conducted on the parents of 396 children who visited to the Pediatric Dentistry clinics. All participants were asked to answer a total of 26 questions. A questionnaire was developed to assess participants' attitudue, behavior and knowledge toward pediatric dental radiographies and provided information on their demographic characteristics. The number of positive attitudes and correct answers was scored based on items asked to the participants. In order to analyze the effect of demographic data on the obtained scores, a multivariate linear regression model was created. The significance level was accepted as 0.05 in all analyzes.
RESULTS
Children's dental radiography experience affects parents' attitude score towards dental radiographs (t = 4.375, < 0.001). Parents' level of knowledge about dental radiography has a positive effect on their attitudes (t = 5.510, = 0.005). The education level of the parents and the frequency of visits to the dentist have a significant effect on the knowledge level of the parents about dental radiography ( < 0.05). When the correlation between knowledge and attitude scores is analyzed, it is observed that there is a statistically significant, weak and positive correlation between the two variables (r = 0.34, < 0.001).
CONCLUSION
In conclusion, parents who did not had dental radiographs before have a more negative attitude towards dental radiographs than those who have had dental radiographs.
PubMed: 37799873
DOI: 10.1016/j.jds.2023.05.015