Arterial health during early childhood following abnormal fetal growth

Background Abnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood. Methods We examined 90 children (median age 5.81 years, interquartile range: 5.67; 5.95), born small for gestational age with fetal growth restriction, large or appropriate for gestational age (SGA, N = 23, LGA, N = 19, AGA N = 48). We measured body composition, anthropometrics, blood pressure, pulse wave velocity (PWV), lipids, glucose and inflammatory markers, and assessed carotid, brachial, radial and femoral arterial morphology and stiffness using very-high resolution ultrasound (46–71 MHz). Results LGA showed increased anthropometry, lean body mass and body mass index. SGA displayed decreased anthropometry and lean body mass. Blood pressure, PWV, carotid artery stiffness and blood work did not differ groupwise. Differences in lumen diameters, intima-media thicknesses (IMT) and adventitia thicknesses disappeared when adjusted for lean body mass and sex. In multiple regression models arterial dimensions were mainly predicted by lean body mass, with birth weight remaining associated only with carotid and brachial lumen dimensions, and not with IMTs. Carotid-femoral PWV was predicted by height and blood pressure only. No independent effect of adiposity was observed. Conclusions Arterial dimensions in childhood associate with current anthropometrics, especially lean body mass, and sex, explaining differences in arterial layer thickness. We found no signs of fetal programming of cardiovascular risk or arterial health in early childhood.

A Non-Endemic Analysis of the Patterns and Prognosis of De Novo Metastatic Nasopharyngeal Carcinomas in Old Patients Aged ≥65 years

This study aimed to investigate the prognostic factors related to overall survival (OS) and cancer-specific survival (CSS) in patients with de novo metastatic nasopharyngeal carcinoma (NPC) aged ≥65 years in non-endemic areas. The Surveillance, Epidemiology, and End Results (SEER) database was queried for elderly patients with M1 stage NPC at initial diagnosis between 2004 and 2016. This study examined 100 patients and evaluated the relationship of gender, age, race, pathological grade, T stage, N stage, number of primary tumors, site of metastasis, number of metastatic organs, and other related factors with OS and CSS. The median survival and follow-up time were 10 and 48 months, respectively. The survival curves of race, N stage, bone metastasis, radiation, and chemotherapy significantly affected OS on the log-rank test. Race, bone metastasis, and chemotherapy were independent prognostic factors of OS. Bone metastasis was associated with poor survival. The survival curves of CSS were significantly differed between races, the number of primary tumors, and bone metastasis. In Cox regression multivariate analysis, only the number of primary tumors had an independent effect on prognosis. This study revealed that chemotherapy prolonged survival in elderly patients with metastatic NPC, whereas bone metastasis shortened survival.

Vagus Nerve Stimulation Reduces Indomethacin-Induced Small Bowel Inflammation

Crohn’s disease is a chronic, idiopathic condition characterized by intestinal inflammation and debilitating gastrointestinal symptomatology. Previous studies of inflammatory bowel disease (IBD), primarily in colitis, have shown reduced inflammation after electrical or pharmacological activation of the vagus nerve, but the scope and kinetics of this effect are incompletely understood. To investigate this, we studied the effect of electrical vagus nerve stimulation (VNS) in a rat model of indomethacin-induced small intestinal inflammation. 1 min of VNS significantly reduced small bowel total inflammatory lesion area [(mean ± SEM) sham: 124 ± 14 mm2, VNS: 62 ± 14 mm2, p = 0.002], intestinal peroxidation and chlorination rates, and intestinal and systemic pro-inflammatory cytokine levels as compared with sham-treated animals after 24 h following indomethacin administration. It was not known whether this observed reduction of inflammation after VNS in intestinal inflammation was mediated by direct innervation of the gut or if the signals are relayed through the spleen. To investigate this, we studied the VNS effect on the small bowel lesions of splenectomized rats and splenic nerve stimulation (SNS) in intact rats. We observed that VNS reduced small bowel inflammation also in splenectomized rats but SNS alone failed to significantly reduce small bowel lesion area. Interestingly, VNS significantly reduced small bowel lesion area for 48 h when indomethacin administration was delayed. Thus, 1 min of electrical activation of the vagus nerve reduced indomethacin-induced intestinal lesion area by a spleen-independent mechanism. The surprisingly long-lasting and spleen-independent effect of VNS on the intestinal response to indomethacin challenge has important implications on our understanding of neural control of intestinal inflammation and its potential translation to improved therapies for IBD.

Independent effect of gestational weight gain and prepregnancy obesity on pregnancy outcomes among Saudi women: A sub-cohort analysis from Riyadh mother and baby cohort study (RAHMA)

Background Gestational weight gain (GWG) and prepregnancy obesity are garnering more attention as determining factors of pregnancy outcomes when it comes to the wellbeing of both the mother and her baby. This study was conducted to describe the pattern of GWG among participants of Riyadh Mother and Baby Multicenter Cohort Study (RAHMA) and to investigate the detrimental effects of excessive GWG and prepregnancy obesity on pregnancy outcomes. Methods RAHMA is a multicentre cohort study conducted in three hospitals in Riyadh, Saudi Arabia. Participants were categorized according to the Institute of Medicine into inadequate, adequate, and excessive GWG, and stratified by body mass index (BMI) into under/normal weight, overweight, and obese. To examine the independent effect of maternal prepregnancy obesity and GWG, a multivariate regression model was used and adjusted odds ratio (AOR) and 95% Confidence Interval (CI) for each outcome were calculated. Results A total of 7029 participants were included in this study; 31.8% had adequate GWG, 25.9% had excessive GWG and 42.3% had inadequate GWG, while 29.7% had normal BMI, 33.3% were overweight, 34.8% were obese, and 2.2% were underweight. Excessive GWG was independently associated with increased risk of hypertensive events, (AOR = 1.77, 95% CI 1.20–2.63). Obesity was associated with higher risk of gestational diabetes (AOR 2.11, 95% CI 1.76–2.53), hypertensive events (AOR 2.06, 95% CI 1.48–3.01), and delivery by emergency caesarean section (AOR = 1.63, 95% CI 1.35–1.97). Infants of obese women had increased odds of macrosomia (AOR 3.11, 95% CI 1.94–4.99) and lower odds of low birth weight (AOR = 0.68, 95% CI 0.53–0.88). Conclusion In comparison to excessive GWG, which increases the risk of hypertensive events during pregnancy, prepregnancy obesity is associated with more adverse outcomes including GDM, hypertensive events in pregnancy and emergency CS.

Effects of salinity and plant-based diet or animal-plant combination diet on the performance and metabolic status of juvenile Nile tilapia

The purpose of this study was to evaluate the effects of salinity and plant-based diet or animal-plant combination diet on the performance and metabolic status of juvenile Nile tilapia (Oreochromis niloticus). The experimental design was completely randomized in a 4 × 2 factorial scheme with four replicates. The treatments were established by the combination of salinities of 0, 10, 20, and 30 g L-1 with an animal-plant combination diet (AP) or plant-based diet (P). The replicates were 60 L tanks with 12 fish per tank. Diets were provided for 32 days, and the fish were fed three times a day (8, 12, and 17 h) until apparent satiety. Daily feed intake (DFI) was measured, body weight (BW) was recorded at the beginning and end of the trial, and total length (TL) and standard length (SL) were measured at the end of the trial. Average daily gain (ADG), specific growth rate (SGR), feed conversion ratio (FCR), and survival rate were calculated. After the biometric measurements were made at the end of the trial, blood samples were collected to determine the plasma concentrations of total protein (TP), glucose, cholesterol, and triglycerides (TG). The fish were euthanized, and the hepatopancreas was collected and weighed; thereafter, the hepatosomatic index (HSI) was calculated. An interaction was detected between salinity and diet type for final BW, ADG, TL, and SL. These traits were not influenced by salinity when it was associated with the AP diet, but reduced linearly with salinity in the P diet. DFI and survival rate were independently affected by salinity: DFI reduced linearly with salinity levels and survival rate was higher at a salinity of 10 g L-1. HSI increased linearly with salinity levels and was lower in the P diet than in the AP diet. Salinity had a quadratic effect on plasma TP, and the maximum value for this metabolite (2.96 g dL-1) is attained at a salinity of 10.26 g L-1. There was an independent effect of diet on the plasma concentrations of cholesterol and TG, which were lower in the P diet than in the AP diet. The salinity of 10 g L-1 associated with diet composed of animal and plant ingredients led to a better performance, higher survival rate, and less stressful environmental conditions for juvenile Nile tilapia.

Descriptors of living alone for elders: based on Turkey national data

Background The objective of this study is to analyze the data of the 2018 Turkey Demographic and Health Survey and determine personal and demographic factors associated with elderly who are 60 and older and living alone. Methods This cross-sectional study is the secondary analysis of the national data obtained with the 2018 Turkey Demographic and Health Survey. Logistic regression analysis was used to estimate differences in living alone based on gender, age, welfare status, region of residence, urban/rural residence, whether the person is working in a paid job and home ownership. Independent effect of every variable is observed in the first stage and then checked for all variables in the equation. Results There is a total of 37,897 participants’ data in the Turkey Demographic and Health Survey Database. In the study, there are 6244 (16.5%) older adults in 11,056 households and 9.79% of the elderly population is alone. The percentage of elderly women living alone is 13.62% while this percentage is 5.48% for elderly men (p < 0.001). The risk of living alone for elderly women is 2.74 times more than elderly men (95% Cl 2.28–3.31). Being poor increases the risk of living alone for elderly people 2.84 fold compared to being rich (95% Cl 2.17–3.71). Those who have high school and higher education level have 2.38 (95% Cl 1.73–3.29) fold higher risk of living alone than people with lower education. Older adults living in the Western region of the country have 3.18 (95% Cl 2.20–4.59) times higher risk of living alone than older adults living in the Eastern region of the country. The risk of living alone for older adults increases 1.90 fold (95% Cl 1.55–2.32) if the house they live in do not belong to a household member. Conclusion Based on these findings, needs of older adults under risk should be met to allow them to be healthy and live their lives in better social, economic and cultural conditions.

Motor restrictions impair divergent thinking during walking and during sitting

Creativity, specifically divergent thinking, has been shown to benefit from unrestrained walking. Despite these findings, it is not clear if it is the lack of restriction that leads to the improvement. Our goal was to explore the effects of motor restrictions on divergent thinking for different movement states. In addition, we assessed whether spontaneous eye blinks, which are linked to motor execution, also predict performance. In experiment 1, we compared the performance in Guilford’s alternate uses task (AUT) during walking vs. sitting, and analysed eye blink rates during both conditions. We found that AUT scores were higher during walking than sitting. Albeit eye blinks differed significantly between movement conditions (walking vs. sitting) and task phase (baseline vs. thinking vs. responding), they did not correlate with task performance. In experiment 2 and 3, participants either walked freely or in a restricted path, or sat freely or fixated on a screen. When the factor restriction was explicitly modulated, the effect of walking was reduced, while restriction showed a significant influence on the fluency scores. Importantly, we found a significant correlation between the rate of eye blinks and creativity scores between subjects, depending on the restriction condition. Our study shows a movement state-independent effect of restriction on divergent thinking. In other words, similar to unrestrained walking, unrestrained sitting also improves divergent thinking. Importantly, we discuss a mechanistic explanation of the effect of restriction on divergent thinking based on the increased size of the focus of attention and the consequent bias towards flexibility.

Inhibitory Control in Children 4–10 Years of Age: Evidence From Functional Near-Infrared Spectroscopy Task-Based Observations

Executive function (EF) is essential to child development, with associated skills beginning to emerge in the first few years of life and continuing to develop into adolescence and adulthood. The prefrontal cortex (PFC), which follows a neurodevelopmental timeline similar to EF, plays an important role in the development of EF. However, limited research has examined prefrontal function in young children due to limitations of currently available neuroimaging techniques such as functional resonance magnetic imaging (fMRI). The current study developed and applied a multimodal Go/NoGo task to examine the EF component of inhibitory control in children 4–10 years of age. Cortical activity was measured using a non-invasive and child-friendly neuroimaging technique – functional near-infrared spectroscopy (fNIRS). Children’s response accuracy and reaction times were captured during the fNIRS session and compared with responses obtained using the standardized assessments from NIH Toolbox cognition battery. Results showed significant correlations between the behavioral measures during the fNIRS session and the standardized EF assessments, in line with our expectations. Results from fNIRS measures demonstrated a significant, age-independent effect of inhibitory control (IC) in the right PFC (rPFC), and an age-dependent effect in the left orbitofrontal cortex (lOFC), consistent with results in previous studies using fNIRS and fMRI. Thus, the new task designed for fNIRS was suitable for examining IC in young children, and results showed that fNIRS measures can reveal prefrontal IC function.

Extreme Birth Weight and Metabolic Syndrome in Children

Small and large birth weights (BWs) for gestational age (GA) represent extremes, but the correlation between extreme BW and metabolic syndrome (MetS) has not been fully elucidated. In this study, we examined this correlation in obese children based on changes in their metabolic profile from childhood to adolescence. A retrospective observational study was performed on 535 obese patients aged 0–18 years in the Clinical and Emergency Hospital for Children “Louis Turcanu” in Timisoara, Romania, based on clinical and biological data from January 2015 to December 2019. We emphasized the links between extreme BW and obesity, extreme BW and cardiometabolic risk, obesity and cardiometabolic risk, and extreme BW, obesity and MetS. Children born large for gestational age (LGA) predominated over those born small for gestational age (SGA). Our findings showed that BW has an independent effect on triglycerides and insulin resistance, whereas obesity had a direct influence on hypertension, impaired glucose metabolism and hypertriglyceridemia. The influences of BW and obesity on the development of MetS and its components are difficult to separate; therefore, large prospective studies in normal-weight patients are needed.

Outcomes of Early versus Late Endotracheal Intubation in Patients with Initial Non-Shockable Rhythm Cardiopulmonary Arrest in the Emergency Department

Background. Sudden cardiac arrest is a critical condition in the emergency department (ED). Currently, there is no considerable evidence supporting the best time to complete advanced airway management (AAM) with endotracheal intubation in cardiac arrest patients presented with initial non-shockable cardiac rhythm. Objectives. To compare survival to hospital discharge and discharge with favorable neurological outcome between the ED cardiac arrest patients who have received AAM with endotracheal intubation within 2 minutes (early AAM group) and those over 2 minutes (late AAM group) after the start of chest compression in ED. Methods. We conducted a retrospective cohort study involving the ED cardiac arrest patients who presented with initial non-shockable rhythm in ED. Multivariable logistic regression analysis was used to evaluate the independent effect of early AAM on outcomes. The outcomes included the survival to hospital discharge and discharge with favorable neurological outcome. Results. There were 416 eligible participants: 209 in the early AAM group and 207 participants in the late AAM group. The early AAM group showed higher survival to hospital discharge compared with the late AAM group, but no statistically significant difference (adjusted odds ratio (aOR): 1.28, 95% confidence interval (CI): 0.59 -2.76, p = 0.524 ). Discharge with favorable neurological outcome is also higher in the early AAM group (aOR: 1.68, 95% CI, 0.52 -5.45, p = 0.387 ). Conclusion. This study did not demonstrate a significant improvement of survival to hospital discharge and discharge with favorable neurological outcome in the ED cardiac arrest patients with initial non-shockable cardiac arrest who underwent early AAM within two minutes. More research is needed on the timing of AAM and on airway management strategies to improve survival.