To be successful takes creativity, flexibility, self-control, and discipline. Central to all those are executive functions, including mentally playing with ideas, giving a considered rather than an ...impulsive response, and staying focused. Diverse activities have been shown to improve children's executive functions: computerized training, noncomputerized games, aerobics, martial arts, yoga, mindfulness, and school curricula. All successful programs involve repeated practice and progressively increase the challenge to executive functions. Children with worse executive functions benefit most from these activities; thus, early executive-function training may avert widening achievement gaps later. To improve executive functions, focusing narrowly on them may not be as effective as also addressing emotional and social development (as do curricula that improve executive functions) and physical development (shown by positive effects of aerobics, martial arts, and yoga).
Background
Alterations in the intestinal microbiome are prospectively associated with the development of asthma; less is known regarding the role of microbiome alterations in food allergy ...development.
Methods
Intestinal microbiome samples were collected at age 3‐6 months in children participating in the follow‐up phase of an interventional trial of high‐dose vitamin D given during pregnancy. At age 3, sensitization to foods (milk, egg, peanut, soy, wheat, walnut) was assessed. Food allergy was defined as caretaker report of healthcare provider‐diagnosed allergy to the above foods prior to age 3 with evidence of IgE sensitization. Analysis was performed using Phyloseq and DESeq2; P‐values were adjusted for multiple comparisons.
Results
Complete data were available for 225 children; there were 87 cases of food sensitization and 14 cases of food allergy. Microbial diversity measures did not differ between food sensitization and food allergy cases and controls. The genera Haemophilus (log2 fold change −2.15, P=.003), Dialister (log2 fold change −2.22, P=.009), Dorea (log2 fold change −1.65, P=.02), and Clostridium (log2 fold change −1.47, P=.002) were underrepresented among subjects with food sensitization. The genera Citrobacter (log2 fold change −3.41, P=.03), Oscillospira (log2 fold change −2.80, P=.03), Lactococcus (log2 fold change −3.19, P=.05), and Dorea (log2 fold change −3.00, P=.05) were underrepresented among subjects with food allergy.
Conclusions
The temporal association between bacterial colonization and food sensitization and allergy suggests that the microbiome may have a causal role in the development of food allergy. Our findings have therapeutic implications for the prevention and treatment of food allergy.
Background:
There is conflicting literature regarding the association of the BRAF V600E mutation and aggressive clinicopathological features of papillary thyroid cancer (PTC). Nevertheless, some ...propose that BRAF status be incorporated into the management of patients with PTC, specifically recommendations regarding lymph node dissection. We therefore performed a meta-analysis to examine the relationship between BRAF and clinicopathological features of PTC.
Methods:
A literature search was performed within PubMed and EMBASE databases using the following Medical Subject Headings (MeSH) and keywords: “braf,” “mutation,” “thyroid,” “neoplasm(s),” “tumor,” “cancer,” and “carcinoma.” Individual study-specific odds ratios and confidence intervals were calculated, as were Mantel-Haenszel pooled odds ratios for the combined studies.
Results:
Thirty-two studies including 6372 patients were reviewed. BRAF mutation was associated with lymph node metastases (LNM), advanced stage, extrathyroidal extension, tumor size, male gender, multifocality, absence of capsule, classic PTC, and tall-cell variant PTC. There was no association with age or vascular invasion. Only two studies were prospective; nine included consecutive patients, whereas one included randomly selected patients; and only two included patients who had undergone routine central lymph node dissection and were thus evaluable for the presence of LNM.
Conclusion:
Meta-analysis found that BRAF mutation is associated with LNM, stage, extrathyroidal extension, tumor size, male gender, multifocality, absence of capsule, classic PTC, and tall-cell variant PTC in PTC. However, almost all studies were retrospective and only two of 32 included patients who had undergone routine central lymph node dissection, emphasizing the need for well-designed studies to appropriately examine this association before making important clinical decisions.
Previous studies on the differences in gut microbiota between exclusively breastfed (EBF) and non-EBF infants have provided highly variable results. Here we perform a meta-analysis of seven ...microbiome studies (1825 stool samples from 684 infants) to compare the gut microbiota of non-EBF and EBF infants across populations. In the first 6 months of life, gut bacterial diversity, microbiota age, relative abundances of Bacteroidetes and Firmicutes, and predicted microbial pathways related to carbohydrate metabolism are consistently higher in non-EBF than in EBF infants, whereas relative abundances of pathways related to lipid metabolism, vitamin metabolism, and detoxification are lower. Variation in predicted microbial pathways associated with non-EBF infants is larger among infants born by Caesarian section than among those vaginally delivered. Longer duration of exclusive breastfeeding is associated with reduced diarrhea-related gut microbiota dysbiosis. Furthermore, differences in gut microbiota between EBF and non-EBF infants persist after 6 months of age. Our findings elucidate some mechanisms of short and long-term benefits of exclusive breastfeeding across different populations.
COVID-19 in the Cancer Patient Yeoh, Cindy B; Lee, Kathleen J; Rieth, Elizabeth F ...
Anesthesia and analgesia,
2020-July, Letnik:
131, Številka:
1
Journal Article
Recenzirano
Odprti dostop
The novel coronavirus disease 2019 (COVID-19) was first reported in China in December 2019. Since then, it has spread across the world to become one of the most serious life-threatening pandemics ...since the influenza pandemic of 1918. This review article will focus on the specific risks and nuanced considerations of COVID-19 in the cancer patient. Important perioperative management recommendations during this outbreak are emphasized, in addition to discussion of current treatment techniques and strategies available in the battle against COVID-19.
Background
Intestinal microenvironmental perturbations may increase food allergy risk. We hypothesize that children with clinical food allergy, those with food sensitization, and healthy children can ...be differentiated by intestinal metabolites in the first years of life.
Methods
In this ancillary analysis of the Vitamin D Antenatal Asthma Reduction Trial (VDAART), we performed untargeted metabolomic profiling in 824 stool samples collected at ages 3–6 months, 1 year and 3 years. Subjects included 23 with clinical food allergy at age 3 and/or 6 years, 151 with food sensitization but no clinical food allergy, and 220 controls. We identified modules of correlated, functionally related metabolites and sought associations of metabolite modules and individual metabolites with food allergy/sensitization using regression models.
Results
Several modules of functionally related intestinal metabolites were reduced among subjects with food allergy, including bile acids at ages 3–6 months and 1 year, amino acids at age 3–6 months, steroid hormones at 1 year, and sphingolipids at age 3 years. One module primarily containing diacylglycerols was increased in those with food allergy at age 3–6 months. Fecal caffeine metabolites at age 3–6 months, likely derived from breast milk, were increased in those with food allergy and/or sensitization (beta = 5.9, 95% CI 1.0–10.8, p = .02) and were inversely correlated with fecal bile acids and bilirubin metabolites, though maternal plasma caffeine levels were not associated with food allergy and/or sensitization.
Conclusions
Several classes of bioactive fecal metabolites are associated with food allergy and/or sensitization including bile acids, steroid hormones, sphingolipids, and caffeine metabolites.
This analysis identifies associations between the fecal metabolome at ages 3–6 months, 1 and 3 years with food allergy and/or sensitization. Fecal metabolites including bile acids, sphingolipids, and caffeine metabolites are associated with food allergy/sensitization. Results suggest that breast‐milk derived intestinal caffeine may impact other fecal metabolites and thereby be associated with risk of food allergy/sensitization.
The Coronavirus disease 2019 (COVID-19) pandemic has led to high numbers of critically ill and dying patients in need of expert management of dyspnea, delirium, and serious illness communication. The ...rapid spread of severe acute respiratory syndrome-Coronavirus-2 creates surges of infected patients requiring hospitalization and puts palliative care programs at risk of being overwhelmed by patients, families, and clinicians seeking help. In response to this unprecedented need for palliative care, our program sought to create a collection of palliative care resources for nonpalliative care clinicians. A workgroup of interdisciplinary palliative care clinicians developed the Palliative Care Toolkit, consisting of a detailed chapter in a COVID-19 online resource, a mobile and desktop Web application, one-page guides, pocket cards, and communication skills training videos. The suite of resources provides expert and evidence-based guidance on symptom management including dyspnea, pain, and delirium, as well as on serious illness communication, including conversations about goals of care, code status, and end of life. We also created a nurse resource hotline staffed by palliative care nurse practitioners and virtual office hours staffed by a palliative care attending physician. Since its development, the Toolkit has helped us disseminate best practices to nonpalliative care clinicians delivering primary palliative care, allowing our team to focus on the highest-need consults and increasing acceptance of palliative care across hospital settings.
Background
The infant fecal microbiome is known to impact subsequent asthma risk, but the environmental exposures impacting this association, the role of the maternal microbiome, and how the ...microbiome impacts different childhood asthma phenotypes are unknown.
Methods
Our objective was to identify associations between features of the prenatal and early‐life fecal microbiomes and child asthma phenotypes. We analyzed fecal 16 s rRNA microbiome profiling and fecal metabolomic profiling from stool samples collected from mothers during the third trimester of pregnancy (n = 120) and offspring at ages 3–6 months (n = 265), 1 (n = 436) and 3 years (n = 506) in a total of 657 mother–child pairs participating in the Vitamin D Antenatal Asthma Reduction Trial. We used clinical data from birth to age 6 years to characterize subjects with asthma as having early, transient or active asthma phenotypes. In addition to identifying specific genera that were robustly associated with asthma phenotypes in multiple covariate‐adjusted models, we clustered subjects by their longitudinal microbiome composition and sought associations between fecal metabolites and relevant microbiome and clinical features.
Results
Seven maternal and two infant fecal microbial taxa were robustly associated with at least one asthma phenotype, and a longitudinal gut microenvironment profile was associated with early asthma (Fisher exact test p = .03). Though mode of delivery was not directly associated with asthma, we found substantial evidence for a pathway whereby cesarean section reduces fecal Bacteroides and microbial sphingolipids, increasing susceptibility to early asthma.
Conclusion
Overall, our results suggest that the early‐life, including prenatal, fecal microbiome modifies risk of asthma, especially asthma with onset by age 3 years.
This analysis identified associations between the fecal microbiome of mothers during pregnancy and offspring at ages 3‐6 months, 1 and 3 years with childhood asthma phenotypes. Associations were identified between maternal microbiome diversity and taxa with offspring asthma. Results suggest that dysbiosis associated with cesarean section birth increases early asthma risk.
Honey bee colony losses are a major concern in the USA and across the globe. Long-term data on losses are critical for putting yearly losses in context. US colony loss surveys have been conducted ...yearly since the winter of 2006–2007. Here, we report the results from the eighth annual survey on winter losses and the second annual survey of summer and annual losses. There were 7425 valid respondents (7123 backyard, 190 sideline, and 112 commercial beekeepers) managing 497,855 colonies, 19 % of the total US colonies. Total losses reported were 19.8 % 95 % CI 19.3–20.3 % over the summer, 23.7 % 95 % CI 23.3–24.1 % over the winter, and 34.1 % 95 % CI 33.6–34.6 % for the whole year. Average losses were 15.1 % 95 % CI 14.5–15.7 % over the summer, 44.8 % 95 % CI 43.9–45.7 % over the winter, and 51.1 % 95 % CI 50.2–51.6 % for the whole year. While total winter loss was one of the lowest reported in 8 years, 66 % of all beekeepers had higher losses than they deemed acceptable.
PDF
