Cause Of Infant Mortality Research Articles

Immunomodulation of cytokine signalling at feto-maternal interface by microRNA-223 and −150–5p in infection-associated spontaneous preterm birth

Spontaneous preterm birth (sPTB) is a global health concern and it is the most prevalent cause of infant mortality and morbidity with occurrence rate of 5 – 18% worldwide. Studies suggest infection and infection-driven activation of inflammatory responses are the potential risk factors for sPTB. MicroRNAs (miRNAs) are thought to control the expression of several immune genes, making them crucial components of the intricate immune regulatory network and the dysregulation of miRNAs in placenta has been associated to several pregnancy-related complications. However, studies on possible role of miRNAs in immunomodulation of cytokine signalling in infection-associated sPTB are scarce. Present study aimed to investigate expression/ correlation of a few circulating miRNAs (miR-223, −150-5p, −185-5p, −191-5p), miRNA target genes and associated cytokines in sPTB women found infected with Chlamydia trachomatis/ Mycoplasma hominis/ Ureaplasma urealyticum. Non-heparinized blood and placental sample were collected from 140 sPTB and 140 term women visiting Safdarjung hospital, New Delhi (India) for conducting PCR and RT-PCR for pathogen detection and miRNA/ target gene/ cytokine expression, respectively. Common target genes of differentially expressed miRNAs were obtained from databases. The correlation between select target genes/ cytokines and serum miRNAs was determined by Spearman’s rank correlation. 43 sPTB were infected with either pathogen and a significant upregulation of serum miRNAs was observed. However, miR-223 and 150–5p showed maximum fold-change (4.78 and 5.58, respectively) in PTB versus control group. IL-6ST, TGF-β R3 and MMP-14 were important target genes among 454 common targets, whereas, IL-6 and TGF-β were associated cytokines. miR-223 and 150–5p showed significant negative correlation with IL-6ST/ IL-6/ MMP-14 and positive correlation with TGF-β R3/ TGF-β. A significant positive correlation was found between IL-6ST and IL-6, TGF-β R3 and TGF-β. However, miR-185–5p and 191–5p were not significantly correlated. Although post-transcriptional validation is required, yet on the basis of mRNA findings, the study concludes that miR-223 and 150–5p are apparently of clinical importance in regulation of inflammatory processes during infection-associated sPTB.

Pneumonia detection with QCSA network on chest X-ray

Worldwide, pneumonia is the leading cause of infant mortality. Experienced radiologists use chest X-rays to diagnose pneumonia and other respiratory diseases. The diagnostic procedure's complexity causes radiologists to disagree with the decision. Early diagnosis is the only feasible strategy for mitigating the disease's impact on the patent. Computer-aided diagnostics improve the accuracy of diagnosis. Recent studies established that Quaternion neural networks classify and predict better than real-valued neural networks, especially when dealing with multi-dimensional or multi-channel input. The attention mechanism has been derived from the human brain's visual and cognitive ability in which it focuses on some portion of the image and ignores the rest portion of the image. The attention mechanism maximizes the usage of the image's relevant aspects, hence boosting classification accuracy. In the current work, we propose a QCSA network (Quaternion Channel-Spatial Attention Network) by combining the spatial and channel attention mechanism with Quaternion residual network to classify chest X-Ray images for Pneumonia detection. We used a Kaggle X-ray dataset. The suggested architecture achieved 94.53% accuracy and 0.89 AUC. We have also shown that performance improves by integrating the attention mechanism in QCNN. Our results indicate that our approach to detecting pneumonia is promising.

P49: Are We Timely Detecting Congenital Heart Defects in Bogotá and Cali (Colombia)?

Background: Congenital heart defects (CHD) are the main cause of infant mortality. Properly attending CHD demands strategies to improve prenatal diagnosis, planning birth on adequate hospitals, assure timely clinical care for complex cases, and guarantee follow-up and health care access for patients lifelong. Accordingly, Colombian normativity dictates that all pregnant women must have at least a first and second trimester screening with fetal heart examination, 7 to 10 prenatal control visits, and psychological support and information on voluntary termination. The aim of this study was to characterize demographics and prenatal care of expectant mothers of pediatric patients with a confirmed CHD diagnosis. Methods: This study was prospective and observational with an incidental sampling of 134 CHD patients treated at Fundación Cardioinfantil (Bogotá), Hospital Universitario San Ignacio (Bogotá), and Clinica Imbanaco (Cali) in Colombia. Women, after consent, were interviewed about demographics, prenatal care, pre and postnatal diagnosis, and children clinical evolution. We analyzed CHD according to their complexity (simple, moderate or complex) and clinical presentation (isolated, multiple anomalies or syndromes). Data were collected using the REDCap tool, descriptive statistics were calculated using Excel. Variables were expressed as mean (range). Results: 43% of all CDH were prenatally detected (66% of complex CHD were only detected postnatally). Mothers were young (mean age 28.1 years, DE 6.2), 82.1% had completed high school, 71.6% had low-income and 82.1% lived in urban areas with the father. Only 3% had twin pregnancies and 19% had chronic comorbidities (hypertensive disorders, diabetes, or hypothyroidism). On average, mothers had 6.8 prenatal control visits (DE 2.6) and 4.6 ultrasound scans (DE 2.5). As for the proper moment for ultrasound scans, only 61.1% of first-trimester scans and 58.9% of second-trimester scans were on time according to normative. 41% of women did not have psychological support, and 49% did not receive information on voluntary termination. About labor, 45% were spontaneous and 55% cesarian deliveries. Regarding babies (50.7% females), 24.0% were small for gestational age and 25.4% were born before 37 weeks. Most babies had an isolated CHD (15% simple, 76% complex), 5% had multiple anomalies, and 5% syndromes. Comparing prenatal diagnosis (ultrasound scans) and postnatal diagnosis, only in 22% of cases we found a complete agreement, and in 56% CDH was not reported on the ultrasound exams. Conclusion: Ultrasonography is a useful tool to detect CHD, but improving early detection requires better and timely access, especially for complex cases. Colombian normative for prenatal care is not working as expected. Delfos program is funded by Minciencias (Contract No.120484267276).

Completeness and Accuracy of Immunization Status and Smoking Habits Associated with the Incidence of Acute Respiratory Infections in Toddlers in the Kaliasin Health Center Working Area

ARI is the leading cause of infectious disease morbidity and mortality in the world. Nearly four million people die from ARI every year. According to WHO in 2016, the morbidity and mortality rate of ARI is quite high, especially in toddlers. ARI is the number one cause of infant mortality in Indonesia. South Lampung Regency ranks first in the number of ARI cases in children under five every year. The purpose of this study was to determine the factors associated with the incidence of ARI in toddlers. This study is a quantitative study with Cross Sectional design with a population of 2,578 toddlers and a sample of 126 toddlers. The sampling technique used was purposive sampling using univariate and bivariate analysis tests using Chi Square. Toddlers who experience ARI 39.7%, toddlers who have complete immunization status 62.7%, toddlers who have completeness and accuracy of immunization status 27.0% and who have smoking habits 57.9%. There is a relationship between completeness of immunization (p-value = 0.000) with OR 4.450 (CI 2.057-9.624), completeness and accuracy of immunization (p-value = 0.000) with OR 5.553 (CI 1.976-15.607) and smoking habits (p-value = 0.000) with OR 9.419 (CI 3.747-23.677) with the incidence of ARI in toddlers. It is expected that health workers can increase promotive and preventive efforts to the community in the form of counseling or socialization to provide knowledge related to ARI disease

Cerebellar structural, astrocytic, and neuronal abnormalities in the SMNΔ7 mouse model of spinal muscular atrophy.

Spinalmuscular atrophy (SMA) is a neuromuscular disease that affects as many as 1 in 6000 individuals at birth, making it the leading genetic cause of infant mortality. A growing number of studies indicate that SMA is a multi-system disease. The cerebellum has received little attention even though it plays an important role in motor function and widespread pathology has been reported in the cerebella of SMA patients. In this study, we assessed SMA pathology in the cerebellum using structural and diffusion magnetic resonance imaging, immunohistochemistry, and electrophysiology with the SMNΔ7 mouse model. We found a significant disproportionate loss in cerebellar volume, decrease in afferent cerebellar tracts, selective lobule-specific degeneration of Purkinje cells, abnormal lobule foliation and astrocyte integrity, and a decrease in spontaneous firing of cerebellar output neurons in the SMA mice compared to controls. Our data suggest that defects in cerebellar structure and function due to decreased survival motor neuron (SMN) levels impair the functional cerebellar output affecting motor control, and that cerebellar pathology should be addressed to achieve comprehensive treatment and therapy for SMA patients.

Natural resources, child mortality and governance quality in African countries

This paper contributes to the resource curse literature by investigating the effect of natural resources on under-five mortality in a sample of 50 African countries over the period 1996 to 2018. Additionally, we examine the extent to which governance shapes the relationship between natural resources and under-five mortality. The empirical analysis is based on the system generalized method of moments and the results show that natural resources have increased under-five mortality. Resource rents also have detrimental effects on child mortality by age, gender, and the three major causes of infant mortality from infectious diseases. However, an extended analysis of different types of natural resources suggests that point resources (such as oil, natural gas, and mineral rents) increase under-five mortality in contrast to diffuse resources (such as forest rent). We also find that governance mitigates the unfavorable effect of natural resources on child mortality. Corresponding governance policy thresholds that should be attained in order to reverse the unfavorable effects of natural resources on child mortality are provided. We thus suggest an increase in the funds allocated to the health sector from resource rents and encourage efforts to improve governance standards in sampled countries.

Preterm congenital heart disease and neurodevelopment: the importance of looking beyond the initial hospitalization.

Congenital heart disease (CHD) and prematurity are leading causes of infant mortality in the United States. Infants with CHD born prematurely are often described as facing "double jeopardy" with vulnerability from their underlying heart disease and from organ immaturity. They endure additional complications of developing in the extrauterine environment while healing from interventions for heart disease. While morbidity and mortality for neonates with CHD have declined over the past decade, preterm neonates with CHD remain at higher risk for adverse outcomes. Less is known about their neurodevelopmental and functional outcomes. In this perspective paper, we review the prevalence of preterm birth among infants with CHD, highlight the medical complexity of these infants, and emphasize the importance of exploring outcomes beyond survival. We focus on current knowledge regarding overlaps in the mechanisms of neurodevelopmental impairment associated with CHD and prematurity and discuss future directions for improving neurodevelopmental outcomes.

Diagnosis of Fetal Congenital Malformation as Risk Factor for Postpartum Depression [ID: 1377045

INTRODUCTION: Annually, more than 7.9 million children, or 6% of all neonates worldwide, are diagnosed with fetal congenital malformations (FCMs). This diagnosis is the second largest cause of infant mortality and is an important cause of maternal vulnerability during pregnancy. This study aims to determine whether the incidence of postpartum depression (PPD) is increased in mothers with FCM, in comparison to mothers without such diagnosis. METHODS: A retrospective chart review was conducted between January 1, 2015, and April 1, 2022. Inclusion criteria required a) at least one prenatal visit, b) a postpartum visit, c) completion of Edinburgh Postpartum Depression Scale (EPDS), and d) prenatal diagnosis of FCM. The control group required a–c with absence of significant perinatal complications. Two hundred FCM and 200 control participants were included. An EPDS score of greater than 12 was considered positive and at risk of PPD. Independent-samples t test and χ2 analysis were conducted. RESULTS: Independent-samples t test, comparing the study and control participants, noted a statistically significant difference in at-risk EPDS scores. Mothers with FCM diagnosis scored higher on questions 3, 7, and 8. Chi-square analysis noted a statistically significant difference in risk of PPD between mothers with FCM and those without such diagnosis. CONCLUSION: Mothers with a diagnosis of FCM are more likely to score higher on EPDS and be at-risk for PPD, thereby revealing the importance to closely monitor their psychiatric status. Future studies should analyze the incidence of maternal psychiatric diagnoses based on the severity of newborn intervention required postpartum.

A Review Article of Corticotrophin-Releasing Hormone and Preterm Birth: A Placental Clock

Preterm Birth is one of the main causes of infant mortality and morbidity worldwide. An estimated 15 million preterm births are birthed each year. Preterm Birth is not a single disease but a complex syndrome. The placenta's production of Corticotrophin-Releasing Hormone (CRH) is one theory for Preterm Birth. The peptide hormone CRH, which levels rise exponentially during pregnancy, has been linked to preterm Birth due to its endocrine, autocrine, and paracrine functions. It has been suggested that CRH functions as a component of the placental clock, with preterm Birth occurring when the placental clock is activated too early. In this review article, we will discuss Preterm Birth and the role of CRH in Preterm Birth. Keywords: Preterm Birth, Corticotrophin-Releasing Hormone (CRH), Placental clock

Hubungan Masa Gestasi dengan Kejadian Ikterus Neonatorum

The Infant Mortality Rate (IMR) in Indonesia has decreased every year, even though it has not yet reached the MDGs target of 23 per 1000 live births. One of the causes of infant mortality in Indonesia is due to neonatal jaundice by 6%. The incidence of neonatal jaundice at Dr. Abdul Aziz Hospital is one of the cases that often occurs every year, in 2019 there were 55 cases out of 912 newborns. The purpose of this study was to determine the relationship between gestational age and the incidence of neonatal jaundice in dr. Abdul Aziz Singkawang hospital. The design of this research is observational analytic with a retrospective approach case control design. The research sample consisted of 60 infants consisting of 30 case samples and 30 control samples. The case sampling technique was consecutive sampling and the control sample was simple random sampling. Data analysis consisted of univariate analysis by calculating percentages and bivariate analysis using chi square test. The results obtained from the chi square test results with a value of ρ value 0.000 < 005, which means that there is a significant relationship between gestational age and the incidence of neonatal infertility.

An overview of diarrhea among infants and under-five in Punjab-Pakistan

BackgroundDiarrhea, pneumonia, malnutrition, tuberculosis, measles, and fever are the leading causes of mortality in children under five-years of age (0–59 months), whereas diarrhea alone is the world's second-biggest cause of mortality in this population. This study is particularly important for Pakistan as it focuses on one of the main causes of infant mortality, diarrhea, which is a major challenge for Pakistan to achieve the Sustainable Development Goals to reduce infant mortality to 12/1000 live births by 2030. AimThis study was planned to investigate the various household, parental, environmental, and child-related factors causing diarrheal diseases in children aged 0–59 months in Punjab Pakistan. MethodsThe study used the data of 38,405 households from the Multiple Indicator Cluster Survey (MICS) 2017–18, directed by the Punjab Bureau of Statistics. Comprehensive descriptive statistics, i.e., cross-tabulations and logistic regression were used for the detailed analysis. FindingsThe results showed that infants are more probable to get diarrhea than older children. A wide range of influences were found to affect the probability of a child getting diarrhea, including child-specific, mother-specific and environment-specific ones. One prominent finding was that, at the mother level, the education of the mother played a significant role in reducing diarrhea among children under five-years of age (0–59 months). DiscussionThe results of the study contribute to the literature by highlighting that it is an interplay of factors that result in diarrhea. Hence, improving the source of drinking water, e.g., tap water and bottled water, can decrease the occurrence of diarrhea, especially in poor households. It was also revealed that households with a toilet facility of flush have less probability of their children being diagnosed with diarrhea than toilet facilities in open drains and fields. On the child level, results suggested that birth order matters as well, with the firstborn child having a lower probability of contracting diarrhea than siblings born after. Application to practiceInterventions targeting infants and mothers of infants aimed at reducing diarrhea are expected to be very effective to reduce child mortality, one of the main child health challenges faced by Pakistan.

The Effect of DEHY PRO (Dehydration Prevention) in Improving Preventive Behaviour among Parents toward Diarrhea Dehydration in Children Under Five

The main cause of infant mortality in diarrhea is dehydration. Children under five are often brought to health services in deteriorating conditions to severe dehydration. Children under five deaths due to diarrhea are likely to be prevented if parents are able to recognize the signs of dehydration in children and take appropriate initial treatment when children have diarrhea. This study aims to determine the effect of the Dehy Pro application improves parents' behavior in preventing diarrhea dehydration in children under five. This study is a pre-experimental study with a one-group pre-posttest design. The research begins with the development of the Dehy Pro application through 4 stages: Define, Design, Develop, and Disseminate. Dehy Pro was introduced and used by 50 mothers with children under five in Karangrejo Village, Sumbersari-Jember District selected by using a purposive sampling technique. The independent variable of this study was the Dehy Pro application, meanwhile, the dependent variable of the study was the preventive behavior of diarrhea dehydration was measured in the form of knowledge, attitudes, and prevention of diarrhea dehydration. The statistical test used is the Wilcoxon Sign Rank Test <0.05. Dehy Pro significantly affected maternal behavior by increasing knowledge (p<0.000), attitude (p>0.000), and prevention of diarrhea dehydration (p<0.000). Dehy Pro can be an effective health promotion effort in reducing the number of diarrhea dehydration in children under five through increasing knowledge and the role of parents to take steps to prevent dehydration due to diarrhea.

Diverse targets of SMN2-directed splicing-modulating small molecule therapeutics for spinal muscular atrophy.

Designing an RNA-interacting molecule that displays high therapeutic efficacy while retaining specificity within a broad concentration range remains a challenging task. Risdiplam is an FDA-approved small molecule for the treatment of spinal muscular atrophy (SMA), the leading genetic cause of infant mortality. Branaplam is another small molecule which has undergone clinical trials. The therapeutic merit of both compounds is based on their ability to restore body-wide inclusion of Survival Motor Neuron 2 (SMN2) exon 7 upon oral administration. Here we compare the transcriptome-wide off-target effects of these compounds in SMA patient cells. We captured concentration-dependent compound-specific changes, including aberrant expression of genes associated with DNA replication, cell cycle, RNA metabolism, cell signaling and metabolic pathways. Both compounds triggered massive perturbations of splicing events, inducing off-target exon inclusion, exon skipping, intron retention, intron removal and alternative splice site usage. Our results of minigenes expressed in HeLa cells provide mechanistic insights into how these molecules targeted towards a single gene produce different off-target effects. We show the advantages of combined treatments with low doses of risdiplam and branaplam. Our findings are instructive for devising better dosing regimens as well as for developing the next generation of small molecule therapeutics aimed at splicing modulation.

Burden of Malnutrition among Under-five Children and Elderly Population in Southern India

Background: Malnutrition remains a leading cause of infant mortality, primarily in low- and middle-income nations such as India. Aim: Based on the existing literature, our systematic review and meta-analysis sought to determine the prevalence of malnutrition among children and the elderly in Southern India. Methods: In accordance with Preferred Reporting Items for Systematic Review and Meta-analysis guidelines, independent researchers searched PubMed, EMBASE, and Web of Science for studies on malnutrition among children and the elderly in Southern India. We estimated the pooled prevalence with confidence intervals (CIs) of 95% using a random-effects model. Results: Twenty studies met the inclusion criteria and were included in the analysis. There were 11,452 children and 1108 elderly population participants included in the review. Thirteen studies reported the prevalence of undernutrition and the pooled number of samples was 8417. The proportion of underweight in under-five children was 41% (95% CI: 36%–46%). Thirteen studies reported wasting, and the pooled sample size was 9789. The pooled proportion of wasting was 25% (95% CI: 20%–31%). Fourteen studies reported stunting, and the pooled sample size was 10,112. The pooled proportion of stunting was 33% among children. Four studies reported malnourishment or undernutrition among the elderly population in southern India. The pooled sample size was 1108 and the pooled proportion of malnourishment among the elderly population was 12% (95% CI: 1%–22%). Conclusion: Combating child malnutrition in India requires public health interventions for cases of mild malnutrition and vulnerable populations, regional strategy implementation and evaluation, investigations on overweight, obesity, and its causes, and socioeconomic development.

Temporal trends in prevalence and infant mortality of birth defects in Brazil, from 2001 to 2018

Congenital anomalies (CA) are a relevant problem for global public health, affecting about 3% to 6% of newborns worldwide. In Brazil, these are the second main cause of infant mortality. Thus, extensive studies are needed to demonstrate the impact of these anomalies on births and deaths. The present study describes the temporal trends of prevalence and infant mortality due to CA among live births in Brazil and regions, from 2001 to 2018, using the related data between the Live Birth Information System (SINASC, acronym in Portuguese) and the Mortality Information System (SIM, acronym in Portuguese). The prevalence and infant mortality due to CA has increased in Brazil and in most regions, especially in the Northeast and North. CAs in the musculoskeletal system were the most frequent at birth (29.8/10,000 live births), followed by those in the circulatory system (12.7/10,000 live births), which represented the primary cause of death in this group. The applied linkage technique made it possible to correct the national prevalence of CA by 17.9% during the analyzed period, after retrieving the anomalies reported in SIM, thereby proving to be a good tool to improve the quality of information on anomalies in Brazil.

Tendência temporal da prevalência e mortalidade infantil das anomalias congênitas no Brasil, de 2001 a 2018

Abstract Congenital anomalies (CA) are a relevant problem for global public health, affecting about 3% to 6% of newborns worldwide. In Brazil, these are the second main cause of infant mortality. Thus, extensive studies are needed to demonstrate the impact of these anomalies on births and deaths. The present study describes the temporal trends of prevalence and infant mortality due to CA among live births in Brazil and regions, from 2001 to 2018, using the related data between the Live Birth Information System (SINASC, acronym in Portuguese) and the Mortality Information System (SIM, acronym in Portuguese). The prevalence and infant mortality due to CA has increased in Brazil and in most regions, especially in the Northeast and North. CAs in the musculoskeletal system were the most frequent at birth (29.8/10,000 live births), followed by those in the circulatory system (12.7/10,000 live births), which represented the primary cause of death in this group. The applied linkage technique made it possible to correct the national prevalence of CA by 17.9% during the analyzed period, after retrieving the anomalies reported in SIM, thereby proving to be a good tool to improve the quality of information on anomalies in Brazil.

Base editing rescue of spinal muscular atrophy in cells and in mice.

Spinal muscular atrophy (SMA), the leading genetic cause of infant mortality, arises from survival motor neuron (SMN) protein insufficiency resulting from SMN1 loss. Approved therapies circumvent endogenous SMN regulation and require repeated dosing or may wane. We describe genome editing of SMN2, an insufficient copy of SMN1 harboring a C6>T mutation, to permanently restore SMN protein levels and rescue SMA phenotypes. We used nucleases or base editors to modify five SMN2 regulatory regions. Base editing converted SMN2 T6>C, restoring SMN protein levels to wild type. Adeno-associated virus serotype 9-mediated base editor delivery in Δ7SMA mice yielded 87% average T6>C conversion, improved motor function, and extended average life span, which was enhanced by one-time base editor and nusinersen coadministration (111 versus 17 days untreated). These findings demonstrate the potential of a one-time base editing treatment for SMA.

Maternal immunization with pneumococcal surface protein A provides the immune memories of offspring against pneumococcal infection.

Streptococcus pneumoniae (S. pneumoniae) is one of the most widespread pathogens in the world and one of the largest infectious causes of infant mortality. Although current vaccines have various benefits, antibiotic resistance and the inability to vaccinate infants less than one year old demands the development of new protective strategies. One strategy, 'maternal immunization', is to protect infants by passive immunity from an immunized mother, although its mechanism is still not fully understood. The current study aimed to acquire immunity against S. pneumoniae in infants by maternal immunization with pneumococcal common antigen, pneumococcal surface protein A (PspA). Four-week-old female mice were immunized with recombinant PspA intranasally twice a week for three weeks. Females were mated with age-matched males after immunization, and delivered offspring. The week-old offspring derived from and fostered by immunized mothers had more anti-PspA-specific antibody producing cells in the spleen than those derived from sham-immunized mothers. The offspring were raised up to four weeks old and were subcutaneously stimulated with recombinant PspA. The levels of anti-PspA IgG in sera after stimulation were significantly higher in the offspring derived from the immunized mothers and the induced specific antibody to PspA showed protective efficacy against systemic pneumococcal infection. Maternal immunization is suggested to be able to provide a sustained immune memory to offspring. The current study would be a milestone in the field of maternal immunization toward a universal pneumococcal vaccine.

Thyroid Abnormalities in Children with Sepsis

Introduction: Sepsis is the most common cause of mortality in infants and children. A hormonal disorder that often affected in sepsis is thyroid hormones which occur in the form of euthyroid sick syndrome (ESS) or nonthyroidal illness syndrome (NTIS). The aim of study was to evaluate thyroid hormones changes and the outcome in children with sepsis. Materials and Methods: Present study is hospital based observational cohort study.70 children with diagnosed sepsis were required in sample size. Serum free T3, free T4 and TSH was measured on day one and also on follow up (7th day). Result: on day one Serum FT3 level was low in 40 (57.2%) subjects and Serum FT4 level was low in 12 (17.2%) subjects. TSH was normal in most 66 (94.2%) of subjects. Mortality was more in children with low serum FT3 (22.5%) as compared to those with normal FT3 (3.4%). Mortality was also more in children with low serum FT4 level (41.6%) as compared to those with normal FT4 level (8.7%), (p=0.002). Mortality was more in children with low serum FT3 (29%) on follow up as compared to those with normal FT3 (2.5%) (p=0.001). Conclusion: Thyroid hormones dysfunctions are common in children with sepsis. Mortality is significantly associated with low levels of serum FT3 & FT4. So Thyroid hormones dysfunctions could be an indicator of disease severity with possible need for hormone supplementation. Keywords: Thyroid hormones, Serum free T3, free T4, TSH, sepsis, children

The TUDOR domain of SMN is an H3K79me1 histone mark reader.

Spinal muscular atrophy is the leading genetic cause of infant mortality and results from depleted levels of functional survival of motor neuron (SMN) protein by either deletion or mutation of the SMN1 gene. SMN is characterized by a central TUDOR domain, which mediates the association of SMN with arginine methylated (Rme) partners, such as coilin, fibrillarin, and RNA pol II (RNA polymerase II). Herein, we biochemically demonstrate that SMN also associates with histone H3 monomethylated on lysine 79 (H3K79me1), defining SMN as not only the first protein known to associate with the H3K79me1 histone modification but also the first histone mark reader to recognize both methylated arginine and lysine residues. Mutational analyzes provide evidence that SMNTUDOR associates with H3 via an aromatic cage. Importantly, most SMNTUDOR mutants found in spinal muscular atrophy patients fail to associate with H3K79me1.