Long-term Longitudinal Studies Research Articles

Integrating Study Designs on Emotional Reactivity and Regulation in Old Age: New Evidence From the EMIL Study

Key insights into emotional reactivity and regulation have been gained by studying how these dynamics evolve as older people are confronted with controlled stressors in the lab, go about their everyday routines, or develop across adulthood and old age. Yet, we are only beginning to understand how the dynamics on the different time scales observed in these study designs interact . Aiming for a comprehensive picture of the predictors, correlates, and consequences of emotional reactivity and regulation, the EMIL study integrates a lab-based study with ambulatory in-vivo assessments and a classic long-term longitudinal study. 130 young-old (65-69 years) and 59 very-old adults (83-89 years) from the ILSE study, contributing four waves of health, cognitive, and psycho-social data over almost 25 years, were tested in the lab and assessed six times a day over seven consecutive days. We provide an overview of and first across-design results from EMIL: Katzorreck et al. examined whether the frequency of exposure to daily stressors affects emotion regulation capacity as tested in the lab. Lücke et al. analyzed daily working memory performance, sleep, and its association with long-term change in cognitive functioning. Wieck et al. present differential effects of discrete negative emotions as induced in the lab and reported in daily life on social cognitive performance as indicated by empathic accuracy. Gerstorf et al. examined how long-term cognitive aging affects positive feelings and stressor reactivity in daily life. Gloria Luong will discuss the presentations, considering challenges and opportunities of integrating lab-based, ambulatory, and longitudinal study designs.

The association between malnutrition and behavioral-cognitive problems in residents of long-term care facilities, a cross-sectional and longitudinal study

Rationale: Older adults with behavioral-cognitive problems are highly care dependent before and during stay in a long-term care facility (LTCF). We hypothesise that these older adults are at increased risk to be malnourished, already on admission, or to become malnourished during stay.

Effects of Alcohol Consumption and Smoking on the Onset of Hypertension in a Long-Term Longitudinal Study in a Male Workers' Cohort.

Aim: To determine the effects of alcohol consumption and smoking on the onset of hypertension in a long-term longitudinal study. Methods: 7511 non-hypertensive male workers were enrolled. This cohort study was performed over an 8-year period using the results of the annual workers-health screening. The end-point was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or use of antihypertensive drugs. For alcohol consumption, weekly alcohol intake (g ethanol/week) was estimated (1 “gou” = 22 g ethanol). Annual survey data were analyzed by pooled logistic regression that included alcohol consumption, smoking, age, body mass index, job schedule types, habitual exercise, and blood test measurements into the statistical model. Results: A significant positive dose–response relationship between alcohol consumption and onset of hypertension was observed, with synergistic health effects present. Compared with abstainers and nonsmokers, the adjusted odds ratios (95% confidence interval) for the onset of hypertension were: 1.51 (1.27–1.79) for 154 g ethanol/week and nonsmokers, and 1.81 (1.54–2.11) for 154 g ethanol/week and smokers. An interaction between alcohol and smoking was confirmed. Conclusions: This study provided information useful to the prevention of hypertension. By reducing alcohol consumption and smoking simultaneously, the risk of hypertension may be considerably lowered.

The Positive Loop at Work: A Longitudinal Long-Term Study of Transformational Leadership, Group Passion, and Employee Results.

Positive psychology and positive organizational behavior studies recognize that leadership is extremely important for generating positive well-being. Despite the frequently reported significant positive correlations, the causal long-term relationship between leadership, positive high intense affect, and employee results remains unclear. The main objective of this study was to analyze the long-term (longitudinal) relation of transformational leadership and positive high-intensity emotions with employee group satisfaction, commitment, and proactive behavior. We built a longitudinal structural equation model to test a mediation model with two time points; 2,480 workers from 166 work units completed questionnaires at both time points. Our results reveal that positive high-intensity emotions mediate the relation between transformational leadership and proactive behavior of workers, the bidirectional relations between the variables were also analyzed. The present study is, to our knowledge, the first analyzing the long-term effect of TFL and collective high-intensity emotions on worker’s results longitudinally. Our findings reflect the great complexity of affect and affect-related results in organizations and highlight the need for more longitudinal research to clarify emotional processes at work.

Many lifetime growth trajectories for a single mammal.

Despite their importance in shaping life history tactics and population dynamics, individual growth trajectories have only been rarely explored in the wild because their analysis requires multiple measurements of individuals throughout their lifetime and some knowledge of age, a key timer of body growth. The availability of long‐term longitudinal studies of two wild boar populations subjected to contrasting environments (rich vs. poor) provided an opportunity to analyze individual growth trajectories. We quantified wild boar growth trajectories at both the population and the individual levels using standard growth models (i.e., Gompertz, logistic, and monomolecular models) that encompass the expected range of growth shapes in determinate growers. Wild boar is a rather altricial species, with a polygynous mating system and is strongly sexually dimorphic in size. According to current theories of life history evolution, we thus expect wild boar to display a sex‐specific Gompertz type growth trajectory and lower sexual size dimorphism in the poorer environment. While wild boar displayed the expected Gompertz type trajectory in the rich site at the population level, we found some evidence for potential differences in growth shapes between populations and individuals. Asymptotic body mass, growth rate and timing of maximum growth rate differed as well, which indicates a high flexibility of growth in wild boar. We also found a cohort effect on asymptotic body mass, which suggests that environmental conditions early in life shape body mass at adulthood in this species. Our findings demonstrate that body growth trajectories in wild boar are highly diverse in relation to differences of environmental context, sex and year of birth. Whether the intermediate ranking of wild boar along the precocial–altricial continuum of development at birth may explain the ability of this species to exhibit this high diversity of growth patterns remains to be investigated.

Selection, optimization and compensation strategies and their relationship with well-being and impulsivity in early, middle and late adulthood in a Polish sample

BackgroundThe model of selection, optimization, and compensation (SOC model) characterises the life management strategies that contribute to successful development. Although the SOC model is an important developmental theory, until now there has been no Polish version of a measurement tool for SOC strategies. The studies conducted so far have consistently indicated a relationship between the use of these strategies and well-being. In contrast, the relationship between SOC strategies and impulsivity has not yet been empirically examined, although there are theoretical premises to assume its existence. The aim of the study was to compare the use of SOC strategies in early, middle and late adulthood, and to investigate the relationship between the use of SOC strategies and well-being and impulsivity, using a newly developed Polish version of the SOC Questionnaire (SOC48-PL).MethodsThe study applied a quantitative approach. The sample comprised 589 Poles from three age groups: early adulthood (n = 186, 20–35 years), middle adulthood (n = 165, 40–55 years) and late adulthood (n = 238, 60–85 years). In the study, in addition to the SOC48-PL questionnaire, the Short Depression-Happiness Scale (SDHS) and the Short UPPS-P Impulsive Behavior Scale (S UPPS-P) were used.ResultsDevelopmental differences in the use of SOC strategies are rather slight, with considerable individual differences within age groups. The study revealed some indications of a ‘developmental peak’ of SOC strategies in middle adulthood. The use SOC strategies is positively related to well-being. In turn, the relationship between the use of SOC strategies and impulsivity is negative, especially for two dimensions of impulsivity: lack of premeditation and lack of perseverance.ConclusionsThe results only slightly confirm the assumed age-related differences in the use of SOC strategies and point to a large role of individual differences. The revealed positive relationships of SOC strategy use with well-being and negative with impulsivity are consistent with expectations. With the present study, the SOC48-PL questionnaire may find application in further studies on the SOC model involving the Polish population, as well as in the measurement of SOC strategies in psychological practice. Furthermore, the identified associations of SOC strategies with well-being and impulsivity can be taken as initial indications for the development of interventions based on teaching the use of SOC strategies. Cross-cultural comparisons, long-term longitudinal studies on changes in the use of SOC strategies over the life course, and combining quantitative and qualitative approaches in the analysis of the use of SOC strategies in practice are worth mentioning as directions for further research.

Ambulatory monitoring of central arterial pressure, wave reflections, and arterial stiffness in patients at cardiovascular risk.

This paper reviews current 24 h ambulatory noninvasive technologies for pulse wave analysis (PWA) providing central arterial pressure, pulse wave velocity, and augmentation index and the scientific evidence supporting their use in the clinical management of patients with arterial hypertension or at risk for cardiovascular complications.The most outstanding value of these techniques lies in the fact that they are user-friendly, mostly operator independent, and enable the evaluation of vascular function during daily-life conditions, allowing to obtain repeated measurements in different out-of-office circumstances, less artificial than those of the laboratory or doctor's office.Studies performed so far suggest that 24 h PWA may represent a potentially promising tool for evaluating vascular function, structure, and damage in daily-life conditions and promoting early screening in subjects at risk. The current evidence in favor of such an approach in the clinical practice is still limited and does not recommend its routine use. In particular, at the moment, there is a shortage of long-term prognostic studies able to support the predictive value of 24 h PWA. Finally, the accuracy of the measures is strongly dependent on the type of technology and device employed with lack of interoperability among the devices that deeply affects comparability of results among studies using different technologies. It is thus mandatory in the near future to promote proper validation studies, for instance using the ARTERY protocol, and to plan well-designed long-term longitudinal studies that may prove the accuracy and high predictive value of PWA in ambulatory conditions.

Average number of anesthetics still in progress in the early evening increased at least proportionally to the numbers of anesthetizing locations in the morning: A retrospective, long-term longitudinal study at two large hospitals

BackgroundAn earlier study examined weekend and holiday cases at many hospitals. Over a decade, treating weekend/holiday caseloads simply as proportional to total caseload resulted in a low error rate of <1 case per day, important when making weekend staffing decisions. In the current study, we examine the comparable issue related to evening staffing for the associations between numbers of anesthetics ongoing in the early evening, 6:00 PM, versus the total numbers of anesthetizing locations, specifically at 9:00 AM. MethodsData from two large teaching hospitals, November 2002 through May 2021 and November 2005 through June 2021, respectively, were retrieved and analyzed. ResultsAt one hospital, over 18.6 studied years, there was a 75% increase in anesthetics ongoing at 9:00 AM; Spearman rank correlation 0.99 (P < .0001). There was positive association with anesthetics ongoing at 6:00 PM; Spearman correlation 0.96 (P < .0001). The ratio of anesthetics at 6:00 PM to 9:00 AM increased over time; Spearman correlation 0.82 (P < .0001). Over the past decade, the simple model of proportional growth had a mean absolute predictive error in cases at 6:00 PM being less than 1 case per workday (mean 0.64 cases per workday, <1 case per workday P = .019). At the second hospital, over 15.6 years, there was a 17% increase in anesthetics ongoing at 9:00 AM; Spearman correlation 0.58 (P = .021). There was positive association between those anesthetic counts at 9:00 AM and those ongoing at 6:00 PM; Spearman correlation 0.85 (P < .0001). The ratio of anesthetics at 6:00 PM to 9:00 AM increased over time; Spearman correlation 0.92 (P < .0001). Over the past decade, the model of proportional growth had a mean absolute predictive error in cases at 6:00 PM that was minimal (mean 0.40 cases per workday, <1 case per workday P = .0001). ConclusionsHospitals should plan that as first case starts are added progressively, workload in the early evening may grow at least proportionally, as found for weekends and holidays. Such knowledge is important for operating room managers to consider when planning staffing, staff scheduling, and managerial decision-support for the end of the workday.

Prevalence and Initial Diagnosis of Cerebral Palsy in Preterm and Term-Born Children in Taiwan: A Nationwide, Population-Based Cohort Study.

The aim of this long-term longitudinal study in Taiwan was to estimate and compare the prevalence of cerebral palsy (CP) and to identify the age of CP diagnosis of term-born and preterm children with different birthweights. Records of 1494 extremely low birth weight (ELBW, <1000 g), 3961 very low birth weight (VLBW, 1000–1499 g), 19,612 low birth weight (LBW, 1500–2499 g) preterm, and 100,268 matched term-born children were retrieved from Taiwan′s National Health Insurance Research Database. According to a 12-year retrospective data review, the results showed the highest prevalence of CP in preterm ELBW children (147.3 cases per 1000 neonatal survivors), followed by preterm VLBW (97.2 cases), preterm LBW (27.7 cases), with the lowest prevalence in term-born children (2.5 cases). Regardless of the birthweight group, 90% of preterm children with CP were diagnosed by 4 years of age, but it was 7 years before 90% of term-born children with CP were diagnosed. After removing the children whose CP was caused by brain infections, injuries, or cerebrovascular accidents after 4 months of age, there were similar mean ages at the initial CP diagnosis (1.58–1.64 years of age) across birthweight groups born prematurely, but initial diagnosis occurred at an older age (2.41 years of age) in term-born children. The results indicate that birthweight is reversely correlated with the prevalence of CP in preterm children. Although the three preterm birthweight groups received different types of developmental follow-up programs after birth, it did not influence their age at the initial diagnosis of CP. Furthermore, we suggest that follow-up for at least 4 years after birth for preterm children, and 7 years for term-born children, is optimal for estimating CP prevalence. In order to identify and provide early intervention for term-born children with CP earlier, it is suggested that parents routinely fill out a self-reported motor developmental screening questionnaire and pediatricians conduct a motor developmental examination on term-born children at each time of scheduled vaccination injections.

Growth in children and in the offspring whose mothers adhere to vegetarian diets: Literature review

The prevalence of vegetarianism is rising worldwide and there is no consensus about whether it is adequate during the growth period. The objective of this descriptive review is to find out if vegetarian children and children born from mothers who follow vegetarian diets, grow different from those who follow omnivorous diets. Results. 25 articles published between 1995 and 2020 were included describing prenatal and postnatal growth and pubertal development in vegetarian children and children of vegetarian mothers. Conclusion. The scarcity of longitudinal studies and long-term results, the heterogeneity in the classification and registration of the diets, in addition to methodological deficiencies, do not allow to conclude that the growth of these children is different from children on omnivorous diets. Long-term longitudinal studies are required to help to solve this controversy.

Analysis of Career Stage, Gender, and Personality and Workplace Violence in a 20-Year Nationwide Cohort of Physicians in Norway

Workplace violence (WPV) is a worldwide problem in health services. Several studies have pointed to organizational factors, such as working in psychiatry and work stress. However, there is a lack of long-term longitudinal cohort studies with respect to trends during the career and individual factors among physicians. To investigate WPV trends during Norwegian physicians' careers and assess individual and work-related factors associated with WPV in a long-term longitudinal study. This cohort study involved 2 nationwide medical student cohorts who graduated 6 years apart and were surveyed at graduation (T1: 1993-1994 and 1999) and 4 years later (T2), 10 years later (T3), 15 years later (T4), and 20 years after graduation (T5). Generalized estimated equations were used. Statistical analysis was performed from January to September 2020. Medical career during 20 years in Norway. WPV was measured as threats or acts of violence from a patient or visitor experienced at least twice, at each of the stages after leaving medical school. Individual factors were obtained at T1 and work-related factors at T2 through T5. We analyzed WPV by repeated measures. At T1, a total of 893 participants (with a mean [SD] age of 28 (2.83) years; 499 [56%] women) responded to the questionnaire. The prevalence of multiple threats of violence was 20.3% (156 of 769) at T2, 17.1% (118 of 691) at T3, 11.2% (66 of 588) at T4, and 8.6% (46 of 536) at T5; and the prevalence of multiple acts of violence was 4.3% (33 of 763) at T2, 5.2% (36 of 687) at T3, 3.1% (18 of 584) at T4, and 2.2% (12 of 532) at T5. There was a decline from T2 to T5 of both multiple threats (β = -1.06; 95% CI, -1.31 to -0.09; P < .001) and acts of violence (β = -1.13; 95% CI, -1.73 to -0.53; P < .001). In adjusted analysis, factors associated with multiple threats of violence were male gender (odds ratio [OR], 2.76; 95% CI, 1.73 to 4.40; P < .001), vulnerability trait (neuroticism) (OR, 0.90; 95% CI, 0.82 to 0.99; P = .03), young physician cohort (OR, 1.63; 95% CI, 1.04 to 2.58; P = .04), and working in psychiatry (OR, 7.50; 95% CI, 4.42 to 12.71; P < .001). Factors associated with multiple acts of violence in adjusted analysis were male gender (OR, 3.37; 95% CI, 1.45 to 7.84; P = .005), young physician cohort (OR, 6.08; 95% CI, 1.68 to 21.97; P = .006), and working in psychiatry (OR, 12.34; 95% CI, 5.40 to 28.23; P < .001). There were no interactions with gender or cohort in the significant associated factors. Higher rates of multiple threats and acts of violence were observed during early medical careers, among male physicians, and in psychiatry. Low levels of the vulnerability trait (neuroticism) were associated with the experience of multiple threats. There was an association between the young physician cohort and WPV. Preventive efforts should include early-career and male physicians, with additional emphasis on personality.

Long-term trajectory of cognitive performance in people with bipolar disorder and controls: 6-year longitudinal study.

Cross-sectional studies have found impaired cognitive functioning in patients with bipolar disorder, but long-term longitudinal studies are scarce. The aims of this study were to examine the 6-year longitudinal course of cognitive functioning in patients with bipolar disorder and healthy controls. Subsets of patients were examined to investigate possible differences in cognitive trajectories. Patients with bipolar I disorder (n = 44) or bipolar II disorder (n = 28) and healthy controls (n = 59) were tested with a comprehensive cognitive test battery at baseline and retested after 6 years. We conducted repeated measures ANCOVAs with group as a between-subject factor and tested the significance of group and time interaction. By and large, the change in cognitive functioning between baseline and follow-up did not differ significantly between participants with bipolar disorder and healthy controls. Comparing subsets of patients, for example those with bipolar I and II disorder and those with and without manic episodes during follow-up, did not reveal subgroups more vulnerable to cognitive decline. Cognitive performance remained stable in patients with bipolar disorder over a 6-year period and evolved similarly to healthy controls. These findings argue against the notion of a general progressive decline in cognitive functioning in bipolar disorder.

Long-term effects of father involvement in childhood on their son's physiological stress regulation system in adulthood.

Using a long-term prospective longitudinal study of U.S. men and their fathers, the present study examined the extent to which the quantity (i.e., shared activities between fathers and sons) and the quality (i.e., assessors' ratings of fathers' positive behaviors toward sons and the relationship quality between fathers and sons) of father involvement during childhood influenced sons' diurnal patterns of salivary cortisol in adulthood (late 30s) directly and indirectly through substance use across the 20s. Findings indicated that the quantity of father involvement during childhood was directly associated with sons' diurnal cortisol patterns assessed almost 30 years later. Specifically, the quantity of father involvement in childhood significantly increased the intercept (i.e., upon awakening) and also led to a greater reduction in cortisol across the day, suggesting a well-regulated diurnal cortisol pattern. The quantity of father involvement significantly reduced the amount of sons' illicit drug and tobacco use across the 20s. Tobacco use across the 20s was associated with a lower cortisol intercept level (upon awakening), although the mediating path was not significant. The present study provided empirical evidence demonstrating long-term physiological and behavioral consequences of father involvement in childhood and its potency as a crucial early caregiving environment for sons.

Integration of Biobanks in National eHealth Ecosystems Facilitating Long-Term Longitudinal Clinical-Omics Studies and Citizens' Engagement in Research Through eHealthBioR.

Biobanks have long existed to support research activities with BBMRI-ERIC formed as a European research infrastructure supporting the coordination for biobanking with 20 country members and one international organization. Although the benefits of biobanks to the research community are well-established, the direct benefit to citizens is limited to the generic benefit of promoting future research. Furthermore, the advent of General Data Protection Regulation (GDPR) legislation raised a series of challenges for scientific research especially related to biobanking associate activities and longitudinal research studies. Electronic health record (EHR) registries have long existed in healthcare providers. In some countries, even at the national level, these record the state of the health of citizens through time for the purposes of healthcare and data portability between different providers. The potential of EHRs in research is great and has been demonstrated in many projects that have transformed EHR data into retrospective medical history information on participating subjects directly from their physician's collected records; many key challenges, however, remain. In this paper, we present a citizen-centric framework called eHealthBioR, which would enable biobanks to link to EHR systems, thus enabling not just retrospective but also lifelong prospective longitudinal studies of participating citizens. It will also ensure strict adherence to legal and ethical requirements, enabling greater control that encourages participation. Citizens would benefit from the real and direct control of their data and samples, utilizing technology, to empower them to make informed decisions about providing consent and practicing their rights related to the use of their data, as well as by having access to knowledge and data generated from samples they provided to biobanks. This is expected to motivate patient engagement in future research and even leads to participatory design methodologies with citizen/patient-centric designed studies. The development of platforms based on the eHealthBioR framework would need to overcome significant challenges. However, it would shift the burden of addressing these to experts in the field while providing solutions enabling in the long term the lower monetary and time cost of longitudinal studies coupled with the option of lifelong monitoring through EHRs.

Drivers of canine distemper virus exposure in dogs at a wildlife interface in Janos, Mexico.

BackgroundHuman population expansion has increased the contact between domestic animals and wildlife, thereby increasing the transmission of infectious diseases including canine distemper virus (CDV). Here, we investigated the risk factors associated with CDV exposure in domestic and wild carnivores from the Janos Biosphere Reserve (JBR), Mexico.MethodsA cross‐sectional household questionnaire study was performed in four rural towns to investigate the risk factors associated with the presence of CDV in domestic and wild carnivores from the JBR, Mexico. In addition, we tested serum samples from 70 dogs and three wild carnivores, including one bobcat (Lynx rufus), one striped skunk (Mephitis mephitis) and one gray fox (Urocyon cinereoargenteus) for CDV antibodies using immunochromatographic and viral neutralization assays.ResultsOverall, 62% of domestic dogs were seropositive for CDV, and the presence of antibodies was significantly higher in free‐roaming owned dogs than dogs with restricted movement. Among the wild carnivores, only the bobcat was seropositive. The rate of vaccination against CDV in dogs was low (7%), and there was a high rate of direct interactions between domestic dogs and wild carnivores.ConclusionOur serological assays show that CDV is circulating in both domestic dogs and wild carnivores, suggesting cross‐species transmission. Our finding of low vaccination rates, high number of unrestrained owned dogs and direct interactions between wildlife and domestic animals reported in the region may be perpetuating the high prevalence of the virus and increasing the risk of CDV transmission between wild and domestic carnivores. Therefore, long‐term longitudinal studies are recommended in order to monitor infectious diseases at the domestic‐wildlife interface in this highly biodiverse region.

Do Antibiotics Cause Obesity Through Long-term Alterations in the Gut Microbiome? A Review of Current Evidence.

Purpose of ReviewIn this review, we summarize current evidence on the association between antibiotics and the subsequent development of obesity through modulation of the gut microbiome. Particular emphasis is given on (i) animal and human studies and their limitations; (ii) the reservoir of antibiotics in animal feed, emerging antibiotic resistance, gut dysbiosis, and obesity; (iii) the role of infections, specifically viral infections, as a cause of obesity; and (iv) the potential therapeutic approaches other than antibiotics to modulate gut microbiome.Recent FindingsOverall, the majority of animal studies and meta-analyses of human studies on the association between antibiotics and subsequent development of obesity are suggestive of a link between exposure to antibiotics, particularly early exposure in life, and the development of subsequent obesity as a result of alterations in the diversity of gut microbiota. The evidence is strong in animal models whereas evidence in humans is inconclusive requiring well-designed, long-term longitudinal studies to examine this association. Based on recent meta-analyses and epidemiologic studies in healthy children, factors, such as the administration of antibiotics during the first 6 months of life, repeated exposure to antibiotics for ≥ 3 courses, treatment with broad-spectrum antibiotics, and male gender have been associated with increased odds of overweight/obesity.Early antibiotic exposure in animal models has shown that reductions in the population size of specific microbiota, such as Lactobacillus, Allobaculum, Rikenellaceae, and Candidatus Arthromitus, are related to subsequent adiposity. These data suggest that the loss of diversity of the gut microbiome, especially early in life, may have potential long-term detrimental effects on the adult host gut microbiome and metabolic health. Genetic, environmental, and age-related factors influence the gut microbiome throughout the lifetime. More large-scale, longer-term, longitudinal studies are needed to determine whether changes that occur in the microbiome after exposure to antibiotics, particularly early exposure, are causal of subsequent weight gain or consequent of weight gain in humans.SummaryFurther well-designed, large-scale RCTs in humans are required to evaluate the effects of administration of antibiotics, particularly early administration, and the subsequent development of overweight/obesity. Therapeutic interventions, such as bacteriophage treatment or the use of probiotics, especially genetically engineered ones, need to be evaluated in terms of prevention and management of obesity.

A long-term longitudinal study of the osteoarthritic changes to the temporomandibular joint evaluated using a novel three-dimensional superimposition method

The aim of this study was to assess the changes in individual condyles from 5 to 8 years in patients with temporomandibular joint (TMJ) osteoarthritis using 3-dimensional cone beam computed tomography (3D CBCT) reconstruction and superimposition. To assess the longitudinal TMJ changes, CBCT was performed at initial (T0) and final (T2) timepoints that were at least 5 years apart and at a middle (T1) timepoint. To improve the accuracy, we used a novel superimposition method that designated areas of coronoid process and mandibular body. The differences in the resorption and apposition amounts were calculated between each model via maximum surface distances. The greatest resorption and apposition observed were − 7.48 and 2.66 mm, respectively. Evaluation of the changes in each condyle showed that osteoarthritis leads to both resorption and apposition. Resorption was mainly observed in the superior region, while high apposition rates were observed (in decreasing order) in the posterior, lateral, and anterior regions. The medial parts showed greater apposition than the lateral parts in all regions. Our superimposition method reveals that both resorption and apposition were observed in condyles with TMJ osteoarthritis, and resorption/apposition patterns depend on the individual condyle and its sites.

Anterior hippocampal dysfunction in early psychosis: a 2-year follow-up study.

Cross-sectional studies indicate that hippocampal function is abnormal across stages of psychosis. Neural theories of psychosis pathophysiology suggest that dysfunction worsens with illness stage. Here, we test the hypothesis that hippocampal function is impaired in the early stage of psychosis and declines further over the next 2 years. We measured hippocampal function over 2 years using a scene processing task in 147 participants (76 individuals in the early stage of a non-affective psychotic disorder and 71 demographically similar healthy control individuals). Two-year follow-up was completed in 97 individuals (50 early psychosis, 47 healthy control). Voxelwise longitudinal analysis of activation in response to scenes was carried out within a hippocampal region of interest to test for group differences at baseline and a group by time interaction. At baseline, we observed lower anterior hippocampal activation in the early psychosis group relative to the healthy control group. Contrary to our hypothesis, hippocampal activation remained consistent and did not show the predicted decline over 2 years in the early psychosis group. Healthy controls showed a modest reduction in hippocampal activation after 2 years. The results of this study suggest that hippocampal dysfunction in early psychosis does not worsen over 2 years and highlight the need for longer-term longitudinal studies.

Prediction of parasitological cure in children infected with Trypanosoma cruzi using a novel multiplex serological approach: an observational, retrospective cohort study

Assessment of therapeutic response with standard serological diagnostic assays in patients with chronic Chagas disease is a major challenge due to the long persistence of parasite-specific antibodies. The current consensus for parasitological cure is to monitor conversion from positive to negative Trypanosoma cruzi serology (seroreversion). However, because of robust humoral immune response, seroreversion by standard serological tests can take years to decades. Developing novel tests of parasitological cure or surrogates is thus a priority in the Chagas disease field. We aimed to evaluate the MultiCruzi assay as a predictive tool for parasitological cure in a cohort of treated infants and children with acute and chronic Chagas disease enrolled in a long-term retrospective longitudinal study with clinical, serological, and parasitological follow-up, and to explore whether MultiCruzi could predict parasitological cure more quickly than the current reference method. Patients from two retrospective paediatric Chagas disease cohort studies with clinical, serological, and parasitological follow-up, diagnosed and treated at the parasitology service, Hospital de Niños Ricardo Gutierrez (Buenos Aires, Argentina) were included in this retrospective cohort study. Serum samples were collected every 6 months to 12 months between Oct 22, 1990, and June 3, 2019, for cohort 1 and 1 month after birth for cohort 2 and then every 3 months for a year between July 23, 2012, and April 19, 2016. We evaluated serological follow-up with the Chagatest ELISA (Wiener Lab, Rosario, Argentina) and used this as a clinical reference method for the evaluation of seroreversion. We compared Chagatest ELISA results with results of MultiCruzi (InfYnity Biomarkers, Lyon, France), a novel antibody profiling multiplex assay, investigating seroreversion events with both of the assays and prediction of seroreversion with MultiCruzi using an interpretation formula. Combining experimental data from discrete analysis of 15 T cruzi antigens efficiently predicted seroreversion at an early stage, which was later confirmed by conventional T cruzi serology. In cohort 1 (n=69), which included children of three different age groups, we observed differences 2 years after therapy. In the 27 individuals from cohort 1 who were treated within the first 12 months of age, MultiCruzi predicted early seroreversion in 21 (78%) patients whereas nine (33%) patients showed seroreversion with Chagatest ELISA (seroreversion difference 0·44, 95% CI 0·26-0·63; p=0·0005). In the 12 patients from cohort 1 treated between 1 year and 2 years of age, MultiCruzi predicted early seroreversion in six (50%) patients, whereas only one (8%) patient was confirmed to be seronegative with Chagatest ELISA (seroreversion difference 0·42, 95% CI 0·14-0·70; p=0·0253). In the 30 patients from cohort 1 who were treated between 2 years and 19 years of age, MultiCruzi predicted early seroreversion in five (6%) patients, whereas no patients were found to be seronegative with Chagatest ELISA (seroreversion difference 0·17, 0·03-0·30; p=0·0253). In cohort 2 (n=27), which included only children younger than 1 year of age and had a shorter follow up (between 5 months and 32 months), the proportion of reported events was significantly different 180 days after treatment for the T cruzi-positive group (early seroreversion predicted in nine [90%] of ten patients with MultiCruzi and confirmed seroreversion in four [40%] of ten patients with Chagatest ELISA; seroreversion difference 0·50, 95% CI 0·19-0·81; p=0·0253) and for the T cruzi-negative group 90 days (early seroreversion predicted in five [29%] of 17 patients with MultiCruzi and confirmed seroreversion in one [6%] of 17 patients with Chagatest ELISA; seroreversion difference 0·24, 0·03-0·44; p=0·0455) and 180 days (early seroreversion predicted in 17 [100%] of 17 patients with MultiCruzi and confirmed seroreversion only in seven [41%] of 17 patients with Chagatest ELISA; seroreversion difference 0·59, 0·35-0·82; p=0·0016) after treatment. The MultiCruzi assay can be used as a predictive monitoring tool to assess parasitological cure in children. This approach might be a solution to forecast forthcoming seroreversion in treated adults infected with T cruzi, but this requires further investigation. Drugs for Neglected Diseases initiative. For the Spanish, Portuguese and French translations of the abstract see Supplementary Materials section.

Prevalence of elevated liver enzymes and their association with type 2 diabetes risk factors in children.

Given their established role in hepatic function and insulin resistance for adults, early screening of type 2 diabetes mellitus (T2DM) in the pediatric population may potentially be improved by the assessment of elevated liver enzymes. Our study enrolled 151 nondiabetic children aged 10-14years. Patients were assessed for demographics and five risk factors for T2DM. The levels of γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) levels were determined in serum samples. The effects of demographics and risk factors on abnormal liver enzyme levels were assessed with univariate chi-square analyses and also with multivariate logistic regression analyses, which were controlled for gender. Frequencies for abnormal liver enzyme values were as follows: 13 (9%) for GGT, 5 (3%) for ALT, and 20 (13%) for ALP. Across analyses, two results were consistently statistically significant. Females were more likely to have abnormal ALP levels, and patients with BMI percentile≥95% and with acanthosis nigricans were more likely to have abnormal GGT levels. Our study suggests GGT as potential marker for T2DM discovery in children. Subsequent long-term longitudinal studies would help to more clearly delineate GGT's association with T2DM. Additionally, future studies that elucidate the molecular contribution of GGT elevation to T2DM pathogenesis are needed.