Severe Childhood Research Articles

Impact of childhood trauma on functioning of patients with bipolar disorder

IntroductionExposure to severe childhood trauma has been associated with the onset and the severity of bipolar disorder in adults.ObjectivesThe aim of this study was to examine the relationship between childhood trauma and functioning of patients suffering from bipolar disorder.MethodsWe conducted a cross-sectional, descriptive, and analytical study, including sixty-one remitted patients with BD. We used the Childhood Trauma Questionnaire (CTQ-SF) to measure history of traumatic childhood experiences and the Functioning Assessment Short Test (FAST) to assess functioning.ResultsThe mean age of patients was 43.4. The sex ratio was 2.4. Almost two-thirds of patients (64%) had experienced at least one type of childhood trauma. An overall functional impairment was found in 70.5% of participants. The CTQ total score was significantly associated with low educational level (p=0.001), low socio-economic status (P=0.034), a family history of psychosis (P=0.022), the number of mood episodes (P=0.001), the number of hospitalizations (P=0.04), the number of relapses with psychotic features (p=0.002) and that of depressive relapses (P<0.001), rapid cycling (P=0.012), higher rates of suicide attempts (P=0.04) and poor functioning (P<0.001).The logistic regression analyses showed a significant association of childhood trauma with low educational level (p=0.001), high number of depressive episodes (p=0.013) and poor functioning (p<0.001).ConclusionsOur findings demonstrate that childhood abuse and neglect are risk factors associated with worsening clinical course of bipolar disorder and higher functional impairment. These findings press the urgency for preventive practices and early intervention strategies to diminish the prevalence of childhood trauma and minimize their impact.DisclosureNo significant relationships.

Childhood trauma and comorbid anxiety disorders in patients with bipolar disorder

IntroductionA history of childhood trauma and Comorbid anxiety disorders have each been identified as potential predictors of unfavorable outcomes in patients with bipolar disorder. Nevertheless, the relationship between these two prognostic features has been little studied.ObjectivesIn the present study, we aim to explore the relationship between childhood trauma and comorbid anxiety disorders in bipolar patients.MethodsWe conducted a cross-sectional, descriptive, and analytical study. Sixty-one euthymic patients with bipolar disorder were recruited in the department of psychiatry B of Razi Hospital, during their follow-up. We assessed history of childhood traumatic experiences with the Childhood Trauma Questionnaire (CTQ) and current diagnosis of anxiety disorders with the M.I.N.I. International Neuropsychiatric Interview.ResultsThe mean age of patients was 43.4. The sex ratio was 2.4. Almost two-thirds of patients (64%) had experienced at least one type of childhood trauma. Twenty-one percent of participants had one anxiety disorder and 12% participants had two or more current anxiety disorders. Of the anxiety disorders, social anxiety disorder was significantly associated with emotional abuse subscale (p=0.002). Generalized anxiety disorder was significantly associated with the physical abuse subscale (p=0.025) and the number of severe childhood trauma per patient (p=). A statistically significant association was found between the number of current anxiety disorders and the emotional abuse sub score (p=0.021).ConclusionsExposure to childhood traumatic experiences is associated with more common comorbid anxiety disorders among bipolar patients. These prognostic features should systematically be a part of clinical assessment and taken into account in the management of these patients.DisclosureNo significant relationships.

Taxonomic and functional alterations in the salivary microbiota of children with and without severe early childhood caries (S-ECC) at the age of 3.

BackgroundPrimary dental caries is the most prevalent oral disease among preschool children, which can cause severe damage to teeth and even affect the mental well-being of children. Various studies have demonstrated that the oral microbiome plays a pivotal role in the onset and development of dental caries. However, it remains uncertain about the key microbial markers associated with caries, owing to the limited evidence.MethodsFifteen S-ECC children and fifteen healthy controls were selected from three-year-old children in this study. Their clinical data and oral saliva samples were collected. Shotgun sequencing was conducted to investigate the microbial differences and the relevant functions between the two groups.ResultsWe observed no apparent difference in oral microbial community diversity between the two groups. Still, at the genus/species levels, several characteristic genera/species such as Propionibacterium, Propionibacterium acidifaciens, Prevotella denticola, Streptococcus mutans and Actinomyces sp. oral taxon 448/414 increased significantly in S-ECC children, compared with the oral health group. Furthermore, we found that functional pathways involving glycolysis and acid production, such as starch and sucrose metabolism, fructose and mannose metabolism, glycolysis/gluconeogenesis, were prominently up-regulated in the high-caries group.ConclusionsOur study showed that dental caries in children were associated with the alterations in the oral microbiota at the composition and functional levels, which may potentially inspire the exploration of microbial diagnosis or therapeutic treatments.

Correlates of Aggression in Men With Methamphetamine Use Disorder: Childhood Trauma and Methamphetamine-Use Characteristics.

BackgroundAggression is common among individuals with methamphetamine use disorder (MAUD) and constitutes a serious public health issue. The current study aimed to examine associations of methamphetamine-use characteristics and childhood trauma with aggression in men with MAUD.MethodsThis cross-sectional study was conducted from December 2017 to August 2018. MAUD patients recruited from a compulsory drug rehabilitation center (n = 360) and healthy comparison subjects (n = 604) completed a survey that measured aggression and childhood trauma, using the Chinese version of Buss-Perry Aggressive Questionnaire (AQ-CV), and the short form of Childhood Trauma Questionnaire (CTQ-SF), respectively. MAUD patients also provided information on methamphetamine-use characteristics such as the age of MAUD onset, MAUD severity, and co-occurring alcohol use disorder (AUD) and tobacco use disorder (TUD) using standard or self-designed questionnaires. Chi-square tests and t-tests were used to compare childhood trauma and aggression between the MAUD and comparison groups. Multiple linear regressions were conducted to determine correlates of overall aggression and its five sub-scales among the MAUD group.ResultsThe MAUD group had higher childhood trauma and aggression scores than the comparison group. Within the MAUD group, age of MAUD onset, having severe MAUD, co-occurring AUD, co-occurring TUD, and childhood trauma were associated with overall aggression, with slightly different correlates found for its five sub-scales.ConclusionsOur study shows a high level of childhood trauma and aggression in the MAUD group. Both methamphetamine-use characteristics (age of MAUD onset, severe MAUD, co-occurring AUD/TUD) and childhood trauma were associated with aggression in MAUD. Our findings provide useful information on potential risk factors for aggression and inform future longitudinal research to establish causal relationships between these factors and aggression to guide further prevention and treatment programs.

Assessment of occlusion and temporomandibular joint after placing preformed metal crowns on all primary molars in children.

Placing preformed metal crowns (PMCs) on all eight primary molars at one single clinical visit may disrupt a child's occlusion; the literature regarding the effects on occlusion and temporomandibular joint (TMJ) is scarce. This study aimed to quantify the changes in occlusion using T-Scan III and to investigate whether there was TMJ dysfunction after placing eight PMCs at the same time. In this study, we enrolled children with severe early childhood caries (S-ECC) and dental phobia, who needed eight PMCs to be placed under general anesthesia. The participants underwent occlusal examinations with a computed occlusal analysis system. The vertical dimension of occlusion (VDO) was measured using a dental vertical dimension gauge, TMJ dysfunction signs were recorded by the clinical dysfunction index (Di), and TMJ dysfunction symptoms were recorded using a questionnaire. The data were collected before treatment (T0 ), 1 week after treatment (T1 ), and 1 month (T2 ) and 3 months (T3 ) after treatment during follow-up visits. Repeated-measures analysis of variance and Friedman's test were used for occlusal data analysis. In addition, the Di and symptoms were compared over time using McNemar's test. Forty patients (mean age=4.25 ± 0.63 years, age range=3-5 years, 21 boys and 19 girls) were followed up for 3 months. The occlusal contact area 3 months after treatment did not return to the pretreatment status (p=.03). The total of force at the 3-month follow-up visit increased significantly (p=.009) compared with that at the pretreatment. The asymmetric ratio of occlusal force at the 1-month follow-up visit was restored to pretreatment. Concerning the occlusion time, no significant changes were observed for any time intervals (p=.069). The VDO was recovered at the 1-month follow-up visit. The statistical analysis of TMJ dysfunction showed no significant differences in the Di and TMJ dysfunction symptoms before and after treatment (p > .05). After undergoing eight PMC restorations under general anesthesia, occlusal re-equilibration was attained approximately after 1 month. There were no significant signs and symptoms of TMJ dysfunction after treatment.

Novel Giomers Incorporated with Antibacterial Quaternary Ammonium Monomers to Inhibit Secondary Caries.

The objective of this study was to develop novel modified giomers by incorporating the antibacterial quaternary ammonium monomers (QAMs), dimethylaminododecyl methacrylate (DMADDM) or dimethylaminohexadecyl methacrylate (DMAHDM) into a commercial giomer. The material performances including mechanical properties, surface characteristics, color data, cytotoxicity and fluoride release of the novel giomers were evaluated. Antibacterial activity against severe early childhood caries (S-ECC) saliva-derived biofilms was assessed by lactic acid production measurement, MTT assay, biofilm staining and 16S rRNA sequencing. A rat model was developed and the anti-caries effect was investigated by micro-CT scanning and modified Keyes’ scoring. The results showed that the material properties of the QAMs groups were comparable to those of the control group. The novel giomers significantly inhibited lactic acid production and biofilm viability of S-ECC saliva-derived biofilms. Furthermore, caries-related genera such as Streptococcus and Lactobacillus reduced in QAMs groups, which showed their potential to change the microbial compositions. In the rat model, lesion depth, mineral loss and scoring of the QAMs groups were significantly reduced, without side effects on oral tissues. In conclusion, the novel giomers incorporated with antibacterial QAMs could inhibit the cariogenic biofilms and help prevent secondary caries, with great potential for future application in restorative treatment.

University Students Who Report Exchanging Sex for Money or Other Compensation: Findings from a Public University Sample.

Whether and how university students exchange sex for financial compensation in the USA is critically understudied. The purpose of this secondary analysis was to determine whether undergraduate and graduate students at a large public university report exchanging sex for financial or other compensation, and identify factors (e.g., demographics, childhood adversity, mental health) associated with exchanging sex. Participants were 600 college students (Mage = 21.3 years [SD = 3.8]); 72% cisgender women; 43.4% racial/ethnic minority) from a large public university in the Northeastern USA who completed cross-sectional, online questionnaires about lifetime trauma, adversity exposure, sexual behaviors, and current mental health and substance use symptoms. A total of 4.5% of participants reported exchanging sex for money, alcohol/drugs, or other forms of compensation. Bivariate analysis revealed that lesbian, gay, bisexual, and trans students (versus cisgender, heterosexual students), students who had more severe childhood trauma, who reported being removed from their family home in childhood, and students who were diagnosed with a mental health disorder before age 18 were more likely to report exchanging sex. In a multivariable model, only emotional neglect and greater alcohol use problems were significantly associated with likelihood of exchanging sex. To our knowledge, this is the first US study to determine whether university students exchange sex for money, alcohol/drugs, or other compensation. Findings suggest that universities could consider addressing exchanging sex in person-centered, supportive sexual health programming, university health services responses, and community spaces that support LGBTQ+ students. Future research is needed to understand students' circumstances in exchanging sex and differentiate compensation type.

Safety and efficacy of BCG re-vaccination in relation to COVID-19 morbidity in healthcare workers: A double-blind, randomised, controlled, phase 3 trial

SummaryBackgroundBCG vaccination prevents severe childhood tuberculosis (TB) and was introduced in South Africa in the 1950s. It is hypothesised that BCG trains the innate immune system by inducing epigenetic and functional reprogramming, thus providing non-specific protection from respiratory tract infections. We evaluated BCG for reduction of morbidity and mortality due to COVID-19 in healthcare workers in South Africa.MethodsThis randomised, double-blind, placebo-controlled trial recruited healthcare workers at three facilities in the Western Cape, South Africa, unless unwell, pregnant, breastfeeding, immunocompromised, hypersensitivity to BCG, or undergoing experimental COVID-19 treatment. Participants received BCG or saline intradermally (1:1) and were contacted once every 4 weeks for 1 year. COVID-19 testing was guided by symptoms. Hospitalisation, COVID-19, and respiratory tract infections were assessed with Cox proportional hazard modelling and time-to-event analyses, and event severity with post hoc Markovian analysis. This study is registered with ClinicalTrials.gov, NCT04379336.FindingsBetween May 4 and Oct 23, 2020, we enrolled 1000 healthcare workers with a median age of 39 years (IQR 30–49), 70·4% were female, 16·5% nurses, 14·4% medical doctors, 48·5% had latent TB, and 15·3% had evidence of prior SARS-CoV-2 exposure. Hospitalisation due to COVID-19 occurred in 15 participants (1·5%); ten (66·7%) in the BCG group and five (33·3%) in the placebo group, hazard ratio (HR) 2·0 (95% CI 0·69–5·9, p = 0·20), indicating no statistically significant protection. Similarly, BCG had no statistically significant effect on COVID-19 (p = 0·63, HR = 1·08, 95% CI 0·82–1·42). Two participants (0·2%) died from COVID-19 and two (0·2%) from other reasons, all in the placebo group.InterpretationBCG did not protect healthcare workers from SARS-CoV-2 infection or related severe COVID-19 disease and hospitalisation.FundingFunding provided by EDCTP, grant number RIA2020EF-2968. Additional funding provided by private donors including: Mediclinic, Calavera Capital (Pty) Ltd, Thys Du Toit, Louis Stassen, The Ryan Foundation, and Dream World Investments 401 (Pty) Ltd. The computations were enabled by resources in project SNIC 2020–5–524 provided by the Swedish National Infrastructure for Computing (SNIC) at UPPMAX, partially funded by the Swedish Research Council through grant agreement No. 2018–05,973.

Omalizumab for severe atopic dermatitis in 4- to 19-year-olds: the ADAPT RCT

BackgroundEvidence for systemic treatments for severe childhood eczema is limited. Systemic immunosuppressants are unlicensed for use in children and are associated with unwanted side effects.ObjectiveTo examine the role of anti-immunoglobulin E (IgE) [omalizumab (Xolair®, Novartis Pharmaceuticals UK Ltd, Frimley, UK)] in children and young people with severe eczema.DesignA double-blind, placebo-controlled, parallel-arm randomised (1 : 1) trial.SettingA single specialist centre – Guy’s and St Thomas’ NHS Foundation Trust, London.ParticipantsAtopic children and young people (aged 4–19 years) with severe eczema.InterventionsTreatment with omalizumab or placebo for 24 weeks.Main outcome measuresThe primary outcome was eczema severity, measured using the objective SCORing Atopic Dermatitis (SCORAD) at 24 weeks. Secondary outcomes included validated measures of eczema severity, quality of life (QoL) and potent topical steroid use.ResultsSixty-two participants, with a median baseline total IgE level of 8373 kU/l, received treatment with omalizumab (n = 30) or placebo (n = 32). The unadjusted mean objective SCORAD score at week 24 was 43.1 [standard deviation (SD) 12.5] for participants in the omalizumab arm and 49.2 (SD 11.3) for participants in the placebo arm. After adjustment for baseline objective SCORAD score, age and IgE level, the mean difference between arms at 24 weeks was –6.9 [95% confidence interval (CI) –12.2 to –1.5;p = 0.013], in favour of omalizumab. The mean objective SCORAD scores improved by –12.4 and –5.1 in the omalizumab and placebo arms, respectively, by 24 weeks. Secondary outcome measure estimates were also in favour of omalizumab for eczema severity at 24 weeks: the adjusted mean treatment arm difference was –8.3 (95% CI –15.1 to –1.1;p = 0.024) for total combined objective and subjective SCORAD and –6.7 (95% CI –13.2 to –0.1;p = 0.046) for the Eczema Area and Severity Index, with less effect on the Patient-Oriented Eczema Measure (POEM; –1.1, 95% CI –4.6 to 2.4;p = 0.527). Treatment estimate precision was limited by the sample size. The QoL measures favoured omalizumab, with an improvement (reduction) in both (Children’s) Dermatology Life Quality Index [(C)DLQI] score (mean –3.5, 95% CI –6.4 to –0.5;p = 0.022) and Paediatric Allergic Disease Quality of Life Questionnaire score (mean –0.5, 95% CI –0.9 to 0.0;p = 0.050). The mean (C)DLQI score improved by 50%, from 17.0 (SD 5.6) at baseline to 8.5 (SD 5.9) at week 24, for patients treated with omalizumab. Improvements were seen despite lower potent topical steroid use in the omalizumab arm, with 48% more days of use than (109 days in the placebo arm vs. 161 days in the omalizumab arm) and twice the body surface area coverage of (15.5% in the placebo arm vs. 31.3% in the omalizumab arm) the placebo arm. There were fewer treatment failures and new systemic immunosuppression initiations in the omalizumab arm. There was no difference in the numbers of cases of infective eczema and eczema exacerbation. There was one suspected severe adverse reaction in the omalizumab arm. In each arm, six participants reported a total of seven severe adverse events that were unrelated to treatment. Non-serious respiratory and dermatological adverse event rates were higher in the placebo arm (incidence rate ratio 0.69, 95% CI 0.49 to 0.96).ConclusionsOmalizumab, in a highly atopic paediatric population with severe eczema, reduced eczema severity and improved QoL despite a reduction in potent steroid use and highly elevated total IgE levels. Omalizumab, with its favourable side effect profile, warrants further study as a treatment option for this difficult-to-manage population. Further studies are needed to clarify the role of omalizumab. Treatment benefit became more apparent towards 24 weeks and persisted after treatment stopped. The optimal duration of treatment needs to be determined.Trial registrationThis trial is registered as ISRCTN15090567, EudraCT 2010-020841-29 and ClinicalTrials.gov NCT02300701.FundingThis project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health and Care Research (NIHR) partnership. This will be published in full inEfficacy and Mechanism Evaluation; Vol. 9, No. 5. See the NIHR Journals Library website for further project information. A grant from the Guy’s and St Thomas’ Charity supported the Atopic Dermatitis Anti-IgE Paediatric Trial (ADAPT). Omalizumab and the placebo were supplied by Novartis Pharmaceuticals UK Ltd.

Heterozygous Genetic Variants in Autosomal Recessive Genes of the Leptin-Melanocortin Signalling Pathway Are Associated With the Development of Childhood Obesity.

Monogenic obesity is a severe, genetically determined disorder that affects up to 1/1000 newborns. Recent reports on potential new therapeutics and innovative clinical approaches have highlighted the need for early identification of individuals with rare genetic variants that can alter the functioning of the leptin-melanocortin signalling pathway, in order to speed up clinical intervention and reduce the risk of chronic complications. Therefore, next-generation DNA sequencing of central genes in the leptin-melanocortin pathway was performed in 1508 children and adolescents with and without obesity, aged 2-19 years. The recruited cohort comprised approximately 5% of the national paediatric population with obesity. The model-estimated effect size of rare variants in the leptin-melanocortin signalling pathway on longitudinal weight gain between carriers and non-carriers was derived. In total, 21 (1.4%) participants had known disease-causing heterozygous variants (DCVs) in the genes under investigation, and 62 (4.1%) participants were carriers of rare variants of unknown clinical significance (VUS). The estimated frequency of potential genetic variants associated with obesity (including rare VUS) ranged between 1/150 (VUS and DCV) and 1/850 (DCV) and differed significantly between participants with and without obesity. On average, the variants identified would result in approximately 7.6 kg (7.0-12.9 kg at the 95th percentile of body weight) (girls) and 8.4 kg (8.2-14.4 kg) (boys) of additional weight gain in carriers at age 18 years compared with subjects without obesity. In conclusion, children with a genetic predisposition to obesity can be promptly identified and may account for more than 6% of obesity cases. Early identification of genetic variants in the LEPR, PCSK1, POMC, MC3R and MC4R genes could reduce the societal burden and improve the clinical management of early severe childhood obesity and its implementation should be further investigated.

Comparison of Laboratory Data between Children with Kawasaki Disease and COVID-19.

Background: Coronavirus disease 2019 (COVID-19) has been an emerging, rapidly evolving situation in China since late 2019 and has even become a worldwide pandemic. The first case of severe childhood novel coronavirus pneumonia in China was reported in March 2020 in Wuhan. The severity differs between adults and children, with lower death rates and decreased severity for individuals under the age of 20 years. Increased cases of Kawasaki disease (KD) have been reported from New York City and some areas of Italy and the U.K., with almost a 6–10 times increase when compared to previous years. We conducted this study to compare characteristics and laboratory data between KD and COVID-19 in children. Methods: We obtained a total of 24 children with COVID-19 from a literature review and 268 KD cases from our hospital via retrospective chart review. Results: We found that patients with KD have higher levels of white blood cells (WBCs), platelets, neutrophil percentage, C-reactive protein (CRP), procalcitonin, and aspartate aminotransferase (AST) and a higher body temperature, while patients with COVID-19 have a higher age, hemoglobin levels, and lymphocyte percentage. After performing multiple logistic regression analysis, we found that age, WBCs, platelets, procalcitonin, and AST are identical markers for distinguishing COVID-19 from KD in children. Conclusion: In this COVID-19 pandemic period, clinicians should pay attention to children with COVID-19 infection when high WBC, platelet, procalcitonin, and AST values are present in order to provide early diagnosis for KD or multisystem inflammatory syndrome in children (MIS-C).

Psychoanalytical Considerations of Emotion Regulation Disorders in Multiple Complex-Traumatized Children-A Study Protocol of the Prospective Study MuKi.

Studies in adults with mental disorders suggest that the experience of early and chronic trauma is associated with changes in reward expectancy and processing. In addition, severe childhood trauma has been shown to contribute to the development of mental disorders in general. Data on effects of early childhood trauma on reward expectancy and processing in middle childhood currently appear insufficient. The present study aims to fill this research gap by examining the effects of developmental trauma disorder (DTD) on reward expectancy and processing in children aged 8–12 years, testing the hypothesis that children with multiple complex traumas exhibit altered reward processing as a result of prior disappointing reward experiences. One main feature of developmental trauma disorder is early experiences of multiple separation from important and close relationships alongside other experiences of emotional or physical harm. In the sequel children often show affect regulation disorders. To investigate this, we have developed an adapted version of the Monetary Incentive Delay (MID) Task, which examines children’s expectation of reward or frustration. In this first study, behavioral data will be collected from N = 40 children (n = 20 experimental group and n = 20 healthy controls) using this adapted version of the MID Task. Children in the experimental group will be recruited from youth welfare centers in Frankfurt a.M., Germany. Healthy control subjects will be recruited from after-school-care facilities. A brief trauma screening will be conducted for both groups, experimental and control. If children show signs of trauma, the presence of a developmental trauma disorder will be further delineated by a German translation of the Developmental Trauma Disorder Structured Interview for Children (DTDSI-C) which was translated the first time in German by our research group. We hypothesize that children in the experimental group will be less accurate in performing the Monetary Incentive Delay Task because of their impaired emotion regulation skills due to emotional avoidance following developmental trauma. If the results of our initial behavioral study are promising, the MID task will be used in a future study to elucidate the relationship between trauma developmental disorder, reward expectancy and processing, and neurobiological processes in middle childhood.

Rates and correlates of well-being among youth experiencing homelessness.

Mental health concerns have been well studied among youth experiencing homelessness, yet few studies have explored factors that contribute to well-being in this population. The current cross-sectional study examined rates and correlates of well-being among youth experiencing homelessness. This is a descriptive, secondary analysis of the baseline data from a clinical intervention study. Ninety-nine youth (aged 16-25) who were experiencing homelessness were recruited in Chicago. Approximately 40% of the sample reported average or above average well-being relative to existing benchmarks. Having medical insurance, a mobile phone, and a history of more severe childhood trauma were unique cross-sectional predictors of worse well-being (all ps < 0.034). A significant portion of our sample experienced well-being. Having access to certain resources may be counterintuitive indicators of poorer well-being among youth experiencing homelessness, perhaps because they are indicators of greater need or increased social comparison among these youth.

PET and MRI-DTI and MRI quantitative volumetric detection of abnormalities consistent with chronic traumatic encephalopathy, early severe childhood emotional abuse, and neglect in a homicide trial mitigation phase

Emotional abuse can result in neurological changes that can affect behavioral regulations of aggression. Multiple traumatic brain injuries (TBI) can result in a high probability of developing chronic traumatic encephalopathy (CTE), and in significant impairment in the ability to regulate aggressive behavior. Neuroimaging can detect abnormalities consistent with changes reported in emotional abuse and in multiple TBIs with greater risk of developing CTE. Such evidence can be presented for use during the mitigation phase in death penalty cases. We report a case of a 60-year-old convicted felon, Raul Roque, who committed two homicides ten years apart. In the second homicide trial, scientific evidence of the defendant’s brain abnormalities (consistent with severe emotional abuse, neglect induced neurological changes, post-traumatic stress disorder, and TBIs with a likely prognosis of high risk of CTE) was displayed using positron emission tomography, diffusion tensor imaging, and quantitative volumetrics. In the defendant’s psychological assessments, a history of childhood trauma, multiple frequent head injuries, and psychological disturbances were documented. Utilization of clinically practiced neuroimaging analyses is a useful component during the mitigation phase of capital punishment court cases and can lead to understanding neuroanatomical correlation with brain function and behavior of incarcerated individuals who commit capital murder.

Effectiveness of Bacillus Calmette-Guérin vaccination against severe childhood tuberculosis in China: a case-based, multicenter retrospective study

BackgroundEvidence varies regarding the efficacy of Bacillus Calmette-Guérin (BCG) vaccine. Data on protection by BCG vaccination against severe tuberculosis (TB) among children in China remain unclear. MethodsWe conducted a case-based, multicenter retrospective study at three children's hospitals in China. Sociological factors affecting BCG vaccination and risk factors associated with disease types were analyzed using a multivariable model. ResultsA total 1701 children with active TB were enrolled. Children who were younger, female, residing in a rural area, living in the western regions, and with no BCG vaccination history were at higher risk of developing severe TB. Children with a BCG scar had significantly lower risk for severe TB (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.51–0.67). Children with no BCG scar but who were vaccinated at birth still had lower risk of severe TB types, such as tuberculous meningitis (OR 0.88, 95% CI 0.80–0.97) and miliary TB (OR 0.77, 95% CI 0.69–0.87). ConclusionsNeonatal BCG vaccination could be an effective means to control TB. In the absence of a new, more effective TB vaccine, our results lend support to continued use of the BCG vaccine in China.

Association between Bifidobacterium and Scardovia Wiggsiae and caries-related factors in severe early childhood caries and caries-free Thai children: a quantitative real-time PCR analysis and a questionnaire cross-sectional study.

To quantitatively identify Bifidobacterium, S. wiggsiae and S. mutans in plaque samples obtained from children with severe-ECC and caries-free groups and to analyze their association with caries-related factors retrieved from the questionnaire in each group. To establish the 2 study groups, clinical examination in 122 Thai children, aged 2-5years, recorded decayed, missing and filled teeth scores (dmft), in addition to plaque and gingival indices. Sixty one children in the caries-free group and 61 in the S-ECC group were identified. A questionnaire was used to assess the parent's attitudes and behavior regarding the child's oral hygiene care and diet. Pooled overnight supra gingival plaque was collected from each child using a sterile toothpick, released in 1ml of TE buffer, transported on ice to the Laboratory and stored at - 20°C. DNA was extracted from the plaque based on enzymatic lysis and quantitative real-time PCR using fluorescent dye (SYBR green) in addition to Agarose gel electrophoresis were performed. All laboratory and retrieved from the questionnaire data per child were recorded and statistically analysed. S. wiggsiae (p < 0.005) and S. mutans (p < 0.001) were higher in the S-ECC group. Bifidobacterium, S. mutans, and S. wiggsiae were associated with the dmft score and gingival index (p < 0.001). The dmft scores of children who detected only S. mutans were significantly lower than the dmft scores of children who detected two bacteria; S. mutans + S. wiggsiae (p = 0.028), S. mutans + Bifidobacterium (p = 0.026), and three bacteria; S. mutans + Bifidobacterium + S. wiggsiae (p = 0.007). Children who found all three bacteria (Bi + Sm + Sw) had the highest dmft scores, followed by children who had two bacteria (Bi + Sw, or Bi + Sm, or Sw + Sm). The guardians' education levels, occupations, household income, prolonged bottle feeding, taking of water after bottle or breast feeding, eating sugar-coated crackers or bread with sweetened cream, and premature birth were the factors that related to S-ECC. Levels of S. wiggsiae and S. mutans, guardian's education, family economics, prolonged bottle feeding, eating high sugar-containing snacks and premature birth were associated with S-ECC.

Severe childhood trauma and emotion recognition in males and females with first-episode psychosis.

Childhood trauma increases social functioning deficits in first-episode psychosis (FEP) and is negatively associated with higher-order social cognitive processes such as emotion recognition (ER). We investigated the relationship between childhood trauma severity and ER capacity, and explored sex as a potential factor given sex differences in childhood trauma exposure. Eighty-three FEP participants (52 males, 31 females) and 69 nonclinical controls (49 males, 20 females) completed the CogState Research Battery. FEP participants completed the Childhood Trauma Questionnaire. A sex×group (FEP, controls) ANOVA examined ER differences and was followed by two-way ANCOVAs investigating sex and childhood trauma severity (none, low, moderate, and severe) on ER and global cognition in FEP. FEP participants had significantly lower ER scores than controls (p=.035). No significant sex×group interaction emerged for ER F(3, 147)=.496, p=.438 [95% CI=-1.20-0.57], partial η2 =.003. When controlling for age at psychosis onset, a significant interaction emerged in FEP between sex and childhood trauma severity F(3, 71)=3.173, p=.029, partial η2 =.118. Males (n=9) with severe trauma showed ER deficits compared to females (n=8) (p=.011 [95% CI=-2.90 to -0.39]). No significant interaction was observed for global cognition F(3, 69)=2.410, p=.074, partial η2 =.095. These preliminary findings provide support for longitudinal investigations examining whether trauma severity differentially impacts ER in males and females with FEP.

Genome-wide study of early and severe childhood asthma identifies interaction between CDHR3 and GSDMB

Asthma with severe exacerbation is one of the most common causes of hospitalization among young children. Exacerbations are typically triggered by respiratory infections, but the host factors causing recurrent infections and exacerbations in some children are poorly understood. As a result, current treatment options and preventive measures are inadequate. We sought to identify genetic interaction associated with the development of childhood asthma. We performed an exhaustive search for pairwise interaction between genetic single nucleotide polymorphisms using 1204 cases of a specific phenotype of early childhood asthma with severe exacerbations in patients aged 2 to 6 years combined with 5328 nonasthmatic controls. Replication was attempted in 3 independent populations, and potential underlying immune mechanisms were investigated in the COPSAC2010 and COPSAC2000 birth cohorts. We found evidence of interaction, including replication in independent populations, between the known childhood asthma loci CDHR3 and GSDMB. The effect of CDHR3 was dependent on the GSDMB genotype, and this interaction was more pronounced for severe and early onset of disease. Blood immune analyses suggested a mechanism related to increased IL-17A production after viral stimulation. We found evidence of interaction between CDHR3 and GSDMB in development of early childhood asthma, possibly related to increased IL-17A response to viral infections. This study demonstrates the importance of focusing on specific disease subtypes for understanding the genetic mechanisms of asthma.

Evaluation of the relationship between severe early childhood caries and vitamin D

To evaluate the relationship between the factors affecting the formation of severe early childhood caries (S-ECC) in preschool children, dental caries and serum 25-hydroxyvitamin D (25(OH)D) and to contribute to the literature on this subject. ASA I-II children aged <72 months and their volunteer parents who had no apparent learning disability were included in the study. 25(OH)D, calcium and albumin levels were measured from the serum samples taken from the children. Dft, dfs and plaque scores were calculated after the oral examination of the children. Parents were asked to fill out a questionnaire assessing the child's dietary habits and family demographics. Total of 175 children (56% male) participating in the study (n = 98; ECC, n = 77; caries-free). S-ECC was present in 42.8% of children with adequate 25(OH)D levels and 63.4% of children with deficient or insufficient levels. Children with S-ECC had significantly lower mean 25(OH)D levels than those caries-free. A very weak negative correlation was detected between 25(OH)D level and dft score. It was difficult to confirm the relationship between 25(OH)D levels and S-ECC. Again, there was a weak correlation between the dft score and 25(OH)D levels.

Severe Early Childhood Caries and General Health in a group of Sudanese Preschool Children

Severe Early Childhood Caries and General Health in a group of Sudanese Preschool Children