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RATIONALE: Asthma studies show many children use inhalers incorrectly even after instruction. For two age groups of children with asthma, we determined the proportions who used the once-daily ELLIPTA dry-powder inhaler (DPI) correctly, and who found it easy to use. METHODS: This was a multicenter, single-arm, stratified, open-label, placebo study (NCT03478657). Children aged 5-7 and 8-11 years were trained in, and required to demonstrate, correct placebo ELLIPTA DPI use at their first clinic visit...

Lung neuroendocrine neoplasms (NENs) encompass the low-, intermediate-, and high-grade entities. Differentiated NENs overexpress somatostatin receptors, which are targeted by 68 Ga-DOTA-conjugated peptides in molecular imaging with positron emission tomography. Less differentiated NENs may have lost their expression of somatostatin receptors and thus show lower uptake of 68 Ga-DOTA-peptides; however, these tumors express GLUT-1 and can be imaged with (18)F-fluordeoxyglucose (FDG). We report the case of a 72-year-old patient with a poorly differentiated, high grade lung NEN, which was 18 F-FDG-positive at initial diagnosis...

PURPOSE: The aim of the study was to develop an optimally designed and comprehensibly formulated patient information leaflet (PIL) to improve patients' memory of information provided by physicians during a radiotherapy (head and neck area) consultation. This PIL was tested on unaffected probands for its usefulness in clinical practice. PATIENTS AND METHODS: A panel of experts compiled the main topics using Lawshe's content validity ratio. Flesch's Reading Ease Score (FRE) and the Baker Able Leaflet Design (BALD) index were adapted to appropriate values to determine text comprehensibility and graphic design...

The neoplastic stromal cells of giant cell tumor of bone (GCTB) carry a mutation in H3F3A, leading to a mutant histone variant, H3.3-G34W, as a sole recurrent genetic alteration. We show that in patient-derived stromal cells H3.3-G34W is incorporated into the chromatin and associates with massive epigenetic alterations on the DNA methylation, chromatin accessibility and histone modification level, that can be partially recapitulated in an orthogonal cell line system by the introduction of H3.3-G34W. These epigenetic alterations affect mainly heterochromatic and bivalent regions and provide possible explanations for the genomic instability, as well as the osteolytic phenotype of GCTB...

Background: It is widely acknowledged that food sensitization is related to atopic dermatitis in infants and young children. Objective: To investigate the association of aeroallergen sensitization with increased rates and severity of atopic dermatitis in school children. Methods: We enrolled 576 children (mean age, 9.4 ± 1.8 years) from six elementary schools. Atopic dermatitis was diagnosed by questionnaires, and severity was rated by physical examinations graded by using the Scoring Atopic Dermatitis (SCORAD) index...

The recommendations of the Association for European Paediatric and Congenital Cardiology for basic training in paediatric and congenital cardiology required to be recognised as a paediatric cardiologist by the Association for European Paediatric and Congenital Cardiology are described below. Those wishing to achieve more advanced training in particular areas of paediatric cardiology should consult the training recommendations of the different Association for European Paediatric and Congenital Cardiology Working Groups available on the Association for European Paediatric and Congenital Cardiology website (www...

STUDY DESIGN: Retrospective cohort study. PURPOSE: To evaluate the incidence and presentation of symptomatic failures (SFs) after metastatic spine tumor surgery (MSTS). To identify the associated risk factors. To categorize SFs based on the management in these patients. OVERVIEW OF LITERATURE: Few studies have reported on the incidence (1.9%-16%) and risk factors of SF after MSTS. It is unclear whether all SFs, occurring in MSTS-patients, result in revision surgery...

STUDY DESIGN: Retrospective cohort study. PURPOSE: To study the incidence, onset, underlying mechanism, clinical course, and factors leading to asymptomatic construct failure (AsCF) after metastatic spinal tumor surgery (MSTS). OVERVIEW OF LITERATURE: The reported incidence rates for implant and/or construct failure after MSTS are low (1.9%-16%) and based on clinical presentations and revisions required for symptomatic failures (SFs). AsCF after MSTS has not been reported...

Targeted analysis of DNA methylation patterns based on bisulfite-treated genomic DNA (BT-DNA) is considered as a gold-standard for epigenetic biomarker development. Existing software tools facilitate primer design, primer quality control or visualization of primer localization. However, high-throughput design of primers for BT-DNA amplification is hampered by limits in throughput and functionality of existing tools, requiring users to repeatedly perform specific tasks manually. Consequently, the design of PCR primers for BT-DNA remains a tedious and time-consuming process...

Changing the aromatic core of C3-symmetric tris(ferrocenyl)arene-based tris-phosphanes has profound effects on their coordination behaviour towards gold(i). Depending on the arene (s-triazine, benzene, or trifluorobenzene), four different coordination modes can be distinguished and their preference has been rationalised using computational methods. The corresponding 1 : 1 ligand-to-metal complexes, studied by variable-temperature NMR spectroscopy, revealed fluctional behaviour in solution. Given the presence of up to three or six ferrocenylene spacers per complex, their electrochemistry was investigated...

BACKGROUND: Mobile health (mHealth) is showing increasing potential to address health outcomes in underresourced settings as smartphone coverage increases. The NeoTree is an mHealth app codeveloped in Malawi to improve the quality of newborn care at the point of admission to neonatal units. When collecting vital demographic and clinical data, this interactive platform provides clinical decision support and training for the end users (health care professionals [HCPs]), according to evidence-based national and international guidelines...

BACKGROUND & GOALS: We observed that the number of colorectal polyps found intraoperatively was often higher than that encountered preoperatively during elective colonoscopic polypectomy. To evaluate whether more polyps can be detected when they are purposely sought than when they are routinely examined during colonoscopy. MATERIALS AND METHODS: Patients undergoing colonoscopy were randomized into groups A and B. Before colonoscopy was performed, endoscopists were instructed to seek polyps for group A purposely but not for group B...

If you are not sure what 'culture' means, you are not alone. In 1952, anthropologists Kroeber and Kluckhohn identified 164 definitions of culture and there has been growth rather than rationalisation in the ensuing 70 years. In everyday English, culture is the knowledge and behaviour that characterises a particular group of people. Under this umbrella definition, culture was for many decades the exclusive province of the humanities and social sciences, where anthropologists, historians, linguists, sociologists and other scholars studied and compared the language, arts, cuisine, and social habits of particular human groups...

The glymphatic system is a recently defined brain-wide network of perivascular spaces along which cerebrospinal fluid (CSF) and interstitial solutes exchange. Astrocyte endfeet encircling the perivascular space form a physical barrier in between these two compartments, and fluid and solutes that are not taken up by astrocytes move out of the perivascular space through the junctions in between astrocyte endfeet. However, little is known about the anatomical structure and the physiological roles of the astrocyte endfeet in regulating the local perivascular exchange...

BACKGROUND: Small vessel disease causes a quarter of ischaemic strokes (lacunar subtype), up to 45% of dementia either as vascular or mixed types, cognitive impairment and physical frailty. However, there is no specific treatment to prevent progression of small vessel disease. AIM: We designed the LACunar Intervention Trial-2 (LACI-2) to test feasibility of a large trial testing cilostazol and/or isosorbide mononitrate (ISMN) by demonstrating adequate participant recruitment and retention in follow-up, drug tolerability, safety and confirm outcome event rates required to power a phase 3 trial...

People living with HIV are at an increased risk of developing cognitive deficits. Physical exercise is an important strategy to improve the brain health of people living with HIV. This randomized, controlled study aimed to investigate the acute effect of a single resistance exercise session on the cognitive function of people living with HIV. Twenty-three people living with HIV were randomized (1:1) to a control group (n = 12) or the exercise group (n = 11). Cognitive function was assessed by the Stroop test and the Trail Making Test...

OBJECTIVE:  The aim of this study was to determine the effect of insertion torque and angulation on the push-out strength of screws in Atraumatic Rigid Fixation (ARIX) system. MATERIALS AND METHODS:   In vitro mechanical tests of the ARIX system were conducted. Screw plate constructs ( n  = 120) were tested using five different insertion torques at four different angles relative to the perpendicular axis of the plate. Before the push-out test, screws were locked into the plates, and the push-out force of the screw was measured by applying a load parallel to the screw axis...

OBJECTIVE: The purpose of this article was to study the characteristics of pediatric meningiomas, including the clinical symptom, anatomic location, radiological finding, treatment approaches, and long-term surgical outcome as well as the possible influence factors of the prognosis. METHODS: We retrospectively reviewed the medical records and follow-up data of 39 pediatric patients who were treated by operation for intracranial meningiomas in West-China Hospital between 2009-2019...

YKL-40, also known as chitinase-3-like protein 1, is an inflammatory glycoprotein that is secreted by various cell types under acute, chronic, and subclinical inflammation conditions. Elevated serum YKL-40 levels are reportedly independently related to diabetes mellitus, coronary artery disease, acute myocardial infarction, and cardiovascular mortality in adults. Therefore, we aimed to investigate the relationship between serum YKL-40 levels, lipid abnormalities, and the atherogenic index of plasma (AIP) in children...

PURPOSE: A patient information leaflet (PIL) on oral and dental care during radiotherapy was tested whether and at which time during therapy it would be helpful to increase the knowledge about the therapy and the resulting side effects and the management of these. Additionally, the participants' subjective perception of being well informed about the topic was examined. PARTICIPANTS AND METHODS: Surveys were conducted in August 2018-April 2019, at the University Hospitals Halle and Leipzig (Germany)...