Project description:Fifteen-year-old adolescents (N = 109) in a longitudinal study of child development were recruited to examine differences in DNA methylation in relation to parent reports of adversity during the adolescents’ infancy and preschool periods. Microarray technology applied to 28,000 cytosine–guanine dinucleotide sites within DNA derived from buccal epithelial cells showed differential methylation among adolescents whose parents reported high levels of stress during their children’s early lives. Maternal stressors in infancy and paternal stressors in the preschool years were most strongly predictive of differential methylation, and the patterning of such epigenetic marks varied by children’s gender. To the authors’ knowledge, this is the first report of prospective associations between adversities in early childhood and the epigenetic conformation of adolescents’ genomic DNA. Genomic DNA was extracted from 109 Buccal DNA samples, bisulphite converted and hybridized, along with 4 technical replicates to the Illumina Infinium HumanMethylation27 Beadchip v1.2 for genome wide DNA methylation profiling. Processed signal intensity data and Detection Pvalues for individual replicates of Samples 006 (reps a,b), 099 (reps a,b,c), 106 (reps a,b) reported in the supplementary file "processed_individual reps.txt."
Project description:To correct the incongruence of document types between the numerator and denominator in the traditional impact factor (IF), we make a corresponding adjustment to its formula and present five corrective IFs: IFTotal/Total, IFTotal/AREL, IFAR/AR, IFAREL/AR, and IFAREL/AREL. Based on a survey of researchers in the fields of ophthalmology and mathematics, we obtained the real impact ranking of sample journals in the minds of peer experts. The correlations between various IFs and questionnaire score were analyzed to verify their journal evaluation effects. The results show that it is scientific and reasonable to use five corrective IFs for journal evaluation for both ophthalmology and mathematics. For ophthalmology, the journal evaluation effects of the five corrective IFs are superior than those of traditional IF: the corrective effect of IFAR/AR is the best, IFAREL/AR is better than IFTotal/Total, followed by IFTotal/AREL, and IFAREL/AREL. For mathematics, the journal evaluation effect of traditional IF is superior than those of the five corrective IFs: the corrective effect of IFTotal/Total is best, IFAREL/AR is better than IFTotal/AREL and IFAREL/AREL, and the corrective effect of IFAR/AR is the worst. In conclusion, not all disciplinary journal IF need correction. The results in the current paper show that to correct the IF of ophthalmologic journals may be valuable, but it seems to be meaningless for mathematic journals.
Project description:Fifteen-year-old adolescents (N = 109) in a longitudinal study of child development were recruited to examine differences in DNA methylation in relation to parent reports of adversity during the adolescents’ infancy and preschool periods. Microarray technology applied to 28,000 cytosine–guanine dinucleotide sites within DNA derived from buccal epithelial cells showed differential methylation among adolescents whose parents reported high levels of stress during their children’s early lives. Maternal stressors in infancy and paternal stressors in the preschool years were most strongly predictive of differential methylation, and the patterning of such epigenetic marks varied by children’s gender. To the authors’ knowledge, this is the first report of prospective associations between adversities in early childhood and the epigenetic conformation of adolescents’ genomic DNA.
Project description:The Rome II pediatric criteria for functional gastrointestinal disorders (FGIDs) were defined in 1999 to be used as diagnostic tools and to advance empirical research. In this document, the Rome III Committee aimed to update and revise the pediatric criteria. The decision-making process to define Rome III criteria for children aged 4-18 years consisted of arriving at a consensus based on clinical experience and review of the literature. Whenever possible, changes in the criteria were evidence based. Otherwise, clinical experience was used when deemed necessary. Few publications addressing Rome II criteria were available to guide the committee. The clinical entities addressed include (1) cyclic vomiting syndrome, rumination, and aerophagia; 2) abdominal pain-related FGIDs including functional dyspepsia, irritable bowel syndrome, abdominal migraine, and functional abdominal pain; and (3) functional constipation and non-retentive fecal incontinence. Adolescent rumination and functional constipation are newly defined for this age group, and the previously designated functional fecal retention is now included in functional constipation. Other notable changes from Rome II to Rome III criteria include the decrease from 3 to 2 months in required symptom duration for noncyclic disorders and the modification of the criteria for functional abdominal pain. The Rome III child and adolescent criteria represent an evolution from Rome II and should prove useful for both clinicians and researchers dealing with childhood FGIDs. The future availability of additional evidence-based data will likely continue to modify pediatric criteria for FGIDs.
Project description:The treatment or prevention of child and adolescent mental health (CAMH) disorders often requires an individualized, sequential approach to intervention, whereby treatments (or prevention efforts) are adapted over time based on the youth's evolving status (e.g., early response, adherence). Adaptive interventions are intended to provide a replicable guide for the provision of individualized sequences of interventions in actual clinical practice. Recently, there has been great interest in the development of adaptive intervenions by investigators working in CAMH. The development of such replicable, real-world, individualized sequences of decision rules to guide the treatment or prevention of CAMH disorders represents an important "next step" in interventions research. The primary purpose of this special issue is to showcase some recent work on the science of adaptive interventions in CAMH. In this overview article, we review why individualized sequences of interventions are needed in CAMH, provide an introduction to adaptive interventions, briefly describe each of the articles included in this special issue, and describe some exciting areas of ongoing and future research. A hopeful outcome of this special issue is that it encourages other researchers in CAMH to pursue creative and significant research on adaptive interventions.
Project description:The United States has a critical shortage of child and adolescent psychiatrists such that 70% of counties in the United States do not have any child and adolescent psychiatrists.1 Since 2014, the number of US and Canadian medical school applicants to psychiatry residencies has increased by 69%; however, the number of child and adolescent psychiatry fellowship applicants has increased by only 11%.2 Up to two-thirds of psychiatry residents report considering a career in child and adolescent psychiatry; however, only one-fourth of residents ultimately apply for a child and adolescent psychiatry subspecialty training.3,4 We surveyed child and adolescent psychiatry fellows across the country to understand the different pathways into child and adolescent psychiatry, with the hope of providing program directors' and faculty mentors' guidance on how to generate interest in child and adolescent psychiatry and to support residents in this pursuit.
Project description:The author, a child and adolescent psychoanalytic psychotherapist working in the UK NHS, ponders the varied impacts of 'lockdown' on adolescents, their parents and the psychotherapists who work with them, during the COVID-19 pandemic. She asks, particularly, how psychological therapies are positioned during such a crisis, and whether the pressures of triage and emergency can leave time and space for sustained emotional and psychological care. She wonders how psychoanalytic time with its sustaining rhythm can be held onto in the face of the need for triage on the one hand and the flight to online and telephone delivery on the other. Above all, the author questions how the apparent suspension of time during lockdown is belied by the onward pressure of adolescent time, and how this can be understood by, and alongside, troubled adolescents.
Project description:BackgroundData on the outcomes of hypertrophic cardiomyopathy (HCM) with biventricular obstruction are limited.ObjectiveOur aim is to compare mid-term outcomes of biventricular outflow tract obstruction (BVOTO) HCM, left ventricular outflow tract obstruction (LVOTO) HCM and nonobstructive hypertrophic cardiomyopathy (NO-HCM) in children and adolescents who were treated with standard medication or surgical resection.MethodsThis retrospective study identified 21 BVOTO patients and recruited 27 LVOTO and 24 NO-HCM patients younger than 18 years presenting at our institution. The primary endpoint was all-cause death, and secondary endpoints were cardiovascular events.ResultsMore BVOTO patients (61.9%) than LVOTO (19.2%) and NO-HCM patients (25%) exhibited New York Heart Association (NYHA) III/IV status (p < 0.01). Fourteen BVOTO and 16 LVOTO patients obtained a significant reduction of outflow tract pressure gradients after surgery (vs. preoperative baseline, p < 0.001). One of the 14 BVOTO patients died, whereas no deaths occurred among LVOTO patients. Three of 14 BVOTO surgery patients had complete heart block (CHB) and 4 had new right bundle branch block (RBBB), while no CHB or RBBB occurred in the LVOTO surgery patients. The BVOTO patients had a longer duration of aortic cross-clamping and postoperative hospital days than the LVOTO patients (p < 0.05). During a median 42-month follow-up, no deaths occurred among the remaining patients. The primary and secondary endpoint-free survival rates of the BVOTO group were comparable to those of the LVOTO and NO-HCM groups.ConclusionsIn children and adolescents, BVOTO patients were associated with more severe symptoms than LVOTO and NO-HCM patients; however, good mid-term outcomes similar to those of the LVOTO and NO-HCM groups can be achieved with the application of contemporary cardiovascular treatment strategies. Notably, BVOTO surgery was associated with an increased risk of CHB and RBBB compared to LVOTO surgery.