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Background: Very preterm (VP) birth is associated with a considerable risk for cognitive impairment, putting children at a disadvantage in academic and everyday life. Despite lower cognitive ability on the group level, there are large individual differences among VP born children. Contemporary theories define intelligence as a network of reciprocally connected cognitive abilities. Therefore, intelligence was studied as a network of interrelated abilities to provide insight into interindividual differences. We described and compared the network of cognitive abilities, including strength of interrelations between and the relative importance of abilities, of VP and full‐term (FT) born children and VP children with below‐average and average‐high intelligence at 5.5 years. Methods: A total of 2,253 VP children from the EPIPAGE‐2 cohort and 578 FT controls who participated in the 5.5‐year‐follow‐up were eligible for inclusion. The WPPSI‐IV was used to measure verbal comprehension, visuospatial abilities, fluid reasoning, working memory, and processing speed. Psychometric network analysis was applied to analyse the data. Results: Cognitive abilities were densely and positively interconnected in all networks, but the strength of connections differed between networks. The cognitive network of VP children was more strongly interconnected than that of FT children. Furthermore, VP children with below average IQ had a more strongly connected network than VP children with average‐high IQ. Contrary to our expectations, working memory had the least central role in all networks. Conclusions: In line with the ability differentiation hypothesis, children with higher levels of cognitive ability had a less interconnected and more specialised cognitive structure. Composite intelligence scores may therefore mask domain‐specific deficits, particularly in children at risk for cognitive impairments (e.g., VP born children), even when general intelligence is unimpaired. In children with strongly and densely connected networks, domain‐specific deficits may have a larger overall impact, resulting in lower intelligence levels. [ABSTRACT FROM AUTHOR]

This article, published in the journal Endoscopy, discusses a study conducted to assess the risk of recurrence and metastasis in patients with pT1 colorectal cancer (CRC) who underwent endoscopic or surgical treatment. The study analyzed various histological biomarkers, including conventional ones such as grade of differentiation and lymphovascular invasion, as well as novel ones like desmoplastic response and tumor infiltrating lymphocytes. The analysis included 75 patients, and after a median follow-up time of 3.7 years, 10.6% of patients experienced recurrence or metastases. The study identified two novel biomarkers that, when combined with conventional ones, could optimize endoscopic treatment of T1 CRC. [Extracted from the article]

The article discusses the validation of the PEACE scale, which assesses cleanliness during esophagogastroduodenoscopy (EGD) to improve the quality of inspection during endoscopy. The study involved 16 international experts who were trained on the PEACE scale and then assessed videos of EGD procedures. The overall agreement on PEACE scores was good, indicating high concordance among the experts. The PEACE scale can be used as a simple and uniform method to assess and document cleanliness during EGD, and it has been validated among international experts. [Extracted from the article]

A large, retrospective, multicenter study examined the use of the Full-Thickness Resection Device (FTRD) for endoscopic full-thickness resection of duodenal neuroendocrine tumors (dNET). The study found that the FTRD procedure had a high rate of technical success, an acceptable rate of complete resection, a low rate of recurrence, and a low rate of severe adverse events. The results suggest that endoscopic full-thickness resection with FTRD may be preferable to other methods for the resection of dNET. [Extracted from the article]

Disaster recovery is not a time of exception, it is a time when existing social, economic, and racial inequalities are reproduced and exacerbated. Housing institutions can amplify inequality during disaster recovery. We use quantitative methods to ask whether evictions increase during disaster recovery periods in four states. We stratify our case selection by the type of statutory protections for landlords and tenants in state law. In three cases that have pro-business or a mixture of pro-business and tenant protections, we find strong, significant increases in eviction rates in disaster-affected neighborhoods relative to neighborhoods in adjacent areas with no disaster declaration. By contrast, in the case that has primarily tenant protections, there is no statistically significant rise in evictions following the disaster. We conclude that tenant protections are not sufficient to prevent swift increases in evictions following disasters in states with a policy environment that is also characterized by landlord protections. We close with policy recommendations to prevent evictions after disasters, and suggestions for further research. [ABSTRACT FROM AUTHOR]

This article compares the patient-related outcomes of two ablation techniques, endoscopic radiofrequency ablation (RFA) and hybrid argon plasma coagulation (h-APC), in the treatment of Barrett's esophagus (BE). The study found that both RFA and h-APC were effective in eradicating BE, but RFA resulted in higher levels of post-ablation chest pain and dysphagia in the first week after the procedure compared to h-APC. However, these symptoms resolved completely in both treatment groups by day 30 after treatment. The study also found no significant difference in the impact on the patient's quality of life between the two methods. [Extracted from the article]

This article discusses the use of the JNET classification system in predicting the histology and submucosal invasion of large non-pedunculated colorectal polyps (LNPCPs). While Japanese endoscopists have achieved accuracies of over 84% with JNET, European experts have struggled to replicate these results, with an accuracy of only 55%. The study compares JNET with a novel tool called CRIS (Colorectal Regular-Irregular Score) among Western experts. The results show that both JNET and CRIS have similar overall accuracies, suggesting that JNET may be simplified for non-experts. Additionally, framing the interpretation of both systems in a clinically relevant fashion can increase their specificity. [Extracted from the article]

Objective: To estimate the prevalence of flatus-only and faecal incontinence, to describe their risk factors and to analyse the association between anal incontinence and psychological distress over the first year postpartum.Design: Cohort study from pregnancy to 12 months postpartum.Setting: Two university hospital maternity wards in France.Population: A total of 2002 pregnant women were recruited between 2003 and 2006. Data on anal incontinence were available for the 1632 women who comprise the sample for analysis.Methods: Women were enrolled during pregnancy. A postal questionnaire was sent at 4 and 12 months postpartum.Main Outcome Measures: Anal (flatus-only and faecal) incontinence was assessed at 4 months postpartum. Mental health was assessed at 4 and 12 months postpartum by the Edinburgh Postpartum Depression Scale (EPDS) and use of antidepressant drugs as well as by self-rated mental health.Results: At 4 months postpartum, the prevalence for flatus-only incontinence was 14.4% and for faecal incontinence 1.7%; multivariate analysis, restricted to women reporting no anal incontinence before the index pregnancy, showed that continuing breastfeeding at 4 months was related to a higher risk of de novo postpartum anal incontinence (OR = 2.23). Women who reported anal incontinence at 4 months were more frequently depressed (EPDS ≥10 or antidepressant use) at 12 months postpartum: 36.0% of those with faecal incontinence were depressed, 23.3% of those with flatus-only incontinence and only 14.8% of the continent women.Conclusion: Postnatal faecal incontinence was rare but associated with poorer maternal mental health. Postnatal screening should be encouraged, and psychological support offered.Tweetable Abstract: Postnatal faecal incontinence was associated with depression; postnatal screening should be encouraged and psychological support offered. [ABSTRACT FROM AUTHOR]

The metabolic derangement is common in heart failure with reduced ejection fraction (HFrEF). The aim of the study was to check feasibility of the combined approach of untargeted metabolomics and machine learning to create a simple and potentially clinically useful diagnostic panel for HFrEF. The study included 67 chronic HFrEF patients (left ventricular ejection fraction-LVEF 24.3 ± 5.9%) and 39 controls without the disease. Fasting serum samples were fingerprinted by liquid chromatography-mass spectrometry. Feature selection based on random-forest models fitted to resampled data and followed by linear modelling, resulted in selection of eight metabolites (uric acid, two isomers of LPC 18:2, LPC 20:1, deoxycholic acid, docosahexaenoic acid and one unknown metabolite), demonstrating their predictive value in HFrEF. The accuracy of a model based on metabolites panel was comparable to BNP (0.85 vs 0.82), as verified on the test set. Selected metabolites correlated with clinical, echocardiographic and functional parameters. The combination of two innovative tools (metabolomics and machine-learning methods), both unrestrained by the gaps in the current knowledge, enables identification of a novel diagnostic panel. Its diagnostic value seems to be comparable to BNP. Large scale, multi-center studies using validated targeted methods are crucial to confirm clinical utility of proposed markers. [ABSTRACT FROM AUTHOR]

A "FUNCTIONAL CURE" MAY BE ACHIEVABLE IN A SUBSET OF PATIENTS WITH FOLLICULAR LYMPHOMA TREATED WITH CHEMOIMMUNOTHERAPY: 15-YEAR FOLLOW-UP OF PHASE III SWOG-S0016 S0016 enrolled patients with untreated advanced FL (bulky stage II or III-IV) between 2001 and 2008 and randomized them to CHOP × 6 followed by (131) I-tositumomab radioimmunotherapy (CHOP-RIT) or CHOP-R × 6; no maintenance was included. B Background: b Follicular lymphoma (FL) is considered incurable with current therapies which include chemoimmunotherapy as the standard of care for first line. [Extracted from the article]

Objective: To investigate the impact of gestational age (GA) at diagnosis of fetal growth restriction (FGR) on obstetric management and rates of live birth and survival for very preterm infants with early-onset FGR.Design: Population-based cohort study.Setting: All maternity units in 25 French regions in 2011.Population: Fetuses diagnosed with FGR before 28 weeks of gestation among singleton births between 22 and 31 weeks of gestation without severe congenital anomalies.Methods: We studied the effects of GA at diagnosis on perinatal management and outcomes. We used multivariable regression to identify antenatal factors (maternal characteristics, ultrasound measurements and sex) associated with the probability of live birth.Main Outcomes Measures: Live birth and survival to discharge from neonatal care.Results: A total of 436 of 3698 fetuses were diagnosed with FGR before 28 weeks (11.8%); 66.9% were live born and 54.4% survived to discharge. 50% were live born when diagnosis occurred before 25 weeks, 66% at 25 weeks and >90% at 26 and 27 weeks of gestation. In all, 94.1% of live births were by prelabour caesarean, principally for maternal indications before 26 weeks. Low GA at diagnosis, an estimated fetal weight or abdominal circumference below the third centile and male sex were adversely associated with live birth in adjusted models.Conclusion: Gestational age at FGR diagnosis had an impact on the probability of live birth and survival, after consideration of other perinatal characteristics. Investigations of the outcomes of births with early-onset FGR need to include stillbirths and information on the GA at which FGR is diagnosed.Tweetable Abstract: Evaluations of active management of pregnancies with early onset growth restriction should include stillbirths. [ABSTRACT FROM AUTHOR]

Background and purpose Aseptic infections of the central nervous system ( CNS) are frequently observed in Germany. However, no study has systematically addressed the spectrum of aseptic CNS infections in Germany. Methods Data on 191 adult patients diagnosed from January 2007 to December 2014 with aseptic meningitis or encephalitis/meningoencephalitis at our hospital were collected by chart review and analyzed for demographic, clinical and laboratory findings. Patients were stratified according to the causative virus and findings were compared between groups. Results In our cohort, meningitis was caused in 36% by enterovirus ( EV), 15% by herpes simplex virus ( HSV), 12% by varicella zoster virus ( VZV) and 5% by tick borne encephalitis ( TBE). Encephalitis/meningoencephalitis was caused in 13% by HSV, 13% by VZV, and three out of 11 tested patients were positive for TBE. The highest incidence of EV infections was between 25 and 35 years and of HSV infections between 30 and 60 years. VZV infections had a bimodal distribution peaking below 30 and above 70 years. VZV and EV infections were more frequently observed during summer, whereas HSV infections showed no seasonal preference. Inflammatory changes in cerebrospinal fluid ( CSF) were highest in HSV and lowest in EV infections. Conclusions Polymerase chain reaction tests for HSV, VZV and EV in CSF and TBE serology determined the causative virus in over 60% of tested patients. The age of affected patients, seasonal distribution, disease course and inflammatory changes in CSF differ between groups of patients affected by the most common viral infections. [ABSTRACT FROM AUTHOR]

Serrated flow is a result of unstable plastic flow, which occurs during tensile and compression tests on some dilute alloys. This phenomenon is referred as the Portevin Le-Chatelier effect (PLC effect). The aim of this research was to investigate and analyze this phenomenon in Inconel 625 solution strengthened superalloy. The tested material was subjected to tensile tests carried out within the temperature range 200-700 °C, with three different strain rates: 0.002 1/s, 0.01/s, and 0.05 1/s and additional compression tests with high deformation speeds of 0.1, 1, and 10 1/s. The tensile strain curves were analyzed in terms of intensity and the observed patterns of serrations Using a modified stress drop method proposed by the authors, the activation energy was calculated with the assumption that the stress drops' distribution is a direct representation of an average solute atom's interaction with dislocations. Subsequently, two models, the standard vacancy diffusion Bilby-Cottrell model and the realistic cross-core diffusion mechanism proposed by Zhang and Curtin, were compared. The results obtained show that the second one agrees with the experimental data. Additional microstructure analysis was performed to identify microstructure elements that may be responsible for the PLC effect. Based on the results, the relationship between the intensity of the phenomenon and the conditions of the tests were determined. [ABSTRACT FROM AUTHOR]

Objective: To analyse the delivery room management of babies born between 22 and 26 weeks of completed gestational age and to identify the factors associated with the withholding or withdrawal of intensive care.Study Design: Population-based cohort study.Patients and Methods: Our study population comprised 2145 births between 22 and 26 completed weeks enrolled in the EPIPAGE-2 study, a French cohort of very preterm infants born in 2011. The primary outcome measure was withholding or withdrawal of intensive care in the delivery room.Results: Among infants born alive at 22-23 weeks, intensive care was withheld or withdrawn for >90%. At 24 weeks, resuscitative measures were withheld or withdrawn for 38%, at 25 weeks for 8% and at 26 weeks for 3%. Other factors besides gestational age at birth associated with this withholding or withdrawal for infants born at 24-26 weeks were birth weight <600 g, emergency delivery (within 24 h of the mother's admission) and singleton pregnancy. Although rates of withholding or withdrawal of intensive care varied substantially between maternity units (from 0% to 100%), the variability was primarily explained by differences in distributions of gestational age at birth.Conclusions: Although gestational age is only one factor predicting survival of preterm infants, practices in France appear to be based primarily on this factor, which thus has direct effects on the survival of extremely preterm infants. The ethical implications of basing life and death decisions only on gestational age before 25 weeks require further examination. [ABSTRACT FROM AUTHOR]

Marine structures are particularly prone to action of waves, winds and currents with stochastically varying composition, intensities and directions. Therefore, resultant stresses may cause multiaxial fatigue in specific welded structural details. For the assessment of multiaxial fatigue in welded joints, a wide variety of methods have been suggested. However, there is still no consensus on a method which can correctly account for non-proportional and variable amplitude loading. This paper beholds a comparative study of multiaxial fatigue methods applicable for design of marine structures. For the purpose of comparison several load cases were defined including non-proportional and variable amplitude loadings with different normal and shear stress amplitude ratios. Three types of methods are compared: those described by three different codes (i.e. Eurocode 3, IIW and DNV-GL), those described by three different multiaxial fatigue approaches from literature (i.e. Modified Carpinteri-Spagnoli Criterion, Modified Wohler Curve Method and Effective Equivalent Stress Hypothesis) and an approach based on Path-Dependent-Maximum-Range multiaxial cycle counting. From this study it has been concluded that non-proportional variable amplitude loading has a significant negative impact on the fatigue lifetime estimates, and that further research and experimental testing are essential to come to a consensus. [ABSTRACT FROM AUTHOR]

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A new PLant chamber Unit for Simulation (PLUS) for use with the atmosphere simulation chamber SAPHIR (Simulation of Atmospheric PHotochemistry In a large Reaction Chamber) has been built and characterized at the Forschungszentrum Jülich GmbH, Germany. The PLUS chamber is an environmentally controlled flow-through plant chamber. Inside PLUS the natural blend of biogenic emissions of trees is mixed with synthetic air and transferred to the SAPHIR chamber, where the atmospheric chemistry and the impact of biogenic volatile organic compounds (BVOCs) can be studied in detail. In PLUS all important environmental parameters (e.g., temperature, photosynthetically active radiation (PAR), soil relative humidity (RH)) are well controlled. The gas exchange volume of 9.32 m³ which encloses the stem and the leaves of the plants is constructed such that gases are exposed to only fluorinated ethylene propy-lene (FEP) Teflon film and other Teflon surfaces to minimize any potential losses of BVOCs in the chamber. Solar radiation is simulated using 15 light-emitting diode (LED) panels, which have an emission strength up to 800 µmol m-2s-1. Results of the initial characterization experiments are presented in detail. Background concentrations, mixing inside the gas exchange volume, and transfer rate of volatile organic compounds (VOCs) through PLUS under different humidity conditions are explored. Typical plant characteristics such as light- and temperature- dependent B VOC emissions are studied using six Quercus ilex trees and compared to previous studies. Results of an initial ozonolysis experiment of B VOC emissions from Quercus ilex at typical atmospheric concentrations inside SAPHIR are presented to demonstrate a typical experimental setup and the utility of the newly added plant chamber. [ABSTRACT FROM AUTHOR]

A new PLant chamber Unit for Simulation (PLUS) for use with the atmosphere simulation chamber SAPHIR (Simulation of Atmospheric PHotochemistry In a large Reaction Chamber) has been built and characterized at the Forschungszentrum Jülich GmbH, Germany. The PLUS chamber is an environmentally controlled flow-through plant chamber. Inside PLUS the natural blend of biogenic emissions of trees is mixed with synthetic air and transferred to the SAPHIR chamber, where the atmospheric chemistry and the impact of biogenic volatile organic compounds (BVOCs) can be studied in detail. In PLUS all important environmental parameters (e.g., temperature, photosynthetically active radiation (PAR), soil relative humidity (RH)) are well controlled. The gas exchange volume of 9.32m3 which encloses the stem and the leaves of the plants is constructed such that gases are exposed to only fluorinated ethylene propylene (FEP) Teflon film and other Teflon surfaces to minimize any potential losses of BVOCs in the chamber. Solar radiation is simulated using 15 light-emitting diode (LED) panels, which have an emission strength up to 800 μmolm-2 s-1. Results of the initial characterization experiments are presented in detail. Background concentrations, mixing inside the gas exchange volume, and transfer rate of volatile organic compounds (VOCs) through PLUS under different humidity conditions are explored. Typical plant characteristics such as light- and temperature-dependent BVOC emissions are studied using six Quercus ilex trees and compared to previous studies. Results of an initial ozonolysis experiment of BVOC emissions from Quercus ilex at typical atmospheric concentrations inside SAPHIR are presented to demonstrate a typical experimental setup and the utility of the newly added plant chamber. [ABSTRACT FROM AUTHOR]

A new PLant chamber Unit for Simulation (PLUS) for use with the atmosphere simulation chamber SAPHIR (Simulation of Atmospheric PHotochemistry In a large Reaction Chamber) has been build and characterized at the Forschungszentrum Jülich GmbH, Germany. The PLUS chamber is an environmentally controlled flow through plant chamber. Inside PLUS the natural blend of biogenic emissions of trees are mixed with synthetic air and are transferred to the SAPHIR chamber where the atmospheric chemistry and the impact of biogenic volatile organic compounds (BVOC) can be studied in detail. In PLUS all important enviromental parameters (e.g. temperature, PAR, soil RH etc.) are well-controlled. The gas exchange volume of 9.32 m³ which encloses the stem and the leafes of the plants is constructed such that gases are exposed to FEP Teflon film and other Teflon surfaces only to minimize any potential losses of BVOCs in the chamber. Solar radiation is simulated using 15 LED panels which have an emission strength up to 800 μmol m-2 s-1. Results of the initial characterization experiments are presented in detail. Background concentrations, mixing inside the gas exchange volume, and transfer rate of volatile organic compounds (VOC) through PLUS under different humidity conditions are explored. Typical plant characteristics such as light and temperature dependent BVOC emissions are studied using six Quercus Ilex trees and compared to previous studies. Results of an initial ozonolysis experiment of BVOC emissions from Quercus Ilex at typical atmospheric concentrations inside SAPHIR are presented to demonstrate a typical experimental set up and the utility of the newly added plant chamber. [ABSTRACT FROM AUTHOR]

Oxidation by hydroxyl radical (OH) and ozonolysis are the two major pathways of daytime biogenic volatile organic compound (BVOC) oxidation and secondary organic aerosol (SOA) formation. In this study, we investigated the particle formation of several common monoterpenes (apinene, β-pinene and limonene) by OH-dominated oxidation, which has seldom been investigated. OH oxidation experiments were carried out in the SAPHIR (Simulation of Atmospheric PHotochemistry In a large Reaction) chamber in Jülich, Germany, at low NOx (0.01 ~1 ppbV) and low ozone (O3) concentration (<20ppbV). OH concentration and total OH reactivity (koH) were measured directly, and through this the overall reaction rate of total organics with OH in each reaction system was quantified. Multi-generation reaction process, particle growth, new particle formation (NPF), particle yield and chemical composition were analyzed and compared with that of monoterpene ozonolysis. Multi-generation products were found to be important in OH-dominated SOA formation. The relative role of functionalization and fragmentation in the reaction process of OH oxidation was analyzed by examining the particle mass and the particle size as a function of OH dose. We developed a novel method which quantitatively links particle growth to the reaction rate of OH with total organics in a reaction system. This method was also used to analyze the evolution of functionalization and fragmentation of organics in the particle formation by OH oxidation. It shows that functionalization of organics was dominant in the beginning of the reaction (within two lifetimes of the monoterpene) and fragmentation started to play an important role after that. We compared particle formation from OH oxidation with that from pure ozonolysis. In individual experiments, growth rates of the particle size did not necessarily correlate with the reaction rate of monoterpene with OH and O3. Comparing the size growth rates at the similar reaction rates of monoterpene with OH or O3 indicates that, generally, OH oxidation and ozonolysis had similar efficiency in particle growth. The SOA yield of a-pinene and limonene by ozonolysis was higher than that of OH oxidation. Aerosol mass spectrometry (AMS) shows SOA elemental composition from OH oxidation follows a slope shallower than --1 in the O/C vs. H/C diagram, also known as Van Krevelen diagram, indicating that oxidation proceeds without significant loss of hydrogen. SOA from OH oxidation had higher H/C ratios than SOA from ozonolysis. In ozonolysis, a process with significant hydrogen loss seemed to play an important role in SOA formation. [ABSTRACT FROM AUTHOR]