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Background: Tourette syndrome (TS) is a childhood-onset neurodevelopmental disorder of complex genetic architecture and is characterized by multiple motor tics and at least one vocal tic persisting for more than 1 year. Methods: We performed a genome-wide meta-analysis integrating a novel TS cohort with previously published data, resulting in a sample size of 6133 individuals with TS and 13,565 ancestry-matched control participants. Results: We identified a genome-wide significant locus on chromosome 5q15. Integration of expression quantitative trait locus, Hi-C (high-throughput chromosome conformation capture), and genome-wide association study data implicated the NR2F1 gene and associated long noncoding RNAs within the 5q15 locus. Heritability partitioning identified statistically significant enrichment in brain tissue histone marks, while polygenic risk scoring of brain volume data identified statistically significant associations with right and left thalamus volumes and right putamen volume. Conclusions: Our work presents novel insights into the neurobiology of TS, thereby opening up new directions for future studies.

Purpose To investigate the effect of lifestyle habits in childhood Metabolic Syndrome (MTS). Design and Methods Descriptive correlation study with 480 participants (5–12 years old) using a specially designed questionnaire was conducted. Anthropometric and biochemical analyses were performed. Results Fifteen percent of children exhibited predisposition for MTS. Regarding sleep habits, logistic regression analysis (LRA) showed that hour of sleep -before 22:00- was associated with decreased waist circumference (WC%) (p = .026). Midday siesta was negatively correlated with systolic (SBP) (p = .001) and diastolic blood pressure (DBP) (p = .046). In children without MTS, lack of sleep and night time sleep was positively correlated with DBP (p = .044) and fasting blood glucose (FBG) (p = .005). Regarding nutrition habits, fast food consumption was positively correlated with SBP (p = .006) and meat consumption was positively correlated with both Body Mass Index% (BMI%) (p = .038) and WC% (p = .023). LRA showed that fruit (p = .001) and legume (p = .040) consumption was associated with decreased FBG; fish consumption with decreased Low Density Lipoprotein (LDL) cholesterol (p = .031), vegetable (p = .054) and cereal consumption (p = .012) with decreased DBP. In children with MTS, fruits were associated with increased FBG (p = .034). In children without MTS, meat consumption was associated with increased LDL (p = .024), cereal with increased WC% (p = .002) and olive products with increased High Density Lipoprotein (HDL) cholesterol and BMI% (p = .037). Conclusions The adoption of both balanced diet and sleep habits seemed to be crucial for the prevention of MTS. Practice Implications Clinical health nurses could develop and implement preventive intervention programs in order to avoid metabolic complications in adulthood.

Background Nursing diagnoses constitute an essential step to the nursing process and a challenging goal in embedding them into clinical practice. The study aimed to explore registered nurses’ perceptions towards the implementation of nursing diagnoses in perioperative care and the factors affecting their applicability. Methods A qualitative study with open-ended questions was carried out between February and April 2020. The study convenient sample consisted of 35 registered nurses working in the operating room and surgical clinics of a university hospital in Greece. Data were analyzed using qualitative content analysis with an inductive approach. Results Three themes emerged from this analysis justifying participants’ agreement with the implementation of nursing diagnoses: ‘quality of the perioperative nursing care’, ‘interdisciplinary collaboration and communication’ and ‘ethical issues’. In addition, facilitating and hindering factors for their implementation in clinical practice were identified. Three themes emerged functioning as facilitators: ‘role of the nurse and nursing care organization’, ‘role of the patient’ and ‘interdisciplinary collaboration’. The themes which were identified as hindering factors were: ‘work organization’, ‘patient needs’ and ‘necessary requirements’. Conclusions Registered nurses in Greece expressed positive perceptions towards the implementation of nursing diagnoses in perioperative care, highlighting their importance and utilization in the care process. These results can be used to develop strategies to promote nursing diagnosing in perioperative nursing and can be used for further research.

The pathological consequences of structural variants disrupting 3D genome organization can be difficult to elucidate in vivo due to differences in gene dosage sensitivity between mice and humans. This is illustrated by branchiooculofacial syndrome (BOFS), a rare congenital disorder caused by heterozygous mutations within TFAP2A, a neural crest regulator for which humans, but not mice, are haploinsufficient. Here, we present a BOFS patient carrying a heterozygous inversion with one breakpoint located within a topologically associating domain (TAD) containing enhancers essential for TFAP2A expression in human neural crest cells (hNCCs). Using patient-specific hiPSCs, we show that, although the inversion shuffles the TFAP2A hNCC enhancers with novel genes within the same TAD, this does not result in enhancer adoption. Instead, the inversion disconnects one TFAP2A allele from its cognate enhancers, leading to monoallelic and haploinsufficient TFAP2A expression in patient hNCCs. Our work illustrates the power of hiPSC differentiation to unveil long-range pathomechanisms., The Tomo Šarić laboratory participates in the EBiSC project, which received support from the Innovative Medicines Initiative Joint Undertaking under grant agreement no. 115582, resources of which are composed of financial contributions from the European Union’s Seventh Framework Programme (FP7/2007-2013) and EFPIA companies’ in-kind contributions. K.K.’s work was supported by the Deutsche Forschungsgemeinschaft (DFG) under grant agreement KO 3588/2-1. Work in the Rada-Iglesias laboratory was supported by CMMC intramural funding and grants from Fritz Thyssen Stiftung and Else Kröner Fresenius Stiftung.