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Extracorporeal life support (ECLS) is an essential component of a modern congenital cardiac surgery program. The circuit components and bedside management team may, however, vary among institutions. Here, we evaluate our initial experience with a modified ventricular assist device-based ECLS circuit primarily managed by the bedside nurse. We hypothesize that our outcomes are comparable to Extracorporeal Life Support Organization (ELSO) registry data. All patients who received ECLS from January 1, 2016 to December 31, 2019 at a single institution were included. Primary outcomes were survival to ECLS decannulation and discharge or transfer. Secondary outcomes included complications from ECLS. Data were compared to available ELSO registry data. Thirty-seven patients underwent 44 ECLS runs during the study period. Forty percent of patients had single ventricle physiology. Nearly 46% of patients received ECLS as part of extracorporeal cardiopulmonary resuscitation (eCPR). Survival to ECLS decannulation (68.2%) and survival to discharge or transfer (61.4%) did not differ from overall ELSO outcomes (69.7%, P = .870 and 50.7%, P = .136), as well as survival to discharge or transfer in a comparable cohort of ELSO centers (53.1%, P = .081). Patients with complications had a lower rate of survival to discharge or transfer but this did not reach statistical significance (47.7% vs. 75.0%, P = .455). Neurologic (50.0%), hemorrhagic (45.5%), and renal complications (31.8%) were most common in this cohort. A modified ventricular assist device-based ECLS circuit with primary management by the bedside nurse can provide comparable support in a neonatal and pediatric cardiac surgery population. Cost analyses and further delineation of the complication profile are necessary for a complete characterization of this system.

Two of the most commonly used substances by adolescents in the United States are cannabis and alcohol. Cannabis Use Disorder (CUD) and Alcohol Use Disorder (AUD) are associated with impairments in decision-making processes. One mechanism for impaired decision-making in these individuals is thought to be an inability to adequately represent future events during decision-making. In the current study involving 112 adolescents, we used a comparative optimism task to examine the relationship between relative severity of CUD/AUD (as indexed by the CUD/AUD Identification Tests [CUDIT/AUDIT]) and atypical function within neural systems underlying affect-based neural represenation future events. Greater CUDIT scores were negatively related to responses within subgenual anterior and posterior cingulate cortex when processing high-intensity potential future positive and negative events. There was also a particularly marked negative relationship between CUD symptoms and blood oxygen level-dependent (BOLD) responses within visual and premotor cortices to high-intensity, negatively valenced potential future events. However, AUD symptom severity was not associated with dysfunction within these brain regions. These data indicate that relative risk/severity of CUD is associated with reduced responsiveness to future high-intensity events. This may impair decision-making where future significant consequences should guide response choice.

False-belief understanding and executive functions are two main sociocognitive abilities reliably linked to child social competence. Although institution-reared children are especially at risk for behavioral problems and cognitive delays, the role that executive function and false-belief understanding might play in the social withdrawal of institutionalized children has not been examined. The current study used two-wave data to investigate the concurrent and longitudinal relations of social withdrawal with executive function and false-belief understanding in institutionalized children; it also allowed investigation of the directionality between executive function and false-belief understanding. Data were collected from 66 Turkish children (T1 M 5 = 57.83 months, SD = 9.20; T2 M = 69.58 months, SD = 8.45) residing in institutions, at two time points, approximately 1 year apart. We measured false-belief understanding and executive function via individual assessments, and social withdrawal via care provider reports at both time points. Results showed that both executive function and false-belief understanding increased between T1 and T2, while social withdrawal did not show a significant change. Path analysis revealed that when T1 age and language were controlled, T1 executive function predicted T2 executive function, and in turn, T2 executive function predicted lessened social withdrawal at T2. In addition, T1 executive function predicted T2 false-belief understanding. T1 false-belief understanding was not related to T2 false-belief understanding, executive function, or social withdrawal. Findings suggested that executive function is an important predictor of social withdrawal in high-risk populations.

We investigated in a pilot study the effects of various types of visual mediation (photos, written words and self-paced syllabic segmentation of written words displayed on a touchscreen tablet) that are thought to facilitate the oral production of nonverbal and minimally verbal children with autism, according to the participants’ level of oral language development and, more specifically, their ability to produce delayed echolalia. We also sought to identify the cognitive characteristics that need to be taken into account when seeking to develop the oral production of nonverbal children with autism. Results showed that the nonverbal and minimally verbal children with autism were able of using written words to produce them orally. Their performance was largely dependent on their level of language development. Tasks combining written and oral modalities prompted some of them to engage in oral production for the first time (isolated syllables for nonverbal children) and allowed others to produce non-random strings of syllables (minimally verbal children).

Harma, Mehmet/0000-0002-3955-1526; Korucu, Irem/0000-0001-7185-2284 WOS:000403047300004 It is argued that self-regulation skill is necessary both for displaying constructive behaviour and for controlling negative social behaviour, and self-regulation might affect social behaviours by increasing the ability to understand others' minds. In this research, in order to examine different aspects of self-regulation and their similarities and differences in terms of their relations with other constructs, we focused on both effortful control and executive function and investigated their concurrent associations with socially competent and aggressive behaviours and theory of mind (ToM). The participants were 212 preschool children in Turkey. We assessed executive functions with behavioural measures and effortful control with mother reports. We used six tasks for comprehensive assessment of mental state understanding. Children's social competency and aggressive behaviour were assessed with teacher reports. Structural equation modelling results showed that when age and receptive language were controlled, ToM was significantly associated with social competence but not aggressive behaviour. Both effortful control and executive functions were significantly related to social competency and ToM; the pathways from each self-regulation skill were similar in strength. ToM was linked with social competence, but it did not have a mediating role in the relations of self-regulation with social competence. The findings highlighted the importance of self-regulation for socio-cognitive and social development in the preschool years. Copyright (c) 2016 John Wiley & Sons, Ltd. Scientific and Technological Research Council of TurkeyTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [TUBITAK 111 K404] This study is part of the MA thesis of the first author, Irem Korucu, who is currently at Purdue University. The data were drawn from a larger project supported by The Scientific and Technological Research Council of Turkey (TUBITAK 111 K404) awarded to the second author, Bilge Selcuk (Yagmurlu). We are grateful to the parents and children who participated in the study.

Aim: A biopsy is often taken as part of the preoperative workup, regardless of the indication for hysterectomy. Some authors believe that dilatation and curettage is a poor diagnostic procedure for intrauterine pathologies, but dilatation and curettage has been the method of choice for obtaining an endometrial sample. The aim of this study was to investigate the concordance between endometrial histopathological diagnoses from preoperative dilatation and curettage and hysterectomy specimens. The differences between premenopausal and postmenopausal women were also investigated. Methods: Histopathological results for dilatation and curettage specimens from 645 women (401 premenopausal and 244 postmenopausal) who underwent a hysterectomy between 2003 and 2009 were analyzed retrospectively. Results: High sensitivity (87.8%), specificity (100%), positive (100%) and negative (98.7%) predictive values, and accuracy (98.8%) were observed for all malignant endometrial pathologies obtained at dilatation and curettage. In postmenopausal women, eight malignancies were missed when the preoperative diagnosis from the dilatation and curettage sample indicated inadequate tissue or premalignant lesions. For premenopausal women, we found only two missed malignancies. The accuracy was 99.5% and 96.8% for malignant pathologies diagnosed from curettage material for pre- and postmenopausal women, respectively. Conclusions: Dilatation and curettage remains the ‘gold standard’ for diagnosing endometrial pathologies, especially malignancies.

Background. Normal pregnant women are known to have increased oxidative stress and lipid peroxidation (which can be estimated by protein carbonyl concentration) but offsetting antioxidant protection (of which plasma thiols are an important component). Aim. This study set out to compare levels of these markers in normal pregnant women and patients with complete hydatidiform mole (CHM). Methods. Blood was taken from 41 healthy pregnant women and 39 patients with CHM attending a university hospital, and protein carbonyl and thiol levels determined spectrophotometrically on plasma. Statistical analysis of the results was performed using Student's t -test and Pearson's correlation. Results. Patients with CHM were found to have significantly higher levels of protein carbonyls and lower (but non-significant) levels of thiols. Conclusion. The results may indicate oxidative stress as a feature of CHM.

In this paper, we will argue that (1) four classes of norm can be distinguished from a neuro-cognitive perspective; (2) learning the prohibitive power of these norms relies on relatively independent emotional systems; (3) individuals with psychopathy show selective impairment for one of these emotional learning systems and two classes of norm: care based and justice based; and (4) while emotional learning systems are necessary for appropriate moral development/reasoning, they are not sufficient for moral development/reasoning.

Background: Cosmetic products contribute considerably to the incidence of contact dermatitis. In response to a resolution of the Council of Europe, the National Institute for Public Health and the Environment (RIVM) in The Netherlands set up a pilot project to report undesirable effects attributed to cosmetic products. Objectives: To provide an overview of undesirable effects attributed to cosmetic products and to identify the ingredients involved. The information could contribute to the assessment of whether current EU legislation on cosmetics provides adequate protection. Patients/methods: General practitioners, dermatologists and consumers in The Netherlands completed questionnaires on reported undesirable effects of cosmetics. Dermatologists also carried out patch tests and, where necessary, tests with specific batch ingredients of the associated cosmetic product. A website and a public awareness campaign were launched to encourage consumers to report undesirable effects. Results: Between July 2009 and May 2011, the RIVM received more than 1600 reports. Severe undesirable effects were claimed in 1–4% of the cases. The most frequently reported cosmetic products were make-up and moisturisers, and the most frequently identified allergens were isothiazolinones and fragrance ingredients. Three patients tested positive for co-polymers/cross-polymers. Conclusions: Further investigations are recommended on the prevalence of isothiazolinone-induced allergic contact dermatitis and the allergenic potential of co-polymers/cross-polymers. (aut. ref.)

Postoperative enteroenteric invagination is rare. The only previously reported case post-cesarean was secondary to colonic adenocarcinoma. A 27-year-old woman with preeclampsia delivered a baby by cesarean section. On the second postoperative day, she had abdominal pain, nausea, vomiting, constipation, and distention. An abdominal x-ray showed air-fluid levels, while free fluid (ascites) was detected by ultrasonography. A computed tomography scan did not show the typical invagination picture. Her condition did not improve after 72 h of conservative treatment, and diagnostic laparotomy was performed. A 10 × 3-cm ileoileal invagination 80 cm proximal to the ileocecal valve was found and manually reduced. The patient was discharged on the fifth postoperative day, and her six-month follow-up was normal.

The prevalence of unhealthy substance use (USU) among medical inpatients can vary, and prior research has not characterized the prevalence of USU among patients cared for by a teaching service (TS) and a nonteaching hospitalist service (NTHS). The objective of this study was to compare the prevalence of USU among patients cared for by a TS and an NTHS. We conducted a cross-sectional study from February to June 2009 at a community teaching hospital. Within 24 hours of admission, all eligible internal medicine admissions to the TS or NTHS were screened for USU, using the Alcohol Use Disorders Identification Test-Consumption and Drug Abuse Screening Test. Patients screening positive then underwent a diagnostic interview and blinded chart review to increase case finding and to assess whether each patient's admission was related to USU. There were 414 eligible and consenting patients out of 656 patients identified. Patients on the TS were younger and more likely to be current smokers, male, unmarried, non-white, and unemployed (p

Background. The Currently used National Cancer Institute (NCI) adverse events criteria for mucosal barrier injury (MBI) are insufficient for use in children. We searched for objective, easily measurable indicators for MBI in children with cancer. Purpose. In children with acute myeloid leukemia, various MBI-related clinical and laboratory tests were investigated, reflecting clinical severity (NCI symptomatic adverse events criteria (gold standard), daily gut score (DGS)), inflammation (plasma and fecal interleukin-8 (IL-8), fecal calprotectin), enterocytic loss (plasma citrulline, ratio fecal human DNA/total DNA) and intestinal permeability (sugar absorption tests). Results. Intestinal MBI as detected by the NCI adverse events criteria was found in 55% of chemotherapy cycles, correlating well with the continuous DGS (n = 55, rho = 0.581; P

At least 128000 women die of postpartum haemorrhage each year. The traditional management of this condition includes the use of oxytocics ergometrine and prostaglandins cord clamping and controlled cord tension. In cases where these measures are not sufficient embolisation and ligation of the uterine or internal iliac arteries is commonly resorted to. The main cause of failure of these procedures is placenta accreta. In such cases hysterectomy is the common procedure. In 1997 Lynch et al. described a technique of oversewing the uterus with a continuous suture to apply ongoing compression which is much quicker and simpler than the other surgical procedures. This report describes a case of placenta accreta in which the technique was successfully used. We review the literature on the procedure. (excerpt)

A regulatory region of the temperate Lactococcus lactis bacteriophage r1t chromosome has been cloned and characterized, It encompasses the two divergently oriented genes rro, encoding the phage repressor, and tee. Both genes, of which the transcription start sites have been mapped, are preceded by consensus -35 and -10 promoter sequences, The region contains three 21 bp direct repeats with internal dyad symmetry which probably act as operators, Two of these repeats partially overlap the two promoter sequences, The distant third repeat is located within the tec coding sequence, Gel mobility shift assays demonstrated that Rro specifically binds to this sequence, To study possible transcriptional regulation of the region, a lacZ translational fusion with an open reading frame following tec was constructed, Under conditions that favour the lysogenic life cycle of r1t, beta-galactosidase activity was very low, Expression of the lacZ fusion could be induced 70-fold by the addition of mitomycin C at a concentration which promotes the switch of r1t from the lysogenic to the lytic life cycle, In non-induced cells, promoter activity was repressed by Rro, as a frameshift mutation in rro resulted in constitutive expression of the lacZ gene fusion.

It is argued that self-regulation skill is necessary both for displaying constructive behaviour and for controlling negative social behaviour, and self-regulation might affect social behaviours by increasing the ability to understand others' minds. In this research, in order to examine different aspects of self-regulation and their similarities and differences in terms of their relations with other constructs, we focused on both effortful control and executive function and investigated their concurrent associations with socially competent and aggressive behaviours and theory of mind (ToM). The participants were 212 preschool children in Turkey. We assessed executive functions with behavioural measures and effortful control with mother reports. We used six tasks for comprehensive assessment of mental state understanding. Children's social competency and aggressive behaviour were assessed with teacher reports. Structural equation modelling results showed that when age and receptive language were controlled, ToM was significantly associated with social competence but not aggressive behaviour. Both effortful control and executive functions were significantly related to social competency and ToM; the pathways from each self-regulation skill were similar in strength. ToM was linked with social competence, but it did not have a mediating role in the relations of self-regulation with social competence. The findings highlighted the importance of self-regulation for socio-cognitive and social development in the preschool years. Copyright © 2016 John Wiley & Sons, Ltd.

Objective: To evaluate retrospectively the prevalence of cervical cytological abnormalities in patient records obtained from healthcare centers in Turkey. Method: Demographic characteristics and data on cervical cytological abnormalities were evaluated from patients who underwent flap tests in healthcare centers in 2007. Results: Data were collected from 33 healthcare centers totaling 140 334 patients. Overall, the prevalence of cervical cytological abnormalities was 1.8%; the prevalence of ASCUS, ASC-H, LSIL, HSIL, and AGC was 1.07%, 0.07%, 0.3%, 0.17%, and 0.08%, respectively. The prevalence of preinvasive cervical neoplasia was 1.7% and the prevalence of cytologically diagnosed invasive neoplasia was 0.06%. Conclusion: The abnormal cervical cytological prevalence rate in Turkey is lower than in Europe and North America. This might be due to sociocultural differences, lack of population-based screening programs, or a lower HPV prevalence rate in Turkey. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

The recent finding that more than one Influenza hemagglutinin (HA) is required at the fusion site for HA-expressing fibroblasts [1], together with the crystal structure of HA at neutral pH [2], provide the basic elements of a plausible model for this fusion site. Within an aggregate of HA trimers at low pH, we propose fusion intermediates which are based upon a minimal alteration to the known neutral pH structure of HA and which should have reasonable activation energies. This is the first model of a glycoprotein-mediated fusion site which explicitly accounts for the disposition of the lipids within these intermediates. While the fusion site created by HA will not be the same as that of eukaryotic fusion complexes [3], general characteristics could be shared.

Ninety-two patients with schizophrenia were included in a double-blind multicentre parallel-group trial comparing remoxipride and haloperidol. The mean daily dose during the last week of treatment was 316 mg (range, 150-600 mg) in the remoxipride group and 8.7 mg (range, 5-20 mg) in the haloperidol group. The study period was six weeks with at least one day of washout. Both Clinical Global Impression (CGI) rating, and Brief Psychiatric Rating Scale (BPRS) total scores declined at the end of the trial compared with pretreatment values in both groups. No significant differences were found between the remoxipride and haloperidol groups with regard to the treatment outcome. Treatment-emergent extrapyramidal symptoms were statistically more frequent and more severe during haloperidol than during remoxipride treatment. Haloperidol-treated patients reported also significantly more concentration difficulties. Severe extrapyramidal side effects in the haloperidol group and clinical ineffectiveness in the remoxipride group were the most frequent reasons for premature discontinuation of treatment.