Barriers and facilitators to implementing a Canadian shared-care ADHD program in pediatric settings in Shanghai: a consolidated framework for implementation research approach.

OBJECTIVES: The vast majority of children with Attention-Deficit Hyperactivity Disorder (ADHD) do not have access to proper diagnosis and treatment in China. The goal of this project is to identify the challenges and facilitators in implementing a Canadian ADHD Shared Care Pathways program in pediatric settings in Shanghai region. METHODS: Purposive semi-structured focus groups were conducted on a total of 13 healthcare practitioners from the Shanghai Xinuha, Ninghai and Chongming hospitals. Two independent researchers conducted a thematic analysis of the data with themes emerging based on the Consolidated Framework for Implementation Research (CFIR). RESULTS: Notable barriers identified by participants included: (1) lack of knowledge in the management of ADHD, primarily among general practitioners; (2) lack of resources such as lack of staff, time, and medication for ADHD; (3) challenges in implementing an international multicentre intervention (such as communication difficulties between teams and integration of resources available in different hospitals); and (4) mental health stigma, difficulties in identifying ADHD patients, and logistical problems related to medication procurement rules put in place by provincial governments. Notable facilitators included: (1) the strong motivation of stakeholders and their confidence in their ability to learn and subsequently execute action plans to achieve the implementation goal; (2) the compatibility between the values and goals of the stakeholders and those of the program despite some cultural tension, a positive learning climate, strong tensions for change, and the high interest of organization leaders in engaging in the program (3) the perceived benefits of the program, such as standardization of the diagnostic and treatment process, and engaging primary care providers in ADHD management; and (4) the strong relationship between participating institutions and schools as well as provincial health initiatives available to support collaborative models of care. Mixed factors to implementation were also explored. CONCLUSIONS: Appropriate training of health care providers, cultural adaptation of the program, increase public awareness about ADHD to decrease stigma, as well as strong project management and guidelines that clearly describe the role and expectations of each team member appeared essential to successful implementation.

Preparation and drug release performance of different gelation type polysaccharide/ß-lactoglobulin fiber composite gels.

Self-assembled protein fibers have attracted much attention in the fields of medicine and food because of their high aspect ratio, polymorphic structure and strong surface hydrophobicity. In this study, three different gelation types of polysaccharides/ß-lactoglobulin fiber (Fblg) composite gels, including ionic alginate-Fblg gels, synergistic xanthan-Fblg gels, and double network agar-Fblg gels, were first prepared. The interactions between the polysaccharides and the Fblgs, the microstructure and mechanical properties of the composite gels were investigated using the light scattering, scanning electron microscopy, rheology and texture analysis in order to reveal their formation mechanisms. Then the loading and release properties of the water-soluble drug 5-fluorouracil (5-FU) and the hydrophobic drug curcumin (Cur) through these composite gels were further studied with release mechanisms determined by fitting different release models. It was found that the mechanical properties of the composite gels were determined by the mesh density of the three-dimensional networks formed inside the gels. The network structure and mechanical strength of the alginate-Fblg gels became weaker with the increase of Fblg content at pH 4 due to their attractive interaction which hindered the binding of Ca2+ to ALG, while the network and the strength of the alginate-Fblg gels didn't change much at pH 7 due to the repulsion between Alg and Fblg. The xanthan-Fblg gels formed lamellar structures with enhanced gel network and mechanical strength due to the hydrogen bonding and the electrostatic interaction with Fblg. The Agar-Fblg composite gel formed at 60 °C (above the gelation temperature of agar of 40 °C) had a denser double network structure and higher mechanical strength than that formed at 0 °C due to inhibition of diffusion of Ca2+ as salt bridges for Fblg. The hydrophilic drugs were loaded in the meshes of the composite gels and their release was determined by the structure of the composite gel networks, whereas the hydrophobic drugs were loaded by attaching to the Fblgs in the composite gels and their release was determined by the loading ability and strength of the gels. The study not only provided a new idea for the preparation and application of polysaccharide-protein fiber composite hydrogels, but also provided insights for improving the efficiency of drug carriers.

Loss-of-function of kinesin-5 KIF11 causes microcephaly, chorioretinopathy, and developmental disorders through chromosome instability and cell cycle arrest.

Kinesin motors play a fundamental role in development by controlling intracellular transport, spindle assembly, and microtubule organization. In humans, patients carrying mutations in KIF11 suffer from an autosomal dominant inheritable disease called microcephaly with or without chorioretinopathy, lymphoedema, or mental retardation (MCLMR). While mitotic functions of KIF11 proteins have been well documented in centrosome separation and spindle assembly, cellular mechanisms underlying KIF11 dysfunction and MCLMR remain unclear. In this study, we generate KIF11-inhibition chick and zebrafish models and find that KIF11 inhibition results in microcephaly, chorioretinopathy, and severe developmental defects in vivo. Notably, loss-of-function of KIF11 causes the formation of monopolar spindle and chromosome misalignment, which finally contribute to cell cycle arrest, chromosome instability, and cell death. Our results demonstrate that KIF11 is crucial for spindle assembly, chromosome alignment, and cell cycle progression of progenitor stem cells, indicating a potential link between polyploidy and MCLMR. Our data have revealed that KIF11 inhibition cause microcephaly, chorioretinopathy, and development disorders through the formation of monopolar spindle, polyploid, and cell cycle arrest.

Screen time and childhood attention deficit hyperactivity disorder: a meta-analysis.

OBJECTIVES: The association between screen time and attention deficit hyperactivity disorder (ADHD) has been controversial. This study sheds light on the contentious correlation between screen time and ADHD. CONTENT: Until August 2022, electronic searches of the PubMed, Embase, and Web of Science databases were carried out. The combined effect value odds ratios (OR) and 95 % confidence interval (95 % CI) were calculated for the meta-analysis using Stata 12.0. There were 81,234 children in the nine studies that made up this meta-analysis which included 28,997 children with ADHD and 52,237 healthy controls. When compared with the screen time <2  h/d, the OR (95 % CI) value of screen time and ADHD in the screen time ≥2 h/d group was 1.51 (1.20-1.90). SUMMARY AND OUTLOOK: Based on the current meta-analysis results, our study found a positive correlation between screen time and the risk of ADHD. Excessive screen exposure may significantly contribute to the development of ADHD in children. Therefore, it is necessary to reduce screen time per day in children to prevent the occurrence of ADHD.

Blood and hair copper levels in childhood autism spectrum disorder: a meta-analysis based on case-control studies.

OBJECTIVES: The association between copper levels and autism spectrum disorder (ASD) has been a controversial topic. This study investigated relationship between copper levels and ASD. CONTENT: The following databases are searched until April 2022: PubMed, EMBASE and Web of Science. Combined effect size standardized mean differences (SMD) and 95% confidence intervals (95% CI) were calculated with Stata 12.0. In this meta-analysis, 29 case-control studies were included, which included 2,504 children with ASD and 2,419 healthy controls. The copper levels in hair (SMD: -1.16, 95% CI: -1.73 to -0.58) was significantly lower in ASD children than healthy controls. The copper levels in blood (SMD: 0.10, 95% CI: -0.12 to 0.32) not significantly compare ASD with controls. SUMMARY AND OUTLOOK: Copper may be associated with the development of ASD in children.

Prosthetic Reconstruction of Superior Vena Cava System for Thymic Tumor: A Retrospective Analysis of 22 Cases.

OBJECTIVE: This study aimed to report our experience in superior vena cava (SVC) resection and reconstruction for 22 thymic tumor patients and to make comparisons with previous related reports. METHODS: A retrospective study on 22 patients (15 thymomas, 7 thymic cancers) who underwent tumor resection with concomitant SVC reconstruction. All the patients underwent vascular conduit reconstruction by the cross-clamping technique. The corresponding data were reviewed, including clinical presentation, operation management (surgery procedure, selection of suitable graft, strategies against SVC syndrome, etc.), postoperative cares (antithrombotic agent application, treatments on brain edema, etc.), and follow-up information. RESULT: Two patients were myasthenic, well controlled by oral pyridostigmine. All resections were radical (R0). Ten patients received induction treatment. All the 15 thymoma patients were Masaoka stage III (type B1-B3). As for thymic cancer, six patients were Masaoka stage III and one was stage IVa. Wedge pulmonary resection was performed in three patients (two right upper lobe, one both upper lobe). Procedures included were single graft replacement in 12 patients, bilateral grafts in 9, and Y-shaped graft in 1 patient. Anticoagulation and dehydration agents were routinely applied after operation. No perioperative mortalities were observed. Major complication rate was 9.1%. The median survival time was 44.2 months (range, 4-92 months). Three- and 5-year overall survival rates were 80.8 and 44.0%, respectively. As for conduit patency, two grafts (9.1%) demonstrated evidence of occlusion during long-term follow-up, but no additional interventions were required due to no complications related. CONCLUSION: Our study, confirming data from existing literature, showed that the prosthetic reconstruction of the SVC system is a feasible additional procedure during resection of thymic tumor infiltrating the venous mediastinal axis, minimally increasing postoperative complications in experienced hands.

Design of Fluorescence-Enhanced Silver Nanoisland Chips for High-Throughput and Rapid Arsenite Assay.

High-throughput and rapid arsenite (As(III)) monitoring is an urgent task to deal with the critical threat from As(III) contamination in the environment. In this study, an effective, portable, and sensitive As(III) assay was developed using the plasmonic silver (pAg) chips for As(III) detection. The pAg chips were fabricated by a simple seed-mediated method to grow the silver nanoisland films (Ag-NIFs) with the compact nanoislands and adjustable interisland gaps on the large-sized substrates. With appropriate surface functionalization and optimal chip manufacturing, Cy7.5 fluorescence dye can be immobilized on the surface of Ag-NIFs in the presence of As(III) to output the enhanced fluorescence signals up to 10-fold and improve the detection limit of As(III) less than 10 ppb. According to our results, the high-throughput detection measurements and wide dynamic range over 4 orders of magnitude implied the broad prospects of pAg chips in fluorescence-enhanced assays. The proposed As(III) assay has shown great opportunities for the practical application of ultratrace As(III) monitoring.

Retrospectively investigating the 12-year experience of prenatal diagnosis of small supernumerary marker chromosomes through array comparative genomic hybridization.

OBJECTIVE: This study retrospectively evaluated the incidences of small supernumerary marker chromosomes (sSMCs) in prenatal diagnoses and detected with gain of pathogenic copy number variation through array comparative genomic hybridization (CGH) in a laboratory in Taiwan. MATERIALS AND METHODS: We retrospectively searched and reviewed the sSMC cases detected during prenatal diagnoses in the Youthgene medical laboratory, between 2004 and 2015 and used array CGH to successfully analyze 45 of 47,XN,+mar or 47,XN + mar/46,XN. RESULTS: A total of 68,087 cases of amniocentesis were analyzed, of which 59 were identified as sSMCs. The overall frequency of sSMCs was 0.087%, and 7 of 45 sSMCs were identified with gain of pathogenic copy number variation (CNV). CONCLUSION: Array CGH offers useful tools that can be used to detect small fragments of chromosomal abnormalities and sSMC origins in prenatal diagnosis. In this study, we successfully used array CGH to detect 7 out of 45 sSMCs, which were identified with gain in pathogenic CNV.

A metal-organic framework with immobilized Ag(i) for highly efficient desulfurization of liquid fuels.

A metal-organic framework immobilized with Ag(i) sites, namely, (Cr)-MIL-101-SO3Ag, was successfully developed as a highly efficient desulfurization adsorbent because of the strong binding of these Ag(i) sites for thiophene derivatives.

Immobilization of Ag(i) into a metal-organic framework with -SO3H sites for highly selective olefin-paraffin separation at room temperature.

Introduction of Ag(i) ions into a sulfonic acid functionalized MOF ((Cr)-MIL-101-SO3H) significantly enhances its interactions with olefin double bonds, leading to its much higher selectivities for the separation of C2H4-C2H6 and C3H6-C3H8 at room temperature over the original (Cr)-MIL-101-SO3H and other adsorbents at room temperature.

Age differences in the control of postural stability during reaching tasks.

Reaching tasks are commonly performed during daily activities and require anticipatory postural adjustments (APAs) to ensure a stable posture during movement execution. Age-related changes in APAs may impact dynamic balance and cause postural instability during reaching tasks made from standing. The present study examined age differences in postural control during reaching to targets located at different heights. Fourteen young adults (aged 20.0±1.5 yrs) and 16 community-dwelling older adults (aged 73.4±5.3 yrs) participated in the study. The task involved reaching forward to grasp a cylinder, and returning to an upright position as fast and accurately as possible. Postural control was analyzed using the center of pressure (COP) during four phases of the task: COP displacement during APA production, COP trajectory smoothness during the reach and return phases, and COP path length during the recovery phase following movement. APA amplitude measured by COP displacement and COP path length during the recovery phase was larger in older compared to young adults. Dynamic balance represented by COP trajectory smoothness was reduced with age. In both age groups, APA amplitude was largest and COP trajectory smoothness the least during low target reaches. The results demonstrate that, while older adults can alter APAs in order to maintain postural stability, control of COP during movement execution, particularly during low target reaches, is compromised with aging. These findings have clinical implications for both the assessment of dynamic balance and the development of balance training programs.