The role of child temperament on low‐income preschool children’s relationships with their parents and teachers

The current study examined the associations between low‐income preschool children’s temperament (reactive and regulatory) and their relationships with parents and teachers. In particular, we focused on the moderating role of regulatory temperament on reactive temperament in the prediction of closeness and conflict with parents and teachers. Two hundred ninety‐one children (M = 53.88 months, SD = 6.44 months), their parents, and teachers from 3 different preschools serving low‐income children in 2 midwestern cities in the United States participated. Parents reported on temperament and parent–child relationships, and teachers reported on teacher–child relationships. Hierarchical regression models using SAS PROCMIXED were employed to allow for nesting of children within classrooms. After controlling for child age, gender, ethnicity, and parent education, children’s reactive temperament was negatively associated with parent– child closeness and positively associated with parent–child conflict and teacher–child conflict. Children’s regulatory temperament was positively related to teacher–child closeness and negatively associated with teacher–child conflict. Regulatory temperament moderated the association between reactive temperament and teacher– child closeness. These findings The current study examined the associations between low‐income preschool children’s temperament (reactive and regulatory) and their relationships with parents and teachers. In particular, we focused on the moderating role of regulatory temperament on reactive temperament in the prediction of closeness and conflict with parents and teachers. Two hundred ninety‐one children (M = 53.88 months, SD = 6.44 months), their parents, and teachers from 3 different preschools serving low‐income children in 2 midwestern cities in the United States participated. Parents reported on temperament and parent–child relationships, and teachers reported on teacher–child relationships. Hierarchical regression models using SAS PROCMIXED were employed to allow for nesting of children within classrooms. After controlling for child age, gender, ethnicity, and parent education, children’s reactive temperament was negatively associated with parent– child closeness and positively associated with parent–child conflict and teacher–child conflict. Children’s regulatory temperament was positively related to teacher–child closeness and negatively associated with teacher–child conflict. Regulatory temperament moderated the association between reactive temperament and teacher– child closeness. These findings suggest that although reactive temperament potentially undermines closeness in relationships with teachers, regulatory temperament can buffer the influence of reactive temperament on teacher–child closeness. Highlights: • This study examined the association between children’s temperament and their relationships with parents and teachers. • Reactive temperament was positively associated with parent/ teacher–child conflict and negatively associated with parent–child closeness. Regulatory temperament was a moderator for the association between reactive temperament and teacher–child closeness. • Improving children’s regulatory temperament may be helpful for children with the reactive temperament to have better social relationships with their teachers

Examining the roles of child temperament and teacher-child relationships as predictors of Turkish children’s social competence and antisocial behavior

The present study examined the concurrent contribution of Turkish children’s temperament and teacher-child relationship quality to their social competence and antisocial behavior, with a specific focus on the moderating role of teacher-child relationships (closeness and conflict) on children’s temperament (inhibitory control and shyness) when predicting social competence and antisocial behavior. Participants were 94 children (56 boys) with mean age of 7.05 years (SD = .88) enrolled in 24 classrooms from five elementary schools in a suburban school district in Turkey. Mothers reported on children’s temperament and teachers reported on their relationships with children as well as children’s social competence and antisocial behavior. SAS PROC MIXED was used to test hierarchical regression models of children nested within classrooms. Results showed that high conflict teacher-child relationships moderated the association between low shyness and antisocial behavior. Less shy children displayed more antisocial behavior at higher levels of teacher-child conflict. In addition, at high levels of child shyness, social competence ratings improved as teacher-child closeness increased. Inhibitory control was positively correlated with social competence and negatively correlated with antisocial behavior. The qualities of teacher-child relationships can effectively support children’s social competence and antisocial behavior depending upon their temperamental characteristics. Limitations and future directions of the current study are discussed

Elementary preservice teachers’ attitudes and pedagogical strategies toward hypothetical shy, exuberant, and average children

Children’s learning and development are directly and indirectly influenced by teachers’ beliefs and pedagogical strategies toward child behaviors. This cross-sectional study explored elementary preservice teachers’ attitudes and pedagogical strategies for working with hypothetical children demonstrating temperament-based shy, exuberant, and average behaviors in the classroom. A secondary goal was to compare attitudes and pedagogical strategies at the beginning and end of teacher training program. A total of 354 participants responded to three vignettes describing children frequently displaying these behaviors. Results indicated preservice teachers were more likely to use social-learning strategies with shy children and high-powered strategies with exuberant children. Participants were more likely to show warmth to shy children, but believed they would be less academically successful. Participants at the end of the program reported higher self-efficacy and more warmth toward all children compared to those beginning the program. Results are discussed in terms of their educational implications

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Loss of runt-related transcription factor 3 expression leads hepatocellular carcinoma cells to escape apoptosis

Background: Runt-related transcription factor 3 (RUNX3) is known as a tumor suppressor gene for gastric cancer and other cancers, this gene may be involved in the development of hepatocellular carcinoma (HCC). Methods: RUNX3 expression was analyzed by immunoblot and immunohistochemistry in HCC cells and tissues, respectively. Hep3B cells, lacking endogenous RUNX3, were introduced with RUNX3 constructs. Cell proliferation was measured using the MTT assay and apoptosis was evaluated using DAPI staining. Apoptosis signaling was assessed by immunoblot analysis. Results: RUNX3 protein expression was frequently inactivated in the HCC cell lines (91%) and tissues (90%). RUNX3 expression inhibited 90 +/- 8% of cell growth at 72 h in serum starved Hep3B cells. Forty-eight hour serum starvation-induced apoptosis and the percentage of apoptotic cells reached 31 +/- 4% and 4 +/- 1% in RUNX3-expressing Hep3B and control cells, respectively. Apoptotic activity was increased by Bim expression and caspase-3 and caspase-9 activation. Conclusion: RUNX3 expression enhanced serum starvation-induced apoptosis in HCC cell lines. RUNX3 is deleted or weakly expressed in HCC, which leads to tumorigenesis by escaping apoptosis

A Controversy That Has Been Tough to Swallow: Is the Treatment of Achalasia Now Digested?

Esophageal achalasia is a rare neurodegenerative disease of the esophagus and the lower esophageal sphincter that presents within a spectrum of disease severity related to progressive pathological changes, most commonly resulting in dysphagia. The pathophysiology of achalasia is still incompletely understood, but recent evidence suggests that degeneration of the postganglionic inhibitory nerves of the myenteric plexus could be due to an infectious or autoimmune mechanism, and nitric oxide is the neurotransmitter affected. Current treatment of achalasia is directed at palliation of symptoms. Therapies include pharmacological therapy, endoscopic injection of botulinum toxin, endoscopic dilation, and surgery. Until the late 1980s, endoscopic dilation was the first line of therapy. The advent of safe and effective minimally invasive surgical techniques in the early 1990s paved the way for the introduction of laparoscopic myotomy. This review will discuss the most up-to-date information regarding the pathophysiology, diagnosis, and treatment of achalasia, including a historical perspective. The laparoscopic Heller myotomy with partial fundoplication performed at an experienced center is currently the first line of therapy because it offers a low complication rate, the most durable symptom relief, and the lowest incidence of postoperative gastroesophageal reflux

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Brain Imaging of Pain

The brain is the principal processor of internal and external sensory experiences including pain. Pain is a multidimensional experience influenced by complex interactions among multiple processes including nociception (the afferent neural activity transmitting sensory information about noxious stimuli), cognitive appraisals (expectation, attention), and emotional aspects (affect)