Laparoscopic versus Open Surgery in Complicated Appendicitis in Children Less Than 5 Years Old: A Six-Year Single-Centre Experience

Introduction. Acute appendicitis is the most common surgical emergency in the pediatric population. The peak incidence occurs in the first decade of life, while it is uncommon to face appendicitis in children younger than 5 years of age. Laparoscopy is now demonstrated to be the optimal approach also to treat complicated appendicitis, but in very young children this standardized operation is not always easy to perform. Material and Methods. From January 2009 to December 2015 we operated on 525 acute appendicitis, with 120 patients less than 5 years of age. Results. 90 children had a complicated appendicitis (localized or diffuse peritonitis): 43 (48%) were operated on by open approach and 47 (52%) by laparoscopy. The overall incidence of postoperative complications was greater in the open appendectomy group (63% versus 26%) and all severe complications requiring reintervention (6% of cases: 3 postoperative abscesses resolved with ultrasound guided percutaneous abscess drainage; 1 tubal surgery for salpingitis; 1 adhesion-related ileus requiring relaparotomy) were mostly associated with open surgery. Conclusions. Laparoscopic surgery resulted as the best approach for treating complicated appendicitis also in younger children, with minor and less severe postoperative complications compared to open surgery

Heritage language anxiety and majority language anxiety among Turkish immigrants in the Netherlands

Aims and objectives: This study examines the language anxiety that occurs in immigrants’ daily lives when speaking the heritage language and the majority language, both in their host country and during visits to their home country. It compares the levels of heritage language anxiety and majority language anxiety across three generations of the Turkish immigrant community in the Netherlands and explores the link between immigrants’ language anxiety, and sociobiographical (i.e. generation, gender, education) and language background variables (i.e. age of acquisition, self-perceived proficiency, frequency of language use). Design: A Likert scale-based questionnaire was administered to 116 participants across three generations who reported their language anxiety levels when speaking the heritage language and the majority language in three social contexts (i.e. family, friendship and speaking with native speakers). Findings: Statistical analyses revealed that heritage language anxiety and majority language anxiety were prevalent in immigrants’ daily life, and that levels of both forms of anxiety differed across generations, and in different daily life situations. First- and second-generation immigrants typically experienced majority language anxiety, while second- and predominantly third-generation immigrants suffered from heritage language anxiety. Relationships emerged between language background variables and both forms of anxiety, but only in certain situations. These findings suggest that language background variables on their own may be insufficient to explain immigrant language anxiety in certain social contexts (i.e. within family). Rather than merely language background factors, a variety of other issues within social, cultural and national currents must be considered when examining language anxiety in the immigrant context. Implications: Taking an interdisciplinary approach that combines language contact and foreign language anxiety/second language anxiety research, this study suggests that the concept of foreign language anxiety/second language anxiety should be expanded beyond the confines of the classroom in order to include daily interactions immigrant or minority communities. Originality: This study contributes to the limited body of evidence on the topic of language anxiety in immigrant contexts and presents a new construct ‘majority language anxiety’

Systemic Exosomal Delivery of shRNA Minicircles Prevents Parkinsonian Pathology

The development of new therapies to slow down or halt the progression of Parkinson's disease is a health care priority. A key pathological feature is the presence of alpha-synuclein aggregates, and there is increasing evidence that alpha-synuclein propagation plays a central role in disease progression. Consequently, the downregulation of alpha-synuclein is a potential therapeutic target. As a chronic disease, the ideal treatment will be minimally invasive and effective in the long-term. Knockdown of gene expression has clear potential, and siRNAs specific to alpha-synuclein have been designed; however, the efficacy of siRNA treatment is limited by its short-term efficacy. To combat this, we designed shRNA minicircles (shRNA-MCs), with the potential for prolonged effectiveness, and used RVG-exosomes as the vehicle for specific delivery into the brain. We optimized this system using transgenic mice expressing GFP and demonstrated its ability to downregulate GFP protein expression in the brain for up to 6 weeks. RVG-exosomes were used to deliver anti-alpha-synuclein shRNA-MC therapy to the alpha-synuclein preformed-fibril-induced model of parkinsonism. This therapy decreased alpha-synuclein aggregation, reduced the loss of dopaminergic neurons, and improved the clinical symptoms. Our results confirm the therapeutic potential of shRNA-MCs delivered by RVG-exosomes for long-term treatment of neurodegenerative diseases

Discourse markers activate their, <i>like</i>, cohort competitors

Speech in everyday conversations is riddled with discourse markers (DMs), such as well, you know, and like. However, in many lab-based studies of speech comprehension, such DMs are typically absent from the carefully articulated and highly controlled speech stimuli. As such, little is known about how these DMs influence online word recognition. The present study specifically investigated the online processing of DM like and how it influences the activation of words in the mental lexicon. We specifically targeted the cohort competitor (CC) effect in the Visual World Paradigm: Upon hearing spoken instructions to “pick up the beaker,” human listeners also typically fixate—next to the target object—referents that overlap phonologically with the target word (cohort competitors such as beetle; CCs). However, several studies have argued that CC effects are constrained by syntactic, semantic, pragmatic, and discourse constraints. Therefore, the present study investigated whether DM like influences online word recognition by activating its cohort competitors (e.g., lightbulb). In an eye-tracking experiment using the Visual World Paradigm, we demonstrate that when participants heard spoken instructions such as “Now press the button for the, like … unicycle,” they showed anticipatory looks to the CC referent (lightbulb)well before hearing the target. This CC effect was sustained for a relatively long period of time, even despite hearing disambiguating information (i.e., the /k/ in like). Analysis of the reaction times also showed that participants were significantly faster to select CC targets (lightbulb) when preceded by DM like. These findings suggest that seemingly trivial DMs, such as like, activate their CCs, impacting online word recognition. Thus, we advocate a more holistic perspective on spoken language comprehension in naturalistic communication, including the processing of DMs

Ebf factors and MyoD cooperate to regulate muscle relaxation via Atp2a1

Jin, Saihong et al.Myogenic regulatory factors such as MyoD and Myf5 lie at the core of vertebrate muscle differentiation. However, E-boxes, the cognate binding sites for these transcription factors, are not restricted to the promoters/enhancers of muscle cell-specific genes. Thus, the specificity in myogenic transcription is poorly defined. Here we describe the transcription factor Ebf3 as a new determinant of muscle cell-specific transcription. In the absence of Ebf3 the lung does not unfold at birth, resulting in respiratory failure and perinatal death. This is due to a hypercontractile diaphragm with impaired Ca2+ efflux-related muscle functions. Expression of the Ca2+ pump Serca1 (Atp2a1) is downregulated in the absence of Ebf3, and its transgenic expression rescues this phenotype. Ebf3 binds directly to the promoter of Atp2a1 and synergises with MyoD in the induction of Atp2a1. In skeletal muscle, the homologous family member Ebf1 is strongly expressed and together with MyoD induces Atp2a1. Thus, Ebf3 is a new regulator of terminal muscle differentiation in the diaphragm, and Ebf factors cooperate with MyoD in the induction of muscle-specific genes. © 2014 Macmillan Publishers Limited.This work was supported by grants from the German Research Foundation (DFG, TRR54; FOR1586; FOR2033) and by a stipend of the Max Planck SocietyPeer Reviewe

Multidimensional signals and analytic flexibility: Estimating degrees of freedom in human speech analyses

Recent empirical studies have highlighted the large degree of analytic flexibility in data analysis which can lead to substantially different conclusions based on the same data set. Thus, researchers have expressed their concerns that these researcher degrees of freedom might facilitate bias and can lead to claims that do not stand the test of time. Even greater flexibility is to be expected in fields in which the primary data lend themselves to a variety of possible operationalizations. The multidimensional, temporally extended nature of speech constitutes an ideal testing ground for assessing the variability in analytic approaches, which derives not only from aspects of statistical modeling, but also from decisions regarding the quantification of the measured behavior. In the present study, we gave the same speech production data set to 46 teams of researchers and asked them to answer the same research question, resulting insubstantial variability in reported effect sizes and their interpretation. Using Bayesian meta-analytic tools, we further find little to no evidence that the observed variability can be explained by analysts’ prior beliefs, expertise or the perceived quality of their analyses. In light of this idiosyncratic variability, we recommend that researchers more transparently share details of their analysis, strengthen the link between theoretical construct and quantitative system and calibrate their (un)certainty in their conclusions