BACKGROUND: Foot morphology is associated with altered loading of the ankle-foot complex in adolescent footballers, predisposing to pain and injury. However, usual singular plane clinical assessments do not accurately capture the 3D nature of foot morphology. A new approach is 3D laser scanning, with statistical shape model techniques creating individual-to-group comparison. However, no research exists on the adolescent, football-playing foot. Furthermore, a link between 3D foot morphology, and usual clinical and performance measures would be beneficial for practical implementation. METHODS: Four hundred forty-seven 3D foot scans from 224 elite male footballers (U12-U19) in bilateral stance were collected and further processed with statistical shape model techniques. Weighted shape parameters for individual principal components (Modes) were extracted for each foot. Centre of pressure displacement expressed as total travelled way in millimetres was calculated for bilateral and unilateral postural stability measures. Clinical assessments (Clarke's Angle, Resting Calcaneal Stance Position) were calculated on the 3D foot scans. Differences in weighted shape parameters, postural stability measures, and clinical assessments between age groups were determined by ANOVA. Correlations determined the relationship of Modes and clinical assessments to postural stability measures. Linear regression established if clinical assessments predicted the mode describing foot arch variation. RESULTS: Age groups significantly differed for Mode 1 (foot length), Mode 2 (foot arch), and Mode 5 (tibial rotation relative to the foot) (p < 0.05). Resting Calcaneal Stance Position (r = .663) and Clarke's Angle (r = -.445) were low-to-moderately correlated to Mode 2 (both p < 0.001), and linear regression found they were both significant predictors of Mode 2, though only moderately (R2 = .522). There were low correlations of foot morphology to the postural stability tests. CONCLUSION: This is the first study to describe the 3D foot morphology of male football-playing adolescents, and discover the differences between age groups. This will improve understanding and assessment of foot morphology in male adolescents because 2D techniques, as discovered in this study, do not strongly correlate to, nor predict, the 3D foot arch. Foot morphology was only lowly correlated to postural stability, thus a multifaceted program would be required for improvements.

• MeSH
• Lower Extremity * MeSH
• Ankle Joint MeSH
• Humans MeSH
• Linear Models MeSH
• Adolescent MeSH
• Calcaneus * MeSH
• Tibia MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Biological maturity (BM) and foot morphology (FM) can independently alter neuromuscular loading on the ankle-foot complex, potentially causing stability deficits and injury predisposition. However, the influence of BM on FM, and how much both explain neuromuscular performance in postural stability (PS) tests, has been understudied. This study aimed to investigate the effect of BM on FM, and then discover to what extent both factors explain the variance in PS performance in adolescent footballers. METHODS: Over one season, 399 three-dimensional foot scans were gathered from 72 footballers (U12-U15). PS was measured by center of pressure (COP) displacement in bilateral and unilateral stance. The Khamis and Roche equation determined maturity status (MS), while formulae from Mirwald and Khamis and Roche estimated timing of biological maturation (TBM). Principal component analysis determined nine principal components that explained the most variance in FM. An ANCOVA determined the effect of TBM on FM principal components, with covariates of age, height, weight, playing position, and foot preference. Step-wise linear regression determined the explanation of COP displacement by the above-mentioned predictors. RESULTS: There was significantly increased foot pronation during and after peak height velocity/puberty. MS and four foot principal components (foot arch and width, great toe width and length) were significant predictors in all PS tests (R2: 0.105-0.180). CONCLUSIONS: TBM had a significant effect on FM presentation, and should be a part of adolescent foot assessment. While they only explained a small amount of variance, determining MS and FM may identify those requiring additional PS attention.

• MeSH
• Lower Extremity * MeSH
• Ankle Joint MeSH
• Ankle MeSH
• Humans MeSH
• Adolescent MeSH
• Postural Balance * MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: With recent changes in legislation regulating recreational and medical cannabis use around the globe, increased use in pregnancy is to be expected. OBJECTIVES: To investigate the association between cannabis use during pregnancy and birth outcomes. METHOD: Data from the Norwegian Mother and Child Cohort Study (MoBa), a prospective pregnancy cohort, were used. Participants were recruited from all over Norway between 1999 and 2008: 9,312 women with 10,373 pregnancies who reported use of cannabis before or in pregnancy. Women reported on their illegal drug use before pregnancy and at pregnancy weeks 17/18 and 30 and at 6 months postpartum. Linear regression was used to estimate crude and adjusted effects of prenatal cannabis exposure on birth outcomes. RESULTS: In 10,101 pregnancies, women had used cannabis before pregnancy but not during pregnancy. In 272 pregnancies, women had used cannabis during pregnancy, and among these, in 63 pregnancies, women had used cannabis in at least 2 periods. In adjusted analyses for potential confounders, only cannabis use during at least 2 periods of pregnancy showed statistically significant effects on birth weight. The effect was observed in the complete cohort (B = -228 g, 95% CI = -354 to -102, p < 0.001) and for the subgroup where information about the child's father was available (B = -225 g, 95% CI = -387 to -63, p = 0.01). Our results may indicate that prolonged use causes more harm, whereas short-term use did not indicate adverse effects on birth outcomes. CONCLUSIONS: There was a statistically significant and clinically relevant association between the use of cannabis during pregnancy and reduced birth weight. Clinicians should screen not only for cannabis use but also for the length and intensity of use as part of a comprehensive substance use screening.

• MeSH
• Cannabis adverse effects   MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Prospective Studies MeSH
• Pregnancy MeSH
• Pregnancy Outcome MeSH
• Check Tag
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Norway MeSH

BACKGROUND: Relationships between right ventricular (RV) and left ventricular (LV) shape and function may be useful in determining optimal timing for pulmonary valve replacement in patients with repaired tetralogy of Fallot (rTOF). However, these are multivariate and difficult to quantify. We aimed to quantify variations in biventricular shape associated with pulmonary regurgitant volume (PRV) in rTOF using a biventricular atlas. METHODS: In this cross-sectional retrospective study, a biventricular shape model was customized to cardiovascular magnetic resonance (CMR) images from 88 rTOF patients (median age 16, inter-quartile range 11.8-24.3 years). Morphometric scores quantifying biventricular shape at end-diastole and end-systole were computed using principal component analysis. Multivariate linear regression was used to quantify biventricular shape associations with PRV, corrected for age, sex, height, and weight. Regional associations were confirmed by univariate correlations with distances and angles computed from the models, as well as global systolic strains computed from changes in arc length from end-diastole to end-systole. RESULTS: PRV was significantly associated with 5 biventricular morphometric scores, independent of covariates, and accounted for 12.3% of total shape variation (p < 0.05). Increasing PRV was associated with RV dilation and basal bulging, in conjunction with decreased LV septal-lateral dimension (LV flattening) and systolic septal motion towards the RV (all p < 0.05). Increased global RV radial, longitudinal, circumferential and LV radial systolic strains were significantly associated with increased PRV (all p < 0.05). CONCLUSION: A biventricular atlas of rTOF patients quantified multivariate relationships between left-right ventricular morphometry and wall motion with pulmonary regurgitation. Regional RV dilation, LV reduction, LV septal-lateral flattening and increased RV strain were all associated with increased pulmonary regurgitant volume. Morphometric scores provide simple metrics linking mechanisms for structural and functional alteration with important clinical indices.

• MeSH
• Child MeSH
• Adult MeSH
• Tetralogy of Fallot * diagnostic imaging   surgery   MeSH
• Ventricular Function, Right MeSH
• Pulmonary Valve Insufficiency * diagnostic imaging   etiology   MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Predictive Value of Tests MeSH
• Cross-Sectional Studies MeSH
• Retrospective Studies MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Research Support, N.I.H., Extramural MeSH

Many physical and psychological characteristics are influenced by prenatal development. Some studies have located links between low birth parameters and behavioural problems, with the latter in turn associated with educational progress, career success, overall health, and subsequent life events. However, few studies have investigated whether this association also applies to children in the normal birth growth range. This study thus investigates the relationship between normal-range birth length, weight, and behavioural problems at the age of seven. We use data from the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) cohort, which provides comprehensive insight into a post-communist country undergoing a period of economic transition. Childhood behavioural problems were measured in 1,796 children using the Strengths and Difficulties Questionnaire. Associations were modelled using weighted logistic regression. Birth weight was found to be linked to the total difficulties score, hyperactivity, and peer relationship problems subscales in a fully adjusted model while birth length was not significantly associated with any subscale in the fully adjusted model. We thus conclude that normal-range birth weight is associated with behavioural problems. It can therefore be assumed that the odds of behavioural problems and their consequences can be mitigated by preventive programs targeting pregnant women and children with lower but still normal weight.

• MeSH
• Child MeSH
• Adult MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Birth Weight * MeSH
• Problem Behavior * MeSH
• Educational Status MeSH
• Pregnancy MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Male MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

OBJECTIVES: Metabolic syndrome (MetS) and its components (high blood pressure, BMI≥30, altered fasting glucose, low HDL cholesterol and high triglycerides) may undermine early perioperative outcomes after radical prostatectomy (RP). We tested this hypothesis. MATERIALS & METHODS: Within the National Inpatient Sample database (2008-2015) we identified RP patients. The effect of MetS was tested in four separate univariable analyses, as well as in multivariable regression models predicting: 1) overall complications, 2) length of stay, 3) total hospital charges and 4) non-home based discharge. All models were weighted and adjusted for clustering, as well as all available patient and hospital characteristics. RESULTS: Of 91,618 patients: 1) 50.2% had high blood pressure, 2) 8.0% had BMI≥30, 3) 13.0% had altered fasting glucose, 4) 22.8% had high triglycerides and 5) 0.03% had low HDL cholesterol. Respectively, one vs. two vs. three vs. four MetS components were recorded in 36.2% vs. 19.0% vs. 5.5% vs. 0.8% patients. Of all patients, 6.3% exhibited ≥3 components and qualified for MetS diagnosis. The rates of MetS increased over time (EAPC:+9.8%; p < 0.001). All four tested MetS components (high blood pressure, BMI≥30, altered fasting glucose and high triglycerides) achieved independent predictor status in all four examined endpoints. Moreover, a highly statistically significant dose-response was also confirmed for all four tested endpoints. CONCLUSION: MetS and its components consistently and strongly predict early adverse outcomes after RP. Moreover, the strength of the effect was directly proportional to the number of MetS components exhibited by each individual patient, even if formal MetS diagnosis of ≥3 components has not been met.

• MeSH
• Databases, Factual MeSH
• Adult MeSH
• Hypertension complications   epidemiology   MeSH
• Body Mass Index MeSH
• Middle Aged MeSH
• Humans MeSH
• Metabolic Syndrome complications   epidemiology   MeSH
• Neoplasm Metastasis MeSH
• Prostatic Neoplasms complications   surgery   MeSH
• Postoperative Complications epidemiology   MeSH
• Prostatectomy MeSH
• Risk Factors MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• United States MeSH

Úvod: Trombotické příhody jsou v dětském věku relativně vzácná onemocnění, jejich incidence však v poslední době narůstá. Vyskytují se zpravidla jako komplikace jiného onemocnění či jeho léčby, přičemž nejvýznamnějším rizikovým faktorem v dětském věku je zavedení centrálního žilního katétru. Současná doporučení pro léčbu a profylaxi trombóz u dětí vycházejí z 9. konsensu ACCP. Strategie léčby se u dětí oproti dospělým pacientům v některých aspektech odlišuje, zejména u nejmenších dětí jsou výrazně upřednostňovány nízkomolekulární hepariny a rovněž je preferována intenzivnější léčba s cílem zachování maximálně průchodného cévního řečiště. Soubor a metodika: Tato práce mapuje trombotické příhody u dětí do 1 roku věku, které byly léčeny na Oddělení dětské hematologie (ODH) Fakultní nemocnice Brno v letech 2011–2018. Výsledky: Ve sledovaném období bylo pro trombózu léčeno 30 dětí v tomto věkovém rozmezí. V souboru výrazně převažovaly žilní trombotické příhody (90 %), nejčastěji asociované se zavedením centrálního žilního katétru (polovina z nich). Všichni pacienti byli léčeni podáváním nízkomolekulárního heparinu (LMWH), zpravidla nejprve ve formě kontinuální infuze a následně byli převedeni na podkožní aplikaci. Medián trvání léčby byl 80 dnů. Alespoň parciální regrese trombózy byla zaznamenána u 80 % léčených pacientů. Komplikace léčby byla zaznamenána pouze u jednoho dítěte, celkově byla léčba pacienty i rodiči dobře tolerována. Závěr: Diagnostika trombotických příhod v dětském věku vyžaduje zkušené zázemí laboratoří a zobrazovacích metod. Léčba těchto onemocnění patří do rukou dětského hematologa na adekvátně vybaveném pracovišti. Lékem volby jsou v současnosti nízkomolekulární hepariny. Antikoagulace LMWH vede společně s léčbou obvykle přítomného základního onemocnění k vysoké šanci na regresi trombózy. Je vhodné, aby každé pracoviště mělo pro léčbu dětských trombotických příhod vytvořen standardní postup.

Introduction: Thrombotic events in childhood are relatively rare; however there has been a rising trend in their incidence. They usually occur as a complication of another disease or its treatment. The single most important risk factor for thrombosis is central venous catheter placement. Current recommendation for treatment and prophylaxis of thrombosis in children are based on 9th ACCP consensus. The treatment strategy differs in some aspects to the treatment of adults. In small children, low-molecular-weight heparins and a more intense therapy are preferred in order to achieve maximum recanalization of affected vessels. Cohort and methods: Thromboses in children up to 1 year of age, who were treated at the Department of Paediatric Haematology at University Hospital Brno from 2011 to 2018, are presented in this article. Results: In above mentioned period of time, 30 children of this age were treated. There was a vast majority (almost 90%) of venous thromboses. They were mostly associated with central venous catheter placement (50% of them). All patients were treated with low-molecular-weight heparins. In most of the cases, the tre-atment was initiated via continuous infusion, later converted to standard subcutaneous administration. The median treatment length was 80 days. In 80% of patients, there was at least partial regression of thrombosis present at the end of the treatment. There was only one adverse event related to the therapy. In general, the treatment was well tolerated by both children and parents. Conclusion: Diagnosis of thrombotic events in childhood requires an experienced laboratory and imaging. The treatment should be guided by a paediatric haematologist. Currently, low-molecular-weight heparins are the treatment of choice. A well guided therapy combined with the treatment of often underlying diseases has a high probability of thrombosis regression. Standardized treatment guidelines should be available at every department, where thromboses in children are treated.

• Keywords
• katétrové trombózy,
• MeSH
• Child MeSH
• Infant MeSH
• Humans MeSH
• Infant, Newborn MeSH
• Catheterization, Peripheral adverse effects   MeSH
• Retrospective Studies MeSH
• Thrombosis * etiology   therapy   MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Infant, Newborn MeSH

We aimed at testing the potential of biomarkers in predicting individual patient response to dopaminergic therapy for Parkinson's disease. Treatment efficacy was assessed in 30 Parkinson's disease patients as motor symptoms improvement from unmedicated to medicated state as assessed by the Unified Parkinson's Disease Rating Scale score III. Patients were stratified into weak and strong responders according to the individual treatment response. A multiple regression was implemented to test the prediction accuracy of age, disease duration and treatment dose and length. Univariate voxel-based morphometry was applied to investigate differences between the two groups on age-corrected T1-weighted magnetic resonance images. Multivariate support vector machine classification was used to predict individual treatment response based on neuroimaging data. Among clinical data, increasing age predicted a weaker treatment response. Additionally, weak responders presented greater brain atrophy in the left temporoparietal operculum. Support vector machine classification revealed that gray matter density in this brain region, including additionally the supplementary and primary motor areas and the cerebellum, was able to differentiate weak and strong responders with 74% accuracy. Remarkably, age and regional gray matter density of the left temporoparietal operculum predicted both and independently treatment response as shown in a combined regression analysis. In conclusion, both increasing age and reduced gray matter density are valid and independent predictors of dopaminergic therapy response in Parkinson's disease.

• MeSH
• Antiparkinson Agents therapeutic use   MeSH
• Levodopa pharmacology   therapeutic use   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging trends   MeSH
• Brain diagnostic imaging   drug effects   MeSH
• Parkinson Disease diagnostic imaging   drug therapy   MeSH
• Predictive Value of Tests MeSH
• Gray Matter diagnostic imaging   drug effects   MeSH
• Aged MeSH
• Aging drug effects   pathology   MeSH
• Age Factors MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

KEY MESSAGE: The major quantitative trait loci associated with bunch weight and its component traits in the East African highland banana-breeding population are located on chromosome 3. Bunch weight increase is one of the major objectives of banana improvement programs, but little is known about the loci controlling bunch weight and its component traits. Here we report for the first time some genomic loci associated with bunch weight and its component traits in banana as revealed through a genome-wide association study. A banana-breeding population of 307 genotypes varying in ploidy was phenotyped in three locations under different environmental conditions, and data were collected on bunch weight, number of hands and fruits; fruit length and circumference; and diameter of both fruit and pulp for three crop cycles. The population was genotyped with genotyping by sequencing and 27,178 single nucleotide polymorphisms (SNPs) were generated. The association between SNPs and the best linear unbiased predictors of traits was performed with TASSEL v5 using a mixed linear model accounting for population structure and kinship. Using Bonferroni correction, false discovery rate, and long-range linkage disequilibrium (LD), 25 genomic loci were identified with significant SNPs and most were localized on chromosome 3. Most SNPs were located in genes encoding uncharacterized and hypothetical proteins, but some mapped to transcription factors and genes involved in cell cycle regulation. Inter-chromosomal LD of SNPs was present in the population, but none of the SNPs were significantly associated with the traits. The clustering of significant SNPs on chromosome 3 supported our hypothesis that fruit filling in this population was under control of a few quantitative trait loci with major effects.

• MeSH
• Musa genetics   MeSH
• Phenotype MeSH
• Genetic Association Studies MeSH
• Genetic Markers MeSH
• Genotype MeSH
• Polymorphism, Single Nucleotide MeSH
• Linear Models MeSH
• Quantitative Trait Loci * MeSH
• Fruit growth & development   MeSH
• Plant Breeding * MeSH
• Linkage Disequilibrium MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Africa, Eastern MeSH

AIMS: In left-sided infective endocarditis (IE), a large vegetation >10 mm is associated with higher mortality, yet it is unknown whether surgery during the acute phase opposed to medical therapy is associated with improved survival. We assessed the association between surgery and 6-month mortality as related to vegetation size. METHODS AND RESULTS: Patients with definite, left-sided IE (2008-2012) from The International Collaboration on Endocarditis prospective, multinational registry were included. We compared clinical characteristics and 6-month mortality (by Cox regression with inverse propensity of treatment weighting) between patients with vegetation size ≤10 mm vs. >10 mm in maximum length by surgical treatment strategy. A total of 1006 patients with left sided IE were included; 422 with a vegetation size ≤10 mm (median age 66.0 years, 33% women) and 584 (median age 58.4 years, 34% women) patients with a large vegetation >10 mm. Operative risk by STS-IE score was similar between groups. Embolic events occurred in 28.4% vs. 44.3% (P < 0.001), respectively. Patients with a vegetation >10 mm was associated with higher 6-month mortality (25.1% vs. 19.4% for small vegetation, P = 0.035). However, after propensity adjustment, the association with higher mortality persisted only in patients with a large vegetation >10 mm vs. ≤10 mm: hazard ratio (HR) 1.55 (1.27-1.90); but only in patients with large vegetation managed medically [HR 1.86 (1.48-2.34)] rather than surgically [HR 1.01 (0.69-1.49)]. CONCLUSION: Left-sided IE with vegetation size >10 mm was associated with an increased mortality at 6 months in this observational study but was dependent on treatment strategy. For patients with large vegetation undergoing surgical treatment, survival was similar to patients with smaller vegetation size.

• MeSH
• Survival Analysis MeSH
• Endocarditis, Bacterial microbiology   mortality   surgery   MeSH
• Time Factors MeSH
• Middle Aged MeSH
• Humans MeSH
• Prospective Studies MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH