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- Sandvik, R. M., et al.
(author)
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Nationwide lung function monitoring from infancy in newborn-screened children with cystic fibrosis
- 2023
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In: European Respiratory Journal Open Research (ERJ Open Research). - 2312-0541. ; 9:5
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Journal article (peer-reviewed)abstract
- Background Cystic fibrosis (CF) lung disease starts in infancy and can be assessed for structural lung abnormalities using computed tomography or magnetic resonance scans, or for lung function impairment using multiple breath washout (MBW). However, in infancy these two methods are not well correlated. Trajectories of CF lung disease assessed by MBW in infants and toddlers remain poorly described, which is why we aimed to 1) describe the trajectory of lung function, 2) explore risk factors for progression and 3) explore the real-life effect of lumacaftor/ivacaftor. Methods This was a nationwide observational cohort study (2018-2021) using data collected as part of the routine clinical surveillance programme (including MBW and monthly endo-laryngeal suction sampling for bacterial pathogens) in children born after implementation of newborn screening for CF (May 2016). Lumacaftor/ivacaftor commenced from age 2 years in children homozygous for F508del. Ventilation distribution efficiency (VDE), recently described to have advantages over lung clearance index (LCI), was reported as the primary MBW outcome after z-score calculations based on published reference data. Mixed effect linear regression models were the main statistical analyses performed in this study. Results 59 children, aged 2-45 months, contributed with 211 MBW occasions (median (interquartile range (IQR)) 3 (2-5) MBW occasions per child) with a median (IQR) follow-up time of 10.8 (5.222.3) months. An overall mean annual deterioration rate of -0.50 (95% CI -0.78-0.22) z-VDE was observed, starting from an estimated mean z-VDE of -1.68 (95% CI -2.15-1.22) at age 0.0 years (intercept). Pseudomonas aeruginosa "ever" (n=14, MBWs 50) had a significantly worse z-VDE trajectory versus P. aeruginosa "never" (mean difference 0.53 (95% CI 0.16-0.89) per year; p=0.0047) and lumacaftor/ivacaftor treatment (n=22, MBWs 46) significantly improved the trajectory of z-VDE (mean difference 1.72 (95% CI 0.79-2.66) per year; p=0.0004), leading to a stable mean z-VDE trajectory after start of treatment. Conclusions Infants and toddlers with CF demonstrated progressive deterioration in z-VDE over the first years of life. P. aeruginosa isolation "ever" was associated with an accelerated deterioration in lung function, while lumacaftor/ivacaftor therapy significantly improved and stabilised the trajectory.
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- Cornelissen, Johannes H C, et al.
(author)
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Global negative vegetation feedback to climate warming responses of leaf litter decomposition rates in cold biomes
- 2007
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In: Ecology Letters. - : Wiley. - 1461-023X .- 1461-0248. ; 10:7, s. 619-627
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Journal article (peer-reviewed)abstract
- Whether climate change will turn cold biomes from large long-term carbon sinks into sources is hotly debated because of the great potential for ecosystem-mediated feedbacks to global climate. Critical are the direction, magnitude and generality of climate responses of plant litter decomposition. Here, we present the first quantitative analysis of the major climate-change-related drivers of litter decomposition rates in cold northern biomes worldwide.Leaf litters collected from the predominant species in 33 global change manipulation experiments in circum-arctic-alpine ecosystems were incubated simultaneously in two contrasting arctic life zones. We demonstrate that longer-term, large-scale changes to leaf litter decomposition will be driven primarily by both direct warming effects and concomitant shifts in plant growth form composition, with a much smaller role for changes in litter quality within species. Specifically, the ongoing warming-induced expansion of shrubs with recalcitrant leaf litter across cold biomes would constitute a negative feedback to global warming. Depending on the strength of other (previously reported) positive feedbacks of shrub expansion on soil carbon turnover, this may partly counteract direct warming enhancement of litter decomposition.
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- Sandvik, R. M., et al.
(author)
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Contemporary N-2 and SF6 multiple breath washout in infants and toddlers with cystic fibrosis
- 2022
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In: Pediatric Pulmonology. - : Wiley. - 8755-6863 .- 1099-0496.
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Journal article (peer-reviewed)abstract
- Introduction Multiple breath washout (MBW) is used for early detection of cystic fibrosis (CF) lung disease, with SF6MBW commonly viewed as the reference method. The use of N2MBW in infants and toddlers has been questioned for technical and physiological reasons, but a new correction of the N(2 )signal has minimized the technical part. The present study aimed to assess the remaining differences and the contributing mechanisms for the differences between SF6 and N2MBW,corrected-such as tidal volume reduction during N-2 washout with pure O-2. Method This was a longitudinal multicenter cohort study. SF6MBW and N2MBW were performed prospectively at three CF centers in the same visits on 154 test occasions across 62 children with CF (mean age: 22.7 months). Offline analysis using identical algorithms to the commercially available program provided outcomes of N-2,N-original and N-2,N-corrected for comparison with SF6MBW. Results Mean functional residual capacity, FRCN2,corrected was 14.3% lower than FRCN2, original, and 1.0% different from FRCSF6. Lung clearance index, LCIN2,corrected was 25.2% lower than LCIN2,original, and 7.3% higher than LCISF6. Mean (SD) tidal volume decreased significantly during N2MBWcorrected, compared to SF6MBW (-13.1 ml [-30.7; 4.6], p < 0.0001, equal to -12.0% [-25.7; 1.73]), but this tidal volume reduction did not correlate to the differences between LCIN2,corrected and LCISF6. The absolute differences in LCI increased significantly with higher LCISF6 (0.63/LCISF6) and (0.23/LCISF6), respectively, for N-2,N-original and N-2,N-corrected, but the relative differences were stable across disease severity for N-2,N-corrected, but not for N-2,N-original. Conclusion Only minor residual differences between FRCN2,corrected and FRCSF6 remained to show that the two methods measure gas volumes very similar in this age range. Small differences in LCI were found. Tidal volume reduction during N2MBW did not affect differences. The corrected N2MBW can now be used with confidence in young children with CF, although not interchangeably with SF6.
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- Eijkholt, M, et al.
(author)
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Should neurosurgeons continue to work in the absence of personal protective equipment during the COVID-19 era?
- 2021
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In: Acta neurochirurgica. - : Springer Science and Business Media LLC. - 0942-0940 .- 0001-6268. ; 163:3, s. 593-598
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Journal article (peer-reviewed)abstract
- The COVID-19 pandemic has resulted in a widespread shortage of personal protective equipment (PPE). Many healthcare workers, including neurosurgeons, have expressed concern about how to safely and adequately perform their medical responsibilities in these challenging circumstances. One of these concerns revolves around the pressing question: should providers continue to work in the absence of adequate PPE? Although the first peak of the COVID-19 crisis seems to have subsided and supply of PPE has increased, concerns about insufficient PPE availability remain. Inconsistent supply, limited efficacy, and continued high demand for PPE, combined with the continued threat of a second COVID-19 wave, mean that the issues surrounding PPE availability remain unresolved, including a duty to work. This paper offers an ethical investigation of whether neurosurgeons should perform their professional responsibilities with limited availability of PPE. We evaluate ethical considerations and conflicting duties and thereby hope to facilitate providers in making a well-considered personal and moral decision about this challenging issue.
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- Laureati, M., et al.
(author)
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Individual differences in texture preferences among European children : Development and validation of the Child Food Texture Preference Questionnaire (CFTPQ)
- 2020
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In: Food Quality and Preference. - : Elsevier BV. - 0950-3293 .- 1873-6343. ; 80
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Journal article (peer-reviewed)abstract
- Texture has an important role in children’s acceptance and rejection of food. However, little is known about individual differences in texture preference. The aim of this study was to develop and validate a child-friendly tool to explore individual differences in texture preferences in school-aged children from six European countries (Austria, Finland, Italy, Spain, Sweden and United Kingdom). Six hundred and ten children aged 9–12 years and their parents participated in a cross-sectional study. Children completed the Child Food Texture Preference Questionnaire (CFTPQ) and a Food Neophobia Scale (FNS). The CFTPQ consisted in asking children to choose the preferred item within 17 pairs of pictures of food varying in texture (hard vs. soft or smooth vs. lumpy). Children also evaluated all food items for familiarity. Parents completed the CFTPQ regarding their preferred items, a food frequency questionnaire for their child, and provided background information. For a subset of children, a re-test was done for the CFTPQ and FNS to assess reliability. The results showed that the tool was child-friendly, had high test-retest reliability, and identified country-related differences as well as segments of children with different texture preferences (hard- vs. soft-likers). These segments differed in consumption frequency of healthy foods, and in food neophobia.
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- Proserpio, C., et al.
(author)
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Cross-national differences in child food neophobia : A comparison of five European countries
- 2020
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In: Food Quality and Preference. - : Elsevier BV. - 0950-3293 .- 1873-6343. ; 81
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Journal article (peer-reviewed)abstract
- Food neophobia (FN) has been extensively explored, especially in children. However, very few studies have compared this food behavior in children from different countries. Considering the clear diversity between European countries in feeding practices and food consumption, it is important to deepen the understanding of cross-national differences in child FN. The aim of this study was to explore and compare FN in five European countries (Finland, Italy, Spain, Sweden and UK) using a food neophobia scale specifically designed for children. Five hundred and twenty-nine children (54% girls) aged 9–12 years were recruited from schools in each country and were asked to complete the Italian Child Food Neophobia Scale (ICFNS, Laureati, Bergamaschi et al., 2015), which was translated into each respective language. Parents (n ≈ 300) completed a food consumption frequency questionnaire for their child, and provided background information. Reliability of the tool was assessed through internal consistency and temporal stability. Total internal consistency was 0.76. When calculated by country, internal consistency was satisfactory (Cronbach’s alpha >0.70) for all countries. FN was negatively associated to fruit and vegetable consumption, liking of wholegrain biscuits, and timing of introduction of semi-solid food. There were small but significant cross-national differences in FN with British and Swedish children being the most neophobic and significantly higher in FN than Finnish children, who were the most neophilic. Results indicate that the tool can be successfully used in all the tested countries with children in the age range of 9–12 years. The tool can be useful to measure the effects of interventions aiming at changing food behaviors, such as reducing FN, among children.
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- De Bourdeaudhuij, I, et al.
(author)
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Personal, social and environmental predictors of daily fruit and vegetable intake in 11-year-old children in nine European countries
- 2008
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In: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 62:7, s. 834-841
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate potential personal, social and physical environmental predictors of daily fruit intake and daily vegetable intake in 11-year-old boys and girls in nine European countries.SUBJECTS: The total sample size was 13 305 (90.4% participation rate).RESULTS: Overall, 43.2% of the children reported to eat fruit every day, 46.1% reported to eat vegetables every day. Daily fruit intake and daily vegetable intake was mainly associated with knowledge of the national recommendations, positive self-efficacy, positive liking and preference, parental modeling and demand and bringing fruit to school (odds ratio between 1.40 and 2.42, P<0.02). These factors were associated fairly consistently with daily fruit intake across all nine European countries, implying that a rather uniform intervention strategy to promote fruit can be used across Europe. For vegetables, the pattern was, however, less consistent. Differences between countries in cooking and preparing vegetables might be responsible for this larger diversity.CONCLUSIONS: This study showed that especially a combination of personal and social factors is related to daily fruit and vegetable intake in schoolchildren. This shows that a comprehensive multilevel intervention strategy based upon a series of individual and social correlates will be most promising in the promotion of daily fruit and vegetable intake in children.
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