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Tick-borne severe fever with thrombocytopenia syndrome (SFTS) is an emerging zoonotic disease caused by the SFTS virus (SFTSV). Serological assays based on the nucleocapsid protein and partial glycoprotein of this virus have been used for detecting SFTSV infections in humans and animals. However, whether the complete SFTSV glycoprotein (Gn/Gc) can induce the assembly of virus-like particles (VLPs) which can be used for serological surveillance and vaccine production remains unclear. In this study, we successfully expressed and secreted SFTSV Gn/Gc antigens by using a single plasmid encoding the complete glycoprotein sequence of the dominant genotype B virus. HEK293T and COS-1 cells were transfected with the aforementioned plasmid; cultivating these cells at 32 °C, instead of 37 °C, led to 4.0- and 3.3-fold higher antigen recovery, respectively. The secreted Gn/Gc antigens at 32 °C retained epitopes resembling those of the virion; these epitopes were recognized by a SFTS human–derived monoclonal antibody. Sucrose density gradient centrifugation, followed by transmission electron microscopy, confirmed the formation of VLPs with a diameter of approximately 100 nm. Overall, our findings highlight the potential of SFTSV VLPs for serological surveillance and vaccine development. Key points •  Cultivating transfected cells at 32 °C boosts SFTSV glycoprotein production. •  Complete SFTSV glycoprotein expression facilitates virus-like particle assembly. •  The assembly does not require any other viral proteins or RNA.

IntroductionBoth thoracic epidural analgesia and thoracic paravertebral analgesia are effective techniques to control pain and minimize the stress response following thoracic surgery. We hypothesized that continuous neuraxial techniques may be associated with a decrease in the incidence of postoperative mortality after thoracotomy. Additionally, we aimed to identify subgroup populations that may benefit more from neuraxial anesthesia.Method1620 patients who underwent open thoracotomy were included in this retrospective study from the German Thoracic Registry database at four university hospitals. All-cause inpatient mortality was determined for patients who had and did not have neuraxial anesthesia. Logistic regression was used to adjust for and explore various covariates.ResultsContinuous neuraxial analgesia was associated with a lower overall mortality in the postoperative period (2.9%, 23/796 vs 5.3%, 44/824, p=0.02) only after the univariate analysis but not the multivariable analysis (OR 0.49, 95 % CI 0.237 to 1.12, p=0.15). In patients with epidural or paravertebral catheters, mortality was significantly lower in the following subgroups: age >75 (5/113 vs 18/77, OR 0.1, 95% CI 0.02 to 0.67, p=0.02), American Society of Anesthesiologists Performance Score >III (11//97 vs 33/155, OR 0.32, 95% CI 0.11 to 0.89, p=0.03), chronic kidney disease (5/83 vs 16/77, OR 0.16, 95% CI 0.03 to 0.82, p=0.03), and postoperative sepsis (9/21 vs 17/25, OR 0.13, 95% CI 0.07 to 0.44, p<0.01).ConclusionsNeuraxial analgesic techniques are associated with reductions in postoperative mortality after open thoracic surgery in selected patients.

This study presents the effects on children’s behavior of Confident Parents, a focused parenting program targeting parental self-efficacy. This parenting program aims to improve child behavior through the enhancement of parental self-efficacy. Confident Parents was experimentally tested on a total sample of 80 parents of three-to-six-year-old preschool aged children with moderate to clinical levels of externalizing behavior. Thirty-seven parents participated in the program, and were compared with a waitlist control group (n = 43). The intervention consisted of eight weekly group sessions. Effect sizes were evaluated through both observational and parent-report measures on the child’s behavior, as well as self-reported parental self-efficacy at pretest, post-test, and a four-month follow-up. Through a multi-level analysis, predictors of the change in the child’s behavior were identified. The moderating effect of socio-economic risk and externalizing behavior at baseline were also included in the analysis. Results show that Confident Parents improved the child’s behavior, both reported by parents and, to a lesser extent, when observed in interaction with the parent. Children with higher levels of behavior difficulty benefited more while those with socio-economic risk benefited less from this program. These results illustrate that focusing a parenting program on improving self-efficacy is effective to reduce externalizing behavior in children. This underdeveloped treatment target is worthy of investigation in parenting intervention research.

Postoperative pulmonary complications have a deleterious impact in regards to thoracic surgery. Pneumonectomy is associated with the highest perioperative risk in elective thoracic surgery. The data from 152 patients undergoing pneumonectomy in this multicenter retrospective study were extracted from the German Thorax Registry database and presented after univariate and multivariate statistical processing. This retrospective study investigated the incidence of postoperative pulmonary complications (PPCs) and their impact on perioperative morbidity and mortality. Patient-specific, preoperative, procedural, and postoperative risk factors for PPCs and in-hospital mortality were analyzed. A total of 32 (21%) patients exhibited one or more PPCs, and 11 (7%) died during the hospital stay. Multivariate stepwise logistic regression identified a preoperative FEV1 < 50% (OR 9.1, 95% CI 1.9–67), the presence of medical complications (OR 7.4, 95% CI 2.7–16.2), and an ICU stay of more than 2 days (OR 14, 95% CI 3.9–59) as independent factors associated with PPCs. PPCs (OR 13, 95% CI 3.2–52), a preoperative FEV1 < 60% in patients with previous pulmonary infection (OR 21, 95% CI 3.2–52), and continued postoperative mechanical ventilation (OR 8.4, 95% CI 2–34) were independent factors for in-hospital mortality. Our data emphasizes that PPCs are a significant risk factor for morbidity and mortality after pneumonectomy. Intensified perioperative care targeting the underlying risk factors and effects of PPCs, postoperative ventilation, and preoperative respiratory infections, especially in patients with reduced pulmonary reserve, could improve patient outcomes.

Introduction: Lung transplantation (LTx) remains the only therapeutic option for selected patients with end-stage lung disease. In comparison to surgical lung volume reduction, few data exist on the risks and benefits of pretransplant endoscopic lung volume reduction (eLVR). Here, we investigate the risk of postoperative pulmonary complications (PPCs) after LTx in patients with emphysematous lung disease bridged with eLVR until transplantation. Methods: Eighty-two patients with emphysematous lung disease who underwent double-LTx (DLTx) were included and retrospectively evaluated. Statistical analysis was performed using SPSS and GraphPad Prism software. Results: 28/82 patients underwent eLVR prior to DLTx. eLVR patients spent comparable time on the waitlist; however, they were older at the time of DLTx (median 60 vs. 58 years, p = 0.02). Both groups showed comparable 90-day (92%) and long-term survival (eLVR 1-/5-/10-year survival: 92/88/77%, vs. control: 89/77/67%, p = 0.5). The odds for PPCs were similar in patients with and without eLVR (OR 0.7; 95% CI: 0.3–1.7), as well as major perioperative surgical and cardiovascular complications. In the entire cohort, we found ≥1 PPC to be a risk factor for death within 90 days (OR 9.7, 95% CI: 1.3–110). Among the PPCs, pneumonia (HR 4.6 95% CI: 1.1–14.9, p = 0.02) and ARDS (HR 11.2 95% CI: 1.6–229.2, p = 0.04) were identified as independent risk factors for reduced long-term survival. Conclusions: eLVR does not increase the risk for PPCs, surgical complications, or reduced survival after LTx in patients with emphysematous lung disease and can serve as a bridge to LTx.

The links between parents’ emotion regulation practices and children’s behavioral outcomes are well established. The aim of the current study designed as a randomized micro-trial was to test experimentally if and to what extent stimulating parents’ emotion coaching practices improves preschoolers’ behavioral outcomes, i.e. positive affect, irritability, non-compliance, persistence and enthusiasm. In line with this objective, the emotion coaching practices of parents of 4-to-5-year-old children were stimulated in a brief 15-min lab session. Immediately afterwards, parents and children were observed during a free-play session and frustration laboratory tasks designed to elicit negative emotions in children. The results indicated that, compared to the control group, parents whose emotion coaching practices had been stimulated displayed higher positive affect and were more emotionally sensitive during free play. Positive behaviors persisted in frustration tasks; parents were more behaviorally and emotionally responsive towards their children. In turn, children of these parents displayed higher persistence and enthusiasm but only when they had to deal with negative emotional arousal during frustration tasks. Mediation analyses also confirmed that the influence of the stimulation of parents’ emotion coaching practices on children’s outcomes, i.e. persistence and enthusiasm, was mediated by the parents’ behavior.

The observation of child behavior has to be made in ecologically valid contexts. Parent-child interaction was thought to be the most suitable context, since empirical evidence displayed strong associations with children’s behavioral outcomes, psychopathology, social relationships and well-being. Using clinical data from 137 caregiver-child dyads, the main goal of the current study was to test the psychometric properties of an adapted version of the Crowell Procedure among preschoolers. Despite the interest that the Crowell Procedure has aroused, its psychometric properties remain relatively under-documented. This research aimed to study (1) the association between parental and child behavior, (2) the discriminant properties of the Crowell Procedure between preschoolers with a clinical level of externalizing behavior and non-clinical children and (3) the correlation between the Crowell Procedure and a behavioral checklist. The results support the consistency of both tasks and scales, the discriminant properties, external validity and fidelity of the coding system. The Crowell Procedure can therefore be used as an observational paradigm to assess both child and parent behavior in clinical and research contexts. The discriminant analyses revealed that the procedure was effective at differentiating children displaying a clinical level of externalizing behavior from normally developing ones.

Research has tried to identify risk factors that increase the likelihood of difficulties with externalizing behavior. The relations between individual or environmental factors and externalizing behavior have been especially documented. Child-oriented and parent-oriented interventions have been designed in order to decrease externalizing behavior in preschoolers. To date, however, research has largely been compartmentalized. It is therefore not known whether child-oriented or parent-oriented intervention is more effective in reducing externalizing behavior. The aim of the current study was to answer this question by comparing two 8-week child with two 8-week parent-oriented group programs sharing a common experimental design. This was done in a pseudo-randomized trial conducted with 73 3–6-year-old children displaying clinically relevant levels of externalizing behavior who were assigned to one of the four interventions and 20 control participants who were allocated to a waiting list. The results indicate that the four programs focusing on a specific target variable, i.e., social cognition, inhibition, parental self-efficacy beliefs, or parental verbal responsiveness, are all effective in reducing externalizing behavior among preschoolers. Their effectiveness was moderated neither by their orientation toward the child or the parent nor by their content, suggesting that several effective solutions exist to improve behavioral adaptation in preschoolers. A second important highlight of this study is that, thanks to comparable effect sizes, brief focused programs appear to be a reasonable alternative to long multimodal programs, and may be more cost-effective for children and their families.

SPIRou is a near-IR échelle spectropolarimeter and high-precision velocimeter under construction as a next-generation instrument for the Canada-France-Hawaii-Telescope. It is designed to cover a very wide simultaneous near-IR spectral range (0.98-2.35 {\\mu}m) at a resolving power of 73.5K, providing unpolarized and polarized spectra of low-mass stars at a radial velocity (RV) precision of 1m/s. The main science goals of SPIRou are the detection of habitable super-Earths around low-mass stars and the study of how critically magnetic fields impact star / planet formation. Following a successful final design review in Spring 2014, SPIRou is now under construction and is scheduled to see first light in late 2017. We present an overview of key aspects of SPIRou's optical and mechanical design.