Mangumvind7192

Twitching motility-mediated biofilm expansion occurs via coordinated, multi-cellular collective behaviour to allow bacteria to actively expand across surfaces. Type-IV pili (T4P) are cell-associated virulence factors which mediate twitching motility via rounds of extension, surface attachment and retraction. The Chp chemosensory system is thought to respond to environmental signals to regulate the biogenesis, assembly and twitching motility function of T4P. In other well characterised chemosensory systems, methyl-accepting chemotaxis proteins (MCPs) feed environmental signals through a CheW adapter protein to the histidine kinase CheA to modulate motility. The Pseudomonas aeruginosa Chp system has an MCP PilJ and two CheW adapter proteins, PilI and ChpC, that likely interact with the histidine kinase ChpA to feed environmental signals into the system. In the current study we show that ChpC is involved in the response to host-derived signals serum albumin, mucin and oligopeptides. We demonstrate that these signals stimulate an increase in twitching motility, as well as in levels of 3'-5'-cyclic adenosine monophosphate (cAMP) and surface-assembled T4P. Interestingly, our data shows that changes in cAMP and surface piliation levels are independent of ChpC but that the twitching motility response to these environmental signals requires ChpC. Furthermore, we show that protease activity is required for the twitching motility response of P. aeruginosa to environmental signals. Based upon our data we propose a model whereby ChpC feeds these environmental signals into the Chp system, potentially via PilJ or another MCP, to control twitching motility. PilJ and PilI then modulate T4P surface levels to allow the cell to continue to undergo twitching motility. Our study is the first to link environmental signals to the Chp chemosensory system and refines our understanding of how this system controls twitching motility-mediated biofilm expansion in P. aeruginosa.Accurate identification of Nocardia species remains a challenge due to the complexities of taxonomy and insufficient discriminatory power of traditional techniques. We report the development of a molecular technique that utilizes real-time PCR-based high-resolution melting (HRM) analysis for differentiation of the most common Nocardia species. Based on a novel fusA-tuf intergenic region sequence, Nocardia farcinica, Nocardia cyriacigeorgica and Nocardia beijingensis were clearly distinguished from one another by HRM analysis. The limit of detection of the HRM assay for purified Nocardia spp. DNA was at least 10 fg. No false positives were observed for specificity testing of 20 non-target clinical samples. In comparison to established matrix-assisted laser desorption/ionization-time of flight MS, the HRM assay improved the identification of N. beijingensis. Additionally, all the products of PCR were verified by direct sequencing. In conclusion, the developed molecular assay allows simultaneous detection and differentiation of N. farcinica, N. cyriacigeorgica and N. beijingensis with high sensitivity and specificity.The aim of this study is to examine the association between maternal adverse childhood experiences (ACEs) and mental health problems in adolescent offspring. Data were obtained from the population-based Kochi Child Health Impact of Living Difficulty (K-CHILD) study in 2016, and participants were 10,810 children in the fifth grade (3,144 pairs), eighth grade (3,497 pairs), and eleventh grade (4,169 pairs) living in Kochi Prefecture, Japan. Mothers of participating children were asked about their ACEs, childhood social economic status, current mental and physical health, current social economic status, positive parenting behaviors, child maltreatment, marital status, and child behavior problems using the Strength and Difficulty Questionnaire. Children reported their depressive symptoms using the Depression Self-Rating Scale. Children of mothers with a larger number of ACEs showed higher levels of behavior problems (p for trend less then .001) and depressive symptoms (p for trend less then .001), adjusting for potential confounders. In particular, maternal psychological distress mediated the association between maternal ACEs and child mental health. The adverse effects of maternal ACEs may have a direct intergenerational impact on behavior problems and depressive symptoms in adolescent offspring. Further studies to elucidate possible mediators are needed.The current study examines the immediate and short-term impact of daily exposure to community violence on same-day and next-day levels of posttraumatic stress symptomatology and various affective states (i.e., dysphoria, hostility, and anxiety), in a sample of 268 African American adolescents living in urban, low-income, high-violence neighborhoods (Mage = 11.65; 59% female). In addition, the moderating role of affective state variability on this relationship was examined. This study utilized experience sampling method and a daily sampling approach, which contributes a more robust investigation of the short-term effects of violence exposure in youth. Hierarchical linear modeling revealed that community violence exposure was positively associated with same-day and next-day symptoms of posttraumatic stress. Violence exposure also exhibited an immediate effect on dysphoria, anxiety, and hostility levels. Youth variability in dysphoria exacerbated the effect of violence exposure on concurrent or next-day posttraumatic stress, dysphoria, and hostility. Moreover, variability in anxiety and hostility exacerbated the experience of next-day hostility. The clinical implications relating to these findings, such as the importance of implementing screening for posttraumatic stress following exposure, the incorporation of preventative treatments among those at risk of exposure, and the targeting of emotion regulation in treatments with adolescents, are discussed.The aim of this study was to evaluate the combined use of different chemical (albendazole, ivermectin, glycerine and Vaseline) and biological (Monacrosporium thaumasium) compounds in the control of Ancylostoma caninum. Infective larvae of A. caninum were obtained from coprocultures of positive faeces from naturally infected dogs. We used 1% ivermectin, 1% albendazole, 100% glycerine, 100% Vaseline and an isolate of the nematophagous fungus M. thaumasium (NF34), alone or in combinations. Next, an experimental test was set up with 16 groups in microtubes, with a 24-h interaction. The groups (G1 to G15) that contained any chemical or biological compound (NF34) and/or their combined use (chemical + biological) showed a difference in relation to the control group, except G5 - Vaseline 100% without combinations. It was concluded that, even on an experimental basis, the combined use of anthelmintic drugs with biological control was efficient; however, more studies must be carried out in order to elucidate the synergistic action between chemical and biological compounds to be used in the effective control of hookworms in the future.Echinococcus granulosus is the causative agent of cystic echinococcosis, which has serious impacts on human and/or animal health, resulting in significant economic losses. Echinococcus granulosus comprises a number of intra-specific variants or strains at the genetic level. In Saudi Arabia, few studies were performed on genetic variations in Echinococcus species. Therefore, the present study aimed to investigate the phenotypic and genetic characterization of hydatid cysts harboured by sheep and camels in Al-Madinah Al-Munawarah. Samples of hydatid cysts were collected from local sheep (n = 25) and camels (n = 8). The morphological criteria of protoscoleces were investigated. To investigate the molecular characterization, random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR), single-stranded conformation polymorphism (SSCP) were carried out. DNA was extracted from individual fertile cysts and subjected to RAPD-PCR analysis (using five arbitrary primers) and PCR amplification of cytochrome c oxidase I (cox1) and 12S ribosomal ribonucleic acid (12S rRNA) genes. The PCR products were subjected to SSCP analysis for genetic discrimination in E. granulosus isolates. In addition, partially sequencing of the mitochondrial DNA cox1 genes was achieved for assessing the phylogenetic positions of collected isolates using some global published sequence data of cox1 genes. The rostellar hooks of camel and local sheep isolates show remarkable variability in their dimensions. Five distinct SSCP patterns were identified in the 12S rRNA gene, showing intraspecific variations in E. granulosus of camels and local sheep. Sequencing of (cox1) genes of both local sheep and camels exhibit high similarity with those of the same gene (E. granulosus sensu stricto) published in NCBI BLAST.Few digeneans of the family Fellodistomidae are known from the Russian Arctic seas. The taxonomic status of these species, their life cycles and host range raised recurrent questions, some of which remain unanswered. To revise the species composition and life cycles of fellodistomids in the White Sea, we searched for them in several known and suspected hosts wolffish, flatfishes (definitive), gastropods of the family Buccinidae (second intermediate) and protobranch bivalves (first intermediate). Species identification was based both on morphology and 28S ribosomal RNA gene sequences. We found Fellodistomum agnotum in the White Sea for the first time. Buccinum undatum was proved to be intermediate host of both F. agnotum and Fellodistomum fellis, and metacercariae of F. fellis were registered from two more buccinid species Buccinum scalariforme and Neptunea despecta. We also found metacercariae of F. agnotum and F. fellis producing eggs in the second intermediate host. Two fellodistomids were found in protobranch bivalves sporocysts and cercariae of Steringophorus furciger in Nuculana pernula, and sporocysts with large furcocercous cercariae in Ennucula tenuis. The latter were identified as F. agnotum by molecular analysis; thus, the entire life cycle of this species was reconstructed.Long-term stability is one of the main challenges for translation of therapeutic proteins into commercially viable biopharmaceutical products. During processing and storage, proteins are susceptible to denaturation. The aim of this work was to evaluate the stability of amphiphilic cyclodextrin-based nanoparticles (NPs) containing insulin glulisine. The stability of the NP dispersion was systematically evaluated following storage at three different temperatures (4 °C, room temperature (RT) and 40 °C). While the colloidal parameters of the NPs in terms of size and zeta potential were maintained (109 ± 9 nm, polydispersity index 0.272, negative zeta potential -25 ± 3 mV), insulin degraded over 60 days during storage. To enhance the shelf life of the product and to circumvent the need for cold-chain maintenance, a lyophilized formulation containing insulin glulisine NPs (1.75 mg/mL of NPs) and 25 mg/mL trehalose was produced. The freeze-dried powder extended the stability of the product for up to 30 days at ambient temperature and 90 days at 4 °C (with 95% and >80% insulin recovery, respectively). Following intra-intestinal administration of the freeze-dried formulation, while no lowering of blood glucose was seen, insulin glulisine was detected in both portal and systemic blood indicating that potential exists for further development of the formulation to simultaneously achieve prolonged stability and therapeutic efficacy.Compression ignition engines are one of the world's largest consumers of fossil oil but have energy extraction efficiency limited to 35%. Addition of hydrogen alongside diesel fuel has been found to improve engine performance and efficiency; however, after a certain limit, hydrogen begins to show adverse effects, mainly because the ratio of oxygen to fuel decreases. This can be overcome by using oxyhydrogen, which is a mixture of hydrogen and oxygen gas. In this study, effects of addition of oxyhydrogen generated by electrolysis, with varying flows at the intake manifold, on a 315 cc compression ignition engine alongside diesel were analyzed. The engine was mounted on a Thepra test bed and torque measurements were taken at predetermined test points for diesel and 6 and 10 standard cubic feet per hour flowrates of oxyhydrogen. H10 showed the maximum improvement in engine performance equating to a 22.4% increase in both torque and power at 3000 r/min, and a 19.4% increase in efficiency at 2600 r/min was recorded. The large increase in engine performance as compared to previous results is because of high oxyhydrogen flowrate to displacement volume ratio. The oxyhydrogen flowrate to displacement ratio is the most important factor as it is directly impacts engine performance. The difference in engine performance because of oxyhydrogen becomes prominent at higher engine speed due to high suction pressure. No experimental flowrates of oxyhydrogen showed any adverse effect on the engine performance.Background In low- and middle-income countries (LMICs), infection is the most frequent complication in surgical procedures, and surgical site infections (SSIs) globally are the most frequent health-care-associated infections (HAIs). Preventing SSI is an important target for overall quality improvement and patient safety as well as supporting the infection prevention and control (IPC) global agenda. Methods In 2018, the World Heath Organization (WHO) presented the first Global Guidelines for the Prevention of Surgical Site Infections. The WHO also simplified SSI surveillance materials and included process measures, critical to addressing the barriers existing in LMICs. Because surveillance activities alone will not lead to improvements and implementation is more challenging than guideline development, the WHO then outlined a novel, step by step approach for implementation based on its tried and tested improvement approach for IPC measures. These documents have been reviewed and summarized to achieve wider reach in the surgical community. Results The WHO implementation guidance notes examples of current practice against the WHO SSI prevention guideline recommendations and considers LMIC settings. It identifies the related problem that needs to be addressed if the recommendation is not being applied consistently and reliably. It breaks down the steps required to make an improvement applying key elements known as the multi-modal improvement strategy. Conclusions Implementation of IPC guidance documents and tools published by global organizations and national governments continues to be a challenge, especially for LMICs. Successful approaches need to include a science-based approach to implementation and improvement, as well as joined up working and learning across IPC and surgical communities. Real improvements can be only achieved, based on WHO workforce recommendations, with IPC programs including the staff to execute these programs and using a proven approach.Context Mitrephora sirikitiae Weeras., Chalermglin & R.M.K. Saunders (Annonaceae) is a plant endemic to Thailand. Its constituents and their biological activities are unknown.Objective Isolation and identification of the compounds in the leaves and stems of M. sirikitiae and determination of their cytotoxicity.Materials and methods Methanol extracts of the leaves and stems of M. sirikitiae were separated by chromatography, and spectroscopic methods were used to determine the structures of the components. The cytotoxicity of the extracts and pure compounds was evaluated using the sulforhodamine B assay with several cell lines. The cells were treated with the compounds at concentrations of 0.16-20 µg/mL for 48 or 72 h.Results The investigation of the extracts of M. sirikitiae leaves and stems resulted in the isolation of a new lignan, mitrephoran, and 15 known compounds. Among these compounds, 2-(3,4-dimethoxyphenyl)-6-(3,5-dimethoxyphenyl)-3,7-dioxabicyclo[3.3.0]octane, ciliaric acid, 6-methoxymarcanine A, and stepharanine were isolated from this genus for the first time. The alkaloids liriodenine and oxoputerine exhibited strong cytotoxicity against all tested cells (IC50 values of 6.59-11.02 µM). In contrast, magnone A, 3',4-O-dimethylcedrusin, and 6-methoxymarcanine A inhibited the growth of some of the tested cells (IC50 values of 2.03-19.73 µM). Magnone A and 6-methoxymarcanine A showed low toxicity for Hek 293 cells (IC50 >20 µM).Discussion and conclusions M. sirikitiae is a source of cytotoxic lignans and alkaloids. Among the cytotoxic compounds, magnone A and 6-methoxymarcanine A are potentially useful lead compounds for the further development of anticancer agents because of their selective inhibitory effects on cancer cell lines.Understanding the co-construction of the interview process between older adult research participants and relatively younger interviewers requires a nuanced analysis of positioning, reflexivity, and power within interviewing dynamics, accounting for differences in historical context and lived experience. Guided by a feminist life span approach, this study examined interviewing dynamics between a younger woman interviewer and older women research participants, ages 57-93 (mean = 65.3), in two qualitative studies completed five years apart. Four themes emerged 1) contrasting experiences drew explicit attention to discrepancies in historical context, age, and life experience between participants and the interviewer. Similarities often arose in the theme of 2) invoking expertise in which participants oriented to or invoked their own expertise in their life story and experiences and the interviewer's expertise in research, sexuality studies, and social services. Participants enacted 3) demonstrating care, by prioritizing the researcher's goals, offering advice, and expressing hopes for younger generations. Finally, 4) the participants and researcher used distinctive conversational strategies when addressing challenging or sensitive topics. This paper contributes a needed analysis of age-related dynamics in qualitative research as well as indicating potential strategies to inform reflexive cross-generational conversations in gerontological research and practice more broadly.Objectives The aim of this study was to assess the reliability of an EDTA-based method for measuring cat blood bioamines. Methods Test 1 involved collecting blood samples from seven university laboratory cats. The samples were transferred to EDTA, heparin and plain tubes to determine concentrations of four bioamines (serotonin, dopamine, epinephrine [adrenaline] and norepinephrine [noradrenaline]). Correlation of measurements performed on EDTA plasma, with those performed on heparinized plasma or serum were assessed by intraclass correlation coefficients (ICCs). In test 2, blood samples from five owned cats were collected and stored in EDTA tubes and divided between duplicate Eppendorf tubes labeled as different cats for blinding purposes and analyzed independently for the same four bioamines as in test 1. Reliability of concentration determination for these duplicates was assessed by ICCs and coefficients of variation (CVs). Results In test 1, there was no significant correlation between the EDTA plasma serotonin and serum serotonin concentrations. There was also no significant correlation between EDTA plasma and heparin plasma concentrations for either epinephrine or norepinephrine. There was a statistically significant but weak correlation between EDTA plasma and heparin plasma dopamine concentrations. In test 2, there was no correlation for repeat-analyzed serotonin and epinephrine concentrations. Although there were statistically significant correlations for dopamine and norepinephrine, CVs for each analyte were in excess of 30%. Conclusions and relevance Before any further attempt is made to measure and report on neurotransmitter concentrations in domestic cats, it is essential that the robustness of the methodology is carefully validated and the data presented.Objectives The aims of this study were to validate a commercially available chemiluminescent assay for measurement of feline plasma adrenocorticotropic hormone concentration (ACTH), to determine the normal reference interval (RI) of plasma ACTH in healthy cats, to assess plasma ACTH in cats with naturally occurring hypercortisolism (HC), primary hypoadrenocorticism (PH) and other diseases (OD), and to evaluate the effect of aprotinin on plasma ACTH degradation. Methods Forty healthy cats, 10 with HC, 11 with PH and 30 with OD, were included. The chemiluminescent enzyme immunometric assay was evaluated by measurement of intra-assay precision, interassay precision and linearity. The RI for plasma ACTH in healthy cats was established using robust methods. Plasma ACTH of samples collected with and without aprotinin, stored at 4°C and assayed over a 6-day period, was measured. Results The intra-assay coefficients of variance (CVs) ranged from 2.7% to 4.3% and interassay CVs from 3.3% to 10.7%. Dilution studies showed excellent accuracy (R2 >0.99). The RI for plasma ACTH in healthy cats was 32-370 pg/ml. Plasma ACTH was not significantly different between healthy cats and the OD group. Cats with pituitary-dependent hypercortisolism (PDH) and PH had significantly higher plasma ACTH than the other groups. Plasma ACTH did not show significant differences when samples collected with and without aprotinin were compared. Conclusions and relevance The Immulite chemiluminescent assay is a valid technique for measuring plasma ACTH in cats and the RI of plasma ACTH is quite wide. Owing to the low overlap between healthy or OD cats and cats with HC or PH, the measurement of plasma ACTH appears to be useful and should be included in the diagnostic work-up when HC or PH are suspected. Furthermore, the measurement of plasma ACTH may be an accurate test for differentiating PDH from adrenal-dependent hypercortisolism.Objectives Urinary tract infections (UTIs) are reported to be relatively common in hyperthyroid cats, with prevalence rates ranging from 12% to 22%. Factors that are associated with UTIs include age, decreasing body weight and active urine sediments. The purpose of this study was to investigate the prevalence of positive urine cultures (PUCs) in hyperthyroid cats and associated risk factors for PUC. Methods In total, 197 hyperthyroid cats presenting for radioiodine therapy had urine cultures prospectively performed on cystocentesis samples. Data pertaining to clinical signs, drug history, age, weight, blood urea nitrogen, creatinine, serum thyroxine and urinalysis were also evaluated. Results The prevalence of PUCs in this population of hyperthyroid cats was 5.1% and all cats were subclinical. Microscopic bacteriuria was significantly associated with a PUC (60%) compared with a negative urine culture (1.6%) status. Age, weight, urine specific gravity less then 1.020, urine pH, hematuria, pyuria, thyroxine concentration, breed and sex were not associated with PUC status. Conclusions and relevance The prevalence of PUCs in this population of cats was lower than previous reports of cats with hyperthyroidism. Cats with a PUC were subclinical at the time of culture, regardless of urine sediment abnormalities. Further studies are necessary to determine the clinical significance of subclinical bacteriuria in hyperthyroid cats.Objectives This study was performed to evaluate retrospectively the clinical signs, complications and postoperative outcomes of feline intracranial meningioma (IM) with concurrent cingulate, transtentorial and foramen magnum herniations. Methods The medical records and MRI scans of cats with IM and cerebral herniation were reviewed. Cases involving concurrent cingulate, transtentorial and foramen magnum herniations were included. Owners were contacted to obtain long-term follow-up information. Results Seven cats (four castrated males and three spayed females) met the inclusion criteria. Median age was 13.0 years (range 9.9-16.1 years) and median duration of clinical signs was 35 days (range 21-163 days). The clinical signs of cats with cerebral herniation included visual impairment (n = 5 [71.4%]), ataxia (n = 4 [57.1%]), impaired consciousness (n = 2 [28.6%]), head pressing (n = 2 [28.6%]), paresis (n = 1 [14.3%]), torticollis (n = 1 [14.3%]) and personality changes (n = 1 [14.3%]). Median tumour volume, cranial cavity volume and tumour volume intracranial volume ratio before surgery were 3.37 cm3 (range 3.23-11.5 cm3), 32.6 cm3 (range 29.8-78.3 cm3) and 10.4% (range 5.3-35.3%), respectively. Median overall tumour excision rate was 90.6%. Preoperative intracranial pressure (ICP) ranged from 15 to 32 mmHg (median 29 mmHg). In all cases, the ICP dropped to 0 mmHg immediately after tumour removal. No adjuvant therapy was required after surgery. The median survival period was 612 days (range 55-1453 days). Conclusions and relevance The results of this study indicate that surgical treatment of rostrotentorial IM is effective and allows prolonged survival, even in cats with concurrent cingulate, transtentorial and foramen magnum herniations.Objectives It can be challenging to collect sufficient blood from feline patients for both a biochemical profile and a complete blood count (CBC). The ability to generate accurate hematologic and biochemical data from a single, small ( less then 2 ml) sample could reduce patient stress and improve clinical efficiency. The objective of this study was to determine the impact of preheparinization and/or sample size on routine hematology findings in cats. Methods Blood was collected from 20 healthy cats; measured aliquots were placed directly into tubes containing either EDTA or lithium-heparin (Hep). Within 2 mins, specific volumes were removed from the Hep tubes and placed in additional EDTA tubes. Four distinct sample sizes/types were created from each cat (1) 1.3 ml EDTA (criterion standard); (2) 0.5 ml EDTA; (3) 1.3 ml Hep + EDTA; and (4) 0.5 ml Hep + EDTA. Three CBCs were performed on each sample using an automated bench-top hematology analyzer. Drops of blood were contemporaneously used to create three airg other hematology machines and in diseased cats.Objectives The aim of our study was to compare the standard fabellotibial suture with Mini TightRope fixation for the treatment of a cranial cruciate ligament (CCL) rupture using a feline custom-made limb press. Methods Cadaveric hindlimbs of 10 cats were inserted in the limb press at predefined joint angles and loads of 10% and 30% body weight (BW) were applied. Mediolateral radiographs were taken and three-dimensional coordinates were recorded using a microscribe digitiser, with intact and transected CCLs and after either fabellotibial suture or Mini TightRope fixation were performed. Different distances and angles from radiographs or microscribe coordinates were analysed. Results Radiographic distances from the femoral condyle to the cranial edge of the tibia (X1-X2) were higher in CCL-deficient stifles than in intact stifles at 10% and 30% BW loads. All fabellotibial sutures and Mini TightRope fixations neutralised excessive cranial tibial thrust. A significant difference in the distance between the patelwell as Mini TightRope tightened with a 20 N load, produces good biomechanical stability, as detected via radiographic assessment.Introduction Irritable bowel syndrome with constipation is associated with higher rates of functional impairment, as compared to other subtypes of the syndrome. Conventional laxative-based pharmacologic therapy of IBS-C, which is mostly symptom-based, is often unsatisfactory. Tenapanor represents a first-in-class orally available inhibitor of NHE3, which is minimally absorbed in the GI tract, what constitutes a significant therapeutic benefit, as it may act on the drug target. Areas covered Aim of this article is to sum up the evidences about pharmacodynamics and pharmacokinetics of tenapanor, focusing on animal models and in vitro studies, but also discuss clinical trials on tenapanor's safety and efficacy in view of its important potential role in IBS-C treatment. Expert opinion In the challenging setting of irritable bowel syndrome with constipation, tenapanor represents a novel strategy in the pipeline of the therapies of IBS-C. Its pharmacokinetic and pharmacodynamic profile provides that it is minimally absorbed from the intestinal lumen and that its action is local, but not systemic action, therefore guaranteeing the reduction of drug-drug interactions, toxicity and severe adverse effects. Phase 2b and 3 trials showed an optimal satisfaction of primary and secondary endpoints.Introduction Combinations of psychotherapy with antidepressants are gold-standard psychiatric treatments. They operate through complex and interactional mechanisms, not unlike the reemergent paradigm of psychedelic-assisted psychotherapy, which promising research suggests may also be highly effective in even challenging populations. Areas covered We review the therapeutic mechanisms behind both conventional and psychedelic paradigms, including the evolution of this knowledge and the associated explanatory frameworks. We explore how psychedelics have provided insights about psychiatric illnesses and treatments over the past decades. We discuss limitations to early explanatory models while highlighting and comparing the psychological and biological mechanisms underlying many psychiatric treatments. Methods A narrative review was conducted based on a search in Medline/Pubmed up to January 1st, 2020, and iterative retrieval of references from recent reviews and clinical trials. Expert opinion The contextual model of the common factors of psychotherapy provides a powerful perspective on psychotherapy, antidepressants, and psychedelics, as well as 3,4-methylenedioxymethamphetamine (MDMA) and ketamine. It aligns well with key tenets of psychedelic-assisted psychotherapy. Conventional antidepressants and especially psychedelics may improve the efficacy of psychotherapy via neurochemical changes and increased environmental sensitivity. Combined treatments hold significant promise for advancing the knowledge and treatment of many forms of psychopathology.Being comfortable in disclosing one's sexual orientation to health and aged care providers is important for older lesbian and gay adults, given that nondisclosure is associated with poorer health and well-being outcomes. In a sample of 752 lesbian and gay adults aged 60 years and older living in Australia, we found only 51% of lesbian women and 64% of gay men felt fully comfortable to disclose their sexual orientation to health and aged care service providers. For both the women and the men, those who felt fully comfortable to disclose reported significantly less internalized homophobia; had fewer experiences of discrimination in the past year; and reported greater lesbian, gay, bisexual, transgender, and intersex (LGBTI) community connectedness. Feeling fully comfortable was also predicted by fewer experiences of lifetime discrimination among the men. These findings may help those seeking to assist older lesbian and gay people in feeling comfortable and being open with health and aged care service providers.Background We assessed survival of breast cancer in women with type 2 diabetes (T2D) treated with metformin, other types of antidiabetic medication (ADM) and statins.Materials and Methods The study cohort consisted of women with T2D and diagnosed with breast cancer in Finland in 1998─2011. Mortality rates from breast cancer and other causes were analysed by Cox models, and adjusted hazard ratios (HRs) with 95% confidence intervals (Cls) were estimated in relation to the use of different types of medication.Results The final cohort consisted of 3,533 women. No clear evidence was found for breast cancer mortality being different in metformin users (HR 0.86, 95% Cl 0.63-1.17), but their other-cause mortality appeared to be lower (HR 0.73, 95% Cl 0.55-0.97) in comparison with women using other types of oral ADM. Other-cause mortality was higher among insulin users (HR 1.45, 95% Cl 1.16-1.80) compared with users of other oral ADMs, other than metformin. Prediagnostic statin use was observed to be associated with decreased mortality from both breast cancer (HR 0.76, 95% Cl 0.63-0.92) and other causes (HR 0.75, 95% Cl 0.64-0.87).Conclusions We did not find any association between ADM use and disease-specific mortality among women with T2D diagnosed with breast cancer. However, interestingly, prediagnostic statin use was observed to predict reduced mortality from breast cancer and other causes. We hypothesise that treating treatment practices of T2D or hypercholesterolaemia of breast cancer patients might affect overall prognosis of women diagnosed with breast cancer and T2D.Numbers of older adults are rising globally. In the UK, rates of mental ill-health are thought to be higher in Black Asian and Minority Ethnic communities than in the white population. Older adults from BAME groups are an under researched group. It is important to understand the experiences and beliefs that underlie help-seeking behaviour among BAME older adults to deliver effective, culturally appropriate, and accessible services. This study aims to explore help-seeking views and strategies utilized in relation to depression among older Black Caribbean people in the UK. Semi-structured interviews were conducted with eight UK Black Caribbean participants, aged between 65 and 79 years. Transcripts were analysed using Interpretative Phenomenological Analysis. Three master themes emerged from the analysis (1) 'If you don't know, you don't seek help', (2) 'I was depressed…I knew I was depressed', 3) 'You have to decide' Attitudes to help-seeking and mental health service use. Participants' past personal experiences of coping with depression, including migratory histories, cultural and religious views, and personal relationships influenced their help-seeking views and preferred coping methods for depression.Introduction Systemic lupus erythematosus (SLE) is an autoimmune disorder that affects almost every organ system and it is treated with immunomodulation and immunosuppression. SLE patients have an intrinsically dysfunctional immune system which is exacerbated by disease activity and leaves them vulnerable to infection. Treatment with immunosuppression increases susceptibility to infection, while hydroxychloroquine use decreases this risk. Infectious diseases are a leading cause of hospitalization and death. Areas covered This narrative review provides an overview of recent epidemiology and predictors of infections in SLE, delineates the risk of infection by therapeutic agent, and provides suggestions for risk mitigation. Articles were selected from Pubmed searches conducted between September 2019 and January 2020. Expert opinion Despite the large burden of infection, effective and safe preventative care such as universal hydroxychloroquine use and vaccination are underutilized. Future efforts should be directed to quality improvement, glucocorticoid reduction, and validation of risk indices that identify patients at the highest risk of infection.De Quervain's tendinopathy (DQT) is a musculoskeletal disorder that limits hand function of affected individuals. Management of DQT can include splinting, activity modification, medications, corticosteroid injections, physical therapist management, and surgery. There is limited evidence to support the combination of manual therapy and exercise interventions within an Orthopedic Manual Physical Therapy (OMPT) approach when managing patients with DQT. Three patients identified with DQT underwent a multi-modal treatment regimen including carpometacarpal (CMC) thrust and non-thrust manipulation, end range radiocarpal mobilization, mobilization with movement (MWM), strengthening exercises, and grip proprioception training. Outcomes were assessed using the numeric pain rating scale (NPRS), Jamar hand dynamometer grip strength, and the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire. These measures were administered at baseline and discharge. Each patient demonstrated improvements in all outcome measures and required ten visits or less to reach a satisfactory outcome. The NPRS improved by a mean of 7.1 points on a 0-10 scale, Quick DASH improved by an average of 37.1%, and grip strength improved by a mean of 27.6 pounds. Each patient was able to return to daily tasks without pain and all improvements were maintained at six month follow-up. An impairment based OMPT management approach was effective in managing three patients with DQT. The inclusion of first CMC manipulation within this multi-modal approach may enhance conservative management of patients with DQT. Because a cause and effect relationship cannot be inferred from a case series, further research is recommended to investigate the efficacy of this management approach.Introduction T cell lymphomas are a heterogeneous group, with varying incidences, geographic patterns, and risk factors. Although until recently approached in a manner similar to B cell lymphomas, the treatment outcomes are poor and this disease is characterized by high relapse rates. The treatment advances in PTCL have been slow compared to B cell lymphomas. The outcomes of patients who progress following stem cell transplantation are worse. Areas covered This review focuses on the novel targeted agents that are approved and/or are under investigation for patients with relapsed/refractory PTCL. We conducted an electronic literature search of the studies using PubMed, clincaltrials.gov, MEDLINE, using the key words 'PTCL,' 'second line therapy,' and 'targeted agents.' Studies published before January 2020 were included in the search criteria. Expert opinion Development of newer therapies such as HDAC inhibitors and kinases are promising new agents with activity in relapsed/refractory PTCL. Combination therapy using novel agents may be the future for treatment of PTCL. Therapies in the next few years may take a more personalized approach taking into consideration not just the histology, but also the epigenomic landscape.Purpose Our previous study discoveredreactive oxygen species (ROS) and apoptosis inducing factor (AIF) increased after retinal detachment. Parthanatos is a cell death form involving ROS and AIF, which is induced by poly (ADP-ribose) polymerase-1 (PARP-1). Therefore, we investigated whether PJ34 (a PARP-1 inhibitor) could inhibit parthanatos and protect the photoreceptors from cell death after retinal detachment (RD). Methods Experimental retinal detachment modelswere created in Sprague-Dawley rats by subretinal injection of sodium hyaluronate.PJ34 orDMSO were introduced into subretinal space at RD induction, respectively. The structure of retinas and the morphology of photoreceptors were observed by hematoxylin eosin (H&E) staining and transmission electron microscope (TEM). Parthanatos related proteins (PARP-1, PAR,AIF) were detected by Western blot. The vision-dependent behavior of rat was tested by Morris water maze. Results H&E staining and TEM results indicated that the structure and outer nuclear layer (ONL) thickness of retinas were preserved, and the photoreceptors death decreasedwith PJ34 treatment. Western blot showed that the expression of PARP-1, PAR and AIF were decreased withPJ34 treatment. In addition, administration of PJ34 also improved the vision-dependent behavior of rat. Conclusions These findings suggested that PJ34 is a potential therapeutic agent that attenuated photoreceptor parthanatos death in retinal detachment through inhibition of PARP-1/AIF pathway.In the context of point of care testing (PoCT) and ISO 22870, internal quality control (IQC) is a crucial part of PoCT accreditation processes. Quality Control materials shall be periodically examined with a frequency that is based on the robustness of the analytical procedure and the risk of harm to the patient from an erroneous result. We propose to apply the statistical quality control (SQC) procedure to develop an individualized QC plan for AQT90 flex instrument used in PoCT. The robustness is determined by the sigma-metric and analytical goal represented by an allowable total error (TEa) is evaluated using a Varela graphic tool. A Sigma-metric SQC run size nomogram for estimating the number of patient samples between IQC events. According to the calculated robustness we can distinguish 3 groups of parameters HCG and CRP with large sample size per event, D-Dimer and Procalcitonin with an average sample size per event and Myoglobin. NT-proBNP. and Troponin T with a limited sample size per event. In PoCT, the SQC strategy can promote more effective, and not necessarily more frequent, IQC.Aim To investigate if the prior use of nontargeted antibiotics induces cross-tolerance in Stenotrophomonas maltophilia. Methods Antibiotic induction was performed to evaluate daptomycin and vancomycin as possible tolerance-inducing drugs measured by minimum bactericidal concentration/minimum inhibitory concentration (MIC) ratio, adapted disk-diffusion tests and time-kill curves. Results After antibiotic exposure, three potentially tolerant strains were isolated, maintaining the same MIC value of levofloxacin, with minimum bactericidal concentration/MIC ratio slightly higher than the parental. In the adapted disk-diffusion test, one strain (D25) showed high tolerance level for levofloxacin, ceftazidime and ticarcillin-clavulanate. In time-kill activity of levofloxacin, D25 presented a subpopulation of persisters with survival rate higher (1.6-fold) than the parental. Conclusion Previous exposure of S. maltophilia to daptomycin can induce cross-tolerance to ceftazidime and ticarcillin-clavulanate and cross-persistence to levofloxacin.Background Extant self-report measures of social anxiety primarily assess the breadth of social situations in which respondents feel anxious, rather than assessing severity in terms of the distress and impairment that individuals experience due to their social anxiety symptoms. This paper describes the development and validation of the Ryerson Social Anxiety Scales (RSAS; Rogojanski et al., 2019; see Appendix), a new measure for assessing both the breadth of situations that trigger social anxiety and the severity (i.e., distress and impairment) associated with social anxiety, across two studies.Method/Design Two samples of university students (N = 501 total) completed demographic and self-report symptom measures. In Study 1, participants completed the RSAS and several other measures of psychological symptoms. In Study 2, participants completed the same measures and were also assessed for the presence of Social Anxiety Disorder (SAD) using a semistructured clinical interview.Results Across both samples, the RSAS demonstrated excellent internal consistency and incremental validity. It consistently emerged as a unique predictor of psychosocial impairment. In Study 2, increases in RSAS scores were associated with increased odds of having SAD.Conclusions The RSAS has robust psychometric properties and fills an important gap among available measures for assessing SAD severity.Introduction Gait impairment is one of the most important post-stroke complications and is associated with reduced mobility, limitations in activities of daily living and decreased quality of life. Gait recovery is an important goal in post-stroke rehabilitation and shoe lifts have been used on the nonaffected lower limb (NLL) to reduce compensatory strategies such as vaulting, pelvic hiking and hip circumduction during the swing phase of the affected lower limb. Moreover, in clinical practice shoe lifts seem to reduce tripping and the risk of falls. Objective Evaluate walking speed and functional mobility with and without a 1.5 cm shoe lift under the non-affected lower limb in post-stroke gait. Methods Forty-two subjects with hemiparesis after stroke were evaluated on a single day, under two conditions with and without a 1.5 cm shoe lift. The assessment sequence was randomized and clinical tests (Ten-meter walk Test - 10MWT and Timed Up and Go - TUG) were performed one after the other. Results There was a significant increase in walking speed in the 10MWT and shorter TUG times, with mean differences of 0.78 (CI95% 0.15-1.41, P ≤ 0.001, EF = 0.55) and 0.57 seconds (-0.11-1.25, P = .022, EF = 0.35), respectively. Conclusion The results showed that the immediate use of 1.5 cm shoe lifts seems to improve gait speed and functional mobility in chronic stroke patients. Further studies should focus on understanding the kinematics strategies and gait pattern alterations caused by shoe lifts under the NLL of post-stroke individuals.Bovine tuberculosis is caused by Mycobacterium bovis (M. bovis), which infects both humans and cattle. In 2018, a dairy farm in Wisconsin was affected by M. bovis, including a farmworker with exposure to the affected herd. Largely eradicated by effective public health strategies in the United States, most cases are now associated with risk factors including occupational hazards, food consumption, and iatrogenic infections. M. bovis continues to cause disease worldwide affecting certain at-risk populations in the United States. Infections more often result in extrapulmonary sequelae and resistance to pyrazinamide is universal. Thus, successful treatment depends on early and correct identification of the mycobacterium species. A One Health approach to control this re-emerging disease is crucial.Purpose To describe a goats' eye training model for teaching of trabeculectomy and releasable suture techniques for Ophthalmology residents. Methods A descriptive report explaining the methodology for setting up a goats' eye wet-lab model for teaching trabeculectomy for Ophthalmology residents. It details the approaches to eyeball preparation, steps of surgery, application and release of two representative types of 'releasable sutures' in a step-by-step manner. Conclusion A systematic approach using goats' eye model to teach trabeculectomy and releasable suture techniques can enhance residents' understanding, confidence and expertise to operate upon human eyes.Irrespective of sex and age, cancer is the leading cause of mortality around the globe. Therapeutic incompliance, unwanted effects, and economic burdens imparted by cancer treatments, are primary health challenges. The heritable features in gene expression that are propagated through cell division and contribute to cellular identity without a change in DNA sequence are considered epigenetic characteristics and agents that could interfere with these features and are regarded as potential therapeutic targets. The genetic modification accounts for the recurrence and uncontrolled changes in the physiology of cancer cells. This review focuses on plant-derived flavonoids as a therapeutic tool for cancer, attributed to their ability for epigenetic regulation of cancer pathogenesis. The epigenetic mechanisms of various classes of flavonoids including flavonols, flavones, isoflavones, flavanones, flavan-3-ols, and anthocyanidins, such as cyanidin, delphinidin, and pelargonidin, are discussed. The outstanding results of preclinical studies encourage researchers to design several clinical trials on various flavonoids to ascertain their clinical strength in the treatment of different cancers. The results of such studies will define the clinical fate of these agents in future.Field studies by squeezing rock deformation have shown that large deformation slips can occurs in tunnels in squeezing rock, the tunnels may be partially or completely broken. This article proposed two schemes for controlling the deformation of squeezing rock, which are "resistance combine release" Scheme 1 and "strong support" Scheme 2, the deformation characteristics and deformation mechanism of squeezing rock is researched by Zhongyi Tunnel. The results show that Scheme 2 is superior to Scheme 1 in terms of deformation rate, cumulative deformation, and monthly construction footage. Research results can provide a reference for similar projects.Previous research has demonstrated that implicit evaluations can be reversed with exposure to a single impression-inconsistent behavior. But what exactly is changing when perceivers encounter diagnostic revelations about someone? One possibility is that rapid changes are occurring in the extent to which perceivers view the person positively or negatively. Another possibility is that they override the expression of initial evaluations through control-oriented processes. We conducted three studies (one preregistered) that used multinomial process trees to distinguish between these possibilities. We find consistent support across two different implicit measures that diagnostic behaviors result in rapid changes in evaluative processes. We obtained only inconsistent evidence for effects on more control-oriented processes. These findings thus help to reveal the cognitive processes underlying rapid implicit revision. Implications for theoretical perspectives on implicit attitudes are discussed.BACKGROUND In Italy, the majority of people treated in Addiction Treatment Service are heroin users. Nurses represent a strategic position in the multiprofessional and multidisciplinary Addiction Treatment Service team. AIMS To describe the addiction nurses' competency in the Italian context. METHOD This research uses the qualitative approach to describes the addiction nurses' competency. The research was divided into two steps ethnographic, to identify activities, habits, settings, critical issues and other distinctive features characterizing addiction nursing specific competencies, and a subsequent phenomenological semistructured interview to understand the lived and the meanings of the experience. RESULTS The meaning units identified could be organized as follows ability to manage unexpected events, work organization, and teamwork relationships, professional responsibility. CONCLUSIONS Many of these described competencies, if considered in general terms, relate to any area of the profession. It is possible to understand their specificity by investigating the meanings and the values attributed to the personal experience This study attempts to develop and define an Italian addiction nursing competency framework.Objective Evidence regarding comedication among individuals with ADHD is lacking, especially in adults. This study investigated comedication and polypharmacy with ADHD medications in adults. Method We identified adults dispensed with ADHD medications during 2013 in Sweden and matched them to controls. Logistic regression was used to calculate odds ratios (ORs) of receiving other medications. Results Individuals receiving ADHD medications had higher risk of receiving any major classes of somatic medications (ORs ranged from 4.1, 95% confidence interval [CI] = [4.0, 4.3], to 7.4, 95% CI = [6.5, 8.5] across age groups). They were more likely to receive respiratory system, alimentary tract and metabolic system, and cardiovascular system medications. In addition, they had higher risk of receiving any other psychotropic medications. The proportion of polypharmacy with five or more medication classes increased from 10.1% to 60.4% from 18 to 64 years. Conclusion Comedication was more common in adults receiving ADHD medications.