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with significant reductions in infusion prescribing errors. Technology-generated errors were common, highlighting the need for on-going research on HIT implementation in pediatric settings. Georg Thieme Verlag KG Stuttgart · New York.Mental practice (MP) using motor imagery is recognized as an effective clinical tool in rehabilitative medicine for improving motor performance. Preliminary data using MP in dysphagia rehabilitation are promising, though nothing is known about the current landscape among speech-language pathologists (SLPs) relating to MP implementation. This nationwide study surveys practicing SLPs about knowledge and practice patterns of using MP to gain a better understanding of the current knowledge, as well as perceived benefits and challenges in using MP. Descriptive data are reported and open-ended questions analyzed for emerging themes using inductive coding. Over half of the participants were familiar or somewhat familiar with motor imagery in the context of dysphagia rehabilitation, though only 16% of those SLPs reported using MP with a patient. Nearly 75% of respondents expressed interest in learning more about MP. Emerging themes include factors SLPs perceive to limit patient engagement, evidence-based practice concerns, and therapeutic environmental factors. More research on MP and access to training for clinicians is needed in the area of dysphagia rehabilitation to address acknowledged interest in MP. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.ESGE recommends the use of a graded pneumatic dilation protocol in achalasia, starting with a 30-mm dilation and followed by a 35-mm dilation at a planned interval of 2 - 4 weeks, with a subsequent 40-mm dilation when there is insufficient relief, over both a single balloon dilation procedure or the use of a larger balloon from the outset.Strong recommendation, high quality of evidence, level of agreement 100 %.ESGE recommends being cautious in treating spastic motility disorders other than achalasia with peroral endoscopic myotomy (POEM).Strong recommendation, very low quality of evidence, level of agreement 87.5 %.ESGE recommends against the routine use of botulinum toxin injections to treat patients with non-achalasia hypercontractile esophageal motility disorders (Jackhammer esophagus, distal esophageal spasm). However, if, in individual patients, endoscopic injection of botulinum toxin is chosen, ESGE recommends performing injections into four quadrants of the lower esophageal sphincter and in the lower g Thieme Verlag KG Stuttgart · New York.In the past decade, active video games (AVGs) have started to find their way into communities, schools, and homes as a possible solution to promote physical activity (PA) and prevent childhood obesity. However, the evidence regarding its effectiveness on body composition and objectively measured PA in youth remains inconclusive. Thus, a systematic review on this topic is needed. This review synthesizes effects of AVGs on body composition and PA in youth. The initial search yielded 260 articles from 10 databases and 18 randomized-controlled trials were included after evaluating against eligibility and removing duplicates. Overall, AVGs showed positive effects in improving body composition and PA in overweight/obese youth as compared to the control conditions with only 2 studies displaying neutral effects on these outcomes as compared to traditional PA or comparison programs. For healthy youth, more than half of the studies (n = 10) demonstrated neutral effects of AVGs on these outcomes whereas only 6 yielded positive effects compared to the control conditions. Further, one study indicated that the control condition observed greater improvement in body composition compared with an AVG intervention in healthy youth. In summary, AVGs are deemed a promising addition to promote PA and health among overweight/obese youth with the goal of fighting childhood obesity. © Georg Thieme Verlag KG Stuttgart · New York.OBJECTIVE  Verification of the accuracy of crown fit before final cementation is imperative. The aim of this in vitro study was to evaluate the film thickness of commonly used dental crown disclosing materials and their comparison with final cement thickness. MATERIALS AND METHODS One hundred fifty provisional crowns (Protemp) were fabricated on standardized resin dies and divided into five groups (N = 150; n = 30) based on five disclosing agents A = Fit-Checker auto-mix; B = Okklu-top; C = Express; D = Fit-Checker hand-mix; E = Coltene PSI, and Final cement = Relyx U200. Crowns were loaded with test materials, tried over dies under load (50N), and later cemented under same load. Film thickness (µm) was recorded between crown margin and the finish line of die after loading with test material and final cementation using a digital microscope. STATISTICAL ANALYSIS  Descriptive statistics, analysis of variance, Tukey's and paired t-test were used for statistical analysis (p less then 0.05). RESULTS  Significant variations were found between the film thicknesses of the five disclosing agents (p = 0.019). Group-A showed the lowest (131.67 ± 101.10 μm), while group-B (295.00 ± 263.88 μm) showed the highest film thickness (p = 0.011). Film thicknesses after cementation were similar for groups (p = 0.957). Significant difference was observed for group-B disclosing agent versus final cement (p = 0.010). The lowest mean difference between the film thicknesses of the disclosing agent and final cementation of 13.1 μm was revealed for group-A. CONCLUSIONS  Variations in the film thicknesses of the tested disclosing agents were found. Fit-Checker auto-mix was found with minimal film thickness and satisfied the requirements as the disclosing agent, while Okklu-top aerosol spray did not.Although glucagon-like peptide-1 (GLP-1) analogue has been reported to suppress oxidative stress in non-alcoholic fatty liver disease (NAFLD), an effective therapeutic agent for NAFLD is currently unavailable. Therefore, in this study, we aimed to investigate the protective effects of the GLP-1 analogue liraglutide against lipotoxicity-induced oxidative stress in HepG2 cells and to elucidate the underlying mechanisms. HepG2 cells were cultured for 48 hours and treated with a free fatty acid (FFA) mixture FFA mixture and liraglutide or FFA mixture, liraglutide, and exendin (9-39). Lipid accumulation was examined by oil red O staining. Oxidative stress was assessed by measuring the levels of intracellular reactive oxygen species using 2',7'-dichlorofluorescein diacetate and thiobarbituric acid-reactive substances, whereas antioxidant capacity was assessed by measuring the activity of superoxide dismutase and catalase. Expression of the nuclear factor erythroid-2-related factor 2 (NRF2) gene and the genes encoding antioxidant enzymes was analyzed using quantitative RT-PCR. Cellular and nuclear NRF2 expression levels were assessed using immunofluorescence cell staining and western blotting. Marizomib Liraglutide treatment reduced high fat-induced lipid formation and the levels of oxidative stress markers and increased antioxidant enzyme activity in HepG2 cells. Liraglutide treatment increased the mRNA expression of NRF2 target genes, induced NRF2 nuclear translocation, and increased nuclear NRF2 levels without altering NRF2 mRNA expression. Collectively, these results indicate that liraglutide exhibits a protective effect against lipotoxicity-induced oxidative stress, possibly via modulation of NRF2 and expression of antioxidant enzymes in liver cells. © Georg Thieme Verlag KG Stuttgart · New York.Although mitochondrial DNA (mtDNA) is prone to accumulate mutations and lacks conventional DNA repair mechanisms, deleterious mutations are exceedingly rare. How the transmission of detrimental mtDNA mutations is restricted through the maternal lineage is debated. Here, we demonstrate that mitochondrial fission, together with the lack of mtDNA replication, segregate mtDNA into individual organelles in the Drosophila early germarium. After mtDNA segregation, mtDNA transcription begins, which activates respiration. Mitochondria harboring wild-type genomes have functional electron transport chains and propagate more vigorously than mitochondria containing deleterious mutations in hetreoplasmic cells. Therefore, mtDNA expression acts as a stress test for the integrity of mitochondrial genomes and sets the stage for replication competition. Our observations support selective inheritance at the organelle level through a series of developmentally orchestrated mitochondrial processes. We also show that the Balbiani body has a minor role in mtDNA selective inheritance by supplying healthy mitochondria to the pole plasm. These two mechanisms may act synergistically to secure the transmission of functional mtDNA through Drosophila oogenesis. This is a work of the U.S. Government and is not subject to copyright protection in the United States. Foreign copyrights may apply.OBJECTIVE The mycobacterium tuberculosis (TB) IFN-γ release assay (TB-IGRA) assesses peripheral blood cell release of IFN-γ upon ex vivo exposure to mitogen (IGRA-MT), TB antigen or a negative/nil control (IGRA-NL); IGRA-NL is a measure of spontaneous IFN-γ release (SIR). Here, we investigate the diagnostic associations of elevated SIR and the potential use of IGRA-NL as a novel biomarker in SLE. METHODS We analysed diagnostic code frequencies among 11 823 individuals undergoing TB-IGRA testing between 2010 and 2015 in a large urban US health-care system. To study the relationship between IGRA-NL and SLE, we identified 99 individuals with SLE and TB-IGRA test results then assessed correlations between IGRA-NL, normalized IGRA-NL (the quotient of IGRA-NL/IGRA-MT), disease manifestations and disease activity. RESULTS We identified a discovery cohort of 108 individuals with elevated SIR (>5 s.d. above median) that was significantly enriched for a limited set of diagnoses, including SLE, TB infection, haemophagocytic lymphohistiocytosis and HIV infection. In SLE patients undergoing TB-IGRA testing, normalized IGRA-NL correlated better with disease activity than did anti-dsDNA or complement levels. This relationship appeared to reflect interactions between normalized IGRA-NL and the presence of acute skin disease, hypocomplementemia, fever and thrombocytopenia. CONCLUSION Elevated SIR appears to be associated with a limited number of disease processes, including SLE. The diagnostic utility of SIR remains to be determined. IFN-γ activation, as measured by the TB-IGRA test, may offer a readily available tool for assessing disease activity in patients with SLE. © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email journals.permissions@oup.com.OBJECTIVES To elucidate the molecular mechanisms underlying pathogenic Th17 cells, we investigated the modulation of epigenetic modifications and its association with SLE. METHODS Naive CD4+ T cells were cultured in Th17 polarizing conditions for 5 days and then treated with various cytokines, including IL-23. Expression of Th17 cell-related markers and phosphorylation of signal transducers and activators of transcription (pSTATs) were analysed using flow cytometry and quantitative PCR. Histone modifications were assessed using chromatin immunoprecipitation PCR. T cell phenotypes and pSTATs were analysed in blood samples of patients with SLE (n = 28). Finally, the effects of baricitinib on memory Th17 cells were investigated in SLE patients (n = 12). RESULTS Stimulation of resting Th17 cells with IL-23 promoted maturation of these cells (P  less then  0.0001). IL-23 induced pSTAT3, but not pSTAT4, during Th17 cell maturation (P  less then  0.05). IL-23-induced STAT3 directly bound the RORγT gene locus. This was accompanied by induction of the H3H4me3 permissive mark and reduction of the H3K27me3 repressive mark, leading to enhanced RORγT gene expression.