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Single-isocenter multitarget (SIMT) stereotactic-radiosurgery (SRS) has recently emerged as a powerful treatment regimen for intracranial tumors. With high specificity, SIMT SRS allows for rapid, high-dose delivery while maintaining integrity of adjacent healthy tissues and minimizing neurocognitive damage to patients. Highly robust and accurate quality assurance (QA) tests are critical to minimize off-targets and damage to surrounding healthy tissues. We have developed a novel QA phantom, named OneIso, to accurately and precisely measure off-axis accuracy, via off-axis Winston-Lutz (OAWL), to assist SIMT SRS programs. In this study, a comparison of three different quantitative numerical methods were performed for isolating and measuring the position of ball-bearings (BBs) used in the OAWL measurement. The three methods evaluated were: 1) feature extraction technique combined with manual intervention 2) a proprietary software utilizing optical image recognition (OIR) techniques, and 3) a machine learning (ML) model employing convolutional neural networks (CNNs). These methods were used to analyze OAWL datasets gathered from a OneIso phantom deployed on a Varian TrueBeam. The precision of localizing positional BBs within the OneIso QA phantom, analysis speed, and robustness were compared across the methods. Significantly, the trained ML model utilizing CNNs was found to exhibit superior precision, analysis speed, and efficiency compared to the other two methods. These results highlight the benefit in shifting from manual and OIR methods to that of ML techniques. The incorporation of CNNs in automated QA analysis can achieve improved precision, allowing for more rapid and wider adoption of SIMT SRS for treating intracranial metastases while preserving integrity of surrounding healthy tissues., (© 2024 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.)

Background: Females are at greater risk of developing patellofemoral pain (PFP) than males, and an excessive patellofemoral joint reaction force (PFJRF) may contribute to this discrepancy. It is unknown if the PFJRF differs between males and females during stair ascent. Additionally, body height may also influence the PFJRF. This study investigated PFJRF differences between males and females and explored relationships between body height and PFJRF during stair ascent., Methods: Thirty males (25.6 (2.7) yr) and thirty females (23.7 (2.2) yr) ascended stairs (96 steps/min). Three-dimensional kinematics (200 Hz) and kinetics (2000 Hz) were recorded and used to calculate biomechanical dependent variables., Results: Females experienced a greater PFJRF magnitude (mean difference (MD) = 3.2 N/kg; 95% CI = 0.5, 5.9; p = 0.022) and rate (MD = 23.8 N/kg/sec; 95% CI = 2.7, 45.1; p = 0.029), quadriceps muscle force (3.1 N/kg; 95% CI = 0.2, 6.0; p = 0.036), and knee flexion angle (MD = 2.3°; 95% CI = 0.3, 4.3; p = 0.026). Females exhibited shorter quadriceps lever arm length (MD = -0.1 cm; 95% CI = -0.2, 0.0; p = 0.024) and body height (MD = -16.9 cm; 95% CI = -20.5, -13.2, p < 0.001) compared to males. Body height was inversely correlated with PFJRF magnitude (r = -0.31; p = 0.017), rate (r = -0.28; p = 0.032), and knee flexion angle (r = -0.54; p < 0.001)., Conclusion: Females experienced a greater PFJRF than males. Additionally, the PFJRF and body height were inversely correlated. This observed difference may contribute to the PFP sex discrepancy and be due, at least in part, to body height differences., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Taxus is a genus of coniferous shrubs and trees, commonly known as the yews, in the family Taxaceae. All species of yew contain taxine alkaloids, which are ascribed as the toxic principles. Anecdotally, free ranging ruminants such as antelope, deer, elk, and moose have been regarded as tolerant to yew. Herein several cases of intoxication of deer, elk, and moose by yew from the state of Utah in the winter of 2022-2023 are documented. Ingestion of yew was documented by three means among the poisoned cervids; plant fragments consistent with yew were visually observed in the rumen contents, chemical analysis, and subsequent detection of the taxines from rumen and liver contents, and identification of exact sequence variants identified as Taxus species from DNA metabarcoding. Undoubtedly, the record snowfall in Utah during the winter of 2022-2023 contributed to these poisonings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Ltd.)

Peptide separations that combine high sensitivity, robustness, peak capacity, and throughput are essential for extending bottom-up proteomics to smaller samples including single cells. To this end, we have developed a multicolumn nanoLC system with offline gradient generation. One binary pump generates gradients in an accelerated fashion to support multiple analytical columns, and a single trap column interfaces with all analytical columns to reduce required maintenance and simplify troubleshooting. A high degree of parallelization is possible, as one sample undergoes separation while the next sample plus its corresponding mobile phase gradient are transferred into the storage loop and a third sample is loaded into a sample loop. Selective offline elution from the trap column into the sample loop prevents salts and hydrophobic species from entering the analytical column, thus greatly enhancing column lifetime and system robustness. With this design, samples can be analyzed as fast as every 20 min at a flow rate of just 40 nL/min with close to 100% MS utilization time and continuously for as long as several months without column replacement. We utilized the system to analyze the proteomes of single cells from a multiple myeloma cell line upon treatment with the immunomodulatory imide drug lenalidomide.

Plantar taping has been used in clinical settings as a short-term conservative treatment for plantar heel pain and related pathologies. The rise of at-home taping methods may offer patients more independence, but effectiveness has not been established. The purpose of this study was to evaluate the effects of plantar taping on foot mechanics during gait. We hypothesized that material compliance would drive mechanical effectiveness, with longitudinally inelastic tape reducing medial longitudinal arch (MLA) motion and anterior/posterior (A/P) plantar tissue spreading forces, and laterally inelastic tape reducing medial/lateral (M/L) tissue spreading. We also hypothesized that these effects would be influenced by foot structure. Fifteen healthy participants were tested in a randomized cross-over study design. Barefoot (BF) plus four taping methods were evaluated, including two inelastic tapes (Low-Dye, LD, and FasciaDerm, FD) along with longitudinally elastic kinesiology tape (KT) and a novel laterally elastic kinesiology tape (FAST, FS). Participants' arch height and flexibility were measured followed by instrumented gait analysis with a multi-segment foot model. Ankle eversion and MLA drop/rise were calculated from rearfoot and forefoot reference frames, while plantar tissue spreading was calculated from shear stresses. ANOVAs with Holm pairwise tests evaluated tape effects while correlations connected arch structure and taping effectiveness (α = 0.05). The three longitudinally inelastic tapes (LD, FD, FS) reduced MLA drop by 11-15% compared with KT and BF. In late stance, these tapes also inhibited MLA rise (LD by 29%, FD and FS by 10-15%). FS and FD reduced A/P spreading forces, while FD reduced M/L spreading forces compared with all other conditions. Arch height had a moderately strong correlation (r = -0.67) with the difference in MLA drop between BF and FS. At-home plantar taping can affect the mechanical function of the foot, but tape elasticity direction matters. Longitudinally elastic kinesiology tape has little effect on mechanics, while inelastic tapes control MLA drop but also restrict MLA rise in late stance. Lateral elasticity does not limit tissue spreading and may increase comfort without sacrificing MLA control. At-home taping has the potential to broaden conservative treatment of plantar heel pain, flat foot deformity, and related pathologies, but additional studies are needed to connect mechanics with symptom relief., (© 2023. The Author(s).)

Mink are susceptible to infection with influenza A virus (IAV) of swine and human origin. In 2019, a Utah mink farm had an outbreak of respiratory disease in kits caused by infection with the pandemic influenza A(H1N1)2009 virus [A(H1N1)pdm09]. In 3 wk, ~325, 1-2-wk-old kits died (10% mortality in kits). All deaths occurred in a single barn that housed 640 breeding females. No clinical signs or deaths occurred among adult mink. Five dead kits and 3 euthanized female mink were autopsied. All kits had moderate-to-severe neutrophilic and lymphohistiocytic interstitial pneumonia; adult mink had minimal-to-moderate lymphohistiocytic bronchointerstitial pneumonia. Immunohistochemistry and real-time PCR targeting the matrix gene detected IAV in lung of kits and adults. Virus isolation and genetic analysis identified the A(H1N1)pdm09 virus. The source of the virus was not determined but is thought to be the result of reverse zoonosis. Our case emphasizes the need for close monitoring on mink farms for interspecies transmission of IAV and for safe work practices on farms and in diagnostic laboratories. Additionally, a pandemic virus may continue to circulate at low levels long after the global event is declared over.

The most basic level of eukaryotic gene regulation is the presence or absence of nucleosomes on DNA regulatory elements. In an effort to elucidate in vivo nucleosome patterns, in vitro studies are frequently used. In vitro, short DNA fragments are more favorable for nucleosome formation, increasing the likelihood of nucleosome occupancy. This may in part result from the fact that nucleosomes prefer to form on the terminal ends of linear DNA. This phenomenon has the potential to bias in vitro reconstituted nucleosomes and skew results. If the ends of DNA fragments are known, the reads falling close to the ends are typically discarded. In this study we confirm the phenomenon of end bias of in vitro nucleosomes. We describe a method in which nearly identical libraries, with different known ends, are used to recover nucleosomes which form towards the terminal ends of fragmented DNA. Finally, we illustrate that although nucleosomes prefer to form on DNA ends, it does not appear to skew results or the interpretation thereof., Competing Interests: Two authors, DAB and CEB, are brothers. CEB owns and operates the software consulting company, Qubit Software LLC. The contributions of Qubit Software LLC were strictly pro bono, and the custom codes written are publicly available. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Thus the authors declare no conflict of interest.

The mass extinction characterizing the Permian/Triassic boundary (PTB; ~ 252 Ma) corresponds to a major faunal shift between the Palaeozoic and the Modern evolutionary fauna. The temporal, spatial, environmental, and ecological dynamics of the associated biotic recovery remain highly debated, partly due to the scarce, or poorly-known, Early Triassic fossil record. Recently, an exceptionally complex ecosystem dated from immediately after the Smithian/Spathian boundary (~ 3 myr after the PTB) was reported: the Paris Biota (Idaho, USA). However, the spatiotemporal representativeness of this unique assemblage remained questionable as it was hitherto only reported from a single site. Here we describe three new exceptionally diverse assemblages of the same age as the Paris Biota, and a fourth younger one. They are located in Idaho and Nevada, and are taxonomic subsets of the Paris Biota. We show that the latter covered a region-wide area and persisted at least partially throughout the Spathian. The presence of a well-established marine fauna such as the Paris Biota, as soon as the early Spathian, indicates that the post-PTB biotic recovery and the installation of complex ecosystems probably took place earlier than often assumed, at least at a regional scale., (© 2021. The Author(s).)

We necropsied an American black bear (Ursus americanus) from central Utah, US and found several liters of cloudy fluid and multiple white nodules in the peritoneal cavity. Histopathologic examination and staining with pancytokeratin and vimentin markers identified a peritoneal mesothelioma. Mesothelioma has not been reported previously in black bears., (© Wildlife Disease Association 2021.)

Objectives: To recommend (1) the adoption of optimal terminology for referring to services in the United States that incorporate horses and other equines to benefit people, and (2) the discontinuation of especially problematic terminology. Design: A diverse multidisciplinary consortium of individuals, including representatives of relevant national organizations, participated in an inclusive, systematic, and comprehensive 2-year consensus-building process. Results: Twelve specific types of services were identified that relate to one of three broad areas of professional work: therapy, learning, or horsemanship. Related to the area of therapy, five distinct types of therapies were identified: counseling, occupational therapy, physical therapy, psychotherapy, and speech-language pathology. Therapy-first language is recommended that foregrounds the exact therapy (e.g., physical therapy ) and adds precise equine-related descriptors as warranted (e.g., physical therapy using equine movement ). Related to the area of learning, three distinct types of nontherapy services were identified. The recommended terminology for referring to these services is equine-assisted learning in education , equine-assisted learning in organizations , and equine-assisted learning in personal development . Related to the area of horsemanship, four distinct types of nontherapy services were identified. The recommended terminology for referring to these services is adaptive equestrian sports, adaptive riding or therapeutic riding , driving , and interactive vaulting . The plural term, equine-assisted services , is recommended as a concise shorthand for easily referencing multiple services that differ from each other, yet share the horse as a common thread. Terms recommended for discontinuation include equine therapy, equine-assisted activities and therapies, equine-assisted therapy, equestrian therapy, hippotherapist, hippotherapy clinic (program), horse therapy, horseback riding therapy, and therapy riding . The consensus-building process culminated in extensive but not unanimous endorsements of all terminology recommendations. Conclusions: Terminology recommended for adoption clearly describes and distinguishes 12 distinct types of services. Terminology recommended for discontinuation was found to be ambiguous, misleading, no longer useful, or to have adversely affected stakeholders. It is hoped that all recommendations will prove useful and serve to enhance the professionalism and viability of specific identified services. It is also hoped that improved precision and clarity in terminology for naming specific services will advance their future scientific development and reliable measurement of effectiveness. Not all terminology-related challenges were resolved, however, and new challenges will likely arise as services continue to evolve and diversify. Significant impacts, if any, of the terminology recommendations herein merit ongoing monitoring and the question of optimal terminology merits revisiting in the foreseeable future.

Background: Critical care nurses routinely care for dying patients. Research on obstacles in providing end-of-life care has been conducted for more than 20 years, but change in such obstacles over time has not been examined., Objective: To determine whether the magnitude scores of obstacles and helpful behaviors regarding end-of-life care have changed over time., Methods: In this cross-sectional survey study, questionnaires were sent to 2000 randomly selected members of the American Association of Critical-Care Nurses. Obstacle and helpful behavior items were analyzed using mean magnitude scores. Current data were compared with data gathered in 1999., Results: Of the 2000 questionnaires mailed, 509 usable responses were received. Six obstacle magnitude scores increased significantly over time, of which 4 were related to family issues (not accepting the poor prognosis, intrafamily fighting, overriding the patient's end-of-life wishes, and not understanding the meaning of the term lifesaving measures). Two were related to nurse issues. Seven obstacles decreased in magnitude, including poor design of units, overly restrictive visiting hours, and physicians avoiding conversations with families. Four helpful behavior magnitude scores increased significantly over time, including physician agreement on patient care and family access to the patient. Three helpful behavior items decreased in magnitude, including intensive care unit design., Conclusions: The same end-of-life care obstacles that were reported in 1999 are still present. Obstacles related to family behaviors increased significantly, whereas obstacles related to intensive care unit environment or physician behaviors decreased significantly. These results indicate a need for better end-of-life education for families and health care providers., (© 2020 American Association of Critical-Care Nurses.)

Background: Neuropathic complications from diabetes mellitus affect multiple nerve types and may manifest in gait. However, gait compensations are still poorly understood, as narrow analyses and lack of speed controls have contributed to conflicting or equivocal results., Purpose: To evaluate gait mechanics and energetics in diabetic peripheral polyneuropathy., Methods: Instrumented gait analysis was performed on 14 participants with diabetic peripheral polyneuropathy and 14 matched controls, walking at 1.0 m/s. A full-body model with a multisegment foot was used to calculate inverse dynamics and analyze sagittal plane metrics and time series waveforms across stance phase., Results: Alterations included increased hip and knee flexion in early stance followed by a prolonged hip extension moment in midstance. Late stance ankle dorsiflexion and power absorption were increased, and final push-off was delayed and truncated., Conclusion: A neuropathic diabetic gait shares important similarities to a mild crouch gait with weakness/dysfunction in the foot and ankle. This study highlights two main compensation mechanisms that have been overlooked in previous literature. First, increased triceps surae stretch in terminal stance may be used to increase proprioception and/or energy storage, while a prolonged hip extension moment in midstance compensates for a limited push-off. These result in an overall workload shift from distal to proximal joints. Clinical assessment, monitoring, and treatment of neuropathy may benefit by focusing on these specific functional alterations., Competing Interests: There were no conflicts of interest., (Copyright © 2019 Adrienne D. Henderson et al.)

A captive-bred Bobwhite Quail ( Colinus virginianus) ranch in southern Utah, US experienced high mortality rates in the late summer and fall of 2012. Nine juvenile birds were necropsied at the Utah Veterinary Diagnostic Laboratory. Gross lesions included pale skeletal muscle with multifocal hemorrhages and petechiae in the air sacs and serosal surfaces of most organs. Histologically there was moderate to severe, multifocal, degenerative myositis with intramyofiber schizonts and minimal lymphoplasmacytic infiltrates in the proventriculus, ventriculus, heart, and skeletal muscle. There was also moderate fibrinoid to heterophilic vasculitis in multiple organs with vascular intraendothelial or intravascular merozoites and scattered thrombosis. In the liver and spleen there were multiple degenerative schizonts that had ruptured. Blood smears from three of the birds were stained with Wright-Giemsa stain and examined at a referral laboratory. Although the blood cells were deteriorated (postmortem artifact), life stages (exact stages not specified) consistent with Haemoproteus spp. were identified in erythrocytes. Polymerase chain reaction done on pooled tissues from two birds produced an amplicon in both pooled samples, and direct sequencing confirmed the presence of 533 base pairs of a Haemoproteus sp. in the subgenus Parahaemoproteus. The identification of Parahaemoproteus spp. in quail in southern Utah implies that appropriate Culicoides spp. vectors are present in the state and that there is potential risk to other birds such as zoo and aviary populations, wild turkeys, and other game birds.

Introduction: Latina breast cancer survivors in the United States face disproportionate risk for poorer quality of life and physical health, as well as greater emotional distress., Method: A cross-sectional survey was conducted to describe the physical, emotional, and general health status of 135 Latina breast cancer survivors served by a community-based program., Results: Of the 135 surveys sent, 48 survivors responded. Of those who responded, time since diagnosis ranged from 0 to 24 years ( M = 4.37; SD = 5.54); and 45.9% of the women rated physical health as poor or fair. Fatigue prevalence was high, with 60.5% reporting fatigue as moderate or severe. Nearly 80% reported having pain (score >0); 38.3% reported pain was moderate or severe. The women reported mild levels of anxiety and depression but high levels of stress ( M = 4.14; SD = 3.02)., Conclusions: Latina breast cancer survivors could benefit from interventions focused on commonly shared problems while tailoring specific interventions for subsets with more severe symptoms.

Primary arthrodesis is a thoroughly studied treatment option for end-stage pathologic entities of the first metatarsophalangeal joint. It is a commonly accepted treatment of many pathologic conditions, including hallux rigidus, severe hallux valgus, hallux varus, and other conditions pertaining to the first ray. Numerous fixation techniques are available for this procedure. Fixation constructs range from simple crossing Kirschner wires to plate and screw fixation or, even, external fixation. We propose a simple and cost-effective fixation technique using an intramedullary Steinmann pin with crossing Kirschner wires. Similar fixation techniques have been described; however, minimal data are available regarding this type of fixation. We present a series of 64 first metatarsophalangeal joint fusion procedures performed on 60 patients using our technique. A retrospective review with attention to several clinical and radiographic parameters was performed. The mean follow-up time was 27 (range 6 to 56) months. This technique resulted in a fusion rate of 90.6% (58 of 64 procedures). Despite the use of a large intramedullary Steinmann pin across the interphalangeal joint (IPJ), only 6 of the 64 procedures (9%) resulted in hallux IPJ degeneration. Of these, only 3 (4.6%) were symptomatic and required therapeutic measures. This suggests that violation of the IPJ with this form of fixation contributes minimally to postoperative pathologic features and is a viable alternative to traditional Association for Osteosynthesis/Association for the Study of Internal Fixation techniques., (Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Bioassay-guided phytochemical investigation of a commercially available maqui berry (Aristotelia chilensis) extract used in botanical dietary supplement products led to the isolation of 16 compounds, including one phenolic molecule, 1, discovered for the first time from a natural source, along with several known compounds, 2-16, including three substances not reported previously in A. chilensis, 2, 14, and 15. Each isolate was characterized by detailed analysis of NMR spectroscopic and HRESIMS data and tested for their in vitro hydroxyl radical scavenging and quinone-reductase inducing biological activities. A sensitive and accurate LC-DAD-MS method for the quantitative determination of the occurrence of six bioactive compounds, 6, 7, 10-12, and 14, was developed and validated using maqui berry isolates purified in the course of this study as authentic standards. The method presented can be utilized for dereplication efforts in future natural product research projects or to evaluate chemical markers for quality assurance and batch-to-batch standardization of this botanical dietary supplement component.

The most reliable test method for the serological confirmation of Lyme disease (LD) is a 2-tier method recommended by the CDC in 1995. The first-tier test is a low-specificity enzyme-linked immunosorbent assay (ELISA), and the second-tier tests are higher-specificity IgG and IgM Western blots. This study describes the selection of two Borrelia burgdorferi recombinant proteins and evaluation of their performance in a simple 1-tier test for the serological confirmation of LD. These two proteins were generated from (i) the full-length dbpA gene combined with the invariable region 6 of the vlsE gene (DbpA/C6) and (b) the full-length ospC gene (OspC). The expressed DbpA/C6 and OspC proteins were useful in detecting anti- Borrelia IgG and IgM antibodies, respectively. A blind study was conducted on a well-characterized panel of 279 human sera from the CDC, comparing ELISAs using these two recombinant antigens with the 2-tier test method. The two methods (DbpA/C6-OspC versus 2-tier test) were equivalent in identifying sera from negative-control subjects (99% and 100% specificity, respectively) and in detecting stage II and III LD patient sera (100% and 100% sensitivity). However, the DbpA/C6-OspC ELISA was markedly better (80% versus 63%) than the 2-tier test method in detecting anti- Borrelia antibodies in stage I LD patients. The findings suggest that these antigens could be used in a simple 1-tier ELISA that is faster to perform, easier to interpret, and less expensive than the 2-tier test method and which is better at detecting Borrelia -specific antibodies in sera from patients with stage I LD., (Copyright © 2017 Bradshaw et al.)

In the wake of the end-Permian mass extinction, the Early Triassic (~251.9 to 247 million years ago) is portrayed as an environmentally unstable interval characterized by several biotic crises and heavily depauperate marine benthic ecosystems. We describe a new fossil assemblage-the Paris Biota-from the earliest Spathian (middle Olenekian, ~250.6 million years ago) of the Bear Lake area, southeastern Idaho, USA. This highly diversified assemblage documents a remarkably complex marine ecosystem including at least seven phyla and 20 distinct metazoan orders, along with algae. Most unexpectedly, it combines early Paleozoic and middle Mesozoic taxa previously unknown from the Triassic strata, among which are primitive Cambrian-Ordovician leptomitid sponges (a 200-million year Lazarus taxon) and gladius-bearing coleoid cephalopods, a poorly documented group before the Jurassic (~50 million years after the Early Triassic). Additionally, the crinoid and ophiuroid specimens show derived anatomical characters that were thought to have evolved much later. Unlike previous works that suggested a sluggish postcrisis recovery and a low diversity for the Early Triassic benthic organisms, the unexpected composition of this exceptional assemblage points toward an early and rapid post-Permian diversification for these clades. Overall, it illustrates a phylogenetically diverse, functionally complex, and trophically multileveled marine ecosystem, from primary producers up to top predators and potential scavengers. Hence, the Paris Biota highlights the key evolutionary position of Early Triassic fossil ecosystems in the transition from the Paleozoic to the Modern marine evolutionary fauna at the dawn of the Mesozoic era.

We examined the clinical safety and efficacy of F105 in 11 subjects with moderate dyslipidemia. F105 is a combination of bergamot fruit extract (Citrus bergamia, BFE) and 9 phytoextracts selected for their ability to improve the antioxidant and anti-inflammatory activity of BFE. In vitro F105 exhibited a synergistic inhibition of oxygen radical absorbing capacity, peroxynitrite formation, and myeloperoxidase activity. Following 12 weeks of F105 daily, no treatment-related adverse events or changes in body mass were seen. Statistically significant changes were noted in total cholesterol (-7.3%), LDL-cholesterol (-10%), non-HDL cholesterol (-7.1%), cholesterol/HDL (-26%), and apolipoprotein B (-2.8%). A post hoc analysis of 8 subjects with HbA1c > 5.4 and HOMA-IR score > 2 or elevated triglycerides revealed additional statistically significant changes in addition to those previously observed in all subjects including triglycerides (-27%), oxLDL (-19%), LDL/HDL (-25%), triglycerides/HDL (-27%), oxLDL/HDL (-25%), and PAI-1 (-37%). A follow-up case report of a 70-year-old female patient, nonresponsive to statin therapy and placed on F105 daily, demonstrated improved cardiometabolic variables over 12 weeks similar to the subgroup. In summary, F105 was clinically well-tolerated and effective for ameliorating dyslipidemia in subjects with moderate cardiometabolic risk factors, particularly in the individuals with HbA1c > 5.4%.

Herpes zoster (HZ) in immunocompetent children is quite uncommon. Initial exposure to the varicella-zoster virus (VZV) may be from a wild-type or vaccine-related strain. Either strain may cause a latent infection and subsequent eruption of HZ. We present a case of HZ in a 15-month-old boy after receiving the varicella vaccination at 12 months of age. A review of the literature regarding the incidence, clinical characteristics, and diagnosis of HZ in children also is provided.

In the aftermath of the end-Permian mass extinction, Early Triassic sediments record some of the largest Phanerozoic carbon isotopic excursions. Among them, a global Smithian-negative carbonate carbon isotope excursion has been identified, followed by an abrupt increase across the Smithian-Spathian boundary (SSB; ~250.8 Myr ago). This chemostratigraphic evolution is associated with palaeontological evidence that indicate a major collapse of terrestrial and marine ecosystems during the Late Smithian. It is commonly assumed that Smithian and Spathian isotopic variations are intimately linked to major perturbations in the exogenic carbon reservoir. We present paired carbon isotopes measurements from the Thaynes Group (Utah, USA) to evaluate the extent to which the Early Triassic isotopic perturbations reflect changes in the exogenic carbon cycle. The δ(13) Ccarb variations obtained here reproduce the known Smithian δ(13) Ccarb -negative excursion. However, the δ(13) C signal of the bulk organic matter is invariant across the SSB and variations in the δ(34) S signal of sedimentary sulphides are interpreted here to reflect the intensity of sediment remobilization. We argue that Middle to Late Smithian δ(13) Ccarb signal in the shallow marine environments of the Thaynes Group does not reflect secular evolution of the exogenic carbon cycle but rather physicochemical conditions at the sediment-water interface leading to authigenic carbonate formation during early diagenetic processes., (© 2016 John Wiley & Sons Ltd.)

Purpose: This integrative review synthesized current information from 28 research articles meeting inclusion criteria that examined sibling experiences when living with a young person with Down syndrome or autism spectrum disorder., Conclusions: Five themes emerged related to sibling experiences: their knowledge of the condition, relationships with others, perceptions of the condition, emotional reactions to the situation, and behavioral/personality outcomes., Practice Implications: Nurses caring for families raising youth with Down syndrome or autism spectrum disorder can enhance sibling development by providing individual interventions reflecting siblings' perceptions of the experience., (© 2015, Wiley Periodicals, Inc.)

Melanodiol 4″-O-protocatechuate (1) and melanodiol (2) represent novel flavonoid derivatives isolated from a botanical dietary supplement ingredient, dried black chokeberry (Aronia melanocarpa) fruit juice. These noncrystalline compounds possess an unprecedented fused pentacyclic core with two contiguous hemiketals. Due to having significant hydrogen deficiency indices, their structures were determined using computer-assisted structure elucidation software. The in vitro hydroxyl radical-scavenging and quinone reductase-inducing activity of each compound are reported, and a plausible biogenetic scheme is proposed.

While oral isotretinoin is renowned for its ability to treat acne vulgaris, many of its off-label uses continue to go underappreciated. Since the last review on the unapproved indications of isotretinoin, relevant publications have surfaced with new recommendations. This article attempts to provide physicians with the latest information regarding successful and unsuccessful use of isotretinoin as an effective treatment for dermatological conditions, such as rosacea, psoriasis, pityriasis rubra pilaris, condyloma acuminatum, granuloma annulare, Darier's disease, systemic cutaneous lupus erythematosus, nonmelanoma skin cancer, and hidradenitis suppurativa. Variations in dosage regimens and isotretinoin viability as an alternative to other standard treatments are also discussed in relation to these conditions.

Purpose: To provide an overview of normal and abnormal temper tantrum behavior as well as give recommendations nurse practitioners (NPs) can use in counseling families., Data Sources: Articles were identified from the following databases: CINAHL, HEALTH SOURCE: Nursing/Academic edition, Medline, Social Work Abstracts, Social Science Abstracts, Psych INFO, Psychology and Behavioral Science Collection. Textbook references were also identified using Stat!Ref., Conclusions: Temper tantrums are one of the most common behavior problems in children. Although most children will have tantrums, with NPs' support and guidance in primary care encounters, most children will not require further intervention., Implications for Practice: NPs caring for children will need to identify normal and abnormal tantrum behavior as well as rule out other causes of tantrums in order to help parents handle the tantrum behavior. To obtain CE credit for this activity, go to http://www.aanp.org and click on the CE Center. Locate the listing for this article and complete the post-test. Follow the instructions to print your CE certificate., (©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.)

Purpose: To examine the use of clinical preventive services (CPSs) by nurse practitioners (NPs) in practice., Data Sources: A total of 53 transcribed NP-patient encounters and 28 NP surveys., Conclusions: Based on content analysis of the transcribed interviews, only a small majority of NPs (60.4%) used at least one CPS per visit. From the post-survey results, it appears that what NPs think they do varies greatly from what they actually do in clinical practice., Implications for Practice: The knowledge gained about the use of recommended CPSs may help promote better clinical practice among NPs and foster improvement in graduate school preparation of NP students.

An HPLC method and an acid hydrolysis HPLC method for the analysis of anthocyanins and anthocyanidins in bilberry extracts have been developed. The HPLC method coupled with a mass detector has identified 11 anthocyanins in bilberry extracts. The method provides anthocyanin profiles that are very useful in verifying the identity of botanical raw materials, monitoring the consistency of the raw material source, and quantitating the total anthocyanins. The acid hydrolysis HPLC method greatly simplifies the anthocyanin profile in bilberry samples and converts anthocyanins to five major anthocyanidin aglycones: delphinidin, cyanidin, petunidin, peonidin, and malvidin. Each of these aglycones can be separated completely and quantitated accurately with external standards. Various extraction and hydrolysis conditions were investigated, and the advantages and disadvantages of the HPLC and acid hydrolysis methods are discussed.

A precise and selective high-performance liquid chromatographic (HPLC) method with diode-array detection for quantifying huperzine A in formulated products was developed and validated. A liquid chromatographic-mass spectrometric (LC/MS) procedure was devised to confirm the HPLC method. Huperzine A was dissolved in 1,2-dichloroethane, chromatographed on a YMCBasic C18 column, and detected at 308 nm. A gradient mobile phase of 10 mM ammonium acetate (pH = 3.5)--methanol was used. Identification was based on retention time, UV spectra and mass spectra by comparison with a commercial standard. The UV peak areas were used for quantitation of huperzine A content. The correlation coefficient (R2) of the calibration curve was 1 over the range 0.8-11.6 microg/ml. Overall recovery of huperzine A was 103.9% +/- 1.8 (mean +/- SD). Relative standard deviations for intra- and interday precision were < 2%.