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Objectives: Motivational Interviewing (MI), a client-centered approach that seeks to evoke and resolve ambivalence, and health education (HE), which provides health information and advice, may both provide some benefit to unmotivated smokers. In HE, it is possible that client language reflective of new learning, or "learning talk" (LT), and rejection of health advice, or "rejection talk," (RT), may uniquely reflect intent of subsequent behavior change., Methods: This project utilized MI and HE sessions from two randomized clinical trials (RCTs), one in a low-income, diverse community civilian sample of 255 unmotivated smokers, and the other in a sample of Veterans with mental illness who were unmotivated smokers (n = 55). Mixed methods approaches were utilized to reliably code sessions using the Motivational Interviewing Skill Code 2.5 (MISC 2.5) 1 and a refined Learning Talk coding system 2 ., Results: Reliability of LT and RT codes ranged from fair to excellent (ICCs from 0.43-0.93)., Conclusion: LT appears to be a unique construct and its impact on post-session changes in smoking is warranted., Practice Implications: This system can be used in a study to code existing interventions for smokers using both MI and HE techniques and relate in-session client LT to subsequent smoking behaviors., 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 B.V.)

Background: Chronic pain and opioid use disorder (OUD) individually represent a risk to health and well-being. Concerningly, there is evidence that they are frequently co-morbid. While few treatments exist that simultaneously target both conditions, preliminary work has supported the feasibility of an integrated behavioral treatment targeting pain interference and opioid misuse. This treatment combined Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Relapse Prevention (ACT+MBRP). This paper describes the protocol for the adequately powered efficacy study of this integrated treatment., Methods: A multisite randomized controlled trial will examine the efficacy of ACT+MBRP in comparison to a parallel education control condition, focusing on opioid safety and pain education. Participants include veterans (n = 160; 21-75 years old) recruited from three Veterans Administration (VA) Healthcare Systems with chronic pain who are on a stable dose of buprenorphine. Both conditions include twelve weekly 90 min group sessions delivered via telehealth. Primary outcomes include pain interference (Patient Reported Outcome Measurement Information System - Pain Interference) and hazardous opioid use (Current Opioid Misuse Measure), which will be examined at the end of the active treatment phase and through 12 months post-intervention. Secondary analyses will evaluate outcomes including pain intensity, depression, pain-related fear, and substance use, as well as treatment mechanisms., Conclusion: This study will determine the efficacy of an integrated behavioral treatment program for pain interference and hazardous opioid use among veterans with chronic pain and OUD who are prescribed buprenorphine, addressing a critical need for more integrated treatments for chronic pain and OUD., Trial Registration: ClinicalTrials.gov Identifier: NCT04648228., Competing Interests: Declaration of Competing Interest These are required for all submissions. Declarations of interest do not indicate wrongdoing, but they must be declared in the interests of full transparency. Authors should declare sources of funding, direct or indirect, and any connection of any of the researchers with the tobacco, alcohol, cannabis, pharmaceutical or gaming industries or any body substantially funded by one of these organizations. Authors are also required to declare any financial conflict of interest arising from involvement with organizations that seek to provide help with or promote recovery from addiction. Any contractual constraints on publishing imposed by the funder must also be disclosed. Declaring a conflict of interest is the responsibility of authors and authors should err on the side of inclusiveness In line with the ICMJE conflict of interest policy, the time window for these financial links is within 3 years of the date of article submission. If an undeclared conflict of interest comes to light, we reserve the right to publish this prominently and to place it on a public register using words along the lines of ‘[name] has the following conflict of interest which h/she has not declared’., (Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.)

In Alzheimer disease, Tau pathology is thought to propagate from cell to cell throughout interconnected brain areas. However, the forms of Tau released into the brain interstitial fluid (ISF) in vivo during the development of Tauopathy and their pathological relevance remain unclear. Combining in vivo microdialysis and biochemical analysis, we find that in Tau transgenic mice, human Tau (hTau) present in brain ISF is truncated and comprises at least 10 distinct fragments spanning the entire Tau protein. The fragmentation pattern is similar across different Tau transgenic models, pathological stages and brain areas. ISF hTau concentration decreases during Tauopathy progression, while its phosphorylation increases. ISF from mice with established Tauopathy induces Tau aggregation in HEK293-Tau biosensor cells. Notably, immunodepletion of ISF phosphorylated Tau, but not Tau fragments, significantly reduces its ability to seed Tau aggregation and only a fraction of Tau, separated by ultracentrifugation, is seeding-competent. These results indicate that ISF seeding competence is driven by a small subset of Tau, which potentially contribute to the propagation of Tau pathology., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Topiramate is an effective treatment for alcohol use disorder (AUD) and has also been used in the care of mild traumatic brain injury (mTBI). This pilot study aimed to obtain a preliminary assessment of topiramate's efficacy in reducing alcohol use and post-concussive symptoms, and its potential negative impact on cognitive function in 32 Veterans with co-occurring AUD and mTBI., Methods: This was a prospective 12-week, randomized, double-blind, placebo-controlled pilot study of flexible-dose topiramate or placebo. Primary outcome was reduction of drinking days per week within the topiramate arm. Secondary outcomes included between group comparisons of alcohol use and craving, post-concussive symptoms, and cognitive function., Results: Drinking days per week significantly decreased within both the topiramate and placebo arm. There were no significant treatment-by-week interactions on alcohol use/craving, or post-concussive symptoms in intent-to-treat analyses. In per-protocol analyses, topiramate significantly reduced number of drinks per week compared with placebo. Topiramate transiently impaired verbal fluency and working memory. Processing speed, cognitive inhibition, and mental flexibility significantly improved between weeks 1 and 12, regardless of treatment arm., Conclusions: Significant improvement occurred in both the topiramate and placebo groups over 12 weeks of treatment in alcohol use and post-concussive symptoms. Among treatment completers there was greater reduction of alcohol use in the topiramate arm. Topiramate was also associated with negative but transient effects on cognitive function. Results suggest both a possible benefit for topiramate treatment in reducing alcohol use and some potential for negative cognitive effects in Veterans with AUD and mTBI., Competing Interests: Declaration of Competing Interest No conflict declared. Name: Topiramate Treatment of Hazardous and Harmful Alcohol Use in Veterans with Traumatic Brain Injury (TBI): A Pilot Trial (VAT). ClinicalTrials.gov Identifier: NCT01750268. https://clinicaltrials.gov/ct2/show/NCT01750268?term=Batki&draw=4&rank=10., (Published by Elsevier B.V.)

Alzheimer's Disease (AD) is the major cause of dementia in the elderly, and cortical neurons differentiated from patient-derived induced pluripotent stem cells (iPSCs) can recapitulate disease phenotypes such as tau phosphorylation or amyloid beta (Aß) deposition. Here we describe the generation of an iPSC cohort consisting of 2 sporadic AD cases and 3 controls, derived from dermal fibroblasts. All lines were karyotypically normal, showed expression of stem cell markers and efficiently differentiated into cells of all three germ layers., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Several reports of severe infections associated with allograft tissue in knee reconstructive surgery have led many surgeons to consider routine intraoperative culture of allograft tissue before implantation. Thus, the purpose of this study was to determine the prevalence of positive soft tissue allograft cultures in reconstructive knee surgery, and evaluate its association with surgical site infection., Methods: Retrospective study of 202 patients who underwent knee reconstructive ligament surgeries, including revisions, between January 2013 and July 2017. Intraoperative culture results were obtained and the report of a surgical site infection during follow-up was recorded. Patients without cultures were excluded. A priori power analysis was performed. The association between positive culture results and development of surgical site infection was evaluated using Fisher's Exact test (P < 0.05)., Results: A total of 300 allografts were implanted in 202 patients. Mean average follow-up was 32.9 ± 12.5 (range 13 to 57.9) months. Sixteen patients had positive intraoperative allograft cultures (7.9%). The most frequently isolated organism was Bacillus species (six cultures); none of these patients presented with clinical signs of infection. Nine patients developed surgical site infections and were treated with oral antibiotics, and one patient developed septic arthritis that required surgical debridement of the implanted graft; all of these patients had a negative soft tissue allograft culture. No significant association was found between a positive culture and surgical site infection (P = 0.43)., Conclusion: There was no apparent association between positive intraoperative irradiated soft tissue allograft cultures and surgical site infection in reconstructive knee surgery., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Variability in anatomic terminology, dissection protocols, and use of embalmed as opposed to fresh frozen specimens has led to the controversy surrounding the "anterolateral ligament of the knee." Conceptually the complex anatomy of the anterolateral knee is made up of the superficial, middle, deep, and capsulo-osseous layers of the iliotibial band. The anterolateral capsule is deep to these tissues and is directly attached to the lateral meniscus. These structures collectively form the anterolateral complex of the knee. The anterolateral complex in conjunction with the anterior cruciate ligament function to prevent anterolateral rotatory instability of the knee., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The role of the anterolateral complex of the knee in providing static and rotatory knee stability has been a source of renewed interest in the literature. Several studies have established a role of the anterolateral complex in controlling knee rotational stability. Although the objective quantification of knee kinematics and stability has been investigated, understanding of the structural properties of the anterolateral complex is evolving. This article highlights recent evidence pertaining to the structural properties of the anterolateral structures. The biomechanical evaluation of the structural properties of the anterolateral complex of the knee yielded minimal involvement in controlling knee rotational stability., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Trochlear dysplasia is an important risk factor associated with patellofemoral instability, but it remains difficult to classify with consistency. Currently there is no objective way to quantify the dysplasia. The purpose of this study is to define and quantify objectively the trochlear morphology by volume and length via computed tomography (CT)., Methods: One-hundred control patients (136 knees) were retrospectively reviewed and compared to 36 consecutive patients (72 knees) who were treated surgically for recurrent patellar instability and known trochlear dysplasia based on a lateral radiograph. Trochlear morphology was analyzed from a pre-operative CT and data presented as trochlear sulcus volume trochlear length. To determine where along the trochlear length dysplasia is most variable, the trochlear length was radiographically divided into thirds, volume was quantified along that section and compared to control trochlear., Results: A significant difference in trochlear morphology exists between cohorts, volume (1.98 vs 3.77cm 3 ) and length (31.97 vs 34.66mm) (p<0.05). However, there appears to be a gender based difference in trochlea morphology. The trochlea volumetric analysis between the female cohorts (L: 2.02cm 3 vs. 2.94cm 3 , R: 1.95cm 3 vs. 2.93cm 3 ) demonstrated significantly less volume in instability patients (p<0.001). The proximal third of the trochlear contributed the majority of dysplasia difference determined by comparing mean trochlear volume, 95% of the difference. This difference decreased in distal sections, 53% and 32% respectively., Conclusion: This reproducible technique can be used to quantify the trochlea morphology, in order to describe the severity of a dysplasia., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Recent studies have described the presence of the anterolateral ligament (ALL). However, there is still no consensus regarding the anatomy of this structure with the topic controversially discussed. The aim of this study was to provide an anatomical description of the ligamentous structures on the anterolateral side of the knee with special emphasis on the ALL., Methods: Forty-four human cadaveric knees were dissected to reveal the ALL and other significant structures in the anterolateral compartment of the knee joint. The ALL was defined as a firm structure running in an oblique direction from the lateral femoral epicondyle to a bony insertion at the anterolateral tibia., Results: The ALL was identified in 45.5% (n=20) of the dissected knee joints. The structure originates together with the fibular collateral ligament (45%) or just posterior and proximal to it (55%). The ligament has an extra-capsular, anteroinferior, oblique course to the anterolateral tibia with a bony insertion between Gerdy's tubercle and the fibular head. The ALL had its greatest extend at 60° of knee flexion and maximal internal rotation., Conclusion: The ALL is a firm ligamentous structure in the anterolateral part of the knee present in 45.5% of the cases. Given the course and characteristics of this structure, a function in providing rotational stability by preventing internal rotation of the knee is likely., Clinical Relevance: The ALL might be an important stabilizer in the knee and may play a significant role in preventing excessive internal tibial rotation and subluxation of the knee joint., (Copyright © 2015 Elsevier B.V. All rights reserved.)

A novel ion cell has been constructed for the purpose of studying rotationally inelastic collisions involving truly thermal molecular ions at low temperatures. With this ion cell, time-resolved double resonance (pump-probe) spectroscopic experiments have been performed to determine the cross sections for relaxation of the J = 2 state of HCO+ in collisions with normal-H2 at temperatures around 40 and 77 K. The HCO+ is pumped through the J = 2<--1 transition and probed via the J = 3<--2 transition. The cross sections at the lower temperature are slightly below those predicted by the simple Langevin theory, while those at the higher temperature are in good agreement with this theory.

Distributions of IgE levels were determined from 312 children (divided into three age groups), living in small Austrian towns with different levels of air pollution. The spread of IgE concentration was extremely wide; the mean value was 124 kU/I with a standard deviation of 240. An increase of concentration was found in the group aged 6 to 11 years. No significant difference was found according to sex and the higher rates of IgE. The reference rates were then used to compare children living in an industrial region with heavy metal production. A significant difference was found in the lower IgE concentrations (25th and 50th percentiles).

A prospective study was conducted in 38 patients with nodular lesions on plain chest radiographs and the clinical suspicion of invasive pulmonary aspergillosis (IPA) to assess the diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT). For early diagnosis of IPA (clinical signs and symptoms < 10 days), CT scans with demonstration of the halo sign had a high sensitivity (16/22) and specificity (8/8). Magnetic resonance imaging performed at the same time revealed a relatively higher sensitivity (22/22), but a very poor specificity (0/8). Gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA) enhanced images did not improve specificity. In the later course of infection (clinical signs and symptoms > 10 days), MRIs showed typical nodular target-like lesions with Gd-DTPA enhancement of the rim area that was not seen in the early course of the disease or in patients with Pseudomonas or staphylococcal infection. In conclusion, MRI findings are not as characteristic as the CT halo sign in diagnosing IPA in the early course of the disease, but the MRI target sign with Gd-DTPA enhancement of the rim area and the "reverse target" on T2-weighted images are strongly suggestive of IPA at a later stage of the disease.

Budd-Chiari syndrome is characterized by splanchnic congestion due to obstruction of the hepatic venous outflow. A variety of treatment modalities have limited applicability due to their invasive nature, complications or low effectivity. The transjugular intrahepatic portosystemic stent-shunt (TIPS) offers a new treatment by creating an intraparenchymal duct between a main branch of the portal vein and hepatic vein i.e. the intrahepatic part of the inferior vena cava. This paper describes the treatment of two patients with fulminant and subacute Budd-Chiari syndrome treated 2 days and 2 months after the onset of clinical symptoms. It demonstrates that TIPS is a feasible treatment of Budd-Chiari syndrome that restores splanchnic blood flow, reduces collateral circulation and ascites and provides sufficient time to allow for elective liver transplantation, if indicated. Further studies are required to evaluate the effect of TIPS on liver function and survival.

Fresh and cryopreserved autologous or allogeneic mononuclear blood cells (MBCs) intravenously injected in 1200 R total-body x-irradiated dogs repopulated lymph nodes within 10 days after tranfusion. Several parameters of the lymphopoietic regeneration were correlated with the number of cells transfused and with the number of colony-forming units contained in the cell suspension when they were cultured in agar (CFUc). Values within the normal or close to normal range were reached in the mesenteric nodes of most of the animals transfused with 10 X 10(9) MBC or more. These values were obtained when 5 X 10(5) CFUc or more were transfused. Axillary nodes showed lower values than mesenteric nodes. They were mostly under the normal range but well over those of the irradiated controls. Frozen and thawed MBCs seem to be as effective as fresh cells for lymphopoietic restoration. The mesenteric nodes of dogs transfused with allogeneic MBCs showed higher cellularity and larger cortical-paracortical areas than those of dogs tranfused with approximately the same number of autologous cells. The repopulation of lymph nodes parallels that of the marrow.

Marrow cellularity in adult beagles (1-2 yr old) is highest in centrally located bones, with values between 8000 and 12,000 nucleated cells per sq mm. It decreases gradually towards the peripheral parts of the body, reaching values below 1000 per sq mm in bones distal to the elbow and knee. The first tail segment always contains some active marrow. The fifth segment has only stromal elements. In spongy bones fat cells appear to be distributed at random among the blood-forming elements. In the middle part of the femur the fatty marrow predominates in the center of the cylinder, while the subendosteal area is very cellular. The proximal and distal ends of the femur are more cellular than the middle. The small standard deviation of the cellularity in the spongy bones of the trunk and in the proximal and middle part of the humerus makes these sites areas of choice for quantitative studies of marrow regeneration. The large variations in cellularity of the marrow in the radius and tibia of young adult dogs make these sites unsuitable for such studies. The distribution of active and fatty marrow in dogs is similar to that of humans. The differential count of active marrow is quite constant between different dogs and in the various sites of each animal.

Dogs were given transfusions of cryopreserved autologous mononuclear blood leukocytes after 1200 roentgens (R) (midline dose) whole-body x-irradiation. Bone marrow repopulation was studied by means of histomorphological methods at days 9 and 10 after transfusion of an average of 3 X 10(9), 7 X 10(9), 13 X 10(9), and 31 X 10(9) cells. The return of marrow cellularity to normal values was related to the number of cells transfused. With low cell doses (3 X 10(9) and 7 X 10(9)), the marrow regeneration at 10 days was focal. There were groups of cells (colonies) showing either erythropoiesis, myelopoiesis, or megakaryocytopoiesis in the osteal niches of the trabecular bones. Frequently such niches were seen showing complete cellular recovery next to niches with complete aplasia. With higher cell doses, all niches showed hemopoietic regeneration, and the cellularity approached normal values. No hemopoietic regeneration was observed in those skeletal parts that do not show hemopoiesis, even under normal circumstances.