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Although the number of patients with Mycobacterium avium complex (MAC) pulmonary disease has been increasing among the elderly individuals due to population aging in Japan, few studies have reported treatment in elderly patients with MAC pulmonary disease. We conducted a retrospective cohort study to evaluate differences in the tolerability of, adverse events associated with and efficacy of treatment for MAC pulmonary disease in elderly and nonelderly patients. The medical records of 96 newly diagnosed MAC pulmonary disease patients at Nagoya City University Hospital between April 2014 and March 2019 were reviewed. Elderly patients ≥75 years old started multidrug treatment less frequently than nonelderly patients <75 years old (17 of 41 patients, 41.5% vs. 41 of 55 patients, 74.5%, P = 0.001). The treated elderly patients had more symptoms, more extensive radiological disease and a higher rate of positivity on sputum smear than the treated nonelderly patients. Eleven elderly patients and 19 nonelderly patients continued the initial multidrug regimen (64.7% vs. 46.3%, P = 0.26). Adverse events occurred in 6 elderly patients and 25 nonelderly patients (35.3% vs. 61.0%, P = 0.074). The rates of achievement of sputum conversion and radiological improvement after treatment for over 1 year were similar between the elderly and nonelderly patients (61.5% vs. 75.0%, P = 0.37; 76.9% vs. 78.1%, P = 1). The tolerability, adverse events, and efficacy of treatment in elderly patients with MAC pulmonary disease were not noticeably different from those in nonelderly patients. [ABSTRACT FROM AUTHOR]

• World Heritage Sites face problems such as an increase in maintenance cost, difficulty to check protection conditions, and destruction. • This paper proposes a new preservation system that might solve the above problems by involving tourists in the preservation activity. • Contingent valuation method and conjoint analysis are used to investigate the possibility of tourists cooperating with the system free of charge and the factors that influence respondents' cooperation with the preservation system. • The results showed that more than 50% of the respondents would be willing to cooperate free of charge. World Heritage Sites (WHSs) face several problems, such as increased maintenance costs, difficulties in checking protection conditions, and graffiti destruction by tourists. Hence, constructing a new system that can effectively lighten the burden of maintenance expenditures is necessary. Presently, a new preservation system that leverages Information and Communication Technology, 3D Restoration Technology by photographic data collection, and artificial intelligence and that involves tourists' participation has been developed. This paper aims to introduce the new preservation system, investigate the possibility of tourists cooperating with the system free of charge, and introduce the details and results of a choice experiment conducted on tourists at Bayon Temple in Cambodia. Analysis results showed that approximately 50% of respondents would be willing to cooperate free of charge, and statistical significance for certain attributes and interactions. The analysis indicated that providing appropriate incentives to tourists who have specific individual characteristics would help promote the use of the preservation system. [ABSTRACT FROM AUTHOR]

Although fluoroquinolones are considered as alternative therapies of pulmonary Mycobacterium avium complex (MAC) disease, the association between fluoroquinolone resistance and MAC genotypes in clinical isolates from individuals not previously treated for MAC infection is not fully clear. Totals of 154 M. avium isolates and 35 Mycobacterium intracellulare isolates were obtained from treatment-naïve patients with pulmonary MAC disease at the diagnosis of MAC infection at 8 hospitals in Japan. Their susceptibilities of moxifloxacin were determined by broth microdilution methods. Moxifloxacin-resistant isolates were examined for mutations of gyrA and gyrB. Variable numbers of tandem repeats (VNTR) assay was performed using 15 M. avium VNTR loci and 16 M. intracellulare VNTR loci. Moxifloxacin susceptibility was categorized as resistant and intermediate for 6.5% and 16.9%, respectively, of M. avium isolates and 8.6% and 17.1% of M. intracellulare isolates. Although the isolates of both species had amino acid substitutions of Thr 96 and Thr 522 at the sites corresponding to Ser 95 in the M. tuberculosis GyrA and Gly 520 in the M. tuberculosis GyrB, respectively, these substitutions were observed irrespective of susceptibility and did not confer resistance. The VNTR assays showed revealed three clusters among M. avium isolates and two clusters among M. intracellulare isolates. No significant differences in moxifloxacin resistance were observed among these clusters. Although resistance or intermediate resistance to moxifloxacin was observed in approximately one-fourth of M. avium and M. intracellulare isolates, this resistance was not associated with mutations in gyrA and gyrB or with VNTR genotypes. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitors (ICIs) have been developed as cornerstones of cancer therapy, but the growing use of ICIs has induced immune-related adverse effects (irAEs). Immune-related colitis, which is one of the most common irAEs, generally occurs 2–4 months after ICI treatment initiation and can be life threatening. Therefore, early diagnosis and appropriate management are required. A rare autopsy case of nivolumab-related severe colitis that occurred 34 months after the start of treatment and recurred despite temporal remission with corticosteroids and infliximab is presented. Physicians should be aware of the possibility of late-onset irAEs in patients on receiving long-term ICI treatment. • Immune-related severe colitis could occur in patients on long-term ICI treatment and could be life-threatening. • Early diagnosis and appropriate management of immune-related adverse effects based on grading are critical in patients on long-term ICI treatment. • Future clinical studies are needed to determine the optimal duration of ICI treatment especially in responders. [ABSTRACT FROM AUTHOR]

This study investigates the economic validity of the diffusion of fuel cell vehicles (FCVs) and all-electric vehicles (EVs), employing a cost-benefit analysis from the social point of view. This research assumes the amount of NOx and tank-to-wheel CO 2 emissions and gasoline use reduction as the benefits and the purchase costs, infrastructure expenses, and maintenance costs of alternative vehicles as the costs of switching internal combustion engine (ICE) vehicles to alternative energy vehicles. In addition, this study conducts a sensitivity analysis considering cost reductions in FCV and EV production and increasing costs for CO 2 abatement as well as increasing gasoline prices. In summary, the results show that the diffusion of FCVs is not economically beneficial until 2110, even if the FCV purchase cost decreases to that of an ICE vehicle. EV diffusion might be beneficial by 2060 depending on increases in gasoline prices and CO 2 abatement costs. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate trends in the isolation of strains of nontuberculous mycobacteria (NTM) and trends in the number of patients with pulmonary Mycobacterium avium complex (MAC) disease. We retrospectively reviewed microbiological results and clinical data to identify patients who were diagnosed with pulmonary MAC disease at Kyoto University Hospital in Japan between 2000 and 2013. NTM were isolated from 6327 of 80,285 samples (7.9%) for mycobacterial culture. The proportion of NTM isolates among all mycobacterial isolates increased from 355 of 792 samples (44.8%) in 2000 to 688 of 847 samples (81.2%) in 2013. MAC was most frequently observed (5436 isolates, 85.9%), followed by Mycobacterium abscessus (175 isolates, 2.8%) and Mycobacterium kansasii (74 isolates, 1.2%). A total of 592 patients with pulmonary MAC disease were identified (age, 66.0 ± 11.5 years; females, 61.1%). Compared with the early cohort (2000–2006, 236 patients), more patients in the late cohort (2007–2013, 356 patients) had an underlying disease (157 [66.5%] vs. 284 [79.8%], P = 0.0003), a Charlson comorbidity index score ≥1 (115 [48.7%] vs. 213 [59.8%], P = 0.008), collagen vascular disease (18 [7.6%] vs. 60 [16.9%], P = 0.001), rheumatoid arthritis (11 [4.7%] vs. 41 [11.5%], P = 0.004), and used immunosuppressive drugs (22 [9.3%] vs. 63 [17.7%], P = 0.004). The numbers of patients with lung disease, malignant disease and diabetes mellitus increased; however, their frequencies did not differ. The recovery rate of NTM and patients with pulmonary MAC disease increased, especially in patients with collagen vascular disease or rheumatoid arthritis or who used immunosuppressive drugs. [ABSTRACT FROM AUTHOR]

Abstract: An increasing number of studies analyze the relationship between natural disaster damage and income levels, but they do not consider the distinction between public and private disaster mitigation. This paper empirically distinguishes these two types of mitigation using Japanese prefectural panel data from 1975 to 2007. Our results show that public mitigation rather than private mitigation has contributed to mitigating the total damage resulting from natural disasters. Our estimation of cost-benefit ratios for each prefecture confirms that the mitigation efforts of urban prefectures are less effective than those of rural prefectures in focusing on both large and frequent/small disasters. Hence, urban prefectures need to reassess their public mitigation measures. Furthermore, to lessen the damage resulting from extreme catastrophes, policy makers are required to invest in improved mitigation infrastructures when faced with a high probability of disasters. [Copyright &y& Elsevier]

While we appreciate the complexity of the intracellular environment as a general property of every living organism, we collectively lack the appropriate tools to analyze protein structures in a cellular context. In-cell NMR spectroscopy represents a novel biophysical tool to investigate the conformational and functional characteristics of biomolecules at the atomic level inside live cells. Here, we review recent in-cell NMR developments and provide an outlook towards future applications in prokaryotic and eukaryotic cells. We hope to thereby emphasize the usefulness of in-cell NMR techniques for cellular studies of complex biological processes and for structural analyses in native environments. [ABSTRACT FROM AUTHOR]

We conducted hospital-based contact investigations of 55 serial sputum smear-positive tuberculosis (TB) patients and 771 health care workers (HCWs) from 2006-2013. HCWs who made contact with TB patients in the absence of appropriate airborne precautions were evaluated using interferon gamma release assays to identify TB infection. Twenty-nine HCWs (3.8%) were newly diagnosed with TB infection. The 10 TB patients responsible for transmission had a duration of contact of >7 days by multivariate analysis. [ABSTRACT FROM AUTHOR]

Homologous recombination, which is critical to genetic diversity, depends on homologous pairing (HP). HP is the switch from parental to recombinant base pairs, which requires expansion of inter-base pair spaces. This expansion unavoidably causes untwisting of the parental double-stranded DNA. RecA/ Rad51-catalyzed ATP-dependent HP is extensively stimulated in vitro by negative supercoils, which compensates for untwisting. However, in vivo, double-stranded DNA is relaxed by bound proteins and thus is an unfavorable substrate for RecA/Rad51. In contrast, Mhr1, an ATP-independent HP protein required for yeast mitochondrial homologous recombination, catalyzes HP without the net untwisting of double-stranded DNA. There- fore, we questioned whether Mhrl uses a novel strategy to promote HP. Here, we found that, like RecA, Mhr1 induced the extension of bound single-stranded DNA. In addition, this structure was induced by all evolutionarily and structurally distinct HP proteins so far tested, including bacterial RecO, viral RecT, and human Rad51. Thus, HP includes the common non-canonical DNA structure and uses a common core mechanism, independent of the species of HP proteins. We discuss the significance of multiple types of HP proteins. [ABSTRACT FROM AUTHOR]

PALS and CL measurements were performed for PET as a function of temperature. The combination of PALS and CL exhibits the character of the transition properties of PET. In PALS, the glass transition of PET was clearly observed as a change in the intensity and lifetime of the o-Ps component. However, no singularity was observed in the CL emission properties at the glass-transition temperature. These differences would illustrate the nature of the glass transition considered to be produced by a cooperative interaction between the molecules.On the other hand, the luminescence from the cascade transition of molecules was illustrated in time-resolved CL spectra. For the first emission peak, the lifetime of this state was estimated to be 23.8 ns. From the temperature dependence of the intensities of the luminescence, a decrease in the yield was found at 390 K. This result suggests that a degeneration of the band structure occurred for the molecules to move to optically inactive states. [Copyright &y& Elsevier]

Reflects on the most common psychiatric disorder of childhood which is attention-deficit hyperactivity disorder (ADHD). Survey carried out; Results and procedures; References.

Accumulating evidence from the experimental and computational studies indicated that the functional properties of proteins are different between in vitro and living cells, raising the necessity to examine the protein structure under the native intracellular milieu. To gain structural information of the proteins inside the living cells at an atomic resolution, in-cell NMR method has been developed for the past two decades. In this review, we will overview the recent progress in the methodological developments and the biological applications of in-cell NMR, and discuss the advances and challenges in this filed. A number of methods were developed to enrich the isotope-labeled proteins inside the cells, enabling the in-cell NMR observation of bacterial cells as well as eukaryotic cells. In-cell NMR has been applied to various biological systems, including de novo structure determinations, protein/protein or protein/drug interactions, and monitoring of chemical reactions exerted by the endogenous enzymes. The bioreactor system, in which the cells in the NMR tube are perfused by fresh culture medium, enabled the long-term in-cell NMR measurements, and the real-time observations of intracellular responses upon external stimuli. In-cell NMR has become a unique technology for its ability to obtain the function-related structural information of the target proteins under the physiological or pathological cellular environments, which cannot be reconstituted in vitro. [ABSTRACT FROM AUTHOR]

A 76-year-old man was admitted to our hospital with cough and dyspnea. He was diagnosed with advanced lung cancer. Nivolumab was given as second-line treatment, cytotoxic chemotherapy was given as third-line treatment, and nivolumab re-challenge was given as fourth-line treatment. Thereafter, 41 chemotherapy courses were administered over 2 years. Currently, he is being followed with no recurrence at least 10 months after treatment. Thus, the case of a patient with advanced lung cancer who was previously unsuccessfully treated with nivolumab and then demonstrated a long-term clinical response to a re-challenge with nivolumab after cytotoxic chemotherapy and radiation therapy is presented. [ABSTRACT FROM AUTHOR]

A monotonic correlation of the Doppler-broadening of positron-annihilation radiation in solid C60 with the temperature was observed between 77 and 299 K. Since the change in the spectrum due to the temperature was very small, the spectrum was analyzed by a method which reduced the effect of the statistical uncertainties of the spectrum. The observed temperature dependence is interpreted as being due to a thermal expansion of the lattice spacing between the C60 molecules, where positron annihilation took place at the interstitial regions between the C60 molecules. [Copyright &y& Elsevier]

Patients with acute vertebral compression fractures (aVCFs) are frequently transferred to an emergency department by ambulance. The most useful imaging modality is magnetic resonance imaging (MRI); however, which patients should be prioritized for MRI evaluation may be unclear. The aim of this study was to evaluate plasma D-dimer levels as a biomarker for aVCFs. This retrospective cohort study included patients with low back pain in the emergency department between November 2017 and October 2020. Patients with infections, patients with coagulation disorders, and patients without D-dimer level measurements were excluded. The presence of an aVCF was detected with MRI. Blood samples were collected for routine blood tests. The predictive factors for aVCFs were evaluated with univariate and multivariable logistic regression analyses. Overall, 191 consecutive MRI evaluations were ordered. After exclusions, 101 patients were reviewed. Based on MRI, 65 (64.4%) patients were diagnosed with aVCF. The presence of aVCF was significantly correlated with age (odds ratio [OR] = 1.052, 95% confidence interval [CI] 1.018–1.191), an old vertebral compression fracture (OR = 3.290, 95% CI 1.342–8.075), hemoglobin (OR = 0.699, 95% CI 0.535–0.912), and D-dimer levels (OR = 1.829, 95% CI 1.260–2.656). Results from a multivariable logistic regression analysis showed that D-dimer levels (OR = 1.642, 95% CI 1.188–2.228) remained a significant risk factor for the presence of aVCFs after adjustment for potential confounders. Plasma D-dimer levels can provide useful diagnostic information about whether an aVCF is present. [ABSTRACT FROM AUTHOR]

Pelvic morphology is an important element in determination of spinal alignment. We retrospectively examined the correlation between spinal alignment, severity, and pelvic morphology in lumbar disc herniation (LDH) surgery. The study included 62 cases of paramedian LDH surgeries (L4-5: 19 cases; L5-S1: 43 cases). For all cases, we performed x-ray imaging of the whole spine in the standing position preoperatively and 1 week postoperatively and measured spinopelvic parameters. Comparing preoperative parameters of patients with 82 healthy subjects, we examined changes before and after surgery. We also examined the relationship between preoperative severity and parameters. Compared with healthy subjects, patients with LDH exhibited significantly decreased lumbar lordosis and sacral slope and increased pelvic tilt and sagittal vertical axis (P < 0.01). Japanese Orthopaedic Association score improved from 16.1 ± 4.6 preoperatively to 23.5 ± 3.2 1 week postoperatively (P < 0.01). Spinopelvic parameters observed preoperatively improved significantly 1 week postoperatively (P < 0.01). Correlation analysis did not confirm any correlation of severity with preoperative pelvic tilt, sagittal vertical axis, or pelvic incidence. However, cases with high pelvic tilt/pelvic incidence were significantly more likely to be severe cases (R 2 = 0.08, P = 0.027). A significant decrease in pelvic tilt was observed in cases with a large improvement in postoperative Japanese Orthopaedic Association score (P = 0.031). For LDH cases, pelvic retroversion is important to avoid pain. The range of mobility for pelvic retroversion varies depending on pelvic morphology of individuals. In cases of LDH, ratio of pelvic tilt to pelvic incidence correlates strongly with severity. [ABSTRACT FROM AUTHOR]

• The PCV7 and PCV13 coverage rates for IPD were 0.8% and 9.2%, respectively. • The IPD cases attributable to serotype 12F increased dramatically. • Serotype 15A-CC63 and serotype 35B-CC558 isolates were multi-drug resistant. • Non-IPD isolates were more resistant than IPD isolates. Streptococcus pneumoniae is still one of the major causes of morbidity and mortality worldwide. In Japan, pneumococcal conjugate vaccine (PCV)7 and PCV13 were licensed in 2010 and 2013, respectively. We conducted a nationwide paediatric invasive pneumococcal disease (IPD) and non-IPD surveillance study in Japan between 2015 and 2017. We collected 498 IPD isolates and 231 non-IPD isolates from a total of 187 medical institutions in Japan. We performed serotyping, antimicrobial susceptibility testing and multi-locus sequencing typing (MLST) for the collected isolates. Among the 498 IPD isolates, the most prevalent serotype was 24F, followed by 12F, 15A and 15B/C. However, 12F increased and 24F significantly decreased during the study period (p < 0.001), resulting in 12F becoming the most prevalent serotype in 2017. Among the IPD isolates, the PCV7 and PCV13 coverage rates were 0.8% and 9.2%, respectively. The most prevalent serotype among the non-IPD isolates was 15A, followed by 35B, 15B/C and 19A. The overall resistance rates to penicillin (PG), cefotaxime (CTX), meropenem (MEM), erythromycin (EM) and levofloxacin (LFX) were 40.5%, 12.2%, 19.4%, 91.8% and 0.5%, respectively. PG, CTX and MEM resistance rates were significantly higher in non-IPD isolates than in IPD isolates (p < 0.001). Serotype 15A-CC63 and serotype 35B-CC558 tended to be multi-drug resistant. In conclusion, the PCV13 coverage rate was significantly lower than that in a previous surveillance study in Japan between 2012 and 2014, and IPD cases attributable to serotype 19A also decreased. We should note the rapid increase in the prevalence of serotype 12F in IPD cases and the spread of the multi-drug resistant serotype 15A-CC63 and 35B-CC558 lineages. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate long-term changes in spinal sagittal balance after microsurgical decompression in lumbar canal stenosis (LCS). Fifty-two patients who underwent microsurgical decompression for symptomatic single level L4/5 spinal canal stenosis at our hospital were included in the study. All patients had standing full spine radiographs taken preoperatively, 1 year postoperatively, and 5 years postoperatively. Spinal parameters including sagittal balance were measured from the obtained images. First, preoperative parameters were compared with 50 age-matched asymptomatic volunteers. Next, the parameters before and after surgery were compared to examine long-term changes. Sagittal vertical axis (SVA) was significantly increased in the LCS cases compared to the volunteers (P = 0.03). Postoperative lumbar lordosis (LL) was significantly increased (P = 0.03). Postoperative mean SVA decreased but the difference was not significant (P = 0.12). Although there was no correlation between preoperative parameters and the Japanese Orthopedic Association score, postoperative pelvic incidence (PI)-LL and pelvic tilt changes correlated with changes in Japanese Orthopedic Association score (PI-LL; P = 0.0001, pelvic tilt; P = 0.04). However, after 5 years of surgery, LL decreased and PI-LL increased (LL; P = 0.08, PI-LL; P = 0.03). Sagittal balance began to deteriorate but was not significant (P = 0.31). At 5 years postoperatively, 18 of 52 patients (34.6%) were found to have L3/4 adjacent segment disease. Cases with adjacent segment disease showed significantly worse SVA and PI-LL (SVA; P = 0.01, PI-LL; P < 0.01). In LCS, lumbar kyphosis improves and sagittal balance tends to improve after microsurgical decompression. However, after 5 years, adjacent intervertebral degeneration occurs more frequently and sagittal balance begins to deteriorate in about one third of cases. [ABSTRACT FROM AUTHOR]

This report describes the first outbreak of methicillin-resistant Staphylococcus aureus USA300 in a general hospital ward in Japan, involving 6 health care workers and 4 patients. This report emphasizes the need for health care personnel to be alert that methicillin-resistant Staphylococcus aureus harboring Panton-Valentine leukocidin gene poses a threat for both nosocomial and occupational infection. [Copyright &y& Elsevier]

Pneumococcal infection in children is a major public health problem worldwide, including in Japan. The pneumococcal conjugate vaccine 7 (PCV7) was licensed for use in Japan in 2010 followed by PCV13 in 2013. This report includes the results of a nationwide surveillance of invasive pneumococcal disease (IPD) and non-IPD in paediatric patients from January 2012 to December 2014. We collected 343 isolates from 337 IPD patients and 286 isolates from 278 non-IPD patients. Of the IPD isolates, the most identified serotypes included 19A, 24F, and 15A. The prevalence of non-PCV13 serotype isolates increased significantly from 2012 to 2014 (51.6–71.4%, p = 0.004). Serotypes 19A, 15A and 35B were highly non-susceptible to penicillin, and the rates of non-susceptible isolates from IPD patients to penicillin and cefotaxime significantly declined during the study period ( p = 0.029 and p = 0.013, respectively). The non-susceptible rate to meropenem increased, particularly for serotype 15A. The IPD isolates comprised clonal complex (CC) 3111 (93.8% was serotype 19A) followed by CC2572 (81.5% was serotype 24F) and CC63 (97.1% was serotype 15A). CC3111, CC63 and CC156 (33.3% was serotype 23A, 28.6% was serotype 6B, and 14.3% was serotype 19A) were highly non-susceptible to penicillin. Of the non-IPD isolates, the most identified serotypes included 19A, 15A, and 3. In conclusion, the introduction of PCV7 and PCV13 resulted in increasing non-PCV13 serotypes and clones, including antimicrobial resistant serotypes 15A and CC63 (Sweden 15A -25 clone). [ABSTRACT FROM AUTHOR]

Microvascular decompression (MVD) is a well-established and definitive treatment option for trigeminal neuralgia (TN). 1 However, complex vascular geometry and numerous offending vessels make it difficult to perform nerve decompression in certain cases. 2 The trigeminocerebellar artery (TCA) is a unique branch of the basilar artery. The vessel is named the TCA because it supplies both the trigeminal nerve root and the cerebellar hemisphere. 3 This anatomical variant may increase the risk of neurovascular compression in the trigeminal nerve. We present the case of a 74-year-old man with left TN in whom a TCA was one of the responsible compression vessels. Preoperative images revealed the ipsilateral anterior inferior cerebellar artery, well-developed TCA, and superior cerebellar artery, wherein these branches were all suspected to be involved in trigeminal nerve compression. In MVD, 3 arteries were suspected to compress the trigeminal nerve in 5 sites, and all of them needed to be meticulously dissected from the nerve root and decompressed. Moreover, 2 of them branched many short perforators to the brainstem. Three decompression procedures (transposition to the dura, transposition to the brain, and interposition) were performed to decompress the trigeminal nerve. Postoperatively, TN was completely resolved immediately. MVD for TN could be difficult to perform in cases with TCA, as in the present case, and rigorous procedures were required intraoperatively. [ABSTRACT FROM AUTHOR]

Background: Childhood abuse has been associated with abnormalities in brain development, particularly corpus callosum (CC) morphology. The impact of neglect has not been assessed, though it is the most prevalent form of childhood maltreatment.Methods: Regional CC area was measured from magnetic resonance imaging scans in 26 boys and 25 girls admitted for psychiatric evaluation (28 with abuse or neglect) and compared with CC area in 115 healthy control subjects. Data were analyzed by multivariate analysis of covariance, with age and midsagittal area as covariates.Results: Total CC area of the abused/neglected patients was 17% smaller than in control subjects (p = .0001) and 11% smaller than in psychiatric patients who had not been abused or neglected (contrast group; p = .01). Control subjects and the contrast group did not differ in total CC area. Neglect was the strongest experiential factor and was associated with a 15%–18% reduction in CC regions 3, 4, 5, and 7 (all p < .02). In contrast, sexual abuse seemed to be the strongest factor associated with reduced CC size in girls.Conclusions: These data are consistent with animal research that demonstrated reduced CC size in nursery-reared compared with semi-naturally reared primates. Early experience might also affect the development of the human CC. [Copyright &y& Elsevier]