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A 3-year-old Great Dane presented with a history of chronic vomiting and diarrhoea. Abdominal computed tomography followed by exploratory laparotomy revealed a perforated, segmental partial mesenteric volvulus, affecting an abnormal section of distal jejunum, which was resected. Histopathology and immunohistochemistry results were consistent with jejunal lymphangiosarcoma. This case represents the first report of primary small intestinal lymphangiosarcoma in dogs and the importance of immunohistochemistry for definitive diagnosis. [ABSTRACT FROM AUTHOR]

An analysis of ordering effects that influence population's willingness to pay for three health care programmes covered by a health survey conducted in Ireland is offered. Additional information on how the three health care programmes were evaluated by the survey respondents is included.

The correlation between unemployment and health status of unemployed individuals in Canada is analyzed. Additional information on the impact of impaired health on the unemployment duration is included.

The COVID-19 pandemic necessitated immediate transition from in person to telehealth encounters; novel nursing practices were needed to ensure that children with cystic fibrosis (CF) receive care that approximates evidence-based guidelines. The aim was to ensure that as many children as possible received routine surveillance of pulmonary pathogens by a CF culture sputum culture during a pandemic. Multiple Plan-Do-Study-Act (PDSA) cycles were utilized to implement practice change over four months. Cultures were obtained via curbside appointment with a registered nurse (RN) or at the patients' home with mailed equipment. 133 cultures obtained: 50.37% (67) by RN collection curbside and 49.62% (66) by self/caregiver at home. 120 culture swabs or sterile cups were mailed; 55% (66) were returned. Cost of mailing equipment was $760.16. Nursing utilization of PDSA cycles developed novel processes that ensured guideline-based care during the initial months of the pandemic. • A Cystic Fibrosis center was able to minimized the risks of exposure to SARS-CoV-2 virus while continuing to deliver care to a vulnerable pediatric population. • Quality improvement principles and the PDSA framework aided in adaptation of clinic practices when external forces demand change. • Return rates of mailed cultures were similar in both groups, those with an affiliated facility in proximity and those without. • Costs were reduced through a PDSA cycle examining shipping providers. [ABSTRACT FROM AUTHOR]

Inflammatory biomarkers may differentiate clinical disorders, which could lead to more targeted interventions. Analyses within a clinical sample (May et al., 2021) revealed that females with substance use disorders (SUD) exhibited lower C-reactive protein (CRP) and higher interleukin (IL)-8 and −10 concentrations than females without SUD who met criteria for mood/anxiety disorders. We aimed to replicate these findings in a new sample. Hypotheses and analyses were preregistered. Treatment-seeking individuals with mood/anxiety disorders and/or SUD (N = 184) completed a blood draw, clinical interview, and questionnaires. Participants were categorized as SUD+ (45 F, 43 M) and SUD- (78 F, 18 M). Principal component analysis (PCA) of questionnaire data resulted in two factors reflecting appetitive and aversive emotional states. SUD group and nuisance covariates (PCA factors, age, body mass index [BMI], medication, nicotine [and hormones in females]) predicted biomarker concentrations (CRP, IL-8, and IL-10) in regressions. In females, the omnibus CRP model [ F (8, 114) = 8.02, p <.001, R²-adjusted =.32] indicated that SUD+ exhibited lower CRP concentrations than SUD- (β = −.33, t = −3.09, p =.002, 95% CI [-.54, −.12]) and greater BMI was associated with higher CRP levels (β =.58, t = 7.17, p <.001, 95% CI [.42,.74]). SUD+ exhibited higher IL-8 levels than SUD- in simple but not omnibus regression models. Findings across two samples bolster confidence that females with SUD show attenuated CRP-indexed inflammation. As SUD+ comorbidity was high, replication is warranted with respect to specific SUD classes (i.e., stimulants versus cannabis). • This study examined inflammatory biomarkers as a function of substance use disorder (SUD). • Females with SUD exhibited lower C-reactive protein (CRP) levels than females without SUD. • Females with SUD exhibited higher interleukin 8 (IL-8) levels than females without SUD. • Within females, higher body mass index was linked to higher CRP levels. [ABSTRACT FROM AUTHOR]

Objective: Catheter placement for thoracic epidural analgesia (TEA) is technically challenging; however, methods for teaching this technique to anesthesia residents have not been well-studied. The present study aimed to determine optimal teaching methods for proficient TEA catheter placement by comparing video-based formal resident education with traditional bedside training by attending physicians. Design: Prospective, randomized study. Setting: Large academic hospital, single institution. Participants: The study comprised 76 postgraduate year 3 and 4 anesthesiology residents (38 intervention, 38 control). Interventions: Formal education included an instructional video on proper TEA technique. Measurements and Main Results: Measures of proficiency in TEA catheter placement included the time needed to complete the procedure successfully and the success of placement as indicated by patient confirmation. Residents who received formal video instruction had similar success in catheter placement and similar procedure times compared with the traditionally trained residents. The overall success rate was 99.2%, with faculty intervention required in only 17% of cases. More experienced residents (ie, having placed more epidural catheters) were faster at TEA catheter placement. Conclusions: Formal video education for TEA catheter placement provided no additional improvement of resident proficiency compared with traditional training at a high-volume academic center. The success rate was very high in this group of residents; however, experiences at other institutions may vary. Future studies are needed to determine optimum teaching strategies for TEA. [ABSTRACT FROM AUTHOR]

Video-assisted thoracoscopic surgery (VATS) has improved patient outcomes; however, postoperative pain remains potentially severe. The objective of this study was to compare adjunct analgesic modalities for VATS, including paravertebral nerve blockade (PVB) and thoracic epidural anesthesia (TEA). Prospective, randomized trial. Large academic hospital, single institution. Adult patients undergoing VATS. Ultrasound-guided PVB catheter, ultrasound-guided single-injection PVB, or TEA. Postoperative visual analog scale pain scores (at rest and with knee flexion) and opioid usage were recorded. Pain scores (with movement) for the TEA group were lower than those for either PVB group at 24 hours (p ≤ 0.008) and for the PVB catheter group at 48 hours (p = 0. 002). Opioid use in TEA group was lower than that for either PVB group at 24 and 48 hours (p < 0. 001) and 72 hours (p < 0. 05). Single-injection PVB was faster compared with PVB catheter placement (6 min v 12 min; p < 0. 001) but similar to TEA (5 min). Patient satisfaction, nausea, sedation, and 6-month postsurgical pain did not differ between groups. TEA led to lower pain scores and opioid requirement for VATS procedures compared with PVB techniques. Single-injection PVB was faster and equally as effective as PVB catheter, and it led to similar patient satisfaction as TEA; therefore, it should be considered in patients who are not ideal candidates for TEA. [ABSTRACT FROM AUTHOR]

The effects of perceived neighborhood disorder and objective neighborhood location that psychologically distress the women with children are examined. The Mexican American women if compared to whites do not differ significantly in the process that sharpens maternal distress.

In this study we extracted bioactive ingredients from fruiting bodies of Laetiporus sulphureus with different solvents and tested the antimicrobial and antitumor activities. The predominant lipid composition of the fruiting bodies was studied with GC–MS and revealed a high amount of oleic acid, octadecenoic acid and ergosterol derivatives. Extracts of L. sulphureus were shown to have antimicrobial activity against all fungal strains tested including Candida albicans , Geotrichum candidum , Aspergillus fumigatus , Aspergillus niger , Curvularia clavata , and Fusarium oxysporum , as well as strains of gram-positive (Staphylococcus aureus and Streptococcus pyogenes) and gram-negative bacteria (Escherichia coli , Klebsiella pneumoniae , Pseudomonas aeruginosa and Shigella enterica). Antimicrobial activity of ethanol and water extracts exceeded that of other extracts based on greater inhibitory activity at a lower minimum inhibitory concentration (MIC) range (MIC of ethanol = 15.6–62.5 μg/ml and of water = 15.6–125 μg/ml). The ethanol extract also exhibited superior anti-proliferative activity against three carcinoma cell lines and did not differ from a water extract against HeLa cells with half maximal inhibitory concentrations (IC 50) of 3.1 ± 1.5 and 5.1 ± 1.2 μg/ml against HCT 116 and MCF-7 cells, respectively and IC 50 of 11.5 ± 2.1 and 12.1 ± 1.7 μg/ml against Hep G2 and HeLa cells, respectively. The extract inhibited growth of isolated normal mouse hepatocytes by <12%. Scanning electron microscopy was applied to characterize the structures of the microbes treated with the ethanol semi-purified fraction. These findings suggest potential use L. sulphureus extract as a natural resource with anti-proliferative activity against tumor cells and microbial infections. [ABSTRACT FROM AUTHOR]

As a potential biofuel feedstock, the marine microalga, Heterosigma akashiwo , accumulates significant lipids, is capable of long-term growth in outdoor photobioreactors, and is an excellent candidate for the bioremediation of industrial emissions. Here, we evaluated resource partitioning in H. akashiwo growing on a CO 2 and NO gas mixture under three light intensities: 160, 560, or 1200 μmol quanta m −2 s −1 . Light levels had no effect on growth; however, cultures in high light accumulated 2.3-fold more carbohydrates and 17% fewer lipids. Light levels did not affect the percentage of saturated fatty acids, but mono-unsaturates increased by 6% and poly-unsaturates decreased by 12% in high light. The fatty acid profiles reported here suggest that H. akashiwo is a good candidate for the production of neutral lipids for biodiesel and also omega-3 fatty acids, and that the quality of biodiesel acquired from feedstocks grown under fluctuating light conditions would be relatively stable. [ABSTRACT FROM AUTHOR]

Aims Altered interoception, how the brain processes afferents from the body, may contribute to the urge to take drugs, and subsequently, the development of addiction. Although chronic stimulant dependent individuals exhibit attenuated brain responses to pleasant interoceptive stimuli, it is unclear whether this deficit exists early-on in the process of transition to stimulant addiction. Methods To this end, we compared problem stimulant users (PSU; n = 18), desisted stimulant users (DSU; n = 15), and stimulant naïve comparison subjects (CTL; n = 15) during functional magnetic resonance imaging (fMRI) while they anticipated and experienced pleasant soft touch (slow brushstroke to the palm and forearm). Results Groups did not differ in behavioral performance or visual analog scale ratings of soft touch stimuli. fMRI results indicated that PSU exhibited greater right anterior insula, left inferior frontal gyrus, and right superior frontal gyrus activation than DSU and CTL during the anticipation and experience of soft touch. Moreover, during the experience of soft touch, PSU demonstrated higher bilateral precentral gyrus/middle insula and right posterior temporal gyrus activation than DSU and CTL. Conclusions In contrast to chronic stimulant dependence, individuals who have recently developed stimulant use disorders show exaggerated neural processing of pleasant interoceptive stimuli. Thus, increased processing of body-relevant information signaling pleasant touch in those individuals who develop problem use may be a predictive interoceptive biomarker. However, future investigations will need to determine whether the combination of probing pleasant interoception using neuroimaging is sufficiently sensitive and specific to help identify individuals at high risk for future problem use. [ABSTRACT FROM AUTHOR]

Background: Drug dependent individuals often make drug-taking decisions when they do not feel well. Yet, few studies have examined the influence of an aversive state on decision-making related neural processing.Methods: We investigate brain activation to decision-making during an aversive interoceptive challenge in methamphetamine users using functional magnetic resonance imaging (fMRI). Recently abstinent inpatients with methamphetamine use disorder (METH; n=20) and healthy comparison subjects (CTL; n=22) performed a two-choice prediction task at three fixed error rates (ER; 20%=reward, 50%=uncertainty, 80%=punishment) while anticipating and experiencing episodes of inspiratory breathing load during fMRI.Results: METH exhibited higher trait anxiety in conjunction with lower anterior insula (AI) and inferior frontal gyrus (IFG) activation than CTL across trials. METH also showed lower posterior insula (PI) and anterior cingulate cortex (ACC) activation than CTL during breathing load independent of ER. For the crucial ER by interoception interaction, METH displayed lower ACC activation to punishment/loss than CTL during breathing load. Within METH, lower trait anxiety was linked to AI/IFG attenuation across trials.Conclusions: AI/IFG attenuations in METH are suggestive of an executive functioning deficit, particularly in users with low anxiety, reflecting reduced resources allocated to choice selection. In contrast, PI/ACC reductions in METH appear specific to impairments in registering and evaluating interoceptive experiences. Taken together, inadequate activation of brain areas that are important for regulating when one does not feel well may be the neural basis for poor decision-making by METH. [ABSTRACT FROM AUTHOR]

Cocaine-dependent individuals show altered brain activation during decision making. It is unclear, however, whether these activation differences are related to relapse vulnerability. This study tested the hypothesis that brain-activation patterns during reinforcement learning are linked to relapse 1 year later in individuals entering treatment for cocaine dependence. Subjects performed a Paper-Scissors-Rock task during functional magnetic resonance imaging (fMRI). A year later, we examined whether subjects had remained abstinent (n=15) or relapsed (n=15). Although the groups did not differ on demographic characteristics, behavioral performance, or lifetime substance use, abstinent patients reported greater motivation to win than relapsed patients. The fMRI results indicated that compared with abstinent individuals, relapsed users exhibited lower activation in (1) bilateral inferior frontal gyrus and striatum during decision making more generally; and (2) bilateral middle frontal gyrus and anterior insula during reward contingency learning in particular. Moreover, whereas abstinent patients exhibited greater left middle frontal and striatal activation to wins than losses, relapsed users did not demonstrate modulation in these regions as a function of outcome valence. Thus, individuals at high risk for relapse relative to those who are able to abstain allocate fewer neural resources to action-outcome contingency formation and decision making, as well as having less motivation to win on a laboratory-based task. [ABSTRACT FROM AUTHOR]

Abstract: Background Although the interaction of brain volume with amphetamine-type stimulants (ATS) and cocaine has been investigated in chronically dependent individuals, little is known about structural differences that might exist in individuals who consume ATS and cocaine occasionally but are not dependent on these drugs. Methods Regional brain volumes in 165 college aged occasional users of ATS (namely: amphetamine, methamphetamine, methylphenidate, and 3,4-methylenedioxymethamphetamine; MDMA) and cocaine were compared by voxel-based morphometry with 48 ATS/cocaine-naive controls. Results Grey matter volume was significantly higher in the left ventral anterior putamen of occasional users, and lower in the right dorsolateral cerebellum and right inferior parietal cortex. A regression in users alone on lifetime consumption of combined ATS (namely: amphetamine, methamphetamine, methylphenidate and MDMA) and cocaine use revealed that individuals who used more ATS/cocaine had greater volume in the right ventromedial frontal cortex. A second regression on lifetime consumption of ATS with cocaine as a covariate revealed that individuals with a greater history of ATS use alone had more grey matter volume in the left mid-insula. Interestingly, structural changes in the ventromedial prefrontal cortex, insula and striatum have been consistently observed in volumetric studies of chronic ATS and cocaine dependence. Conclusion The present results suggest that these three brain regions may play a role in stimulant use even in early occasional users. [Copyright &y& Elsevier]

The role of interoception and its neural basis with relevance to drug addiction is reviewed. Interoception consists of the receiving, processing, and integrating body-relevant signals with external stimuli to affect ongoing motivated behavior. The insular cortex is the central nervous system hub to process and integrate these signals. Interoception is an important component of several addiction relevant constructs including arousal, attention, stress, reward, and conditioning. Imaging studies with drug-addicted individuals show that the insular cortex is hypo-active during cognitive control processes but hyperactive during cue reactivity and drug-specific, reward-related processes. It is proposed that interoception contributes to drug addiction by incorporating an “embodied” experience of drug uses together with the individual's predicted versus actual internal state to modulate approach or avoidance behavior, i.e. whether to take or not to take drugs. This opens the possibility of two types of interventions. First, one may be able to modulate the embodied experience by enhancing insula reactivity where necessary, e.g. when engaging in drug seeking behavior, or attenuating insula when exposed to drug-relevant cues. Second, one may be able to reduce the urge to act by increasing the frontal control network, i.e. inhibiting the urge to use by employing cognitive training. This article is part of a Special Issue entitled ‘NIDA 40th Anniversary Issue’. [ABSTRACT FROM AUTHOR]