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To reduce breast motion with a bra, we need to understand what drives the motion of the breasts, and what variables change as support increases. Quantifying breast-torso coordination and movement complexity across the gait cycle may offer deeper insights than previously reported discrete time lag. We aimed to compare breast-torso coordination and mutual influence across breast support conditions during running. Twelve female participants ran on a treadmill at 10 km h−1 with an encapsulation and compression sports bra, and in no bra. Nipple and torso position was recorded. Vector coding, granger causality and transfer entropy were calculated within gait cycles. In both bra conditions, a greater percentage of gait cycles was spent with the breast and torso in-phase (> 90%) compared to no bra running (~ 66%, p < 0.001), with most time spent in-phase in the encapsulation versus compression bra (p = 0.006). There was a main effect of breast support condition on Granger causality (p < 0.001), both from breast to torso and torso to breast. Transfer of information was highest from torso to breast, compared to breast to torso in all conditions. Overall, these results provide novel insight into the mutual and complex interaction between the breast and the torso while running in different bra conditions. The approaches presented allow for a greater understanding of bra support conditions than existing discrete measures, which may relate to comfort and performance. Therefore, measures of coupling, predictability and transfer of complexity should be employed in future work examining these features. [ABSTRACT FROM AUTHOR]

Purpose: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an integral part of the management algorithm of patients with severe respiratory failure refractory to evidence-based conventional treatments. Right ventricular injury (RVI) pertaining to abnormalities in the dimensions and/or function of the right ventricle (RV) in the context of VV-ECMO significantly influences mortality. However, in the absence of a universally accepted RVI definition and evidence-based guidance for the management of RVI in this very high-risk patient cohort, variations in clinical practice continue to exist. Methods: Following a systematic search of the literature, an international Steering Committee consisting of eight healthcare professionals involved in the management of patients receiving ECMO identified domains and knowledge gaps pertaining to RVI definition and management where the evidence is limited or ambiguous. Using a Delphi process, an international panel of 52 Experts developed Expert position statements in those areas. The process also conferred RV-centric overarching open questions for future research. Consensus was defined as achieved when 70% or more of the Experts agreed or disagreed on a Likert-scale statement or when 80% or more of the Experts agreed on a particular option in multiple‐choice questions. Results: The Delphi process was conducted through four rounds and consensus was achieved on 31 (89%) of 35 statements from which 24 Expert position statements were derived. Expert position statements provided recommendations for RVI nomenclature in the setting of VV-ECMO, a multi-modal diagnostic approach to RVI, the timing and parameters of diagnostic echocardiography, and VV-ECMO settings during RVI assessment and management. Consensus was not reached on RV-protective driving pressure thresholds or the effect of prone positioning on patient-centric outcomes. Conclusion: The proposed definition of RVI in the context of VV-ECMO needs to be validated through a systematic aggregation of data across studies. Until further evidence emerges, the Expert position statements can guide informed decision-making in the management of these patients. [ABSTRACT FROM AUTHOR]

Background and Objectives: Forequarter and hindquarter amputations have traditionally been closed with local tissues, but the technique is plagued by a high rate of complication such as marginal necrosis, seroma, infection, and dehiscence. Filet of limb flaps have been used when local tissues are insufficient for closure, and despite their use in more extensive and complex wounds, outcomes seem to be better in these cases. Recognizing that filet of limb flaps not only serve to cover the wound, but also eliminate dead space, supplement at-risk and/or radiated tissue, pad underlying hard structures, and facilitate neuroma prevention with target muscle reinnervation, we have change our practice to utilize buried filet of limb flaps even when local tissues are technically "sufficient" to close the wound. The purpose of this article to organize and describe the ways in which buried filet-of-limb flaps can be used to achieve important and discrete surgical objectives in forequarter and hindquarter amputation, and to facilitate increased recognition of collaborative interdisciplinary opportunities for spare-part reconstruction. Methods: Retrospective data from the medical records of seven patients, collected between 2010 to 2023 at our single tertiary referral center, were reviewed. This included all patients for whom a buried (or partially buried) filet of limb flap was attempted for forequarter or hindquarter amputation reconstruction. Results: Five males and two females ranging 55 to 75 years of age, met the inclusion criteria. Three cases of forequarter amputation and four cases of hindquarter amputation were included. Six flaps were successfully transferred without major flap-related complications. The mean follow-up period was eight and a half months. Conclusion: Even when local tissues are technically "sufficient" to close forequarter and hindquarter amputation wounds, we have found buried filet of limb flaps to be useful in several ways. These include occupying dead space, providing double-layer coverage, padding hard structures, preventing neuromas, and reconstructing sacro- and spino-pelvic continuity. Our approach emphasizes interdisciplinary collaboration and highlights the potential advantages of buried filet of limb flaps in optimizing patient outcomes for complex limb amputations. [ABSTRACT FROM AUTHOR]

Objective: Cabotegravir long-acting (CAB–LA) administered every 2 months was approved in the USA as pre-exposure prophylaxis (PrEP) for individuals at risk of acquiring human immunodeficiency virus (HIV)-1 infection based on the HIV Prevention Trials Network (HPTN) 083 and HPTN 084 clinical trials, which demonstrated superior reduction in HIV-1 acquisition compared with daily oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) in men who have sex with men (MSM), transgender women (TGW), and cisgender women. A decision-analytic model was developed to assess the lifetime cost-effectiveness of initiating CAB–LA versus generic oral FTC/TDF for HIV PrEP in the USA from a healthcare sector perspective. Methods: PrEP-eligible adults entered the Markov model receiving CAB–LA or FTC/TDF and could continue initial PrEP, transition to a second PrEP option, or discontinue PrEP over time. Efficacy was taken from the HPTN 083 and HPTN 084 clinical trials. Individuals who acquired HIV-1 infection incurred lifetime HIV-related costs, could transmit HIV onwards, and could develop PrEP-related resistance mutations. Input parameter values were obtained from public and published sources. Model outcomes were discounted at 3%. Results: The model estimated that the CAB–LA pathway prevented 4.5 more primary and secondary HIV-1 infections per 100 PrEP users than the oral PrEP pathway, which yielded 0.2 fewer quality-adjusted life-years (QALYs) lost per person. Additional per-person lifetime costs were $9476 (2022 US dollars), resulting in an incremental cost-effectiveness ratio of $46,843 per QALY gained. Results remained consistent in sensitivity and scenario analyses, including in underserved populations with low oral PrEP usage. Conclusions: Our analysis suggests that initiating CAB–LA for PrEP is cost-effective versus generic daily oral FTC/TDF for individuals at risk of acquiring HIV-1 infection. [ABSTRACT FROM AUTHOR]

Background: To retrospectively review lateral wall orbital decompression for thyroid eye disease (TED) and to evaluate pre-operative CT scans to analyse the variation in proptosis reduction. Methods: Consecutive lateral wall orbital decompressions performed by a single surgeon were retrospectively reviewed. Pre-operative CT scan features and post-operative proptosis reduction were analysed. The sphenoid trigone cross-sectional areas were summed and multiplied by the slice thickness to yield bone volume. Cumulative extraocular muscle thickness was calculated by combining the maximum thickness of the four recti. "Trigone volume" and "cumulative muscle thickness" were correlated with proptosis reduction at 3 months post-surgery. Results: Out of 73 consecutive lateral wall orbital decompressions, 17 orbits had prior endonasal medial wall orbital decompression. In the remaining 56 orbits, the mean pre-operative and post-operative proptosis were 24.3 ± 1.6 mm and 20.9 ± 2.3 mm respectively. The proptosis reduction ranged from 1 to 7 mm (mean of 3.5 mm ± 1.3 (p < 0.001)). Mean sphenoid trigone volume was 895 ± 434.4 mm3. The mean cumulative muscle thickness was 20.4 ± 5 mm. The correlation coefficient between muscle thickness and proptosis reduction was − 0.3 and was statistically significant (p = 0.043). The correlation coefficient between sphenoidal trigone volume and proptosis reduction was 0.2 (p = 0.068). With a multivariate analysis, the coefficient of efficient of regression for muscle thickness was − 0.007 (p = 0.42) and the coefficient of regression for trigone volume was 0.0 (p = 0.046). Conclusion: Proptosis reduction following lateral wall orbital decompression can be variable. Extraocular muscle thickness had a significant correlation with the outcome, with greater proptosis reduction in orbits with thin muscles. The sphenoidal trigone size had a weak correlation with decompression outcome. [ABSTRACT FROM AUTHOR]

Animals must make route choices every day when moving through their habitat while foraging. Choosing an optimal route can be cognitively costly, and primates and other animals have been shown to use simple heuristics, "rules of thumb", to make foraging route choices. We investigated the potential use of heuristics among foraging free-ranging Japanese monkeys (Macaca fuscata) during solitary foraging trials. We also investigated the potential influence of individual variables (age and sex) and social variables (presence in the central group, presence of potential inter- and intraspecific competitors), on the use of heuristics, route length and trial time. We used a multi-destination foraging experiment with 6 platforms in a (4 m × 8 m) Z-array, completed by 29 Japanese macaques in 155 runs at the Awajishima Monkey Center in Japan. Our results showed that the macaques chose routes consistent with heuristics (e.g. nearest neighbour heuristic 19.4%, convex hull heuristic 4.5%) and selected optimal routes (shortest path in 23.9% of the trials). We also identified a potential new heuristic that was used most frequently, that we termed the "sweep heuristic" (27.1% of trials), which we interpreted as a strategy to deal with competitive foraging trade-offs – choosing routes to prioritize not leaving isolated food pieces behind. Age was significantly related to trial time; juvenile macaques were faster than adults and young adults, using speed to gain access to resources. Solitary trials with conspecifics present took significantly longer routes. Our results suggest that contextual factors led to variation in Japanese macaque decision-making, and we suggest that the preferential use of a sweep heuristic may have been a response to high intragroup competition. [ABSTRACT FROM AUTHOR]

Adolescents living in residential juvenile justice facilities often receive mental health services during their stay to address committed offenses, yet some display challenging behavior during moments of conflict within the facility. These challenging behaviors could result in risk of harm to self or others, or the individual may experience punishment from facility staff. The purpose of this study was to explore the effects of an additive voluntary focused intervention for individuals who continued to display challenging behavior despite participation in "treatment as usual" in a juvenile justice facility. We implemented a self-management intervention, supported through interprofessional collaboration, via telehealth with four male adolescents. Using Behavior Skills Training, we taught participants to self-monitor precursors for challenging behavior and identify an alternative behavior to engage in to prevent overt challenging behavior events. Alternative behaviors were responses incompatible with the challenging behavior, or served as a rule to prompt self-management of further behavior. Results show all four participants increased their selection of alternative behaviors when presented with an evocative situation and a precursor for a severe behavior event during simulations. In addition, three participants stated they would use alternative behaviors across precursors not presented during teaching; however, two participants required booster sessions to maintain appropriate responding during simulations. Outside of simulated sessions, facility staff reported modest decreases in participants' challenging behavior during and after the intervention. [ABSTRACT FROM AUTHOR]

Aedes aegypti, presented with a source of L-lactic and 2-ketoglutaric acid in a wind-tunnel bioassay, takeoff, fly upwind, and land on the odorant substrate at rates comparable to those exhibited by mosquitoes presented with a skin-odor stimulus. Addition of carbon dioxide decreased takeoff latency but was not required to elicit upwind flight nor landings. Ketoglutaric acid, a recently identified component of human skin odor, combined with lactic acid elicits the full repertoire of mosquito host-seeking behaviors. [ABSTRACT FROM AUTHOR]

Purpose: To determine the predictive validity of the STarT Back tool (SBT) undertaken at baseline and 6 weeks to classify Emergency Department (ED) patients with LBP into groups at low, medium or high risk of persistent disability at 3 months. A secondary aim was to evaluate the clinical effectiveness of pragmatic risk-matched treatment in an ED cohort at 3 months. Methods: A prospective observational multi-centre study took place in the physiotherapy services linked to the ED in four teaching hospitals in Dublin, Ireland. Patients were stratified into low, medium and high-risk groups at their baseline assessment. Participants received stratified care, where the content of their treatment was matched to their risk profile. Outcomes completed at baseline and 3 months included pain and disability. Linear regression analyses assessed if baseline or 6-week SBT score were predictive of disability at 3 months. Changes in the primary outcome of disability were dichotomised into those who achieved/ did not achieve a 30% improvement in their RMDQ at 6 weeks and 3 months. Results: The study enrolled 118 patients with a primary complaint of LBP ± leg pain with 67 (56.7%) completing their 6-week and 3-month follow-up. Baseline RMDQ and being in medium or high risk SBT group at 6 weeks were predictive of persistent disability at 3 months. A total of 54 (80.6%) participants reported a > 30% improvement at 3 months. Conclusion: Disability at baseline and SBT administered at 6 weeks more accurately predicted disability at 3 months than SBT at baseline in an ED population. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this work was to assess the impact of prolonged low immunoglobulin (IgG or IgM) serum concentrations on the potential cumulative serious infection (SI) risk in pediatric patients following rituximab treatment for granulomatosis with polyangiitis or microscopic polyangiitis (GPA/MPA) in PePRS. Methods: Patients aged ≥ 2 to < 18 years received four weekly intravenous rituximab infusions of 375 mg/m2 and concomitant glucocorticoid taper. After 6 months, patients could receive further rituximab and/or other immunosuppressants per investigator discretion. Immunoglobulin levels and SIs were assessed throughout the 4.5-year observation period. Prolonged low IgG or IgM was defined as below the lower limit of normal age-specific reference range for ≥ 4 months. Results: A total of 25 patients were included, of whom 19 (76%) had GPA and six (24%) had MPA; 18 (72%) had newly diagnosed disease and seven (28%) had relapsing disease. All 25 patients completed the rituximab induction regimen; 24 completed ≥ 18 months of follow-up. At month 18, eighteen patients (72%) had prolonged low IgG; 19 (76%), prolonged low IgM; and 15 (60%), both. Seven patients (28%) had nine SIs; one occurred during or after prolonged low IgG only, two during or after prolonged low IgM only, and six during or after concurrent prolonged low IgG and IgM. No patients died or discontinued the study due to SI. All patients had complete and sustained peripheral B-cell depletion for ≥ 6 months. Conclusions: The majority of pediatric patients who received rituximab for GPA/MPA with prolonged low immunoglobulin levels did not experience SIs. In patients with SIs, these events were manageable, and the number of SIs did not increase over time or with multiple rituximab treatments. These observations are consistent with the rituximab safety profile in adults with GPA/MPA. Trial registration: ClinicalTrials.gov identifier, NCT01750697. [ABSTRACT FROM AUTHOR]

The small hive beetle, Aethina tumida (Coleoptera: Nitidulidae), is an economically important pest of the Western honeybee, Apis mellifera (Hymenoptera: Apidae). We investigated the effect of rearing environment on the cuticular chemical profile of adult A. tumida, using hexane to extract the hydrocarbons and other compounds from the cuticles of beetles. Beetles were collected from A. mellifera colonies in Australia as well as reared in single sex laboratory cultures on different diets. We investigated whether rearing environment (laboratory vs. field, different apiaries, access to mating partners, diet) had any effect on cuticular hydrocarbons. Coupled gas chromatography–mass spectrometry analyses of the extracts showed that rearing environment had significant qualitative and quantitative effects on the hydrocarbons detected. The data support the hypothesis that cuticular profiles of A. tumida are contingent on environment, partitioning on the basis of rearing diet and source hives. The finding has implications for the regulation of interactions between A. tumida and honeybees and improvements in targeting of management strategies. [ABSTRACT FROM AUTHOR]

Empathy, the understanding of the emotional state of others, can be examined across species using the Perception Action Model, where shared affect promotes an action by "Observers" to aid a distressed "Target". The anterior insula (AI) has garnered interest in empathic behavior due to its role integrating sensory and emotional information of self and other. In the following studies, the AI was inhibited pharmacologically and chemogenetically during targeted helping. We demonstrate the insula is active during, and is necessary for the maintenance of, targeted helping. Analysis of ultrasonic vocalizations revealed distress calls from Targets increased when Observers' helping was attenuated due to insula inhibition. Targets' elevated distress was directly correlated to Observers' diminished helping behavior, suggesting emotional transfer between Observer and Target is blunted following Observer AI inhibition. Finally, the AI may selectively blunt targeted helping, as social exploration did not change in a social reward place conditioning task. These studies help further establish the anterior insula as a critical node in the empathic brain during targeted helping, even in the absence of direct social contact. [ABSTRACT FROM AUTHOR]

The U.S. Federal Communications Commission is responsible for regulation in the communications marketplace and for management of the nation's non-federal radio frequency spectrum. During the past year, FCC economists assisted in the development of initiatives that were aimed at closing the connectivity gap which proved especially critical in light of the COVID-19 pandemic; contributed to the Commission's extensive responses to COVID-19; were involved in various spectrum auctions; evaluated competition in the communications marketplace in the 2020 Communications Marketplace Report; and published a series of working papers. [ABSTRACT FROM AUTHOR]

Background: Ibalizumab-uiyk (ibalizumab) is a first-in-class, long-acting, postattachment HIV-1 inhibitor for adults with multidrug-resistant (MDR) HIV-1 infection. This analysis examines the cost-effectiveness and budget impact of ibalizumab treatment for this difficult-to-treat population in the United States. Methods: A Markov model followed cohorts of adults with MDR HIV-1 infection through two final lines of antiretroviral therapy: ibalizumab + optimized background therapy (OBT) or OBT alone followed by nonsuppressive therapy. Model inputs were based on ibalizumab clinical trial data, market uptake projections, and published literature, with costs in 2019 dollars. The cost-effectiveness analysis assessed costs and health outcomes from a health care sector perspective for individuals receiving ibalizumab + OBT versus OBT alone over a lifetime time horizon. The budget-impact analysis estimated the impact on payer budgets of the introduction of ibalizumab over 3 years for a hypothetical commercial health plan. Results: Compared with individuals receiving OBT alone, individuals receiving ibalizumab + OBT incurred higher costs but lived longer, healthier lives, with an incremental cost of $133,040 per QALY gained. For a hypothetical commercial health plan with 1 million members, the introduction of ibalizumab + OBT was estimated to increase budgets by $217,260, $385,245, and $560,310 ($0.018, $0.032, and $0.047 per member per month) in years 1, 2, and 3, respectively. These results were found to be robust in sensitivity and scenario analyses. Conclusions: Ibalizumab may represent a cost-effective and affordable option to improve health outcomes for individuals with MDR HIV-1 infection. [ABSTRACT FROM AUTHOR]

The U.S. Federal Communications Commission is responsible for regulation in the communications marketplace and for management of the nation's non-federal radio frequency spectrum. During the past year, FCC economists helped develop efficient mechanisms for making available more flexible-use spectrum for the deployment of advanced broadband technologies; developed two new universal service funding mechanisms that aim to close the digital broadband divide; and, through careful analysis of firm cost data, contributed to a renewed effort by the Commission to develop price caps for interstate calls on prison inmate calling services. FCC economists also contributed to the Commission's extensive response to COVID-19. [ABSTRACT FROM AUTHOR]

Climate change is likely to negatively affect the habitats of non-human primate species. Recent research has identified a near-linear relationship between cumulative CO2 emissions, and the resulting regional and seasonal temperature increase. Here, we use this relationship to assess the potential impact that cumulative CO2 emissions could have on the ranges available to primate species. We used data from the International Union for Conservation of Nature on ranges for 426 species and subspecies of non-human primates, combined with spatial climate data from the Coupled Model Intercomparison Project Phase 5 that represent regional and seasonal temperature changes per unit CO2 emissions. Using these data, we estimated the portion of the area of each species' range where annual average temperatures exceed the Pre-industrial Seasonal Maximum Temperatures (PSMT), for cumulative CO2 emissions from 600 to 2000 billion tonnes of carbon. For the level of emissions corresponding to a 2 °C global temperature increase scenario, 26.1% of all ranges had temperatures in excess of their PSMTs, and for 8% of species, the entire current range was above their PSMT. This suggests the potential for considerable loss of or compromised habitat for non-human primates on a global scale, as a result of the emergence of climate conditions that are outside of the scope of historical experience for many species. Our results point to key priorities for conservation efforts, as well as the need for future research on strategies to increase the resilience of vulnerable local non-human primate populations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if using student recorded PechaKucha™ 20 × 20 presentations as an assignment in an online classroom yielded equivalent student learning compared to a similar written assignment. Twenty-one (15 women and 6 men) online graduate students participated in a mixed-method study using online surveys with a quasi-experimental design. While it was determined that student learning was similar regardless of assignment type (t(20) = 1.481, p =.154), the study revealed benefits of using recorded PechaKucha presentations, including increased content engagement and increased student enjoyment. [ABSTRACT FROM AUTHOR]

Ionic liquids offer exciting possibilities for biocatalysis as solvent properties provide rare opportunities for customizable, energy-efficient bioprocessing. Unfortunately, proteins and enzymes are generally unstable in ionic liquids and several attempts have been made to explain why; however, a comprehensive understanding of the ionic liquid–protein interactions remains elusive. Here, we present an analytical framework (circular dichroism (CD), fluorescence, ultraviolet-visible (UV/Vis) and nuclear magnetic resonance (NMR) spectroscopies, and small-angle X-ray scattering (SAXS)) to probe the interactions, structure, and stability of a model protein (green fluorescent protein (GFP)) in a range (acetate, chloride, triflate) of pyrrolidinium and imidazolium salts. We demonstrate that measuring protein stability requires a similar holistic analytical framework, as opposed to single-technique assessments that provide misleading conclusions. We reveal information on site-specific ionic liquid–protein interactions, revealing that triflate (the least interacting anion) induces a contraction in the protein size that reduces the barrier to unfolding. Robust frameworks such as this are critical to advancing non-aqueous biocatalysis and avoiding pitfalls associated with single-technique investigations. Ionic liquids are used as solvents in biocatalysis but how they interact with the structures of proteins is imperfectly understood. Here the effect of three common ionic liquids on the structure of green fluorescent protein is studied using a suite of experimental techniques, finding a complex relationship which is poorly captured by any single technique. [ABSTRACT FROM AUTHOR]

An immunoassay was previously developed as a technique to improve methods for detection and analysis of fly artifacts found at crime scenes. The dot blot assay utilized a polyclonal antiserum (anti-md3) based on a unique digestive cathepsin D found in cyclorrhaphous Diptera. In this study, artifacts produced by adults of Calliphora vicina, Cynomya cadaverina, Sarcophaga bullata, and Protophormia terraenovae were examined using the immunoassay to determine if insect-derived stains could be distinguished from a range of human body fluid stains. A lift technique was developed which permitted transfer of fly artifacts from test materials to filter paper for dot blot analyses. All species readily deposited artifacts on all test household materials regardless of diet consumed. Despite differences in texture and porosity of the household materials, artifacts of all species transferred to the filter paper. With all fly species, anti-md3 serum bound to artifacts produced after feeding on semen, blood, feces, urine, and saliva. By contrast, anti-md3 serum did not react with any of the human fluids tested, nor with any of the lifts from household materials not exposed to flies. There was no evidence of false positives with any of the fly species tested, regardless of diet consumed. There was also no indication of false negatives with any of the dot blot assays. These observations suggest that immunoassays using anti-md3 serum performed on a simple lift of suspected fly artifacts can be used effectively as a confirmatory assay to distinguish fly regurgitate and fecal stains from human body fluids. [ABSTRACT FROM AUTHOR]

In a series of experiments with undergraduate participants, we used a force-transducing device to determine how response force varies across different conjugate reinforcement and extinction conditions. In Experiment 1, we assessed how different parameters of response-contingent volume change in audiovisual stimuli maintained conjugate responding on a force transducer during conjugate reinforcement and extinction components. Response force and schedule force-multiplier values covaried, such that response force tended to decrease as force multipliers increased. Furthermore, proportionally greater response force was observed in extinction components following denser (i.e., 100x conjugate reinforcement) components compared to leaner (i.e., 5x conjugate reinforcement) components. In Experiment 2, we assessed the degree to which responding was maintained when conjugate changes in the audiovisual stimuli were delivered response-contingently or response-independently across reinforcement and extinction components. Response-independent reinforcer delivery yielded mixed results, but mean response force was proportionally higher in extinction sessions for all four participants following response-independent reinforcer delivery compared to extinction following response-contingent reinforcer delivery. Results from this project highlight the utility of the preparation described by Falligant, Rapp, Brogan, and Pinkston (2018) for studying response force in conjugate schedules to assess extinction-induced variability. [ABSTRACT FROM AUTHOR]

Grapevine leafroll-associated virus 3 (GLRaV-3) is an economically significant virus of grapevines, with secondary spread mediated by several species of mealybug and soft scale insects. To better understand virus-vector interactions, sensitive virus detection in these insects is a key tool. In this research, two new hydrolysis-probe-based real-time assays for GLRaV-3 detection were developed and compared to three existing assays. Of the five assays compared, the one-step RT-qPCR probe-based assay was the most sensitive and reliable, with as few as 10 virus RNA copies detected. This is the first description of a real-time molecular assay for virus detection in mealybugs with such sensitivity. [ABSTRACT FROM AUTHOR]

Persons who inject drugs (PWID) continue to experience disproportionate HIV burden. Though studies demonstrate PWID find pre-exposure prophylaxis (PrEP) acceptable, awareness and uptake remains low. Data from the 2015 PWID cycle of the National HIV Behavioral Surveillance (n = 612) in Philadelphia, Pennsylvania (USA) were analyzed to evaluate how socio-demographics and behavioral factors impact PrEP awareness. Only 12.4% of PWID surveyed were PrEP-aware and 2.6% reported receiving a prescription. Factors associated with PrEP awareness included having at least some college education (aOR 2.13, 95% CI 1.03, 4.43), sharing paraphernalia (aOR 2.37, 95% CI 1.23, 4.56), obtaining syringes/needles primarily from a syringe exchange program (aOR 2.28, 95% CI 1.35, 3.87), STI testing (aOR 1.71, 95% CI 1.01, 2.89) and drug treatment (aOR 2.81, 95% CI 1.62, 4.87). Accessing prevention and health services increased the odds of being PrEP-aware; however, awareness was low overall. Additional promotion efforts are warranted. [ABSTRACT FROM AUTHOR]

Purpose: Spondylodiscitis represents a condition with significant heterogeneity. A significant proportion of patients are managed without surgical intervention, but there remains a group where surgery is mandated. The aim of our study was to create a scoring system to guide clinicians as to which patients with spondylodiscitis may require surgery.Methods: A retrospective analysis of patients presenting to our institution with a diagnosis of spondylodiscitis between 2005 and 2014 was performed. Data for 35 variables, characterised as potential risk factors for requiring surgical treatment of spondylodiscitis, were collected. Logistic regression analysis was performed to evaluate the predictability of each. A prediction model was constructed, and the model was externally validated using a second series of patients from 2014 to 2015 meeting the same standards as the first population. The predicted odds were calculated for every patient in the data set. Receiver operating characteristic (ROC) curves were created, and the area under curve (AUC) was determined.Results: Sixty-five patients were identified. Surgery was deemed necessary in 21 patients. Six predictors: distant site infection, medical comorbidities, the immunocompromised patient, MRI findings, anatomical location and neurology, were found to be the most consistent risk factors for surgical intervention. An internally validated scoring system with an AUC of 0.83 and an Akaike information criterion (AIC) of 115.2 was developed. External validation using a further 20 patients showed an AUC of 0.71 at 95% confidence interval of 0.50-0.88.Conclusions: A new scoring system has been developed which can help guide clinicians as to when surgical intervention may be required. Further prospective analyses are required to validate this proposed scoring system. These slides can be retrieved under Electronic Supplementary Material. [ABSTRACT FROM AUTHOR]

Rationale: Parkinson’s disease (PD) impairs working memory (WM)—the ability to maintain items in memory for short periods of time and manipulate them. There is conflicting evidence on the nature of the deficits caused by the disease, and the potential beneficial and detrimental effects of dopaminergic medication on different WM processes.Objectives: We hypothesised that PD impairs both maintenance and manipulation of items in WM and dopaminergic medications improve this in PD patients but impair it in healthy older adults.Methods: We tested 68 PD patients ON and OFF their dopaminergic medication, 83 healthy age-matched controls, and 30 healthy older adults after placebo and levodopa administration. We used the digit span, a WM test with three components (forwards, backwards, and sequence recall) that differ in the amount of manipulation required. We analysed the maximum spans and the percentage of lists correctly recalled, which probe capacity of WM and the accuracy of the memory processes within this capacity, respectively.Results: PD patients had lower WM capacity across all three digit span components, but only showed reduced percentage accuracy on the components requiring manipulation (backwards and sequence spans). Dopaminergic medication did not affect performance in PD patients. In healthy older adults, levodopa did not affect capacity, but did impair accuracy on one of the manipulation components (sequence), without affecting the other (backwards).Conclusions: This suggests that the deficit of maintenance capacity and manipulation accuracy in PD patients is not primarily a dopaminergic one and supports a potential “overdosing” of intact manipulation mechanisms in healthy older adults by levodopa. [ABSTRACT FROM AUTHOR]

In conjugate schedules of reinforcement, the amplitude or intensity of a reinforcing event is proportional to an aspect of the target behavior or response (e.g., MacAleese, Ghezzi, & Rapp, Journal of the Experimental Analysis of Behavior, 104, 63-73, 2015). In a novel series of experiments, MacAleese et al. demonstrated that changes in clarity of a visual stimulus conjugately reinforced an arbitrary target response in a sample of undergraduates. In Experiment 1, we extended the results from MacAleese et al. (2015) by evaluating whether different parameters of response-contingent volume change in audiovisual stimuli conjugately reinforced responses on a force transducer in a sample of undergraduates. In Experiment 2, we evaluated the degree to which responding was maintained when conjugate changes in the volume of audiovisual stimuli (either high-preferred or low-preferred) were provided as a consequence for exerting force on the manipulandum. In Experiment 3, we evaluated the degree to which responding was maintained across multiple extinction components. Results from these experiments indicate response force covaries with changes to the amount of force required to produce conjugate changes in audiovisual stimulation. Furthermore, results suggest force may be an important index of response effort and preference across low-and-high preferred stimuli within this conjugate schedule framework, as well as an important index of extinction-induced variability. [ABSTRACT FROM AUTHOR]

Successful family-based weight loss interventions for African American adolescents are rare. Parent-adolescent interactions supporting adoption of healthier nutrition and physical activity practices are not well understood. African American caregivers' and adolescents' perspectives on how they worked together to achieve weight loss need further exploration. This study describes the relationships experienced by adolescents and caregivers during the 6-month, evidence-based FIT Families weight loss trial and explores differences between families whose adolescents were successful and unsuccessful with weight loss. Exit interviews conducted with 136 adolescents (age 12–16 years; BMI percentile ≥95) and their caregivers (primarily mothers) were taped and transcribed verbatim. Content and thematic analysis was conducted to explore differences between groups stratified by weight loss. Five adolescent-caregiver relationship patterns emerged which describe dyads working together, working alone, working against each other; caregiver support and caregiver working on self. When relationship patterns were compared between groups stratified by weight loss, three themes emerged: motivation, support, and persistence. Families that achieved the greatest weight loss referred more often to working together to reach weight loss goals, attributed their success to adolescent self-motivation, with engaged caregiver support which allowed families to persist in change efforts. Family relationships involving adolescent autonomy, engaged parental support, and persistence despite challenges, clustered differently among adolescents who were successful at weight loss compared to those who were not. Interventionists trained to reinforce effective adolescent-parent interactions will advance behavioral interventions for families who have typically benefited least in prior interventions. [ABSTRACT FROM AUTHOR]

Better understanding of the pathogenesis and treatment of primary systemic vasculitides (PSV) has led to the development of many potentially clinically relevant biomarkers. Genome-wide association studies have highlighted that MHC class II polymorphisms may influence the development of particular anti-neutrophil cytoplasmic antibody (ANCA) serotypes, but not the clinical phenotype of ANCA-associated vasculitis (AAV). Although ANCAs are overall poor biomarkers of disease activity, they may be useful for the prediction of flares of renal and/or pulmonary vasculitis. Moreover, patients with proteinase 3 (PR3)-AAV may respond better to rituximab than cyclophosphamide. Newer biomarkers of renal vasculitis in AAV include urinary soluble CD163, and may in the future reduce the requirement for renal biopsy. Better understanding of dysregulated neutrophil activation in AAV has led to the identification of novel biomarkers including circulating microparticles, and neutrophil extracellular traps (NETs), although their clinical utility has not yet been realised. Studies examining endothelial injury and repair responses have additionally revealed indices that may have utility as disease activity and/or prognostic biomarkers. Last, next-generation sequencing technologies are revealing monogenic forms of vasculitis, such as deficiency of adenosine deaminase type 2 (DADA2), and are profoundly influencing the approach to the diagnosis and treatment of vasculitis in the young. [ABSTRACT FROM AUTHOR]

Among the stressors confronting urban wildlife, chemical contaminants pose a particular problem for high trophic feeding species. Previous data from fortuitous carcass collections revealed surprisingly high levels of persistent organic pollutants in raptor species, including the Cooper's hawk ( Accipiter cooperii), from urbanized areas of southwestern British Columbia, Canada. Thus, in 2012 and 2013, we followed up on that finding by measuring POPs in blood samples from 21 adult and 15 nestling Cooper's hawks in Vancouver, a large urban area in southwestern Canada. Reproductive success and circulating thyroid hormones were measured to assess possible toxicological effects. Model comparisons showed concentrations of polychlorinated biphenyls (ΣPCBs) were positively influenced by the level of urbanization. Total thyroxin (TT4) was negatively associated with increases in ΣPCBs. Total triiodothyronine (TT3) was negatively associated with ΣPCBs and polybrominated diphenyl ethers (ΣPBDEs). The legacy insecticide, dieldrin, appeared to have some negative influence on reproductive success. There is some evidence of biochemical perturbation by PBDEs and lingering impact of legacy POPs which have not been used for at least 40 years, but overall Cooper's hawks have successfully populated this urban environment. [ABSTRACT FROM AUTHOR]

Considerable progress has been made over the last decades in thermal spray technologies, practices and applications. However, like other technologies, they have to continuously evolve to meet new problems and market requirements. This article aims to identify the current challenges limiting the evolution of these technologies and to propose research directions and priorities to meet these challenges. It was prepared on the basis of a collection of short articles written by experts in thermal spray who were asked to present a snapshot of the current state of their specific field, give their views on current challenges faced by the field and provide some guidance as to the R&D required to meet these challenges. The article is divided in three sections that deal with the emerging thermal spray processes, coating properties and function, and biomedical, electronic, aerospace and energy generation applications. [ABSTRACT FROM AUTHOR]

Inadequately managed cancer pain continues to be a significant problem despite increased awareness, improved knowledge and understanding of pain pathophysiology, and standardized treatment guidelines of this distressing and debilitating symptom complex. Small subsets of patients who are refractory to optimal medical management because of drug toxicity or unsatisfactory analgesia may be candidates for exteriorized or implantable intrathecal drug delivery systems. By delivering opioids and other agents directly to the central nervous system, intrathecal drug administration can offer superior pain relief with less toxicity at a fraction of the systemic dose. With adjuncts such as local anesthetics and clonidine, intrathecal therapy also allows for broader therapeutic options in the most difficult of cases. In general, intrathecal therapy is underused despite evidence of its efficacy, safety, and cost-effectiveness. [ABSTRACT FROM AUTHOR]

There are currently limited data regarding paediatric Behçet's disease (BD), particularly in the UK. We describe the clinical spectrum, treatment and outcome of BD, and explore the relative sensitivities of the criteria for the diagnosis of BD in a UK paediatric cohort. Single retrospective case note review of children with a clinical diagnosis of BD presenting between 1987 and 2012. Demographics, clinical features, treatment and outcomes were recorded. The sensitivities of the International Study Group (ISG) and International Criteria for BD (ICBD) criteria were explored. BD disease activity was calculated using the Behçet's Disease Activity Index (BDAI). Forty-six patients (22 male) were identified. Median age of onset was 4.87 (0.04-15.71) years; median time to diagnosis was 3.74 (0.25-13.48) years. Clinical features were recurrent oral ulceration (97.8 %), recurrent genital ulceration (73.9 %), gastrointestinal (58.7 %), musculoskeletal (47.83 %), cutaneous (23.9 %) involvement and uveitis (2 %). Recurrent genital ulceration was more common in female patients ( P = 0.044). Thirty-seven patients (80.4 %) fulfilled the ICBD criteria; only 12 patients (26.1 %) fulfilled the ISG criteria. BDAI score at diagnosis was 7/20 (0-10/20) and significantly decreased to 5/20 (0-9/20) ( P < 0.0001) at latest follow-up. The commonest systemic treatment was colchicine (76.1 %); anti-TNFα treatment was reserved for severe cases (15.5 %). Paediatric BD in the UK may present very early in life, sometimes with a family history, and with a low incidence of ocular involvement. Diagnostic delay is common. The majority of our patients required systemic therapy; anti-TNFα was reserved for severe cases and has largely superseded the use of thalidomide. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the abnormalities identified with conventional MRI in children with neuropsychiatric systemic lupus erythematosus (NPSLE). This was single-centre (Great Ormond Street Hospital, London) retrospective case series of patients with juvenile NPSLE seen in 2003-2013. Brain MR images of the first episode of active NPSLE were reviewed. All patients fulfilled the 1999 ACR case definitions for NPSLE syndromes. Presenting neuropsychiatric manifestations, immunological findings and treatment are reported. Results are expressed as median and ranges or percentages. Fisher's exact test was used to identify clinical predictors of abnormal MRI. A total of 27 patients (22 females), median age 11 years (4-15), were identified. Presenting clinical symptoms included the following: headaches (85.1 %), mood disorder/depression (62.9 %), seizures (22.2 %), acute psychosis (18.5 %), cognitive dysfunction (14.8 %), movement disorder (14.8 %), acute confusional state (14.8 %), aseptic meningitis (7.4 %), demyelinating syndrome (3.7 %), myelopathy (3.7 %), dysautonomia (3.7 %) and cranial neuropathy (3.7 %). The principal MR findings were as follows: (1) absence of MRI abnormalities despite signs and symptoms of active NPSLE (59 %); (2) basilar artery territory infarction (3 %); (3) focal white matter hyperintensities on T2-weighted imaging (33 %); (4) cortical grey matter lesions (3 %); and (5) brain atrophy (18.5 %). The presence of an anxiety disorder strongly associated with abnormal MRI findings ( p = 0.008). In over half the children with NPSLE, no conventional MRI abnormalities were observed; white matter hyperintensities were the most commonly described abnormalities. Improved MR techniques coupled with other alternative diagnostic imaging modalities may improve the detection rate of brain involvement in juvenile NPSLE. [ABSTRACT FROM AUTHOR]