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OBJECTIVE: This randomized clinical trial tested the effectiveness of an addiction-based digital weight-loss intervention, focusing on withdrawal/abstinence from self-identified problem foods, snacking and excessive amounts at meals, and discomfort displacement, with and without coaching, compared to an in-person, multi-disciplinary, care model among adolescents with obesity. We hypothesized that the digital intervention with coaching would yield greater weight loss and lower delivery burden than the standard clinical arm, and greater participant engagement than the digital arm without coaching. METHODS: Adolescents were randomized to app intervention, with or without coaching, or in-person multidisciplinary obesity intervention for 6 months. The primary outcome was change in %BMI(p95) at weeks 12 and 24. A mixed-effects linear regression model was used to assess the association between change in %BMI(p95) and intervention arm. We were also interested in assessing delivery burden, participant engagement and evaluating the relationships between weight change and demographic characteristics, mood, executive function and eating behaviours. RESULTS: All adolescents (n = 161; BMI ≥95th%, age 16 ± 2.5 year; 47% Hispanic, 65% female, 59% publicly insured) lost weight over 24-weeks (−1.29%, [−1.82, −0.76], p < 0.0001), with no significant weight loss difference between groups (p = 0.3). Girls lost more weight than boys, whereas binge eating behaviour at baseline was associated with increase in %BMI(p95) when controlling for other covariates. There was no association between ethnicity, mood, timing of intervention in relation to the pandemic, or executive function and change in %BMI(p95). CONCLUSIONS: Contrary with our hypothesis, our results showed no difference in the change in BMI status between treatment arms. Since efficacy of this digital intervention was not inferior to in-person, multi-disciplinary care, this could offer a reasonable weight management option for clinicians, based on youth and family specific characteristics, such as accessibility, resources, and communication styles.

Adequate anchoring of the placenta in the uterus through invasion of first trimester cytotrophoblasts (CTB) is required for a successful pregnancy. This process is mediated by matrix metalloproteinases (MMPs) and regulated by the maternal environment. Obesity is known to alter the intrauterine milieu and has been related to impaired invasion. We hypothesized that placental MMP15, a novel membrane‐type MMP, is involved in CTB invasion and regulated by maternal obesity in early pregnancy. Thus, in this study MMP15 was immunolocalized to invasive extravillous and interstitial CTB. MMP15 silencing in chorionic villous explants using two different siRNAs reduced trophoblast outgrowth length (−35%, P ≤ .001 and −26%, P

Natural killer (NK) cells are innate lymphocytes that efficiently eliminate cancerous and infected cells. NKp46 is an important NK activating receptor shown to participate in recognition and activation of NK cells against pathogens, tumor cells, virally infected cells, and self-cells in autoimmune conditions, including type I and II diabetes. However, some of the NKp46 ligands are unknown and therefore investigating human NKp46 activity and its critical role in NK cell biology is problematic. We developed a unique anti-human NKp46 monocloncal antibody, denoted hNKp46.02 (02). The 02 mAb can induce receptor internalization and degradation. By binding to a unique epitope on a particular domain of NKp46, 02 lead NKp46 to lysosomal degradation. This downregulation therefore enables the investigation of all NKp46 activities. Indeed, using the 02 mAb we determined NK cell targets which are critically dependent on NKp46 activity, including certain tumor cells lines and human pancreatic beta cells. Most importantly, we showed that a toxin- conjugated 02 inhibits the growth of NKp46- positive cells ; thus, exemplifying the potential of 02 in becoming an immunotherapeutic drug to treat NKp46-dependent diseases, such as, type I diabetes and NK and T cell related malignancies.

Are most disputes in mediation just about money? That's an old and familiar question that many lawyers still seem to reply to with an emphatic “yes.” Mediated cases are frequently viewed as a clash of binary claims, subject only to a sorting out of financial winners and losers.

The American Psychiatric Association estimates that 3 to 7 per cent of all school aged children are diagnosed with attention deficit hyperactivity disorder (ADHD). Even after correcting for general cognitive ability, numerous studies report a negative association between ADHD and educational achievement. With polygenic scores we examined whether genetic variants that have a positive influence on educational attainment have a protective effect against ADHD. The effect sizes from a large GWA meta-analysis of educational attainment in adults were used to calculate polygenic scores in an independent sample of 12-year-old children from the Netherlands Twin Register. Linear mixed models showed that the polygenic scores significantly predicted educational achievement, school performance, ADHD symptoms and attention problems in children. These results confirm the genetic overlap between ADHD and educational achievement, indicating that one way to gain insight into genetic variants responsible for variation in ADHD is to include data on educational achievement, which are available at a larger scale. (C) 2014 Wiley Periodicals, Inc.

Die hydrothermale Carbonisierung (HTC) eroffnet eine verfahrenstechnisch praktikable Moglichkeit, um aus einer Vielzahl von organischen Rest- und Abfallstoffen wertvollere Produkte zu erzeugen. Diese konnen Humus oder eine Art Biokohle sein, die als lagerfahiger und leicht zu transportierender Brennstoff oder evtl. als Bodenverbesserer genutzt werden kann. Daruber hinaus konnen spezialisierte, nanostrukturierte Materialien hergestellt werden. Im Gegensatz zu anderen Prozessen der Biomasseumwandlung sind die Anforderungen an den Rohstoff relativ gering. Besonders fur feuchte Biomasse mit geringen Anteilen an reinen Wertstoffen wie Pflanzenol, Starke oder Zucker bietet sich die HTC an. Der Beitrag fasst den Stand des Wissens zusammen und erganzt an geeigneten Stellen durch eigene Untersuchungen.

Unlike the United States, all Canadian provinces and the federal government have adopted legislation implementing the UNCITRAL Model Law on International Commercial Arbitration (bit.ly/1DbWZiC) that governs international arbitrations conducted in Canada and the enforcement of international arbitration awards. Principles first enunciated in the 1958 New York Convention (bit.ly/1n4KXNT) and amplified in the Model Law that limit judicial intervention and preclude any review of the merits of an arbitral award on matters of either fact or law are therefore applicable and consistently enforced throughout Canada with respect to international arbitrations. The Canadian province of British Columbia was the first jurisdiction anywhere in the world to adopt the Model Law.

Although anxiety is one of the most prominent psychiatric complaints of methamphetamine (MA) users, little is known about the association between anxiety disorders and treatment outcomes in this population. Using data from 526 adults in the largest psychosocial clinical trial of MA users conducted to date, this study examined psychiatric, substance use, and functional outcomes of MA users with concomitant anxiety disorders 3 years after treatment. Anxiety disorders were associated with poorer alcohol and drug use outcomes, increased health service utilization, and higher levels of psychiatric symptomatology, including suicidality. Addressing anxiety symptoms and syndromes in MA users may be helpful as a means of optimizing treatment outcomes. (Am J Addict 2010;00:1–6)

Different laboratory crystal populations of potassium chloride are described and compared with similar types of industrial crystals. Laboratory experiments have shown that the crystal characteristics, i.e. size distribution, crystal habit and degree of agglomeration are strongly affected by the degree of supersaturation at the beginning of crystallisation. Similarity of crystal characteristics indicates similarity of factors governing growth conditions, hence the industrial growth conditions, especially supersaturation in a crystalliser, may be determined by inspection of the final product.

Introduction and Aims. Although psychiatric symptoms are frequently observed in methamphetamine (MA) users, little is known about the prevalence of psychiatric disorders in MA-dependent individuals. This is the first study to examine the association of psychiatric disorders with substance use and psychosocial functioning in a large sample of MA users 3 years after treatment. We predicted that psychiatric diagnoses and severity would be associated with substance use and poorer overall functioning over the 3 year post-treatment course. Design and Methods. Participants (N = 526) received psychosocial treatment for MA dependence as part of the Methamphetamine Treatment Project and were reassessed for psychosocial functioning and substance use at a mean of 3 years after treatment initiation. DSM-IV psychiatric diagnoses were assessed at follow-up using the Mini-International Neuropsychiatric Interview. Psychosocial functioning was assessed using the Addiction Severity Index. Results. Overall, 48.1% of the sample met criteria for a current or past psychiatric disorder other than a substance use disorder. Consistent with prior reports from clinical samples of cocaine users, this rate was largely accounted for by mood disorders, anxiety disorders and antisocial personality. Those with an Axis I psychiatric disorder evidenced increased MA use and greater functional impairment over time relative to those without a psychiatric disorder. Discussion and Conclusions. This initial investigation of psychiatric diagnoses in MA users after treatment indicates elevated rates of Axis I and II disorders in this population and underscores the need for integrated psychiatric assessment and intervention in drug abuse treatment settings.[Glasner-Edwards S, Mooney LJ, Marinelli-Casey P, Hillhouse M, Ang A, Rawson RA, The Methamphetamine Treatment Project Corporate Authors. Psychopathology in methamphetamine-dependent adults 3 years after treatment. Drug Alcohol Rev 2009]

Lysosomal storage disorders (LSDs) constitute a diverse group of inherited diseases that result from lysosomal storage of compounds occurring in direct consequence to deficiencies of proteins implicated in proper lysosomal function. Pathology in the LSD mucolipidosis type IV (MLIV), is characterized by lysosomal storage of lipids together with water-soluble materials in cells from every tissue and organ of affected patients. Mutations in the mucolipin 1 (TRPML1) protein cause MLIV and TRPML1 has also been shown to interact with two of its paralogous proteins, mucolipin 2 (TRPML2) and mucolipin 3 (TRPML3), in heterologous expression systems. Heterogeneous lysosomal storage is readily identified in electron micrographs of MLIV patient cells, suggesting that proper TRPML1 function is essential for the maintenance of lysosomal integrity. In order to investigate whether TRPML2 and TRPML3 also play a role in the maintenance of lysosomal integrity, we conducted gene-specific knockdown assays against these protein targets. Ultrastructural analysis revealed lysosomal inclusions in both TRPML2 and TRPML3 knockdown cells, suggestive of a common mechanism for these proteins, in parallel with TRPML1, in the regulation of lysosomal integrity. However, co-immunoprecipitation assays revealed that physical interactions between each of the endogenous TRPML proteins are quite limited. In addition, we found that all three endogenous proteins only partially co-localize with each other in lysosomal as well as extra-lysosomal compartments. This suggests that native TRPML2 and TRPML3 might participate with native TRPML1 in a dynamic form of lysosomal regulation. Given that depletion of TRPML2/3 led to lysosomal storage typical to an LSD, we propose that depletion of these proteins might also underlie novel LSD pathologies not described hitherto.

We investigate the class of groups admitting an action on a set with an invariant mean. It turns out that many free products admit such an action. We give a complete characterisation of such free products in terms of a strong fixed point property.

Kenneth Glasner, of Vancouver, describes how a society of British Columbia dentists set up a mediation program to deal with a wide variety of patient, insurance, and interoffice disputes. The program could be adapted for other self-regulating bodies.

wodurch das Adsorbens samt Kartusche ohne Umfullvorgang in die Mikrowellenanlage eingebracht werden kann. In Laborversuchen wurde fur 40 – 160 g Adsorbat eine Desorptionszeit von 1 – 2 h bei einer Desorptionsrate von 80 % fur Sevofluran und 90 – 100 % fur Isofluran ermittelt. Die Desorption wird bei 80 – 100 °C durchgefuhrt. Bei vergleichbarer konventioneller Beheizung betragt die Desorptionszeit 3 – 8 h. Durch Einsatz von dealuminierten Zeolithen lasst sich die Hydrolyseempfindlichkeit von Sevofluran und somit die Zersetzung zu Hexafluorisopropanol reduzieren. Mit dem vorgestellten Verfahren ist sowohl eine dezentrale als auch zentrale Wiedergewinnung von Anasthetika moglich.