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Flash pulmonary oedema can occur as a result of multiple triggers that may act independently or in concert. One such precipitating factor is bilateral renal artery stenosis which can be treated either with revascularisation or with medical therapy. Unilateral renal artery stenosis, however, is a rare cause of flash pulmonary oedema, especially when the contralateral kidney is still functional. We describe a case of an elderly woman with a history of heart failure with preserved ejection fraction and multiple hospitalisations for hypertensive crisis and flash pulmonary oedema who was found to have right, ostial renal artery stenosis that was treated with stent placement.

Background Informal caregivers of people with dementia provide the majority of health-based care to people with dementia. Providing this care requires knowledge and access to resources, which caregivers often do not receive. We set out to evaluate the effect of online educational tools on informal caregiver self-efficacy, quality of life, burden/stress, depression, and anxiety, and to identify effective processes for online educational tool development. Methods We conducted a scoping review of articles on online educational interventions for informal caregivers of people with dementia searching CINAHL, MEDLINE, EMBASE, and PubMed from 1990 to March 2018, with an updated search conducted in 2020. The identified articles were screened and the data were charted. Results 33 articles that reported on 24 interventions were included. There is some evidence that online interventions improve caregiver-related outcomes such as self-efficacy, depression, dementia knowledge, and quality of life; and decrease caregiver burden. Common findings across the studies included the need for tailored, stage-specific information applicable to the caregiver’s situation and the use of psychosocial techniques to develop the knowledge components of the interventions. Conclusion We demonstrate the importance of having caregivers and health-care professionals involved at all stages of tool conceptualization and development. Online tools should be evaluated with robust trials that focus on how increased knowledge and development approaches affect caregiver-related outcomes.

Families of persons with acquired brain injuries need to be supported from the early phase of hospitalization. To date, no known early family intervention is available for this population. Using the Medical Research Council Framework, we developed a new intervention based on the Calgary Assessment and Intervention Models that includes the family preferences, clinician’s expertise, and the contextual resources. This paper aims to describe the complete development process including a scoping review, an assessment of families and clinicians’ needs, an evaluation of the contextual resources, and an adaptation of the theoretical framework. Using a systemic perspective, we tailored the new intervention to involve the stakeholder’s preferences. The result is an early family intervention named SAFIR©, led by a clinical nurse specialist, including five core components and structured around three phases and a follow-up. The next steps will be focused on assessment of the clinical feasibility of this new intervention.

Purpose of review Here, we provide an overview of Vogt-Koyanagi-Harada disease (VKH), including recent updates in our understanding of disease pathophysiology, classification and therapeutics. Recent findings Advancements in bioinformatics, metabolomics and genomics investigations continue to illuminate VKH pathogenesis, and may provide insight into future therapeutic options. Multimodal imaging is indispensable in the initial evaluation of VKH, and is becoming increasingly important in understanding disease pathogenesis, as well as monitoring therapeutic response. Enhanced VKH classification criteria, released in 2021, provide standardized guidelines and terminology for clinical and research purposes. Summary Modern research and imaging techniques continue to improve our understanding of VKH; more work is needed to further elucidate pathogenic mechanisms and establish optimal therapeutic recommendations.

Relatively little is known about the relations between psychopathic traits and interpersonally-directed versus organizationally-directed workplace behaviors despite the implications of these traits for maladaptive (e.g., bullying, harassing, white-collar crime, slacking) and adaptive (e.g., improving the workplace, supporting others) workplace behaviors. In a sample of employed US-based community members (N = 352), we investigated the relations between the Triarchic Psychopathy Measure (TriPM) and an expanded version of the Levenson Self-Report Psychopathy Scale (E-LSRP), on the one hand, and interpersonal and organizational counterproductive behaviors and citizenship behaviors directed towards co-workers and the organization, on the other. As predicted, we found stronger positive associations between impulsive-antisocial traits (Disinhibition, Antisocial) and both interpersonal and organizational workplace deviance; however, these traits did not relate significantly to citizenship behaviors. We further found that interpersonal traits (Boldness, Egocentric) may play an adaptive role in the workplace, as demonstrated by increased citizenship behaviors. Affective traits (Callous, Meanness) were related to lesser engagement in citizenship behaviors and higher engagement in some interpersonally-directed counterproductive behaviors. In several analyses, statistical interactions among triarchic psychopathy traits, but not E-LSRP traits, predicted adaptive and maladaptive workplace behaviors. Our results suggest that employees’ psychopathic traits bear differential implications for both adaptive and maladaptive workplace behavior, and that these traits may operate in concert to increase the likelihood of such behavior.

Evidence-based assessment (EBA) involves using empirically validated psychological assessment measures to inform case conceptualization and treatment planning. EBA can improve clinical care by providing information relevant for treatment targets and expectations and can clarify how specific client characteristics may be associated with treatment outcomes. Research on EBA practices in relation to particularly challenging clinical problems (e.g., borderline personality disorder) can be especially useful for practitioners. The current study examines Personality Assessment Inventory-Adolescent (PAI-A) predictors of treatment completion, therapeutic alliance, and symptom change in a sample of 44 adolescent boys (Mage = 16.70, SD = 0.56; 75.0% White) in a residential boot camp program for at-risk youths. Participants completed Dialectical Behavior Therapy for Adolescents-informed skills training groups. PAI-A scales related to somatic complaints, depression, antisocial traits, aggression, borderline traits, problematic alcohol use, and interpersonal dominance, as well as an index measuring overall clinical severity, distinguished adolescents who completed the intervention from those who discontinued the intervention. Adolescents with more borderline personality features reported more modest improvements in emotion dysregulation. Additionally, interpersonal warmth was positively related to therapeutic alliance suggesting that client interpersonal style is an important contributor to client-rated therapeutic alliance.

Obstructive sleep apnea is a common sleep disorder that increases risk for cardiovascular disease and mortality. The severity of sleep-disordered breathing in obstructive sleep apnea patients fluctuates with the seasons, opening the possibility that seasonal changes in light duration, or photoperiod, can influence mechanisms of breathing. Photoperiod can have profound effects on internal timekeeping and can reshape metabolic rhythms in mammals. While the daily rhythm in ventilation is largely shaped by the metabolic rate, less is known about whether ventilatory rhythms are altered in accordance with metabolism under different photoperiods. Here, we investigate the relationship between ventilation and metabolism under different photoperiods using whole-body plethysmography and indirect calorimetry. We find that the daily timing of ventilation is chiefly synchronized to dark onset and that light cues are important for maintaining daily ventilatory rhythms. Moreover, changes in ventilatory patterns are not paralleled by changes in oxygen consumption, energy expenditure, or respiratory exchange rate under different photoperiods. We conclude that ventilatory patterns are not only shaped by the metabolic rate and circadian timing but are also influenced by other light-driven factors. Collectively, these findings have clinical implications for the seasonal variations in sleep-disordered breathing found in individuals with obstructive sleep apnea.

INTRODUCTION: Sarcoidosis has traditionally been thought of as a compartmentalized disease – the inflammatory milieu within pulmonary granulomas harbors products of activated genes leading to the manifestation of the autoimmune process. However, recent research has shown that such a compartmentalized view of sarcoidosis may not be entirely accurate and that distinguishing biomarkers may be identified from the peripheral blood.(1) METHODS: Twenty participants were recruited from a convenience sample from the Francis I. Proctor Foundation at the University of California, San Francisco (UCSF). This study was approved by the UCSF Institutional Review Board and adhered to the tenets of the Declaration of Helsinki. Participants had peripheral whole blood drawn into PAXgene blood RNA tubes (QIAGEN, Germantown, MD) and prepared and stored at −80C according to manufacturer’s recommendations. Samples were deidentified and laboratory personnel handing samples and interpreting data were masked. Differential gene expression was performed to identify host transcriptome signatures.(2) Briefly, analysis of sequenced data was made using a rapid computational pipeline developed in-house to classify host genes. Quality filtered RNA transcripts were aligned to the ENSEMBL CRCh38 human genome using STAR2. Genes were filtered to include only protein-coding genes that were expressed in at least 25% of the patients. Gene count data were analyzed with DESeq2.(3) Differentially expressed genes with false discovery rate (FDR)

This study used latent profile analysis (LPA) to identify differing classes of psychopathic traits in a large sample of military personnel (90.7% Army National Guard) and examined how membership across profiles can be differentiated by mean scores on external correlates relevant to psychopathy and/or to military service (e.g., aggression, posttraumatic stress symptoms, impulsivity). Psychopathy was operationalized via the three-factor model of the Levenson Self-Report Psychopathy Scales (LSRP; Brinkley et al. 2008; Levenson et al. 1995). LPA revealed optimal fit for a four-profile solution. Three profiles had roughly equivalent within-profile means across the three factors, characterized by below average, average, and above/high average LSRP scores. The fourth profile emerged as qualitatively different: high on LSRP-Callous but below average on LSRP-Egocentricity and LSRP-Antisocial. The four profiles were differentiable based on their mean scores on external correlates, suggesting varied implications for externalizing and internalizing features across psychopathic trait configurations in a military sample. Implications for studying psychopathy in military and other novel samples are discussed.

Prior literature has supported associations between psychopathic personality traits and aggressive behavior among criminal and non-criminal populations. Extant literature is limited in examining af...

Highlights • Hypofractionated stereotactic ablative radiotherapy (SABR) in patients with spinal oligometastases. • High rates of efficacy and minimal toxicity. • Oligometastatic patients with metachronous spinal metastases seem to benefit the most., Background To investigate progression free survival (PFS), local control (LC) and overall survival (OS) outcomes for patients treated with spine hypofractionated stereotactic ablative radiotherapy (SABR) and to evaluate possible predictors of rapid progression in view of a correct patient selection for this potentially curative SABR. Materials and methods A cohort of 59 patients with spinal metastases were treated with SABR. Patient selection criteria were the following: histologically proven diagnosis of a solid tumor, a World Health Organization (WHO) score ≤ 2, life expectancy > 6 months, Spinal Instability Neoplastic Score (SINS) ≤ 12 points and presenting with radically treated oligometastatic disease (≤5 lesions) or stable polymetastatic disease with an oligoprogressive lesion. Results From March 2015 to June 2019, 59 patients were treated with Linac-based SABR to 64 spinal metastases with a median follow-up of 55 months. SABR was standard delivered every other day in 3 to 10 fractions with median prescription dose of 27 Gy (range 21–49 Gy). The 1-,2- and 5-year PFS was 98%, 85% and 75% for all patients. OS at 5 years for all patients was 92%. Metachronous lesions (p

This study examined beliefs, expectations, and preferences related to mental health problems and treatment in a sample of young adults who are in a developmental period when many types of psychopathology emerge. Prior studies on this topic have primarily included samples that are older and predominately White. It is not clear whether results from that research generalize to diverse samples of young adults. Participants were 370 undergraduate students (41.3% African American; 76.5% female) who completed questionnaires about expectations and preferences for psychotherapy and therapists. Findings regarding racial differences include African Americans having less experience with mental health services and different goals for psychotherapy than did Whites. Additionally, African Americans, relative to Whites, demonstrated stronger preferences for couple, family, and group psychotherapy, a male therapist their same race, and a therapist who is assertive and structured in session. The results of this study provide information about young adults’ perceptions, expectations, and preferences related to mental health problems and psychotherapy. Findings suggest some barriers to treatment that might be addressed to improve treatment engagement and utilization of psychological services among young adults in general and among African American young adults specifically.

Recent calls to action rightly emphasize the need for early and preventative intervention for youth at risk for or currently exhibiting borderline personality disorder (BPD) features, nonsuicidal self-injury (NSSI), and/or suicidality. However, there is a lack of information in both the research literature and clinical practice guidelines about the acceptability and effectiveness of such interventions for male youth, particularly those who have dropped out of high school and, thus, are at even greater risk for a multitude of adverse psychological and functional outcomes. The current study aims to address this gap by examining the acceptability and pilot efficacy of a modified Dialectical Behavior Therapy for Adolescents (DBT-A) skills training group intervention among a sample of 73 non-treatment-seeking male youth (aged 16–18) with borderline personality features, self-harm, or suicidal ideation who had dropped out of high school and were enrolled in a military-style residential program (relative to youth participating in the residential program alone). Both quantitative and qualitative feedback from youth point to the high acceptability of DBT-A skills training with this population. Within-subjects and between-groups comparisons support the preliminary efficacy of DBT-A skills training with this population. At posttreatment, participants reported statistically significant decreases in emotion regulation (ER) difficulties (d = 0.43) and increases in distress tolerance (d = -0.50). Further, compared to a similar group of male youth who did not receive DBT-A skills training, those who received skills training showed greater improvements in ER difficulties, albeit not distress tolerance. Data from this pilot trial provide preliminary support for the efficacy of brief, stand-alone DBT-A skills training in improving ER difficulties in a high-risk group of male youth.

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011) has demonstrated utility in suicide risk assessment. Limited research with the MMPI-2-RF in higher acuity populations exists, particularly regarding the impact of possible underreporting on prediction of suicide risk. The current study serves to extend previous findings of the utility of clinically indicated MMPI-2-RF scales and proxy indices in 293 veterans (83.62% White, 85.32% male, and 74.40% with past-week suicide ideation) enrolled in a Veterans Affairs Medical Center partial psychiatric hospitalization program. Differences in self-report indicators and MMPI-2-RF scales and proxy indices relevant in assessing suicide ideation between veterans indicated as possibly underreporting and those who were not and the ability of the scales and proxy indices to predict current suicide ideation were examined. These indicators, scales, and proxy indices, with the exception of SUI, were significantly impacted by underreporting, and none of the examined scales or proxy indices (or their interaction) were consistently associated with self-reported suicide ideation after accounting for SUI. However, SUI was consistently associated with suicide ideation and was less influenced by under-reporting. In acutely ill psychiatric patients, SUI may be the most robust indicator of current suicide ideation.

Cannabis is the most consumed drug of abuse, making it the primary target for identification and quantification in human whole blood regarding forensic and clinical toxicology analyses. Among biological matrices, blood is the reference for toxicological interpretation. A highly sensitive and selective liquid chromatography (LC) hyphenated with high-resolution mass spectrometry (HRMS) was developed for the quantification of Δ9-tetrahydrocannabinol (THC), 11-hydroxytetrahydrocannabinol (THC-OH), 11-nor-9-carboxy-tetrahydrocannabinol (THC-COOH) and cannabidiol (CBD). Those cannabinoids were extracted from 1 mL of whole blood by a simple liquid–liquid extraction (LLE) in acidic conditions. HRMS was performed on an Orbitrap-based instrument using its trapping capabilities and increased selectivity for parallel reaction monitoring (PRM) quantification in positive polarity with a negative polarity switching for THC-OH and THC-COOH. Although selected reaction monitoring (SRM) and PRM-targeted methods have similar performance in terms of linearity, dynamic range, precision and repeatability, Orbitrap-based PRM provides a higher specificity due to the use of high-resolution mode separating background ions from the targeted molecules. The method was fully validated according to guidelines set forth by the “Société Française des Sciences et des Techniques Pharmaceutiques” (SFSTP). Trueness was measured below 107% for all tested concentrations. Repeatability and intermediate precision were found to be lower than 12% while the assay was found to be linear in the concentration range of 0.4–20 ng/mL for THC, THC-OH and CBD and of 2–100 ng/mL for THC-COOH. Recovery (RE) and matrix effect (ME) ranged from 70.6 to 102.5% and from −40 to 6.6%, respectively. The validated method provides an efficient procedure for the simultaneous and rapid quantification of cannabinoids in PRM mode providing an alternative over classical SRM.

Alzheimer's disease (AD) is a major health concern as the world population ages. Yet, few studies have examined what the public over the age of 50 knows about AD. This qualitative study, based on 40 in-depth interviews, examines the knowledge of AD by Flemish people between 50 and 80 years old and their cross-source engagement with information sources. Building on AD media representations and theories on media complementarity and health information behaviour, we find that respondents mostly encounter AD information non-purposively via traditional mass media and interpersonal communication, while the internet is occasionally used to purposefully seek information. Novels, personal experiences/social proximity, public figures and particularly film stand out as channels and sources of AD information, suggesting that fictional narratives, personal experiences and being able to identify with others leave lasting impressions and help to communicate and disperse AD information. However, common misconceptions and gaps in knowledge persist, including AD being considered part of the normal ageing process and old age as well as confusing AD with Parkinson's disease. The biomedical perspective and the tragedy discourse prevail among the majority of respondents, who describe AD in terms of decline, loss and death and as ‘the beginning of the end’. Only a few, typically female respondents, appear aware of the role of individual health behaviour and lifestyle choices to prevent dementia or delay its onset. The misconceptions of AD and gaps in knowledge, as well as the fact that a third of all cases of dementia might be delayed or prevented by managing lifestyle and other risk factors, stress the importance of public educational programmes and the need to emphasise and raise awareness of preventative behaviour. Overall, the findings from this study can be of help to public health communicators and dementia-awareness campaigns, as well as AD training programmes for health-care professionals and family care-givers.

Background and purpose Individualized assessment of cytochrome P450 2D6 (CYP2D6) activity is usually performed through phenotyping following administration of a probe drug to measure the enzyme's activity. In order to avoid any iatrogenic harm (allergic drug reaction, dosing error) related to the probe drug, the development of non-burdensome tools for real-time phenotyping of CYP2D6 could significantly contribute to the expansion of precision medicine. This study focuses on the identification of markers of the CYP2D6 enzyme in human biofluids using a liquid chromatography-high-resolution mass spectrometry-based metabolomic approach. Experimental approach Plasma and urine samples from healthy volunteers were analysed before and after intake of a daily dose of paroxetine 20 mg over seven days. CYP2D6 genotyping and phenotyping, using single oral dose of dextromethorphan 5 mg, were also performed in all participants. Key results In this study, we reported four metabolites of solanidine and two unknown compounds as possible novel CYP2D6 markers. Mean relative intensities of these features were significantly reduced during the inhibition session compared to the control session (n = 37). Semi-quantitative analysis showed that the largest decrease (-85%) was observed for the ion m/z 432.3108 normalized to solanidine (m/z 398.3417). Furthermore, mean relative intensities of these ions were significantly higher in the CYP2D6 normal-ultrarapid metabolizer group (n = 37) compared to the poor metabolizer group (n = 6). Solanidine intensity was more than 15 times higher in CYP2D6-deficient individuals compared to other volunteers. Conclusion and implications The applied untargeted metabolomic strategy identified potential novel markers capable of semi-quantitatively predicting CYP2D6 activity, a promising discovery for personalised medicine.

Cannabis contains more than 100 phytocannabinoids. Most of these remain poorly characterized, particularly in neurons. We tested a panel of five phytocannabinoids—cannabichromene (CBC), cannabidiolic acid (CBDA), cannabidivarin (CBDV), cannabidivarinic acid (CBDVA), and Δ9-tetrahydrocannabivarin (THCV) in two neuronal models, autaptic hippocampal neurons and dorsal root ganglion (DRG) neurons. Autaptic neurons expressed a form of CB1-dependent retrograde plasticity while DRGs expressed a variety of transient receptor potential (TRP) channels. CBC, CBDA, and CBDVA had little or no effect on neuronal cannabinoid signaling. CBDV and THCV differentially inhibited cannabinoid signaling. THCV inhibited CB1 receptors presynaptically while CBDV acted post-synaptically, perhaps by inhibiting 2-AG production. None of the compounds elicited a consistent DRG response. In summary, we find that two of five ‘minor’ phytocannabinoids tested antagonized CB1-based signaling in a neuronal model, but with very different mechanisms. Our findings highlight the diversity of potential actions of phytocannabinoids and the importance of fully evaluating these compounds in neuronal models.

One type of functional food that has been receiving much attention is food rich in prebiotics. The old but still valid definition of prebiotics defines them as non-digestible food components that selectively stimulate the growth and/or activity of the beneficial bacteria in the colon and, as a result, improve the host health. Cereals, as one of the main components in the human diet, contain substantial levels of dietary fiber with probable prebiotic potential. In addition, dietary fiber, particularly soluble dietary fiber, has recently emerged as a promising natural highly functional food ingredient in food production. This review focuses on the prebiotic potential of cereal dietary fiber types and covers the achievements and developments regarding its isolation. First, the probiotic and prebiotic concepts will be discussed. Next, different components of dietary fiber and their effect on the host bacteria through in vitro and/or in vivo studies will be reviewed. In a last part, this paper also discusses means of boosting the prebiotic properties of cereal components and innovative strategies for the extraction of cereal dietary fiber. The review focuses on wheat as a leading cereal crop that is widely and intensely used throughout the world in food production.

Objectives The aim of this study was to report the 2-year results of the SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation) trial and confirm the interim Bayesian analysis. Background Transcatheter aortic valve replacement (TAVR) with a self-expanding valve was noninferior to surgery in patients with severe aortic stenosis and intermediate operative risk using Bayesian statistical methods. Novel Bayesian designs have been used to shorten the time to primary endpoint analysis in randomized clinical trials, although the predictive value of Bayesian analysis compared with frequentist approaches remains debated. Methods The SURTAVI trial randomized 1,660 patients. An interim analysis was performed 1 year after the 1,400th patient was treated to estimate the primary 2-year endpoint of all-cause mortality or disabling strokes for all patients. Results The Kaplan-Meier rate for the complete 2-year primary endpoint was 12.7% in the TAVR group and 12.6% in the surgery group (0.0% difference; 95% confidence interval: −3.4% to 3.5%), compared with 12.6% with TAVR and 14.0% with surgery (−1.4% difference; Bayesian credible interval: −5.2% to 2.3%) in the interim Bayesian analysis. A comparison of individual clinical, hemodynamic, and quality-of-life endpoints using Bayesian and frequentist methods found no significant differences. Conclusions The complete analysis of all patients with aortic stenosis at intermediate risk for surgery in the SURTAVI trial confirmed the noninferiority, with respect to the frequency of all-cause mortality or disabling stroke, of TAVR to surgery, as determined in the interim Bayesian analysis. Follow-up will extend out to 10 years.

Purpose: To describe high-resolution DNA typing of HLA-A29 in patients with familial birdshot chorioretinopathy (BSCR).Methods: A retrospective clinical chart review was performed of all patients at the Francis I. Proctor Foundation with BSCR with a documented family history of HLA-A29 positive BSCR. High-resolution HLA-A29 typing was performed for these patients.Results: Two families with familial BSCR were identified. Family 1 consisted of a mother, daughter and maternal aunt with BSCR. All were positive for the HLA-A29*02 allele. Family 2 consisted of two sisters with BSCR who were both positive for the HLA-A29*02 allele.Conclusions: Familial BSCR is rare and we report the high-resolution DNA typing of HLA-A29 in two families with familial BSCR and their associated clinical outcomes, including the first documented case of multigenerational BSCR.

This study examined the extent to which empathy and emotion dysregulation facilitate the relationships between psychopathic personality traits and aggression, using a sample of 368 university students. Psychopathic traits were assessed with the Psychopathic Personality Inventory-Revised (PPI-R; Lilienfeld and Widows 2005), empathy via the Affective and Cognitive Measure of Empathy (ACME; Vachon and Lynam Assessment, 23, 135-149, 2016), and emotion dysregulation using the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer Journal of Psychopathology and Behavioral Assessment, 26, 41-54, 2004). A series of structural equation models (SEM) compared indirect effects of psychopathic traits on proactive and reactive aggression (Reactive Proactive Aggression Questionnaire; Raine et al. Aggression and Violent Behavior, 16, 512-524, 2006) through empathy and emotion dysregulation. Findings indicated a significant and positive indirect effect of Self-Centered Impulsivity traits on proactive aggression through low empathy, whereas the positive indirect effect of Self-Centered Impulsivity on reactive aggression was through high emotion dysregulation. Both Fearless Dominance and Coldheartedness had significant negative indirect effects on reactive aggression through (low) levels of emotion dysregulation; Fearless Dominance also exhibited a negative indirect effect on proactive aggression via ACME total score. Moreover, Coldheartedness had a significant, positive indirect effect on proactive aggression through (low) empathy. In a final model that accounted for shared variance between empathy and emotion dysregulation, all indirect relationships were maintained, suggesting that each path is not better accounted for by variance in the other. In all, this study builds upon prior research on emotion-related correlates of psychopathy, suggesting differential pathways from psychopathic traits to proactive and reactive aggression.

Purpose Systematic investigations into the interplay of sociodemographic factors in the relations of psychopathic traits to criminal behaviors, criminogenic, and treatment-related factors are underdeveloped, particularly concerning the triarchic conceptualization of psychopathy (Patrick, Fowles, & Krueger, 2009). The current study examined the potential moderating roles played by sociodemographic factors within the triarchic psychopathy framework in relation to criminal history and pertinent external correlates. Broadly, we anticipated stronger relations between psychopathic traits and external correlates for European-Americans compared with African-Americans, at lower levels of SES, and for males. Methods Using a forensic mental health clinic sample (n = 1058), primary hypotheses were evaluated by modeling interaction effects, estimated using 10,000 bootstraps in PROCESS v.2.16 (Hayes, 2013). Results Psychopathic traits largely manifested equivalent relations to external criteria across race, SES, and gender, with a few notable exceptions. For example, relations of psychopathic traits (Meanness, Disinhibition) to some legal history variables were unexpectedly more pronounced in African-Americans. However, the nuanced relations across psychopathic traits were consistent with theoretical conceptualizations of the triarchic framework. Conclusions In all, this study supports the use of the triarchic psychopathy framework within diverse samples in forensic settings, but some findings may additionally reflect well-established racial and social disparities in legal decision-making.

Kingella kingaeis a gram-negative coccobacillus belonging to the HACEK group (Haemophilusspecies,Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, andKingellaspecies) and is a common oropharyngeal colonizer of healthy young children. Osteoarticular infection is the most commonly reported invasiveKingella kingaeinfection in children, usually presenting a mild clinical picture. However, it can also cause severe invasive infections, especially infective endocarditis, with a high complication rate. We report the case of a 6-year-old girl, with no past medical history, who presented with fulminant infective endocarditis due toKingella kingae. She received emergency venoarterial extracorporeal membrane oxygenation support, rapidly underwent cardiac surgery, and was then treated using ceftriaxone for 4 weeks as recommended by the American Heart Association. The patient's postoperative course was marked by a cerebral ischemic stroke consistent with septic embolism. She also presented with a para-aortic pseudoaneurysm that required a secondary surgical procedure, with a good postoperative result. This report illustrates a case of fulminant infective endocarditis due toKingella kingaeand responsible for two major complications. We also describe the preventive valve surgery performed to ensure the preservation of valve function and its capacity for growth.

Stanley et al. (Psychological Assessment, 2018, 20, 1249) examined Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, Minnesota Multiphasic Personality Inventory-2 Restructured Form: Manual for administration, scoring, and interpretation, 2008/2011, University of Minnesota Press) profile configurations to predict which individuals engage in suicidal behavior using an outpatient psychiatric sample. Their results revealed that an interaction of overarousal [Hypomanic Activation (RC9) or Activation (ACT)] and shutdown [Demoralization (RCd)] indicators predicted increased history of suicide attempts. The purpose of the present study was to replicate and extend these results to a psychiatric inpatient sample in order to determine their generalizability to a clinically severe, at-risk population. The present study examined 581 valid MMPI-2-RF protocols of adult psychiatric inpatients who endorsed any level of suicide ideation on the Columbia-Suicide Severity Rating Scale (C-SSRS; Posner et al., The American Journal of Psychiatry, 2011, 168, 1266) in the 2 weeks prior to admission. Results revealed that in four of the six models tested, shutdown (Low Positive Emotions [RC2], Helplessness/Hopelessness [HLP]) but not overactivation (RC9, ACT) indicators provided an additional prediction of suicide attempt history beyond Suicidal/Death Ideation (SUI) and the covariates. The two models containing RCd did not provide additional predictive value above Suicidal/Death Ideation (SUI) with main effects or interaction terms. Overall, our results do not replicate those of Stanley et al. (Psychological Assessment, 2018, 20, 1249). Furthermore, while SUI was the best predictor of a history of suicide attempts, results indicate the main effects of RC2 and HLP were negative predictors of prior suicide attempts. Limitations of the study and clinical implications of the results are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Author(s): Takhar, Jaskirat S; Joye, Ashlin S; Lopez, Sarah E; Marneris, Athanasios G; Tsui, Edmund; Seitzman, Gerami D; Keenan, Jeremy D; Gonzales, John A | Abstract: PurposeThe purposes of this study were to assess the reproducibility of a novel standardized technique for capturing corneal subbasal nerve plexus images with in vivo corneal confocal microscopy and to compare nerve metrics captured with this method in participants with dry eye and control participants.MethodsCases and controls were recruited based on their International Statistical Classification of Diseases and Related Health Problems (ICD-10) diagnoses. Participants completed the following 3 ocular symptom questionnaires: the Ocular Surface Disease Index, Neuropathic Pain Symptom Inventory, and Dry Eye Questionnaire 5. A novel eye fixation-grid system was used to capture 30 standardized confocal microscopy images of the central cornea. Each participant was imaged twice by different operators. Seven quantitative nerve metrics were analyzed using automated software (ACCmetrics, Manchester, United Kingdom) for all 30 images and a 6-image subset.ResultsForty-seven participants were recruited (25 classified as dry eye and 22 controls). The most reproducible nerve metrics were corneal nerve fiber length [intraclass correlation (ICC) = 0.86], corneal nerve fiber area (ICC = 0.86), and fractal dimension (ICC = 0.90). Although differences were not statistically significant, all mean nerve metrics were lower in those with dry eye compared with controls. Questionnaire scores did not significantly correlate with nerve metrics. Reproducibility of nerve metrics was similar when comparing the entire 30-image montage to a central 6-image subset.ConclusionsA standardized confocal imaging technique coupled with quantitative assessment of corneal nerves produced reproducible corneal nerve metrics even with different operators. No statistically significant differences in in vivo corneal confocal microscopy nerve metrics were observed between participants with dry eye and control participants.