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Abstract Objective To identify characteristics of acute otitis media (AOM) at primary care presentation associated with TT placement and outcomes. Methods A retrospective cohort study of pediatric patients (birth—12 years old) with AOM at an academic primary care pediatric practice and affiliated tertiary referral free‐standing Children's hospital from August 1, 2017 to December 31, 2019 was performed. The outcomes measured were TT placement, postoperative otorrhea, need for additional tube placement, and other complications (i.e., perforation and/or granulation). Results The 3189 patients were included, 484 of whom were referred to otolaryngology. Multivariate logistic regression analysis revealed that a greater number of AOM episodes diagnosed at primary care was associated with tube placement (OR = 1.21; 95% CI, 1.04–1.41, p = .02). Of the 336 patients who received tubes, older age at first AOM diagnosis was associated with postoperative otorrhea (OR = 1.02; 95% CI, 1.01–1.03; p = .001) and additional tube placement (OR = 1.03; 95% CI, 1.02–1.04; p

Objective: Nutrition and physical activity are key components of daily diabetes care in young children with type I diabetes (T1D). Normative developmental behavioral challenges related to nutrition and physical activity complicate management of T1D. The current pilot study evaluated the feasibility, acceptability, and indications of behavior change of an intervention aimed at improving nutrition and physical activity in young children with T1D. Method: Thirty-6 parents of young children (ages 2-5 years, M - 4.2) with T1D from 2 clinics in the Washington, DC area were randomized to receive the type One Training (TOTs) program or Usual Care (UC). Assessments included recruitment and completion rates, participant acceptability, and outcomes including glycemic variability via continuous glucose monitoring, nutritional intake via remote food photography, physical activity via accelerometers, and parental report on behavior and psychosocial functioning. Results: Despite recruitment challenges, the TOTs program was feasible to administer, with high program and assessment completion rates. Acceptability ratings were very high but differed by recruitment site. Participants randomized to TOTs had an increase in percent of time in target glycemic range and reduction in behavioral feeding problems between baseline and follow-up while those randomized to UC did not. Participants in UC demonstrated a decrease in in moderate to vigorous physical activity at follow-up. Conclusions: The TOTs program demonstrated preliminary feasibility and acceptability. Future research will examine components of treatment for evidence of efficacy and target the intervention to those most likely to benefit. Keywords: type 1 diabetes, young children, parents, eating, Type I diabetes (T1D) occurs in 1 in 500-600 children and incidence is increasing annually, with higher growth in young children ages 0-9 years (Dabelea et al., 2014; Mayer-Davis et [...]

Facebook offers a “village” for mothers to come together and seek and share parenting information, but while there has been substantial research examining both positive and negative aspects of parents’ Facebook use, there is no research on use of Facebook by mothers of adolescents and its association with parent-adolescent relationships. Given the intense challenges of raising adolescents and the dearth of research into potential benefits and drawbacks of mothers of adolescents seeking support from Facebook, we sought to fill this gap by focusing on the caregiving and parenting practices of mothers of adolescents who were members of mothers’ groups on Facebook. The sample included 74 Israeli dyads of mothers (Mage = 43.73, SD = 4.41), who participated in Facebook groups for mothers and their adolescent children (Mage = 12.26, SD = 3.11) during 2019. Mothers reported on their Facebook use and caregiving strategies. The adolescents answered a parenting practices questionnaire. It was found that higher permissiveness and greater psychological intrusiveness were related to higher use of Facebook by the mothers. Among mothers who were high on hyperactivation, greater permissiveness and psychological intrusiveness were related to higher Facebook use to a greater extent than among mothers who were low on hyperactivation. Alongside Facebook’s benefits as a community for mothers come serious risks for some mothers. As research in this area grows, an examination of the characteristics of Facebook use by mothers of adolescent children involved in Facebook mothers’ groups is meaningful.

Phytomedicines such as valerian and St. John’s wort are widely used for the treatment of sleeping disorders, anxiety and mild depression. They are perceived as safe alternatives to synthetic drugs, but limited information is available on the intestinal absorption and interaction with human intestinal microbiota of pharmacologically relevant constituents valerenic acid in valerian, and hyperforin and hypericin in St. John’s wort. The intestinal permeability of these compounds and the antidepressant and anxiolytic drugs citalopram and diazepam was investigated in the Caco-2 cell model with bidirectional transport experiments. In addition, interaction of compounds and herbal extracts with intestinal microbiota was evaluated in artificial human gut microbiota. Microbiota-mediated metabolisation of compounds was assessed, and bacterial viability and short-chain fatty acids (SCFA) production were measured in the presence of compounds or herbal extracts. Valerenic acid and hyperforin were highly permeable in Caco-2 cell monolayers. Hypericin showed low-to-moderate permeability. An active transport process was potentially involved in the transfer of valerenic acid. Hyperforin and hypericin were mainly transported through passive transcellular diffusion. All compounds were not metabolized over 24 h in the artificial gut microbiota. Microbial SCFA production and bacterial viability was not substantially impaired nor promoted by exposure to the compounds or herbal extracts.

The new and rapid advancement in the complexity of biologics drug discovery has been driven by a deeper understanding of biological systems combined with innovative new therapeutic modalities, paving the way to breakthrough therapies for previously intractable diseases. These exciting times in biomedical innovation require the development of novel technologies to facilitate the sophisticated, multifaceted, high-paced workflows necessary to support modern large molecule drug discovery. A high-level aspiration is a true integration of "lab-on-a-chip" methods that vastly miniaturize cellulmical experiments could transform the speed, cost, and success of multiple workstreams in biologics development. Several microscale bioprocess technologies have been established that incrementally address these needs, yet each is inflexibly designed for a very specific process thus limiting an integrated holistic application. A more fully integrated nanoscale approach that incorporates manipulation, culture, analytics, and traceable digital record keeping of thousands of single cells in a relevant nanoenvironment would be a transformative technology capable of keeping pace with today's rapid and complex drug discovery demands. The recent advent of optical manipulation of cells using light-induced electrokinetics with micro- and nanoscale cell culture is poised to revolutionize both fundamental and applied biological research. In this review, we summarize the current state of the art for optical manipulation techniques and discuss emerging biological applications of this technology. In particular, we focus on promising prospects for drug discovery workflows, including antibody discovery, bioassay development, antibody engineering, and cell line development, which are enabled by the automation and industrialization of an integrated optoelectronic single-cell manipulation and culture platform. Continued development of such platforms will be well positioned to overcome many of the challenges currently associated with fragmented, low-throughput bioprocess workflows in biopharma and life science research.

Abstract Background Our goal was to improve pediatric residents' advanced communication skills in the setting of referral to address the entrustable professional activity of subspecialty referral identified by the American Board of Pediatrics. To accomplish this aim, we created a referral and consultation curriculum to teach and assess core communication skills in subspecialty referral involving an adolescent with syncope, an anxiety-provoking symptom that is rarely associated with serious pathology. Methods We utilized blended multimodal educational interventions to improve resident communication skills in referral of patients. Trainees participated in 1) an interactive online module on syncope focusing on “red-flag” symptoms that would warrant a subspecialty cardiology referral and 2) a 4-h intervention with Standardized Parents (SPs), focusing on the case-based application of communication skills. Communication skills were assessed by two pre- and post- Objective Structured Clinical Examination encounters of patients with syncope, with an SP evaluation using a 20-item checklist. Analysis was performed with Sign test and McNemar’s test. Trainees provided feedback on a Critical Incident Questionnaire, which was analyzed qualitatively. Results Sixty-four residents participated. There was an overall improvement in communication skills based on SP scores (82.7 ± 10.9% to 91.7 ± 5.0%, p

In a screening of a small library of extracts from plants of the Amazonian and Cerrado biomes, a hexane extract of Connarus tuberosus roots was found to significantly potentiate the GABA induced fluorescence in a fluorescence (FLIPR) assay in CHO cells stably expressing the α1β2γ2 subtype of human GABAA receptors. With the aid of HPLC-based activity profiling the activity was linked to the neolignan connarin. In CHO cells the activity of connarin was not abolished by increasing concentrations of flumazenil, while the effect of diazepam was increased by increasing concentrations of connarin. The effect of connarin was abolished by pregnenolone sulfate (PREGS) in a concentration-dependent manner, and the effect of allopregnanolone was further increased by increasing concentrations of connarin. In a two-microelectrode voltage clamp assay with Xenopus laevis oocytes transiently expressing GABAA receptors composed of human α1β2γ2S and α1β2 subunits connarin potentiated the GABA-induced currents, with EC50 values of 1.2 ± 0.3 μM (α1β2γ2S) and 1.3 ± 0.4 μM (α1β2), and with a maximum enhancement of currents Emax of 1959 ± 70% (α1β2γ2S) and 185 ± 48% (α1β2). The activation induced by connarin was abolished by increasing concentrations of PREGS.

Increased activation and proliferation of T lymphocytes plays an essential role in the development of chronic inflammation and autoimmune diseases. Currently used immunosuppressive drugs often do not provide long-lasting relief of symptoms and show a gradual loss of efficacy over time, and are accompanied by various side effects. Therefore, novel immunosuppressive lead substances are needed. For this purpose, an in-house library consisting of 600 extracts of plants from Panama was screened for inhibition of human T lymphocyte proliferation. As one of the hits, an ethyl acetate extract from the aerial parts of Hyptis brachiata (Lamiaceae) exhibited strong inhibitory effects. Subsequent investigation resulted in the isolation of seven aryltetralin lignans, five arylnaphthalene lignans, two flavonoids, three triterpenes, and cinnamyl cinnamate. Aryltetralin lignans inhibited T lymphocyte proliferation in a concentration-dependent manner without induction of apoptosis. No relevant inhibition was observed for the arylnaphthalene lignans, flavonoids, and triterpenes. Additional cell cycle arrest investigations revealed that isolated aryltetralin lignans potently inhibited cell division in G2/M phase similarly to podophyllotoxin. Multifluorescence panel analyses of the extract also showed weak suppressive effects on the production of IL-2 and TNF-α. Therefore, preparations made out of H. brachiata could be further explored as an interesting herbal alternative in the treatment of autoimmune diseases.

Safe medications for mild mental diseases in pregnancy are needed. Phytomedicines from St. John’s wort and valerian are valid candidates, but safety data in pregnancy are lacking. The transplacental transport of hyperforin and hypericin (from St. John’s wort), and valerenic acid (from valerian) was evaluated using the ex vivo cotyledon perfusion model (4 h perfusions, term placentae) and, in part, the in vitro Transwell assay with BeWo b30 cells. Antipyrine was used for comparison in both models. U(H)PLC-MS/MS bioanalytical methods were developed to quantify the compounds. Perfusion data obtained with term placentae showed that only minor amounts of hyperforin passed into the fetal circuit, while hypericin did not cross the placental barrier and valerenic acid equilibrated between the maternal and fetal compartments. None of the investigated compounds affected metabolic, functional, and histopathological parameters of the placenta during the perfusion experiments. Data from the Transwell model suggested that valerenic acid does not cross the placental cell layer. Taken together, our data suggest that throughout the pregnancy the potential fetal exposure to hypericin and hyperforin – but not to valerenic acid – is likely to be minimal.

Pre-clinical studies suggest that extracts prepared from the fruits of Vitex agnus castus (VAC) interact with dopamine D2 receptors, leading to reduced prolactin secretion. In previous experiments, dopaminergic activity was mostly evaluated using radioligand binding assays or via the inhibition of prolactin release from rat pituitary cells. Diterpenes featuring a clerodadienol scaffold were identified as major active compounds, but no conclusive data regarding their potency and intrinsic activity are available. Utilising advances in chromatography, we re-examined this topic using HPLC-based tracking of bioactivity via microfractionation of the VAC extract Ze 440. Using a cAMP-based assay, we measured dopaminergic activity in CHO-K1 cells that overexpress the human D2 receptor. Six diterpenes were isolated from two active HPLC microfractions. Viteagnusin I emerged as the most potent diterpene (EC50: 6.6 µM), followed by rotundifuran (EC50: 12.8 µM), whereas vitexilactone was inactive (EC50: >50 µM). Interestingly, triterpenes were also identified as active, with 3-epi-maslinic acid being the most active compound (EC50: 5.1 µM). To better understand these interactions at the molecular level, selected diterpenes and triterpenes were analysed through molecular docking against D2 receptor structures. Our data show that the dopaminergic activity of VAC diterpenes seems to depend on the configuration and on ring substitution in the side chain. This study also highlights for the first time the dopaminergic contribution of triterpenes such as 3-epi-maslinic acid. [ABSTRACT FROM AUTHOR]

This article examines the television work made by Lilith Video (1983–1988), active in the city of São Paulo, and one of the first feminist video collectives in Brazil. Lilith was founded by Jacira Melo, Márcia Meireles, and Silvana Afram, producing documentaries and the unprecedented Feminino Plural, a series of five episodes, each one focused on an aspect of the everyday life of Brazilian women. In 1987, TV Cultura public television broadcast the series twice. Feminino Plural still remains perhaps the only feminist programme ever made by an independent collective to go on air. We start by situating the works of the group within Brazilian and international literature; we highlight the ways in which its history interweaves video art, television production, and feminist social movements in immediate Brazilian post-dictatorship. As we move to the analysis of the series, we discuss how the combination of testimony, dramatization, archive, and voice over allowed for a sensible approach to private issues in the virtual public space. By mapping Feminino Plural’s intersectional connections, this article suggests the ways in which the series helped to expand the scope of what was possible for women, understood as plural, opened to colour, class, age, and geographic regions. [ABSTRACT FROM AUTHOR]

Autonomous Vehicles (AV) hold a significant promise in creating a positive disruption of transportation. However, the majority of people perceive AV with fear, anxiety and public resistance. Our study aims to examine how controllability mediates the relationships between main personality traits (sensation seeking and big five), and AV acceptance. In a cross-sectional study, we found that low desirability of control and high external driving locus of control are associated with high AV acceptance. Moreover. We found that individuals high in sensation seeking, perceive high external driving locus of control, and low desirability to control, which in turn leads to low AV acceptance. In addition, the desirability of control and external driving locus mediated the relationships between extraversion, conscientiousness and neuroticism with AV acceptance. Overall, our results support the hypothesized model and suggest that for people to trust AV they need to have some sense of controlling the vehicle. [ABSTRACT FROM AUTHOR]

This study examined narrative ability in ASD and parents across two contexts differing in structure and emotional content, and explored gaze patterns that may underlie narrative differences by presenting narrative tasks on an eye tracker. Participants included 37 individuals with ASD and 38 controls, 151 parents of individuals with ASD and 63 parent controls. The ASD and ASD parent groups demonstrated lower narrative quality than controls in the less structured narrative task only. Subtler, context-dependent differences emerged in gaze and showed some associations with narrative quality. Results indicate a narrative ability profile that may reflect genetic liability to ASD, and subtle links between visual attention and complex language skills that may be influenced by ASD genetic risk.