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Although most Human papillomavirus (HPV) infections are mild and are cleared by the immune system, some high-risk HPV strains can cause various cancers. Vaccines have been developed that protect against high-risk HPV strains. HPV vaccines have been approved for use by the CDC (Centers for Disease Control and Prevention) and are recommended for everyone aged 11–26. Despite the availability of safe and effective vaccines, uptake is low. HPV vaccine uptake has been extensively studied on a national and international level, but less is known about vaccine acceptance on a state or local level. The state of Utah, in the United States of America, has a relatively low HPV vaccination rate. In this study, we identified factors that impact the intent of Utah parents to vaccinate their children against HPV. A survey was distributed electronically to Utah residents. Survey results were analyzed using confirmatory factor analysis, structural equation modeling, and univariate analysis. Knowledge about HPV and positive vaccine attitudes had the greatest positive effect on intent to vaccinate children against HPV. Cautious sexual attitudes and high religious practice were found to have a negative impact on intent to vaccinate. Effective public health messaging will consider the cultural and religious influences of the target population.

Background: The project aims to establish an interprofessional diabetes team within a Federally Qualified Health Center (FQHC) to increase patient access and improve the health of underserved patients with diabetes. Methods: The program is a community-academic practice partnership implemented in a FQHC in the Southeastern United States. The program utilizes an interprofessional diabetes care model (in-person and telehealth) with a nurse practitioner, pharmacist, population health specialist, certified medical assistant, dietician, and primary care team to provide comprehensive diabetes care focused on treatment optimization, self-management, and identification of medical and community resources. Results: A total of 175 patients were seen from November 2020 to October 2021. The median (IQR) A1C at baseline was 9.6% (8.4-11.5%) versus 8.6% (7.0-10.0%) at follow-up (p Conclusions: A community-academic practice partnership supports comprehensive diabetes management and improved health outcomes. Next steps include expansion of the program to additional practice sites and continued data analysis on patient outcomes, cost, and satisfaction. Disclosure T.O.Fowler: None. J.Sterrett: None. L.T.Collins: None. A.D.Poole: None. E.Weeda: None. R.A.Dubose-morris: None. K.Roever: None. Funding The Duke Endowment (6878-SP)

The development of vaccines has significantly contributed to the success of disease prevention. However, there has been a sharp decline in immunization rates since COVID-19 spread globally. Seemingly overnight, the world shut down and most non-essential medical procedures were postponed. Since the COVID-19 vaccine became available, and the world started going back to normal these vaccine rates have not recovered. In this paper, we review the published literature to explore how convenience factors, perceived risk of vaccination, media or anti-vaccination ideals/movements, and healthcare professionals affect an individual’s compliance to be vaccinated to better understand the factors that contribute to the change in overall vaccination rates.

Research examining excellence in teaching is extensive. Nevertheless, research examining the inverse—what constitutes poor or ineffective teaching—has not been as systematic. The current research addresses this gap in the literature by examining student and faculty perceptions of the qualities and behaviors of ineffective teachers. Students and faculty identified being disrespectful as the number one perceived quality of ineffective teachers. Both groups of respondents also agreed that having weak rapport was indicative of ineffective teachers. Overall, students had a tendency to focus more on the social aspects of the student–teacher relationship, whereas faculty focused more on professional competencies. These findings provide additional support on teaching misbehaviors to avoid both in and outside of the classroom.

The Africanized honey bee (AHB) is a New World amalgamation of several subspecies of the western honey bee (

Background: Juvenile systemic lupus erythematosus (JSLE) is diagnosed in children younger than 18 years of age. Depression and anxiety are common, but not well understood in JSLE. We investigated the clinical and psychological factors associated with the psychological manifestations of JSLE. Methods: Twenty-nine JSLE patients were recruited for the study. They responded to surveys testing their psychological status and perceptions about their health, including the Hospital Anxiety and Depression scale, the Fatigue Severity Scale, and a Medical outcomes questionnaire (the SF-36). Clinical lab results were obtained from the patients’ medical records. Univariate and multivariate analyses were used to compare the patient populations with adult-onset SLE (ASLE) patients and unaffected controls, finding indicators that correlated with depression and anxiety in JSLE patients. Results: Kidney disease was associated with depression in the JSLE patients. The BUN levels, BUN/creatinine ratio, and leukocyturia were all significantly associated with depressive symptoms. The BUN/creatinine ratio was the most predictive laboratory value for both depression and anxiety. The JSLE patients had less depression than the ASLE, although not less anxiety. JSLE patients had comparable levels of fatigue and pain to the adult-onset SLE patients. Age and education were protective against depression in the JSLE patients. Conclusions: Kidney function correlated with symptoms of depression and anxiety. This may mean that symptomatology is an important indicator of whether the patient needs psychiatric care. Age and education were likely protective against depression in the JSLE population.

The pharmacological treatment of systemic lupus erythematosus (SLE) aims to decrease disease activity, progression, systemic compromise, and mortality. Among the pharmacological alternatives, there are chemically synthesized drugs whose efficacy has been evaluated, but which have the potential to generate adverse events that may compromise adherence and response to treatment. Therapy selection and monitoring will depend on patient characteristics and the safety profile of each drug. The aim of this review is to provide a comprehensive understanding of the most important synthetic drugs used in the treatment of SLE, including the current treatment options (mycophenolate mofetil, azathioprine, and cyclophosphamide), review their mechanism of action, efficacy, safety, and, most importantly, provide monitoring parameters that should be considered while the patient is receiving the pharmacotherapy.

Moving our elementary curriculum to emergency remote instruction presented numerous challenges to our elementary school, as teachers recognized that elementary-age children could not be expected to spend the amount of time on computer screens that they had spent in face-to-face classrooms. Working with our colleagues, we adopted a “less is more” approach, using inquiry processes to make systematic and informed choices as to which state standards would be covered. We acted as instructional designers to develop coherent learning units for remote instruction, using inquiry processes to study the effectiveness of our lessons and adjust instruction accordingly. This work could only transpire because we viewed ourselves (and were viewed by our administration) as professionals, rather than technicians. At, P. K. Yonge, we were empowered to critically examine our curriculum, to modify and adjust our lessons in response to the crisis, and to design innovative ways to deliver our curriculum. Conceptualizing teachers’ work as professional was foundational to our ability to be effective during the pandemic.

Introduction: New York City is one of the areas most affected by the COVID-19 pandemic in the United States. Healthcare workers are among those at high risk of contracting the virus, and a vital source of information and trust in vaccines to the community. Methods: This study was conducted about attitudes towards COVID-19 vaccination among healthcare workers at a public hospital in New York City during the beginning of COVID-19 vaccination. 428 hospital employees responded. Results: Several factors were significantly associated with vaccine attitudes, including demographics such as gender (p = 0.002), age (p = 0.005), race (p &lt, 0.001) and home location (p &lt, 0.001), role within the hospital (p &lt, 0.001), knowledge about the virus (p &lt, 0.001) and confidence in and expectations about personal protective equipment and behaviors (p &lt, 0.001). Structural equation modeling revealed that the most predictive factors were prior vaccine attitudes and concern with the speed of testing and approval of the vaccines (p &lt, 0.001). Multivariate analysis reinforced these, while also identifying perceived personal risk as significant (p = 0.033). Conclusions: Several modifiable factors that reflect confidence in science, scientific knowledge, personal risk perception, experience and medical authority are correlated with vaccine attitudes, indicating that a holistic educational approach to improve trust in science is likely to be effective in long-term reduction in vaccine hesitancy.

Background and purposeNon-traditional risk factors such as chronic inflammation, oxidative stress and thrombogenic factors are believed to contribute to the excess stroke risk in chronic kidney disease (CKD) by triggering vascular injury and endothelial dysfunction. We aimed to determine how well a panel of biomarkers representative of these factors would correlate with estimated glomerular filtration rate (eGFR) in patients with recent transient ischaemic attack (TIA) or stroke. We also investigated whether eGFR would confound previously reported associations between biomarkers and mortality.MethodsWe studied a panel of 16 blood biomarkers related to inflammation, thrombosis, atherogenesis and cardiac or neuronal cell damage in TIA or ischaemic stroke in a population-based study (Oxford Vascular Study). Biomarker levels were log-transformed and correlated with eGFR, adjusted for age. Cox proportional hazard models were used for survival analysis.ResultsAmong 1297 patients with TIA or stroke, 52.7% (n=684) of patients had CKD (eGFR 2). There was a moderate correlation between log-eGFR and the log-transformed soluble tumour necrosis factor receptor-1 (R2=0.21), attenuating with adjustment for age (R2=0.12). There were moderate-to-strong correlations with markers of cardiac injury, N-terminal pro-brain natriuretic peptide and heart-type fatty acid binding protein (hFABP, R2=0.14 and 0.34, respectively). The strongest correlation after adjustment for age was between hFABP and eGFR (R2=0.20). Adjusting for eGFR did not impact any biomarker associations with mortality.ConclusionsCorrelations between biomarkers related to inflammation and thrombosis with renal dysfunction in the setting of cerebrovascular events were generally modest after adjustment for age, suggesting that putative risk factors such as chronic inflammation or coagulopathy are unlikely to be important stroke mechanisms in patients with CKD.

Summary Background SARS-CoV-2 is the virus responsible for the current global pandemic, COVID-19. Because this virus is novel, little is known about its sensitivity to disinfection. Methods We performed suspension tests against SARS-CoV-2 using three commercially available quaternary ammonium compound (Quat) disinfectants and one laboratory-made 0.2% benzalkonium chloride solution. Findings Three of the four formulations completely inactivated the virus within 15 s of contact, even in the presence of a soil load or when diluted in hard water. Conclusion Quats rapidly inactivate SARS-CoV-2, making them potentially useful for controlling SARS-CoV-2 spread in hospitals and the community.

Patients with autoimmune disorders (AD) have altered cancer risks compared to the general population. Systemic lupus erythematosus and multiple sclerosis lead to a heightened risk for hematological malignancies and decreased risk for breast, ovarian, and prostate malignancies. Often patients with autoimmune disease have dysregulated antiviral immune responses, including against oncogenic viruses. To uncover the relationship between viral incidence and cancer risk in the context of autoimmune disease, we extracted electronic health records (EHR) from Vanderbilt University. ICD-9/10 codes and laboratory values were collected for hematological, lung, anal-vaginal, thyroid, hepatobiliary, bladder, prostate, and breast cancers; and viruses including Epstein Barr virus (EBV), Human papilloma virus (HPV), and Hepatitis A/B/C (Hep). Only viral infections that led to a physician visit or laboratory test were entered into the EMR; therefore, only clinically relevant cases were noted and considered positive in this study. The relationship between virus infection and cancer in an SLE cohort (SLE-cases n = 2,313, and SLE-controls n = 5,702) and an MS cohort (MS-case n = 7,277, MS-control n = 7,277) was examined by multilinear logistic regression. Viral infection was strongly associated with increased risk for cancer overall. SLE and MS patients were more susceptible to all viral infections. MS patients trended toward increased risk for cancers overall, while decreased risk for hormone-based cancers in SLE patients non-significantly reduced their risk for overall cancer. Both SLE and MS patients had increased clinically relevant EBV infection, which was associated with risk for hematological cancers. Preventing viral infections by vaccination may be especially helpful in controlling risk for cancer in SLE and MS patients.

Chronic immune inflammation (CII) is a characteristic symptom of HIV-1 infection that contributes to acquired immunodeficiency syndrome (AIDS) progression in infected patients. Distinct AIDS development rates have shown that there are Rapid Progressor (RP) and Long-Term Non-Progressor (LTNP) patients, but the circumstances governing these differences in disease progression are poorly understood. Mutations in the Viral Protein R (Vpr) have been suggested to have a direct impact on disease progression. Studies have shown that Vpr interacts with both host and viral factors; these interactions affect cellular activities such as cell cycle progression and enhancement of apoptosis. The Vpr mutants R36W and R77Q have been associated with RP and LTNP phenotypes, respectively; however, these findings are still controversial. This study sheds light on the effects that Vpr mutations have in the context of HIV-1 infection of the HUT78 T cell line, using replication-competent CXCR4-tropic virus strains. Our results show a replication enhancement of the R36W mutant (increased viral load and percentage of p24+ cells) accompanied by increased cytotoxicity. Interestingly, the R77Q mutant showed a unique enhancement of apoptosis (measured by Annexin V and TUNEL staining) and G2 cell cycle arrest; these effects were not seen with WT or R36W viruses. Since necrosis is associated with the release of pro-inflammatory factors, the R36 mutation could lead to more robust CII and the RP phenotype. Conversely, the R77Q mutation leads to apoptosis, potentially avoiding CII and leading to a LTNP phenotype. Thus, Vpr mutations may impact HIV-1 related progression to AIDS. Importance The vpr gene is thought to be an important virulence factor in Human Immunodeficiency Virus type 1 (HIV-1). vpr polymorphisms have been associated with different rates of acquired immunodeficiency syndrome (AIDS) progression. However, there is controversy about the cytopathic and virulence phenotypes of Vpr mutants, with contradictory conclusions about the same mutants. Here, we examine the replication capacity, apoptosis induction, and G2 cell cycle arrest phenotypes of three vpr mutants compared to wild-type HIV-1. One mutant associated with rapid AIDS progression replicated more efficiently and killed cells more rapidly than wild-type HIV-1. Another mutant associated with slow AIDS progression triggered apoptosis more efficiently than wild-type HIV-1. These results shed additional light on the role of vpr polymorphisms in T cell killing by HIV-1 and may help to explain the role of Vpr in different rates of AIDS progression.

The COVID-19 pandemic continues to ravage the world, with the United States being highly affected. A vaccine provides the best hope for a permanent solution to controlling the pandemic. However, to be effective, a vaccine must be accepted and used by a large majority of the population. The aim of this study was to understand the attitudes towards and obstacles facing vaccination with a potential COVID-19 vaccine. To measure these attitudes a survey was administered to 316 respondents across the United States by a survey corporation. Structural equation modeling was used to analyze the relationships of several factors with attitudes toward potential COVID-19 vaccination. Prior vaccine usage and attitudes predicted attitudes towards COVID-19 vaccination. Assessment of the severity of COVID-19 for the United States was also predictive. Approximately 68% of all respondents were supportive of being vaccinated for COVID-19, but side effects, efficacy and length of testing remained concerns. Longer testing, increased efficacy and development in the United States were significantly associated with increased vaccine acceptance. Messages promoting COVID-19 vaccination should seek to alleviate the concerns of those who are already vaccine-hesitant. Messaging directed at the benefits of vaccination for the United States as a country would address the second predictive factor. Enough time should be taken to allay concerns about both short- and long-term side effects before a vaccine is released.

Background and aims: Patients with Juvenile-onset Systemic lupus erythematosus (jSLE) have to overcome the burden of unpredictable and disabling disorder. Coping strategies influence patient’s ability to cope with negative emotions, treatment exigencies and physical impairment related with the disease. Our aim was to explore the relationship between coping mechanisms and the presence of anxiety and depression. Methods: Thirty jSLE patients answered the Brief Coping Orientation to Problems Experienced (COPE) questionnaire, the Hospital Anxiety and Depression Questionnaire (HADS) and the Subjective Happiness Scale (SHS). Results: Clinically relevant anxiety (63.3%) and depressive symptoms (13.3%) were present in the jSLE patients. Our population showed higher coping scores for problem-focused (0,7±0,2), emotion-focused (0,6±0,2) and social supported coping (0,5±0,2), than avoidant coping (0,3± 0,1). Higher depression scores and lower subjective happiness levels correlated with higher anxiety scores (r=0.673, p=0.000 and r=0.592, p=0.001, respectively). Problem focused coping was associated with higher self-reported happiness (r=0.564, p=0.002) and avoidant coping was positively correlated with higher number of anxious symptoms (r=0.560, p=0.002). Conclusions: These results underscore the relevance of psychological assessment in jSLE patients. Adaptive coping strategies led to greater happiness, while avoidant coping strategies were associated with higher anxiety. Teaching of adaptive coping mechanisms, in combination with other interventions are likely to enhance the patients’ ability to respond to the multiple physical, social and emotional challenges imposed by this autoimmune disorder.

GPR55, an orphan G-protein coupled receptor, is activated by lysophosphatidylinositol (LPI) and the endocannabinoid anandamide, as well as by other compounds including THC. LPI is a potent endogenous ligand of GPR55 and neither GPR55 nor LPIs' functions in the brain are well understood. While endocannabinoids are well known to modulate brain synaptic plasticity, the potential role LPI could have on brain plasticity has never been demonstrated. Therefore, we examined not only GPR55 expression, but also the role its endogenous ligand could play in long-term potentiation, a common form of synaptic plasticity. Using quantitative RT-PCR, electrophysiology, and behavioral assays, we examined hippocampal GPR55 expression and function. qRT-PCR results indicate that GPR55 is expressed in hippocampi of both rats and mice. Immunohistochemistry and single cell PCR demonstrates GPR55 protein in pyramidal cells of CA1 and CA3 layers in the hippocampus. Application of the GPR55 endogenous agonist LPI to hippocampal slices of GPR55+/+ mice significantly enhanced CA1 LTP. This effect was absent in GPR55-/- mice, and blocked by the GPR55 antagonist CID 16020046. We also examined paired-pulse ratios of GPR55-/- and GPR55+/+ mice with or without LPI and noted significant enhancement in paired-pulse ratios by LPI in GPR55+/+ mice. Behaviorally, GPR55-/- and GPR55+/+ mice did not differ in memory tasks including novel object recognition, radial arm maze, or Morris water maze. However, performance on radial arm maze and elevated plus maze task suggests GPR55-/- mice have a higher frequency of immobile behavior. This is the first demonstration of LPI involvement in hippocampal synaptic plasticity.

The National Blood Transfusion Service (NBTS) in England and Wales was established as a single entity in 1946 and operated as such for almost half a century. During those 50 years, the blood service in Wales, as in the rest of the UK, saw many technological and operational changes. The automation of donation testing, the introduction of successive layers of microbiological screening, the creation of the Tissue Typing Laboratory (later renamed the Welsh Transplantation and Immunogenetics Laboratory) and the development of information technology brought - over a relatively long period - highly significant improvements to an organisation that had begun life as an Emergency Medical Service. Differing funding and reporting arrangements for the Welsh and English blood services made little difference in practice, but the devolution of government following the 1997 referendum in Wales would have a profound influence. Four years before the Government of Wales Act (1998) was passed through the UK parliament, the National Blood Authority (NBA) assumed executive control of the English blood services but not the blood service in Wales. The Scottish National Blood Transfusion Service and the Northern Ireland Blood Transfusion Service had been created as independent organisations in 1946; thus, the scene was set for diversification between the four independent blood services, each operating in different political environments with different funding streams. The creation of the UK Blood Services Forum and its Joint Professional Advisory Committee in 1999 has, however, ensured consistency in professional matters. The blood transfusion service in Wales, in its new headquarters in Talbot Green, became known as the Welsh Blood Service (WBS), or Gwasanaeth Gwaed Cymru in Welsh, reporting for most of its life to the Velindre NHS Trust, part of NHS Wales. Considerable changes would impact the WBS in the 21st century. Social changes would mean that the role of recruitment and marketing would become ever more important, although the impact of this was lessened somewhat by a decreasing demand for blood following the Better Blood Transfusion initiatives. The Medicines and Healthcare Products Regulatory Agency found new powers and impetus after the so-called EU Blood Directive was transposed into British law, and the inspection regime became significantly more onerous, requiring more resources to be put in this area. A strategic review found that some parts of the service required extensive modernisation, such as the information technology system in use and the deployment of staff on the blood collection teams, and these matters were attended to. The review also prompted the Welsh Government to consider the question of blood supply to and blood collection in North Wales, which had been the remit of the Liverpool Centre since the establishment of the NBTS in 1946. The Welsh Government duly announced the creation of an all-Wales Blood Service, and finally, in May 2016, 70 years after its creation, the WBS took over responsibility for blood collection and blood provision in the whole of Wales.

We describe 2 cases of child maltreatment who presented as common pediatric conditions: preseptal cellulitis and gastroenteritis. The first case is an 8-year-old girl who presented with progressive right eye pain, swelling, and discharge. She was initially treated for preseptal cellulitis, but eye cultures ultimately grew Neisseria gonorrhoeae. Further investigation revealed sexual abuse by a male family member. The second case is a 2-year-old previously healthy girl who presented with 6 hours of emesis, lethargy, and abdominal pain. Initially attributed to viral gastroenteritis, her serum blood urea nitrogen and creatinine were above what was expected for her clinical course, and she later developed signs of peritonitis. She was ultimately found to have a large bladder wall defect secondary to inflicted blunt abdominal trauma. These cases are presented to emphasize the need for pediatricians to consider child abuse even when patients present with common pediatric complaints.

Evan M Pucillo,1 Nancy Christensen-Mayer,2 Shelly D Poole,2 Denise M Whitten,2 Danielle Freeman,3 Blake R Bohe,4 Brandon R Swensen,3 A Gordon Smith,1 Nicholas E Johnson1 1Department of Neurology, School of Medicine, 2Department of Physical Medicine & Rehabilitation, 3Outpatient Neurology, University of Utah Hospitals and Clinics, 4Business Support, University of Utah Information Technology, Salt Lake City, UT, USA Background: Team-based care has been shown to offer more comprehensive benefits to patients when compared to standard physician-based care alone in clinics for chronic conditions. However, apart from grant-funded multidisciplinary clinics, there are no reports on the usage of same-day physical therapy (PT) consults within a daily outpatient neuromuscular disease (NMD) physician clinic.Objective: To determine the impact of same-day PT consults at the University of Utah’s outpatient Clinical Neurosciences Center.Design: A qualitative assessment and survey of patient satisfaction.Methods: An eight question Health Insurance Portability and Accountability Act-compliant patient satisfaction survey using a 5-point Likert scale was administered. Demographic data and Press-Ganey Provider Satisfaction surveys were retrospectively collected from electronic medical records for patients receiving same-day PT encounters in the neuromuscular division over 1 year.Results: Mean (standard deviation) age was 54.22 (19.81) years for 134 patient encounters, median age was 60 years, with 76 male (57%) and 58 female (43%) patients. Mean Likert score for 61 self-reported patient satisfaction surveys for same-day PT consults was 4.87 (97.4%). Press-Ganey Provider Satisfaction scores improved from 89.9% (N=287) for the year prior to 90.8% (N=320) for the corresponding year (P=0.427). A total of 46 (75.4%) patients have either never before received PT care or never before received PT care for their NMD, 67.4% of whom were male.Conclusion: Same-day PT consults in an outpatient NMD physician clinic demonstrated excellent patient satisfaction and improved access to specialty care. This model could potentially be implemented in other academic medical centers to improve access to rehabilitation services for patients with NMD. Keywords: neuromuscular therapy, neuromuscular care, team-based health care, physical therapy consults, same-day physical therapy, physician clinics, patient satisfaction

Use of selective serotonin reuptake inhibitors (SSRIs) is common during pregnancy. Fetal exposure to SSRIs is associated with persistent pulmonary hypertension of the newborn (PPHN); however, a direct link between the two has yet to be established. Conversely, it is well known that PPHN can be caused by premature constriction of the ductus arteriosus (DA), a fetal vessel connecting the pulmonary and systemic circulations. We hypothesized that SSRIs could induce in utero DA constriction. Using isolated vessels and whole-animal models, we sought to determine the effects of two commonly prescribed SSRIs, fluoxetine and sertraline, on the fetal mouse DA. Cannulated vessel myography studies demonstrated that SSRIs caused concentration-dependent DA constriction and made vessels less sensitive to prostaglandin-induced dilation. Moreover, in vivo studies showed that SSRI-exposed mice had inappropriate DA constriction in utero. Taken together, these findings establish that SSRIs promote fetal DA constriction and provide a potential mechanism by which SSRIs could contribute to PPHN.

Background NLRP1 is a central component of the inflammasome. Several polymorphisms in the gene are linked to increased risk for autoimmune and autoinflammatory diseases. We examined the effects of these risk polymorphisms on cytokine levels and NLRP1 expression levels in human volunteers. Materials and Methods NLRP1 was genotyped at the SNPs rs2670660 and rs12150220 using TaqMan on peripheral blood cells. Homozygous individuals were selected for further study. Serum IL-18 and IL-1B levels were quantified using ELISA. NLRP1 gene expression was measured semiquantitatively by SybrGreen real-time PCR. Results The risk variants at rs2670660 and rs12150220 were almost never found separately. There was no case in which a volunteer with homozygous risk SNP variant also had a homozygous protective variant at the other, indicating very strong linkage (p Volunteers with the risk haplotype (AAAA) had significantly higher levels of serum IL-18 than volunteers with the protective haplotype (GGTT) (0.439 ng/μL compared to 0.152 ng/μL, p=0.024) A trend towards increased NLRP1 expression was seen in the risk haplotype compared to the protective (4.4-fold increase, p=0.101). Discussion The risk haplotype showed increased production of IL-18 even in non-autoimmune individuals, with a trend towards higher NLRP1 expression. This suggests that the risk variants lead to higher NLRP1 activity, and therefore a pro-inflammatory phenotype. Because of the strong linkage of the AAAA and GGTT genotypes, it was impossible to differentiate which SNP was responsible for these effects. Further studies with increased numbers of volunteers should allow an increased understanding of the contribution of NLRP1 risk variants to autoimmune disease

Background Although studies involving preterm infants ≤34 weeks gestation report a decreased incidence of patent ductus arteriosus after antenatal betamethasone, studies involving younger gestation infants report conflicting results. Methods We used preterm baboons, mice and humans (≤276/7 weeks gestation) to examine betamethasone’s effects on ductus gene expression and constriction both in vitro and in vivo. Results In mice, betamethasone increased the sensitivity of the premature ductus to the contractile effects of oxygen without altering the effects of other contractile or vasodilatory stimuli. Betamethasone’s effects on oxygen sensitivity could be eliminated by inhibiting endogenous prostaglandin/nitric oxide signaling. In mice and baboons, betamethasone increased the expression of several developmentally-regulated genes that mediate oxygen-induced constriction (K+ channels) and inhibit vasodilator signaling (phosphodiesterases). In human infants, betamethasone increased the rate of ductus constriction at all gestational ages. However, in infants born ≤256/7 weeks gestation, betamethasone’s contractile effects were only apparent when prostaglandin signaling was inhibited, whereas, at 26-27 weeks gestation betamethasone’s contractile effects were apparent even in the absence of prostaglandin inhibitors. Conclusions We speculate that betamethasone’s contractile effects may be mediated through genes that are developmentally regulated. This could explain why betamethasone’s effects vary according to the infant’s developmental age at birth.

Depression and anxiety cause severe loss of quality of life for patients with systemic lupus erythematosus. The causes and factors that contribute to these psychological manifestations in lupus are difficult to disentangle. This study compared clinical, psychological, and demographic factors between lupus patients, depressed patients, and rheumatoid arthritis patients to discover lupus-specific contributors to depression. Lupus-specific manifestations of depression were also investigated. Physiological, clinical, and psychosocial data were collected from 77 patients. ELISA was used to measure cytokine levels. Univariate and Multivariate analyses were used to compare the patient populations and identify correlations between key physical and psychological indicators. The prevalence of depression in the SLE cohort was 6 times greater than the healthy control subjects. Pain, IL-6, and Pittsburgh Sleep Quality index values were all significantly higher in SLE patients compared with the healthy control group (P < .001, P = .038, and P = .005, respectively). Anxiety levels were significantly higher in SLE patients compared to healthy and RA control patients (P = .020 and .011, respectively). Serum IL-10 concentrations, relationship assessment scale, and fatigue severity scale values were found to be correlated with depression among the SLE patients (P = .036, P = .007, and P = .001, respectively). Relationship assessment and fatigue severity scale scores were found to be the best indicators of depression for the SLE patients (P = .042 and .028, respectively). Fatigue Severity, relationship satisfaction, and IL-10 concentrations are indicators of depression in lupus patients. Despite also suffering from the pain and disability that accompanies chronic autoimmune disease, the rheumatoid arthritis patients had less anxiety and better relationship scores. The authors thank the Portugal Fulbright Commission for funding Dr. Poole