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A number of neuropsychological studies have revealed that memory problems are relatively common in patients with multiple sclerosis (MS). It may be useful to compare MS with conditions such as Huntington's disease (HD), which have been referred to as subcortical dementia. A characteristic of these conditions may be an impairment in implicit (unconscious) memory, but not in explicit (conscious) memory. The present study examined the functioning of explicit and implicit memory in MS. Results showed that implicit memory was not significantly impaired in the MS subjects, and that they were impaired on recall but not recognition. A correlation was found between implicit memory performance and disability status in MS patients. Findings also suggest the possibility of long-term priming of implicit memory in the control subjects. The implications of these results are discussed.

This study examined the use of teasing during observed videotaped interactions of Mexican American adolescent dating couples ( N  = 34; 15-17 years old) from an urban area of the Southwest United States. During the interaction task, couples discussed two relationship problems for 14 min and nearly all interactions (88.2%) contained teasing. In turn, we developed a grounded theory of teasing that delineated who initiated the teasing (boys/girls), teasing types, levels of severity of teasing incidents, youth's motivations for teasing, and the resulting consequences of teasing in real time. We found that most teasing incidents were mild to moderately severe and that girls initiated teasing to a greater extent than boys. Regarding motives, youth used teasing to exert power during the interaction and/or to repair a problem in the relationship. Despite various types of teasing, the resulting consequences were hurt feelings, power struggles, and shame. Participants overtly stated that they desired improved communication. We recommend that socioemotional learning and dating violence prevention programs include teasing as part of conflict resolution skill sets and that these programs be informed by the cultural values of Mexican-origin youth., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

9-Aminoacridine structures hold much potential for accessing small molecule therapeutics. This core is present in a range of pharmaceuticals for the treatment of ailments such as malaria, inflammation, viral and bacterial infections, and cancer. For the latter, there remains a need to develop and/or improve chemotherapeutics to counteract issues of uptake, drug resistance, and selectivity for cancer cells over healthy cells. In the design of molecules to address these issues, identifying structural units that present as promising leads for drug developments is key. In this study, four 9-aminoacridine derivatives under consideration as precursors for a drug design project are assessed for their cytotoxicity with representative cell lines PC3 and A549, and for their leadlikeness with SwissADME. Together, the cytotoxicity and in silico investigations coalesce around the same derivative as the most promising lead.

Introduction: The long-term impact of COVID-19 is unknown. We developed a 5-year prospective cohort study designed to generate actionable community-informed research about the consequences of COVID-19 on adolescents ages 12-17 years in Arizona., Methods: The study has two primary outcomes: 1) acute and long-term outcomes of COVID-19 illness and 2) symptoms of depression and anxiety. Data is collected using an online survey with plans to integrate qualitative data collection methods. The survey is administered at baseline, 4, and 8 months in year one, and annually in years two through five. This study is informed by Intersectionality Theory, which considers the diverse identities adolescents have that are self and socially defined and the influence they have collectively and simultaneously. To this end, a sample of variables collected is race/ethnicity, language usage, generational status, co-occurring health conditions, and gender. Additional measures capture experiences in social contexts such as home (parent employment, food, and housing security), school (remote learning, type of school), and society (racism)., Results: Findings are not presented because the manuscript is a protocol designed to describe the procedure instead of report results., Discussion: The unique contributions of the study is its focus on COVID-19 the illness and COVID-19 the socially experienced pandemic and the impact of both on adolescents., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Leybas Nuño, Mantina, Dawodu, Dykinga, Carr, Pogreba-Brown, Cordova-Marks, Jehn, Peace-Tuskey, Barraza and Garcia-Filion.)

Introduction: Great advances have been made in screening for and treatment of colorectal cancer (CRC), but recurrence rates remain high and additional therapies are needed. There is great excitement around the field of immunotherapy and many attempts have been made to bring immunotherapy to CRC through a cancer vaccine. Areas covered: This is a detailed review of the last decade's significant CRC vaccine trials. Expert commentary: Monotherapy with a CRC vaccine is likely best suited for adjuvant therapy in disease free patients. Vaccine therapy elicits crucial tumor infiltrating lymphocytes, which are lacking in microsatellite-stable tumors, and therefore may be better suited for these patients. The combination of CRC vaccines with checkpoint inhibitors may unlock the potential of immunotherapy for a much broader range of patients. Future studies should focus on vaccine monotherapy in correctly selected patients and combination therapy in more advanced disease.

Object: Follow-up head CT scans are important in neurocritical care but involve intrahospital transport that may be associated with potential hazards including a deleterious effect on brain tissue oxygen pressure (PbtO(2)). Portable head CT (pHCT) scans offer an alternative imaging technique without a need for patient transport. In this study, the investigators examined the effects of pHCT scans on intracranial pressure (ICP), cerebral perfusion pressure (CPP), and PbtO(2) in patients with severe brain injury., Methods: Fifty-seven pHCT scans were obtained in 34 patients (mean age of 42 ± 15 years) who underwent continuous ICP, CPP, and PbtO(2) monitoring in the neuro intensive care unit at a university-based Level I trauma center. Patient ICU records were retrospectively reviewed and physiological data obtained during the 3 hours before and after pHCT scans were examined., Results: Before pHCT, the mean ICP and CPP were 14.3 ± 7.4 and 78.9 ± 20.2 mm Hg, respectively. Portable HCT had little effect on ICP (mean ICP 14.1 ± 6.6 mm Hg, p = 0.84) and CPP (mean CPP 81.0 ± 19.8 mm Hg, p = 0.59). The mean PbtO(2) was similar before and after pHCT (33.2 ± 17.0 mm Hg and 31.6 ± 15.9 mm Hg, respectively; p = 0.6). Ten episodes of brain hypoxia (PbtO(2) < 15 mm Hg) were observed before pHCT; these episodes prompted scans. Brain hypoxia persisted in 5 patients after pHCT despite treatment. No new episodes of brain hypoxia were observed during or after pHCT., Conclusions: These data suggest that pHCT scans do not have a detectable effect on a critically ill patient's ICP, CPP, or PbtO(2).

Transport of critically ill intensive care unit (ICU) patients may be hazardous. In this study, we examined the use of a portable head CT scanner (CereTom) in the ICU to assess its feasibility, safety, and radiological quality. Two hundred and twenty-five portable head CT scans were obtained from 114 patients (mean age = 57 +/- 18 years) treated in a neurosurgical intensive care unit at a university-based Level I trauma center. Patient radiological and ICU records were retrospectively reviewed. The vast majority of portable CT scans were performed after an intracranial procedure (24%) due to neurological deterioration (16%) or in routine follow-up (16%). Diagnostic quality was judged to be adequate, and no scans needed to be repeated because of poor quality. No scans were complicated by accidental disconnection of an intravenous line. In ventilated patients, there were no interruptions in mechanical ventilation and no inadvertent extubations. In addition, continuous intracranial monitoring, when in use, remained connected. The average total time to perform a portable head CT scan was 19.5 +/- 3.5 min. The actual scan time was 2.5 +/- 0.7 min. These results suggest that the portable CT scanner (CereTom) is feasible, easy to use, and safe and provides adequate radiological quality for diagnostic decisions.

Defendants commonly claim amnesia for their criminal actions especially in cases involving extreme violence. While some claims are malingered or result from physiological factors, other cases may represent genuine partial or complete amnesia resulting from the psychological distress and/or extreme emotion associated with the perpetration of the crime. Fifty Canadian homicide offenders described their memories of their homicide, a non-homicide violent offense, and their most positive adulthood life experience. Self-reported and objective measures of memories for these events revealed that homicides were recalled with the greatest level of detail and sensory information. Although dissociative tendencies were associated with a self-reported memory loss, objective measures of memory quality did not reflect this perceived impairment, suggesting a failure of meta-memory. Recollections of positive life events were superior to those of non-homicidal violence, possibly due to greater impact and meaning attached to such experiences. Findings suggest that memory for homicide typically is enhanced by the powerful emotion associated with its perpetration.

The objective of this paper was to correlate optical changes of tissue during wound healing measured by near infrared (NIR) and diffuse reflectance spectroscopy (DRS) with histologic changes in an animal model. Amplitude and phase of scattered light were obtained in a diabetic rat and control model and biopsies were taken for blood vessel ingrowth and collagen concentration. NIR absorption coefficient correlated with blood vessel ingrowth over time, in both the control and diabetic animals. DRS data correlated with collagen concentration. Previous publications by this group documented only the NIR changes during the wound healing process but this is the first reported correlation with histology data. The ability to correlate DRS scattering with collagen concentration during healing is another important and novel finding. This technology may play an important role clinically in assessing the efficacy of wound healing agents in diabetics.

Foot and ankle pain is common in ballet dancers. Although clinical examination often points to the underlying cause, imaging is often necessary to confirm the diagnosis and thus ensure appropriate future management. Factors predisposing to the increased incidence of injuries in this population include the classical position in which ballet dancers stand, which is on the tips of the toes in the en pointe position or on the balls of the feet in the demi-pointe position. Furthermore, the repetitious nature of ballet and the long hours spent rehearsing cause over-use injuries. The causes of foot and ankle pain can be thought of in four different groups: the impingement syndromes; tendon abnormalities; osseous pathology; and ligament abnormalities. These will be discussed and illustrated.

Objective: To compare the global cognitive functioning and frontal lobe functioning of children with and without DSM-IV combined type Attention Deficit Hyperactivity Disorder (ADHD)., Method: Participants were 6 to 10 year old, clinic-referred children diagnosed with combined type ADHD, who were medication naïve; and an age (+/- 3 months) and sex matched group of children without behaviour problems. The performance of the two groups were compared on measures of intellectual functioning and tests designed to assess the functions of the frontal lobes (verbal and-non-verbal fluency, reasoning, problem solving, spatial working memory, attention)., Results: The children with ADHD obtained significantly lower Wechsler Intelligence Scale for Children-third edition IQ scores than controls and performed more poorly across the range of frontal lobe tests. Group differences on these tests were attenuated when IQ scores were included in the analyses as a covariate., Conclusions: Children with combined type ADHD have mild to moderate global cognitive impairment together with some impairment of functions subserved by the frontal lobes. Longitudinal studies are required to determine if the deficit in global cognitive functioning is a primary deficit or secondary to the deficit in frontal lobe functioning. The importance of neuro-psychological assessment and follow-up for children with ADHD is stressed. Study limitations relate to the generalizability of the findings and the absence of a psychiatric control group.

Tacrine, a cholinesterase inhibitor, has beneficial effects on cognition and global status in patients with Alzheimer's disease. These effects have been demonstrated in clinical trials by double-blind comparisons with placebo. Tacrine dosages have been studied in 5 protocols that used either enrichment or parallel designs. We have used a population pharmacodynamic model to describe the response to tacrine and placebo in the 3 trials that used the enrichment design. The time-course of the response and its relation to tacrine dosage obtained from the enrichment design analysis were used to define the parallel design. The effects of tacrine on cognition and global status was estimated separately from each trial. Analysis of the 2 trials using the parallel design confirmed the predictions from the enrichment design. By combining the data from all 5 trials it was possible to show that tacrine potency was similar in all studies, but that the placebo response was different in some. The effect of tacrine was linearly proportional to dosage from 40 to 160 mg per day. One of the enrichment design trials included a sub-group treated with lecithin, a choline precursor. The potency of lecithin was equivalent to about 40 mg per day of tacrine. Using the combined data from all 5 trials it was possible to distinguish a responder population, approximately one-third of all patients, with a 4-fold greater effect compared with poor responders. Tacrine has beneficial effects on cognitive status in patients with Alzheimer's disease. Lecithin has a small additional benefit independent of tacrine.(ABSTRACT TRUNCATED AT 250 WORDS)

The assessment of health status and quality of life among chronically ill patients is an area of current scientific interest. This paper considers the utility of a short but comprehensive instrument to assess the quality of life for end-stage renal failure patients. the Spitzer QL-Index was completed by 8 nurses for all patients in the Wellington region currently being treated with home hemodialysis (n = 58); hospital hemodialysis (n = 13); and continuous ambulatory peritoneal dialysis (n = 37). Results indicated that home hemodialysis patients achieve the highest quality of life in comparison to the other two treatment modalities. It is concluded that the QL-Index has some discriminative validity for this patient population, and its use may contribute to informed decision making by both patients and doctors.

71 recipients of cadaver primary and secondary renal transplants were investigated in a prospective randomised double-blind study. Patients were given one of two rabbit antilymphocyte globulin (A.L.G.) preparations made by similar techniques but differing in potency as measured by skin-graft prolongation in rhesus monkeys. Patient selection and management were otherwise similar. A statistically significant difference (P less than 0-05) in graft survival (78% vs. 42%) developed between the two groups at a mean follow-up of 18-4 months and patient entry into the study was terminated. After a 3-5 year interval from the start of the trial the double-blind code was broken. It was found that the high-potency-A.L.G. group had better graft survival and fewer rejection episodes (P less than 0-05) than the moderate-potency group. The results suggest that preclinical testing of A.L.G. by the primate skin graft test can be a valid indicator of the potential efficacy of an A.L.G. preparation in renal-transplant recipients. It is suggested that quality-control standards may improve the clinical results of A.L.G. therapy.

In a series of previous studies, we showed that misoprostol protects the gastric and duodenal mucosae against ulceration seen with the administration of both aspirin and the nonsteroidal antiinflammatory drug tolmetin. The purpose of this study was to confirm, in addition, that misoprostol protects the mucosae against aspirin-induced damage and, for the first time, to compare its cytoprotective properties with those of sucralfate. Thirty healthy volunteers were randomized into three equal groups receiving either misoprostol 200 micrograms, sucralfate 1 g, or placebo, co-administered with 650 mg of aspirin, four times a day for 7 days. All subjects had endoscopically normal mucosae on entry and were reendoscoped 2 h after a single final dose on day 7. The mucosae were graded on a 0-4 scale as follows: 0 = normal, 1 = single hemorrhage or erosion, 2 = 2-10 hemorrhages or erosions, 3 = 11-25 hemorrhages or erosions, 4 = more than 25 hemorrhages or erosions or an invasive ulcer of any size. Utilizing a previously established criterion of a score of 2 or less as a clinically significant degree of protection to the gastric mucosae, we found that the success rate for misoprostol was 100% (10/10), compared to 20% (2/10) for sucralfate and 0% (0/10) for placebo. Misoprostol was statistically significantly superior to both sucralfate (p = 0.0001) and placebo (p = 0.00001), with 95% confidence intervals on the difference in success rates between misoprostol and sucralfate and between misoprostol and placebo of (44%; 100%) and (61%; 100%), respectively. In the duodenum, nine of 10 subjects taking misoprostol showed no damage (0 grade), whereas this was seen in only five sucralfate and three placebo patients. Misoprostol was significantly superior to placebo (p = 0.020) and marginally superior to sucralfate (p = 0.141) with confidence intervals of (29%; 91%) and (-5%; 67%), respectively. Adverse experiences were minor and did not differ in the three groups.

The authors studied the reliability of axis V of DSM-III by analyzing ratings of 97 psychiatric inpatients made by a multidisciplinary team of clinicians. The intraclass correlation coefficient for ratings of the overall sample was .49, lower than the figure found during the DSM-III field trials. The psychiatric diagnosis, age, ethnicity, marital status, and sex of the patient did not significantly influence reliability. The authors recommend more explicit instructions in the administration of the scale, the use of a standardized interview, and more training for raters as ways of increasing reliability.

This prospective study examined the concept of pre-admission adaptive functioning and its relationship with outcome. Pre-admission adaptive functioning was assessed by the self-report Social Adjustment Scale and the therapist rated Axis V of DSM-III. In addition, an instrument designed to look separately at the areas of interpersonal relationships, occupational functioning and use of leisure time was given to a subgroup. These measures were compared with outcome at six months as assessed by the General Health Questionnaire. Adaptive functioning proved to be a significant predictor of outcome, with the Social Adjustment Scale being a better predictor than Axis V for the whole group. In contrast, for patients with schizophrenia, the initial Axis V rating was the best predictor of the outcome score. Statistically significant correlations were found between the three areas of adaptive functioning for the group as a whole but, when examined by diagnosis, they proved to be statistically significant only in the schizophrenia sub-group, suggesting that it would be invaluable to rate the three areas separately in non-psychotic patients.

A sample of 36 patients who had undergone gastric reduction surgery for severe obesity was seen postoperatively and psychobiological changes assessed. Subjects reported substantial weight losses with reduced food intake and normalisation of eating habits. In the majority of patients positive changes had occurred in attitudes and improvements were found in mood, social and sexual functioning. Low rates of psychological disturbance were reported.

A study of the incapacity and socioeconomic scales in 120 patients with multiple sclerosis (MS) living in Wellington, New Zealand, is described. The questionnaire has been compared by different health professionals. There was good correlation between the observations of different professionals on incapacity analysis and this may be improved by reducing the questions to six. The findings on the socioeconomic scale, however, cannot be predicted accurately from the incapacity scale. The socioeconomic survey revealed major improvement in patient support in New Zealand during the last decade. We consider that our New Zealand findings indicate the value of field officers concerned with co-ordination of services and provision of information for patients with MS. Future research should be directed towards assessment of support systems.

Alcohol dependence and abuse have been commonly found to coexist with other psychiatric disorders. In order to further investigate this relationship two populations with combined dysfunctional alcohol use and psychiatric illness were studied, one at an alcohol treatment centre and one at a general hospital psychiatric service. Sixty of the 63 people screened at the alcohol treatment centre and 41 of the 43 people with an alcohol problem at the psychiatric unit, met the combined criteria, thus confirming that a very high proportion of people with alcohol problems, and who present for treatment, also have additional psychiatric disorders. The two sample populations were similar on sociodemographic variables. There were differences in the types of psychiatric disorders occurring at the two treatment centres with depression predominating at the psychiatric unit and anxiety disorders occurring more frequently at the alcohol treatment facility. Both samples showed a high rate of schizophrenia. The sample at the alcohol treatment centre showed higher levels of alcohol consumption and had higher rates of problems associated with alcohol. Service delivery issues are discussed in relation to these results. The importance of psychiatric symptoms in both the genesis of dysfunctional drinking and in service utilisation are highlighted.

Over the past 50 years the relationship between alcoholism and psychiatric disorders, such as depression, anxiety and schizophrenia, has been the subject of a great deal of research. Psychiatric problems have been seen as both a cause and a result of alcoholism. Whatever the relation between alcoholism and psychiatric disorder is, it may have significance for the development of differentially effective treatment strategies. Several authors have argued that the presence and nature of psychiatric symptoms should form the basis of a classification system for alcoholics. Given the potential rewards of such a system for both understanding the aetiology of alcoholism and developing effective treatment strategies, it is important to have a clear picture of the nature and extent of this relationship. This paper reviews critically the published studies of the association between alcoholism and psychiatric disorder and outlines directions for future research.

A double-blind, parallel, placebo-controlled study was performed to assess the efficacy of a combination drug product containing the antihistamine, triprolidine, and the sympathomimetic, pseudoephedrine, in the treatment of allergic rhinitis. Allergic rhinitis was defined on the basis of coexistent nasal congestion and an aggregate symptom complex score which exceeded a pre-established value. Pseudoephedrine and triprolidine were shown to make distinct and separate contributions to the treatment of allergic rhinitis defined in this manner.