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We report a complete genome sequence of bovine coronavirus (BCoV) isolated from a goat in the state of Pennsylvania in 2022. BCoV often causes calf scours and winter dysentery in cattle.

Robust research indicates that social support is negatively associated with depression and anxiety. Less work has investigated social support as a network of support across sources like parents and classmates. Past work suggests that sources of support have differential associations with internalizing outcomes. More work exploring the differential associations between each source along with the cumulative network of social support and internalizing symptoms is warranted. In a sample of female adolescents, the current study explored (1) what patterns of social support across sources emerged, and (2) how do depressive and anxiety symptoms vary based on those social support patterns?. The study utilized Latent Profile Analysis on a sample of female adolescents from four different high schools (N = 143) to identify patterns of social support across sources. Parent support emerged as a unique, individual predictor of depressive symptoms. Five unique profiles of social support emerged. Profile membership was associated with reports of depression but not with reports of anxiety. Reports of depression differed by profile such that profiles with moderate support from most sources and low support from siblings had the highest levels of depressive symptoms. Social support is associated with symptoms of depression in female adolescents. The study highlights the importance of parent–child relationships for female adolescents and suggests that additional work on sibling support is warranted. The study promotes that the network of social support is an important factor to consider when researching associations between social support and internalizing outcomes.

Interleukin-4 (IL-4) is a signature cytokine pivotal in Type 2 helper T cell (Th2) immune response, particularly in allergy and hypersensitivity. Interestingly, IL-4 increases endogenous levels of prostaglandin D(2) (PGD(2)) and its metabolites, Δ(12)-prostaglandin J(2) (Δ(12)-PGJ(2)) and 15-deoxy-Δ(12,14)-prostaglandin J(2) (15d-PGJ(2)), collectively called cyclopentenone PGs (CyPGs). However, the therapeutic role of IL-4 in hematologic malignancies remains unclear. Here, we employed a murine model of acute myeloid leukemia (AML), where human MLL-AF9 fusion oncoprotein was expressed in hematopoietic progenitor cells, to test the effect of IL-4 treatment in vivo. Daily intraperitoneal treatment with IL-4 at 60 μg/kg/d significantly alleviated the severity of AML, as seen by decreased leukemia-initiating cells (LICs). The effect of IL-4 was mediated, in part, by the enhanced expression of hematopoietic- PGD(2) synthase (H-PGDS) to effect endogenous production of CyPGs, through autocrine and paracrine signaling mechanisms. Similar results were seen with patient-derived AML cells cultured ex vivo with IL-4. Use of GW9662, a peroxisome proliferator-activated receptor gamma (PPARγ) antagonist, suggested endogenous CyPGs-PPARγ axis mediated p53-dependent apoptosis of LICs by IL-4. Taken together, our results reveal a beneficial role of IL-4 treatment in AML suggesting a potential therapeutic regimen worthy of clinical trials in AML patients.

Background: Topical sinus irrigation plays a critical role in the management of sinonasal diseases. Yet, the penetration of irrigant to targeted sinuses may be highly variable and difficult to predict. Here, we investigate the use of 3D printing as a planning tool to optimize outcomes. Methods: Eight post-operative models were 3D printed with a FormLabs Form3 printer based on individual CT scans. Irrigations were performed and video recorded with a squeeze bottle attached via silicon water-tight seal, in 4 head positions: 45° to-the-side, 90° to-the-side, 45° forward and 45° to-the-side, and 90° forward, with irrigation fluid entering the upper (conventional) or lower (backfill) nostrils. Results: Significant individual variations were observed in sinus penetration as a function of head position. In general, the maxillary sinus was the easiest to irrigate in most head positions ( P Conclusion: Variations in technique and position significantly impacted irrigation outcome. Backfill irrigation that pushes fluid against gravity to pool around the ostium, seems to provide overall better outcomes. This study demonstrates the advantage of 3D printing as a rapid planning tool to guide irrigation strategies.

Students often hear their peers use biased language regarding race, religion, sexual orientation, or disability status in the school setting. Prior research has indicated that biased language is related to school climate, and specifically to school-based relationships between peers and between students and their teachers. This study investigated the longitudinal associations among student-student relationships, teacher-student relationships, and being the target of or hearing biased language in middle school students. Students (N = 501; 46.5% White, 21.8% Hispanic, 13% African American, and 15% Multi-Racial; 48.7% female) reported on how much they were targeted or heard biased language related to race/religion, sexual orientation, and disability status. Students also reported on their relationships with their peers and teachers. Using a cross-lagged panel model with the overall sample, a negative unidirectional association from being the target of or hearing biased language and student-student relationships and teacher-student relationships was identified. Separate models for boys and girls identified unique patterns. For boys, biased-language exposure predicted more negative student-student relationships and teacher-student relationships, whereas for girls, biased-language exposure was not associated with school-based relationships. Implications include addressing language use and building positive student-student and teacher-student relationships.

Although some research has evidenced a negative association between involvement in bullying and academic performance, more work is needed to understand the associations between academic performance and involvement in a more comprehensive range of bully role behaviors. The goals of the current study were to determine (a) the associations among a broader range of bully role behaviors (i.e., bullying, assisting, victimization, defending, and outsider behavior) and academic performance (i.e., grade point average; GPA), and (b) gender differences within these associations. The current study investigated these issues over the course of an academic year with 7794 students in middle through high school. Bullying behaviors were assessed in the fall and GPA data were gathered from school records from the spring of the same academic year. The results identified significant negative associations between bullying (b = -0.07, p = .001), assisting (b = -0.16, p < .001), victimization (b = -0.06, p < .001), and defending (b = -0.04, p < .001) with student GPA, whereas no significant association emerged for outsider behavior and GPA (b = -0.02, p = .13). In addition, several gender differences were found in these associations, including a stronger negative association between assisting and GPA for girls (b = -0.23, p = .001) than for boys (b = -0.08, p = .014) and a significant negative association between victimization and GPA for girls (b = -0.09, p < .001), but not boys (b = -0.02, p = .117). Differences in results across schools were also examined in an exploratory manner. The educational impact associated with bullying behaviors, limitations of the current study, and suggestions for future research are discussed.

p53 has been implicated in the pathogenesis of obesity and diabetes, in part, by regulating whole body energy homeostasis. Conflicting evidence from mice with global alterations in p53 expression suggests the effects of p53 on metabolism are tissue-specific. Despite the critical metabolic role of the hepatocyte, the role of hepatocyte p53 is undefined. Bariatric surgery, such as vertical sleeve gastrectomy (VSG), causes high rates of type 2 diabetes remission and improves energy homeostasis at the cellular level. To define the role of hepatocyte p53 in metabolic regulation and the impact of VSG in this context, we performed VSG or sham (S) surgery in high fat diet-fed male hepatocyte-specific p53 knockout (KO) and wild type (WT) mice (n=9-12). Sham-operated mice were fed ad libitum (S-AL) or food restricted to match their body weight to VSG-operated mice (S-WM). Body weight, food intake, adiposity, energy expenditure, and oral glucose tolerance were measured. Hepatocyte p53 ablation increased body weight which was corrected by food restriction and VSG (final weight (g): S-AL-WT=33±1, S-WM-WT=27±1, VSG-WT=29±1, S-AL-KO=38±1, S-WM-KO=28±1, VSG-KO=28±1, P Disclosure M.M. Holter: None. D. Garibay: None. A.K. McGavigan: None. L. Nguyen: None. E. Moore: None. E. Daugherity: None. P. Cohen: None. K.M. Kelly: None. R. Weiss: None. B. Cummings: None. Funding Cornell University; National Cancer Institute (R21CA195002)

BACKGROUND AND PURPOSEThere has been much concern and discussion about the lack of standardization in clinical education as an integral component of physical therapist entry-level education. The clinical education system described in the first goal of the 2006 Education Road Map (formerly, 2006 APTA Education Strategic Plan),1 includes a strong partnership between academic programs and clinical sites, supports contemporary physical therapist (PT) practice, and is collaborative with other professions, while being economically feasible.1 More importantly, this clinical education system should reflect the degree of rigor and intensity commensurate with a doctoring profession. This system serves to bridge the gap between theory and practice, providing students with opportunities to learn in the real-world context of the clinical environment; not only to develop the necessary knowledge, skills, attitudes, and behaviors, but to actually develop a unique professional identity.2,3According to the Normative Model of Physical Therapist Professional Education,4 the ultimate goal of clinical education is to prepare students to enter the profession of physical therapy. Despite efforts by the American Physical Therapy Association (APTA) to promote greater standardization in clinical education across programs through commentary, conferences, summits, and discussions (eg, "Clinical Education: Dare to Innovate,"5 and "Embracing Clinical Education Standards"6 conferences), there continues to be great variability in the delivery of clinical education, and some would argue, the quality of clinical education.7'12 Currently, the total length of time spent in full-time clinical education in physical therapist education programs varies, with final clinical experiences ranging from 8 to 68 weeks. The length of time students spend in final clinical experiences has increased from a mean of 19.6 to 21.2 weeks between 2010 and 2012.13There are 4 primary clinical education models used in physical therapist education programs, with the integrated model being the most common.2 As described by other authors in this issue of the Journal of Physical Therapy Education, the integrated model of clinical education consists of part-time or full-time clinical experiences dispersed throughout the didactic portion of the curriculum, with extended full time clinical education experiences at the end of the curriculum. Currently, there is not sufficient evidence demonstrating that 1 model is better or more effective than another, nor is there consensus on a preferred model.2,6 A recent systematic review published by McCallum and colleagues,14 concluded that there is a lack of evidence about what constitutes quality in clinical education, or for that matter, "best practice." Based on a review of 54 articles that met their inclusion criteria, the authors were unable to conclude that a single model of clinical education was more effective, or provided better quality of clinical education.14Aside from lengthening the total time in clinical education, the infrastructure of clinical education has not changed significantly with the transition to the Doctor of Physical Therapy degree as a requirement for entry into the profession, and integrated clinical education continues to be the dominant model of clinical education in the United States. However, health care delivery and health care systems have changed, and physical therapists are pressured with increased demands on their productivity even as reimbursement has decreased. The demands on contemporary physical therapist practice include, but are not limited to, productivity and reimbursement challenges, increased billing restrictions on services provided by students, and fluctuations in staffing. There are additional demands placed on facilities, and the ability of clinical instructors to keep pace with the needs of students while managing a caseload of patients is challenging. Private practices appear to be especially vulnerable because of the time requirements and regulations involving student supervision that diminish productive patient care time for the clinical instructor, often making it too costly to accept the responsibility for the education of students at these clinical sites. …

Ventriculoatrial (VA) shunting is rarely used for patients with normal-pressure hydrocephalus (NPH), likely due to surgeon technical preference and case reports indicating cardiopulmonary complications. However, these complications have typically been limited to adults in whom VA shunts had been placed when they were children. Few studies have directly compared VA shunting to ventriculoperitoneal (VP) shunting in cases of NPH.The authors retrospectively analyzed all NPH patients treated by a single surgeon at their center from January 2002 through December 2011. Thirty patients were treated with VA shunts (14 male) and 157 with VP shunts (86 male). The patients' mean age (± SD) at surgery was 73.7 ± 9.4 years for VA shunting and 76.0 ± 8.2 years for VP shunting; the median durations of follow-up were 42.0 months (IQR 19.2-63.6 months) and 34.2 months (IQR 15.8-67.5), respectively. Statistical analysis was performed using chi-square tests and Wilcoxon rank-sum tests.Perioperative and postoperative complications for VA and VP shunting cohorts, respectively, included distal revision (2.7% vs 6.6%, p = 0.45), proximal revision (2.7% vs 2.5%, p = 0.97), and postoperative seizure (2.7% vs 1.5%, p = 0.62). Shunt drainage-related subdural hematomas/hygromas developed in 8.1%/27.0% of VA shunt-treated patients versus 6.6%/26.4% of VP shunt-treated patients (p = 0.76/0.98) and were nearly always successfully managed with programmable-valve adjustment. Symptomatic intracerebral hemorrhage (1.5%) and shunt infection (2.0%) were only observed in those who underwent VP shunting. Of note, no cardiovascular complications were observed in any patient, and there were no cases of distal occlusion of the VA shunt.The authors found no significant differences in complication rates between VA and VP shunting, and VA shunting was not associated with any cardiopulmonary complications. Thus, in the authors' experience, VA shunting is at least as safe as VP shunting for treating NPH.

In small series, endoscopic third ventriculostomy (ETV) has been shown to potentially have efficacy similar to that of ventriculoperitoneal shunting (VPS) for idiopathic normal-pressure hydrocephalus (iNPH). Therefore, some clinicians have advocated for ETV to avoid the potential long-term complications associated with VPS. Complication rates for these procedures vary widely based on limited small series data.We used a nationwide database that provides a comprehensive investigation of the perioperative safety of ETV for iNPH compared with VPS.We identified discharges with the primary diagnosis of iNPH (International Classification of Diseases, Ninth Revision code 331.5 [ICD-9]) with ICD-9 primary procedure codes for VPS (02.34) and ETV (02.2) from 2007 to 2010. We analyzed short-term safety outcomes using univariate and hierarchical logistic regression analyses.There were a total of 652 discharges for ETV for iNPH and 12,845 discharges for VPS for iNPH over the study period. ETV was associated with a significantly higher mortality (3.2% vs 0.5%) and short-term complication (17.9% vs 11.8%) rates than VPS despite similar mean modified comorbidity scores. On multivariate analysis, ETV alone predicted increased mortality and increased length of stay when adjusted for other patient and hospital factors.This is the first study that robustly assesses the perioperative complications and safety outcomes of ETV for iNPH. Compared with VPS, ETV is associated with higher perioperative mortality and complication rates. This consideration is important to weigh against the potential benefit of ETV: avoiding long-term shunt dependence. Prospective, randomized studies are needed.

The molecular mechanisms underlying learning and memory impairment in patients with HIV-associated neurological disease have remained unclear. Calcium/calmodulin-dependent kinase II (CaMKII) has key roles in synaptic potentiation and memory storage in neurons and also may have immunomodulatory functions. To determine whether HIV and simian immunodeficiency virus (SIV) induce alterations in CaMKII expression and/or activation (autophosphorylation) in the brain, we measured CaMKII alterations by quantitative immunoblotting in both an in vitro HIV/neuronal culture model and in vivo in an SIV-infected macaque model of HIV-associated neurological damage. Using primary rat hippocampal neuronal cultures treated with culture supernatants harvested from HIV-1–infected human monocyte-derived macrophages (HIV/MDM), we found that CaMKII activation declined after exposure of neurons to HIV/MDM. Consistent with our in vitro measurements, a significant decrease in CaMKII activation was present in both the hippocampus and frontal cortex of SIV-infected macaques compared with uninfected animals. In SIV-infected animals, total CaMKII expression in the hippocampus correlated well with levels of synaptophysin. Furthermore, CaMKII expression in both the hippocampus and frontal cortex was inversely correlated with viral load in the brain. These findings suggest that alterations in CaMKII may compromise synaptic function in the early phases of chronic neurodegenerative processes induced by HIV.

Inhaled nitric oxide has been shown to improve oxygenation in acute lung injury.To evaluate the clinical efficacy of low-dose (5-ppm) inhaled nitric oxide in patients with acute lung injury.Multicenter, randomized, placebo-controlled study, with blinding of patients, caregivers, data collectors, assessors of outcomes, and data analysts (triple blind), conducted in the intensive care units of 46 hospitals in the United States. Patients were enrolled between March 1996 and September 1999.Patients (n = 385) with moderately severe acute lung injury, a modification of the American-European Consensus Conference definition of acute respiratory distress syndrome (ARDS) using a ratio of PaO2 to FiO2 ofor =250, were enrolled if the onset was within 72 hours of randomization, sepsis was not the cause of the lung injury, and the patient had no significant nonpulmonary organ system dysfunction at randomization.Patients were randomly assigned to placebo (nitrogen gas) or inhaled nitric oxide at 5 ppm until 28 days, discontinuation of assisted breathing, or death.The primary end point was days alive and off assisted breathing. Secondary outcomes included mortality, days alive and meeting oxygenation criteria for extubation, and days patients were alive following a successful unassisted ventilation test.An intent-to-treat analysis revealed that inhaled nitric oxide at 5 ppm did not increase the number of days patients were alive and off assisted breathing (mean [SD], 10.6 [9.8] days in the placebo group and 10.7 [9.7] days in the inhaled nitric oxide group; P =.97; difference, -0.1 day [95% confidence interval, -2.0 to 1.9 days]). This lack of effect on clinical outcomes was seen despite a statistically significant increase in PaO2 that resolved by 48 hours. Mortality was similar between groups (20% placebo vs 23% nitric oxide; P =.54). Days patients were alive following a successful 2-hour unassisted ventilation trial were a mean (SD) of 11.9 (9.9) for placebo and 11.4 (9.8) for nitric oxide patients (P =.54). Days alive and meeting criteria for extubation were also similar: 17.0 placebo vs 16.7 nitric oxide (P =.89).Inhaled nitric oxide at a dose of 5 ppm in patients with acute lung injury not due to sepsis and without evidence of nonpulmonary organ system dysfunction results in short-term oxygenation improvements but has no substantial impact on the duration of ventilatory support or mortality.

The role of interferon alpha/beta (IFN) induction by the immunomodulators pICLC and CL246,738 was investigated in CD-1 mice infected with murine cytomegalovirus (MCMV) or herpes simplex virus type 2 (HSV-2). Mice were treated with either normal sheep serum or anti-alpha/beta IFN antiserum, inoculated with the immunomodulators, and infected with virus. Because anti-IFN treatment also decreased natural resistance to HSV-2 and MCMV, two viral challenge doses were used to ensure that the mice with control serum or anti-IFN antiserum received biologically equivalent infections. Antiviral protection of pICLC and CL246,738 against HSV-2 infection was completely abrogated by treatment with anti-alpha/beta interferon antiserum. Mice treated with pICLC also lost antiviral protection against MCMV when interferon alpha/beta was depleted. These results indicate that induction of interferon alpha/beta appears to be a major mechanism for both natural resistance and pICLC-induced antiviral protection against MCMV and HSV-2 herpesvirus infections.

A self-help movement for people with chronic mental illness is growing but is not as advanced as the system of self-help for the chemically dependent. Barriers to organized self-help among those with chronic mental illness include stigma, denial, and the debilitating effects of the illnesses themselves. The authors developed a coping group on a 12-bed psychiatric unit to address these problems. The group was designed to strengthen ties with a local self-help club and to foster the idea that people with chronic mental illness can have a positive impact on the course of their illness. Mental health consumers who were successfully coping with their illnesses were guest speakers and role models for group members. The coping group, which was well received by participants, stimulated research questions and suggested potential modifications of clinical practice. In recent years, a mental health consumer movement has gathered momentum. Individuals who have been receiving psychiatric services are now clamoring for a more active role. There are currently several national consumer organizations that are growing in power and visibility. Some self-help groups, like Recovery Inc., are primarily therapy groups concerned with personal growth. Others, like the National Mental Health Consumers Association, are involved in supporting research and empowerment through political action as well as focusing on mutual-aid groups.

Paired surveys designed to assess the nutritional status of adult inpatients were conducted in two acute care medical centers: University of Maryland Hospital (UMH) and its affiliated Veterans Administrtion Medical Center (VAMC). Nutritional profiles of the patients were determined by anthropometric measurements: measured height and weight, triceps skinfold (TSF), and mid-arm muscle circumference (MAMC), and by a chart review. The criteria used to define severe deficits were less than 80% for ideal body weight (IBW) and MAMC and less than 50% for TSF of sex specific standards. A serum albumin of 2.8g/100ml or less was regarded as a severe deficit. Chart review revealed missing admission weights in UMH and VAMC charts in 40% and 65% and missing heights in 60% and 88%, respectively. The VAMC had a greater percentage of patients that were below standards for IBW (p