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Early glycemic variability (GV) in diabetic patients is a poor prognosis factor following cardiovascular events. However, its influence on the course of acute ischemic stroke (AIS) with large vessel occlusion remains unclear. We investigated the relationship between high GV during acute stroke and three-month functional outcome among patients treated with combined intravenous thrombolysis and endovascular therapy for large vessel occlusion.A single-center retrospective analysis of AIS patients with proximal intracranial occlusion who underwent thrombolysis and mechanical thrombectomy between January 2015 and May 2017. Early GV was assessed using standard deviation (SD) of blood glucose levels for the first 24hours. The main outcome was functional status at three months as defined by the modified Rankin scale (mRS). Secondary outcomes were change in NIHSS score from baseline to 24hours and occurrence of severe hemorrhagic transformation. Multivariate logistic regression analyses including GV, admission glycemia and mean glycemia were performed.Among the 93 patients evaluated, 26 had early high GV (≥20.9mg/dl). High GV was associated with poor functional outcome (OR=8.00; 95%CI [1.34-47.89]; P=0.02) unlike admission glycemia and mean glycemia (OR=2.92; 95%CI [0.51-16.60]; P=0.23 and OR=0.36; 95%CI [0.05-2.6]; p=0.31, respectively). High GV was not associated with NIHSS at 24hours or hemorrhagic transformation.Acute high GV contributes to poorer functional outcome following AIS related to large vessel occlusion and should be considered as a new target in acute stroke management.

School staff who work with autistic students are at a high risk of exhaustion. More training and guidance are needed to enable them to respond to these students' needs. The purpose of this study was to design and evaluate a professional development program offered by an occupational therapist to help a team of school staff facilitate the participation of autistic students and their peers.A design-based research approach guided the development and evaluation of the modalities of the program. A case study was conducted in a school with nine school staff members using individual interviews, questionnaires, and a logbook.The program comprised five modalities: regular presence of the occupational therapist, a needs analysis, content focused on the features of an inclusive school, individual coaching, and team coaching. The following elements emerged as particularly helpful for the participants: frequent interactions with the occupational therapist, opportunities to collaborate, personalized support, experimentation of new practices with the occupational therapist, and concrete training content that can benefit all students.The modalities of the program appear promising to help a school team facilitate the participation of all students, including those who are autistic.Implications for rehabilitationOccupational therapists can help school teams to facilitate the participation of autistic students and their peers.A combination of individual and team coaching sessions appears promising in helping school staff adopt practice changes to make their school more inclusive.Using a multi-tiered approach can help therapists collaborate with school staff members to first find solutions that will be applicable with all of their students.

Polar amplification of climate change has the potential to cause large-scale shifts in the dissolved oxygen (DO) dynamics of Arctic lakes, with implications for fish survival, greenhouse gas production, and drinking water quality. While DO is also a sentinel of environmental changes of physical, chemical, and biological nature (e.g., ice cover, temperature, dissolved organic carbon, photosynthesis, and respiration), no synthesis exists of current knowledge of DO dynamics across the diverse freshwater systems of the Arctic. We thus conducted a systematic review of the literature that yielded DO data from 167 sites north of the Subarctic limit (based on vegetation zones), spanning 76 years and including 40 sites with time series. The compilation revealed insufficient observations for adequate representativeness of oxygen dynamics over Arctic ecosystem gradients. We described the main processes controlling DO budgets of Arctic lakes and tested relationships of summer oxygen depletion with maximum depth and latitude. The meta-analysis showed that most sites with low O2 concentrations were shallow (Polar amplification of climate change has the potential to cause large-scale shifts in the dissolved oxygen (DO) dynamics of Arctic lakes, with implications for fish survival, greenhouse gas production, and drinking water quality. While DO is also a sentinel of environmental changes of physical, chemical, and biological nature (e.g., ice cover, temperature, dissolved organic carbon, photosynthesis, and respiration), no synthesis exists of current knowledge of DO dynamics across the diverse freshwater systems of the Arctic. We thus conducted a systematic review of the literature that yielded DO data from 167 sites north of the Subarctic limit (based on vegetation zones), spanning 76 years and including 40 sites with time series. The compilation revealed insufficient observations for adequate representativeness of oxygen dynamics over Arctic ecosystem gradients. We described the main processes controlling DO budgets of Arctic lakes and tested relationships of summer oxygen depletion with maximum depth and latitude. The meta-analysis showed that most sites with low O2 concentrations were shallow (

Cyclic amines are ubiquitous structural motifs found in pharmaceuticals and biologically active natural products, making methods for their elaboration via direct C–H functionalization of considerable synthetic value. Herein, we report the development of an iron-based biocatalytic strategy for enantioselective a-C–H functionalization of pyrrolidines via a carbene transfer reaction with diazoacetone. Currently unreported for organometallic catalysts, this transformation can be accomplished in high yields, high catalytic activity and high stereoselectivity (up to 99:1 e.r. and 20,350 TON) using engineered variants of cytochrome P450 CYP119 from Sulfolobus solfataricus. This methodology was further extended to enable enantioselective a-C–H functionalization in the presence of ethyl diazoacetate as carbene donor (up to 89:11 e.r. and 8,920 TON), and the two strategies were combined to achieve a one-pot as well as a tandem dual C–H functionalization of the cyclic amine substrate with enzyme-controlled diastereo- and enantiodivergent selectivity. This biocatalytic approach is amenable to gram-scale synthesis and can be applied to drug scaffolds for late-stage C–H functionalization. This work provides an efficient and tunable method for direct asymmetric a-C–H functionalization of saturated N-heterocycles which should offer new opportunities for the synthesis, discovery, and optimization of bioactive molecules.

Social anhedonia has been employed in psychometric high risk studies to identify putative schizotypes. The current study reports three-year longitudinal results from a community study of social anhedonia: the Maryland Longitudinal Study of Schizotypy (MLSS). The initial recruitment for the MLSS involved mailed questionnaire screening of 2434 18-year olds. Baseline and three-year follow-up laboratory assessments were subsequently conducted with individuals identified as being high in social anhedonia (N = 79) and a comparison sample (N = 79). Across the assessments both groups showed maturational improvement on all clinical symptom measures with declining symptom severity at the follow-up compared to baseline and there were no group differences in personality disorder diagnoses at follow-up. However, compared to the control group, over the three-year follow-up individuals in the social anhedonia group were found to have elevated schizophrenia-spectrum personality disorder (Cluster A) characteristics, greater negative symptom characteristics, and lower global functioning. The social anhedonia group also had lower educational attainment, higher unemployment, and higher rates of mental health service utilization than did the control group. Within the social anhedonia group, social support and family relationships were cross-sectionally related to symptom severity at follow-up, although social support and family variables from baseline were not predictive of clinical symptom outcomes at follow-up. Results indicate that social anhedonia is associated with persistent schizophrenia-spectrum symptoms and functional impairment in early adulthood.

Rotenone is a pesticide commonly used to eradicate Northern Pike (Esox lucius), an invasive species, in Southcentral Alaska. The present work incorporates a field investigation of rotenone attenuation in eight lakes of the Kenai Peninsula, following a CFT Legumine® treatment in October 2018 and a laboratory simulation to determine persistence under light/dark and sterile/nonsterile conditions representative of Southcentral Alaskan winters. In the field, rotenone degraded within

When a small amount of liquid is quickly injected into another liquid with similar density, the fluid jet usually does not propagate very far. However, when the two solutions chemically react to form a flexible membrane at their interface, then structures that are long and branching can form. Here, we describe the tube networks produced when a small amount of AlCl3 solution is quickly injected into a NaOH solution. Single straight tubes do not occur, but straight tubular "stems" with 2-5 "branches" are observed. The branches emerge relatively symmetrically from the stem at a common branching junction. These structures can have a ratio of propagation distance to stem width as large as 50. The stem and branches grow by the stretching of the membrane sheathing the closed tube system. These tube networks occasionally exhibit the spontaneous creation of new branches at a junction and also the splitting of a branching junction. A model explains why the branches occur, why they are symmetric around the central stem, and why the initial growth speed is insensitive to the flow rate.

Aim To compare the impact of covered stent-graft transjugular intrahepatic portosystemic shunt (TIPS) versus serial paracentesis on survival of patients with medically refractory ascites. Materials and methods In this retrospective study, cirrhotic patients who underwent covered stent-graft TIPS for refractory ascites from 2003–2013 were compared with similar patients who underwent serial paracentesis during 2009–2013. Demographic and liver disease data, Model for End-Stage Liver Disease (MELD) scores, and survival outcomes were obtained from hospital electronic medical records and the social security death index. After propensity score weighting to match study group characteristics, survival outcomes were compared using Kaplan–Meier statistics with log-rank analysis. Results Seventy TIPS (70% men, mean age 55.7 years, mean MELD 15.1) and 80 paracentesis (58% men, mean age 53.5 years, mean MELD 22.5) patients were compared. The TIPS haemodynamic success rate was 100% (mean portosystemic pressure gradient reduction 13 mmHg). Paracentesis patients underwent a mean of 7.9 procedures. After propensity score weighting to balance group features, TIPS patients showed a trend toward enhanced survival compared with paracentesis patients (median survival 1037 versus 262 days, p = 0.074). TIPS conferred a significant increase or trend toward improved survival compared with paracentesis at 1 (66% versus 44%, p = 0.018), 2 (56% versus 38%, p = 0.057), and 3 year (49% versus 32%, p = 0.077) time points. Thirty and 90 day mortality rates were not statistically increased by TIPS. Conclusion Covered stent-graft TIPS improves intermediate- to long-term survival without significantly increasing short-term mortality of ascites patients, and suggests a greater potential role for TIPS in properly selected ascitic patients when medical management fails.

The purpose of this article is to characterize the temporal evolution and clinical impact of laboratory liver function parameters after transjugular intrahepatic portosystemic shunt (TIPS) creation.In this single-institution retrospective study, 157 patients (98 men and 59 women; median age, 55 years) underwent TIPS between 2000 and 2012 and had 1-month hepatobiliary laboratory follow-up. Medical record review was used to compare baseline, peak, and low bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, and international normalized ratio (INR) levels within 30 days after TIPS in surviving and dying patients to assess laboratory responses to shunt creation.TIPSs were created with a hemodynamic success rate of 98%, with median pressure gradient reduction of 13 mm Hg. Ninety-day mortality was 21%. Hepatobiliary laboratory values showed significant increases in the days after TIPS compared with baseline levels (bilirubin, 1.6 vs 3.5 mg/dL; AST, 49 vs 149 U/L; ALT, 26 vs 90 U/L; alkaline phosphatase, 97 vs 177 U/L; and INR, 1.5 vs 2.0; p0.05 in all cases). Patients surviving to 90 days experienced statistically significant but transient laboratory value elevations-up to twofold over baseline-within days of TIPS, whereas patients dying within 90 days experienced three-to fourfold increases over a longer period that did not return to baseline. Differences in laboratory evolution were statistically significant in surviving versus dying patients.TIPS results in acute transient elevation of hepatobiliary enzymes, which may be more pronounced in patients with early mortality. An exaggerated laboratory elevation in excess of threefold greater than baseline or a prolonged increase exceeding 1 week may herald poorer clinical outcome.

Chemical cells that spontaneously form in simple inorganic systems are presented. The cells are surrounded by semipermeable membranes that allow water and some ions to diffuse through. These cells exhibit dynamical behaviors that are typically associated with biological entities. These behaviors may be used to perform tasks such as rotation or linear translation in the vertical and horizontal directions. Yet another system builds “curtains”. Behaviors are controlled by a complex network of physical and chemical processes that are organized in space and time. The type of dynamical behavior is determined by the chemical composition of the cell and the environment. By studying these systems we may learn general rules for the growth of living entities, or at least about the spontaneous growth of complex chemical structures. Understanding and mastering the synthesis of these systems may lead to new technologies where complex structures are grown rather than assembled.

For social workers, identification of older adult mistreatment is a complex social process that requires making decisions based on available information while following organizational procedures. Clinical supervision is a promising avenue to support social workers in their decision-making process since discussing cases with colleagues or a superior has been recognized as a facilitator. Up to date, few studies explored real-life clinical supervision in social work. The aim of this study was to explore the type of information discussed and supervision strategies used by clinical supervisors to support identification of older adult mistreatment by social workers. Qualitative data collection included the content of fifteen clinical supervision meetings, individual interviews with two clinical supervisors, and a focus group with eight social workers. All data were transcribed and analyzed using the Miles, Huberman and Saldaña (2014) analytical method. Results demonstrated three main functions of clinical supervision to support identification of older adult mistreatment: 1) clarifying case features that are relevant for the decision-making process; 2) choosing individualized intervention options; and 3) managing difficulties encountered by social workers. Strategies used by supervisors included a questions-and-answers approach to guide data collection; reinforcing/praising; challenging the point of view of the social worker and collaborating in the development of the individualized intervention plan. Social workers considered that identification is intertwined with the responsibility to intervene in the context of older adult mistreatment. This study is a first step in the elaboration of a model illustrating the functions of clinical supervision in the fight against older adult mistreatment.

Introduction La pemphigoide bulleuse (PB) est la plus frequente des maladies bulleuses auto-immunes. Elle represente 70 % des dermatoses bulleuses de la jonction dermo-epidermique. Le traitement de premiere intention repose sur la corticotherapie locale tres forte. Un passage systemique du propionate de clobetasol est constant aux doses elevees et provoque des effets secondaires locaux et parfois generaux. Le methotrexate (MTX) s’est montre efficace dans la PB. L’objectif de notre etude etait d’evaluer l’efficacite et la tolerance du MTX dans les PB traitees au CHU de Limoges. Materiel et methodes Cinquante-deux patients atteints de PB ont ete traites par MTX en relais des dermocorticoides entre janvier 2004 et decembre 2017. Toutes les PB etaient confirmees par histologie et immunofluorescence directe. Le critere de jugement principal etait la reponse complete (moins de 3 bulles sur 3 jours consecutifs) a la consultation de 1 mois apres l’introduction du MTX. Le taux de reponse complete a 3 mois, 12 mois et les effets secondaires sous MTX etaient evalues. Resultats L’âge moyen au diagnostic etait de 80,2 ans (58–101 ans). La cohorte comprenait 22 hommes et 30 femmes ; 38,5 % des PB etaient diagnostiquees comme moderees (− de 10 bulles) et 61,5 % comme severes (+ de 10 bulles) ; 40 % avaient ete traitees des leur premiere poussee par MTX et 60 % etaient considerees comme recidivantes. Sur 44 serums, les anticorps anti-BP 180 etaient detectes dans 86 % des cas avec des taux superieurs a 200 UR/mL dans 46 % des cas. Tous les patients avaient recu des dermocorticoides sauf deux. Deux patients ont ete exclus de l’analyse, avec un deces et un perdu de vue avant la consultation a un mois. A la consultation de 1 mois, 88 % (44 patients sur 50) avaient moins de 3 bulles sur 3 jours consecutifs. A 3 mois, 90 % (35 patients sur 39) etaient en reponse complete. A 12 mois, 89 % (24 patients sur 27) etaient en reponse complete. La duree moyenne d’utilisation du MTX etait de 11,3 mois. Des effets secondaires ont ete notes chez 50 % des patients (anemie, cytolyse hepatique), avec 21 % (11 patients sur 51) d’effets secondaires graves necessitant l’arret du traitement. Discussion Deux etudes retrospectives montrent des resultats concordants avec notre etude, une reponse complete chez 100 % des patients a 21 jours et une reponse de 94 % a 1 mois. Les principaux effets secondaires constates etaient hematologiques, hepatiques, et digestifs. Dans l’une des etudes, 11 % d’effets secondaires graves ont ete signales, provoquant l’arret du traitement. Le methotrexate, utilise a faible dose et au long cours, associe aux dermocorticoides sur une courte duree permet donc un controle prolonge des PB en limitant les effets secondaires. Conclusion Ces resultats doivent etre confirmes par l’essai therapeutique randomise et controle comparant le methotrexate aux dermocorticoides seuls utilises a long terme actuellement en cours.

Background. To assess within-patient temporal variability in Model for End Stage Liver Disease (MELD) scores and impact on outcome prognostication after transjugular intrahepatic portosystemic shunt (TIPS) creation. Material and methods. In this single institution retrospective study, MELD score was calculated in 68 patients (M:F = 42:26, mean age 55 years) at 4 pre-procedure time points (1, 2-6, 7-14, and 15-35 days) before TIPS creation. Medical record review was used to identify 30- and 90-day clinical outcomes. Within-patient variability in pre-procedure MELD scores was assessed using repeated measures analysis of variance, and the ability of MELD scores at different time points to predict post-TIPS mortality was evaluated by comparing area under receiver operating characteristic (AUROC) curves. Results. TIPS were successfully created for ascites (n = 30), variceal hemorrhage (n = 29), hepatic hydrothorax (n = 8), and portal vein thrombosis (n = 1). Pre-TIPS MELD scores showed significant (P = 0.032) within-subject variance that approached ± 18.5%. Higher MELD scores demonstrated greater variability in sequential scores as compared to lower MELD scores. Overall 30- and 90-day patient mortality was 22% (15/67) and 38% (24/64). AUROC curves showed that most recent MELD scores performed on the day of TIPS had superior predictive capacity for 30- (0.876, P = 0.037) and 90-day (0.805 P = 0.020) mortality compared to MELD scores performed 2-6 or 7-14 days prior. Conclusions. In conclusion, MELD scores show within-patient variability over time, and scores calculated on the day of TIPS most accurately predict risk and should be used for patient selection and counseling.

The Clinical Assessment Interview for Negative Symptoms (CAINS) is an empirically developed interview measure of negative symptoms. Building on prior work, this study examined the reliability and validity of a self-report measure based on the CAINS - the Motivation and Pleasure Scale - Self Report (MAP-SR) - that assesses the motivation and pleasure domain of negative symptoms. Thirty-seven participants with schizophrenia or schizoaffective disorder completed the 18-item MAP-SR, the CAINS, and other measures of functional outcome. Item analyses revealed three items that performed poorly. The revised 15-item MAP-SR demonstrated good internal consistency and convergent validity with the clinician-rated Motivation and Pleasure scale of the CAINS, as well as good discriminant validity, with little association with psychotic symptoms or depression/anxiety. MAP-SR scores were related to social anhedonia, social closeness, and clinician-rated social functioning. The MAP-SR is a promising self-report measure of severity of negative symptoms.

Internalized stigma refers to the process by which individuals with mental illness apply negative stereotypes to themselves, expect to be rejected by others, and feel alienated from society. Though internalized stigma has been hypothesized to be associated with maladaptive cognitions and expectations of failure, this relationship with dysfunctional attitudes has not been fully examined. In the present study, 49 individuals with schizophrenia or schizoaffective disorder completed the Internalized Stigma of Mental Illness Scale (ISMI; Ritsher et al., 2003) in addition to measures tapping defeatist performance beliefs, beliefs regarding low likelihood of success and limited resources, negative symptoms, depression, and quality of life. Consistent with prior research, internalized stigma was correlated with depression and quality of life but not with negative symptoms. Further, internalized stigma was correlated with both measures of dysfunctional attitudes. After controlling for depressive symptomatology, the relationship between internalized stigma and beliefs regarding low likelihood of success and limited resources remained significant, and though the correlation between defeatist performance beliefs and internalized stigma was no longer significant, it was of a similar magnitude. Overall, these data suggest that dysfunctional attitudes play a role in internalized stigma in individuals with schizophrenia, indicating a possible point of intervention.

Social anhedonia is a promising indicator for the vulnerability towards developing schizophrenia-spectrum disorders and is an important determinant of the social impairment associated with these disorders. It is unknown if social anhedonia is associated with true deficits in experiential reactions or if lower social functioning in social anhedonia reflects behavioral deficits in social skill or initiation of social contact. Using a novel social interaction task, the current study compared controls (n=60) to individuals elevated on social anhedonia (n=49) on observer-rated social skill and facial affect and participant self-reports of their experiential reactions to an affiliative interaction. Compared to the control group, the social anhedonia group was rated as behaviorally less affiliative and less socially skilled during the affiliative interaction. In response to the social interaction, the social anhedonia group reported less change in positive affect, less willingness to engage in future social interactions with the interaction partner, and less positive reactions toward the interaction partner compared to controls. There were no group differences in facial displays of emotion. Using a standardized affiliative stimulus, it was demonstrated that individuals high in social anhedonia have alterations in both their social skill and in their self-reported experiential reactions during a social interaction.

SiPM-based detectors are foreseen as good candidates for low light level detection applications requiring timing resolution in the few hundreds of picoseconds range. We report here the development of a UV enhanced SiPM with low dark count rate particularly well suited for high energy physics and medical imaging. In order to address different applications, we have produced a range of 1, 3, and 5 mm SiPMs with 25, 50, and 100 μm micro-cells size (1600, 400, and 100 micro-cells) with geometrical efficiencies ranging from 21% to 79%. Our highest geometrical efficiency 1 mm SiPM has reached a PDE of 40% in photon counting mode at 440 nm and a dark count rate as low as 200 kcps/mm 2 at 25 °C and an overvoltage of 3%. To our knowledge this is the lowest dark count rate under above conditions reported so far. Breakdown voltage is in the 130–150 V range, quench resistance is in the order of 1.5 MΩ, while the chip capacitance is of the order of 10 pF/mm 2 . All characteristics from this novel low dark count SiPM design will be presented and compared, further developments and improvements will also be discussed.

There is now a shift from traditional Cyber Security to Cyber Intelligence. We are only beginning to leverage the intelligence that can be extracted from the thousands of malware samples that are currently being gathered on a daily basis. By automatically creating analysis reports for each of these malware samples, it is possible to improve our understanding of the current cyber security situation on the Internet and of how malware evolves over time. However, research is still required in order to extract, summarize, and present this information to leverage its full potential. In this article, we present two approaches to navigate and visualize what we call the Malware Intelligence Space (i.e., the documentation of millions of malware samples). The first approach, called BeAVER, was built to navigate the Malware Intelligence Space. The second approach, called Malware Threat Radar, was designed to visualize relationships between malware samples and their evolution over time. We also present the technological detail of our implementation prototypes.

Negative symptoms have clear functional implications in schizophrenia and are typically unresponsive to current treatments. The cognitive model of negative symptoms suggests that dysfunctional beliefs are influential in the development and maintenance of negative symptoms and schizophrenia. The current study reports on a preliminary investigation of a new measure of Negative Expectancy Appraisals (specifically beliefs about limited probability of success and perception of limited cognitive resources), and also evaluates whether dysfunctional beliefs are more closely linked to particular subdomains of negative symptoms. Sixty two individuals with schizophrenia completed measures of dysfunctional beliefs and were rated on negative symptoms. Analyses indicated that the endorsement of beliefs regarding low expectations for success and perception of limited resources (Negative Expectancy Appraisals) are robustly associated with diminished experience negative symptoms (avolition, asociality, and anhedonia), but are not associated with negative symptoms reflecting diminished expressivity (blunted affect, alogia). Similarly, Defeatist Performance Beliefs are modestly related to diminished experience, but not diminished expression, negative symptoms. Negative Expectancy Appraisals were also robustly linked to depressive symptoms. Results from the current study provide evidence that dysfunctional beliefs are clearly relevant to consider in relation to negative symptoms, and may represent a fruitful treatment target.

A new staining method for differentiating WBCs from immature germ cells in seminal fluid has been studied. It is a combination of Bryan's sperm stain, which particulary stains the acrosomal cap of the spermatozoa and the spermatid, and Leishman's blood stain which stains the WBCs in the same way as found in blood smears. The peroxidase positive granules in the cytoplasm of the PMN leukocytes are seen clearly. Thus, it is possible to differentiate PMN leukocytes from non-separated spermatids when they are present in a common cytoplasm. The staining of acrosomal cap permits differentiation between spermatids and lymphocytes.

Research has suggested those with chronic schizophrenia are impaired in social functioning, and that those early in the illness also exhibit these impairments. However, the factors underlying and contributing to social dysfunction have not yet been well delineated, particularly within a first episode sample. The current study sought to investigate the role of attachment style and personality characteristics in the social dysfunction of those diagnosed with a first episode of psychosis. Ninety-six participants experiencing a first episode of psychosis were compared with control participants from 2 different samples on attachment and personality variables. Results suggested that those with a first episode of psychosis may experience more problematic attachment in peer relationships compared with nonclinical controls, and that the type and amount of differences observed may vary by gender. In addition, those experiencing a first episode of psychosis report different levels of the "big five" personality traits when compared with nonclinical controls. Finally, within the first episode sample, both personality and attachment appear to contribute variance to 3 domains of social functioning: social and individual living skills, inappropriate community behavior, and quality of life. These findings have implications for the functional significance of these psychological constructs.

Significant changes in the nature of military systems and the military environment require improvements of the current military systems acquisition process. The Capability Engineering Process (CEP), to be delivered through the CapDEM project, aims at improving military capabilities acquisition in the Department of National Defence and the Canadian Forces (DND/CF). However, opportunities to improve capability acquisition are too numerous to implement all of them within the CEP. This paper presents a structured approach to better orient the development of a CEP.

Title: Interpersonal contact and the stigma of mental illness: A review of the literature Background. Stigmatization of mental illness is widespread in Western societies ( Crisp et al., 2001 ) and other cultures ( Chung et al., 2001 ). Furthermore, researchers have found that stigma is detrimental to the well being of persons with a mental illness ( Wahl, 1999 ), potentially resulting in decreased life satisfaction and discrimination in obtaining housing and employment ( Link & Phelan, 2001 ). It is for these reasons researchers have sought methods for reducing stigma. Aims: One strategy purported to reduce stigma is interpersonal contact with people with a mental illness. This article reviews the literature of contact and stigma reduction and provides considerations and recommendations for future research. Method: A thorough review of article databases...

Most sprint interval training (SIT) research involves cycling as the mode of exercise and whether running SIT elicits a similar excess postexercise oxygen consumption (EPOC) response to cycling SIT is unknown. As running is a more whole-body–natured exercise, the potential EPOC response could be greater when using a running session compared with a cycling session. The purpose of the current study was to determine the acute effects of a running versus cycling SIT session on EPOC and whether potential sex differences exist. Sixteen healthy recreationally active individuals (8 males and 8 females) had their gas exchange measured over ∼2.5 h under 3 experimental sessions: (i) a cycle SIT session, (ii) a run SIT session, and (iii) a control (CTRL; no exercise) session. Diet was controlled. During exercise, both SIT modes increased oxygen consumption (cycle: male, 1.967 ± 0.343; female, 1.739 ± 0.296 L·min−1; run: male, 2.169 ± 0.369; female, 1.791 ± 0.481 L·min−1) versus CTRL (male, 0.425 ± 0.065 L·min−1; female, 0.357 ± 0.067; P < 0.001), but not compared with each other (P = 0.234). In the first hour postexercise, oxygen consumption was still increased following both run (male, 0.590 ± 0.065; female, 0.449 ± 0.084) and cycle SIT (male, 0.556 ± 0.069; female, 0.481 ± 0.110 L·min−1) versus CTRL and oxygen consumption was maintained through the second hour postexercise (CTRL: male, 0.410 ± 0.048; female, 0.332 ± 0.062; cycle: male, 0.430 ± 0.047; female, 0.395 ± 0.087; run: male, 0.463 ± 0.051; female, 0.374 ± 0.087 L·min−1). The total EPOC was not significantly different between modes of exercise or males and females (P > 0.05). Our data demonstrate that the mode of exercise during SIT (cycling or running) is not important to O2 consumption and that males and females respond similarly.

Introduction La pemphigoide bulleuse est la dermatose bulleuse auto-immune la plus frequente. Son incidence en France est estimee a 21,7 nouveaux cas par an par million d’habitants. Le traitement de reference est la corticotherapie locale a forte dose. La cascade inflammatoire joue un role essentiel dans le processus lesionnel mais la place des differentes cytokines reste a definir. Materiel et methodes Une etude retrospective avait pour but d’etudier l’expression de l’IL-6, IL-10, IL-17A, IL-17F, IL-21, IL-22, TNF-alpha, INF-gamma dans le serum des patients atteints de pemphigoide bulleuse. Elle portait sur 66 cas de pemphigoide bulleuse (PB) et 35 cas de pemphigoide cicatricielle (PC). L’objectif secondaire cherchait une correlation entre l’expression de ces cytokines et une presentation clinique ou un profil immunologique particulier ainsi que l’expression de ces memes cytokines dans la pemphigoide cicatricielle. Les taux d’IL-6, IL-10, IL-17A, IL-17F, IL-21, IL-22, TNF-alpha, et INF-gamma par cytometrie de flux etaient mesures. Resultats La moyenne des taux d’IL-6 dans le groupe des patients atteints de PB etait de 22,23 pg/mL et celle des controles etait de 4,21 pg/mL. Le taux d’IL-6 dans le serum des patients etait significativement superieur a celui de la population controle (p = 0,0146). Parmi les sous groupes etudies, la moyenne des taux d’IL-6 des patients ayant des formes severes de PB avec des taux d’anticorps anti-BP180 > 200 etait significativement augmentee (p = 0,0029) contrairement au sous groupe ayant une forme peu severe de PB (p = 0,3397). Les taux d’IL-10, IL-17A, IL-17F, IL-21, IL-22, TNF-alpha, INF-gamma n’etaient pas augmentes. Il n’y avait pas d’augmentation des differentes cytokines etudiees dans le groupe des patients atteints de pemphigoide cicatricielle. Discussion Il semble que l’IL-6 joue un role important dans la cascade inflammatoire de la PB. Le taux d’IL-6 semble egalement correle a la severite de la pemphigoide bulleuse. Ce constat nous permet d’envisager un traitement par anti-IL-6 dans les cas severes de PB. Conclusion L’IL-6 est augmentee de maniere significative dans le serum des patients atteints de formes severes PB.

Introduction La sclerodermie systemique se complique frequemment d’ulceres digitaux, qui sont source de plaies, de douleur, et de limitation fonctionnelle, aboutissant dans certains cas a des amputations. Le retentissement dans la vie quotidienne et sur la qualite de vie est majeur et souvent sous-estime. Actuellement, le traitement des ulceres digitaux de la sclerodermie systemique repose sur l’association de traitements locaux et generaux (Ilomedine ® , sildenafil) et de mesures preventives (eviction des facteurs de risque, inhibiteurs calciques, bosentan). Observations Nous rapportons le cas d’une femme de 46 ans presentant des ulceres digitaux recidivants, resistant aux traitements usuels (bosentan, Ilomedine ® , sildenafil et soins locaux adaptes) depuis plusieurs annees. Un traitement par rituximab 1 g j1-j15 etait mis en place en novembre 2013, devant l’apparition d’une atteinte systemique associant une atteinte pulmonaire interstitielle et une cardiomyopathie. L’evolution clinique des ulceres digitaux etait initialement favorable. A 11 mois, le bilan d’evaluation mettait en evidence une aggravation de la fonction respiratoire ainsi que l’apparition de nouveaux ulceres digitaux. Le bilan biologique trouvait une normalisation du taux de CD 19. La patiente recevait alors une nouvelle cure de rituximab 1 g j1–j15, permettant une disparition complete des ulceres digitaux ; le benefice persistait a 6 mois du traitement. Discussion De recentes etudes, notamment l’etude Eustar, ont demontre l’efficacite du rituximab sur l’atteinte pulmonaire et la sclerose cutanee. Nous rapportons le cas d’une efficacite prometteuse du rituximab sur les ulceres digitaux refractaires. Conclusion Le rituximab pourrait etre une option therapeutique dans le traitement des ulceres digitaux refractaires de la sclerodermie systemique mais son efficacite reste a confirmer par des etudes plus larges.

The object of the study was to provide recommendations for improving the work situations of airplane maintenance workers. This paper specifically bears on the improvement of workstations. Seventeen different tasks were videotaped and characterized through an observation grid, and 26 mechanics were questioned at the end of each video session. The results show that MSD is a major issue that highlights the importance and potential impact of the accuracy required to perform tasks. We were also able to delineate the main issues surrounding workstation design. The value of using both observation and surveys, and the potential of body rigidification as a risk factor are also discussed.

Introduction Les melanomes muqueux metastatiques ont la particularite d’etre frequemment mutes sur le gene KIT (20 %). Ceux presentant ce type de mutation repondent parfois spectaculairement aux therapies ciblees. Parmi elles, l’imatinib parait etre efficace d’apres plusieurs cas cliniques de la litterature. Observations Une femme de 61 ans sans aucun antecedent consultait en septembre 2012 pour decouverte d’un melanome clitoridien initialement non metastatique. Une chirurgie en marge saine et une surveillance avaient alors ete decides en RCP. En aout 2013, cette patiente presentait une recidive locale sur cicatrice d’exerese ainsi que des adenopathies inguinales metastatiques bilaterales. La recherche de mutations BRAF , NRAS et KIT n’a revele qu’une mutation KIT L576P sur l’exon 11. La patiente etait d’abord traitee par 5 cures de dacarbazine 1 g/m 2 /3 semaines, puis par 4 cures d’ipilimumab 3 mg/kg/3 semaines sans reelle efficacite (apparition de nodules de permeation ainsi que de metastases pulmonaires et ganglionnaires). Un nouveau traitement etait alors initie par imatinib 400 mg/j, suivi d’une diminution spectaculaire du volume des metastases viscerales et ganglionnaires objectivee au TDM TAP et au TEP 18FDG, avec normalisation des LDH apres 1 mois de traitement. La patiente n’a presente aucun effet secondaire lie a cette therapie ciblee. Discussion Le gene KIT code pour un recepteur a activite tyrosine kinase intracellulaire ayant un role dans la migration et le developpement melanocytaire via plusieurs voies de signalisation intracellulaire. Les mutations de ce gene sont peu frequentes dans les melanomes metastatiques (2 %) mais sont plus frequentes chez les melanomes acro-lentigineux (11 a 23 %) et muqueux (9 a 21 %). Seules les mutations L576P de l’exon 11 codant pour le domaine juxta-membranaire du recepteur et K642E de l’exon 13 codant pour le domaine kinase I intracellulaire du recepteur semblent repondre pertinemment a cette therapie ciblee. L’imatinib a la propriete d’inhiber la proteine tyrosine kinase des recepteurs KIT en entrant en competition avec l’ATP. Cette molecule est couramment utilisee pour traiter les leucemies myeloides chronique, la maladie de Vaquez ou les tumeurs stromales gastro-intestinales. Lors des etudes de phase 2, une dose de 400 mg/j semble etre optimale. Les effets secondaires se limitent a nausees, vomissements et myalgies. Les premiers resultats des etudes de phase II montrent une survie globale de 12,5 mois et une progression au bout de 3 a 4 mois de traitement. Conclusion L’imatinib semble etre efficace pour les melanomes metastatiques mutes KIT. Actuellement, plusieurs essais de phase 2 sont en cours, evaluant d’autres inhibiteurs tyrosine kinase du recepteurs KIT. Seul un essai de phase 3 multicentrique est en cours, comparant l’efficacite du masitinib versus dacarbazine chez 200 patients ayant un melanome metastatique mute KIT .

Purpose To identify prognostic factors for early mortality among patients with intermediate-risk Model for End-stage Liver Disease (MELD) scores undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation. Materials and Methods In this single-institution retrospective study, 47 patients (31 men; mean age, 54 y) with intermediate MELD scores (ie, 18–25) underwent TIPS creation between 1999 and 2012. Medical records were reviewed to identify demographic (age, sex), liver disease (Child–Pugh, MELD), and procedure data (indication, urgency, stent type, portosystemic pressure gradient reduction, complications), and the influence of these parameters on 90-day mortality was assessed by multivariate binary logistic regression analysis. Results TIPSs were successfully created for variceal hemorrhage (n = 24), ascites (n = 17), hydrothorax (n = 5), and portal vein thrombosis (n = 1). Hemodynamic success rate was 94% (44 of 47), and mean portosystemic pressure gradient reduction was 13 mm Hg. The 90-day mortality rate was 36% (17 of 47). Patient age ( P = .026) was significantly associated with 90-day mortality. Mean ages of living versus dead patients were 51 and 60 years, and mortality rates in patients aged 54 years or younger versus 55 years or older were 21% (five of 24) and 52% (12 of 23), respectively. There was no difference in MELD scores between these age groups (20.6 vs 21.0; P = .600), and MELD score was not a predictive factor on regression analysis. Conclusions Age is a prognostic factor for early mortality in TIPS recipients with intermediate MELD scores. Mortality rates are higher in patients at least 55 years of age, but MELD score does not predict survival in this subset. Age should be contemplated when selecting patients at intermediate risk for TIPS creation.

We define Hopf algebras that are characterized by Pμ statistics where Pμ is a generalized permutation operator [Formula: see text]. These structures may be viewed as the end result of a deformation of the statistics of GLq(2, C) and Uq(sl(2, C)).

Suspension bioreactors are an attractive alternative to static culture of human embryonic stem cells (hESCs) for the generation of clinically relevant cell numbers in a controlled system. In this study, we have developed a scalable suspension culture system using serum-free defined media with spinner flasks for hESC expansion as cell aggregates. With optimized cell seeding density and splitting interval, we demonstrate prolonged passaging and expansion of several hESC lines with overall expansion, yield, viability and maintenance of pluripotency equivalent to adherent culture. Human ESCs maintained in suspension as aggregates can be passaged at least 20 times to achieve over 1 × 10 13 fold calculated expansion with high undifferentiation rate and normal karyotype. Furthermore, the aggregates are able to differentiate to cardiomyocytes in a directed fashion. Finally, we show that the cells can be cryopreserved in serum-free medium and thawed into adherent or suspension cultures to continue passaging and expansion. We have successfully used this method under cGMP or cGMP-equivalent conditions to generate cell banks of several hESC lines. Taken together, our suspension culture system provides a powerful approach for scale-up expansion of hESCs under defined and serum-free conditions for clinical and research applications.

Though negative symptoms in schizophrenia are associated with a host of deleterious outcomes (e.g., White et al., 2009), not all individuals with schizophrenia suffer from negative symptoms (e.g., Blanchard et al., 2005). Thus, methods to quickly screen and identify patients for more intensive clinical interview assessments may have significant clinical and research utility. The present study is a preliminary examination of the reliability and validity of a self-report version of the newly developed Clinical Assessment Interview for Negative Symptoms (CAINS; Blanchard et al., 2011; Forbes et al., 2010; Horan et al., 2011). The CAINS-SR is a 30-item self-report measure that assesses Experiential (avolition, anhedonia, asociality) and Expressive (blunted affect, alogia) domains of negative symptoms. Participants (N = 69) completed the CAINS-SR questionnaire and were evaluated with symptom interviews using the CAINS and other non-negative symptom interviews that assessed psychotic, affective, and other symptoms. The Experience subscale of the CAINS-SR demonstrated good internal consistency, convergent validity, and discriminant validity, while the poorer psychometric properties of the Expression subscale suggest that self-report of negative symptoms should focus on the experiential domain. Overall, preliminary findings indicate that the CAINS-SR (addressing experiential deficits) may be a useful complement to the clinician-rated interview measure. Future research on the sensitivity and specificity of the CAINS-SR will determine its suitability as a screening measure.

Social anhedonia is an important feature of schizophrenia and it is a promising indicator of schizotypy. Although social anhedonia is defined as an affective construct (less pleasure derived from social encounters), little is known about the emotional responsivity and expressivity of individuals with high levels of social anhedonia. After screening a large sample of female undergraduate students (N = 1 085), a cohort of psychometrically identified individuals with high levels of social anhedonia (n = 34) and normally hedonic controls (n = 45) participated in laboratory assessments involving trait affectivity, self-reported dispositional emotional expressiveness, and the expression and experience of emotion in response to neutral, non-affiliative (i.e., comedy) and affiliative film clips. Results revealed that individuals with high levels of social anhedonia are characterized by lower positive affect, both as a trait and in response to emotionally evocative stimuli, and are less facially expressive, both by their own self-report and in response to film clips. Attenuated positive affect was observed across film stimuli, indicating a general reduction in affective response rather than a specific decrease in responsivity for affiliative stimuli. Future work should continue to investigate whether there is a unique role for social stimuli in the emotional lives of individuals with high levels of social anhedonia or whether these individuals tend to experience anhedonia more broadly regardless of social context.

Problems in real-world functioning are pervasive in schizophrenia and much recent effort has been devoted to uncovering factors which contribute to poor functioning. The goal of this study was to examine the role of four such factors: social cognition (theory of mind), neurocognition, negative symptoms, and functional capacity (social competence). 178 individuals with schizophrenia or schizoaffective disorder completed measures of theory of mind, neurocognition, negative symptoms, social competence, and self-reported functioning. Path models sought to determine the relationships among these variables. Theory of mind as indexed by the Hinting Task partially mediated the relationship between neurocognition and social competence, and negative symptoms and social competence demonstrated significant direct paths with self-reported functioning. Study results suggest theory of mind serves as an important mediator in addition to previously investigated social cognitive domains of emotional and social perception. The current study also highlights the need to determine variables which mediate the relationship between functional capacity and real-world functioning.

BackgroundIndividuals with schizophrenia and individuals with high-functioning autism (HFA) seem to share some social, behavioral and biological features. Although marked impairments in social cognition have been documented in both groups, little empirical work has compared the social cognitive functioning of these two clinical groups.MethodForty-four individuals with schizophrenia, 36 with HFA and 41 non-clinical controls completed a battery of social cognitive measures that have been linked previously to specific brain regions.ResultsThe results indicate that the individuals with schizophrenia and HFA were both impaired on a variety of social cognitive tasks relative to the non-clinical controls, but did not differ from one another. When individuals with schizophrenia were divided into negative symptom and paranoid subgroups, exploratory analyses revealed that individuals with HFA may be more similar, in terms of the pattern of social cognition impairments, to the negative symptom group than to the paranoia group.ConclusionsOur findings provide further support for similarities in social cognition deficits between HFA and schizophrenia, which have a variety of implications for future work on gene–brain–behavior relationships.

The quantum algebras associated with the R-matrix obtained from the two parameter free fermion model are examined. It is shown that in addition to Uq,s(gl(1, 1)) there exists another algebra which is isomorphic to Uq,s(gl(1, 1)) as an algebra but has a different Hopf structure. It does not have a classical limit and is related to Up(sl(2, c)) at a root of unity (p=i, i2=-1).

The quantum algebraic structures associated with a family of R-matrices one extracts from the Perk-Schultz model are studied. Starting with the quantum spaces one can define from the R-matrices, the author shows how different duality conditions at the level of quantum spaces (Manin's construction) translate in different quantum groups and quantized universal enveloping algebras.

The Wigner–Inonu contraction is generalized to include gradings other than Z2 and the formalism is applied to obtain all toroidal contractions of sl(3,C). Examples of contractions based on nontoroidal gradings are also given.

Through the examples associated with simple Lie algebras B2, C2 and D2, an approach of constructing new solutions of the spectral-independent Yang-Baxter equation (i.e. the braid group representations) was shown. These new solutions possess some particular features, such as that they do not have the classical limit in the usual sense of Refs. 2, 5, etc., and give rise to the new solutions of the x-dependent Yang-Baxter equation by using the Yang-Baxterization prescription.

The author constructs quantum R matrices associated with certain non-cyclic irreducible representations of Uq(sl(2,c)) at roots of unity which are parametrized by one continuous parameter. The author finds solutions for the two- and three-dimensional representations via Baxterization. The two-dimensional case corresponds to the free fermion model of Fan and Wu (1970).

New braid group (bn) representations of the D2 and D3 types are obtained by solving the defining relations of bn directly. The authors discuss a procedure (Baxterization) which allows one to construct their corresponding quantum R matrices.