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Imaging technologies such as positron emission tomography (PET) and magnetic resonance imaging (MRI) present unparalleled opportunities to investigate the neural basis of autism spectrum disorder (ASD). However, challenges such as deficits in social interaction, anxiety around new experiences, impaired language abilities, and hypersensitivity to sensory stimuli make participating in neuroimaging studies challenging for individuals with ASD. In this commentary, we describe the existent training protocols for preparing individuals with ASD for PET/MRI scans and our own experience developing a training protocol to facilitate the inclusion of low-functioning adults with ASD in PET-MRI studies. We hope to raise awareness of the need for more information exchange between research groups about lessons learned in this context in order to include the entire disease spectrum in neuroimaging studies.

The use of laser energy to ignite gas and liquid based fuel-air mixtures has been the subject of a number of studies and laboratory experiments at a fundamental level over the past 30 years. Yet, the practical implementation of this laser application has still to be fully realised in a commercial automotive application. Laser Ignition (LI), as a replacement for Spark Ignition (SI) in the internal combustion (IC) engines of automotive vehicles, offers several potential advantages including extending lean burn capability, reducing the cyclic variants between combustion cycles and reducing the overall ignition package costs, weight and energy requirements. The continued development of increasingly compact and efficient laser sources and new associated laser beam delivery techniques have provided the basis for significant steps forward in research towards practical proof-of-concept demonstration of LI in engines for automotive vehicles. This paper reports on some results of research recently undertaken in the Department of Engineering, University of Liverpool, in which a Q-switched Nd:YAG laser operating at 1064 nm wavelength has been used to successfully ignite and run (for extended periods) one cylinder of a 4-cylinder internal combustion (IC) test engine. The variation of several laser parameters and their effect on the engine performance are reported; namely, pulse energies of 5–20 m J, pulse lengths of 6–15 ns and focused beam waist diameters at the combustion point of 40–100/μm. The engine performance was measured in terms of changes in Coefficient of Variant (COV) in both Indicated Mean Effective Pressure (IMEP) and the Peak Cylinder Pressure Position (PPP). Further experiments on the focal position of laser ignition were undertaken. [ABSTRACT FROM AUTHOR]

Abstract: The treatment of olecranon fractures frequently involves the use of tension-band fixation. Although associated with high union rates, this method has a high incidence of morbidity associated with soft tissue compromise and limitation of range of movement requiring frequent re-operation for removal of metal. We describe the use of a simple jig to ensure intramedullary placement of longitudinal K-wires and compare the accuracy of placement of Kirschner (K)-wires using this device with the traditional free-hand method. We found the distance from the centre of the medullary canal, the range and standard deviations of K-wire positions to be significantly more precise when the jig was used. This has applications for the use of the device, both with standard metallic radio-opaque wires and potentially with bio-absorbable pins. [Copyright &y& Elsevier]

Cytogenetic maps of sorghum chromosomes 3–7, 9, and 10 were constructed on the basis of the fluorescence in situ hybridization (FISH) of ∼18–30 BAC probes mapped across each of these chromosomes. Distal regions of euchromatin and pericentromeric regions of heterochromatin were delimited for all 10 sorghum chromosomes and their DNA content quantified. Euchromatic DNA spans ∼50% of the sorghum genome, ranging from ∼60% of chromosome 1 (SBI-01 ) to ∼33% of chromosome 7 (SBI-07). This portion of the sorghum genome is predicted to encode ∼70% of the sorghum genes (∼1 gene model/12.3 kbp), assuming that rice and sorghum encode a similar number of genes. Heterochromatin spans ∼411 Mbp of the sorghum genome, a region characterized by a ∼34-fold lower rate of recombination and ∼3-fold lower gene density compared to euchromatic DNA. The sorghum and rice genomes exhibit a high degree of macrocolinearity; however, the sorghum genome is ∼2-fold larger than the rice genome. The distal euchromatic regions of sorghum chromosomes 3–7 and 10 are ∼1.8-fold larger overall and exhibit an ∼1.5-fold lower average rate of recombination than the colinear regions of the homeologous rice chromosomes. By contrast, the pericentromeric heterochromatic regions of these chromosomes are on average ∼3.6-fold larger in sorghum and recombination is suppressed ∼15-fold compared to the colinear regions of rice chromosomes. [ABSTRACT FROM AUTHOR]

The objectives of this study were to characterize the sleep habits of 50 clinically referred individuals with Angelman syndrome (AS) and to retrospectively compare the effectiveness/tolerability of the three most commonly prescribed sleep medications in the sample. An experienced physician assigned a Clinical Global Impressions-Severity scale (CGI-S) score for each subject's AS-specific symptoms. Caregivers completed the Child Sleep Habits Questionnaire (CSHQ; screen for sleep problems in school-aged [4-10 years] children), a screening assessment for sleep problems. Caregivers provided information about medication trials targeting disturbed sleep, with the physician assigning a CGI-Improvement scale (CGI-I) score for each trial. Linear regression showed significant negative association between age and CSHQ score. In their lifetime, 72% of participants had taken a medication for sleep, most commonly melatonin, clonidine and trazodone. The majority continued these for 6 months or longer. With these medications, many demonstrated significant improvement in sleep disturbances, with no difference in odds of improvement between medications. Disturbed sleep was common in this cohort and significantly worse in younger-aged participants. The majority received at least one medication trial for disturbed sleep and each of the most commonly prescribed medication was effective for a substantial percentage of participants. Most participants remained on medication for at least 6 months, suggesting favorable tolerability., (© 2020 Wiley Periodicals, Inc.)

Objectives: Angelman syndrome (AS) is a neurogenetic disorder associated with impaired expression of the ubiquitin-protein ligase E3A gene on chromosome 15. AS results in intellectual disability with limited expressive language, epilepsy, ataxia, sleep impairment, and problematic behavior which may include anxiety. Buspirone is a serotonin (5-HT)1A receptor partial agonist used in the treatment of anxiety disorders and may, therefore, have a treatment role for patients with AS., Methods: We describe three patients who were given open-label buspirone for the treatment of behaviors thought to be related to anxiety., Results: We found significant improvement in symptoms of anxiety with buspirone. Patients tolerated long-term usage of the medication., Conclusion: The findings of this study suggest that buspirone may be effective for the amelioration of behaviors related to anxiety in patients with AS, and well tolerated. Limitations include the open-label nature of these treatments, the small sample size and the absence of a control group.

Objectives: To provide opportunities for intergenerational knowledge sharing for healthy lifestyles; to facilitate youth and Elder mentorship; and to increase the self-esteem of youth by celebrating identity, cultural practices and community connection through the creation and sharing of digital stories., Participants: A youth research team (8 youth) aged 13-25, youth participants (60 core participants and 170 workshop participants) and Elders (14) from First Nations communities., Setting: The project was conducted with participants from several communities on Vancouver Island through on-site workshops and presentations., Intervention: Youth and Elders were invited to a 3-day digital story workshop consisting of knowledge-sharing sessions by Elders and digital story training by the youth research team. Workshop attendees returned to their communities to develop stories. The group re-convened at the university to create digital stories focused on community connections, family histories and healthy lifestyles. During the following year the research team delivered instructional sessions in communities on the digital story process., Outcomes: The youth involved reported increased pride in community as well as new or enhanced relationships with Elders., Conclusions: The digital stories method facilitated intergenerational interactions and engaged community members in creating a digital representation of healthy lifestyles. The process itself is an intervention, as it affords critical reflection on historical, cultural and spiritual ideas of health and what it means to be healthy in an Aboriginal community. It is a particularly relevant health promotion tool in First Nations communities with strong oral history traditions.

Individuals with Williams syndrome (WS) often experience significant anxiety. A promising approach to anxiety intervention has emerged from cognitive studies of attention bias to threat. To investigate the utility of this intervention in WS, this study examined attention bias to happy and angry faces in individuals with WS (N = 46). Results showed a significant difference in attention bias patterns as a function of IQ and anxiety. Individuals with higher IQ or higher anxiety showed a significant bias toward angry, but not happy faces, whereas individuals with lower IQ or lower anxiety showed the opposite pattern. These results suggest that attention bias interventions to modify a threat bias may be most effectively targeted to anxious individuals with WS with relatively high IQ.

Objective: Hyperactivity, impulsiveness, and distractibility are common problems in children with autism spectrum disorder (ASD). Extended-release guanfacine is approved for children with attention deficit hyperactivity disorder but not well studied in ASD., Method: In a multisite, randomized clinical trial, extended-release guanfacine was compared with placebo in children with ASD accompanied by hyperactivity, impulsiveness, and distractibility., Results: Sixty-two subjects (boys, N=53; girls, N=9; mean age=8.5 years [SD=2.25]) were randomly assigned to guanfacine (N=30) or placebo (N=32) for 8 weeks. The guanfacine group showed a 43.6% decline in scores on the Aberrant Behavior Checklist-hyperactivity subscale (least squares mean from 34.2 to 19.3) compared with a 13.2% decrease in the placebo group (least squares mean from 34.2 to 29.7; effect size=1.67). The rate of positive response (much improved or very much improved on the Clinical Global Impression-Improvement scale) was 50% (15 of 30) for guanfacine compared with 9.4% (3 of 32) for placebo. A brief cognitive battery tapping working memory and motor planning showed no group differences before or after 8 weeks of treatment. The modal dose of guanfacine at week 8 was 3 mg/day (range: 1-4 mg/day), and the modal dose was 3 mg/day (range: 2-4 mg/day) for placebo. Four guanfacine-treated subjects (13.3%) and four placebo subjects (12.5%) exited the study before week 8. The most common adverse events included drowsiness, fatigue, and decreased appetite. There were no significant changes on ECG in either group. For subjects in the guanfacine group, blood pressure declined in the first 4 weeks, with return nearly to baseline by endpoint (week 8). Pulse rate showed a similar pattern but remained lower than baseline at endpoint., Conclusions: Extended-release guanfacine appears to be safe and effective for reducing hyperactivity, impulsiveness, and distractibility in children with ASD.

Objective: To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers., Design: Interviews and focus groups were conducted., Setting: Nanaimo, BC., Participants: A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site., Methods: A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team., Main Findings: Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians., Conclusion: This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients' perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses., (Copyright© the College of Family Physicians of Canada.)

How do psychiatric nurses make decisions about pain management for hospitalized psychiatric patients? This is the question addressed by this research. Using an exploratory, naturalistic interview approach, 20 nurses and managers in varied settings described their decision making when providing pain relief. Analysis of these narratives indicates that decision making about pain, in this unique context, is influenced by a number of intrapersonal and interpersonal factors such as the patients' needs, history, and diagnosis; nurses' beliefs about pain tolerance and drug addiction; collegial pressure; and unit safety. For example, diagnosis and patient history impact pain relief negatively, while the responsibility to maintain a safe environment imposes pressure to administer medication. Although, in a psychiatric unit, the nurse-patient relationship is essential to the healing process, nurses often face a dilemma as to whether the pain medication will contribute to healing or exacerbate the patient's issues. In psychiatric wards, the means of recovery are far less clear, tangible, and immediate than in other clinical settings. Recommendations are made for better preparing and supporting nurses to work effectively in these practice settings where pain relief is confounded by addiction and psychiatric diagnoses.

A series of pyrimidine nitrile inhibitors of Cathepsin K with reduced glutathione reactivity has been identified and Molecular Core Matching (MoCoM) has been used to quantify the effect of an amino substituent at C5.

Rationale: There are no drugs that have been shown to effectively treat the core social impairment of autism., Objectives: The purpose of this study was to examine the effectiveness and tolerability of memantine for social impairment in children and adolescents with pervasive developmental disorders (PDDs)., Materials and Methods: Medical records of 18 patients with PDDs consecutively treated with open-label memantine were retrospectively reviewed. The data reviewed included prospectively obtained assessments of severity (S) and improvement (I) using the Clinical Global Impressions Scale (CGI). Pretrial and follow-up parent ratings were also available on six patients using the Aberrant Behavior Checklist (ABC)., Results: Eighteen patients (15 male, 3 female; mean age=11.4 years, range 6-19 years) received memantine (mean dosage=10.1 mg/day, range 2.5-20 mg/day) over a mean duration of 19.3 weeks (range 1.5-56 weeks). Eleven of 18 (61%) patients were judged responders to memantine based on a rating of "much improved" or "very much improved" on the CGI-I. Significant improvement was also seen on the CGI-S. Improvement was primarily seen clinically in social withdrawal and inattention. Adverse effects occurred in 7 of 18 (39%) patients and led to drug discontinuation in 4 of 18 (22%) patients. Thirteen of 18 (72%) patients received stable doses of concomitant medications during the memantine trial., Conclusions: In this open-label retrospective study, memantine was effective in a number of patients with PDDs. Controlled studies are warranted to further assess the efficacy and safety of memantine in PDDs.

Optimisation of ADS100380, a sub-micromolar HDAC inhibitor identified using a virtual screening approach, led to a series of substituted 5-(1H-pyrazol-3-yl)-thiophene-2-hydroxamic acids (6a-i), that possessed significant HDAC inhibitory activity. Subsequent functionalisation of the pendent phenyl group of compounds 6f and 6g provided analogues 6j-w with further enhanced enzyme and anti-proliferative activity. Compound 6j demonstrated efficacy in a mouse xenograft experiment.

It is well known that gender is a determinant of health, but less understood is whether differences in health status attributable to gender can be mitigated through the implementation of primary health care. Primary health care, notably distinct from primary care, refers to a wide-ranging approach to the delivery of a comprehensive variety of health services. This article traces the similarities between primary health care and women-centred care from their overlapping philosophical foundations to the similar health, social, and economic benefits of both approaches. It is argued that investments in primary health care positively impact women's health, and, as such, should be a preferred option for the delivery of women's community health services. Several models of health service delivery that operate in accordance with principles of primary health care and also address the key tenets of women's-centred care are examined and their merits are compared. The article also identifies the major impediments to the adoption of both primary health care and women's-centred care approaches.

We argue that policies for women-centred care ought to be developed to address the inadequacy of the current health system to recognize that women are affected differently by health policies and programs and that gender is a determinant of health; furthermore, such policies must be created with representatives from relevant health professional organizations so that the policies are translated and operationalized at the organizational and practice level. A collaborative research process, co-operative inquiry, was used to conduct the research. This process engages the participants in rigorous iterations of action and reflection. The result was a clear definition of women-centred care, a set of general guidelines for practice, and specific changes to existing organizational policies. The process and the product of the research built a bridge between existing macro government policies and the guidelines, standards, and ethical codes of the professional health associations.