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Restless legs syndrome (RLS) is a neurological disorder characterized by an urge to move and uncomfortable sensations. Genetic studies have identified polymorphisms in up to 19 risk loci, including MEIS1 and BTBD9. Rodents deficient in either homolog show RLS-like phenotypes. However, whether MEIS1 and BTBD9 interact in vivo is unclear. Here, with C. elegans, we observed that the hyperactive egg-laying behavior caused by loss of BTBD9 homolog was counteracted by knockdown of MEIS1 homolog. This was further investigated in mutant mice with Btbd9, Meis1, or both knocked out. The double knockout mice showed an earlier onset of the motor deficit in a wheel running test but did not have increased sensitivity to heat stimuli as observed in single knock outs. Meis1 protein level was not influenced by Btbd9 deficiency, and Btbd9 transcription was not affected by Meis1 haploinsufficiency. Our results demonstrate that MEIS1 and BTBD9 do not regulate each other.
Field trials were conducted in North Carolina in 2017 and Louisiana and Mississippi in 2018 to determine the effect of pretransplanting applications of diquat on sweetpotato crop tolerance, yield, and storage root quality. In North Carolina treatments consisted of two rates of diquat (560 or 1,120 g ai ha−1) alone or mixed with 107 g ai ha−1 flumioxazin and applied 1 d before transplanting (DBP), sequential applications of diquat (560 or 1,120 g ha−1) 1 and 17 DBP, 107 g ha−1 flumioxazin alone, and a nontreated check. In Louisiana and Mississippi treatments consisted of diquat (560 or 1,120 g ha−1) applied 1 DBP either alone or followed by (fb) rehipping rows or 107 g ha−1 flumioxazin immediately prior to transplanting. Additional treatments included 546 g ha−1 paraquat applied 1 DBP and a nontreated check. In North Carolina injury was ≤3% for all treatments through 23 d after transplanting (DAP), and no injury was observed after 23 DAP. Visual sweetpotato stunting pooled across the Mississippi and Louisiana trials ranged from 1% to 14%, 0% to 6%, and 0% to 3% at 2, 4, and 6 wk after planting (WAP), respectively, and no crop injury was observed after 6 WAP. Diquat applied 1 DBP and not fb rehipping resulted in greater crop injury (12%) than comparable treatments that were rehipped (2%). In North Carolina single and sequential diquat applications resulted in reduced No. 1 sweetpotato yield (24,230 and 24,280 kg ha−1, respectively) compared with the nontreated check, but No. 1 yield when diquat plus flumioxazin (26,330 kg ha−1) was used was similar to that of the nontreated check. No. 1 yield did not differ by treatment in Louisiana and Mississippi.
Challenges faced by older people include losses of loved ones through death; declining health, mobility, and function of the five senses; loss of independence; diminishing cognitive ability; and the struggle with Erik Erikson’s final two stages of life, namely generativity versus stagnation and ego integrity versus despair. Those who dedicate their energies to helping the elderly meet these challenges will be well served by the toolbox of techniques within the rubric of interpersonal psychotherapy (IPT). This chapter will serve as a brief overview of IPT principles, a review of the extant scientific literature on its efficacy in late life, and case vignettes to illustrate how it was used for each of the four foci of IPT, namely, role transition, grief, role disputes, and interpersonal deficit.
There is robust evidence that compromised parenting, stemming from persistently high stress, mediates the impact of war and displacement on children's mental health and psychosocial wellbeing. Parenting interventions generally prioritize the acquisition of parenting knowledge and skills, while under-attending to parental stress and distress. This paper describes the development of the Caregiver Support Intervention (CSI), a nine-session group intervention for conflict-affected parents of children aged 3–13, that aims to strengthen parenting both indirectly, by lowering stress and improving psychosocial wellbeing among parents, and directly, by increasing knowledge and skill related to positive parenting.
We describe the multi-phase, iterative process by which we developed the CSI, and illustrate the essential role of community input in shaping the intervention and strengthening its cultural fit and perceived usefulness. We used focus group data from participants in successive cycles of implementation, feedback, and revision, as well as quantitative data and expert consultation to develop a culturally and empirically grounded intervention.
This mixed-method, iterative approach to intervention development enabled us to develop a psychosocial intervention for conflict-affected caregivers that is feasible, acceptable, and perceived by participants as useful in addressing their own wellbeing and their parenting. Focus group data support the underlying model in which caregiver wellbeing powerfully influences parenting.
Programs aimed at strengthening parenting in conflict-affected communities should substantively address caregiver wellbeing. An iterative approach incorporating community feedback can help ensure intervention acceptability and feasibility. We also illustrate the feasibility of involving men in parenting interventions.
Field trials were conducted near Pontotoc, Mississippi; Chase, Louisiana; and Clinton, North Carolina, in 2017 and 2018 to determine the effect of pendimethalin rate and timing application on sweetpotato crop tolerance, yield, and storage root quality. Treatments consisted of five pendimethalin rates (266, 532, 1,065, 1,597, and 2,130 g ai ha−1) by two application timings (0 to 1 or 10 to 14 d after transplanting). Additionally, a nontreated check was included for comparison. Crop injury (stunting) was minimal (≤4%) through 6 wk after transplanting (WAP) and no injury was observed from 8 to 14 WAP, regardless of application timing or rate. The nontreated check yielded 6.6, 17.6, 5.5, and 32.1 × 103 kg ha−1 of canner, no. 1, jumbo, and total grades, respectively. Neither pendimethalin application timing nor rate influenced jumbo, no. 1, marketable, or total sweetpotato yield. Overall, these results indicate that pendimethalin will be a valuable addition to the toolkit of sweetpotato growers.
The Japanese Murrelet Synthliboramphus wumizusume is a rare, globally ‘Vulnerable’ seabird, endemic to Japan and South Korea. However, little is known of its at-sea distribution, habitat or threats. We conducted several years of at-sea surveys around Japan to model Japanese Murrelet density in relation to habitat parameters, and make spatial predictions to assess the adequacy of the current Japanese marine Important Bird and Biodiversity Area (IBA) network for the species. During a five-year period, 3,485 km of at-sea surveys recorded 3,161 Japanese Murrelets around four breeding locations. Maximum murrelet group size was 90 individuals with a mean group size of 2.9 ± 4.2 individuals. Models of Japanese Murrelet at-sea density around the two largest breeding locations predicted that almost all murrelets occur within 30 km of the breeding colony and most within 10 km. Murrelets were predicted closer to the colony in May than in April and closer to the colony at a neritic colony than at an offshore island colony. Additionally, murrelets breeding on an offshore island colony also commuted to mainland neritic habitat for foraging. The marine habitat used by Japanese Murrelets differed between each of the four surveyed colonies, however oceanographic variables offered little explanatory power in models. Models with colony, month and year generated four foraging radii (9–39 km wide) containing murrelet densities of > 0.5 birds/km2. Using these radii the Japanese marine IBA network was found to capture between 95% and 25% of Japanese Murrelet at-sea habitat while breeding and appears appropriately configured to protect near-colony murrelet distributions. Given the range of marine habitats that breeding murrelets inhabit, our simple models offer an applicable method for predicting to unsampled colonies and generating ecologically-informed seaward extension radii. However, data on colony populations and further at-sea surveys are necessary to refine models and improve predictions.
Externalizing disorders are known to be partly heritable, but the biological pathways linking genetic risk to the manifestation of these costly behaviors remain under investigation. This study sought to identify neural phenotypes associated with genomic vulnerability for externalizing disorders.
One-hundred fifty-five White, non-Hispanic veterans were genotyped using a genome-wide array and underwent resting-state functional magnetic resonance imaging. Genetic susceptibility was assessed using an independently developed polygenic score (PS) for externalizing, and functional neural networks were identified using graph theory based network analysis. Tasks of inhibitory control and psychiatric diagnosis (alcohol/substance use disorders) were used to measure externalizing phenotypes.
A polygenic externalizing disorder score (PS) predicted connectivity in a brain circuit (10 nodes, nine links) centered on left amygdala that included several cortical [bilateral inferior frontal gyrus (IFG) pars triangularis, left rostral anterior cingulate cortex (rACC)] and subcortical (bilateral amygdala, hippocampus, and striatum) regions. Directional analyses revealed that bilateral amygdala influenced left prefrontal cortex (IFG) in participants scoring higher on the externalizing PS, whereas the opposite direction of influence was observed for those scoring lower on the PS. Polygenic variation was also associated with higher Participation Coefficient for bilateral amygdala and left rACC, suggesting that genes related to externalizing modulated the extent to which these nodes functioned as communication hubs.
Findings suggest that externalizing polygenic risk is associated with disrupted connectivity in a neural network implicated in emotion regulation, impulse control, and reinforcement learning. Results provide evidence that this network represents a genetically associated neurobiological vulnerability for externalizing disorders.
Posttraumatic stress disorder (PTSD) and stress/trauma exposure are cross-sectionally associated with advanced DNA methylation age relative to chronological age. However, longitudinal inquiry and examination of associations between advanced DNA methylation age and a broader range of psychiatric disorders is lacking. The aim of this study was to examine if PTSD, depression, generalized anxiety, and alcohol-use disorders predicted acceleration of DNA methylation age over time (i.e. an increasing pace, or rate of advancement, of the epigenetic clock).
Genome-wide DNA methylation and a comprehensive set of psychiatric symptoms and diagnoses were assessed in 179 Iraq/Afghanistan war veterans who completed two assessments over the course of approximately 2 years. Two DNA methylation age indices (Horvath and Hannum), each a weighted index of an array of genome-wide DNA methylation probes, were quantified. The pace of the epigenetic clock was operationalized as change in DNA methylation age as a function of time between assessments.
Analyses revealed that alcohol-use disorders (p = 0.001) and PTSD avoidance and numbing symptoms (p = 0.02) at Time 1 were associated with an increasing pace of the epigenetic clock over time, per the Horvath (but not the Hannum) index of cellular aging.
This is the first study to suggest that posttraumatic psychopathology is longitudinally associated with a quickened pace of the epigenetic clock. Results raise the possibility that accelerated cellular aging is a common biological consequence of stress-related psychopathology, which carries implications for identifying mechanisms of stress-related cellular aging and developing interventions to slow its pace.
To determine whether probiotic prophylaxes reduce the odds of Clostridium difficile infection (CDI) in adults and children.
Individual participant data (IPD) meta-analysis of randomized controlled trials (RCTs), adjusting for risk factors.
We searched 6 databases and 11 grey literature sources from inception to April 2016. We identified 32 RCTs (n=8,713); among them, 18 RCTs provided IPD (n=6,851 participants) comparing probiotic prophylaxis to placebo or no treatment (standard care). One reviewer prepared the IPD, and 2 reviewers extracted data, rated study quality, and graded evidence quality.
Probiotics reduced CDI odds in the unadjusted model (n=6,645; odds ratio [OR] 0.37; 95% confidence interval [CI], 0.25–0.55) and the adjusted model (n=5,074; OR, 0.35; 95% CI, 0.23–0.55). Using 2 or more antibiotics increased the odds of CDI (OR, 2.20; 95% CI, 1.11–4.37), whereas age, sex, hospitalization status, and high-risk antibiotic exposure did not. Adjusted subgroup analyses suggested that, compared to no probiotics, multispecies probiotics were more beneficial than single-species probiotics, as was using probiotics in clinical settings where the CDI risk is ≥5%. Of 18 studies, 14 reported adverse events. In 11 of these 14 studies, the adverse events were retained in the adjusted model. Odds for serious adverse events were similar for both groups in the unadjusted analyses (n=4,990; OR, 1.06; 95% CI, 0.89–1.26) and adjusted analyses (n=4,718; OR, 1.06; 95% CI, 0.89–1.28). Missing outcome data for CDI ranged from 0% to 25.8%. Our analyses were robust to a sensitivity analysis for missingness.
Moderate quality (ie, certainty) evidence suggests that probiotic prophylaxis may be a useful and safe CDI prevention strategy, particularly among participants taking 2 or more antibiotics and in hospital settings where the risk of CDI is ≥5%.
Laboratory experiments were performed on a geometrically scaled vertical-axis wind turbine model over an unprecedented range of Reynolds numbers, including and exceeding those of the full-scale turbine. The study was performed in the high-pressure environment of the Princeton High Reynolds number Test Facility (HRTF). Utilizing highly compressed air as the working fluid enabled extremely high Reynolds numbers while still maintaining dynamic similarity by matching the tip speed ratio (defined as the ratio of tip velocity to free stream,
) and Mach number (defined at the turbine tip,
). Preliminary comparisons are made with measurements from the full-scale field turbine. Peak power for both the field data and experiments resides around
. In addition, a systematic investigation of trends with Reynolds number was performed in the laboratory, which revealed details about the asymptotic behaviour. It was shown that the parameter that characterizes invariance in the power coefficient was the Reynolds number based on blade chord conditions (
). The power coefficient reaches its asymptotic value when
, which is higher than what the field turbine experiences. The asymptotic power curve is found, which is invariant to further increases in Reynolds number.
In this investigation, we reported the increase in emergency department and inpatient admission cases during the month of November 2012 post Hurricane Sandy as compared with baseline (November 2010, 2011, and 2013) for elderly patients aged 65 and up.
Medical claims data for patients aged 65 and over treated at emergency department and inpatient health care facilities in New Jersey were analyzed to examine the surge in frequencies of diagnoses treated immediately following Hurricane Sandy. The differences were quantified using gap analysis for 2 years before and 1 year after the event.
There was an average increase of 1700 cases for the month of November 2012 relative to baseline for the top 15 most frequently diagnosed emergency department medical conditions. On a daily basis, a volume increase by an average 57 cases could be expected, including significant numbers of limb fractures and other trauma cases for these most frequently encountered medical conditions.
Understanding the surge level in medical services needed in emergency departments and inpatient facilities during a natural disaster aftermath is critical for effective emergency preparation and response for the elderly population. (Disaster Med Public Health Preparedness. 2018;12:730-738)
On August 25, 2017, Hurricane Harvey made landfall near Corpus Christi, Texas. The ensuing unprecedented flooding throughout the Texas coastal region affected millions of individuals.1 The statewide response in Texas included the sheltering of thousands of individuals at considerable distances from their homes. The Dallas area established large-scale general population sheltering as the number of evacuees to the area began to amass. Historically, the Dallas area is one familiar with “mega-sheltering,” beginning with the response to Hurricane Katrina in 2005.2 Through continued efforts and development, the Dallas area had been readying a plan for the largest general population shelter in Texas. (Disaster Med Public Health Preparedness. 2019;13:33–37)
The seventh meeting of the World Congress of Pediatric Cardiology and Cardiac Surgery was an opportunity for healthcare professionals from around the world to meet and discuss current issues affecting patients with acquired and CHD. A dedicated anaesthesia track facilitated the exchange of ideas and fostered many new friendships. This review highlights the congenital cardiac anaesthesia track and the involvement of the Congenital Cardiac Anesthesia Society in the congress.
To determine the risk of Clostridium difficile transmission from index cases with C. difficile infection (CDI) to their household contacts and domestic pets.
A prospective study from April 2011 to June 2013.
Patients with CDI from Canadian tertiary care centers.
Patients with CDI, their household human contacts, and pets.
Epidemiologic information and stool or rectal swabs were collected from participants at enrollment and monthly for up to 4 months. Pulsed-field gel electrophoresis (PFGE) was performed on C. difficile isolates. Probable transmission was defined as the conversion of a C. difficile culture–negative contact to C. difficile culture–positive contact with a PFGE pattern indistinguishable or closely related to the index case. Possible transmission was defined as a contact with a positive C. difficile culture at baseline with a strain indistinguishable or closely related to the index case.
A total of 51 patients with CDI participated in this study; 67 human contacts and 15 pet contacts were included. Overall, 9 human contacts (13.4%) were C. difficile culture positive; 1 contact (1.5%) developed CDI; and 8 contacts were asymptomatic. Of 67 human contacts, probable transmission occurred in 1 human contact (1.5%) and possible transmission occurred in 5 human contacts (7.5%). Of 15 pet contacts, probable transmission occurred in 3 (20%) and possible transmission occurred in 1 (6.7%).
There was a high proportion of C. difficile culture positivity at 13.4% among human contacts and asymptomatic carriage of domestic pets reached 26.7%. These results suggest that household transmission of C. difficile may be a source of community-associated cases.
Metsulfuron is used for POST control of spotted spurge in many warm-season
turfgrasses. A suspected resistant (R) biotype of spotted spurge was
collected from turfgrass in Georgia with a history of exclusive metsulfuron
use. Research was conducted to evaluate the resistance level of this biotype
to metsulfuron, efficacy of other mechanisms of action for control, and the
molecular basis for resistance. Compared with a susceptible (S) biotype, the
R biotype required >90 and >135 times greater metsulfuron rates to
reach 50% injury and reduce biomass 50% from the nontreated, respectively.
The R biotype was also resistant to trifloxysulfuron but was injured
equivalent to the S biotype from dicamba, glyphosate, and triclopyr. Gene
sequencing of the R biotype revealed a Trp574 to Leu substitution
that has conferred resistance to acetolactate synthase (ALS) inhibitors in
previous research. This is the first report of ALS resistance in spotted
spurge. More importantly, this is the first report of a herbicide-resistant
broadleaf weed from a turfgrass system in the United States.
To determine whether real-time availability of rapid molecular results of Staphylococcus aureus would impact emergency department clinician antimicrobial selection for adults with cutaneous abscesses.
We performed a prospective, randomized controlled trial comparing a rapid molecular test with standard of care culture-based testing. Follow-up telephone calls were made at between 2 and 7 days, 1 month, and 3 months after discharge.
Two urban, academic emergency departments.
Patients at least 18 years old presenting with a chief complaint of abscess, cellulitis, or insect bite and receiving incision and drainage were eligible. Seven hundred seventy-eight people were assessed for eligibility and 252 met eligibility criteria.
Clinician antibiotic selection and clinical outcomes were evaluated. An ad hoc outcome of test performance was performed.
We enrolled 252 patients and 126 were randomized to receive the rapid test. Methicillin-susceptible S. aureus–positive patients receiving rapid test results were prescribed beta-lactams more often than controls (absolute difference, 14.5% [95% CI, 1.1%–30.1%]) whereas methicillin-resistant S. aureus–positive patients receiving rapid test results were more often prescribed anti–methicillin-resistant S. aureus antibiotics (absolute difference, 21.5% [95% CI, 10.1%–33.0%]). There were no significant differences between the 2 groups in 1-week or 3-month clinical outcomes.
Availability of rapid molecular test results after incision and drainage was associated with more-targeted antibiotic selection.