Therapeutic Actions Positive Mood

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What's the point? The contribution of a sustainability view in contaminated site remediation.

What's the point? The contribution of a sustainability view in contaminated site remediation. Sci Total Environ. 2018 Feb 20;630:103-116 Authors: Anderson R, Norrman J, Back PE, Söderqvist T, Rosén L Abstract Decision support tools (DST) are often used in remediation projects to aid in the complex decision on how best to remediate a contaminated site. In recent years, the sustainable remediation concept has brought increased attention to the often-overlooked contradictory effects of site remediation, with a number of sustainability assessment tools now available. The aim of the present study is twofold: (1) to demonstrate how and when different assessment views affect the decision support outcome on remediation alternatives in a DST, and (2) to demonstrate the contribution of a full sustainability assessment. The SCORE tool was used in the analysis; it is based on a holistic multi-criteria decision analysis (MCDA) approach, assessing sustainability in three dimensions: environmental, social, and economic. Four assessment scenarios, compared to a full sustainability assessment, were considered to reflect different possible assessment views; considering public and private problem owner perspectives, as well as green and traditional assessment scopes. Four real case study sites in Sweden were analyzed. The results show that the decision support outcome from a full sustainability assessment most often differs to that of other assessment views, and results in remediation alternatives which balance trade-offs in most of the scenarios. In relation to the public perspective and traditional scope, which is seen to lead to the most extensive and expensive remediation alternatives, the trade-off is related to less contaminant removal in favour of reduced negative secondary effects such as emissions and waste disposal. Compared to the private perspective, associated with the lowest cost alternatives, the trade-off is higher costs, but more positive environmental and social effects. Generally, both the green and traditional assessment scopes miss out on relevant social and local environmental secondary effects which may ultimately be very important for the actual decision in a remediation project. PMID: 29475112 [PubMed - as supplied by publisher]

Anxiolytic effects of ascorbic acid and ketamine in mice.

Anxiolytic effects of ascorbic acid and ketamine in mice. J Psychiatr Res. 2018 Feb 13;100:16-23 Authors: Fraga DB, Olescowicz G, Moretti M, Siteneski A, Tavares MK, Azevedo D, Colla ARS, Rodrigues ALS Abstract Some studies have demonstrated that ascorbic acid, similarly to ketamine, exhibits antidepressant-like effects mediated, at least in part, by modulation of the glutamatergic system. Despite the involvement of glutamatergic system in the pathophysiology of anxiety disorders, the ability of ascorbic acid and ketamine to elicit anxiolytic effects in animal models remains to be established. Therefore, this study investigated the effects of a single administration of ascorbic acid, ketamine or diazepam (positive control) in different animal models of anxiety. Mice were treated with ascorbic acid (1, 3 and 10 mg∕kg, p.o.), ketamine (1 and 10 mg∕kg, i.p.) or diazepam (2 mg∕kg, p.o) and their behavioral responses were assessed in the elevated plus maze, open field test (OFT), ligh∕dark preference test and marble burying test. Ascorbic acid increased total time spent in the open arms of elevated plus maze, increased total time in the center of the OFT, decreased rearing responses, increased the latency to grooming, decreased the rostral grooming, but did not affect body grooming. Furthermore, ascorbic acid increased the latency time and total time in light area in the ligh∕dark preference test, but did not affect the performance of mice in the marble burying test. Ketamine demonstrated an anxiolytic-like effect in elevated plus maze, OFT, and ligh∕dark preference test. Diazepam exhibited an anxiolytic-like effect in all the behavioral tests. Altogether, the results indicate the potential anxiolytic effect of ascorbic acid and ketamine, providing a possible new avenue for the management of anxiety-related disorders. PMID: 29475017 [PubMed - as supplied by publisher]

Transgenerational effects of prenatal restricted diet on gene expression and histone modifications in the rat.

Transgenerational effects of prenatal restricted diet on gene expression and histone modifications in the rat. PLoS One. 2018;13(2):e0193464 Authors: Nowacka-Woszuk J, Szczerbal I, Malinowska AM, Chmurzynska A Abstract Dietary triggers acting on a developing fetus can affect the functioning of the body in later life; this can be observed on various levels, including epigenetic modifications and gene expression. Early-life programmed changes may be transmitted to successive generations. In this study, the impact of prenatal restricted diet was studied in four generations of rats. We hypothesized that this diet can induce changes in the expression of major genes involved in two epigenetic mechanisms: DNA methylation and histone modifications. The transcript level of six genes involved in these processes (Dnmt1, Dnmt3a, Dnmt3b, Mecp2, Hdac1, and Sin3a) was therefore determined in three tissues (liver, adipose, and muscle). This diet was found to have no effect on the F0 pregnant females. In the F1 progeny (fetuses at day 19 of pregnancy and 4-week-old rats) significant differences in the expression of the genes were observed mostly in the liver; in subsequent generations, we therefore studied only this tissue. Among the genes encoding DNA methyltransferases, significant changes were observed for Dnmt1 in the F1 animals from the restricted group, but these were no longer evident in F2 and F3. The Dnmt3a and Dnmt3b genes showed no differences in mRNA level in F1 fetuses. Concerning the transcript level of the Mecp2 gene only in F1 generation significant changes were found. For the histone modification genes, an increase in the expression of Hdac1 in fetus liver was found in F1 and F2, while its level decreased in F3. The abundance of the Sin3a transcript varied in all generations. It was also found that the mRNA levels of the studied genes correlated highly positive with each other, but only in fetuses from the F1 restricted group. The DNA methylation cell potential, defined as the ratio of SAM (S-adenosylmethionine) to SAH (S-adenosylhomocysteine), was measured in the liver, with no alterations being found in the restricted groups. Evaluation of global histone H3 acetylation showed that it underwent a significant increase in the fetal livers of F1, while during aging (four-week old animals) this difference was no longer maintained. A tendency of increased H3 acetylation in fetuses was also detected in F2 generation. In F1 fetuses from restricted group the increased H3 acetylation positively correlated with transcriptional status of the studied genes. Our results indicate that the prenatal restriction diet can affect the activity of genes involved in epigenetic mechanisms in the liver across generations. Moreover, this feeding type influenced the global histone H3 acetylation in fetal liver. PMID: 29474484 [PubMed - in process]

The impact of poverty reduction and development interventions on non-communicable diseases and their behavioural risk factors in low and lower-middle income countries: A systematic review.

The impact of poverty reduction and development interventions on non-communicable diseases and their behavioural risk factors in low and lower-middle income countries: A systematic review. PLoS One. 2018;13(2):e0193378 Authors: Pullar J, Allen L, Townsend N, Williams J, Foster C, Roberts N, Rayner M, Mikkelsen B, Branca F, Wickramasinghe K Abstract INTRODUCTION: Non-communicable diseases (NCDs) disproportionately affect low- and lower-middle income countries (LLMICs) where 80% of global NCD related deaths occur. LLMICs are the primary focus of interventions to address development and poverty indicators. We aimed to synthesise the evidence of these interventions' impact on the four primary NCDs (cardiovascular disease, diabetes, chronic respiratory disease and cancer) and their common behavioural risk factors (unhealthy diets, physical inactivity, tobacco and alcohol use). METHODS: We systematically searched four online databases (Medline, Embase, Web of Science and Global Health) for primary research conducted in LLMICS, published between January 1st 1990 and February 15th 2016. Studies involved development or poverty interventions which reported on outcomes relating to NCDs. We extracted summary level data on study design, population, health outcomes and potential confounders. RESULTS: From 6383 search results, 29 studies from 24 LLMICs published between 1999 and 2015 met our inclusion criteria. The quality of included studies was limited and heterogeneity of outcome measures required narrative synthesis. One study measured impact on NCD prevalence, one physical activity and 27 dietary components. The majority of papers (23), involved agricultural interventions. Primary outcome measures tended to focus on undernutrition. Intensive agricultural interventions were associated with improved calorie, vitamin, fruit and vegetable intake. However, positive impacts were reliant on participant's land ownership, infection status and limited in generalisability. Just three studies measured adult obesity; two indicated increased income and consequential food affordability had the potential to increase obesity. Overall, there was poor alignment between included studies outcome measures and the key policy options and objectives of the Global Action Plan on NCDs. CONCLUSIONS: Though many interventions addressing poverty and development have great potential to impact on NCD prevalence and risk, most fail to measure or report these outcomes. Current evidence is limited to behavioural risk factors, namely diet and suggests a positive impact of agricultural-based food security programmes on dietary indicators. However, studies investigating the impact of improved income on obesity tend to show an increased risk. Embedding NCD impact evaluation into development programmes is crucial in the context of the Sustainable Development Goals and the rapid epidemiological transitions facing LLMICs. PMID: 29474454 [PubMed - in process]

Reproductive ecology and stand structure of Joshua tree forests across climate gradients of the Mojave Desert.

Reproductive ecology and stand structure of Joshua tree forests across climate gradients of the Mojave Desert. PLoS One. 2018;13(2):e0193248 Authors: St Clair SB, Hoines J Abstract Climate change is restructuring plant populations and can result in range shifts depending on responses at various life stages of plants. In 2013, a widespread and episodic flowering event provided an opportunity to characterize how Joshua tree's reproductive success and population structure vary in response to the climate variability across its range. We examined the reproductive success and stand structure of 10 Joshua tree populations distributed across the Mojave Desert. Joshua tree density varied by more than an order of magnitude across sites. At 8 of the 10 sites, nearly 80% of the Joshua trees were in bloom, and at the other two 40% were in bloom. The range of seed production and fruit set across the study populations varied by more than an order of magnitude. Fruit production occurred at all of our study sites suggesting that yucca moth pollinators were present at our sites. Increasing temperature had strong positive correlations with the number of trees in bloom (R2 = 0.42), inflorescences per tree (R2 = 0.37), and fruit mass (R2 = 0.77) and seed size (R2 = 0.89. In contrast, temperature was negatively correlated with Joshua tree stand density (R2 = -0.80). Positive correlations between temperature and greater flower and seed production suggest that warming may positively affect Joshua Tree reproduction while negative relationships between temperature and stand density are suggestive of potential constraints of warmer temperatures on establishment success. PMID: 29474414 [PubMed - in process]

Levels of regulatory B cells do not predict serological responses to hepatitis B vaccine.

Levels of regulatory B cells do not predict serological responses to hepatitis B vaccine. Hum Vaccin Immunother. 2018 Feb 23;:1-14 Authors: Bolther M, Andersen KLD, Tolstrup M, Visvanathan K, Woolley I, Skinner N, Millen R, Warner N, Østergaard L, Jensen-Fangel S Abstract This study investigated the immunomodulatory influence of IL10 producing B regulatory cells, Bregs (CD19+CD24hiCD38hi) to standard Twinrix® vaccination. We also investigated HBsAg specific T-cell mediated IFN-γ responses to Twinrix® which in theory could provide effective immunity despite low anti-HBs titer. A total of 309 hepatitis B negative health care students and workers completed a standard Twinrix® vaccination schedule (0, 1 and 6 months). Depending on the vaccination response the participants were divided in to non-, low- and high responders according to anti-HBs titer (<10, <100 and >1000 mIU/mL respectively) two months after completed vaccination schedule. Blood samples from baseline and after vaccination from all non- and low-responders (23 participants) and the same number of high-responders were used for flow cytometric analyses of IL10 producing Bregs and T-cell mediated IFN-γ responses. A decrease in levels of IL10 producing Bregs was observed after vaccination in high responders compared to non- and low-responders. Compiling non-and low-responders against high-responders showed a lower T-cell mediated IFN-γ response at baseline in non-and low-responders when stimulated with Engerix® vaccine. In contrary no positive correlation between IL10 producing Bregs or IFN-γ positive T-cells and anti-HBs titer was observed. Hence this study cannot prove that levels of IL10 producing Bregs or IFN-γ positive T cell affect HBV vaccine response. EudraCT number: 2011-001943-6. PMID: 29474139 [PubMed - as supplied by publisher]

Couples' Perceptions of Each Other's Daily Affect: Empathic Accuracy, Assumed Similarity, and Indirect Accuracy.

Couples' Perceptions of Each Other's Daily Affect: Empathic Accuracy, Assumed Similarity, and Indirect Accuracy. Fam Process. 2018 Feb 23;: Authors: Kouros CD, Papp LM Abstract This study examined couples' perceptions of each other's daily affect, using a daily diary methodology. Specifically, we tested the extent to which couples accurately inferred how their partner was feeling (empathic accuracy) and the extent to which spouses used their own feelings as a gauge for how their partner was feeling (assumed similarity). We also tested for indirect accuracy in couples' perceptions; that is, that assumed similarity in the context of actual similarity leads to empathic accuracy. Participants were 51 couples who completed daily diaries for seven consecutive nights. Results based on the Actor-Partner Interdependence Model indicated that couples showed both empathic accuracy and assumed similarity in their perception of their partner's positive affect; however, they used assumed similarity in rating their partner's hard negative (anger, hostility) and soft negative (sadness, fear) affect. Furthermore, tests of indirect accuracy found that wives were indirectly accurate in perceiving their husbands' positive affect and both husbands and wives were indirectly accurate in perceiving each other's hard negative affect because they were biased. Complementing laboratory studies, the present study highlights that examining couples' perceptions of each other's feelings in contexts of daily life, and differentiating positive and negative emotions, can further our understanding of the role of emotions for healthy relationship functioning. PMID: 29473151 [PubMed - as supplied by publisher]

Hypoxia Exacerbates Negative Emotional State during Inactivity: The Effect of 21 Days Hypoxic Bed Rest and Confinement.

Hypoxia Exacerbates Negative Emotional State during Inactivity: The Effect of 21 Days Hypoxic Bed Rest and Confinement. Front Physiol. 2018;9:26 Authors: Stavrou NAM, Debevec T, Eiken O, Mekjavic IB Abstract Hypoxia and confinement have both been shown to influence emotional state. It is envisaged that the inhabitants of future planetary habitats will be exposed to concomitant confinement, reduced gravity and hypoxia. We examined the independent and combined effects of a 21-day inactivity/unloading and normobaric hypoxia under confined conditions on various psychological factors. Eleven healthy men participated in three 21-day experimental campaigns designed in a cross-over manner: (1) Normobaric hypoxic ambulatory confinement, (2) Normobaric hypoxic bed rest and (3) Normobaric normoxic bed rest. The Profile of Mood States, and the Positive and Negative Affect Schedule were employed to assess the participants' psychological responses before (Pre), during (Day 7, Day 14, and Day 21) and after (Post) the confinements. The most negative psychological profile appeared on days 14 and 21 of the hypoxic bed rest campaign. A significant increase in depression, tension, and confusion was noted on days 14 and 21 of the hypoxic bed rest condition. Concomitantly, a decrease, albeit not statistically significant, in positive psychological responses was observed. The psychological profile returned to the initial level at Post following all confinements. These data suggest that the combined effect of hypoxia and bed rest induced the most negative effects on an individual's mood. However, significant intra- and inter-individual differences in psychological responses were noted and should be taken into consideration. PMID: 29472866 [PubMed]

Association of BRCA1, ERCC1, RAP80, PKM2, RRM1, RRM2, TS, TSP1, and TXR1 mRNA expression levels between primary tumors and infiltrated regional lymph nodes in patients with resectable non-small cell lung cancer.

Association of BRCA1, ERCC1, RAP80, PKM2, RRM1, RRM2, TS, TSP1, and TXR1 mRNA expression levels between primary tumors and infiltrated regional lymph nodes in patients with resectable non-small cell lung cancer. Pharmacogenomics J. 2018 Feb 22;: Authors: Tryfonidis K, Papadaki C, Assele S, Lagoudaki E, Menis J, Koutsopoulos A, Trypaki M, Tsakalaki E, Sfakianaki M, Hasan B, Stathopoulos E, Georgoulias V, Souglakos J Abstract Differences in gene expression levels between the primary tumors (PTs) and matched regional lymph nodal metastases (LNs) in patients with totally excised non-small cell lung cancer (NSCLC) were explored. Microdissected formalin-fixed paraffin-embedded (FFPE) samples from (PT) and their matched infiltrated LNs, from 239 patients [183 (with matched PT and LNs samples)-case and 56 PT only samples-control cohorts] were analyzed for BRCA1, ERCC1, RAP80, PKM2, RRM1, RRM2, TS, TSP1, and TXR1 mRNA expression by quantitative real-time polymerase-chain reaction (PCR). Moderately positive correlation between the expression of each gene in the PT and the matched LNs was observed. Concordance rates between the PT and the LNs were: BRCA1 (67.7%), ERCC1 (68.4%), PKM2 (63.4%), RAP80 (68.8%), RRM1 (70.9%), RRM2 (69%), TS (72.9%), TSP1 (69.8%), TXR1 (63.7%). Expression levels and their differences were correlated with Relapse-Free Survival (RFS) and Overall Survival (OS). High BRCA1 PT in patients with squamous histology was associated with increased OS (p = 0.036). High TSP1 PT levels were shown to be the only independent prognostic factor for OS and RFS (p = 0.023 and p = 0.007). PKM2 low levels in both PT and matched LNs were associated with better OS irrespective of the underlying histology (p = 0.031). RRM1 discordant levels between PT and matched LNs were associated with worse OS in squamous tumors (p = 0.019) compared to patients with both low expression in PT and LN.TXR1 high levels in both PT and matched LNs were associated with better OS in patients with squamous tumors (p = 0.007).These findings indicate that there is different gene expression between PT and matched LNs which may affect the outcome in early NSCLC and therefore PT's molecular biology should not be the sole determinant for prognostication. PMID: 29472587 [PubMed - as supplied by publisher]

Prevalence estimation and familial tendency of common forefoot deformities in Turkey: A survey of 2662 adults.

Prevalence estimation and familial tendency of common forefoot deformities in Turkey: A survey of 2662 adults. Acta Orthop Traumatol Turc. 2018 Feb 19;: Authors: Şaylı U, Altunok EÇ, Güven M, Akman B, Biros J, Şaylı A Abstract OBJECTIVE: This survey was designed to evaluate the prevalence estimations of HV, bunionette, hammertoe as well as their relations to shoe wearing and also familial tendency, in Turkey. MATERIAL AND METHODS: Two thousand six hundred sixty two volunteers (1615 females and 1047 males) with a mean age of 34.15 ± 14.23 (range; 18 to 96) years were asked to answer the predetermined questionnaire between January and June, 2016. Hallux valgus, hammertoe and bunionette images were provided as references and every adult participant without any known forefoot problems or past forefoot surgery history was asked to rate his/her foot and to respond the questions about family history and shoe wearing habits. Responses were statistically analyzed. RESULTS: The prevalence estimations of hallux valgus, bunionette and hammertoe were calculated as 54.3%, 13.8% and 8.9% and positive family history rates were 53.2%, 61.2% and 56.1%, respectively. All three deformities were more common in females than in males (p < 0.001). Nonetheless the older age group reported significantly higher prevalence rates for only HV (p < 0.001). Likewise, among the three deformities, females reported a higher rate of positive family history only in HV compared to men (p < 0.001). Constricting shoe wear was found to affect HV incidence in women (p < 0.001) and bunionette incidence in both sexes (p < 0.01). CONCLUSION: This study concludes that forefoot deformities are common with high familial tendency. Hence it is worthwhile to work on molecular genetics and this may enable the anticipation of forthcoming deformities in order to take early action in prevention, in nearly the half of the population. PMID: 29472047 [PubMed - as supplied by publisher]

Effects of motivational interviewing fidelity on substance use treatment engagement in primary care.

Effects of motivational interviewing fidelity on substance use treatment engagement in primary care. J Subst Abuse Treat. 2018 Apr;87:64-69 Authors: Osilla KC, Watkins KE, D'Amico EJ, McCullough CM, Ober AJ Abstract OBJECTIVE: Primary care (PC) may be an opportune setting to engage patients with opioid and alcohol use disorders (OAUDs) in treatment. We examined whether motivational interviewing (MI) fidelity was associated with engagement in primary care-based OAUD treatment in an integrated behavioral health setting. METHODS: We coded 42 first session therapy recordings and examined whether therapist MI global ratings and behavior counts were associated with patient engagement, defined as the patient receiving one shot of extended-release injectable naltrexone or any combination of at least two additional behavioral therapy, sublingual buprenorphine/naloxone prescriptions, or OAUD-related medical visits within 30days of their initial behavioral therapy visit. RESULTS: Autonomy/support global ratings were higher in the non-engaged group (OR=0.28, 95%CI: 0.09-0.93; p=0.037). No other MI fidelity ratings were significantly associated with engagement. CONCLUSION: We did not find positive associations between MI fidelity and engagement in primary care-based OAUD treatment. More research with larger samples is needed to examine how providing autonomy/support to patients who are not ready to change may affect engagement. PRACTICE IMPLICATIONS: Training providers to strategically use MI to reinforce change as opposed to the status quo is needed. This may be especially important in primary care where patients may not be specifically seeking help for their OAUDs. PMID: 29471928 [PubMed - in process]

Longitudinal Effects of Adjuvant Endocrine Therapy on the Quality of Life of Post-menopausal Women with Non-metastatic ER+ Breast Cancer: A Systematic Review.

Related Articles Longitudinal Effects of Adjuvant Endocrine Therapy on the Quality of Life of Post-menopausal Women with Non-metastatic ER+ Breast Cancer: A Systematic Review. Pharmacoecon Open. 2018 Feb 22;: Authors: Xiao H, Jiang X, Chen C, Montero AJ, Diaby V Abstract BACKGROUND: Anti-estrogen (ER) endocrine therapy is an effective treatment strategy in reducing breast cancer mortality. This therapy has a better therapeutic index than chemotherapy but can still affect patients' quality of life (QOL) over time. OBJECTIVE: The objectives of this systematic review were to (1) describe QOL instruments used in ER-positive (ER+) non-metastatic breast cancer trials and (2) document the longitudinal effects of adjuvant endocrine therapy on the QOL of post-menopausal women with ER+ non-metastatic breast cancer. METHODS: We searched three electronic bibliographic databases for articles published from inception to October 2017 that described (1) a randomized controlled trial (RCT) of non-metastatic breast cancer containing an adjuvant endocrine regimen in at least one arm; (2) the use of a patient self-report measure assessing general or breast cancer-specific QOL; and (3) QOL outcomes at multiple time points during follow-up of at least 5 years. All included trials were independently evaluated by two reviewers, and data were extracted using standardized forms. RESULTS: In total, 13 studies met our inclusion criteria and were assessed in this review. The quality of the trials was reasonably good. The top three most commonly used QOL instruments in the trials were the Functional Assessment of Cancer Therapy/Functional Assessment of Chronic Illness Therapy, the Short Form-36 and the Menopause-Specific Quality of Life. Most studies found no differences between tamoxifen and aromatase inhibitor groups in terms of global QOL. QOL data affected treatment regimen recommendations in a few cases. A meta-analysis was not feasible because the RCTs included in our review varied in terms of sample size, comparators, QOL instrument used, and timing of QOL measurement. Additionally, as no search strategy has perfect sensitivity, specificity and accuracy, there is always a chance that potentially relevant articles were missed. CONCLUSION: This systematic review suggests that the QOL of post-menopausal women is unlikely to be adversely affected by long-term use of adjuvant endocrine therapy. Efforts are needed to improve the quality of QOL reporting in clinical trials. PMID: 29470807 [PubMed - as supplied by publisher]

Considering the context: social factors in responses to drugs in humans.

Related Articles Considering the context: social factors in responses to drugs in humans. Psychopharmacology (Berl). 2018 Feb 22;: Authors: de Wit H, Sayette M Abstract BACKGROUND: Drugs are typically used in social settings. Here, we consider two factors that may contribute to this observation: (i) the presence of other people may enhance the positive mood effects of a drug, and conversely, (ii) drugs may enhance the value of social stimuli. METHODS: We review evidence from controlled laboratory studies with human volunteers, which investigated either of these interactions between social factors and responses to drugs. We examine the bidirectional effects of social stimuli and single doses of alcohol, stimulants, opioids, and cannabis. RESULTS: All four classes of drugs interact with social contexts, but the nature of these interactions varies across drugs, and depends on whether the context is positive or negative. CONCLUSIONS: Alcohol and stimulant drugs enhance the attractiveness of social stimuli and the desire to socialize, and social contexts, in turn, enhance these drugs' effects. In contrast, opioids and cannabis have subtler effects on social interactions and their effects are less influenced by the presence of others. Overall, there is stronger evidence that drugs enhance positive social contexts than that they dampen the negativity of unpleasant social settings. Controlled research is needed to understand the interactions between drugs of abuse and social contexts, to model and understand the determinants of drug use outside the laboratory. PMID: 29470605 [PubMed - as supplied by publisher]

Blood transfusion management in the severely bleeding military patient.

Related Articles Blood transfusion management in the severely bleeding military patient. Curr Opin Anaesthesiol. 2018 Feb 22;: Authors: Gurney JM, Spinella PC Abstract PURPOSE OF REVIEW: Hemorrhage remains the primary cause of preventable death on the battlefield and in civilian trauma. Hemorrhage control is multifactorial and starts with point-of-injury care. Surgical hemorrhage control and time from injury to surgery is paramount; however, interventions in the prehospital environment and perioperative period affect outcomes. The purpose of this review is to understand concepts and strategies for successful management of the bleeding military patient. Understanding the life-threatening nature of coagulopathy of trauma and implementing strategies aimed at full spectrum hemorrhage management from point of injury to postoperative care will result in improved outcomes in patients with life-threatening bleeding. RECENT FINDINGS: Timely and appropriate therapies impact survival. Blood product resuscitation for life-threatening hemorrhage should either be with whole blood or a component therapy strategy that recapitulates the functionality of whole blood. The US military has transfused over 10 000 units of whole blood since the beginning of the wars in Iraq and Afghanistan. The well recognized therapeutic benefits of whole blood have pushed this therapy far forward into prehospital care in both US and international military forces. Multiple hemostatic adjuncts are available that are likely beneficial to the bleeding military patient; and other products and techniques are under active investigation. SUMMARY: Lessons learned in the treatment of combat casualties will likely continue to have positive impact and influence and the management of hemorrhage in the civilian trauma setting. PMID: 29470190 [PubMed - as supplied by publisher]

The effect of skin surface topography and skin colouration cues on perception of male facial age, health, and attractiveness.

Related Articles The effect of skin surface topography and skin colouration cues on perception of male facial age, health, and attractiveness. Int J Cosmet Sci. 2018 Feb 22;: Authors: Fink B, Matts PJ, Brauckmann C, Gundlach S Abstract OBJECTIVE: Previous studies investigating the effects of skin surface topography and colouration cues on perception of female faces reported a differential weighting for perception of skin topography and colour evenness, where topography was a stronger visual cue for perception of age, whereas skin colour evenness was a stronger visual cue for perception of health. We extend these findings in a study of the effect of skin surface topography and colour evenness cues on perceptions of facial age, health, and attractiveness in males. METHODS: Facial images of six men (aged 40 to 70 years), selected for co-expression of lines / wrinkles and discolouration, were manipulated digitally to create eight stimuli, namely, separate removal of these two features (a) on the forehead, (b) in the periorbital area, (c) on the cheeks and (d) across the entire face. Omnibus (within-face) pairwise combinations, including the original (unmodified) face, were presented to a total of 240 male and female judges, who selected the face they considered younger, healthier, and more attractive. RESULTS: Significant effects were detected for facial image choice, in response to skin feature manipulation. The combined removal of skin surface topography resulted in younger age perception compared with that seen with the removal of skin colouration cues, whereas the opposite pattern was found for health preference. No difference was detected for perception of attractiveness. These perceptual effects were seen particularly on the forehead and cheeks. Removing skin topography cues (but not discolouration) in the periorbital area resulted in higher preferences for all three attributes. CONCLUSION: Skin surface topography and colouration cues affect perception of age, health, and attractiveness in men's faces. The combined removal of these features on the forehead, cheeks, and in the periorbital area results in the most positive assessments. This article is protected by copyright. All rights reserved. PMID: 29469966 [PubMed - as supplied by publisher]

Implicit attitudes toward eating stimuli differentiate eating disorder and non-eating disorder groups and predict eating disorder behaviors.

Related Articles Implicit attitudes toward eating stimuli differentiate eating disorder and non-eating disorder groups and predict eating disorder behaviors. Int J Eat Disord. 2018 Feb 22;: Authors: Smith AR, Forrest LN, Velkoff EA, Ribeiro JD, Franklin J Abstract OBJECTIVE: The current study tested whether people with and without eating disorders (EDs) varied in their implicit attitudes toward ED-relevant stimuli. Additionally, the study tested whether implicit evaluations of ED-relevant stimuli predicted ED symptoms and behaviors over a 4-week interval. METHOD: Participants were people without EDs (N = 85) and people seeking treatment for EDs (N = 92). All participants completed self-report questionnaires and a version of the affect misattribution procedure (AMP) at baseline. The AMP indexed implicit evaluations of average body stimuli, eating stimuli, and ED-symptom stimuli. Participants with EDs completed weekly follow-up measures of ED symptoms and behaviors for 4 weeks. RESULTS: Contrary to predictions, the anorexia nervosa (AN) group did not differ from the no ED group on implicit attitudes toward ED-symptom stimuli, and the bulimia nervosa (BN) group had less positive implicit attitudes toward ED-symptom stimuli relative to the no ED group. In line with predictions, people with AN and BN had more negative implicit attitudes toward average body and eating stimuli relative to the no ED group. In addition, among the ED group more negative implicit attitudes toward eating stimuli predicted ED symptoms and behaviors 4 weeks later, over and above baseline ED symptoms and behaviors. DISCUSSION: Taken together, implicit evaluations of eating stimuli differentiated people with AN and BN from people without EDs and longitudinally predicted ED symptoms and behaviors. Interventions that increase implicit liking of eating-related stimuli may reduce ED behaviors. PMID: 29469933 [PubMed - as supplied by publisher]

Importance of investing in adolescence from a developmental science perspective.

Related Articles Importance of investing in adolescence from a developmental science perspective. Nature. 2018 Feb 21;554(7693):441-450 Authors: Dahl RE, Allen NB, Wilbrecht L, Suleiman AB Abstract This review summarizes the case for investing in adolescence as a period of rapid growth, learning, adaptation, and formational neurobiological development. Adolescence is a dynamic maturational period during which young lives can pivot rapidly-in both negative and positive directions. Scientific progress in understanding adolescent development provides actionable insights into windows of opportunity during which policies can have a positive impact on developmental trajectories relating to health, education, and social and economic success. Given current global changes and challenges that affect adolescents, there is a compelling need to leverage these advances in developmental science to inform strategic investments in adolescent health. PMID: 29469094 [PubMed - in process]

The Role of Neurohypophyseal Hormones Vasopressin and Oxytocin in Neuropsychiatric Disorders.

Related Articles The Role of Neurohypophyseal Hormones Vasopressin and Oxytocin in Neuropsychiatric Disorders. Endocr Metab Immune Disord Drug Targets. 2018 Feb 19;: Authors: Iovino M, Messana T, De Pergola G, Iovino E, Dicuonzo F, Guastamacchia E, Giagulli VA, Triggiani V Abstract Although the neurohypophyseal hormones vasopressin and oxytocin are mostly known for their role respectively in antiduresis the former and in labour, lactation and maternal behavior the latter, both might exert widespread influences either on emotion and cognition in healthy subjects, showing some gender-related differences. They interact one each other facilitating shifts between positive socially- oriented and defensive states. In fact, vasopressin amplifies the reactivity to stressors showing also beneficial effects on attention, verbal learning as well as memory, whereas oxytocin reduces the amplitude of the stress response, improves emotion processing, and can play a negative effect on memory and verbal learning in healthy individuals. Several data indicate the possible involvement of this neuropeptides in the pathophysiology of psychiatric conditions involving social interactions, such as autism, as well as in schizophrenia and depression. Aim of this paper is to review the literature dealing with the role played by neurohypophyseal hormones in neuropsychiatric disorders. PMID: 29468985 [PubMed - as supplied by publisher]

Comparative Genetic Variability in HIV-1 Subtype C vpu Gene in Early Age Groups of Infants.

Related Articles Comparative Genetic Variability in HIV-1 Subtype C vpu Gene in Early Age Groups of Infants. Curr HIV Res. 2018 Feb 19;: Authors: Sharma U, Gupta P, Gupta S, Venkatesh S, Husain M Abstract OBJECTIVE: Identifying the genetic variability in vertically transmitted viruses in early infancy is important to understand the disease progression. Being important in HIV-1 disease pathogenesis, vpu gene, isolated from young infants was investigated to understand the viral characteristics. METHOD: Blood samples were obtained from 80 HIV-1 positive infants, categorized in two age groups; acute (<6 months) and early (>6-18 months). A total of 77 PCR positive samples, amplified for vpu gene, were sequenced and analyzed. RESULTS: 73 isolates belonged to subtype C. Analysis of heterogeneity of amino acid sequences in infant groups showed that in the sequences of acute age group both insertions and deletions were present while in the early age group only deletions were present. In the acute age group, a deletion of 3 residues (RAE) in the first alfa helix in one sequence and insertions of 1-2 residues (DM, GH, G and H) in the second alfa helix in 4 sequences were observed. In the early age group deletion of 2 residues (VN) in the cytoplasmic tail region in 2 sequences were observed. Length of the amino terminal was observed to be gradually increasing with the increasing age of the infants. Protein Variation Effect Analyzer software showed that deleterious mutations were more in the acute than the early age group. Entropy analysis revealed that heterogeneity of the residues was comparatively higher in the sequences of acute than the early age group. CONCLUSION: Mutations observed in the helixes may affect the conformation and lose the ability to degrade CD4 receptors. Heterogeneity was decreasing with the increasing ages of the infants indicating positive selection for robust virion survival. PMID: 29468970 [PubMed - as supplied by publisher]

Efficacy analysis of routine catheter tip cultures in a neonatal intensive care unit.

Related Articles Efficacy analysis of routine catheter tip cultures in a neonatal intensive care unit. Pediatr Int. 2018 Feb 22;: Authors: Kitano T, Takagi K, Arai I, Yasuhara H, Ebisu R, Ohgitani A, Kitagawa D, Oka M, Masuo K, Minowa H Abstract OBJECTIVES: Although routine catheter tip cultures are not recommended, previous reports have indicated that some cases of colonization, such as with S. aureus, can lead to subsequent bacteremia. To evaluate the safety of colonized cases without antimicrobial treatment, as well as the effectiveness of routine catheter tip cultures in the neonatal intensive care unit (NICU), we performed a retrospective data analysis in a Japanese community hospital. METHODS: We reviewed all peripherally inserted central venous catheter tip culture results from the NICU ward between April 2012 and June 2017 to determine whether they had antimicrobial treatments or subsequent infections. We then performed a cost analysis for routine catheter tip culturing on patients who were symptom-free during the study period. RESULTS: Of the 93 positive cases in 80 patients from 1,051 catheter tip cultures, 7 cases had suspected infections and were treated with antimicrobials. The other 73 symptom-free, positive cases had no subsequent or exacerbated symptoms to suggest they had an infection without antimicrobial treatment. The total cost for catheter tip culturing during the study period was 548,731 JPY. After excluding cases with symptoms of infection at the time of culturing, the efficacy of routine catheter tip cultures on symptom-free patients was estimated to be zero. CONCLUSION: Symptom-free colonization did not affect clinician management in this study, and all colonized cases without suspected infections were safely managed without antimicrobials. Furthermore, this study found that routine catheter tip culturing is not cost-effective; therefore, this practice may be no longer recommended in the NICU. This article is protected by copyright. All rights reserved. PMID: 29468780 [PubMed - as supplied by publisher]
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