Intrinsic religiosity buffers the longitudinal effects of peer victimization on adolescent depressive symptoms.

Peer victimization is a common and potentially detrimental experience for many adolescents. However, not all youth who are exposed to peer victimization experience maladaptive outcomes, such as depression. Thus, greater attention to potential moderators of peer victimization is particularly important. The current study examined the potential moderating effect of intrinsic religiosity and religious attendance on the longitudinal association between physical and relational victimization and depressive symptoms. A diverse sample of adolescents (N = 313; M(age) = 17.13 years; 54% female; 49% Caucasian, 24% African American, 19% Latino, 8% mixed race/other; 80% Christian religious affiliation) were recruited from a rural, low-income setting. Adolescents completed self-report measures of religious attendance and intrinsic religiosity, and two forms of victimization (i.e., physical and relational) were assessed using sociometric procedures in 11th grade. Depressive symptoms were measured in both 11th and 12th grade. Results suggest that relational victimization is associated prospectively with depressive symptoms only under conditions of adolescents' low intrinsic religiosity. Findings may contribute to efforts aimed at prevention and intervention among adolescents at risk for peer victimization and depression.

An unusual complication of PEG feeding after pancreatico-gastrostomy.

CONTEXT: We describe a late complication of the pancreatico-gastrostomy (PG) anastomosis following pancreatico-duodenectomy (PD). CASE REPORT: A percutaneous endoscopic gastrostomy (PEG) feeding tube was inserted many months post-operatively. In this patient activated pancreatic enzymes eroded the gastrostomy tract, resulting in pain, recurrent infection and eventual removal of the gastrostomy tube. CONCLUSIONS: Where surgical insertion of a feeding jejunostomy is not viable or deemed too high risk after Whipple or PPPD, we recommend careful consideration of PEG tube insertion in patients with PG reconstruction. If a PEG is used the prophylactic use of Lanreotide is recommended.

A Case of Multiple Self-Involuting, Mixed Presentation, Giant Congenital Juvenile Xanthogranuloma.

Juvenile xanthogranuloma (JXG) is an uncommon benign skin disorder of infants and young children characterized by dermal proliferation and infiltration of dendrocytes. We present a unique case of giant congenital JXG with a mixed presentation of macules, papules, nodules, and ulcerations in a neonatal male who was observed until the age of 23 months, by which time all lesions had spontaneously self-involuted. Prior to complete resolution, some lesions took the form of pedunculated protrusions. To our knowledge, this is the first of this atypical case to be presented in the literature.

Bone marrow stromal cells generate an osteoinductive microenvironment when cultured on titanium-aluminum-vanadium substrates with biomimetic multiscale surface roughness.

Osseointegration of titanium-based implants possessing complex macroscale/microscale/mesoscale/nanoscale (multiscale) topographies support a direct and functional connection with native bone tissue by promoting recruitment, attachment and osteoblastic differentiation of bone marrow stromal cells (MSCs). Recent studies show that the MSCs on these surfaces produce factors, including bone morphogenetic protein 2 (BMP2) that can cause MSCs not on the surface to undergo osteoblast differentiation, suggesting they may produce an osteogenic environmentin vivo. This study examined if soluble factors produced by MSCs in contact with titanium-aluminum-vanadium (Ti6Al4V) implants possessing a complex multiscale biomimetic topography are able to induce osteogenesis ectopically. Ti6Al4V disks were grit-blasted and acid-etched to create surfaces possessing macroscale and microscale roughness (MM), micro/meso/nanoscale topography (MN), and macro/micro/meso/nanoscale topography (MMNTM). Polyether-ether-ketone (PEEK) disks were also fabricated by machining to medical-grade specifications. Surface properties were assessed by scanning electron microscopy, contact angle, optical profilometry, and x-ray photoelectron spectroscopy. MSCs were cultured in growth media (GM). Proteins and local factors in their conditioned media (CM) were measured on days 4, 8, 10 and 14: osteocalcin, osteopontin, osteoprotegerin, BMP2, BMP4, and cytokines interleukins 6, 4 and 10 (IL6, IL4, and IL10). CM was collected from D14 MSCs on MMNTMand tissue culture polystyrene (TCPS) and lyophilized. Gel capsules containing active demineralized bone matrix (DBM), heat-inactivated DBM (iDBM), and iDBM + MMN-GM were implanted bilaterally in the gastrocnemius of athymic nude mice (N= 8 capsules/group). Controls included iDBM + GM; iDBM + TCPS-CM from D5 to D10 MSCs; iDBM + MMN-CM from D5 to D10; and iDBM + rhBMP2 (R&D Systems) at a concentration similar to D5-D10 production of MSCs on MMNTMsurfaces. Legs were harvested at 35D. Bone formation was assessed by micro computed tomography and histomorphometry (hematoxylin and eosin staining) with the histology scored according to ASTM 2529-13. DNA was greatest on PEEK at all time points; DNA was lowest on MN at early time points, but increased with time. Cells on PEEK exhibited small changes in differentiation with reduced production of BMP2. Osteoblast differentiation was greatest on the MN and MMNTM, reflecting increased production of BMP2 and BMP4. Pro-regenerative cytokines IL4 and IL10 were increased on Ti-based surfaces; IL6 was reduced compared to PEEK. None of the media from TCPS cultures was osteoinductive. However, MMN-CM exhibited increased bone formation compared to iDBM and iDBM + rhBMP2. Furthermore, exogenous rhBMP2 alone, at the concentration found in MMN-CM collected from D5 to D10 cultures, failed to induce new bone, indicating that other factors in the CM play a critical role in that osteoinductive microenvironment. MSCs cultured on MMNTMTi6Al4V surfaces differentiate and produce an increase in local factors, including BMP2, and the CM from these cultures can induce ectopic bone formation compared to control groups, indicating that the increased bone formation arises from the local response by MSCs to a biomimetic, multiscale surface topography.

Cognitive inflexibility as a prospective predictor of suicidal ideation among young adults with a suicide attempt history.

BACKGROUND: Previous studies suggest that people attempt suicide because they are cognitively inflexible, but past research suggesting a link between cognitive inflexibility and suicidal thoughts and behavior has been limited by cross-sectional designs. This study examined whether cognitive inflexibility differentially and prospectively predicted suicidal ideation among young adults with and without a history of a suicide attempt. METHODS: A sample of 45 young adults with (n = 13) or without (n = 32) a suicide attempt history completed the Wisconsin Card Sorting Test (WCST), a diagnostic interview, and self-report measures of hopelessness, depressive symptoms, and suicidal ideation, and were followed up 6 months later to reassess suicidal ideation. RESULTS: Cognitive inflexibility, as measured by perseverative errors on the WCST, predicted suicidal ideation at 6-month follow-up, among suicide attempters, but not among nonattempters, adjusting for the presence of a baseline mood or anxiety diagnosis, hopelessness, and baseline suicidal ideation. CONCLUSIONS: Cognitive inflexibility may increase vulnerability to suicidal ideation over time among individuals with a previous suicide attempt history. Implications for interventions with suicide attempters are discussed.

Evidence for ligand non-innocence in a formally ruthenium(I) hydride complex.

Formally zerovalent, dinitrogen-bridged ruthenium complex, {[N(3)(Xyl)]Ru}(2)(mu-eta(1):eta(1)-N(2)) (1), where [N(3)(Xyl)] = 2,6-(XylN horizontal lineCMe)(2)C(5)H(3)N, reacts with excess H(2) to give the binuclear hydride species, {[N(3)]Ru(H)}(2)(mu-eta(1):eta(1)-N(2)) (2) bearing a single hydrogen per ruthenium. Complex 2 is an unusual example of a structurally characterized paramagnetic transition metal hydride, and the first such example for ruthenium. Structural data and DFT calculations suggest unpaired electron density is strongly delocalized onto the non-innocent [N(3)] ligand, with a relatively small degree of the metalloradical character implied by the Ru(I) formal oxidation state, and that the [N(3)](-)/Ru(II) formalism may be more informative. Consistent with an effective oxidation state greater than Ru(I), further reaction of 2 with excess H(2) to give metal dihydride species ([N(3)]RuH(2)(L)) is not observed. The magnetic moment of 2 (3.50 mu(B)) in solution is consistent with one unpaired electron per [N(3)]Ru moiety; however, 2 is diamagnetic in the solid due to close (3.26 A) head-to-tail contact between Ru pyridine planes of neighboring molecules. Although the geometry is reminiscent of the weak "pi-stacking" observed for closed-shell aromatic ring systems, DFT calculations indicate the structure and associated spin pairing result from in-phase overlap of the delocalized SOMOs on neighboring molecules-that is the interaction is best viewed as a weak covalent bond delocalized over 22 atoms.

Using telemedicine to improve access, cost and quality of secondary care for people in prison in England: a hybrid type 2 implementation effectiveness study.

INTRODUCTION: People in prison tend to experience poorer health, access to healthcare services and health outcomes than the general population. Use of video consultations (telemedicine) has been proven effective at improving the access, cost and quality of secondary care for prisoners in the USA and Australia. Implementation and use in English prison settings has been limited to date despite political drivers for change. We plan to research the implementation of a new prison-hospital telemedicine model in an English county to understand what factors drive or hinder implementation and whether the model can improve healthcare outcomes as demonstrated in other contextual settings. METHODS AND ANALYSIS: We will undertake a hybrid type 2 implementation effectiveness study to gather evidence on both clinical and implementation outcomes. Data collection will be guided by the theoretical constructs of Normalisation Process Theory. We will prospectively collect data through: (1) prisoner/patient focus groups, interviews and questionnaires, (2) prison healthcare, hospital and wider prison staff interviews and questionnaires, (3) routine quality improvement and service evaluation data. Up to four prisons and three hospital settings in Surrey (England) will be included in the telemedicine research, dependent on their telemedicine readiness during the study period. Prisons proposed include male and female prisoners, remand (not yet sentenced) and sentenced individuals and different security categorisations. In addition, focus groups in five telemedicine naïve prisons will provide information on patient preconceptions and concerns surrounding telemedicine. ETHICS AND DISSEMINATION: This study has received National Health Service Research Ethics Committee, Her Majesty's Prison and Probation Service National Research Committee and Health Research Authority approval. Dissemination of results will take place through peer-reviewed journals, conferences and existing health and justice networks.

Psychometric functions for ternary odor mixtures and their unmixed components.

People are often able to reliably detect a mixture of 2 or more odorants, even if they cannot reliably detect the individual mixture components when presented individually. This phenomenon has been called mixture agonism. However, for some mixtures, agonism among mixture components is greater in barely detectable mixtures than in more easily detectable mixtures (level dependence). Most studies that have used rigorous methods have focused on simple, 2-component (binary) mixtures. The current work takes the next logical step to study detection of 3-component (ternary) mixtures. Psychometric functions were measured for 5 unmixed compounds and for 3 ternary mixtures of these compounds (2 of 5, forced-choice method). Experimenters used air dilution olfactometry to precisely control the duration and concentration of stimuli and used gas chromatography/mass spectrometry to verify vapor-phase concentrations. For 2 of the 3 mixtures, agonism was approximately additive in general agreement with similar work on binary mixtures. A third mixture was no more detectable than the most detectable component, demonstrating a lack of agonism. None of the 3 mixtures showed evidence of level dependence. Agonism may be common in ternary mixtures, but general rules of mixture interaction have yet to emerge. For now, detection of any mixture must be measured empirically.

Meeting Complex Needs Through Community Collaboration: a Case Study.

This case study focuses on complex trauma in a refugee family. It explores the barriers faced while supporting a family presenting with complex and multifaceted needs. It reviews the roles, processes and participation of practitioners from Service Coordination (case management) and Treatment (therapeutic intervention) perspectives. This case study also examines the gaps in existing services for new immigrant and refugee populations within a community and provides recommendations for closing these gaps.

Human mesenchymal stem cell morphology, migration, and differentiation on micro and nano-textured titanium.

Orthopedic implants rely on facilitating a robust interaction between the implant material surface and the surrounding bone tissue. Ideally, the interface will encourage osseointegration with the host bone, resulting in strong fixation and implant stability. However, implant failure can occur due to the lack of integration with bone tissue or bacterial infection. The chosen material and surface topography of orthopedic implants are key factors that influence the early events following implantation and may ultimately define the success of a device. Early attachment, rapid migration and improved differentiation of stem cells to osteoblasts are necessary to populate the surface of biomedical implants, potentially preventing biofilm formation and implant-associated infection. This article explores these early stem cell specific events by seeding human mesenchymal stem cells (MSCs) on four clinically relevant materials: polyether ether ketone (PEEK), Ti6Al4V (smooth Ti), macro-micro rough Ti6Al4V (Endoskeleton®), and macro-micro-nano rough Ti6Al4V (nanoLOCK®). The results demonstrate the incorporation of a hierarchical macro-micro-nano roughness on titanium produces a stellate morphology typical of mature osteoblasts/osteocytes, rapid and random migration, and improved osteogenic differentiation in seeded MSCs. Literature suggests rapid coverage of a surface by stem cells coupled with stimulation of bone differentiation minimizes the opportunity for biofilm formation while increasing the rate of device integration with the surrounding bone tissue.

Endplate Deformation Due to Open and Strutted Intervertebral Devices.

BACKGROUND: There is an absence of work on vertebral endplate response to peripheral loading following disc removal and interbody placement. Endplate deflection into the interbody space may impart beneficial strain on the developing fusion mass, influencing bone formation and remodeling. The aim of this study was to verify endplate deformation due to peripheral loading using a custom transducer and to investigate whether endplate motion is inhibited by implant design. METHODS: A total of 14 porcine (L4, L5) vertebrae were assigned to open or strutted implant designs. A custom transducer was placed on the endplate while 500 N was applied to the implant at 1 Hz for 500 cycles. Endplate motion was acquired for each time point and averaged among specimens of the same design. The rates and magnitudes of endplate deformation were compared between implant designs using unpaired t tests. RESULTS: Peripheral loading of both implant designs resulted in endplate deflection into the interbody space. The open implant design demonstrated an increased rate and magnitude of endplate deformation when compared with strutted implants. CONCLUSION: Interbody cage design directly influences the dynamic motion of the vertebral endplate during cyclic loading. A larger, faster deflection of the endplate could increase the strain rate, duration, and magnitude on the developing interbody fusion mass. These parameters of dynamic strain have been correlated with increased bone formation and remodeling. CLINICAL RELEVANCE: Unimpeded endplate deformation in an open cage design could impart a strain pattern on the developing fusion mass that increases bone formation and remodeling, ultimately leading to a faster and stronger fusion.

Synergistic mixture interactions in detection of perithreshold odors by humans.

Laboratory demonstrations of synergistic mixture interactions in human odor perception have been rare. The current study examined perithreshold mixture interactions between maple lactone (ML) and selected carboxylic acids. An air-dilution olfactometer allowed precise stimulus control. Experimenters measured stimulus concentrations in vapor phase using a combination of solid-phase microextraction and gas chromatography/mass spectrometry. A probability of detection versus concentration, or a psychometric, functions was measured for pure ML. Psychometric functions were also measured for ML with the addition of fixed, subthreshold concentrations of carboxylic acids. Relative to statistical independence in detection, clear synergy occurred over a range of ML concentrations. To the best of our knowledge, the current results constitute the first clear demonstration of synergy in odor detection by humans from an experiment that combined precise stimulus control, vapor-phase calibration of stimuli, and a clear statistical definition of synergy.

Surveillance and management of upper gastrointestinal disease in Familial Adenomatous Polyposis.

Almost all patients affected by Familial Adenomatous polyposis (FAP) will develop foregut as well as hindgut polyps, and following prophylactic colectomy duodenal cancer constitutes one of the leading causes of death in screened populations. Without prophylactic colectomy, FAP patients predictably develop colorectal cancer, but the lifetime risk of upper gastrointestinal cancer is lower, estimated at approximately 5%. Management of the upper gastrointestinal cancer risk is one of the greatest challenges facing clinicians involved in the care of Polyposis families, and with improved survival following prophylactic colectomy, the burden of foregut disease (particularly duodenal adenomatosis) will increase. Until recently, the value of upper gastrointestinal surveillance in FAP populations has been contentious, but with improved understanding of the natural history coupled with developments in surgery, interventional endoscopy and medical therapy, treatment algorithms for duodenal adenomatosis in FAP are becoming clearer.

Synthesis and Characterization of Tetrahydrofurfurylcyclopentadienyl Molybdenum Tricarbonyl Dimer: Evidence for 19-Electron Intramolecular "Solvento" Interactions.

The synthesis and characterization of a THF pendant, dimeric Mo cyclopentadienyl complex is reported and the structure characterized by NMR, FTIR, and UV-vis spectroscopies. The dimer was found to undergo metal-metal bond homolysis under either photochemical or electrochemical conditions to yield an odd-electron complex. Cyclic voltammetry under varying scan rate conditions from 25 to 10 000 mV/s demonstrates a dynamic equilibrium process that we assign to the formation of either an intramolecular 19-electron (18 + delta) complex or a bare 17-electron complex. Photolysis of the dimer in room temperature solution could be monitored as a loss of the dpi-dsigma transition at 503 nm by transient absorption spectroscopy. The recovery of the transient absorption signal at 410 nm follows first-order kinetics at a rate of 5 x 10(3) s(-1).

Social anxiety symptoms and suicidal ideation in a clinical sample of early adolescents: examining loneliness and social support as longitudinal mediators.

Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12-15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived social support were assessed via structured interviews and self-report instruments. Structural equation modeling revealed a significant direct relationship between social anxiety symptoms at baseline and suicidal ideation at 18 months post-baseline, even after controlling for baseline depressive symptoms and ideation. A second multiple mediation model revealed that baseline social anxiety had a significant indirect effect on suicidal ideation at 18 months post-baseline through loneliness at 9 months post-baseline. Social anxiety did not have a significant indirect effect on suicidal ideation through perceived social support from either parents or close friends. Findings suggest that loneliness may be particularly implicated in the relationship between social anxiety and suicidality in teens. Clinicians should assess and address feelings of loneliness when treating socially anxious adolescents.

Adult attachment, emotion dysregulation, and symptoms of depression and generalized anxiety disorder.

Differences in attachment style have been linked to both emotion regulation and psychological functioning, but the emotion regulatory mechanism through which attachment style might impact symptoms of depression and anxiety is unclear. The present study examined the explanatory role of emotion dysregulation in the relation between adult attachment style and symptoms of depression and generalized anxiety disorder (GAD) in a sample of 284 adults. Secure attachment was associated with lower depression and GAD symptoms and lower emotion dysregulation, whereas insecure attachment styles were generally associated with higher depression and GAD scores and higher emotion dysregulation. Perceived inability to generate effective emotion regulation strategies mediated the relation between insecure attachment and both depression and GAD symptoms. Nonacceptance of negative emotions and inability to control impulsive behaviors emerged as additional mediators of the relation between insecure attachment styles and GAD symptoms. The differential contribution of attachment style and emotion regulation to the prediction of depression and GAD symptoms may reflect differences in vulnerability to depression and GAD.

Cognitive inflexibility and suicidal ideation: mediating role of brooding and hopelessness.

Previous research suggests that cognitive inflexibility prospectively increases vulnerability to suicidal ideation, but the specific cognitive factors that may explain the relation have not been examined empirically. The present study examined the brooding subtype of rumination and hopelessness as potential mediators of the prospective relation between cognitive inflexibility and suicidal ideation. Fifty-six young adults who completed a measure of cognitive inflexibility and suicidal ideation at baseline were followed up 2-3 years later and completed measures of brooding, hopelessness, and suicidal ideation. Cognitive inflexibility at baseline predicted suicidal ideation at follow up, adjusting for baseline ideation. This relation was mediated by brooding but not by hopelessness. However, there was an indirect relation between perseverative errors and suicidal ideation through brooding, followed by hopelessness, such that brooding was associated with greater hopelessness and hopelessness, in turn, was associated with greater suicidal ideation. Cognitive inflexibility may increase vulnerability to suicidal thinking because it is associated with greater brooding rumination, while brooding, in turn, is associated with hopelessness.

Volatile biomarkers from human melanoma cells.

Dogs can identify, by olfaction, melanoma on the skin of patients or melanoma samples hidden on healthy subjects, suggesting that volatile organic compounds (VOCs) from melanoma differ from those of normal skin. Studies employing gas chromatography-mass spectrometry (GC-MS) and gas sensors reported that melanoma-related VOCs differed from VOCs from normal skin sources. However, the identities of the VOCs that discriminate melanoma from normal skin were either unknown or likely derived from exogenous sources. We employed solid-phase micro-extraction, GC-MS and single-stranded DNA-coated nanotube (DNACNT) sensors to examine VOCs from melanoma and normal melanocytes. GC-MS revealed dozens of VOCs, but further analyses focused on compounds most likely of endogenous origin. Several compounds differed between cancer and normal cells, e.g., isoamyl alcohol was higher in melanoma cells than in normal melanocytes but isovaleric acid was lower in melanoma cells. These two compounds share the same precursor, viz., leucine. Melanoma cells produce dimethyldi- and trisulfide, compounds not detected in VOCs from normal melanocytes. Furthermore, analyses of the total volatile metabolome from both melanoma cells and normal melanocytes by DNACNT sensors, coupled with the GC-MS results, demonstrate clear differences between these cell systems. Consequently, monitoring of melanoma VOCs has potential as a useful screening methodology.