Pro-anorexia coaches prey on individuals with eating disorders.

OBJECTIVE: While studies have focused on pro-ana communities and pro-anorexia websites, no research has been conducted on the presence of pro-anorexia coaches within these communities. This study aimed to gain insight into the modus operandi of pro-anorexia coaches. METHOD: First, three fake profiles were used to attempt interaction with pro-anorexia coaches (n = 31). Second, an online questionnaire on experiences with pro-anorexia coaches was completed by 79 respondents. Third, a follow-up in-depth interview was conducted with 14 of these respondents. RESULTS: The results show that pro-anorexia coaches' behavior fits a five-staged model which has similarities to stages of online grooming. They focus on (1) building trust and developing a dependency relationship with the aim of (2) obtaining sexually explicit materials. Subsequently, they (3) increase pressure, (4) utilize blackmail methods with acquired content, and (5) groom respondents to meet in person. DISCUSSION: Pro-anorexia coaches deliberately abuse vulnerable young people who suffer from eating disorders to receive sexually explicit material or to meet face-to-face with a sexual intention. This study shows that the modus operandi of pro-ana coaches is similar to online grooming. Clinical professionals need to be aware of this practice to detect victims and potential victims in order to support and treat them. Prevention is invaluable to further combat pro-anorexia coaches and protect potential victims. PUBLIC SIGNIFICANCE: Individuals with an eating disorder are avid internet users. A minority frequent pro-anorexia websites and fora seeking help in losing weight. This study showed that pro-anorexia coaches prey on these individuals, often to obtain sexually explicit content. The modus operandi of pro-anorexia coaches shows similarities to online grooming. Awareness of this phenomenon and the way in which pro-anorexia coaches operate is valuable for clinicians, parents, and teachers.

Retinal ganglion cell loss and gliosis in the retinofugal projection following intravitreal exposure to amyloid-beta.

Pathological accumulations of amyloid-beta (Aß) peptide are found in retina early in Alzheimer's disease, yet its effects on retinal neuronal structure remain unknown. To investigate this, we injected fibrillized Aß1-42 protein into the eye of adult C57BL/6 J mice and analyzed the retina, optic nerve (ON), and the superior colliculus (SC), the primary retinal target in mice. We found that retinal Aß exposure stimulated microglial activation and retinal ganglion cell (RGC) loss as early as 1-week post-injection. Pathology was not limited to the retina, but propagated into other areas of the central nervous system. Microgliosis spread throughout the retinal projection (retina, ON, and SC), with multiplex protein quantitation demonstrating an increase in endogenously produced Aß in the ON and SC corresponding to the injected retinas. Surprisingly, this pathology spread to the opposite side, with unilateral Aß eye injections driving increased Aß levels, neuroinflammation, and RGC death in the opposite, un-injected retinal projection. As Aß-mediated microglial activation has been shown to propagate Aß pathology, we also investigated the role of the Aß-binding microglial scavenger receptor CD36 in this pathology. Transgenic mice lacking the CD36 receptor were resistant to Aß-induced inflammation and RGC death up to 2 weeks following exposure. These results indicate that Aß pathology drives regional neuropathology in the retina and does not remain isolated to the affected eye, but spreads throughout the nervous system. Further, CD36 may serve as a promising target to prevent Aß-mediated inflammatory damage.

Post-operative enteral immunonutrition for gynecologic oncology patients undergoing laparotomy decreases wound complications.

OBJECTIVES: The aim of this study is to determine if peri-operative immune modulating dietary supplements decrease wound complications in gynecologic oncology patients undergoing laparotomy. METHODS: In July 2013 we instituted a practice change and recommended pre- and post-operative oral immune modulating diets (IMDs) to patients undergoing laparotomy. We retrospectively compared patients who received IMDs to those who did not for the study period July 2012 to June 2014. Our outcome of interest was the frequency of Centers for Disease Control surgical site infections (CDC SSIs). RESULTS: Of the 338 patients who underwent laparotomy during the study period, 112 (33%) received IMDs post-operatively. There were 89 (26%) wound complications, including 69 (78%) CDC SSI class 1, 7(8%) class 2 and 13(15%) class 3. Patients receiving IMDs had fewer wound complications than those who did not (19.6% vs. 33%, p=0.049). After controlling for variables significantly associated with the development of a wound complication (ASA classification, body mass index (BMI), history of diabetes mellitus or pelvic radiation, length of surgery and blood loss) consumption of IMDs remained protective against wound complications (OR 0.45, CI 0.25-0.84, p=0.013) and was associated with a 78% reduction in the incidence of CDC SSI class 2 and 3 infections (OR=0.22, CI 0.05-0.95, p=0.044). CONCLUSIONS: Post-operative IMDs are associated with fewer wound complications in patients undergoing laparotomy for gynecologic malignancy and may reduce the incidence of CDC SSI class 2 and 3 infections.

Hospital-acquired Clostridium difficile infection: determinants for severe disease.

Risk factors of severity (need for surgical intervention, intensive care or fatal outcome) were analysed in hospital-acquired Clostridium difficile infection (CDI) in a 777-bed community hospital. In a prospective analytical cross-sectional study, age (≥ 65 years), sex, CDI characteristics, underlying diseases, severity of comorbidity and PCR ribotypes were tested for associations with severe CDI. In total, 133 cases of hospital-acquired CDI (mean age 74.4 years) were identified, resulting in an incidence rate of 5.7/10,000 hospital-days. A recurrent episode of diarrhoea occurred in 25 cases (18.8%) and complications including toxic megacolon, dehydration and septicaemia in 69 cases (51.9%). Four cases (3.0%) required ICU admission, one case (0.8%) surgical intervention and 22 cases (16.5%) died within the 30-day follow-up period. Variables identified to be independently associated with severe CDI were severe diarrhoea (odds ratio [OR] 3.64, 95% confidence interval [CI] 1.19-11.11, p=0.02), chronic pulmonary disease (OR 3.0, 95% CI 1.08-8.40, p=0.04), chronic renal disease (OR 2.9, 95% CI 1.07-7.81, p=0.04) and diabetes mellitus (OR 4.30, 95% CI 1.57-11.76, p=0.004). The case fatality of 16.5% underlines the importance of increased efforts in CDI prevention, in particular for patients with underlying diseases.

Glucocorticoids for the treatment of anaphylaxis: Cochrane systematic review.

BACKGROUND: Anaphylaxis is a serious hypersensitivity reaction that is rapid in onset and may result in death. A number of guidelines recommend glucocorticoids for the treatment of people experiencing anaphylaxis. OBJECTIVES: We sought to assess the benefits and harms of glucocorticoid treatment during episodes of anaphylaxis. METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 3), MEDLINE (Ovid) (1966 to September 2009), EMBASE (Ovid) (1988 to September 2009), CINAHL (EBSCOhost) (to September 2009) and The Science Citation Index Expanded (SCI-EXPANDED) (1945 to September 2009). We also searched the UK National Research Register and websites listing ongoing trials and contacted international experts in anaphylaxis in an attempt to locate unpublished material. We sought to include randomized and quasi-randomized controlled trials comparing glucocorticoids with any control (either placebo, adrenaline (epinephrine), an antihistamine, or any combination of these). Two authors independently assessed articles for inclusion. RESULTS: None of the 2496 reports identified satisfied the inclusion criteria. CONCLUSIONS: We conclude that there is no evidence from high-quality studies for the use of steroids in the emergency management of anaphylaxis. Therefore, we can neither support nor refute the use of these drugs for this purpose.

Systematics of early and middle Miocene Old World monkeys.

New information about the early cercopithecoids Prohylobates tandyi (Wadi Moghra, Egypt) and Prohylobates sp. indet. (Buluk and Nabwal, Kenya) is presented. Comparisons are made among all major collections of Early and Middle Miocene catarrhine monkeys, and a systematic revision of the early Old World monkeys is provided. Previous work involving the systematics of early Old World monkeys (Victoriapithecidae; Cercopithecoidea) has been hampered by a number of factors, including the poor preservation of Prohylobates material from North Africa and lack of comparable anatomical parts across collections. However, it is now shown that basal cercopithecoid species from both northern and eastern Africa can be distinguished from one another on the basis of degree of lower molar bilophodonty, relative lower molar size, occlusal details, symphyseal construction, and mandibular shape. Results of particular interest include: 1) the first identification of features that unambiguously define Prohylobates relative to Victoriapithecus; 2) confirmation that P. tandyi is incompletely bilophodont; and 3) recognition of additional victoriapithecid species.

Dental microwear texture analysis of two families of subfossil lemurs from Madagascar.

This study employs dental microwear texture analysis to reconstruct the diets of two families of subfossil lemurs from Madagascar, the archaeolemurids and megaladapids. This technique is based on three-dimensional surface measurements utilizing a white-light confocal profiler and scale-sensitive fractal analysis. Data were recorded for six texture variables previously used successfully to distinguish between living primates with known dietary differences. Statistical analyses revealed that the archaeolemurids and megaladapids have overlapping microwear texture signatures, suggesting that the two families occasionally depended on resources with similar mechanical properties. Even so, moderate variation in most attributes is evident, and results suggest potential differences in the foods consumed by the two families. The microwear pattern for the megaladapids indicates a preference for tougher foods, such as many leaves, while that of the archaeolemurids is consistent with the consumption of harder foods. The results also indicate some intraspecific differences among taxa within each family. This evidence suggests that the archaeolemurids and megaladapids, like many living primates, likely consumed a variety of food types.

Subcellular localization of the b-cytochrome component of the human neutrophil microbicidal oxidase: translocation during activation.

We describe a new method for subcellular fractionation of human neutrophils. Neutrophils were disrupted by nitrogen cavitation and the nuclei removed by centrifugation. The postnuclear supernatant was applied on top of a discontinuous Percoll density gradient. Centrifugation for 15 min at 48,000 g resulted in complete separation of plasma membranes, azurophil granules, and specific granules. As determined by ultrastructure and the distribution of biochemical markers of these organelles, approximately 90% of the b-cytochrome in unstimulated cells was recovered from the band containing the specific granules and was shown to be in or tightly associated with the membrane. During stimulation of intact neutrophils with phorbol myristate acetate or the ionophore A23187, we observed translocation of 40-75% of the b-cytochrome to the plasma membrane. The extent of this translocation closely paralleled release of the specific granule marker, vitamin B12-binding protein. These data indicate that the b-cytochrome is in the membrane of the specific granules of unstimulated neutrophils and that stimulus-induced fusion of these granules with the plasma membrane results in a translocation of the cytochrome. Our observations provide a basis for the assembly of the microbicidal oxidase of the human neutrophil.

Human origins.

New discoveries combine to indicate that all the major steps in human evolution took place in Africa. Skeletal analysis of oldest human forbears around 3 million years ago reveal many anatomical similarities to African Great Apes. These and biochemical resemblances indicate a common ancestry for humans and apes, perhaps only a few million years earlier. Enlarged knowledge through recent recovery of skeletons of several successive stages in the line leading to modern peoples shows that many attributes or skills by which we define humanity arose much more recently in time than heretofore believed.

Discovery of the oldest known anthropoidean skull from the paleogene of Egypt.

A group of primate fossils newly discovered in the Fayum badlands of Egypt is probably of Eocene age. The site is much older than the localities of previously known Egyptian early Tertiary primates. These finds include a crushed cranium that is the oldest skull found to date of a higher primate. This skull shows four characteristics of higher primates: a catarrhine dental formula, an ectotympanic at the rim of the auditory bulla, a fused frontal bone, and postorbital closure. Details of tooth structure (premolars and molars) and a possibly unfused mandibular symphysis resemble these parts in certain Eocene prosimians.

Skulls and anterior teeth of Catopithecus (primates:Anthropoidea) from the Eocene and anthropoid origins.

Recent finds of Catopithecus browni at an upper Eocene fossil site in the Fayum depression, Egypt, reveal features of the earliest higher primates. This basal anthropoidean shows a set of derived cranial and dental features that first occur in combination in this fossil. Old World Anthropoidea or Catarrhini can now be traced back to Catopithecus in Egypt. Size, shape, orientation of incisors and canines, and other features of the teeth and skull relate Catopithecus both to later Anthropoidea and to the early and middle Eocene cercamoniine adapoids. Most defining characteristics of higher primates cannot be documented earlier than the late Eocene of Africa.

A gorilla-sized ape from the miocene of India.

A large ape existed in India at the close of the Miocene or the beginning of the Pliocene epochs; this ape shows a complex of anatomical structures at the opposite pole from its contemporary, Ramapithecus. Although found in the same beds, the two seldom occur at the same exact sites and levels. Considering the thickness of these beds, recovery close to Haritalyangar does not, of itself, prove sympatry of these two different kinds of Hominoidea. However, both are definitely present at one recently located site representing, most probably, a death assemblage. Observations by the authors on scores of chimpanzees suggest that, at least in this ape, wear gradients on molar crowns exist, but that the wear differential between adjacent molars is almost never raised to the degree seen in most Ramapithecus. Dryopithecus itdicus and D. fontani (from southern France), in contrast, show almost no wear gradient at all; that is, whether an individual is dentally young or old, wear on all three molars and the two premolars has proceeded to about the same degree. It is of considerable importance in understanding hominid phylogeny to be able to stress that an ape known to be contemporary with Ramapithecus shows far less differential wear than does the hominid. This, in turn, strongly suggests that the molar eruption sequence of D. indicus was rapid, while that of the hominid was delayed. The implication is that, as far back as the late Miocene, the hominid maturation period was lengthened, relative to that of apes. A further fact which emerges is that the rate of interstitial wear was faster in the Haritalyangar ape than in the hominid contemporary with it. This, together with its large size, flatness of unworn tooth crowns, and other associated characters, suggests that D. indicus is in, or close to, the ancestry of Gigantopithecus. From this emerges yet another object lesson, emphasizing the caution one has to observe in the manner and method by which ancient and modern apes are compared and contrasted. None of the species of Hominoidea dealt with here, whether pongid (D. indicus and Pan troglodytes) or hominid (R. punjabicus), accumulates either interstitial or crown wear at the same rate or in the same manner.

Hind limbs of eocene basilosaurus: evidence of feet in whales.

New specimens of middle Eocene Basilosaurus isis from Egypt include the first functional pelvic limb and foot bones known in Cetacea. These are important in corroborating the intermediate evolutionary position of archaeocetes between generalized Paleocene land mammals that used hind limbs in locomotion and Oligocene-to- Recent whales that lack functional pelvic limbs. The foot is paraxonic, consistent with derivation from mesonychid Condylarthra. Hind limbs of Basilosaurus are interpreted as copulatory guides.

Ape limb bone from the oligocene of Egypt.

An ulna attributed to Aegyptopithecus zeuxis provides the first evidence for interpreting the locomotor behavior of the earliest apes. The fossil indicates that Aegyptopithecus was an arboreal quadruped and that the primitive hominoid locomotor pattern was most nearly analogous, among living primates, to that of Alouatta, the howler monkey.

Age of the earliest african anthropoids.

The earliest fossil record of African anthropoid primates (monkeys and apes) comes from the Jebel Qatrani Formation in the Fayum depression of Egypt. Reevaluation of both geologic and faunal evidence indicates that this formation was deposited in the early part of the Oligocene Epoch, more than 31 million years ago, earlier than previous estimates. The great antiquity of the fossil higher primates from Egypt accords well with their primitive morphology compared with later Old World higher primates. Thus, the anthropoid primates and hystricomorph rodents from Fayum are also considerably older than the earliest higher primates and rodents from South America.

Targeted therapies for ROS1-rearranged non-small cell lung cancer.

ROS1 gene fusions account for approximately 1-2% of all cases of non-small cell lung cancer (NSCLC). Similarly to anaplastic lymphoma kinase (ALK)-positive NSCLC, patients with ROS1+ NSCLC tend to have minimal smoking and be of the female sex. In most cases, adenocarcinoma is the dominant histology. The ROS1 gene has homology to ALK and this structural similarity formed the basis for utilizing ALK inhibitors for ROS1+ NSCLC. On the basis of impressive progression-free survival of 19.2 months from the PROFILE 1001 trial, crizotinib obtained Food and Drug Administration (FDA) approval as first-line therapy for treatment of ROS1+ NSCLC. Since then, there has been a growing appreciation of the incidence of brain metastases in ROS1+ NSCLC and rates of central nervous system progression on crizotinib. Additionally, appreciation of novel resistance mechanisms to crizotinib has led to the development of newer tyrosine kinase inhibitors (TKIs). In this review, we highlight known and emerging TKIs for the management of ROS1+ NSCLC.

A genome-wide linkage scan in a Dutch family identifies a premature ovarian failure susceptibility locus.

BACKGROUND: Premature ovarian failure (POF) is characterized by elevated gonadotrophins and amenorrhea before the age of 40 years and occurs approximately in 1% of women. POF etiology is highly heterogeneous with a wide spectrum of etiological pathogenic mechanisms including genetic causes. These mostly involve numerical, structural or monogenic defects on the X-chromosome. Mutations in a small number of autosomal genes (such as FOXL2 and NOBOX) have been identified as a cause of POF. However, in most cases, the disease underlying mechanisms are largely unknown. METHODS: We performed a genome-wide linkage analysis in a relatively large Dutch family with seven patients suffering from POF, showing a dominant pattern of inheritance. A genome-wide analysis, using 50K single nucleotide polymorphism arrays, was combined with conventional parametric linkage analysis. RESULTS: We identified three genomic regions on chromosomes 5, 14 and 18 yielding suggestive linkage (multipoint LOD score of 2.4 for each region). After inclusion of one elder unaffected family member, only the region on chromosome 5 remains as a putative POF locus. In addition, we investigated a second family (three living patients over three generations) for the regions on chromosome 5, 14 and 18. Haplotype analysis supported only the locus on chromosome 5q14.1-q15. CONCLUSION: We performed the first genome-wide linkage search in familial POF and identified a region on chromosome 5q14.1-q15, which may harbor a novel POF susceptibility gene.

Misdiagnosis of asthma in schoolchildren.

BACKGROUND: A correct diagnosis of asthma is the cornerstone of asthma management. Few pediatric studies have examined the accuracy of physician-diagnosed asthma. OBJECTIVES: We determined the accuracy of parent reported physician-diagnosed asthma in children sampled from a community cohort. METHODS: Nested case-control study that recruited 203 children, aged 9-12, from a community-based sample. Three groups were recruited: asthma cases had a parental report of physician-diagnosed asthma, symptomatic controls had respiratory symptoms without a diagnosis of asthma, and asymptomatic controls had no respiratory symptoms. All participants were assessed and assigned a clinical diagnosis by one of three study physicians, and then completed spirometry, methacholine challenge, and allergy skin testing. The reference standard of asthma required a study physician's clinical diagnosis of asthma and either reversible bronchoconstriction or a positive methacholine challenge. Diagnostic accuracy, sensitivity and specificity were calculated for parent-reported asthma diagnosis compared to the reference standard. RESULTS: One hundred two asthma cases, 52 controls with respiratory symptoms but no asthma diagnosis, and 49 asymptomatic controls were assessed. Physician agreement for the diagnosis of asthma was moderate (kappa 0.46-0.81). Compared to the reference standard, 45% of asthma cases were overdiagnosed and 10% of symptomatic controls were underdiagnosed. Parental report of physician-diagnosed asthma had 75% sensitivity and 92% specificity for correctly identifying asthma. CONCLUSIONS: There is significant misclassification of childhood asthma when the diagnosis relies solely on a clinical history. This study highlights the importance of objective testing to confirm the diagnosis of asthma. Pediatr Pulmonol. 2017;52:293-302. © 2016 Wiley Periodicals, Inc.