In obese hypertensives cholecalciferol inhibits circulating TH17 cells but not macrophage infiltration on adipose tissue.

In arterial hypertension, increased Th17 cells and reduced Tregs are the hallmarks of immunological dysfunction and the basis for the investigation of immunomodulatory drugs. Although cholecalciferol is not a primary immunomodulator, it has recognized action on immune cells, leading us to hypothesise if cholecalciferol can induce a more tolerogenic phenotype in obese hypertensives. In a phase-2, single-centre, randomised, open, 24-week trial, we assigned adults with obesity-associated hypertension and vitamin D deficiency to receive usual therapy plus 50,000 IU/week of cholecalciferol or usual therapy alone. The primary endpoint was the percentual variation in T CD4+, T CD8+, Tregs, and Th17 cells. Secondary endpoints included the percentual variation in Th1, Tc1, Tc17, and monocytes and variation in the number of perivascular and non-perivascular macrophages, T CD4+ and T CD8+ lymphocytes in subcutaneous abdominal adipose tissue. A control group of 12 overweight normotensives was also evaluated for peripheral immune cells. A total of 36 obese hypertensives were randomised, 18 in each group. In comparison with normotensive controls, hypertensives presented higher percentages of T lymphocytes (p = 0.016), Tregs (p = 0.014), and non-classical monocytes (p < 0.001). At week 24, Th17 cells increased in control group (p = 0.017) but remained stable in cholecalciferol group. For Tregs, downregulation towards the values of normotensive controls was observed (p = 0.003), and in multivariate analysis, an increased loading in the setting of the cells of adaptive immunity observed (eigenvalue 1.78, p < 0.001). No changes were documented for monocytes. In adipose tissue, a baseline negative correlation between vitamin D and perivascular macrophages was observed (r = -0.387, p = 0.024) that persisted in the control group (r = -0.528, p = 0.024) but not in the cholecalciferol group, which presented an increase in non-perivascular macrophages (p = 0.029) at week 24. No serious adverse events were reported for all the participants. In this trial, we found that supplementation with cholecalciferol interfered with peripheral and adipose tissue immune cell profile, downregulating peripheral Th17 cells, but increasing the number of infiltrating subcutaneous adipose tissue macrophages. (Funded by Núcleo Estudos Hipertensão da Beira Interior; EudraCT number: 2015-003910-26).

Electrodermal and respiratory synchrony in couple therapy in distinct therapeutic subsystems and reflection periods.

Objective Synchrony in the multi-person context of systemic therapy is a complex and understudied phenomenon. We analyzed respiratory and electrodermal synchronies within a couple therapy system with two therapists to determine whether dyadic subsystems between each client and therapist synchronized differently. We also studied synchrony in reflection periods, in which the therapists discussed the therapy process with clients listening. Finally, we examined the association of synchronies with alliance and outcome.Method: A sample of 22 therapy sessions in which electrodermal activity (EDA) and respiration were recorded were analyzed. Self-report measures of session alliance and outcome were obtained. Synchrony computation was based on windowed cross-correlation using surrogate synchrony and segment-wise shuffling of physiological time series.Results: The results supported the presence of EDA synchrony for the client-therapist and therapist-therapist dyads but not client-client dyads across entire sessions. No significant synchronies were found for respiration behavior. A similar picture was found in reflection periods. Clients' well-being as well as therapists' alliance ratings were significant predictors of client-client EDA synchrony.Conclusion: Our results point to the relational meaning of synchrony and its importance for understanding couple psychotherapy, particularly the reflection periods. Challenges involved in extending synchrony computation to multi-person settings were highlighted.

Association between service readiness and PMTCT cascade effectiveness: a 2018 cross-sectional analysis from Manica province, Mozambique.

BACKGROUND: Despite high coverage of maternal and child  health services in Mozambique, prevention of mother-to-child transmission of HIV (PMTCT) cascade outcomes remain sub-optimal. Delivery effectiveness is modified by health system preparedness. Identifying modifiable factors that impact quality of care and service uptake can inform strategies to improve the effectiveness of PMTCT programs. We estimated associations between facility-level modifiable health system readiness measures and three PMTCT outcomes: Early infant diagnosis (polymerase chain reaction (PCR) before 8 weeks of life), PCR ever (before or after 8 weeks), and positive PCR test result. METHODS: A 2018 cross-sectional, facility-level survey was conducted in a sample of 36 health facilities covering all 12 districts in Manica province, central Mozambique, as part of a baseline assessment for the SAIA-SCALE trial (NCT03425136). Data on HIV testing outcomes among 3,427 exposed infants were abstracted from at-risk child service registries. Nine health system readiness measures were included in the analysis. Logistic regressions were used to estimate associations between readiness measures and pediatric HIV testing outcomes. Odds ratios (OR) and 95% confidence intervals (95%CI) are reported. RESULTS: Forty-eight percent of HIV-exposed infants had a PCR test within 8 weeks of life, 69% had a PCR test ever, and 6% tested positive. Staffing levels, glove stockouts, and distance to the reference laboratory were positively associated with early PCR (OR = 1.02 [95%CI: 1.01-1.02], OR = 1.73 [95%CI: 1.24-2.40] and OR = 1.01 [95%CI: 1.00-1.01], respectively) and ever PCR (OR = 1.02 [95%CI: 1.01-1.02], OR = 1.80 [95%CI: 1.26-2.58] and OR = 1.01 [95%CI: 1.00-1.01], respectively). Catchment area size and multiple NGOs supporting PMTCT services were associated with early PCR testing OR = 1.02 [95%CI: 1.01-1.03] and OR = 0.54 [95%CI: 0.30-0.97], respectively). Facility type, stockout of prophylactic antiretrovirals, the presence of quality improvement programs and mothers' support groups in the health facility were not associated with PCR testing. No significant associations with positive HIV diagnosis were found. CONCLUSION: Salient modifiable factors associated with HIV testing for exposed infants include staffing levels, NGO support, stockout of essential commodities and accessibility of reference laboratories. Our study provides insights into modifiable factors that could be targeted to improve PMTCT performance, particularly at small and rural facilities.

Peripersonal space in social context is modulated by action reward, but differently in males and females.

The peripersonal space (PPS) is a multisensory representation of the near-body region of space where objects appear at hand. It also represents a buffer zone protecting the body from external threats and as such it contributes to the organization of social interactions. However, how the combination of embodied objects processing and constraints inherent to social interactions contributes to PPS representation remains an open issue. By using a cooperative task where two male (N = 22) or female (N = 18) participants, sharing the same action space, were requested to select a number of stimuli on a touch-screen table, we investigated the effect of non-uniform distribution of reward-yielding stimuli on selection strategy and perceptual judgments of reachability, used as a proxy of PPS representation. The probability to select a reward-yielding stimulus (50% of the stimuli) was 75% in the proximal space of one of the two confederates. Results showed that participants initially prioritized stimuli in their proximal space and were progressively influenced by the spatial distribution of reward-yielding stimuli, thus invading their confederate's action space when associated with higher probability of reward. The distribution of reward-yielding stimuli led to an increase of reachability threshold, but only when biased towards the participants' distal space. Although the invasion of others' PPS was more pronounced in male participants, the biased distribution of reward-yielding stimuli altered the reachability threshold similarly in males and females. As a whole, the data revealed that reward expectations in relation to motor actions influence both PPS exploration and representation in social context, but differently in males and females.

[Co/Fe(α-Alkyl-tpdt)2]x-: Alkyl-Substituted Cobalt and Iron Bis-dithiolenethiophenic Complexes.

Tetraphenylphosphonium salts of Co and Fe complexes with alkyl-substituted, tert-butyl (tb), and isopropyl (dp) 2,3-thiophenedithiolate (α-tpdt) ligands, namely, TPP[Co(α-tb-tpdt)2] (3), TPP2[Fe(α-tb-tpdt)2]2 (4a-b), TPP[Co(α-dp-tpdt)2] (5), and TPP[Fe(α-dp-tpdt)2] (6) were prepared and characterized by cyclic voltammetry, single crystal X-ray diffraction, magnetic susceptibility measurements, and 57Fe Mössbauer spectroscopy. Compound 3 and 5 are isostructural with their Au and Ni analogues with a square-planar coordination geometry. Compound 4 presents two polymorphs (4a-b) both showing a Fe(III) bisdithiolene dimerization. The magnetic susceptibility of 3 and 5 exhibits behavior dominated by antiferromagnetic interactions, with room-temperature magnetic moments of 3.40 and 3.36 µB, respectively, indicating that these square-planar Co(III) complexes assume an intermediate spin electronic configuration (S = 1) as supported by multiconfigurational and DFT calculations.

Psychometric Properties and Construct Validity of the Short Version of the Self-Report Psychopathy Scale in a Southern European Sample.

The Self-Report Psychopathy Scale-Short Form (SRP-SF) is a brief measure of psychopathy, developed via model-based test theory. The SRP-SF has a 4-factor structure with items reflecting affective, interpersonal, lifestyle, and antisocial domains, in line with the Psychopathy Checklist-Revised (PCL-R), which can be aggregated to form the traditional F1 and F2 dimensions of psychopathy. Previous research indicates the SRP is a viable tool for examining the prevalence of psychopathic propensities and their correlates in nonoffender populations. Currently, a substantial amount of nonoffender research on psychopathy is conducted in North America. Here, we inspect the psychometric properties of the SRP-SF and probe its association with general personality and empathy in a large southern European (Portuguese) community sample. Consistent with previous studies, results indicated good fit for the 4-factor model, including for separate female and male subsamples, good internal consistency across its scales and subscales, and the predicted pattern of associations with the correlates of psychopathy. The results of this cross-cultural study provide further evidence of the validity of the SRP-SF in the assessment of psychopathy in community samples, and help to extend the nomological net on the larger construct to a southern European sample.

Spectroscopic Determination of the Electronic Structure of a Uranium Single-Ion Magnet.

Early actinide ions have large spin-orbit couplings and crystal field interactions, leading to large anisotropies. The success in using actinides as single-molecule magnets has so far been modest, underlining the need for rational strategies. Indeed, the electronic structure of actinide single-molecule magnets and its relation to their magnetic properties remains largely unexplored. A uranium(III) single-molecule magnet, [UIII {SiMe2 NPh}3 -tacn)(OPPh3 )] (tacn=1,4,7-triazacyclononane), has been investigated by means of a combination of magnetic, spectroscopic and theoretical methods to elucidate the origin of its static and dynamic magnetic properties.

Psychophysiological Synchrony During Verbal Interaction in Romantic Relationships.

Previous studies about romantic relationships have shown that the reciprocal influence between partners occurs not only at the behavioral and socio-emotional levels, but also at the psychophysiological level. This reciprocal influence is expressed in a pattern of physiological synchrony between partners (i.e., coordinated dynamics of the physiological time series). The main aim of the present study was to explore the presence of a pattern of physiological synchrony in electrodermal activity (EDA) during a couple interaction task. A second objective was to compare the synchrony levels during a negative interaction condition versus a positive interaction condition. Finally, we analyzed the association between synchrony and self-perception of empathy, dyadic empathy, and relationship satisfaction. Thirty-two couples (64 individuals) participated in this study. Each couple performed a structured interaction task while the EDA of both partners was being registered. The quantification of synchrony was based on the cross-correlation of both members' EDA time-series. In order to control for coincidental synchrony, surrogate datasets were created by repeatedly shuffling the original data of spouses X and Y of a dyad and computing synchronies on the basis of the shuffled data (pseudosynchrony values). Our results confirmed the presence of significant EDA synchrony during the interaction. We also found that synchrony was higher during the negative interactions relative to the positive interactions. Additionally, physiological synchrony during positive interaction was higher for those couples in which males scored higher in dyadic empathy. The clinical implications of these findings are discussed.

Estudios anteriores acerca de las relaciones amorosas han demostrado que la influencia recíproca entre las parejas no solo ocurre en los niveles conductuales y socioemocionales, sino también en el nivel psicofisiológico. Esta influencia recíproca se expresa en un patrón de sincronía fisiológica entre los integrantes de la pareja (p. ej.: la dinámica coordinada de las series temporales fisiológicas). El objetivo principal del presente estudio fue analizar la presencia de un patrón de sincronía fisiológica en la actividad electrodérmica (AED) durante una tarea de interacción de la pareja. Un segundo objetivo fue comparar los niveles de sincronía durante una situación de interacción negativa frente a una situación de interacción positiva. Finalmente, analizamos la asociación entre la sincronía y la autopercepción de empatía, la empatía diádica y la satisfacción con la relación. Treinta y dos parejas (64 personas) participaron en este estudio. Cada pareja llevó a cabo una tarea de interacción estructurada mientras se registraba la AED de ambos integrantes de la pareja. La cuantificación de la sincronía se basó en la correlación cruzada de las series temporales de la AED de ambos miembros. A fin de controlar la sincronía simultánea, se crearon conjuntos de datos sustitutos entremezclando continuamente los datos originales de los cónyuges X e Y de una díada y computando las sincronías sobre la base de los datos mezclados (valores de seudosincronía). Nuestros resultados confirmaron la presencia de una sincronía considerable de la AED durante la interacción. También descubrimos que la sincronía fue mayor durante las interacciones negativas respecto de las interacciones positivas. Además, la sincronía fisiológica durante la interacción positiva fue mayor en aquellas parejas en las cuales los hombres obtuvieron un puntaje más alto en la empatía diádica. Se debaten las consencuencias clínicas de estos resultados.

Renal transplantation in Birt-Hogg-Dubé syndrome: should we?

BACKGROUND: Birt-Hogg-Dubé (BHD) Syndrome is a rare genodermatosis caused by a mutation on folliculin gene, with a strong link to renal cancer. To date few patients with such condition have reached dialysis stage, as nephron-sparing surgery is usually possible at the time of diagnosis. To our best knowledge no patient with BHD syndrome has been submitted to renal transplantation. CASE PRESENTATION: We report the case of a woman diagnosed with multifocal bilateral renal cell carcinoma that underwent bilateral radical nephrectomy and was started on a regular hemodialysis program at the age of 29. While on hemodialysis program she was diagnosed clinically with BHD syndrome and molecular testing confirmed an heterozygous mutation on FLCN gene. The patient has been kept on surveillance program for 2 years with no clinical complications from the genetic syndrome and in complete remission from renal cancer. Though there has not been any report of a patient with BHD being transplanted, risks and benefits for this patient were weighted. She has been considered apt by the transplant team and is currently waitlisted for cadaveric renal transplantation. DISCUSSION: It is a matter of discussion which should be cancer-free period for anephric patients with an inherited cancer syndrome to be candidates for renal transplant. So far BHD syndrome has not been causally associated with any other neoplastic disorder elsewhere. Accepting cancer biology is very complex and knowledge of the behaviour of this genetic syndrome is limited to a few cases reported worldwide, the authors believe that renal transplantation is the best treatment option for this young patient. The choice of post transplantation immunosuppression is debatable, but considering experience in other inherited cancer syndromes a maintenance scheme with mTOR inhibitor will be favoured.

Gold and Nickel Extended Thiophenic-TTF Bisdithiolene Complexes.

Gold and nickel bisdithiolene complexes with methyl and tert-butyl substituted thiophenetetrathiafulavalenedithiolate ligands (α-mtdt and α-tbtdt) were prepared and characterized. These complexes were obtained, under anaerobic conditions, as tetrabutylammonium salts. The diamagnetic gold monoanion (n-Bu4N)[Au(α-mtdt)2] (3) and nickel dianionic species (n-Bu4N)x[Ni(α-mtdt)2] (x = 1,2) (4) were similar to the related non-substituted extended thiophenic-TTF (TTF = tetrathiafulvalene) bisdithiolenes. However the introduction of the large, bulky substituent tert-butyl, led to the formation of a Au (I) dinuclear complex, (n-Bu4N)2[Au2(α-tbtdt)2] (5). The neutral methyl substituted gold and nickel complexes were easily obtained through air or iodine exposure as polycrystalline or amorphous fine powder. [Au(α-mtdt)2] (6) and [Ni(α-mtdt)2] (7) polycrystalline samples display properties of a metallic system with a room temperature electrical conductivity of 0.32 S/cm and ≈4 S/cm and a thermoelectric power of ≈5 µV/K and ≈32 µV/K, respectively. While [Au(α-mtdt)2] (6) presented a Pauli-like magnetic susceptibility typical of conducting systems, in [Ni(α-mtdt)2] (7) large magnetic susceptibilities indicative of high spin states were observed. Both electric transport properties and magnetic properties for gold and nickel [M(α-mtdt)2] are indicative that these compounds are single component molecular conductors.

A Mononuclear Uranium(IV) Single-Molecule Magnet with an Azobenzene Radical Ligand.

A tetravalent uranium compound with a radical azobenzene ligand, namely, [{(SiMe2 NPh)3 -tacn}U(IV) (η(2) -N2 Ph2 (.) )] (2), was obtained by one-electron reduction of azobenzene by the trivalent uranium compound [U(III) {(SiMe2 NPh)3 -tacn}] (1). Compound 2 was characterized by single-crystal X-ray diffraction and (1) H NMR, IR, and UV/Vis/NIR spectroscopy. The magnetic properties of 2 and precursor 1 were studied by static magnetization and ac susceptibility measurements, which for the former revealed single-molecule magnet behaviour for the first time in a mononuclear U(IV) compound, whereas trivalent uranium compound 1 does not exhibit slow relaxation of the magnetization at low temperatures. A first approximation to the magnetic behaviour of these compounds was attempted by combining an effective electrostatic model with a phenomenological approach using the full single-ion Hamiltonian.

Magnetic properties of the layered lanthanide hydroxide series Y(x)Dy(8-x)(OH)20Cl4·6H2O: from single ion magnets to 2D and 3D interaction effects.

The magnetic properties of layered dysprosium hydroxides, both diluted in the diamagnetic yttrium analogous matrix (LYH:0.04Dy), and intercalated with 2,6-naphthalene dicarboxylate anions (LDyH-2,6-NDC), were studied and compared with the recently reported undiluted compound (LDyH = Dy8(OH)20Cl4·6H2O). The Y diluted compound reveals a single-molecule magnet (SMM) behavior of single Dy ions, with two distinct slow relaxation processes of the magnetization at low temperatures associated with the two main types of Dy sites, 8- and 9-fold coordinated. Only one relaxation process is observed in both undiluted LDyH and intercalated compounds as a consequence of dominant ferromagnetic Dy-Dy interactions, both intra- and interlayer. Semiempirical calculations using a radial effect charge (REC) model for the crystal field splitting of the Dy levels are used to explain data in terms of contributions from the different Dy sites. The dominant ferromagnetic interactions are explained in terms of orientations of easy magnetization axes obtained by REC calculations together with the sign of the superexchange expected from the Dy-O-Dy angles.

Dithiophene-TTF Salts; New Ladder Structures and Spin-Ladder Behavior.

(α-DT-TTF)2[Au(i-mnt)2] and (α-DT-TTF)2[Co(mnt)2] are two new salts of the donor α-dithiophene-tetrathiafulvalene with stable diamagnetic anions, both presenting a ladder structure of the donors organized in paired segregated stacks. The first one is isostructural with previously reported closely related compounds and presents a magnetic spin-ladder behavior with J∥= 83.5 K and J⊥ = 110.3 K as estimated from spin susceptibility data in single crystals. (α-DT-TTF)2[Co(mnt)2] presents a new structural type with a different arrangement of pairs of donor stacks, alternating with stacks of dimerized [Co(mnt)2] anions which are however arranged in an uncorrelated fashion perpendicular to the stacking axis. Due to the strong coupling between the disordered anion chains and the donor chains, this compound does not present a magnetic spin-ladder behavior. The low temperature superstructure of (DT-TTF)2[Cu(mnt)2] below the transition at 235 K, previously known to be associated with a lattice doubling along the stacking axis, was solved by synchrotron radiation diffraction in small single crystals. It is found that this dimerization is due to donor charge localization with the spin carriers being associated with fully oxidized donor species alternating with neutral donors.

Thermal and magnetic properties of iron oxide colloids: influence of surfactants.

Iron oxide nanoparticles (NPs) have been extensively studied in the last few decades for several biomedical applications such as magnetic resonance imaging, magnetic drug delivery and hyperthermia. Hyperthermia is a technique used for cancer treatment which consists in inducing a temperature of about 41-45 °C in cancerous cells through magnetic NPs and an external magnetic field. Chemical precipitation was used to produce iron oxide NPs 9 nm in size coated with oleic acid and trisodium citrate. The influence of both stabilizers on the heating ability and in vitro cytotoxicity of the produced iron oxide NPs was assessed. Physicochemical characterization of the samples confirmed that the used surfactants do not change the particles' average size and that the presence of the surfactants has a strong effect on both the magnetic properties and the heating ability. The heating ability of Fe3O4 NPs shows a proportional increase with the increase of iron concentration, although when coated with trisodium citrate or oleic acid the heating ability decreases. Cytotoxicity assays demonstrated that both pristine and trisodium citrate Fe3O4 samples do not reduce cell viability. However, oleic acid Fe3O4 strongly reduces cell viability, more drastically in the SaOs-2 cell line. The produced iron oxide NPs are suitable for cancer hyperthermia treatment and the use of a surfactant brings great advantages concerning the dispersion of NPs, also allowing better control of the hyperthermia temperature.

Volumetric alterations in the nucleus accumbens and caudate nucleus in bulimia nervosa: a structural magnetic resonance imaging study.

OBJECTIVE: Bulimia nervosa (BN) is an eating disorder characterized by recurrent episodes of binge eating and inappropriate compensatory behaviors (such as purging, fasting, or excessive exercise) to prevent weight gain. BN has been associated with deficits in inhibitory control processes. The basal ganglia specifically, the nucleus accumbens (NAc) and the caudate nucleus (CN) are part of the frontostriatal circuits involved in inhibitory control. The main goal of this study was to investigate the presence of morphological alterations in the NAc and the CN in a sample of patients diagnosed with BN. METHOD: Forty-one female participants, 21 diagnosed with BN and 20 healthy matched controls (HC), underwent a structural magnetic resonance imaging (MRI) acquisition and clinical assessment. The NAc and the CN were manually segmented using the software Slicer 3D. RESULTS: The results reveal a significant volumetric decrease in the CN and a preserved NAc volume in BN compared to the control group. DISCUSSION: These findings suggest a contributory role of the caudate nucleus part of the dorsal striatum in the psychopathology of BN.

Single-molecule-magnet behavior in mononuclear homoleptic tetrahedral uranium(III) complexes.

The magnetic properties of the two uranium coordination compounds, [K(18c6)][U(OSi(O(t)Bu)3)4] and [K(18c6)][U(N(SiMe3)2)4], both presenting the U(III) ion in similar pseudotetrahedral coordination environments but with different O- or N-donor ligands, have been measured. The static magnetic susceptibility measurements and density functional theory studies suggest the presence of different ligand fields in the two compounds. Alternating-current susceptibility studies conducted at frequencies ranging from 95 to 9995 Hz and at temperatures in the 1.7-10 K range revealed for both compounds slow magnetic relaxation already at zero static magnetic field with similar energy barriers U ∼24 K.

Neurosciences, empathy, and healthy interpersonal relationships: recent findings and implications for counseling psychology.

In this article, we define the construct of empathy and its relevance for counseling psychology. The importance of deficits in empathic processes for most of the psychological disorders is presented within the context of the social brain hypothesis (Frith, 2007). We provide a review of empirical research about the neural correlates of empathy in terms of both the central and peripheral nervous system. We present recent evidence on the cortical and subcortical regions involved in different dimensions of empathy-emotional contagion, cognitive and emotional empathy, and self-regulation. Regarding the autonomic correlates of empathy, we present evidence about the correlates of sympathetic arousal associated with empathic processes and review data supporting the idea of the physiological linkage or synchrony as indicator of empathy in interpersonal relationships. The implications of these findings for counseling psychology, particularly for the psychotherapist-client relationship and for context of intimate relationships or couples therapy, are discussed.

The effects of C-tactile stimulation on temporal summation of second pain: A study of the central and peripheral neural correlates.

Affective touch is mediated by specialized receptors sensitive to gentle and slow touch called C-tactile afferents (CT). The activation of these receptors has shown promise in reducing subjective pain ratings, however, how this type of touch can affect central sensitization processes is poorly studied. This work aimed to investigate if affective touch is able to modulate pain sensitization and its electrophysiological correlates during Temporal Summation of Second Pain (TSSP), a phenomenon characterized by an increase in pain perception due to repeated noxious stimuli. Thirty-seven participants underwent a TSSP protocol involving three conditions: TSSP alone, TSSP during vibrotactile stimulation, and TSSP during CT stimulation (administered with a brush mounted in a robot arm). We measured subjective pain ratings, electroencephalographic (N2-P2 complex) and electrocardiographic activity during these conditions. Participants reported a significantly lower increase of pain during CT stimulation compared to vibrotactile stimulation, but not to TSSP alone. In addition, TSSP was reduced when administered in the ipsilateral arm compared to the other somatosensory stimulation. Subjective reports of attention towards painful stimuli, amplitude of the N2-P2 complex, and heart rate were also reduced during CT stimulation. Conclusion: Our results indicated that the activation of CT receptors may reduce sensitization compared to other types of somatosensory stimulation, which is possibly related to the reduction of the attention devoted to nociceptive stimulation. Our results suggest that activation of CT receptors may alleviate the occurrence of central pain sensitization.

Posttrial Experiences in Sustainment of a Scaled Model of the Systems Analysis and Improvement Approach (SAIA-SCALE) in the Absence of External Funding in Manica Province, Mozambique.

BACKGROUND: Following the conclusion of a stepped-wedge cluster randomized trial of the Systems Analysis and Improvement Approach (SAIA) to optimize the prevention of mother-to-child HIV transmission cascade in Manica Province, Mozambique, we conducted a natural experiment to test the sustainability of the delivery model with limited financial inputs. METHODS: District nurse supervisors were encouraged to continue to facilitate SAIA cycles in subordinate health facilities and provided phone credit and tablet access to upload implementation data. No additional resources (eg, funds for transport, refreshments, or supplies) were provided. Barriers to implementation were collected via conversations with district supervisors. RESULTS: Monthly facilitation of SAIA cycles continued in 11 of 12 (92%) districts and 13 of 36 (36%) facilities through 12 months posttrial, which declined to 10 districts and 10 facilities by the end of the 15-month posttrial period. Despite interest among district supervisors to continue implementation, logistical and financial barriers prevented visits to facilities not in close proximity to district management offices. Turnover of district supervisors resulted in replacements not having knowledge and experience facilitating SAIA. The lack of refreshments for facility staff and limited supplies (pens and papers) were cited as additional barriers. CONCLUSION: Despite the scalability of the SAIA model, it is susceptible to implementation decay without sufficient health system resources. Additional research is needed to test sustainment strategies that address identified barriers and enable continued delivery of the implementation strategy core components at a sufficient level of fidelity to maintain desired health system improvements and patient-level outcomes.

[Fe(nsal2trien)]SCN, a new two-step iron(III) spin crossover compound, with symmetry breaking spin-state transition and an intermediate ordered state.

We report the synthesis of the iron(III) complex of the hexadentate Schiff base ligand nsal2trien obtained from the condensation of triethylenetetramine and 2 equiv. of 2-hydroxy-1-naphthaldehyde. The study of the salt [Fe(nsal2trien)]SCN (1) by magnetic susceptibility measurements and Mössbauer spectroscopy reveals a rather unique behavior that displays thermally induced spin crossover (SCO) with two well-separated steps at 250 (gradual transition) and 142 K (steep transition). Single crystal X-ray structures were obtained at 294, 150, and 50 K, for the high spin (HS), intermediate (Int), and low spin (LS) phases. The HS and LS phases are isostructural, and based on a single Fe(III) site (either HS or LS) an unusual symmetry break occurs in the transition to the Int ordered phase, where the unit cell includes two distinct Fe(III) sites and is based on a repetition of the [HS-LS] motif. The two-step SCO behavior of 1 must result from the existence of structural constraints preventing the full conversion HS ↔ LS in a single step.