Identification of factors associated with virus level in tonsils of pigs experimentally infected with porcine reproductive and respiratory syndrome virus.

Porcine reproductive and respiratory syndrome (PRRS) is one of the most important global swine diseases from both an economic and animal welfare standpoint. PRRS has plagued the US swine industry for over 25 yr, and containment of PRRS virus (PRRSV) has been unsuccessful to date. The primary phase of PRRS, tracked by serum viremia, typically clears between 21 and 42 d postinfection (dpi) but tonsils are a main site of PRRSV persistence and PRRSV can be detected in tonsils in excess of 150 dpi. Measuring tonsil virus (TV) levels at late stages of infection (6 to 7 wk postinfection) can be used to assess tonsil persistence, as levels of virus in tonsil at this time likely influence how long the virus will remain in the tissue. TV levels were measured on pigs experimentally infected with either the NVSL-97-7895 (NVSL; n = 524) or KS-2006-72109 (KS06; n = 328) PRRSV type 2 isolates across five trials. The objectives of this study were to (i) estimate the heritability of TV levels at 35 or 42 dpi; (ii) identify factors the affect TV level, including serum viremia; (iii) identify genomic regions associated with TV level; and (iv) compare results for the two PRRSV isolates. TV level was lowly heritable for both isolates (NVSL: 0.05 ± 0.06; KS06: 0.11 ± 0.10). Level of TV was phenotypically associated with traits related to viral clearance from serum: pigs with low TV levels had an earlier and faster rate of maximal serum viral clearance, lower total serum viral load, and lower viremia level at 35 or 42 dpi. Although no genomic regions with major effects on TV level were identified, several showed some association (>0.1% of total genetic variance in the NVSL-infected dataset, the KS06-infected dataset, and the combined dataset). These regions contained the genes CCL1, CCL2, CCL8, HS3ST3B1, GALNT10, TCF7, C1QA/B/C, HPSE, G0S2, and CD34, which are involved in viral infiltration or replication, immune cell migration, and viral clearance from tissue. Results were similar between the two PRRSV isolates. In conclusion, selection for viral clearance traits in serum may reduce PRRSV persistence in the tonsil across PRRSV isolates. However, genetic correlations need to be estimated to determine whether this will be successful.

Increasing HIV testing engagement through provision of home HIV self-testing kits for patients who decline testing in the emergency department: a pilot randomisation study.

OBJECTIVE: Up to 60% of patients decline routine HIV testing offer in US emergency departments (EDs). The objective of this study is to determine whether the provision of HIV self-testing (HIVST) kit would increase engagement of HIV testing among these HIV test 'Decliners'. METHODS: Patients who declined a test offered in an ED-based triage nurse-driven HIV screening programme were enrolled and randomised to either the HIVST or the control group. The patients in the HIVST group received HIVST kits to take home, were encouraged to report test results to an established internet-based STI/HIV testing recruitment website 'I Want the Kit' (IWTK) and received five referral cards for their peers to request HIVST kits from IWTK. The control group received pamphlets about publicly available HIV testing sites. HIV testing from both groups after enrolment was determined via telephone follow-up at 1 month. Testing rate ratio (RR) was determined using χ2 tests. RESULTS: Fifty-two patients were randomised to the HIVST group and 48 to the control group. Among all 64 patients completing any follow-up, 14/29 (48%) patients in the HIVST group tested themselves at home with the provided kit. Four of these had never had an HIV test. Only 2/35 (6%) in the control group reported having an HIV test after enrolment (RR: 8.45 (95% CI: 2.09 to 34.17)). 57% (8/14) in the HIVST group reported test results to IWTK. CONCLUSION: Provision of HIVST kits supplements ED-based screening programme and significantly improved engagement of HIV testing among those test 'Decliners' in the ED. TRIAL REGISTRATION NUMBER: NCT03021005, results.

Establishing an Efficient Care Paradigm for Trigger Finger.

BACKGROUND: To identify the time course for efficacy of corticosteroid injections in the treatment of trigger finger. METHODS: A prospective single-center observational study was conducted, consisting of 38 patients with 41 trigger digits that were injected. Enrolled patients completed an initial Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire to determine the severity of their symptoms. Following the injection, patients were contacted at scheduled time points for up to 12 weeks to determine if, and when, objective resolution of symptoms occurred. Patients who received additional treatment, such as a second injection or surgery, and those who did not have objective relief of symptoms by 12 weeks were classified as failed. Upon symptom resolution or injection failure, patients were given a DASH exit questionnaire. RESULTS: 30 of 41 injected trigger digits resolved and 11 failed treatment with a single corticosteroid injection. The latest that any study participant experienced resolution of symptoms was 69 days. At 38 days, the rate of resolution of the study population slowed significantly. CONCLUSIONS: Although symptomatic resolution of trigger finger from a single corticosteroid injection can occur early on, a follow-up of 4 weeks (28 days) does not allow enough time for symptom resolution. The earliest a surgeon and patient should consider a secondary treatment is at 38 days. After 69 days without resolution, both surgeon and patient can be confident that further treatment is needed.

The use of BMP-2 and screw exchange in the treatment of scaphoid fracture non-union.

Scaphoid non-union, particularly following internal fixation, is a vexing problem. A retrospective review was conducted analysing the outcome of 4 patients who failed initial open reduction and internal fixation of scaphoid fractures. Three fractures were located in the waist and the fourth in the proximal pole. All patients underwent screw exchange and Bone Morphogenic Protein (BMP)-2 sponge placement with no additional bone grafting. Patients were immobilised for 4 weeks and followed with serial radiographs in all cases and CT scans in 3 cases. All patients demonstrated evidence of bony union at an average of 53 days from surgery and ultimately returned to pain-free full activity. There were no complications. BMP-2 and screw exchange yielded a 100% union rate in patients with established scaphoid non-union. While this retrospective study represents a small number of patients and clearly requires further investigation, it presents a promising technique for managing a difficult clinical problem.

Pernicious Residues of Foundational Postulates: Their Impact on Women.

It has long been recognized that many of the original psychoanalytic views of women were derived from misguided theories. Regrettably, residues of the foundational postulates that informed those theories still persist, assuring a pervasive gender bias even in contemporary psychoanalytic investigations. This contribution describes where those postulates reside, while proposing alternates that could prove far more useful for the theory and practice of our profession.

Increasing gene discovery and coverage using RNA-seq of globin RNA reduced porcine blood samples.

BACKGROUND: Transcriptome analysis of porcine whole blood has several applications, which include deciphering genetic mechanisms for host responses to viral infection and vaccination. The abundance of alpha- and beta-globin transcripts in blood, however, impedes the ability to cost-effectively detect transcripts of low abundance. Although protocols exist for reduction of globin transcripts from human and mouse/rat blood, preliminary work demonstrated these are not useful for porcine blood Globin Reduction (GR). Our objectives were to develop a porcine specific GR protocol and to evaluate the GR effects on gene discovery and sequence read coverage in RNA-sequencing (RNA-seq) experiments. RESULTS: A GR protocol for porcine blood samples was developed using RNase H with antisense oligonucleotides specifically targeting porcine hemoglobin alpha (HBA) and beta (HBB) mRNAs. Whole blood samples (n = 12) collected in Tempus tubes were used for evaluating the efficacy and effects of GR on RNA-seq. The HBA and HBB mRNA transcripts comprised an average of 46.1% of the mapped reads in pre-GR samples, but those reads reduced to an average of 8.9% in post-GR samples. Differential gene expression analysis showed that the expression level of 11,046 genes were increased, whereas 34 genes, excluding HBA and HBB, showed decreased expression after GR (FDR <0.05). An additional 815 genes were detected only in post-GR samples. CONCLUSIONS: Our porcine specific GR primers and protocol minimize the number of reads of globin transcripts in whole blood samples and provides increased coverage as well as accuracy and reproducibility of transcriptome analysis. Increased detection of low abundance mRNAs will ensure that studies relying on transcriptome analyses do not miss information that may be vital to the success of the study.

Exploring the Dialectical Space: A Brief History of The Psychoanalytic Study of the Child.

Abrams, currently the longest serving editor of The Psychoanalytic Study of the Child, offers his views of emerging models and themes in the understanding of children, which has characterized The PSOC since its inception in 1945. In his view, the first of its published papers, Hartmann and Kris's "The Genetic Approach in Psychoanalysis," set the stage for examining innovative ways to view the growth of the mind in general and the psychological development of children in particular. In his judgment, many of its published papers have highlighted expectable dispositional discontinuities as well as recognizable continuities interacting with a varying and sometimes unexpected set of environment circumstances. That interaction occurs within a dialectical space that contributes its own unique influences. This investigative trend, scattered throughout its nearly seventy-year history, may reflect the recognition for the need for a different foundational theory for our discipline or perhaps a new paradigm altogether.

"Frankie" Revisited: Foundational Concepts In Flux--An Introduction to the Section.

The author offers his own historical review of the celebrated "Frankie" case, contextualizing it within political as well as scientific challenges. In addition, he provides an introductory survey of the three contributions that are to follow in the section. Similarities and differences are underscored, as contemporary child analysts revisit this acknowledged "classic" reported more than sixty years ago. In the revisiting and even in one instance where it is surprisingly a first reading, similarities and differences between there-and-then as contrasted with here-and-now reflections prove quite illuminating. There is considerable lauding of the revolutionary nature of the original case on the one hand, along with some open criticisms on the other. Several of the scholars suggest that the technique and the theories of pathogenesis and therapeutic action might well benefit from some selective updating of cognitive stance to the organization of clinical data. In this regard, adding nonlinear thinking to the original reductionism bias gets a strong boost--although that proposal doesn't quite achieve the decisive definition that permits it to flourish.

Historiography 101 for psychoanalysts.

I plant to propose an outline for a course for psychoanalytic clinicians called Historiography 101. My presentation is made up of three parts: an argument justifying the proposal, a clinical anecdote to anchor the argument, and a description of what the course might actually look like.

The Senate Electoral Cycle and Bicameral Appropriations Politics.

We consider the consequences of the Senate electoral cycle and bicameralism for distributive politics, introducing the concept of contested credit claiming, i.e. that members of a state's House and Senate delegations must share the credit for appropriations that originate in their chamber with delegation members in the other chamber. Using data that isolates appropriations of each chamber, we test a model of the strategic incentives contested credit claiming creates. Our empirical analysis indicates that the Senate electoral cycle induces a back-loading of benefits to the end of senatorial terms, but that the House blunts this tendency with countercyclical appropriations. Our analysis informs our understanding of appropriations earmarking, and points a way forward in studying the larger consequences of bicameral legislatures.

Transformation: identifying a specific mode of change: descriptive and conceptual considerations.

Treatment induces changes in many ways. The paper attempts to differentiate "transformation" from other modes of change. Descriptively, transformation yields results that could not have been anticipated from the antecedent parts, i.e., the whole is greater than the sum of the parts. Contemplating transformations in psychoanalytic treatment requires some understanding of non-linear activities, although analysts--attuned to reductionism--are usually preoccupied with linear ones. The potential applications with children and adults are outlined.

A forward view. Celebrating the 150th birthday of the founder of psychoanalysis.

The author notes that the two principal goals of psychoanalysis have always been the development of a general psychology and the enhancement of its clinical theories. Integrating the two would certainly be profitable to both, but the integration has been difficult to achieve. Teaching and learning are burdened by ambiguous terms, clinical controversies, the inclination to favor reductionism while putting constructivist thinking aside, and the sheer weight of the complexities of the human mind. Many of the writings of Sigmund Freud and Anna Freud provide opportunities to overcome these obstacles.

Looking forwards and backwards.

A study group examines ways of clinically integrating the developmental process with the psychoanalytic process. The intentions of the group are described along with the degree to which its aims are realized. The capacity to bring together the expectations of the future and the pathogenic impact upon the past proves to be a challenging endeavor for the child clinician. Some obstacles are confronted and a variety of ways of overcoming them are regarded.