[Stroke in children: experience of the Center for the Treatment of Cerebrovascular Diseases in Children and Adolescents in Moscow]. / Insul't u detei: opyt raboty Tsentra po lecheniyu tserebrovaskulyarnykh zabolevanii u detei i podrostkov Moskvy.

OBJECTIVE: To analyze the work of the Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents, operating on the basis of the Morozov Children's City Clinical Hospital of the Moscow Health Department for the period 2018-2021 and to assess the peculiarities of organizing the provision of specialized care to children and adolescents with acute cerebrovascular accident (ACA). MATERIAL AND METHODS: Annual reports of the Center for the period 2018-2021; included children and adolescents aged 1 month to 17 years 11 months 29 days, with new onset ischemic stroke (IS) and hemorrhagic stroke (HS), cerebral venous thrombosis (sinus thrombosis), confirmed clinically and radiologically. RESULTS: Statistical data on stroke and organization of care for children with this pathology in Moscow are presented. The incidence of IS in Moscow for the period 2018-2021 ranged from 1.6 to 2.5 per 100.000 children, HI - from 2.35 to 3.3 per 100.000, sinus thrombosis from 0.5 to 1.38 per 100.000. When assessing the main etiological factors of stroke in The Center for International Pediatric Stroke Research categories, we noted a prevalence of chronic head and neck diseases (20-37%) and chronic systemic conditions (conditions or diseases with known changes in coagulation or vascular structure, including connective tissue dysplasia, genetic, hematological, inflammatory or diseases of the immune system) (15-20%). In addition, data on reperfusion therapy carried out at the Center are presented. From 2018 (first thrombolysis was performed) to 2021, 7.3-14.7% of all patients with IS underwent thrombolysis. CONCLUSION: The experience of functioning of the Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents has shown that the creation of such centers in the regions of the Russian Federation is relevant, but requires taking into account the characteristics of the pediatric population when organizing their work.

Effect of sodium concentration and mucosal pH on apical uptake of acetate and butyrate, and barrier function of the isolated bovine ruminal epithelium.

This study was conducted to investigate the role of Na+ on ruminal short-chain fatty acid (SCFA) absorption and barrier function when isolated ruminal epithelium was exposed to high and low pH ex vivo. Nine Holstein steer calves (322 ± 50.9 kg of body weight) consuming 7.05 ± 1.5 kg dry matter of a total mixed ration were euthanized and ruminal tissue was collected from the caudal-dorsal blind sac. Tissues were mounted between 2 halves of Ussing chambers (3.14 cm2) and exposed to buffers that contained low (10 mM) or high (140 mM) Na+ with low (6.2) or high (7.4) mucosal pH. The same buffer solutions were used on the serosal side except that pH was maintained at 7.4. Buffers used to evaluate SCFA uptake contained bicarbonate to determine total uptake or excluded bicarbonate and included nitrate to determine noninhibitable uptake. Bicarbonate-dependent uptake was calculated as the difference between the total and noninhibitable uptake. Acetate (25 mM) and butyrate (25 mM) were spiked with 2-3H-acetate and 1-14C-butyrate, respectively, and were then added to the mucosal side, incubated for 1 min, and tissues were analyzed to evaluate rates of SCFA uptake. Tissue conductance (Gt) and the mucosal-to-serosal flux of 1-3H-mannitol were used to assess barrier function. There were no Na+ × pH interactions for butyrate or acetate uptake. Decreasing mucosal pH from 7.4 to 6.2 increased total acetate and butyrate uptake, and bicarbonate-dependent acetate uptake. Flux of 1-3H-mannitol was not affected by treatment. However, high Na+ concentration reduced Gt and prevented an increase in Gt from flux period 1 to flux period 2. The results of this study indicate that although providing more Na+ to the ruminal epithelium does not affect SCFA uptake or mannitol flux, it may help stabilize tissue integrity.

[Stroke in children and adolescents]. / Insul't u detei i podrostkov.

OBJECTIVE: A comparative analysis of symptoms in arterial ischemic and stroke-like conditions in children, the development and analysis of the «Presumptive stroke in children¼ scale for prehospital diagnosis of ischemic strokes in children. MATERIAL AND METHODS: This article analyzes cases of emergency hospitalization of children in a stroke center with suspected cerebrovascular pathology as well as the symptoms of patients with suspected ischemic stroke, compares the leading and final diagnoses, identifies the main «mimics¼ of stroke and their symptom complexes. A comparison of the obtained data with the results of previous studies was carried out. RESULTS: The results show the prevalence of motor disorders and coordination disorders in cases of ischemic stroke and cerebral symptoms in cases of stroke-like conditions in children. The most frequent stroke-mimic is migraine. Based on the results of the study, we propose a screening scale for pre-hospital diagnosis of ischemic stroke in children. A preliminary assessment of the effectiveness of the scale using examples of cases of confirmed stroke and stroke-mimic was performed. CONCLUSION: Timely hospitalization of children with stroke can not only reduce mortality, but also use modern diagnostic and treatment methods to reduce the volume of brain damage with a possible complete restoration of motor and cognitive functions. Further analysis of the sensitivity and specificity of the «Presumptive stroke in children¼ scale is required.

[Peculiarities of preparing a patient with a cochlear implant for a magnetic resonance imaging]. / Osobennosti podgotovki patsienta s kokhlearnym implantatom k provedeniyu magnitno-rezonansnoi tomografii.

OBJECTIVE: To develop an algorithm of actions aimed at preparing a patient with a cochlear implant for magnetic resonance imaging (MRI). MATERIAL AND METHODS: A deaf patient after bilateral cochlear implantation (CI) came to St. Vladimir Children's City Clinical Hospital (Moscow) with symptoms of the demyelinating disease for MRI of the brain and spinal cord. Magnet were removed for MRI, then new magnets were installed. CONCLUSION: The temporary removing magnet for MRI of the brain and spinal cord allows to significantly reduce artifacts of MRI images.

Functional amino acid supplementation postweaning mitigates the response of normal birth weight more than for low birth weight pigs to a subsequent Salmonella challenge.

Previous work has shown that dietary supplementation with key functional amino acids (FAA) improves growth performance and immune status of disease-challenged normal birth weight (NBW) pigs. It is not known whether FAA supplementation attenuates the effects of a subsequent disease challenge or whether this response is similar in low birth weight (LBW) pigs. The objective was to determine the effects of birth weight and FAA supplementation during the postweaning period in Salmonella-challenged pigs. Thirty-two LBW (1.08 ± 0.11 kg) and NBW (1.58 ± 0.11 kg) pigs were assigned to a nursery feeding program at weaning (25 d) for 31 days in a 2 × 2 factorial arrangement. Factors were birth weight category (LBW vs. NBW) and basal (FAA-) or supplemented FAA profile (FAA+; Thr, Met, and Trp at 120% of requirements). At d 31, pigs were placed onto a common grower diet and, after a 7-d adaptation period, were inoculated with Salmonella Typhimurium (ST; 2.2 × 109 colony-forming units/mL) and monitored for 7-d postinoculation. Growth performance, rectal temperature, fecal score, indicators of gut health, ST shedding score in feces, intestinal ST colonization and translocation, and blood parameters of acute-phase response and antioxidant balance were measured pre- and postinoculation. Inoculation with ST increased temperature and fecal score, and the overall rectal temperature was higher in LBW compared to NBW pigs (P < 0.05). Postinoculation (d 7), reduced:oxidized glutathione was increased in NBW compared to LBW pigs (P < 0.05). Salmonella shedding and translocation to spleen were lower in NBW-FAA+ compared to NBW-FAA- pigs (P < 0.05). Postinoculation average daily gain was higher in NBW-FAA+ (P < 0.05) compared to the other groups. Postinoculation haptoglobin, superoxide dismutase, and colonic myeloperoxidase were increased in LBW-FAA- pigs (P < 0.05). Ileal alkaline phosphatase was decreased in LBW compared to NBW (P < 0.05). Overall, FAA supplementation represents a potential strategy to mitigate the effect of enteric disease challenge in NBW, but not LBW pigs.

Development of a Coccidiosis Disease Challenge Model Using a Commercially Available Live Oocyst Vaccine.

With growing cross-disciplinary collaboration among researchers, it is increasingly important to record detailed methodology to prevent the repetition of preliminary experiments. The purpose of this paper is to explain the development of a coccidiosis challenge model for the investigation of dietary interventions to coccidiosis in broiler chickens. The objectives are to select a dose of mixed species coccidial vaccine and evaluate the suitability (ability to produce a consistent, marked change) of selected response variables important to nutritional studies at different times postinfection (PI). Coccivac-B and Coccivac-B52 (Merck Animal Health) were evaluated as the source of coccidia in three trials. Trials 1 and 2 were randomized complete block designs with four doses (0, 10, 20, or 30 times (×) label dose) of Coccivac-B administered to 12 replicate cages of six birds by repeater pipette (Trial 1) or gavaging needle (Trial 2). Trial 3 used a completely randomized design with 0× or 30× label dose of Coccivac-B52 administered by gavaging needle to six replicate cages of six birds. Birds were gavaged at 15 days of age, and response criteria were evaluated 7 days PI in all trials and again at 10 days PI in Trials 1 and 2. All means are reported in order of increasing coccidia dose with significance accepted at P ≤ 0.05. Broiler performance was not affected by coccidia in Trials 1 or 3 but grew poorer with increasing dose from 0 to 7 days PI in Trial 2 (body weight gain, 465, 421, 388, 365 g; feed to gain, 1.37, 1.47, 1.52, 1.58). As coccidia dose increased, nitrogen corrected apparent metabolizable energy decreased (Trial 1, 3387, 3318, 3267, 3170 kcal kg-1; Trial 2, 3358, 2535, 2422, 2309 kcal kg-1; Trial 3, not measured), while relative weight, length, and content for intestinal sections increased (Trials 1through 3). Gross lesion (duodenum, jejunum/ileum, ceca) and oocyst count scores (jejunum/ileum, ceca) increased with dose; however, gross scoring often suggested infection in unchallenged birds, a finding unsupported by oocyst count scores. At 7 days PI there was no correlation between midgut gross lesion score and midgut oocyst count score (r = 0.06, P = 0.705), but cecal scores were weakly correlated (r = 0.55, P < 0.001). Administering coccidia via repeater pipette (Trial 1) resulted in respiratory distress in some birds, while use of the gavaging needle (Trials 2 and 3) successfully induced intestinal damage in chickens without resulting in coccidia related mortality. Thirty times the label dose at 7 days PI resulted in the greatest number of response variables that produced a consistent, marked change. Therefore, consideration should be given to these conditions when designing future coccidiosis challenge models using vaccines as a source of coccidia.

Artículo regular­Desarrollo de un modelo de desafío para coccidiosis utilizando una vacuna de ooquistes vivos disponible comercialmente. Con la creciente colaboración interdisciplinaria entre investigadores, es cada vez más importante registrar la metodología detallada para evitar la repetición de experimentos preliminares. El propósito de este artículo es explicar el desarrollo de un modelo de desafío de coccidiosis para la investigación de intervenciones dietéticas para coccidiosis en pollos de engorde. Los objetivos son seleccionar una dosis de vacuna coccidial de especies mixtas y evaluar la idoneidad (capacidad de producir un cambio marcado y consistente) de las variables de respuesta seleccionadas que son importantes para los estudios nutricionales en diferentes momentos posteriores a la infección (PI). Las vacunas Coccivac-B o Coccivac B-52 (Merck Animal Health) se evaluaron como fuente de coccidias en tres ensayos. Los ensayos 1 y 2 fueron diseños de bloques completamente aleatorios con cuatro dosis (0, 10, 20 o 30 veces (×) la dosis indicada en la etiqueta) de Coccivac-B administradas a 12 jaulas repetidas de seis aves mediante una pipeta repetidora (ensayo 1) o por sonda oral. (Prueba 2). El ensayo 3 utilizó un diseño completamente aleatorio con una dosis de etiqueta de 0 × o 30 × de Coccivac-B52 administrada con una sonda oral en seis jaulas repetidas de seis aves. Las aves fueron inoculadas por sonda a los 15 días de edad y los criterios de respuesta se evaluaron a los 7 días postinoculación en todos los ensayos y nuevamente a los 10 días postinoculación en los ensayos 1 y 2. Todos los promedios se reportan en orden de dosis crecientes de coccidias con significancia aceptada en P ≤ 0.05. El rendimiento de los pollos de engorde no se vio afectado por las coccidias en los Ensayos 1 o 3, pero empeoró al aumentar la dosis de los cero a 7 días después de la inoculación en el Ensayo 2 (aumento de peso corporal, 465, 421, 388, 365 g; alimento para ganar, 1.37, 1.47, 1.52, 1.58). A medida que aumentaba la dosis de coccidia, la energía metabolizable de nitrógeno aparente y corregida disminuyó (Prueba 1, 3387, 3318, 3267, 3170 kcal kg-1; Prueba 2, 3358, 2535, 2422, 2309 kcal kg-1; Prueba 3, no medida), mientras que el peso relativo, la longitud y el contenido de las secciones intestinales aumentaron (ensayos 1 a 3). La lesión macroscópica (duodeno, yeyuno/íleon, ciego) y las puntuaciones del recuento de oocistos (yeyuno/íleon, ciego) aumentaron con la dosis; sin embargo, la puntuación bruta a menudo sugirió infección en aves no desafiadas, un hallazgo que no está respaldado por las puntuaciones del recuento de ooquistes. A los 7 días después de la infección no hubo correlación entre la puntuación de la lesión macroscópica del intestino medio y la puntuación del recuento de oocistos del intestino medio (r= 0,06, P= 0,705), pero las puntuaciones cecales se correlacionaron débilmente (r = 0.55, P <0.001). La administración de coccidias a través de una pipeta repetidora (Ensayo 1) provocó dificultad respiratoria en algunas aves, mientras que el uso de la sonda oral (Ensayos 2 y 3) indujo con éxito el daño intestinal en los pollos sin dar como resultado mortalidad relacionada con los coccidias. Treinta veces la dosis de la etiqueta a los 7 días después de la infección resultó en el mayor número de variables de respuesta que produjeron un cambio marcado y consistente. Por lo tanto, deben tenerse en cuenta estas condiciones al diseñar futuros modelos de exposición a la coccidiosis que utilicen vacunas como fuente de coccidias.

[Formation and Unique Experience of the Center For the Treatment of Cerebrovascular Pathology in Children and Adolescents Located in a Multidisciplinary Pediatric Hospital, as the Only Primary Center of Pediatric Stroke in the Russian Federation].

Stroke is in the top ten causes of children death, ahead of brain tumors. Х-ray diagnostics development has significantly improved the detectability of pediatric stroke. The average incidence of cerebrovascular diseases in children was 13 per 100,000 children annually. The main feature of children's stroke is its multifactorial character, which complicates diagnostic process and requires involvement of doctors of different specialties to determine the leading etiological factors and choose optimal therapy and management tactics. The Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents was established on the basis of Morozov Children City Clinical Hospital by Moscow Healthcare Department, Order No. 169, dated February 27, 2014. The main task was to create a pediatric stroke center on the basis of multidisciplinary Morozov Children City Clinical Hospital, which met the main international requirements of the primary center for pediatric stroke. It was done to improve early diagnostic process, refine the algorithm for maintaining patient data in acute periods, develop preventive measures, maintain city pediatric stroke register, introduce family consultations, coordinate medical care for children with cerebrovascular pathology at various levels in Moscow, and improve medical care quality for children with cerebrovascular pathology and their families. Since April 2014 more than 800 children have undergone inpatient treatment and more than 420 have been treated in outpatient departments of Morozov Children City Clinical Hospital.

In vivo digestion characteristics of protein sources fed to broilers.

The rate and extent of protein digestion are relevant to broiler performance and health, but information is lacking on the rate of digestion and the characteristics of the undigested fraction for common protein feed ingredients. Therefore, this study evaluated the digestion kinetics and the distal ileum (DI) digesta protein characteristics of protein meals fed to broiler chickens. Using a completely randomized design, 360 male broilers at 14 D of age were assigned to 60 battery cages and fed semi-purified diets composed of wheat starch (N-free) or wheat starch with either corn distillers dried grains with solubles (CDDGS), corn gluten meal, meat and bone meal, soybean meal, fish meal (FM), porcine meal (PCM), canola meal, blood meal (BM), or feather meal. At day 21, the protein digestion kinetics and total and soluble protein of the DI content were determined. Differences were considered significant when P ≤ 0.05. Protein source affected the extent of amino acid (AA) and CP digestibility at the DI. The results demonstrated differences in digesta mean retention time (MRT) and the rate of digestion of AA and CP among protein sources. FM had the shortest MRT of 46 min, whereas CDDGS had the longest at 142 min. Both FM and PCM had the highest digestion rates for most of the AA evaluated among the protein sources, whereas CDDGS had the lowest. In turn, the total and soluble CP in the distal ileal contents ranged from 54 to 1466 mg and 6 to 347 mg, respectively. In conclusion, dietary protein source influences the amount and solubility of the undigested protein in the DI and the digestion kinetics of AA and CP along the small intestine of broilers. These parameters may contribute to the effects of protein source on muscle deposition and could influence the impact protein sources may have on gut health through protein fermentation.

[Sturge-Weber syndrome in children. Clinical features, diagnosis and approaches to therapy on the example of three clinical cases]. / Sindrom Shturge-Vebera u detei. Osobennosti kliniki, diagnostiki i podkhodov k terapii paroksizmal'nykh sostoianii na primere trekh klinicheskikh nabliudenii.

Sturge-Weber syndrome belongs to the group of phacomotoses and is characterized by a combined lesion of the skin, eyes, nervous system and internal organs. The clinical course of Sturge-Weber syndrome is quite diverse. Of particular interest in the practice of pediatric neurology and neurosurgery is the fact that 72-90% of patients present with epilepsy. Of particular difficulty is the differential diagnosis of epileptic seizures and stroke-like episodes. The article presents clinical cases of patients with Sturge-Weber syndrome of various ages with epileptic seizures and transient ischemic attacks.

Effect of live yeast Saccharomyces cerevisiae (Actisaf Sc 47) supplementation on the performance and hindgut microbiota composition of weanling pigs.

As an alternative to antibiotic growth promoters, live yeast supplementation has proven useful in reducing weaning stress and improving performance parameters of piglets. Here, we compared the performance and hindgut microbiota of weanling piglets subjected to different pre- and post-weaning yeast supplementation regimens using a live strain of Saccharomyces cerevisiae (Actisaf Sc 47). Average feed intake and average daily weight gain of piglets within Yeast-Control and Yeast-Yeast groups were higher than those in the Control-Control group. Yeast supplementation resulted in development of microbial communities that were phylogenetically more homogenous and less dispersed compared to the microbiota of control piglets. Key bacterial taxa overrepresented in the microbiota of yeast supplemented piglets included phylum Actinobacteria, specifically family Coriobacteriaceae, as well as Firmicutes families Ruminococcaceae, Clostridiaceae, Peptostreptococcaceae, and Peptococcaceae. Correlation network analysis revealed that yeast supplementation was associated with enrichment of positive correlations among proportions of different bacterial genera within the hindgut ecosystem. In particular, within the cecal microbiota of supplemented piglets, higher numbers of positive correlations were observed among potentially beneficial genera of the phyla Actinobacteria and Firmicutes, suggesting a mechanism by which yeast supplementation may contribute to regulation of intestinal homeostasis and improved performance of piglets.

Germline activating TYK2 mutations in pediatric patients with two primary acute lymphoblastic leukemia occurrences.

The contribution of genetic predisposing factors to the development of pediatric acute lymphoblastic leukemia (ALL), the most frequently diagnosed cancer in childhood, has not been fully elucidated. Children presenting with multiple de novo leukemias are more likely to suffer from genetic predisposition. Here, we selected five of these patients and analyzed the mutational spectrum of normal and malignant tissues. In two patients, we identified germline mutations in TYK2, a member of the JAK tyrosine kinase family. These mutations were located in two adjacent codons of the pseudokinase domain (p.Pro760Leu and p.Gly761Val). In silico modeling revealed that both mutations affect the conformation of this autoregulatory domain. Consistent with this notion, both germline mutations promote TYK2 autophosphorylation and activate downstream STAT family members, which could be blocked with the JAK kinase inhibitor I. These data indicate that germline activating TYK2 mutations predispose to the development of ALL.

The genetic heterogeneity of colorectal cancer predisposition - guidelines for gene discovery.

BACKGROUND: Colorectal cancer (CRC) is a cumulative term applied to a clinically and genetically heterogeneous group of neoplasms that occur in the bowel. Based on twin studies, up to 45 % of the CRC cases may involve a heritable component. Yet, only in 5-10 % of these cases high-penetrant germline mutations are found (e.g. mutations in APC and DNA mismatch repair genes) that result in a familial aggregation and/or an early onset of the disease. Genome-wide association studies have revealed that another ~5 % of the CRC cases may be explained by a cumulative effect of low-penetrant risk factors. Recent attempts to identify novel genetic factors using whole exome and whole genome sequencing has proven to be difficult since the remaining, yet to be discovered, high penetrant CRC predisposing genes appear to be rare. In addition, most of the moderately penetrant candidate genes identified so far have not been confirmed in independent cohorts. Based on literature examples, we here discuss how careful patient and cohort selection, candidate gene and variant selection, and corroborative evidence may be employed to facilitate the discovery of novel CRC predisposing genes. CONCLUSIONS: The picture emerges that the genetic predisposition to CRC is heterogeneous, involving complex interplays between common and rare (inter)genic variants with different penetrances. It is anticipated, however, that the use of large clinically well-defined patient and control datasets, together with improved functional and technical possibilities, will yield enough power to unravel this complex interplay and to generate accurate individualized estimates for the risk to develop CRC.

Attosecond nanoscale near-field sampling.

The promise of ultrafast light-field-driven electronic nanocircuits has stimulated the development of the new research field of attosecond nanophysics. An essential prerequisite for advancing this new area is the ability to characterize optical near fields from light interaction with nanostructures, with sub-cycle resolution. Here we experimentally demonstrate attosecond near-field retrieval for a tapered gold nanowire. By comparison of the results to those obtained from noble gas experiments and trajectory simulations, the spectral response of the nanotaper near field arising from laser excitation can be extracted.

The Ebola epidemic and public health response.

INTRODUCTION: An unprecedented global effort has been required to tackle the Ebola outbreak in West Africa. In this paper, we describe the contribution of Public Health England (PHE) in West Africa and the UK. SOURCES OF DATA: Public Health England AREAS OF AGREEMENT: The epidemic has been a humanitarian crisis for the three worst affected countries. PHE contributions have included expertise in outbreak control and microbiology services in West Africa, and UK preparedness for an imported case. AREAS OF CONTROVERSY: National and international systems require change to enhance the response to the next international public health crisis. GROWING POINTS: Legacy planning following the epidemic will be crucial, supporting the recovery of the health and public health systems in West Africa and ensuring that the knowledge gained during this outbreak is put to best use. AREAS TIMELY FOR DEVELOPING RESEARCH: Ongoing PHE-associated research includes efforts to understand the pathogenicity of Ebola virus disease, improve diagnostic capability, explore therapeutic options and develop new vaccines.

Risk Factors for Sexual Transmission of Hepatitis C Virus Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men: A Case-Control Study.

Background. Since 2000, incidence of sexually acquired hepatitis C virus (HCV)-infection has increased among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). To date, few case-control and cohort studies evaluating HCV transmission risk factors were conducted in this population, and most of these studies were initially designed to study HIV-related risk behavior and characteristics. Methods. From 2009 onwards, HIV-infected MSM with acute HCV infection and controls (HIV-monoinfected MSM) were prospectively included in the MOSAIC (MSM Observational Study of Acute Infection with hepatitis C) study at 5 large HIV outpatient clinics in the Netherlands. Written questionnaires were administered, covering sociodemographics, bloodborne risk factors for HCV infection, sexual behavior, and drug use. Clinical data were acquired through linkage with databases from the Dutch HIV Monitoring Foundation. For this study, determinants of HCV acquisition collected at the inclusion visit were analyzed using logistic regression. Results. Two hundred thirteen HIV-infected MSM (82 MSM with acute HCV infection and 131 MSM without) were included with a median age of 45.7 years (interquartile range [IQR], 41.0-52.2). Receptive unprotected anal intercourse (adjusted odds ratio [aOR], 5.01; 95% confidence interval [CI], 1.63-15.4), sharing sex toys (aOR, 3.62; 95% CI, 1.04-12.5), unprotected fisting (aOR, 2.57; 95% CI, 1.02-6.44), injecting drugs (aOR, 15.62; 95% CI, 1.27-192.6), sharing straws when snorting drugs (aOR, 3.40; 95% CI, 1.39-8.32), lower CD4 cell count (aOR, 1.75 per cubic root; 95% CI, 1.19-2.58), and recent diagnosis of ulcerative sexually transmitted infection (aOR, 4.82; 95% CI, 1.60-14.53) had significant effects on HCV acquisition. Conclusions. In this study, both sexual behavior and biological factors appear to independently increase the risk of HCV acquisition among HIV-infected MSM.

Field propagation-induced directionality of carrier-envelope phase-controlled photoemission from nanospheres.

Near-fields of non-resonantly laser-excited nanostructures enable strong localization of ultrashort light fields and have opened novel routes to fundamentally modify and control electronic strong-field processes. Harnessing spatiotemporally tunable near-fields for the steering of sub-cycle electron dynamics may enable ultrafast optoelectronic devices and unprecedented control in the generation of attosecond electron and photon pulses. Here we utilize unsupported sub-wavelength dielectric nanospheres to generate near-fields with adjustable structure and study the resulting strong-field dynamics via photoelectron imaging. We demonstrate field propagation-induced tunability of the emission direction of fast recollision electrons up to a regime, where nonlinear charge interaction effects become dominant in the acceleration process. Our analysis supports that the timing of the recollision process remains controllable with attosecond resolution by the carrier-envelope phase, indicating the possibility to expand near-field-mediated control far into the realm of high-field phenomena.

Health and happiness is more important than weight': a qualitative investigation of the views of parents receiving written feedback on their child's weight as part of the National Child Measurement Programme.

BACKGROUND: The present study aimed to explore parental perceptions of overweight children and associated health risks after receiving National Child Measurement Programme (NCMP) weight feedback. METHODS: Fifty-two parents of overweight and obese children aged 4-5 years and 10-11 years enrolled in the NCMP programme in England in 2010-2011 participated in qualitative, semi-structured interviews about their perceptions of their child's weight and health risk after receiving weight feedback. Interviews were audio tape recorded and were conducted either by telephone (n = 9) or in the respondents' homes (n = 41). Interviews were transcribed verbatim and analysed using interpretative thematic analysis. RESULTS: Parents who received NCMP written feedback informing them that their child was overweight disregarded the results because they viewed 'health and happiness as being more important than weight'. The feedback was viewed as less credible because it did not consider the individual child's lifestyle.'Broad definitions of healthy' were described that did not include weight,such as reference to the child having good emotional and physical health and a healthy diet. Parents attributed weight to 'inherited/acquired factors' such as genetics or puppy fat, or did not regard their child's 'appearance' as reflecting being overweight. 'Cultural influence' also meant that being overweight was not viewed negatively by some non-white parents. CONCLUSIONS: After receiving written weight feedback, parents use methods other than actual weight when evaluating their child's weight status and health risks. Parents' conceptions of health and weight should be considered when communicating with parents, with the aim of bridging the gap between parental recognition of being overweight and subsequent behaviour change.

Primary resistance to integrase strand-transfer inhibitors in Europe.

OBJECTIVES: The objective of this study was to define the natural genotypic variation of the HIV-1 integrase gene across Europe for epidemiological surveillance of integrase strand-transfer inhibitor (InSTI) resistance. METHODS: This was a multicentre, cross-sectional study within the European SPREAD HIV resistance surveillance programme. A representative set of 300 samples was selected from 1950 naive HIV-positive subjects newly diagnosed in 2006-07. The prevalence of InSTI resistance was evaluated using quality-controlled baseline population sequencing of integrase. Signature raltegravir, elvitegravir and dolutegravir resistance mutations were defined according to the IAS-USA 2014 list. In addition, all integrase substitutions relative to HXB2 were identified, including those with a Stanford HIVdb score ≥ 10 to at least one InSTI. To rule out circulation of minority InSTI-resistant HIV, 65 samples were selected for 454 integrase sequencing. RESULTS: For the population sequencing analysis, 278 samples were retrieved and successfully analysed. No signature resistance mutations to any of the InSTIs were detected. Eleven (4%) subjects had mutations at resistance-associated positions with an HIVdb score ≥ 10. Of the 56 samples successfully analysed with 454 sequencing, no InSTI signature mutations were detected, whereas integrase substitutions with an HIVdb score ≥ 10 were found in 8 (14.3%) individuals. CONCLUSIONS: No signature InSTI-resistant variants were circulating in Europe before the introduction of InSTIs. However, polymorphisms contributing to InSTI resistance were not rare. As InSTI use becomes more widespread, continuous surveillance of primary InSTI resistance is warranted. These data will be key to modelling the kinetics of InSTI resistance transmission in Europe in the coming years.