Avoidance and fear day by day in social anxiety disorder.

OBJECTIVE: Theories assert that avoidance maintains maladaptive anxiety over time, yet a clear prospective test of this effect in the day-by-day lives of people with social anxiety disorder (SAD) is lacking. METHOD: We used intensive longitudinal data to test prospective relationships between social fear and social avoidance in 32 participants with SAD who reported on a total of 4256 time points. RESULTS: Results suggested that avoidance strongly predicted future anxiety, but only in a minority of people with SAD. Relationships between anxiety and avoidance varied considerably across individuals. Pre-registered tests found that the strength of autocorrelation for social fear is a good target for future testing of prediction of exposure response. Participants with lower autocorrelations were less likely to show between-session habituation. CONCLUSIONS: Overall, results suggest avoidance maintains fear in SAD for at least some individuals, but also indicates considerable variability. Further intensive longitudinal data is needed to examine individuals with SAD across varying time courses.

Acceptability of Cognitive Behavioral Therapy for Tinnitus: A Study With Veterans and Nonveterans.

PURPOSE: Cognitive behavioral therapy (CBT) is a gold standard yet underutilized treatment for tinnitus, and tinnitus is especially highly prevalent among veterans. The aims of this study were twofold: to determine (a) if CBT for tinnitus is underutilized because participants find it less acceptable than other behavioral treatments for tinnitus and (b) if veterans and nonveterans rate behavioral treatments for tinnitus differently. METHOD: This cross-sectional study was conducted online with a sample of 277 adults in the United States who self-reported at least some level of bothersome tinnitus in the past week. The sample for this study consisted of 129 veterans and 148 nonveterans. Participants read descriptions of CBT, tinnitus retraining therapy (TRT), and mindfulness-based stress reduction (MBSR). For each treatment, presented to them in random order, they provided credibility, expectancy, and acceptability ratings. RESULTS: Among 277 participants, 147 (53.07%) reporting gender were women, 216 (77.98%) reporting race/ethnicity were White, and 129 (46.57%) were veterans of any branch of the U.S. Armed Forces. Veteran ratings of credibility, expectancy, and acceptability were significantly lower than nonveteran ratings across treatments. There were differences in credibility, expectancy, and acceptability ratings across treatments, and post hoc testing revealed that TRT was consistently rated higher than CBT or MBSR. CONCLUSIONS: Despite strong research support, CBT was rated as less acceptable than a different, less widely empirically supported treatment. Veterans' ratings of acceptability were lower than those of nonveterans across all treatments.

Factors Associated with Self-Reported Dysphagia in Older Adults Receiving Meal Support.

OBJECTIVES: Dysphagia is common in older adults. However, there are no current estimates of dysphagia in community-dwelling older adults those receiving meal support. It is unknown whether dysphagia is associated with other measures of physical function (activities of daily living [ADL] ability or nutrition status). The study purposes were to determine the prevalence of self-reported dysphagia and to identify factors associated with self-reported dysphagia in community-dwelling older adults receiving meal support. DESIGN: A cross-sectional study. SETTING AND PARTICIPANTS: 476 community-dwelling older adults (78.5±0.51 years) across five Elder Nutrition Program meal services in Wisconsin participated in the study. MEASUREMENTS: Data were collected through administration of validated ADL and nutrition questionnaires (nutritional status, functional status with ADLs, chewing ability, dental conditions, and prior diagnoses of dysphagia, pneumonia, and dementia). For self-reported dysphagia, the validated 10-item eating assessment tool (EAT-10) was used. RESULTS: The prevalence of self-reported dysphagia (EAT-10 score of ≥ 3) was 20.4%. Multivariate logistic regression results indicated that poor nutritional status (OR=3.1, p=0.04), difficulty chewing (OR=2.2, p=0.03), prior dysphagia diagnosis (OR=34.8, p<0.001), prior pneumonia diagnosis (OR=2.1, p=0.04), and meal service site (OR=2.68, p=0.02) were associated with self-reported dysphagia. CONCLUSION: Approximately one in five community-dwelling older adults receiving meal support had self-reported dysphagia. Increased risk for poor nutrition, reduced chewing ability, prior dysphagia and pneumonia diagnosis, and meal service site were identified as factors associated with dysphagia on the EAT-10. Results highlight the need for further studies across more sites to identify dysphagia risk indicators in community-dwelling older adults receiving meal support state-wide.

Uso de bebidas energizantes y síntomas de insomnio en estudiantes de medicina de una universidad peruana / Use of energy drinks and insomnia symptoms in medical students from a Peruvian university

OBJETIVO: Determinar la asociación entre el consumo de bebidas energizantes y síntomas de insomnio en estudiantes de medicina de una universidad en Lima, Perú. MATERIALES Y MÉTODO: El tipo de estudio realizado es transversal analítico. La población objetivo fueron los estudiantes de medicina de una universidad peruana ubicada en Lima sur de segundo y quinto año. Hubo 289 participantes en el estudio. Se utilizó una encuesta compuesta por un cuestionario sobre el consumo de bebidas energizantes y el Insomnia Severity Index, del cual se determinó un punto de corte de 15 para considerar la presencia de síntomas de insomnio. El análisis multivariado crudo y ajustado se realizó usando la regresión de Poisson con varianza robusta ajustado para sexo, edad, consumo de café, y antecedente de ansiedad y depresión, para obtener el PR (Razón de Prevalencias) con un intervalo de confianza de 95%. RESULTADOS Y DISCUSIÓN: La prevalencia de síntomas de insomnio en la muestra estudiada fue de 21,80%, mientras que la de consumo de bebidas energizantes fue de 39,45%. Se encontró asociación significativa (p=0,008) entre el consumo de este tipo de bebidas y la presencia de síntomas de insomnio. Además, se encontró que los estudiantes que consumen bebidas energizantes tuvieron 1,78 veces más probabilidad de presentar síntomas de insomnio (IC95%: 1,13-2,82), en comparación con los que no consumieron bebidas energizantes (p=0,013). CONCLUSIONES: Existe asociación entre el consumo de bebidas energizantes y síntomas de insomnio.

OBJECTIVE: To determine the association between the consumption of energy drinks and symptoms of insomnia in medical students of a university in Lima, Peru. Materials and METHODS: This study is cross-sectional analytical. The target population was the second-and fifth-year medical students of a private Peruvian university in southern Lima. There were 289 participants in this study. For this study, a survey composed of a questionnaire about the consumption of energy drinks and the Insomnia Severity Index were used, from which a cut-off point of 15 was determined to consider the presence of insomnia symptoms. The multivariate crude and adjusted analysis were done with Poisson regression with robust variance adjusted for sex, age, coffee consumption, previous diagnosis of depression and previous diagnosis of anxiety; to calculate the PR (Prevalence Ratio) with a 95% CI. RESULTS AND DISCUSSION: The prevalence of insomnia symptoms in the sample studied was 21,80%, while the consumption of energy drinks was 39,45%. A significant association was found (p = 0.008) between the consumption of this type of drinks and the presence of insomnia symptoms. In addition, it was found that students who consumed energy drinks were 1,78 times more likely to have symptoms of insomnia (95% CI: 1,13-2,82), compared to those who did not consume energy drinks (p=<0,013). CONCLUSIONS: There is an association between the consumption of energy drinks and symptoms of insomnia.

Fungal Planet description sheets: 1284-1382.

Novel species of fungi described in this study include those from various countries as follows: Antartica, Cladosporium austrolitorale from coastal sea sand. Australia, Austroboletus yourkae on soil, Crepidotus innuopurpureus on dead wood, Curvularia stenotaphri from roots and leaves of Stenotaphrum secundatum and Thecaphora stajsicii from capsules of Oxalis radicosa. Belgium, Paraxerochrysium coryli (incl. Paraxerochrysium gen. nov.) from Corylus avellana. Brazil, Calvatia nordestina on soil, Didymella tabebuiicola from leaf spots on Tabebuia aurea, Fusarium subflagellisporum from hypertrophied floral and vegetative branches of Mangifera indica and Microdochium maculosum from living leaves of Digitaria insularis. Canada, Cuphophyllus bondii from a grassland. Croatia, Mollisia inferiseptata from a rotten Laurus nobilis trunk. Cyprus, Amanita exilis on calcareous soil. Czech Republic, Cytospora hippophaicola from wood of symptomatic Vaccinium corymbosum. Denmark, Lasiosphaeria deviata on pieces of wood and herbaceous debris. Dominican Republic, Calocybella goethei among grass on a lawn. France (Corsica), Inocybe corsica on wet ground. France (French Guiana), Trechispora patawaensis on decayed branch of unknown angiosperm tree and Trechispora subregularis on decayed log of unknown angiosperm tree. Germany, Paramicrothecium sambuci (incl. Paramicrothecium gen. nov.) on dead stems of Sambucus nigra. India, Aureobasidium microtermitis from the gut of a Microtermes sp. termite, Laccaria diospyricola on soil and Phylloporia tamilnadensis on branches of Catunaregam spinosa. Iran, Pythium serotinoosporum from soil under Prunus dulcis. Italy, Pluteus brunneovenosus on twigs of broadleaved trees on the ground. Japan, Heterophoma rehmanniae on leaves of Rehmannia glutinosa f. hueichingensis. Kazakhstan, Murispora kazachstanica from healthy roots of Triticum aestivum. Namibia, Caespitomonium euphorbiae (incl. Caespitomonium gen. nov.) from stems of an Euphorbia sp. Netherlands, Alfaria junci, Myrmecridium junci, Myrmecridium juncicola, Myrmecridium juncigenum, Ophioceras junci, Paradinemasporium junci (incl. Paradinemasporium gen. nov.), Phialoseptomonium junci, Sporidesmiella juncicola, Xenopyricularia junci and Zaanenomyces quadripartis (incl. Zaanenomyces gen. nov.), from dead culms of Juncus effusus, Cylindromonium everniae and Rhodoveronaea everniae from Evernia prunastri, Cyphellophora sambuci and Myrmecridium sambuci from Sambucus nigra, Kiflimonium junci, Sarocladium junci, Zaanenomyces moderatricis-academiae and Zaanenomyces versatilis from dead culms of Juncus inflexus, Microcera physciae from Physcia tenella, Myrmecridium dactylidis from dead culms of Dactylis glomerata, Neochalara spiraeae and Sporidesmium spiraeae from leaves of Spiraea japonica, Neofabraea salicina from Salix sp., Paradissoconium narthecii (incl. Paradissoconium gen. nov.) from dead leaves of Narthecium ossifragum, Polyscytalum vaccinii from Vaccinium myrtillus, Pseudosoloacrosporiella cryptomeriae (incl. Pseudosoloacrosporiella gen. nov.) from leaves of Cryptomeria japonica, Ramularia pararhabdospora from Plantago lanceolata, Sporidesmiella pini from needles of Pinus sylvestris and Xenoacrodontium juglandis (incl. Xenoacrodontium gen. nov. and Xenoacrodontiaceae fam. nov.) from Juglans regia. New Zealand, Cryptometrion metrosideri from twigs of Metrosideros sp., Coccomyces pycnophyllocladi from dead leaves of Phyllocladus alpinus, Hypoderma aliforme from fallen leaves Fuscopora solandri and Hypoderma subiculatum from dead leaves Phormium tenax. Norway, Neodevriesia kalakoutskii from permafrost and Variabilispora viridis from driftwood of Picea abies. Portugal, Entomortierella hereditatis from a biofilm covering a deteriorated limestone wall. Russia, Colpoma junipericola from needles of Juniperus sabina, Entoloma cinnamomeum on soil in grasslands, Entoloma verae on soil in grasslands, Hyphodermella pallidostraminea on a dry dead branch of Actinidia sp., Lepiota sayanensis on litter in a mixed forest, Papiliotrema horticola from Malus communis, Paramacroventuria ribis (incl. Paramacroventuria gen. nov.) from leaves of Ribes aureum and Paramyrothecium lathyri from leaves of Lathyrus tuberosus. South Africa, Harzia combreti from leaf litter of Combretum collinum ssp. sulvense, Penicillium xyleborini from Xyleborinus saxesenii, Phaeoisaria dalbergiae from bark of Dalbergia armata, Protocreopsis euphorbiae from leaf litter of Euphorbia ingens and Roigiella syzygii from twigs of Syzygium chordatum. Spain, Genea zamorana on sandy soil, Gymnopus nigrescens on Scleropodium touretii, Hesperomyces parexochomi on Parexochomus quadriplagiatus, Paraphoma variabilis from dung, Phaeococcomyces kinklidomatophilus from a blackened metal railing of an industrial warehouse and Tuber suaveolens in soil under Quercus faginea. Svalbard and Jan Mayen, Inocybe nivea associated with Salix polaris. Thailand, Biscogniauxia whalleyi on corticated wood. UK, Parasitella quercicola from Quercus robur. USA, Aspergillus arizonicus from indoor air in a hospital, Caeliomyces tampanus (incl. Caeliomyces gen. nov.) from office dust, Cippumomyces mortalis (incl. Cippumomyces gen. nov.) from a tombstone, Cylindrium desperesense from air in a store, Tetracoccosporium pseudoaerium from air sample in house, Toxicocladosporium glendoranum from air in a brick room, Toxicocladosporium losalamitosense from air in a classroom, Valsonectria portsmouthensis from air in men's locker room and Varicosporellopsis americana from sludge in a water reservoir. Vietnam, Entoloma kovalenkoi on rotten wood, Fusarium chuoi inside seed of Musa itinerans, Micropsalliota albofelina on soil in tropical evergreen mixed forests and Phytophthora docyniae from soil and roots of Docynia indica. Morphological and culture characteristics are supported by DNA barcodes. Citation: Crous PW, Osieck ER, Jurjevic Z, et al. 2021. Fungal Planet description sheets: 1284-1382. Persoonia 47: 178-374. https://doi.org/10.3767/persoonia.2021.47.06.

Fungal Planet description sheets: 1284-1382.

Novel species of fungi described in this study include those from various countries as follows: Antartica, Cladosporium austrolitorale from coastal sea sand. Australia, Austroboletus yourkae on soil, Crepidotus innuopurpureus on dead wood, Curvularia stenotaphri from roots and leaves of Stenotaphrum secundatum and Thecaphora stajsicii from capsules of Oxalis radicosa. Belgium, Paraxerochrysium coryli (incl. Paraxerochrysium gen. nov.) from Corylus avellana. Brazil, Calvatia nordestina on soil, Didymella tabebuiicola from leaf spots on Tabebuia aurea, Fusarium subflagellisporum from hypertrophied floral and vegetative branches of Mangifera indica and Microdochium maculosum from living leaves of Digitaria insularis. Canada, Cuphophyllus bondii from a grassland. Croatia, Mollisia inferiseptata from a rotten Laurus nobilis trunk. Cyprus, Amanita exilis on calcareous soil. Czech Republic, Cytospora hippophaicola from wood of symptomatic Vaccinium corymbosum. Denmark, Lasiosphaeria deviata on pieces of wood and herbaceous debris. Dominican Republic, Calocybella goethei among grass on a lawn. France (Corsica), Inocybe corsica on wet ground. France (French Guiana), Trechispora patawaensis on decayed branch of unknown angiosperm tree and Trechispora subregularis on decayed log of unknown angiosperm tree. Germany, Paramicrothecium sambuci (incl. Paramicrothecium gen. nov.) on dead stems of Sambucus nigra. India, Aureobasidium microtermitis from the gut of a Microtermes sp. termite, Laccaria diospyricola on soil and Phylloporia tamilnadensis on branches of Catunaregam spinosa. Iran, Pythium serotinoosporum from soil under Prunus dulcis. Italy, Pluteus brunneovenosus on twigs of broadleaved trees on the ground. Japan, Heterophoma rehmanniae on leaves of Rehmannia glutinosa f. hueichingensis. Kazakhstan, Murispora kazachstanica from healthy roots of Triticum aestivum. Namibia, Caespitomonium euphorbiae (incl. Caespitomonium gen. nov.) from stems of an Euphorbia sp. Netherlands, Alfaria junci, Myrmecridium junci, Myrmecridium juncicola, Myrmecridium juncigenum, Ophioceras junci, Paradinemasporium junci (incl. Paradinemasporium gen. nov.), Phialoseptomonium junci, Sporidesmiella juncicola, Xenopyricularia junci and Zaanenomyces quadripartis (incl. Zaanenomyces gen. nov.), from dead culms of Juncus effusus, Cylindromonium everniae and Rhodoveronaea everniae from Evernia prunastri, Cyphellophora sambuci and Myrmecridium sambuci from Sambucus nigra, Kiflimonium junci, Sarocladium junci, Zaanenomyces moderatricis-academiae and Zaanenomyces versatilis from dead culms of Juncus inflexus, Microcera physciae from Physcia tenella, Myrmecridium dactylidis from dead culms of Dactylis glomerata, Neochalara spiraeae and Sporidesmium spiraeae from leaves of Spiraea japonica, Neofabraea salicina from Salix sp., Paradissoconium narthecii (incl. Paradissoconium gen. nov.) from dead leaves of Narthecium ossifragum, Polyscytalum vaccinii from Vaccinium myrtillus, Pseudosoloacrosporiella cryptomeriae (incl. Pseudosoloacrosporiella gen. nov.) from leaves of Cryptomeria japonica, Ramularia pararhabdospora from Plantago lanceolata, Sporidesmiella pini from needles of Pinus sylvestris and Xenoacrodontium juglandis (incl. Xenoacrodontium gen. nov. and Xenoacrodontiaceae fam. nov.) from Juglans regia. New Zealand, Cryptometrion metrosideri from twigs of Metrosideros sp., Coccomyces pycnophyllocladi from dead leaves of Phyllocladus alpinus, Hypoderma aliforme from fallen leaves Fuscopora solandri and Hypoderma subiculatum from dead leaves Phormium tenax. Norway, Neodevriesia kalakoutskii from permafrost and Variabilispora viridis from driftwood of Picea abies. Portugal, Entomortierella hereditatis from a biofilm covering a deteriorated limestone wall. Russia, Colpoma junipericola from needles of Juniperus sabina, Entoloma cinnamomeum on soil in grasslands, Entoloma verae on soil in grasslands, Hyphodermella pallidostraminea on a dry dead branch of Actinidia sp., Lepiota sayanensis on litter in a mixed forest, Papiliotrema horticola from Malus communis, Paramacroventuria ribis (incl. Paramacroventuria gen. nov.) from leaves of Ribes aureum and Paramyrothecium lathyri from leaves of Lathyrus tuberosus. South Africa, Harzia combreti from leaf litter of Combretum collinum ssp. sulvense, Penicillium xyleborini from Xyleborinus saxesenii, Phaeoisaria dalbergiae from bark of Dalbergia armata, Protocreopsis euphorbiae from leaf litter of Euphorbia ingens and Roigiella syzygii from twigs of Syzygium chordatum. Spain, Genea zamorana on sandy soil, Gymnopus nigrescens on Scleropodium touretii, Hesperomyces parexochomi on Parexochomus quadriplagiatus, Paraphoma variabilis from dung, Phaeococcomyces kinklidomatophilus from a blackened metal railing of an industrial warehouse and Tuber suaveolens in soil under Quercus faginea. Svalbard and Jan Mayen, Inocybe nivea associated with Salix polaris. Thailand, Biscogniauxia whalleyi on corticated wood. UK, Parasitella quercicola from Quercus robur. USA, Aspergillus arizonicus from indoor air in a hospital, Caeliomyces tampanus (incl. Caeliomyces gen. nov.) from office dust, Cippumomyces mortalis (incl. Cippumomyces gen. nov.) from a tombstone, Cylindrium desperesense from air in a store, Tetracoccosporium pseudoaerium from air sample in house, Toxicocladosporium glendoranum from air in a brick room, Toxicocladosporium losalamitosense from air in a classroom, Valsonectria portsmouthensis from air in men's locker room and Varicosporellopsis americana from sludge in a water reservoir. Vietnam, Entoloma kovalenkoi on rotten wood, Fusarium chuoi inside seed of Musa itinerans, Micropsalliota albofelina on soil in tropical evergreen mixed forests and Phytophthora docyniae from soil and roots of Docynia indica. Morphological and culture characteristics are supported by DNA barcodes. Citation: Crous PW, Osieck ER, Jurjevic Z, et al. 2021. Fungal Planet description sheets: 1284-1382. Persoonia 47: 178-374. https://doi.org/10.3767/persoonia.2021.47.06.

Advantageous Feeding on Different Blood Meal Sources by the Chagas Disease Vector Triatoma barberi (Hemiptera: Reduviidae).

Triatominae bugs (Hemiptera: Reduviidae) are usually associated with different vertebrate species, upon which many of them feed. Yet how these different blood meal sources influence key biological parameters is rarely investigated for triatomines. To fill this knowledge gap, this study sought to determine the effect of a domestic rat species (Rattus norvegicus Berkenhout (Rodentia: Muridae)), a domestic mice species (Mus musculus L. (Rodentia: Muridae)), and chickens (Gallus gallus domesticus L. (Galliformes: Phasianidae)), as blood meal sources upon several biological parameters (development time, number of required blood meals to moult and feeding and defecation behaviors) of the Mexican major vector Triatoma barberi Usinger. The three studied cohorts' development times were similar (325-338 d), but the number of required blood meals to moult (21), as well as the total mortality rate (26%), were both the highest in the cohort that fed on chickens. The longevity of females (186-190 d) was similar among the three studied cohorts, as was that of males. The median time elapsed between the presentation of a blood meal source and onset of feeding (10 min) was similar among the three studied cohorts, as were their feeding times and defecation patterns. Most of our studied parameters demonstrate how T. barberi can effectively take advantage of feeding on rodents as much as it does on hens. Those parameter results also show that T. barberi should be considered as a potential yet underappreciated vector in some areas, thus warranting a surveillance program of its current distribution area in Mexico.

Efecto nefroprotector del Camu Camu (Myrciaria dubia) en un modelo de nefrotoxicidad inducida por gentamicina en ratas / Nephroprotective effect of Camu Camu (Myrciaria dubia) in a model of nephrotoxicity induced by Gentamicin in rats

RESUMEN El objetivo del estudio fue determinar el efecto nefroprotector del extracto de camu camu en un modelo de nefrotoxicidad inducida por la gentamicina. Estudio de tipo experimental formado por 50 ratas Sprague Dawley que se dividieron aleatoriamente en cinco grupos de estudio: Al grupo control se le administró la solución salina, al grupo gentamicina se le indujo la nefrotoxicidad y a los grupos experimentales 1, 2 y 3 se les protegió con el extracto alcohólico de camu camu a diferentes dosis. La actividad nefroprotectora se evaluó por la cuantificación de la creatinina sérica, el peso y análisis histopatológico de los riñones. Los resultados evidenciaron una disminución significativa del nivel de creatinina en los grupos protegidos con el extracto alcohólico de camu camu con respecto al grupo gentamicina (p<0,05). Los grupos que recibieron camu camu presentaron un aumento gradual del peso de los riñones en una relación directa a la dosis del extracto (p<0,05). El análisis histológico evidenció pérdida epitelial, infiltrado inflamatorio intenso y congestión vascular en el grupo gentamicina, mientras que los grupos que recibieron camu camu con el extracto disminuyeron la gravedad del daño. Se concluye que el extracto de camu camu presentó una actividad nefroprotectora significativa en un modelo de nefrotoxicidad inducida por gentamicina.

ABSTRACT The aim of the study was to determine the nephroprotective effect of camu camu extract on a gentamicin-induced nephrotoxicity model. The study design was experimental using 50 Sprague Dawley rats randomly allocated into 1 of 5 five groups: a control group that was administered a saline solution, a gentamicin group in which nephrotoxicity was induced and experimental groups 1, 2 and 3 that were provided different doses of Camu Camu alcoholic extract. Nephroprotective activity was evaluated via quantification of seric creatinine, histopathological analysis and weighing of the kidneys. Results showed a significant decrease in creatinine levels between the group administered camu camu alcoholic extract and the gentamicin group (p<0.05). Groups who received camu camu presented a gradual increase in kidneys weight which corresponded directly to the extract dose (p<0.05). The histopathological analysis showed epithelial loss, intense inflammatory infiltrate and vascular congestion in the gentamicin group, while the groups who received the extract had a lower level of damage. Camu Camu extract provided a significant nephroprotective activity on a gentamicin-induced nephrotoxicity model.

Older Donation After Circulatory Death Kidneys for Older Recipients: A Single-Center Experience.

The number of older patients is increasing on the transplant waiting list. Donation after circulatory death (DCD) kidney transplantation has increased, but there remains hesitancy in use of older DCD organs. The aim of this study was to evaluate outcomes of directing older DCD donor kidneys into older recipients. METHODS: Patients 60 years or older who received transplants from DCD donors 60 years or older, between February 2010 and January 2014, were identified from a prospectively maintained database. RESULTS: Over a 4-year period, 88 patients 60 years or older received DCD kidney transplants from donors 60 years or older. Of these 44 (55%) were 60 to 69 years old and 40 (45%) were 70 years or older. Median follow up was 63 months. Patient survival was 95% and 79% at 1 and 5 years, respectively, with a survival in those 70 years and older (69%) compared with those aged 60 to 69 (88%) years (P = .01). Censored for death graft survival was 94% and 80% at 1 and 5 years, respectively. Median estimated glomerular filtration rate at 12 months and 36 months was 36 mL/min (range, 11-70 mL/min) and 39.5 mL/min (range, 11-77 mL/min), respectively. CONCLUSIONS: Older DCD kidneys, when transplanted into older recipients, result in good patient and graft survival and an acceptable graft function, especially considering their age. This represents a good use of this organ resource.

Fungal Planet description sheets: 951-1041.

Novel species of fungi described in this study include those from various countries as follows: Antarctica, Apenidiella antarctica from permafrost, Cladosporium fildesense from an unidentified marine sponge. Argentina, Geastrum wrightii on humus in mixed forest. Australia, Golovinomyces glandulariae on Glandularia aristigera, Neoanungitea eucalyptorum on leaves of Eucalyptus grandis, Teratosphaeria corymbiicola on leaves of Corymbia ficifolia, Xylaria eucalypti on leaves of Eucalyptus radiata. Brazil, Bovista psammophila on soil, Fusarium awaxy on rotten stalks of Zea mays, Geastrum lanuginosum on leaf litter covered soil, Hermetothecium mikaniae-micranthae (incl. Hermetothecium gen. nov.) on Mikania micrantha, Penicillium reconvexovelosoi in soil, Stagonosporopsis vannaccii from pod of Glycine max. British Virgin Isles, Lactifluus guanensis on soil. Canada, Sorocybe oblongispora on resin of Picea rubens. Chile, Colletotrichum roseum on leaves of Lapageria rosea. China, Setophoma caverna from carbonatite in Karst cave. Colombia, Lareunionomyces eucalypticola on leaves of Eucalyptus grandis. Costa Rica, Psathyrella pivae on wood. Cyprus, Clavulina iris on calcareous substrate. France, Chromosera ambigua and Clavulina iris var. occidentalis on soil. French West Indies, Helminthosphaeria hispidissima on dead wood. Guatemala, Talaromyces guatemalensis in soil. Malaysia, Neotracylla pini (incl. Tracyllales ord. nov. and Neotracylla gen. nov.) and Vermiculariopsiella pini on needles of Pinus tecunumanii. New Zealand, Neoconiothyrium viticola on stems of Vitis vinifera, Parafenestella pittospori on Pittosporum tenuifolium, Pilidium novae-zelandiae on Phoenix sp. Pakistan, Russula quercus-floribundae on forest floor. Portugal, Trichoderma aestuarinum from saline water. Russia, Pluteus liliputianus on fallen branch of deciduous tree, Pluteus spurius on decaying deciduous wood or soil. South Africa, Alloconiothyrium encephalarti, Phyllosticta encephalarticola and Neothyrostroma encephalarti (incl. Neothyrostroma gen. nov.) on leaves of Encephalartos sp., Chalara eucalypticola on leaf spots of Eucalyptus grandis × urophylla, Clypeosphaeria oleae on leaves of Olea capensis, Cylindrocladiella postalofficium on leaf litter of Sideroxylon inerme, Cylindromonium eugeniicola (incl. Cylindromonium gen. nov.) on leaf litter of Eugenia capensis, Cyphellophora goniomatis on leaves of Gonioma kamassi, Nothodactylaria nephrolepidis (incl. Nothodactylaria gen. nov. and Nothodactylariaceae fam. nov.) on leaves of Nephrolepis exaltata, Falcocladium eucalypti and Gyrothrix eucalypti on leaves of Eucalyptus sp., Gyrothrix oleae on leaves of Olea capensis subsp. macrocarpa, Harzia metrosideri on leaf litter of Metrosideros sp., Hippopotamyces phragmitis (incl. Hippopotamyces gen. nov.) on leaves of Phragmites australis, Lectera philenopterae on Philenoptera violacea, Leptosillia mayteni on leaves of Maytenus heterophylla, Lithohypha aloicola and Neoplatysporoides aloes on leaves of Aloe sp., Millesimomyces rhoicissi (incl. Millesimomyces gen. nov.) on leaves of Rhoicissus digitata, Neodevriesia strelitziicola on leaf litter of Strelitzia nicolai, Neokirramyces syzygii (incl. Neokirramyces gen. nov.) on leaf spots of Syzygium sp., Nothoramichloridium perseae (incl. Nothoramichloridium gen. nov. and Anungitiomycetaceae fam. nov.) on leaves of Persea americana, Paramycosphaerella watsoniae on leaf spots of Watsonia sp., Penicillium cuddlyae from dog food, Podocarpomyces knysnanus (incl. Podocarpomyces gen. nov.) on leaves of Podocarpus falcatus, Pseudocercospora heteropyxidicola on leaf spots of Heteropyxis natalensis, Pseudopenidiella podocarpi, Scolecobasidium podocarpi and Ceramothyrium podocarpicola on leaves of Podocarpus latifolius, Scolecobasidium blechni on leaves of Blechnum capense, Stomiopeltis syzygii on leaves of Syzygium chordatum, Strelitziomyces knysnanus (incl. Strelitziomyces gen. nov.) on leaves of Strelitzia alba, Talaromyces clemensii from rotting wood in goldmine, Verrucocladosporium visseri on Carpobrotus edulis. Spain, Boletopsis mediterraneensis on soil, Calycina cortegadensisi on a living twig of Castanea sativa, Emmonsiellopsis tuberculata in fluvial sediments, Mollisia cortegadensis on dead attached twig of Quercus robur, Psathyrella ovispora on soil, Pseudobeltrania lauri on leaf litter of Laurus azorica, Terfezia dunensis in soil, Tuber lucentum in soil, Venturia submersa on submerged plant debris. Thailand, Cordyceps jakajanicola on cicada nymph, Cordyceps kuiburiensis on spider, Distoseptispora caricis on leaves of Carex sp., Ophiocordyceps khonkaenensis on cicada nymph. USA, Cytosporella juncicola and Davidiellomyces juncicola on culms of Juncus effusus, Monochaetia massachusettsianum from air sample, Neohelicomyces melaleucae and Periconia neobrittanica on leaves of Melaleuca styphelioides × lanceolata, Pseudocamarosporium eucalypti on leaves of Eucalyptus sp., Pseudogymnoascus lindneri from sediment in a mine, Pseudogymnoascus turneri from sediment in a railroad tunnel, Pulchroboletus sclerotiorum on soil, Zygosporium pseudomasonii on leaf of Serenoa repens. Vietnam, Boletus candidissimus and Veloporphyrellus vulpinus on soil. Morphological and culture characteristics are supported by DNA barcodes.

Integral small field output factor measurements using a transmission ionisation chamber.

Previous studies describe the use of a large area parallel-plate chamber, the PTW Bragg Peak chamber, for measuring dose-area product (DAP) and output factors in small megavoltage photon fields. However, in radiotherapy departments without protons, this detector would have to be purchased separately for this purpose. This work investigated the feasibility of alternatively using a large transmission ionisation chamber, the IBA round Stealth chamber (SC), for output factor measurements of stereotactic fields. This type of detector is more commonly found in radiotherapy departments as a reference chamber for water tank scanning of small fields, and hence DAP could be performed without an additional purchase. The SC's large sensitive area (diameter of 94 mm) measures the integral dose, also known as DAP, over the whole two-dimensional (2D) dose distribution of the small field. The measurements were performed using a 6 MV beam from an Elekta Infinity linear accelerator. Conversion of DAP to central axis point dose was performed using 2D dose maps from Gafchromic EBT3 films. The field sizes measured ranged from side length of 5 mm to 50 mm (all square). The resultant output factors were compared against measurements with a stereotactic diode. The small field output factors measured using SC + film were in good agreement with the stereotactic diode (within 2% for field sizes as small as 6 mm; 3% difference at 5 mm). The new proposed method showed that a transmission chamber like SC is a good alternative large-area parallel plate chamber to measure DAP and derive small field OFs. Furthermore, the feasibility of using 2D reconstructed dose maps from water tank profiles and hence filmless approach was investigated. Results showed that filmless conversion of DAP to central axis point dose is feasible using profiles. However, a large number of profiles are required (i.e. 15° increments (star pattern) are required for accurate 2D dose reconstruction), and hence the water tank scanning for this approach may be prohibitively time-consuming.

SOX9 protein is stabilized by TGF-ß and regulates PAPSS2 mRNA expression in chondrocytes.

OBJECTIVE: We previously identified 3'-phosphoadenosine 5'-phosphosulfate synthase 2 (PAPSS2) as a transcriptional target of transforming growth factor ß (TGF-ß) in chondrocytes. PAPSS2 is required for proper sulfation of proteoglycans in cartilage. Defective sulfation in the matrix results in alterations in mechanical properties of the cartilage that would be expected to result in degeneration. The objective of this study was to identify factors that regulate PAPSS2 expression and compare to a known TGF-ß responsive gene, proteoglycan 4/lubricin (PRG4). In this study, TGF-ß-mediated regulation of SOX9 was characterized, and the involvement of SOX9 in regulation of PAPSS2 mRNA was investigated. DESIGN: Primary bovine articular chondrocytes grown in micromass culture and ATDC5 cells were used as the model system. Adenoviruses were used to express SOX9 and SMAD3. siRNA was used to knock-down Sox9 and Smad3. Western blot and real-time quantitative RT-PCR (qPCR) were used to measure changes in protein and mRNA levels in response to treatment. RESULTS: Over-expression of SOX9 was sufficient to up-regulate PAPSS2 mRNA. TGF-ß treatment of SOX9-expressing cells resulted in enhanced up-regulation of PAPSS2 mRNA, suggesting that SOX9 cooperates with TGF-ß signaling. Furthermore, Sox9 was required for full TGF-ß-mediated induction of Papss2. In contrast, PRG4 was regulated by SMAD3 but not SOX9. SOX9 protein levels were increased after treatment with TGF-ß, although SOX9 mRNA was not. SOX9 protein was post-translationally stabilized after treatment with TGF-ß. CONCLUSIONS: TGF-ß stabilizes SOX9 protein, and SOX9 is sufficient and necessary for TGF-ß-mediated regulation of PAPSS2 mRNA, providing a novel mechanism for TGF-ß-mediated gene regulation in chondrocytes.

Dual Kidney Transplantation Offers a Valuable Source for Kidneys With Good Functional Outcome.

BACKGROUND: Reasons for declining kidney donors are older age, with or without, hypertension, kidney dysfunction, and diabetes. Implantation of both kidneys into a single recipient from such donors may improve their acceptability and outcome. METHODS: Patients who underwent dual kidney transplantation (DKT) between June 2010 and May 2014 were identified from a prospectively maintained database. Single kidney transplantations (SKT) with matching donor criteria were also identified. Donors considered for DKT were the following: DBDs >70 years of age with diabetes and/or hypertension; DCDs >65 years of age with diabetes and/or hypertension; and DCDs >70 years of age. RESULTS: Over a 4-year period, 34 patients underwent adult DKT, and 51, with matching donor criteria, underwent SKT. The median estimated glomerular filtration rate (eGFR) at 12 and 36 months of DKT was 49 (range, 5-79) and 42 (range, 15-85) mL/min compared with SKT of 35 (range, 10-65) and 32 (range, 6-65), respectively. The 1-year graft survival for DKT and SKT was 88% and 96% (P = .52), and patient survival was 94% and 98%, respectively (P = .12). Median hospital stay, intensive care unit admission, and wound complications were more frequent in the DKT group. CONCLUSIONS: Graft function following DKT is significantly better compared with matched criteria SKT; graft and patient survival are similar. There is an increased rate of complications following DKT, with longer hospital stay and ICU admission.

The association of PTPN22 rs2476601 with juvenile idiopathic arthritis is specific to females.

A preponderance of females develop autoimmune disease, including juvenile idiopathic arthritis (JIA), yet the reason for this bias remains elusive. Evidence suggests that genetic risk of disease may be influenced by sex. PTPN22 rs2476601 is associated with JIA and numerous other autoimmune diseases, and has been reported to show female-specific association with type 1 diabetes. We performed main effect and sex-stratified association analyses to determine whether a sex-specific association exists in JIA. As expected, rs2476601 was associated with JIA in our discovery (413 cases and 690 controls) and replication (1008 cases and 9284 controls) samples. Discovery sample sex-stratified analyses demonstrated an association specifically in females (odds ratio (OR)=2.35, 95% confidence interval (CI)=1.52-3.63, P=0.00011) but not males (OR=0.91, 95% CI=0.52-1.60, P=0.75). This was similarly observed in the replication sample. There was evidence for genotype-by-sex interaction (Pinteraction=0.009). The association between rs2476601 and JIA appears restricted to females, partly accounting for the predominance of females with this disease.

[Laparoscopic splenectomy in hematologic diseases in children. Analysis of 11-year experience]. / Esplenectomía laparoscópica por enfermedades hematológicas en niños. Análisis de 11 años.

OBJECTIVES: A common indication for splenectomy in children is hematologic diseases. Indications, clinical course and complications of laparoscopic splenectomy are shown; factors associated with open conversion are analyzed. MATERIAL AND METHODS: Retrospective, longitudinal, descriptive series of laparoscopic splenectomy during 11 years and its long-term follow-up. RESULTS: We studied 88 laparoscopic splenectomies. Average age was 9 years and weight 30 kg. The indication was hemolytic anemia in 77% and thrombocytopenic purpura in 18%. Eleven percent was operated with severe thrombocytopenia and two patients urgently; cholecystectomy was done in 13%. The median surgical time was 180 minutes and bleeding 100 ml. Conversion rate was 5.7% mainly because of persistent bleeding, being risk bleeding greater than 300 ml and the need for red cell concentrate transfusion. The median length of stay was 3 days, longer in those affected by purpura. Three patients developed pneumonia and one, intra-abdominal abscess. Follow-up was 3.6 years average with two late complications. Treatment response was cure in 72%, improvement in 11.3% and failure in 6.8%. DISCUSSION: It is feasible to operate patients under 5 years of age and patients with anemia or thrombocytopenia at the time of surgery without major problems. The conversion rate is low and risk factors for conversion are bleeding more than 300 ml and needing to transfuse erythrocyte concentrate.

INTRODUCCION: Una indicación frecuente de esplenectomía en niños son las enfermedades hematológicas. Se muestran las indicaciones, curso clínico y complicaciones en niños con esplenectomía laparoscópica y se analizan los factores de conversión a cirugía abierta. MATERIAL Y METODOS: Estudio de cohorte, longitudinal, descriptivo de esplenectomía laparoscópica en un periodo de 11 años y su seguimiento a largo plazo. RESULTADOS: Se analizaron 88 esplenectomías laparoscópicas. Edad promedio 9 años y peso 30 kg. La indicación fue anemia hemolítica en el 77% y púrpura trombocitopénica en el 18%. El 11% se operó con trombocitopenia grave y dos pacientes en forma urgente, se hizo colecistectomía en el 13%. La mediana de tiempo quirúrgico fue de 180 minutos con sangrado de 100 ml. Se convirtió el 5,7% por sangrado persistente, siendo los factores de riesgo el sangrado mayor a 300 ml y la necesidad de transfusión de concentrado eritrocitario. La mediana de estancia fue 3 días, superior en los pacientes afectos de púrpura. Tres pacientes desarrollaron neumonía y uno, absceso intra-abdominal. El seguimiento promedio es de 3,6 años con dos complicaciones tardías. Hubo curación con normalización del hemograma y sin necesidad de transfusiones en el 72%, mejoría con necesidad de transfusiones ocasionales en el 11,3% y fallo con requerimientos transfusionales iguales a los preoperatorios en el 6,8% de los pacientes. DISCUSION: Es posible operar a pacientes menores de 5 años y a pacientes con anemia o trombocitopenia en el momento de la cirugía, sin mayor complicación. La tasa de reconversión es baja y los factores de riesgo para reconversión son un sangrado mayor de 300 ml y la necesidad de transfundir concentrado de hematíes.

[Psychometric properties and diagnostic value of 'lexical screening for aphasias']. / Propiedades psicometricas y utilidad diagnostica del 'screening lexico para las afasias'

INTRODUCTION. Language assessment in persons with brain injury makes it possible to know whether they require language rehabilitation or not. Given the importance of a precise evaluation, assessment instruments must be valid and reliable, so as to avoid mistaken and subjective diagnoses. AIM. To validate 'lexical screening for aphasias' in a sample of 58 Chilean individuals. SUBJECTS AND METHODS. A screening-type language test, lasting 20 minutes and based on the lexical processing model devised by Patterson and Shewell (1987), was constructed. The sample was made up of two groups containing 29 aphasic subjects and 29 control subjects from different health centres in the regions of Biobio and Maule, Chile. Their ages ranged between 24 and 79 years and had between 0 and 17 years' schooling. Tests were carried out to determine discriminating validity, concurrent validity with the aphasia disorder assessment battery, reliability, sensitivity and specificity. RESULTS. The statistical analysis showed a high discriminating validity (p < 0.001), an acceptable mean concurrent validity with aphasia disorder assessment battery (rs = 0.65), high mean reliability (alpha = 0.87), moderate mean sensitivity (69%) and high mean specificity (86%). CONCLUSION. 'Lexical screening for aphasias' is valid and reliable for assessing language in persons with aphasias; it is sensitive for detecting aphasic subjects and is specific for precluding language disorders in persons with normal language abilities.

TITLE: Propiedades psicometricas y utilidad diagnostica del 'screening lexico para las afasias'Introduccion. La evaluacion del lenguaje en personas con lesion cerebral permite conocer si estas requeriran o no rehabilitacion de lenguaje. Debido a la importancia de una evaluacion precisa, los instrumentos de evaluacion deben ser validos y fiables, con el fin de evitar diagnosticos equivocados y subjetivos. Objetivo. Validar el 'screening lexico para las afasias' (SLA) en una muestra de 58 individuos chilenos. Sujetos y metodos. Se construyo una prueba de lenguaje, tipo cribado, de 20 minutos de duracion y basada en el modelo de procesamiento lexico de Patterson y Shewell de 1987. La muestra estuvo compuesta por dos grupos, 29 sujetos afasicos y 29 sujetos control, pertenecientes a distintos centros de salud de las regiones del Biobio y del Maule, Chile. Sus edades fluctuaban entre 24 y 79 años, y sus años de escolaridad, de 0 a 17. Se determino validez discriminante, validez concurrente con la bateria para la evaluacion de los trastornos afasicos (BETA), fiabilidad, sensibilidad y especificidad. Resultados. El analisis estadistico mostro una alta validez discriminante (p < 0,001), aceptable validez concurrente media con la BETA (rs = 0,65), una alta fiabilidad media (alfa = 0,87), una moderada sensibilidad media (69%) y una alta especificidad media (86%). Conclusion. El SLA es valido y fiable para evaluar el lenguaje de personas con afasias, es sensible para detectar sujetos afasicos y es especifico para descartar trastornos del lenguaje en personas con lenguaje normal.

Distribution of A(H1N1)pdm09 Influenza Vaccine: Need for Greater Consideration of Smaller Jails.

To identify factors associated with vaccine receipt among correctional facilities during the A(H1N1)pdm09 influenza pandemic, this study surveyed one third of U.S. correctional facilities. Analysis of the association of average daily population (ADP) on A(H1N1)pdm09 influenza vaccine receipt found that an ADP increase of 100 inmates resulted in a 32% increased likelihood of receiving influenza vaccine among smaller jails. Zero percent of large jails, 14% of federal prisons, 11% of nonfederal prisons, and 57% of small jails reported never receiving pandemic influenza vaccine. A qualitative assessment identified barriers to vaccine delivery, lessons learned from pandemic response, and recommendations for public health partners. Building stronger relationships between public health entities and correctional facilities to collaborate in influenza pandemic preparedness efforts may help protect correctional and community populations.

Malformación arterio-venosa uterina y hemorragia obstétrica: diagnóstico y manejo en tres casos clínicos / Uterine arteriovenous malformation and obstetric hemorrhage: diagnosis and management in three cases

Las malformaciones vasculares uterinas son muy infrecuentes y se presentan asociadas a metrorragia con riesgo vital. Su incidencia no es conocida porque las series son de pocos casos. Presentamos tres pacientes con hemorragia obstétrica cuyo estudio diagnóstico con ultrasonido y angiografía, demostró malformación arteriovenosa uterina. En un caso, dada la extensión de la lesión, el tratamiento fue con embolización bilateral de arterias uterinas seguida de histerectomía. Otras dos pacientes, por preservación de fertilidad, fueron sometidas solo a embolización. La evolución clínica y las imágenes confirmaron que los procedimientos fueron exitosos. Se discute la importancia de la interpretación correcta de las imágenes para el diagnóstico, la adaptación de los métodos terapéuticos al caso individual y el manejo multidisciplinario.

The uterine vascular malformations are very infrequent and associated to maternal hemorrhage with vital risk. The incidence is unknown because the published series are little with few cases. We described three cases with obstetrical hemorrhage and the image study with ultrasound and angiography showed an arteriovenous malformation. One patient, for the extensive lesion, was treated with bilateral embolization of uterine arteries and then, histerectomy. The others patients, for preservation her fertility, were treated with embolization only. The clinical evolution and the vascular images study confirm the success of the procedures. We discuss the importance of images analysis for the diagnosis, the individual application of therapeutic methods and a multidisciplinary approach for this scope.

Esplenectomía laparoscópica por enfermedades hematológicas en niños. Análisis de 11 años / Laparoscopic splenectomy in hematologic diseases in children. Analysis of 11-year experience

Introducción. Una indicación frecuente de esplenectomía en niños son las enfermedades hematológicas. Se muestran las indicaciones, curso clínico y complicaciones en niños con esplenectomía laparoscópica y se analizan los factores de conversión a cirugía abierta. Material y métodos. Estudio de cohorte, longitudinal, descriptivo de esplenectomía laparoscópica en un periodo de 11 años y su seguimiento a largo plazo. Resultados. Se analizaron 88 esplenectomías laparoscópicas. Edad promedio 9 años y peso 30 kg. La indicación fue anemia hemolítica en el 77% y púrpura trombocitopénica en el 18%. El 11% se operó con trombocitopenia grave y dos pacientes en forma urgente, se hizo colecistectomía en el 13%. La mediana de tiempo quirúrgico fue de 180 minutos con sangrado de 100 ml. Se convirtió el 5,7% por sangrado persistente, siendo los factores de riesgo el sangrado mayor a 300 ml y la necesidad de transfusión de concentrado eritrocitario. La mediana de estancia fue 3 días, superior en los pacientes afectos de púrpura. Tres pacientes desarrollaron neumonía y uno, absceso intra-abdominal. El seguimiento promedio es de 3,6 años con dos complicaciones tardías. Hubo curación con normalización del hemograma y sin necesidad de transfusiones en el 72%, mejoría con necesidad de transfusiones ocasionales en el 11,3% y fallo con requerimientos transfusionales iguales a los preoperatorios en el 6,8% de los pacientes. Discusión. Es posible operar a pacientes menores de 5 años y a pacientes con anemia o trombocitopenia en el momento de la cirugía, sin mayor complicación. La tasa de reconversión es baja y los factores de riesgo para reconversión son un sangrado mayor de 300 ml y la necesidad de transfundir concentrado de hematíes

Objectives. A common indication for splenectomy in children is hematologic diseases. Indications, clinical course and complications of laparoscopic splenectomy are shown; factors associated with open conversion are analyzed. Methods. Retrospective, longitudinal, descriptive series of laparoscopic splenectomy during 11 years and its long-term follow-up. Results. We studied 88 laparoscopic splenectomies. Average age was 9 years and weight 30 kg. The indication was hemolytic anemia in 77% and thrombocytopenic purpura in 18%. Eleven percent was operated with severe thrombocytopenia and two patients urgently; cholecystectomy was done in 13%. The median surgical time was 180 minutes and bleeding 100 ml. Conversion rate was 5.7% mainly because of persistent bleeding, being risk bleeding greater than 300 ml and the need for red cell concentrate transfusion. The median length of stay was 3 days, longer in those affected by purpura. Three patients developed pneumonia and one, intra-abdominal abscess. Follow-up was 3.6 years average with two late complications. Treatment response was cure in 72%, improvement in 11.3% and failure in 6.8%.Discussion. It is feasible to operate patients under 5 years of age and patients with anemia or thrombocytopenia at the time of surgery without major problems. The conversion rate is low and risk factors for conversion are bleeding more than 300 ml and needing to transfuse erythrocyte concentrate