Seroprevalence of trypanosomosis and associated risk factors in cattle from coast and amazonian provinces of Ecuador.

Trypanosomosis is a tropical disease caused by various protozoan haemoparasites, which affects wild and domestic animals, the latter ones related to worldwide livestock production systems. Species such as Trypanosoma vivax and Trypanosoma evansi have been described using serological and molecular tools in several countries from South and Central America. However, Ecuador presents a relevant knowledge gap in the associated general epidemiology and risk factors of the disease. Therefore, the objective of this study was to determine the seroprevalence of trypanosomosis in cattle from different regions of Ecuador. 745 serum samples from 7 Coastal and 3 Amazon provinces were screened for IgG anti-Trypanosoma spp. antibodies, using an in-house indirect ELISA. The seropositivity was explored and associated with several variables such as sex, age, breed, region, management, and province, using statistical tools. The general seroprevalence of trypanosomosis was 19.1% (95% CI: 16.30-22.1%). The Amazonian provinces of Sucumbíos and Napo and the Coastal province of Esmeraldas presented the highest seroprevalence values of 36.7% (95% CI: 27.67-46.47%), 23.64% (95% CI: 16.06-32.68%) and 25% (95% CI: 15.99-35.94%), respectively. Statistical significance was found for the region, province, and management variables, indicating as relevant risk factors the extensive management and Amazon location of the cattle analyzed. Specific actions should be taken to identify the exact species on reservoirs and susceptible hosts, evaluate the implication of farm management and cattle movement as risk factors, and implement surveillance and treatment plans for affected herds.

Assessment of nitrification process in a sequencing batch reactor: Modelling and genomic approach.

Nitrification of ammoniacal nitrogen (N-NH4+) to nitrate (N-NO3-) was investigated in a lab-scale sequencing batch reactor (SBR) to evaluate its efficiency. During the nitrification process the removal of N-NH4+ reached 96%, resulting in 73% formation of N-NO3-. A lineal correlation (r2 = 0.9978) was obtained between the concentration of volatile suspended solids (VSS) and the maximal N-NO3- concentration at the end of each batch cycle under stationary state. The bacterial taxons in the initial inoculum were identified, revealing a complex diverse community mainly in the two major bacterial phyla Proteobacteria and Actinobacteria. The FAPROTAX algorithm predicted the presence in the inoculum of taxa involved in relevant processes of the nitrogen metabolism, highlighting the bacterial genera Nitrospira and Nitrosomonas that are both involved in the nitrification process. A kinetic model was formulated for predicting and validating the transformation of N-NH4+, N-NO2- and N-NO3- and the removal of organic and inorganic carbon (TOC and IC, respectively). The results showed how the increase in biomass concentration slowed down the transformation to oxidised forms of nitrogen and increased denitrification in the settling and filling stages under free aeration conditions.

Consensus recommendations on sleeping problems in Phelan-McDermid syndrome.

Early onset sleep problems and disorders are very common in individuals with Phelan-McDermid Syndrome (PMS) with rates of up to 90%. These sleep problems and disorders cannot be taken lightly. Not only do they have a major impact on the health, behaviour, functioning and learning opportunities of affected individuals, they can also have detrimental effects on the well-being and resilience of parents and caregivers, ultimately affecting the physical health, mental health and well-being of the whole social system. In this review we aim to understand the types and frequencies of sleeping problems in PMS as the basis for recommendations on their management and treatment and to provide general guidelines for clinicians and practitioners. We conducted an in-depth literature search, summarised findings, and participated in a series of consensus meetings with other consortium members - experts on PMS and stakeholders - to agree on guidelines and recommendations. In parallel, a world-wide survey was created and distributed amongst parents to include their perspective. Our literature search found only four articles specifically focused on sleeping problems in PMS, although some other articles mentioned prevalence and associated factors. Country-specific prevalence rates ranged between 24% and 46%, whereas our parental survey reported 59%. The main problems reported involved difficulty falling asleep and numerous night awakenings, with being restless in sleep, night-time incontinence, and tooth grinding also commonly reported. Only a small number of individuals had undergone a sleep study monitored by a specialist. Bedtime resistance normally decreases with age, but sleep-onset delay, sleep anxiety, parasomnias, problems falling and remaining asleep remain throughout lifespan, with total sleep time improving during adulthood. However, this improvement was also accompanied by a substantial increase in parasomnias. Ultimately, an increase in sleep disorders in children correlates with increased sleep disorders and daytime sleepiness in parents/caregivers. No study to date has focused on the underlying causes of sleeping problems in PMS, but comorbid mental health conditions, somatic causes, or (poly)pharmacy have been proposed as triggers for sleeping disturbances. Currently there is no PMS-specific treatment for sleeping problems, and current recommendations are mostly based on individuals with intellectual disability and/or neurodevelopmental conditions.

Assessing Internalizing Symptoms and Their Relation with Levels of Impairment: Evidence-Based Cutoffs for Interpreting Inventory of Depression and Anxiety Symptoms (IDAS-II) Scores.

Tests and scales measuring psychological disorders should provide information about how scores relate to other constructs such as quality of life or functional impairment. Such information is necessary to allow that their scores contribute to clinical decision making. The current study analyzes the clinical utility of the Spanish version of the Inventory for Depression and Anxiety Symptoms (IDAS-II) to discriminate between different levels of functional impairment and identify the IDAS-II scales that contribute most to explaining impairment. The total sample (N = 1390) consists of two subsamples: a community sample of the general population (n = 1072) selected by random sampling; and a sample of patients (n = 318) from public and private mental health services. The Spanish IDAS-II for measuring internalizing symptoms and WHODAS 2.0 for measuring impairment were administered to all participants. All scales show statistically significant higher scores in the patient sample, with Cohen's d effect sizes values greater than 0.30, except for well-being (d = 0.19). The cutoff values and their confidence intervals do not overlap with the means of either the community or patient sample. AUC values for most of the scales are above .70, except for appetite gain, ordering, euphoria, cleaning, and well-being. Multiple linear regression model using IDAS-II scales explain 57.1% of the variance of the WHODAS 2.0 (F 12.1377 = 155.305; p < .001). Cutoff values provided allow us to reliably differentiate between the patients and community samples. Spanish IDAS-II scores show greater sensitivity and specificity in detecting those with greater impairment. General Depression, Lassitude, Panic and Claustrophobia contribute to impairment in a greater extent. Knowledge of which symptoms are most related with impairment, allows healthcare providers to improve treatment planning based on empirical evidence.

Comparison of two coprological methods for the diagnosis of Eurytrema ssp. in cattle and sheep.

Eurytrematosis is a disease caused by flukes of the genus Eurytrema. These parasites infect the pancreatic ducts of a wide variety of species, including cattle, sheep and humans. Diagnosing eurytrematosis through the analysis of faecal samples can be difficult because most of the available techniques are considered of low sensitivity. In this context, a modification of the Dennis, Stone and Swanson technique (Belem Sedimentation Technique, BST) was previously developed to increase the probability of detecting infected animals; nevertheless, the values of eggs per gram obtained using the modified technique are generally low. We proposed a modification of the this technique (MBST), to increase the sensitivity and detection rate of infected animals. The objective of this work was to describe MBST and compare it with BST. Faecal samples of 212 clinically healthy animals (174 from cattle and 38 from sheep) from 20 farms were taken by the intra-rectal route and stored at 4°C. The samples were processed using BST and MBST. Positive samples amounted to 55 (25.9%) using BST and 121 (57.1%) using MBST. In the simples from cattle, 52 (29.8%) and 107 (61.4%) were positive in BST and MBST, respectively. In sheep, three (7.8%) and 14 (36.8%) positive samples were obtained in BST and MBST, respectively.The results obtained using the two methods were significantly different, indicating a lack of agreement between their findings. The results suggest that MBST is a more sensitive method to detect Eurytrema spp. eggs in faeces than BST.

Cocaine use disorder criteria in a clinical sample: an analysis using Item Response Theory, factor analysis, and network analysis.

Background: The conceptualization of substance use disorders (SUDs) was modified in successive editions of the DSM. Dimensionality and inclusion/exclusion of several criteria was studied using various analytic approaches.Objective: The study aimed to deepen our knowledge of the interrelationships between the diagnostic criteria for cocaine use disorder (CUD), applying three different analytical techniques: factor analysis, Item Response Theory (IRT) models, and network analysis.Methods: 425 (85.4% male) outpatients were evaluated for CUD using the Substance Dependence Severity Scale. Confirmatory Factor Analysis, 2-parameter logistic model (IRT) and network analysis were applied to analyze the relationships between the diagnostic criteria.Results: The results show that "legal problems" criterion is not congruent with the CUD measure on three analyses. Also, network analysis suggests the usefulness of the "craving" criterion. The criterion "quit/control" is the one that presents the best centrality indices and expected influence, showing strong relationships with the criteria of "craving," "tolerance," "neglect roles" and "activities given up."Conclusions: Network analysis appears to be a useful and complementary technique to factor analysis and IRT for understanding CUD. The "quit/control" criterion emerges as a central criterion to understand CUD.

Primer registro de Cooperia curticei (Strongylida: Trichostrongylidae) en un ovino de la región del noroeste argentino / First report of Cooperia curticei (Strongylida: Trichostrongylidae) in sheep from northwestern Argentina

Resumen Cooperia curticei, es un nematodo afín a los ovinos que se aloja en el intestino delgado de estos. Su presencia en Argentina ha sido registrada en ambientes como la región semiárida en la Pampa, subhúmeda pampeana en Buenos Aires y en la región subtropical en Corrientes. El objetivo de este trabajo es notificar la presencia de Cooperia curticei en intestino delgado de un ovino proveniente de la localidad de Cerrillos en Salta. En el intestino delgado se determinó una carga de 600 formas adultas de Cooperia spp.Estas fueron identificadas como Cooperia curticei. Como características taxonómicas de relevancia las ramas del rayo dorsal se curvaban hacia atrás mostrando una forma de lira. En cuanto a las espículas, midieron en promedio 146,8 µm (± 5,24), con una concavidad marcada en parte media del cuerpo y con un tallo con una curvatura final similar a un pie. Este hallazgo constituye el primero en su tipo en la región del NOA y demuestra la adaptación de C. curticei a un clima de tipo serrano sub-andino. Este trabajo complementa lo descripto previamente en la región, en donde se menciona la presencia de Cooperia spp en ovinos, sin especificar su especie.

Abstract Cooperia curticei is a nematode related to sheep that is housed in the small intestine. Its presence in Argentina has been reported in environments such as the semi-arid region in the Pampa, the sub-humid Pampas in Buenos Aires and in the subtropical region in Corrientes. The objective of this work is to report the presence of Cooperia curticei in the small intestine of a sheep from the town of Cerrillos in Salta. A worm burden of 600 adult forms of Cooperia spp. was determined in the small intestine. These were identified as Cooperia curticei. As relevant taxonomic features the branches of the dorsal ray curved backwards showing a lyre shape. As for the spicules, they measured an average of 146.8 µm (± 5.24), with a marked concavity in the middle part of the body and with a stem with a final curvature similar to a foot. This finding is the first of its kind in the NOA region and demonstrates the adaptation of C. curticei to a sub-Andean mountain type climate. This work complement that previously described in the region, where the presence of Cooperia spp. in sheep was described but without species determination.

First record of clinical coccidiosis (Eimeria ovinoidalis) in adult sheep from northwestern Argentina.

Coccidiosis of sheep is an intestinal infection caused by protozoa of the genus Eimeria. An outbreak of the disease in adult sheep from Salta province, northwestern Argentina, was studied to establish its clinical, epidemiological, pathological and etiological aspects. The affected animals were part of a flock of 20 sheep brought from Formosa province about 10 days before. Most sheep (80% incidence) showed hemorrhagic diarrhea, dehydration and loss of body condition; six of them died and two that became permanently recumbent were euthanized. Three necropsied sheep showed mild mesenteric lymphadenomegaly, diffuse proliferative enteritis in the small and large intestines, and mucosal thickening. Histopathological studies exhibited diffuse proliferative enteritis and presence of structures compatible with intracellular coccidia at different stages of development. Parasitological studies (n = 12) resulted in an average of 16,636.6 (± 15,266.8) Eimeria oocysts per gram of feces (range 1680-46,400). Taxonomy of Eimeria species based on analysis of sporulated oocysts derived from 4 fecal samples (n = 100 oocyst per sample) showed, on average, a high prevalence of E. ovinoidalis (61.5%), followed by E. parva (27.2%), and lower proportions of E. crandallis (5.3%), E. ahsata (3.2%) and E. intricata (2.8%). Clinical and pathological findings confirmed the diagnosis of coccidiosis in the affected sheep; parasitological results showed that E. ovinoidalis was the main species responsible for the clinical signs. Clinical coccidiosis is considered unusual in adult sheep, but the present case shows that under favorable environmental and/or management conditions, this infection may be highly deleterious for adult sheep.

Correction to: Stingray spear injury to the pediatric spinal cord: case report and review of the literature.

The original version of this article unfortunately contained an error in the spelling of the last name of one of the co-authors. The corresponding author did not notice that the last name of one of the co-authors, Nathan Shlobin, was misspelled as "Schlobin". The correct spelling of his last name is "Shlobin". Given in this article is the corrected author name.

Spanish Adaptation of the Inventory of Depression and Anxiety Symptoms (IDAS-II) and a study of its psychometric properties.

BACKGROUND: The Inventory of Depression and Anxiety Symptoms (IDAS-II) is composed of 99 items organized into 18 specific scales that provides dimensional assessment of depression, anxiety and bipolar symptoms. To date, IDAS-II is only available in the English and Turkish population. The main purpose of this study is to adapt the IDAS-II to the Spanish population and to assess the psychometric properties. METHODS: Participants included community adults (n = 620) and college students (n = 378). All participants completed the Beck Depression Inventory-II, Beck Anxiety Inventory, Hypomania Check List-32, Post-traumatic Stress Disorder Checklist-Civilian Version and Obsessive-Compulsive Inventory-Revised, in addition to the Spanish version of the IDAS-II. RESULTS: The results indicate good internal consistency and high temporal stability of the Spanish version of the IDAS-II. Confirmatory factor analyses show for the first time that the three-factor structure of the IDAS-II (Distress, Obsessions/Fear, and Positive Mood) loads on a second order factor, labeled "Internalizing" according to the Hierarchical Taxonomy Of Psychopathology (HiTOP). LIMITATIONS: Study was conducted exclusively on student and community samples and some of the measures used as gold-standard have presented limitations CONCLUSIONS: According to previous studies, the results supported the convergent and discriminant validity of the majority of IDAS-II scales. IDAS-II is useful in assessing the severity of depression, anxiety and bipolar symptoms in research contexts in a Spanish population according to the HiTOP model. However, more evidence is required to prove the adequate functioning of the IDAS-II in clinical samples.

Stingray spear injury to the pediatric spinal cord: case report and review of the literature.

Stingray injuries are rare, mostly causing injuries to the lower extremities but occasionally fatal if there is direct puncture of the thorax, abdomen, or neck. Direct combined stingray injury to the central nervous system has not been reported in the literature. Herein we present the case of a 12-year-old boy who, while wading at the seashore of the Costa Rica's Pacific Ocean, sustained a combined oblique penetrating injury to the C6 vertebra caused by a Stingray. He initially presented to the hospital with a complete asymmetric right C6/left T1 ASIA A examination, priapism, and loss of anal sphincter tone. Imaging revealed fracture of the posterior elements of C6 with an oblique trajectory into the left radicular foramen. T2W images did not reveal anatomical section but rather edema and minor bleeding in the epidural space. The patient underwent medical management and serial imaging. During the next 3 months, there was recovery of sensation on the right hemi body, bilateral paresthesias and asymmetric progressive improvement in strength on both legs. Acute care management and midterm term follow up are provided, along with a review of the literature for salient management considerations when evaluating and treating combined penetrating and envenomation injuries caused by stingrays. To our knowledge, this is the first report of such injury to the spine.

Descripción de dos casos de babesiosis cerebral en terneros de hasta 15 días de edad / Description of two cases of cerebral babesiosis in calves up to 15 days of age

Resumen La babesiosis es una enfermedad causada por Babesia bovis y Babesia bigemina, integrante del complejo conocido como "Tristeza bovina" y relevante en el Noroeste argentino (NOA). La presentación clínica de esta enfermedad es infrecuente en bovinos jóvenes, a los que se considera parcialmente resistentes a la babesiosis. Este trabajo describe dos casos de babesiosis cerebral en terneros de dos rodeos de cría diferentes, que a la necropsia mostraron ictericia, esplenomegalia y severa congestión cerebral y hemoglobinuria. Estructuras intraeritrocitarias compatibles morfológicamente con B. bovis fueron identificadas en extendidos de sistema nervioso central y sangre periférica teñidos con Giemsa y se confirmó luego la infección por medio de técnicas moleculares. La evaluación del estatus epidemiológico en los rodeos de origen determinó diferentes contextos: uno de los casos fue aislado en un rodeo con estabilidad enzoótica para babesiosis, donde la enfermedad clínica era escasa a pesar de altas tasas de transmisión de B. bovis; el segundo caso ocurrió en un rodeo en situación de brote con niveles significativos de mortandad. La ocurrencia de babesiosis (B. bovis) no había sido descripta todavía en terneros de la Argentina, sumándose ahora al diagnóstico diferencial para esta categoría de bovinos en zonas donde la enfermedad es enzoótica.

Abstract Bovine babesiosis is a disease caused by Babesia bovis and Babesia bigemina, as part of the tick fever complex and relevant in the Northwest of Argentina. Clinical occurrence of this illness is uncommon in young cattle, considered resistant to babesiosis. This work described two cases of cerebral babesiosis in calves of different beef herds. Jaundice, splenomegaly, severe cerebral congestion and hemoglobinuria was observed at necropsy. Babesia bovis-like structures were identified in cerebral and blood smears Giemsa stained and confirmed by molecular techniques. Different situations were recognized following the evaluation of the epidemiological status of both herds: the first one was a single case in a herd with enzootic stability for babesiosis, with scarce clinical cases despite high rates of B. bovis transmission; the other case was in a context of outbreak with high level of mortality within a herd susceptible to babesiosis. Clinical babesiosis was not previously described in calves from Argentina. Babesiosis must be taken into account for the differential diagnosis in calves from endemic areas of the disease.

Impactación ruminal y abomasal en vacas de cría asociada al consumo de una pastura diferida de Megathyrsus maximus cv. Gatton / Ruminal and abomasal impaction in beef cattle associated with the consumption of a deferred Megathyrsus maximus cv. Gatton pasture

La impactación ruminal y abomasal es una afección de los rumiantes que se produce cuando estos consumen un alimento de muy baja digestibilidad y bajo contenido proteico y energético. En este trabajo, se describe una mortandad debido a esta afección, en vacas de cría en el Noroeste argentino. La pastura donde los animales permanecían correspondía a Megathyrsus maximus cv. Gatton, vulgarmente más conocido como “Gatton Panic”. Los signos clínicos fueron anorexia, pérdida de estado hasta que los animales cayeron sin posibilidades de incorporarse y posteriormente morían. El diagnóstico se confirmó por los antecedentes clínicos, patológicos y epidemiológicos sumados al análisis de la pastura. El cuadro de impactación ruminal y abomasal está bien descripto en la bibliografía, pero ha sido poco reportado en Argentina.

Ruminal and abomasal impaction is a pathological condition of ruminants that occurs when they consume a food with very low digestibility, low protein and energy content. Ruminal and abomasal impaction was registered in breeding cows in the Argentina northwest grazing Megathyrsus maximus cv. Gatton. The clinical signs were anorexia, loss of body condition, recumbency and death. The clinical presentation of ruminal and abomasal impaction is well described in the bibliography but reports are scarce in Argentina.

Pronóstico de la infección profunda en la cirugía raquídea con implante, tratada mediante retención, retirada del injerto óseo y antibioterapia prolongada / Prognosis of deep infection in spinal surgery using implants, treated by retention, removal of bone graft and lengthy antibiotherapy

Objetivo: La infección profunda de la herida quirúrgica (IPHQ) es una complicación que predispone a un alto riesgo de fracaso en cirugía raquídea con fijación vertebral. El objetivo del presente estudio ha sido valorar la tasa de IPHQ en este tipo de pacientes y su pronóstico siguiendo un abordaje terapéutico homogéneo. Material y método: Estudio observacional retrospectivo en el que se incluyó a 799 pacientes mayores de 14 años, intervenidos de cirugía raquídea con fijación vertebral entre enero de 2010 y diciembre de 2014, en el Servicio de Traumatología y Cirugía Ortopédica de nuestro centro. Todos los pacientes diagnosticados de IPHQ fueron tratados de forma homogénea mediante desbridamiento, sustitución del injerto óseo, retención del implante y tratamiento antimicrobiano de 8 semanas. Tras finalizar el tratamiento, los pacientes fueron seguidos durante un periodo de 12 meses. Resultados: De total de los pacientes tratados mediante artrodesis, 32 (4%) tuvieron una IPHQ. Tres pacientes fueron perdidos en el seguimiento. La muestra final analizable fue de 29 casos, los cuales tenían una mediana de edad de 54,9 años (IQR: 45,7-67 años) y un índice de comorbilidad de Charlson de 2,0 (IQR: 0-3). El diagnóstico microbiológico fue establecido en el 75,8% de los casos. De ellos, la IPHQ fue monomicrobiana en el 68,2% y polimicrobiana en el 31,8%. Con el abordaje terapéutico aplicado curaron sin secuelas el 96% y la tasa de recidivas y reintervención fue del 4%. Conclusión: El tratamiento mediante desbridamiento, retención, sustitución del injerto y tratamiento antimicrobiano de 8 semanas parece una estrategia muy eficaz para los pacientes con fijación vertebral que desarrollan IPHQ

Objective: Surgical site infections (SSIs) are complications that predispose to a high risk of unfavourable surgical outcomes. The aim of this study was to assess the SSI rate in this type of patients and their prognosis with similar treatment. Materials and methods: A retrospective case series of 799 patients above 18 years old with spinal instrumentation surgery, between January 2010 and December 2014 in the traumatology and orthopaedic surgery department of our institution. All patients with SSIs were treated by debridement, graft replacement, retention of the instrumentation and lengthy courses of antimicrobial therapy. The patients were followed up for a period of 12 months. Results: Of all the patients with arthrodesis, 32 (4%) had spinal SSIs. Three patients were lost to follow-up. The final sample analyzed comprised 29 cases, with a median age of 54.9 years (IQR, 45.7-67 years) and a Charlson comorbidity index of 2.0 (IQR; 0-3). A microbiological diagnosis was obtained in 75.8% of the cases. Of these, the ISSs were monomicrobial in 68.2% and polymicrobial in 31.8%. Once treatment had been completed, 96% were cured without sequelae, and the rate of recurrence and reoperation was 4%. Conclusions: Treatment based on debridement, retention of the instrumentation, graft replacement and lengthy courses of antimicrobial therapy seems a very effective strategy in the treatment of patients with deep surgical site infection in spine surgery

Prognosis of deep infection in spinal surgery using implants, treated by retention, removal of bone graft and lengthy antibiotherapy. / Pronóstico de la infección profunda en la cirugía raquídea con implante, tratada mediante retención, retirada del injerto óseo y antibioterapia prolongada.

OBJECTIVE: Surgical site infections (SSIs) are complications that predispose to a high risk of unfavourable surgical outcomes. The aim of this study was to assess the SSI rate in this type of patients and their prognosis with similar treatment. MATERIALS AND METHODS: A retrospective case series of 799 patients above 18 years old with spinal instrumentation surgery, between January 2010 and December 2014 in the traumatology and orthopaedic surgery department of our institution. All patients with SSIs were treated by debridement, graft replacement, retention of the instrumentation and lengthy courses of antimicrobial therapy. The patients were followed up for a period of 12 months. RESULTS: Of all the patients with arthrodesis, 32 (4%) had spinal SSIs. Three patients were lost to follow-up. The final sample analyzed comprised 29 cases, with a median age of 54.9 years (IQR, 45.7-67 years) and a Charlson comorbidity index of 2.0 (IQR; 0-3). A microbiological diagnosis was obtained in 75.8% of the cases. Of these, the ISSs were monomicrobial in 68.2% and polymicrobial in 31.8%. Once treatment had been completed, 96% were cured without sequelae, and the rate of recurrence and reoperation was 4%. CONCLUSIONS: Treatment based on debridement, retention of the instrumentation, graft replacement and lengthy courses of antimicrobial therapy seems a very effective strategy in the treatment of patients with deep surgical site infection in spine surgery.

Assessment of Susceptibility Risk Factors for ADHD in Imaging Genetic Studies.

OBJECTIVE: ADHD consists of a count of symptoms that often presents heterogeneity due to overdispersion and excess of zeros. Statistical inference is usually based on a dichotomous outcome that is underpowered. The main goal of this study was to determine a suited probability distribution to analyze ADHD symptoms in Imaging Genetic studies. METHOD: We used two independent population samples of children to evaluate the consistency of the standard probability distributions based on count data for describing ADHD symptoms. RESULTS: We showed that the zero-inflated negative binomial (ZINB) distribution provided the best power for modeling ADHD symptoms. ZINB reveals a genetic variant, rs273342 (Microtubule-Associated Protein [MAPRE2]), associated with ADHD ( p value = 2.73E-05). This variant was also associated with perivascular volumes (Virchow-Robin spaces; p values < 1E-03). No associations were found when using dichotomous definition. CONCLUSION: We suggest that an appropriate modeling of ADHD symptoms increases statistical power to establish significant risk factors.

Enolase from Trypanosoma cruzi is inhibited by its interaction with metallocarboxypeptidase-1 and a putative acireductone dioxygenase.

Purification of enolase (ENO) from the cytosol of Trypanosoma cruzi indicated that it may interact with at least five other proteins. Two of them were identified as metallocarboxypeptidase-1 (TcMCP-1) and a putative acireductone dioxygenase (ARDp). Subcellular localization studies confirmed the presence of ARDp in the cytosol, as is the case for ENO and TcMCP-1. Analysis of the ARDp sequence showed that this protein has two domains, an N-terminal ARD and a C-terminal TRP14 (thioredoxin-related protein) domain. The interactions between ENO, TcMCP-1 and ARDp were confirmed for the natural proteins from the trypanosome (using size-exclusion chromatography and co-immunoprecipitation from a cytosolic fraction) and recombinant forms (using ELISA ligand-binding assay and ENO activity assays). The ELISA ligand-binding assays permitted to verify the optimal physicochemical conditions for the interactions (representative for the physiological conditions) and to determine the affinity constants (Kd): ENO/ARDp: 9.54 ±â€¯0.82 nM, ARDp/ENO 10.05 ±â€¯1.11 nM, and ENO/TcMCP-1: 5.66 ±â€¯0.61 nM. The data also show that the interaction between TcMCP-1 and ARDp is mediated by ENO acting as a "bridge". Furthermore, considerable inhibition of the ENO activity, up to 85%, is observed when the enzyme interacts with TcMCP-1 and ARDp simultaneously. All these data confirm that the interaction between ENO, TcMCP-1 and ARDp, occurring in T. cruzi's cytosol, modulates the ENO activity and suggest a possible physiological mechanism for regulation of the ENO activity by the protein-protein interaction.

Molecular and biochemical characterization of natural and recombinant phosphoglycerate kinase B from Trypanosoma rangeli.

T. rangeli epimastigotes contain only a single detectable phosphoglycerate kinase (PGK) enzyme in their cytosol. Analysis of this parasite's recently sequenced genome showed a gene predicted to code for a PGK with the same molecular mass as the natural enzyme, and with a cytosolic localization as well. In this work, we have partially purified the natural PGK from T. rangeli epimastigotes. Furthermore, we cloned the predicted PGK gene and expressed it as a recombinant active enzyme. Both purified enzymes were kinetically characterized and displayed similar substrate affinities, with KmATP values of 0.13 mM and 0.5 mM, and Km3PGA values of 0.28 mM and 0.71 mM, for the natural and recombinant enzyme, respectively. The optimal pH for activity of both enzymes was in the range of 8-10. Like other PGKs, TrPGK is monomeric with a molecular mass of approximately 44 kDa. The enzyme's kinetic characteristics are comparable with those of cytosolic PGK isoforms from related trypanosomatid species, indicating that, most likely, this enzyme is equivalent with the PGKB that is responsible for generating ATP in the cytosol of other trypanosomatids. This is the first report of a glycolytic enzyme characterization from T. rangeli.

Robotic laparoendoscopic single-site benign gynecologic surgery: a single-center experience.

The da Vinci Xi surgical system was released with several upgrades and modifications compared to the previous robotic generations to facilitate minimal invasive surgery. Herein, we present our preliminary experience of robotic laparoendoscopic single-site gynecologic surgery performed for benign indications with the da Vinci Xi robotic system in a single center. Thirty-five female patients underwent robotic single-site surgery between June 2016 and January 2017. The median console time for hysterectomy with or without salpingo-oophorectomy was 41 min. The median intracorporeal vaginal cuff closure time was 18 min. Two cases (5.7%) were converted to robotic-assisted multiport surgery. There was one major intraoperative complication (2.9%). None of the patient required blood transfusion. When comparing our first 12 cases to subsequent 12 cases of R-LESS hysterectomy, there was a statistically significant decrease in surgical times and estimated blood loss. On logistic regression analysis, no association was detected between BMI and port entry time (OR 0.93, 95% CI 0.83-1.04, p = 0.23), console time (OR 0.98, 95% CI 0.94-1.02, p = 0.37), cuff closure time (OR 0.9, 95% CI 0.76-1.09, p = 0.33), operative time (OR 1, 95% CI 0.98-1.01, p = 0.97), and estimated blood loss (OR 0.98, 95% CI 0.96-1.01, p = 0.33). Our preliminary experience with robotic laparoendoscopic single-site surgery using the da Vinci Xi system has demonstrated feasibility and safety in select patients. Further studies with greater number of patients in multiple settings will help us to fully elucidate the role of da Vinci Xi surgical system in single-site gynecologic surgery.

Adaptive behavior in autism: Minimal clinically important differences on the Vineland-II.

Autism Spectrum Disorder (ASD) is associated with persistent impairments in adaptive abilities across multiple domains. These social, personal, and communicative impairments become increasingly pronounced with development, and are present regardless of IQ. The Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) is the most commonly used instrument for quantifying these impairments, but minimal clinically important differences (MCIDs) on Vineland-II scores have not been rigorously established in ASD. We pooled data from several consortia/registries (EU-AIMS LEAP study, ABIDE-I, ABIDE-II, INFOR, Simons Simplex Collection and Autism Treatment Network [ATN]) and clinical investigations and trials (Stanford, Yale, Roche) resulting in a data set of over 9,000 individuals with ASD. Two approaches were used to estimate MCIDs: distribution-based methods and anchor-based methods. Distribution-based MCID [d-MCID] estimates included the standard error of the measurement, as well as one-fifth and one-half of the covariate-adjusted standard deviation (both cross-sectionally and longitudinally). Anchor-based MCID [a-MCID] estimates include the slope of linear regression of clinician ratings of severity on the Vineland-II score, the slope of linear regression of clinician ratings of longitudinal improvement category on Vineland-II change, the Vineland-II change score maximally differentiating clinical impressions of minimal versus no improvement, and equipercentile equating. Across strata, the Vineland-II Adaptive Behavior Composite standardized score MCID estimates range from 2.01 to 3.2 for distribution-based methods, and from 2.42 to 3.75 for sample-size-weighted anchor-based methods. Lower Vineland-II standardized score MCID estimates were observed for younger and more cognitively impaired populations. These MCID estimates enable users of Vineland-II to assess both the statistical and clinical significance of any observed change. Autism Res 2018, 11: 270-283. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The Vineland Adaptive Behavior Scales (2nd edition; Vineland-II) is the most widely used scale for assessing day-to-day "adaptive" skills. Yet, it is unknown how much Vineland-II scores must change for those changes to be regarded as clinically significant. We pooled data from over 9,000 individuals with ASD to show that changes of 2-3.75 points on the Vineland-II Composite score represent the "minimal clinically-important difference." These estimates will help evaluate the benefits of potential new treatments for ASD.