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The reward positivity (RewP) is an event-related potential that indexes reinforcement learning and reward system activation. The RewP has been shown to increase across adolescence; however, most studies have examined the RewP across two assessments, and no studies have examined within-person changes across adolescence into young adulthood. Moreover, the RewP has been identified as a neurobiological risk factor for adolescent-onset depression, but it is unclear whether childhood psychosocial risk factors might predict RewP development across adolescence. In a sample of 317 8- to 14-year-old girls (Mage = 12.4, SD = 1.8), the present study examined self-report measures of depression symptoms and stressful life events at baseline and the ΔRewP during the doors guessing task across three timepoints. Growth modeling indicated that, across all participants, the ΔRewP did not demonstrate linear change across adolescence. However, baseline anhedonia symptoms predicted within-person changes in the ΔRewP, such that individuals with low anhedonia symptoms demonstrated a linear increase in the ΔRewP, but individuals with high anhedonia symptoms had no change in the ΔRewP across adolescence. Similar patterns were observed for stressful life events. The present study suggests that childhood risk factors impact the development of reward-related brain activity, which might subsequently increase risk for psychopathology.
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The English SARS-CoV-2 epidemic has been affected by the emergence of new viral variants such as B.1.177, Alpha and Delta, and changing restrictions. We used statistical models and the agent-based model Covasim, in June 2021, to estimate B.1.177 to be 20% more transmissible than the wild type, Alpha to be 50-80% more transmissible than B.1.177 and Delta to be 65-90% more transmissible than Alpha. Using these estimates in Covasim (calibrated 1 September 2020 to 20 June 2021), in June 2021, we found that due to the high transmissibility of Delta, resurgence in infections driven by the Delta variant would not be prevented, but would be strongly reduced by delaying the relaxation of restrictions by one month and with continued vaccination. This article is part of the theme issue 'Technical challenges of modelling real-life epidemics and examples of overcoming these'.
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COVID-19 , SARS-CoV-2 , Humanos , Modelos Estatísticos , SARS-CoV-2/genética , Análise de SistemasRESUMO
OBJECTIVES: We evaluated the association of HIV infection and immunodeficiency with acute coronary syndrome (ACS) recurrence, and with all-cause mortality as a secondary outcome, after hospitalization for ACS among HIV-infected and HIV-uninfected individuals. METHODS: We conducted a retrospective cohort study within Kaiser Permanente Northern California of HIV-infected and HIV-uninfected adults discharged after ACS hospitalization [types: ST-elevation myocardial infarction (STEMI), non-STEMI, or unstable angina] during 1996-2010. We compared the outcomes of ACS recurrence and all-cause mortality within 3 years, both overall by HIV status and stratified by recent CD4 count, with HIV-uninfected individuals as the reference group. Hazard ratios (HRs) were obtained from Cox regression models with adjustment for age, sex, race/ethnicity, year, ACS type, smoking, and cardiovascular risk factors. RESULTS: Among 226 HIV-infected and 86 321 HIV-uninfected individuals with ACS, HIV-infected individuals had a similar risk of ACS recurrence compared with HIV-uninfected individuals [HR 1.08; 95% confidence interval (CI) 0.76-1.54]. HIV infection was independently associated with all-cause mortality after ACS hospitalization overall (HR 2.52; 95% CI 1.81-3.52). In CD4-stratified models, post-ACS mortality was higher for HIV-infected individuals with CD4 counts of 201-499 cells/µL (HR 2.64; 95% CI 1.66-4.20) and < 200 cells/µL (HR 5.41; 95% CI 3.14-9.34), but not those with CD4 counts ≥ 500 cells/µL (HR 0.67; 95% CI 0.22-2.08), compared with HIV-uninfected individuals (P trend < 0.001). CONCLUSIONS: HIV infection and immunodeficiency were not associated with recurrence of ACS after hospitalization. All-cause mortality was higher among HIV-infected compared with HIV-uninfected individuals, but there was no excess mortality risk among HIV-infected individuals with high CD4 counts.
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Síndrome Coronariana Aguda/epidemiologia , Infecções por HIV/complicações , Hospitalização/estatística & dados numéricos , Síndrome Coronariana Aguda/imunologia , Síndrome Coronariana Aguda/mortalidade , Contagem de Linfócito CD4 , Estudos de Casos e Controles , Causas de Morte , Feminino , Infecções por HIV/imunologia , Infecções por HIV/mortalidade , Humanos , Modelos Logísticos , Masculino , Recidiva , Estudos RetrospectivosRESUMO
After spinal cord injury (SCI), reflexes become hyperexcitable, leading to debilitating muscle spasms and compromised motor function. Previous work has described adaptations in spinal systems that might underlie this hyperexcitability, including an increase in constitutively active 5-HT2C receptors in spinal motoneurons. That work, however, examined adaptations following complete transection SCI, whereas SCI in humans is usually anatomically and functionally incomplete. We therefore evaluated whether constitutive activity of 5-HT2C receptors contributes to reflex hyperexcitability in an incomplete compression model of SCI and to spasms in vitro and in vivo. Our results confirm that 5-HT2C receptor constitutive activity contributes to reflex excitability after incomplete SCI. We also evaluated whether constitutive activity could be altered by manipulation of neural activity levels after SCI, testing the hypothesis that it reflects homeostatic processes acting to maintain spinal excitability. We decreased neural activity after SCI by administering baclofen and increased activity by administering the selective serotonin reuptake inhibitor (SSRI) fluoxetine. We found that drug administration produced minimal alterations in in vivo locomotor function or reflex excitability. Similarly, we found that neither baclofen nor fluoxetine altered the contribution of constitutively active 5-HT2C receptors to reflexes after SCI, although the contribution of 5-HT2C receptors to reflex activity was altered after SSRIs. These results confirm the importance of constitutive activity in 5-HT2C receptors to spinal hyperexcitability following SCI in the clinically relevant case of incomplete SCI but suggest that this activity is not driven by homeostatic processes that act to maintain overall levels of spinal excitability.NEW & NOTEWORTHY After spinal cord injury (SCI), most people will develop muscle spasms below their level of injury that can severely impact function. In this work, we examine the adaptations that occur within the spinal cord after SCI that contribute to these motor dysfunctions. We also evaluate one hypothesis about how these adaptations develop, which will potentially lead to intervention strategies to improve functional outcomes in persons with SCI.
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Baclofeno/farmacologia , Fluoxetina/farmacologia , Relaxantes Musculares Centrais/farmacologia , Receptor 5-HT2C de Serotonina/metabolismo , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Traumatismos da Medula Espinal/metabolismo , Animais , Feminino , Camundongos , Neurônios Motores/efeitos dos fármacos , Neurônios Motores/metabolismo , Neurônios Motores/fisiologia , Reflexo , Traumatismos da Medula Espinal/fisiopatologiaRESUMO
BACKGROUND: The effect of life stress on suicidal symptoms during adolescence is well documented. Stressful life events can trigger suicidality, but most adolescents are resilient and it is unclear which factors protect against the deleterious impact of stress. Social support is thought to be one such factor. Therefore, we investigated the buffering effect of specific sources of social support (parental and peer) on life stress (interpersonal and non-interpersonal) in predicting suicidal symptoms during adolescence. In order to test the specificity of this stress buffering, we also examined it with regard to dysphoric mood. METHOD: Data come from the Adolescent Development of Emotions and Personality Traits (ADEPT) Project, a cohort of 550 adolescent females aged 13.5-15.5 recruited from Long Island. Self-reported social support, suicidality, and dysphoria were assessed at baseline and suicidality and dysphoria were assessed again at 9-month follow-up. Life stress was assessed by interview at the follow-up. RESULTS: High levels of parental support protected adolescent girls from developing suicidal symptoms following a stressor. This effect was less pronounced for peer support. Also, social support did not buffer the pathogenic effects of non-interpersonal stress. Finally, social support did not buffer the effect of life stress on dysphoric symptoms. CONCLUSIONS: Altogether, our results highlight a distinct developmental pathway for the development of suicidal symptoms involving parental support that differs from the development of dysphoria, and signifies the importance and specificity of social support in protecting against suicidality in adolescent girls.
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Comportamento do Adolescente/psicologia , Relações Interpessoais , Comportamento Autodestrutivo/psicologia , Apoio Social , Estresse Psicológico/psicologia , Ideação Suicida , Adolescente , Feminino , HumanosRESUMO
BACKGROUND: Little is known about the predictive validity of disruptive mood dysregulation disorder (DMDD). This longitudinal, community-based study examined associations of DMDD at the age of 6 years with psychiatric disorders, functional impairment, peer functioning and service use at the age of 9 years. METHOD: A total of 473 children were assessed at the ages of 6 and 9 years. Child psychopathology and functional impairment were assessed at the age of 6 years with the Preschool Age Psychiatric Assessment with parents and at the age of 9 years with the Kiddie-Schedule of Affective Disorders and Schizophrenia (K-SADS) with parents and children. At the age of 9 years, mothers, fathers and youth completed the Child Depression Inventory (CDI) and the Screen for Child Anxiety Related Disorders, and teachers and K-SADS interviewers completed measures of peer functioning. Significant demographic covariates were included in all models. RESULTS: DMDD at the age of 6 years predicted a current diagnosis of DMDD at the age of 9 years. DMDD at the age of 6 years also predicted current and lifetime depressive disorder and attention-deficit/hyperactivity disorder (ADHD) at the age of 9 years, after controlling for all age 6 years psychiatric disorders. In addition, DMDD predicted depressive, ADHD and disruptive behavior disorder symptoms on the K-SADS, and maternal and paternal reports of depressive symptoms on the CDI, after controlling for the corresponding symptom scale at the age of 6 years. Last, DMDD at the age of 6 years predicted greater functional impairment, peer problems and educational support service use at the age of 9 years, after controlling for all psychiatric disorders at the age of 6 years. CONCLUSIONS: Children with DMDD are at high risk for impaired functioning across childhood, and this risk is not accounted for by co-morbid conditions.
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Ansiedade/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Depressão/diagnóstico , Transtorno Depressivo/epidemiologia , Humor Irritável , Criança , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Pais , Escalas de Graduação Psiquiátrica , Estados UnidosRESUMO
BACKGROUND: According to diathesis-stress models, personality traits, such as negative emotionality (NE) and positive emotionality (PE), may moderate the effects of stressors on the development of depression. However, relatively little empirical research has directly examined whether NE and PE act as diatheses in the presence of stressful life events, and no research has examined whether they moderate the effect of disaster exposure on depressive symptoms. Hurricane Sandy, the second costliest hurricane in US history, offers a unique opportunity to address these gaps. METHOD: A total of 318 women completed measures of NE and PE 5 years prior to Hurricane Sandy. They were also assessed for lifetime depressive disorders on two occasions, the latter occurring an average of 1 year before the hurricane. Approximately 8 weeks after the disaster (mean = 8.40, s.d. = 1.48 weeks), participants completed a hurricane stress exposure questionnaire and a measure of current depressive symptoms. RESULTS: Adjusting for lifetime history of depressive disorders, higher levels of stress from Hurricane Sandy predicted elevated levels of depressive symptoms, but only in participants with high levels of NE or low levels of PE. CONCLUSIONS: These findings support the role of personality in the development of depression and suggest that personality traits can be useful in identifying those most vulnerable to major stressors, including natural disasters.
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Tempestades Ciclônicas , Transtorno Depressivo/psicologia , Desastres , Personalidade , Estresse Psicológico/psicologia , Adulto , Suscetibilidade a Doenças , Feminino , Humanos , Estudos Longitudinais , Estudos Prospectivos , Inquéritos e Questionários , Estados UnidosRESUMO
BACKGROUND: Assistive robots could be a future means to support independent living for seniors. OBJECTIVE: This article provides insights into the latest developments in social service robots (SSR) based on the recently finished HOBBIT project. The idea of the HOBBIT project was to develop a low-cost SSR which is able to reduce the risk of falling, to detect falls and handle emergencies in private homes. The main objective of the project was to raise the technology to a level that allows the robot to be fully autonomously deployed in the private homes of older users and to evaluate technology market readiness, utility, usability and affordability under real-world conditions. METHOD: During the initial phase of the project, a first prototype (PT1) was developed. The results of laboratory tests with PT1 were used for the development of a second prototype (PT2), which was finally tested in seven households of senior adults (mean age 79 years) for 3 weeks each, i.e. in total more than 5 months. RESULTS: The results showed that PT2 is intuitive to handle and that the functions offered meet the needs of older users; however, the robot was considered more as a toy than a supportive device for independent living. Furthermore, despite an emergency function of the robot, perceived security did not increase. CONCLUSION: Reasons for this might be a lack of technological robustness and slow performance of the prototype and also the good health conditions of the users; however, users believed that a market-ready version of the robot would be vital for supporting people who are more fragile and more socially isolated. Thus, SSRs have the potential to support independent living of older people although the technology has to be considerably improved to reach market readiness.
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Acidentes por Quedas/prevenção & controle , Vida Independente/psicologia , Preferência do Paciente/psicologia , Robótica/instrumentação , Tecnologia Assistiva/psicologia , Apoio Social , Atividades Cotidianas/psicologia , Idoso , Idoso de 80 Anos ou mais , Áustria , Desenho de Equipamento , Análise de Falha de Equipamento , Feminino , Humanos , Vida Independente/estatística & dados numéricos , Masculino , Sistemas Homem-Máquina , Avaliação das Necessidades/organização & administração , Preferência do Paciente/estatística & dados numéricos , Tecnologia Assistiva/estatística & dados numéricos , Suécia , Interface Usuário-Computador , Revisão da Utilização de Recursos de SaúdeRESUMO
BACKGROUND: Identifying early markers of risk for anxiety disorders in children may aid in understanding underlying mechanisms and informing prevention efforts. Affective modulation of the startle response indexes sensitivity to pleasant and unpleasant environmental contexts and has been shown to relate to anxiety, yet the extent to which abnormalities in affect-modulated startle reflect vulnerability for anxiety disorders in children has yet to be examined. The current study assessed the effects of parental psychopathology on affective modulation of startle in offspring. METHOD: Nine-year-old children (n = 144) with no history of anxiety or depressive disorders completed a passive picture viewing task in which eye-blink startle responses were measured during the presentation of pleasant, neutral, and unpleasant images. RESULTS: Maternal anxiety was associated with distinct patterns of affective modulation of startle in offspring, such that children with maternal histories of anxiety showed potentiation of the startle response while viewing unpleasant images, but not attenuation during pleasant images, whereas children with no maternal history of anxiety exhibited attenuation of the startle response during pleasant images, but did not exhibit unpleasant potentiation - even when controlling for child symptoms of anxiety and depression. No effects of maternal depression or paternal psychopathology were observed. CONCLUSIONS: These findings suggest that both enhanced startle responses in unpleasant conditions and failure to inhibit startle responses in pleasant conditions may reflect early emerging vulnerabilities that contribute to the later development of anxiety disorders.
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Transtornos de Ansiedade/psicologia , Comportamento Infantil/psicologia , Filho de Pais com Deficiência/psicologia , Pai/psicologia , Mães/psicologia , Reflexo de Sobressalto , Sintomas Afetivos , Análise de Variância , Transtornos de Ansiedade/epidemiologia , Piscadela , Criança , Depressão/epidemiologia , Depressão/psicologia , Eletromiografia , Humanos , Entrevista Psicológica , Estudos Longitudinais , Psicologia da Criança , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: The late positive potential (LPP) is an event-related potential component that is sensitive to the motivational salience of stimuli. Children with a parental history of depression, an indicator of risk, have been found to exhibit an attenuated LPP to emotional stimuli. Research on depressive and anxiety disorders has organized these conditions into two empirical classes: distress and fear disorders. The present study examined whether parental history of distress and fear disorders was associated with the LPP to emotional stimuli in a large sample of adolescent girls. METHOD: The sample of 550 girls (ages 13.5-15.5 years) with no lifetime history of depression completed an emotional picture-viewing task and the LPP was measured in response to neutral, pleasant and unpleasant pictures. Parental lifetime history of psychopathology was determined via a semi-structured diagnostic interview with a biological parent, and confirmatory factor analysis was used to model distress and fear dimensions. RESULTS: Parental distress risk was associated with an attenuated LPP to all stimuli. In contrast, parental fear risk was associated with an enhanced LPP to unpleasant pictures but was unrelated to the LPP to neutral and pleasant pictures. Furthermore, these results were independent of the adolescent girls' current depression and anxiety symptoms and pubertal status. CONCLUSIONS: The present study demonstrates that familial risk for distress and fear disorders may have unique profiles in terms of electrocortical measures of emotional information processing. This study is also one of the first to investigate emotional/motivational processes underlying the distress and fear disorder dimensions.
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Sintomas Afetivos/fisiopatologia , Sintomas Afetivos/psicologia , Medo/psicologia , Predisposição Genética para Doença/epidemiologia , Pais/psicologia , Estresse Psicológico/psicologia , Adolescente , Sintomas Afetivos/epidemiologia , Transtornos de Ansiedade/psicologia , Depressão/psicologia , Eletroencefalografia , Potenciais Evocados/fisiologia , Análise Fatorial , Feminino , Predisposição Genética para Doença/psicologia , Humanos , Estudos Longitudinais , Escalas de Graduação Psiquiátrica , Testes Psicológicos , Fatores de Risco , Estresse Psicológico/epidemiologiaRESUMO
BACKGROUND: Despite its importance as a public health concern, relatively little is known about the natural course of cannabis use disorders (CUDs). The primary objective of this research was to provide descriptive data on the onset, recovery and recurrence functions of CUDs during the high-risk periods of adolescence, emerging adulthood and young adulthood based on data from a large prospective community sample. METHOD: Probands (n = 816) from the Oregon Adolescent Depression Project (OADP) participated in four diagnostic assessments (T1-T4) between the ages of 16 and 30 years, during which current and past CUDs were assessed. RESULTS: The weighted lifetime prevalence of CUDs was 19.1% with an average onset age of 18.6 years. Although gender was not significantly related to the age of initial CUD onset, men were more likely to be diagnosed with a lifetime CUD. Of those diagnosed with a CUD episode, 81.8% eventually achieved recovery during the study period. Women achieved recovery significantly more quickly than men. The recurrence rate (27.7%) was relatively modest, and most likely to occur within the first 36 months following the offset of the first CUD episode. CUD recurrence was uncommon after 72 months of remission and recovery. CONCLUSIONS: CUDs are relatively common, affecting about one out of five persons in the OADP sample prior to the age of 30 years. Eventual recovery from index CUD episodes is the norm, although about 30% of those with a CUD exhibit a generally persistent pattern of problematic use extending 7 years or longer.
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Abuso de Maconha/epidemiologia , Abuso de Maconha/reabilitação , Adolescente , Adulto , Idade de Início , Feminino , Humanos , Incidência , Entrevistas como Assunto , Masculino , Abuso de Maconha/diagnóstico , Oregon/epidemiologia , Prevalência , Modelos de Riscos Proporcionais , Recidiva , Distribuição por Sexo , Resultado do Tratamento , Adulto JovemRESUMO
AIM: The prevalence of obesity and motor deficits in children is on the rise in western industrialized countries. Due to the negative health related consequences, effective early preventive measures are of urgent need. In the present study the effects of the kindergarten-based low-threshold interventions "Kindergarten Mobile (KiMo)", "Ball and Pear (BP)" and "Nursery Fit (NF)" were determined. METHODS: One thousand five hundred ten children (53.4% male) participated in the study (age: 4.7 ± 0.9 years, height: 108.3 ± 7.9cm, weight: 19.1 ± 3.6 kg, BMI: 16.1±1.6kg/m²). The children were divided in the groups KiMo (N.=690), BP (N.=74), NF-P (N.=95), NF-NP (N.=289) and CG (N.=362). Anthropometric data and motor abilities were assessed at T1 (baseline) and T2 (follow-up after 6 months). The interventions included an information session for parents/educators, where key guidelines for a healthy lifestyle were communicated and individual fitness passes were handed over (KiMo, NF-P, NF-NP), respectively an instructed activity lesson once per week (BP, NF-P). RESULTS: The results showed a decrease of the BMI in the groups KiMo (-0.1 ± 0.6 kg/m²), NF-P (-0.1 ± 0.7 kg/m²) and NF-NP (-0.2 ± 0.6 kg/m²; each P<0.001 in comparison to the CG) and an increase in the group BP (0.1 ± 0.5 kg/m²; P=0.998 in comparison to the CG). Inconsistent results were shown in all groups regarding motor abilities. CONCLUSION: To date, no evidence-based recommendations concerning the optimal procedure for health promotion at pre-school age can be concluded. It seems assured, that the entire social environment of children has to be involved in the prevention of overweight and motor deficits, including parents, educators and pediatricians.
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Índice de Massa Corporal , Teste de Esforço , Promoção da Saúde , Pré-Escolar , Feminino , Educação em Saúde , Humanos , Masculino , PaisRESUMO
BACKGROUND: Despite the inclusion of disruptive mood dysregulation disorder (DMDD) in DSM-5, little empirical data exist on the disorder. We estimated rates, co-morbidity, correlates and early childhood predictors of DMDD in a community sample of 6-year-olds. METHOD: DMDD was assessed in 6-year-old children (n = 462) using a parent-reported structured clinical interview. Age 6 years correlates and age 3 years predictors were drawn from six domains: demographics; child psychopathology, functioning, and temperament; parental psychopathology; and the psychosocial environment. RESULTS: The 3-month prevalence rate for DMDD was 8.2% (n = 38). DMDD occurred with an emotional or behavioral disorder in 60.5% of these children. At age 6 years, concurrent bivariate analyses revealed associations between DMDD and depression, oppositional defiant disorder, the Child Behavior Checklist - Dysregulation Profile, functional impairment, poorer peer functioning, child temperament (higher surgency and negative emotional intensity and lower effortful control), and lower parental support and marital satisfaction. The age 3 years predictors of DMDD at age 6 years included child attention deficit hyperactivity disorder, oppositional defiant disorder, the Child Behavior Checklist - Dysregulation Profile, poorer peer functioning, child temperament (higher child surgency and negative emotional intensity and lower effortful control), parental lifetime substance use disorder and higher parental hostility. CONCLUSIONS: A number of children met DSM-5 criteria for DMDD, and the diagnosis was associated with numerous concurrent and predictive indicators of emotional and behavioral dysregulation and poor functioning.
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Manual Diagnóstico e Estatístico de Transtornos Mentais , Humor Irritável , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Comportamento Problema , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Criança , Pré-Escolar , Comorbidade , Depressão/epidemiologia , Feminino , Humanos , Masculino , Prevalência , TemperamentoRESUMO
The well-known arcuate fasciculus that connects the posterior superior temporal region with the language production region in the ventrolateral frontal cortex constitutes the classic peri-Sylvian dorsal stream of language. A second temporofrontal white matter tract connects ventrally the anterior to intermediate lateral temporal cortex with frontal areas via the extreme capsule. This temporofrontal extreme capsule fasciculus (TFexcF) constitutes the ventral stream of language processing. The precise origin, course, and termination of this pathway has been examined in invasive tract tracing studies in macaque monkeys, but there have been no standard protocols for its reconstruction in the human brain using diffusion imaging tractography. Here we provide a protocol for the dissection of the TFexcF in vivo in the human brain using diffusion magnetic resonance imaging (MRI) tractography which provides a solid basis for exploring its functional role. A key finding of the current dissection protocol is the demonstration that the TFexcF is left hemisphere lateralized. Furthermore, using the present dissection protocol, we demonstrate that the TFexcF is related to lexical retrieval scores measured with the category fluency test, in contrast to the classical arcuate fasciculus (the dorsal language pathway) that was also dissected and was related to sentence repetition.
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Imagem de Difusão por Ressonância Magnética , Lobo Frontal , Humanos , Vias Neurais/diagnóstico por imagem , Lobo Frontal/diagnóstico por imagem , Imagem de Tensor de Difusão , Lobo Temporal/diagnóstico por imagemRESUMO
BACKGROUND: Prurigo nodularis Hyde (PN) is a highly pruritic condition due to a vicious circle of repeated itching and scratching. There are no representative clinical studies investigating comorbidities in a large collective of PN patients. OBJECTIVE: This pilot study aimed to investigate the exact distribution of the coexisting diseases in a large representative consecutive cohort of PN patients. METHODS: A total of 108 PN patients (36.1% male; mean age of 61.5 ± 16.7 years) were enrolled in the study. RESULTS: In 87.0% of patients, diseases underlying PN could be established (18.5% skin disease, 7.4% systemic origin, 1.8% neurological diseases, 59.3% mixed origin). Due to several possible causative co-factors, the majority of patients were classified in the group of mixed origin (59.3%). In 53.1% of these patients, at least one dermatological factor was involved in the induction of PN. Interestingly, nearly half (46.3%) of all PN patients had either an atopic predisposition or atopic dermatitis as a single cause of PN (18.5%) or as one co-factor of PN of mixed origin (27.8%). Considering the different underlying diseases, there was no significant age or gender difference. CONCLUSION: PN does not seem to represent a characteristic symptom of one disease only. Multiple pruritogenic diseases are linked to evolution and improvement of PN upon treatment. Atopic predisposition is a major factor in nearly half of PN patients. The large collective of the present study helped detect a broad range of underlying diseases and thus to provide recommendations for rational diagnostics.
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Prurigo/etiologia , Dermatopatias/complicações , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Dermatopatias/classificaçãoRESUMO
The objectives of this study were to evaluate the presence of thermophilic Campylobacter in feces of calves with and without diarrhea on dairy farms and to survey farm characteristics and management practices to define risk factors for the presence of Campylobacter. Fifty dairy farms were chosen based on the presence of calf diarrhea, and 50 farms in which calves were free from diarrhea served as a standard of comparison. In total, fecal samples were taken from 382 calves. Farm data and management practices were surveyed using a questionnaire on farm. Campylobacter were isolated from fecal samples and colonies were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry analysis. Campylobacter spp., mainly Campylobacter jejuni (93% of isolated species), were detected on 33% of the farms and in 14.9% of the calves. Detection of Campylobacter did not differ between farms or between calves with and without diarrhea, although we found a tendency for calves suffering from diarrhea to shed Campylobacter more often. Calves may act as a reservoir of Campylobacter and may therefore lead to infections of other animals and humans. To define control strategies to reduce Campylobacter in calves, we identified on-farm risk factors. The presence of poultry on the farm, the time of cow-calf separation following birth, the use of an individual bucket for each calf, the feeding of waste milk, and the duration of individual housing were variables significantly associated with the appearance or absence of Campylobacter.
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Derrame de Bactérias , Infecções por Campylobacter/veterinária , Campylobacter , Doenças dos Bovinos/microbiologia , Diarreia/veterinária , Animais , Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/microbiologia , Campylobacter jejuni , Bovinos , Doenças dos Bovinos/epidemiologia , Indústria de Laticínios , Diarreia/epidemiologia , Diarreia/microbiologia , Fezes/microbiologia , Feminino , Prevalência , Fatores de RiscoRESUMO
The aim of this study was to investigate the course of expression of platelet-activating factor (PAF), PAF-receptor (PAF-R), epidermal growth factor (EGF), EGF-R, vascular endothelial growth factor (VEGF), VEGF-R1 and VEGF-R2 in uterine tissue during canine pregnancy. For this purpose, 20 bitches were ovariohysterectomized at days 10-12 (n = 10), 18-25 (n = 5) and 28-45 (n = 5) days after mating, respectively. The pre-implantation group was proven pregnant by embryo flushing of the uterus after the operation, the others by sonography. Five embryo negative, that is, non-pregnant, bitches in diestrus (day 10-12) served as controls. Tissue samples from the uterus (placentation sites and horn width, respectively) were excised and snap-frozen in liquid nitrogen after embedding in Tissue Tec(®). Extraction of mRNA for RT-PCR was performed with Tri-Reagent. In the embryos, mRNA from all factors except VEGF was detected. In the course of pregnancy, significantly higher expression of PAF and PAFR as well as VEGF and VEGFR2 during the pre-implantation stage than in all other stages and a strong upregulation of EGF during implantation were characteristic. The course of EGF was in diametrical opposition to the course of the receptor. These results point towards an increased demand for VEGF, EGF and PAF during the earliest stages of canine pregnancy.
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Cães/fisiologia , Fator de Crescimento Epidérmico/metabolismo , Receptores ErbB/metabolismo , Fator de Ativação de Plaquetas/metabolismo , Receptores de Fatores de Crescimento do Endotélio Vascular/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Animais , Implantação do Embrião/fisiologia , Fator de Crescimento Epidérmico/genética , Receptores ErbB/genética , Feminino , Regulação da Expressão Gênica/fisiologia , Placenta/fisiologia , Fator de Ativação de Plaquetas/genética , Glicoproteínas da Membrana de Plaquetas/genética , Glicoproteínas da Membrana de Plaquetas/metabolismo , Gravidez , RNA/genética , RNA/metabolismo , Receptores Acoplados a Proteínas G/genética , Receptores Acoplados a Proteínas G/metabolismo , Receptores de Fatores de Crescimento do Endotélio Vascular/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa/veterinária , Útero/metabolismo , Fator A de Crescimento do Endotélio Vascular/genéticaRESUMO
BACKGROUND: For the quality indicator "preoperative stay" a part of the external quality assurance for proximal femoral fractures (module 17/1), a tolerance range for surgery within 48 h after admission of ≤ 15 % is given. MATERIALS AND METHODS: Over a period of 5 years all cases were analyzed with respect to reasons for delayed surgery of more than 48 h after admission. RESULTS: A total of 165 patients (16%) out of 1,036 documented cases had surgery later than 48 h after admission. Reasons were pathological bleeding, preoperative poor general condition, lack of informed consent, intake of metformin and lacking initial radiological detection of fractures. Due to a lack of software-related specifications in ten patients a wrong preoperative length of stay was generated. CONCLUSION: The significance of the quality indicator "preoperative stay" without division into whether this was administrative or patient-related must be considered critically. For fall-related fractures in hospital the time of the accident or diagnosis should be considered.
Assuntos
Fraturas do Colo Femoral/epidemiologia , Fraturas do Colo Femoral/cirurgia , Fidelidade a Diretrizes/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Período Pré-Operatório , Garantia da Qualidade dos Cuidados de Saúde/estatística & dados numéricos , Listas de Espera , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Alemanha/epidemiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Prevalência , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE: To investigate the prevalence of urogenital chlamydial infections in women from Eastern Slovakia and to compare the occurrence in women with and without clinical signs of disease. MATERIAL AND METHODS: We examined a total of 1978 women from Eastern Slovakia for the presence of C. trachomatis over a three year period. Antichlamydial antibodies of classes IgG and IgA were detected by ELISA while PCR was applied to detect pathogen. RESULTS: 3.6 % of the population had presence of antibodies while 10.1 % of the women showed presence of bacteria by PCR. CONCLUSIONS: Obtained results when compared with clinical examination revealed clear distinction, which was age dependent. Lower age categories were more likely affected by acute infection with positivity for IgA and IgG antibodies as well as PCR. Middle age categories showed significantly higher level of IgG antibodies in comparison to IgA, while pathogen was readily detected by PCR. In women older than 51 years the results reflected more likely a past infection that is presence of only IgG and negative PCR (Tab. 4, Ref. 18).
Assuntos
Infecções por Chlamydia/epidemiologia , Infecções do Sistema Genital/epidemiologia , Infecções Urinárias/epidemiologia , Adolescente , Adulto , Infecções por Chlamydia/sangue , Chlamydia trachomatis/imunologia , Feminino , Humanos , Imunoglobulina A/sangue , Pessoa de Meia-Idade , Prevalência , Infecções do Sistema Genital/sangue , Eslováquia/epidemiologia , Infecções Urinárias/sangue , Adulto JovemRESUMO
Fas is a membrane-bound protein which upon activation causes programmed cell death. Fas ligand (FasL) binds Fas on target cells. Both these factors are known to regulate apoptosis at implantation in different species and thus might be involved in the regulation of implantation in dogs. The aim of the study was to assess the expression of Fas and FasL in canine uterine tissue throughout pregnancy as well as in pre-implantation embryos using RT-PCR and RT-qPCR. Uterine tissues was collected from of 21 healthy pregnant bitches (group I: days 10-12, n = 5; group II: days 18-25, n = 6; group III: days 28-45, n = 6) and from 4 non-pregnant bitches (controls: days 10-12). Pregnancy stage was determined by days after mating, that is, 2-3 days after ovulation as determined by vaginal cytology and progesterone measurement. After ovariohysterectomy, uteri from group I bitches were flushed with PBS and the embryos washed and stored frozen at -80°. Tissues from the other groups were taken from the implantation and placentation sites, respectively, covered with Tissue Tek(®) and frozen at -80°. Extraction of RNA was performed with Trizol Reagent and RT-qPCR using SYBR green probes. In pre-implantation embryos, only FasL but not Fas could be detected. In all tissues from pregnant and non-pregnant bitches, both parameters were detectable. Before implantation (group I) expression of FasL resembled that of non-pregnant bitches in early dioestrus and decreased significantly during implantation and thereafter (p < 0.05). Expression of Fas did not change significantly until day 45. The relative expression of Fas exceeded that of FasL at each stage investigated, which is comparable to observations of other species; however, high standard deviations indicate high individual differences. These preliminary results point towards a regulatory function of the Fas/FasL system during early canine pregnancy.