NADH is a naturally fluorescent metabolite associated with cellular respiration. Exploiting the different fluorescence lifetime of free and bound NADH has the potential to quantify the relative ...amount of bound and free NADH, enhancing understanding of cellular processes including apoptosis, cancer pathology, and enzyme kinetics. We use the phasor- fluorescence lifetime image microscopy approach to spatially map NADH in both the free and bound forms of live undifferentiated and differentiated myoblast cells. The phasor approach graphically depicts the change in lifetime at a pixel level without the requirement for fitting the decay. Comparison of the spatial distribution of NADH in the nucleus of cells induced to differentiate through serum starvation and undifferentiated cells show differing distributions of bound and free NADH. Undifferentiated cells displayed a short lifetime indicative of free NADH in the nucleus and a longer lifetime attributed to the presence of bound NADH outside of the nucleus. Differentiating cells displayed redistribution of free NADH with decreased relative concentration of free NADH within the nucleus whereas the majority of NADH was found in the cytoplasm.
Idiopathic intracranial hypertension (IIH), also known as primary pseudotumor cerebri syndrome (PTCS), is a condition of unknown etiology which affects primarily overweight, reproductive-aged women ...and causes increased intracranial pressure (ICP). This review discusses the recently revised diagnostic criteria for PTCS for adults and children. Additionally, the role of obesity in the epidemiology, etiology, and management of IIH as well as the current knowledge of obesity profiles and markers in IIH are reviewed. We also highlight the emerging, unifying theory of the neuroendocrine effects on the mineralocorticoid receptor to explain a possible mechanism for the increased cerebrospinal fluid production and ICP in secondary PTCS.
To describe (1) self-care trajectories among adults with heart failure (HF) and insomnia over 1-year; (2) the extent to which trajectories varied between cognitive behavioral therapy for insomnia ...(CBT-I) or HF self-care intervention; and (3) the associations between self-care trajectories and clinical and demographic characteristics, sleep, symptoms and stress, and functional performance.
We conducted secondary analysis of data from a randomized controlled trial of the effects of CBT-I compared with HF self-care education among adults with stable HF and insomnia. We used the Self-Care of Heart Failure Index v6.2. The analytic approaches included t-tests, group-based trajectory modeling, ANOVA, and chi-square.
We included 175 participants (M age=63.0 (12.9) years, White, N = 100. We found four self-care trajectories: Low self-care (N = 47, 26.8%); Moderate self-care (N = 68, 38.9%): Adequate self-care (N = 42, 24.0%); and Optimal self-care (N = 18, 10.3%). There was no difference in self-care trajectories between interventions. The low self-care group had the most severe baseline fatigue, anxiety, and perceived stress, and lowest cognitive abilities.
Both interventions prevented declining self-care. Future research is needed to determine the most efficacious intervention to improve self-care trajectories.
Healthcare providers should provide ongoing self-care support for those with persistently low and moderate self-care.
•People with stable heart failure and insomnia fall into four distinct self-care trajectories.•Self-care trajectories were not different between CBT-I and self-care.•Both interventions prevented self-care from declining over 1-year.•The low self-care group had the highest fatigue, anxiety, and perceived stress.
Skin biopsies are routinely collected from sea turtles for a variety of molecular analyses; however, almost no information exists on the natural healing rates at the site of the biopsy. Here, we ...monitored the healing rates of 17 juvenile green turtles (Chelonia mydas) for up to 488 d after we took a 6-mm biopsy tissue sample in Eleuthera, The Bahamas. Although scarring persisted for several months, biopsy sampling had a minimal long-term impact—tissue repair and maturation was observed after a year and a half, and there was no evidence of infection at any point during the healing process.
AAV2-sFLT01 is a vector that expresses a modified soluble Flt1 receptor designed to neutralize the proangiogenic activities of vascular endothelial growth factor (VEGF) for treatment of age-related ...macular degeneration (AMD) via an intravitreal injection. Owing to minimal data available for the intravitreal route of administration for adeno-associated virus (AAV), we initiated a 12-month safety study of AAV2-sFLT01 administered intravitreally at doses of 2.4 × 109 vector genomes (vg) and 2.4 × 1010 vg to cynomolgus monkeys. Expression of sFlt01 protein peaked at ~1-month postadministration and remained relatively constant for the remainder of the study. Electroretinograms, fluorescein angiograms, and tonometry were assessed every 3 months, with no test article-related findings observed in any group. Indirect ophthalmoscopy and slit lamp exams performed monthly revealed a mild to moderate but self-resolving vitreal inflammation in the high-dose group only, which follow-up studies suggest was directed against the AAV2 capsid. Histological evaluation revealed no structural changes in any part of the eye and occasional inflammatory cells in the trabecular meshwork, vitreous and retina in the high-dose group. Biodistribution analysis in rats and monkeys found only trace amounts of vector outside the injected eye. In summary, these studies found AAV2-sFLT01 to be well-tolerated, localized, and capable of long-term expression.
Background: Extracorporeal membrane oxygenation (ECMO), a rescue treatment for patients with severe pulmonary and/or cardiac dysfunction, is increasingly being used worldwide. A better understanding ...of long-term health-related quality of life (HRQOL) is needed. Objective: To synthesize research on long-term (at least 6 months post-ECMO) HRQOL of adults treated with ECMO. Methods: In this integrative review, we searched 3 electronic databases and did a hand search of relevant journals for articles published 2000–2019, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Thirty-one studies, representing 913 patients treated with ECMO, were included. Long-term HRQOL was slightly better for patients treated with veno-venous ECMO than veno-arterial ECMO, and mental health outcomes tended to be better than physical ones. Survivors frequently experienced physical complications, functional limitations, anxiety, depression, and post-traumatic stress symptoms, although improvements were observed over time. Conclusions: Early identification and management of physical and mental health problems may improve HRQOL outcomes.
Hyperemesis Gravidarum (HG) is a rare condition of pregnancy that exerts a profound effect on a woman's physical and psychological health, but limited research regarding women's perceptions of ...healthcare for this condition exists. The aim of this study was to gain insight into the personal and healthcare experiences of women with HG. Eligible participants included women who had experienced HG in a current or recent pregnancy and were referred to the dietitian at the National Maternity Hospital, Dublin, Ireland. Suitable women were invited to participate by letter, with a follow-up phone call to confirm eligibility. Four semi-structured focus groups were conducted (n = 11). Audio recordings were transcribed and data was thematically analyzed using an inductive, data-driven approach. Participants emphasized the psychological hardship of HG, which manifested in many different ways, and unveiled the far-reaching burden of HG. Women advocated for a dedicated service for HG and the need for increased knowledge, understanding and support for HG, in order to ensure optimal HG management and woman-centered care. Women also highlighted the need for obvious clinical leadership of HG and a continuum of care throughout pregnancy and post-partum. Improvements to the day ward setting and access to HG-specific mental health support would be welcomed. At a government level, timely resolution of the financial assistance for first-line anti-emetics is needed. Overall, greater awareness and understanding of the condition is needed to improve support from family, friends and colleagues. Further research is warranted to determine whether these recommendations would result in improved pregnancy outcomes.
Background/Objectives
There is a paucity of pediatric hidradenitis suppurativa (HS) literature. The objective of this study was to characterize differences in management of pediatric HS patients by ...dermatology versus non‐dermatology clinicians.
Methods
We examined a retrospective cohort of 195 pediatric patients with HS seen at our institution (3/1/19–3/1/20). Two‐sample t‐tests and two‐proportion z‐tests were performed.
Results
A total of 76.1% of subjects were seen by dermatology at least once, and of these, 79.1% were referred. HS diagnosis was most often made by dermatology (36.6%), followed by pediatrics (21.6%). Patients managed by dermatology were significantly more likely to have used standard of care therapies (p < .001). Of dermatology‐managed patients, 19.7% were currently prescribed a biologic, as compared with zero patients not managed by dermatology. Those managed by dermatology were less likely to undergo surgical excision (13.3% vs. 25.5%, p = .04).
Conclusions
Our results support increased likelihood of treatment escalation with medical management by dermatologists. Relatively high utilization of referral to dermatology exists, but with only moderate patient adherence. There is a need for improved access to dermatologic care and prospective studies to determine whether differences in specialty management translate to improved patient outcomes.
Somewhat surprisingly, social anxiety has been linked with aggressive behavior in adults. Among youth, this connection has been demonstrated with anxiety symptoms more broadly. This review extends ...previous work by evaluating this association specifically with social anxiety in the child and adolescent literature. Given the complexities of aggressive behavior, the review is organized by its various forms (relational and physical) and functions (reactive and proactive). Findings from sixteen identified studies are suggestive of links between social anxiety and reactive and relational forms of aggression. Albeit more tenuous, there appear to be associations with physical aggression as well. Overall, though suggestive of connections between social anxiety and aggression, confidence in the findings is attenuated by the relatively small number of relevant studies combined with inconsistent gender findings. Before suggesting directions for further study, we propose putative dysfunctional biological, emotional, and cognitive processes as factors that may underlie associations between social anxiety and these particular forms of aggression. Future research should target differences in age, gender, relationship type, and anxiety subtype. Determining the extent to which these associations may be attributable to comorbid pathology such as depression or a broader internalizing syndrome is also important.
•Social anxiety is associated with reactive and relational aggression.•Current child/adolescent literature is limited with discrepant gender findings.•Shared underlying biological, emotional, and cognitive processes are proposed.
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