Background
Adolescents with autism spectrum disorder (ASD) face many challenges as they age into adulthood. Because little is known about the perspectives of caregivers and youth during this critical ...transition, this study explored their social, educational, and vocational needs and experiences.
Method
Two focus groups were conducted with youth with ASD (n = 13) and two focus groups were conducted with their caregivers (n = 19), where theme analysis strategies derived from Grounded Theory were utilized to identify themes.
Results
Both groups experienced fear and anxiety about transitioning, unmet needs were also high, leaving caregivers struggling to fill gaps. Most caregivers and youth reported lacking individualized services. Caregivers faced difficulty in motivating youth and creating opportunities for education and employment. Although youth have future goals, they were unaware of steps needed to accomplish them and hesitant to talk to caregivers.
Conclusions
Findings indicate considerable unmet needs for caregivers and youth with ASD. Perspectives of both groups should be considered when developing programmes and educating providers.
Proliferating cyanobacterial blooms due eutrophication in reservoirs is a major global problem. The production of cyanotoxins often increases with grazing pressure and temperature while the ...sensitivity of zooplankton to cyanotoxins is directly related to temperature. Here we evaluate the effect of different concentrations of the crude extract of cyanobacteria from Valle de Bravo reservoir during dry (January) and rainy (September) seasons at 20 and 25 °C on the rotifer Brachionus calyciflorus based on acute and chronic toxicity tests. We filtered 20 or 150 l of lake water, depending on the intensity of the bloom, and estimated the density and diversity of the cyanobacteria. The crude extracts, after 5 cycles of freezing, thawing and sonication at 14 MHz, were filtered and the microcystin concentration quantified based on ELISA. The extracts were used to conduct the acute and chronic toxicity tests, all in quadruplicate. Acute toxicity tests were based on 24 h mortality. Chronic toxicity tests (population growth and life table experiments) were conducted at 5 and 10% of the median lethal concentration. The field samples were dominated by Microcystis sp. (January) or Woronichinia naegeliana (September). The microcystin concentration in lake water was 9.57 μg/l and 0.097 μg/l and the median lethal concentration was 5.34 μg microcystin/L and 0.35 μg microcystin/L in January and September, respectively. Survival and reproduction of B. calyciflorus were lower in the presence of the cyanobacteria crude extract, more so at 20° than at 25 °C. Our results highlight the urgency of regular monitoring based on zooplankton assays for reservoirs in tropical and temperate regions, subject to frequent and dominant cyanobacterial blooms, often as a result of climate change.
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•Valle de Bravo reservoir, source of drinking water, suffers frequent cyanobacterial blooms.•Cyanobacteria extract from Valle de Bravo reservoir was tested for toxicity.•Brachionus calyciflorus was more sensitive at 25° than at 20 °C.•Samples with Microcystis were less toxic than those with Woronichinia.
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•Immunecheckpoint inhibitors have a definite place in the management of endometrial cancer.
The incidence of endometrial cancer (EC) is increasing worldwide. The prognosis for ...patients diagnosed with early-stage remains good, whereas for patients with recurrent or metastatic disease, the prognosis is poor and treatment options, until recently, were limited. In 2017, pembrolizumab was approved by the US Food and Drug Administration (FDA) for those patients with mistmach repair deficiency (MMRd) or high microsatellite instability (MSI-H) tumors. However, only 20–30 % of EC have MSI, and just over half of these patients benefit from treatment. In 2019, the FDA granted breakthrough therapy designation to lenvatinib in combination with pembrolizumab for the potential treatment of patients with advanced microsatellite stable EC that has progressed after treatment with at least one previous systemic therapy. It appears clear that immune check-point inhibitors will have a definite place in the management of EC, both as single agent or in combination with other targeted agents. In this review, we summarize the current evidence of immune check point blockade and the identification of potential biomarkers, beyond MSI-H or MMRd, that could help to predict response to this agents in correlation with the genomic EC subtypes.
Although usual interstitial pneumonia (UIP) appears to portend better survival when associated with connective tissue disease (CTD-UIP), little is known about the presenting clinical, radiologic, and ...pathologic features that differentiate pathologically confirmed UIP with CTD from idiopathic pulmonary fibrosis (IPF). In patients with atypical radiologic and clinical features, what specific findings predict underlying IPF vs. CTD-UIP diagnosis and their respective long term survival?
A large retrospective cohort analysis was done of consecutive patients seen from 1995 through 2010 with biopsy confirmed UIP completed or reviewed at our institution. CTD-UIP was defined by independent rheumatology consultation with exclusion of all other secondary causes of lung fibrosis. Primary clinical data was collected and compared for IPF and CTD-UIP along with logistic regression performed for predictors of disease likelihood and Cox proportional hazards analysis for predictors of survival.
Six hundred and twenty five patients were included in the study of which 89 had diagnosed CTD-UIP representing 7 disease entities. Survival was better among those with CTD-UIP except in UIP associated with rheumatoid arthritis, which had similar presenting features and survival to IPF. Predictors of underlying CTD included female gender, younger age, positive autoimmune serology, and inconsistent presenting radiologic findings. Only age and forced vital capacity corrected for a priori covariates were predictive of survival in CTD-UIP.
UIP pathology occurs frequently among patients with atypically presenting clinical and radiologic features, and may represent IPF or CTD-UIP with improved prognosis if underlying CTD is diagnosed. Presenting radiologic and pathologic features alone are not predictive of underlying secondary cause or survival between the two groups.
Summary
Cutaneous leishmaniasis caused by Leishmania mexicana is associated with an important inflammatory response. We here analysed the kinetics of Th17 cells and neutrophils in ear lobe lesions ...caused by Leishmania mexicana throughout 90 days of disease progression in susceptible BALB/c and semi‐resistant C57BL/6 mice infected with 1 × 105 Leishmania mexicana promastigotes. Cells in the lesions were extracted and quantified by flow cytometry, whereas their distribution in the tissues in relation to the parasites was analysed by immunohistochemistry. Our results show that in BALB/c mice, both Th17 cells and neutrophils increase concomitantly and to significantly higher levels on day 90 post‐infection, as compared to C57BL/6 mice. Our results provide novel evidence on the cells causing chronic inflammation throughout Leishmania mexicana infections, resulting as a consequence of neutrophil recruitment together with Th17 cell differentiation and recruitment, both of which remain in the infection site throughout the late phase of the infection. We conclude that the more enhanced levels of Th17 cells and neutrophils during chronic inflammatory lesions in BALB/c mice participate in their enhanced susceptibility towards a progressive disease evolution, whereas the more controlled response of these cells in C57BL/6 mice possibly relates to the more resistant profile of this mouse strain.
Objective Evaluate the reliability and validity of the Medical Outcomes Study Short-Form version 2 (SF-12v2) in the 2003-2004 Medical Expenditure Panel Survey (MEPS). Research design Data were ...collected in the self-administered mail-out questionnaire and face-to-face interviews of the MEPS (n = 20,661). Internal consistency and testretest reliability and construct, discriminate, predictive and concurrent validity were tested. The EQ-5D, perceived health and mental health questions were used to test construct and discriminate validity. Self-reported work, physical and cognitive limits tested predictive validity and number of chronic conditions assessed concurrent validity. Results Both Mental Component Summary Scores (MCS) and Physical Component Summary Scores (PCS) were shown to have high internal consistency reliability (α > .80). PCS showed high test-retest reliability (ICC = .78) while MCS demonstrated moderate reliability (ICC = .60). PCS had high convergent validity for EQ-5D items (except selfcare) and physical health status (r > .56). MCS demonstrated moderate convergent validity on EQ-5D and mental health items (r > .38). PCS distinguish between groups with different physical and work limitations. Similarly, MCS distinguished between groups with and without cognitive limitations. The MCS and PCS showed perfect dose response when variations in scores were examined by participant's chronic condition status. Conclusions Both component scores showed adequate reliability and validity with the 2003-2004 MEPS and should be suitable for use in a variety of proposes within this database.
Purpose
Previous research alludes to two wiregrass (
Aristida beyrichiana
) ecotypes from mesic and xeric environments. It is unknown whether these ecotypes are restricted by conspecific plant-soil ...feedbacks or specific components of mesic and xeric soils. We investigated whether biomass production of wiregrass ecotypes grown in mesic and xeric soil was affected by conspecific plant-soil feedbacks, and whether wiregrass ecotypes responded differently to the soil biota and nutrients that characterize each of the two soil types.
Methods
We established a greenhouse experiment to compare the biomass production of mesic and xeric wiregrass ecotypes in mesic and xeric soil. To establish the effects of conspecific soil conditioning, each soil type was either conditioned or unconditioned by wiregrass. To to isolate the effects of soil biota and nutrients, each combination of soil type and conditioning was replicated in three soil manipulations (i.e., whole, inoculated, and sterile soil) where each wiregrass ecotype was grown.
Results
Biomass of the xeric ecotype was marginally greater in xeric soil than in mesic soil. The mesic ecotype tended to grow more in mesic than xeric soil, but it was not significant. Soil conditioning did not affect biomass production of either ecotype. Soil biota coupled with nutrients affected biomass production of both ecotypes when not growing in their own soil.
Conclusions
We found some evidence for wiregrass ecotypes that have increased growth in their own soil type, but not for conspecific plant-soil feedbacks. Ecotypes were affected by negative interactions with soil biota when growing in a different type. Thus, the soil environment should be considered when sourcing seeds for restoration.
The forced relocation of several thousand Africans during Mexico’s historic period has so far been documented mostly through archival sources, which provide only sparse detail on their origins and ...lived experience. Here, we employ a bioarchaeological approach to explore the life history of three 16th century Africans from a mass burial at the San José de los Naturales Royal Hospital in Mexico City. Our approach draws together ancient genomic data, osteological analysis, strontium isotope data from tooth enamel, δ13C and δ15N isotope data from dentine, and ethnohistorical information to reveal unprecedented detail on their origins and health. Analyses of skeletal features, radiogenic isotopes, and genetic data from uniparental, genome-wide, and human leukocyte antigen (HLA) markers are consistent with a Sub-Saharan African origin for all three individuals. Complete genomes of Treponema pallidum sub. pertenue (causative agent of yaws) and hepatitis B virus (HBV) recovered from these individuals provide insight into their health as related to infectious disease. Phylogenetic analysis of both pathogens reveals their close relationship to strains circulating in current West African populations, lending support to their origins in this region. The further relationship between the treponemal genome retrieved and a treponemal genome previously typed in an individual from Colonial Mexico highlights the role of the transatlantic slave trade in the introduction and dissemination of pathogens into the New World. Putting together all lines of evidence, we were able to create a biological portrait of three individuals whose life stories have long been silenced by disreputable historical events.
•Genomic and isotopes data suggest an African origin for the three individuals•One ∼14X Treponema pallidum sub. pertenue genome was recovered•One ∼1,500X hepatitis B virus genome was recovered•Both pathogen genomes cluster together with present day pathogens from Africa
Barquera et al. analyze individuals from a colonial period burial from Mexico. Using an interdisciplinary approach, they reconstruct the genetic ancestry, origins, and health status of three enslaved Africans. Genomes of pathogens recovered from them provide insight on infectious diseases brought to the Americas by the transatlantic slave trade.
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