Autism spectrum disorder and anorexia nervosa: an Italian prospective study

Background: Potential overlaps exist between psychopathological features of Anorexia Nervosa (AN) and Autism Spectrum Disorder (ASD). The impact of malnutrition on autistic traits in patients with AN should be considered. This study investigates possible associations among the psychopathology of Eating Disorders (EDs), ASD traits and BMI in a group of young patients with AN, using the EDI-3 (Eating Disorder Inventory-3) test and gold-standard measures for ASD. Methods: Prospective study involving 23 inpatients admitted to an Italian Centre for paediatric ED. ASD traits and ED psychopathology were assessed administering the ADOS-2 (Autism Diagnostic Observation Schedule-2), AQ (Autism Quotient) and EDI-3 tests. Both present and past autistic traits were investigated using different versions of AQ. Correlations were adjusted for BMI, Obsessive Compulsive Disorder (OCD) comorbidity and concurrent antipsychotic treatments. Results: An ASD diagnosis was possible in 22% of patients. Significant correlations were documented between ASD traits and ED psychopathology: AQ total-Interpersonal problems (IPC) (p = 0.041); AQ total-Global psychological maladjustment (GMPC) (p = 0.027); AQ social skills-Ineffectiveness (IC) (p = 0.018); AQ social skills-IPC (p = 0.019); AQ social skills-Affective problems (APC) (p = 0.025); AQ social skills-GMPC (p = 0.007); AQ attention switching-IPC (p = 0.020); ADOS-2 imagination-IC (p = 0.035). These correlations were independent of BMI, OCD and antipsychotic treatments. Conclusions: ASD traits presented high prevalence in a group of young inpatients with AN. These traits were significantly correlated to 4 specific EDI-3 subscales and independent of BMI. This is the first study to investigate the relationship between ASD traits as measured with gold-standard measures, EDI-3 scores, and BMI

Role of catestatin as such as slowly released by fibronectin-coated pharmacologically active microcarriers (Fn-Pam) in limiting hypoxicinduced cell death

Objectives: Catestatin (CST), a 21-amino acid derivate of Chromogranin A, exerts several biological functions, including inhibition of catecholamine release and cardioprotective role. Moreover positive effect of CST on monocyte migration in vitro and the induction of angiogenesis, arteriogenesis and vasculogenesis in the mouse hind limb ischemia model have been demonstrated. Collateral arteries may provide a biological bypass for occluded atherosclerotic vessels, increasing blood flow to ischemic tissue. In such a prospective, CST is a very promising agent for revascularization purposes, in “NO-OPTION” patients. However, proteins have a very short half-life after administration and must be conveniently protected. FN-PAMs, biodegradable and biocompatible polymeric microspheres, have ideal characteristic for this purpose: besides to convey peptides and allow in situ prolonged/controlled delivery, they may also convey cells on their biomimetic surface and may favor their survival and engraftment after cell transplantation. In this study, we show that CST can be incorporated within FN-PAM and aim to demonstrate that CST may be released in a slowly/prolonged manner by FN-PAM. We also aim to demonstrate that CST released by FN-PAM may reduce cell death under different stress conditions. Materials and methods: CST has to be precipitated to ensure its stability upon subsequent encapsulation. Protein precipitate is formed from aqueous solution by the addition of a watermiscible organic solvent. PLGA–P188–PLGA (triblock) copolymeric microspheres are prepared using solid/oil/water emulsion solvent evaporation–extraction technique. PAMs are coated with Fibronectin and characterized by Immunofluroscence (confocal microscopy). Mesenchymal stem cells (MSC) are exposed to hypoxia (72 h in 1–2%O2) and reoxygenation (6 h in 21% O2) in a hypoxic chamber with or without CTS, FN-PAMs or CTS-FN-PAMs. The protective effects of treatments are detected by MTT assay. Results: To define the optimum condition of nanoprecipitation we used an experimental design, modifying parameters influencing protein precipitation: ionic strength, mixing and centrifugation time. Nanoprecipitation of CST was found to be 72%. Controlled release of CST from CTS-FNPAM greatly limits hypoxic MSC death and enhances MSC survival in post-hypoxic environment. Conclusions: FN-PAMs are successfully formulated with CST. By an experimental design, we found optimal conditions to obtain a good CTS nanoprecipitation yield. MSC readily adhere to the FN-PAM and CST-FN-PAMs reduce MSC death enhancing survival in post-hypoxic environment. Data suggest that CST-FN-PAMs are promising tools for therapeutic purpose

Uptake of home-based voluntary HIV testing in sub-Saharan Africa: a systematic review and meta-analysis

Improving access to HIV testing is a key priority in scaling up HIV treatment and prevention services. Home-based voluntary counselling and testing (HBT) as an approach to delivering wide-scale HIV testing is explored here

Traces of Fallback Breccia on the Rim of Barringer Meteorite Crater (a.k.a. Meteor Crater), Arizona

Barringer Meteorite Crater (a.k.a. Meteor Crater), Arizona, is one of the youngest and best preserved impact craters on Earth. For that rea-son, it provides a baseline for similar craters formed in the geologic past, formed elsewhere in the Solar Sys-tem, and illuminates the astronomical and geological processes that produce them. The crater has not, how-ever, escaped erosion completely. While Shoemaker [1] mapped a breccia with fallback components inside the crater, he did not locate it beyond the crater rim. He only found remnants of that type of debris in re-worked alluvium [1; see also 2]. Fallback breccia and any base-surge deposits have, thus, been missing components in studies of material ejected beyond the transient crater rim

Knowledge and Perceptions of Couples' Voluntary Counseling and Testing in Urban Rwanda and Zambia: A Cross-Sectional Household Survey

Most incident HIV infections in sub-Saharan Africa occur between cohabiting, discordant, heterosexual couples. Though couples' voluntary HIV counseling and testing (CVCT) is an effective, well-studied intervention in Africa, <1% of couples have been jointly tested.We conducted cross-sectional household surveys in Kigali, Rwanda (n = 600) and Lusaka, Zambia (n = 603) to ascertain knowledge, perceptions, and barriers to use of CVCT.Compared to Lusaka, Kigali respondents were significantly more aware of HIV testing sites (79% vs. 56%); had greater knowledge of HIV serodiscordance between couples (83% vs. 43%); believed CVCT is good (96% vs. 72%); and were willing to test jointly (91% vs. 47%). Stigma, fear of partner reaction, and distance/cost/logistics were CVCT barriers.Though most respondents had positive attitudes toward CVCT, the majority were unaware that serodiscordance between cohabiting couples is possible. Future messages should target gaps in knowledge about serodiscordance, provide logistical information about CVCT services, and aim to reduce stigma and fear

Agglomeration, Inequality and Economic Growth (WP)

The impact of income inequality on economic growth is dependent on several factors, including the time horizon considered, the initial level of income and its initial distribution. Yet, as growth and inequality are also uneven across space, it is also pertinent to consider the effects of the geographical agglomeration of economic activity. Moreover, it would also seem pertinent to consider not just the levels of inequality and agglomeration, but also the changes they undergo -i.e., their within-country evolution- and how these two processes interact with each other. By applying different econometric specifications and by introducing different measures of agglomeration at country level -specifically, urbanization and urban concentration rates-, this study analyzes how inequality and agglomeration -both their levels and their evolution- influence economic growth in function of the country’s level of development and its initial income distribution. Our results suggest, in line with previous studies, that while high inequality levels are a limiting factor for long-run growth, increasing inequality and increasing agglomeration have the potential to enhance growth in low-income countries where income distribution remains relatively equal, but can result in congestion diseconomies in high-income countries, especially if income distribution becomes particularly unequal

The burden of knowing: balancing benefits and barriers in HIV testing decisions. a qualitative study from Zambia

<p>Abstract</p> <p>Background</p> <p>Client-initiated HIV counselling and testing has been scaled up in many African countries, in the form of voluntary counselling and testing (VCT). Test rates have remained low, with HIV-related stigma being an important barrier to HIV testing. This study explored HIV testing decisions in one rural and one urban district in Zambia with high HIV prevalence and available antiretroviral treatment.</p> <p>Methods</p> <p>Data were collected through 17 in-depth interviews and two focus group discussions with individuals and 10 in-depth interviews with counsellors. Interpretive description methodology was employed to analyse the data.</p> <p>Results</p> <p>'To know your status' was found to be a highly charged concept yielding strong barriers against HIV testing. VCT was perceived as a diagnostic device and a gateway to treatment for the severely ill. Known benefits of prevention and early treatment were outweighed by a perceived burden of knowing your HIV status related to stigma and fear. The manner in which the VCT services were organised added to this burden.</p> <p>Conclusions</p> <p>This study draws on social stigma theory to enhance the understanding of the continuity of HIV related stigma in the presence of ART, and argues that the burden of knowing an HIV status and the related reluctance to get HIV tested can be understood both as a form of label-avoidance and as strong expressions of the still powerful embodied memories of suffering and death among non-curable AIDS patients over the last decades. Hope lies in the emerging signs of a reduction in HIV related stigma experienced by those who had been tested for HIV. Further research into innovative HIV testing service designs that do not add to the burden of knowing is needed.</p

Transitional Care for Patients with Congenital Colorectal Diseases: An EUPSA Network Office, ERNICA, and eUROGEN Joint Venture

Background: Transition of care (TOC; from childhood into adulthood) of patients with anorectal malformations (ARM) and Hirschsprung disease (HD) ensures continuation of care for these patients. The aim of this international study was to assess the current status of TOC and adult care (AC) programs for patients with ARM and HD. Methods: A survey was developed by members of EUPSA, ERN eUROGEN, and ERNICA, including patient representatives (ePAGs), comprising of four domains: general information, general questions about transition to adulthood, and disease-specific questions regarding TOC and AC programs. Recruitment of centres was done by the ERNs and EUPSA, using mailing lists and social media accounts. Only descriptive statistics were reported. Results: In total, 82 centres from 21 different countries entered the survey. Approximately half of them were ERN network members. Seventy-two centres (87.8%) had a self-reported area of expertise for both ARM and HD. Specific TOC programs were installed in 44% of the centres and AC programs in 31% of these centres. When comparing centres, wide variation was observed in the content of the programs. Conclusion: Despite the awareness of the importance of TOC and AC programs, these programs were installed in less than 50% of the participating centres. Various transition and AC programs were applied, with considerable heterogeneity in implementation, content and responsible caregivers involved. Sharing best practice examples and taking into account local and National Health Care Programs might lead to a better continuation of care in the future. Level of Evidence: III