Clinically Significant Anxiety in Children with Autism Spectrum Disorder and Varied Intellectual Functioning.

Objective: To evaluate how distinct presentations of anxiety symptoms and intellectual impairment influence the measurement and estimated rate of clinically significant anxiety in autism spectrum disorder (ASD).Method: The sample included 75 children (ages 9-13 years) with ASD and varied IQ and 52 typically developing (TD) controls and parents. Parents completed anxiety symptom scales and a diagnostic interview, designed to (1) differentiate anxiety and ASD and (2) examine DSM-specified and unspecified ("distinct") anxiety presentations in each child, including fears of change, special interests, idiosyncratic stimuli and social confusion rather than evaluation. Children completed standard intellectual and ASD diagnostic assessments.Results: 69% of those with ASD had clinically-significant anxiety, including 21% DSM-specified anxiety disorders, 17% distinct anxiety, and 31% both. Only 8% of TD children had clinically-significant anxiety, all DSM-specified. DSM-specified anxiety disorders in children with ASD and intellectual impairment (IQ<70) were predominantly specific phobias. DSM-specified anxiety other than specific phobia was significantly less common in children with, versus without, intellectual impairment; this was not the case for distinct anxiety. The sensitivities of anxiety scales were moderate to poor, particularly in cases with intellectual impairment.Conclusions: ASD is associated with more frequent and varied presentations of clinical anxiety, which may align with and differ from the specified anxiety disorders of the DSM. Standard parent report anxiety scales have reduced sensitivity to detect clinical anxiety in ASD, particularly in children with intellectual impairment

Phase II Proof-of-Concept Trial of the Orexin Receptor Antagonist Filorexant (MK-6096) in Patients with Major Depressive Disorder.

BackgroundWe evaluated the orexin receptor antagonist filorexant (MK-6096) for treatment augmentation in patients with major depressive disorder.MethodsWe conducted a 6-week, double-blind, placebo-controlled, parallel-group, Phase II, proof-of-concept study. Patients with major depressive disorder (partial responders to ongoing antidepressant therapy) were randomized 1:1 to once-daily oral filorexant 10 mg or matching placebo.ResultsDue to enrollment challenges, the study was terminated early, resulting in insufficient statistical power to detect a prespecified treatment difference; of 326 patients planned, 129 (40%) were randomized and 128 took treatment. There was no statistically significant difference in the primary endpoint of change from baseline to week 6 in Montgomery Asberg Depression Rating Scale total score; the estimated treatment difference for filorexant-placebo was -0.7 (with negative values favoring filorexant) (P=.679). The most common adverse events were somnolence and suicidal ideation.ConclusionsThe interpretation of the results is limited by the enrollment, which was less than originally planned, but the available data do not suggest efficacy of orexin receptor antagonism with filorexant for the treatment of depression. (Clinical Trial Registry: clinicaltrials.gov: NCT01554176)

Probing Structural Transitions in the Intrinsically Disordered C-Terminal Domain of the Measles Virus Nucleoprotein by Vibrational Spectroscopy of Cyanylated Cysteines

A proof-of-concept demonstration that our methodology (infrared spectroscopy and cyanylated cysteine) is useful for monitoring structural transitions in unstructure proteins. --author-supplied descriptio

Characterization of Virgin, Re-Used, and Oxygen-Reduced Copper Powders Processed by the Plasma Spheroidization Process

Fabrication of parts with high mechanical properties heavily depend on the quality of powder deployed in the fabrication process. Copper powder in three different powder types were spheroidized using radio-frequency inductively coupled plasma (ICP) spheroidization process (TekSphero-15 system). The characterized powders include virgin powder as purchased from the powder manufacturer, powder used in electron beam powder bed fusion (EB-PBF) process, and reconditioned powder, which was used powder that underwent an oxygen-reduction treatment. The goal of spheroidizing these powder types was to evaluate the change in powder morphology, the possibility of enhancing the powder properties back to their as-received conditions, and assess oxygen reduction of the powder lots given their initial oxygen contents. Also, to investigate the impact of re-spheroidization on powder properties, the second round of spheroidization was performed on the already used-spheroidized powder. The impact of powder type on powder sphericity and particle size distribution was evaluated using the image analysis of scanning electron microscope (SEM) micrographs and laser diffraction, respectively. The spheroidized powder showed higher sphericity and more uniform particle size distribution overall. Depending on the powder collection bin, second round of spheroidization affected the powder sphericity differently. The possibility of deploying the plasma spheroidization process as an alternative oxygen-reduction technique was also investigated through tracking the powders\u27 oxygen content using inert gas fusion method before and after the spheroidization. The plasma spheroidized powder showed less oxygen content than the hydrogen-treated powder. The second round of spheroidization caused no change in oxygen content. The correlation between oxygen-reduction and created cracks was discussed and compared between plasma spheroidization and hydrogen-treatment. The plasma spheroidization process created a powder with higher sphericity, uniform particle size, and less oxygen content

Targeted deletion of Fgf9 in tendon disrupts mineralization of the developing enthesis

The enthesis is a transitional tissue between tendon and bone that matures postnatally. The development and maturation of the enthesis involve cellular processes likened to an arrested growth plate. In this study, we explored the role of fibroblast growth factor 9 (Fgf9), a known regulator of chondrogenesis and vascularization during bone development, on the structure and function of the postnatal enthesis. First, we confirmed spatial expression of Fgf9 in the tendon and enthesis using in situ hybridization. We then used Cre-lox recombinase to conditionally knockout Fgf9 in mouse tendon and enthesis (Scx-Cre) and characterized enthesis morphology as well as mechanical properties in Fgf

Value of systematic sampling in an mp-MRI targeted prostate biopsy strategy

The clinical utility of systematic prostate biopsy in addition to multi-parametric magnetic resonance imagining (mp-MRI) targeted biopsy pathways remains unclear. Despite radiological advancements in mp-MRI and utilisation of international standardised reporting systems (i.e., PI-RADS, LIKERT), undetected clinically significant prostate cancer (csPCa) on imaging persists. This has prevented the widespread adoption of an exclusively targeted biopsy approach. The current evidence on csPCa cancer detection rates in mp-MRI targeted alone and combined with a non-targeted systematic sampling is presented. Arguments for and against routine limited systematic sampling as an adjunct to an mp-MRI targeted biopsy are discussed. Our review will report the clinical utility of a combined sampling strategy on csPCa detection rate. The available evidence suggests that we are yet to reach a stage where non-targeted systematic prostate biopsy can be routinely omitted in mp-MRI targeted prostate biopsy pathways. Research should focus on improving the accuracy of mp-MRI, prostate biopsy techniques, and in identifying those men that will most benefit from a combined prostate biopsy. Such strategies may help future urologists reduce the burden of non-targeted cores in modern mp-MRI prostate biopsy pathways