Comparing Fixed-amount and Progressive-amount DRO Schedules for Tic Suppression in Youth with Chronic Tic Disorders

Chronic tic disorders (CTDs) involve motor and/or vocal tics that often cause substantial distress and impairment. Differential reinforcement of other behavior (DRO) schedules of reinforcement produce robust, but incomplete, reductions in tic frequency in youth with CTDs; however, a more robust reduction may be needed to affect durable clinical change. Standard, fixed‐amount DRO schedules have not commonly yielded such reductions, so we evaluated a novel, progressive‐amount DRO schedule, based on its ability to facilitate sustained abstinence from functionally similar behaviors. Five youth with CTDs were exposed to periods of baseline, fixed‐amount DRO (DRO‐F), and progressive‐amount DRO (DRO‐P). Both DRO schedules produced decreases in tic rate and increases in intertic interval duration, but no systematic differences were seen between the two schedules on any dimension of tic occurrence. The DRO‐F schedule was generally preferred to the DRO‐P schedule. Possible procedural improvements and other future directions are discussed

Factors associated with attendance at the postpartum blood pressure visit in pregnancies complicated by hypertension.

OBJECTIVES: Women with hypertensive disorders of pregnancy should have a blood pressure evaluation no later than 7-10 days after delivery. The objective of this study was to identify the factors associated with patient attendance at the postpartum blood pressure follow-up visit. STUDY DESIGN: This was a retrospective cohort study of postpartum women who had a hypertensive disorder of pregnancy. Postpartum follow-up rates were recorded, and characteristics of women who attended a postpartum visit for blood pressure evaluation were compared to women who did not return for the visit. Multiple logistic regression was performed. MAIN OUTCOME MEASURES: Characteristics of women who returned for a blood pressure visit. RESULTS: There were 378 women who met inclusion criteria; 193(51.1%) attended the blood pressure visit. Women who returned were older and more likely to have preeclampsia, severe features, magnesium sulfate use, or severe hypertension during hospitalization. They were less likely to have gestational hypertension. Adjusted analysis demonstrated that black/non-Hispanic women (OR 0.53, 95% CI 0.34-0.83), the presence of any preeclampsia diagnosis (OR 2.19, 95% CI 1.03-4.81), and whether the woman underwent a cesarean delivery (OR 3.06, 95% CI 1.85-5.14) remained significant factors in predicting adherence. CONCLUSIONS: Women who returned for a blood pressure visit were more likely to have had significant hypertensive disease or a cesarean delivery. Non-Hispanic black women had the lowest rate of follow-up. Given black women have the highest rates of maternal morbidity and mortality nationwide, effective interventions to increase follow-up for them are needed

Combining EEG and Eye Tracking: Using Fixation-Locked Potentials in Visual Search

Visual search is a complex task that involves many neural pathways to identify relevant areas of interest within a scene. Humans remain a critical component in visual search tasks, as they can effectively perceive anomalies within complex scenes. However, this task can be challenging, particularly under time pressure. In order to improve visual search training and performance, an objective, process-based measure is needed. Eye tracking technology can be used to drive real-time parsing of EEG recordings, providing an indication of the analysis process. In the current study, eye fixations were used to generate ERPs during a visual search task. Clear differences were observed following performance, suggesting that neurophysiological signatures could be developed to prevent errors in visual search tasks

Impact of an Opioid Harm Reduction Consortium: Emergency and Justice Engagement

Utah State University Extension engaged first responders and law enforcement officials in a consortium to identify local needs related to opioid use disorder (OUD). To this end, the Tooele Opioid Response Network (TORN) conducted three first-responder harm reduction summits to meet local overdose prevention needs. The initiative trained over 200 personnel, which resulted in an 87.5% increase in knowledge related to harm reduction. TORN also facilitated the acquisition of $90,000 in funding for jail-based opioid medication and the disbursement of 400 naloxone kits and training to incarcerated persons at discharge

Aseptic meningitis in a patient taking etanercept for rheumatoid arthritis: a case report

Background \ud We report a case of a 53 year old lady recently commenced on etanercept, an anti-TNF (tumour necrosis factor) therapy for rheumatoid arthritis presenting with \ud confusion, pyrexia and an erythematous rash. \ud \ud Case presentation \ud A lumbar puncture was highly suggestive of bacterial meningitis, but CSF cultures produced no growth, and polymerase chain reactions (PCR) for all previously reported bacterial, fungal and viral causes of meningitis were negative. \ud \ud Conclusions \ud This case report describes aseptic meningitis as a previously unreported complication of etanercept therapy, and serves as a reminder of the rare but potentially lifethreatening risk of serious infections in patients taking anti-TNF therapy for a variety of conditions

NS2 is dispensable for efficient assembly of hepatitis C virus-like particles in a bipartite trans-encapsidation system.

Infectious hepatitis C virus (HCV) particle production in the genotype 2a JFH-1-based cell culture system involves non-structural proteins in addition to canonical virion components. NS2 has been proposed to act as a protein adaptor, co-ordinating the early stages of virion assembly. However, other studies have identified late-acting roles for this protein, making its precise involvement in infectious particle production unclear. Using a robust, bipartite trans-encapsidation system based upon baculovirus expression of HCV structural proteins, we have generated HCV-like particles (HCV-LP) in the absence of NS2 with overt similarity to wild-type virions. HCV-LP could transduce naive cells with trans-encapsidated subgenomic replicon RNAs and shared similar biochemical and biophysical properties with JFH-1 HCV. Both genotype 1b and JFH-1 intracellular HCV-LP were produced in the absence of NS2, whereas restoring NS2 to the JFH-1 system dramatically enhanced secreted infectivity, consistent with a late-acting role. Our system recapitulated authentic HCV particle assembly via trans-complementation of bicistronic, NS2-deleted, chimeric HCV, which is otherwise deficient in particle production. This closely resembled replicon-mediated NS2 trans-complementation, confirming that baculovirus expression of HCV proteins did not unduly affect particle production. Furthermore, this suggests that separation of structural protein expression from replicating HCV RNAs that are destined to be packaged alleviates an early stage requirement for NS2 during particle formation. This highlights our current lack of understanding of how NS2 mediates assembly, yet comparison of full-length and bipartite systems may provide further insight into this process

Designing processing and fermentation conditions for long-life set yoghurt for made-in-transit (MIT) product

Extending yoghurt fermentations could facilitate yoghurt distribution by allowing the fermentation to occur during transportation - a concept known as "made-in-transit" (MIT). The objective was to determine the starter culture composition, inoculum size and fermentation temperature for extending yoghurt fermentations to 168 h. The yoghurt was processed using a milk base sterilized by ultra-high temperature (UHT) treatment at 138C for 6 s. Factorial experiments for yoghurt processing were designed with starter culture combinations of STLB (Streptococcus thermophilus with Lactobacillus delbrueckii subsp. bulgaricus) and STLA (S. thermophilus with L. acidophilus), inoculum sizes of 2.0 and 0.2% (v/v) and fermentation temperatures of 25 or 35C. The fermentation was monitored over 168 h using pH, starter culture concentration and firmness. The combination of STLA, and a 0.2% inoculum, fermented at 25C extended the yoghurt fermentation to 168 h; however, no gel formed. The best product was produced with a STLB starter combination of 2.0% inoculum fermented at 35C for 24 h. This shows the constraints and limitations of applying the MIT concept to a fermented food

Survey for a Vector of Zika Virus and Two Other Mosquito Species in Four Ecoregions of Missouri: An <em>A Posteriori</em> Analysis

In 2015, Zika emerged as a vector-borne disease in the Americas, causing a variety of health issues ranging from Guillain-Barre syndrome in adults to microcephaly in newborns. Following the documentation of mosquito-borne transmission of the disease in the southern United States, the Missouri Department of Health and Senior Services contracted with researchers at Missouri State University to complete a survey of possible mosquito vectors of the Zika in the state. The primary vector of the disease, Aedes aegypti, had been reported from Missouri in previous surveys from several decades ago, but a comprehensive survey of the state mosquitoes and never been completed. Researchers focused on mosquitoes that spend the immature stages in artificial containers because this is descriptive of the most important Zika vectors. The large survey over three years provided an opportunity for post hoc analysis of mosquito occurrence data across a variety of ecoregions inside the state, documenting changes in the vector populations as a result of invasive species. The survey also allowed an analysis of different trapping techniques for important species in the state. The results are reported in this chapter along with a discussion of the potential impact on human health of changes to the mosquito population

Sustaining remission of psychotic depression: rationale, design and methodology of STOP-PD II

BACKGROUND: Psychotic depression (PD) is a severe disabling disorder with considerable morbidity and mortality. Electroconvulsive therapy and pharmacotherapy are each efficacious in the treatment of PD. Expert guidelines recommend the combination of antidepressant and antipsychotic medications in the acute pharmacologic treatment of PD. However, little is known about the continuation treatment of PD. Of particular concern, it is not known whether antipsychotic medication needs to be continued once an episode of PD responds to pharmacotherapy. This issue has profound clinical importance. On the one hand, the unnecessary continuation of antipsychotic medication exposes a patient to adverse effects, such as weight gain and metabolic disturbance. On the other hand, premature discontinuation of antipsychotic medication has the potential risk of early relapse of a severe disorder. METHODS/DESIGN: The primary goal of this multicenter randomized placebo-controlled trial is to assess the risks and benefits of continuing antipsychotic medication in persons with PD once the episode of depression has responded to treatment with an antidepressant and an antipsychotic. Secondary goals are to examine age and genetic polymorphisms as predictors or moderators of treatment variability, potentially leading to more personalized treatment of PD. Individuals aged 18-85 years with unipolar psychotic depression receive up to 12 weeks of open-label treatment with sertraline and olanzapine. Participants who achieve remission of psychosis and remission/near-remission of depressive symptoms continue with 8 weeks of open-label treatment to ensure stability of remission. Participants with stability of remission are then randomized to 36 weeks of double-blind treatment with either sertraline and olanzapine or sertraline and placebo. Relapse is the primary outcome. Metabolic changes are a secondary outcome. DISCUSSION: This trial will provide clinicians with much-needed evidence to guide the continuation and maintenance treatment of one of the most disabling and lethal of psychiatric disorders. TRIAL REGISTRATION AND URL: NCT: NCT01427608