Positivity bias in past and future episodic thinking: Relationship with anxiety, depression, and retrieval-induced forgetting

Positivity biases in autobiographical memory and episodic future thinking are considered important in mental wellbeing and are reduced in anxiety and depression. The inhibitory processes underlying retrieval-induced forgetting (RIF) have been proposed to contribute to these biases. This investigation found reduced positivity in past and future thinking to be associated with reduced memory specificity alongside greater levels of anxiety, depression, and rumination. Most notably, however, RIF was found to significantly predict memory valence. This indicates that RIF may be important in maintaining such biases, facilitating the forgetting of negative memories when a positive item is actively retrieved

Using pharmacokinetics for tailoring prophylaxis in people with hemophilia switching between clotting factor products: A scoping review

The objective of this scoping review is to summarize the current use of pharmacokinetics for tailoring prophylaxis in hemophilia patients switching between clotting factor products. Patients with hemophilia may require switching of clotting factor concentrates due to a variety of factors, but there have been perceived risks associated with switching, such as inhibitor development or suboptimal protection due to inadequate dosing while titrating treatment. Studies that look at patients switching from one clotting factor concentrate to another are categorized in terms of their primary and/or secondary objectives, notably biosimilarity and comparative pharmacokinetic studies and inhibitor development studies. Research on how best to switch concentrates with respect to dosing regimen are lacking, and currently a trial-and-error approach is used for dosing the new factor concentrate. In the future, studies looking at the predictability of pharmacokinetics (PK) of a new factor concentrate based on individual PK knowledge of the original factor concentrate may offer clinical benefit by providing a safer switching approach and protocol

Symptom screen: diagnostic usefulness in detecting pulmonary tuberculosis in HIV-infected pregnant women in Kenya

OBJECTIVE: To determine the diagnostic usefulness of tuberculosis (TB) symptom screening to detect active pulmonary TB among human immunodeficiency virus (HIV) infected pregnant women in two PMTCT (prevention of mother-to-child transmission) clinics in western Kenya that are supported by the United States Agency for International Development–Academic Model Providing Access to Healthcare partnership. DESIGN: Cross-sectional study. Participants were interviewed for TB symptoms with a standardized questionnaire (cough >2 weeks, fever, night sweats, weight loss or failure to gain weight). Those with cough submitted sputum specimens for smear microscopy for acid-fast bacilli and mycobacterial culture. Women at >14 weeks gestation underwent shielded chest radiography (CXR). RESULTS: Of 187 HIV-infected women, 38 (20%) were symptom screen-positive. Of these, 21 had a cough for >2 weeks, but all had negative sputum smears and mycobacterial cultures. CXRs were performed in 26 symptomatic women: three were suggestive of TB (1 miliary, 1 infiltrates and 1 cavitary). Of 149 women with a negative symptom screen, 100 had a CXR and seven had a CXR suggestive of TB (1 cavitary, 2 miliary and 4 infiltrates). CONCLUSION: This study did not support the utility of isolated symptom screening in identification of TB disease in our PMTCT setting. CXR was useful in identification of TB suspects in both symptomatic and asymptomatic women

Hyperinsulinism in short-chain L-3-hydroxyacyl-CoA dehydrogenase deficiency reveals the importance of beta-oxidation in insulin secretion

A female infant of nonconsanguineous Indian parents presented at 4 months with a hypoglycemic convulsion. Further episodes of hypoketotic hypoglycemia were associated with inappropriately elevated plasma insulin concentrations. However, unlike other children with hyperinsulinism, this patient had a persistently elevated blood spot hydroxybutyrylcarnitine concentration when fed, as well as when fasted. Measurement of the activity of L-3-hydroxyacyl-CoA dehydrogenase in cultured skin fibroblasts with acetoacetyl-CoA substrate showed reduced activity. In fibroblast mitochondria, the activity was less than 5% that of controls. Sequencing of the short-chain L-3-hydroxyacyl-CoA dehydrogenase (SCHAD) genomic DNA from the fibroblasts showed a homozygous mutation (C773T) changing proline to leucine at amino acid 258. Analysis of blood from the parents showed they were heterozygous for this mutation. Western blot studies showed undetectable levels of immunoreactive SCHAD protein in the child's fibroblasts. Expression studies showed that the P258L enzyme had no catalytic activity. We conclude that C773T is a disease-causing SCHAD mutation. This is the first defect in fatty acid beta -oxidation that has been associated with hyperinsulinism and raises interesting questions about the ways in which changes in fatty acid and ketone body metabolism modulate insulin secretion by the beta cell. The patient's hyperinsulinism was easily controlled with diazoxide and chlorothiazide

The Union and Médecins Sans Frontières approach to operational research.

Operational research (OR) has become a hot topic at national meetings, international conferences and donor fora. The International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) Operational Centre Brussels strongly promote and implement OR with colleagues in low- and middle-income countries. Here we describe how the two organisations define OR, and explain the guiding principles and methodology that underpin the strategy for developing and expanding OR in those countries. We articulate The Union's and MSF's approach to supporting OR, highlighting the main synergies and differences. Then, using the Malawi National Tuberculosis Control Programme as an example, we show how OR can be embedded within tuberculosis control activities, leading to changes in policy and practice at the national level. We discuss the difficult, yet vitally important, issue of capacity building, and share our vision of a new paradigm of product-related training and performance-based OR fellowships as two ways of developing the necessary skills at country level to ensure research is actually performed. Finally, we highlight the need to consider and incorporate into practice the ethical components of OR. This is a key moment to be involved in OR. We are confident that in partnership with interested stakeholders, including the World Health Organization, we can stimulate the implementation of quality, relevant OR as an integral part of health service delivery that in turn will lead to better health for people, particularly for those living in the poorer parts of the world

Management of Post Traumatic Stress Disorder (PTSD) in Patients’ Relatives and Intensive Care Personnel in a Teaching Hospital

Post-traumatic stress disorder (PTSD) is a condition triggered by the experience of traumatic events and it can lead to long-term difficulties for patients and relatives in regards with their quality of life. There is growing body of evidence regarding the prevalence of PTSD amongst intensive care personnel. We set out to investigate whether there is a need for psychological support for both critically ill patients’ relatives and the intensive care unit (ICU) personnel. Method: A prospective two-stage survey was conducted in the ICU of a teaching hospital in the United Kingdom. Two predefined questionnaires composed of closed and open questions focusing on emotional needs and individual views of psychological support were distributed to Group 1 formed by families members (Group 1A) and ICU personnel (Group 1B) in the surveySupporting Families Emotional Needs, and to Group 2 composed by ICU personnel in the survey Supporting Staff Emotional Needs. Results: There were 77 questionnaires completed. In Group 1 there were 41 questionnaires completed on the “Supporting Families Emotional Needs” survey (16 by Group 1A and 25 by Group 1B members) and in Group 2 there were 36 questionnaires completed on the “Supporting Staff Emotional Needs” survey. Both surveys highlighted the need for a psychological support service. The design of this type of service was also investigated and was formed by opinions of the participants. Conclusion: There is a need for additional emotion support within the ICU. Yet further work is needed to identify strategies in order to provide this support

The Effect of Varied Recumbent Stepping Conditions on Lower Extremity Muscle Activity

Topics in Exercise Science and Kinesiology Volume 3: Issue 1, Article 9, 2022. The purpose of this study was to measure lower extremity muscle activity during recumbent stepping under varied conditions. We hypothesized that different stepping conditions would lead to significant changes in muscle activity. Fifteen healthy adults (4 men, 11 women; mean age 24.5 ± 7.7 yrs) provided informed consent to participate. During a single session, electromyography (EMG) was used to measure muscle activity of the tibialis anterior (TA), medial gastroc (MG), rectus femoris (RF), and biceps femoris (BF) muscles as a percent of maximal voluntary contraction (%MVC) during five different stepping conditions: 1) Stepping with no foot strap (SnS), 2) Stepping with a strap (SS), 3) Pulling with toes with a strap (PullTS), 4) Pushing with heel with a strap (PushHS) and, 5) Pushing with toes with a strap (PushTS). There were significant differences (p \u3c 0.05) in muscle activity between stepping conditions for the TA, MG and RF muscles. TA muscle activity was greatest (21.3 ± 13.7%MVC) during the PullTS condition, MG activity was greatest (7.4 ± 3.4%MVC) during the PushTS condition, and RF activity was greatest (12.9 ± 6.1%MVC) during the PullTS condition. There were no significant differences for the BF between conditions. Different recumbent stepping conditions can significantly alter lower extremity muscle activity with the largest changes observed in the ankle muscles. Therefore, when prescribing recumbent stepping exercise, clinicians should be aware of how factors such as stepping direction, the use of a foot strap, and verbal cueing can alter lower extremity muscle recruitment to optimize therapeutic benefit