Characterization of lymphocyte subsets over a 24-hour period in Pineal-Associated Lymphoid Tissue (PALT) in the chicken

BACKGROUND: Homeostatic trafficking of lymphocytes in the brain has important relevance to the understanding of CNS disease processes. The pineal gland of the chicken contains large accumulations of lymphocytes that suggest an important role related to homeostatic circadian neuro-immune interactions. The purpose of this initial study was to characterize the lymphocyte subsets in the pineal gland and quantitate the distribution and frequency of lymphocyte phenotypes at two time points over the 24-hour light:dark cycle. RESULTS: PALT comprised approximately 10% of the total pineal area. Image analysis of immunocytochemically stained sections showed that the majority of lymphocytes were CD3(+ )(80%) with the remaining 20% comprising B-cells and monocytes (Bu-1(+)), which tended to distribute along the periphery of the PALT. T-cell subsets in PALT included CD4(+ )(75–80%), CD8(+ )(20–25%), TCRαβ/Vβ(1)(+ )(60%), and TCRγδ(+ )(15%). All of the T-cell phenotypes were commonly found within the interfollicular septa and follicles of the pineal gland. However, the ratios of CD8(+)/CD4(+ )and TCRγδ(+)/TCRαβ/Vβ(1)(+ )within the pineal tissue were each 1:1, in contrast to the PALT where the ratios of CD8(+)/CD4(+ )and TCRγδ(+)/TCRαβ/Vβ(1)(+ )each approximated 1:4. Bu-1(+ )cells were only rarely seen in the pineal interstitial spaces, but ramified Bu-1(+ )microglia/macrophages were common in the pineal follicles. Effects of the 24-h light:dark cycle on these lymphocyte-pineal interactions were suggested by an increase in the area of PALT, a decline in the density of TCRαβ/Vβ(1)(+ )cells, and a decline in the area density of Bu-1(+ )microglia at the light:dark interphase (1900 h) compared to the dark:light interphase (0700 h). CONCLUSION: The degree of lymphocyte infiltration in the pineal suggests novel mechanisms of neuro-immune interactions in this part of the brain. Our results further suggest that these interactions have a temporal component related to the 24-hour light:dark cycle and that CD8(+ )and TCRγδ(+ )T-cells are preferentially recruited to the pineal follicles. Pineal microglia/macrophages were common and represent an important candidate for mediating these lymphocyte-pineal interactions via secretion of cytokines and chemokines

Food neophobia across the life course: Pooling data from five national cross-sectional surveys in Ireland

Food neophobia describes a reluctance to eat novel foods. Levels of food neophobia vary throughout life and are thought to peak in childhood. However, the trajectory of food neophobia across the life course is not fully clear. Using data from five national cross-sectional surveys in Ireland we explored levels of food neophobia in males and females aged 1–87 years. In addition, we assessed the influence of sociodemographic factors, breastfeeding and parental food neophobia on food neophobia. Food neophobia was measured using the Food Neophobia Scale in adults and adolescents and with the Children\u27s Eating Behaviour Questionnaire in preschool and school aged children. A total of 3246 participants (female, 49.9%) were included. Food neophobia increased with age from 1 to ∼6 years, then decreased until early adulthood where it remained stable until increasing with age in older adults (\u3e54 years). In adults, lower education level, social class and rural residency were associated with higher food neophobia. When preschool and school aged children surveys were pooled (ages 1–12), higher food neophobia was seen in males, children with lower parental education and those who were not breastfed. Sociodemographic factors were not significantly associated with food neophobia in adolescents. Breastfeeding duration was negatively associated with food neophobia in children and adolescents and parental food neophobia was positively associated with child\u27s food neophobia in preschool and school aged children. The influence of socioeconomic factors was more pronounced in adults than in children or adolescents. However, sociodemographic factors only explained a small proportion of the variation in food neophobia across all ages. Longitudinal studies are needed to understand how changes in age or socioeconomic circumstance influence food neophobia at an individual level

An analysis of lecture video utilization in undergraduate medical education: associations with performance in the courses

<p>Abstract</p> <p>Background</p> <p>Increasing numbers of medical schools are providing videos of lectures to their students. This study sought to analyze utilization of lecture videos by medical students in their basic science courses and to determine if student utilization was associated with performance on exams.</p> <p>Methods</p> <p>Streaming videos of lectures (n = 149) to first year and second year medical students (n = 284) were made available through a password-protected server. Server logs were analyzed over a 10-week period for both classes. For each lecture, the logs recorded time and location from which students accessed the file. A survey was administered at the end of the courses to obtain additional information about student use of the videos.</p> <p>Results</p> <p>There was a wide disparity in the level of use of lecture videos by medical students with the majority of students accessing the lecture videos sparingly (60% of the students viewed less than 10% of the available videos. The anonymous student survey revealed that students tended to view the videos by themselves from home during weekends and prior to exams. Students who accessed lecture videos more frequently had significantly (p < 0.002) lower exam scores.</p> <p>Conclusion</p> <p>We conclude that videos of lectures are used by relatively few medical students and that individual use of videos is associated with the degree to which students are having difficulty with the subject matter.</p

“Everything…Fell Apart Once COVID-19 Hit”—Leveraging the COVID-19 Response to Strengthen Public Health Activities toward Ending the HIV Epidemic: A Qualitative Study

COVID-19 caused widespread disruption of activities for Ending the HIV Epidemic (EHE). In this study we assessed public health perspectives on leveraging the COVID-19 response to advance the goals of EHE. We conducted a qualitative study with 33 public health partners in the Midwestern and Southern United States from October 2020 to February 2022. Participants were asked how the strategies developed for COVID-19 could be applied to the HIV epidemic. Interviews were recorded, transcribed, and examined using rapid qualitative analysis. Four themes emerged: (1) Rebuilding teams and adapting culture for success in EHE activities; (2) Recognizing and modernizing the role of disease intervention specialists (DIS); (3) Enhanced community awareness of the public health role in disease response and prevention; and (4) Leveraging COVID-19 data systems and infrastructure for EHE activities. The COVID-19 pandemic called attention to the dearth of public health funding and outdated information technology (IT) infrastructure used for HIV activities. It also led to greater public health knowledge, including increased familiarity with partner services and molecular epidemiology of HIV, and opportunities to develop new data systems for surveillance that can be applied to efforts for EHE

Precision medicine to improve use of bleeding avoidance strategies and reduce bleeding in patients undergoing percutaneous coronary intervention: Prospective cohort study before and after implementation of personalized bleeding risks

Objective To examine whether prospective bleeding risk estimates for patients undergoing percutaneous coronary intervention could improve the use of bleeding avoidance strategies and reduce bleeding. Design Prospective cohort study comparing the use of bleeding avoidance strategies and bleeding rates before and after implementation of prospective risk stratification for peri-procedural bleeding. Setting Nine hospitals in the United States. Participants All patients undergoing percutaneous coronary intervention for indications other than primary reperfusion for ST elevation myocardial infarction. Main outcome measures Use of bleeding avoidance strategies, including bivalirudin, radial approach, and vascular closure devices, and peri-procedural bleeding rates, stratified by bleeding risk. Observed changes were adjusted for changes observed in a pool of 1135 hospitals without access to pre-procedural risk stratification. Hospital level and physician level variability in use of bleeding avoidance strategies was examined. Results In a comparison of 7408 pre-intervention procedures with 3529 post-intervention procedures, use of bleeding avoidance strategies within intervention sites increased with pre-procedural risk stratification (odds ratio 1.81, 95% confidence interval 1.44 to 2.27), particularly among higher risk patients (2.03, 1.58 to 2.61; 1.41, 1.09 to 1.83 in low risk patients, after adjustment for control sites; P for interaction=0.05). Bleeding rates within intervention sites were significantly lower after implementation of risk stratification (1.0% v 1.7%; odds ratio 0.56, 0.40 to 0.78; 0.62, 0.44 to 0.87, after adjustment); the reduction in bleeding was greatest in high risk patients. Marked variability in use of bleeding avoidance strategies was observed across sites and physicians, both before and after implementation. Conclusions Prospective provision of individualized bleeding risk estimates was associated with increased use of bleeding avoidance strategies and lower bleeding rates. Marked variability between providers highlights an important opportunity to improve the consistency, safety, and quality of care. Study registration Clinicaltrials.gov NCT01383382

Ariel - Volume 4 Number 3

Editors David A. Jacoby Eugenia Miller Tom Williams Associate Editors Paul Bialas Terry Burt Michael Leo Gail Tenikat Editor Emeritus and Business Manager Richard J. Bonnano Movie Editor Robert Breckenridge Staff Richard Blutstein Mary F. Buechler Steve Glinks Len Grasman Alice M. Johnson J.D. Kanofsky Tom Lehman Dave Mayer Bernie Odd

Assessing readiness to implement long-acting injectable HIV antiretroviral therapy: Provider and staff perspectives

Background: Long-acting injectable antiretroviral therapy (LAI-ART) represents the next innovation in HIV therapy. Pre-implementation research is needed to develop effective strategies to ensure equitable access to LAI-ART to individuals living with HIV. Methods: We conducted focus group discussions (FGDs) with providers and staff affiliated with HIV clinics in San Francisco, Chicago, and Atlanta to understand barriers to and facilitators of LAI-ART implementation. Participants also completed a short survey about implementation intentions. FGDs were held via video conference, recorded, transcribed, and thematically analyzed using domains associated with the Consolidated Framework for Implementation Research (CFIR). Results: Between September 2020 and April 2021, we led 10 FDGs with 49 participants, of whom ~60% were prescribing providers. Organizational readiness for implementing change was high, with 85% agreeing to being committed to figuring out how to implement LAI-ART. While responses were influenced by the unique inner and outer resources available in each setting, several common themes, including implementation mechanisms, dominated: (1) optimism and enthusiasm about LAI-ART was contingent on ensuring equitable access to LAI-ART; (2) LAI-ART shifts the primary responsibility of ART adherence from the patient to the clinic; and (3) existing clinic systems require strengthening to meet the needs of patients with adherence challenges. Current systems in all sites could support the use of LAI-ART in a limited number of stable patients. Scale-up and equitable use would be challenging or impossible without additional personnel. Participants outlined programmatic elements necessary to realize equitable access including centralized tracking of patients, capacity for in-depth, hands-on outreach, and mobile delivery of LAI-ART. Sites further specified unknown logistical impacts on implementation related to billing/payer source as well as shipping and drug storage. Conclusions: Among these HIV care sites, clinic readiness to offer LAI-ART to a subset of patients is high. The main challenges to implementation include concerns about unequal access and a recognition that strengthening the clinic system is critical.</p

Assessment of the Environmental Impact of Food Consumption in Ireland-Informing a Transition to Sustainable Diets

Dietary changes are required to mitigate the climatic impact of food consumption. Food consumption databases can support the development of sustainable food based dietary guidelines (SFBDG) when linked to environmental indicators. An improved knowledge base is crucial to the transition to sustainable diets, and multiple environmental indicators should be considered to ensure this transition is evidence based and accounts for trade-offs. The current study aimed to quantify the environmental impact of daily diets across population groups in Ireland. Nationally representative food consumption surveys for Irish children (NCFSII; 2017-2018), teenagers (NTFSII; 2019-2020), and adults (NANS; 2008-2010) were used in this analysis. Blue water use (L) and greenhouse gas emissions (GHGe; kgCO2eq) were assigned at food level to all surveys. Cropland (m2), nitrogen (kgN/t), and phosphorous use (kgP/t) were assigned at the agricultural level for adults. Multiple linear regressions, Spearman correlations, and ANCOVAs with Bonferroni corrections were conducted. Higher environmental impact diets were significantly associated with demographic factors such as age, education status, residential location, and sex, but these associations were not consistent across population groups. The median greenhouse gas emissions were 2.77, 2.93, and 4.31 kgCO2eq, and freshwater use per day was 88, 144, and 307 L for children, teenagers, and adults, respectively. The environmental impact of the Irish population exceeded the planetary boundary for GHGe by at least 148% for all population groups, however the boundary for blue water use was not exceeded. Meat and meat alternatives (27-44%); eggs, dairy, and dairy alternatives (15-21%); and starchy staples (10-20%) were the main contributors to GHGe. For blue water use, the highest contributors were meat and meat alternatives in children; savouries, snacks, nuts, and seeds in teenagers; and eggs, dairy, and dairy alternatives in adults (29-52%). In adults, cropland use, nitrogen use, and phosphorous use exceeded planetary boundaries by 277-382%. Meat, dairy, and grains were the main contributors to cropland, nitrogen, and phosphorous use (79-88%). The quantified environmental impact of Irish diets provides a baseline analysis, against which it will be possible to track progress towards sustainable diets, and the basis for the development of Sustainable Food Based Dietary Guidelines in Ireland

The factors associated with food fussiness in Irish school-aged children

Objective: To establish the factors that determine food fussiness, to explore if child age determines the extent to which these factors influence food fussiness and to identify whether parental neophobia is an independent determinant of food fussiness. Design: Cross-sectional data from the National Children’s Food Survey (2003–2004). The Children’s Eating Behaviour Questionnaire (CEBQ) assessed eating behaviours in children. The Food Neophobia Scale (FNS) assessed parental food neophobia. Young children were classified as 5–8 years old with older children classified as 9–12 years old. Setting: Republic of Ireland. Participants: Nationally representative sample of Irish children aged 5–12 years (n 594). Results: Parents identifying child’s food preferences as a barrier to providing their child with a healthy diet was significantly associated with increased food fussiness in younger (P<0·001) and older children (P<0·001). Higher levels of parental neophobia were significantly associated with an increase in food fussiness in younger (P<0·05) and older (P<0·001) children. Food advertising as a barrier to providing a healthy diet was inversely associated with food fussiness in younger children (P<0·05). In older children, there was a significant inverse association between child’s BMI and food fussiness (P<0·05), but not to the extent that a difference in weight status was noted. Family mealtimes in older children were associated with significantly lower levels of food fussiness (P<0·05). Conclusions: Findings from the present study identify that a child’s age does determine the extent to which certain factors influence food fussiness and that parental neophobia is an independent determinant of food fussiness