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The hydration shells of phosphate ions and phosphate groups of nucleotides and phospholipid membranes display markedly different structures and hydrogen-bond strengths. Understanding phosphate hydration requires insight into the spatial arrangements of water molecules around phosphates and in thermally activated structure fluctuations on ultrafast time scales. Femtosecond two-dimensional infrared spectroscopy of phosphate vibrations, particularly asymmetric stretching vibrations between 1000 and 1200 cm−1, and ab initio molecular dynamics (AIMD) simulations are combined to map and characterize dynamic local hydration structures and phosphate–water interactions. Phosphoric acid H3PO4 and its anions H2PO4−, HPO42−, and PO43− are studied in aqueous environments of different pH value. The hydration shells of phosphates providing OH donor groups in hydrogen bonds with the first water layer undergo ultrafast structural fluctuations, which induce a pronounced spectral diffusion of vibrational excitations on a sub-300 fs time scale. With a decreasing number of phosphate OH groups, the hydration shell becomes more ordered and rigid. The 2D-IR line shapes observed with hydrated PO43− ions display a pronounced inhomogeneous broadening, reflecting a distribution of hydration geometries without fast equilibration. The AIMD simulations allow for an in-depth characterization of the hydration geometries with different numbers of water molecules in the first hydration layer and different correlation functions of the fluctuating electric field that the water environment exerts on the vibrational phosphate oscillators. [ABSTRACT FROM AUTHOR]

The GDS(L)-like lipase from the Basidiomycota Pleurotus sapidus (PSA_Lip) was heterologously expressed using Trichoderma reesei with an activity of 350 U L−1. The isoelectric point of 5.0 was determined by isoelectric focusing. The novel PSA_Lip showed only 23.8–25.1%, 25.5%, 26.6% and 28.4% identity to the previously characterized GDSL-like enzymes phospholipase, plant lipase, acetylcholinesterase and acetylxylan esterase, from the carbohydrate esterase family 16, respectively. Therefore, the enzyme was purified from the culture supernatant and the catalytic properties and the substrate specificity of the enzyme were investigated using different assays to reveal its potential function. While no phospholipase, acetylcholinesterase and acetylxylan esterase activities were detected, studies on the hydrolysis of ferulic acid methyl ester (~ 8.3%) and feruloylated carbohydrate 5-O-transferuloyl-arabino-furanose (~ 0.8%) showed low conversions of these substrates. By investigating the hydrolytic activity towards p-nitrophenyl-(pNP)-esters with various chain-lengths, the highest activity was determined for medium chain-length pNP-octanoate at 65 °C and a pH value of 8, while almost no activity was detected for pNP-hexanoate. The enzyme is highly stable when stored at pH 10 and 4 °C for at least 7 days. Moreover, using consensus sequence analysis and homology modeling, we could demonstrate that the PSA_Lip does not contain the usual SGNH residues in the actives site, which are usually present in GDS(L)-like enzymes. [ABSTRACT FROM AUTHOR]

Limited research has been conducted on coaching of paraprofessionals who serve students with disruptive behaviors. This study builds upon a randomized controlled trial investigating the intervention effects of the Behavior Support Coaching for Paraprofessionals model by examining the specific behavior concerns, coaching goals, and interventions used during behavior support coaching implementation. This study consists of 83 elementary school paraprofessionals who received behavior support coaching and served 163 elementary school students from 27 schools. Behavior support coaches used observational data to identify student behavior needs, set goals, prioritize intervention supports, and monitor progress toward goals. Results revealed inappropriate physical and verbal behaviors were most often targeted as behavior goals. Coaches and paraprofessionals and classroom teachers utilized a broad range of research‐based behavior interventions, with token economy and behavioral contract most often implemented. Results indicated significant change in observed student nonengagement and inappropriate physical behaviors when these are targeted as behavior goals. Implications of these findings for research and school practice are presented. Practitioner Points: Token economy, behavioral contract, and response cost raffle are popular behavioral interventions used with children who have or are at risk of developing disruptive behavior disorder.Aligning a behavior intervention to a specific behavior goal makes it more likely that the intervention will be effective.However, intervention effects can also generalize to behaviors that are not targeted in a behavior goal, showing "carryover effects." [ABSTRACT FROM AUTHOR]

An empirical multi-parameter equation of state in terms of the reduced Helmholtz energy is presented for the Mie (λr-6) fluid with a repulsive exponent λr from 11 to 13. The equation is fitted to an extensive dataset from molecular dynamics simulation as well as the second and third thermal virial coefficients. It is comprehensively compared with the SAFT-VR model and is a more accurate description of the considered fluid class. The equation is valid for reduced temperatures T/Tc from 0.55 to 4.5 and for reduced pressures of up to p/pc = 265. A good extrapolation behavior and the occurrence of a single Maxwell loop down to the vicinity of the triple point temperature are realized. [ABSTRACT FROM AUTHOR]

Although introns are typically tens to thousands of nucleotides, there are notable exceptions. In flies as well as humans, a small number of genes contain introns that are more than 1000 times larger than typical introns, exceeding hundreds of kilobases (kb) to megabases (Mb). It remains unknown why gigantic introns exist and how cells overcome the challenges associated with their transcription and RNA processing. The Drosophila Y chromosome contains some of the largest genes identified to date: multiple genes exceed 4Mb, with introns accounting for over 99% of the gene span. Here we demonstrate that co-transcriptional splicing of these gigantic Y-linked genes is important to ensure successful transcription: perturbation of splicing led to the attenuation of transcription, leading to a failure to produce mature mRNA. Cytologically, defective splicing of the Y-linked gigantic genes resulted in disorganization of transcripts within the nucleus suggestive of entanglement of transcripts, likely resulting from unspliced long RNAs. We propose that co-transcriptional splicing maintains the length of nascent transcripts of gigantic genes under a critical threshold, preventing their entanglement and ensuring proper gene expression. Our study reveals a novel biological significance of co-transcriptional splicing. Author summary: A small number of genes in our genome are characterized by excessively large introns, sometimes exceeding megabases. It remains poorly understood why such large introns exist or how they are processed during gene expression. By examining genes on Drosophila Y chromosome that contain gigantic introns, it is shown that the transcripts of these genes are co-transcriptionally spliced, and co-transcriptional splicing of these genes is critical for proper gene expression. Perturbation of splicing led to attenuation of transcription specifically in genes with gigantic introns, but not genes with average-sized introns. Whereas transcripts of genes with gigantic introns normally form separate nuclear domains, splicing perturbation led to intermingling of these domains, leading to a proposal that co-transcriptional splicing may function to keep transcript length short to avoid entanglement of transcripts, which may stall the progression of RNA polymerase II. Taken together, these results reveal a novel function of co-transcriptional splicing that specifically impacts the expression of genes with gigantic introns. [ABSTRACT FROM AUTHOR]

Subgroup analysis aims to identify subgroups (usually defined by baseline/demographic characteristics), who would (or not) benefit from an intervention under specific conditions. Often performed post hoc (not pre-specified in the protocol), subgroup analyses are prone to elevated type I error due to multiple testing, inadequate power, and inappropriate statistical interpretation. Aside from the well-known Bonferroni correction, subgroup treatment interaction tests can provide useful information to support the hypothesis. Using data from a previously published randomized trial where a p value of 0.015 was found for the comparison between standard and Hemopatch® groups in (the subgroup of) 135 patients who had hand-sewn pancreatic stump closure we first sought to determine whether there was interaction between the number and proportion of the dependent event of interest (POPF) among the subgroup population (patients with hand-sewn stump closure and use of Hemopatch®), Next, we calculated the relative excess risk due to interaction (RERI) and the "attributable proportion" (AP). The p value of the interaction was p = 0.034, the RERI was − 0.77 (p = 0.0204) (the probability of POPF was 0.77 because of the interaction), the RERI was 13% (patients are 13% less likely to sustain POPF because of the interaction), and the AP was − 0.616 (61.6% of patients who did not develop POPF did so because of the interaction). Although no causality can be implied, Hemopatch® may potentially decrease the POPF after distal pancreatectomy when the stump is closed hand-sewn. The hypothesis generated by our subgroup analysis requires confirmation by a specific, randomized trial, including only patients undergoing hand-sewn closure of the pancreatic stump after distal pancreatectomy. Trial registration: INS-621000-0760. [ABSTRACT FROM AUTHOR]

It is shown that the residual entropy (entropy minus that of the ideal gas at the same temperature and density) is mostly synonymous with the independent variable of density scaling, identifying a direct link between these two approaches. The residual entropy and the effective hardness of interaction (itself a derivative at constant residual entropy) are studied for the Lennard-Jones monomer and dimer as well as a range of rigid molecular models for carbon dioxide. It is observed that the density scaling exponent appears to be related to the two-body interactions in the dilute-gas limit. [ABSTRACT FROM AUTHOR]

Limited research has examined the qualities of paraprofessional and teacher relationships in schools. Teachers' and paraprofessionals' ability to communicate and collaborate are important for guiding supports for their students. The present study examined characteristics affecting the professional relationship of paraprofessional and teacher pairs working within the same classroom across 58 elementary schools. A total of 108 pairs of paraprofessionals and teachers were asked to independently complete a multidimensional assessment of relationship quality, as well as a demographic survey. Findings overall indicate that both classroom teachers and their paraprofessionals rate their relationship qualities favorably, with paraprofessionals rating relationships more positively than teachers (ds =.28 −.34). However, there are differences in relationship ratings by race and ethnicity. Implications are discussed and suggestions are given so that paraprofessionals and teachers can continue to develop positive relationships. [ABSTRACT FROM AUTHOR]

There are currently a multitude of quantification techniques that have been developed for use with single-case designs. As a result, choosing an appropriate quantification technique can be overwhelming and it can be difficult for researchers to properly describe and justify their use of quantification techniques. However, providing clear descriptions and justifications is important for enhancing the credibility of single-case research, and allowing others to evaluate the appropriateness of the quantification technique used. The aim of this systematic literature review is to provide an overview of the quantification techniques that are used to analyze single-case designs, with a focus on the descriptions and justifications that are provided. A total of 290 quantifications occurred across 218 articles, and the descriptions and justifications that were provided for the quantification techniques that were used are systematically examined. Results show that certain quantification techniques, such as the non-overlap indices, are more commonly used. Descriptions and justifications provided for using the quantification techniques are sometimes vague or subjective. Single-case researchers are encouraged to complement visual analysis with the use of quantification techniques for which they can provide objective and appropriate descriptions and justifications, and are encouraged to use tools to guide their choice of quantification techniques. [ABSTRACT FROM AUTHOR]

The Lennard-Jones potential is taken as a basis to study the structure and dynamics of the face centered cubic (fcc) solid along an isochore from low temperatures up to the solid/fluid transition. The Z method is applied to estimate the melting point. Molecular dynamics simulations are used to calculate the pair distribution function, numbers of nearest neighbors, and the translational order parameter, analyzing the weakening of the fcc-symmetry due to emerging premelting effects. A range of dynamic properties, such as the mean-squared displacement, non-Gaussian parameter, Debye–Waller factor, and vibrational density of states, is considered for the analysis of the solid state. All of these parameters clearly show that bulk mobility is activated at about 2/3 of the melting temperature, known as the Tammann temperature. This indicates that vibrational motion of atoms is not maintained exclusively in the entire stable solid state and that collective atomic motion constitutes a precursor of the melting process. [ABSTRACT FROM AUTHOR]

Drosophila sperm development is characterized by extensive posttranscriptional regulation whereby thousands of transcripts are preserved for translation during later stages. A key step in translation initiation is the binding of eukaryotic initiation factor 4E (eIF4E) to the 5' mRNA cap. In addition to canonical eIF4E-1, Drosophila has multiple eIF4E paralogs, including four (eIF4E-3, -4, -5, and -7) that are highly expressed in the testis. Among these, only eIF4E-3 has been characterized genetically. Here, using CRISPR/Cas9 mutagenesis, we determined that eIF4E-5 is essential for male fertility. eIF4E-5 protein localizes to the distal ends of elongated spermatid cysts, and eIF4E-5 mutants exhibit defects during postmeiotic stages, including a mild defect in spermatid cyst polarization. eIF4E-5 mutants also have a fully penetrant defect in individualization, resulting in failure to produce mature sperm. Indeed, our data indicate that eIF4E-5 regulates non-apoptotic caspase activity during individualization by promoting local accumulation of the E3 ubiquitin ligase inhibitor Soti. Our results further extend the diversity of non-canonical eIF4Es that carry out distinct spatiotemporal roles during spermatogenesis. [ABSTRACT FROM AUTHOR]

Discrete trial training is a popular teaching method for individuals with autism, but it is not easily implemented with fidelity due to its complexity. This is the first meta-analysis of single-case experimental design studies to quantify the impact of behavioral skills training on individuals' ability to implement discrete trials with fidelity. Furthermore, this meta-analysis examines the four training methods that make up behavioral skills training—feedback, instruction, modeling, and rehearsal—to determine the "active ingredients" of behavioral skills training. A total of 46 single-case experimental design studies are included in this meta-analysis. Hierarchical linear modeling, which has the ability to analyze clustered data, is the meta-analytic technique used to estimate the effectiveness of behavioral skills training across studies. Results show that behavioral skills training has a statistically significant positive effect on discrete trial training implementation fidelity; therefore, behavior skills training is recommended for discrete trial training implementation instruction. [ABSTRACT FROM AUTHOR]

Microbial keratitis (MK) is an infection of the cornea, caused by bacteria, fungi, parasites, or viruses. MK leads to significant morbidity, being the fifth leading cause of blindness worldwide. There is an urgent requirement to better understand pathogenesis in order to develop novel diagnostic and therapeutic approaches to improve patient outcomes. Many in vitro, ex vivo and in vivo MK models have been developed and implemented to meet this aim. Here, we present current in vitro and ex vivo MK model systems, examining their varied design, outputs, reporting standards, and strengths and limitations. Major limitations include their relative simplicity and the perceived inability to study the immune response in these MK models, an aspect widely accepted to play a significant role in MK pathogenesis. Consequently, there remains a dependence on in vivo models to study this aspect of MK. However, looking to the future, we draw from the broader field of corneal disease modelling, which utilises, for example, three-dimensional co-culture models and dynamic environments observed in bioreactors and organ-on-a-chip scenarios. These remain unexplored in MK research, but incorporation of these approaches will offer further advances in the field of MK corneal modelling, in particular with the focus of incorporation of immune components which we anticipate will better recapitulate pathogenesis and yield novel findings, therefore contributing to the enhancement of MK outcomes. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Cognitive reserve (CR) has been postulated to contribute to the variation observed between neuropathology and clinical outcomes in Alzheimer's disease (AD).Objective: We investigated the effect of an education-occupation derived CR proxy on biological properties of white matter tracts in patients with amnestic mild cognitive impairment (aMCI) and healthy elders (HC).Methods: Educational attainment and occupational complexity ratings (complexity with data, people, and things) from thirty-five patients with aMCI and twenty-eight HC were used to generate composite CR scores. Quantitative magnetic resonance imaging (qMRI) and multi-shell diffusion MRI were used to extract macromolecular tissue volume (MTV) across major white matter tracts.Results: We observed significant differences in the association between CR and white matter tract MTV in aMCI versus HC when age, gender, intracranial volume, and memory ability were held constant. Particularly, in aMCI, higher CR was associated with worse tract pathology (lower MTV) in the left and right dorsal cingulum, callosum forceps major, right inferior fronto-occipital fasciculus, and right superior longitudinal fasciculus (SLF) tracts. Conversely higher CR was associated with higher MTV in the right parahippocampal cingulum and left SLF in HC.Conclusion: Our results support compensatory CR mechanisms in aMCI and neuroprotective mechanisms in HC and suggest differential roles for CR on white matter macromolecular properties in healthy elders versus prodromal AD patients. [ABSTRACT FROM AUTHOR]

Background: The FeverApp registry uses ecological momentary assessment (EMA) to collect parental data on pediatric fever for scientific research. The mobile app FeverApp educates parents on safe fever management and serves as a fever diary. Objective: The focus of this study was to evaluate the completeness and concordance of the EMA-based FeverApp registry with regard to its data quality from a multilevel perspective. Methods: Structured descriptions of fever episodes by health care professionals from an office were used as reference. The number of children, their sociodemographic data, and agreement of fever episodes, with maximum temperature, intake of antipyretics and antibiotics, and physician visits, were compared with the entries in the corresponding physician's reference records. The data quality indicators for completeness, meaning the extent to which the necessary data for the registry has actually been submitted, and concordance, which is the correspondence of the value of a data element with a reference source, were chosen to analyze whether EMA may be a suitable method for this kind of registry. Results: In both data sources, 1012 children were available for comparison over 16 months. The completeness of gender (1012/1012, 100%) and date of birth (1004/1012, 99.2%) information was high, and the mismatches were 0.69% (7/1012) and 1.19% (12/1012), respectively, between the sources. Of these 1012 children, 668 (66%) registered fever episodes in FeverApp. They relate to 534 families with 953 fever episodes in the reference records and 1452 episodes in the FeverApp registry. Of the 534 families, 183 (34.3%) refrained from visiting the office during fever episodes but nevertheless documented them in FeverApp. Largest part (766/1452, 52.75%) episodes were recorded exclusively in the FeverApp registry by 371 (371/534, 69.5%) families. The remaining 686 (47.2%) episodes of 391 (58.5%) children from 351 (65.7%) families were comparable with the reference data source in terms of physician visits, medication, and temperature. The completeness ranged, depending on the kind of variable, from 11.5% to 65% in the registry and from 7.6% to 42.6% in the office. The 953 fever episodes reported by the reference office consisted of 681 (71.5%) acute and 272 (28.5%) past episodes. In FeverApp, most past (262/272, 96.3%) but less acute (424/681, 62.3%) episodes have been entered. The concordance rates were varied: 90.2% for antibiotic use, 66.6% for antipyretic use, 61.7% for physician visits, and 16% for the highest temperature during the fever episode. Conclusions: Both sources delivered only partial data, and the rates of completeness and concordance depended on the kind of variable. However, the FeverApp registry showed higher documentation and precision rates than professional records for all considered variables. Therefore, EMA may play a unique supplement for research in ambulatory care. FeverApp could support pediatric offices, especially during the pandemic. [ABSTRACT FROM AUTHOR]

Satellite DNAs are arrays of tandem repeats found in the eukaryotic genome. They are mainly found in pericentromeric heterochromatin and have been believed to be mostly inert, leading satellite DNAs to be erroneously regarded as junk. Recent studies have started to elucidate the function of satellite DNA, yet little is known about the peculiar case where satellite DNA is found within the introns of protein coding genes, resulting in incredibly large introns, a phenomenon termed intron gigantism. Studies in Drosophila demonstrated that satellite DNA-containing introns are transcribed with the gene and require specialized mechanisms to overcome the burdens imposed by the extremely long stretches of repetitive DNA. Whether intron gigantism confers any benefit or serves any functional purpose for cells and/or organisms remains elusive. Here we review our current understanding of intron gigantism: where it is found, the challenges it imposes, how it is regulated and what purpose it may serve. [ABSTRACT FROM AUTHOR]

Background/purpose: Health disparities between sexual minorities and heterosexuals are well documented and have been explained by differential access to healthcare as well as exposure to discrimination. The current research examines the role that healthcare stereotype threat, or the fear of being judged by healthcare providers based on negative group stereotypes, plays in the health of LGB individuals.Methods: LGB individuals (N = 1507) in three age cohorts were recruited via random digit dialing to participate in a larger study on sexual minority health. Participants completed measures assessing healthcare stereotype threat, lifetime health diagnoses, life satisfaction, and number of bad physical health days and personal distress in the past 30 days.Results: Healthcare stereotype threat was associated with higher psychological distress and number of reported bad physical health days. Additionally, the Younger and Middle cohorts reported more stereotype threat than the Older cohort, but reported significantly higher levels of life satisfaction in the face of this threat than those in the Older cohort.Conclusions: Healthcare stereotype threat was related to poorer mental and physical health among LGB individuals; this was true when these outcomes were assessed over the past 30 days but not when they were assessed in general. Cohort differences in healthcare stereotype threat suggest potential important within group variation that needs further investigating. The research broadens the contexts to which stereotype threat is relevant and establishes a stressor related to LGB health. [ABSTRACT FROM AUTHOR]

The description of non-Markovian effects imposed by low frequency bath modes poses a persistent challenge for path integral based approaches like the iterative quasi-adiabatic propagator path integral (iQUAPI) method. We present a novel approximate method, termed mask assisted coarse graining of influence coefficients (MACGIC)-iQUAPI, that offers appealing computational savings due to substantial reduction of considered path segments for propagation. The method relies on an efficient path segment merging procedure via an intermediate coarse grained representation of Feynman-Vernon influence coefficients that exploits physical properties of system decoherence. TheMACGICiQUAPI method allows us to access the regime of biological significant long-time bath memory on the order of hundred propagation time steps while retaining convergence to iQUAPI results. Numerical performance is demonstrated for a set of benchmark problems that cover bath assisted long range electron transfer, the transition from coherent to incoherent dynamics in a prototypical molecular dimer and excitation energy transfer in a 24-state model of the Fenna-Matthews-Olson trimer complex where in all cases excellent agreement with numerically exact reference data is obtained. [ABSTRACT FROM AUTHOR]

The article reports that since October 2021, all newborns in Germany have been screened for spinal muscular atrophy (SMA) and sickle cell disease (SCD) in addition to the previous several target diseases. Topics inlcude consideed that the introduction of SMA screening represents a fundamental paradigm shift because, for the first time, screening is carried out primarily and exclusively via genetic diagnostics.

The structure and dynamics of polyanionic biomolecules, like RNA, are decisively determined by their electric interactions with the water molecules and the counterions in the environment. The solvation dynamics of the biomolecules involves a subtle balance of non-covalent and many-body interactions with structural fluctuations due to thermal motion occurring in a femto- to subnanosecond time range. This complex fluctuating many particle scenario is crucial in defining the properties of biological interfaces with far reaching significance for the folding of RNA structures and for facilitating RNA–protein interactions. Given the inherent complexity, suited model systems, carefully calibrated and benchmarked by experiments, are required to quantify the relevant interactions of RNA with the aqueous environment. In this feature article we summarize our recent progress in the understanding of the electrostatics at the biological interface of double stranded RNA (dsRNA) and transfer RNA (tRNA). Dimethyl phosphate (DMP) is introduced as a viable and rigorously accessible model system allowing the interaction strength with water molecules and counterions, their relevant fluctuation timescales and the spatial reach of interactions to be established. We find strong (up to ≈90 MV cm−1) interfacial electric fields with fluctuations extending up to ≈20 THz and demonstrate how the asymmetric stretching vibration νAS(PO2)− of the polarizable phosphate group can serve as the most sensitive probe for interfacial interactions, establishing a rigorous link between simulations and experiment. The approach allows for the direct interfacial observation of interactions of biologically relevant Mg2+ counterions with phosphate groups in contact pair geometries via the rise of a new absorption band imposed by exchange repulsion interactions at short interatomic distances. The systematic extension to RNA provides microscopic insights into the changes of the hydration structure that accompany the temperature induced melting of the dsRNA double helix and quantify the ionic interactions in the folded tRNA. The results show that pairs of negatively charged phosphate groups and Mg2+ ions represent a key structural feature of RNA embedded in water. They highlight the importance of binding motifs made of contact pairs in the electrostatic stabilization of RNA structures that have a strong impact on the surface potential and enable the fine tuning of the local electrostatic properties which are expected to be relevant for mediating the interactions between biomolecules. [ABSTRACT FROM AUTHOR]

Electric forces play a key role in the interaction of negatively charged phosphate groups with the dipolar water molecules of an aqueous environment. Both fluctuation amplitudes and effective spatial range of the electric fields that fluctuate on a multitude of time scales have remained highly controversial. We employ the dimethylphosphate anion (DMP) as a fundamental building block of the phosphodiester backbone in DNA to model electric fields at the phosphate-water interface. DMP is considered to be solvated in bulk water and the fluctuating electric forces exerted on the (PO2)- moiety are calculated by combining the ab initio based effective fragment potential approach that accounts for electric fields due to static multipoles and polarization contributions due to induced dipoles, with molecular dynamics. We demonstrate that the total time-averaged electric field generated by water molecules arises to a large extent from the first water layer. The second layer contributes some 18% with noticeable contributions from induction. We further show that the solvent electric field experienced by the phosphate group is the dominant contribution to the pronounced solvatochromism of the asymmetric (PO2)- stretch vibration. Accounting for a field expansion up to quadrupoles and polarization due to induced dipoles allows us to simulate solvent induced frequency shifts and lineshapes in almost quantitative agreement to experiment. Our theoretical model strongly supports the picture of short-range electric forces that arise locally from the first and second hydration shell. [ABSTRACT FROM AUTHOR]

One cycle of adjuvant chemotherapy with bleomycin, etoposide and cisplatin (BEP) has shown superiority in recurrence-free survival over retroperitoneal lymph node dissection (RPLND) in patients with clinical stage (CS) I non-seminomatous germ cell tumours (NSGCTs) of the testis in the setting of a phase III trial. We report the recurrences and late toxicities of this study after 13 years of follow-up. Questionnaires from 382 patients with CS I NSGCT treated with 1 cycle of adjuvant BEP (arm A) or RPLND + two cycles of adjuvant BEP in cases of pathological stage II disease (arm B) were evaluated regarding recurrences and late toxicity. Overall, information on recurrence status was available in 337 patients, and 170 questionnaires were evaluable for toxicity (arm A: 95; arm B: 75). With a median follow-up of 13.8 years (0–22), 3 patients (1.6%) in arm A and 16 patients (8.4%) in arm B experienced recurrence. The 15-year PFS in arm A/B was 99% (CI 96–100%)/92% (CI 89–99%) (p = 0.0049). The 15-year OS in arm A/B was 93% (CI 87–97%)/93% (CI 86–97%) (p = 0.83). Eight patients (4.2%) in arm A and four patients (2.1%) in arm B showed metachronous secondary testicular cancer (p = 0.26). Five patients (2.6%) in arm A and four patients (2.1%) in arm B developed other malignancies. Toxicities were not significantly different apart from retrograde ejaculation, which occurred more frequently after RPLND (10% versus 24%, p = 0.01). With long-term observation, one cycle of BEP remains superior to RPLND in preventing recurrence and was tolerated without any clinically relevant long-term toxicities. • >13-year follow-up recurrences in CS I NSGCT more frequent with RPLND than after BEP x1. • No excess mortality due to secondary malignancies could be detected. • Late toxicities do not differ between 1 x BEP and RPLND. [ABSTRACT FROM AUTHOR]

Real-time 3-D ultrasound (US) provides a complete visualization of inner body organs and blood vasculature, crucial for diagnosis and treatment of diverse diseases. However, 3-D systems require massive hardware due to the huge number of transducer elements and consequent data size. This increases cost significantly and limit both frame rate and image quality, thus preventing the 3-D US from being common practice in clinics worldwide. A recent study presented a technique called sparse convolutional beamforming algorithm (SCOBA), which obtains improved image quality while allowing notable element reduction in the context of 2-D focused imaging. In this article, we build upon previous work and introduce a nonlinear beamformer for 3-D imaging, called COBA-3D, consisting of 2-D spatial convolution of the in-phase and quadrature received signals. The proposed technique considers diverging-wave transmission and achieves improved image resolution and contrast compared with standard delay-and-sum beamforming while enabling a high frame rate. Incorporating 2-D sparse arrays into our method creates SCOBA-3D: a sparse beamformer that offers significant element reduction and, thus, allows performing 3-D imaging with the resources typically available for 2-D setups. To create 2-D thinned arrays, we present a scalable and systematic way to design 2-D fractal sparse arrays. The proposed framework paves the way for affordable ultrafast US devices that perform high-quality 3-D imaging, as demonstrated using phantom and ex-vivo data. [ABSTRACT FROM AUTHOR]

The Fick diffusion coefficient matrix of the highly associating quaternary mixture water + methanol + ethanol + 2-propanol as well as its ternary and binary subsystems is analyzed with molecular dynamics simulation techniques. Three of the ternary subsystems are studied in this sense for the first time. The predictive capability of the employed force fields, which were sampled with the Green–Kubo formalism and Kirkwood–Buff integration, is confirmed by comparison with experimental literature data on vapor-liquid equilibrium, shear viscosity and Fick diffusion coefficient, wherever possible. A thorough analysis of the finite size effects on the simulative calculation of diffusion coefficients of multicomponent systems is carried out. Moreover, the dependence of the Fick diffusion coefficient matrix on the velocity reference frame and component order is analyzed. Their influence is found to be less significant for the main matrix elements, reaching a maximum variation of 19%. The large differences found for the cross elements upon variation of the reference frame hinder a straightforward interpretation of the Fick diffusion coefficient matrix with respect to the presence of diffusive coupling effects. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic cholecystectomy is still fraught with bile duct injuries (BDI). A number of methods such as intra-operative cholangiography, use of indocyanine green (ICG) with infrared imaging, and the critical view of safety (CVS) have been suggested to ensure safer Laparoscopic cholecystectomy (LC).To these, we add posterior infundibular dissection as the initial operative maneuver during LC. Here, we report specific technical details of this approach developed over 30 years with no bile duct injuries and update our experience in 1402 LC. Methods: In this manuscript, we present a detailed and illustrated description of a posterior infundibular dissection as the initial approach to laparoscopic cholecystectomy (LC). This technique developed after thirty years of experience with LC and have used it routinely over the past ten years with no bile duct injury. Results: Between January of 2010 and December 2019, 1402 Laparoscopic cholecystectomies were performed using the posterior infundibular approach. Operations performed on elective basis constituted 80.3% (1122/1402) and 19.97% were emergent (280/1402). One intra-operative cholangiogram was performed after a posterior sectoral duct was identified. There was one conversion to open cholecystectomy due to bleeding. There were 4 bile leaks that were managed with endoscopic retrograde cholangio-pancreatography (ERCP). There were no bile duct injuries. Conclusion: Adopting an initial posterior mobilization of the gallbladder infundibulum lessens the need for medial and cephalad dissection to the node of Lund, allowing for a safer laparoscopic cholecystectomy. In fact the safety of the technique comes from the initial dissection of the lateral border of the infundibulum. The risk of BDI can be reduced to null as was our experience. This approach does not preclude the use of other intra-operative maneuvers or methods. [ABSTRACT FROM AUTHOR]

Excited-state vibrational dynamics in molecules can be studied by an electronically off-resonant Raman process induced by a probe pulse with variable delay with respect to an actinic pulse. We establish the connection between several variants of the technique that involve either spontaneous or stimulated Raman detection and different pulse configurations. By using loop diagrams in the frequency domain, we show that all signals can be described as six wave mixing which depend on the same four point molecular correlation functions involving two transition dipoles and two polarizabilities and accompanied by a different gating. Simulations for the stochastic two-state-jump model illustrate the origin of the absorptive and dispersive features observed experimentally. [ABSTRACT FROM AUTHOR]

Aim: After extended left colectomy, traditional colorectal anastomosis is often not feasible because of insufficient length of the remaining colon to perform a tension‐free anastomosis. Total colectomy with ileorectal anastomosis could be an alternative but this can lead to unsatisfactory quality of life. Trans‐mesenteric colorectal anastomosis or inverted right colonic transposition (the so‐called Deloyers procedure) are two possible solutions for creating a tension‐free colorectal anastomosis after extended left colectomy. Few studies have reported their results of these two techniques and mostly via laparotomy. The aim of this study was to describe the trans‐mesenteric colorectal anastomosis and the inverted right colonic transposition procedure via a laparoscopic approach and report the outcome in a series of 13 consecutive patients. Method: This was retrospective chart review of laparoscopic colorectal surgery with trans‐mesenteric colorectal anastomosis or the inverted right colonic transposition procedure from January 2015 up to 2019. An accompanying video demonstrates these two techniques. Results: Thirteen consecutive patients underwent either a laparoscopic trans‐mesenteric colorectal anastomosis (n = 9) or an inverted right colonic transposition procedure (n = 4). One patient had intra‐operative presacral bleeding that was stopped successfully without conversion. Two patients had a postoperative intra‐abdominal abscess, but no anastomotic complications were recorded. The median number of bowel movements per day after 6 months was 2 (range 2–5). Conclusions: Trans‐mesenteric colorectal anastomosis or the inverted right colonic transposition procedure is feasible laparoscopically. The now well‐established classical advantages of the laparoscopic approach are associated with good functional outcome after these procedures. [ABSTRACT FROM AUTHOR]

Cytoplasmic cilia, a specialized type of cilia in which the axoneme resides within the cytoplasm rather than within the ciliary compartment, are proposed to allow for the efficient assembly of very long cilia. Despite being found diversely in male gametes (e.g., Plasmodium falciparum microgametocytes and human and Drosophila melanogaster sperm), very little is known about cytoplasmic cilia assembly. Here, we show that a novel RNP granule containing the mRNAs for axonemal dynein motor proteins becomes highly polarized to the distal end of the cilia during cytoplasmic ciliogenesis in Drosophila sperm. This allows for the incorporation of these axonemal dyneins into the axoneme directly from the cytoplasm, possibly by localizing translation. We found that this RNP granule contains the proteins Reptin and Pontin, loss of which perturbs granule formation and prevents incorporation of the axonemal dyneins, leading to sterility. We propose that cytoplasmic cilia assembly requires the precise localization of mRNAs encoding key axonemal constituents, allowing these proteins to incorporate efficiently into the axoneme. [ABSTRACT FROM AUTHOR]

White matter abnormalities of the human brain are implicated in typical aging and neurodegenerative diseases. However, our understanding of how fine-grained changes in microstructural properties along white matter tracts are associated with memory and cognitive decline in normal aging and mild cognitive impairment remains elusive. We quantified tract profiles with a newer method that can reliably measure fine-grained changes in white matter properties along the tracts using advanced multi-shell diffusion magnetic resonance imaging in 25 patients with amnestic mild cognitive impairment (aMCI) and 23 matched healthy controls (HC). While the changes in tract profiles were parallel across aMCI and HC, we found a significant focal shift in the profile at specific locations along major tracts sub-serving memory in aMCI. Particularly, our findings depict white matter alterations at specific locations on the right cingulum cingulate, the right cingulum hippocampus and anterior corpus callosum (CC) in aMCI compared to HC. Notably, focal changes in white matter tract properties along the cingulum tract predicted memory and cognitive functioning in aMCI. The results suggest that white matter disruptions at specific locations of the cingulum bundle may be a hallmark for the early prediction of Alzheimer's disease and a predictor of cognitive decline in aMCI. [ABSTRACT FROM AUTHOR]

In the fight for equality, outgroup allies have played a critical role. Despite this, little is known about what motivates these individuals and keeps them committed long term. The current research applies Omoto and Snyder's (1995) volunteerism model to better understand the experiences of White ally activists. White individuals (N = 355) involved in racial justice work completed an online survey assessing antecedents (helping personality, motivations, social support), experiences (satisfaction, sense of community), and consequences (degree of involvement, well-being) of their antiracism work. Results showed a direct link between social support and degree of involvement, and an indirect link mediated by sense of community. Additionally, there was a direct link between social support and well-being, and an indirect link mediated by satisfaction. Helping personality and other-focused motives were not related to the outcomes. Implications for future research and for those working with White ally activists are discussed. [ABSTRACT FROM AUTHOR]

We define aesthetic emotions as emotions that underlie the evaluative assessment of artworks. They are separated from the wider class of art-elicited emotions. Aesthetic emotions historically have been characterized as calm, as lacking specific patterns of embodiment, and as being a sui generis kind of pleasure. We reject those views and argue that there is a plurality of aesthetic emotions contributing to praise. After presenting a general account of the nature of emotions, we analyze twelve positive aesthetic emotions in four different categories: emotions of pleasure, contemplation, amazement, and respect. The emotions that we identify in each category, including feelings of fluency, intrigue, wonder, and adoration, have been widely neglected both within aesthetics and in emotion research more broadly. [ABSTRACT FROM AUTHOR]

Expressions for the thermodynamic factor matrix Γ of quaternary mixtures are derived in terms of Kirkwood–Buff integrals and implemented into the massively parallel simulation tool ms2. To assess these expressions, a liquid-like supercritical quaternary Lennard–Jones mixture is sampled throughout its entire composition range, employing molecular dynamics in the canonical ensemble. Good agreement is found between numerical chemical potential derivatives and the results from the present Kirkwood–Buff integral expressions. Moreover, the limits of the thermodynamic factor matrix for pure, binary and ternary subsystems are discussed. [ABSTRACT FROM AUTHOR]

Aims:The Life Participation for Parents (LPP®) is a Quality of Life assessment designed to measure family-centered practice outcomes. Previous studies of the LPP have established its internal consistency (Cronbach's alpha =.85), test–retest reliability (r =.89), construct validity, and concurrent validity. This study examined the responsiveness of the LPP, hypothesizing change scores after 3 months of intervention would exceed that explained by standard error. Methods: Thirty-two parents of children with disabilities completed the LPP to identify family-centered issues. The LPP was completed a second time after 3 months of intervention. Wilcoxon Signed Rank test was used to compare the median differences between two administrations. Minimal clinically important differences (MCID) were calculated for the total and two LPP subscales (efficiency and effectiveness). Cohen's effect size was calculated using the standardized response mean (SRM) to quantify the change. Results: The age range of the parents was 31–50 (72%), including 31 mothers (96.9%). Median differences between the two administrations were significantly different (p <.05). The MCID were 11.34, 9.82, and 4.48; the SRM were 0.42, 0.54, and 0.04, for the LPP total score, efficiency subscale and effectiveness subscale, respectively. Conclusions: The LPP is responsive to detect a change larger than measurement error in parental ability of participating in life occupations while raising a child with disabilities. [ABSTRACT FROM AUTHOR]

Non-adiabatic on-the-fly molecular dynamics (NA-O-MD) simulations require the electronic wavefunction, energy gradients, and derivative coupling vectors in every timestep. Thus, they are commonly restricted to the excited state dynamics of molecules with up to ≈20 atoms. We discuss an approximation that combines the ONIOM(QM:QM) method with NA-O-MD simulations to allow calculations for larger molecules. As a proof of principle we present the excited state dynamics of a (6-4)-lesion containing dinucleotide (63 atoms), and especially the importance to include the confinement effects of the DNA backbone. The method is able to include electron correlation on a high level of theory and offers an attractive alternative to QM:MM approaches for moderate sized systems with unknown force fields. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if parents receiving emotional support is positively correlated with children's participation in physical and social activities and if such a correlation exists between parental emotional support in children labeled as autistic. Data were drawn from 30,501 children aged 6 to 17 years in the 2020 National Survey of Children's Health database and analyzed using a retrospective cross-sectional approach based on multivariate linear regression models. Results showed parental emotional support was statistically significantly correlated with children's physical and social activity in the total sample but was not significant for the emotional support of parents with autistic children. The findings suggest that other issues must be considered as contributing factors for parents of autistic children in relation to social and physical activity participation. [ABSTRACT FROM AUTHOR]

Intron gigantism, where genes contain megabase-sized introns, is observed across species, yet little is known about its purpose or regulation. Here we identify a unique gene expression program utilized for the proper expression of genes with intron gigantism. We find that two Drosophila genes with intron gigantism, kl-3 and kl-5, are transcribed in a spatiotemporal manner over the course of spermatocyte differentiation, which spans ~90 hours. The introns of these genes contain megabases of simple satellite DNA repeats that comprise over 99% of the gene loci, and these satellite-DNA containing introns are transcribed. We identify two RNA-binding proteins that specifically localize to kl-3 and kl-5 transcripts and are needed for the successful transcription or processing of these genes. We propose that genes with intron gigantism require a unique gene expression program, which may serve as a platform to regulate gene expression during cellular differentiation. [ABSTRACT FROM AUTHOR]

Abstract Kirkwood-Buff integration (KBI) is implemented into the massively-parallel molecular simulation tool ms 2 and assessed by molecular dynamics simulations of binary liquid mixtures. The formalism of Krüger et al. (P. Krüger et al., J. Phys. Chem. Lett. 4: 235–238, 2013) that adopts NVT ensemble data to the μVT ensemble is employed throughout. Taking advantage of its linear scaling with inverse system size, the extrapolation to the thermodynamic limit is analyzed. KBI are calculated with standard radial distribution functions (RDF) and two corrected RDF forms. Simulations in the NVT ensemble are carried out in the entire composition range for four Lennard-Jones mixtures, studying system size dependence by varying N = 4000, 8000 and 16000 molecules. Moreover, four mixtures of "real" components are considered with N = 4000. Thermodynamic factor, partial molar volumes and isothermal compressibility are calculated from KBI and compared with benchmark data from NpT ensemble simulations. The assessment shows that the formalism of Krüger et al. greatly improves KBI and that extrapolation is important, particularly for smaller systems. [ABSTRACT FROM AUTHOR]

Evaluative concepts qualify as abstract because they seem to go beyond what is given in experience. This is especially clear in the case of moral concepts. Justice, for example, has no fixed appearance. Less obviously, aesthetic concepts may also qualify as abstract. The very same sensory input can be regarded as beautiful by one person and ugly by another. Artistic success can also transcend sensory accessible features. Here, we focus on moral badness and aesthetic goodness and argue that both can be grounded in emotional responses. Emotions, in turn, are grounded in bodily perceptions, which correspond to action tendencies. When we conceptualize something as good or bad (whether in the moral or aesthetic domain), we experience our bodily responses to that thing. The moral and aesthetic domains are distinguished by the emotions that they involve. [ABSTRACT FROM AUTHOR]

Recent studies showed gadolinium depositions following serial administrations of gadolinium-based contrast agents (GBCAs) for magnetic resonance imaging examinations in various parts of the brain with the dentate nucleus (DN) being most affected. Even though no clinical correlates of the deposits are known yet, an intensive debate developed if this might be harmful. The aim of the current study was to specify the gadolinium distribution in brain tissue of patients who received serial injections of GBCAs in the low-µm range and to explore any potential pathological tissue changes caused by gadolinium deposits. Thirteen autopsy cases—eight receiving GBCA administrations, five serving as controls—were identified and analyzed. For all patients, total gadolinium quantification after acidic digestion by means of inductively coupled plasma-mass spectrometry (ICP-MS) was performed. Six cases were utilized for the spatially resolved quantification of gadolinium within the cerebellum and the basal ganglia by means of high-resolution laser ablation (LA)-ICP-MS. Histopathological and immunohistochemical examinations were performed to determine tissue reactions. LA-ICP-MS revealed gadolinium depositions in the walls of small blood vessels of the DN in all GBCA exposed patients, while no gadolinium was found in the control group. Additionally, the detection of phosphorus and metals like copper, zinc and iron provides evidence that transmetalation reactions might have occurred. No significant pathological changes of the brain tissue in the vicinity of the DN with respect to micro-/astrogliosis and neuronal loss were found in any of the patients. This notably holds true even for a patient who died from nephrogenic systemic fibrosis exhibiting extremely high gadolinium concentrations within the DN. The findings show that gadolinium depositions in the brain are restricted to blood vessel walls, while the neuropil is spared and apparent cellular reactions are absent. [ABSTRACT FROM AUTHOR]

Background: Pregnancy is a significant transition period for women that can be markedly stressful. The presence of elevated depressed mood and anxiety during pregnancy places mothers, fetuses, and neonates at greater risk for developing biological and psychological difficulties. It appears that no general measures of distress currently exist that can be used to screen for both prenatal anxiety and mood. Materials and Methods: This study explores the applicability of postpartum distress measure (PDM), a validated general distress postpartum screening tool, in a prenatal sample. One hundred ninety pregnant women were recruited from online websites with themes relevant to pregnancy. Women completed a demographics questionnaire, the Edinburgh Postnatal Depression Scale, The Mood and Anxiety Symptom Questionnaire, Full Version, Prenatal Distress Measure (Pre-DM), and Relationship Assessment Scale. Results: An exploratory factor analysis with Varimax rotation identified two factors: general distress and obsessive-compulsive symptoms. These two factors formed the basis of the 10-item Pre-DM. The Pre-DM demonstrated very good reliability, with coefficient alphas of 0.85 for the Pre-DM total score, 0.84 for the general distress scale, and 0.80 for the obsessive-compulsive symptoms scale. Adequate convergent and discriminant validity with other established measures was also demonstrated. Conclusions: Ten total items were selected for the final Pre-DM and are representative of the two factors that emerged from the exploratory factor analysis: general distress and obsessive-compulsive symptoms. It appears that before this study, no measure had been created for the primary purpose of screening for broad psychosocial distress during pregnancy. It is hoped that with further research, the Pre-DM will serve as a screening tool for distress during pregnancy and will be used as a companion measure to the PDM. [ABSTRACT FROM AUTHOR]

Crossings of electronic potential energy surfaces in nuclear configuration space, known as conical intersections, determine the rates and outcomes of a large class of photochemical molecular processes. Much theoretical progress has been made in computing strongly coupled electronic and nuclear motions at different levels, but how to incorporate them in different spectroscopic signals and the approximations involved are less established. This will be the focus of the present review. We survey a wide range of time-resolved spectroscopic techniques which span from the infrared to the X-ray regimes and can be used for probing the nonadiabatic dynamics in the vicinity of conical intersections. Transient electronic and vibrational probes and their theoretical signal calculations are classified by their information content. This includes transient vibrational spectroscopic methods (transient infrared and femtosecond off-resonant stimulated Raman), resonant electronic probes (transient absorption and photoelectron spectroscopy), and novel stimulated X-ray Raman techniques. Along with the precise definition of what to calculate for predicting the various signals, we outline a toolbox of protocols for their simulation. [ABSTRACT FROM AUTHOR]

Health disparities exist between lesbian, gay, and bisexual (LGB) individuals and heterosexuals and can be explained by differential access to healthcare, unique experiences with discrimination, and higher prevalence of HIV/AIDS. This article will examine another possible explanation, namely healthcare stereotype threat and social identity threat in the healthcare experiences of sexual minority individuals. In doing so, this article integrates previous research on stereotypes and discrimination with regard to LGB individuals as well as research concerning LGB individuals' experiences with healthcare providers. The article concludes with a discussion about future research and potential interventions to ameliorate identity threats for LGB individuals in healthcare contexts. From a social justice perspective, identity threats serve as an important contextual variable feeding health disparities among sexual minorities. If better understood, such threats and resultant disparities may be reduced via cost-effective changes in environmental cues and educational strategies. [ABSTRACT FROM AUTHOR]

Solvation and transport of excess protons in aqueous systems play a fundamental role in acid-base chemistry and biochemical processes. We mapped ultrafast proton excursions along the proton transfer coordinate by means of two-dimensional infrared spectroscopy, both in bulk water and in a Zundel cation (H5O2)+ motif selectively prepared in acetonitrile. Electric fields from the environment and stochastic hydrogen bond motions induce fluctuations of the proton double-minimum potential. Within the lifetime of a particular hydration geometry, the proton explores a multitude of positions on a sub-100-femtosecond time scale. The proton transfer vibration is strongly damped by its 20- to 40-femtosecond population decay. Our results suggest a central role of Zundel-like geometries in aqueous proton solvation and transport. [ABSTRACT FROM AUTHOR]

Introduction: Colorectal anastomoses after anterior resection for cancer carry a high risk of leakage. Different factors might influence the correct healing of anastomosis, but adequate perfusion of the bowel is highlighted as one of the most important elements. Fluorescence angiography (FA) is a new technique that allows the surgeon to perform real-time intraoperative angiography to evaluate the perfusion of the anastomosis and hence, potentially, reduce leak rate.Aim: The aim of this study was to evaluate the impact of FA of the bowel on postoperative complications and anastomotic leakage after laparoscopic anterior resection with total mesorectal excision (TME).Methods: FA was performed in all patients undergoing laparoscopic anterior resection with TME for cancer followed by colorectal or coloanal anastomosis. Results were compared to a historical controls group of 38 patients previously operated by the same surgeon for the same indication but without the use of FA.Results: From October 2014 to November 2015, 42 patients underwent laparoscopic anterior resection with TME and FA of the bowel. The surgeon subjectively decided to change the planned anastomotic level of the descending colon due to hypoperfused distal segment in two out of 42 patients in the FA group (4.7 %). Anastomotic leakage, confirmed by postoperative CT scan and water-soluble contrast enema, was found in two cases of a historical controls group and none in the FA group. No adverse events (side effects or allergic reaction) related to FA were recorded. All the other postoperative complications were comparable between the two groups.Conclusion: In our experience, ICG FA was safe and effective in low rectal cancer resection, possibly leading to a reduction in the anastomotic leakage rate after TME. [ABSTRACT FROM AUTHOR]

Objective: This study examined the consistency of self-reported symptoms and concussive events in combat veterans who reported experiencing concussive events. Method: One hundred and forty, single deployed, Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn combat veterans with Veteran Health Administration (VHA) Comprehensive Traumatic Brain Injury Evaluations (CTBIE) and no post-deployment head injury were examined to assess consistency of self-reported (a) traumatic brain injury (TBI)-related symptoms, (b) post-traumatic stress disorder (PTSD)-related symptoms, and (c) TBI-related concussive events from soon after deployment to time of VHA CTBIE. Results: Compared to their self-report of symptoms and traumatic events at the time of their Post-Deployment Health Assessment, at the time of their comprehensive VHA evaluation, subjects reported significantly greater impairment in concentration, decision making, memory, headache, and sleep. In addition, although half the subjects denied any PTSD symptoms post-deployment, approximately three quarters reported experiencing all four PTSD screening symptoms near the time of the VHA CTBIEs. At the latter time, subjects also reported significantly more TBI-related concussive events, as well as more post-concussive sequelae such as loss of consciousness immediately following these concussive events. Finally, although 84% reported a level of impairment so severe as to render all but the simplest activity doable, the vast majority simultaneously reported working and/or attending college. Conclusions: These findings raise questions regarding the accuracy of veteran self-report of both near and distant traumatic events, and argue for the inclusion of contemporaneous Department of Defense (DOD) records in veteran assessment and treatment planning. [ABSTRACT FROM AUTHOR]

Anastomotic leaks represent one of the most alarming complications following any gastrointestinal anastomosis due to the substantial effects on post-operative morbidity and mortality of the patient with long-lasting effects on the functional and oncologic outcomes. There is a lack of consensus related to the definition of an anastomotic leak, with a variety of options for prevention and management. A number of patient-related and technical risk factors have been found to be associated with the development of an anastomotic leak and have inspired the development of various preventative measures and technologies. The International Multispecialty Anastomotic Leak Global Improvement Exchange group was convened to establish a consensus on the definition of an anastomotic leak as well as to discuss the various diagnostic, preventative, and management measures currently available. [ABSTRACT FROM AUTHOR]