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Background: Complex PTSD is a recent addition to the ICD-11 diagnostic system., Aims: This case study describes the delivery of Skills Training in Affective and Interpersonal Regulation and Narrative Therapy (SNT), a flexible, multi-component therapy that addresses the symptoms of complex posttraumatic stress disorder. SNT balances interventions that address current-day stressors with those that reappraise the meaning of traumatic past events. This paper outlines 16 sessions of SNT with a 55-year-old gay man., Discussion: The case analysis describes the ways in which SNT is relevant and effective in addressing the client's mulitple concerns. The skills work helped the client effectively  manage ongoing minority stress, discrimination, and micro-aggressions related to his identity as a gay man. Review and re-appraisal of his traumatic memories, which focused on the sudden death of his partner from AIDS along with discussion of events from his childhood that shaped his reactions to this loss, allowed the client to create a more integrated sense of self as well as a more compassionate view of himself. Implications regarding the relevance of SNT for sexual and gender minority individuals are discussed., (© 2023 Wiley Periodicals LLC.)

Background: The public health policies and school closures in response to the Covid-19 pandemic have created disruptions in school meal programs. Research is needed to understand the changes in school food service revenue before and during the initial Covid-19-related school shutdowns., Methods: A longitudinal cohort study examining federal and state reimbursements as well as sales revenues for all public local education agencies (LEAs) in Maryland from school years (SY) 2018-2019 and 2019-2020 was conducted. Monthly changes in federal and state reimbursements for Child Nutrition Programs, including the National School Lunch Program (NSLP), School Breakfast Program (SBP), Summer Food Service Program (SFSP), and Child and Adult Care Food Program (CACFP) were examined., Results: In the SY 2018-2019, the total revenues from federal and state reimbursements for SBP, NSLP, SFSP, and at-risk CACFP were $272.9 million; in comparison, for the SY 2019-2020, the total revenues were $241.8 million (11.4% reduction from SY 2018-2019). On average, the school shutdown (during March to June 2020) was associated with a $450,385 (p-value < .01) reduction in federal and state reimbursements per LEA-month (41% reduction)., Conclusions: The school shutdown during the Covid-19 pandemic was associated with a statistically significant reduction in school food service revenues across Maryland's public LEAs., (© 2023 American School Health Association.)

The International Workshop for Ex-Situ Marine Teleost Nutrition and Health, hosted by Disney's Animals, Science and Environment in conjunction with the Comparative Nutrition Society, brought together over 50 animal experts and scientists representing 20 institutions to review current science and identify challenges of marine teleost nutrition and health. Invited speakers presented critical information and current research topics for areas of emphasis and expertise. Subject matter experts identified knowledge gaps and primary areas of focus to guide the scientific community's research efforts to improve the care of ex situ marine teleosts. The clinical medicine working group highlighted standardized approaches to ante- and postmortem sample collection, diet biosecurity and supplementation, advanced diagnostic methods, and expanded training in fish nutrition. Nutrition identified the creation of a husbandry and feeding management manual, comprehensive feeding program review and design, and specialty feeder/life stage nutrition as areas of focus, while animal husbandry focused on body condition scoring, feed delivery techniques, and behavioral husbandry topics. The physiology and chemistry and water quality working groups discussed components of the aquatic environment and their effects on fish health, including organic matter constituents, microbial diversity, disinfection, and managing microbiota. Finally, we reviewed how epidemiological approaches and considerations can improve our evaluation of aquarium teleost nutrition and health. The goals outlined by each working group and supporting literature discussion are detailed in this communication and represent our goals for the next 3 to 5 years, with the ultimate objective of the workshop being the production of a husbandry manual for marine teleost nutrition and health. Any scientists who feel that their experience, research, or interests align with these goals are invited to participate by contacting the authors., (© 2022 The Authors. Journal of Aquatic Animal Health published by Wiley Periodicals LLC on behalf of American Fisheries Society.)

Background: Fungal extracellular vesicles (EVs) have been implicated in host-pathogen and pathogen-pathogen communication in some fungal diseases. In depth research into fungal EVs has been hindered by the lack of specific protein markers such as those found in mammalian EVs that have enabled sophisticated isolation and analysis techniques. Despite their role in fungal EV biogenesis, ESCRT proteins such as Vps23 (Tsg101) and Bro1 (ALIX) are not present as fungal EV cargo. Furthermore, tetraspanin homologs are yet to be identified in many fungi including the model yeast S. cerevisiae. Objective: We performed de novo identification of EV protein markers for the major human fungal pathogen Candida albicans with adherence to MISEV2018 guidelines. Materials and methods: EVs were isolated by differential ultracentrifugation from DAY286, ATCC90028 and ATCC10231 yeast cells, as well as DAY286 biofilms. Whole cell lysates (WCL) were also obtained from the EV-releasing cells. Label-free quantitative proteomics was performed to determine the set of proteins consistently enriched in EVs compared to WCL. Results: 47 proteins were consistently enriched in C. albicans EVs. We refined these to 22 putative C. albicans EV protein markers including the claudin-like Sur7 family (Pfam: PF06687) proteins Sur7 and Evp1 (orf19.6741). A complementary set of 62 EV depleted proteins was selected as potential negative markers. Conclusions: The marker proteins for C. albicans EVs identified in this study will be useful tools for studies on EV biogenesis and cargo loading in C. albicans and potentially other fungal species and will also assist in elucidating the role of EVs in C. albicans pathogenesis. Many of the proteins identified as putative markers are fungal specific proteins indicating that the pathways of EV biogenesis and cargo loading may be specific to fungi, and that assumptions made based on studies in mammalian cells could be misleading. Abbreviations: A1 - ATCC10231; A9 - ATCC90028; DAY B - DAY286 biofilm; DAY Y - DAY286 yeast; EV - extracellular vesicle; Evp1 - extracellular vesicle protein 1 (orf19.6741); GO - gene ontology; Log 2 (FC) - log 2 (fold change); MCC - membrane compartment of Can1; MDS - multidimensional scaling; MISEV - minimal information for studies of EVs; sEVs - small EVs; SP - signal peptide; TEMs - tetraspanin enriched microdomains; TM - transmembrane; VDM - vesicle-depleted medium; WCL - whole cell lysate., (© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of The International Society for Extracellular Vesicles.)

Background: School environmental characteristics may be associated with youth's participation in different types of physical activities (PAs). This study aimed to identify which school policies and built environmental characteristics were associated with participation in organized, nonorganized, individual, and group-based activities., Methods: This cross-sectional analysis included 776 students in grade 5 or 6 from 16 schools. The school environment was assessed through school-based questionnaires completed by school representatives. Types of PA and attainment of PA recommendations were obtained using self-administered student questionnaires. Associations between environment and student PA were examined using multilevel logistic regressions., Results: Schools with favorable active commuting environments were positively associated with girls' participation in organized (odds ratio [OR] = 1.34, confidence interval [CI] = 1.04-1.74) and group-based PA (OR = 1.54, CI = 1.19-1.99) and with boys' odds of participating in individual activities (OR = 1.45, CI = 1.04-2.04). There was also a positive relationship between having a school environment favorable to active commuting and boys' odds of meeting PA recommendations (OR = 2.19, CI = 1.43-3.37). School policies supporting PA were positively associated with girls' odds of participating in nonorganized activities (OR = 1.18, CI = 1.00-1.40)., Conclusions: School environments that favor active commuting may encourage participation in different types of PA. School policies promoting PA also may encourage girls to participate in organized activities., (© 2015, American School Health Association.)

Photosynthetic euglenids acquired chloroplasts by secondary endosymbiosis, which resulted in changes to their mode of nutrition and affected the evolution of their morphological characters. Mapping morphological characters onto a reliable molecular tree could elucidate major trends of those changes. We analyzed nucleotide sequence data from regions of three nuclear-encoded genes (nSSU, nLSU, hsp90), one chloroplast-encoded gene (cpSSU) and one nuclear-encoded chloroplast gene (psbO) to estimate phylogenetic relationships among 59 photosynthetic euglenid species. Our results were consistent with previous works; most genera were monophyletic, except for the polyphyletic genus Euglena, and the paraphyletic genus Phacus. We also analyzed character evolution in photosynthetic euglenids using our phylogenetic tree and eight morphological traits commonly used for generic and species diagnoses, including: characters corresponding to well-defined clades, apomorphies like presence of lorica and mucilaginous stalks, and homoplastic characters like rigid cells and presence of large paramylon grains. This research indicated that pyrenoids were lost twice during the evolution of phototrophic euglenids, and that mucocysts, which only occur in the genus Euglena, evolved independently at least twice. In contrast, the evolution of cell shape and chloroplast morphology was difficult to elucidate, and could not be unambiguously reconstructed in our analyses., (© 2014 The Author(s) Journal of Eukaryotic Microbiology © 2014 International Society of Protistologists.)

Objective: The main objective of this study is to determine whether change in migraine frequency is correlated with a denervation pattern of the corrugator muscle after local botulinum toxin type A injections., Background: Recent studies suggest botulinum toxin type A is effective in preventing migraine. Relaxation of the corrugator muscle may be one of multiple targets of botulinum toxin type A in relieving migraine pain., Methods: The pretreatment amplitude of the compound muscle action potential (CMAP) was obtained in 10 patients with a migraine frequency of two to six attacks per month following stimulation of the temporal branch of the facial nerve. Patients were subsequently injected with 20 units of botulinum toxin type A at predefined sites in the procerus and corrugator muscles. CMAP was obtained on days 7, 30, 60, and 90 after injection. Migraine frequency, as reported in headache diaries, was compared with the amplitudes obtained., Results: A 50% decrease in CMAP was demonstrated in the total group by day 7. Maximal decline of CMAP was observed by day 30, and was sustained at day 60. Migraine frequency declined by 50% or more in 7 of 10 patients by day 60. Migraine response to botulinum toxin type A treatment did not correlate with the denervation pattern., Conclusion: Relaxation of the corrugator muscles is not solely responsible for the pain relief in migraine patients treated with botulinum toxin type A.

Objectives: We studied the association between the severity of pretreatment CT scan findings and the improvement in symptoms of chronic sinusitis after treatment., Methods: We analyzed data from an ongoing prospective, nonrandomized clinical outcomes study of patients treated for chronic sinusitis at a tertiary-care academic medical center (n = 57, mean age 46.8 years). Disease-specific symptom severity was measured with a validated health status instrument, and CT stage was quantified with the Harvard CT staging system., Results: In a multivariate analysis, symptom severity based on CT findings emerged as a strong predictor of both improvement in symptom score outcome (beta = 0.47, P = 0.01) and absolute symptom level after treatment (beta = -0.58, P = 0.001)., Conclusions: Severity as assessed by a pretreatment CT scan is a strong predictor of outcome. Patients with higher symptom severity based on CT scans showed significantly larger improvement and lower absolute levels of symptom severity after treatment. This study links CT scan findings and subjective patient-based outcomes (symptom scores) using a validated outcomes instrument.

Background: The objective of this study was to determine the ability of doxorubicin, encapsulated in sterically stabilized liposomes (Doxil [Liposome Technology, Inc., Menlo Park, CA]), to inhibit the spontaneous development of mammary carcinomas in mice., Methods: Monthly prophylactic intravenous injections of 6 mg/kg doses of Doxil were started when retired breeding C3H/He mice were 26 weeks old. Mice that developed a mammary carcinoma were then given weekly intravenous injections of 6 mg/kg doses to determine whether the tumors were susceptible or resistant to Doxil therapy., Results: The monthly injections reduced the incidence of first mammary carcinomas in up to 88-week-old retired breeding C3H/He mice from 65 of 66 (98%) in untreated mice to 22 of 47 (47%) in treated mice. The first 15 mice that developed a mammary tumor while on the prophylactic protocol were then placed on a weekly therapeutic protocol. The therapeutic use of Doxil cured 3 of 15 mice and inhibited the growth of 12 tumors. Drug resistance as a result of treatments was not observed. The mean survival of tumor-bearing mice was extended from 24 days in untreated mice to 87 days in treated mice. Toxic side effects were limited to transient weight loss during the weekly Doxil treatments and to epidermal necrosis and dermal fibrosis due to drug extravasation at the sites of intravenous injections., Conclusions: The authors concluded that doxorubicin in sterically stabilized liposomes deserves to be explored further in comparative studies with free doxorubicin for the prophylaxis and therapy of mammary cancer.

Background: This study compared the therapeutic effects of doxorubicin hydrochloride in saline and in sterically stabilized, long-circulating liposomes composed of hydrogenated soy phosphatidylcholine/cholesterol/polyethylene glycol-distearoyl-phosphatidyl-ethanolamine (Doxil)., Methods: The drug formulations were injected intravenously or intraperitoneally to treat the human ovarian carcinoma HEY, which was implanted subcutaneously or intraperitoneally into mature female Swiss nude mice., Results: The long-circulating liposome formulation was significantly more effective than was the free drug in inhibiting tumor growth and in producing cure. The liposome formulation was significantly less toxic than was the free drug. This is the first demonstration of the therapeutic effectiveness of doxorubicin in sterically stabilized liposomes against human tumor xenografts., Conclusions: The encapsulation of doxorubicin in long-circulating liposomes significantly enhanced the therapeutic efficacy of the drug against a human ovarian carcinoma.

A new midfacial myocutaneous flap that is particularly useful in nasolabial-columella reconstruction is described. The mini alar flap is a randomized myocutaneous island flap incorporating portions of the orbicularis oris, levator labi superioris alae (labial portion), levator labi superioris, and zygomaticus minor, based on a vascular supply from the terminal branches of the facial artery. The flaps allow for a bilateral elipse of skin and underlying muscle to be transferred from the lateral nasal area into the midportion of the columella and the upper lip for reconstruction of ablative, traumatic, or congenital defects. The primary advantage of the mini alar flap lies in the ability to transpose moderate quantities of viable, well-matched tissue with minimal donor area deformity.

Randomly assigned 44 outpatient Ss, enrollees of the George Washington University Health Plan, a Health Maintenance Organization (HMO), to one of three treatment modalities: (1) a cognitive behavior therapy group; (2) a traditional process-oriented interpersonal group; and (3) cognitive behavior therapy in an individual format. All Ss were referred by their physicians to the HMO Mental Health Practice for treatment for anxiety and/or depression. Beck's Depression Inventory, Speilberger's State-Trait Anxiety Inventory and Gay and Galassi's Adult Self-Expression Scale (an assertion measure) were administered pre- and post-treatment to all Ss. A subsample of these Ss also were rated pre- and post-treatment on the Hamilton Rating Scale for Depression by experienced clinicians blind to the treatment groups. All three experimental groups significantly improved on all dependent measures from pre- to post-treatment, and no differential treatment effects were found.

Investigated the utility of subtests from the Wechsler-Bellevue Intelligence Scale and the Halstead-Reitan Neuropsychological Test Battery to differentiate between alcoholics and nonalcoholics (N = 76). Analyses of variance indicated that the alcoholics were more impaired than nonalcoholics. It was found that the Wechsler-Bellevue Performance subtests were more discriminative than were Verbal subtests, with performance on the Halstead-Reitan variables being intermediate. The nine measures that differentiated most significantly between groups were subjected to a stepwise multivariate discriminant analysis. The resulting function correctly classified Ss with an overall accuracy of 74.7%. It was found that the Block Design subtest was the best single discriminator. The findings were discussed in relationship to previous findings and with respect to general issues of clinical neuropsychological assessment.

The Group Embedded Figures Test and the Defense Mechanism Inventory were administered to 50 alcoholics approximately 10 days after admission and again after about 6 weeks of treatment. The posttreatment scores on the embedded figures test were significantly higher, more field independent, than initial scores. Ss also had significantly higher scores on the defense of turning against an object and lower scores on reversal when compared to pretreatment scores on the defense inventory. The changes in defensive style were not related to the initial level of or changes in perceptual differentiation.

Alcoholic Ss were categorized into four subtypes based upon differential levels of perceived locus of control and experienced control. The relationship between generalized psychopathology, as measured by the MMPI, and subtype classification was investigated. Alcoholics with an internal locus of control and high levels of experienced control exhibited the least psychopathology. The greatest degree of psychopathology was found among Ss with an external locus of control and minimal levels of experienced control. The implications of these results with respect to psychosocial functioning and drinking behavior among alcoholic subgroups were discussed.

This study investigated the Luria-Nebraska Intellectual Processes Scale (IPS) as a predictor of Wechsler Adult Intelligence Scale (WAIS) IQs among alcoholic inpatients. Strong correlations were found between the IPS and WAIS Verbal IQ and Full Scale IQ; however, the correlation with Performance IQ was only -.41. IQ estimates based on Prifitera and Ryan's (1981) regression equations derived on psychiatric inpatients differed significantly from obtained IQs in the current alcoholic sample. The importance of adequately assessing Performance IQ among patients with alcohol-related problems is discussed.