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Objective: Within the UPPS‐P model of impulsive personality, negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking dimensions have been linked to unique etiological mechanisms and outcomes. Yet, additional research is needed exploring direct relations among dimensions to determine how these relations may contribute to the nature of impulsive personality and its correlates. The current study used network analysis to clarify relations among UPPS‐P dimensions and assess global robustness of these relations across young adulthood. Method: Participants included a longitudinal sample of 525 college students (48% male, 18–26 years) who completed the UPPS‐P once per year for three consecutive years. Results: Network structure was globally robust with particularly strong relations emerging between positive and negative urgency, as well as between lack of premeditation and lack of perseverance, across waves. Lack of premeditation consistently emerged as a central dimension. Additional analyses suggested lack of premeditation and sensation seeking as most robustly related with retrospectively reported frequency of alcohol use. Conclusions: Results suggested general robustness in the relations among impulsive personality dimensions, with relations involving lack of premeditation being particularly important for characterizing impulsive personality's nature. Sensation seeking and lack of premeditation may warrant particular focus when linking impulsive personality with frequency of alcohol use. [ABSTRACT FROM AUTHOR]

Platelets have a predominant role in haemostasis, the maintenance of blood volume and emerging roles as innate immune cells, in wound healing and in inflammatory responses. Platelets express receptors that are important for platelet adhesion, aggregation, participation in inflammatory responses, and for triggering degranulation and enhancing thrombin generation. They carry a cargo of granules bearing enzymes, adhesion molecules, growth factors and cytokines, and have the ability to generate reactive oxygen species. The platelet is at the frontline of a host of cellular responses to invading pathogens, injury, and infection. Perhaps because of this intrinsic responsibility of a platelet to rapidly respond to thrombotic, pathological and immunological factors as part of their infantry role; platelets are susceptible to targeted attack by the adaptive immune system. Such attacks are often transitory but result in aberrant platelet activation as well as significant loss of platelet numbers and platelet function, paradoxically leading to elevated risks of both thrombosis and bleeding. Here, we discuss the main molecular events underlying immune-based platelet disorders with specific focus on events occurring at the platelet surface leading to activation and clearance. [ABSTRACT FROM AUTHOR]

Efforts to parse ADHD's heterogeneity in the DSM system has generally relied on subtypes, or presentations, based on different symptom combinations. Promising recent work has suggested that biologically-relevant and clinically predictive subgroups may be identified via an alternative feature set based on either a) temperament traits or b) executive function measures. Yet, the potential additive ability of these domains for specifying ADHD sub-phenotypes remains unknown. We thus sought to determine whether temperament traits and executive function, together, could facilitate a more nuanced and clinically meaningful subgrouping of children with ADHD. Participants included 828 children aged 7–11 years (62% with ADHD, 38% female). Latent profile and community detection analyses using both temperament and cognitive input features provided support for a primarily temperament-based three-subgroup solution (i.e., "Mild," "Irritable," and "Surgent"), although the distinction between Surgent and Mild subgroups may have been better explained as an ADHD symptom severity effect. There was also evidence of a five-subgroup solution, in which cognitive measures differentiated the Surgent subgroup into those with and without cognitive impairment. Cognitive measures also appeared to differentiate the Irritable subgroup based on severity, although differences in resulting subgroups appeared better explained via differences in negative affect and shyness. Subgroups within the five-subgroup solution meaningfully differed with respect to concurrent comorbidity. The utility of the five-subgroup solution for predicting comorbid diagnoses 2 years later was more limited. Additional work is needed to fully characterize the integration of cognitive and affective functioning in ADHD and their overlapping or additive value for clinical prediction. [ABSTRACT FROM AUTHOR]

Absence seizures result from 3 to 5 Hz generalized thalamocortical oscillations that depend on highly regulated inhibitory neurotransmission in the thalamus. Efficient reuptake of the inhibitory neurotransmitter GABA is essential, and reuptake failure worsens human seizures. Here, we show that blocking GABA transporters (GATs) in acute rat brain slices containing key parts of the thalamocortical seizure network modulates epileptiform activity. As expected, we found that blocking either GAT1 or GAT3 prolonged oscillations. However, blocking both GATs unexpectedly suppressed oscillations. Integrating experimental observations into single-neuron and network-level computational models shows how a non-linear dependence of T-type calcium channel gating on GABAB receptor activity regulates network oscillations. Receptor activity that is either too brief or too protracted fails to sufficiently open T-type channels necessary for sustaining oscillations. Only within a narrow range does prolonging GABAB receptor activity promote channel opening and intensify oscillations. These results have implications for therapeutics that modulate inhibition kinetics. [ABSTRACT FROM AUTHOR]

TE measures liver stiffness to assess fibrosis. Its use in post‐transplant patients was reported in few small pediatric studies. We evaluated TE ability to predict liver graft fibrosis in a large cohort while comparing it to the performance of APRI and FIB‐4. We also investigated the effect of graft type on LSMs. Patients at Boston Children's Hospital who underwent LT and LSM ≤ 1 year from biopsy (2007‐2018) were eligible. Ninety‐four patients (45%M) aged 1‐21 years (89% < 18 years; 13% < 2 years) were eligible. Median time between transplant/biopsy and LSM was 5.1 years and 52 days, respectively. Thirty‐nine percent received whole‐liver grafts, 54% TV grafts, and 6% as part of MV. At LSM, median ALT was 25 [IQR 16‐33] IU/L. Twenty‐one percent had METAVIR ≥ F2. LSM was statistically higher among those with significant fibrosis (METAVIR ≥ F2) compared to those with METAVIR F0/F1 (median [IQR] 7.5 [4.6, 13.6] vs 5.1 [4.0, 6.4] kPa, respectively) (P =.005 by Wilcoxon rank‐sum test). APRI and FIB‐4 distributions were not different across METAVIR stages. The AUROC for LSM was 0.71 (95% CI 0.56‐0.85) with an optimal cut‐point of 6.5 kPa. Graft type had no influence on the AUROC for LSM. TE is useful for assessing significant graft fibrosis in children and young adult LT recipients and performs better than APRI and FIB‐4. TV grafts demonstrate similar correlation with histology as whole‐liver grafts. [ABSTRACT FROM AUTHOR]

Previous studies of secular change in cranial size among black South Africans have produced conflicting results. We re-examined cranial size change in this population during the 19th and 20th century by evaluating its relationship with individual year-of-birth, and the significance of trends among eight decennial cohorts. This study is based on 102 male and 89 female adults born between 1865 and 1959. Linear regressions were employed to evaluate possible relationships between year-of-birth and cranial dimensions; ANOVAs were used to evaluate the significance of long-term trends among decennial cohorts. No analysis revealed a secular change in cranial length in either sex; however, the ANOVA for cranial length in the combined sex sample was significant. There is no secular trend in female cranial breadth, but males display a negative trend in this dimension. This results in a secular trend for increased male dolichocephaly. The factors that underlie the negative secular trend in male cranial breadth and the absence of a secular trend in overall cranial size in this population are unclear. Nevertheless, these observations accord with findings related to stature and long bone strength in this population and are consistent with observations for other sub-Saharan African populations. [ABSTRACT FROM AUTHOR]

This article discusses seven different techniques for pituitary transposition in endoscopic endonasal surgery. The techniques are categorized based on their relationship with the dura mater and include extradural, hybrid extradural/intradural, interdural transcavernous, extended interdural transcavernous, intradural hemitransposition, intradural, and pituitary sacrifice. The article evaluates the clinical application and selection of these techniques in different anatomical regions and types of pathology. The authors emphasize the importance of selecting the most appropriate technique based on the specific case and preoperative pituitary function for successful surgical outcomes. [Extracted from the article]

The slope conjecture relates the degree of the colored Jones polynomial of a knot to boundary slopes of essential surfaces. We develop a general approach that matches a state-sum formula for the colored Jones polynomial with the parameters that describe surfaces in the complement. We apply this to Montesinos knots proving the slope conjecture for Montesinos knots, with some restrictions. [ABSTRACT FROM AUTHOR]

The current study investigated the clinical utility and validity of a bifactor model for representing ADHD symptoms in young adults. Two-hundred and seventy-eight participants (33.8% male) aged 18–24 and informants completed well-validated measures of ADHD symptoms and internalizing and externalizing behaviors. Results across self- and informant-report methods suggested a bifactor model with inattentive and hyperactive/impulsive specific factors as the best fitting conceptualization of ADHD symptoms. Within this bifactor model, the general ("g") factor was found to be an interpretable representation of most ADHD symptoms that demonstrated significant associations with several internalizing and externalizing behaviors. Over and above "g," inattentive and hyperactive/impulsive specific factors appeared to account for unique information in ADHD symptoms, particularly those corresponding with difficulties following through on instructions and verbal impulsivity, respectively. Specific factors also appeared to account for unique information pertaining to anxious/depressed and intrusive behavioral dysfunction, over and above either "g" or total ADHD symptom count scores. Overall, results suggested that integration of different components of the bifactor model, particularly HI, into clinical practice may help parse heterogeneity in ADHD-related phenotypes during young adulthood. [ABSTRACT FROM AUTHOR]

Platelets play a critical role in both haemostasis and thrombosis, and it is now evident that not all platelets behave the same when they are called to action. A functionally distinct subpopulation of platelets forms in response to maximal agonist stimulation: the procoagulant platelet. This platelet subpopulation is defined by its ability to expose phosphatidylserine on its surface, allowing for coagulation factor complexes to form and generate bursts of thrombin and fibrin to stabilize platelet clots. Reduced levels of procoagulant platelets have been linked to bleeding in Scott's syndrome and haemophilia A patients, and elevated levels have been demonstrated in many thrombotic disorders, including identifying patients at higher risk for stroke recurrence. One obstacle for incorporating an assay for measuring procoagulant platelets into clinical management algorithms is the lack of consensus on the exact definition and markers for this subpopulation. This review will outline the biological characteristics of procoagulant platelets and the laboratory assays currently used to identify them in research settings. It will summarize the findings of clinical research demonstrating the relevance of measuring the procoagulant platelet levels in patients and will discuss how an appropriate assay can be used to elucidate the mechanism behind the formation of this subpopulation, facilitating novel drug discovery to improve upon current outcomes in cardiovascular and other thrombotic disorders. [ABSTRACT FROM AUTHOR]

When a breast lesion is seen on only magnetic resonance imaging (MRI) and needs to be excised, pre-operative MRI-guided radioactive seed localization (RSL) is preferred. However, MRI safety and radiation safety issues associated with the inability to recover a potentially lost seed in the MRI scanner room (Zone IV) have precluded this in the past. This manuscript provides a protocol for MRI-guided RSLs that meets MRI safety and radiation safety criteria established by the American College of Radiology and the Nuclear Regulatory Commission. To the authors' best knowledge, this has never been published in the literature. The complete protocol is provided. [ABSTRACT FROM AUTHOR]

Objective: Biopsy markers are often placed into biopsy-proven metastatic axillary lymph nodes to ensure later accurate node excision. Ultrasound is the preferred imaging modality in the axilla. However, sonographic identification of biopsy markers after neoadjuvant therapy can be challenging. This is due to poor conspicuity relative to surrounding parenchymal interfaces, treatment-related alteration of malignant morphology during neoadjuvant chemotherapy, or extrusion of the marker from the target. To the authors' knowledge, the literature provides no recommendations for ultrasound scanning parameters that improve the detection of biopsy markers. The purpose of this manuscript is 3-fold: (1) To determine scanning parameters that improve sonographic conspicuity of biopsy markers in a phantom and cadaver model; (2) to implement these scanning parameters in the clinical setting; and (3) to provide strategies that might increase the likelihood of successful ultrasound detection of biopsy markers in breast imaging practices. Materials and Methods: An ex vivo study was performed using a phantom designed to simulate the heterogeneity of normal mammary or axillary soft tissues. A selection of available biopsy markers was deployed into this phantom and ultrasound (GE LOGIQ E9) was performed. Scanning parameters were adjusted to optimize marker conspicuity. For the cadaver study, the biopsy markers were deployed using ultrasound guidance into axillary lymph nodes of a female cadaver. Adjustments in transducer frequency, dynamic range, cross-beam (spatial compound imaging), beam steering, speckle reduction imaging, harmonic imaging, colorization, and speed of sound were evaluated. Settings that improved marker detection were used clinically for a year. Results: Sonographic scanning settings that improved biopsy marker conspicuity included increasing transducer frequency, decreasing dynamic range, setting cross-beam to medium hybrid, turning on beam steering, and setting speckle reduction imaging in the mid-range. There was no appreciable improvement with harmonic imaging, colorization, or speed of sound. Conclusion: On a currently available clinical ultrasound scanning system, ultrasound scanning parameters can be adjusted to improve the conspicuity of biopsy markers. Overall, optimization requires a balance between techniques that clinically increase contrast (dynamic range, harmonic imaging, and steering) and those that minimize graininess (spatial compound imaging, speckle reduction imaging, and steering). Additional scanning and procedural strategies have been provided to improve the confidence of sonographic detection of biopsy markers closely associated with the intended target. [ABSTRACT FROM AUTHOR]

Background: Alcohol and marijuana are psychoactive substances commonly used by young adults and are independently associated with numerous acute and long‐term consequences. Many young adults engage in simultaneous alcohol and marijuana (SAM) use to cross‐fade (i.e., to enhance the effects of intoxication), although the extent to which alcohol use and alcohol‐related consequences increase on SAM occasions compared to alcohol‐only occasions is unclear. This study examines daily data among a sample of SAM users comparing SAM days to other days when young adults only used alcohol. Methods: A sample of 409 young adults (age 18 to 25; Mage = 21.6, SD = 2.2; 50.9% women) who reported SAM use in the past month completed 2 bursts of 14 days of daily surveys (28 days in total) assessing alcohol use, alcohol‐related consequences, and SAM use. Results: Multilevel models based on alcohol‐only and SAM days (n = 3,016 days; 391 individuals) indicated young adults drank more alcohol on SAM days compared to alcohol‐only days (with no marijuana use). Similarly, days with SAM use were associated with more alcohol‐related positive and negative consequences. The daily association between SAM use and positive consequences was statistically significant, after accounting for the amount of alcohol consumed; in contrast, the association between SAM use and negative consequences was diminished and nonsignificant. Conclusions: Among young adult SAM users, days with SAM use were associated with more alcohol use and positive consequences compared to days they only drank alcohol. Further examination of the motivational context for engaging in SAM use, as well as potential physiological interactions between alcohol and marijuana use on alcohol's effects, is warranted. Alcohol interventions might benefit from addressing increased alcohol use and alcohol‐related consequences as risks associated with SAM use. Many young adults engage in simultaneous alcohol and marijuana (SAM) use, although less is known about comparative risk of these days compared to days with alcohol‐only use. Multilevel models with two 14‐day bursts of daily data indicated young adults drank more alcohol on SAM days compared to alcohol‐only days. Similarly, days with SAM use were associated with more alcohol‐related positive and negative consequences, although the association with negative consequences was accounted for by the increase in alcohol use. [ABSTRACT FROM AUTHOR]

Background: In order to combat rising rates of antimicrobial resistant infections, it is vital that antimicrobial stewardship become embedded in primary health care (PHC). Despite the high use of antimicrobials in PHC settings, there is a lack of data regarding the integration of antimicrobial stewardship programs (ASP) in non-hospital settings. Our research aimed to determine which antimicrobial stewardship interventions are optimal to introduce into PHC clinics beginning to engage with an ASP, as well as how to optimize those interventions. This work became focused specifically around management of viral upper respiratory tract infections (URTIs), as these infections are one of the main sources of inappropriate antibiotic use. Methods: This mixed methods study of sequential explanatory design was developed through three research projects over 3 years in Regina, Saskatchewan, Canada. First, a survey of PHC providers was performed to determine their perceived needs from a PHC-based ASP. From this work, a "viral prescription pad" was developed to provide a tool to help PHC providers engage in patient education regarding appropriate antimicrobial use, specifically for URTIs. Next, interviews were performed with family physicians to discuss their perceived utility of this tool. Finally, we performed a public survey to determine preferences for the medium by which information is received regarding symptom management for viral URTIs. Results: The majority of PHC providers responding to the initial survey indicated they were improperly equipped with tools to aid in promoting conversations with patients and providing education about the appropriate use of antimicrobials. Following dissemination of the viral prescription pad and semi-structured interviews with family physicians, the viral prescription pad was deemed to be a useful educational tool. However, about half of the physicians interviewed indicated they did not actually provide a viral prescription to patients when providing advice on symptom management for viral URTIs. When asked about their preferences, 76% of respondents to the public survey indicated they would prefer to receive written or a combination of verbal and written information in this circumstance. Conclusions: PHC providers indicated a need for educational tools to promote conversations with patients and provide education about the appropriate use of antimicrobials. Viral prescription pads were regarded by family physicians and patients as useful tools in facilitating discussion on the appropriate use of antimicrobials. PHC providers should exercise caution in opting out of providing written forms of information, as many respondents to the general public survey indicated their preference in receiving both verbal and written information. [ABSTRACT FROM AUTHOR]

Objective: Substantial research has demonstrated the importance of implicit cognitive processes underlying substance use. However, there is a scarcity of research on implicit processes related to marijuana use. We adapted and tested the predictive validity (concurrent and prospective) of an implicit measure evaluating the strength of associations between marijuana and harm based on research demonstrating less marijuana use among individuals who report stronger explicit attitudes of marijuana's harms.Method: A community sample of 187 U.S. young adults living in a state with legal recreational marijuana use completed an Implicit Association Test (IAT) evaluating marijuana-harm associations and measures of marijuana use and risk of cannabis use disorder (CUD) over time.Results: The marijuana-harm IAT had good internal consistency, and scores did not vary as a function of biological sex, legal age status for recreational marijuana use, or college student status. Scores did vary as a function of lifetime and recent use such that lifetime and current abstainers had stronger marijuana-harm associations. Zero-inflated negative binomial regression models demonstrated that marijuana-harm IAT scores significantly predicted concurrent risk of CUD and use such that stronger marijuana-harm associations were associated with less use and risk of CUD. Results evaluating outcomes longitudinally found limited support for IAT scores predicting increases in use over time and no support for predicting changes in risk of CUD over time.Conclusions: Findings provide preliminary evidence that stronger marijuana-harm associations may act as a protective factor against marijuana use and risk of CUD. [ABSTRACT FROM AUTHOR]

Prediction models of post-liver transplant mortality are crucial so that donor organs are not allocated to recipients with unreasonably high probabilities of mortality. Machine learning algorithms, particularly deep neural networks (DNNs), can often achieve higher predictive performance than conventional models. In this study, we trained a DNN to predict 90-day post-transplant mortality using preoperative variables and compared the performance to that of the Survival Outcomes Following Liver Transplantation (SOFT) and Balance of Risk (BAR) scores, using United Network of Organ Sharing data on adult patients who received a deceased donor liver transplant between 2005 and 2015 (n = 57,544). The DNN was trained using 202 features, and the best DNN's architecture consisted of 5 hidden layers with 110 neurons each. The area under the receiver operating characteristics curve (AUC) of the best DNN model was 0.703 (95% CI: 0.682-0.726) as compared to 0.655 (95% CI: 0.633-0.678) and 0.688 (95% CI: 0.667-0.711) for the BAR score and SOFT score, respectively. In conclusion, despite the complexity of DNN, it did not achieve a significantly higher discriminative performance than the SOFT score. Future risk models will likely benefit from the inclusion of other data sources, including high-resolution clinical features for which DNNs are particularly apt to outperform conventional statistical methods. • Liver transplant mortality can be predicted by using deep neural networks that use UNOS data. • Deep neural networks outperformed the BAR score in predicting mortality. • Deep neural networks did not significantly outperform the SOFT score. • Deep learning using higher resolution features may achieve superior performance. [ABSTRACT FROM AUTHOR]

The state of many complex systems, such as ecosystems formed by multiple microbial taxa that interact in intricate ways, is often summarized as a probability distribution on the nodes of a weighted network. This paper develops methods for modeling the organization of such data, as well as their Euclidean counterparts, across spatial scales. Using the notion of diffusion distance, we introduce diffusion Fréchet functions and diffusion Fréchet vectors associated with probability distributions on Euclidean space and the vertex set of a weighted network, respectively. We prove that these functional statistics are stable with respect to the Wasserstein distance between probability measures, thus yielding robust descriptors of their shapes. We provide several examples that illustrate the geometric characteristics of a distribution that are captured by multi-scale Fréchet functions and vectors. [ABSTRACT FROM AUTHOR]

Vincristine is a cytotoxic chemotherapeutic agent used as first‐line therapy for pediatric acute lymphocytic leukemia. It is cleared by hepatic oxidative metabolism by CYP3A4 and CYP3A5 and via hepatic (biliary) efflux mediated by P‐glycoprotein (P‐gp) transporter. Bottom‐up physiologically based pharmacokinetic (PBPK) models were developed to predict vincristine disposition in pediatric and adult populations. The models incorporated physicochemical properties, metabolism by CYP3A4/5, efflux by P‐gp, and intracellular binding to β‐tubulin. The adult and pediatric PBPK models predicted pharmacokinetics (PK) within twofold of the observed PK parameters (area under the curve, terminal half‐life, volume of distribution, and clearance). Simulating a higher hypothetical (4.9‐fold) pediatric expression of β‐tubulin relative to adult improved predictions of vincristine PKs. To our knowledge, this is the first time that intracellular binding has been incorporated into a pediatric PBPK model. Utilizing this PBPK modeling approach, safe and effective doses of vincristine could be predicted. [ABSTRACT FROM AUTHOR]

• Past month simultaneous alcohol and marijuana (SAM) users engaged in greater risky driving than single substance users • SAM users perceived risky driving behaviors to be safer than single substance users • SAM users engaged in greater risky driving than concurrent users including driving after using marijuana • SAM users thought that driving after smoking marijuana was safer than concurrent users of alcohol and marijuana [ABSTRACT FROM AUTHOR]

Fecal microbiota transplant (FMT) is a safe and effective treatment for recurrent or refractory Clostridioides (Clostridium) difficile infection (RCDI) in the short term. However, there are a paucity of data on long-term durability and safety of FMT. The aim of this study is to determine the long-term efficacy and safety of FMT for RCDI. Ninety-four patients underwent FMT via retention enema for RCDI between 2008 and 2012 and completed a follow-up questionnaire 4 to 8 years following the last FMT. Of these, 32 were unreachable and 37 were deceased; 23 of the remaining 25 participants completed the survey. No CDI recurrences were reported in patients treated with FMT; 12 of the 23 participants (52.2%) received at least one course of non-CDI antibiotic(s). Nine participants (40.9%) received probiotics and 4 (17.4%) received both non-CDI antibiotics and probiotics. All 23 participants rated their overall health compared with pre-FMT. Current health was considered "much better" in 17 patients (73.9%); "somewhat better" in 3 patients (13.0%); and "about the same" in 3 patients (13.0%). A total of 11 participants (47.8%) reported an increase in weight of more than 5 kg (kg) post-FMT and 9 participants (39.1%) reported no change in weight (± 5 kg). Four of the 23 participants (17.4%) reported improvement or resolution (undifferentiated colitis, n = 1; Crohn's disease, n = 2; ulcerative colitis, n = 1) of pre-existing gastrointestinal condition following FMT. Eight of 23 participants (34.8%) experienced new medical condition(s) post-FMT. The long-term efficacy (48–96 months) of FMT for RCDI appears to be durable even after non-CDI antibiotic use. Thirty percent had improvement of their pre-existing medical conditions following FMT; 73.9% reported "much better" overall health following FMT. [ABSTRACT FROM AUTHOR]

Background: Evidence from college samples suggests that changes in peer norms (perception about peer use) mediate changes in alcohol use. There is relatively little intervention-based research in adolescents. Objectives: To investigate whether changes in peer norms mediate the relationship between a brief intervention to reduce alcohol use, and level of use; additionally, to determine whether any mediation effects differ by adolescent age. Methods: Eighty-four adolescents aged 14–18 (Mean = 16.49, SD = 1.00), presenting to school-based health centers with moderate to high risk alcohol use were randomized to receive an electronic screening and feedback tool (Check Yourself) in addition to their visit, or their visit alone. Check Yourself includes provision of normative feedback regarding adolescent alcohol use. Measures of self-reported alcohol use, and peer norms were collected at baseline and 2-month follow-up. Results: Changes in perceptions of the proportion of peers using alcohol significantly mediated the relationship between the intervention and all three alcohol outcomes (frequency, typical quantity, and maximum quantity) such that reductions in perceived peer use were associated with reduced use. Moderated mediation suggested that these effects were stronger for younger adolescents compared with older adolescents. Perceptions of the frequency and quantity of peer use were not significant mediators of alcohol use. Conclusions/Importance: Results suggest that integrating normative feedback regarding peer alcohol use is a promising approach in adolescent focused school interventions. They extend previous findings by suggesting that perceptions of the proportion of peers using may be particularly meaningful, and that effects may be more pronounced in younger adolescents. [ABSTRACT FROM AUTHOR]

Several different conceptualizations of Oppositional Defiant Disorder (ODD) symptoms have been proposed, including one undivided set of symptoms (DSM-IV-TR; APA 2000); two domains of symptoms subdivided into affective and behavioral; and three domains of symptoms subdivided as angry/irritable, argumentative/defiant, and spiteful. The current study utilizes a novel approach to examining the division of ODD symptoms through use of network analysis. Participants were 109 preschoolers (64 male) between the ages of three and six (M = 4.34 years, SD = 1.08) and their parents and teachers/caregivers, who provided ratings of ODD symptoms. Results are consistent with one-, two-, and three- cluster solutions of ODD, but perhaps provide most support for the three-cluster solution. In addition, results support the idea that negative affect, particularly anger, forms the core of the ODD symptom network during preschool. These results suggest the importance of targeting anger in preschool interventions for ODD. [ABSTRACT FROM AUTHOR]

Impulsivity is posited to be a key part of the externalizing spectrum during childhood, but this idea has received minimal empirical attention. The goal of the present investigation was to utilize network analysis to determine whether behavioral impulsivity symptoms are key components of the externalizing network across several developmental periods from preschool into adolescence. Participants were 109 preschoolers (64 % male) ages 3 to 6, 237 children (59 % male) ages 6 to 9, 372 children (59 % male) ages 10 to 13, and 357 adolescents (59 % male) ages 13 to 17 and their parents. Parents completed ratings of Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) symptoms on a well-validated rating scale. Network analyses indicated that ADHD and ODD were somewhat differentiated in preschool, becoming united by behavioral impulsivity symptoms during early childhood, and then differentiating into inattention versus externalizing clusters later during childhood and in adolescence. Behavioral impulsivity symptoms were core to the externalizing spectrum across most developmental periods, but core inattentive and ODD symptoms were also identified in line with progressive differentiation. These results suggest the increasing importance of impulsivity symptoms across development, explaining externalizing comorbidity and potentially serving as a viable target for childhood interventions for externalizing problems. [ABSTRACT FROM AUTHOR]

Idiopathic granulomatous mastitis (IGM) is a rare, benign inflammatory disorder of the breast that is often underrecognized. The exact etiology and pathophysiology are unknown, but milk stasis is felt to play a role. Classically, this condition is noninfectious, but many cases are noted to be associated with Corynebacterium species. Most patients affected are parous women with a mean age of 35, and many have breastfed within five years of diagnosis. Patients typically present with a painful mass and symptoms of inflammation, and these features can sometimes mimic breast cancer. Biopsy is needed to make a definitive diagnosis, and noncaseating granulomas are found on core biopsy. Many patients have a waxing and waning course over a period of six months to two years. Goal of treatment is to avoid surgery given poor wound healing, high risk of recurrence, and poor cosmetic outcomes. Medical treatment is preferred and includes observation, antibiotics, steroids, and immune modulators such as methotrexate. In more recent years, topical and intralesional steroids have become the treatment of choice, with similar outcomes to oral steroids. [ABSTRACT FROM AUTHOR]

An increasing number of older patients are undergoing evaluation for kidney transplantation; however, older patients experience increased rates of complications compared with younger patients, leading to the study of frailty assessments. Although many centers have evaluated the Fried Frailty Phenotype (FFP), less is known about the ability of the Short Performance Physical Battery (SPPB) to predict outcomes. Frailty assessment by FFP and SPPB was introduced into routine outpatient evaluation for patients aged 55 years and older referred for transplantation. Transplant rate, length of stay, readmission up to 3 months posttransplant, and death were reviewed. Patients were evaluated in an initial cohort followed by a validation cohort by FFP and SPPB. Multivariate analysis correcting for demographic characteristics was applied. Patient cohorts reflected the racial and ethnic diversity of our population, including approximately 40% Hispanic patients. The first cohort of 514 patients demonstrated a significant association between frailty as measured by SPPB and transplantation (odds ratio [OR], 2.27; 95% CI, 1.38-3.83; p =.002). The second cohort of 1408 patients validated the association between frailty measured by SPPB and transplantation (OR, 2.81; 95% CI, 1.83-4.48; p <.001). In addition, there was a significant association between nonfrail status measured by SPPB and death (OR, 0.16; 95% CI, 0.04-0.62; p =.006). Frailty assessment is a potentially useful approach for the assessment of transplant candidates. Our real-world study examined the performance of 2 methods of frailty evaluation methods in a diverse population, demonstrating that SPPB but not FFP was predictive of clinical outcomes. Incorporation of frailty assessments into transplant evaluation may improve risk stratification and optimize outcomes for older patients. [ABSTRACT FROM AUTHOR]

It is known that the colored Jones polynomial of a + -adequate link has a well-defined tail consisting of stable coefficients, and that the coefficients of the tail carry geometric and topological information on the + -adequate link complement. We show that a power series similar to the tail of the colored Jones polynomial for + -adequate links can be defined for all links, and that it is trivial if and only if the link is non + -adequate. [ABSTRACT FROM AUTHOR]

Most young adults with mental health symptoms do not receive treatment or access services. It remains important to identify barriers to service utilization to improve access to care. The current study was a prospective analysis examining predictors of (a) mental health service utilization and (b) perceived unmet need for mental health services. Barriers to service utilization were examined by prior depression severity status and college student status. Participants included a subsample of young adults ages 18-23 at time of recruitment who were participating in a longitudinal monthly study who completed both baseline and a 15-month follow-up assessment (N = 622, 80% of larger study). At month 15, 23% of young adults reported receiving mental health services in the past 12 months; 26% of young adults reported a perceived unmet need for mental health services at some point in the past 12 months. There were differences in demographic and mental health predictors of service utilization and perceived unmet need for services. Women, sexual minorities, those with moderate depression, those with more impairment from depression, and perceived past year poor mental health were associated with greater likelihood of receiving services. Similar demographic characteristics were associated with greater likelihood of perceiving unmet need for services. Barriers to service utilization differed by severity of depression symptoms and student status. Young adults have distinct reasons for not accessing mental health services; addressing these to improve accessibility to care remains critical. [ABSTRACT FROM AUTHOR]

Late endosome-resident interferon-induced transmembrane protein 3 (IFITM3) inhibits fusion of diverse viruses, including Influenza A virus (IAV), by a poorly understood mechanism. Despite the broad antiviral activity of IFITM3, viruses like Lassa virus (LASV), are fully resistant to its inhibitory effects. It is currently unclear whether resistance arises from a highly efficient fusion machinery that is capable of overcoming IFITM3 restriction or the ability to enter from cellular sites devoid of this factor. Here, we constructed and validated a functional IFITM3 tagged with EGFP or other fluorescent proteins. This breakthrough allowed live cell imaging of virus co-trafficking and fusion with endosomal compartments in cells expressing fluorescent IFITM3. Three-color single virus and endosome tracking revealed that sensitive (IAV), but not resistant (LASV), viruses become trapped within IFITM3-positive endosomes where they underwent hemifusion but failed to release their content into the cytoplasm. IAV fusion with IFITM3-containing compartments could be rescued by amphotericin B treatment, which has been previously shown to antagonize the antiviral activity of this protein. By comparison, virtually all LASV particles trafficked and fused with endosomes lacking detectable levels of fluorescent IFITM3, implying that this virus escapes restriction by utilizing endocytic pathways that are distinct from the IAV entry pathways. The importance of virus uptake and transport pathways is further reinforced by the observation that LASV glycoprotein-mediated cell-cell fusion is inhibited by IFITM3 and other members of the IFITM family expressed in target cells. Together, our results strongly support a model according to which IFITM3 accumulation at the sites of virus fusion is a prerequisite for its antiviral activity and that this protein traps viral fusion at a hemifusion stage by preventing the formation of fusion pores. We conclude that the ability to utilize alternative endocytic pathways for entry confers IFITM3-resistance to otherwise sensitive viruses. [ABSTRACT FROM AUTHOR]

Background. BRCA gene mutations significantly increase the risk of breast and ovarian cancers where the lifetime risk of the ovarian cancer is about 40%. Therefore, many women with such mutations undergo prophylactic bilateral mastectomy and salpingo-oophorectomy. About 5-6% of these individuals display occult carcinomas in tubo-ovarian locations of which over 85% are tubal in origin. The objective of this case study was to emphasize emergence of benign lesions mimicking cancer under these circumstances. Case Report. We present a case with positive BRCA1 mutation who underwent the prophylactic procedure where a small mass was identified in her fallopian tube. Our initial encounter with this tumor was during intraoperative consultation. The tumor was associated with extensive psammoma bodies arranged in closely packed small tubules, mimicking serous carcinoma. Frozen section limitations including artifact, time constraint, and lack of ancillary studies as well as the clinical history further complicated our diagnostic assessment, which was deferred. A diagnosis of adenomatoid tumor was rendered on permanent sections. Conclusion. It is important to be familiar with this morphologic presentation of adenomatoid tumor as it is a pitfall for carcinoma, particularly on frozen section, and inaccurate diagnosis could lead to further unnecessary extensive procedures. [ABSTRACT FROM AUTHOR]

Background: Prior research on romantic relationships and alcohol use among young adults has not distinguished between differences in patterns of relationship status over extended periods of time and within-person changes in status that only occur for some individuals. Objectives: This study captured between-person differences in relationship patterns, assessed associations between relationship patterns and alcohol use, and examined within-person associations between alcohol use and relationship status changes. In addition, age and sex differences in between- and within-person associations were tested. Methods: We used multilevel modeling of monthly data collected over one year on alcohol use and romantic relationship status from a Seattle area community sample of 620 young adults (ages 18-24). Results: Participants were coded into six relationship pattern groups: (1) single-not-dating (16%), (2) stable-in-a-relationship (30%), (3) single-dating (10%), (4) ended-a-relationship (14%), (5) started-a-relationship (13%), and (6) ended-and-started-a-relationship (18%). Single-not-dating and stable-in-a-relationship groups reported the least drinking across the entire year; the single-dating, ended-a-relationship, and ended-and-started-a-relationship groups reported higher levels of drinking. Examining within-person changes in groups 3-6 revealed increases in drinking associated with months of dating among the single-dating group, months postbreakup among the ended-a-relationship group, and months of breaking up and starting a new relationship among the ended-and-started-a-relationship group. Few differences by age or sex were found for between- or within-person associations. Conclusions: The findings point to heterogeneity in patterns of relationship status over time, differences in relationship patterns associated with variations in drinking, and particular time points of elevated risk for young adults who experience changes in status. [ABSTRACT FROM AUTHOR]

Background Despite advancements, recurrent Clostridium difficile infections (CDI) remain an urgent public health threat with insufficient response rates to currently approved antibiotic therapies. Microbiota-based treatments appear effective, but rigorous clinical trials are required to optimize dosing strategies and substantiate long-term safety. Methods This randomized, double-blind, placebo-controlled phase 2B trial enrolled adults with 2 or more CDI recurrences to receive: 2 doses of RBX2660, a standardized microbiota-based drug (group A); 2doses of placebo (group B); or 1 dose of RBX2660 followed by 1 dose of placebo (group C). Efficacy was defined as prevention of recurrent CDI for 8 weeks following treatment. Participants who had a recurrence within 8 weeks were eligible to receive up to 2 open-label RBX2660 doses. The primary endpoint was efficacy for group A compared to group B. Secondary endpoints included the efficacy of group C compared to group B, combined efficacy in the blinded and open-label phases, and safety for 24 months. Results The efficacy for groups A, B, and C were 61%, 45%, and 67%, respectively. The primary endpoint was not met (P =.152). One RBX2660 dose (group C) was superior to placebo (group B; P =.048), and the overall efficacy (including open-label response) for RBX2660-treated participants was 88.8%. Adverse events did not differ significantly among treatment groups. Conclusions One, but not 2, doses of RBX2660 was superior to placebo in this randomized, placebo-controlled trial. These data provide important insights for a larger phase 3 trial and continued clinical development of RBX2660. Clinical Trials Registration NCT02299570. [ABSTRACT FROM AUTHOR]

What We Already Know About This Topic: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: The authors tested the hypothesis that deep neural networks trained on intraoperative features can predict postoperative in-hospital mortality.Methods: The data used to train and validate the algorithm consists of 59,985 patients with 87 features extracted at the end of surgery. Feed-forward networks with a logistic output were trained using stochastic gradient descent with momentum. The deep neural networks were trained on 80% of the data, with 20% reserved for testing. The authors assessed improvement of the deep neural network by adding American Society of Anesthesiologists (ASA) Physical Status Classification and robustness of the deep neural network to a reduced feature set. The networks were then compared to ASA Physical Status, logistic regression, and other published clinical scores including the Surgical Apgar, Preoperative Score to Predict Postoperative Mortality, Risk Quantification Index, and the Risk Stratification Index.Results: In-hospital mortality in the training and test sets were 0.81% and 0.73%. The deep neural network with a reduced feature set and ASA Physical Status classification had the highest area under the receiver operating characteristics curve, 0.91 (95% CI, 0.88 to 0.93). The highest logistic regression area under the curve was found with a reduced feature set and ASA Physical Status (0.90, 95% CI, 0.87 to 0.93). The Risk Stratification Index had the highest area under the receiver operating characteristics curve, at 0.97 (95% CI, 0.94 to 0.99).Conclusions: Deep neural networks can predict in-hospital mortality based on automatically extractable intraoperative data, but are not (yet) superior to existing methods. [ABSTRACT FROM AUTHOR]

We describe a normal surface algorithm that decides whether a knot, with known degree of the colored Jones polynomial, satisfies the Strong Slope Conjecture. We also discuss possible simplifications of our algorithm and state related open questions. We establish a relation between the Jones period of a knot and the number of sheets of the surfaces that satisfy the Strong Slope Conjecture (Jones surfaces). We also present numerical and experimental evidence supporting a stronger such relation which we state as an open question. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study was to examine daily-level associations between alcohol-related consequences and next-day expectancies and alcohol use among frequently drinking college students using a measurement-burst daily diary study.Method: College students (N = 327; mean age = 19.7 years, SD = 1.26; 53.4% female) participated in a yearlong study in which they completed computerized interviews daily via mobile phones for 2 weeks in each academic quarter. Multilevel modeling was used to examine whether positive and negative consequences were associated with next-day alcohol expectancies and alcohol consumption.Results: Experiencing positive consequences from drinking was significantly associated with higher positive expectancies and a greater number of drinks consumed on the following day. The within-person association between daily consequences and next-day positive expectancies was stronger for those who were in fraternities/sororities compared with those who were not. Negative consequences were significantly associated with higher negative expectancies the next day but were not associated with number of drinks consumed the next day.Conclusions: Results of this study highlight the role of direct drinking experiences in influencing future expectations and drinking behavior using a method that enables analysis of both between- and within-person associations. [ABSTRACT FROM AUTHOR]

Background: Previous research on peer status of children with attention‐deficit/hyperactivity disorder (ADHD) has focused on already‐established peer groups, rendering the specific social behaviors that influence peers' initial impressions largely unknown. Recently, theorists have argued that emotion dysregulation is a key aspect of ADHD, with empirical work finding relations between emotion dysregulation and social outcomes. Therefore, the current study focuses on the initial interactions among children varying in ADHD symptoms duringh a novel playgroup, proposing that emotion dysregulation displayed during the playgroup may serve as a possible pathway between ADHD symptoms and peers' initial negative impressions. Methods: Participants were 233 elementary‐age children ranging from 8 to 10 years old (M = 8.83, 70% male). Parents and teachers rated children's ADHD symptoms and related impairment; 51% of the children met criteria for an ADHD diagnosis. Then, children participated with unfamiliar peers in a three‐hour playgroup that included three structured and two unstructured tasks. After the tasks, children and staff rated each child on social outcomes. Coders unaware of child's diagnostic status watched videos of the groups and rated each child's global emotion dysregulation during each task. Results: Using multiple raters and methods, ADHD severity was associated with more negative peer ratings, through observed emotion dysregulation. Results were consistent for both parent and teacher ratings of ADHD severity as well as for both peer ratings of likeability and staff ratings of perceived peer likeability. Conclusions: When focusing on improving peers' initial impressions of children with ADHD symptoms, emotion dysregulation may be a valuable target for intervention. [ABSTRACT FROM AUTHOR]

Introduction: With many young adults pursuing post-secondary education and many working, understanding the importance of education and work roles on alcohol use are of developmental and clinical importance. Utilizing a sample of 18-20year-olds transitioning from adolescence to young adulthood, the current study examined how social role statuses in education (i.e., not in school, 2-year students, 4-year students) and work status (i.e., unemployed, employed part-time, employed full-time) were associated with alcohol use, alcohol-related consequences, and perceived drinking norms.Method: Participants were 18-20year old young adults (54% female) participating in a one-time online survey about alcohol use and sexual behavior. Regression models were conducted to examine associations between school status and work status with alcohol related outcomes.Results: Individuals who were unemployed had a significantly lower likelihood of any heavy episodic drinking (HED) in the past month, consumed fewer drinks per week, and experienced fewer alcohol-related consequences compared to individuals who worked full-time. Individuals who worked part-time consumed fewer drinks per week and had lower perceived drinking norms compared to individuals who worked full-time. No significant associations were found for alcohol use and consequences by education status.Discussion: Working full-time is a risk factor for HED, greater weekly drinking and negative alcohol-related consequences when compared to young adults who are unemployed, and to a lesser extent with young adults working part-time. Workplace interventions may be one approach to reach heavy drinking young adults. [ABSTRACT FROM AUTHOR]

Purpose To characterize the MRI appearance of inflammatory hepatic adenomas using hepatobiliary contrast agents. Materials and methods MRI was performed using hepatobiliary contrast agents (3 with gadobenate dimeglumine and 24 with gadoxetic acid) in 27 patients with immunohistochemistry-confirmed diagnosis of inflammatory hepatic adenoma. The appearance of the lesions on T2 and diffusion-weighted images, pre-gadolinium T1-weighted images, dynamic post-gadolinium images, and hepatobiliary phase images was assessed. Results Seven lesions (26%) showed predominant hyperenhancement on hepatobiliary phase images in comparison with adjacent hepatic parenchyma: 1 lesion showed diffuse, mildly heterogeneous hyperenhancement, and the remaining 6 lesions showed peripheral hyperenhancement and central hypoenhancement. Twenty lesions (74%) were predominantly hypoenhancing compared to adjacent liver on hepatobiliary phase images. Nine lesions showed a pattern of peripheral hyperenhancement and central hypoenhancement on hepatobiliary phase images; in 6 of these lesions a majority of the mass appeared hyperenhancing, while the remaining 3 lesions showed predominant hypoenhancement. Conclusions This investigation shows that a significant percentage of inflammatory hepatic adenomas appear isointense or hyperintense in comparison to adjacent normal liver on hepatobiliary phase images, and therefore this feature should not be used to distinguish hepatic adenomas from focal nodular hyperplasia without additional supporting evidence. [ABSTRACT FROM AUTHOR]

Background Posterior fossa decompression surgeries for Chiari malformations are susceptible to postoperative complications such as pseudomeningocele, external cerebrospinal fluid (CSF) leak, and meningitis. Various dural substitutes have been used to improve surgical outcomes. Objective This study examined whether the collagen matrix dural substitute type correlated with the incidence of postoperative complications after posterior fossa decompression in adult patients with Chiari I malformations. Methods A retrospective cohort study was conducted of 81 adult patients who underwent an elective decompressive surgery for treatment of symptomatic Chiari I malformations, with duraplasty involving a dural substitute derived from either bovine or porcine collagen matrix. Demographics and treatment characteristics were correlated with surgical outcomes. Results A total of 81 patients were included in the study. Compared with bovine dural substitute, porcine dural substitute was associated with a significantly higher risk of pseudomeningocele occurrence (odds ratio, 5.78; 95% confidence interval, 1.65–27.15; P = 0.01) and a higher overall complication rate (odds ratio, 3.70; 95% confidence interval, 1.23–12.71; P = 0.03) by univariate analysis. There was no significant difference in the rate of meningitis, repeat operations, or overall complication rate between the 2 dural substitutes. In addition, estimated blood loss was a significant risk factor for meningitis ( P = 0.03). Multivariate analyses again showed that porcine dural substitute was associated with pseudomeningocele occurrence, although the association with higher overall complication rate did not reach significance. Conclusions Dural substitutes generated from porcine collagen, compared with those from bovine collagen, were associated with a higher likelihood of pseudomeningocele development in adult patients undergoing Chiari I malformation decompression and duraplasty. [ABSTRACT FROM AUTHOR]

Background: Although there are serious negative harms associated with simultaneous alcohol and marijuana (SAM) use, little is known about the self-reported acute effects of SAM use and how they may be similar to or different than effects experienced when using alcohol or marijuana only. The current study examines the perceived acute effects of SAM use, compared to using alcohol or marijuana only, as well as demographic and substance use predictors of overall SAM effects.Methods: Participants were a community sample of young adults ages 18-23 participating in a longitudinal study on social role transitions and substance use during young adulthood. Young adults who reported SAM use at least once in their lifetime were selected for the present analyses (N=315; mean age=21.42; 58% female) and reported the effects they experienced from typical alcohol use, marijuana use, and SAM use.Results: There were significant differences in the extent to which young adults perceived the effects depending on the substances used. Most effects (i.e., clumsy, confused, dizzy, difficulty concentrating) were rated strongest when engaging in SAM use, compared to typical alcohol or marijuana use alone. Feeling high and feeling marijuana effects were rated strongest when engaging in marijuana use alone compared to SAM use, but feeling drunk was greater during SAM use compared to alcohol use alone. Greater alcohol use and increased time spent high during typical SAM use were associated with greater overall SAM effects.Conclusions: When young adults engage in SAM use they report experiencing greater negative physiological and cognitive effects. [ABSTRACT FROM AUTHOR]

Motives for substance use have garnered considerable attention due to the strong predictive utility of this construct, both in terms of use and problems associated with use. The current study examined the cross-lagged relations between alcohol use and motives, and marijuana use and motives over three yearly assessment periods in a large sample (N=526, 48% male) of college students. The relations between substance use and motives were assessed at each time point, allowing for the examination of these inter-relations over time. Results indicated different trends based on the type of substance. For alcohol use, cross-lagged trends were found between freshman and sophomore year for coping, social, and conformity motives with cross-lagged relations between enhancement motives and alcohol use across all years. However, outside of enhancement motives, cross-lagged relations were not found between sophomore and junior year. In contrast, cross-lagged effects were found for marijuana use and coping, enhancement, and expansion motives between sophomore and junior year, but not freshman year. These results suggest that people's expectations that drinking or smoking marijuana makes activities more reinforcing and helps them cope with distress may perpetuate use. In turn, use itself may enhance these expectations over time. Results have direct implications for treatment, with recommended focus on motives, behavior activation, and healthy coping skills in order to interrupt the cycle of substance use. [ABSTRACT FROM AUTHOR]

It has long been known that the quadratic term in the degree of the colored Jones polynomial of a knot is bounded above in terms of the crossing number of the knot. We show that this bound is sharp if and only if the knot is adequate. As an application of our result we determine the crossing numbers of broad families of non-adequate prime satellite knots. More specifically, we exhibit minimal crossing number diagrams for untwisted Whitehead doubles of zero-writhe adequate knots. This allows us to determine the crossing number of untwisted Whitehead doubles of any amphicheiral adequate knot, including, for instance, the Whitehead doubles of the connected sum of any alternating knot with its mirror image. We also determine the crossing number of the connected sum of any adequate knot with an untwisted Whitehead double of a zero-writhe adequate knot. [ABSTRACT FROM AUTHOR]

The purpose of the present paper was to examine the extent to which college students underestimate the quantity of alcohol they will consume during Spring Break (SB), and whether individual, interpersonal, and contextual factors may be related to underestimation of SB drinking and drinking consequences. College students participated in web-based surveys prior to and after SB (N=603; 57% women). Overall, results indicated that individual factors (being male, being a member of a fraternity or sorority, previously experiencing more alcohol-related consequences, and intending to drink less during SB), interpersonal factors (reporting friends encourage getting drunk), and contextual factors (going on a SB trip with friends and receiving drinks from others) predicted underestimating peak drinks consumed during SB. Underestimating the peak number of drinks to be consumed on SB was associated with experiencing a greater number of alcohol-related consequences. Targeted interventions designed specifically to focus on underestimation of college student drinking and the impact of SB contextual and interpersonal factors may be an important area of study to reduce negative consequences of alcohol use during SB. [ABSTRACT FROM AUTHOR]

Theorists argue that self-control failure is the underlying cause of criminal behavior, with previous research linking poor self-control to delinquency and drug use. The path from self-control to crime is well-established, but less is known about whether criminal behavior contributes to self-control deficits over time. We investigated bi-directional relations between self-control assessed via a delay discounting task and self-reported crime over a three-year period. During their first, second (73.38% retention rate), and third (63.12% retention rate) years of college, 526 undergraduates completed a delay discounting task and reported on their criminal behavior. In order to maximize variability, participants with conduct problems were overrecruited, comprising 23.1% of the final sample. As expected, more discounting of hypothetical monetary rewards significantly predicted future property crime across a one and two-year period, even when controlling for initial levels of both. This study also demonstrated evidence of a bi-directional relationship; violent crime predicted higher rates of delay discounting one year later. These results suggest that bi-directional relations exist between self-control and types of crime. [ABSTRACT FROM AUTHOR]

College students experience a variety of effects resulting from alcohol use and evaluate their experiences on a continuum from negative to positive. Using daily reports collected via cell phone, we examined the psychometric properties of alcohol use consequences and evaluations of those consequences. Participants were 349 undergraduate students (mean age 19.7 [SD = 1.26], 53.4% female). Data were analyzed using a multilevel factor analysis framework, incorporating binary items (consequences) and normally distributed items (evaluations). Our model converged on 2 factors-positive and negative-with similar loadings between- and within-persons. Intraclass correlation coefficients for positive consequences and their evaluations ranged from .30 to .40, whereas values for negative consequences were more variable. Intraclass correlation coefficients for negative evaluations were higher, suggesting evaluations were more trait-like compared to experience of consequences which may be context dependent. Generalizability coefficients on the whole were good to excellent, suggesting highly reliable scales at both person-mean and daily-mean levels. However, likely due to binary scale and infrequency, the generalizability coefficients for negative consequences at the daily level was somewhat low. Convergent validity was demonstrated by (a) positive associations between baseline Rutgers Alcohol Problem Index and Alcohol Use Disorders Identification Test scores with latent factors for daily positive and negative consequences, and (b) positive associations between daily drinking and daily consequences and evaluations of consequences. Overall, this measure demonstrated good psychometric properties for use in studies examining daily and lagged relationships between alcohol use and related consequences. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Objectives: Clostridium difficile infection (CDI) is a major public health concern. Treatment with commonly prescribed antibiotics is associated with high rates of recurrence after initial cure. Here, we present the efficacy and safety of surotomycin, an orally administered, minimally absorbed, selective bactericidal cyclic lipopeptide, compared with vancomycin, in patients with CDI.Methods: In this Phase 2, randomized, controlled, double-blind, non-inferiority, multicentre trial, participants received surotomycin 125 mg twice daily, surotomycin 250 mg twice daily or vancomycin 125 mg four times daily for 10 days. The primary efficacy outcome was clinical response at end of treatment. The registration number of the study on clinicaltrials.gov is NCT01085591.Results: Clinical cure rates were similar among treatment groups (92.4% for surotomycin 125 mg twice daily, 86.6% for surotomycin 250 mg twice daily and 89.4% for vancomycin). Recurrence rates were 27.9% for surotomycin 125 mg twice daily, 17.2% for surotomycin 250 mg twice daily and 35.6% for vancomycin. The lower recurrence rate with surotomycin 250 mg twice daily versus vancomycin was statistically significant (P = 0.035). Recurrence rates were statistically similar between the surotomycin dose groups (P = 0.193). Rates of sustained clinical response at end of study were 66.7% for surotomycin 125 mg twice daily, 70.1% for surotomycin 250 mg twice daily and 56.1% for vancomycin. Incidence of adverse events was similar among treatment arms.Conclusions: Recurrence rates of CDI were lower with surotomycin with higher sustained clinical response rates compared with vancomycin, both of which may offer potential clinical benefits. [ABSTRACT FROM AUTHOR]

The article presents two case studies of the 76‐year‐old woman with 3‐year history of exquisite left breast pain and the 31‐year‐old woman with a complex medical history including nonspecific systemic illness and long‐standing inflammatory type condition of the right breast of unclear etiology. It also mentions stereotactic‐guided biopsy using a 9‐gauge vacuum‐assisted biopsy device to remove the ribbon clip and barbellshaped clip. It also discussed the risk of bleeding, infection and injury.