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Healthcare associated infections (HAIs) are a concern to patients, hospital administrators and policymakers. For over than a decade, efforts have been made to hold hospitals accountable for the costs of HAIs. This study uses contingency theory as a framework to examine the association between HAIs and hospital financial performance. We use publicly available data on 2059 hospitals in 2014 to 2016 that include HAIs, staffing financial performance, and hospital and hospital market characteristics. The key independent variables are available infection rates and nurse staffing. The dependent variables are indicators of financial performance: operating margin, total margin, and days cash on hand. We find nearly identical negative direct associations between infections and operating margins and total margins (-0.07%), and positive associations between the interaction of infections and nurse staffing (0.05%). A 10% higher infection rate would be predicted to be associated with only a 0.2% lower profit margin. The associations between HAIs, nurse staffing and days cash on hand were insignificantly different from zero.

We seek to completely revise current models of airborne transmission of respiratory viruses by providing never-before-seen atomic-level views of the SARS-CoV-2 virus within a respiratory aerosol. Our work dramatically extends the capabilities of multiscale computational microscopy to address the significant gaps that exist in current experimental methods, which are limited in their ability to interrogate aerosols at the atomic/molecular level and thus obscure our understanding of airborne transmission. We demonstrate how our integrated data-driven platform provides a new way of exploring the composition, structure, and dynamics of aerosols and aerosolized viruses, while driving simulation method development along several important axes. We present a series of initial scientific discoveries for the SARS-CoV-2 Delta variant, noting that the full scientific impact of this work has yet to be realized., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Introduction: Negative affective states contribute to the chronic-relapsing nature of addiction. Mesolimbic dopamine D3 receptors are well placed to modulate emotion and are dysregulated in substance dependence. Selective antagonists might restore dopaminergic hypofunction, thus representing a potential treatment target. We investigated the effects of selective D3 antagonist, GSK598809, on the neural response to negative emotional processing in substance dependent individuals and healthy controls., Methodology: Functional MRI BOLD response was assessed during an evocative image task, 2 h following acute administration of GSK598809 (60 mg) or placebo in a multi-site, double-blind, pseudo-randomised, cross-over design. Abstinent drug dependent individuals (DD, n = 36) comprising alcohol-only (AO, n = 19) and cocaine-alcohol polydrug (PD, n = 17) groups, and matched controls ( n = 32) were presented with aversive and neutral images in a block design (contrast of interest: aversive > neutral). Whole-brain mixed-effects and a priori ROI analyses tested for group and drug effects, with identical models exploring subgroup effects., Results: No group differences in task-related BOLD signal were identified between DD and controls. However, subgroup analysis revealed greater amygdala/insular BOLD signal in PD compared with AO groups. Following drug administration, GSK598809 increased BOLD response across HC and DD groups in thalamus, caudate, putamen, and pallidum, and reduced BOLD response in insular and opercular cortices relative to placebo. Multivariate analyses in a priori ROIs revealed differential effects of D3 antagonism according to subgroup in substantia nigra; GSK598809 increased BOLD response in AO and decreased response in PD groups., Conclusion: Acute GSK598809 modulates the BOLD response to aversive image processing, providing evidence that D3 antagonism may impact emotional regulation. Enhanced BOLD response within D3-rich mesolimbic regions is consistent with its pharmacology and with attenuation of substance-related hypodopaminergic function. However, the lack of group differences in task-related BOLD response and the non-specific effect of GSK598809 between groups makes it difficult to ascertain whether D3 antagonism is likely to be normalising or restorative in our abstinent populations. The suggestion of differential D3 modulation between AO and PD subgroups is intriguing, raising the possibility of divergent treatment responses. Further study is needed to determine whether D3 antagonism should be recommended as a treatment target in substance dependence., Competing Interests: This study received funding from GlaxoSmithKline (GSK) who provided the GSK598809 medication, and funded the functional and structural MRI scans that took place at Imperial College London. GSK was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. DN has been an advisor to British National Formulary, MRC, GMC, Department of Health, is President of the European Brain Council, past President of the British Neuroscience Association and European College of Neuropsychopharmacology, chair of the Independent Scientific Committee on Drugs [UK], is a member of the International Centre for Science in Drug Policy, advisor to Swedish government on drug, alcohol and tobacco research, editor of the Journal of Psychopharmacology, has sat on advisory boards at Lundbeck, MSD, Nalpharm, Orexigen, Shire, Awakn, COMPASS Pathways; has received speaking honoraria (in addition to above) from BMS/Otsuka, GSK, Lilly, Janssen, Servier, is a member of the Lundbeck International Neuroscience Foundation, has received grants or clinical trial payments from P1vital, MRC, NHS, Lundbeck, has share options with P1vital, has been expert witness in a number of legal cases relating to psychotropic drugs, and has edited/written 27 books – some purchased by pharma companies. TR has held research grants with Eli Lilly and Lundbeck, has received royalties from Cambridge Cognition (CANTAB), has received editorial honoraria from Springer Verlag, Elsevier, Society for Neuroscience; has performed educational lectures for Merck, Sharpe and Dohme and does consultancy work for Cambridge Cognition, Eli Lilly, Lundbeck, Teva and Shire Pharmaceuticals. BD has carried out research funded by Autifony, Sunovion, Lundbeck, AstraZeneca, and Servier. All payment is to the University of Manchester. AL-H has received funding for research and/or Ph.D. studentships from Alcarelle Ltd, Lundbeck, GSK; received Honoraria (paid into University account) from Silence Therapeutics, NET Device Corp and consulted by but received no monies from Opiant, Camurus, Dobrin Consulting, Lightlake, GLG; received Honoraria for talks and/or chairing from Janssen-Cilag, Lundbeck, Servier; led the British Association for Psychopharmacology addiction guidelines (2012) that received support from Archimedes Pharma, Lundbeck, Pfizer, Schering. LP has acted as research consultant (pharmacology) to Alcarelle Holdings Limited and received no payment. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Vamvakopoulou, Fonville, Hayes, McGonigle, Elliott, Ersche, Flechais, Orban, Murphy, Smith, Suckling, Taylor, Deakin, Robbins, Nutt, Lingford-Hughes and Paterson.)

Background: Vaccinating susceptible populations quickly and safely is vital during a pandemic. Mass vaccination programs using a drive-through method have been shown to reach large numbers of people efficiently during vaccine campaigns., Methods: We performed a quantitative, cross-sectional study analyzing data collected by the COVID-19 mass vaccination program conducted by Louisiana State University Health Shreveport (LSUSH)., Results: Between December 2020 and September 2021, the vaccination program administered 90,655 COVID-19 vaccines. Among those who received at least the first dose of the vaccine, there were 21,700 men and 28,269 women; 22,820 were ≥60 years of age; 28,031 identified as Caucasian, 19,249 as African American, 47,916 as non-Hispanic, and most of them reported that they had not tested positive for COVID-19 before vaccination., Discussion: The LSUHS vaccination center served people from different regions within Louisiana as well as those from outside Louisiana. Vaccination is a crucial public health measure in the fight against the COVID-19 pandemic., Conclusions: Our study showed that the mass vaccination program conducted by LSUHS had a considerable positive impact on communities in Northwest Louisiana. This drive-through method is an effective strategy with which to reach a significant number of people during a pandemic., Competing Interests: Conflicts of interest The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

Background: The objective of this 3-arm randomized controlled trial was to evaluate the efficacy of computerized cognitive training (CCT) in improving primary outcomes of delayed-recall memory and serum brain-derived neurotrophic factor (BDNF) levels; and the secondary outcomes were working memory, instrumental activities of daily living (IADLs) and health-related quality of life (HRQL) in patients with heart failure (HF)., Methods and Results: Patients (n = 256) were randomly assigned to 8 weeks of CCT using BrainHQ, computerized crossword puzzles active control intervention, and usual care. All patients received weekly nurse-enhancement interventions. Data were collected at enrollment and baseline visits and at 10 weeks and 4 and 8 months. In mixed effects models, there were no statistically significant group or group-by-time differences in outcomes. There were statistically significant differences over time in all outcomes in all groups. Patients improved over time on measures of delayed-recall memory, working memory, IADLs, and HRQL and had decreased serum BDNF., Conclusions: CCT did not improve outcomes compared with the active control intervention and usual care. Nurse-enhancement interventions may have led to improved outcomes over time. Future studies are needed to test nurse-enhancement interventions in combination with other cognitive interventions to improve memory in persons with HF., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Hyperhidrosis (HH) is a relatively common disorder involving excessive sweating, typically of the palms or axilla. HH can also frequently occur after limb amputation, where the remaining residual limb excessively perspires, leading to an increased risk of dermatological disorders and functional limitations, such as the inability to comfortably or safely wear a prosthesis. Although many treatments have been proposed to treat HH within the dermatology community, they are not widely known by healthcare providers typically involved in caring for individuals with acquired limb loss., Objectives: To appraise the current state of quantitative and qualitative assessment of HH within the residual limb and examine existing and future treatment strategies for this problem., Study Design: Narrative Literature Review., Methods: A literature review focused on the assessment and treatment of excessive sweating of residual limbs., Results: There is currently no objective or subjective standard to assess or diagnose HH of the residual limb. Conventional therapies for HH do not always translate to the population of individuals with limb loss. Emerging modalities for treating HH show promise toward a permanent resolution of excess perspiration but require additional studies within people with amputation., Conclusions: Further research is needed to quantify standard values to objectively and subjectively assess and diagnose hyperhidrosis of the residual limb. New and developing treatments for hyperhidrosis require additional studies to assess efficacy and safety in the residual limb., (Copyright © 2021 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.)

Reimbursement to U.S. healthcare service providers is largely transitioning from fee for service to fee for value for those clinicians who code using current procedural terminology and through their coding, describe their professional services. The Orthotic, Prosthetic and Pedorthic profession (O&P), currently codes using a system that describes the devices they evaluate for, fabricate, fit and maintain and their professional services are incorporated into their codes. These O&P codes, in contrast to those for other healthcare disciplines, are predominantly product based rather than service based, focusing on product features and function more than clinical service. This editorial manuscript provides a brief overview of the system the US O&P profession uses currently, particularly in the context of other healthcare professions transitioning to value based coding and reimbursement and culminates in a call to action for the profession to academically consider the strengths and weaknesses of the current system relative to alternative systems., Competing Interests: The opinions and assertions expressed herein are those of the authors and do not necessarily reflect the official policy or position of any government or healthcare agency or academic institution to include the Uniformed Services University, the Department of Defense and/or the Department of Veterans Affairs. Dr. Douglas Smith received salary support through the Uniformed Services University of the Health Sciences under Award number HU00011920105 to the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., and has been prepared in collaboration with the Center for Rehabilitation Sciences Research, Department of Physical Medicine & Rehabilitation, Uniformed Services University and the Department of Rehabilitation, Walter Reed National Military Medical Center., (Copyright (c) 2021 Highsmith MJ, Fantini CM, Smith DG.)

The National Research Council recommends that genetic differentiation among subgroups of ethnic samples be lower than 3% of the total genetic differentiation within the ethnic sample to be used for estimating reliable random match probabilities for forensic use. Native American samples in the United States' Combined DNA Index System (CODIS) database represent four language families: Algonquian, Na-Dene, Eskimo-Aleut, and Salishan. However, a minimum of 27 Native American language families exists in the US, not including language isolates. Our goal was to ascertain whether genetic differences are correlated with language groupings and, if so, whether additional language families would provide a more accurate representation of current genetic diversity among tribal populations. The 21 short tandem repeat (STR) loci included in the Globalfiler® PCR Amplification Kit were used to characterize six indigenous language families, including three of the four represented in the CODIS database (i.e. Algonquian, Na-Dene, and Eskimo-Aleut), and two language isolates (Miwok and Seri) using major population genetic diversity metrics such as F statistics and Bayesian clustering analysis of genotype frequencies. Most of the genetic variation (97%) was found to be within language families instead of among them (3%). In contrast, when only the three of the four language families represented in both the CODIS database and the present study were considered, 4% of the genetic variation occurred among the language groups. Bayesian clustering resulted in a maximum posterior probability indicating three genetically distinct groups among the eight language families and isolates: (1) Eskimo, (2) Seri, and (3) all other language groups and isolates, thus confirming genetic subdivision among subgroups of the CODIS Native American database. This genetic structure indicates the need for an increased number of Native American populations based on language affiliation in the CODIS database as well as more robust sample sets for those language families. Supplemental data for this article is available online at https://doi.org/10.1080/20961790.2021.1963088 ., Competing Interests: No potential conflict of interest was reported by the authors., (© 2021 The Author(s). Published by Taylor & Francis Group on behalf of the Academy of Forensic Science.)

Background: As hospitals are under increasing pressure to improve quality and safety, safety culture has become a focal issue for high-risk organizations, including hospitals. Prior research has examined how structural characteristics directly impact safety culture. However, and based on Donabedian's structure-process-outcome quality model, there is a need to understand the processes that intermediate the relationship between structural characteristics and safety culture perceptions., Purpose: The processes by which registered nurse (RN) and hospitalist staffing may affect safety culture perceptions were examined in this study. Specifically, this study investigates the processes of perceived teamwork across units and perceived handoffs., Methodology: Data sources for this research included Hospital Survey on Patient Safety Culture from the Agency for Healthcare Research and Quality, the American Hospital Association's Annual Survey Data, the American Hospital Association Information Technology supplement, and the Area Health Resource File. Two separate mediation models for each process were used. Propensity weights were assigned to each hospital in the sample ( N = 207) to adjust for potential nonresponse bias of hospitals that did not assess employee's safety culture perceptions., Results: Results suggest that RN staffing influences safety culture perceptions, but hospitalist staffing does not. In addition, RN staffing has an indirect effect on safety culture perceptions through better processes., Practice Implications: Our study sheds light on how staffing affects safety culture perceptions. Specifically, our findings suggest that positive perceptions of teamwork across units and handoffs are integral in the relationship between RN staffing and safety culture perceptions. Hospital managers should, therefore, invest resources in staff recruitment and retention. In addition, a targeted focus on perceived teamwork and handoffs may allow hospital managers to improve safety culture perceptions., (Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.)

The dramatic uptake of virtual care, or telehealth, utilization because of COVID-19 restrictions for persons with limb loss has led to a much greater understanding of this health care delivery method for this complex patient population. However, much is still unknown. Therefore, the authors provide a comprehensive literature review of existing evidence for virtual care delivery across the phases of amputation rehabilitation, as well as anecdotal evidence, to provide a platform for further discussion and development of research and innovative opportunities. Evidence reveals that virtual care serves as a complement to in-person health care for individuals with limb loss because it allows for increased accessibility to these services. The authors conclude that continued use of telehealth beyond the COVID-19 restrictions to optimize outcomes across the continuum of care for persons with limb loss is warranted., (© 2021 The Authors. PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.)

Two new moray eels of the genera Diaphenchelys and Gymnothorax from Taiwan and the Philippines are described. Diaphenchelys laimospila sp. nov. is described based on two specimens that represent the third species and a new geographic record of the genus. It can be distinguished from the other two congeners by the number of cephalic sensory pores, vertebral formula, morphometric measurements, and the coloration pattern. Gymnothorax pseudokidako sp. nov. is a muraenid with a dark brown body covered by pale snowflake-like blotches. It differs from the most similar species Gymnothorax kidako (Temminck and Schlegel) by having a relatively short tail (50.5-53.0% vs. 52.9-56.4% of TL), more dentary teeth (17-26 vs. 16-20), fewer total vertebrae (134-139 vs. 137-143), and the absence of white margin on anal fin (vs. prominent white margin). These two new species were also confirmed by molecular analyses, the mitochondrial COI gene (593 bp) for D. laimospila , and the nuclear EGR3 gene (767 bp) for G. pseudokidako .

Hypothesis: College pitchers with increased external rotation gain (ERG) produce increased medial elbow torque (elbow stress) whereas those with reduced total rotational range of motion (ROM) have reduced medial elbow torque during pitching., Methods: Pitchers were recruited from 3 college baseball teams. Players with prior injury or on pitching restrictions because of pain were excluded. Players were evaluated within 2 weeks before their first game of the season. Pitchers completed an intake survey, and shoulder and arm measurements were taken. Pitchers were fitted with a baseball sleeve that included a sensor at the medial elbow. The sensor calculated elbow torque, arm speed, arm slot, and shoulder rotation for each pitch, while a radar gun measured peak ball velocity. After adequate warm-up, pitchers threw 5 fastballs in a standardized manner off the mound at game-speed effort. The primary outcome evaluated the relationship between shoulder ROM and medial elbow torque. Additional outcomes evaluated pitcher characteristics and demographic characteristics in the context of shoulder ROM., Results: Twenty-eight pitchers were included in the preseason analysis. The average age and playing experience were 20.1 years (standard deviation [SD], 1.3 years) and 15.3 years (SD, 1.8 years), respectively, with 2.5 years (SD, 1.2 years) playing at collegiate level. The dominant shoulder showed decreased internal rotation and increased external rotation (ER) relative to the nondominant side (P < .001). The average glenohumeral internal rotation deficit and ERG were 11.3° (SD, 9.87°) and 5.71° (SD, 8.8°), respectively. ERG ≥ 5° was a significant predictor of elbow stress during pitching (47.4 Nm [SD, 0.7 Nm] vs. 45.1 Nm [SD, 0.6 Nm], P = .014). Univariate associations showed that each additional degree of ER resulted in increased elbow torque (β estimate, 0.35 ± 0.06 Nm; P = .003). Conversely, decreased medial elbow torque was found in pitchers with reduced shoulder ROM (glenohumeral internal rotation deficit ≥ 20°: 43.5 Nm [SD, 1.1 Nm] vs. 46.6 Nm [SD, 0.5 Nm], P = .011; loss of total rotational ROM ≥ 5°: 43.6 Nm [SD, 1.1 Nm] vs. 46.6 Nm [SD, 0.5 Nm], P = .013) and in those with greater arm length (P < .05)., Conclusions: College pitchers with increased ER produce greater medial elbow torque during the pitching movement. Each degree of increased ER was found to correlate with increased elbow torque and ball velocity. On the contrary, arm length and reduced shoulder ROM were associated with reduced medial elbow torque. This study suggests that increased ER in pitchers is associated with greater elbow stress during pitching., (Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Background: Postoperative rehabilitation protocols after ulnar collateral ligament (UCL) reconstruction typically involve a structured interval throwing program. In an effort to minimize torque placed on the UCL, athletes are often instructed to throw with a crow hop, even at short throwing distances. However, the effect of the crow hop on medial elbow stress is unknown., Purpose/hypothesis: The purpose was to determine whether elbow stress differs with and without a crow hop across the throwing distances of a typical interval throwing program. We hypothesized that crow hop throws would generate lower torque on the elbow than standing throws at each distance of the interval throwing program., Study Design: Controlled laboratory study., Methods: Healthy high school and collegiate pitchers and position players were recruited from the surrounding area. Each player was outfitted with a wearable athletic sleeve and device that recorded elbow torque (Newton-meters), arm slot (degrees), arm speed (revolutions per minute), and shoulder rotation (degrees). Ball velocity (miles per hour) was measured using a radar gun. Players were instructed to perform 3 crow hop throws and 3 standing throws at distances of 30, 45, 60, 90, 120, 150, and 180 feet. A repeated measures analysis of variance was used to compare ball velocity, elbow torque, arm slot, arm speed, and shoulder rotation between crow hop and standing throws at each throwing distance., Results: Twenty athletes participated in this study (average age, 17.8 years; range, 15-25 years). The average medial elbow torque increased at each distance for both crow hop and standing throws at distances of 30, 45, 60, and 90 feet ( P < .05), after which there were no significant increases in elbow torque ( P > .05). The average torque was higher for crow hop throws than standing throws at distances of 30 feet (13.9 N·m vs 12.0 N·m; P = .002), 45 feet (21.8 N·m vs 19.3 N·m; P = .005), and 60 feet (28.0 N·m vs 24.5 N·m; P = .02)., Conclusion: Crow hop throws generated greater medial elbow torque than standing throws at distances up to 60 feet; however, there were no differences in elbow torque at distances greater than 60 feet between the 2 throw types. For both crow hop and standing throws, elbow stress increased at each distance interval up to 90 feet before plateauing at distances greater than 90 feet. The crow hop throwing technique does not reduce medial elbow stress during a simulated interval throwing program, and it may actually increase torque at shorter throwing distances., Clinical Relevance: The results of our study indicate that it would be prudent for players to initially perform standing throws at shorter distances and only later be allowed to employ a natural crow hop at greater distances to minimize torque placed on the medial elbow during UCL rehabilitation protocols.

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) has emerged as a dynamic, efficient, and validated patient-reported outcome measure in the field of orthopaedics. However, the responsiveness, which is defined as the ability to detect changes in scores over time, of PROMIS computer adaptive tests (CATs) after anterior cruciate ligament reconstruction (ACLR) has not been well documented., Purpose: To investigate the responsiveness up to 1 year postoperatively of multiple PROMIS CAT domains in patients undergoing ACLR., Study Design: Cohort study (diagnosis); Level of evidence, 3., Methods: All patients who underwent ACLR by 1 of 2 fellowship-trained sports medicine orthopaedic surgeons, with preoperative and at least 6 months postoperative visits, were included in this study. PROMIS CAT physical function (PF), pain interference (PI), and depression (D) scores from each visit were collected and analyzed. Preoperative patient-centric factors, including demographic factors and meniscal pathology, were analyzed for associations with improvements in PROMIS scores., Results: A total of 100 patients (62 male patients and 38 female patients; mean age, 27.6 ± 11.8 years) with an average follow-up of 338.5 ± 137.5 days were included in this study. Preoperative PF, PI, and D scores improved significantly from 38.5 ± 7.3, 60.3 ± 7.0, and 47.9 ± 9.1, respectively, to 53.6 ± 10.3, 48.1 ± 8.5, and 41.0 ± 9.9, respectively ( P < .001 for each domain). Lower preoperative PF scores, PI scores, and a lower body mass index (BMI) were predictive for greater improvements in PF. Higher preoperative PI scores and a lower BMI were predictors for greater improvements in PI. Meniscal pathology was not predictive of improvement in PROMIS scores., Conclusion: PROMIS CAT assessments of PF, PI, and D demonstrated responsiveness in patients undergoing ACLR up to 1 year. Worse preoperative PROMIS scores and a lower BMI were predictive of greater improvements in PROMIS scores., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: E.C.M. has received educational support from Arthrex and Pinnacle, consulting fees from Smith & Nephew, speaking fees from Xodus Medical, royalties from Springer, and hospitality payments from Stryker. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2021.)

Previous studies demonstrate that Mycobacterium vaccae NCTC 11659 ( M. vaccae ), a soil-derived bacterium with anti-inflammatory and immunoregulatory properties, is a potentially useful countermeasure against negative outcomes to stressors. Here we used male C57BL/6NCrl mice to determine if repeated immunization with M. vaccae is an effective countermeasure in a "two hit" stress exposure model of chronic disruption of rhythms (CDR) followed by acute social defeat (SD). On day -28, mice received implants of biotelemetric recording devices to monitor 24-h rhythms of locomotor activity. Mice were subsequently treated with a heat-killed preparation of M. vaccae (0.1 mg, administered subcutaneously on days -21, -14, -7, and 27) or borate-buffered saline vehicle. Mice were then exposed to 8 consecutive weeks of either stable normal 12:12 h light:dark (LD) conditions or CDR, consisting of 12-h reversals of the LD cycle every 7 days (days 0-56). Finally, mice were exposed to either a 10-min SD or a home cage control condition on day 54. All mice were exposed to object location memory testing 24 h following SD. The gut microbiome and metabolome were assessed in fecal samples collected on days -1, 48, and 62 using 16S rRNA gene sequence and LC-MS/MS spectral data, respectively; the plasma metabolome was additionally measured on day 64. Among mice exposed to normal LD conditions, immunization with M. vaccae induced a shift toward a more proactive behavioral coping response to SD as measured by increases in scouting and avoiding an approaching male CD-1 aggressor, and decreases in submissive upright defensive postures. In the object location memory test, exposure to SD increased cognitive function in CDR mice previously immunized with M. vaccae . Immunization with M. vaccae stabilized the gut microbiome, attenuating CDR-induced reductions in alpha diversity and decreasing within-group measures of beta diversity. Immunization with M. vaccae also increased the relative abundance of 1-heptadecanoyl-sn-glycero-3-phosphocholine, a lysophospholipid, in plasma. Together, these data support the hypothesis that immunization with M. vaccae stabilizes the gut microbiome, induces a shift toward a more proactive response to stress exposure, and promotes stress resilience., Competing Interests: CL serves on the Scientific Advisory Board of Immodulon Therapeutics, Ltd., is cofounder and Chief Scientific Officer of Mycobacteria Therapeutics Corporation, serves as an unpaid scientific consultant with Aurum Switzerland AG and serves at a member of the faculty of the Integrative Psychiatry Institute, Boulder, Colorado, United States. KPW has received research support from the National Institutes of Health, the Pac-12 Conference, and SomaLogic, Inc. outside of this work; consulting fees from or served as a paid member of scientific advisory boards for the Sleep Disorders Research Advisory Board – National Heart, Lung and Blood Institute and CurAegis Technologies, Circadian Therapeutics, Ltd.; and has received speaker/educational/travel consultant honorarium fees from the American Academy of Sleep Medicine, American College of Chest Physicians, American College of Sports Medicine, American Diabetes Association, Associated Professional Sleep Societies, Kellogg Company, and The European Association for the Study of Obesity. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Foxx, Heinze, González, Vargas, Baratta, Elsayed, Stewart, Loupy, Arnold, Flux, Sago, Siebler, Milton, Lieb, Hassell, Smith, Lee, Appiah, Schaefer, Panitchpakdi, Sikora, Weldon, Stamper, Schmidt, Duggan, Mengesha, Ogbaselassie, Nguyen, Gates, Schnabel, Tran, Jones, Vitaterna, Turek, Fleshner, Dorrestein, Knight, Wright and Lowry.)

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) is a powerful set of patient-reported outcome measures (PROMs) that are gaining popularity throughout orthopaedic surgery. The use of both adult and pediatric PROMIS questionnaires in orthopaedic sports medicine limits the value of the PROMIS in routine sports medicine clinical care, research, and quality improvement. Because orthopaedic sports medicine surgeons see patients across a wide age range, simplifying the collection of PROMIS computer adaptive tests (CATs) to a single set of questionnaires, regardless of age, is of notable value., Purpose/hypothesis: The purpose was to determine the strength of the correlation between the pediatric and adult PROMIS questionnaires. We hypothesized that there would be a high correlation between the adult and pediatric versions for each PROMIS domain, thereby justifying the use of only the adult version for most sports medicine providers, regardless of patient age., Study Design: Cohort study (Diagnosis); Level of evidence, 2., Methods: Between December 2018 and December 2019, all pediatric sports medicine patients presenting to a single, academic, orthopaedic sports medicine clinic were asked to participate in the present study with their parents' consent. Patients were asked to complete a set of adult PROMIS domains (Physical Function and/or Upper Extremity, Pain Interference, and Depression) as well as a set of pediatric PROMIS domains (Mobility and/or Upper Extremity, Pain Interference, and Depressive Symptoms). Concurrent validity was assessed using Pearson correlation coefficients ( r ). Ceiling and floor effects were determined., Results: A total of 188 patients met our inclusion criteria. The correlation between the adult and pediatric PROMIS Upper Extremity, Physical Function and Mobility, Pain Interference, and Depression and Depressive Symptoms forms were high-moderate ( r = 0.68; P < .01), high-moderate ( r = 0.69; P < .01), high ( r = 0.78; P < .01), and high ( r = 0.85; P < .01), respectively. Both adult and pediatric depression-related PROMIS domains demonstrated notable floor effects (adult: 38%; pediatric: 24%). The pediatric PROMIS Upper Extremity domain demonstrated a ceiling effect (20%)., Conclusion: Adult PROMIS CATs may be used in an orthopaedic sports medicine clinic for both adult and pediatric patients. Our findings will help decrease the amount of resources needed for the implementation and use of PROMs for patient care, research, and quality improvement in orthopaedic sports medicine clinics.

We have discovered and studied a tele -substitution reaction in a biologically important heterocyclic ring system. Conditions that favor the tele -substitution pathway were identified: the use of increased equivalents of the nucleophile or decreased equivalents of base or the use of softer nucleophiles, less polar solvents, and larger halogens on the electrophile. Using results from X-ray crystallographic and isotope labeling experiments, a mechanism for this unusual transformation is proposed. We focused on this triazolopyrazine as it is the core structure of the in vivo active antiplasmodium compounds of Series 4 of the Open Source Malaria consortium.

Objectives: Term limits might be appropriate for leadership positions in academic public health. This study assessed the appointment processes and terms for deans, directors, and chairs of schools and programs of public health and their views on term limits., Methods: A 10-question survey was developed for the Association of Schools and Programs of Public Health and provided electronically to 127 deans and program directors in November and December 2019, of whom 58 (46%) responded., Results: Of 54 respondents to the question on term limits, 45 deans and directors of schools and programs of public health served with no terms or limits and 9 served with terms of 3-5 years with no limits on the number of terms. Respondents largely agreed with most arguments for or against term limits. Of 51 respondents, most indicated completely or moderately valid support for 2 arguments for term limits: diversity (n = 40) and succession planning (n = 40). Of 51 respondents, most indicated completely or moderately valid support for 3 arguments against term limits: stable and continuous leadership (n = 40), time for leadership development (n = 37), and loss of institutional memory (n = 35). Twenty-seven of 53 responding deans and directors viewed the most appropriate terms and limits as being more restrictive than their current terms; the other 26 viewed the most appropriate terms as being the same as their current terms. No respondents preferred less restrictive limits than their current terms., Conclusion: Although term limits for deans, directors, and chairs are rare in schools and programs of public health, many deans and directors view term limits as appropriate. Schools and programs may reconsider their current policies for term limits.

A new species of congrid eel, Bathycongrus villosus sp. nov., is described from the Philippines and Vanuatu. It is similar to some of the small-toothed species currently placed in Bathycongrus and to the species of Bassanago. In this paper we compare the new species to Bassanago albescens (Barnard, 1923) and to Bathycongrus parviporus Karmovskaya, 2011, which it most closely resembles. An analysis of 19 characters shows that it agrees with Bat. parviporus in 16 characters and with Bas. albescens in one. In two characters, the three species are all different. We therefore place it in Bathycongrus.

The COVID-19 pandemic has made the public more aware of public health and the role its professionals play in addressing the pandemic. Schools and programs in public health have a new opportunity to recruit, train, and sustain the public health workforce. Academic public health can further educate the public and prepare students for meaningful careers through interprofessional education and practice-based learning.

Background: Patient safety and safety culture have received increasing attention from agencies such as the Agency of Healthcare Research and Quality and the Institute of Medicine. Safety culture refers to the fundamental values, attitudes, and perceptions that provide a unique source of competitive advantage to improve performance. This study contributes to the literature and expands understanding of safety culture and hospital performance outcomes when considering electronic health record (EHR) usage., Purpose: Based on the resource-based view of the firm, this study examined the association between safety culture and hospital quality and financial performance in the presence of EHR., Methodology/approach: Data consist of the 2016 Hospital Survey on Patient Safety, Hospital Compare, American Hospital Association's annual survey, and the American Hospital Association's Information Technology supplement. Our final analytic sample consisted of 154 hospitals. We used a two-part nested regression model approach., Results/conclusion: Safety culture has a direct positive relationship with financial performance (operating margin). Furthermore, having basic EHR as compared to not having EHR further enhances this positive relationship. On the other hand, safety culture does not have a direct association with quality performance (readmissions) in most cases. However, safety culture coupled with basic EHR functionalities, compared to not having EHR, is associated with lower readmissions., Practice Implications: Hospitals should strive to improve patient safety culture as part of their strategic plan for quality improvement. In addition, hospital managers should consider implementing EHR as a resource that can support safety culture's effect on outcomes such as financial and quality performance indicators. Future studies can examine the differences between basic and advanced EHR presence in relation to safety culture.

Background: Macaque species share >93% genome homology with humans and develop many disease phenotypes similar to those of humans, making them valuable animal models for the study of human diseases (e.g., HIV and neurodegenerative diseases). However, the quality of genome assembly and annotation for several macaque species lags behind the human genome effort., Results: To close this gap and enhance functional genomics approaches, we used a combination of de novo linked-read assembly and scaffolding using proximity ligation assay (HiC) to assemble the pig-tailed macaque (Macaca nemestrina) genome. This combinatorial method yielded large scaffolds at chromosome level with a scaffold N50 of 127.5 Mb; the 23 largest scaffolds covered 90% of the entire genome. This assembly revealed large-scale rearrangements between pig-tailed macaque chromosomes 7, 12, and 13 and human chromosomes 2, 14, and 15. We subsequently annotated the genome using transcriptome and proteomics data from personalized induced pluripotent stem cells derived from the same animal. Reconstruction of the evolutionary tree using whole-genome annotation and orthologous comparisons among 3 macaque species, human, and mouse genomes revealed extensive homology between human and pig-tailed macaques with regards to both pluripotent stem cell genes and innate immune gene pathways. Our results confirm that rhesus and cynomolgus macaques exhibit a closer evolutionary distance to each other than either species exhibits to humans or pig-tailed macaques., Conclusions: These findings demonstrate that pig-tailed macaques can serve as an excellent animal model for the study of many human diseases particularly with regards to pluripotency and innate immune pathways., (© The Author(s) 2020. Published by Oxford University Press.)

The taxonomic status of the widely distributed Indo-Pacific undulated moray eel, Gymnothorax undulatus, is revised using morphological and genetics features. Ninety-seven specimens previously identified as G. undulatus were examined and their mitochondrial COI and 16S rRNA genes were analysed. The multivariate analysis of eight morphometric characters resulted in separation with little to no overlap among some geographic regions. These groupings explained more than 90% of the total variation, with 86.6% overall classification. Two color morphs were identified, and the South African population was described as new species, Gymnothorax elaineheemstrae n. sp., distinct from G. undulatus in having mottled and faintly reticulated color pattern, 134-136 total vertebrae and further confirmed by the genetic analysis of COI and 16S rRNA with > 0.1 genetic distance. The morphological and genetics results indicate that G. undulatus, previously treated as a single species, consists of more than one species.

Background: Rehabilitation following elbow ulnar collateral ligament reconstruction in baseball pitchers relies on a progression of pitching activities to ensure protection and gradual strengthening of the reconstructed ligament. The purpose of this study was to determine the medial elbow torque associated with pitches at various effort levels and determine whether radar gun assistance improves players' abilities to accurately match partial-effort pitches with true references based on maximum pitch velocity., Methods: Thirty-seven healthy high school and collegiate baseball pitchers were included in this study. Participants were excluded if they were injured, recovering from injury, or otherwise not currently pitching at full effort. Pitch parameters were collected using a validated wearable sensor. Participants threw 5 pitches at 50%, 75%, and 100% subjective effort. Pitchers then threw 5 pitches at 50% maximum velocity and 75% maximum velocity, as measured by a radar gun., Results: Thirty-seven pitchers completed this study. Pitches thrown at 50% and 75% partial effort were significantly faster and generated higher elbow torque than did pitches thrown at 50% and 75% velocity, respectively (P < .001). A 10% decrease in percentage of maximum velocity was associated with a 13% decrease in percentage of maximum elbow torque (β coefficient = 1.3, R 2 = 0.81, P < .001)., Conclusion: Pitchers generate higher-than-intended forces when throwing at 50% and 75% effort during a subjective partial-effort throwing protocol. Use of a radar gun to guide partial-effort throwing during throwing rehabilitation programs may protect the reconstructed elbow from excess medial torque., (Copyright © 2019. Published by Elsevier Inc.)

Purpose: To perform a systematic review to answer the following: (1) What are the floor and ceiling (F/C) effects of the Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive test (CAT) domains of physical function (PF), upper extremity physical function (UE), pain interference (PI), and depression (D) in adult orthopaedic patients? (2) Do the PROMIS-PF and PROMIS-PI domains have differing F/C effects depending on use in upper extremity, lower extremity, spine, neck, and back, or trauma patients?., Methods: (Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines were followed, the review was registered on PROSPERO, and the methodological index for non-randomized studies was used for this systematic review. Studies reporting the F/C effects of at least 1 of 4 PROMIS CAT domains in orthopaedic patient cohorts accessed through PubMed and Embase on October 30, 2018, were included. F/C effects for each study were reported within forest plots., Results: Forty-three studies were included. Generally, varying cohorts demonstrated no F/C effects for PROMIS-PF (0%-9.0%), variable ceiling effects for PROMIS-UE (lower in v2.0; 0%-28.2%), variable floor effects for PROMIS-PI (0%-19.0%), and significant floor effects for PROMIS-D (0.4%-23.4%)., Conclusions: The orthopaedic literature demonstrated generally favorable floor and ceiling effects for PROMIS CAT domains, with the exception of variable ceiling effects for PROMIS-UE (the newer version exhibits only minor effects), variable floor effects for PROMIS-PI, and significant floor effects for PROMIS-D. In addition, the F/C effects of PROMIS-PF did not vary based on patient population. Although the floor effects of PROMIS-PI did vary based on patient population, the variability does not appear to be based solely on anatomic location. The PROMIS-PF and PROMIS-UE v2.0 demonstrate consistently low floor and ceiling effects. However, the PROMIS-PI and PROMIS-D may need modification before widespread adoption for clinical and research purposes., Level of Evidence: III; systematic review of Level I-III studies., (Copyright © 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)

Background: Overuse injuries of the shoulder and elbow continue to be prevalent in elite baseball pitchers. Pitch velocity has been shown to impact medial elbow torque in adolescent baseball pitchers. However, the determinants of medial elbow torque in professional baseball pitchers are not known., Purpose: To determine the influence of pitch type, velocity, and player characteristics on medial elbow torque in professional baseball pitchers., Methods: Professional baseball pitchers were recruited for participation. Height, weight, body mass index (BMI), and throwing arm measurements were obtained for all study participants. While wearing a gyroscopic sensor equipped with an accelerometer, participants were instructed to throw a standard, randomized sequence of fastballs, changeups, and curveballs. Elbow torque, arm slot, arm speed, shoulder rotation, and ball velocity were recorded for each pitch. A linear mixed model was used to evaluate the association of pitch type with each pitch parameter, adjusting for pitchers' demographics., Results: A total of 12 professional baseball pitchers were included in this study. Among the pitch types, medial elbow torque was significantly higher in fastballs than in curveballs (P = .001). An increased BMI value was independently associated with decreased elbow torque in pitchers (P = .035)., Conclusion: Fastballs place significantly higher torque on the medial elbow than do curveballs, which is consistent with previous studies done on high school and collegiate populations. Pitchers with a higher BMI experience significantly less torque across the medial elbow., (Copyright © 2019. Published by Elsevier Inc.)

Study Objective: A large proportion (50%-75%) of youth (younger than 21 years old) who become pregnant gain more weight during pregnancy than is recommended by the National Academy of Medicine. Excess weight gain during pregnancy is a strong risk factor for long-term obesity among mothers and their infants. There is a significant gap in our understanding of youth's knowledge and behavior related to weight gain during pregnancy. To develop effective interventions for pregnant youth, it is necessary to understand their distinct needs and preferences. Using a youth-centered qualitative approach, the purpose of this study was to explore the knowledge, behaviors, and social factors that influence weight gain during pregnancy for youth., Design: Participants completed weekly text message surveys and semistructured interviews to explore their perspectives of weight gain during pregnancy. Data were analyzed using qualitative thematic analysis on the basis of grounded theory., Setting and Participants: Pregnant youth ages 16-24 years old recruited from 2 urban, low-income, primary care clinics in Southeast Michigan., Interventions, Main Outcome Measures, and Results: Among our sample (N = 54) 4 themes emerged. First, many youths were knowledgeable about healthy behaviors in pregnancy. However, the second theme showed that many youths reported barriers to engaging in these healthy behaviors, including stress, poor motivation, and issues of convenience. Third, they showed inadequate knowledge about exercise in pregnancy, and fourth, many endorsed food cravings that significantly influenced diet choices., Conclusion: Many pregnant youths have appropriate knowledge about healthy behaviors during pregnancy, but face many youth-specific barriers to achieving these behaviors. Interventions should address logistical challenges (eg, food access, cost, transportation) to healthy behaviors in pregnancy to make healthy diet and exercise more convenient for pregnant youth., (Copyright © 2020 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Thirty-eight species of moray eels (Muraenidae) from the Red Sea are reported in an updated review. A species account is provided for each species, along with a full synonymy of all nominal species described from the Red Sea. One species is new to science, G. pharaonis, and two species are new for the Red Sea, Gymnothorax phasmatodes (Smith) and Scuticaria tigrina (Lesson). Gymnothorax pharaonis n. sp. is a common species that has long been misidentified as G. undulatus (Lacepède), although it more closely resembles G. margaritophorus Bleeker, to which it is closely related phylogenetically. It is characterized by the following combination of characters: total vertebrae 123-128; body slender, depth at anus 17-28 in TL; maxillary teeth biserial, dentary and vomerine teeth in a single row; color brown with irregular dendritic pale markings, not interconnected or chain-like, with oblique, conspicuous, parallel streaks posteriorly in dorsal fin. The new record of the distinctive whitish G. phasmatodes is based on an underwater photograph taken at Jeddah, Saudi Arabia. The new record of Scuticaria tigrina is based on a specimen collected from Jeddah, Saudi Arabia, and underwater photographs taken from the northern part of the Red Sea. Based on an integrative taxonomical approach by a combination of morphological and phylogenetic analyses and re-examination of holotype specimens, Gymnothorax cinerascens (Rüppell) is resurrected as a valid species, and it is shown that previous records of G. hepaticus (Rüppell), with which it has previously been synonymized, should refer to G. cinerascens. The true G. hepaticus is redescribed based on examination of the holotype and additional specimens collected during the course of this study. The two species are distinguished by the color of the jaws, the position of the median intermaxillary teeth, and a slight difference in the preanal length. They are also clearly distinct genetically. The Red Sea record of Gymnothorax atolli (Pietschmann) is based on an error, possibly a misidentification of G. griseus (Lacepède). A key to the species of Red Sea moray eels and a phylogenetic tree of presently known lineages of Indo-Pacific moray eels are provided including recently collected Red Sea specimens.

The Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CATs) have emerged as an efficient technique for measuring patient-reported outcomes among orthopaedic patients. The purpose of this study was to investigate the floor and ceiling (F/C) effects, time to completion (TTC), and question burden of PROMIS CATs administered to patients presenting to a shoulder and sports medicine orthopaedic clinic., Methods: Patients prospectively completed PROMIS CATs including the physical function (PROMIS-PF) or upper-extremity function (PROMIS-UE), pain interference (PROMIS-PI), and depression (PROMIS-D) domains at their initial encounter and were retrospectively included in this study. Adult patients indicating a single problem involving either the shoulder or knee were included. Patients were also grouped as either preoperative or nonoperative. F/C effects were defined as the proportion of respondents scoring the highest (ceiling) or lowest (floor) possible score across a given domain., Results: Included were 2,952 patients (average age, 51.0 ± 16.9 years). The PROMIS-UE, PROMIS-PF, and PROMIS-PI demonstrated negligible F/C effects across all shoulder and knee patients (<2%). The PROMIS-D displayed moderate to significant floor effects (13.9% to 18.9%) and a 0% ceiling effect in all main patient groups. The mean TTC and mean question burden of the PROMIS-UE, PROMIS-PF, and PROMIS-PI ranged from 45.3 to 54.4 seconds and 4.1 to 4.9 questions for all patient groups, while the PROMIS-D exhibited a TTC ranging from 20.9 to 38.6 seconds for all groups and a question burden that ranged from 6.2 to 6.7 questions., Conclusions: The PROMIS-PF, PROMIS-UE, and PROMIS-PI demonstrated favorable F/C effects, TTC, and question burden among both nonoperative and preoperative patients. These findings justify consideration of the PROMIS-PF, PROMIS-UE, and PROMIS-PI for clinical and research applications involving shoulder and knee sports medicine patients. Additionally, we found moderate to significant floor effects for the PROMIS-D in all patient groups, which may be multifactorial in nature and may not be unexpected in patients with an isolated joint concern., Clinical Relevance: This study highlights the psychometric properties of PROMIS CAT forms for knee and shoulder patients. Understanding these basic properties is important in considering the adoption of PROMIS CAT forms for patients with musculoskeletal conditions., (Copyright © 2019 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved.)

Compatibility tests to identify A, B, and O alleles are critical for establishing suitable donor-recipient matches among experimental animals. Using a qPCR-based SNP probe assay, we have identified A, B, AB, and indeterminate blood group phenotypes in cynomolgus and rhesus macaques. We have hypothesized, albeit without molecular confirmation, that the indeterminate phenotype represents homozygosity for the null O allele at the macaque ABO locus. The indeterminate phenotype represents the unsuccessful detection of either A or B alleles using primers targeting the A-specific and B-specific single nucleotide polymorphisms (SNPs) in a variable region of exon 7 of the ABO locus. These SNPs are associated with two functional sites, detected using two allele-specific probes in the qPCR assay where the codons leucine and methionine (at codon 266) and glycine and alanine (at codon 268) are required for the synthesis of the A and B transferases, respectively. While reference sequences for the A and B alleles exhibited no novel mutations in the functional exon, plasmid Sanger sequence analyses showed unique mutations within the diagnostic target sites in 10 macaques exhibiting the indeterminate phenotype. Eight of these indeterminate individuals exhibited SNPs at codon 268 that should prevent the syntheses of an A or B transferase. While the two other indeterminate samples had functional codons that were consistent with A or B alleles, mutations in either their probe- or primer-binding sites that altered their peptide sequences probably impeded their detection by our assay., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Under pressures to support health system transformation, many health professional accreditation organizations have incorporated standards requiring interprofessional education. However, the inclusion of population health topics and public health or health administration students into IPE experiences is limited. With the belief that understanding and cooperation among the health professions will be important to support health system transformation, The Louisiana State University Health Sciences Center-New Orleans has created several IPE experiences focused on population health, programs that are examined in this article along with insights that could prove useful for other programs seeking to build IPE into their regular curricula.

Objectives Pregnant young women gain more weight than recommended by the National Academy of Medicine, increasing the likelihood of adverse maternal and fetal outcomes. The purpose of this study is to use online social media to understand beliefs and practices surrounding weight gain, diet and exercise during pregnancy among young women. Methods Facebook posts were mined from young women ages 16 to 24 during pregnancy who were consented from two Midwest primary care clinics serving low-income communities. Natural language processing was used to identify posts related to weight gain, exercise and diet by keyword searching. Two investigators iteratively coded the mined posts and identified major themes around health behaviors. Outcome measures included the frequency of posts and major themes regarding health behaviors during pregnancy. Results Participants (n = 43) had a mean age of 21 (SD 2.3), and the largest subgroups identified as black (49%; 26% white, 16% Hispanic, 9% other) and having graduated from high school (49%; 24% completed some high school and 24% completed at least some post-secondary education). Among the 2899 pregnancy posts analyzed, 311 were related to weight. Major themes included eating behaviors and cravings (58% of identified posts), body image (24%), the influence of family, partners and friends (14%), and the desire to exercise (4%). Conclusions for practice Facebook posts revealed that young women often frame their thoughts and feelings regarding weight gain in pregnancy in the context of food cravings and body image and that friends and family are important influencers to these behaviors.

Background: Alterations in throwing mechanics have been identified as a risk factor for overuse injuries in baseball players. Glenohumeral internal rotation deficit (GIRD) has been found to adversely affect throwing mechanics, but the effect of GIRD on medial elbow torque is unclear., Purpose: To investigate the relationship between GIRD and medial elbow torque in high school-aged baseball pitchers., Study Design: Descriptive laboratory study., Methods: High school baseball pitchers (14-18 years old) were recruited for participation in this study. Players' height, weight, body mass index, and arm measurements were recorded as well as shoulder and elbow range of motion measurements. GIRD was calculated from the difference between dominant and nondominant shoulder internal rotation. Participants then pitched 5 fastballs at maximum effort while wearing a wireless sensor that recorded elbow torque, arm slot, arm speed, shoulder rotation, and ball velocity. Principal component analysis was performed to determine which variables were associated with elbow torque or ball velocity., Results: Twenty-three high school pitchers participated in this study; 35% (n = 8) of participants exhibited GIRD of at least 20°. The mean GIRD was 15.3°± 11.2° and was not a predictor of medial elbow torque ( P = .205) or ball velocity ( P = .333). Ball velocity, age, and height were predictors of medial elbow torque ( P = .012, P = .003, and P = .024, respectively)., Conclusion: In high school baseball pitchers, GIRD was not associated with medial elbow torque during the pitching motion. Instead, ball velocity, player age, and player height carried greater significance., Clinical Relevance: This study suggests that high school pitchers with GIRD do not have an inherently greater risk for increased medial elbow torque during the throwing motion. It is recommended that pitchers instead assess their ball velocity to evaluate for relative differences in medial elbow torque.

Purpose: Diabetes leads to progressive complications such as diabetic retinopathy, which is the leading cause of blindness within the working-age population worldwide. Interleukin (IL)-17A is a cytokine that promotes and progresses diabetes. The objective of this study was to determine the role of IL-17A in retinal capillary degeneration, and to identify the mechanism that induces retinal endothelial cell death. These are clinically meaningful abnormalities that characterize early-stage non-proliferative diabetic retinopathy., Methods: Retinal capillary degeneration was examined in vivo using the streptozotocin (STZ) diabetes murine model. Diabetic-hyperglycemia was sustained for an 8-month period in wild type (C57BL/6) and IL-17A -/- mice to elucidate the role of IL-17A in retinal capillary degeneration. Further, ex vivo studies were performed in retinal endothelial cells to identify the IL-17A-dependent mechanism that induces cell death., Results: It was determined that diabetes-induced retinal capillary degeneration was significantly lower in IL-17A -/- mice. Further, retinal endothelial cell death occurred through an IL-17A/IL-17R ➔ Act1/FADD signaling cascade, which caused caspase-mediated apoptosis., Conclusion: These are the first findings that establish a pathologic role for IL-17A in retinal capillary degeneration. Further, a novel IL-17A-dependent apoptotic mechanism was discovered, which identifies potential therapeutic targets for the early onset of diabetic retinopathy., (Published by Elsevier Inc.)

Rationale: Mycobacterium vaccae (NCTC 11659) is an environmental saprophytic bacterium with anti-inflammatory, immunoregulatory, and stress resilience properties. Previous studies have shown that whole, heat-killed preparations of M. vaccae prevent allergic airway inflammation in a murine model of allergic asthma. Recent studies also demonstrate that immunization with M. vaccae prevents stress-induced exaggeration of proinflammatory cytokine secretion from mesenteric lymph node cells stimulated ex vivo, prevents stress-induced exaggeration of chemically induced colitis in a model of inflammatory bowel disease, and prevents stress-induced anxiety-like defensive behavioral responses. Furthermore, immunization with M. vaccae induces anti-inflammatory responses in the brain and prevents stress-induced exaggeration of microglial priming. However, the molecular mechanisms underlying anti-inflammatory effects of M. vaccae are not known., Objectives: Our objective was to identify and characterize novel anti-inflammatory molecules from M. vaccae NCTC 11659., Methods: We have purified and identified a unique anti-inflammatory triglyceride, 1,2,3-tri [Z-10-hexadecenoyl] glycerol, from M. vaccae and evaluated its effects in freshly isolated murine peritoneal macrophages., Results: The free fatty acid form of 1,2,3-tri [Z-10-hexadecenoyl] glycerol, 10(Z)-hexadecenoic acid, decreased lipopolysaccharide-stimulated secretion of the proinflammatory cytokine IL-6 ex vivo. Meanwhile, next-generation RNA sequencing revealed that pretreatment with 10(Z)-hexadecenoic acid upregulated genes associated with peroxisome proliferator-activated receptor alpha (PPARα) signaling in lipopolysaccharide-stimulated macrophages, in association with a broad transcriptional repression of inflammatory markers. We confirmed using luciferase-based transfection assays that 10(Z)-hexadecenoic acid activated PPARα signaling, but not PPARγ, PPARδ, or retinoic acid receptor (RAR) α signaling. The effects of 10(Z)-hexadecenoic acid on lipopolysaccharide-stimulated secretion of IL-6 were prevented by PPARα antagonists and absent in PPARα-deficient mice., Conclusion: Future studies should evaluate the effects of 10(Z)-hexadecenoic acid on stress-induced exaggeration of peripheral inflammatory signaling, central neuroinflammatory signaling, and anxiety- and fear-related defensive behavioral responses.

Caffeine is the most commonly used drug in the world. However, animal studies suggest that chronic consumption of caffeine during adolescence can result in enhanced anxiety-like behavioral responses during adulthood. One mechanism through which chronic caffeine administration may influence subsequent anxiety-like responses is through actions on brainstem serotonergic systems. In order to explore potential effects of chronic caffeine consumption on brainstem serotonergic systems, we evaluated the effects of a 28-day exposure to chronic caffeine (0.3 g/L; postnatal day 28-56) or vehicle administration in the drinking water, followed by 24 h caffeine withdrawal, and subsequent challenge with caffeine (30 mg/kg; s.c.) or vehicle in adolescent male rats. In Experiment 1, acute caffeine challenge induced a widespread activation of serotonergic neurons throughout the dorsal raphe nucleus (DR); this effect was attenuated in rats that had been exposed to chronic caffeine consumption. In Experiment 2, acute caffeine administration profoundly decreased tph2 and slc22a3 mRNA expression throughout the DR, with no effects on htr1a or slc6a4 mRNA expression. Chronic caffeine exposure for four weeks during adolescence was sufficient to decrease tph2 mRNA expression in the DR measured 28 h after caffeine withdrawal. Chronic caffeine administration during adolescence did not impact the ability of acute caffeine to decrease tph2 or slc22a3 mRNA expression. Together, these data suggest that both chronic caffeine administration during adolescence and acute caffeine challenge during adulthood are important determinants of serotonergic function and serotonergic gene expression, effects that may contribute to chronic effects of caffeine on anxiety-like responses., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The association between stimulant drug use and aberrant reward processing is well-documented in the literature, but the nature of these abnormalities remains elusive. The present study aims to disentangle the separate and interacting effects of stimulant drug use and pre-existing familial risk on abnormal reward processing associated with stimulant drug addiction. We used the Monetary Incentive Delay task, a well-validated measure of reward processing, during fMRI scanning in four distinct groups: individuals with familial risk who were either stimulant drug-dependent (N = 41) or had never used stimulant drugs (N = 46); and individuals without familial risk who were either using stimulant drugs (N = 25) or not (N = 48). We first examined task-related whole-brain activation followed by a psychophysiological interaction analysis to further explore brain functional connectivity. For analyses, we used a univariate model with two fixed factors (familial risk and stimulant drug use). Our results showed increased task-related activation in the putamen and motor cortex of stimulant-using participants. We also found altered task-related functional connectivity between the putamen and frontal regions in participants with a familial risk (irrespective of whether they were using stimulant drugs or not). Additionally, we identified an interaction between stimulant drug use and familial risk in task-related functional connectivity between the putamen and motor-related cortical regions in potentially at-risk individuals. Our findings suggest that abnormal task-related activation in motor brain systems is associated with regular stimulant drug use, whereas abnormal task-related functional connectivity in frontostriatal brain systems, in individuals with familial risk, may indicate pre-existing neural vulnerability for developing addiction.

Evidence suggests that affective disorders are associated with altered thermoregulation, and it has been hypothesized that therapeutic strategies targeting body-to-brain thermosensory systems may be effective for treating depression. Consistent with this hypothesis, a recent randomized, double blind, placebo-controlled clinical trial has suggested that infrared whole-body hyperthermia has therapeutic potential for the treatment of depression. Preclinical models may help uncover the mechanism(s) underlying the antidepressant-like effects of whole-body heating. We have previously shown that exposure to whole-body heating potentiates antidepressant-like behavioural responses following administration of a behaviourally subthreshold dose of the selective serotonin reuptake inhibitor citalopram, but the neurochemical and behavioural interactions between whole body heating and behaviourally effective doses of citalopram are not known. In these experiments, we examined the effects of whole-body heating, either with or without treatment of a suprathreshold dose of citalopram (20 mg/kg, s.c.), on body temperature, antidepressant-like behavioural responses in the forced swim test, and tissue concentrations of serotonin and its metabolite, 5-hydoxyindoleacetic acid (5-HIAA), in the prefrontal cortex of adolescent male Wistar rats. Although whole-body heating did not potentiate the behavioural effects of suprathreshold citalopram, citalopram was observed to increase body temperature and potentiate the effects of whole-body heating on body temperature. Whole-body heating, by itself, decreased serotonin concentrations in the infralimbic cortex to a level similar to that observed following treatment with citalopram, suggesting that these treatments have convergent effects on a mesolimbocortical system innervating the medial prefrontal cortex, an effect that was correlated with effects of treatment on body temperature., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Knowledge of the macaque ABO blood group system has been critical in the development of nonhuman primates (NHPs) as a translational model. Serving not only as a useful homologue of the disease-linked ABO system in humans, macaque ABO blood groups must be typed in colonies prior to performing experimental procedures requiring blood transfusion or transplantation. While the rates of blood type incompatibility and the distributions of A, B and AB blood groups are known in large samples of rhesus (Macaca mulatta) and cynomolgus (M. fascicularis) macaques, there is a dearth of blood type data from macaque populations occupying the rhesus-cynomolgus hybrid zone in Southeast Asia. Using molecular phenotyping, we profiled ABO blood group distributions of 232 macaques from 10 populations in the hybrid zone and compared them to pure blood populations of the two species. We found that while these distributions are significantly different in most populations, there was a lack of differentiation between the hybrid and cynomolgus macaques as well as between the Thai and neighbouring populations. This supports a more expansive model of hybridization between rhesus and cynomolgus macaques than often proposed and highlights the increased need for consideration of population genetic structure in biomedical studies that employ macaques as animal models. Additionally, we report an enrichment of indeterminate blood types in the hybrid populations., (© 2018 John Wiley & Sons Ltd.)

This longitudinal study examines whether readmission rates, made transparent through Hospital Compare, affect hospital financial performance by examining 98 hospitals in the State of Washington from 2012 to 2014. Readmission rates for acute myocardial infarction (AMI), pneumonia (PN), and heart failure (HF) were examined against operating revenues per patient, operating expenses per patient, and operating margin. Using hospital-level fixed effects regression on 276 hospital year observations, the analysis indicated that a reduction in AMI readmission rates is related with increased operating revenues as expenses associated with costly treatments related with unnecessary readmissions are avoided. Additionally, reducing readmission rates is related with an increase in operating expenses. As a net effect, increased PN readmission rates may show marginal increase in operating margin because of the higher operating revenues due to readmissions. However, as readmissions continue to happen, a gradual increase in expenses due to greater use of resources may lead to decreased profitability.

Pattern recognition methods such as linear discriminant analysis and principal component analysis are useful tools for the identification of analytes such as metal ions. These typically use a number of distinct molecular probes that exhibit cross-reactivity. Here we report a single molecule that demonstrates varying response in different solvents, therefore enabling the combination of probe and solvent to generate the required array diversity. Seven toxic metal ions were introduced as aqueous samples, and PCA and LDA techniques applied. The array could correctly identify all metals in pure water samples, all metals in doped lake-water samples. Further, we have explored the limit of detection of the system for two metal ions, Cu(ii) and Hg(ii), confirming the promise of the system as a candidate to identify toxic metals in environmental water sources.

Background: Knowledge of major histocompatibility complex (MHC) composition and distribution in rhesus macaque colonies is critical for management strategies that maximize the utility of this model for biomedical research., Methods: Variation within the Mamu-A and Mamu-B (class I) and DRB, DQA/B, and DPA/B (class II) regions of 379 animals from the Caribbean Primate Research Center's (CPRC) specific pathogen free (SPF) colony was examined using massively parallel sequencing., Results: Analyses of the 7 MHC loci revealed a background of Indian origin with high levels of variation despite past genetic bottlenecks. All loci exhibited mutual linkage disequilibria while conforming to Hardy-Weinberg expectations suggesting the achievement of mutation-selection balance., Conclusion: The CPRC's SPF colony is a significant resource for research on AIDS and other infectious agents. Characterizing colony-wide MHC variability facilitates the breeding and selection of animals bearing desired haplotypes and increases the investigator's ability to understand the immune responses mounted by these animals., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)