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The objectives of this investigation were to (1) identify elements that comprise an acceptable quality of life (Q-L) post-traumatic brain injury (TBI) from the perspectives of patients and families, and (2) explore patient and family satisfaction with treatment decisions relevant to QoL. The authors created, tested, and administered two forms (patient; family) of a 35-question interview to 33 participants in a longitudinal TBI study (14 women, 19 men) and 33 associated family members. Men associated ratings of QoL with numerous variables, while women's responses revealed no significant relationships shared by QoL and other variables. Women reported a poorer QoL than did men. Older patients reported a better QoL than did younger patients. Families emphasized the family relationship, emotional control, and ability to concentrate when considering overall QoL. Patients did not. The majority of patients and families expressed satisfaction with decisions made about acute treatment. QoL research is essential to illuminate best practice models. [ABSTRACT FROM AUTHOR]

A discontinuous preparative polyacrylamide gel electrophoresis system has been developed and used to purify both the nicked and unnicked forms of tetanus toxin. The system was also used to prepare purified H and L chain peptides from the nicked toxin. The results show that the endogenous protease(s), which convert unnicked toxin to the nicked form, produce multiple species of nicked toxin, and heterogeneity in the H and L chains. The major amino termini of the toxins and their peptide components are: extract toxin, proline; filtrate toxin, proline, serine and asparagine; L chain, proline; and H chain, serine and asparagine. The L chain is located in the amino terminal position of the toxin molecule and the H chain the carboxy terminal end. A model is proposed to explain these results. Using the analytical ultracentrifuge, we have determined the molecular weights of extract and filtrate toxins to be 140 000 ± 5 000 and 128 000 ± 3 000, respectively. Using S DS-polyacrylamide gel electrophoresis we estimate the molecular weights of the H and L chains to be 87 000 and 48 000 daltons, respectively. Circular dichroic spectra of the toxins and their peptide components indicate that: the major tryptophanyl band in the toxin is contributed almost entirely by the H chain, the microenvironments of all the aromatics and disulfides in the two toxins appear to have small if any differences, the two toxins show little difference in their ordered secondary structure, and the two peptides when separated from one another still retain 80% of the helical structure that is present in the intact toxin but show a considerable loss of β-structure. The crystalline form of the nicked toxin has a hexagonal symmetry with two dimensional reciprocal lattice constants of 1/150 Å and 1/150 Å. The crystals appear to belong to the two dimensional plane group P6 suggesting that each unit cell contains 6 or a multiple of 6 toxin molecules. [ABSTRACT FROM AUTHOR]

Backgrounds: Exposure to adverse childhood experiences (ACEs) is associated with adverse neurobiological, developmental, cognitive, behavioral, psychological, and social consequences among children and adolescents. Psychosocial interventions hold promise for mitigating the negative impacts of ACEs, but there is a lack of updated and comprehensive evidence summarizing their effects qualitatively and quantitatively., Aims: We performed a systematic review and meta-analysis of existing evidence on the effectiveness of psychosocial interventions on children's outcomes, including internalizing and externalizing problems., Methods: We searched five database sources from inception to April 2024 for studies on the effectiveness of any psychosocial intervention in any outcome among children and adolescents aged 6-18 who experienced ACEs. We qualitatively synthesized the characteristics of the studies, samples, interventions, and outcomes. We quantitatively estimated the pooled effects of psychosocial interventions on a range of outcomes encompassing internalizing problems, externalizing problems, family relationships, coping, and self-esteem using meta-analysis. Additionally, we conducted a series of subgroup meta-analyses to compare the intervention effects based on sample and intervention characteristics., Results: Forty-four studies were included, with 20 randomized controlled trials, nine controlled trials, and 15 pre-post trials. Significant intervention effects were observed in internalizing problems (standardized mean difference, SMD = -0.36) and externalizing problems (SMD = -0.57), but not in family relationships, coping, or self-esteem. Subgroup analyses have identified various effective interventions for internalizing problems and externalizing problems, respectively., Conclusions: The evidence suggests that psychosocial interventions are effective in preventing internalizing and externalizing problems among children and adolescents who have experienced ACEs. Recommendations are provided for designing and evaluating future psychosocial interventions., Competing Interests: Declaration of competing interest All authors declare no conflicts of interest in this paper., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Background: Sleep problems are reported for up to 80% of autistic individuals. We examined whether parsimonious sets of items derived from the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and the Brief Infant Sleep Questionnaire (BISQ) are superior to the standard M-CHAT-R in predicting subsequent autism spectrum disorder (ASD) diagnoses., Methods: Participants from 11 Environmental influences on Child Health Outcomes (ECHO) cohorts were included. We performed logistic LASSO regression models with 10-fold cross-validation to identify whether a combination of items derived from the M-CHAT-R and BISQ are superior to the standard M-CHAT-R in predicting ASD diagnoses., Results: The final sample comprised 1552 children. The standard M-CHAT-R had a sensitivity of 44% (95% CI: 34, 55), specificity of 92% (95% CI: 91, 94), and AUROC of 0.726 (95% CI: 0.663, 0.790). A higher proportion of children with ASD had difficulty falling asleep or resisted bedtime during infancy/toddlerhood. However, LASSO models revealed parental reports of sleep problems did not improve the accuracy of the M-CHAT-R in predicting ASD diagnosis., Conclusion: While children with ASD had higher rates of sleep problems during infancy/toddlerhood, there was no improvement in ASD developmental screening through the incorporation of parent-report sleep metrics., Impact: Parental-reported sleep problems are common in autism spectrum disorder (ASD). We investigated whether the inclusion of parental-reports of infant/toddler sleep patterns enhanced the effectiveness of developmental screening for autism. We reported higher rates of difficulty falling asleep and resisting bedtime during infancy and toddlerhood among children later diagnosed with ASD; however, we did not find an improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. In our sample, the standard M-CHAT-R had a sensitivity of 39% among children of mothers with government insurance compared with a sensitivity of 53% among children of mothers with employer-based insurance., Competing Interests: Competing interests: The authors declare no competing interests. Consent to participate: The study protocol was approved by the single ECHO institutional review board, WCG IRB. Written informed consent or parent’s/guardian’s permission was obtained along with child assent as appropriate, for the ECHO Cohort Data and Biospecimen Collection Protocol participation and for participation in specific study sites., (© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

Introduction: The response to medical management of young dogs with osteoarthritis (OA) associated pain has not been evaluated. Using an open-label design, the effectiveness, over a 4-month period, of standardized management (grapiprant/fish oil/exercise) for treating OA pain in young dogs was evaluated., Methods: Included dogs were 9 months-4 years of age; ≥3.6 kg body weight; had ≥1 appendicular joint with radiographic OA and obvious joint pain; had a Liverpool Osteoarthritis in Dogs (LOAD) score of ≥5. The non-steroidal anti-inflammatory piprant (grapiprant) was given at the recommended dose daily, omega-3 fatty acid supplementation was initiated at 100 mg/kg and then increased to 200 mg/kg daily, and leash exercise was gradually increased to a target of 60 min daily. Client-reported outcome measures (CROMs) and force plate gait analysis were collected at baseline and monthly for 4 months. The index limb was defined as the most severely affected limb at baseline., Results: Forty-eight dogs were enrolled (mean ± SD age of 30.7 ± 10.7 months). Hips, elbows, and stifles were commonly affected. Medication and supplement compliance was excellent (≥95% of target administered), and treatments were well-tolerated. CROMs showed significant improvement over time and at each time point. Overall, peak vertical force (PVF) increased significantly (<0.001), and vertical impulse increased numerically. Increase in PVF from baseline was significant at all time points except 4-months., Discussion: This study demonstrates a clinically meaningful benefit of a multimodal treatment regimen over a 4-month period for young dogs (<4 years old) with OA-pain. Future work should determine if early, effective treatment is of long-term benefit., Competing Interests: The authors declare that this study received funding from Elanco Animal Health (NC State Grant # 2020-0044). The funder was not involved in the study design, collection, analysis, interpretation of data, or the decision to submit it for publication. However, the manuscript went through an internal review and approval process at Elanco Animal Health before submission to check for potential disclosure of confidential information. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Enomoto, Hash, Cole, Porcel Sanchez, Thomson, Perry, Aker, Nakanishi-Hester, Haupt, Opperman, Roe, Thompson, Innes and Lascelles.)

This study aimed to determine the prevalence of osteoarthritis (OA) and associated clinical signs in young dogs. Owners of dogs aged 8 months-4 years from a single practice, were contacted in random order, to participate in a general health screen. Clinical and orthopedic examinations were performed. Each joint was scored for pain reactions (0-4). Orthogonal radiographs of all joints were made under sedation. Each joint was scored for radiographic OA (rOA) severity on an 11-point scale. Clinical OA (cOA) was defined as an overlap of rOA and joint pain in ≥ 1 joint. Owners completed OA questionnaires. The owners of 123 dogs agreed to participate. Overall, 39.8% (49/123) of dogs had rOA in ≥ 1 joint, and 16.3% (20/123) or 23.6% (29/123) dogs had cOA, depending on the cut-off value of joint pain; moderate (2), or mild (1), respectively. Owners of dogs with cOA observed signs of impairment in approximately 30% of cases. Only 2 dogs with cOA were receiving OA pain management. The most commonly affected joints in descending order of frequency were elbow, hip, tarsus, and stifle. Radiographically visible OA is common in young dogs, and 40-60% of dogs with rOA had cOA. However, OA-pain appears underdiagnosed and undertreated in young dogs., (© 2024. The Author(s).)

Theoretical Principles: Social Cognitive Theory (SCT) is a middle-range theory with triadic determinism between behavioral, environmental, and personal. SCT has been a guiding framework in health promotion research as it helps understand people's behaviors., Phenomena Addressed: Behavioral Insomnia of Childhood (BIC) is highly prevalent, affecting up to 45% of typically developing children and 80% of children with special healthcare needs. BIC leads to sleep deficiency, disrupted physical and psychological health, poor school performance, behavioral dysfunction, and negatively affects parental and family functioning. Using Fawcett's framework, we analyzed and evaluated SCT in a pediatric sleep context and propose a reformulation of SCT to better inform sleep research., Research Linkages: SCT is individually focused and does not account for interdependence within relationships. Pediatric sleep interventions have limited long-term effects and sustainability without considering the parent-child dyadic interdependency. We advance the argument that the parent-child shared management (PCSM) perspective is beneficial for understanding pediatric sleep health. PCSM is a concept that reflects the shared responsibility and interdependence that parent and child have for managing child health. It assumes that with parents' ongoing support, children's responsibility for their health management increases over time, along with developmental progression and health-related experiences. We propose reformulating SCT by integrating PCSM in the pediatric sleep context: SCT with Shared Management (SCT-SM). The proposed SCT-SM accounts for parent-child interdependence and role transition. Shared management interventions that engage parents and children in active roles in managing sleep have potential sustainable effects in improving sleep and quality of life. (250)., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Accelerometry has been used to evaluate activity in dogs with osteoarthritis (OA) pain, especially in relation to effect of treatment; however no studies have compared accelerometry-measured activity in dogs with OA-pain and healthy dogs. The aims of this study were to (1) compare activity output from the PetPace collar with the validated Actical monitor and (2) determine if PetPace collar outputs (overall activity, activity levels, body position, and vital signs) differed between healthy dogs and dogs with OA-pain., Methods: This was an observational, non-interventional study in healthy dogs and dogs with OA-pain. All dogs were outfitted with the PetPace collar and the Actical monitor simultaneously for 14 days. Output from these devices was compared (correlations), and output from the PetPace device was used to explore differences between groups across the activity and vital sign outputs (including calculated heart rate variability indices)., Results: There was moderate correlation between the PetPace collar and Actical monitor output ( R 2 = 0.56, p < 0.001). Using data generated by the PetPace collar, OA-pain dogs had lower overall activity counts and spent less time standing than healthy dogs. Healthy dogs spent more time at higher activity levels than OA-pain dogs. Certain heart rate variability indices in OA-pain dogs were lower than in healthy dogs., Conclusions and Clinical Relevance: The results of this study suggest that the PetPace collar can detect differences between healthy dogs and those with OA-pain, and that OA-pain negatively impacts overall activity levels in dogs, and especially higher intensity activity., Competing Interests: Author BDXL has been a paid consultant for Boehringer Ingelheim Animal Health. This work was funded by Boehringer Ingelheim Animal Health (Duluth, GA, USA) (grant number 2017-0917) and the PetPace collars and data were supplied by PetPace Ltd (Burlington, MA, USA). The funders had no involvement in the study design, collection, analysis, interpretation of data, the writing of the article or the decision to submit it for publication. However, the funders were shown the results as a courtesy, and their input/comments were taken into consideration. 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 Rowlison de Ortiz, Belda, Hash, Enomoto, Robertson and Lascelles.)

Background: Various studies show that sleep quality, life skills, and cortisol are associated with depressive symptoms, separately. However, the relationships between sleep quality, life skills, cortisol, and depressive symptoms remain unclear. Thus, this study aims to examine the mediating or moderating roles of life skills and cortisol in the relationship between sleep quality and depressive symptoms., Methods: A retrospective cross-sectional study was performed among 212 adolescents with childhood household dysfunction (CHD) from August to October 2020 in China. We used the Pittsburgh Sleep Quality Index, the Secondary School Student Life Skills Rating Scale, and the Center for Epidemiologic Studies Depression Scale to measure sleep quality, life skills, and depressive symptoms, respectively. Additionally, 65 participants provided blood samples to assess their blood cortisol levels. Analyses included correlations, regressions, and structural equation models. Bootstrapping was performed to examine the mediation effect. Multiple regression analysis was performed to examine the moderation effect., Results: The results showed that sleep quality and life skills were significantly associated with depressive symptoms ( p < 0.01). Life skills mediated the relationship between sleep quality and depressive symptoms. Cortisol moderated the relationship between sleep quality and depressive symptoms., Conclusion: Our findings support potential mediating and moderating roles of life skills and cortisol in the relationship between sleep quality and depressive symptoms, which suggests improving sleep quality, life skills are of great significance in the prevention and intervention of depression in adolescents with CHD, and disseminating knowledge about the high risk of developing increased depressive symptoms among adolescents with CHD with higher cortisol levels is indicated., Competing Interests: The 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 Mao, Peng, Yuwen, Liu, Yan, Chen, Long and Hash.)

Endogenous Pain Modulation (EPM) impairment is a significant contributor to chronic pain. Conditioned pain modulation (CPM) testing assesses EPM function. Osteoarthritic (OA) dogs are good translational models, but CPM has not been explored. Our aim was to assess EPM impairment in OA dogs compared to controls using CPM. We hypothesized that CPM testing would demonstrate EPM impairment in OA dogs compared to controls. Dogs with stifle/hip OA and demographically-matched controls were recruited. The pre-conditioning test stimulus, using mechanical/thermal quantitative sensory testing (MQST or TQST), were performed at the metatarsus. A 22N blunt probe (conditioning stimulus) was applied to the contralateral antebrachium for 2 minutes, followed by MQST or TQST (post-conditioning test stimulus). The threshold changes from pre to post-conditioning (∆MQST and ∆TQST) were compared between OA and control dogs. Twenty-four client-owned dogs (OA, n = 11; controls, n = 13) were recruited. The ∆MQST(p < 0.001) and ∆TQST(p < 0.001) increased in control dogs but not OA dogs (∆MQST p = 0.65; ∆TQST p = 0.76). Both ∆MQST(p < 0.001) and ∆TQST(p < 0.001) were different between the OA and control groups. These are the first data showing that EPM impairment is associated with canine OA pain. The spontaneous OA dog model may be used to test drugs that normalize EPM function.

Background: Lower urinary tract transitional cell carcinoma (TCC) is an important but rarely described disease of cats., Objectives: To report the clinical characteristics, treatments, and outcomes in a cohort of cats with lower urinary tract TCC and to test identified variables for prognostic relevance., Animals: One-hundred eighteen client-owned cats with lower urinary tract carcinoma., Methods: Medical records were retrospectively reviewed to obtain information regarding clinical characteristics, treatments, and outcomes. Recorded variables were analyzed statistically., Results: Median age of affected cats was 15 years (range, 5.0-20.8 years) and median duration of clinical signs was 30 days (range, 0-730 days). The trigone was the most common tumor location (32/118; 27.1%) as assessed by ultrasound examination, cystoscopy, or both. Treatment was carried out in 73 of 118 (61.9%) cats. Metastatic disease was documented in 25 of 118 (21.2%) cats. Median progression-free survival and survival time for all cats were 113 days (95% confidence interval [CI], 69-153) and 155 days (95% CI, 110-222), respectively. Survival increased significantly (P < .001) when comparing cats across the ordered treatment groups: no treatment, treatment without partial cystectomy, and treatment with partial cystectomy. Partial cystectomy (hazard ratio [HR], 0.31; 95% CI, 0.17-0.87) and treatment with nonsteroidal anti-inflammatory drugs (HR, 0.55; 95% CI, 0.33-0.93) were significantly associated with longer survival times., Conclusions and Clinical Importance: The results support treatment using partial cystectomy and NSAIDs in cats with TCC., (© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

The present study examines how different chronic illnesses and mental illness comorbidity (chronic illness with complexity [CIC]) associate with components of advance care planning (ACP). We also explore the role self-perceived burden plays in the relationship between illness and ACP. Data were gathered from a cross-sectional survey of 305 elderly participants from the New Jersey End-of-Life study. Participants with diabetes and those with cardiovascular disease (CVD) are less likely, while participants with CIC are more likely, to plan for the end-of-life. Participants with diabetes are less likely to make formal plans, whereas those with CVD are less likely to hold informal discussions. CIC is associated with increased odds of having an advance directive, but no other form of ACP. Self-perceived burden did not appear to be the gateway by which illness groups differentially engaged in ACP. Future research should investigate what aspects of illnesses drive ACP.

Study of all flies (Diptera) collected for one year from a four-hectare (150 x 266 meter) patch of cloud forest at 1,600 meters above sea level at Zurquí de Moravia, San José Province, Costa Rica (hereafter referred to as Zurquí), revealed an astounding 4,332 species. This amounts to more than half the number of named species of flies for all of Central America. Specimens were collected with two Malaise traps running continuously and with a wide array of supplementary collecting methods for three days of each month. All morphospecies from all 73 families recorded were fully curated by technicians before submission to an international team of 59 taxonomic experts for identification.        Overall, a Malaise trap on the forest edge captured 1,988 species or 51% of all collected dipteran taxa (other than of Phoridae, subsampled only from this and one other Malaise trap). A Malaise trap in the forest sampled 906 species. Of other sampling methods, the combination of four other Malaise traps and an intercept trap, aerial/hand collecting, 10 emergence traps, and four CDC light traps added the greatest number of species to our inventory. This complement of sampling methods was an effective combination for retrieving substantial numbers of species of Diptera. Comparison of select sampling methods (considering 3,487 species of non-phorid Diptera) provided further details regarding how many species were sampled by various methods.        Comparison of species numbers from each of two permanent Malaise traps from Zurquí with those of single Malaise traps at each of Tapantí and Las Alturas, 40 and 180 km distant from Zurquí respectively, suggested significant species turnover. Comparison of the greater number of species collected in all traps from Zurquí did not markedly change the degree of similarity between the three sites, although the actual number of species shared did increase.        Comparisons of the total number of named and unnamed species of Diptera from four hectares at Zurquí is equivalent to 51% of all flies named from Central America, greater than all the named fly fauna of Colombia, equivalent to 14% of named Neotropical species and equal to about 2.7% of all named Diptera worldwide. Clearly the number of species of Diptera in tropical regions has been severely underestimated and the actual number may surpass the number of species of Coleoptera.        Various published extrapolations from limited data to estimate total numbers of species of larger taxonomic categories (e.g., Hexapoda, Arthropoda, Eukaryota, etc.) are highly questionable, and certainly will remain uncertain until we have more exhaustive surveys of all and diverse taxa (like Diptera) from multiple tropical sites.        Morphological characterization of species in inventories provides identifications placed in the context of taxonomy, phylogeny, form, and ecology. DNA barcoding species is a valuable tool to estimate species numbers but used alone fails to provide a broader context for the species identified.

Estimations of tropical insect diversity generally suffer from lack of known groups or faunas against which extrapolations can be made, and have seriously underestimated the diversity of some taxa. Here we report the intensive inventory of a four-hectare tropical cloud forest in Costa Rica for one year, which yielded 4332 species of Diptera, providing the first verifiable basis for diversity of a major group of insects at a single site in the tropics. In total 73 families were present, all of which were studied to the species level, providing potentially complete coverage of all families of the order likely to be present at the site. Even so, extrapolations based on our data indicate that with further sampling, the actual total for the site could be closer to 8000 species. Efforts to completely sample a site, although resource-intensive and time-consuming, are needed to better ground estimations of world biodiversity based on limited sampling., Competing Interests: The authors declare no competing interests.

Background: Non-steroidal anti-inflammatory drugs (NSAIDs), transdermal fentanyl patches, and transmucosal buprenorphine are probably the most commonly used options for providing post-operative analgesia in the early at-home period. However, these require daily administration or are associated with abuse concerns. One of the significant unmet needs in veterinary surgery and pain management is for longer acting opioids for cats to effectively bridge the gap between the in-hospital and at-home recovery periods. A proof of concept study of an extended release formulation of buprenorphine HCL (ER-Bup) was conducted using objective kinetic measures and a unilateral onychectomy model. Using a blinded, randomized, two period crossover design, four cats were allocated to control (saline) or ER-Bup (0.6 mg/kg, subcutaneously [SC]) treatment groups. All animals underwent a unilateral forelimb onychectomy per period with a washout/recovery period in between. Observational pain scores and kinetic data (using a pressure sensitive walkway [PSW]) were collected prior to (baseline) and at intervals for 72 h following surgery. Symmetry indices were derived for kinetic variables (peak vertical force [PVF]; vertical impulse [VI]) of each forelimb for landing following a jump and for walking. A rescue analgesic protocol was in place. Effect of surgery and treatment were evaluated using a mixed model statistical approach., Results: No cats required rescue analgesics based on subjective pain score. ER-Bup had a positive influence on subjective pain scores during the 72 h postsurgery (p = 0.0473). PVF and VI of the operated limb were significantly decreased for both landing (p < 0.0001 and p < 0.0001) and walking (p < 0.0001 and p < 0.0001 respectively) compared to control. ER-Bup resulted in significantly decreased asymmetry in limb use during landing (PVF, p < 0.0001; VI, p < 0.0001) and walking (PVF, p = 0.0002, VI, p < 0.0001). The novel use of data collected following a jump from an elevated platform appeared to provide all desired information and was easier to collect than walking data., Conclusion: This study demonstrates that SC administration of ER-Bup may be an effective analgesic for a 72 h period postoperatively. Furthermore, landing onto a PSW from an elevated perch may be a useful and efficient way to assess analgesics in cats using a unilateral model of limb pain.