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Effective coping with acute stress is important to promote mental health and to build stress resilience. Interventions improving stress coping usually require long training periods. In this study, we present a hypnosis-based intervention that produces long-term effects after a single hypnosis session. In that session, we established a post-hypnotic safety suggestion that participants can activate afterwards with a cue, the Jena Safety Anchor. We tested 60 participants in our study who all received the hypnosis session and a stress task. The safety group used the Jena Safety Anchor during acute stress (Trier Social Stress Test, TSST). The control group used a neutral anchor. We measured subjective stress responses via self-reports and physiological stress responses via saliva and blood samples as well as heart rate. One week later, all participants filled in an online survey to measure long-term effects of the post-hypnotic safety suggestion. We found that participants using the Jena Safety Anchor during the TSST reported significantly lower stress compared to the control group. The safety group also reported significantly fewer negative thoughts concerning their TSST performance than the control group during the stress recovery phase and 1 week later. All participants indicated that the Jena Safety Anchor still worked 1 week after its establishment. Suggestibility did not affect the efficacy of the Jena Safety Anchor. Our findings demonstrate that post-hypnotic safety suggestions improve stress coping with long-lasting effects, which makes it a promising intervention to promote mental health and establish stress resilience in just one hypnosis session. [ABSTRACT FROM AUTHOR]

In our study, we use the post-hypnotic suggestion of easy remembering to improve memory with long-lasting effects. We tested 24 highly suggestible participants in an online study. Participants learned word lists and recalled them later in a recognition memory task. At the beginning of the study, participants were hypnotized and the post-hypnotic suggestion to remember easily was associated with a cue that participants used during the recognition memory task. In a control condition, the same participants used a neutral cue. One week later, participants repeated both conditions with new word lists. Participants were significantly faster and more confident in their recognition ratings in the easy-remembering condition compared to the control condition, and this effect persisted over one week. Crucially, the increased speed and confidence in the easy-remembering condition did not affect memory accuracy. That makes our hypnosis intervention promising for patients experiencing subjective memory impairments. 2343 (Learning and Memory), 2380 (Consciousness States), 3351 (Clinical Hypnosis) • We tied the feeling of remembering easily to a post-hypnotic anchor • Participants remembered faster and more confident in the easy remembering condition • The post-hypnotic anchor still worked one week after the hypnosis session [ABSTRACT FROM AUTHOR]

Increased reward sensitivity has been proposed as an important transdiagnostic feature for a series of disorders, including addictive behaviors. Earlier studies suggest that a positive affective state characterized by the feeling of safety could reduce an individual's reward sensitivity. A promising technique to establish a feeling of safety on demand is to utilize post‐hypnotic suggestions. We hypothesized that the feeling of safety elicited by post‐hypnotic suggestions reduces neural signals of reward sensitivity. To test our predictions, we hypnotized 24 highly suggestible participants, suggested them to feel safe and coupled this feeling of safety to a post‐hypnotic trigger that reactivates the feeling of safety outside the hypnotic state. Participants then played a risk game both in a safety condition using the post‐hypnotic safety trigger and in a control condition using a neutral trigger. Simultaneously, we recorded their EEG. Participants reported significantly higher ratings of safety in the safety condition compared to the control condition. Even several weeks after the main experimental session, the post‐hypnotic safety trigger still elicited a significantly stronger feeling of safety compared to the control condition. Moreover, the Reward Positivity (RewP) was significantly reduced in the safety condition. As the RewP amplitude has been proposed as a psychophysiological marker for reward sensitivity, we conclude that the suggestion of safety by post‐hypnotic suggestions turns participants into a quiescence motivational state that makes them less reward sensitive. Therefore, we discuss implications of the post‐hypnotic safety trigger for the treatment of disorders associated with increased reward sensitivity such as addictive behaviors. Impact StatementThe contents of this page will be shown on the eTOC on the online version only. It will not be published as part of the article PDF. This study is the first to investigate the link between positive affective states associated with low approach motivation and neural reward sensitivity. We show that the post‐hypnotic activation of a feeling of safety makes participants feel safe on a short‐ and long‐term basis and reduces their neuronal reward sensitivity as measured by the Reward Positivity (RewP). Our findings open new ways for the treatment of disorders associated with increased reward sensitivity such as addictive behaviors. [ABSTRACT FROM AUTHOR]

A brief description of a day trip to the northernmost autochthonous population of the wall lizard (Podarcis muralis) in the city of Maastricht (province of Limburg) in the Netherlands, that took place on 20 September 2020. Besides the description of the habitat some remarks on the population of the midwife toad (Alytes obstetricans), living in the same biotope, are made. [ABSTRACT FROM AUTHOR]

Several theories of hypnosis assume that responses to hypnotic suggestions are implemented through top-down modulations via a frontoparietal network that is involved in monitoring and cognitive control. The current study addressed this issue re-analyzing previously published event-related-potentials (ERP) (N1, P2, and P3b amplitudes) and combined it with source reconstruction and connectivity analysis methods. ERP data were obtained from participants engaged in a visual oddball paradigm composed of target, standard, and distractor stimuli during a hypnosis (HYP) and a control (CON) condition. In both conditions, participants were asked to count the rare targets presented on a video screen. During HYP participants received suggestions that a wooden board in front of their eyes would obstruct their view of the screen. The results showed that participants' counting accuracy was significantly impaired during HYP compared to CON. ERP components in the N1 and P2 window revealed no amplitude differences between CON and HYP at sensor-level. In contrast, P3b amplitudes in response to target stimuli were significantly reduced during HYP compared to CON. Source analysis of the P3b amplitudes in response to targets indicated that HYP was associated with reduced source activities in occipital and parietal brain areas related to stimulus categorization and attention. We further explored how these brain sources interacted by computing time-frequency effective connectivity between electrodes that best represented frontal, parietal, and occipital sources. This analysis revealed reduced directed information flow from parietal attentional to frontal executive sources during processing of target stimuli. These results provide preliminary evidence that hypnotic suggestions of a visual blockade are associated with a disruption of the coupling within the frontoparietal network implicated in top-down control. [ABSTRACT FROM AUTHOR]

• We present an unusual case of a young COVID-19 patient presenting with hyperinflammation and severe liver injury. • The underlying causative events were sHLH, hepatic SARS-CoV-2 infection induced by immunosuppression and Wilson's disease. • SARS-CoV-2 was detected in hepatocytes by EM as well as virus isolation from a diagnostic liver biopsy. • When immunosuppression is applied, (systemic) virus replication has to be closely monitored. A 21-year-old woman was hospitalized due to coronavirus disease 2019 (COVID-19)-associated respiratory and hepatic impairment concomitant with severe hemolytic anemia. Upon diagnosis of secondary hemophagocytic lymphohistiocytosis, immunosuppression with anakinra and steroids was started, leading to a hepatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and viremia. Subsequent liver biopsy revealed virus particles in hepatocytes by electron microscopy and SARS-CoV-2 virus could be isolated and cultured. Immunosuppression was stopped and convalescent donor plasma given. In the differential diagnosis, an acute crisis of Wilson's disease was raised by laboratory and genetic testing. This case highlights the complexity of balancing immunosuppression to control hyperinflammation versus systemic SARS-CoV-2 dissemination. [ABSTRACT FROM AUTHOR]

Waiting for delayed rewards is important to reach long-term goals, yet most people prefer immediate rewards. This tendency is called delay discounting. Evidence shows that people are more willing to wait for delayed rewards when they believe that the delayed reward is certain. We hypothesized that feeling safe makes delayed outcomes subjectively more certain, which should in turn reduce neuronal signals of delay discounting. We hypnotized 24 highly suggestible participants and gave them a suggestion to feel safe. We then used EEG to measure their brain responses to immediate and delayed rewards while they played a delayed gratification game. As compared to a control condition without hypnosis, participants that were suggested to feel safe under hypnosis reported feeling significantly safer. Further, their reward-related brain activity differentiated less between immediate and delayed rewards. We conclude that feeling safe makes delayed outcomes subjectively more certain and therefore reduces neuronal signals of delay discounting. [ABSTRACT FROM AUTHOR]

Hypnosis is a powerful tool to affect the processing and perception of stimuli. Here, we investigated the effects of hypnosis on the processing of auditory stimuli, the time course of event-related-potentials (ERP; N1 and P3b amplitudes) and the activity of cortical sources of the P3b component. Forty-eight participants completed an auditory oddball paradigm composed of standard, distractor, and target stimuli during a hypnosis (HYP), a simulation of hypnosis (SIM), a distraction (DIS), and a control (CON) condition. During HYP, participants were suggested that an earplug would obstruct the perception of tones and during SIM they should pretend being hypnotized and obstructed to hear the tones. During DIS, participants' attention was withdrawn from the tones by focusing participants' attention onto a film. In each condition, subjects were asked to press a key whenever a target stimulus was presented. Behavioral data show that target hit rates and response time became significantly reduced during HYP and SIM and loudness ratings of tones were only reduced during HYP. Distraction from stimuli by the film was less effective in reducing target hit rate and tone loudness. Although, the N1 amplitude was not affected by the experimental conditions, the P3b amplitude was significantly reduced in HYP and SIM compared to CON and DIS. In addition, source localization results indicate that only a small number of neural sources organize the differences of tone processing between the control condition and the distraction, hypnosis, and simulation of hypnosis conditions. These sources belong to brain areas that control the focus of attention, the discrimination of auditory stimuli, and the organization of behavioral responses to targets. Our data confirm that deafness suggestions significantly change auditory processing and perception but complete deafness is hard to achieve during HYP. Therefore, the term 'deafness' may be misleading and should better be replaced by 'hypoacusis'. [ABSTRACT FROM AUTHOR]

When a stimulus is important, the corresponding brain responses increase, especially the P300 brain response. This is true for all kinds of important stimuli, also monetary rewards. In our study, we developed a hypnotic suggestion to reduce the subjective importance of monetary rewards. As successful suggestions do not contain negations, we suggested participants to feel safe during hypnosis instead of suggesting that money is not important anymore. We predicted lower P300 amplitudes when participants feel safe during hypnosis. We tested 24 highly suggestible participants playing a risk game in 2 conditions with monetary rewards while we measured their EEG brain responses. In the safety condition, we induced a hypnotic state and suggested that participants feel safe. In the control condition, participants played the risk game without hypnosis. Here we show that participants felt significantly safer in the safety condition and showed significantly lower P300 amplitudes to monetary rewards. Risk behavior did not differ significantly between conditions. Our results are important for substance use disorders, as decreased P300 responses to substance-related stimuli are associated with less craving and better abstinence. Therefore, we conclude that suggestions to feel safe during hypnosis might work as a treatment for individuals with substance use disorders. [ABSTRACT FROM AUTHOR]

A recent study claims that participants wearing a bike helmet behave riskier in a computer‐based risk task compared to control participants without a bike helmet. We hypothesized that wearing a bike helmet reduces cognitive control over risky behavior. To test our hypothesis, we recorded participants' EEG brain responses while they played a risk game developed in our laboratory. Previously, we found that, in this risk game, anxious participants showed greater levels of cognitive control as revealed by greater frontal midline theta power, which was associated with less risky decisions. Here, we predicted that cognitive control would be reduced in the helmet group, indicated by reduced frontal midline theta power, and that this group would prefer riskier options in the risk game. In line with our hypothesis, we found that participants in the helmet group showed significantly lower frontal midline theta power than participants in the control group, indicating less cognitive control. We did not replicate the finding of generally riskier behavior in the helmet group. Instead, we found that participants chose the riskier option in about half of trials, no matter how risky the other option was. Our results suggest that wearing a bike helmet reduces cognitive control, as revealed by reduced frontal midline theta power, leading to risk indifference when evaluating potential behaviors. We show that cognitive control is reduced when participants wear a bike helmet while they play a risk game. The reduction of cognitive control was measured by reduced frontal midline theta power and risk behavior that showed insensitivity to risk differences in contrast to a control group without bike helmet. We conclude that cognitive control, mirrored by frontal midline theta power, is enhanced in anxious participants and reduced in participants wearing a safety feature. Therefore, we substantially extend the existing literature concerning frontal midline theta and cognitive control. [ABSTRACT FROM AUTHOR]

The β-shielded acrylamide N , N -diisopropyl-α-(1,1,3,3-tetramethylindan-2-ylidene)acet-amide was prepared through ketone addition of an α-lithiated acetamide, followed by H 2 O elimination. Its α-deprotonation by n -butyllithium occurred readily in THF without any tendency towards addition reactions at C=O or C-β. The resultant single crystals of a dimeric lithio derivative had triple Li–O coordination and a weakly bonding, ion-pair type Li–C(α) relationship. In tert -butyl methyl ether as the solvent, up to seven pairs of diastereotopic nuclei (both 1H and 13C) established a C S -symmetric lithium 1-aminoallen-1-olate structure that is ascribed to either a thermal ground state or a very rapid (on the NMR time scales) oscillation between two chiral ground states that may resemble the solid-state structure. Image 1 • (tert -Alkyl) 2 C = CH(α)–C(=O)–N(CHMe 2) 2 reacts with n -BuLi by α-deprotonation only. • The dissolved lithio product is C S -symmetric (tert -alkyl) 2 C = C(α)–C(OLi)–N(CHMe 2) 2. • The solid lithio product shows a Li–O(amide) bond and a Li/C(α) ion pair interaction. [ABSTRACT FROM AUTHOR]

Highlights • ROS preincubated ORAI1 proteins lead to a large decrease of ICRAC. • WT combined with mutated ORAI1 leads to dynamic (un)binding of CRAC channel states. • ICRAC strongly depends on the ratio of STIM1/ORAI1 (highest for S/O larger than 2.5). • Dominant channel form depends on the interaction of different channel states. Abstract Release of C a 2 + from endoplasmatic retriculum (ER) C a 2 + stores causes stromal interaction molecules (STIM) in the ER membrane and ORAI proteins in the plasma membrane (PM) to interact and form the C a 2 + release activated C a 2 + (CRAC) channels, which represent a major C a 2 + entry route in non-excitable cells and thus control various cell functions. It is experimentally possible to mutate ORAI1 proteins and therefore modify, especially block, the C a 2 + influx into the cell. On the basis of the model of Hoover and Lewis (2011), we formulate a reaction-diffusion model to quantify the STIM1-ORAI1 interaction during CRAC channel formation and analyze different ORAI1 channel stoichiometries and different ratios of STIM1 and ORAI1 in comparison with experimental data. We incorporate the inhibition of ORAI1 channels by ROS into our model and calculate its contribution to the CRAC channel amplitude. We observe a large decrease of the CRAC channel amplitude evoked by mutations of ORAI1 proteins. [ABSTRACT FROM AUTHOR]

In economic studies, it is standard practice to pay out the reward of only one randomly selected trial (pay-one) instead of the total reward accumulated across trials (pay-all), assuming that both methods are equivalent. We tested this assumption by recording electrophysiological activity to reward feedback from participants engaged in a decision-making task under both a pay-one and a pay-all condition. We show that participants are approximately 12% more risk averse in the pay-one condition than in the pay-all condition. Furthermore, we observed that the electrophysiological response to monetary rewards, the reward positivity, is significantly reduced in the pay-one condition relative to the pay-all condition. The difference of brain responses is associated with the difference in risky behavior across conditions. We concluded that the two payment methods lead to significantly different results and are therefore not equivalent. [ABSTRACT FROM AUTHOR]

Abstract Steric shielding of an α,β-unsaturated nitrile R 2 C = CH–C N by tert -alkyl β-substituents (R) prevented 1,4-additions of organolithiums and showed a remarkably solvent-dependent selectivity of tert -butyllithium (tBuLi): 1,2-addition at C N and α-deprotonation occurred almost equally fast in THF, while C N addition was exclusive in Et 2 O. The resultant N -lithioimine was cleanly α-deprotonated (albeit with unusual slowness) in situ by an excess of tBuLi. The imine was hydrolyzed to produce an enone R 2 C = CH–C(R') = O with bulky substituents R and R', which admitted C O addition but did not undergo α-deprotonation by mesityllithium, n -butyllithium (nBuLi), and even the very strong base tBuLi. 2,4,6-Tri- tert -butylphenyllithium ("Mes*Li") did not add or deprotonate the enone. With N -lithio-2,2,6,6-tetramethylpiperidine (LTMP) as the catalyst, however, Mes*Li achieved α-deprotonation simultaneously with the known Mes* radical rearrangement and a subsequent carbonyl addition. With KOH or KOtBu as a base in [D 6 ]DMSO (but not in DOCH 3), the enone accomplished a rapid α-H/α-D exchange reaction at rt. Graphical abstract Image 1 [ABSTRACT FROM AUTHOR]

Abstract: In this study, we address the effect of anxiety measured with the State‐Trait Anxiety Inventory (STAI) on EEG and risk decisions. We selected 20 high and 20 low anxious participants based on their STAI trait scores in the upper or lower quartile of the norm distribution and implemented a risk game developed in our laboratory. We investigate if high anxious individuals exert more cognitive control, reflected in higher frontal midline theta (FMT) power when they make a risky decision, and if they act less risky compared to low anxious individuals. Participants played a risk game while we recorded their brain responses via EEG. High anxious participants played less risky compared to low anxious participants. Further, high anxious participants showed higher FMT power immediately before they chose one of two risk options, suggesting higher cognitive control during the decision time compared to low anxious participants. Via a mediation analysis, we show that the effect of anxiety on risk behavior is fully mediated by FMT power. Further, questionnaire responses revealed that high anxious participants rated risk situations as riskier compared to low anxious participants. We conclude that anxious individuals perceive risky situations as riskier and thus exert more cognitive control during their risk choices, reflected in higher FMT power, which leads to less risky decisions. [ABSTRACT FROM AUTHOR]

Neighborly intermolecular assistance is common within the clusters of aggregating organolithium compounds but rarely as continual and kinetically helpful as for the β-shielded α-lithioacrylonitrile 2Li of the type N≡C–C(Li) = C( tert -alkyl) 2 . Intermolecular NLi coordination with the α-cyano substituent of 2Li was discovered not only in single crystals of a cyclohexamer or of a (Li–C–C≡N) 2 eight-membered ring; it provided also in several solvents for a single kind of a THF-solvated cluster (presumably a cyclodimer or cyclooligomer). These NLi connections are thought to be the “glue” in this cluster and are proposed to substantially accelerate the molecular cis/trans stereoinversion. Due to such a neighborly assistance, the rate constants of this stereoinversion are surprisingly insensitive to usually very effective factors (cations, solvents, and electron-pair donor ligands at Li) if the NLi connections are not weakened or suppressed. The corresponding α-potassio and α-cesio congeners resemble 2Li with regard to both the ground states in solution and the fast stereoinversion processes with extrapolated rate constants roughly on the microsecond time scale at 25 °C. [ABSTRACT FROM AUTHOR]

Background: Aspiration of gastric acid is an important cause of acute lung injury. The time course of the pulmonary response to such an insult beyond the initial 48 hours is incompletely characterized. The purpose of this study was to comprehensively describe the pulmonary effects of focal lung acid injury over a seven day period in both directly injured and not directly injured lung tissue. Methods: Male Wistar rats underwent left-endobronchial instillation with hydrochloric acid and were sacrificed at 4, 24, 48, 96 or 168 h after the insult. Healthy non-injured animals served as controls. We assessed inflammatory cell counts and cytokine levels in right and left lung lavage fluid and blood, arterial oxygen tension, alterations in lung histology, lung wet-to-dry weight ratio and differential lung perfusion. Results: Lung acid instillation induced an early strong inflammatory response in the directly affected lung, peaking at 4–24 hours, with only partial resolution after 7 days. A less severe response with complete resolution after 4 days was seen in the opposite lung. Alveolar cytokine levels, with exception of IL-6, only partially reflected the localization of lung injury and the time course of the functional and histologic alterations. Alveolar leucocyte subpopulations exhibited different time courses in the acid injured lung with persistent elevation of alveolar lymphocytes and macrophages. After acid instillation there was an early transient decrease in arterial oxygen tension and lung perfusion was preferentially distributed to the non-injured lung. Conclusion: These findings provide a basis for further research in the field of lung acid injury and for studies exploring effects of mechanical ventilation on injured lungs. Incomplete recovery in the directly injured lung 7 days after acid instillation suggests that increased vulnerability and susceptibility to further noxious stimuli are still present at that time. [ABSTRACT FROM AUTHOR]

Criteria lists of academic skills are widely used to assess the work readiness of people who are looking to enter or re-enter the apprenticeship market. These instruments represent a particular hurdle in the path to vocational training for low-skilled would-be trainees. We investigate the validity of one such list used in Germany. As different workplaces have diverse requirements, we question whether the same criteria hold for various professions. The study surveyed 538 trainees enrolled in vocational training programmes in eight different professions. Participants were asked about the requirements of their professions with respect to the minimum standards (as specified in the German Catalogue of Criteria for Apprenticeship Readiness) for work readiness. The results showed that the trainees consider the requirements during training to be lower than the minimum standards specified in the German Catalogue of Criteria for Apprenticeship Readiness and that substantial heterogeneity in requirements exists both between and within professions. We argue that criteria lists, which are also used in other countries in similar ways, should be treated with caution, as they might not be able to predict would-be trainees' readiness to successfully complete an apprenticeship programme due to enormous variability in job requirements. [ABSTRACT FROM AUTHOR]

Background: Better systems of care are required to address chronic disease in Indigenous people to ensure they can access all their care needs. Health research has produced evidence about effective models of care and chronic disease strategies to address Indigenous health, however the transfer of research findings into routine clinical practice has proven challenging. Complex interventions, such as those related to chronic disease, have many components that are often poorly implemented and hence rarely achieve implementation fidelity. Implementation fidelity is "the degree to which programs are implemented as intended by the program developer". Knowing if an intervention was implemented as planned is fundamental to knowing what has contributed to the success of an intervention.Methods: The aim of this study is to adapt the implementation fidelity framework developed by Keith et al. and apply it to the intervention implemented in phase 1 of the Getting Better at Chronic Care in North Queensland study. The objectives are to quantify the level of implementation fidelity achieved during phase 1 of the study, measure the association between implementation fidelity and health outcomes and to explore the features of the primary health care system that contributed to improved health outcomes. A convergent parallel mixed methods study design will be used to develop a process for assessing implementation fidelity. Information collected via a questionnaire and routine data generated during phase 1 of the study will be used to explain the context for the intervention in each site and develop an implementation fidelity score for each component of the intervention. A weighting will be applied to each component of the intervention to calculate the overall implementation score for each participating community. Statistical analysis will assess the level of association between implementation fidelity scores and health outcomes.Discussion: Health services research seeks to find solutions to social and technical problems to improve health outcomes. The development of a tool and methodology for assessing implementation fidelity in the Indigenous primary health care context will help address some of the barriers to the translation of research into practice.Trial Registration: ACTRN12610000812099 : 29.9.2010. [ABSTRACT FROM AUTHOR]

Task motivation depends on what we did before. A recent theory differentiates between tasks that we want to do and tasks that we have to do. After a have-to task, motivation shifts towards a want-to task. We measured this shift of motivation via brain responses to monetary feedback in a risk game that was used as want-to task in our study. We tested 20 healthy participants that were about 28 years old in a within-subjects design. Participants worked on a Stroop task (have-to task) or an easier version of the Stroop task as a control condition and played a risk game afterwards (want-to task). After the Stroop task, brain responses to monetary feedback in the risk game were larger compared to the easier control task, especially for feedback indicating higher monetary rewards. We conclude that higher amplitudes of feedback-related brain responses in the risk game reflect the shift of motivation after a have-to task towards a want-to task. [ABSTRACT FROM AUTHOR]

Waiting for rewards is difficult, and highly impulsive individuals with low self-control have an especially hard time with it. Here, we investigated whether neural responses to rewards in a delayed gratification task predict impulsivity and self-control. The EEG was recorded from participants engaged in a guessing game in which on each trial they could win either a large or small reward, paid either now or after 6 months. Ratings confirmed that participants preferred immediate, large rewards over small, delayed rewards. Electrophysiological reward signals reflecting the difference between immediate and future rewards predicted self-report measures of impulsivity and self-control. Further, these signals were highly reliable across two sessions over a 1-week interval, showing high temporal stability like stable personality traits. These results suggest that greater valuation of immediate rewards causes impulsive individuals to redirect control away from delayed rewards, indicating why it is so hard for them to wait. [ABSTRACT FROM AUTHOR]

We compute the decay rate of the Standard Model Higgs boson to bottom quarks to order α α s . We apply the optical theorem and calculate the imaginary part of three-loop corrections to the Higgs boson propagator using asymptotic expansions in appropriately chosen mass ratios. The corrections of order α α s are of the same order of magnitude as the O ( α s 3 ) QCD corrections but have the opposite sign. [ABSTRACT FROM AUTHOR]

To investigate risk behavior, behavioral economic researchers use gambles consisting of many trials. But participants usually do not receive the sum of all outcomes. Instead, participants are paid out according to one trial that is randomly selected in the end. As the payment method might influence risk behavior, in this study we let participants play a gamble two times. In the pay-all condition, the outcome of every trial is paid out, and in the pay-one condition, the outcome of one randomly selected trial, multiplied by the number of trials, is paid out. Our results show that participants made 10 % more risky decisions in the pay-all compared to the pay-one condition. In an additional questionnaire with hypothetical risk choices, participants also showed substantially riskier behavior in the pay-all condition. Risk behavior was highly correlated in both conditions.The results suggest that the absolute level of risk choices is higher in pay-all paradigms than in pay-one paradigms. [ABSTRACT FROM AUTHOR]

Background: Health outcomes for Indigenous Australians with diabetes in remote areas remain poor, including high rates of avoidable complications which could be reduced with better primary level care. We aimed to evaluate the effectiveness of a community-based health-worker led case management approach to the care of Indigenous adults with poorly controlled type 2 diabetes in primary care services in remote northern Australia. Methods: Two hundred and thirteen adults with poorly controlled diabetes (HbA1c > 8.5%) and significant comorbidities in 12 remote communities were randomly assigned by service cluster to receive chronic care co-ordination from a community-based health worker supported by a clinical outreach team, or to a waitlist control group which received usual care. Results: At baseline, mean age of participants was 47.9 years, 62.4% were female, half were Aboriginal and half identified as Torres Strait Islander, 67% had less than 12 years of education, 39% were smokers, median income was $18,200 and 47% were unemployed. Mean HbA1c was 10.7% (93 mmol/mol) and BMI 32.5. At follow-up after 18 months, HbA1c reduction was significantly greater in the intervention group (-1.0% vs -0.2%, SE (diff) = 0.2, p = 0.02). There were no significant differences between the groups for blood pressure, lipid profile, BMI or renal function. Intervention group participants were more likely to receive nutrition and dental services according to scheduled care plans. Smoking rates were unchanged. Conclusions: A culturally safe, community level health-worker led model of diabetes care for high risk patients can be effective in improving diabetes control in remote Indigenous Australian communities where there is poor access to mainstream services. This approach can be effective in other remote settings, but requires longer term evaluation to capture accrued benefits. Trial registration: ANZCTR 12610000812099, Registered 29 September 2010. [ABSTRACT FROM AUTHOR]

Before and after the non-invasive ventilation session, patients rated their subjective valence, arousal and anxiety as well as their subjective breathing mask comfort. We developed an intervention containing hypnotic suggestions to improve patients' well-being during non-invasive ventilation in the ICU [[3]-[5]]. [Extracted from the article]

Importance: The goal of oxygen therapy is to deliver sufficient oxygen to the tissues while minimizing oxygen toxicity and oxidative stress. It remains uncertain what values of arterial oxygen saturations achieve this balance in preterm infants.Objective: To compare the effects of targeting lower or higher arterial oxygen saturations on the rate of death or disability in extremely preterm infants.Design, Setting, and Participants: Randomized, double-blind trial in 25 hospitals in Canada, the United States, Argentina, Finland, Germany, and Israel in which 1201 infants with gestational ages of 23 weeks 0 days through 27 weeks 6 days were enrolled within 24 hours after birth between December 2006 and August 2010. Follow-up assessments began in October 2008 and ended in August 2012.Interventions: Study participants were monitored until postmenstrual ages of 36 to 40 weeks with pulse oximeters that displayed saturations of either 3% above or below the true values. Caregivers adjusted the concentration of oxygen to achieve saturations between 88% and 92%, which produced 2 treatment groups with true target saturations of 85% to 89% (n = 602) or 91% to 95% (n = 599). Alarms were triggered when displayed saturations decreased to 86% or increased to 94%.Main Outcomes and Measures: The primary outcome was a composite of death, gross motor disability, cognitive or language delay, severe hearing loss, or bilateral blindness at a corrected age of 18 months. Secondary outcomes included retinopathy of prematurity and brain injury.Results: Of the 578 infants with adequate data for the primary outcome who were assigned to the lower target range, 298 (51.6%) died or survived with disability compared with 283 of the 569 infants (49.7%) assigned to the higher target range (odds ratio adjusted for center, 1.08; 95% CI, 0.85 to 1.37; P = .52). The rates of death were 16.6% for those in the 85% to 89% group and 15.3% for those in the 91% to 95% group (adjusted odds ratio, 1.11; 95% CI, 0.80 to 1.54; P = .54). Targeting lower saturations reduced the postmenstrual age at last use of oxygen therapy (adjusted mean difference, -0.8 weeks; 95% CI, -1.5 to -0.1; P = .03) but did not alter any other outcomes.Conclusion and Relevance: In extremely preterm infants, targeting oxygen saturations of 85% to 89% compared with 91% to 95% had no significant effect on the rate of death or disability at 18 months. These results may help determine the optimal target oxygen saturation.Trial Registrations: ISRCTN Identifier: 62491227; ClinicalTrials.gov Identifier: NCT00637169. [ABSTRACT FROM AUTHOR]

The article describes a study whose aim was to compare the effects of targeting lower or higher arterial oxygen saturations on the rate of death or disability in extremely preterm infants and states that as part of the study 1201 infants were included from randomized, double-blind trial in 25 hospitals in Canada, the U.S., Argentina, Finland, Germany and Israel. As mentioned, study participants were monitored until postmenstrual ages of 36 to 40 weeks with pulse oximeters that displayed saturations of either 3% above or below the true values. Also the result of the study revealed that in extremely preterm infants, targeting oxygen saturations of 85%-89% compared with 91%-95% had no significant effect on the rate of death or disability at 18 months.

Theories of an optimal level of arousal suggest that underaroused humans seek stimulation to enhance their arousal. One way to increase arousal is risky behavior during gambling. In the current study, we show that the lower the participants' resting arousal, measured via resting heart rate, the riskier they acted in a gamble and the faster they responded, indicating less impulse control. Participants with low resting heart rate also perceived the risk options in the gamble as less arousing and less risky compared to participants with higher resting heart rate. Partial correlations show that resting heart rate, risk behavior, and ratings were interrelated. After physical exercise, participants tended to behave less risky in the gamble compared to a control condition without exercise. Thus, both trait and state arousal effects indicate an inverse relationship of arousal and risky behavior. [ABSTRACT FROM AUTHOR]

Skin wound repair requires complex and highly coordinated interactions between keratinocytes, fibroblasts, and immune cells to restore the epidermal barrier and tissue architecture after acute injury. The cytokine IL-22 mediates unidirectional signaling from immune cells to epithelial cells during injury of peripheral tissues such as the liver and colon, where IL-22 causes epithelial cells to produce antibacterial proteins, express mucins, and enhance epithelial regeneration. In this study, we used IL-22−/− mice to investigate the in vivo role for IL-22 in acute skin wounding. We found that IL-22−/− mice displayed major defects in the skin's dermal compartment after full-thickness wounding. We also found that IL-22 signaling is active in fibroblasts, using in vitro assays with primary fibroblasts, and that IL-22 directs extracellular matrix (ECM) gene expression and myofibroblast differentiation both in vitro and in vivo. These data define roles of IL-22 beyond epithelial cross talk, and suggest that IL-22 has a previously unidentified role in skin repair by mediating interactions between immune cells and fibroblasts. [ABSTRACT FROM AUTHOR]

Acute wound healing in the skin involves the communication of multiple cell types to coordinate keratinocyte and fibroblast proliferation and migration for epidermal and dermal repair. Many studies have focused on the interplay between hematopoietic cells, keratinocytes and fibroblasts during skin wound healing, yet the possible roles for other cell types within the skin, such as intradermal adipocytes, have not been investigated during this process. Here, we identify that adipocyte lineage cells are activated and function during acute skin wound healing. We find that adipocyte precursor cells proliferate and mature adipocytes repopulate skin wounds following inflammation and in parallel with fibroblast migration. Functional analysis of mice with defects in adipogenesis demonstrates that adipocytes are necessary for fibroblast recruitment and dermal reconstruction. These data implicate adipocytes as a key component of the intercellular communication that mediates fibroblast function during skin wound healing. [ABSTRACT FROM AUTHOR]

Here, we explore the established and potential roles for intradermal adipose tissue in communication with hair follicle biology. The hair follicle delves deep into the rich dermal macroenvironment as it grows to maturity where it is surrounded by large lipid-filled adipocytes. Intradermal adipocytes regenerate with faster kinetics than other adipose tissue depots and in parallel with the hair cycle, suggesting an interplay exists between hair follicle cells and adipocytes. While adipocytes have well-established roles in metabolism and energy storage, until recently, they were overlooked as niche cells that provide important growth signals to neighbouring skin cells. We discuss recent data supporting adipocytes as niche cells for the skin and skin pathologies that may be related to alterations in skin adipose tissue defects. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the proliferation and differentiation behaviour of a defined cell population gained from the human growth plate, namely, chondro-progenitorcells (CPCs), in the initial inflammatory phase of growth plate injury response in vitro. Methods: Growth plate cells were sorted via FACS and differentiated along adipogenic and osteogenic lineage to confirm their progenitor features. To mimic the inflammatory phase of injury response at the growth plate they were treated with IL-1β and exposed to cyclic mechanical loading. A BrdU assay was used to investigate CPC proliferation. CPC differentiation behaviour was analysed by RT-PCR. Results: CPCs (CD45-, CD34-, CD73+, CD90+, and CD105+) showed a successful differentiation along adipogenic and osteogenic lineage. Under conditions simulating the inflammatory phase of injury response at the growth plate in vitro CPCs differentiated towards hypertrophy while chondrogenesis and ossification were inhibited. Proliferation was not significantly altered. Conclusion: This study showed that CPCs can be isolated from the human growth plate and expanded in vitro. In the first phase of injury response at the growth plate these cells differentiate towards hypertrophy. As longitudinal growth is obtained by chondrocyte proliferation and volume increase during hypertrophy this maturation might be the first step towards post-traumatic growth disorders such as unwanted premature ossification of the growth plate. [ABSTRACT FROM AUTHOR]

Medicinal plant extracts are widely used as active ingredients in cosmetics. Plant material can come from a variety of sources, including commercial production horticulture and wild harvest in developing countries. Sustainably produced plant material does not threaten biodiversity, release pollution, compete with the food supply, or exploit local people. International treaties like the Rio Convention on Biological Diversity and CITES (Washington Convention) and regulations like Good Agricultural Practices (GAP) have been established to guide sustainable sourcing and production of plant material. Non-profit organizations like the Round Table Sustainable Palm Oil have been organized to create sustainability standards. Once a reliable and sustainable supply chain has been established, cosmetic companies must be aware of regulations set by the U.S. Food and Drug Administration, U.S. Department of Agriculture, and international regulatory agencies that guide the marketing of cosmetics with medicinal plant ingredients. Efficacy claims should be supported with evidence and cannot state that the product treats medical conditions. In the end, responsibly sourced medicinal plants can bring economic benefit to producers, processors, and marketers. [ABSTRACT FROM AUTHOR]

The article discusses a research study that aims to find out whether neonatal caffeine therapy has lasting benefits or newly apparent risks at early school age. Results of the study reveal that the combined outcome of death or disability was not significantly different for the children assigned to caffeine from that for the children assigned to placebo. The rates of death, behavior problems, deafness, motor impairment, poor general health, and blindness did not differ significantly between the two groups.

Background: Prevalence and incidence of diabetes and other common comorbid conditions (hypertension, coronary heart disease, renal disease and chronic lung disease) are extremely high among Indigenous Australians. Recent measures to improve quality of preventive care in Indigenous community settings, while apparently successful at increasing screening and routine check-up rates, have shown only modest or little improvements in appropriate care such as the introduction of insulin and other scaled-up drug regimens in line with evidence-based guidelines, together with support for risk factor reduction. A new strategy is required to ensure high quality integrated family-centred care is available locally, with continuity and cultural safety, by community-based care coordinators with appropriate system supports. Methods/design: The trial design is open parallel cluster randomised controlled trial. The objective of this pragmatic trial is to test the effectiveness of a model of health service delivery that facilitates integrated community-based, intensive chronic condition management, compared with usual care, in rural and remote Indigenous primary health care services in north Queensland. Participants are Indigenous adults (aged 18-65 years) with poorly controlled diabetes (HbA1c>=8.5) and at least one other chronic condition. The intervention is to employ an Indigenous Health Worker to case manage the care of a maximum caseload of 30 participants. The Indigenous Health Workers receive intensive clinical training initially, and throughout the study, to ensure they are competent to coordinate care for people with chronic conditions. The Indigenous Health Workers, supported by the local primary health care (PHC) team and an Indigenous Clinical Support Team, will manage care, including coordinating access to multidisciplinary team care based on best practice standards. Allocation by cluster to the intervention and control groups is by simple randomisation after participant enrolment. Participants in the control group will receive usual care, and will be wait-listed to receive a revised model of the intervention informed by the data analysis. The primary outcome is reduction in HbA1c measured at 18 months. Implementation fidelity will be monitored and a qualitative investigation (methods to be determined) will aim to identify elements of the model which may influence health outcomes for Indigenous people with chronic conditions. Discussion: This pragmatic trial will test a culturally-sound family-centred model of care with supported case management by IHWs to improve outcomes for people with complex chronic care needs. This trial is now in the intervention phase. Trial registration: Australian New Zealand Clinical Trials Registry ACTR12610000812099 [ABSTRACT FROM AUTHOR]

Patients after solid organ transplantation are at increased risk of developing herpes zoster and are more likely to develop major complications such as cutaneous dissemination, post-herpetic neuralgia and visceral organ involvement. We report on a 68-year-old woman being varicella-zoster virus (VZV)-seropositive prior to transplantation, who developed fatal VZV meningoencephalitis after renal transplantation presenting with non-specific neurologic symptoms. The case illustrates that VZV reactivation may occur in renal transplant recipients in the absence of skin lesions. Approaches towards risk assessment pretransplantation and prophylactic regimens for the prevention of VZV recurrence are needed. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance: Grains of Paradise (Aframomum melegueta [Roscoe] K. Schum.) seeds are used in West Africa as a remedy for variety of ailments such as stomach ache, snakebite, diarrhea and they have reported anti-inflammatory properties. Additionally, the seeds contain gingerols and related compounds that may be useful against cardiovascular disease, diabetes, and inflammation. Aim of study: A 28-day sub-chronic toxicity study in male and female Sprague–Dawley rats was conducted to evaluate the safety of a Grains of Paradise extract. Materials and methods: An ethanolic extract of the seeds was evaluated for toxicological effect on rats. Results: A dose-related increase in absolute and relative liver weights was observed in males and females dosed with 450 and 1500mg/kg. There was a corresponding increase in alkaline phosphatase with no signs of steatosis or cirrhosis. At the same doses, there was a significant decrease in blood glucose in male rats. Conclusions: This study shows that Grains of Paradise extract may be useful as a treatment for diabetes, however liver toxicity should be considered. [Copyright &y& Elsevier]

Abstract: Resting frontal electroencephalographic (EEG) alpha-asymmetry was measured in 16 participants to predict affective responses to musical stimuli. Three affective musical stimuli either expressing neutral, positive or negative mood were evaluated by the subjects concerning “expressed mood” and “level of enjoyment”. The results show that individuals with relatively higher alpha power over right frontal electrode sites rated all stimuli more positive than participants with relatively higher alpha power over left frontal electrode sites. On the “expressed mood” scale, the valence of the stimuli did not influence the difference between the ratings of left- and right-active individuals. On the “enjoyment” scale, the largest difference between the ratings of left- and right-active individuals emerged in the negative condition. The results are specific to the alpha frequency band. In line with previous studies, these results suggest that resting frontal alpha-asymmetry reflects a person''s predisposition to respond affectively. [Copyright &y& Elsevier]

AbstractCorticosteroids, intramuscular vitamin A and caffeine reduce the risk of bronchopulmonary dysplasia (BPD) in very-low-birth-weight infants. We compared the size of the beneficial drug effects on BPD and evaluated long-term drug safety by estimating the number needed to treat (NNT) and the number needed to harm (NNH) for the outcome of cerebral palsy (CP). When given prophylactically during the first 4 days of life, corticosteroids increase the risk of CP (NNH 22; 95 CI: 12–133). When prescribed between days 7 and 14, corticosteroids reduce the 28-day mortality rate in addition to reducing BPD. Their effect on CP remains uncertain: the limited data available are consistent with a best-case scenario (NNT 15) and a worst-case scenario (NNH 14). Although repeated intramuscular injections of vitamin A during the 1st month of life reduce BPD (NNT 12; 95 CI: 6–94), estimates for CP range from an NNT of 11 to an NNH of 33. Early use of caffeine reduces both BPD and CP. The NNT for BPD is 10 (95 CI: 7–16), while the NNT for CP is 34 (95 CI: 20–132). We conclude that caffeine is the drug of choice for the prevention of BPD in very-low-birth-weight infants. Corticosteroids should be avoided during the first few days of life. However, when given during the 2nd week of life to infants at high risk of BPD corticosteroids may have important short- and long-term benefits. These should be urgently confirmed or refuted in well-designed controlled trials.Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: To test an evaluation framework designed to evaluate implementation of the North Queensland Indigenous communities between August and December 2005. Setting: Both communities are located in Cape York, North Queensland. Community A has an estimated population of around 600 people; Community B has an enumerated population of 750, although health centre records indicate a higher number. Participants: Process evaluation involved health centre staff in both communities; clinical audits used random samples from the adult population (each sample n = 30); ethnographic fieldwork was conducted with resident population. Main outcome measures: Health centre scores and qualitative findings using a System Assessment Tool; clinical audits – extent to which scheduled services recorded; selected primary health performance indicators; qualitative ethnographic findings. Results: On almost all indicators, implementation of NQICDS had progressed further in Community A than in Community B; however, some common issues emerged, especially lack of linkages between health centres and other groups, and lack of support for client self-management. Conclusions: The evaluation framework is an effective and acceptable framework for monitoring implementation of the NQICDS at the primary health centre level. [ABSTRACT FROM AUTHOR]

Background: Methylxanthine therapy is commonly used for apnea of prematurity but in the absence of adequate data on its efficacy and safety. It is uncertain whether methylxanthines have long-term effects on neurodevelopment and growth. Methods: We randomly assigned 2006 infants with birth weights of 500 to 1250 g to receive either caffeine or placebo until therapy for apnea of prematurity was no longer needed. The primary outcome was a composite of death, cerebral palsy, cognitive delay (defined as a Mental Development Index score of <85 on the Bayley Scales of Infant Development), deafness, or blindness at a corrected age of 18 to 21 months. Results: Of the 937 infants assigned to caffeine for whom adequate data on the primary outcome were available, 377 (40.2%) died or survived with a neurodevelopmental disability, as compared with 431 of the 932 infants (46.2%) assigned to placebo for whom adequate data on the primary outcome were available (odds ratio adjusted for center, 0.77; 95% confidence interval [CI], 0.64 to 0.93; P=0.008). Treatment with caffeine as compared with placebo reduced the incidence of cerebral palsy (4.4% vs. 7.3%; adjusted odds ratio, 0.58; 95% CI, 0.39 to 0.87; P=0.009) and of cognitive delay (33.8% vs. 38.3%; adjusted odds ratio, 0.81; 95% CI, 0.66 to 0.99; P=0.04). The rates of death, deafness, and blindness and the mean percentiles for height, weight, and head circumference at follow-up did not differ significantly between the two groups. Conclusions: Caffeine therapy for apnea of prematurity improves the rate of survival without neurodevelopmental disability at 18 to 21 months in infants with very low birth weight. (ClinicalTrials.gov number, NCT00182312.) N Engl J Med 2007;357:1893-1902. [ABSTRACT FROM AUTHOR]

Abstract: An Ames test and a 28-day sub-chronic toxicity study in male and female Sprague–Dawley rats were conducted to evaluate the safety of a chicory root extract being investigated as a therapeutic for inflammation. Chicory extract had no mutagenic activity in the Ames test although it was cytotoxic to certain strains of Salmonella at higher doses with and without metabolic activation. For the 28-day rat study, measurements included clinical observations, body weights, food consumption, clinical pathology, gross necropsy and histology. There were no treatment-related toxic effects from chicory extract administered orally at 70, 350, or 1000mg/kg/day. Since there were no observed adverse effects of chicory extract in these studies, the NOAEL for the extract is 1000mg/kg/g administered orally for 28days. [Copyright &y& Elsevier]

The article discusses the role played by multicomponent botanical therapeutics (MCBTs) in the future world of medicine. Several researches have revealed that MCBTs provide combination therapies which can simultaneously target various elements of human diseases, providing efficacy and safety. Thus, the author hopes that future regulatory policies will favor scientifically designed, validated and standardized MCBTs aside from the fact that it can be advanced to clinical testing.

Abstract: Introduction: Activation of the coagulation system and severe acquired antithrombin (AT) deficiency are common and prognostically important findings in sick and preterm neonates. It has been hypothesised that treatment of the acquired AT deficiency with AT concentrate may improve the outcome of conditions such as the neonatal respiratory distress syndrome (RDS), intracranial hemorrhage (ICH) and sepsis. Materials and methods: We performed a systematic review of randomised controlled trials (RCTs) of AT replacement therapy in newborn infants. Results: Two full-length trial reports were found. Both were placebo-controlled. The first RCT examined the effects of AT therapy in 122 preterm infants with RDS. Administration of AT prolonged rather than shortened the duration of mechanical ventilation and oxygen therapy. The second RCT determined whether AT replacement decreased the incidence of ICH in 60 preterm infants who were born before 30 weeks of gestation. No beneficial effect on ICH was found. Conclusions: Preterm infants with RDS do not benefit from therapy with AT concentrate and may be harmed. There is also little evidence that the administration of AT reduces the risk of ICH. The role of AT replacement during neonatal sepsis remains uncertain. [Copyright &y& Elsevier]

Abstract: Blueberries are rich in health-promoting polyphenolic compounds including proanthocyanidins. The purpose of this study was to determine if proanthocyanidin-rich fractions from both wild and cultivated blueberry fruit have the same inhibitory effects on the proliferation of LNCaP, an androgen-sensitive prostate cancer cell line, and DU145, a more aggressive androgen insensitive prostate cancer cell line. When 20μg/ml of a wild blueberry proanthocyanidin fraction (fraction 5) was added to LNCaP media, growth was inhibited to 11% of control with an IC50 of 13.3μg/ml. Two similar proanthocyanidin-rich fractions from cultivated blueberries (fractions 4 and 5) at the same concentration inhibited LNCaP growth to 57 and 26% of control with an IC50 of 22.7 and 5.8μg/ml, respectively. In DU145 cells, the only fraction that significantly reduced growth compared to control was fraction 4 from cultivated blueberries with an IC50 value of 74.4μg/ml, indicating only minor inhibitory activity. Differences in cell growth inhibition of LNCaP and DU145 cell lines by blueberry fractions rich in proanthocyanidins indicate that blueberry proanthocyanidins have an effect primarily on androgen-dependant growth of prostate cancer cells. Possible molecular mechanisms for growth inhibition are reviewed. [Copyright &y& Elsevier]

The article reports on the analysis of virome, which refers to the collection of nucleic acids, both RNA and DNA, that make up the viral community associated with a particular ecosystem or holobiont. While the topic microbiome is "on everyone's lips," the virome is still a shadowy existence, although the total number of viruses exceeds that of the bacteria in the body by about ten times. There is growing evidence that viruses have more than just a say in intestinal diseases.

Abstract: Plasmacytoid dendritic cells (PDC), natural type-1 interferon (IFN) producing cells, could play a role in the innate anti-HIV immune response. Previous reports indicated that PDC IFN production is induced by HIV. Our results show a more robust IFN induction when purified PDC (>95%) were exposed to HIV-infected cells. This effect was not observed with non-viable cells, DNA, and RNA extracted from infected cells, and viral proteins. The response was blocked by anti-CD4 and neutralizing anti-gp120 antibodies as well as soluble CD4. IFN induction by HIV-infected cells was also prevented by low-dose chloroquine, which inhibits endosomal acidification. PDC IFN release resulted in reduced HIV production by infected CD4+ cells, supporting an anti-HIV activity of PDC. Stimulated CD4+ cells induced PDC activation and maturation; markers for PDC migration (CCR7) were enhanced by HIV-infected CD4+ cells only. This latter finding could explain the decline in circulating PDC in HIV-infected individuals. [Copyright &y& Elsevier]

Diagnostic evaluation and treatment of blunt liver trauma in children have changed essentially over the last decades. In the period between January 1975 and December 2002, a total of 45 children, 18 girls and 27 boys, between the ages of 1 and 16 years (mean 8.19) were treated for liver rupture following blunt abdominal trauma. The most common causes of injury were traffic accidents (49%), followed by falls (22%), direct trauma due to impact (20%) and being run over by a vehicle (9%). A total of 26 patients had one or more concomitant injuries; the injury severity score was between 16 and 57 (mean 22.9), and 16 patients had additional injuries to other solid abdominal organs. Since we last used laparotomies to explore the abdomen and manage liver ruptures in 1984, we divided our patients into two groups with respect to the choice of diagnostic and treatment modalities: group I, consisting of children treated before 1984, and group II, consisting of children treated after 1985. In group I (n=12), a diagnosis was made in eight cases based on exploratory laparotomy, in two cases based on sonography and laparoscopy, in one case based on laparoscopy only, and in another case based on sonography only. In eight cases the rupture was treated operatively; there was one postsurgical sepsis and one ileus due to adhesions. One child hemorrhaged to death when the vena cava ruptured during surgery. In group II (n=33), sonography was sufficient for a diagnosis in 18 cases. In 12 cases an additional computed tomographic scan was performed following initial sonography, and in three cases a diagnostic laparotomy was done elsewhere. In five cases the rupture was treated operatively in other hospitals. Twenty-eight patients could be treated conservatively and without any complications. One child died 3 days after the accident as a result of a severe brain injury. Over the past 15 years we have seen a clear tendency toward conservative treatment of our patients, which is also in agreement with current literature. Initial sonography, supplemented by computed tomography when necessary, allows not only noninvasive initial diagnostic evaluation but is also helpful in the further course in hemodynamic stable patients. All patients who had been treated conservatively (n=30) had no complications related to the liver rupture. [ABSTRACT FROM AUTHOR]

Plasmacytoid dendritic cells (PDC), the natural type-1 interferon (IFN) producing cells, are part of the innate immune defense against human immunodeficiency virus (HIV). PDC numbers are reduced in advanced stages of infection. These cells can be infected in vivo by HIV since highly purified PDC showed evidence of infectious HIV. Moreover, when PDC derived from uninfected donors were exposed to high-titered HIV isolates, productive infection occurred although with low-level replication. Using real-time amplification, PDC and unstimulated CD4+ cells were found equally susceptible to HIV infection; however, HIV replication was considerably limited in the PDC. Virus replication was enhanced after PDC treatment with CD40L and antibodies against IFN-α, most likely reflecting the reduction in IFN-α activity. On maturation, the infected PDC showed multinuclear cell syncytia formation and death. These findings indicate that PDC can be reservoirs for HIV dissemination and that HIV infection of PDC can contribute to their decline. [Copyright &y& Elsevier]