Pediatric autoimmune neuropsychiatric disorders associated with or without streptococcal and other bacterial infections (PANDAS/CANS) are emerging as a featured pediatric disorder. Although there is some controversy r...Pediatric autoimmune neuropsychiatric disorders associated with or without streptococcal and other bacterial infections (PANDAS/CANS) are emerging as a featured pediatric disorder. Although there is some controversy regarding treatment approaches, especially related to the behavioral sequelae, we have hypothesized in other published work that it is characterized by the rapid onset of Reward Deficiency Syndrome (RDS) in children. We propose utilizing a multi-systems biological approach involving the coupling of genetic addiction risk testing and pro-dopamine regulation (KB220/POLYGEN®) to help induce “dopamine homeostasis” in patients with PANDAS, especially those with known DNA-induced hypodopaminergia. This case study examines a 12-year-old Caucasian male with no prior psychiatric issues who presented with a sudden onset of severe anxiety, depression, emotional liability, and suicidal ideation. The patient underwent genotyping and the genetic addiction risk score (GARS) testing, which revealed risk polymorphisms in the dopamine D2 (-DRD2/ANKK (Taq1A), OPRM1 (A/G), DRD3 (C/T), and MAOA (4R) genes. These polymorphisms have been linked to hypodopaminergia. The patient was subsequently placed on research ID-KB220ZPBMPOLY (POLYGEN®), and albeit the possibility of bias, based upon self and parental assessment, a marked rapid improvement in psychiatric symptoms was observed. In the second phase of treatment (102 days utilizing KB220), the patient received standard antibody testing, which was positive for Lyme. Antibacterial therapy started immediately, and KB220z was discontinued to provide a wash-out period. A monotonic trend analysis was performed on each outcome measure, and a consistently decreasing trend was observed utilizing antibacterial therapy. Our recommendation, albeit only one case, is to utilize and further research a combined therapeutic approach, involving precision-guided DNA testing and pro-dopamine regulation along with antibacterial therapy, as well as glutathione to address offensive enhanced展开更多
Chile is one of the first countries in Latin America to have established diplomatic relations with China, so there is a long history of friendship with China. One afternoon, Dr. Gloria Pollack,wife of Benny Pollack, t...Chile is one of the first countries in Latin America to have established diplomatic relations with China, so there is a long history of friendship with China. One afternoon, Dr. Gloria Pollack,wife of Benny Pollack, the Chilean Ambassador to China, sat down for a question and answer session with Women of China, during which she talked about herself, her country and her feelings and about her life before and after she came to China.展开更多
By using the conformal method, solutions of the Einstein-scalar ficld gravitational constraint equations are obtained. Handling scalar fields is a bit more challenging than handling matter fields such as fluids, Maxwe...By using the conformal method, solutions of the Einstein-scalar ficld gravitational constraint equations are obtained. Handling scalar fields is a bit more challenging than handling matter fields such as fluids, Maxwell fields or Yang-Mills fields, because the scalar field introduces three extra terms into the Lichnerowicz equation, rather than just one. The proofs are constructive and allow for arbitrary dimension （〉 2） as well as low regularity initial data.展开更多
Background The Anxiety Symptoms Questionnaire(ASQ)is a brief self-report questionnaire which measures frequency and intensity of symptoms and was developed to improve assessment of anxiety symptoms in a clinical setti...Background The Anxiety Symptoms Questionnaire(ASQ)is a brief self-report questionnaire which measures frequency and intensity of symptoms and was developed to improve assessment of anxiety symptoms in a clinical setting.We examined the reliability and validity of the ASQ in patients with anxiety disorders and/or depression,nonclinical control subjects and college students.Methods 240 outpatients with generalised anxiety disorder,social anxiety disorder,panic disorder or major depressive disorder were administered the ASQ and additional questionnaires measuring depression and anxiety,as were 111 non-clinical control subjects and 487 college students.Factor analysis,Pearson's correlation coefficients and logistic regression were used to assess reliability and validity.Test-retest reliability of the ASQ was measured using a subset who were re-administered the ASQ after 4 weeks.Results Factor analysis revealed measurement of a single dimension by the ASQ.Internal consistency and test-retest reliability were strong.The ASQ total score also significantly distinguished patients with an anxiety disorder from the clinical controls above and beyond the clinicianrated Hamilton Anxiety Scale.Conclusions The ASQ is a valid,reliable and effective self-rated measure of anxiety and may be a useful tool for screening and assessing anxiety symptoms in psychiatric as well as college settings.展开更多
Urban-dwelling birds have the potential to serve as powerful biomonitors that reveal the impact of environmental change due to urbanization. Specifically, urban bird populations can be used to sur- vey cities for fact...Urban-dwelling birds have the potential to serve as powerful biomonitors that reveal the impact of environmental change due to urbanization. Specifically, urban bird populations can be used to sur- vey cities for factors that may pose both public and wildlife health concerns. Here, we review evi- dence supporting the use of avian biomonitors to identify threats associated with urbanization, including bioaccumulation of toxicants and the dysregulation of behavior and physiology by related stressors. In addition, we consider the use of birds to examine how factors in the urban en- vironment can impact immunity against communicable pathogens. By studying the behavior, physiology, and ecology of urban bird populations, we can elucidate not only how avian popula- tions are responding to environmental change, but also how unintended consequences of urban- ization affect the well-being of human and non-human inhabitants.展开更多
BACKGROUND Online surveys can align with youth’s increased use of the internet and can be a mechanism for expanding youth participation in research.This is particularly important during the coronavirus disease 2019(C...BACKGROUND Online surveys can align with youth’s increased use of the internet and can be a mechanism for expanding youth participation in research.This is particularly important during the coronavirus disease 2019(COVID-19)pandemic,when inperson interactions are limited.However,the advantages and drawbacks of online systems used for research need to be carefully considered before utilizing such methodologies.AIM To describe and discuss the strengths and limitations of an online system developed to recruit adolescent girls for a sexual health research study and conduct a three-month follow up survey.METHODS This methodology paper examines the use of an online system to recruit and follow participants three months after their medical visit to evaluate a mobile sexual and reproductive health application,Health-E You/Salud iTuTM,for adolescent girls attending school-based health centers(SBHCs)across the United States.SBHC staff gave adolescent girls a web link to an online eligibility and consent survey.Participants were then asked to complete two online surveys(baseline and 3-month follow-up).Surveys,reminders,and incentives to complete them were distributed through short message service(SMS)text messages.Upon completing each survey,participants were also sent an email with a link to an electronic gift card as a thank-you for their participation.Barriers to implementing this system were discussed with clinicians and staff at each participating SBHC.RESULTS This online recruitment and retention system enabled participant recruitment at 26 different SBHCs in seven states across the United States.Between September 2021 and June 2022,415 adolescent girls were screened using the Qualtrics online survey platform,and 182 were eligible to participate.Of those eligible,78.0%(n=142)completed the baseline survey.Participants were racially,geographically,and linguistically diverse.Most of the participants(89.4%)were non-White,and 40.8%spoke Spanish.A total of 62.0%(n=88)completed the 3-month follow-up survey.Limitations of t展开更多
BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential the...BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential therapeutic impact of using pharmacotherapy to target sleep disturbance in patients with PTSD.Eszopiclone(ESZ)is a non-benzodiazepine y-aminobutyric acid-A receptor agonist indicated for the treatment of sleep and may affect sleep in patients with PTSD.AIM To evaluate the efficacy of ESZ vs placebo(PBO)for patients with PTSD and insomnia.METHODS The study was a 12-wk,double blind,randomized controlled trial with 3 mg of ESZ(n=13)or PBO(n=12).RESULTS Patients in both arms experienced significant improvement in PTSD symptoms as assessed by the Clinician-Administered PTSD Scale for DSM-IV(CAPS):ESZ(t11=-3.12,P=0.005)and PBO(t11=-3.5,P=0.002)and by self-report with the Short PTSD Rating Interview(ESZ t11=-3.38,P=0.003 and PBO t11=-4.48,P=0.0005).There were no significant differences between treatments on the CAPS(t22=-0.13,P=0.70)or the Short PTSD Rating Interview(t22=-0.58,P=0.56).Similarly,both treated groups improved on sleep measures as assessed by the Pittsburgh Sleep Quality Index with PTSD Addendum(PSQI)and on total sleep time(TST)and sleep latency assessed by actigraphy with no significant differences between groups(PSQI t22=-0.24,P=0.81;total sleep time t10=0.13,P=0.90 and sleep latency t10=0.68,P=0.50).There was a significant correlation between improvement in sleep and overall improvement in PTSD as measured by change scores on the PSQI and CAPS,r(8)=0.79,P=0.01 for ESZ treated subjects,but not for those treated with PBO r(9)=0.16,P=0.69.Adverse events of ESZ were consistent with the known profile of the medication including dysgeusia(30%,mild),sedation(20%,mild)and headache(20%,moderate to severe).CONCLUSION Results do not support the hypothesis of a specific positive effect of ESZ compared to PBO for measures of PTSD and associated sleep disturbance.展开更多
This paper describes a rare case in which the oral ad-ministration of mesalamine resulted in the exacerbation of ulcerative colitis (UC) in a patient who was previously responsive to mesalamine and whose colitis had b...This paper describes a rare case in which the oral ad-ministration of mesalamine resulted in the exacerbation of ulcerative colitis (UC) in a patient who was previously responsive to mesalamine and whose colitis had been in remission for eight years. Mesalamine and other 5-ami-nosalicylic acid compounds are the mainstay of treatment for UC; however up to 8% of patients are unable to take the medications due to intolerance or hypersensitivity reactions. Common drug reactions are fever, nausea, di-arrhea and abdominal pain; however, exacerbation of UC has rarely been reported. This study highlights the impor-tance of ruling out mesalamine as the causative agent in cases of UC exacerbations.展开更多
Background: Mucoepidermoid carcinoma ex-pleomorphic adenoma (MECxPA) is an extremely rare salivary gland malignancy. With only nine prior reported cases, this entity represents a challenging histopathological diagnosi...Background: Mucoepidermoid carcinoma ex-pleomorphic adenoma (MECxPA) is an extremely rare salivary gland malignancy. With only nine prior reported cases, this entity represents a challenging histopathological diagnosis. Methods: We present a case of a 71-year-old male with an enlarging left neck mass over several months. CT showed both a parapharyngeal space mass and a separate level II neck mass. Results: The patient underwent resection of the left parapharyngeal mass and ipsilateral selective level II-IV lymphadenectomy. The final pathologic diagnosis was metastatic high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma. Conclusions: We describe a novel presentation of high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma as a metastatic parapharyngeal mass.展开更多
众所周知，Euclid（欧几里得）的推理可用来证明3k-1^1）形的素数个数无限．我们对所有这样的素数的倒数之和是发散的提出一个简单的证明．更一般地，若q是一个正整数，并且H是单位群（Z/qZ）^×2）的一个真子群，我们证明了∑p是素...众所周知，Euclid（欧几里得）的推理可用来证明3k-1^1）形的素数个数无限．我们对所有这样的素数的倒数之和是发散的提出一个简单的证明．更一般地，若q是一个正整数，并且H是单位群（Z/qZ）^×2）的一个真子群，我们证明了∑p是素数p mod q￠H p/1=∞.展开更多
PURPOSE:Preoperative radiotherapy improves local control in rectal cancer treatment,but there are fewreports on the influence of radiotherapy on anorectal function.The aim of the present study was to assess late effec...PURPOSE:Preoperative radiotherapy improves local control in rectal cancer treatment,but there are fewreports on the influence of radiotherapy on anorectal function.The aim of the present study was to assess late effects of short-course,high-dose radiotherapy on anorectal function after low anterior resection for rectal cancer.METHODS:Sixty-four patients,randomized within the Stockholm Radiotherapy Trials and operated on with lowanterior resectionwith or without preoperative radiotherapy(mean,14 years),previously were followed up with quality-of life questionnaires,clinical examination,anorectal manometry,and endoanal ultrasound.Twenty-one patients had received preoperative radiotherapy of the rectum and 43 patients had been treated with surgery alone.RESULTS:Impaired anorectal function was common after low anterior resection for rectal cancer and the risk was increased after radiotherapy.Irradiated patients had significantly more symptoms of fecal incontinence(57 vs.26 percent,P = 0.01),soiling(38 vs.16 percent,P = 0.04),and significantly more bowel movements per week(20 vs.10,P = 0.02).At anorectal manometry,irradiated patients had significantly lower resting(35 mmHg vs.62 mmHg,P < 0.001)and squeeze pressures(104 mmHg vs.143 mmHg,P = 0.05).At endoanal ultrasound,irradiated patients had significantly more scarring of the anal sphincters(33 vs.13 percent,P = 0.03).There were no significant differences in quality-of-life scores between irradiated and nonirradiated patients;however,patients with anal incontinence had significantly lower quality-of-life scores compared to continent patients.CONCLUSIONS:Short-course radiotherapy,including the anal sphincters,impairs anorectal function and increases gastrointestinal symptoms permanently when the anal sphincters are irradiated.展开更多
文摘Pediatric autoimmune neuropsychiatric disorders associated with or without streptococcal and other bacterial infections (PANDAS/CANS) are emerging as a featured pediatric disorder. Although there is some controversy regarding treatment approaches, especially related to the behavioral sequelae, we have hypothesized in other published work that it is characterized by the rapid onset of Reward Deficiency Syndrome (RDS) in children. We propose utilizing a multi-systems biological approach involving the coupling of genetic addiction risk testing and pro-dopamine regulation (KB220/POLYGEN®) to help induce “dopamine homeostasis” in patients with PANDAS, especially those with known DNA-induced hypodopaminergia. This case study examines a 12-year-old Caucasian male with no prior psychiatric issues who presented with a sudden onset of severe anxiety, depression, emotional liability, and suicidal ideation. The patient underwent genotyping and the genetic addiction risk score (GARS) testing, which revealed risk polymorphisms in the dopamine D2 (-DRD2/ANKK (Taq1A), OPRM1 (A/G), DRD3 (C/T), and MAOA (4R) genes. These polymorphisms have been linked to hypodopaminergia. The patient was subsequently placed on research ID-KB220ZPBMPOLY (POLYGEN®), and albeit the possibility of bias, based upon self and parental assessment, a marked rapid improvement in psychiatric symptoms was observed. In the second phase of treatment (102 days utilizing KB220), the patient received standard antibody testing, which was positive for Lyme. Antibacterial therapy started immediately, and KB220z was discontinued to provide a wash-out period. A monotonic trend analysis was performed on each outcome measure, and a consistently decreasing trend was observed utilizing antibacterial therapy. Our recommendation, albeit only one case, is to utilize and further research a combined therapeutic approach, involving precision-guided DNA testing and pro-dopamine regulation along with antibacterial therapy, as well as glutathione to address offensive enhanced
文摘Chile is one of the first countries in Latin America to have established diplomatic relations with China, so there is a long history of friendship with China. One afternoon, Dr. Gloria Pollack,wife of Benny Pollack, the Chilean Ambassador to China, sat down for a question and answer session with Women of China, during which she talked about herself, her country and her feelings and about her life before and after she came to China.
基金Project supported by NSF Grant PHY-0354659 at the University of Oregonby NSF Grant DMS-0305048 at the University of Washington.
文摘By using the conformal method, solutions of the Einstein-scalar ficld gravitational constraint equations are obtained. Handling scalar fields is a bit more challenging than handling matter fields such as fluids, Maxwell fields or Yang-Mills fields, because the scalar field introduces three extra terms into the Lichnerowicz equation, rather than just one. The proofs are constructive and allow for arbitrary dimension （〉 2） as well as low regularity initial data.
文摘Background The Anxiety Symptoms Questionnaire(ASQ)is a brief self-report questionnaire which measures frequency and intensity of symptoms and was developed to improve assessment of anxiety symptoms in a clinical setting.We examined the reliability and validity of the ASQ in patients with anxiety disorders and/or depression,nonclinical control subjects and college students.Methods 240 outpatients with generalised anxiety disorder,social anxiety disorder,panic disorder or major depressive disorder were administered the ASQ and additional questionnaires measuring depression and anxiety,as were 111 non-clinical control subjects and 487 college students.Factor analysis,Pearson's correlation coefficients and logistic regression were used to assess reliability and validity.Test-retest reliability of the ASQ was measured using a subset who were re-administered the ASQ after 4 weeks.Results Factor analysis revealed measurement of a single dimension by the ASQ.Internal consistency and test-retest reliability were strong.The ASQ total score also significantly distinguished patients with an anxiety disorder from the clinical controls above and beyond the clinicianrated Hamilton Anxiety Scale.Conclusions The ASQ is a valid,reliable and effective self-rated measure of anxiety and may be a useful tool for screening and assessing anxiety symptoms in psychiatric as well as college settings.
文摘Urban-dwelling birds have the potential to serve as powerful biomonitors that reveal the impact of environmental change due to urbanization. Specifically, urban bird populations can be used to sur- vey cities for factors that may pose both public and wildlife health concerns. Here, we review evi- dence supporting the use of avian biomonitors to identify threats associated with urbanization, including bioaccumulation of toxicants and the dysregulation of behavior and physiology by related stressors. In addition, we consider the use of birds to examine how factors in the urban en- vironment can impact immunity against communicable pathogens. By studying the behavior, physiology, and ecology of urban bird populations, we can elucidate not only how avian popula- tions are responding to environmental change, but also how unintended consequences of urban- ization affect the well-being of human and non-human inhabitants.
基金Supported by a Patient-Centered Outcomes Research Institute(PCORI)Dissemination and Implementation Award,No.DI-2020C2-20372.
文摘BACKGROUND Online surveys can align with youth’s increased use of the internet and can be a mechanism for expanding youth participation in research.This is particularly important during the coronavirus disease 2019(COVID-19)pandemic,when inperson interactions are limited.However,the advantages and drawbacks of online systems used for research need to be carefully considered before utilizing such methodologies.AIM To describe and discuss the strengths and limitations of an online system developed to recruit adolescent girls for a sexual health research study and conduct a three-month follow up survey.METHODS This methodology paper examines the use of an online system to recruit and follow participants three months after their medical visit to evaluate a mobile sexual and reproductive health application,Health-E You/Salud iTuTM,for adolescent girls attending school-based health centers(SBHCs)across the United States.SBHC staff gave adolescent girls a web link to an online eligibility and consent survey.Participants were then asked to complete two online surveys(baseline and 3-month follow-up).Surveys,reminders,and incentives to complete them were distributed through short message service(SMS)text messages.Upon completing each survey,participants were also sent an email with a link to an electronic gift card as a thank-you for their participation.Barriers to implementing this system were discussed with clinicians and staff at each participating SBHC.RESULTS This online recruitment and retention system enabled participant recruitment at 26 different SBHCs in seven states across the United States.Between September 2021 and June 2022,415 adolescent girls were screened using the Qualtrics online survey platform,and 182 were eligible to participate.Of those eligible,78.0%(n=142)completed the baseline survey.Participants were racially,geographically,and linguistically diverse.Most of the participants(89.4%)were non-White,and 40.8%spoke Spanish.A total of 62.0%(n=88)completed the 3-month follow-up survey.Limitations of t
基金Supported by National Institute of Mental Health,No.5R34MH91338-03 and No.K23 MH103394(to Zalta AK)
文摘BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential therapeutic impact of using pharmacotherapy to target sleep disturbance in patients with PTSD.Eszopiclone(ESZ)is a non-benzodiazepine y-aminobutyric acid-A receptor agonist indicated for the treatment of sleep and may affect sleep in patients with PTSD.AIM To evaluate the efficacy of ESZ vs placebo(PBO)for patients with PTSD and insomnia.METHODS The study was a 12-wk,double blind,randomized controlled trial with 3 mg of ESZ(n=13)or PBO(n=12).RESULTS Patients in both arms experienced significant improvement in PTSD symptoms as assessed by the Clinician-Administered PTSD Scale for DSM-IV(CAPS):ESZ(t11=-3.12,P=0.005)and PBO(t11=-3.5,P=0.002)and by self-report with the Short PTSD Rating Interview(ESZ t11=-3.38,P=0.003 and PBO t11=-4.48,P=0.0005).There were no significant differences between treatments on the CAPS(t22=-0.13,P=0.70)or the Short PTSD Rating Interview(t22=-0.58,P=0.56).Similarly,both treated groups improved on sleep measures as assessed by the Pittsburgh Sleep Quality Index with PTSD Addendum(PSQI)and on total sleep time(TST)and sleep latency assessed by actigraphy with no significant differences between groups(PSQI t22=-0.24,P=0.81;total sleep time t10=0.13,P=0.90 and sleep latency t10=0.68,P=0.50).There was a significant correlation between improvement in sleep and overall improvement in PTSD as measured by change scores on the PSQI and CAPS,r(8)=0.79,P=0.01 for ESZ treated subjects,but not for those treated with PBO r(9)=0.16,P=0.69.Adverse events of ESZ were consistent with the known profile of the medication including dysgeusia(30%,mild),sedation(20%,mild)and headache(20%,moderate to severe).CONCLUSION Results do not support the hypothesis of a specific positive effect of ESZ compared to PBO for measures of PTSD and associated sleep disturbance.
文摘This paper describes a rare case in which the oral ad-ministration of mesalamine resulted in the exacerbation of ulcerative colitis (UC) in a patient who was previously responsive to mesalamine and whose colitis had been in remission for eight years. Mesalamine and other 5-ami-nosalicylic acid compounds are the mainstay of treatment for UC; however up to 8% of patients are unable to take the medications due to intolerance or hypersensitivity reactions. Common drug reactions are fever, nausea, di-arrhea and abdominal pain; however, exacerbation of UC has rarely been reported. This study highlights the impor-tance of ruling out mesalamine as the causative agent in cases of UC exacerbations.
文摘Background: Mucoepidermoid carcinoma ex-pleomorphic adenoma (MECxPA) is an extremely rare salivary gland malignancy. With only nine prior reported cases, this entity represents a challenging histopathological diagnosis. Methods: We present a case of a 71-year-old male with an enlarging left neck mass over several months. CT showed both a parapharyngeal space mass and a separate level II neck mass. Results: The patient underwent resection of the left parapharyngeal mass and ipsilateral selective level II-IV lymphadenectomy. The final pathologic diagnosis was metastatic high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma. Conclusions: We describe a novel presentation of high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma as a metastatic parapharyngeal mass.
文摘PURPOSE:Preoperative radiotherapy improves local control in rectal cancer treatment,but there are fewreports on the influence of radiotherapy on anorectal function.The aim of the present study was to assess late effects of short-course,high-dose radiotherapy on anorectal function after low anterior resection for rectal cancer.METHODS:Sixty-four patients,randomized within the Stockholm Radiotherapy Trials and operated on with lowanterior resectionwith or without preoperative radiotherapy(mean,14 years),previously were followed up with quality-of life questionnaires,clinical examination,anorectal manometry,and endoanal ultrasound.Twenty-one patients had received preoperative radiotherapy of the rectum and 43 patients had been treated with surgery alone.RESULTS:Impaired anorectal function was common after low anterior resection for rectal cancer and the risk was increased after radiotherapy.Irradiated patients had significantly more symptoms of fecal incontinence(57 vs.26 percent,P = 0.01),soiling(38 vs.16 percent,P = 0.04),and significantly more bowel movements per week(20 vs.10,P = 0.02).At anorectal manometry,irradiated patients had significantly lower resting(35 mmHg vs.62 mmHg,P < 0.001)and squeeze pressures(104 mmHg vs.143 mmHg,P = 0.05).At endoanal ultrasound,irradiated patients had significantly more scarring of the anal sphincters(33 vs.13 percent,P = 0.03).There were no significant differences in quality-of-life scores between irradiated and nonirradiated patients;however,patients with anal incontinence had significantly lower quality-of-life scores compared to continent patients.CONCLUSIONS:Short-course radiotherapy,including the anal sphincters,impairs anorectal function and increases gastrointestinal symptoms permanently when the anal sphincters are irradiated.
