Association between HTLV-1/2 infection and COVID-19 severity in a migrant Shipibo-Konibo population in Lima, Peru.

OBJECTIVES: The migrant community of the Shipibo-Konibo indigenous people in Lima, Peru were extremely vulnerable during the COVID-19 pandemic. Additionally, infection with human T-cell lymphotropic virus type 1 and 2 (HTLV-1/2) is endemic in this population causing immunosuppression. The aim of the study was to describe the association between HTLV-1/2 infection and the clinical severity of COVID-19. METHODS: This was a cross-sectional descriptive study involving a survey of adult Shipibo-Konibo indigenous migrants residing in Cantagallo-Rímac who were identified as suspected or confirmed cases of COVID-19. Blood samples were collected for SARS-CoV-2 antibody and HTLV-1/2 ELISA testing. A confirmatory Western Blot test was performed for those with a positive ELISA test. RESULTS: A total of 182 individuals were surveyed and sampled. No significant association was found between HTLV-1/2 infection and the clinical severity of COVID-19. The prevalence of HTLV-1/2 was 8.8% (95%CI: 5.0-14.1) with Western Blot. Age was the only statistically significant risk factor for developing a more severe form of COVID-19 (OR: 1.03; 95%CI: 1.00-1.06; p = 0.032). CONCLUSIONS: There was no association found between HTLV-1/2 infection and the clinical severity of COVID-19. The prevalence of HTLV-1/2 infection in the Shipibo-Konibo population is high and warrants continuous monitoring in the advent of other infectious disease outbreaks and the development of HTLV-associated comorbidities.

Impairments in operant probabilistic reversal learning in BTBR T+tf/J male and female mice.

Autism spectrum disorder (ASD) presents with two core symptoms, impairments in social communication and the presence of restricted, repetitive behaviors (RRBs). RRBs are commonly linked to a lack of behavioral flexibility, having a significant negative impact on daily functioning for ASD individuals and their caregivers. Commonly utilized tests of behavioral flexibility employ a traditional deterministic reward approach where choices are either correct or incorrect throughout testing. The incorporation of an 80 %/20 % probabilistic reversal learning paradigm allows for the examination of flexible behavior in the face of variable outcomes, a more ecologically relevant approach. In this task, one specific choice is reinforced on 80 % of trials and the opposite or incorrect choice is reinforced on 20% of trials. Upon successful discrimination learning, the reward contingencies are switched so that the correct choice is now reinforced 20% of trials and the incorrect choice reinforced 80 % of trials, making it the new optimal choice. This translational task has been previously validated in ASD individuals and animal models of ASD, including the BTBR T + tf/J strain. Our lab and others have demonstrated that male BTBR T + tf/J mice have higher expression of lower order RRBs and display deficits in spatial probabilistic reversal learning tasks using a T-maze apparatus. Instead, female BTBR mice do not express the same lower order RRBs and results are mixed on whether females demonstrate similar probabilistic reversal learning deficits in a T-maze. Therefore, the purpose of this study was to assess the validity of using operant chambers to examine BTBR mouse performance on an 80 %/20 % probabilistic reversal learning task and to also examine the sex-specific differences in reversal learning performance in both mouse strains. Results show that BTBR mice, irrespective of sex, were impaired on the reversal learning, requiring more days and trials to reach reversal criterion compared to C57BL/6J mice. These results parallel previous strain findings in the spatial dependent T-maze task in male mice. Further error analysis showed that the impaired behavioral flexibility was due to elevated regressive errors and lose-shift probabilities. BTBR mice have more difficulty maintaining new choice patterns compared to C57BL/6J mice, which supports findings utilizing a spatial T-maze task. Together, these findings further support the use of the BTBR mouse as preclinical models of ASD due to their validity as an ASD model.

Lactobacilli displacement and Candida albicans inhibition on initial adhesion assays: a probiotic analysis.

OBJECTIVE: This study evaluates the probiotic activity of three vaginal Lactobacillus gasseri (H59.2, IMAUFB014, and JCM1131) and one non-vaginal L. plantarum ATCC14917 against three Candida albicans (ATCC10231, candidiasis, and healthy vaginal microbiota). Displacement of lactobacilli and adhesion inhibition of C. albicans were evaluated on an abiotic surface through adhesion assays with different experimental settings (ES) through low (1.0E + 03 CFU/ml) and high (1.00E + 09 CFU/ml) levels of colonization. ES simulated dysbiosis (ES1 and ES4), candidiasis (ES2), and healthy vaginal microbiota (ES3). RESULTS: At ES2 and ES3, L. gasseri H59.2 showed discrepant inhibition values among C. albicans isolates (ES2: P = 0.008, ES3: P = 0.030; two-way ANOVA). L. plantarum was only displaced by 23%, 31%, 54%, and 94% against low and high levels of C. albicans ATCC10231. L. plantarum was less displaced, when compared to L. gasseri strains (ES1: 61-84%, ES2: 82-96%, ES3: 83-95%, and ES4: 73-97%), showing multiple statistical differences (ES1: P = < 0.001, ES2: P = 0.003, and ES3: P = < 0.001; two-way ANOVA). L. plantarum also showed a superior inhibition of C. albicans ATCC10231 in ES1 (81%) and ES2 (58%) when compared to L. gasseri strains (ES1: 27-73%, P < 0.001; and ES2:1-49%, P < 0.001; two-way ANOVA).

Acute serotonin 1B/1A receptor activation impairs behavioral flexibility in C57BL/6J mice.

Pharmacological activation of the serotonin (5-HT) 1B and 5-HT1A receptors has been shown to induce OCD-like perseverative circling and locomotor stereotypy in rodents. Although, several studies have examined how activation of these receptors facilitates these motor-associated OCD-like behaviors, it is not known how acute 5-HT1B and 5-HT1A activation impacts behavioral inflexibility, a common trait related to OCD. The current study examined how acute 5-HT1B/1A receptor agonist RU24969 treatment at 0.01, 0.1, and 1.0 mg/kg impacted behavioral flexibility in both female and male C57BL/6J mice. Behavioral flexibility was tested using a spatial reversal learning task, with probabilistic reward contingencies. In addition, locomotor activity and anxiety-like behaviors were also measured. RU24969 at 0.1 and 1.0 mg/kg impaired behavioral flexibility in both female and male C57BL/6J mice. RU24969 treatment at 1.0 mg/kg reduced locomotor activity in male mice, although RU24969 treatment did not significantly reduce locomotor activity in female mice. In the open field, 1.0 mg/kg elevated anxiety-like behavior in male mice only. Overall, these results demonstrate that acute 5-HT1B and 5-HT1A receptor activation leads to impairments in behavioral flexibility, a common trait associated with OCD.

Impact of specific serotonin receptor modulation on restricted repetitive behaviors.

Restricted, repetitive behaviors (RRBs) are commonly divided into two behavioral categories, lower-order and higher-order RRBs. Individuals displaying lower-order motoric RRBs may express repetitive hand flapping behaviors, body rocking back and forth movements, and continuous body spinning. Higher-order RRBs most commonly cover the behavior inflexibility and cognitive rigidity commonly found in disorders such as autism spectrum disorder and obsessive-compulsive disorder. Various neuropsychiatric disorders are plagued by RRBs yet no FDA-approved treatments have been identified. In rodents, lower-order RRBs are commonly measured through various tasks, such as repetitive self-grooming, marble burying, and stereotypic motor behaviors. This review focuses on the effects that modulation of specific serotonin receptors have on lower-order RRBs. Although there is research examining how changes in 5-HT1A, 5-HT1B, 5-HT2A, 5-HT2B, 5-HT2C, 5-HT3, 5-HT6, and 5-HT7 receptor modulation, more research has focused on the 5-HT1A, 5-HT2A, and 5-HT2C receptors. The accumulating data suggest that increasing 5-HT1A activation decreases RRBs while blocking 5-HT1A activation has no effect on RRBs. While there are mixed findings regarding the impact of 5-HT2A modulation on RRBs, the general trend shows mixed effects of 5-HT2A receptor activation RRB expression, whereas blockade generally decreases RRBs. 5-HT2C receptor activation can modulate RRBs in either direction depending on the 5-HT2C drug used, blocking 5-HT2C activation only seems to show therapeutic properties when 5-HT2C activation is already elevated. The other 5-HT receptors have been explored far less but show promise as potential targets for regulating RRBs. Although it is less clear due to the involvement of 5-HT1D, 5-HT1A activation increases RRBs, and blocking 5-HT1A tends to decrease RRBs. 5-HT2B activation could reduce RRBs, while inhibiting 5-HT2B does not impact RRBs. Increasing 5-HT3 has not been shown to affect RRBs. Yet, increases in RRBs have been observed in Htr3a KO mice. 5-HT6 receptor activation can increase RRBs, while blocking 5-HT6 activity tends to decrease RRBs. Lastly, neither increasing or blocking 5-HT7 activity can reduce RRBs. In sum, there is no uniform pattern in whether all specific 5-HT receptors affect RRBs in either direction, instead, there is evidence suggesting that different 5-HT receptors can modulate RRBs in different directions. Further researching the less explored receptors and aiming to understand why these receptors can differently modulate RRBs, may play a key role in developing therapeutics that treat RRBs.

Impact of specific serotonin receptor modulation on behavioral flexibility.

Serotonin (5-HT) is known to play a critical role in regulation of essential neural processes, whereas more recent research highlights serotonin's modulatory effects on cognition and executive functioning. Current examinations have identified specific serotonin receptors for their direct impact on behavioral flexibility. Providing definitive evidence for the impact of specific receptor targets on behavioral flexibility is difficult, due to the range of behavioral tests used. Due to limited studies and the sheer amount of different serotonin receptor targets, beginning to bring these studies together is important for the field. Our current review of the literature aims to differentiate how modulation of specific 5-HT receptors affects behavioral flexibility. Although more studies have examined 5-HT2A, 5-HT2C, and 5-HT6 receptors, it is unclear why this is the case. Above all, there are some paradoxical results pertaining to these receptor targets. There is a clear distinction between 5-HT2A and 5-HT2C, which conveys that these two receptor subtypes have inverse effects when compared to each other. In addition, some findings support one another, such as upregulation of 5-HT6 receptors impairs flexibility, while blockade alleviates this impairment in both drug-induced and disease model rodent studies. Further understanding how modulatory effects of specific 5-HT receptors impact behavioral flexibility is imperative to advance the development of new therapeutics for neuropsychiatric disorders afflicted by behavioral inflexibility.

The Termination of Deferred Action for Childhood Arrival (DACA) Protections and Medical Education in the U.S.

The termination of the Deferred Action for Childhood Arrivals (DACA) immigration policy poses unique challenges for medical education and healthcare. A survey on DACA was administered online using Qualtrics Software System to 121 unique U.S.-MD granting medical school admissions leadership using e-mails between January 2018 and April 2018. A total of 39 individuals out of 121 (32%) responded to the survey; 23 (59%) of respondents identified as medical school admissions deans, 11 (28%) identified as directors and 5 (13%) as staff/officers. During the past 4 years, 19 (49%) reported having accepted DACA students. The majority either incorrectly answered or were otherwise unsure about the effect of DACA on medical education. The correlation between perception of understanding DACA and mean knowledge composite score was 0.38, P < 0.05. This study found that U.S.-MD granting medical school admissions leaders self-reported knowledge was moderately correlated with actual knowledge about DACA.

Superior learning in synesthetes: Consistent grapheme-color associations facilitate statistical learning.

In synesthesia activation in one sensory domain, such as smell or sound, triggers an involuntary and unusual secondary sensory or cognitive experience. In the present study, we ask whether the added sensory experience of synesthesia can aid statistical learning-the ability to track environmental regularities in order to segment continuous information. To investigate this, we measured statistical learning outcomes, using an aurally presented artificial language, in two groups of synesthetes alongside controls and simulated the multimodal experience of synesthesia in non-synesthetes. One group of synesthetes exclusively had grapheme-color (GC) synesthesia, in which the experience of color is automatically triggered by exposure to written or spoken graphemes. The other group had both grapheme-color and sound-color (SC+) synesthesia, in which the experience of color is also triggered by the waveform properties of a voice, such as pitch, timbre, and/or musical chords. Unlike GC-only synesthetes, the experience of color in the SC+ group is not perfectly consistent with the statistics that signal word boundaries. We showed that GC-only synesthetes outperformed both non-synesthetes and SC+ synesthetes, likely because the visual concurrents for GC-only synesthetes are highly consistent with the artificial language. We further observed that our simulations of GC synesthesia, but not SC+ synesthesia produced superior statistical learning, showing that synesthesia likely boosts learning outcomes by providing a consistent secondary cue. Findings are discussed with regard to how multimodal experience can improve learning, with the present data indicating that this boost is more likely to occur through explicit, as opposed to implicit, learning systems.

Genomic features of bacterial adaptation to plants.

Plants intimately associate with diverse bacteria. Plant-associated bacteria have ostensibly evolved genes that enable them to adapt to plant environments. However, the identities of such genes are mostly unknown, and their functions are poorly characterized. We sequenced 484 genomes of bacterial isolates from roots of Brassicaceae, poplar, and maize. We then compared 3,837 bacterial genomes to identify thousands of plant-associated gene clusters. Genomes of plant-associated bacteria encode more carbohydrate metabolism functions and fewer mobile elements than related non-plant-associated genomes do. We experimentally validated candidates from two sets of plant-associated genes: one involved in plant colonization, and the other serving in microbe-microbe competition between plant-associated bacteria. We also identified 64 plant-associated protein domains that potentially mimic plant domains; some are shared with plant-associated fungi and oomycetes. This work expands the genome-based understanding of plant-microbe interactions and provides potential leads for efficient and sustainable agriculture through microbiome engineering.

The effect of race/ethnicity on gestational weight gain.

Minority women are gaining more weight than recommended during pregnancy. This study aimed to determine the risk of excessive gestational weight gain (GWG) in Hispanic and Black women compared to non-Hispanic women in Colorado. A retrospective cohort study of all birth records from 2007 to 2010 in Colorado was conducted. The primary outcome was GWG, and the exposure was race/ethnicity. Covariates were marital status, education, intensity of prenatal care, age, parity, tobacco use, alcohol use and years in the US. Chi square and multiple logistic regression was performed. 230,698 records were analyzed. Half of the Hispanic and Black women began their pregnancy overweight or obese. Hispanic women had a 0.84 (95% CI 0.8-0.9) and Black women had a 0.95 (95% CI 0.9-1.0) risk of excessive GWG than NHW women. Pre-pregnancy weight is an independent risk for adverse outcomes. The study findings provide healthcare providers focal points in preconception health care and programming.

White matter microstructure throughout the brain correlates with visual imagery in grapheme-color synesthesia.

In this study we show, for the first time, a correlation between the neuroanatomy of the synesthetic brain and a metric that measures behavior not exclusive to the synesthetic experience. Grapheme-color synesthetes (n=20), who experience colors triggered by viewing or thinking of specific letters or numbers, showed altered white matter microstructure, as measured using diffusion tensor imaging, compared with carefully matched non-synesthetic controls. Synesthetes had lower fractional anisotropy and higher perpendicular diffusivity when compared to non-synesthetic controls. An analysis of the mode of anisotropy suggested that these differences were likely due to the presence of more crossing pathways in the brains of synesthetes. Additionally, these differences in white matter microstructure correlated negatively, and only for synesthetes, with a measure of the vividness of their visual imagery. Synesthetes who reported the most vivid visual imagery had the lowest fractional anisotropy and highest perpendicular diffusivity. We conclude that synesthetes as a population vary along a continuum while showing categorical differences in neuroanatomy and behavior compared to non-synesthetes.

Two plus blue equals green: grapheme-color synesthesia allows cognitive access to numerical information via color.

In grapheme-color synesthesia, graphemes (e.g., numbers or letters) evoke color experiences. It is generally reported that the opposite is not true: colors will not generate experiences of graphemes or their associated information. However, recent research has provided evidence that colors can implicitly elicit symbolic representations of associated graphemes. Here, we examine if these representations can be cognitively accessed. Using a mathematical verification task replacing graphemes with color patches, we find that synesthetes can verify such problems with colors as accurately as with graphemes. Doing so, however, takes time: ~250 ms per color. Moreover, we find minimal reaction time switch-costs for switching between computing with graphemes and colors. This demonstrates that given specific task demands, synesthetes can cognitively access numerical information elicited by physical colors, and they do so as accurately as with graphemes. We discuss these results in the context of possible cognitive strategies used to access the information.

An update of dermatologist usage of the Physician Quality Reporting System in Colorado for 2011.

The Physician Quality Reporting System (PQRS) was established in 2006 by the Centers for Medicare and Medicaid Services (CMS) as part of an incentive process to improve healthcare preventive practices. As of 2011, there were 235 PQRS measures but only three specific to skin diseases, specifically melanoma. To measure current usage of the PQRS among dermatologists in Colorado, a survey was distributed at the 2011 Colorado Dermatological Society Meeting. Of the 120 physician attendees, 60 responded, yielding a response rate of 50%. Compared with responses from a similar 2010 survey, a significantly higher number of physicians are using PQRS, as well as E-prescribing and EHR systems. This is likely owing to the fact that CMS will require mandatory reporting of these measures in 2015. Respondents from the current survey commented that a major hurdle to PQRS reporting is the inability to submit data through existing EHR or billing systems. Currently, CMS requires PQRS reporting through a designated registry such as that provided by the AAD. Some practices have opted to report metrics such as tobacco and alcohol screening, since these can be reported through their billing systems. The results suggest structural improvements in the PQRS reporting system could improve compliance.

The interaction of synesthetic and print color and its relation to visual imagery.

Synesthetic color induced by graphemes is well understood to be an automatic perceptual phenomenon paralleling print color in some ways, but also differing in others. We addressed this juxtaposition by asking how synesthetes are affected by synesthetic and print colors that are the same. We tested two groups of grapheme-color synesthetes using a basic color-priming method in which a grapheme prime was presented, followed by a color patch (probe), the color of which was to be named as quickly and accurately as possible. The primes induced either no color, print color only, synesthetic color only, or both forms of color (e.g., a letter "A" printed in red that also triggered synesthetic red). As expected, responses to name the probe color were faster if it was congruent with the prime color than if it was incongruent. The new finding (Exp. 1) was that a prime that induced the same print and synesthetic colors led to substantially larger priming effects than did either type of color individually, an effect that could not be attributed to semantic priming (Exp. 2). In addition, the synesthesia effects correlated with a standard measure of visual imagery. These findings are discussed as being consistent with the hypothesis that print and synesthetic color converge on similar color mechanisms.

Seroepidemiologic investigation of an outbreak of pandemic influenza A H1N1 2009 aboard a US Navy vessel--San Diego, 2009.

BACKGROUND: During summer 2009, a US Navy ship experienced an influenza-like illness outbreak with 126 laboratory-confirmed cases of pandemic influenza A (H1N1) 2009 virus among the approximately 2000-person crew. METHODS: During September 24-October 9, 2009, a retrospective seroepidemiologic investigation was conducted to characterize the outbreak. We administered questionnaires, reviewed medical records, and collected post-outbreak sera from systematically sampled crewmembers. We used real-time reverse transcription-PCR or microneutralization assays to detect evidence of H1N1 virus infection. RESULTS: Retrospective serologic data demonstrated that the overall H1N1 virus infection attack rate was 32%. Weighted H1N1 virus attack rates were higher among marines (37%), junior-ranking personnel (34%), and persons aged 19-24 years (36%). In multivariable analysis, a higher risk of illness was found for women versus men (odds ratio [OR] = 2.2; 95% confidence interval [CI]: 1.1-4.4), marines versus navy personnel (OR = 1.7; 95% CI, 1.0-2.9), and those aged 19-24 versus ≥ 35 years (OR = 3.9; 95% CI, 1.2-12.8). Fifty-three percent of infected persons did not recall respiratory illness symptoms. Among infected persons, only 35% met criteria for acute respiratory illness and 11% for influenza-like illness. CONCLUSIONS: Approximately half of H1N1 infections were asymptomatic, and thus, the attack rate was higher than estimated by clinical illness alone. Enhanced infection control measures including pre-embarkation illness screening, improved self-reporting of illness, isolation of ill and quarantine of exposed contacts, and prompt antiviral chemoprophylaxis and treatment might be useful in controlling shipboard influenza outbreaks.

Ultrasound-guided percutaneous drainage of a traumatic abdominal wall hematoma in the emergency department.

BACKGROUND: Abdominal wall hematoma is due to trauma, coagulation disorders or anticoagulation therapy complications. METHODS: In this report we present a case of a 44-year-old female who suffered from blunt abdominal trauma and presented to the emergency department with sharp abdominal pain and ecchymosis. FAST and abdominal computerized tomography (CT) revealed an abdominal wall hematoma. Treatment with an ultrasound-guided percutaneous drainage was performed successfully. RESULTS: The patient remained under observation for six hours with serial ultrasound scans, and no signs of hematoma recurrence were present. She was discharged the same day with clinical improvement. CONCLUSION: Complete history investigation and clinical examination help to make a correct diagnosis of abdominal wall hematoma, select a prompt treatment, and reduce complications.

Ultrasound-guided percutaneous drainage of a traumatic abdominal wall hematoma in the emergency department / 世界急诊医学杂志（英文）

BACKGROUND: Abdominal wall hematoma is due to trauma, coagulation disorders or anticoagulation therapy complications. METHODS: In this report we present a case of a 44-year-old female who suffered from blunt abdominal trauma and presented to the emergency department with sharp abdominal pain and ecchymosis. FAST and abdominal computerized tomography (CT) revealed an abdominal wall hematoma. Treatment with an ultrasound-guided percutaneous drainage was performed successfully. RESULTS: The patient remained under observation for six hours with serial ultrasound scans, and no signs of hematoma recurrence were present. She was discharged the same day with clinical improvement. CONCLUSION: Complete history investigation and clinical examination help to make a correct diagnosis of abdominal wall hematoma, select a prompt treatment, and reduce complications.

Shifting attention in viewer- and object-based reference frames after unilateral brain injury.

The aims of the present study were to investigate the respective roles that object- and viewer-based reference frames play in reorienting visual attention, and to assess their influence after unilateral brain injury. To do so, we studied 16 right hemisphere injured (RHI) and 13 left hemisphere injured (LHI) patients. We used a cueing design that manipulates the location of cues and targets relative to a display comprised of two rectangles (i.e., objects). Unlike previous studies with patients, we presented all cues at midline rather than in the left or right visual fields. Thus, in the critical conditions in which targets were presented laterally, reorienting of attention was always from a midline cue. Performance was measured for lateralized target detection as a function of viewer-based (contra- and ipsilesional sides) and object-based (requiring reorienting within or between objects) reference frames. As expected, contralesional detection was slower than ipsilesional detection for the patients. More importantly, objects influenced target detection differently in the contralesional and ipsilesional fields. Contralesionally, reorienting to a target within the cued object took longer than reorienting to a target in the same location but in the uncued object. This finding is consistent with object-based neglect. Ipsilesionally, the means were in the opposite direction. Furthermore, no significant difference was found in object-based influences between the patient groups (RHI vs. LHI). These findings are discussed in the context of reference frames used in reorienting attention for target detection.

Enhanced performance with brain stimulation: attentional shift or visual cue?

The premotor theory of visual spatial attention proposes that the same brain activity that prepares for saccades to one part of the visual field also facilitates visual processing at that same region of the visual field. Strong support comes from improvements in performance by electrical stimulation of presaccadic areas, including the frontal eye field and superior colliculus (SC). Interpretations of these stimulation experiments are hampered by the possibility that stimulation might be producing an internal visual flash or phosphene that attracts attention as a real flash would. We tested this phosphene hypothesis in the SC by comparing the effect of interchanging real visual stimuli and electrical stimulation. We first presented a veridical visual cue at the time SC stimulation improved performance; if a phosphene improved performance at this time, a real cue should do so in the same manner, but it did not. We then changed the time of SC visual-motor stimulation to when we ordinarily presented the veridical visual cue, and failed to improve performance. Last, we shifted the site of SC stimulation from the visual-motor neurons of the SC intermediate layers to the visual neurons of the superficial layers to determine whether stimulating visual neurons produced a larger improvement in performance, but it did not. Our experiments provide evidence that a phosphene is not responsible for the shift of attention that follows SC stimulation. This added evidence of a direct shift of attention is consistent with a key role of the SC in the premotor theory of attention.