Association of Project ECHO Training With Buprenorphine Prescribing by Primary Care Clinicians in Minnesota for Treating Opioid Use Disorder.

Importance: Buprenorphine is an approved medication for opioid use disorder (MOUD); however, prescribing buprenorphine is limited by a requirement to obtain a waiver to prescribe it (hereinafter, "DATA [Drug Abuse Treatment Act]-waiver") and a lack of knowledge of the best practices among clinicians. Objective: To examine how Project ECHO (Extension for Community Healthcare Outcomes) telementoring is associated with changes in DATA-waiver attainment and buprenorphine prescribing among primary care clinicians in Minnesota. Design, Setting, and Participants: In this retrospective matched-cohort study of 918 clinicians, ECHO-trained clinicians were enrolled on the date they first attended ECHO (January 3, 2018, to June 11, 2020); comparison clinicians were assigned an enrollment date from the distribution of the first ECHO sessions. The baseline period was 12 months preceding enrollment, with follow-up for 18 months or until June 30, 2020. The ECHO-trained clinicians were a population-based sample of primary care clinicians who treated Medicaid patients in Minnesota 12 months prior to the initiation of ECHO training. This analysis used propensity score matching to select comparison clinicians who were similar across demographic and clinical practice characteristics at baseline in a 2:1 ratio. Follow-up was available for 167 ECHO-trained clinicians (54.6%) and 330 comparison clinicians (53.9%) at 18 months. Exposures: ECHO-trained clinicians attended at least 1 weekly, hour-long ECHO session. Comparison clinicians never participated in any ECHO sessions. Main Outcomes and Measures: DATA-waiver attainment, any buprenorphine prescribing, and the percentage of patients with opioid use disorder (OUD) who were prescribed buprenorphine. Results: The final sample included 918 clinicians (ECHO-trained [306]; comparison [612]), of whom 620 (67.5%) practiced outside the metropolitan Twin Cities (Minneapolis-St Paul) region. The mean (SD) age of the ECHO-trained clinicians was 46.0 (12.1) years and that of the comparison clinicians was 45.7 (12.3) years. Relative to the changes among the matched comparison clinicians, the ECHO-trained clinicians were more likely to obtain a DATA-waiver (difference-in-differences, 22.7 percentage points; 95% CI, 15.5-29.9 percentage points; P < .001) and prescribe any buprenorphine (16.5 percentage points; 95% CI, 10.4-22.5 percentage points; P < .001) after 6 quarters of follow-up. ECHO-trained clinicians prescribed buprenorphine to a greater share of patients with OUD (a difference of 7.6 percentage points per month; 95% CI, 4.6-10.6 percentage points per month; P < .001), relative to that prescribed by the comparison clinicians. Conclusions and Relevance: According to the findings of this matched-cohort study, ECHO telementoring may be associated with greater prescribing of buprenorphine by primary care clinicians. These findings suggest that Project ECHO training could be a useful tool for expanding access to MOUD.

Management of early treated adolescents and young adults with phenylketonuria: Development of international consensus recommendations using a modified Delphi approach.

BACKGROUND: Early treated patients with phenylketonuria (PKU) often become lost to follow-up from adolescence onwards due to the historical focus of PKU care on the pediatric population and lack of programs facilitating the transition to adulthood. As a result, evidence on the management of adolescents and young adults with PKU is limited. METHODS: Two meetings were held with a multidisciplinary international panel of 25 experts in PKU and comorbidities frequently experienced by patients with PKU. Based on the outcomes of the first meeting, a set of statements were developed. During the second meeting, these statements were voted on for consensus generation (≥70% agreement), using a modified Delphi approach. RESULTS: A total of 37 consensus recommendations were developed across five areas that were deemed important in the management of adolescents and young adults with PKU: (1) general physical health, (2) mental health and neurocognitive functioning, (3) blood Phe target range, (4) PKU-specific challenges, and (5) transition to adult care. The consensus recommendations reflect the personal opinions and experiences from the participating experts supported with evidence when available. Overall, clinicians managing adolescents and young adults with PKU should be aware of the wide variety of PKU-associated comorbidities, initiating screening at an early age. In addition, management of adolescents/young adults should be a joint effort between the patient, clinical center, and parents/caregivers supporting adolescents with gradually gaining independent control of their disease during the transition to adulthood. CONCLUSIONS: A multidisciplinary international group of experts used a modified Delphi approach to develop a set of consensus recommendations with the aim of providing guidance and offering tools to clinics to aid with supporting adolescents and young adults with PKU.

Responsiveness to inhibitory signals changes as a function of colony size in honeybees (Apis mellifera).

Biological collectives, like honeybee colonies, can make intelligent decisions and robustly adapt to changing conditions via intricate systems of excitatory and inhibitory signals. In this study, we explore the role of behavioural plasticity and its relationship to network size by manipulating honeybee colony exposure to an artificial inhibitory signal. As predicted, inhibition was strongest in large colonies and weakest in small colonies. This is ecologically relevant for honeybees, for which reduced inhibitory effects may increase robustness in small colonies that must maintain a minimum level of foraging and food stores. We discuss evidence for size-dependent plasticity in other types of biological networks.

Real-World Use of Once-Weekly Semaglutide in Type 2 Diabetes: Results from the SURE UK Multicentre, Prospective, Observational Study.

INTRODUCTION: Once-weekly (OW) semaglutide was associated with clinically relevant improvements in glycaemic control and body weight versus comparators in the SUSTAIN randomised controlled trials (RCTs). SURE UK, which is one of a series of individual studies that comprise the SURE programme, evaluated the use of OW semaglutide in a real-world patient population with type 2 diabetes (T2D) in the UK. METHODS: In this prospective, observational study, adults (≥ 18 years) with ≥ 1 documented glycated haemoglobin (HbA1c) value ≤ 12 weeks before semaglutide initiation were enrolled. The primary endpoint was change in HbA1c from baseline to end of study (EOS; ~ 30 weeks, although due to the COVID-19 pandemic, visits up to week 52 were permitted). Secondary endpoints included change in body weight, waist circumference and patient-reported outcomes (PROs). Physicians were to report all episodes of documented or severe hypoglycaemia, fatal events, serious adverse drug reactions, pregnancies and adverse events (AEs) in foetuses/newborn infants; other AEs during the study period could be reported on a voluntary basis. RESULT: The estimated mean change in HbA1c from baseline to EOS was - 16.3 mmol/mol [95% confidence interval (CI): - 18.22, - 14.37] (- 1.5%-points [95% CI - 1.67, - 1.31]; p < 0.0001) among the 171 enrolled patients who completed the study on treatment. Mean body weight change was - 5.8 kg (95% CI - 6.75, - 4.94; p < 0.0001). Sensitivity analyses showed similar results. Improvements were also observed in other secondary endpoints, including PROs. No new safety concerns were identified with semaglutide treatment. CONCLUSION: Patients receiving OW semaglutide experienced statistically significant and clinically relevant reductions from baseline in HbA1c and body weight. These results are in line with those of the SUSTAIN RCTs and support the use of OW semaglutide in routine clinical practice in adults with T2D in the UK. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT03876015.

Effects of Nosema ceranae (Dissociodihaplophasida: Nosematidae) and Flupyradifurone on Olfactory Learning in Honey Bees, Apis mellifera (Hymenoptera: Apidae).

The health of insect pollinators, particularly the honey bee, Apis mellifera (Linnaeus, 1758), is a major concern for agriculture and ecosystem health. In response to mounting evidence supporting the detrimental effects of neonicotinoid pesticides on pollinators, a novel 'bee safe' butenolide compound, flupyradifurone (FPF) has been registered for use in agricultural use. Although FPF is not a neonicotinoid, like neonicotinoids, it is an excitotoxic nicotinic acetylcholine receptor agonist. In addition, A. mellifera faces threats from pathogens, such as the microsporidian endoparasite, Nosema ceranae (Fries et al. 1996). We therefore sought 1) to increase our understanding of the potential effects of FPF on honey bees by focusing on a crucial behavior, the ability to learn and remember an odor associated with a food reward, and 2) to test for a potential synergistic effect on such learning by exposure to FPF and infection with N. ceranae. We found little evidence that FPF significantly alters learning and memory at short-term field-realistic doses. However, at high doses and at chronic, field-realistic exposure, FPF did reduce learning and memory in an olfactory conditioning task. Infection with N. ceranae also reduced learning, but there was no synergy (no significant interaction) between N. ceranae and exposure to FPF. These results suggest the importance of continued studies on the chronic effects of FPF.

General patient satisfaction after elective and acute thoracic surgery is associated with postoperative complications.

BACKGROUND: Patient's satisfaction has been regarded as a subjective reflection of the quality of care received by patients during their hospital stay. However, which factors may influence patient satisfaction in different healthcare settings needs to be determined. METHODS: Cross-sectional investigation of satisfaction at the time of discharge in 52 consecutive patients admitted in a UK Referral Centre for Thoracic Surgery for either elective (41 patients) or acute (11 patients) procedures. We evaluated patients' satisfaction with the inpatient service through the European Organisation for the Research and Treatment of Cancer IN-PATSAT32 standardised questionnaire. Major cardiopulmonary complications were defined according to the definition of the European Society of Thoracic Surgeons database. We focused on the General Patient Satisfaction Scale of the questionnaire to explore its relationship with several demographic and clinical factors. Relationships were tested using univariate regression analyses. RESULTS: General inpatient satisfaction was lower in patients with complications rather than those without (P=0.006) and in males rather than females (P=0.04). Living area, sex, and complications explained 22% of the variation in general inpatient satisfaction (P=0.006). CONCLUSIONS: Regardless of the diagnosis, post-operative complications were associated with a lower patient satisfaction following thoracic surgery in our group of patients. This was particularly so for males and patients from rural areas. Research should focus on different clinical groups in our speciality to determine the specific strategies warranted to improve their quality of care and hence increase their satisfaction with inpatient services.

The novel butenolide pesticide flupyradifurone does not alter responsiveness to sucrose at either acute or chronic short-term field-realistic doses in the honey bee, Apis mellifera.

BACKGROUND: Sublethal exposure to neonicotinoids, a popular class of agricultural pesticides, can lead to behavioral effects that impact the health of pollinators. Therefore, new compounds, such as flupyradifurone (FPF), have recently been developed as 'safer' alternatives. FPF is an excitotoxic nicotinic acetylcholine receptor agonist, similar to neonicotinoids. Given the novelty of FPF, what data exist are focused mostly on assessing the effect of FPF on pollinator mortality. One important avenue for investigation is the potential effect of FPF on the sensitivity of nectar foragers, such as Apis mellifera, to sucrose concentrations. Neonicotinoids can alter this sucrose responsiveness and disrupt foraging. Compounding this effect, neonicotinoid-containing solutions are preferred by A. mellifera over pure sucrose solutions. We therefore conducted four studies, administering FPF under both acute and chronic conditions, and at field-realistic and higher than field-realistic doses, to assess the influence of FPF exposure on sucrose responsiveness and sucrose solutions with FPF in A. mellifera nectar foragers. RESULTS: We found no evidence that FPF exposure under acute or chronic field-realistic conditions significantly altered sucrose responsiveness, and we did not find that bees exposed to FPF consumed more of the solution. However, at the much higher median lethal dose (48 h), among bees that survived, FPF-exposed foragers responded to significantly lower concentrations of sucrose than controls and responded at significantly higher rates to all concentrations of sucrose than controls. CONCLUSION: We found no evidence that FPF alters the sucrose responsiveness of nectar foragers at field-realistic doses during winter or early spring, but caution and further investigation are warranted, particularly on the effects of FPF in conjunction with other stressors. © 2019 Society of Chemical Industry.

Adult patient perspectives on phenylketonuria care: Highlighting the need for dedicated adult management and services.

Phenylketonuria (PKU) is an autosomal recessive metabolic disorder characterized by an inability to metabolize the amino acid phenylalanine (Phe). If left untreated, an accumulation of Phe results in neurodevelopmental, neurological and psychological impairments. Advancements in detection and treatment of PKU have improved outcomes and life expectancy for these patients, emphasizing the need for life-long, specialized care. Due to the paucity of adult-focused PKU clinics, patients who are well into adulthood are still being treated in pediatric centers. This retrospective study evaluates the perceived expectations, benefits and challenges of 50 adult PKU patients (mean age 31.3 ± 10.4 years) transitioning from a pediatric to adult care setting using a transition questionnaire administered at the first clinic visit at the adult PKU care center. Patients reported a lack of access to adult resources and adult-specific PKU educational material in their pediatric PKU clinic. In contrast, the established relationships with the pediatric health care team and familiarity with treatment plans were aspects of pediatric care that patients enjoyed. The results from this study will contribute to the optimization of adult PKU patient care, establishment of strategies for transitioning adults with PKU and other metabolic disorders from pediatric to adult care, and support the need to establish adult-only PKU care facilities.

A case of secondary acute myeloid leukemia on a background of glycogen storage disease with chronic neutropenia treated with granulocyte colony stimulating factor.

Congenital neutropenias due to mutations in ELANE, SBDS or HAX1 or in the setting of glycogen storage disease (GSD) which is caused by SLC37A4 mutation, often require prolonged granulocyte colony stimulating factor (G-CSF) therapy to prevent recurrent infections and hospital admission. There has been emerging evidence that prolonged exposure to G-CSF in cases with congenital neutropenia other than GSD is associated with transformation to myelodysplastic syndrome/acute myeloid leukemia.

Foragers of sympatric Asian honey bee species intercept competitor signals by avoiding benzyl acetate from Apis cerana alarm pheromone.

While foraging, animals can form inter- and intraspecific social signalling networks to avoid similar predators. We report here that foragers of different native Asian honey bee species can detect and use a specialized alarm pheromone component, benzyl acetate (BA), to avoid danger. We analysed the volatile alarm pheromone produced by attacked workers of the most abundant native Asian honey bee, Apis cerana and tested the responses of other bee species to these alarm signals. As compared to nest guards, A. cerana foragers produced 3.38 fold higher levels of BA. In foragers, BA and (E)-dec-2-en-1-yl acetate (DA) generated the strongest antennal electrophysiological responses. BA was also the only compound that alerted flying foragers and inhibited A. cerana foraging. BA thereby decreased A. cerana foraging for risky sites. Interestingly, although BA occurs only in trace amounts and is nearly absent in sympatric honeybee species (respectively only 0.07% and 0.44% as much in A. dorsata and A. florea), these floral generalists detected and avoided BA as strongly as they did to their own alarm pheromone on natural inflorescences. These results demonstrate that competing pollinators can take advantage of alarm signal information provided by other species.

The role of the medial prefrontal cortex in regulating interanimal coordination of movements.

Rats with juvenile play experience display a greater ability in coordinating their movements with social partners than those deprived of such experience, and this may be due to the play-induced neural restructuring of the medial prefrontal cortex (mPFC). The present study investigates the role of the mPFC in interanimal coordination. Rats with and without bilateral mPFC lesions were tested on a robbing-and-dodging task. This food protection task measures the ability of rats to protect pieces of food by gaining and maintaining an interanimal distance between themselves and the rat attempting to rob the food. Given that mPFC lesions have been associated with sensory and motor deficits, the same rats were also subjected to a task to measure skilled motor movements. Rats with bilateral mPFC lesions had more food stolen and displayed an inability to maintain interanimal distance with partner, but did not exhibit any motor or sensory deficits. These findings suggest that the mPFC is involved in interanimal coordination and that the play-induced neural restructuring of this area may account for the enhanced coordination seen in rats with prior play experience.

Defining the role of CD2 in disease progression and overall survival among patients with completely resected stage-II to -III cutaneous melanoma.

BACKGROUND: Accurate assessment of prognosis remains clinically challenging in stage II to III cutaneous melanoma. Studies have implicated CD2 in immune surveillance, T-cell activation, and antitumor immunity, but its role in melanoma progression warrants further investigation. OBJECTIVE: We sought to investigate the prognostic role of CD2 in primary cutaneous melanoma. METHODS: Patients with American Joint Committee on Cancer stage II and III cutaneous melanoma were identified by retrospective review of dermatopathology databases from 2001 to 2010 at Mount Sinai Medical Center and Geisinger Medical Center. Additional patients were provided by New York University Medical Center based on retrospective review and tissue availability. Immunohistochemistry was performed on tumors from 90 patients with known recurrence status and documented follow-up. RESULTS: Primary tumors from patients who developed recurrent disease had fewer CD2(+) cells (P = .0003). In multivariable analyses including standard clinicopathologic predictors, CD2 was an independent predictor of disease recurrence (P = .008) and overall survival (P = .007). CD2 count correlated with characterization of tumor-infiltrating lymphocytes (P = .0004). Among the intermediate prognosis group of patients with nonbrisk tumor-infiltrating lymphocytes, CD2 count was predictive of disease recurrence (P = .0006) and overall survival (P = .0318). LIMITATIONS: Our retrospective design may have resulted in incomplete representation of patients lacking documented follow-up. CONCLUSIONS: CD2 may be an independent predictor of disease recurrence and overall survival among patients with primary cutaneous melanoma.

An improved predictive recognition model for Cys(2)-His(2) zinc finger proteins.

Cys(2)-His(2) zinc finger proteins (ZFPs) are the largest family of transcription factors in higher metazoans. They also represent the most diverse family with regards to the composition of their recognition sequences. Although there are a number of ZFPs with characterized DNA-binding preferences, the specificity of the vast majority of ZFPs is unknown and cannot be directly inferred by homology due to the diversity of recognition residues present within individual fingers. Given the large number of unique zinc fingers and assemblies present across eukaryotes, a comprehensive predictive recognition model that could accurately estimate the DNA-binding specificity of any ZFP based on its amino acid sequence would have great utility. Toward this goal, we have used the DNA-binding specificities of 678 two-finger modules from both natural and artificial sources to construct a random forest-based predictive model for ZFP recognition. We find that our recognition model outperforms previously described determinant-based recognition models for ZFPs, and can successfully estimate the specificity of naturally occurring ZFPs with previously defined specificities.

Infertility: help for couples starts with you.

A patient tells you she's "starting to worry" that getting pregnant won't be as easy as she'd hoped. Before you provide a referral, look for clues in the couple's histories.

A versatile and tunable coating strategy allows control of nanocrystal delivery to cell types in the liver.

There are many liver diseases that could be treated with delivery of therapeutics such as DNA, proteins, or small molecules. Nanoparticles are often proposed as delivery vectors for such therapeutics; however, achieving nanoparticle accumulations in the therapeutically relevant hepatocytes is challenging. In order to address this issue, we have synthesized polymer coated, fluorescent iron oxide nanoparticles that bind and deliver DNA, as well as produce contrast for magnetic resonance imaging (MRI), fluorescence imaging, and transmission electron microscopy (TEM). The composition of the coating can be varied in a facile manner to increase the quantity of poly(ethylene glycol) (PEG) from 0% to 5%, 10%, or 25%, with the aim of reducing opsonization but maintaining DNA binding. We investigated the effect of the nanoparticle coating on DNA binding, cell uptake, cell transfection, and opsonization in vitro. Furthermore, we exploited MRI, fluorescence imaging, and TEM to investigate the distribution of the different formulations in the liver of mice. While MRI and fluorescence imaging showed that each formulation was heavily taken up in the liver at 24 h, the 10% PEG formulation was taken up by the therapeutically relevant hepatocytes more extensively than either the 0% PEG or the 5% PEG, indicating its potential for delivery of therapeutics to the liver.

Closing the circle between perceptions and behavior: a cybernetic view of behavior and its consequences for studying motivation and development.

The dynamic aspect of behavior is exaggerated during social interactions such as sex, combat and rough-and-tumble play where the movements of the two animals involved continually influence one another. The behavioral 'markers' abstracted from this stream can greatly influence the conclusions drawn about the effects of experimental procedures and how changes during development are interpreted. By using methods of analysis that treat behaving systems as being dynamic and governed by negative feedback processes, the behavioral markers that are abstracted can more accurately reflect the underlying mechanisms. Using examples from rats engaged in play fighting, serious fighting and food defense, it is shown that motivational from non-motivational contributions to behavioral output and changes in that output with age can be discerned. For example, while sex differences in the frequency of initiating play by juvenile rats are shown to reflect differences in the motivation to engage in this behavior, sex differences in preferred motor patterns used during play do not. Rather, they reflect differences in perceptual and motor systems. Although an issue that is often neglected, we show that behavioral description, and the theoretical underpinnings of that description, is critical for the study of the mechanisms that produce and regulate behavior.

Pinning down vulnerability: from narratives to numbers.

Social vulnerability analyses have typically relied upon narratives to capture the nuances of the concept. While narratives have enhanced our understanding of the multiple drivers of vulnerability, they have had limited influence on hazards and climate adaptation policy. This is partially a function of the different needs and goals of the policy and research communities. The former prioritises generalised quantitative information, while the latter is more concerned with capturing complexity. A theoretically driven and empirically tested quantitative vulnerability and capacities index (VCI) for use at the local scale is presented to help connect vulnerability research and policy. There are four versions of the index for use in rural and urban contexts at the household and community levels. There can be an infinite number of drivers of vulnerability, but the VCI draws upon 12 indicators to represent material, institutional and attitudinal aspects of differential vulnerability and capacities.

Impact of serum estradiol on postprandial lipemia, oxidative stress, and inflammation across a single menstrual cycle.

BACKGROUND: An abrupt rise in circulating lipids, oxidative stress, and inflammatory biomarkers is a common finding after ingestion of a high-fat meal. Estradiol, typically provided via hormone replacement therapy to postmenopausal women, has been reported to possess lipidemic, antioxidant, and antiinflammatory properties, all of which may minimize postprandial oxidative stress. OBJECTIVE: The purpose of this study was to compare the postprandial triglyceride (TG), oxidative stress, and inflammatory responses after a lipid meal in menstruating women during the early follicular (days 1-3) and preovulatory (day 14) phases of the menstrual cycle. METHODS: Healthy normolipidemic women (fasting blood TG, <200 mg/dL) with regular menstrual cycles reported to the Cardiorespiratory/Metabolic Laboratory at the University of Memphis, Memphis, Tennessee (October-December 2008) and consumed an identical lipid meal (heavy whipping cream and water) on 2 separate days during the menstrual cycle. Blood samples were collected premeal and 1, 2, 4, and 6 hours postmeal, then assayed for TG, malondialdehyde (MDA), hydrogen peroxide, Trolox equivalent antioxidant capacity (TEAL), nitrate/nitrite, and C-reactive protein (CRP). The AUC was calculated for each variable, and a 2 (menstrual cycle phase) x 5 (time) ANOVA with Tukey post hoc testing was also conducted. Estradiol concentration was measured in premeal samples for verification of cycle phase. RESULTS: Ten women (mean [SD] age, 29 [11] years; 8 white, 2 black; body mass index, 22 [3] kg/m(2)) participated in the study. Despite a higher serum estradiol concentration on day 14 (113 [56] pg/mL) compared with the early follicular phase (61 [34] pg/mL), the TG, oxidative stress, and inflammatory AUC responses to feeding were not significantly different. TG (P = 0.03), MDA (P = 0.02), and hydrogen peroxide (P < 0.001) were significantly increased in response to feeding (time effect), whereas nitrate/nitrite was decreased (P = 0.01). TEAC and CRP were not significantly affected. CONCLUSIONS: These data indicate that estradiol, at the concentrations noted in the present study, had no significant effect on postprandial TG or biomarkers of oxidative stress or inflammation in a sample of young, healthy women. It is possible that a greater divergence in circulating estradiol may be needed for significant differences to be detected, as may be the case with chronic hormone replacement therapy in postmenopausal women.

The effect of long-term, high-volume aerobic exercise training on postprandial lipemia and oxidative stress.

AIMS: We have previously found no effect of moderate-volume aerobic exercise training (approximately 3 hrs*wk(-1)) on postprandial oxidative stress. It is possible that a higher volume of exercise is needed to impact postprandial oxidative stress in young, otherwise healthy individuals. Our purpose was to compare blood triglycerides (TAGs) and oxidative stress biomarkers in 10 healthy untrained and 10 healthy highly aerobically trained (eg, >or= 40 miles running*wk(-1) or >or= 150 miles cycling*wk(-1)) men and women following ingestion of a lipid meal. METHODS: Blood samples were collected before (in a 10-hour fasted state), and 1, 2, 4, and 6 hours after ingestion of a lipid load (heavy whipping cream at 1 g*kg(-1)). Blood samples were analyzed for TAGs, malondialdehyde (MDA), hydrogen peroxide (H(2)O(2)), and nitrate/nitrite (NOx). RESULTS: No training status or interaction effects were noted for TAGs, MDA, H2O2, or NOx (P > 0.05). However, a time effect was noted for TAGs (P = 0.01), with values higher at 2 hours (67 +/- 6 mg*dL(-1)) compared with premeal (41 +/- 6 mg*dL(-1)). A time effect was also noted for H2O2 (P = 0.0001), with values higher at 2 hours (24 +/- 3 micromol*L(-1)), 4 hours (23 +/- 3 micromol*L(-1)), and 6 hours (21 +/- 3 mumol.L(-1)) compared with premeal (7 +/- 2 micromol*L(-1)). The time effect for MDA approached significance (P = 0.07), with values peaking at 4 hours post-meal (1.59 +/- 0.16 micromol*L(-1)) compared with premeal (0.99 +/- 0.15 micromol*L(-1)). CONCLUSION: These data indicate that aerobic exercise training (even when performed at a relatively high volume) does not attenuate postprandial lipemia or oxidative stress as compared with no exercise when healthy men and women consume a lipid load in the form of heavy whipping cream. Fasting TAG values may be most important in this regard. It is possible that long-term exercise may be capable of attenuating postprandial lipemia or oxidative stress in older individuals, those with chronic disease, or those with elevated fasting TAG values. Future work is needed to confirm these hypotheses.

Juvenile peer play experience and the development of the orbitofrontal and medial prefrontal cortices.

The experience of peer play during the juvenile phase in rats is known to be important for the development of adult social competence. Adult social competence is also compromised by damage to the orbitofrontal cortex (OFC), an area known to be involved in social behavior. We therefore hypothesized that the functioning of the OFC in social behavior is facilitated through the experience of peer play during the juvenile period. Further, because the OFC and medial prefrontal cortex (mPFC) are known to be reciprocally responsive to a variety of manipulations, we suspected that the functioning of the mPFC is also responsive to the experience of peer play during development. Female Long-Evans rats were raised in conditions that varied with respect to the experience of peer play, and Golgi techniques were used to examine the neuronal morphology of the OFC and mPFC. The results indicated that the neurons of the OFC responded to the number of peers present, not whether those peers engaged in play or not, whereas the neurons of the mPFC responded specifically to the experience of play.