Nocturnal Urinary Symptoms as Screening Tools for Obstructive Sleep Apnea.

IMPORTANCE: Nocturnal lower urinary tract symptoms are part of obstructive sleep apnea (OSA), and urogynecology clinics may serve as OSA screening sites. OBJECTIVE: This study's aim was to determine the accuracy of nocturia and nocturnal enuresis (NE) as screening tools for OSA in new patients at a urogynecology clinic. STUDY DESIGN: Using a retrospective study design, we gathered information regarding diagnostic OSA testing, continuous positive airflow pressure use, and lower urinary tract symptoms improvement from women in a urogynecology clinic who were previously screened for OSA using validated questionnaires. Nocturia and NE were tested for sensitivity and specificity using positive OSA diagnosis by polysomnography as the gold standard. RESULTS: Nocturia with a cutoff of ≥2 episodes per night had the best test characteristics-86.4% sensitivity (95% confidence interval [CI], 65.1-97.1) and 58.5% specificity (95% CI, 44.1-71.9) for an overall accuracy of 78.4% (95% CI, 67.0-89.8). Nocturnal enuresis with a cutoff of ≥1 episode per week had the best NE characteristics with 31.8% sensitivity (95% CI, 13.9-54.9) and 79.3% specificity (95% CI, 65.9-89.2) for an overall accuracy of 56.1% (95% CI, 41.2-71). CONCLUSIONS: Lower urinary tract symptoms such as nocturia and NE are routinely assessed in urogynecology clinics, making them useful for OSA screening and referral. The present study found nocturia symptoms with ≥2 episodes per night to retain acceptable test characteristics in screening for OSA, whereas NE was found to have less acceptable test characteristics for OSA screening. Urogynecology clinics may utilize nocturia symptoms in clinical decision making for OSA referral.

Intercellular Propagation and Aggregate Seeding of Mutant Ataxin-1.

Intercellular propagation of aggregated protein inclusions along actin-based tunneling nanotubes (TNTs) has been reported as a means of pathogenic spread in Alzheimer's, Parkinson's, and Huntington's diseases. Propagation of oligomeric-structured polyglutamine-expanded ataxin-1 (Atxn1[154Q]) has been reported in the cerebellum of a Spinocerebellar ataxia type 1 (SCA1) knock-in mouse to correlate with disease propagation. In this study, we investigated whether a physiologically relevant polyglutamine-expanded ATXN1 protein (ATXN1[82Q]) could propagate intercellularly. Using a cerebellar-derived live cell model, we observed ATXN1 aggregates form in the nucleus, subsequently form in the cytoplasm, and finally, propagate to neighboring cells along actin-based intercellular connections. Additionally, we observed the facilitation of aggregate-resistant proteins into aggregates given the presence of aggregation-prone proteins within cells. Taken together, our results support a pathogenic role of intercellular propagation of polyglutamine-expanded ATXN1 inclusions.

Seeking recognition through carceral health care bureaucracy: Analysis of medical care request forms in a County Jail.

People experiencing incarceration in the U.S. have a constitutional right to have access to health care. Yet actualizing this right is constrained by the everyday reality of an environment designed to punish and limit autonomy. The principal means for accessing health care in a carceral facility is for an individual to submit a written request, which then gets handled through the jail's bureaucratic processes. In this paper, we provide quantitative and qualitative analyses of the content and circulation of one month of these written requests-called "medical care request" (MCR) forms-at an urban, U.S. jail to understand the meanings of health and health care for a group of individuals who are systematically marginalized. In one month in 2012 at this jail housing 140 individuals, 527 MCRs were submitted. We coded requests into categories: medications, amelioration of living conditions, specific symptoms, and requests for a specific health care service. The most common request was for pain medication. In qualitative analysis, four key themes emerged: reliance on the clinic to mediate the needs of daily life; deservingness of health care; hyperawareness of bodily and psychic discomfort; and temporal techniques for asserting control over individuals' time and bodies in jail. We show that MCRs are a key mechanism through which incarcerated individuals seek recognition of their physical and psychic suffering, and more broadly, of their very existences. When considered in the broader context of controlling carceral regimes and health inequities that characterize U.S. society, MCRs become dynamic terrain through which jail health care providers and incarcerated people negotiate the tensions of deservingness of care.

The Compendium of U.S. jails: creating and conducting research with the first comprehensive contact database of U.S. jails.

BACKGROUND: Millions of people pass through U.S. jails annually. Conducting research about these public institutions is critical to understanding on-the-ground policies and practices, especially health care services, affecting millions of people. However, there is no existing database of the number, location, or contact information of jails. We created the National Jails Compendium to address this gap. In this paper, we detail our comprehensive methodology for identifying jail locations and contact information. We then describe the first research project to use the Compendium, a survey assessing jails' treatment practices for incarcerated pregnant people with opioid use disorder. RESULTS: This study sent surveys electronically or in paper form to all 2986 jails in the Compendium, with 1139 surveys returned. We outline the process for using the Compendium, highlighting challenges in reaching contacts through case examples, cataloging responses and non-responses, and defining what counts as a jail. CONCLUSION: We aim to provide tools for future researchers to use the Compendium as well as a pathway for keeping it current. The Compendium provides transparency that aids in understanding jail policies and practices. Such information may help devise interventions to ensure humane, evidence-based treatment of incarcerated people.

Heterogeneity of retinogeniculate axon arbors.

The retinogeniculate synapse transmits information from retinal ganglion cells (RGC) in the eye to thalamocortical relay neurons in the visual thalamus, the dorsal lateral geniculate nucleus (dLGN). Studies in mice have identified genetic markers for distinct classes of RGCs encoding different features of the visual space, facilitating the dissection of RGC subtype-specific physiology and anatomy. In this study, we examine the morphological properties of axon arbors of the BD-RGC class of ON-OFF direction selective cells that, by definition, exhibit a stereotypic dendritic arbor and termination pattern in the retina. We find that axon arbors from the same class of RGCs exhibit variations in their structure based on their target region of the dLGN. Our findings suggest that target regions may influence the morphologic and synaptic properties of their afferent inputs.