The Suppression of Inferences From Counterfactual Conditionals

We examine two competing effects of beliefs on conditional inferences. The suppression effect occurs for conditionals, for example, "if she watered the plants they bloomed," when beliefs about additional background conditions, for example, "if the sun shone they bloomed" decrease the frequency of inferences such as modus tollens (from "the plants did not bloom" to "therefore she did not water them"). In contrast, the counterfactual elevation effect occurs for counterfactual conditionals, for example, "if she had watered the plants they would have bloomed," when beliefs about the known or presupposed facts, "she did not water the plants and they did not bloom" increase the frequency of inferences such as modus tollens. We report six experiments that show that beliefs about additional conditions take precedence over beliefs about presupposed facts for counterfactuals. The modus tollens inference is suppressed for counterfactuals that contain additional conditions (Experiments 1a and 1b). The denial of the antecedent inference (from "she did not water the plants" to "therefore they did not bloom") is suppressed for counterfactuals that contain alternatives (Experiments 2a and 2b). We report a new "switched-suppression" effect for conditionals with negated components, for example, "if she had not watered the plants they would not have bloomed": modus tollens is suppressed by alternatives and denial of the antecedent by additional conditions, rather than vice versa (Experiments 3a and 3b). We discuss the implications of the results for alternative theories of conditional reasoning.

Goodbye SIRS? Innate, trained and adaptive immunity and pathogenesis of organ dysfunction

The novel concepts within Sepsis‑3 criteria include a focus on dysregulated host responses, removal of the systemic inflammation response syndrome (SIRS) criteria from sepsis diagnosis, the use of Sepsis-related (Sequential) Organ Failure Assessment (SOFA) scores to define organ dysfunction, and the explicit recognition of the septic shock as a subset of sepsis. Protection against infection requires a surveillance system, an effector response against "perceived" pathogens, a method for regaining immune homeostasis following an immune response, and generation of immunological memory. In comparison to normally regulated responses to infection, the innate immune system shows profoundly abnormal neutrophil and macrophage function. Similarly, the adaptive immune system is typically depleted numerically of lymphocytes and functionally with T and B cell exhaustion. Although there are numerous proposed mechanisms by which these dysregulated immune responses may be associated with organ failure, it is unclear what the unifying organ failure mechanisms in sepsis are. Furthermore, in sepsis survivors, the epigenetic changes on immune cells and widespread changes to lymphocyte populations may increase the risk of adverse events such as rehospitalisation and mortality. Finally, our current gaps in understanding of the immune response trajectory and the associated modifiable mechanisms in sepsis leave us a long way from successful immunomodulation for these patients. This article is freely available.

MiR-206 suppresses proliferation and epithelial-mesenchymal transition of renal cell carcinoma by inhibiting CDK6 expression

Increasing evidence indicates that miRNAs are involved in tumorigenesis of human renal cell carcinoma (RCC). However, the role of miR-206 is still unknown. This study aimed to investigate the possible mechanism of miR-206 in progression of RCC. Here, compared with adjacent normal renal tissues and HK-2 cells, miR-206 level was markedly decreased, whereas CDK6 level was obviously increased in RCC tissues and cell lines. MiR-206 was inversely associated with lymph node metastasis and TNM stage, and acted as an independent prognostic factor in RCC. MiR-206 effectively caused apoptosis and cell cycle arrest at G0/G1 phase, and affected the growth of xenograft tumor of nude mice. MiR-206 also inhibited migration and invasion of RCC cells by modulating the expressions of EMT-related genes. Dual-luciferase assay demonstrated CDK6 was a direct target of miR-206. CDK6 silencing aggravated the inhibition effects of miR-206. In conclusion, miR-206 suppresses proliferation and EMT of RCC by inhibiting CDK6 expression. The miR-206/CDK6 axis may provide a novel insight into tumorigenesis of RCC.

Design of a lightweight passive orthosis for tremor suppression

Background

Tremor is the most common movement disorder with the highest prevalence in the upper limbs. The mechanical suppression of involuntary movements is an alternative and additional treatment to medication or surgery. Here we present a new, soft, lightweight, task asjustable and passive orthosis for tremor suppression.

Methods

A new concept of a manual, textile-based, passive orthosis was designed with an integrated, task adjustable, air-filled structure, which can easily be inflated or deflated on-demand for a certain daily activity. The air-filled structure is placed on the dorsal side of the wrist and gets bent and compressed by movements when inflated. In a constant volume air-filled structure, air pressure increases while it is inflating, creating a counterforce to the compression caused by bending. We characterised the air-filled structure stiffness by measuring the reaction torque as a function of the angle of deflection on a test bench. Furthermore, we evaluated the efficacy of the developed passive soft orthosis by analysing the suppression of involuntary movements in the wrist of a tremor-affected patient during different activities of daily living (i.e. by calculating the power spectral densities of acceleration).

Results

By putting special emphasis on the comfort and wearability of the orthosis, we achieved a lightweight design (33 g). The measurements of the angular deflection and resulting reaction torques show non-linear, hysteretic, behaviour, as well as linear behaviour with a coefficient of determination (R²) between 0.95 and 0.99. Furthermore, we demonstrated that the soft orthosis significantly reduces tremor power for daily living activities, such as drinking from a cup, pouring water and drawing a spiral, by 74 to 82% (p = 0.03); confirmed by subjective tremor-reducing perception by the patient.

Conclusion

The orthosis we developed is a lightweight and unobtrusive assistive technology, which suppresses involuntary movements and shows high wearability properties, with the potential to be comfortable. This air-structure technology could also be applied to other movement disorders, like spasticity, or even be integrated into future exoskeletons and exosuits for the implementation of variable stiffness in the systems.

MiR-186 represses progression of renal cell cancer by directly targeting CDK6

The function of miR-186 in the progression of renal cell carcinoma (RCC) remains poorly investigated. Our study aims to identify the molecular mechanism underlying miR-186-regulated proliferation, migration and invasion of RCC. Firstly, our data confirmed that miR-186 was significantly reduced and CDK6 was obviously increased in RCC tissues and cells. MiR-186 or CDK6 was associated with advanced TNM stage, lymph node metastasis and poor prognosis. MiR-186 significantly inhibited cell proliferation, migration, invasion and in vivo tumor growth, induced apoptosis, and blocked cell cycle progression in G0/G1 phase. MiR-186 also induced Bax expression and inhibited the expressions of Bcl-2, cyclin D1 and epithelial-mesenchymal transition (EMT)-related genes. Additionally, CDK6 expression was downregulated by miR-186 via binding to its 3'-untranslated region (3'-UTR). Moreover, ectopic expression of CDK6 could partially abrogate the inhibitory effect of miR-186. In conclusion, miR-186 suppresses proliferation, migration and invasion of RCC by inhibiting CDK6 expression.

Neural responses to dynamic adaptation reveal the dissociation between the processing of the shape of contours and textures

Shape-adaptation studies show that surround textures can inhibit the processing of contours. Using event-related potentials (ERP), we examined the time-course of neural processes involved in contour-shape and texture-shape processing following adaptation to contours and textures. Contours were made of Gabor strings whose orientations were either tangential or orthogonal to the contour path, while textures were made of a series of contours arranged in parallel. We focused on two ERP components -P1, related to low-level visual processes and N1, broadly indicative of mid-level vision- and, on ERP difference waves (no-adaptor minus with-adaptor) to isolate the effects of adaptation, which are fundamentally distinct from individual processes driving P1 and N1 components. We found that in the absence of adaptation, the N1 component for contour-tests peaked later and increased in amplitude compared to the N1 for texture-tests. Following adaptation, the ERP difference wave for contour-tests revealed an early and a late component that were differentially affected by the presence of surround texture, but critically not by its orientation. For texture-tests, the early component was of opposite polarity for contours compared to texture adaptors. From the temporal sequence of ERP modulations, we conclude that texture processing begins before contour processing and encompasses the stages of perceptual processing reflected in both the low-level P1 and the mid-level N1 vision-related components. Our study provides novel evidence on the nature of separable and temporally distinct texture and contour processing mechanisms, shown in two difference wave components, that highlights the multi-faceted nature of dynamic adaptation to shape when presented in isolation and in context.

Motivated forgetting increases the recall time of learnt items: Behavioral and event related potential evidence

We investigated modulation of the recall time in a motivated forgetting (MF) paradigm and the neural manifestation of it through event related potential (ERP) analysis. We studied whether compared to failed attempts in suppression, partial success can potentiate control mechanisms and this might manifest, neurally as modulation of ERP components related to conscious recollection, and behaviorally as delayed recall of learnt items. We employed a modified version of the Think\No-Think paradigm with dominant number of No-Think words (cued to forget). We defined a forgetting index as FI = Final Recall Time-Initial Recall Time. The MF trials were separated into three conditions according to their corresponding FI; Forget, Delayed Recall, and Recall conditions. The findings revealed significant late ERP effects in terms of a late parietal positivity (LPP), modulated by the item condition, that appeared to reflect the consequence of conscious suppression on actual retrieval of stored memory. Over the same topographic location, FI was negatively correlated with the LPP amplitude, demonstrating the consequence of inhibition processing during MF in modulating the recall time. The negative correlation between LPP and FI provides evidence that increased recall time due to MF is also related to reduced activity, probably in the hippocampal-parietal network, corresponding to recollection of suppressed memories.

Associations of negative cognitions, emotional regulation, and depression symptoms across four continents: International support for the cognitive model of depression

BACKGROUND

Cognitive-behavioral therapy (CBT) is one of the most widely tested and empirically supported psychological treatments for depression. Beck and other scholars established the theoretical foundations of CBT among North American populations, yet surprisingly few studies have examined central hypotheses of the cognitive model of depression among people living in non-Western regions.

METHODS

In the present study, we used the alignment method to minimize measurement bias to examine several central hypotheses of the cognitive model among adults living on four continents (n = 752): North America (n = 103; female = 29.1%), Europe (n = 404; female = 36.4%), South America (n = 108; female = 18.5%), and Asia (n = 136; female = 19.9%).

RESULTS

Depressive symptoms were positively and strongly correlated with negative automatic thoughts about self (ATQ-N), and moderately associated with dysfunctional attitudes (DAS) among people living on the four continents. Further, use of emotional suppression strategies to regulate emotion (ERQ-Suppression) was moderately and positively associated with depressive symptoms among people on all four continents, while use of cognitive-reappraisal (ERQ-Reappraisal) was not systematically associated with depressive symptoms.

CONCLUSIONS

Results of this study offer preliminary cross-continental support for foundational hypotheses of the cognitive model of depression. Negative thoughts appear to be associated with depression in all regions of the world, cementing this construct as a hallmark feature of the disorder.

Distance Suppression as a Predictive Factor in Progression of Intermittent Exotropia

Purpose

To address the natural course of intermittent exotropia with small exodeviations (less than 20 prism diopters [PD]) according to the status of suppression, and to evaluate whether suppression testing at the initial visit can assist in predicting the progression of intermittent exotropia.

Methods

Clinical records of patients at the Korea University Anam Hospital, Seoul, Korea diagnosed between January 2014 and December 2018 with basic-type intermittent exotropia and initial distance deviations of less than 20 PD, older than four years of age and a minimum of three follow-up visits within a 6-month span were retrospectively reviewed. The participants were divided into two groups, the suppression group and the non-suppression group, based on the Vectogram results at the initial visit. Clinical characteristics, rate of surgery, and rate of progression were compared between the two groups.

Results

A total of 71 patients were included. Among them, 16 patients (22.5%) had visual suppression at the initial visit, while 55 patients (77.5%) had no suppression. At the initial visit, the mean distant angle of deviation was 13.7 ± 3.2 PD (range, 4 to 18 PD) in the suppression group and 12.7 ± 3.4 PD (range, 10 to 18 PD) in the non-suppression group. Ten patients (62.5%) underwent surgery in the suppression group and 12 patients (21.8%) underwent surgery in the non-suppression group (p < 0.01). Eleven patients (68.8%) in the suppression group and 13 (23.6%) in the non-suppression group developed progression (p < 0.01).

Conclusions

Suppression testing was important to predict the progression of intermittent exotropia, in patients with exodeviation angles less than 20 PD at the initial visit.

Time to viral load suppression and its associated factors in cohort of patients taking antiretroviral treatment in East Shewa zone, Oromiya, Ethiopia, 2018

BACKGROUND

A key goal of Antiretroviral Treatment (ART) is to achieve and maintain durable viral suppression. Thus, the most important use of viral load measurement is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East Shewa Zone, Oromiya, Ethiopia.

METHODS

Patients diagnosed with Human Immunodeficiency Virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurements were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of (Statistical Package for the Social Sciences) SPSS, International Business Machines (IBM) Inc. Significance group comparison was done by Kaplan Meier log-rank test. Cox proportional hazard model was used to select significant factors to the variability between groups.

RESULT

Plasma viral load was suppressed below the detection level in 72% of individuals taking a different regimen of ART. The median Human Immunodeficiency virus (HIV)-1 plasma viral load in the cohort was estimated to be log 5.3111 copies/ml. The study observed Survival curve difference in the category of marital status (p-value 0.023) and baseline cluster of differentiation 4 (CD4) value (p-value 0.023). The estimated median time to Plasma Viral Load (PVL) suppression was 181 days (CI: 140.5-221.4) with the age group of 30-39 years having minimum time to achieve suppression with 92 days (CI: 60.1-123.8) and the maximum time required to reach the level was found among the age group between 50 and 59 years.

CONCLUSION

The study found that the estimated time to achieve PVL after taking ART to be 181 days. Factors affecting time to suppression level were marital status and baseline CD4.

Simpson's Paradox is suppression, but Lord's Paradox is neither: clarification of and correction to Tu, Gunnell, and Gilthorpe (2008)

Tu et al. (Emerg Themes Epidemiol 5:2, 2008. https://doi.org/10.1186/1742-7622-5-2) asserted that suppression, Simpson’s Paradox, and Lord’s Paradox are all the same phenomenon—the reversal paradox. In the reversal paradox, the association between an outcome variable and an explanatory (predictor) variable is reversed when another explanatory variable is added to the analysis. More specifically, Tu et al. (2008) purported to demonstrate that these three paradoxes are different manifestations of the same phenomenon, differently named depending on the scaling of the outcome variable, the explanatory variable, and the third variable. According to Tu et al. (2008), when all three variables are continuous, the phenomenon is called suppression; when all three variables are categorical, the phenomenon is called Simpson’s Paradox; and when the outcome variable and the third variable are continuous but the explanatory variable is categorical, the phenomenon is called Lord’s Paradox. We show that (a) the strong form of Simpson’s Paradox is equivalent to negative suppression for a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${2 \times 2 \times 2}$$\end{document}2×2×2 contingency table, (b) the weak form of Simpson’s Paradox is equivalent to classical suppression for a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${2 \times 2 \times 2}$$\end{document}2×2×2 contingency table, and (c) Lord’s Paradox is not the same phenomenon as suppression or Simpson’s Paradox.

Suppression of coal dust by microbially induced carbonate precipitation usingStaphylococcus succinus

Coal dust from open-cast mines is a significant air pollutant; thus, dust particles and toxins contained in the dust are a severe threat to human health and ecosystems. Microbially induced carbonate precipitation (MICP) is a low-cost and environmentally friendly way to suppress coal dust. With high urease activity and tolerance to coal dust, a bacterial strain, Staphylococcus succinus J3, was isolated from soil in a mine area. Thus, in dust suppression experiments, we used coal dust dominated by fine granule particles (100-250 μm) from an open-cast mine. Consequently, four factors were identified: initial bacterial biomass, calcium concentration, urea concentration, and spraying frequency; we investigated their effects on MICP as a dust suppression technique using one-factor-at-a-time experiments. Maximum threshold broken wind speed (45.5 m s^-1) and pressure (912 kPa) were obtained under the following condition: OD₆₀₀ = 0.7, 40 mmol calcium, 6% (w/w) urea in the bonding solution which was sprayed five times in 35 days. Pearson correlation analysis described that urea concentration and spraying frequency both significantly positive correlations with the threshold broken wind speed and pressure via Pearson analysis. When the coal dust suppression process was complete, scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy showed that a solidified layer of calcareous precipitate had formed on the surface of the dust. These results indicate that Staphylococcus succinus J3 has considerable potential for use in MICP as a coal dust suppression technique.

Use of a new composite index to demonstrate improved stereoacuity after training on stimuli with dichoptically asymmetric contrast

Many people with stereo-deficiency cannot perform stereoacuity tasks at any binocular disparity, so their threshold cannot be measured. We developed a generally useful new composite stereodepth or CSD score, with range 0 to 20, that combines stereoacuity (from 0 to 13.3) and percent correct (13.3 to 20) into a single index. CSD allows differences in stereodepth performance to be measured across groups when thresholds cannot be reliably measured, and across time when individuals gain stereodepth perception during training. We used CSD scores to assess the benefit of unequal (mixed) left- and right-eye contrast during dichoptic stereoacuity training in people with amblyopia. Nineteen adult participants with anisometropic amblyopia were assigned randomly to 10 sessions of either mixed-contrast or fixed-contrast training. Stimuli were rectangles, one above the other, viewed through a four-mirror stereoscope. Participants indicated which rectangle appeared closer. A staircase controlled disparity within the stimulus. CSD improvement was better by 1.6 CSD units for participants who received mixed-contrast training. Thus, mixed-contrast stereo training was more effective than fixed-contrast training in adults with anisometropic amblyopia.

Suppression tuning of spontaneous otoacoustic emissions in the barn owl (Tyto alba)

Spontaneous otoacoustic emissions (SOAEs) have been observed in a variety of different vertebrates, including humans and barn owls (Tyto alba). The underlying mechanisms producing the SOAEs and the meaning of their characteristics regarding the frequency selectivity of an individual and species are, however, still under debate. In the present study, we measured SOAE spectra in lightly anesthetized barn owls and suppressed their amplitudes by presenting pure tones at different frequencies and sound levels. Suppression effects were quantified by deriving suppression tuning curves (STCs) with a criterion of 2 dB suppression. SOAEs were found in 100% of ears (n = 14), with an average of 12.7 SOAEs per ear. Across the whole SOAE frequency range of 3.4-10.2 kHz, the distances between neighboring SOAEs were relatively uniform, with a median distance of 430 Hz. The majority (87.6%) of SOAEs were recorded at frequencies that fall within the barn owl's auditory fovea (5-10 kHz). The STCs were V-shaped and sharply tuned, similar to STCs from humans and other species. Between 5 and 10 kHz, the median Q_10dB value of STC was 4.87 and was thus lower than that of owl single-unit neural data. There was no evidence for secondary STC side lobes, as seen in humans. The best thresholds of the STCs varied from 7.0 to 57.5 dB SPL and correlated with SOAE level, such that smaller SOAEs tended to require a higher sound level to be suppressed. While similar, the frequency-threshold curves of auditory-nerve fibers and STCs of SOAEs differ in some respects in their tuning characteristics indicating that SOAE suppression tuning in the barn owl may not directly reflect neural tuning in primary auditory nerve fibers.

"I Despise Myself for Thinking about Them." A Thematic Analysis of the Mental Health Implications and Employed Coping Mechanisms of Self-Reported Non-Offending Minor Attracted Persons

'Non-offending pedophiles' or 'minor attracted persons' are individuals who suppress an attraction to children. Previous analyses of this population's mental illness employed overt self-report methods, limited by social desirability. Additionally, studies assessing the coping mechanisms employed to remain offense-free are underpowered; understanding of these would facilitate the rehabilitation of prior offenders. A thematic analysis of coping mechanisms and mental illness was conducted on 5,210 posts on the 'Virtuous Pedophiles' forum. Four themes emerged for coping mechanisms: Managing risk and attraction to children, Managing mood, Managing preferences prosocially and Friends, family and relationships, with 13 subthemes. Five themes emerged for mental ill-health, including: Addiction, Anxiety, Depression, Self-hatred/Self-harm/Suicide and Other. Self-hatred/Self-harm/Suicide accounted for almost a third of discussed mental ill-health. These results highlight the severity of mental ill-health amongst this population and the coping mechanisms employed to remain offense-free.

Impulsivity and compulsivity are differentially associated with automaticity and routine on the Creature of Habit Scale

Habits may develop when meaningful action patterns are frequently repeated in a stable environment. We measured the differing tendencies of people to form habits in a population sample of n = 533 using the Creature of Habit Scale (COHS). We confirmed the high reliability of the two latent factors measured by the COHS, automaticity and routines. Whilst automatic behaviours are triggered by context and do not serve a particular purpose or goal, routines often have purpose, and because they have been performed so often in a given context, they become automatic only after their action sequence has been activated. We found that both types of habitual behaviours are influenced by the frequency of their occurrence and they are differentially influenced by personality traits. Compulsive personality is associated with an increase in both aspects of habitual tendency, whereas impulsivity is linked with increased automaticity, but reduced routine behaviours. Our findings provide further evidence that the COHS is a useful tool for understanding habitual tendencies in the general population and may inform the development of therapeutic strategies that capitalise on functional habits and help to treat dysfunctional ones.

Working memory interacts with emotion regulation to predict symptoms of mania

Although neurocognitive deficits and emotion regulation are closely linked within unipolar depression, little research has tested links between these two variables within bipolar disorder. The present study tested whether working memory is related to individual differences in emotion regulation strategies in bipolar disorder and whether working memory and emotion regulation can explain variability in symptoms over time. Fifty-nine euthymic adults with bipolar I disorder completed a working memory span task, symptom interviews assessing depression and mania, and questionnaires assessing brooding rumination, reappraisal, and suppression. At baseline, working memory was unrelated to emotion regulation. Symptom interviews were repeated at six months (n = 41) and 12 months (n = 36) follow-up. At 12 months, baseline working memory significantly interacted with baseline suppression to predict higher mania. Tests of simple slopes showed that at lower working memory levels, low use of suppression was associated with significantly greater mania symptoms. These results help to clarify previous inconsistent findings regarding cognitive functioning and emotion regulation strategies in bipolar disorder, suggesting that deficits in both domains combine to predict outcomes.

Effects of temporal frequency on binocular deficits in amblyopia

Amblyopia is associated with a range of well-known visual spatial deficits, which include reduced contrast sensitivity, spatial distortions, interocular suppression, and impaired stereopsis. Previous work has also pointed to deficits in processing dynamic visual information, but it is unknown whether these deficits influence performance under binocular conditions. We examined the effects of temporal modulation on contrast sensitivity and binocular interactions in a preliminary study of 8 adults with amblyopia and 14 normally-sighted control subjects. For each observer, we measured interocular balance and stereopsis thresholds with binocular flicker across a range of four temporal (0, 4, 7.5, and 12 Hz) and spatial (1, 2, 4, and 8 cpd) frequencies. Interocular balance was estimated by varying the relative contrast of dichoptic letter pairs to produce perceptual reports of each letter with equal frequency, and stereopsis thresholds were measured by determining the minimum disparity at which subjects identified a front-depth target with 75% accuracy. Consistent with previous findings, we observed greater interocular imbalance and impaired stereoacuity at high spatial frequencies in amblyopes. In contrast, the effects of temporal frequency on performance were smaller: across both groups, interocular imbalance was largest at mid-to-low temporal frequencies, and stereopsis thresholds were unaffected by temporal frequency. Our results suggest that there may be a previously unreported effect of temporal frequency on interocular balance, as well as a possible dissociation between the effects of flicker on interocular balance and stereopsis.

Implementation of an Immediate HIV Treatment Initiation Program in a Public/Academic Medical Center in the U.S. South: The Miami Test and Treat Rapid Response Program

Test and Rapid Response Treatment (TRRT) linkage programs have demonstrated improved HIV suppression rates. This paper describes the design and implementation of the Miami TRRT initiative and its clinical impact. Assisted by a dedicated care navigator, patients receiving a reactive HIV rapid test at the Florida Department of Health STD Clinic were offered same-day HIV care at the University of Miami/Jackson Memorial Medical Center Adult HIV Outpatient Clinic. Patient retention and labs were tracked for 12 months. Of the 2337 individuals tested, 46 had a reactive HIV test; 41 (89%) consented to participate. For the 36 patients in continued care for a year, 33 (91.7%) achieved virological suppression (< 200 copies/mL) within 70 days of their reactive HIV rapid test; at 12 months, 35 (97.2%) remained suppressed, and mean CD4 T cell counts increased from 452 ± 266 to 597 ± 322 cells/mm³. The Miami TRRT initiative demonstrated that immediate linkage to care is feasible and improves retention and suppression in a public/academic medical center in the U.S. South.

Nitrite oxidizing bacteria (NOB) contained in influent deteriorate mainstream NOB suppression by sidestream inactivation

Sidestream sludge treatment approaches have been developed in recent years to achieve mainstream nitrite shunt or partial nitritation, where NOB are selectively inactivated by biocidal factors such as free nitrous acid (FNA) or free ammonium (FA) in a sidestream reactor. The existence of NOB in raw wastewater has been increasingly realized and could pose critical challenge to stable NOB suppressions in those systems. This study, for the first time, evaluated the impact of influent NOB on the NOB suppressions in a mainstream nitrite shunt system achieved through sidestream sludge treatment. An over 500-day sequential batch reactor operation with six experimental phases rigorously demonstrated the negative effects of influent NOB on mainstream NOB control. Continuously seeding of NOB contained in influent stimulated NOB community shifts, leading to different extents of ineffective NOB suppression. The role of primary wastewater treatment in NOB removal from raw wastewater was also investigated. Results suggest primary settling and High Rate Activated Sludge system could remove a large part of NOB contained in raw wastewater. Primary treatment for raw wastewater is necessary for ensuring stable mainstream NOB suppressions.

Silicic protective surface films for pyrite oxidation suppression to control acid mine drainage at the source

The tailings produce acid mine drainage (AMD) due to sulfide minerals, especially pyrite oxidation. AMD has caused serious pollution to the surrounding aquatic and terrestrial ecosystems because of its famous low pH value and high metal and sulfate concentration, which is an urgent environmental problem faced by the world's ore mining industry. Here, we show that silicic protective surface films can suppress the oxidation of pyrite-bearing tailings for AMD control at-source without pre-oxidation of pyrite and solution pH adjuster and buffer. We found that the silicic protective surface films formed by calcium silicate can inhibit the oxidation of pyrite-bearing tailings and reduce the production of AMD through chemical leaching tests. Fourier transform infrared (FTIR) analyses and scanning electron microscopy with energy-dispersive spectrometry (SEM/EDS) confirmed the presence of silicic protective surface films of calcium silicate on the surface of pyrite-bearing tailings.

Unraveling the crosstalk between melanoma and immune cells in the tumor microenvironment

Cutaneous melanoma is the most common skin cancer with an incidence that has been rapidly increasing in the past decades. Melanomas are among the most immunogenic tumors and, as such, have the greatest potential to respond favorably to immunotherapy. However, like many cancers, melanomas acquire various suppressive mechanisms, which generally act in concert, to escape innate and adaptive immune detection and destruction. Intense research into the cellular and molecular events associated with melanomagenesis, which ultimately lead to immune suppression, has resulted in the discovery of new therapeutic targets and synergistic combinations of immunotherapy, targeted therapy and chemotherapy. Tremendous effort to determine efficacy of single and combination therapies in pre-clinical and clinical phase I-III trials has led to FDA-approval of several immunotherapeutic agents that could potentially be beneficial for aggressive, highly refractory, advanced and metastatic melanomas. The increasing availability of approved combination therapies for melanoma and more rapid assessment of patient tumors has increased the feasibility of personalized treatment to overcome patient and tumor heterogeneity and to achieve greater clinical benefit. Here, we review the evolution of the immune system during melanomagenesis, mechanisms exploited by melanoma to suppress anti-tumor immunity and methods that have been developed to restore immunity. We emphasize that an effective therapeutic strategy will require coordinate activation of tumor-specific immunity as well as increased recognition and accessibility of melanoma cells in primary tumors and distal metastases. This review integrates available knowledge on melanoma-specific immunity, molecular signaling pathways and molecular targeting strategies that could be utilized to envision therapeutics with broader application and greater efficacy for early stage and advanced metastatic melanoma.

Need for mechanically and ergonomically enhanced tremor-suppression orthoses for the upper limb: a systematic review

INTRODUCTION

Tremor is the most common movement disorder, affecting 5.6% of the population with Parkinson's disease or essential tremor over the age of 65. Conventionally, tremor diseases like Parkinson's are treated with medication. An alternative non-invasive symptom treatment is the mechanical suppression of the oscillation movement. The purpose of this review is to identify the weaknesses of past wearable tremor-suppression orthoses for the upper limb and identify the need for further research and developments.

METHOD

A systematic literature search was conducted by performing a keyword combination search of the title, abstract and keyword sections in the four databases Web of Science, MedLine, Scopus, and ProQuest. Initially, the retrieved articles were selected by title and abstract using selection criteria. The same criteria were then applied to the full publication text. After the selection process, relevant information on the retrieved orthoses was isolated, sorted and analysed systematically.

RESULTS

Forty-six papers, representing 21 orthoses, were identified and analysed according to the mechanical and ergonomic properties. The identified orthoses can be divided into 5 concepts and 16 functional prototypes, then subdivided further based upon their use of passive, semi-active, or active suppression mechanisms. Most of the orthoses concentrate on the wrist and elbow flexion and extension. They mainly rely on rigid structures and actuators while having tremor-suppression efficacies for tremorous subjects from 30 to 98% using power spectral density or other methods.

CONCLUSION

The comparison of tremor-suppression orthoses considered and mapped their various mechanical and ergonomic properties, including the degrees of freedom, weight, suppression characteristics, and efficacies. This review shows that most of the orthoses are bulky and heavy, with a non-adapted human-machine interface which can cause rejection by the user. The main challenge of the design of an effective, minimally intrusive and portable tremor-suppressing orthosis is the integration of compact, powerful, lightweight, and non-cumbersome suppression mechanisms. None of the existing prototypes combine all the desired characteristics. Future research should focus on novel suppression orthoses and mechanisms with compact dimensions and light weight in order to be less cumbersome while giving a good tremor-suppression performance.

Long-term antimicrobial suppression prevents treatment failure of streptococcal periprosthetic joint infection

OBJECTIVES

To evaluate the effect of oral antimicrobial suppression on the outcome of streptococcal periprosthetic joint infection (PJI).

METHODS

Consecutive patients with streptococcal PJI receiving antimicrobial suppression for >6 months were prospectively included and compared to a retrospective control group without suppression. Outcome was assessed with Kaplan-Meier analysis and compared by the log-rank Mantel-Cox test. Multivariate analysis was used to identify factors associated with treatment failure.

RESULTS

Of 69 streptococcal PJI episodes (37 knee, 31 hip and one shoulder PJI), 43 (62%) were caused by beta-hemolytic streptococci and 26 (38%) by viridans group streptococci. Debridement and prosthesis retention was performed in 27 (39%), one-stage exchange in 5 (7%), multi-stage exchange in 31 (44%) and prosthesis removal in 6 patients (9%). 24 patients (35%) were treated with antimicrobial suppression receiving oral amoxicillin (n = 22), doxycycline (n = 1) or clindamycin (n = 1). After a median follow-up of 13 months (range, 0.5-111 months), 38 of 65 patients (58%) were infection-free. Suppressive antimicrobial treatment was associated with higher success rate compared with no suppression (93% vs. 57%, p = 0.002), representing the only significant independent factor preventing treatment failure.

CONCLUSIONS

Long-term antimicrobial suppression was associated with significantly better treatment outcome and should be strongly considered in streptococcal PJI.

Suppression processes of anionic pollutants released from fly ash by various Ca additives

Harmful trace elements, which are initially included in the coal fly ash, have the potential to be leached when coal fly ash comes in contact with water. This causes a risk of pollutant species being released, considering the long lifetime of building structures where coal fly ash was applied. Some Ca additives effectively function to suppress the release of anionic pollutants; however, the detailed suppression processes remains unclear. In this work, the influences of various Ca additives on the released anionic pollutants (B, F, S, As, and Cr) was systematically investigated. According to the comprehensive results of solution data with the solid characterization, the 60% hydroxylated calcined dolomite (HCD 60) was the best Ca additive for the suppression of different anionic pollutants since this Ca source not only simply provides an alkaline reagent but also supplies MgO and Mg(OH)₂, which affect the phase transformation that accompanies with hydration. The phase transformation occurs from Ca(OH)₂ to ettringite via hydrocalumite, which is the most important suppression processes of released pollutants. The precipitation of Ca salts is another pathway to immobilize these pollutants. In this scheme, MgO and Mg(OH)₂ were proven to enhance the formation of ettringite and hydrocalumite, respectively.