An investigation of worry content among generally anxious individuals

The hypothesis of a distinctive content pattern of worry in generalized anxiety disorder (GAD) was investigated with the use of content categorization of GAD versus nonanxious control worries from both clinical and analogue samples. The GAD groups reported significantly more worry topics than the control groups. Some similarity in content patterns emerged across groups, with the most frequent content category for all groups involving family/interpersonal issues. However, a significant difference in the pattern of relative frequencies across groups was found: GAD was characterized by equally high relative frequencies for miscellaneous and work/school worries, whereas control groups had higher relative frequencies for work/school concerns and lower relative frequencies for miscellaneous worries. The miscellaneous worries of GAD individuals were particularly characterized by worry about minor/routine issues. These findings support DSM-IV descriptions of GAD as involving pervasive worry that includes worry about minor things.

Selective reduction in complicated monochorionic pregnancies: radiofrequency ablation vs. bipolar cord coagulation

OBJECTIVE

To compare radiofrequency ablation (RFA) and bipolar cord coagulation (BPC) methods for selective fetal reduction in the treatment of complicated monochorionic (MC) multifetal gestations.

METHODS

This was a retrospective review of patients who underwent selective reduction by RFA and BPC. Computer-generated random sampling was performed to match patients who had undergone BPC with patients who had undergone RFA, in a 2 : 1 ratio, controlling for gestational age and indication. The primary outcome was fetal survival.

RESULTS

Twenty patients in the RFA group were matched with 40 patients in the BPC group. Fewer additional intra-operative procedures were performed in the RFA group compared with the BPC group: amnioinfusion, 10% vs. 75%, respectively (P < 0.01); and amnioreduction, 5% vs. 40%, respectively (P = 0.004). The overall survival rates were 87.5% in the RFA group and 88% in the BPC group (P = 0.94). Median gestational age at delivery was 36 (range, 26-41) weeks in the RFA group and 39 (range, 19-40) weeks in the BPC group (P = 0.59). Preterm delivery (at < 28, < 32 or < 37 weeks), weeks gained after the procedure and birth weight at delivery were also similar. Although the preterm premature rupture of membranes (PPROM) rate was higher in the BPC group (22.5%) compared with the RFA group (5%), the difference was not statistically significant (P = 0.09).

CONCLUSIONS

Overall fetal survival rate following selective reduction in complicated MC pregnancies is similar whether reduction is performed by RFA or BPC. Fewer additional intraoperative procedures are required for RFA than for BPC. The possibility that RFA is associated with a lower rate of postoperative PPROM than is BPC will have to be confirmed in larger series.

Cognitive-motor interference during gait in patients with Multiple Sclerosis: a mixed methods Systematic Review

BACKGROUND

Cognitive-motor interference (CMI) has been proposed as a valid marker of daily life impairment in Multiple Sclerosis (MS). The heterogeneity and scarce number of studies regarding CMI in MS has hampered the synthesis of the existing evidence. The present systematic review employed a mixed methods approach with the aim of identifying and describing variables under which CMI is particularly useful to assess patients with MS.

RESULTS

MS patients showed significant CMI. The motor variables that were most sensitive in detecting significant CMI were velocity (m/s), cadence (steps/min), and double support (% gait cycle), which was also specific for MS. Among the cognitive tasks, Alternate Alphabet and Serial Subtracting 7 s were sensitive, whereas Verbal Fluency were both sensitive and specific to CMI in MS.

CONCLUSIONS

CMI should be assessed in MS with a standardised dual task such as the Verbal Fluency task while walking, with measurements of the double support time and the effect on the cognitive task. The clinical usefulness of CMI in the assessment of patients with MS is discussed.

Cocaine-induced alterations in prostaglandin production in rabbit aorta

To determine if alterations in endothelial prostaglandin production occur after long-term cocaine use, 26 New Zealand White rabbits were randomized to a low fat diet with (n = 12) or without (n = 14) daily intravenous cocaine (2 mg/kg body weight). Rabbits were killed at 6 or 12 weeks. Segments of aorta were examined in blinded manner for histologic changes. Additional slices were incubated in oxygenated Krebs buffer and release of 6-keto-prostaglandin F1 alpha, thromboxane B2 and prostaglandin E2 was assayed by radioimmunoassay. Minimal intimal histologic changes were seen in the aorta of three cocaine-treated rabbits. At 12 weeks 6-keto-prostaglandin F1 alpha was increased in the cocaine group (p = 0.063) as compared with levels in the control group. When rabbits killed at 6 and 12 weeks were considered together, increases in thromboxane B2 (p = 0.044) and a trend to increased prostaglandin E2 (p = 0.083) were seen in the cocaine group. The ratio of thromboxane B2 to 6-keto-prostaglandin F1 alpha was increased in the cocaine group compared with that in the control group (p less than 0.02). These data suggest that an increase in prostaglandin production occurs in the vascular endothelium of rabbits ingesting cocaine before gross histologic changes are evident. In addition, thromboxane B2 increases disproportionately with respect to 6-keto-prostaglandin F1 alpha, suggesting that a milieu for thrombosis may exist in users of cocaine.

Preliminary investigation of the role of previous exposure to potentially traumatizing events in generalized anxiety disorder

Theories of generalized anxiety disorder (GAD) highlight the relevance of stressful life events to this disorder's etiology. However, little empirical work has addressed the stressful events that may act as historical contributors to the development or maintenance of GAD. The present study provides an initial exploration of the association between exposure to potentially traumatizing events and GAD. In both analogue and clinical samples, GAD individuals were found to be more likely than nonanxious controls to report exposure to a potentially traumatizing event. These findings are discussed within the context of current theories of worry and GAD.

Chorioamnion plugging and the risk of preterm premature rupture of membranes after laser surgery in twin-twin transfusion syndrome

OBJECTIVE

To examine the incidence of preterm premature rupture of membranes (PPROM) in pregnancies affected by twin-twin transfusion syndrome (TTTS) treated with laser photocoagulation where an absorbable gelatin sponge was used as a chorioamnion sealant of the fetoscopic access port.

METHOD

A retrospective review was undertaken of consecutive cases undergoing fetoscopic directed laser surgery for TTTS between October 2006 and November 2008 at Texas Children's Fetal Center, in which an absorbable gelatin sponge, used as a chorioamnion 'plug', was placed at the conclusion of the intervention as a possible prophylactic measure to prevent PPROM. We excluded cases that had a failure of plug placement and those in which it was not attempted. PPROM was defined as rupture of membranes before 34 weeks' gestation. A comparison was performed between the PPROM group and a no-PPROM group to determine risk factors and outcomes.

RESULTS

Successful plug placement occurred in 79 of 84 cases (94%) in which it was attempted after laser surgery, with a rate of PPROM of 34% in these patients. PPROM occurred at an average gestational age of 26.5 +/- 3.6 weeks, with an average procedure-to-PPROM interval of 5.2 +/- 3.5 weeks. There were no statistically significant differences between the PPROM group and the no-PPROM group in maternal demographics or preoperative parameters including: amniotic fluid volumes in the recipient twin's gestational sac, volume of amnioreduction, and location of the placenta. The procedure-to-delivery interval for the total cohort (n = 79) was 9.2 +/- 4.7 weeks, without a significant difference between the two groups (P = 0.08). However, after exclusion of one PPROM outlier, the PPROM group had an average procedure-to-delivery time 2 weeks shorter than the group with no PPROM (P = 0.03). The live birth rates were similar in the PPROM and no-PPROM groups, at 77 and 73%, respectively. However, the average recipient's weight in the PPROM group was significantly lower than in the no-PPROM group (1321 +/- 493 vs. 1705 +/- 576 g; P = 0.02).

CONCLUSION

The rate of PPROM and the mean gestational age at delivery in pregnancies in which an absorbable gelatin sponge was used as a sealant of the fetoscopic port following laser photocoagulation for TTTS were comparable to those that have been reported by other laser centers where membrane sealants were not used. A randomized controlled trial should be considered to evaluate the effect of chorioamnion plugging.

Recycled desalination membranes as a support material for biofilm development: A new approach for microcystin removal during water treatment

Increased harmful cyanobacterial blooms and drought are some negative impacts of global warming. To deal with cyanotoxin release during water treatment, and to manage the massive quantities of end-of-life membrane waste generated by desalination processes, we propose an innovative biological system developed from recycled reverse osmosis (RO) membranes to remove microcystins (MC). Our system, named the Recycled-Membrane Biofilm Reactor (R-MBfR), effectively removes microcystins, while reducing the pollution impact of RO membrane waste by prolonging their life span at the same time. This multidisciplinary work showed that the inherent flaw of RO membranes, i.e., fouling, can be considered an advantageous characteristic for biofilm attachment. Factors such as roughness, hydrophilic surfaces, and the role of calcium in cell-cell and cell-surface interactions, encouraged bacterial growth on discarded membranes. Biofilm development was stimulated by using a laboratory-scale membrane module simulator cell. The R-MBfR proved versatile and was capable of degrading 2 mg·L^-1 of MC in 24 h. The economic feasibility of the scaling-up of the hypothetical R-MBfR was also validated. Therefore, this membrane recycling could be a future green cost-effective alternative technology for MC removal.

In vitro culture and labeling of neural cell aggregates followed by transplantation

Septal, cortical, or whole brain fetal (E15-17) cells were dissociated and cultured in serum-supplemented Dulbecco minimum essential medium under rotating culture conditions. Preincubation and exposure to cytosine arabinoside was utilized to produce "neuron-rich" cultures. Fluorescent latex microbeads were added to cultures at seeding time or early after aggregate formation. All cell types were found to incorporate the fluorescent beads, although apparently not to the same extent. Two- to five-day-old aggregates tended to attach and grow neurites after their transfer to poly-l-lysine- or Matrigel-coated dishes under stationary conditions. Early aggregates transplanted to the hippocampus of adult rats developed into identifiable grafts, with fluorescent-labeled cells. We conclude that "young" neural cell aggregates maintain their ability to undergo two basic phenomena for cellular interaction, i.e., attachment and neuritic growth. Floating aggregates may provide a convenient cellular condition whenever culturing of neural cells is to be used before grafting them into a host animal.

Exploring microcystin-degrading bacteria thriving on recycled membranes during a cyanobacterial bloom

Microcystins (MC) are highly toxic secondary metabolites produced by cyanobacterial blooms in many freshwater ecosystems used for recreational and drinking water purposes. So far, biological processes remain to be optimized for an efficient cyanotoxin removal, and new approaches are necessary to compete with physical-chemical treatments. In previous studies we provided a new concept of membrane biofilm reactor made of recycled material, in which a single MC-degrading bacterial strain was inoculated. The present study evaluates the capacity of bacterial consortia associated with freshwater cyanobacterial blooms to form biofilms on recycled membranes and remove MC. Three different discarded reverse osmosis (RO) membranes, previously used in desalination plants after treating brackish water (BWd), seawater (SWd) and brackish water but transformed into nanofiltration (BWt-NF), were exposed to a cyanobacterial bloom in San Juan reservoir (central Spain). Results showed that the three recycled membranes developed a bacterial community with MC removal capacity. Little differences in bacterial coverage and MC removal efficiency between membranes were observed after their exposure in the reservoir. High-throughput sequencing of 16S rRNA gene analysis showed similar bacterial community composition at the phylum level but dissimilar at the order level between the three membranes. This suggests possible surface selectivity on the attached bacterial community. The mlr^- candidates such as Burkholderiales and Methylophilales were highly abundant in BWt-NF and BWd, respectively, while mlr⁺ candidates (e.g. Sphingomonadales) were low abundant in all membranes. Analysis of mlrA and mlrB genes used as markers for MC degradation following mlr-pathway confirmed the presence of this pathway in all membranes. These results suggest the co-existence of both genotypes in membrane-attached native biofilms. Therefore, this study confirms that recycled membranes are suitable support for many MC-degrading bacteria, thus giving value to discarded membranes for eco-friendly and low-cost biological filters.

Management of Stage I twin-to-twin transfusion syndrome: an international survey

OBJECTIVE

To determine practice patterns for evaluation and treatment of Stage I twin-to-twin transfusion syndrome (TTTS) among international physicians.

METHODS

An e-mail cross-sectional survey of members from the IFMSS, NAFTNet and SMFM societies and participants at a Eurofoetus-sponsored TTTS meeting was undertaken between May 2008 and November 2008. Questionnaires consisted of physician demographics and their recommendations for managing Stage I TTTS. Alternative therapies to expectant management were assessed based on the following special circumstances of the patient: residence more than 200 miles from the center, severe symptoms, or a cervical length of </= 15 mm.

RESULTS

Eighty-one surveys were returned, giving a response rate of 84%. Five surveys were excluded as a result of duplication or missing data. Of the remaining 76 surveys, 48 were from North America, 20 were from Europe and eight were from other continents. Expectant management was the predominant recommendation (78%), followed by amnioreduction (11%), laser ablation (11%) and septostomy (1%). Recommendations for amnioreduction were exclusively from North American centers. Laser centers recommended expectant management more frequently than non-laser facilities (89% vs. 59%; P < 0.01). When examples of special patient circumstances were presented, North American centers changed their recommendation from expectant management to amnioreduction more often than did European centers. However, a greater proportion of European centers recommended laser surgery for special patient circumstances.

CONCLUSION

Expectant management remains the predominant management of Stage I TTTS. In some patient circumstances, North American centers are more likely to recommend amnioreduction while European centers are more likely to recommend laser therapy. A randomized controlled trial will be necessary to evaluate the most efficacious management strategy for Stage I TTTS.

Recycling of end-of-life reverse osmosis membranes for membrane biofilms reactors (MBfRs). Effect of chlorination on the membrane surface and gas permeability

Reducing human impacts on drinking water is one of the main challenges for the water treatment industry. This work provides new results to support the recycling of EoL desalination reverse osmosis (RO) membranes for Membranes Biofilm Reactors (MBfRs). We investigate if the controlled-removal of fouling and polyamide layer may favor the use of these membranes in MBfRs. It also would allow establishing a normalized methodology of membrane recycling, regardless of inherited fouling during its lifespan. For this purpose, we transform by chlorination discarded brackish (BWd) and seawater (SWd) membranes into nanofiltration (BWt-NF and SWt-NF) and ultrafiltration (BWt-UF and SWt-UF) membranes. Our results show that chlorine attacks allow the fouling cleaning while improves the hydrophilicity and maintains roughness only in BWt-NF. Therefore, the bacterial deposition in this membrane is greater than the other tested membranes. Besides, the microcystin (MC) degradation capacity of BWt-NF verifies the compatibility of the chemical modification for the biological activity of MC-degrading bacteria. Finally, our results also provide that polyamide thin-film composite (PA-TFC) membranes, originally manufactured for salt rejection during desalination processes, offer competitive gases diffusion at low pressures. Therefore, we conclude that the membrane recycling may provide alternative low cost and gas permeable membranes for MBfRs, according to circular economy principles.

Choosing a career in oncology: results of a nationwide cross-sectional study

BACKGROUND

Little information is currently available concerning young medical students desire to pursue a career in oncology, or their career expectations.

METHODS

This project is a cross-sectional epidemiological study. A voluntary and anonymous questionnaire was distributed to all young oncologists studying in France between the 2nd of October 2013 and the 23rd of February 2014.

RESULTS

The overall response rate was 75.6%. A total of 505 young oncologists completed the questionnaire. The main determining factors in the decision to practice oncology were the cross-sectional nature of the field (70.8%), the depth and variety of human relations (56.3%) and the multi-disciplinary field of work (50.2%). Most residents would like to complete a rotation outside of their assigned region (59.2%) or abroad (70.2%) in order to acquire additional expertise (67.7%). In addition, most interns would like to undertake a fellowship involving care, teaching and research in order to hone their skills (85.7%) and forge a career in public hospitals (46.4%). Career prospects mainly involve salaried positions in public hospitals. Many young oncologists are concerned about their professional future, due to the shortage of openings (40.8%), the workload (52.8%) and the lack of work-life balance (33.4%).

CONCLUSIONS

This investigation provides a comprehensive profile of the reasons young oncologists chose to pursue a career in oncology, and their career prospects.

Effects of maternal deprivation on adrenal and behavioural responses in rats with anterodorsal thalami nuclei lesions

There is evidence that repeated maternal isolation of neonatal rats may influence both emotional behavior and Hypothalamic-Pituitary Adrenal (HPA) activity. On the other hand the Anterodorsal Thalami Nuclei (ADTN) exerts an inhibitory influence on the hypophyso-adrenal system under basal and stressful conditions. In the present work we investigated whether neonatal maternal deprivation produces long term effects on the ADTN regulation of behavioral patterns (open field test) and on HPA axis activity. Specifically, we sought to determine whether adult female rats with ADTN lesions, previously isolated for 4.5 hours daily during the first 3 weeks of life, react in endocrinologically and behaviourally distinct manner as compared to controls. The examined groups were: non maternally deprived (NMD)/sham lesioned, NMD/lesioned, maternally deprived (MD)/sham lesioned, MD/lesioned with and without the open field test. At 3 months MD/sham lesioned animals showed a marked decrease in ambulation (P < 0.01), and with ADTN lesion, the rearing values were lower (P < 0.01) and grooming higher (P < 0.05) than NMD. This last data would indicate a high emotional index. Regarding the activity of the HPA axis, maternal deprivation induced a significant decrease in plasma ACTH concentration both in sham and lesioned animals (P < 0.001), and plasma Corticosterone (C) increased in sham animals (P < 0.001). This data would indicate a higher sensitivity of the adrenal glands. After the open field test ACTH and C were different between deprived and non-deprived animals depending on the ADTN lesion. Taking into consideration the increase of ACTH levels in sham lesioned MD animals exposed to the test, we could conclude that this new situation was a stressful situation. Finally in the present work, it was very difficult to relate the behavioral parameters with the endocrine data. It is known that depending on the context, corticosteroids may produce opposite effects on emotional behavior via different receptors in the brain.In summary, neonatal maternal deprivation induced alterations of behavioral patterns and affected the ADTN inhibitory influence on ACTH and C secretion.

Characterisation of the mitogenic-induced capacity of peritoneal effluent on human and mice fibroblasts in culture

During continuous ambulatory peritoneal dialysis, solutes capable of stimulating fibroblast activity could be transferred into dialysate; their significance and consequences remain to be established. Sixty-three stable non-selected patients on CAPD were included in this study. Peritoneal transport for water and small solutes was assessed. To explore the mitogenic-induced capacity of peritoneal nocturnal effluent, 50 microliters were added to culture plates of mice and human fibroblasts. Peritoneal effluent alone shows a mitogenic potency slightly greater than insulin and clearly less than bovine fetal serum. When coadjuvants are added, mitogenicity increases but in a variable manner among patients. No differences can be observed in relation to diabetes mellitus, time on CAPD, previous peritonitis, and losses of diffusion capacity. We noted significant inverse linear correlations between mitogenicity value and ultrafiltration, effluent calcium, and creatinine. Neither adrenergic nor calcium-channel blockers influenced these values. We conclude that the peritoneal effluent of CAPD patients has a variable effect on fibroblast growth. Some of the blood components seem to be implicated in this activity. Reduced peritoneal ultrafiltration capacity, probably by a concentration mechanism, is related to a greater mitogenic potency in peritoneal effluent. CAPD patients with impaired ultrafiltration may be at high risk for autoactivation of peritoneal fibroblasts, mainly in mesothelial denudate states.

Nitrate-Selective Anion Exchange Membranes Prepared using Discarded Reverse Osmosis Membranes as Support

The present work shows a methodology for the preparation of membranes with a high affinity for nitrates. For this purpose, a polymeric mixture containing an anion exchange resin was extended on a recycled pressure filtration membrane used as mechanical support. Different ion exchange resins were tested. The influence in ion fractionation of (i) the type of ion exchange resin, (ii) the use of a recycled membrane as support and (iii) the operating current density during the separation process were studied. Results revealed that the employed anion exchange resin could tune up the transport numbers of the anions in the membrane and enhance the transport of nitrates over sulfates. The use of the recycled filtration membrane as support further increased the transport of nitrates in detriment of sulfates in nitrate-selective membranes. Moreover, it considerably improved the mechanical stability of the membranes. Lowering the operational current density also boosted ion fractionation. In addition, the use of recycled membranes as support in membrane preparation is presented as an alternative management route of discarded reverse osmosis membranes, coupling with the challenging management of waste generated by the desalination industry. These membranes could be used for nitrate recovery from wastewater or for nitrate separation from groundwater.

Understanding the regioselectivity of Michael addition reactions to asymmetric divinylic compounds

In the present paper, we describe the synthesis of novel monomers prepared by regioselective Michael addition to asymmetric divinylic compounds.