Distributional Properties and Criterion Validity of a Shortened Version of the Social Responsiveness Scale: Results from the ECHO Program and Implications for Social Communication Research

Prior work proposed a shortened version of the Social Responsiveness Scale (SRS), a commonly used quantitative measure of social communication traits. We used data from 3031 participants (including 190 ASD cases) from the Environmental Influences on Child Health Outcomes (ECHO) Program to compare distributional properties and criterion validity of 16-item “short” to 65-item “full” SRS scores. Results demonstrated highly overlapping distributions of short and full scores. Both scores separated case from non-case individuals by approximately two standard deviations. ASD prediction was nearly identical for short and full scores (area under the curve values of 0.87, 0.86 respectively). Findings support comparability of shortened and full scores, suggesting opportunities to increase efficiency. Future work should confirm additional psychometric properties of short scores.

     

Effects of gas-filled temporary breast tissue expanders on radiation dose from modulated rotational photon beams

Gas-filled temporary tissue expanders (TTEs), implanted to assist in post mastectomy breast reconstructions, are expected to produce increased dosimetric uncertainty in breast radiotherapy treatments, due to their containing both a substantial metallic component and a comparatively large volume of gas. This study therefore builds on previous investigations of the dosimetric effects of gas-filled TTEs in static photon and electron beams, by examining the effects of these implants on dose distributions from common modulated rotational treatment techniques; volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT). Radiochromic film measurements were used to evaluate the accuracy of VMAT and HT dose calculations, for a humanoid phantom augmented with a sample Aeroform CO₂-filled TTE (AirXpanders Inc, San Jose, USA) as well as purpose-designed and 3D printed “breast tissue.” Results showed that the TomoTherapy Hi-Art VoLO convolution-superposition algorithm (Accuray Inc, Sunnyvale, USA) produced comparatively accurate calculations of treatment dose within this complex phantom, including immediately anterior and posterior to the TTE. The Varian Eclipse Acuros (AXB) algorithm generally showed better agreement with the film measurement than the Varian Eclipse AAA algorithm (Varian Medical Systems, Palo Alto, USA), although the film measurements showed regions of 5% to 10% disagreement with both AAA and AXB in the dosimetrically-challenging region on the anterior side of the implant. Although the Aeroform CO₂-filled TTE has substantial and obvious effects on the downstream dose from a static photon beam, the results of this study showed how inverse-planning of modulated rotational radiotherapy treatments can produce modulated fluence distributions that compensate for the dramatic density heterogeneities in the implant. Despite some disagreements with the planned dose, all film measurements showed that the use of inverse-planned modulated rotational photon beams resulted in comparatively homogeneous coverage of the radiotherapy target, in the complex patient-like phantom with a gas-filled TTE. Due to the importance of matching each planned fluence distribution to the density distribution within each TTE, careful use of available 3D imaging techniques is advisable, when modulated rotational radiotherapy treatments are delivered to patients with gas-filled TTEs.     

PAK1 Positively Regulates Oligodendrocyte Morphology and Myelination

The actin cytoskeleton is crucial for oligodendrocyte differentiation and myelination. Here we show that p21-activated kinase 1 (PAK1), a well-known actin regulator, promotes oligodendrocyte morphologic change and myelin production in the CNS. A combination of in vitro and in vivo models demonstrated that PAK1 is expressed throughout the oligodendrocyte lineage with highest expression in differentiated oligodendrocytes. Inhibiting PAK1 early in oligodendrocyte development decreased oligodendrocyte morphologic complexity and altered F-actin spreading at the tips of oligodendrocyte progenitor cell processes. Constitutively activating AKT in oligodendrocytes in male and female mice, which leads to excessive myelin wrapping, increased PAK1 expression, suggesting an impact of PAK1 during active myelin wrapping. Furthermore, constitutively activating PAK1 in oligodendrocytes in zebrafish led to an increase in myelin internode length while inhibiting PAK1 during active myelination decreased internode length. As myelin parameters influence conduction velocity, these data suggest that PAK1 may influence communication within the CNS. These data support a model in which PAK1 is a positive regulator of CNS myelination.SIGNIFICANCE STATEMENT Myelin is a critical component of the CNS that provides metabolic support to neurons and also facilitates communication between cells in the CNS. Recent data demonstrate that actin dynamics drives myelin wrapping, but how actin is regulated during myelin wrapping is unknown. The authors investigate the role of the cytoskeletal modulator PAK1 during differentiation and myelination by oligodendrocytes, the myelinating cells of the CNS. They demonstrate that PAK1 promotes oligodendrocyte differentiation and myelination by modulating the cytoskeleton and thereby internode length, thus playing a critical role in the function of the CNS.     

Risk factors for enterococcal urinary tract infections: a multinational,retrospective cohort study

European Journal of Clinical Microbiology & Infectious Diseases - Complicated urinary tract infection (cUTI) is a frequent cause of morbidity. In this multinational retrospective cohort study,...