Home Food Environment Changes and Dietary Intake during an Adolescent Behavioral Weight Loss Intervention Differ by Food Security Status

Behavioral weight loss (BWL) for pediatric obesity includes guidance on improving the home food environment and dietary quality; yet food insecurity presents barriers to making these changes. This study examined if home food environment, dietary quality, energy intake, and body weight changes during adolescent obesity treatment differed by food security status, and if changes in the home food environment were associated with changes in dietary quality and energy intake by food security status. Adolescents (n = 82; 13.7 ± 1.2 years) with obesity participated in a 4-month BWL treatment. Food insecurity, home food environment (Home Food Inventory [HFI]), dietary quality (Healthy Eating Index [HEI]), energy intake, and body mass index (BMI) were assessed at baseline and post-treatment. A reduced obesogenic home food environment and improved dietary quality were observed for food secure (ps < 0.01), but not insecure households (ps > 0.05) (mean difference, HFI: −6.6 ± 6.4 vs. −2.4 ± 7.4; HEI: 5.1 ± 14.4 vs. 2.7 ± 17.7). Energy intake and BMI decreased for adolescents in food secure and insecure households (ps < 0.03) (mean difference; energy intake: −287 ± 417 vs. −309 ± 434 kcal/day; BMI: −1.0 ± 1.4 vs. −0.7 ± 1.4). BWL yielded similar reductions in energy intake and body weight yet did not offer the same benefits for improved dietary quality and the home food environment for adolescents with food insecurity.     

Rigidoporus corticola Colonization and Invasive Fungal Disease in Immunocompromised Patients,United States

We report 2 cases of Rigidoporus corticola (Oxyporus corticola) infection in humans in the United States. Clinical manifestations consisted of angioinvasive fungal sinusitis in 1 patient and pulmonary intracavitary fungus ball in the other patient. These cases illustrate previously undescribed clinicopathologic manifestations of infection by this filamentous basidiomycete in humans.     

Functional genomic screen of human stem cell differentiation reveals pathways involved in neurodevelopment and neurodegeneration

Human embryonic stem cells (hESCs) can be induced and differentiated to form a relatively homogeneous population of neuronal precursors in vitro. We have used this system to screen for genes necessary for neural lineage development by using a pooled human short hairpin RNA (shRNA) library screen and massively parallel sequencing. We confirmed known genes and identified several unpredicted genes with interrelated functions that were specifically required for the formation or survival of neuronal progenitor cells without interfering with the self-renewal capacity of undifferentiated hESCs. Among these are several genes that have been implicated in various neurodevelopmental disorders (i.e., brain malformations, mental retardation, and autism). Unexpectedly, a set of genes mutated in late-onset neurodegenerative disorders and with roles in the formation of RNA granules were also found to interfere with neuronal progenitor cell formation, suggesting their functional relevance in early neurogenesis. This study advances the feasibility and utility of using pooled shRNA libraries in combination with next-generation sequencing for a high-throughput, unbiased functional genomic screen. Our approach can also be used with patient-specific human-induced pluripotent stem cell-derived neural models to obtain unparalleled insights into developmental and degenerative processes in neurological or neuropsychiatric disorders with monogenic or complex inheritance.     

Mechanical Thrombectomy for Acute Ischemic Stroke: A Case Study Using the Penumbra Stroke System

Over recent years, there have been dramatic advances in the ability to treat an acute ischemic stroke. Thrombolysis with intravenous recombinant tissue plasminogen activator can now be performed up to 4.5 hr after stroke onset in certain circumstances, and new mechanical thrombectomy devices allow intervention up to and beyond 8 hr in some instances. The Penumbra Stroke System (Penumbra Inc., Alameda, CA), one of these mechanical thrombectomy devices, uses a series of catheters to aspirate thrombus from occluded cerebral arteries and thus restore flow to the adjacent ischemic brain.This case study highlights the clinical and procedural issues involved in the treatment and postprocedural care of a patient with an acute ischemic stroke treated with the Penumbra Stroke System.     

Anger Mediates the Relation Between Violence Exposure and Violence Perpetration in Incarcerated Boys

Youth who are exposed to violence are more likely to perpetrate violence. Incarcerated youth are a special population that is at a significantly greater risk for violent offending because of their relatively greater rates of violence exposure. Two important outcomes of violence exposure that may help explain its link with violence perpetration are posttraumatic stress disorder and problematic anger. The primary aim of the current study is to examine whether these important risk factors mediate the relation between two types of violence exposure (i.e., witnessing and victimization) and various types of violence perpetration in a sample of 373 incarcerated male adolescent offenders. A second aim is to test whether another well-established correlate of violence in youth, callous-unemotional (CU) traits (lack of empathy, guilt), adds unique variance beyond violence exposure, anger, and PTSD symptomatology. Findings suggest that anger is a robust predictor of violence and appears to at least partially act as the mechanism through which violence exposure is linked with violence perpetration. CU traits also contribute unique variance, beyond the significant effect of anger, to the statistical prediction of community, but not institutional, violence.     

Subcutaneous Midline Nasal Mass in an Infant due to an Intramuscular Lipoma

Intramuscular lipomas are rare, benign, mesenchymal tumors occurring deep in the fascia, typically involving large muscle groups in adults. We report a case of an intramuscular lipoma occurring as a subcutaneous midline nasal mass in a 3‐month‐old infant. The differential diagnosis of a midline mass on the glabella of an infant is important and should include developmental anomalies such as nasal glioma, nasal dermoid cyst, and encephalocele, so neuroimaging is an essential first step in evaluating these lesions to exclude intracranial extension.