The topography of binge eating,vomiting and laxative abuse

Data on the frequency and time distribution of bulimic episodes were examined in three groups of patients: those who reported binge eating and vomiting, those who reported binge eating and laxative abuse, and those who reported binge eating and both vomiting and laxative abuse. The probability of binge eating increased during the afternoon and evening for all three groups. Those who did not use laxatives reported a high frequency of binge eating, whereas those who used laxatives exclusively usually did so very late in the day.     

Activity of PD-1 blockade with nivolumab among patients with recurrent atypical/anaplastic meningioma: phase II trial results

BackgroundProgrammed death ligand 1 (PD-L1) contributes to tumor immunosuppression and is upregulated in aggressive meningiomas. We performed a phase II study of nivolumab, a programmed death 1 (PD-1) blocking antibody among patients with grade ≥2 meningioma that recurred after surgery and radiation therapy.MethodsTwenty-five patients received nivolumab (240 mg biweekly) until progression, voluntary withdrawal, unacceptable toxicity, or death. Tumor mutational burden (TMB) and quantification of tumor-infiltrating lymphocytes (TIL) were evaluated as potential immunocorrelative biomarkers. Change in neurologic function was prospectively assessed using the Neurologic Assessment in Neuro-Oncology (NANO) scale.ResultsEnrolled patients had multiple recurrences including ≥3 prior surgeries and ≥2 prior courses of radiation in 60% and 72%, respectively. Nivolumab was well tolerated with no unexpected adverse events. Six-month progression-free survival (PFS-6) rate was 42.4% (95% CI: 22.8, 60.7) and the median OS was 30.9 months (95% CI: 17.6, NA). One patient achieved radiographic response (ongoing at 4.5 years). TMB was >10/Mb in 2 of 15 profiled tumors (13.3%). Baseline TIL density was low but increased posttreatment in 3 patients including both patients with elevated TMB. Most patients who achieved PFS-6 maintained neurologic function prior to progression as assessed by NANO.ConclusionNivolumab was well tolerated but failed to improve PFS-6, although a subset of patients appeared to derive benefit. Low levels of TMB and TIL density were typically observed. NANO assessment of neurologic function contributed to outcome assessment. Future studies may consider rationally designed combinatorial regimens.     

Assessing depression in fibromyalgia patients

Purpose. This study investigated the relationships among four methods of detecting depression in patients with fibromyalgia. Methods. Data were obtained from 100 women (mean age 43 years) who had been diagnosed with fibro-myalgia. Instruments included a computerized Diagnostic Interview Schedule (C-DIS), Beck Depression Inventory (BDI), an adjusted “disease-free” BDI (BDI-A), and Minnesota Multiphasic Personality Inventory depression subscale (MMPI-D). Chance-corrected concordance, sensitivity, specificity, and accuracy among the four methods were calculated. Results. The C-DIS detected 22% and BDI-A 29% with current major depression. The BDI and MMPI-D yielded higher estimates of 55% of the 44%, respectively. Agreement on the diagnosis among the four methods was significantly greater than chance. When compared with the C-DIS, the BDI was the most sensitive instrument and the BDI-A most specific. Conclusions. The C-DIS and BDI-A appear to be more reliable methods for determining the presence of major depression in women with fibromyalgia than are the MMPI-D or standard BDI.     

Engineering bacteria to control electron transport altering the synthesis of non-native polymer

The use of bacteria as catalysts for radical polymerisations of synthetic monomers has recently been established. However, the role of trans Plasma Membrane Electron Transport (tPMET) in modulating these processes is not well understood. We sort to study this by genetic engineering a part of the tPMET system NapC in E. coli. We show that this engineering altered the rate of extracellular electron transfer coincided with an effect on cell-mediated polymerisation using a model monomer. A plasmid with arabinose inducible PBAD promoters were shown to upregulate NapC protein upon induction at total arabinose concentrations of 0.0018% and 0.18%. These clones (E. coli_{(IP_0.0018%)} and E. coli_{(IP_0.18%)}, respectively) were used in iron-mediated atom transfer radical polymerisation (Fe ATRP), affecting the nature of the polymerisation, than cultures containing suppressed or empty plasmids (E. coli_{(IP_S)} and E. coli_(E), respectively). These results lead to the hypothesis that EET (Extracellular Electron Transfer) in part modulates cell instructed polymerisations.

The use of bacteria as catalysts for radical polymerisations of synthetic monomers has recently been established.     

Streptococcus pneumoniae Serotypes Associated with Death,South Africa, 2012–2018

The Streptococcus pneumoniae polysaccharide capsule plays a role in disease severity. We assessed the association of serotype with case-fatality ratio (CFR) in invasive pneumococcal disease (IPD) and meningitis in South Africa, 2012–2018 (vaccine era), using multivariable logistic regression by manual backward elimination. The most common serotypes causing IPD were 8 and 19A. In patients <15 years of age, serotypes associated with increased CFR in IPD, compared with serotype 8 and controlling for confounding factors, were 11A, 13, 19F, 15A, and 6A. None of these serotypes were associated with increased CFR in meningitis. Among IPD patients >15 years of age, serotype 15B/C was associated with increased CFR. Among meningitis patients of all ages, serotype 1 was associated with increased CFR. PCV13 serotypes 1, 3, 6A, 19A, and 19F should be monitored, and serotypes 8, 12F, 15A, and 15B/C should be considered for inclusion in vaccines to reduce deaths caused by S. pneumoniae.     

A 7-Tesla MRI study of the periaqueductal gray: resting state and task activation under threat

The periaqueductal gray (PAG) is a region of the midbrain implicated in a variety of behaviors including defensive responses to threat. Despite the wealth of knowledge pertaining to the differential functional roles of the PAG columns in nonhuman and human research, the basic functional connectivity of the PAG at rest has not been well characterized. Therefore, the current study utilized 7-Tesla magnetic resonance imaging (MRI) to characterize PAG functional connectivity at rest and task activation under uncertain threat. A sample of 53 neurologically healthy undergraduate participants (M_age = 22.2, s.d._age = 3.62) underwent structural and resting state functional MRI scans. Supporting previous work, voxel-wise analyses showed that the PAG is functionally connected to emotion regulation and fear networks. The comparison of functional connectivity of PAG columns did not reveal any significant differences. Thirty-five participants from the same sample also completed an uncertain threat task with blocks of three conditions—no shock, predictable shock and unpredictable shock. There were no robust activity differences within the PAG columns or the whole PAG across conditions although there was differential activity at the voxel level in the PAG and in other regions theoretically relevant to uncertain threat. Results of this study elucidate PAG connectivity at rest and activation in response to uncertain threat.     

Bulimia nervosa and resting metabolic rate

This study investigated the relationship between bulimia nervosa and resting metabolic rate. It was hypothesized that severe levels of bulimia, characterized by purging through self-induced vomiting as well as restrictive eating patterns, would be associated with a decrease in the rate of energy utilization and thus a lower resting metabolic rate. Forty-two female subjects participated in the metabolic assessment. Twenty-six were given the diagnosis of bulimia nervosa, and only those subjects purging through self-induced vomiting were included. Sixteen nonbulimic women of comparable age, height, and weight were included as a control group. Resting metabolic rate was measured by continuous monitoring of expired oxygen and carbon dioxide fractions by indirect calorimetry via open-circuit spirometry. Mean values of kilocalories per hour per kilogram were utilized as the dependent variable in the statistical analysis. Bulimic subjects were divided into severe and less severe groups using a median split on the Bulimia Test (BULIT) and compared with normals. Results showed a negative correlation between severity of bulimia, as measured by the BULIT, and resting metabolic rate. It was found that severe bulimics had lower resting metabolic rates than less severe bulimics and normals, who did not differ. These data indicate that severe levels of bulimia are associated with lower resting metabolism, although the correlational nature of the data prohibits a direct causal statement regarding bulimic behavior and its effects on metabolism.     

An investigation of life satisfaction following a vacation: A domain-specific approach

The relationship of a vacation to global and domain-specific life satisfaction was examined. Comparison of pre-and postvacation measures indicated an increase in global life satisfaction and a slight increase in satisfaction within the domain of money, but no significant change in the domains of marriagel/family, work, leisure, community, or outdoors/nature. Retrospective measures of domain and global vacation satisfactions increased the predictability of postvacation satisfaction significantly for four of the six specific domains and for overall satisfaction. The domain specificity of satisfactions was supported only for the domains of marriage/family and work. The results are discussed in terms of their support for a domain-specific approach to life satisfaction.     

COVID-19 Mortality and Social Inequalities: Escherichia coli O103 outbreak associated with minced celery among hospitalized individuals in Victoria,British Columbia, 2021

BackgroundIn April 2021, a Shiga toxin-producing Escherichia coli (E. coli) (STEC) O103 outbreak was identified among patients at two hospitals in Victoria, British Columbia (BC). The objective of this study is to describe this outbreak investigation and identify issues of food safety for high-risk products prepared for vulnerable populations.MethodsConfirmed cases of E. coli O103 were reported to the Island Health communicable disease unit. The provincial public health laboratory conducted whole genome sequencing on confirmed case isolates, as per routine practice for STEC in BC. Exposure information was obtained through case interviews and review of hospital menus. Federal and local public health authorities conducted an inspection of the processing plant for the suspect source.ResultsSix confirmed cases of E. coli O103 were identified, all related by whole genome sequencing. The majority of cases were female (67%) and the median age was 61 years (range 24–87 years). All confirmed cases were inpatients or outpatients at two hospitals and were exposed to raw minced celery within prepared sandwiches provided by hospital food services. A local processor supplied the minced celery exclusively to the two hospitals. Testing of product at the processor was infrequent, and chlorine rinse occurred before mincing. The spread of residual E. coli contamination through the mincing process, in addition to temperature abuse at the hospitals, are thought to have contributed to this outbreak.ConclusionRaw vegetables, such as celery, are a potential source of STEC and present a risk to vulnerable populations. Recommendations from this outbreak include more frequent testing at the processor, a review of the chlorination and mincing process and a review of hospital food services practices to mitigate temperature abuse.