On the valency of incomplete anti-Rh antibodies

The univalency concept of the mechanism responsible for the failure of incomplete antibodies to produce direct agglutination of appropriate untreated red cells has been investigated. Artificially produced univalent (hybrid) 7S antibodies were found to differ in serologic behaviour from incomplete anti-Rh antibodies of the same molecular size. The data suggest that the so-called `univalent' anti-Rh antibody molecule is bivalent.     

COVID-19 among LGBTQ+ individuals living with HIV/AIDS: psycho-social challenges and care options

Prolonged social isolation during the COVID-19 lockdown has adversely impacted the mental, social, and physical wellbeing of the global populace. Coping with mental and physical stressors amidst the global lockdown is especially strenuous for the Lesbian, Gay, Bisexual, Transgender, and more (LGBT+) community, who are frequently subjected to social stigma and minority stress. Systematic stigma and discrimination place LGBT+ individuals at higher risk for deleterious behaviors, such as substance abuse (e.g., injection drug use, smoking, alcohol) and risky sexual practices (e.g., anal/vaginal/oral sex). Maladaptive coping behaviors consequently increase the chances of HIV/AIDS risk among LGBT+ individuals, compared to heterosexual individuals. LGBT+ individuals Living with HIV/AIDS perpetually face higher rates of unemployment, income disparity, and intimate partner violence. Prolonged home confinement, and impaired accessibility to healthcare, legal, and criminal justice services during lockdown may deplete the quality of life of LGBT+ individuals Living with HIV/AIDS. Therefore, it is critical that multidisciplinary service providers, including health professionals, employers, social services providers, educational institutions and community organizations, move toward online service delivery, so that homebound HIV-positive LGBT+ individuals are secured with a wide range of care options. Non-judgemental, tele-counseling may bridge the gap to mental health services. Community clinics catering to HIV-positive and/or LGBT+ clients may consider precociously supplying essential amenities, such as Preexposure (PrEP)/postexposure prophylaxis (PEP), condoms, emergency contraception, and sterile needles. Lastly, efforts directed at the sustenance of at-risk/HIV-positive LGBT+ health should persevere, even after the pandemic.     

Pediatric Group Care: A Systematic Review

Maternal and Child Health Journal - To describe characteristics and outcomes of Group Well-Child Care programs and provide recommendations for future research. Informed by Preferred Reporting Items...     

Human Diversity of Killer Cell Immunoglobulin-Like Receptors and Human Leukocyte Antigen Class I Alleles and Ebola Virus Disease Outcomes

We investigated the genetic profiles of killer cell immunoglobulin-like receptors (KIRs) in Ebola virus–infected patients. We studied the relationship between KIR–human leukocyte antigen (HLA) combinations and the clinical outcomes of patients with Ebola virus disease (EVD). We genotyped KIRs and HLA class I alleles using DNA from uninfected controls, EVD survivors, and persons who died of EVD. The activating 2DS4–003 and inhibitory 2DL5 genes were significantly more common among persons who died of EVD; 2DL2 was more common among survivors. We used logistic regression analysis and Bayesian modeling to identify 2DL2, 2DL5, 2DS4–003, HLA-B-Bw4-Thr, and HLA-B-Bw4-Ile as probably having a significant relationship with disease outcome. Our findings highlight the importance of innate immune response against Ebola virus and show the association between KIRs and the clinical outcome of EVD.     

Trends and Outcomes in Simultaneous Liver and Kidney Transplantation in Australia and New Zealand

AimRates of simultaneous liver and kidney transplantation (SLKT) have increased, but indications for SLKT remain poorly defined. Additional data are needed to determine which patients benefit from SLKT to best direct use of scarce donor kidneys.MethodsData were extracted from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) database for all SLKT performed until the end of 2017. Patients were divided by pretransplant dialysis status into no dialysis before SLKT (preemptive kidney transplant) and any dialysis before SLKT (nonpreemptive). Baseline characteristics and outcomes were compared.ResultsBetween 1989 and 2017, inclusive, 84 SLKT procedures were performed in Australia, of which 24% were preemptive. Preemptive and nonpreemptive SLKT recipients did not significantly differ in age (P = .267), sex (P = .526), or ethnicity (P = .870). Over a median follow-up time of 4.5 years, preemptively transplanted patients had a statistically equivalent risk of kidney graft failure (hazard ratio (HR) 1.83, 95% confidence interval [CI]: 0.36-12.86, P = .474) and all-cause mortality (HR 1.69, 95% CI: 0.51-5.6, P = .226) compared to nonpreemptive patients. Overall, 1- and 5-year survival rates for all SLKTs were 92% (95% CI: 86-96) and 60% (95% CI: 45-75), respectively.ConclusionKidney graft and overall patient survival were similar between patients with preemptive kidney transplant and those who were dialysis dependent.     

An Exploration of Dyadic Relationship Approach-Avoidance Goals and Relationship and Sexual Satisfaction in Couples Coping with Endometriosis

Endometriosis affects women of reproductive age and is associated with higher levels of sexual and relational distress. Despite the relational context of endometriosis, the research pertaining to dyadic relationship goals is lacking. An exploration of the relationship goals of couples coping with endometriosis can facilitate the understanding of potential protective mechanisms that mitigate the relational components of the condition. Guided by the approach-avoidance theoretical framework, the current cross-sectional study aimed to examine the role relationship goals play in sexual and relationship satisfaction in couples coping with endometriosis. Approach goals relate to the pursuit of a positive outcomes, whereas avoidance goals relate to the avoidance of negative outcomes. Women with endometriosis and their partners (N?=?61) completed an online survey measuring relationship goals and relationship and sexual satisfaction. The study results indicated that, for women, their own and their partner’s higher relationship approach goals were linked to higher sexual satisfaction. For partners of women with endometriosis, their own higher relationship approach goals were associated with their own higher relationship satisfaction. Higher relationship avoidance goals in both women with endometriosis and partners were associated with higher relationship satisfaction. The study’s findings highlight relationship goals as relevant to the relational and sexual experience of couples coping with endometriosis. When treating women with endometriosis, the inclusion of partners and consideration of factors beyond the physical illness are important for a holistic management approach.

     

Disruption of rat forebrain development by glucocorticoids: critical perinatal periods for effects on neural cell acquisition and on cell signaling cascades mediating noradrenergic and cholinergic neurotransmitter/neurotrophic responses.

Glucocorticoids are the consensus treatment for the prevention of respiratory distress in preterm infants, but there is evidence for increased incidence of neurodevelopmental disorders as a result of their administration. We administered dexamethasone (Dex) to developing rats at doses below or within the range of those used clinically, evaluating the effects on forebrain development with exposure in three different stages: gestational days 17-19, postnatal days 1-3, or postnatal days 7-9. At 24 h after the last dose, we evaluated biomarkers of neural cell acquisition and growth, synaptic development, neurotransmitter receptor expression, and synaptic signaling mediated by adenylyl cyclase (AC). Dex impaired the acquisition of neural cells, with a peak effect when given in the immediate postnatal period. In association with this defect, Dex also elicited biphasic effects on cholinergic presynaptic development, promoting synaptic maturation at a dose (0.05 mg/kg) well below those used therapeutically, whereas the effect was diminished or lost when doses were increased to 0.2 or 0.8 mg/kg. Dex given postnatally also disrupted the expression of adrenergic receptors known to participate in neurotrophic modeling of the developing brain and evoked massive induction of AC activity. As a consequence, disparate receptor inputs all produced cyclic AMP overproduction, a likely contributor to disrupted patterns of cell replication, differentiation, and apoptosis. Superimposed on the heterologous AC induction, Dex impaired specific receptor-mediated cholinergic and adrenergic signals. These results indicate that, during a critical developmental period, Dex administration leads to widespread interference with forebrain development, likely contributing to eventual, adverse neurobehavioral outcomes.     

Evaluation of MindMatters Buddy Support to Secondary Schools in South West Sydney

This study assessed the outcomes of a buddy support scheme designed to increase the capacity of secondary schools to adopt a whole school approach to improving the well-being of students and to enhance uptake of MindMatters. The scheme supported schools implementing MindMatters, forming partnerships, and creating links with health services, organisations and community groups. The results showed that intervention schools were significantly more likely to ensure internal support by assigning a person responsible for MindMatters (90% vs 38%), forming a core team (79% vs 21%), reporting changes (94% vs 26%) and connectedness (100% vs 21%) and continuing MindMatters implementation (90% vs 33%) than non-intervention schools. They also reported positive outcomes in student and community participation, policy development and implementation. The results indicated the usefulness of the scheme and a plausible contribution to a greater level of sustainable changes than standard delivery of MindMatters. To assess the impact, further investigation with a larger sample is needed.