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Coronavirus exacerbating ''disordered world'' warns EU's top diplomat

Coronavirus exacerbating ''disordered world'' warns EU's top diplomat




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18 bodies of drowned Afghans recovered at Iran border

HERAT: Afghanistan has recovered 18 bodies of migrants who were allegedly beaten and tortured before being forced into a river by Iranian border guards last week, a senior Afghan official said...

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18 bodies of drowned Afghans recovered at Iran border

HERAT, Afghanistan: Afghanistan has recovered 18 bodies of migrants who were allegedly beaten and tortured before being forced into a river by Iranian border guards last week, a senior Afghan official said Friday.Afghan authorities are investigating claims the migrants drowned while illegally...




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'Trump ordered mercenary attack on Venezuela'

CARACAS: Venezuelan President Nicolas Maduro says there is evidence his American counterpart Donald Trump “personally ordered” the recent military raid on the Latin American country, arguing that Washington swiftly cut remaining ties with Caracas thereafter. Maduro made the comments in...




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18 bodies of drowned Afghans recovered at Iran border

HERAT, Afghanistan: Afghanistan has recovered 18 bodies of migrants who were allegedly beaten and tortured before being forced into a river by Iranian border guards last week, a senior Afghan official said on Friday.Afghan authorities are investigating claims the migrants drowned while illegally...




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Pandemic fuels historic US job losses, EU wants borders kept shut

The United States recorded Friday its steepest job losses in history over the coronavirus pandemic as Europe moved to keep its borders shut for another month.




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Delhi upping border tension: Indian CFVs cross 1,000 in 2020

ISLAMABAD: The Foreign Office on Friday said it had summoned a senior Indian diplomat to register a strong protest over the Indian ceasefire violations along the Line of Control .The statement by the FO said that in the unprovoked Indian firing across the LoC in Nezapir and Rakchikri sectors, six...




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Even with borders closing, we need to keep trade flowing -- by Steven Beck

The COVID-19 pandemic underscores the need to support trade to not only move medical supplies but also to bolster economies




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CCI orders fresh probe against DLF firm for Gurgaon project

New Delhi : The Competition Commission of India (CCI) has ordered a fresh probe against a DLF group firm, DLF Universal, for allegedly imposing unfair and unreasonable conditions on office buyers at one of its commercial projects — Corporate Greens at Sector 74A — in Gurgaon. CCI said in its 11-page order dated June 23 that “the conduct of DLF Group, emanating from its dominant position in the relevant market, prima facie, amounts to imposition of unfair terms and conditions on the commercial office buyers which is anti-competitive”. After looking into the complaint, CCI said its prima facie opinion was that despite the presence of other developer in commercial real […]




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Tours to Border Truce Village Could Resume in June

Tours to the border truce village of Panmunjom could resume as early as next month.Unification Minister Kim Yeon-chul told reporters Thursday that improved security measures will ensure that tours can resume on a trial basis after they were suspended last October as a preventive measure against Afri...




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Coronavirus stay-at-home orders in Colorado

A roundup of stay-at-home orders in Colorado due to the coronavirus outbreak. Read the details of the orders in San Miguel County, Denver, Boulder, Piktin County and the Southern Ute Tribe.




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6 FC personnel martyred in IED blast near Pak-Iran border

Five Frontier Corps (FC) soldiers and one officer were martyred after their vehicle was targeted with an improvised explosive device (IED) near the Pakistan-Iran border, the military's media wing said on Friday.

In a tweet, the Inter-Services Public Relations (ISPR) said the security personnel were returning from patrolling in Buleda — 14 kilometres from the Pakistan-Iran border — to "check possible routes used by terrorists in the mountainous terrain of Makran".

As they were returning, their vehicle was targeted with a remote controlled IED, it added.

The martyred were identified as Major Nadeem, Naik Jamshed, Lance Naik Khizar Hayat, Lance Naik Taimor, Sepoy Nadeem and Sepoy Sajid.

In December 2019, one FC soldier was martyred and two others were injured in an exchange of fire with terrorists after they raided an FC checkpost in North Waziristan.

"Terrorists raided an FC post in North Waziristan district near the Pak-Afghan border," an ISPR statement had said.

"During the exchange of fire, two terrorists were killed," it had added.




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HC sets aside order to ‘benefit’ landowners

Tribune News Service Chandigarh, February 21 Displaying the humanitarian side of law, the Punjab and Haryana High Court in a rare judgment has set aside a lower court order, though it was neither illegal, nor erroneous. Justice Rajiv Narain Raina made it clear that the judgment granting yet another opportunity to farmers to plead their case for a higher compensation for acquired land was being passed to “avoid miscarriage of justice”. The order came on a petition filed by Vijay Kumar and another petitioner against Haryana and other respondents. Their evidence in support of plea to enhance compensation awarded by the Land Acquisition Collector was turned down on the ground […]




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18 bodies of drowned Afghans recovered at Iran border

Afghanistan has recovered 18 bodies of migrants who were allegedly beaten and tortured before being forced into a river by Iranian border guards last week, a senior Afghan official said Friday.




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Palestinians say they will defy Israeli order in prisoner payments dispute

Palestinian leaders vowed Friday to defy a new Israeli military order which they fear could lead to the confiscation of money destined for prisoners, their relatives and the families of those killed in unrest.




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Raising Food Standards for Cross-Border Trade in the Lao People's Democratic Republic

Ensuring food is safe to eat is a public good. People’s health depends on it, and so does the health of economies.




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Trade Impact of Reducing Time and Costs at Borders in the Central Asia Regional Economic Cooperation Region

Trade facilitation, by reducing trade costs and raising the efficiency of moving goods across borders, is integral to international trade.




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The universe tends towards disorder. But how come nobody knows why?

Entropy is the physicist’s magic word, invoked to answer to some of the biggest questions in cosmology. Yet a quantum rethink may be needed to tell us what it actually is




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The universe tends towards disorder. But how come nobody knows why?

Entropy is the physicist’s magic word, invoked to answer to some of the biggest questions in cosmology. Yet a quantum rethink may be needed to tell us what it actually is




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AHA News: Persistent Asthma Linked to Increased Risk for Heart Rhythm Disorder

Title: AHA News: Persistent Asthma Linked to Increased Risk for Heart Rhythm Disorder
Category: Health News
Created: 2/4/2020 12:00:00 AM
Last Editorial Review: 2/5/2020 12:00:00 AM




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Many Adults Delay Getting Help for Eating Disorders

Title: Many Adults Delay Getting Help for Eating Disorders
Category: Health News
Created: 4/21/2020 12:00:00 AM
Last Editorial Review: 4/22/2020 12:00:00 AM




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New Treatment for Bleeding Disorder Approved

Title: New Treatment for Bleeding Disorder Approved
Category: Health News
Created: 5/1/2007 2:00:00 AM
Last Editorial Review: 5/1/2007 12:00:00 AM




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Napping Habits Tied to Sleep Disorders

Title: Napping Habits Tied to Sleep Disorders
Category: Health News
Created: 5/2/2008 2:00:00 AM
Last Editorial Review: 5/2/2008 12:00:00 AM




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Like Humans, Ravens Understand There's a Pecking Order

Title: Like Humans, Ravens Understand There's a Pecking Order
Category: Health News
Created: 4/25/2014 4:36:00 PM
Last Editorial Review: 4/28/2014 12:00:00 AM




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Trump Orders Meat Plants to Stay Open as U.S. Coronavirus Cases Pass 1 Million

Title: Trump Orders Meat Plants to Stay Open as U.S. Coronavirus Cases Pass 1 Million
Category: Health News
Created: 4/29/2020 12:00:00 AM
Last Editorial Review: 4/29/2020 12:00:00 AM




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A Cohort Comparison of Differences Between Regional and Buncombe County Patients of a Comprehensive Perinatal Substance Use Disorders Program in Western North Carolina

BACKGROUND Pregnant patients from rural counties of Western North Carolina face additional barriers when accessing comprehensive perinatal substance use disorders care at Project CARA as compared to patients local to the program in Buncombe County. We hypothesized regional patients would be less engaged in care.

METHOD Using a retrospective cohort design, univariate analyses (2, t-test; P < .05) compared patients' characteristics, engagement in care, and delivery outcomes. Engagement in care, the primary outcome, was operationalized as: attendance at expected, program-specific prenatal and postpartum visits, utilization of in-house counseling, community-based and/or inpatient substance use disorders treatment, and maternal urine drug screen at delivery negative for illicit substances.

RESULTS Regional patients (n = 324) were more likely than Buncombe County patients (n = 284) to have opioid [209 (64.5%) versus 162 (57.0%)] or amphetamine/methamphetamine use disorders (25 [7.7%] versus 13 [4.6%]), but less likely to have cannabis use (19 [5.9%] versus 38 [13.4%]; P = .009) and concurrent psychiatric disorders (214 [66.0%] versus 220 [77.5%]; P = .002). Engagement at postpartum visits was the significantly different outcome between patients (110/221 [49.8%] versus 146/226 [64.6%]; P = .002).

LIMITATIONS Outcomes were available for 66.8% of regional and 79.6% of Buncombe County patients of one program in one predominately white, non-Hispanic region of the state.

CONCLUSION Contrary to our hypothesis, regional and Buncombe County women engaged in prenatal care equally. However, a more formal transition into the postpartum period is needed, especially for regional women. A "hub-and-spokes" model that extends delivery of perinatal substance use disorders care into rural communities may be more effective for engagement retention.




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Expanding the phenotype of MTOR-related disorders and the Smith-Kingsmore syndrome

Heterozygous germline mutations in mammalian target of rapamycin (MTOR) (OMIM 601231) are known to underlie Smith-Kingsmore syndrome (SKS; OMIM 616638), an infrequent entity with autosomal dominant inheritance, also known as macrocephaly-intellectual disability-neurodevelopmental disorder-small thorax syndrome (ORPHA 457485).1 Among the clinical features of SKS, the most common features include intellectual disability, macrocephaly, epilepsy, and facial dysmorphism. The aim of this case is to raise awareness of a distinct phenotypical presentation of SKS manifesting with bilateral cataracts and no history of seizures.




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Author response: Functional neurologic disorders: Bringing the informal and hidden curriculum to light

Dr. Sethi raises an excellent point about the term functional neurologic disorder (FND) in his comment on the editorial.1 It seems clear that reticence to use the term functional creates the ambiguity he mentions. Medically unexplained symptoms, categorized in the international classification of diseases as undifferentiated somatoform disorders, are a diagnosis that many providers are loathed to give. Whether that is because of concern about missing a diagnosis is not clear. Having evaluated and treated more than 400 of these individuals in the FND clinic at the University of Colorado, I can attest to the fact that patients arrive confused about their diagnosis. Multiple incorrect diagnoses, as Dr. Sethi points out, pack the medical histories of patients with FND, leading doctors and patients astray. I believe that the commentary by Perez et al.2 gives us the best chance for a way forward, by teaching a new generation of residents and fellows how to approach patients in a nonjudgmental and open-minded fashion. It took 30 years to add Functional Neurologic Disorder to the Diagnostic and Statistical Manual, and it is still parenthetical to the term Conversion.3 Stripping the diagnosis of FND of its stigma and empowering care providers to rule in functional disorders is an actionable step which should be taken.




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Reader response: Functional neurologic disorders: Bringing the informal and hidden curriculum to light

I read with interest the editorial by Strom1 about functional neurologic disorders (FNDs). As a treating physician, I have struggled with the multiple diagnostic labels attached to these patients by physicians of different medical specialties during the course of their clinical disease presentation. A neurologist may assign a patient who presents with chronic fatigue the diagnostic labels of narcolepsy, idiopathic hypersomnia, or chronic Lyme disease. A rheumatologist may assign the label of collagen vascular disease, and a psychiatrist may diagnose depression. This diagnostic ambiguity is troublesome for patients and clinicians alike. I contend that even the term FND needs to be revisited. A patient should be broadly labeled as having a functional disorder and only after characterization sublabeled and referred to an appropriate specialty physician.




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Rates and Stability of Mental Health Disorders in Children Born Very Preterm at 7 and 13 Years

OBJECTIVES:

Children born very preterm (VPT) are at an increased risk of developing mental health (MH) disorders. Our aim for this study was to assess rates of MH disorders in children born VPT and term at 13 years of age and stability of MH disorders between ages 7 and 13 years by using a diagnostic measure.

METHODS:

Participants were from the Victorian Infant Brain Study longitudinal cohort and included 125 children born VPT (<30 weeks’ gestational age and/or <1250 g) and 49 children born term (≥37 weeks’ gestational age) and their families. Participants were followed-up at both 7 and 13 years, and the Development and Well-Being Assessment was administered to assess for MH disorders.

RESULTS:

Compared with term peers, 13-year-olds born VPT were more likely to meet criteria for any MH disorder (odds ratio 5.9; 95% confidence interval 1.71–20.03). Anxiety was the most common disorder in both groups (VPT = 14%; term = 4%), whereas attention-deficit/hyperactivity disorder carried the greatest differential elevated risk (odds ratio 5.6; 95% confidence interval 0.71–43.80). Overall rates of MH disorders remained stable between 7 and 13 years, although at an individual level, many participants shifted in or out of diagnostic categories over time.

CONCLUSIONS:

Children born VPT show higher rates of MH disorders than their term peers, with changing trajectories over time. Findings highlight the importance of early identification and ongoing assessment to support those with MH disorders in this population.




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Use of Standing Orders for Vaccination Among Pediatricians

OBJECTIVES:

Standing orders are an effective way to increase vaccination rates, yet little is known about how pediatricians use this strategy for childhood immunizations. We assessed current use of, barriers to using, and factors associated with use of standing orders for vaccination among pediatricians.

METHODS:

Internet and mail survey from June 2017 to September 2017 among a nationally representative sample of pediatricians. In the principal component analysis of barrier items, we identified 2 factors: physician responsibility and concerns about office processes. A multivariable analysis that included barrier scales and physician and/or practice characteristics was used to identify factors associated with use of standing orders.

RESULTS:

The response rate was 79% (372 of 471); 59% of respondents reported using standing orders. The most commonly identified barriers among nonusers were concern that patients may mistakenly receive the wrong vaccine (68%), concern that patients prefer to speak with the physician about a vaccine before receiving it (62%), and belief that it is important for the physician to be the person who recommends a vaccine to patients (57%). These 3 items also made up the physician responsibility barrier factor. Respondents with higher physician responsibility scores were less likely to use standing orders (risk ratio: 0.59 [95% confidence interval: 0.53–0.66] per point increase). System-level decision-making about vaccines, suburban or rural location, and lower concerns about office processes scores were each associated with use of standing orders in the bivariate, but not the multivariable, analysis.

CONCLUSIONS:

Among pediatricians, use of standing orders for vaccination is far from universal. Interventions to increase use of standing orders should address physicians’ attitudinal barriers as well as organizational factors.




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Developmental Support for Infants With Genetic Disorders

As the technical ability for genetic diagnosis continues to improve, an increasing number of diagnoses are made in infancy or as early as the neonatal period. Many of these diagnoses are known to be associated with developmental delay and intellectual disability, features that would not be clinically detectable at the time of diagnosis. Others may be associated with cognitive impairment, but the incidence and severity are yet to be fully described. These neonates and infants with genetic diagnoses therefore represent an emerging group of patients who are at high risk for neurodevelopmental disabilities. Although there are well-established developmental supports for high-risk infants, particularly preterm infants, after discharge from the NICU, programs specifically for infants with genetic diagnoses are rare. And although previous research has demonstrated the positive effect of early developmental interventions on outcomes among preterm infants, the impact of such supports for infants with genetic disorders who may be born term, remains to be understood. We therefore review the literature regarding existing developmental assessment and intervention approaches for children with genetic disorders, evaluating these in the context of current developmental supports postdischarge for preterm infants. Further research into the role of developmental support programs for early assessment and intervention in high-risk neonates diagnosed with rare genetic disorders is needed.




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Marketing Messages in Continuing Medical Education (CME) Modules on Binge-Eating Disorder (BED)

Background:

In 2015, Vyvanse (lisdexamfetamine) became the first Food and Drug Administration (FDA)-approved treatment for binge-eating disorder (BED), a condition first recognized by the DSM–V in 2013. Because pharmaceutical companies use continuing medical education (CME) to help sell drugs, we explored possible bias in CME modules on BED.

Methods:

We utilized a qualitative thematic analysis research approach to identify and classify patterns in CME activities focusing on BED.

Results:

We identified 27 online CME activities on BED in 2015. All were funded by Shire, which manufactures lisdexamfetamine. Seven of 16 presenters disclosed financial ties with Shire. Twenty-nine slides recurred in at least 2 CME modules, and 12 slides were repeated in 5 or more modules. Diagnosis-related themes included: BED is a real, treatable disease; BED is highly prevalent but often missed; BED can occur in anyone; BED results in poor quality of life; many patients with BED are obese; and BED makes losing weight difficult. Treatment-related themes included: lisdexamfetamine is highly effective; topiramate is limited by substantial adverse effects; and other therapeutic options for BED are inferior to lisdexamfetamine because they do not cause weight loss. Although amphetamines can cause addiction, myocardial infarction, stroke, and death, no module mentioned these serious adverse effects.

Conclusions:

It seems that CME is being used to promote lisdexamfetamine for weight loss (a contraindicated use) and to highlight benefits of lisdexamfetamine while underplaying the risks.




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Templated folding of intrinsically disordered proteins [Molecular Biophysics]

Much of our current knowledge of biological chemistry is founded in the structure-function relationship, whereby sequence determines structure that determines function. Thus, the discovery that a large fraction of the proteome is intrinsically disordered, while being functional, has revolutionized our understanding of proteins and raised new and interesting questions. Many intrinsically disordered proteins (IDPs) have been determined to undergo a disorder-to-order transition when recognizing their physiological partners, suggesting that their mechanisms of folding are intrinsically different from those observed in globular proteins. However, IDPs also follow some of the classic paradigms established for globular proteins, pointing to important similarities in their behavior. In this review, we compare and contrast the folding mechanisms of globular proteins with the emerging features of binding-induced folding of intrinsically disordered proteins. Specifically, whereas disorder-to-order transitions of intrinsically disordered proteins appear to follow rules of globular protein folding, such as the cooperative nature of the reaction, their folding pathways are remarkably more malleable, due to the heterogeneous nature of their folding nuclei, as probed by analysis of linear free-energy relationship plots. These insights have led to a new model for the disorder-to-order transition in IDPs termed “templated folding,” whereby the binding partner dictates distinct structural transitions en route to product, while ensuring a cooperative folding.




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Monoclonal antibody treatment during pregnancy and/or lactation in women with MS or neuromyelitis optica spectrum disorder

Objective

To assess possible adverse effects on breastfed infants of mothers receiving monoclonal antibodies (MAbs) during pregnancy and/or lactation.

Methods

We identified 23 patients from the German Multiple Sclerosis and Pregnancy Registry (DMSKW) who received MAbs (17 natalizumab and 6 anti-CD20) during lactation. Thirteen were already exposed to natalizumab during the third trimester of pregnancy, and 1 received ocrelizumab during pregnancy. Data were obtained from standardized, telephone-administered questionnaires completed by the mother during pregnancy and at 1, 3, 6, and 12 months postpartum. Natalizumab concentration in mother’s milk was analyzed in 3 patients and natalizumab serum concentration in 2 of these patients and their breastfed infants.

Results

We did not observe a negative impact on infant health and development attributable to breast milk exposure after a median follow-up of 1 year. Infants exposed to natalizumab during the third trimester had a lower birth weight and more hospitalizations in the first year of life. The concentration of natalizumab in breast milk and serum of infants was low; B cells normal in infants breastfed under anti-CD20.

Conclusion

More data on the effect of Mab exposure during pregnancy are needed. Otherwise, our data suggest that treatment with natalizumab, ocrelizumab, or rituximab during lactation might be safe for breastfed infants.




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Checking responses of goal- and sign-trackers are differentially affected by threat in a rodent analog of obsessive-compulsive disorder [RESEARCH]

In obsessive–compulsive disorder (OCD), functional behaviors such as checking that a door is locked become dysfunctional, maladaptive, and debilitating. However, it is currently unknown how aversive and appetitive motivations interact to produce functional and dysfunctional behavior in OCD. Here we show a double dissociation in the effects of anxiogenic cues and sensitivity to rewarding stimuli on the propensity to develop functional and dysfunctional checking behavior in a rodent analog of OCD, the observing response task (ORT). While anxiogenic manipulations of perceived threat (presentation of threat-associated contextual cues) and actual threat (punishment of incorrect responding on the ORT) enhanced functional checking, dysfunctional checking was unaffected. In contrast, rats that had previously been identified as "sign-trackers" on an autoshaping task—and therefore were highly sensitive to the incentive salience of appetitive environmental cues—selectively showed elevated levels of dysfunctional checking under a range of conditions, but particularly so under conditions of uncertainty. These data indicate that functional and dysfunctional checking are dissociable and supported by aversive and appetitive motivational processes, respectively. While functional checking is modulated by perceived and actual threat, dysfunctional checking recruits appetitive motivational processes, possibly akin to the "incentive habits" that contribute to drug-seeking in addiction.




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More than Smoke and Patches: The Quest for Pharmacotherapies to Treat Tobacco Use Disorder [Review Articles]

Tobacco use is a persistent public health issue. It kills up to half its users and is the cause of nearly 90% of all lung cancers. The main psychoactive component of tobacco is nicotine, primarily responsible for its abuse-related effects. Accordingly, most pharmacotherapies for smoking cessation target nicotinic acetylcholine receptors (nAChRs), nicotine’s major site of action in the brain. The goal of the current review is twofold: first, to provide a brief overview of the most commonly used behavioral procedures for evaluating smoking cessation pharmacotherapies and an introduction to pharmacokinetic and pharmacodynamic properties of nicotine important for consideration in the development of new pharmacotherapies; and second, to discuss current and potential future pharmacological interventions aimed at decreasing tobacco use. Attention will focus on the potential for allosteric modulators of nAChRs to offer an improvement over currently approved pharmacotherapies. Additionally, given increasing public concern for the potential health consequences of using electronic nicotine delivery systems, which allow users to inhale aerosolized solutions as an alternative to smoking tobacco, an effort will be made throughout this review to address the implications of this relatively new form of nicotine delivery, specifically as it relates to smoking cessation.

Significance Statement

Despite decades of research that have vastly improved our understanding of nicotine and its effects on the body, only a handful of pharmacotherapies have been successfully developed for use in smoking cessation. Thus, investigation of alternative pharmacological strategies for treating tobacco use disorder remains active; allosteric modulators of nicotinic acetylcholine receptors represent one class of compounds currently under development for this purpose.




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Platelet Disorders

After vascular injury and exposure of subendothelial matrix proteins to the intravascular space, mediators of hemostasis are triggered and allow for clot formation and restoration of vascular integrity. Platelets are the mediators of primary hemostasis, creating a platelet plug and allowing for initial cessation of bleeding. Platelet disorders, qualitative and quantitative, may result in bleeding signs and symptoms, particularly mucocutaneous bleeding such as epistaxis, bruising, petechiae, and heavy menstrual bleeding. Increasing evidence suggests that platelets have functional capabilities beyond hemostasis, but this review focuses solely on platelet hemostatic properties. Herein, normal platelet function as well as the effects of abnormal function and thrombocytopenia are reviewed.




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On the Cretaceous origin of the Order Syracosphaerales and the genus Syracosphaera

New scanning electron microscope observations of unadulterated calcareous nannofossil assemblages on lamina surfaces of Cretaceous Tanzania Drilling Project sediments reveal high diversity in the <3 µm size-range and high abundances of small and frangible morphologies. These assemblages prompt comparison to modern assemblages, which show similar high diversity and abundance of very small and fragile taxa, although these assemblages are generally not preserved in the fossil record due to taphonomic filtering. Not only are there broad similarities between the general composition of modern assemblages and those of the Tanzanian lagerstätte, but also our discovery of several new Cretaceous taxa provides evidence for greatly extended fossil lineages of extant orders, with implications for both deep-time biodiversity divergence and survival through the end-Cretaceous mass extinction. Our findings include: new species that are the first-recorded Mesozoic representatives of the extant Syracosphaeraceae and Papposphaeraceae; potentially previously unrecorded diversity in the Mesozoic Calciosoleniaceae, another extant order, represented by extant species that have been described already; and new species and unusually high abundances of the Mesozoic Stephanolithiaceae. We also highlight the extended range of an incertae sedis Cenozoic genus, Ellipsolithus, into at least the Turonian.

Here, we describe seven new miniscule to very small Cretaceous species: Syracosphaera antiqua, S. repagula, Pocillithus macleodii, P. crucifer, Stradnerlithus wendleri, S.? haynesiae and Tortolithus foramen.




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Borderlands: the difficulty of the liminal in primary care




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Metabolic Disorders with Kidney Transplant

Metabolic disorders are highly prevalent in kidney transplant candidates and recipients and can adversely affect post-transplant graft outcomes. Management of diabetes, hyperparathyroidism, and obesity presents distinct opportunities to optimize patients both before and after transplant as well as the ability to track objective data over time to assess a patient’s ability to partner effectively with the health care team and adhere to complex treatment regimens. Optimization of these particular disorders can most dramatically decrease the risk of surgical and cardiovascular complications post-transplant. Approximately 60% of nondiabetic patients experience hyperglycemia in the immediate post-transplant phase. Multiple risk factors have been identified related to development of new onset diabetes after transplant, and it is estimated that upward of 7%–30% of patients will develop new onset diabetes within the first year post-transplant. There are a number of medications studied in the kidney transplant population for diabetes management, and recent data and the risks and benefits of each regimen should be optimized. Secondary hyperparathyroidism occurs in most patients with CKD and can persist after kidney transplant in up to 66% of patients, despite an initial decrease in parathyroid hormone levels. Parathyroidectomy and medical management are the options for treatment of secondary hyperparathyroidism, but there is no randomized, controlled trial providing clear recommendations for optimal management, and patient-specific factors should be considered. Obesity is the most common metabolic disorder affecting the transplant population in both the pre- and post-transplant phases of care. Not only does obesity have associations and interactions with comorbid illnesses, such as diabetes, dyslipidemia, and cardiovascular disease, all of which increase morbidity and mortality post-transplant, but it also is intimately inter-related with access to transplantation for patients with kidney failure. We review these metabolic disorders and their management, including data in patients with kidney transplants.




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Continuous professional development: elevating sleep and breathing disorder education in Europe

Sleep and breathing disorders are highly prevalent, representing a growing subspecialty of respiratory medicine. The term sleep disordered breathing (SDB) encompasses a range of conditions characterised by abnormal breathing during sleep, from chronic or habitual snoring, to frank obstructive sleep apnoea (OSA) or, in some cases, central sleep apnoea (CSA) and hypoventilation syndromes. OSA is the commonest form of SDB, leading to many potential consequences and adverse clinical outcomes, including excessive daytime sleepiness, impaired daytime function, metabolic dysfunction, and an increased risk of cardiovascular disease and mortality [1]. The estimated reported prevalence of moderate-to-severe SDB (≥15 events·h–1) was 23.4% in women and 49.7% in men, and the prevalence of symptomatic OSA was 9% and 13%, respectively [2]. However, in some populations, the prevalence of OSA is substantially higher, such as in patients been evaluated for bariatric surgery (estimated range 70–80%), in patients who have had a transient ischaemic attack or stroke (estimated range 60–70%) and in patients with cardiometabolic disease [3–6]. Limited data have been reported on CSA and non-obstructive sleep-related hypoventilation, which have received considerable interest in the sleep field within the past 10 years. Even if their prevalence was noted to be quite low relative to the prevalence of OSA [7], they are quite common in specific subpopulations [8–10].




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Distribution of Highly Prevalent Musculoskeletal Disorders and Their Association With Diabetes Complications in a Population of 140 Individuals With Type 1 Diabetes: A Retrospective Study in a French Diabetes Center

Although they are usually not considered to be diabetes complications, musculoskeletal disorders (MSKDs) are common in individuals with type 1 or type 2 diabetes and can strongly interfere with daily diabetes care, especially in people using diabetes technologies. The authors of this retrospective study in a population of 140 patients with type 1 diabetes report the distribution of subtypes of MSKDs and speculate about the mechanisms involved. The authors emphasize the need for multidisciplinary care involving not only the diabetes care team but also orthopedic surgeons. This report should lead to large, prospective studies to increase knowledge about these under-studied complications.




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Increased Notching of the Corpus Callosum in Fetal Alcohol Spectrum Disorder: A Callosal Misunderstanding? [PEDIATRICS]

BACKGROUND AND PURPOSE:

In the medicolegal literature, notching of the corpus callosum has been reported to be associated with fetal alcohol spectrum disorders. Our purpose was to analyze the prevalence of notching of the corpus callosum in a fetal alcohol spectrum disorders group and a healthy population to determine whether notching occurs with increased frequency in the fetal alcohol spectrum disorders population.

MATERIALS AND METHODS:

We performed a multicenter search for cases of fetal alcohol spectrum disorders and included all patients who had a sagittal T1-weighted brain MR imaging. Patients with concomitant intracranial pathology were excluded. The corpus callosum was examined for notches using previously published methods. A 2 test was used to compare the fetal alcohol spectrum disorders and healthy groups.

RESULTS:

Thirty-three of 59 patients with fetal alcohol spectrum disorders (0–44 years of age) identified across all centers had corpus callosum notching. Of these, 8 had an anterior corpus callosum notch (prevalence, 13.6%), 23 had a posterior corpus callosum notch (prevalence, 39%), and 2 patients demonstrated undulated morphology (prevalence, 3.4%). In the healthy population, the anterior notch prevalence was 139/875 (15.8%), posterior notch prevalence was 378/875 (43.2%), and undulating prevalence was 37/875 (4.2%). There was no significant difference among the anterior (P = .635), posterior (P = .526), and undulating (P = .755) notch prevalence in the fetal alcohol spectrum disorders and healthy groups.

CONCLUSIONS:

There was no significant difference in notching of the corpus callosum between patients with fetal alcohol spectrum disorders and the healthy population. Although reported to be a marker of fetal alcohol spectrum disorders, notching of the corpus callosum should not be viewed as a specific finding associated with fetal alcohol spectrum disorders.




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Beautiful, clean, mordern room for rent near Tan Son Nhat airport, 3 minutes by motorcycle

The room is beautiful, clean and convenience. On top of that, it nears to the airport. We have free wifi, amenities, modern furniture, elevator, TV. We also have a kitchen shared with everyone. In the kitchen, we have modern equipment for cooking. We have laundry, clothes drier,....




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$136 million needed for building border expressway in Lang Son

Authorities of the Northern province Lang Son has requested VND3.16 trillion ($136 million) from the government to build the Chi Lang-Huu Nghi Expressway.




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RPGCast – Episode 259: “Don’t Preorder Those Shoes!”

Bethesda challenges our hipster fashion instincts. Nintendo is doing something with that NFC sensor. Square Enix is faring pretty well, actually. And then there’s EA…who...




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RPGCast – Episode 304: “Castomel and Order”

We remember Andrew Long. We’ll miss you, buddy. But the show must go on and we talk about Happy Meals, luminescent children, Kemco games, and...




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Silence of the Lambs Sequel Series 'Clarice' Officially Ordered at CBS

Kal Penn and The Walking Dead's Michael Cudlitz join Lecter-less sequel show.




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Ariana Grande granted a restraining order against fan who was found trespassing at her home

Ariana Grande has reportedly been granted a restraining order against a fan who was found trespassing at her home.