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Zhang SX,Shoptaw S,Reback CJ,Yadav K,Nyamathi AM
Cost-effective way to reduce stimulant-abuse among gay/bisexual men and transgender women: a randomized clinical trial with a cost comparison.
Public Health. 2017 Dec 12;154:151-160
A randomized controlled study was conducted with 422 homeless, stimulant-using gay/bisexual (G/B) men and 29 transgender women (n†=†451) to assess two community-based interventions to reduce substance abuse and improve health: (a) a nurse case-managed program combined with contingency management (NCM†+†CM) versus (b) standard education plus contingency management (SE†+†CM).
PMID: 29245022

Getahun D,Jacobsen SJ,Fassett MJ,Wing DA,Xiang AH,Chiu V,Peltier MR
Association between maternal hypothyroidism and autism spectrum disorders in the children.
Pediatr Res. 2017 Dec 15;
To determine if hypothyroidism is associated with ASD and how this association is influenced by race-ethnicity, sex, and timing of exposure.
PMID: 29244797

Krolewski DM,Kumar V,Martin B,Tomer R,Deisseroth K,Myers RM,Schatzberg AF,Lee FS,Barchas JD,Bunney WE,Akil H,Watson SJ
Quantitative validation of immunofluorescence and lectin staining using reduced CLARITY acrylamide formulations.
Brain Struct Funct. 2017 Dec 14;
The CLARITY technique enables three-dimensional visualization of fluorescent-labeled biomolecules in clarified intact brain samples, affording a unique view of molecular neuroanatomy and neurocircuitry. It is therefore, essential to find the ideal combination for clearing tissue and detecting the fluorescent-labeled signal. This method requires the formation of a formaldehyde-acrylamide fixative-generated hydrogel mesh through which cellular lipid is removed with sodium dodecyl sulfate. Several laboratories have used differential acrylamide and detergent concentrations to achieve better tissue clearing and antibody penetration, but the potential effects upon fluorescent signal retention is largely unknown. In an effort to†optimize CLARITY processing procedures we performed quantitative parvalbumin immunofluorescence and lectin-based vasculature staining using either 4 or 8% sodium dodecyl sulfate detergent in combination with different acrylamide formulas in mouse brain slices. Using both confocal and CLARITY-optimized lightsheet microscope-acquired images, we demonstrate that 2% acrylamide monomer combined with 0.0125% bis-acrylamide and cleared with 4% sodium dodecyl sulfate generally provides the most optimal signal visualization amongst various hydrogel monomer concentrations, lipid removal times, and detergent concentrations.
PMID: 29243106

Gardiner DM
Regulation of regeneration by Heparan Sulfate Proteoglycans in the Extracellular Matrix.
Regen Eng Transl Med. 2017 Sep;3(3):192-198
Just as the building of a house requires a blueprint, the rebuilding of lost or damaged body parts through regeneration requires a set of instructions for the assembly of the various tissues into the right places. Much progress has been made in understanding how to control the differentiation of different cell types to provide the building blocks for regeneration, such as bone, muscle, blood vessels and nerves/Schwann cells. These are the cells that follow the blueprint (the pattern-following cells) and end up in the right places relative to each other in order to restore the lost function. Much less is known about the cells that are specialized to generate and regenerate the blueprint (the pattern-forming cells) in order to instruct the pattern-following cells as to how and where to rebuild the structures. Recent studies provide evidence that the pattern-forming cells synthesize an information-rich extracellular matrix (ECM) that controls the behavior of pattern-following cells leading to the regeneration of limb structures. The ability of the ECM to do this is associated with glycosaminoglycans that have specific spatial and temporal modifications of sulfation patterns. This mechanism for controlling pattern formation appears to be conserved between salamanders and mammals, and thus the next challenge for inducing human regeneration is to identify and understand the biology of these pattern-forming cells and the ECM that they synthesize.
PMID: 29242821

Calais J,Fendler WP,Eiber M,Gartmann J,Chu FI,Nickols NG,Reiter RR,Rettig MB,Marks LS,Ahlering TE,Huynh L,Slavik R,Gupta P,Quon A,Allen-Auerbach MS,Czernin J,Herrmann K
Actual impact of 68Ga-PSMA-11 PET/CT on the management of prostate cancer patients with biochemical recurrence.
J Nucl Med. 2017 Dec 14;
Purpose: In this prospective survey of referring physicians, we investigated whether and how Gallium-68 Prostate Specific Membrane Antigen Positron Emission Tomography/Computed Tomography (PSMA-11 PET/CT) affects the actually implemented management of prostate cancer patients wih biochemical recurrence (BCR). Methods: We conducted a prospective survey of physicians (NCT02940262) who referred 161 patients with prostate cancer BCR (median Prostate Specific Antigen (PSA) value 1.7 ng/ml (range 0.05-202)). Referring physicians completed one questionnaire prior to the scan to indicate the treatment plan without PSMA-11 PET/CT information (Q1; n = 101); one immediately after the scan to denote intended management changes (Q2; n = 101); and one 3 to 6 months later to document the final implemented management (Q3; n = 56). Implemented management was also obtained via electronic chart review and/or patient contact (n = 45). Results: Complete documented management strategy (Q1+Q2+implemented management) was available in 101/161 patients (63%). Seventy-six of these (75%) had a positive PSMA-11 PET/CT study. The actually implemented management differed from the pre-scan intended treatment plan (Q1) in 54/101 patients (53%). The post-scan intended management (Q2) differed from the pre-scan intended management (Q1) in 62/101 patients (61%); however, these intended changes were not implemented in 29/62 patients (47%). Pelvic nodal and extra-pelvic metastatic disease on PSMA-11 PET/CT (PSMA T0N1M0 and PSMA T0N1M1 patterns) were significantly associated with implemented management changes (P = 0,001, 0.05). Conclusion: PSMA-11 PET/CT results in actually implemented management changes in more than 50% of prostate cancer patients with BCR (54/101; 53%). However, intended management changes early after PSMA-11 PET/CT frequently differ from actually implemented management changes.
PMID: 29242398

Davey RJ,Digman MA,Gratton E,Moens PDJ
Quantitative image mean squared displacement (iMSD) analysis of the dynamics of Profilin 1 at the membrane of live cells.
Methods. 2017 Dec 11;
Image mean square displacement analysis (iMSD) is a method allowing the mapping of diffusion dynamics of molecules in living cells. However, it can also be used to obtain quantitative information on the diffusion processes of fluorescently labelled molecules and how their diffusion dynamics change when the cell environment is modified. In this paper, we describe the use of iMSD to obtain quantitative data of the diffusion dynamics of a small cytoskeletal protein, profilin 1 (pfn1), at the membrane of live cells and how its diffusion is perturbed when the cells are treated with Cytochalasin D and/or the interactions of pfn1 are modified when its actin and polyphosphoinositide binding sites are mutated (pfn1-R88A). Using total internal reflection fluorescence microscopy images, we obtained data on isotropic and confined diffusion coefficients, the proportion of cell areas where isotropic diffusion is the major diffusion mode compared to the confined diffusion mode, the size of the confinement zones and the size of the domains of dynamic partitioning of pfn1. Using these quantitative data, we could demonstrate a decreased isotropic diffusion coefficient for the cells treated with Cytochalasin D and for the pfn1-R88A mutant. We could also see changes in the modes of diffusion between the different conditions and changes in the size of the zones of pfn1 confinements for the pfn1 treated with Cytochalasin D. All of this information was acquired in only a few minutes of imaging per cell and without the need to record thousands of single molecule trajectories.
PMID: 29242135

Cameron DB,Williams R,Geng Y,Gosain A,Arnold MA,Guner YS,Blakely ML,Downard CD,Goldin AB,Grabowski J,Lal DR,Dasgupta R,Baird R,Gates RL,Shelton J,Jancelewicz T,Rangel SJ,Austin MT
Time to appendectomy for acute appendicitis: A systematic review.
J Pediatr Surg. 2017 Nov 20;
The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations regarding time to appendectomy for acute appendicitis in children within the context of preventing adverse events, reducing cost, and optimizing patient/parent satisfaction.
PMID: 29241958

Sin J,McIntyre L,Stotland A,Feuer R,Gottlieb RA
Coxsackievirus B Escapes the Infected Cell in Ejected Mitophagosomes.
J Virol. 2017 Dec 15;91(24)
Coxsackievirus B (CVB) is a common enterovirus that can cause various systemic inflammatory diseases. Because CVB lacks an envelope, it has been thought to be inherently cytolytic, wherein CVB can escape from the infected host cell only by causing it to rupture. In recent years, however, we and others have observed that various naked viruses, such as CVB, can trigger the release of infectious extracellular microvesicles (EMVs) that contain viral material. This mode of cellular escape has been suggested to allow the virus to be masked from the adaptive immune system. Additionally, we have previously reported that these viral EMVs have LC3, suggesting that they originated from autophagosomes. We now report that CVB-infected cells trigger DRP1-mediated fragmentation of mitochondria, which is a precursor to autophagic mitochondrial elimination (mitophagy). However, rather than being degraded by lysosomes, mitochondrion-containing autophagosomes are released from the cell. We believe that CVB localizes to mitochondria, induces mitophagy, and subsequently disseminates from the cell in an autophagosome-bound mitochondrion-virus complex. Suppressing the mitophagy pathway in HL-1 cardiomyocytes with either small interfering RNA (siRNA) or Mdivi-1 caused marked reduction in virus production. The findings in this study suggest that CVB subverts mitophagy machinery to support viral dissemination in released EMVs.IMPORTANCE Coxsackievirus B (CVB) can cause a number of life-threatening inflammatory diseases. Though CVB is well known to disseminate via cytolysis, recent reports have revealed a second pathway in which CVB can become encapsulated in host membrane components to escape the cell in an exosome-like particle. Here we report that these membrane-bound structures derive from mitophagosomes. Blocking various steps in the mitophagy pathway reduced levels of intracellular and extracellular virus. Not only does this study reveal a novel mechanism of picornaviral dissemination, but also it sheds light on new therapeutic targets to treat CVB and potentially other picornaviral infections.
PMID: 28978702

Glynn LM,Howland MA,Sandman CA,Davis EP,Phelan M,Baram TZ,Stern HS
Prenatal maternal mood patterns predict child temperament and adolescent mental health.
J Affect Disord. 2017 Nov 14;228:83-90
This study quantifies the dynamics of maternal mood focusing on unpredictability, and to assess if greater unpredictability of prenatal maternal mood predicts child temperament and internalizing symptoms through early adolescence.
PMID: 29241049

Easter QT,Blum SA
Evidence for Dynamic Chemical Kinetics at Individual Ruthenium Catalysts.
Angew Chem Int Ed Engl. 2017 Dec 14;
Catalytic cycles are typically depicted as possessing time-invariant steps with fixed rates. Yet the true behavior of individual catalysts with respect to time is unknown, hidden by the ensemble averaging inherent to bulk measurements. Herein, focused on a ring-opening metathesis polymerization reaction catalyzed by the second-generation Grubbs' ruthenium catalyst, we show evidence for variable chemical kinetics at individual catalysts with fluorescence microscopy possessing sufficient sensitivity for the detection of single chemical reactions. Insertion reactions in submicron regions likely occur at groups of many (not single) catalysts, yet not so many that their unique kinetic behavior is ensemble averaged.
PMID: 29240972

Bender M,Avolio A,Baker P,Harris JL,Hilton N,Hites L,Roussel L,Shirley B,Thomas PL,Williams M
Developing the Clinical Nurse Leader Survey Instrument: A Modified Delphi Study.
J Nurs Care Qual. 2017 Dec 13;
Clinical nurse leader (CNL)-integrated care delivery is an emerging nursing model, with growing adoption in diverse health systems. To generate a robust evidence base for this promising nursing model, it is necessary to measure CNL practice to explicitly link it to observed quality and safety outcome improvements. This study used a modified Delphi approach with an expert CNL panel to develop and test the face, content, and construct validity of the CNL Practice Survey instrument.
PMID: 29240571

Ficke JR,Moroski NM,Ross SD,Gupta R
Integrative Medicine as an Adjunct to Orthopaedic Surgery.
J Am Acad Orthop Surg. 2017 Dec 11;
Patients often seek nontraditional forms of treatment, including alternative/complementary medical options, such as chiropractic care and acupuncture, to meet their personal needs. In the United States, interest has grown in methods to reduce pain and improve function through Ayurvedic medicine, which uses plant-based supplements, such as turmeric. Traditional allopathic medicine attempts to provide patients with evidence-based therapeutic regimens for their musculoskeletal conditions. Integrative medicine often is used to prevent and manage the sequelae associated with injuries and illnesses; however, competitive athletes and military personnel use complementary medicine for performance enhancement. Thus, physicians should be aware of the evolving field of integrative medicine, including the reported benefits as well as any potential drawbacks, to facilitate an educated discussion with their patients.
PMID: 29239871

Dong TX,Othy S,Jairaman A,Skupsky J,Zavala A,Parker I,Dynes JL,Cahalan MD
T cell calcium dynamics visualized in a ratiometric tdTomato-GCaMP6f transgenic reporter mouse.
Elife. 2017 Dec 14;6
Calcium is an essential cellular messenger that regulates numerous functions in living organisms. Here we describe development and characterization of 'Salsa6f', a fusion of GCaMP6f and tdTomato optimized for cell tracking while monitoring cytosolic Ca2+, and a transgenic Ca2+ reporter mouse with Salsa6f targeted to the Rosa26 locus for Cre-dependent expression in specific cell types. The development and function of T cells was unaffected in Cd4-Salsa6f mice. We describe Ca2+ signals reported by Salsa6f during T cell receptor activation in naÔve T cells, helper Th17 T cells and regulatory T cells, and Ca2+ signals mediated in T cells by an activator of mechanosensitive Piezo1channels. Transgenic expression of Salsa6f enables ratiometric imaging of Ca2+ signals in complex tissue environments found in vivo. Two-photon imaging of migrating T cells in the steady-state lymph node revealed both cell-wide and localized sub-cellular Ca2+ transients ('sparkles') as cells migrate.
PMID: 29239725

Dong TX,Othy S,Greenberg ML,Jairaman A,Akunwafo C,Leverrier S,Yu Y,Parker I,Dynes JL,Cahalan MD
Intermittent Ca2+ signals mediated by Orai1 regulate basal T cell motility.
Elife. 2017 Dec 14;6
Ca2+ influx through Orai1 channels is crucial for several T cell functions, but a role in regulating basal cellular motility has not been described. Here we show that inhibition of Orai1 channel activity increases average cell velocities by reducing the frequency of pauses in human T cells migrating through confined spaces, even in the absence of extrinsic cell contacts or antigen recognition. Utilizing a novel ratiometric genetically encoded cytosolic Ca2+ indicator, Salsa6f, which permits real-time monitoring of cytosolic Ca2+ along with cell motility, we show that spontaneous pauses during T cell motility in vitro and in vivo coincide with episodes of cytosolic Ca2+ signaling. Furthermore, lymph node T cells exhibited two types of spontaneous Ca2+ transients: short-duration 'sparkles' and longer duration global signals. Our results demonstrate that spontaneous and self-peptide MHC-dependent activation of Orai1 ensures random walk behavior in T cells to optimize immune surveillance.
PMID: 29239723

Zachary C
Commentary on significant skin tightening by closure of fractional ablative laser holes.
Lasers Surg Med. 2017 Dec 14;
PMID: 29239486

Pop A,Williams M,Struys EA,Monnť M,Jansen EEW,De Grassi A,Kanhai WA,Scarcia P,Ojeda MRF,Porcelli V,van Dooren SJM,Lennertz P,Nota B,Abdenur JE,Coman D,Das AM,El-Gharbawy A,Nuoffer JM,Polic B,Santer R,Weinhold N,Zuccarelli B,Palmieri F,Palmieri L,Salomons GS
An overview of combined D-2- and L-2-hydroxyglutaric aciduria: functional analysis of CIC variants.
J Inherit Metab Dis. 2017 Dec 13;
Combined D-2- and L-2-hydroxyglutaric aciduria (D/L-2-HGA) is a devastating neurometabolic disorder, usually lethal in the first years of life. Autosomal recessive mutations in the SLC25A1 gene, which encodes the mitochondrial citrate carrier (CIC), were previously detected in patients affected with combined D/L-2-HGA. We showed that transfection of deficient fibroblasts with wild-type SLC25A1 restored citrate efflux and decreased intracellular 2-hydroxyglutarate levels, confirming that deficient CIC is the cause of D/L-2-HGA. We developed and implemented a functional assay and applied it to all 17 missense variants detected in a total of 26 CIC-deficient patients, including eight novel cases, showing reduced activities of varying degrees. In addition, we analyzed the importance of residues affected by these missense variants using our existing scoring system. This allowed not only a clinical and biochemical overview of the D/L-2-HGA patients but also phenotype-genotype correlation studies.
PMID: 29238895

Kovaleva NV,Cotter PD
Mosaicism for structural non-centromeric autosomal rearrangement in prenatal diagnoses: evidence for sex-specific selection against chromosomal abnormalities.
Mol Cytogenet. 2017;10:45
Mosaicism for chromosome rearrangements is common in preimplantation diagnoses, yet is rare in prenatal diagnoses as well as in other groups of patients referred to cytogenetic testing. Consequently, there is a lack of detailed studies on this kind of mosaicism in all groups of patients. Previous reports have identified a deficit of males among asymptomatic carriers of N/unbalanced Rea. Three mechanisms were proposed for explaining this phenomenon, including a high instability in the early female embryonic development, a male-specific selection against abnormal cells in the early embryo development, or a high intrauterine lethality of male carriers. To address these possibilities, we have performed a meta-analysis of male-to-female ratio (sex ratio, SR) in prenatally diagnosed and in spontaneously aborted carriers of mosaic Rea.
PMID: 29238403

Wray A,Bennett K,Boysen-Osborn M,Wiechmann W,Toohey S
Efficacy of an asynchronous electronic curriculum in emergency medicine education in the United States.
J Educ Eval Health Prof. 2017 Dec 11;
The aim of this study was to measure the effect of an iPad-based asynchronous curriculum on emergency medicine (EM) resident performance on the in-training exam (ITE). We hypothesized that the implementation of an asynchronous curriculum (replacing one hour of weekly didactic time) would result in non-inferior ITE scores compared to those scores from historical residents who had participated in the traditional five-hour weekly didactic curriculum.
PMID: 29237247

Kessel J,Dolff B,Wichelhaus T,Keiner N,Hogardt M,Reinheimer C,Wieters I,Harder S,Kempf VAJ,Stephan C,
[Piperacillin/Tazobactam Shortage: Central Restriction and Alternative Recommendations as Effective Antibiotic-Stewardship Intervention at a Maximal Care Hospital].
Dtsch Med Wochenschr. 2017 Dec 13;
Background Drug supply bottleneck is a worldwide challenge, e.?g. the antibiotics Piperacillin/Tazobactam shortage in 2016/2017. The efficacy of an appropriate replacement management was evaluated at the University Hospital Frankfurt (UHF). Methods The Antibiotic-Stewardship (ABS)-Team at UHF decreed a restriction of PIP/TAZ and provided alternative antibiotic therapy recommendations during the shortage period. Consequences of this intervention on antibiotic consumption and overall costs were investigated. Results Over 12-weeks, PIP/TAZ-mean application rate was reduced by 71?% and was predominantly used to treat hospital acquired pneumonia (62?%), febrile neutropenian children (12?%), followed by other indications (
PMID: 29237206

Borelli JL,Palmer A,Vanwoerden S,Sharp C
Convergence in Reports of Adolescents' Psychopathology: A Focus on Disorganized Attachment and Reflective Functioning.
J Clin Child Adolesc Psychol. 2017 Dec 13;:1-14
Although convergence in parent-youth reports of adolescent psychopathology is critical for treatment planning, research documents a pervasive lack of agreement in ratings of adolescents' symptoms. Attachment insecurity (particularly disorganized attachment) and impoverished reflective functioning (RF) are 2 theoretically implicated predictors of low convergence that have not been examined in the literature. In a cross-sectional investigation of adolescents receiving inpatient psychiatric treatment, we examined whether disorganized attachment and low (adolescent and parent) RF were associated with patterns of convergence in adolescent internalizing and externalizing symptoms. Compared with organized adolescents, disorganized adolescents had lower parent-youth convergence in reports of their internalizing symptoms and higher convergence in reports of their externalizing symptoms; low adolescent self-focused RF was associated with low convergence in parent-adolescent reports of internalizing symptoms, whereas low adolescent global RF was associated with high convergence in parent-adolescent reports of externalizing symptoms. Among adolescents receiving inpatient psychiatric treatment, disorganized attachment and lower RF were associated with weaker internalizing symptom convergence and greater externalizing symptom convergence, which if replicated, could inform assessment strategies and treatment planning in this setting.
PMID: 29236525

Thornton LC,Frick PJ,Ray JV,Wall Myers TD,Steinberg L,Cauffman E
Risky Sex, Drugs, Sensation Seeking, and Callous Unemotional Traits in Justice-Involved Male Adolescents.
J Clin Child Adolesc Psychol. 2017 Dec 13;:1-12
The current study examined whether callous-unemotional (CU) traits predicted risky sexual behavior (i.e., unprotected sex, casual sex) and whether substance use and sensation seeking mediated this relationship over 24†months in justice-involved young men. Participants (N†=†1,216) were an ethnically and racially diverse sample (46.3% White Latino, 38% Black, 15.7% White non-Latino) of first-time offending male adolescents (ages 13-17†years) from 3 U.S. cities. Participants completed 5 self-reported interviews at 6-month intervals over 2 years. Bootstrapped mediation analyses were conducted to test direct effects of CU traits on risky sexual behaviors, as well as indirect effects through substance use and sensation seeking. CU traits at baseline were positively associated with risky sexual behavior 18-24†months later. CU traits were also associated with the hypothesized mediators, sensation seeking and substance use, measured 6-12†months after baseline. CU traits exerted direct effects on later unprotected sex and casual sex, as well as indirect effects through substance use but not sensation seeking. These effects were largely unchanged when accounting for the youth's level of self-reported delinquency. These findings demonstrate that CU traits predict later risky sexual outcomes, and this is at least partly explained by substance use. Further, the findings highlight the importance of CU traits for several outcomes that are of significant public health concern among justice-involved adolescents, namely, risky sexual behavior and substance use.
PMID: 29236522

Ing NL,Nusca TD,Hochbaum AI
Correction: Geobacter sulfurreducens pili support ohmic electronic conduction in aqueous solution.
Phys Chem Chem Phys. 2017 Dec 13;
Correction for 'Geobacter sulfurreducens pili support ohmic electronic conduction in aqueous solution' by Nicole L. Ing et al., Phys. Chem. Chem. Phys., 2017, 19, 21791-21799.
PMID: 29236109

Younan D,Tuvblad C,Franklin M,Lurmann F,Li L,Wu J,Berhane K,Baker LA,Chen JC
Longitudinal Analysis of Particulate Air Pollutants and Adolescent Delinquent Behavior in Southern California.
J Abnorm Child Psychol. 2017 Dec 13;
Animal experiments and cross-sectional human studies have linked particulate matter (PM) with increased behavioral problems. We conducted a longitudinal study to examine whether the trajectories of delinquent behavior are affected by PM2.5 (PM with aerodynamic diameter?‚ȧ?2.5 Ķm) exposures before and during adolescence. We used the parent-reported Child Behavior Checklist at age 9-18 with repeated measures every ~2-3†years (up to 4 behavioral assessments) on 682 children from the Risk Factors for Antisocial Behavior Study conducted in a multi-ethnic cohort of twins born in 1990-1995. Based on prospectively-collected residential addresses and a spatiotemporal model of ambient air concentrations in Southern California, monthly PM2.5 estimates were aggregated to represent long-term (1-, 2-, 3-year average) exposures preceding baseline and cumulative average exposure until the last assessment. Multilevel mixed-effects models were used to examine the association between PM2.5 exposure and individual trajectories of delinquent behavior, adjusting for within-family/within-individual correlations and potential confounders. We also examined whether psychosocial factors modified this association. The results sĶggest that PM2.5 exposure at baseline and cumulative exposure during follow-up was significantly associated (p?
PMID: 29234991

Valentovich V,Goldberg WA,Garfin DR,Guo Y
Emotion Coregulation Processes between Mothers and their Children With and Without Autism Spectrum Disorder: Associations with Children's Maladaptive Behaviors.
J Autism Dev Disord. 2017 Dec 12;
A dyadic microanalysis approach was used to examine emotion coregulation processes in mother-child interactions in relation to children's maladaptive behaviors. Seventy-two mother-child dyads (46 children with Autism Spectrum Disorder (ASD); 26 neurotypical children) were previously videotaped in a semi-structured play procedure at home and mothers reported on children's internalizing and externalizing behaviors. Mother-child interactions were reliably coded in 5-second intervals and analyzed using Space State Grid software. Regression analyses supported moderation, whereby greater dyadic flexibility and more mutual-positive engagements were significantly associated with lower levels of maladaptive outcomes for children with ASD. Results have implications for initiating positive interactions and promoting effective parenting that help improve behavior in young children with ASD.
PMID: 29234932

Rhee CM,Kalantar-Zadeh K
Further clarifying the relationship between metformin, acute kidney injury and lactic acidosis.
Nat Rev Nephrol. 2017 Dec 13;14(1):70
PMID: 29234161

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