Childhood Asthma Control Test and spirometry values in school-age children.

Objective: To determine the relationship between child and parent reports of asthma control using the Childhood Asthma Control Test (C-ACT) and spirometry.

Methods: This descriptive study included 648 children ages 5-11 years from a school-based asthma program. Not well-controlled asthma was defined as forced expiratory volume in 1 s (FEV1) and by FEV1/forced vital capacity (FVC) of 80% predicted or lower.

Synergistic phase separation of two pathways promotes integrin clustering and nascent adhesion formation.

Integrin adhesion complexes (IACs) are integrin-based plasma-membrane-associated compartments where cells sense environmental cues. The physical mechanisms and molecular interactions that mediate initial IAC formation are unclear. We found that both p130Cas ('Cas') and Focal adhesion kinase ('FAK') undergo liquid-liquid phase separation in vitro under physiologic conditions.

The Feasibility of a School Nurse-Led Mindfulness Program.

The purpose of this study was to evaluate the feasibility of a school nurse-led mindfulness program in a public school. Elementary students in an urban public school system are exposed to many stressors including poverty, family disturbances, and mental health conflicts. Previous research suggests that mindfulness interventions given by teachers promote prosocial behavior and stress reduction; however, there are no studies that have determined whether the school nurse could lead the program.

Organization of Chromatin by Intrinsic and Regulated Phase Separation.

Eukaryotic chromatin is highly condensed but dynamically accessible to regulation and organized into subdomains. We demonstrate that reconstituted chromatin undergoes histone tail-driven liquid-liquid phase separation (LLPS) in physiologic salt and when microinjected into cell nuclei, producing dense and dynamic droplets. Linker histone H1 and internucleosome linker lengths shared across eukaryotes promote phase separation of chromatin, tune droplet properties, and coordinate to form condensates of consistent density in manners that parallel chromatin behavior in cells.

Pertussis outbreak in an Amish Community: Kent County, Delaware, 2018.

The Amish lead a very simplistic lifestyle free of modern conveniences. They have unique perceptions and beliefs regarding health and illness and generally do not adhere to conventional preventive measures such as immunizations, which can result in un- or under-immunized populations. Populations with low vaccination coverage are at greater risk of outbreaks compared to vaccinated populations as a result of low herd immunity.

Effect of a school-based asthma clinic on asthma outcomes.

The St. Louis Children's Hospital Healthy Kids Express Asthma (HKEA) program was developed to improve asthma control in children who attend schools with the highest asthma prevalence in the metropolitan area. The HKEA program differs from other programs because unscheduled visits occur at school without parents present.

Cognitive functioning following stabilisation from first episode mania.

Background: The purpose of this study was to examine cognitive functioning in people following first-episode mania relative to a demographically similar healthy control group.

Methods: Forty-one patients, who had recently stabilised from a first manic episode, and twenty-one healthy controls, were compared in an extensive cognitive assessment.

Results: First-episode mania participants had significantly lower Full-Scale IQ (FSIQ) relative to healthy controls; however, this finding could be driven by premorbid differences in intellectual functioning.

Rac1 GTPase activates the WAVE regulatory complex through two distinct binding sites.

The Rho GTPase Rac1 activates the WAVE regulatory complex (WRC) to drive Arp2/3 complex-mediated actin polymerization, which underpins diverse cellular processes. Here we report the structure of a WRC-Rac1 complex determined by cryo-electron microscopy. Surprisingly, Rac1 is not located at the binding site on the Sra1 subunit of the WRC previously identified by mutagenesis and biochemical data.

Timeliness of Breast Cancer Treatment in Delaware.

Studies have shown timely screening, diagnosis, and treatment of breast cancer reduces mortality rates. The objective of this study is to evaluate the overall timeliness of breast cancer diagnosis and treatment for Delawarean women using the Centers for Disease Control and Prevention's (CDC) National Breast and Cervical Cancer Early Detection Program's (NBCCEDP) recommendations of 60 days maximum for screening to diagnosis and 60 days maximum for diagnosis to treatment. This study analyzed Delaware Cancer Registry (DCR) data for female Delawarean breast cancer patients diagnosed in 2010 who had valid screening, diagnosis, and treatment dates.

Quetiapine lithium in the maintenance phase following a first episode of mania: randomised controlled trial.

Lithium and quetiapine are considered standard maintenance agents for bipolar disorder yet it is unclear how their efficacy compares with each other.To investigate the differential effect of lithium and quetiapine on symptoms of depression, mania, general functioning, global illness severity and quality of life in patients with recently stabilised first-episode mania.Maintenance trial of patients with first-episode mania stabilised on a combination of lithium and quetiapine, subsequently randomised to lithium or quetiapine monotherapy (up to 800 mg/day) and followed up for 1 year.

Asthma control and obesity in urban African American children.

Objective: To examine the relationship between body mass index (BMI), gender, age, controller medication use, household smoke exposure, season, and allergic rhinitis status with asthma control in a group of lower income, African American children. We hypothesized that non-obese children would have better asthma control.

Methods: Baseline data from a longitudinal study of children in a school-based asthma program in a Midwest urban area were analyzed.

Timeliness of Breast Cancer Treatment in Delaware.

Studies have shown timely screening, diagnosis, and treatment of breast cancer reduces mortality rates. The objective of this study was to evaluate the overall timeliness of breast cancer diagnosis and treatment for Delawarean women using the Centers for Disease Control and Prevention (CDC)'s National Breast and Cervical Cancer Early Detection Program (NBCCEDP)'s recommendations of 60 days maximum for screening to diagnosis and 60 days maximum for diagnosis to treatment. This study analyzed Delaware Cancer Registry data for female Delawarean breast cancer patients diagnosed in 2010 who had valid screening, diagnosis, and treatment dates.

Nutritional support in children and young people with cancer undergoing chemotherapy.

Background: It is well documented that malnutrition is a common complication of paediatric malignancy and its treatment. Malnutrition can often be a consequence of cancer itself or a result of chemotherapy. Nutritional support aims to reverse malnutrition seen at diagnosis, prevent malnutrition associated with treatment and promote weight gain and growth.

A Pilot Study of Ultrasound-Guided Cryoablation of Invasive Ductal Carcinomas up to 15 mm With MRI Follow-Up and Subsequent Surgical Resection.

Objective: The purpose of this study was to evaluate the effectiveness of ultrasound-guided cryoablation in treating small invasive ductal carcinoma and to assess the role of contrast-enhanced (CE) MRI in determining the outcome of cryoablation.

Subjects And Methods: Twenty consecutive participants with invasive ductal carcinomas up to 15 mm, with limited or no ductal carcinoma in situ (DCIS), underwent ultrasound-guided cryoablation. Preablation mammography, ultrasound, and CE-MRI were performed to assess eligibility.

Medical anthropology and the physician assistant profession.

Medical anthropology is a subfield of anthropology that investigates how culture influences people's ideas and behaviors regarding health and illness. Medical anthropology contributes to the understanding of how and why health systems operate the way they do, how different people understand and interact with these systems and cultural practices, and what assets people use and challenges they may encounter when constructing perceptions of their own health conditions. The goal of this article is to highlight the methodological tools and analytical insights that medical anthropology offers to the study of physician assistants (PAs).

Long-term follow-up of all-cause and unnatural death in young people with first-episode psychosis.

Objective: To determine mortality-related estimates and causes of death in young people with first-episode psychosis (FEP), and to identify baseline predictors of mortality.

Method: Mortality outcomes in 723 young people presenting to an early psychosis service were prospectively ascertained up to 20 years. Predictors of all-cause and unnatural death were investigated using survival techniques.

The impact of insight in a first-episode mania with psychosis population on outcome at 18 months.

Background: To explore whether poor initial insight during a first episode of mania with psychotic features was predictive of poor psychosocial and clinical outcomes at 18 months.

Methods: Secondary analysis was performed on data collected during an 8-week RCT comparing the efficacy of olanzapine versus chlorpromazine as an adjunct to lithium, and at 18-month follow-up. 74 participants were divided into three groups (no insight, partial insight, and full insight) according to the insight item from the Young Mania Rating Scale (YMRS).

The WAVE regulatory complex links diverse receptors to the actin cytoskeleton.

The WAVE regulatory complex (WRC) controls actin cytoskeletal dynamics throughout the cell by stimulating the actin-nucleating activity of the Arp2/3 complex at distinct membrane sites. However, the factors that recruit the WRC to specific locations remain poorly understood. Here, we have identified a large family of potential WRC ligands, consisting of ∼120 diverse membrane proteins, including protocadherins, ROBOs, netrin receptors, neuroligins, GPCRs, and channels.

Transcatheter aortic valve replacement options for severe aortic stenosis in high-risk patients.

Background: Calcific aortic stenosis has now become the most common valvular disease in Western countries. It is a disease of the old and very old. Senile calcific aortic stenosis affects 5% of the population 70 years or older in the United States.