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Background. A 10-question screening scale of psychological distress and a six-question short-form scale embedded within the 10-question scale were developed for the redesigned US National Health Interview Survey (NHIS). Methods. Initial pilot questions were administered in a US national mail survey (N = 1401). A reduced set of questions was subsequently administered in a US national telephone survey (N = 1574). The 10-question and six-question scales, which we refer to as the K10 and K6, were constructed from the reduced set of questions based on Item Response Theory models. The scales were subsequently validated in a two-stage clinical reappraisal survey (N = 1000 telephone screening interviews in the first stage followed by N = 153 face-to-face clinical interviews in the second stage that oversampled first-stage respondents who screened positive for emotional problems) in a local convenience sample. The second-stage sample was administered the screening scales along with the Structured Clinical Interview for DSM-IV (SCID). The K6 was subsequently included in the 1997 (N = 36116) and 1998 (N = 32440) US National Health Interview Survey, while the K10 was included in the 1997 (N = 10641) Australian National Survey of Mental Health and Well-Being. Results. Both the K10 and K6 have good precision in the 90th–99th percentile range of the population distribution (standard errors of standardized scores in the range 0·20–0·25) as well as consistent psychometric properties across major sociodemographic subsamples. The scales strongly discriminate between community cases and non-cases of DSM-IV/SCID disorders, with areas under the Receiver Operating Characteristic (ROC) curve of 0·87–0·88 for disorders having Global Assessment of Functioning (GAF) scores of 0–70 and 0·95–0·96 for disorders having GAF scores of 0–50. Conclusions. The brevity, strong psychometric properties, and ability to discriminate DSM-IV cases from non-cases make the K10 and K6 attractive for use in general-purpose health surveys. The scales are already being used in annual government health surveys in the US and Canada as well as in the WHO World Mental Health Surveys. Routine inclusion of either the K10 or K6 in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.

Background Intensive delivery of evidence-based treatment for posttraumatic stress disorder (PTSD) is becoming increasingly popular for overcoming barriers to treatment for veterans. Understanding how and for whom these intensive treatments work is critical for optimizing their dissemination. The goals of the current study were to evaluate patterns of PTSD and depression symptom change over the course of a 3-week cohort-based intensive outpatient program (IOP) for veterans with PTSD, examine changes in posttraumatic cognitions as a predictor of treatment response, and determine whether patterns of treatment outcome or predictors of treatment outcome differed by sex and cohort type (combat versus military sexual trauma [MST]). Method One-hundred ninety-one veterans (19 cohorts: 12 combat-PTSD cohorts, 7 MST-PTSD cohorts) completed a 3-week intensive outpatient program for PTSD comprised of daily group and individual Cognitive Processing Therapy (CPT), mindfulness, yoga, and psychoeducation. Measures of PTSD symptoms, depression symptoms, and posttraumatic cognitions were collected before the intervention, after the intervention, and approximately every other day during the intervention. Results Pre-post analyses for completers ( N  = 176; 92.1% of sample) revealed large reductions in PTSD ( d  = 1.12 for past month symptoms and d  = 1.40 for past week symptoms) and depression symptoms ( d  = 1.04 for past 2 weeks). Combat cohorts saw a greater reduction in PTSD symptoms over time relative to MST cohorts. Reduction in posttraumatic cognitions over time significantly predicted decreases in PTSD and depression symptom scores, which remained robust to adjustment for autocorrelation. Conclusion Intensive treatment programs are a promising approach for delivering evidence-based interventions to produce rapid treatment response and high rates of retention. Reductions in posttraumatic cognitions appear to be an important predictor of response to intensive treatment. Further research is needed to explore differences in intensive treatment response for veterans with combat exposure versus MST.

Flavones represent a class of polyphenols that are found in many plant-derived food sources. Herein, we provide evidence that the anti-inflammatory and antiproliferative effect of the flavone apigenin relies on the regulation of the gut microbiota by the NOD-like receptor family pyrin domain containing 6 (Nlrp6). When challenged by dextran sulfate sodium (DSS) in drinking water, mice were protected against colitis upon cohousing with apigenin-treated animals. In contrast, the protective effect was lost in the absence of Nlrp6. Sequencing of the 16S ribosomal RNA gene revealed a shift in the composition of the gut microbiota in apigenin-treated mice that was not observed in the absence of Nlrp6. Equally important, we find that the antiproliferative effect of apigenin was dominantly transmitted after cohousing, while being compromised in Nlrp6-deficient mice. In contrast, the symptoms of colitis were alleviated upon apigenin administration even in the absence of either caspase-1/11 or Asc. Collectively, these data indicate that apigenin modulated an inflammasome-independent mechanism by which Nlrp6 reprograms the gut microbiota for protecting mice against colitis. Our study highlights a modulation of the Nlrp6 signaling pathway by a prominent constituent of the human diet that may point toward improved ways to treat inflammatory bowel diseases.

Background/Objectives: Degenerative joint disease (DJD) of the TMJ can impact patients’ quality of life and complicate orthodontic treatment. Stabilizing splints are a common conservative treatment in managing TMDs symptoms, although their long-term effects on condylar morphology are poorly studied. This study aimed to assess the impact of stabilizing splints on condyle morphology using cone-beam computed tomography (CBCT) in patients with various stages of DJD. Forty-two condyles with pre- (T1) and post- (T2) splint therapy scans were analyzed. Methods: CBCT scans were sectioned into sagittal and coronal slices for condyle classification and measurement. T1 and T2 CBCTs were superimposed before linear and area measurements at different poles. Results: Our results indicate that condyles in the normal group remain unchanged after splint therapy. The majority of subjects in the degenerative groups remained in the same classification group: six out of fourteen degenerative-active patients became degenerative-repair, while three out of twenty-two degenerative-repair patients progressed to degenerative-active. There is no significant remodeling of condylar width pre- and post-splint therapy. On average, there is more bone deposition than reduction in condylar height after splint therapy, although individual variation exists. Conclusions: Stabilizing splints offer a low-risk intervention for managing DJD and may contribute to favorable adaptive changes in the condyles.

Demographic processes and demographic data are increasingly being included in models of the spatio–temporal dynamics of species' ranges. In this special issue, we explore how the integration of demographic processes further the conceptual understanding and prediction of species' range dynamics. The 12 papers originate from two workshops entitled ‘Advancing concepts and models of species range dynamics: understanding and disentangling processes across scales’. The papers combine theoretical and empirical evidence for the interplay between environmental conditions, species interactions, demographic processes (births, deaths, dispersal), physiology, and evolution, and they point out promising avenues towards a better understanding and prediction of species' range dynamics.

This study aims to determine if a large anterior and reduced posterior/superior joint space is highly predictable for disc displacement. From patients with temporomandibular disorders symptoms, fifty-two experimental joints and fourteen control joints were included. The cone beam computed tomography (CBCT) images were used to calculate posterior-to-anterior (P-A) and superior-to-anterior (S-A) joint space ratios, while disc position was determined using magnetic resonance imaging (MRI). One-way analysis of covariance test and receiver operating characteristics analysis were carried out. The results showed that among the 52 experimental joints, 45 were diagnosed as disc displacement and 7 as normal disc positions (N). All 14 control joints showed normal disc positions. The P-A ratio was 1.46 ± 0.21, 0.99 ± 0.23, and 0.86 ± 0.30 in the control, N, and DD groups, respectively (p < 0.001). The S-A ratio was 1.80 ± 0.27, 1.44 ± 0.33, and 1.08 ± 0.35 in the control, N, and DD groups, respectively (p < 0.001). When an altered P-A ratio and/or S-A ratio are observed on the CBCT, the diagnosis of disc displacement is quite predictable with high sensitivity and specificity.

ObjectivesCurrently available reports on mandibular transverse growth are limited to two-dimensional images and cross-sectional studies. The objective of this study was to examine transverse growth of the mandibular body in untreated growing individuals during the mixed dentition stage using longitudinal three-dimensional imaging.MethodsCBCT images of 25 (13 females and 12 males) untreated subjects at two time points were analyzed. The average age was 9.1 years at T1 and 11.3 years at T2. Mandibular segmentation and superimposition were performed to obtain linear and angular measurements at different axial levels.ResultsAt the superior (mental foramen) axial level, transverse growth between the buccal surfaces gradually increased from the premolars to the ramus. At the inferior axial level, significant transverse growth differences were detected between the ramus and the dentition regions. In contrast, between the lingual surfaces, both superior and inferior levels showed minimal change in the region under the dentition and a significant amount of resorption in the ramus region. This difference between buccal and lingual surface changes led to a mandibular body angulation change in the premolar and molar regions. In contrast, the overall mandibular body angulation measured from the posterior-most border of the mandible to the symphysis remained the same. Differences were detected between males and females, with males tending to exhibit greater transverse growth in the ramus region at the inferior level.ConclusionsThe mandibular body exhibited different transverse growth patterns at different axial levels. Differences were also found between genders.Clinical relevanceAn in-depth understanding of craniofacial growth and development is crucial to diagnosis and treatment planning. The current study provides additional insight into the transverse growth of the mandible.

Lip bumpers (LB) treatment has been used to expand the mandibular arch during mixed dentition. The aim of this study is to evaluate the effects of LB on the mandibular transverse changes in the canine and premolar regions using CBCT. This retrospective study utilized pre- (T1) and post-treatment (T2) CBCT images from the children who were treated either with rapid maxillary expander (RME) alone (RME group) or with RME and lip bumpers (RME + LB group) for interceptive orthodontic treatment. The T1 (pre-interceptive orthodontic treatment evaluation) and T2 (pre-comprehensive orthodontic treatment evaluation) CBCT images from the children who did not go through the interceptive orthodontic treatment were used as control. The CBCT images were oriented according to the occlusal plane and the three-dimensional superimposition on the mandible of T1 and T2 images was performed in the Dolphin 3D software, followed by a series of dental and alveolar linear and angular measurements. Only the mandibular canine and premolar regions with solid primary teeth that showed root structure below the furcation bilaterally at T1 and permanent teeth fully erupted in occlusion bilaterally at T2 were included. The intergroup comparisons were performed using the Mann-Whitney test. As the control group did not have a sufficient number of subjects after excluding the non-qualified regions, the following comparisons were only performed and reported between the RME group and the RME + LB group. RME + LB group (  = 30, 9.00 ± 0.86 years old at T1, 11.99 ± 0.59 years old at T2) showed significantly more bodily buccal movement of mandibular canines and premolars than the RME group (  = 25, 8.72 ± 0.88 years old at T1, 12.00 ± 0.96 years old at T2), but inter-mandibular buccal surface width increase was only observed in the second premolar region. In addition, the RME + LB groups showed less buccal alveolar bone thickness and height than the RME group in the mandibular canine and first premolar regions. LB significantly expanded the mandibular transverse dimension dentally, with permanent canine and premolars erupting more buccally. However, it does not increase the skeletal transverse dimension of the alveolar bone at the canine and first premolar regions. Further studies are needed to evaluate the long-term effects of LB.

Background/Objectives: Foods with high contents of slowly digestible starch (SDS) elicit lower glycemic responses than foods with low contents of SDS but there has been debate on the underlying changes in plasma glucose kinetics, that is, respective contributions of the increase in the rates of appearance and disappearance of plasma glucose (RaT and RdT), and of the increase in the rate of appearance of exogenous glucose (RaE) and decrease in endogenous glucose production (EGP). Subjects/Methods: Sixteen young healthy females ingested in random order four types of breakfasts: an extruded cereal (0.3% SDS: Lo-SDS breakfast) or one of three biscuits (39–45% SDS: Hi-SDS breakfasts). The flour in the cereal products was labeled with 13 C, and plasma glucose kinetics were measured using [6,6- 2 H 2 ]glucose infusion, along with the response of plasma glucose, insulin and glucose-dependent insulinotropic peptide (GIP) concentrations. Results: When compared with the Lo-SDS breakfast, after the three Hi-SDS breakfasts, excursions in plasma glucose, the response of RaE, RaT and RdT, and the reduction in EGP were significantly lower ( P <0.05). The amount of exogenous glucose absorbed over the 4.5-h postprandial period was also significantly lower by ~31% ( P <0.001). These differences were associated with lower responses of GIP and insulin concentrations. Conclusions: Substituting extruded cereals with biscuits slows down the availability of glucose from the breakfast and its appearance in peripheral circulation, blunts the changes in plasma glucose kinetics and homeostasis, reduces excursions in plasma glucose, and possibly distributes the glucose ingested over a longer period following the meal.

Objective To characterize the absolute risks for older patients of readmission to hospital and death in the year after hospitalization for heart failure, acute myocardial infarction, or pneumonia.Design Retrospective cohort study.Setting 4767 hospitals caring for Medicare fee for service beneficiaries in the United States, 2008-10.Participants More than 3 million Medicare fee for service beneficiaries, aged 65 years or more, surviving hospitalization for heart failure, acute myocardial infarction, or pneumonia.Main outcome measures Daily absolute risks of first readmission to hospital and death for one year after discharge. To illustrate risk trajectories, we identified the time required for risks of readmission to hospital and death to decline 50% from maximum values after discharge; the time required for risks to approach plateau periods of minimal day to day change, defined as 95% reductions in daily changes in risk from maximum daily declines after discharge; and the extent to which risks are higher among patients recently discharged from hospital compared with the general elderly population.Results Within one year of hospital discharge, readmission to hospital and death, respectively, occurred following 67.4% and 35.8% of hospitalizations for heart failure, 49.9% and 25.1% for acute myocardial infarction, and 55.6% and 31.1% for pneumonia. Risk of first readmission had declined 50% by day 38 after hospitalization for heart failure, day 13 after hospitalization for acute myocardial infarction, and day 25 after hospitalization for pneumonia; risk of death declined 50% by day 11, 6, and 10, respectively. Daily change in risk of first readmission to hospital declined 95% by day 45, 38, and 45; daily change in risk of death declined 95% by day 21, 19, and 21. After hospitalization for heart failure, acute myocardial infarction, or pneumonia, the magnitude of the relative risk for hospital admission over the first 90 days was 8, 6, and 6 times greater than that of the general older population; the relative risk of death was 11, 8, and 10 times greater.Conclusions Risk declines slowly for older patients after hospitalization for heart failure, acute myocardial infarction, or pneumonia and is increased for months. Specific risk trajectories vary by discharge diagnosis and outcome. Patients should remain vigilant for deterioration in health for an extended time after discharge. Health providers can use knowledge of absolute risks and their changes over time to better align interventions designed to reduce adverse outcomes after discharge with the highest risk periods for patients.