Exposure to chronic stress has been argued to produce maladaptive anxiety-like behavioral states, and many of the brain regions associated with stressor responding also mediate anxiety-like behavior. Pituitary adenylate cyclase activating polypeptide (PACAP) and its specific G protein-coupled PAC 1 receptor have been associated with many of these stress-and anxiety-associated brain regions, and signaling via this peptidergic system may facilitate the neuroplasticity associated with pathological affective states. Here we investigated whether chronic stress increased transcript expression for PACAP, PAC 1 receptor, brain-derived neurotrophic factor (BDNF), and tyrosine receptor kinase B (TrkB) in several nuclei. In rats exposed to a 7 day chronic variate stress paradigm, chronic stress enhanced baseline startle responding induced by handling and exposure to bright lights. Following chronic stress, quantitative transcript assessments of brain regions demonstrated dramatic increases in PACAP and PAC 1 receptor, BDNF, and TrkB receptor mRNA expression selectively in the dorsal aspect of the anterolateral bed nucleus of the stria terminalis (dBNST). Related vasoactive intestinal peptide (VIP) and VPAC receptor, and other stress peptide transcript levels were not altered compared to controls. Moreover, acute PACAP38 infusion into the dBNST resulted in a robust dose-dependent anxiogenic response on baseline startle responding that persisted for 7 days. PACAP/PAC 1 receptor signaling has established trophic functions and its coordinate effects with chronic stress-induced dBNST BDNF and TrkB transcript expression may underlie the maladaptive BNST remodeling and plasticity associated with anxiety-like behavior.

Although factors such as more aggressive chemotherapy or a different spectrum of malignant diseases may contribute to the statistically significant increase in identification of bacteremic patients, a standardized method of blood culture collection is merited. The consistent volumes of blood per culture and the minimum of two cultures per febrile episode follow the principles of blood culture collection established for adults. The same principles should apply to pediatric patients.

The current study examined how hemispheric asymmetries in perceptual processing affect control processes associated with voluntary task choice during multitask behaviour. In a voluntary task-switching paradigm, where participants are free to choose which task to perform on each trial, participants identified either the global-or local-level features of hierarchical stimuli presented to either the left or right visual field. Hemispheric asymmetries in perception of lateralised hierarchical stimuli were evident in reaction times. Importantly, participants were more likely to categorize the stimulus in line with the processing efficiency of the hemisphere to which it was initially presented: the global task for left visual field presentation and the local task for right visual field presentation. Perceptual processing characteristics influence control processes associated with task choice in multitask environments.

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Background/introductionWhilst guidelines recommend NG TOC 2 weeks after treatment, there is little data on the optimum time to perform a TOC for CT in those for whom this is indicated. Current BASHH guidelines recommend deferring TOC for at least 3 weeks after treatment because residual chlamydial DNA may persist.Aim(s)/objectivesPatients who are treated for NG and CT co-infection re-attending for subsequent NG TOC are tested for both infections by NAAT providing the opportunity to evaluate the CT positivity rate at re-attendance.MethodsA retrospective case review of co-infected GC/CT positive (analysed with Cepheid GeneXpert) patients tested in a’London sexual health clinic over 12 consecutive months was’performed. TOC details were evaluated, and appropriate antibiotic treatment according to BASHH guidelines was assessed.Results480 patients tested positive for both infections and 132 attended for TOC within 21 days of treatment (median 15 days, IQR 14–17). Of these 131 were male, of whom 126 MSM; median age was 35 y and median number of sexual partners in previous 3 months was 5. Site of CT infection was rectal (94), urethral (49), throat (11), vulvovaginal (1). At TOC, 6 (4.5%) had a persistent positive CT NAAT: rectum (3), urethra (3). One patient with persistent rectal CT had received treatment with azithromycin; the other 5 received BASHH preferred treatment. By comparison, 3 (2.3%) had a positive NG NAAT at TOC.DiscussionCT positivity 15 days after treatment is low, suggesting that TOC at 2 weeks may be a possible management strategy.