Background Restless legs syndrome (RLS) is a potentially debilitating sleep disorder that affects a significant percentage of North American and European adults. Although standardized RLS diagnostic criteria are now established and widely accepted, reported prevalence estimates have varied widely. In this paper, we review the literature regarding RLS prevalence in North American and Western European adult populations, examine potential sources of variation, briefly discuss the impact of RLS, and offer recommendations for future research. Methods To identify qualifying studies, we searched 6 scientific databases and scanned bibliographies of relevant review papers and all identified articles. Studies including fewer than 300 participants that did not use any of the 4 standard diagnostic criteria were published prior to 1995, or targeted clinical populations were excluded. Results Thirty-four papers detailing results of large, population-based studies in 16 North American and Western European countries met our inclusion criteria, including 5 multi-country studies (N=69,992 participants) and 29 single country studies (N=163,188 participants); all but one were cross-sectional. Reported general prevalence rates ranged from 4 to 29% of adults, averaging 14.5±8.0% across studies. Reported prevalence averaged higher in primary care populations than in populations derived from random sampling or geographically defined cohorts (19.5±7.9% vs. 12.3±7.2%). Diagnostic and severity criteria differed considerably among studies, as did inclusion criteria, with corresponding variation in prevalence estimates. Prevalence averaged higher in women and older adults; more limited data suggest race/ethnicity, parity, health status, and other factors may also contribute to the observed variation in prevalence. RLS has profound, negative effects on health, well-being, and quality of life, yet detection rates remain low. Conclusions Collectively, these studies indicate that RLS is a common disorder of major clinical and public health significance in the Western industrialized world, affecting between 4 and 29% of adults. The wide variation in reported prevalence likely reflects differences in demographic factors, health status, and other population characteristics; study population source and sampling frame; and inconsistencies in RLS diagnostic criteria and procedures. In addition, prospective studies and corresponding incidence data on RLS are lacking, hindering the evaluation of both causal factors and sequelae.

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Hepatocellular carcinoma (HCC) has emerged as a major cause of cancer deaths globally. The landscape of systemic therapy has recently changed, with six additional systemic agents either approved or awaiting approval for advanced stage HCC. While these agents have the potential to improve outcomes, a survival increase of 2-5 months remains poor and falls short of what has been achieved in many other solid tumor types. The roles of genomics, underlying cirrhosis, and optimal use of treatment strategies that include radiation, liver transplantation, and surgery remain unanswered. Here, we discuss new treatment opportunities, controversies, and future directions in managing HCC.

Identification of the candidate gene responsible for the seed coat colour variation in Brassica juncea was undertaken following an earlier study where two independent loci (BjSc1 and BjSc2) were mapped to two linkage groups, LG A9 and B3 (Padmaja et al. in Theor Appl Genet 111:8-14, 2005). The genome search from BRAD data for the presence of flavonoid genes in B. rapa identified three candidate genes namely, DFR, TT1 and TT8 in the LG A9. Quantitative real-time PCR revealed absence of transcript for the late biosynthetic genes (LBGs) and showed significant reduction of transcript in the TT8 from the developing seeds of yellow-seeded line. While mapping of two DFR genes, the BjuA.DFR and BjuB.DFR did not show perfect co-segregation with the seed coat colour loci, that of the two TT8 genes, BjuA.TT8 and BjuB.TT8 showed perfect co-segregation with the seed coat colour phenotype. The BjuA.TT8 allele from the yellow-seeded line revealed the presence of an insertion of 1,279 bp in the exon 7 and did not produce any transcript as revealed by reverse transcriptase PCR. The BjuB.TT8 allele from the yellow-seeded line revealed the presence of an SNP (C→T) in the exon 7 resulting in a stop codon predicting a truncated protein lacking the C-terminal 8 amino acid residues and produced significantly low level of transcript than its wild-type counterpart. Hence, it is hypothesized that the mutations in both the TT8 genes are required for inhibiting the transcription of LBGs in the yellow-seeded mutant of B. juncea.

BACKGROUND: Depression is common among individuals with osteoarthritis and leads to increased healthcare burden. The objective of this study was to examine excess total healthcare expenditures associated with depression among individuals with osteoarthritis in the US. DESIGN: Adults with self-reported osteoarthritis (n= 1881) were identified using data from the 2010 Medical Expenditure Panel Survey (MEPS). Among those with osteoarthritis, chi-square tests and ordinary least square regressions (OLS) were used to examine differences in healthcare expenditures between those with and without depression. Post-regression linear decomposition technique was used to estimate the relative contribution of different constructs of the Anderson's behavioral model, i.e., predisposing, enabling, need, personal healthcare practices, and external environment factors, to the excess expenditures associated with depression among individuals with osteoarthritis. All analysis accounted for the complex survey design of MEPS. KEY RESULTS: Depression coexisted among 20.6 % of adults with osteoarthritis. The average total healthcare expenditures were $13,684 among adults with depression compared to $9284 among those without depression. Multivariable OLS regression revealed that adults with depression had 38.8 % higher healthcare expenditures (p<0.001) compared to those without depression. Postregression linear decomposition analysis indicated that 50 % of differences in expenditures among adults with and without depression can be explained by differences in need factors. CONCLUSIONS: Among individuals with coexisting osteoarthritis and depression, excess healthcare expenditures associated with depression were mainly due to comorbid anxiety, chronic conditions and poor health status. These expenditures may potentially be reduced by providing timely intervention for need factors or by providing care under a collaborative care model.