were found to have ≥2 FH-causing variants. High plasma ceramide levels and ratios are associated with poor outcomes in individuals with cardiovascular disease; less is known about their relation to cerebral small vessel disease. We examined whether high plasma ceramide levels or ratios were associated with cerebral microbleeds (CMBs) and lacunes and whether associations differ by sex. Approach and Results We included 548 participants enrolled in the MCSA (Mayo Clinic Study of Aging) with concurrent plasma ceramide assays and magnetic resonance imaging. CMBs were quantified on T2* magnetic resonance imaging and lacunes on T2 fluid-attenuated inversion recovery magnetic resonance imaging. Fasting plasma ceramides were assayed using liquid chromatography-electrospray ionization tandem mass spectrometry. We used logistic regression models adjusting for age, sex, hypertension, and diabetes mellitus to examine the relationship between ceramides and presence of a lacune; hurdle models were used for presence and number of CMBs. Each SD increase in the log ceramide C160/240 ratio was associated with greater odds of a CMB (odds ratio, 1.28 [95% CI, 1.01-1.64]). There was an interaction between sex and the ceramide C160/240 ratio ( =0.049). The association between this ratio and presence of a CMB was stronger for women (odds ratio, 1.87 [95% CI, 1.20-3.00]) than men (odds ratio, 1.09 [95% CI, 0.80-1.46]). Several ceramides and all ceramide ratios were associated with number of CMBs. We did not find associations between plasma ceramides and lacunes. In a population-based sample, the plasma ceramide C160/240 ratio was associated with CMBs and was stronger for women. Plasma ceramides are differentially associated with cerebral small vessel pathologies.In a population-based sample, the plasma ceramide C160/240 ratio was associated with CMBs and was stronger for women. Plasma ceramides are differentially associated with cerebral small vessel pathologies.Aim To comprehensively understand microbiota-regulated lincRNA-miRNA-mRNA networks in psychiatric disorders. Materials & methods Integrated analyses of lincRNAs, mRNAs and miRNAs, obtained by microarray analysis of hippocampus from specific pathogen-free, germ-free and colonized germ-free mice, were performed. Results Expression of 139 mRNAs, seven miRNAs and one lincRNA was restored following colonization. The restored transcripts were mainly involved in CREB and Ras/MAPK signaling pathways. RNA transcription and post-transcriptional regulation were the primary perturbed functions. Finally, 12 lincRNAs, six miRNAs and 47 mRNAs were included in a lincRNA-miRNA-mRNA network, and lincRNA0926-miR-190a-5p-Celf4 interactions may play a pivotal role in this regulatory network. Conclusion This study provides clues for understanding the molecular basis of gut microbiota-brain interactions in depressive- and anxiety-like behaviors. There is a need for improved primary palliative care (PC) education and resident comfort with providing end-of-life care. Utilize a new instrument derived from published PC competencies to assess baseline Internal Medicine (IM) resident knowledge and self-efficacy in PC to identify educational gaps and create new PC curricula. We created a 2-part instrument including a Knowledge Test (KT) and a Self-Efficacy Inventory (SEI) addressing 18 PC resident competencies across 5 domains Pain and Symptom Management (PSM), Communication (COMM), Psychosocial, Spiritual, and Cultural Aspects of Care (PSC), Terminal Care and Bereavement (TCB), and Palliative Care Principles and Practice (PCPP). The instrument was emailed to IM residents at our institution during academic years 2015-2016 and 2016-2017. Basic descriptive statistics were performed for the KT and SEI. Mean Rank Analysis and One-way ANOVA were utilized for the KT and SEI, respectively. Congruence was calculated between knowledge and self-efficacy. The mean score on the KT was 73% (range 33-80%). There was no significant difference in knowledge among post-graduate year cohorts. Self-efficacy scores were lower for interns overall and in PCPP, TCB, and COMM domains. Knowledge was concordant with self-efficacy in 42% of participants, higher than self-efficacy in 10% of participants, and lower than self-efficacy in 48% of participants. For approximately half of respondents, high self-efficacy in PC did not correlate with high PC knowledge. A more focused curriculum is needed to help IM residents facilitate mastery of PC competencies by graduation.For approximately half of respondents, high self-efficacy in PC did not correlate with high PC knowledge. A more focused curriculum is needed to help IM residents facilitate mastery of PC competencies by graduation. To present a modified surgical technique, based on a combination of human amniotic membrane (hAM) patch and autologous Platelet-rich plasma (PRP) in a case of recurrent retinal detachment (RRD) due to a perivascular retinal hole over an area of staphyloma in an eye with pathologic myopia. Presenting the surgical technique with the disposal of surgical video. After performing 23-gauge pars plana vitrectomy (PPV) the hAM patch was inserted under the neuroretina through the perivascular hole and PRP was injected on top to speed up the closure of the hole. To complete the surgical procedure High Viscosity Silicon oil (5000cst) was used as tamponade. The patient was prescribed to maintain a face-down position for the first 3 days after the operation. Follow-up was evaluated through Optical coherence tomography (OCT) scans. The 3 days postoperative OCT showed a flat retina with the filling of the myopic staphyloma. The hAM patch was well positioned and the retinal hole could not be identified. At 6 weeks from intervention, the site of the retinal hole at OCT scan was covered by new tissue. Silicone oil was removed 3 months later with no recurrence. hAM transplantation is a novel technique in case of retinal detachment recurrences to seal retinal holes over high myopic chorioretinal atrophy. click here The adjunctive use of PRP and high viscosity silicon oil allows to reducing the standard face-down positioning timing, representing a valid solution for elderly patients who have difficulties maintaining the position for long periods.hAM transplantation is a novel technique in case of retinal detachment recurrences to seal retinal holes over high myopic chorioretinal atrophy. The adjunctive use of PRP and high viscosity silicon oil allows to reducing the standard face-down positioning timing, representing a valid solution for elderly patients who have difficulties maintaining the position for long periods.