However, blocking CB1R selectively increased GABAergic gIPSCs, supporting a role for endocannabinoid signaling in the regulation of glutamate-evoked GABAergic inhibitory feedback to OFF BCs. this website Conclusions CB1R activation shape types 2, 3a, and 3b OFF BC responses by selectively regulate GABAergic feedback inhibition at their axon terminals, thus cannabinoid signaling might play an important role in the fine-tuning of visual signal processing in the mammalian inner retina.Purpose To investigate the clinical significance of the changes in the macular microvasculature in patients with diabetes mellitus type 2 without diabetic retinopathy. Methods Fifty-five patients with diabetes mellitus type 2 without diabetic retinopathy and 48 healthy individuals were enrolled in a prospective cross-sectional study. We identified the changes of optical coherence tomography angiography parameters (foveal avascular zone [FAZ] area and circularity, vessel density, and perfusion index) of the 6 × 6-mm macular scan. Correlation and multiple regression analyses were performed between optical coherence tomography angiography parameters and previously known diabetes mellitus type 2-related demographic and systemic characteristics, and serum biochemical markers. Results FAZ parameters and perfusion index of the superficial and deep vascular plexus showed significant correlation with serum insulin level, and homeostasis model assessment indices. In multiple linear regression analysis, low insulin levels predicted increased FAZ areas in both the superficial (β = -0.007; P = 0.030) and deep layers (β = -0.010; P = 0.018) and a decreased perfusion index in the deep layer (β = 0.003; P = 0.001). Conclusions The expansion and loss of circularity of the FAZ and the decrease in the perfusion index may be affected by insulin resistance and secretory capacity in patients with diabetes mellitus type 2 with no diabetic retinopathy.INTRODUCTION Cryptosporidiosis has been identified as one of the major causes of diarrhoea and diarrhoea-associated deaths in young children in sub-Saharan Africa. This study traces back Cryptosporidium positive children to their human and animal contacts to identify transmission networks. METHODS Stool samples were collected from children below five years with diarrhoea in Gabon, Ghana, Madagascar and Tanzania. Cryptosporidium positive and negative initial cases (IC) were followed to the community, where stool samples from households, neighbours and animal contacts were obtained. Samples were screened for Cryptosporidium spp. by immunochromatographic tests and by sequencing the 18S rRNA gene and further subtyped at the 60 kDa glycoprotein gene (gp60). Transmission clusters were identified and risk ratios (RR) calculated. RESULTS In total, 1,363 paediatric ICs, 184 (13%) were diagnosed with Cryptosporidium spp. One hundred eight contact networks were sampled from Cryptosporidium positive and 68 from negative ICs. Identical gp60 subtypes were detected amongst two or more contacts in 39 (36%) of the networks from positive ICs and in one (1%) from negative ICs. In comparison to Cryptosporidium negative ICs, positive ICs had an increased risk of having Cryptosporidium positive household members (RR = 3.6; 95%-confidence interval (CI) 1.7-7.5) or positive neighbouring children (RR = 2.9; 95%-CI 1.6-5.1), but no increased risk of having positive animals (RR = 1.2; 95%-CI 0.8-1.9) in their contact network. CONCLUSION Cryptosporidiosis in rural sub-Saharan Africa is characterized by infection clusters among human contacts, to which zoonotic transmission appears to contribute only marginally. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.Importance Millions of low-income children in the United States reside in substandard or unaffordable housing. Relieving these burdens may be associated with changes in asthma outcomes. Objectives To examine whether participation in the US Department of Housing and Urban Development's (HUD) rental assistance programs is associated with childhood asthma outcomes and to examine whether associations varied by program type (public housing, multifamily housing, or housing choice vouchers). Design, Setting, and Participants This survey study used data from the nationally representative National Health Interview Survey linked to administrative housing assistance records from January 1, 1999, to December 31, 2014. A total of 2992 children aged 0 to 17 years who were currently receiving rental assistance or would enter a rental assistance program within 2 years of survey interview were included. Data analysis was performed from January 15, 2018, to August 31, 2019. Exposures Participation in rental assistance provided6; 95% CI, -54.8 to -18.4) but not housing choice vouchers (percentage point change, -7.2; 95% CI, -24.6 to 10.3). No statistically significant evidence of changes in asthma attacks was found (percentage point change, -2.7; 95% CI, -12.3 to 7.0 percentage points). Results for asthma diagnosis were smaller and only significant at the 10% level (-4.3; 95% CI, -8.8 to 0.2 percentage points). Conclusions and Relevance Among children with a recent asthma attack, rental assistance was associated with less emergency department use. These results may have important implications for the well-being of low-income families and health care system costs.Importance It is uncertain whether and when angiotensin-converting enzyme inhibitor (ACE-I) and angiotensin II receptor blocker (ARB) treatment should be discontinued in individuals with low estimated glomerular filtration rate (eGFR). Objective To investigate the association of ACE-I or ARB therapy discontinuation after eGFR decreases to below 30 mL/min/1.73 m2 with the risk of mortality, major adverse cardiovascular events (MACE), and end-stage kidney disease (ESKD). Design, Setting, and Participants This retrospective, propensity score-matched cohort study included 3909 patients from an integrated health care system that served rural areas of central and northeastern Pennsylvania. Patients who initiated ACE-I or ARB therapy from January 1, 2004, to December 31, 2018, and had an eGFR decrease to below 30 mL/min/1.73 m2 during therapy were enrolled, with follow-up until January 25, 2019. Exposures Individuals were classified based on whether they discontinued ACE-I or ARB therapy within 6 months after an eGFR decrease to below 30 mL/min/1.