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Background and Objectives: Recruitment of underrepresented minorities (URM) in medicine has risen to the forefront as a strategy to address health inequities, but the experiences of URM residents within their own programs are poorly understood. We describe the development and implementation of a diversity, equity, and inclusion (DEI) climate survey at our residency program, the results of which have informed our DEI efforts.Methods: A resident-faculty work group collaboratively developed an 81-item questionnaire, informed by other institutional climate surveys. We administered the survey annually from 2018 through 2021 to all residents and faculty at our large academic family medicine residency program. The anonymous survey covered six key areas: general climate, climate for specific group, personal experience with discrimination and harassment, recruitment, burnout, and curriculum.Results: Average response rates were 84% and 50% for residents and faculty, respectively. Survey results show low satisfaction with resident and faculty diversity; higher rates of burnout for respondents who self-identify as URM, persons of color (POC), and/or LGBTQ; and racial and gender differences in experiences of workplace discrimination and sexual harassment.Conclusions: Instituting an annual internal climate survey at our residency has provided invaluable information regarding the perspectives and experiences of our residents and faculty that has informed our DEI initiatives. We envision that our survey will inform continual improvement and serve as a model for similar introspection leading to meaningful action at other programs. [ABSTRACT FROM AUTHOR]

Objective: This was a pilot study testing a cognitive enhancement program to improve rate of cognitive recovery in early substance abuse treatment. It is hypothesized that if patients were able to accelerate the rate of cognitive improvement, they may be able to better engage in substance abuse treatment and potentially have better long-term outcomes. Participants and Methods: Participants were 47 adults newly admitted to a residential substance abuse treatment facility (74.5% male, 76.6% white, mean age=34.5 years, education=12+ years). All were post-detox. All were being treated for opioid abuse, with the majority in treatment for polysubstance abuse. Participants were randomly assigned to either the intervention group (BrainHQ research cognitive training program) or active control group (inert computer games) and completed 34 training sessions per week for a minimum of 3 weeks. NIH Toolbox cognition battery was administered at baseline and endpoint. Results: Regardless of study group, most participants had a significant improvement in cognitive performance across most subtests and composite scores of the NIH Toolbox cognition battery. The RAVLT and Oral Symbol Digit subtests had the greatest change (p<.001) for both groups, as well as a significant improvement (p=.002) in Cognitive Function Composite Score for both groups. The only difference between the control and intervention group was on the Pattern Comparison subtest, with the intervention group scoring significantly higher at endpoint (p=.004). Conclusions: Although substance abuse is known to cause injury to the brain that may not be fully repaired by sobriety, cognitive recovery was significant in this group of patients during early inpatient treatment for opioid abuse. Although it has yielded significant effect in other patient populations, the BrainHQ program did not show a significant enhancement in cognitive recovery, compared to the active control group, in this pilot study of patients in treatment for opioid abuse. This study was limited by a small sample size and potential future variations should be considered, such as changes to intervention intensity and specific intervention exercises. [ABSTRACT FROM AUTHOR]

The concept of urban sustainability governance has developed as an institutional guiding concept to holistically address the vitality of cities under a long-term perspective and is based on the collaborative efforts of government, administration, business, science, and the civil society. Yet, the initiation and implementation of this guiding concept faces a variety of barriers, including deficient conceptualization, unfamiliarity, detrimental organizational structures, and inertia. We examine the initiation of urban sustainability governance in the City of Richmond, British Columbia, Canada. On the basis of the reviews of administrative documents and interviews with staff across various administrative levels and units, we reflect on achievements and shortcomings against guidelines of urban sustainability governance spelled out in the literature. Our study indicates accomplishments in the conceptualization of a vision and overall framework to operate from, but also a number of deficits in specifying sustainability targets, applying governance principles, and evaluating impacts. Additionally, we discuss how administrative structures influence how urban sustainability governance is being implemented. We draw conclusions regarding general factors for succeeding in the initiation and implementation of urban sustainability governance. [ABSTRACT FROM AUTHOR]

The geology of New York City (USA) consists primarily of metasedimentary rocks that were deformed during the series of orogenies between ca. 470 Ma and ca. 300 Ma that culminated in the amalgamation of Pangea. The rocks in New York City play a key role in understanding the tectonic history of these orogenies because they lie at a critical location at the boundary between the Northern and Southern Appalachian Mountains. The primary question addressed here is where these metasedimentary rocks originated prior to the assembly of Pangea. Through detrital zircon and whole-rock Nd isotope analyses, we show that all the metasedimentary rocks of New York City, mapped as the Manhattan Schist and the Hartland Group, are primarily derived from Laurentia as indicated by detrital zircon populations dominated by 1200-900 Ma grains and εNd values between -7 and -13. The results presented here do not necessitate an exclusively Laurentian source for the detrital material found in New York City, but the data strongly suggests protoliths represent sedimentary units that are primarily derived from the Laurentian margin. Another important result from this study is the limited contributions from any rift volcanics and/or Gondwanan material(s). There is some subtle variability across our zircon sample suite, but there is no convincing evidence for major changes in bulk provenance signal that would be consistent with derivation from vastly different continental sources for these rocks. The shared provenance signal observed here is counter to the previous suggestions that a major terrane boundary, often called Cameron's Line, exists in New York City, separating Laurentian rocks from those of a Gondwanan affinity. [ABSTRACT FROM AUTHOR]

The social and educational handicaps of speakers of nonstandard English in America are increasingly the fruits of earlier out-migrations of Southerners, mainly uneducated and mostly Black, whose language has now become even more highly stigmatized because of the geographical displacement of its speakers. Since the first attacks by American linguists, a decade ago, on both traditional and 'compensatory' language education, positions taken by English educators toward nonstandard language have followed the changing positions of the linguists themselves, to which the history of research in dialects and language varieties gives clues. Thus does the resolution by CCCC (1974) partly reflect concurrent sociolonguistic interest in language attitudes. The peculiarities of the social-class structure. Although the school will continue to be viewed as an agent of social change, no language-education policy will have more than a negligible effect on the leveling either of social class or of language variety. [ABSTRACT FROM AUTHOR]

AbstractObjective: To systematically review the literature on the neurocognitive effects of drug use to determine if there are significant gender differences. Methods: In April 2023, we conducted a broad search in MEDLINE (via PubMed), PsycINFO, and Embase for original research studies that used objective neuropsychological assessment to evaluate neurocognition in persons with drug use. Data extraction was performed in a masked, duplicate fashion. Results: Our initial search returned 22,430 records, of which 273 articles were included in our analysis. We found significant underrepresentation of women as participants in the studies. Twenty-one percent of studies had exclusively male participants; when women were included, they averaged only 23% of the sample. Only 49 studies sufficiently documented an analysis of their results by gender; due to the heterogeneity in study characteristics, no conclusions about cognitive differences between women and men could be made. Conclusions: Women are significantly underrepresented in the research on cognition in drug use. Increased efforts to include more women participants and consistent analysis and reporting of data for potential gender differences will be required to close this gap in knowledge, which may lead to improved substance abuse treatment approaches for women. [ABSTRACT FROM AUTHOR]

Case Diagnosis: 39 year old male with bilateral hand paresthesia was diagnosed with right ulnar nerve entrapment proximal to the elbow. This was discovered with a Tinel sign along the ulnar nerve proximal to the cubital tunnel. Case Description: He was referred for an EMG for bilateral hand numbness and paresthesia. The symptoms were intermittent along the medial forearm and throughout the hands. Symptoms are often initiated by physical labor but can occur while sedentary. On exam his sensation and strength were normal. Negative Spurling, Phalen, and Tinel (at the wrist and the cubital tunnel) were noted. Because of the suspicion of ulnar neuropathy the Tinel was performed more proximally along the ulnar nerve. The Tinel was positive 5 cm proximal to the cubital tunnel. Because of this finding an inching technique was employed for the bilateral ulnar motor studies. The conduction velocity dropped to 25 m/s at the site positive Tinel. He was referred for ultrasound examination. Discussions: This patient's presentation and symptoms were consistent with a C8 radiculopathy versus ulnar neuropathy. Though his Tinel was negative at the elbow, a high suspicion of ulnar neuropathy was maintained. Because of this suspicion, further investigation of the ulnar nerve was performed with percussion. This finding guided the use of the inching technique which is not commonly performed at this institution. The patient was instructed to follow up for an ultrasound of the ulnar nerve with another physiatrist in this practice. Conclusions: The Tinel test is commonly used at the frequent sites of entrapment. If there continues to be a high suspicion of nerve entrapment the Tinel test can be used to localize entrapment along the accessible portions of the nerve. A positive Tinel at an uncommon location can help to guide further electrodiagnostics and imaging. [ABSTRACT FROM AUTHOR]

Cytosolic calcium influx activates signaling pathways known to support pancreatic beta cell function and survival by modulating gene expression. Impaired calcium signaling leads to decreased beta cell mass and diabetes. To appreciate the causes of these cytotoxic perturbations, a more detailed understanding of the relevant signaling pathways and their respective gene targets is required. In this study, we examined the calcium-induced expression of the cytoprotective beta cell transcription factor Npas4. Pharmacological inhibition implicated the calcineurin, Akt/protein kinase B, and Ca2/ calmodulin-dependent protein kinase signaling pathways in the regulation of Npas4 transcription and translation. Both Npas4 mRNA and protein had high turnover rates, and, at the protein level, degradation was mediated via the ubiquitinproteasome pathway. Finally, beta cell cytotoxicity of the calcineurin inhibitor and immunosuppressant tacrolimus (FK-506) was prevented by Npas4 overexpression. These results delineate the pathways regulating Npas4 expression and stability and demonstrate its importance in clinical settings such as islet transplantation. [ABSTRACT FROM AUTHOR]

Roundup herbicides, with glyphosate as their active ingredient, are used in agriculture, forestry management, horticulture and in urban settings. When exposed to Roundup formulations and glyphosate, worms endure a suite of sublethal changes, potentially impacting their ability to provide ecosystem services. Roundup applications also impact soil microbes, which aid soil in delivering ecosystem services. The experiment described here sought to establish the length of time needed between herbicide application and earthworm and soil microbe recovery. We found that exposing worms and soil microbes to a Roundup formulation commonly used in urban settings, at about twice the recommended dose, did not impact earthworm mortality or body mass. However, worms significantly decreased their stress-test survival time, and soil microbes significantly declined in biomass after exposure. While worms demonstrated the strongest decline one-week post exposure, and soil microbes demonstrated the strongest decline two-weeks post exposure, both worms and soil microbes recovered by the third week. Roundup applications can potentially be timed so as to maximize the probability that soil-dwelling organisms remain unharmed by contamination. Unlabelled Image • Roundup® contamination reduced worm stress test survival time at Weeks 1 and 2. • Roundup® contamination caused soil microbe biomass to drop significantly in Week 2. • Worms and microbes recovered from exposure to Roundup® contamination by Week 3. • Roundup® contamination at double the label dose did not cause worm mortality. • Roundup® contamination at double the label dose did not reduce worm body mass. [ABSTRACT FROM AUTHOR]

Participation in cancer research trials by minority populations is imperative in reducing disparities in clinical outcomes. Even with increased awareness of the importance of minority patient inclusion in clinical research to improve cancer care and survival, significant barriers persist in accruing and retaining minority patients into clinical trials. This study sought to identify and address barriers to minority accrual to a minimal risk clinical research study in real-time., (© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)