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In silico modeling offers an opportunity to supplement and accelerate cardiac safety testing. With in silico modeling, computational simulation methods are used to predict electrophysiological interactions and pharmacological effects of novel drugs on critical physiological processes. The O'Hara-Rudy's model was developed to predict the response to different ion channel inhibition levels on cardiac action potential duration (APD) which is known to directly correlate with the QT interval. APD data at 30% 60% and 90% inhibition were derived from the model to delineate possible ventricular arrhythmia scenarios and the marginal contribution of each ion channel to the model. Action potential values were calculated for epicardial, myocardial, and endocardial cells, with action potential curve modeling. This study assessed cardiac ion channel inhibition data combinations to consider when undertaking in silico modeling of proarrhythmic effects as stipulated in the Comprehensive in Vitro Proarrhythmia Assay (CiPA). As expected, our data highlight the importance of the delayed rectifier potassium channel (IKr) as the most impactful channel for APD prolongation. The impact of the transient outward potassium channel (Ito) inhibition on APD was minimal while the inward rectifier (IK1) and slow component of the delayed rectifier potassium channel (IKs) also had limited APD effects. In contrast, the contribution of fast sodium channel (INa) and/or L-type calcium channel (ICa) inhibition resulted in substantial APD alterations supporting the pharmacological relevance of in silico modeling using input from a limited number of cardiac ion channels including IKr, INa, and ICa, at least at an early stage of drug development. [ABSTRACT FROM AUTHOR]

This study assesses adults' perceptions of and predictors of intention to use prescription drug take-back boxes. This mixed methods study utilized focus groups and an online survey to examine factors related to intention to use a prescription drug take-back box. This study was conducted in [State] during the spring and summer of 2018. Themes identified in focus group data included the importance of take-back box location, benefits of take-back box use (such as reducing opportunities for medication misuse), and barriers to take-back box use (such as lack of awareness, stigma associated with law enforcement). Survey results indicate that pharmacies are the most preferred take-back box location and that attitudes, subjective norms, and perceived behavioral control are statistically significant predictors of intention to use a take-back box. Results suggest that individuals are open to using take-back boxes in secure, convenient locations, but many are unaware of take-back boxes as an option for safe disposal. These findings have implications for health communication and policy efforts designed to increase the use of take-back boxes for prescription drug disposal. [ABSTRACT FROM AUTHOR]

We explore the relationship between placeways and public art in the case of ephemeral architecture entitled "Temple," installed in Northern Ireland in 2015. Synthesizing our own published ethnographies of the event, we employ a method we call auto-meta-ethnography to discover a grounded theory of emplacement that synergizes prior work undertaken on the concept of -scapes. We emphasize conjuncture over disjuncture and probe the isomorphism of cultural flows. We examine the imbrication of the installation in a cluster of -scapes we label landscape, mythscape, brandscape, giftscape, griefscape, artscape, and Templescape, together which comprise a chorography of the Temple's emplacement. These micrometaphors provide more precision and nuance to existing macrometaphors, illuminate the intimate intermingling of -scapes, and illustrate the synergy their propinquity occasions. [ABSTRACT FROM AUTHOR]

In the U.S., evidence has emerged suggesting that divorce is lower among those with many versus few siblings, a pattern that may indicate that children develop important social skills via their childhood interactions with siblings. However, this pattern has yet to be tested in other countries with varying fertility and divorce rates. We extend the empirical basis of the sibship size/divorce literature by exploring the association in China and Europe, each with unique demographic characteristics. Each additional sibling is associated with an 11 percent decline in the probability of divorce in China and a two percent decline in Europe, net a wide range of covariates. We also test whether these patterns vary across cohorts and alternative coding schemes. The results have implications for our understanding of how growing up with siblings influences later life outcomes and the contextual features that form that relationship. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the perceptions of university students who served as outside facilitators for evidence-based nutrition education for elementary-age children. Design: Qualitative case study. Methods: Thirteen undergraduate university students facilitated four nutrition education sessions for elementary-age students in an after-school programme using the Choice, Control, Change model as part of service learning curriculum. University students completed pre- and post-participation surveys. Elementary-age participants completed surveys after each session. Results: University students saw the benefit of this type of experiential learning with the following themes: knowledge application, learning about diverse perspectives and having a positive impact. Before the first nutrition education session, the university students felt excited, nervous and/or enthusiastic, and during and immediately after the sessions reported they felt confident. Participant engagement was low/mixed and classroom management was challenging, which may be linked to the university students' perceptions that they were underprepared to work in a distracting social environment, and with behaviour typical to elementary-age children. The education session recipients reported they gained knowledge about healthy behaviours and believed that eating healthy foods is important. Conclusion: There are gaps in nutrition education programme theory and implementation by outside facilitators. These findings are relevant to those who provide health education services for surrounding communities. This study provides information about implementation barriers when outside facilitators lead nutrition education, alongside recommendations to improve these types of programmes in the future. [ABSTRACT FROM AUTHOR]

Background: Despite increasing medical cannabis use, research has yet to establish whether and to what extent products containing delta-9-tetrahydrocannabinol (THC) impact driving performance among patients. Stable doses of prescribed cannabinoid products during long-term treatment may alleviate clinical symptoms affecting cognitive and psychomotor performance. Aim: To examine the effects of open-label prescribed medical cannabis use on simulated driving performance among patients. Methods: In a semi-naturalistic laboratory study, 40 adults (55% male) aged between 23 and 80 years, consumed their own prescribed medical cannabis product. Driving performance outcomes including standard deviation of lateral position (SDLP), the standard deviation of speed (SDS), mean speed and steering variability were evaluated using the Forum8 driving simulator at baseline (pre-dosing), 2.5 h and 5 -h (post-dosing). Perceived driving effort (PDE) was self-reported after each drive. Oral fluid and whole blood samples were collected at multiple timepoints and analysed for THC via liquid chromatography-mass spectrometry. Results: A significant main effect of time was observed for mean speed (p = 0.014) and PDE (p = 0.020), with patients displaying modest stabilisation of vehicle control, increased adherence to speed limits and reductions in PDE post-dosing, relative to baseline. SDLP (p = 0.015) and PDE (p = 0.043) were elevated for those who consumed oil relative to flower-based products. Detectable THC concentrations were observed in oral fluid at 6-h post-dosing (range = 0–24 ng/mL). Conclusions: This semi-naturalistic study suggests that the consumption of medical cannabis containing THC (1.13–39.18 mg/dose) has a negligible impact on driving performance when used as prescribed. [ABSTRACT FROM AUTHOR]

In the aftermath of Dobbs v. Jackson Women's Health Organization, which overturned the federal constitutional right to abortion, states have begun to recriminalize the procedure. These abortion bans raise important questions about the political and social status of women and pregnant people in the United States. Moreover, restrictions in social welfare programs such as the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children and Temporary Assistance for Needy Families, which serve low-income pregnant people and parents, raise similar questions. The regulation and administration of all three are framed by race, class, and gender. To understand how these restrictions (a) claim to protect women but ultimately function to control, police, and surveil and (b) rely on imagined, stereotype-laden psychological states such as vulnerability, irresponsibility, or irrationality, we turn to the British Common Law doctrine of coverture, which subsumed a married woman's legal, financial, and political identities under her husband's. The American colonies, and later, states of the United States, drew from British Common Law to craft laws that regulated relationships between men and women. Taken together, this analysis can provide a more comprehensive accounting of the cumulative harms experienced by women, poor people, people of color, and pregnant people in today's health and social welfare landscape. We conclude with recommendations for psychologists and other mental health providers to address, in practice and advocacy, the ethical dilemmas and obligations raised by the reach of coverture's logics in people's lives. [ABSTRACT FROM AUTHOR]

Background: Recreational co-consumption of benzodiazepines and alcohol is a common practise; yet, the cognitive effects of this combination remain poorly understood. This study aimed to investigate the acute cognitive effects of combining a 1 mg dose of alprazolam with a moderate dose of alcohol (target 0.04% blood alcohol concentration (BAC)) in a non-clinical population. Methods: In this randomised, double-blind, placebo-controlled, crossover trial, participants completed computerised cognitive assessments and the brief biphasic alcohol effects scale (B-BAES) after consuming 1 mg of alprazolam, both with and without a moderate dose of alcohol (target 0.04% BAC). Results: Among 20 healthy participants (mean age = 28.6, SD ± 4.0 years, 60% female), we found that a peak BAC of 0.03% had no significant impact on cognitive performance. Both the individual use of alprazolam and its combination with alcohol resulted in impaired reaction time, digit vigilance, and verbal, spatial and numeric working memory tasks, although an additive effect when alcohol and alprazolam were consumed together was not evident. The most pronounced cognitive effects occurred at 100 min after dosing, coinciding with increased alprazolam concentrations. Sedative effects were heightened with alcohol, alprazolam and their combination while no stimulative effects were reported. Conclusions: Our findings highlight the significant implications of a therapeutic dose of alprazolam on impairing cognitive performance. This is particularly relevant considering the frequency of non-medical alprazolam use. Future studies should explore different dosages, administration timings and long-term effects to inform the development of public health policies and guidelines regarding the combined use of alcohol and benzodiazepines. [ABSTRACT FROM AUTHOR]

Background: Research approaches used to understand Indigenous people in Canada have predominately used Western approaches and have not reflected Indigenous ways of knowing, protocols, or worldviews. The landscape of research involving Indigenous people is changing with a growing number of Indigenous scholars reclaiming and revitalizing Indigenous knowledge. Two-Eyed Seeing provides a framework whereby conscious and deliberate conversations and research approaches are determined prior to and throughout the research process by the research team to guide a balance of each knowledge. However, Two-Eyed Seeing approaches or methods used during data analysis within the literature remains sparse necessitating this integrative review. Purpose: To review the literature where Two-Eyed Seeing has been applied and to identify the approaches or methods used during data analysis and discuss the implications for research with Indigenous communities worldwide. Methods: The five-stage approach outlined by Whittemore and Knafl (2005) was used to guide this integrative review. Results: A total of 321 articles were reviewed from four databases, yielding 32 articles. Conclusions: This integrative review is novel in that it is the first review known to specifically explore the use and application of a Two-Eyed Seeing framework during data analysis. Five main themes are presented including (1) Indigenous community member involvement with analysis, (2) Co-Learning during data analysis, (3) Visual or symbolic conceptualizations to guide analysis, (4) Statement acknowledging Indigenous knowledge during data analysis, and (5) Sharing of Traditional stories to guide data analysis. Additionally, five Two-Eyed Seeing approaches less commonly used during data analysis are provided. [ABSTRACT FROM AUTHOR]

Background: Methamphetamine is often recreationally co-consumed with alcohol due to desirable off-target effects; however, the acute neurocognitive and subjective consequences of combined use are unclear. Methods: In a randomised, placebo-controlled, counterbalanced, cross-over study design, the effects of acute oral methamphetamine (0.42 mg/kg) were assessed with and without low doses of alcohol (target 0.04% blood–alcohol concentration, BAC) on subjective intoxication, alertness, physiological outcomes and neurocognition during the ascending and descending phases of the BAC curve. Sixteen healthy adults (mean age = 30.4 years, SD ± 4.4, 67% male) completed four experimental sessions over 4 weeks involving a one-week washout period. Results: Cardiovascular measures [heart rate (beats/minute), blood pressure (mmHg)] were predictably elevated following methamphetamine, but unaffected by combined alcohol use. Methamphetamine and alcohol produce divergent effects on subjective alertness and sedation across time, yet their combination produced predominantly sustained stimulative effects independent of the biphasic alcohol curve. At a peak BAC of 0.029%, alcohol alone impaired performance across most functional neurocognitive domains relative to placebo and methamphetamine only, and the addition of methamphetamine attenuated these effects. Methamphetamine alone produced isolated improvement in psychomotor speed consistent with peak drug effects. Conclusion: Methamphetamine combined with alcohol does not substantially alter the physiological or metabolic profile compared to either drug alone. Strong stimulative effects of methamphetamine appear to mask the biphasic sedative and performance effects of low doses of alcohol, which may underlie motivations for co-consumption in recreational settings and increase propensity for harm. [ABSTRACT FROM AUTHOR]

Network visualizations are alluring yet deceptively difficult to interpret. This article demonstrates several strategies for integrating qualitative data into interactive network diagrams for the purposes of providing contextual information about actors and their relationships. The result is a new joint display called a Narrated Network Diagram (NND). The development of NNDs aims to make network visualizations more reliable tools for reporting research findings, especially for researchers integrating Social Network Analysis tools into multi- and mixed-methods research designs. Until now, researchers primarily use interactivity to support exploratory analysis of large networks at various scales. However, interactivity can also be used to integrate diverse forms of data without sacrificing perceptual efficiency by essentially hiding significant amounts of text within nodes and edges as tooltips or by delineating additional data within legends, titles, and subtitles. [ABSTRACT FROM AUTHOR]

Students with intellectual and developmental disabilities (IDD) who attend inclusive postsecondary education (IPSE) programs gain many new and beneficial skills, including independent living, social, and employability skills. Another skill set that may be strengthened by attending an IPSE program is self-determination. There is limited research available identifying the impact of IPSE programs on self-determination growth. We addressed this gap by using a longitudinal study designed to examine the changes in self-determination levels of students with IDD across 3 years in an IPSE program. Data collected from 23 students with IDD at 4 points of time within 3 years showed that there was an increasing trend in students' self-determination levels at the end of each year. The difference was highly significant between the baseline and the end of the third year. This suggests that IPSE programs can play a critical role in the improvement of the self-determination levels in students with IDD. Implications and future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Medicinal cannabis products containing Δ9-tetrahydrocannabinol (THC) are increasingly accessible. Yet, policy guidelines regarding fitness to drive are lacking, and cannabinoid-specific indexations of impairment are underdeveloped. Aims: To determine the impact of a standardised 1 mL sublingual dose of CannEpil®, a medicinal cannabis oil containing 100 mg cannabidiol (CBD) and 5 mg THC on simulated driving performance, relative to placebo and whether variations in vehicle control can be indexed by ocular activity. Methods: A double-blind, within-subjects, randomised, placebo-controlled, crossover trial assessed 31 healthy fully licensed drivers (15 male, 16 female) aged between 21 and 58 years (M = 38.0, SD = 10.78). Standard deviation of lateral position (SDLP), standard deviation of speed (SDS) and steering variability were assessed over time and as a function of treatment during a 40 min simulated drive, with oculomotor parameters assessed simultaneously. Oral fluid and plasma were collected at 30 min and 2.5 h. Results: CannEpil did not significantly alter SDLP across the full drive, although increased SDLP was observed between 20 and 30 min (p < 0.05). CannEpil increased SDS across the full drive (p < 0.05), with variance greatest at 20–30 min (p < 0.001). CannEpil increased fixation duration (p < 0.05), blink rate (trend p = 0.051) and decreased blink duration (p < 0.001) during driving. No significant correlations were observed between biological matrices and performance outcomes. Conclusions: CannEpil impairs select aspects of vehicle control (speed and weaving) over time. Alterations to ocular behaviour suggest that eye tracking may assist in determining cannabis-related driver impairment or intoxication. Australian and New Zealand Clinician Trials Registry, https://anzctr.org.au(ACTRN12619000932167). [ABSTRACT FROM AUTHOR]

Background: Palliative care requires innovative methods to understand what works, for whom, in what circumstances and why. Realist evaluation has become one prominent approach due to its preoccupation with building, and testing, causal theories to explain the influence of contextual factors on outcomes. Undertaking realist evaluation is not without challenges and may amplify issues of underrepresentation, disempower those working in palliative care, and produce results with poor ecological validity. Complementary approaches are needed which mitigate these challenges, whilst producing credible findings that advances knowledge. Purpose: In this article it is outlined how realist evaluation provides a toolkit to advance research to explain, and empirically test, the complex contours of palliative care. Moreover, it is proposed that transformative evaluation can provide a catalyst to engage and empower those within palliative care, create the opportunity for care transformation, and produce more informed and authentic theories. Discussion: Contemporary issues in palliative care pertain to the complexity of palliative care, the insufficiency of experimental designs alone, and the challenges of achieving inclusive research participation. In this article it is argued that theory led, participatory, opportunistic and naturalistic approaches can provide an antidote to the issues in the literature. The combination also mitigates many methodological critiques of the individual approaches, by increasing the transformative potential of realist evaluation, and explanatory potential of transformative evaluation. [ABSTRACT FROM AUTHOR]

Researchers have paid relatively little attention to the role that sexual and gender violence play in reinforcing neoliberal discourse. We address this issue by demonstrating that the portrayal of women and girls in the mainstream media, female body practices based on this portrayal, gendered sexual-agency norms, sexual harassment, and rape are not only sexualized and violent, but they also display a common set of cultural scripts drawn from both patriarchal and neoliberal discourse. We thus conclude that these images, practices, and norms are forms of sexualized violence that reinforce patriarchal and neoliberal discourse and, thus, the gender and class orders. [ABSTRACT FROM AUTHOR]

A bag-valve-mask (BVM) is a portable handheld medical device commonly used in airway management and manual ventilation. Outside of the operating theatre, BVM devices are often used to pre-oxygenate spontaneously breathing patients before intubation to reduce the risk of hypoxaemia. Pre-oxygenation is considered adequate when the end-tidal expiratory fraction of oxygen is greater than 0.85. There are reports that some BVM devices fail to deliver a satisfactory inspired oxygen (FiO2) in spontaneously breathing patients due to variability in design. The primary aim of this study was to evaluate the efficacy of oxygen delivery of a broad range of adult and paediatric BVM devices at increasing tidal volumes using a mechanical lung to simulate spontaneous ventilation. The secondary aim was to evaluate the effect of BVM design on performance. Forty BVM devices were evaluated in a laboratory setting as part of a safety assessment requested by HealthShare New South Wales. The oxygen inlet of each BVM device was primed with 100% oxygen (15 l/min) for two min. The BVM device was then attached to the mechanical lung and commenced spontaneous breathing at a fixed respiratory rate of 12 breaths/min with an inspiratory: expiratory ratio of 1:2. For each device FiO2 was measured after two min of spontaneous breathing. This process was repeated with small (250 ml), medium (500 ml) and large (750 ml) tidal volumes simulating adult breathing in adult BVM devices, and small (150 ml), medium (300 ml) and large (450 ml) tidal volumes simulating paediatric breathing in paediatric BVM devices. The test was repeated using up to five BVM devices of the same model (where supplied) at each tidal volume as a manufacturing quality control measure. Eight of the 40 devices tested failed to deliver a FiO2 above 0.85 for at least one tidal volume, and five models failed to achieve this at any measured tidal volume. Concerningly, three of these devices delivered a FiO2 below 0.55. Six of the eight poorly performing devices delivered reducing concentrations of inspired oxygen with increasing tidal volumes. Devices which performed the worst were those with a duckbill non-rebreather valve and without a dedicated expiratory valve. Several BVM devices available for clinical use in Australia did not deliver sufficient oxygen for reliable pre-oxygenation in a spontaneously breathing in vitro model. Devices with a duckbill non-rebreather valve and without a dedicated expiratory valve performed the worst. It is imperative that clinicians using BVM devices to deliver oxygen to spontaneously breathing patients are aware of the characteristics and limitations of the BVM devices, and that the standards for manufacture are updated to require safe performance in all clinical circumstances. [ABSTRACT FROM AUTHOR]

Rheumatic diseases cover a wide spectrum of conditions, including primary and secondary degenerative joint diseases and autoimmune inflammatory rheumatic diseases. The risks of cardiovascular disease and osteoporosis and resultant fractures in aging female rheumatic disease populations, especially those with autoimmune rheumatic diseases, are increased. Changes in the immune system in aging populations need to be considered especially among patients with autoimmune rheumatic diseases. Immunosenescence is closely aligned to reduced adaptive immunity and increased non-specific innate immunity leading to chronic inflammation of inflammaging. The effective use of disease-modifying antirheumatic drugs to control autoimmune rheumatic diseases may also mitigate factors leading to cardiovascular disease and osteoporosis. Rheumatic diseases, which largely manifest as arthritis, predispose patients to premature joint degeneration and poor bone health and therefore have a higher risk of developing end-stage arthritis requiring joint arthroplasties sooner or more often than other patients without rheumatic disease. [ABSTRACT FROM AUTHOR]

Our divided democracy—characterized by partisan polarization and moralized opposition—presents significant challenges to sociologists who would use our discipline to create a more just society. I focus here on the strategic role of, and need for, deeper engagement across the political divide. I review current research on polarization—increasingly focused on attitudinal consolidation and partisan identity—to emphasize challenges to and opportunities for persuasion. I call for increased engagement in three strategic subfields of sociology: (1) social movements, to integrate persuasion more centrally into theories and research on collective social action; (2) social psychology, to engage the interdisciplinary field of moral cognition to develop effective strategies for persuasion; and (3) rural sociology, to understand more deeply the perspectives and moral frameworks essential to engagement across the divide. [ABSTRACT FROM AUTHOR]

Background: Medical technologies have the potential to improve quality and efficiency of healthcare. The design of clinical trials should consider participants' perspectives to optimise enrolment, engagement and satisfaction. This study aims to assess patients' perceptions of their involvement in medical device trials, to inform the designs of future medical technology implementation and evaluation.Methods: Four focus groups were undertaken with a total of 16 participants who had participated in a study testing hospital inpatient remote monitoring devices. Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis.Results: Four main themes emerged: patients' motivations for participating in medical device research; patients' perceptions of technology in medicine; patients' understanding of trial methodology; and patients' perceptions of the benefits of involvement in medical device trials. The appeal of new technology is a contributing factor to the decision to consent, although concerns remain regarding risks associated with technology in healthcare settings. Perceived benefits of participating in device trials include extra care, social benefits and comradery with other participants seen using the devices, although there is a perceived lack of confidence in using technology amongst older patients.Conclusion: Future device trials should prioritise information sharing with participants both before and after the trial. Verbal and written information alongside practical demonstrations can help to combat a lack of confidence with technology. Randomised trials and those with placebo- or sham-controlled arms should not be considered as barriers to participation. Study results should be disseminated to participants in lay format as soon as possible, subject to participant permission. [ABSTRACT FROM AUTHOR]

This survey was designed to investigate levels of stress, anxiety and depression, and to identify factors exacerbating or relieving stress in anaesthesia trainees within the Australian and New Zealand College of Anaesthetists training scheme. In addition, the survey investigated levels of personal healthcare, some working conditions, and reports of bullying and reported discrimination along with stigmatisation of mental health issues in this cohort. Psychological distress was assessed using the Kessler psychological distress scale (K10). An electronic survey was sent to 1310 randomly selected registrars, and 417 (32%) responses were received. The majority of respondents (67%) reported being satisfied or very satisfied with their job and training. However, 31% had K10 scores indicating high or very high levels of distress. Eleven percent reported being currently on treatment for anxiety and/or depression. Major stressors were examinations, job prospects, critical incidents and fear of making errors. Forty-five percent of respondents reported having experienced bullying during anaesthesia training, 25% discrimination and 7% sexual harassment. Twenty-six percent reported an excessive workload and 21% reported that they felt their workload compromised patient safety. Forty-two percent reported that they would avoid seeking help for anxiety or depression and 50% reported that they thought revealing mental health problems would jeopardise their careers. The results of this survey demonstrate a high incidence of psychological distress, and high levels of bullying and discrimination, as well as stigmatisation of mental ill health among respondents. Appropriate education, a review of assessment tools, effective management of bullying and discrimination, a review of working conditions, and destigmatisation of mental illness appear to be indicated. [ABSTRACT FROM AUTHOR]

Robot-assisted laparoscopic prostatectomy requires a pneumoperitoneum combined with steep Trendelenburg positioning, and these conditions can be associated with impairment of cerebral autoregulation. The objective of this study was to determine if choice of anaesthetic agent affects the preservation of cerebral autoregulation during robot-assisted laparoscopic prostatectomy. We randomly assigned 30 patients to maintenance of general anaesthesia with either propofol or sevoflurane. Cerebral autoregulation was tested by administration of intravenous phenylephrine to increase mean arterial pressure from approximately 80 mmHg to 100 mmHg while assessing cerebral blood flow using transcranial Doppler ultrasonography. Autoregulation was first tested in the supine position and then approximately once every hour after Trendelenburg positioning. The main outcome measure was the result of the final autoregulation test prior to completion of surgery. At that time, we found cerebral autoregulation to be significantly impaired in six of the 15 patients receiving sevoflurane and none of the 15 patients receiving propofol (P = 0.02). However, it should be noted that some patients in the propofol group had impaired autoregulation on earlier tests. In conclusion, we found that autoregulation during robot-assisted laparoscopic prostatectomy is less likely to be impaired with propofol compared to sevoflurane anaesthesia, particularly towards the end of the surgery. [ABSTRACT FROM AUTHOR]

Growing evidence suggests that contrary to popular belief, schools mostly do not generate achievement gaps in cognitive skills but, rather, reflect the inequalities that already exist. In the case of socioeconomic status, exposure to school often reduces gaps. Surprisingly little is known, however, about whether this pattern extends to gender gaps in cognitive skills. We compare how gender gaps in math and reading change when children are in school versus out (in the summer) among over 900,000 U.S. children. We find that girls learn faster than boys when school is out (in both reading and math), but this advantage is completely eliminated when school is in session. Compared to the family environment, schools act as a relatively standardizing institution, producing more similar gendered patterns in learning. [ABSTRACT FROM AUTHOR]

Background Renal transplant patients are at increased risk for mucormycosis. Diabetes, neutropenia, deferoxamine therapy, and immunosuppressive medications have been associated with increased risk of mucormycosis in studies of solid organ transplant recipients. To focus on renal transplant patients, the US Renal Data System (USRDS) was queried to determine the incidence and risk factors for mucormycosis. Methods All renal transplant patients in the USRDS from 1988 to 2015 were queried for a diagnosis of mucormycosis after the first transplant date using ICD-9 and ICD-10 codes. The International Classification of Diseases (ICD) codes, which currently exist in the ninth and tenth revisions, are a global system of classification used to code diagnoses, procedures, and symptoms. We defined proven mucormycosis by a histopathologic or fungal stain procedure code within 7 days of the diagnosis code. Logistic regression controlling for person-years at risk was used to examine demographic and clinical diagnosis risk factors for mucormycosis. Results Of the 306,482 renal transplant patients, 222 (0.07%) had codes consistent with proven mucormycosis. The incidence of mucormycosis increased from 1990 to 2000 (peak 17.6 per 100,000 person-years) and subsequently demonstrated more variability. Hispanic ethnicity (OR=1.45), age 65 years or greater (OR=1.64), other or black race compared with white race (OR=1.96 and 1.74), cadaver or other donor type (OR=2.41), and receiving tacrolimus (OR=2.09) were associated with increased risk. Comorbidities associated with decreased risk of mucormycosis included female sex (OR=0.68), iron overload (OR=0.56), and receiving mycophenolate mofetil (OR=0.67) or azathioprine (OR=0.53).Conclusions In renal transplant patients, age, deceased donor graft transplant, tacrolimus administration, race other than white, and Hispanic ethnicity were associated with increased risk of mucormycosis. Unexpectedly, iron overload was protective. Mucormycosis is a rare infection in renal transplant patients which should be considered in patients with the above risk factors after more common infections have been ruled out. [ABSTRACT FROM AUTHOR]

College students with intellectual and developmental disabilities (IDD) face challenges searching for jobs, often lacking communication and social skills needed during formal interviews. The COVID-19 pandemic complicates interviews, forcing students to search online and attend virtual interviews. This study used a multiple probe design across participants to examine the acquisition of literacy-based behavioral interventions (LBBIs) on virtual job interviews. Using a video conference platform, students answered interview questions from researchers acting as employers. LBBIs were customized, incorporating students' input. Results indicated that LBBIs were effective for teaching and maintaining virtual job interview skills, and across novel employers. The findings have implications for using LBBIs to teach virtual job interview skills to students with IDD, and for researchers including these students in remote instruction. [ABSTRACT FROM AUTHOR]

Background: Historically, there have been many factors that have influenced mumps, measles and rubella (MMR) vaccine uptake, including media bias, social/economic determinants, parental education level, deprivation and concerns over vaccine safety. Readability metrics through online tools are now emerging as a means for healthcare professionals to determine the readability of patient-facing vaccine information. The aim of this study was to examine the readability of patient-facing materials describing MMR vaccination, through employment of nine readability and text parameter metrics, and to compare these with MMR vaccination literature for healthcare professionals and scientific abstracts relating to MMR vaccination. Materials and methods: The subscription-based online Readable program (readable.com) was used to determine nine readability indices using various readability formulae: Established readability metrics (n = 5) (Flesch–Kinkaid Grade Level, Gunning Fog Index, SMOG Index, Flesch Reading Ease and New Dale-Chall Score), as well as Text parameters (n = 4) (sentence count, word count, number of words per sentence, number of syllables per word) with 47 MMR vaccination texts [patient-facing literature (n = 22); healthcare professional–focused literature (n = 8); scientific abstracts (n = 17)]. Results: Patient-facing vaccination literature had a Flesch Reading Ease score of 58.4 and a Flesch–Kincaid Grade Level of 8.1, in comparison with poorer readability scores for healthcare professional literature of 30.7 and 12.6, respectively. MMR scientific abstracts had the poorest readability (24.0 and 14.8, respectively). Sentence structure was also considered, where better readability metrics were correlated with significantly lower number of words per sentence and less syllables per word. Conclusion: Use of these readability tools enables the author to ensure their research is more readable to the lay audience. Patient co-production initiatives would help to ensure that not only can the target audience read the literature, but that they understand the content. Increased patient-centric focus groups would give better insights into reasons for MMR-associated vaccine hesitation and vaccine refusal. [ABSTRACT FROM AUTHOR]

In this article, I evaluate historian of science and technology W. Patrick McCray's 2020 publication Making Art Work: How Cold War Engineers and Artists Forged a New Creative Culture, a historical account of collaborations between artists and engineers in the 'long 1960s.' Positioning McCray's work in a broader discourse around art's postwar entanglements with science and technology (one that has unfolded largely within art history), I work to differentiate McCray's approach to this period's 'art-and-technology movement' and make sense of his historiographic interventions. I discuss McCray's close attention to the engineers and industrial entities involved in art-and-technology collaborations-agents rarely given equal billing with artists in existing histories—and argue that this redistribution of focus both complicates and enriches working understandings of the art-and-technology movement's rise and fall. [ABSTRACT FROM AUTHOR]

Humans have long interacted with animals. Recently, market-based responses to societal challenges, including loneliness and mental well-being include the use of animals. Considerable research concerning consumer–animal relationships has also examined the benefits (micro, meso, and macro) of human-animal interaction and companionship. However, much of this research is fragmented and lacks a broader organizing framework. It also suffers from an anthropomorphic bias, whereby the interests of animals are excluded. To address this, we provide a macromarketing perspective on consumer–animal relations and explore the interdependencies of consumer–animal relationships on consumer, animal, and community well-being. We introduce and apply the Interactive Well-Being framework to four contexts –ranging from private to public consumption spaces– that highlight the interdependencies and systems involved in consumer–animal relationships: (1) co-habitation with animals, (2) emotional support animals, (3) working with animals, and (4) animals in commercial service contexts. We discuss the implications of our framework for the resilience of marketing systems and how the framework aligns with alternative economy development. [ABSTRACT FROM AUTHOR]

The authors describe a case of clinically apparent idiosyncratic hepatotoxicity in association with unfractionated heparin (UFH). A 52-year-old woman with increasingly symptomatic rheumatic mitral valvular disease and severe pulmonary hypertension underwent elective minimally-invasive bioprosthetic mitral valve replacement. The patient received 42 000 units of UFH intraoperatively 10 days after receiving 3100 units during a left heart catheterization. Standard prophylactic doses of unfractionated heparin were started on POD 2 for prevention of venous thromboembolism. On the evening of postoperative day (POD) 3, the patient was lethargic, encephalopathic, and hypoglycemic with an acute liver injury and hyperlactatemia. Similar events occurred on POD 7 after clinical improvement from the initial injury and an unintentional rechallenge with UFH. Heparins are usually not suspected of idiosyncratic hepatotoxicity due to their widespread utilization and reports of milder episodes of hepatotoxicity. This case highlights the need to consider UFH in the differential of drug-induced liver injury, including severe cases. [ABSTRACT FROM AUTHOR]

Respiratory monitoring, using impedance with implanted telemetry in socially housed animals, was not possible until the recent development of digital signal transmission. The objective of this study was to evaluate digital telemetry monitoring of cardiopulmonary parameters (respiratory rate, tidal volume, minute volume, electrocardiography (DII), systemic arterial blood pressure, physical activity, and body temperature) in conscious, single-housed, non-rodent species commonly used in toxicology studies following administration of positive/negative controls (saline, dexmedetomidine, morphine, amphetamine, and doxapram), and also, the effects of various social housing arrangements in untreated female and/or male cynomolgus monkeys, Beagle dogs, and Göttingen minipigs (n = 4 per species). Aggressions were observed in socially housed male minipigs, however, which prevented pair-housed assessments in this species. All tested pharmacological agents significantly altered more than one organ system, highlighting important inter-organ dependencies when analyzing functional endpoints. Stress-related physiological changes were observed with single-housing or pair-housing with a new cage mate in cynomolgus monkeys and Beagle dogs, suggesting that stable social structures are preferable to limit variability, especially around dosing. Concomitant monitoring of cardiovascular and respiratory parameters from the same animals may help reduce the number of animals (3 Rs) needed to fulfill the S7A guidelines and allows for identification of organ system functional correlations. Globally, the data support the use of social housing in non-rodents for safety pharmacology multi-organ system (heart and lungs) monitoring investigations. [ABSTRACT FROM AUTHOR]

While ischemia itself can kill heart muscle, much of the infarction after a transient period of coronary artery occlusion has been found to result from injury during reperfusion. Here we review the role of inflammation and possible pyroptosis in myocardial reperfusion injury. Current evidence suggests pyroptosis's contribution to infarction may be considerable. Pyroptosis occurs when inflammasomes activate caspases that in turn cleave off an N-terminal fragment of gasdermin D. This active fragment makes large pores in the cell membrane thus killing the cell. Inhibition of inflammation enhances cardiac tolerance to ischemia and reperfusion injury. Stimulation of the purinergic P2X7 receptor and the β-adrenergic receptor and activation of nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) by toll-like receptor (TLR) agonists are all known to contribute to ischemia/reperfusion (I/R) cardiac injury through inflammation, potentially by pyroptosis. In contrast, stimulation of the cannabinoid CB2 receptor reduces I/R cardiac injury and inhibits this pathway. MicroRNAs, Akt, the phosphate and tension homology deleted on chromosome 10 protein (PTEN), pyruvate dehydrogenase and sirtuin-1 reportedly modulate inflammation in cardiomyocytes during I/R. Cryopyrin and caspase-1/4 inhibitors are reported to increase cardiac tolerance to ischemic and reperfusion cardiac injury, presumably by suppressing inflammasome-dependent inflammation. The ambiguity surrounding the role of pyroptosis in reperfusion injury arises because caspase-1 also activates cytotoxic interleukins and proteolytically degrades a surprisingly large number of cytosolic enzymes in addition to activating gasdermin D. [ABSTRACT FROM AUTHOR]

Tasked with a greater role in the coproduction of expert services, consumers often face an immense burden in coproducing service and well-being outcomes. While some prior research has explored customer work, we delineate unique aspects of expert services and articulate consumer efforts that transpire outside the dyadic service interaction. Through netnographic inquiry in a health care context, we find that coproduction efforts are job-like and require job crafting efforts. Upon this foundation, three major themes emerged: (1) consumers leverage their context expertise by adapting content expertise to their unique circumstances, (2) consumers develop and deploy strategies (hacks) through affordances in order to manage their coproduction jobs, and (3) consumers move through the expert service journey in a variety of ways that shift them toward or away from well-being outcomes. After assessing the transferability of our results by analyzing a second expert service context (financial services/debt management), we suggest implications for theory, practice, and future research. [ABSTRACT FROM AUTHOR]

How does schooling affect inequality in students' academic skills? Studies comparing children's trajectories during summers and school years provide a provocative way of addressing this question, but the most persuasive seasonal studies (1) focus primarily on skill gaps between social categories (e.g., social class, race/ethnicity), which constitute only a small fraction of overall skill inequality, and (2) are restricted to early grades, making it difficult to know whether the patterns extend into later grades. In this study, we use seasonal comparisons to examine the possibilities that schooling exacerbates, reduces, or reproduces overall skill inequality in math, reading, language use, and science with recent national data on U.S. public school students spanning numerous grade levels from the Northwest Evaluation Association. Our results suggest that schooling has a compensatory effect on inequality in reading, language, and science skills but not math skills. We conclude by discussing the theoretical implications of our findings, possible reasons why the math findings differ from those of other subjects, and discrepant seasonal patterns across national data sets. [ABSTRACT FROM AUTHOR]

Objectives: To report our urethral surveillance programme and urethral cancer recurrence rate following radical cystoprostatectomy (RC). Patients and methods: A retrospective analysis of clinical and histopathological data of men who underwent RC and urethral surveillance, between January 2011 and October 2016. Results: RC was performed for 491 men; 31 and 19 men had a synchronous (malignancy, n = 10, 32.3%) and interval (malignancy, n = 6, 31.6%) urethrectomy, respectively. The remaining 441 men underwent surveillance; 183 (41.5%) men had at least one urethroscopy, 14 (3.2%) urethrectomies were performed and 12 (2.7%) specimens confirmed urethral recurrence (UR). Within the URs, 7/12 (58.3%) men presented symptomatically and 5/12 (41.7%) were detected through surveillance. At a median (interquartile range) follow-up of 21.8 (9.7–36.7) months, the 2-year disease-specific survival in men who had synchronous urethrectomy was 71.4% (versus no urethrectomy (84.6%) interval urethrectomy (92.9%) and urethrectomy for recurrence (83.8%)). Conclusion: UR following RC is low in men without risk factors for urethral disease. Annual urethroscopy and urine cytology may not be feasible and appropriate in all men after RC, and does not appear to impact survival at 2 years. A risk-adapted approach may allow the avoidance of annual urethroscopy in asymptomatic men post RC. Level of Evidence: 3b [ABSTRACT FROM AUTHOR]

VicRK (WalRK or YycFG) is a conserved 2-component regulatory system (TCS) that regulates cell division, cell wall biosynthesis, and homeostasis in low-GC Gram-positive bacteria. VicRK is also associated with biofilm formation of Streptococcus mutans on the tooth surface as it directly regulates the extracellular polysaccharide (EPS) synthesis. Of the 2 components, VicK possesses both autokinase and phosphatase activities, which regulate the phosphorylation and dephosphorylation of the regulator VicR in response to environmental cues. However, the dual mechanism of VicK as the autokinase/phosphatase in regulating S. mutans ' responses is not well elucidated. Previously, it has been shown that the phosphatase activity depends on the PAS domain and residues in the DHp domain of VicK in S. mutans. Specifically, mutating proline at 222 in the PAS domain inhibits VicK phosphatase activity. We generated a VicKP222A mutant to determine the level of VicR-P in the cytoplasm by Phos-tag sodium dodecyl sulfate polyacrylamide gel electrophoresis. We show that in VicKP222A phosphatase, attenuation increased phosphorylated VicR (VicR-P) that downregulated glucosyltransferases, gtfBC, thereby reducing the synthesis of water-insoluble polysaccharides (WIS-EPS) in the biofilm. In addition, VicKP222A presented as long-rod cells, reduced growth, and displayed asymmetrical division. A major adhesin of S. mutans, SpaP was downregulated in VicKP222A, making it unable to agglutinate in saliva. In summary, we have confirmed that VicK phosphatase activity is critical to maintain optimal phosphorylation status of VicR in S. mutans, which is important for cell growth, cell division, EPS synthesis, and bacterial agglutination in saliva. Hence, VicK phosphatase activity may represent a promising target to modulate S. mutans ' pathogenicity. [ABSTRACT FROM AUTHOR]

What role does schooling play in the development of racial/ethnic inequalities in academic skills? Seasonal learning studies, which allow researchers to compare the growth of achievement gaps when school is in versus out of session, provide important evidence regarding whether schools reduce, reproduce, or exacerbate educational inequalities. Most studies that have compared the growth of achievement gaps when school is in versus out of session have been restricted to the early grades. In this study, we examine seasonal patterns of racial/ethnic achievement gaps using test scores from over 2.5 million kindergarten to eighth-grade students. Following three different cohorts of students from 2015 to 2018, we find that Black-White achievement gaps widen during school periods and shrink during summers, whereas Asian students generally pull ahead of White students at a faster rate during summers. At the same time, we find that disparities observed among older students are largely in place among kindergartners. Our results imply that although schooling does have disparate impacts on the learning trajectories of students, schools play less of a role in widening racial/ethnic achievement gaps than children's prekindergarten environments. [ABSTRACT FROM AUTHOR]

Adults with intellectual and developmental disabilities (IDD) often have deficits in interpersonal skills due to limited social-communication opportunities. Knowing how to engage in "small talk" or simple social conversational exchanges can be beneficial in postsecondary schooling, employment sites, community environments, and social gatherings. Recently, covert audio coaching (CAC) showed a positive impact on increasing conversational exchanges. As the COVID-19 pandemic increased the need for remote delivery tools, we explored the effectiveness of remote audio coaching (RAC) to teach this skill to college students with IDD. We used a multiple baseline design across participants to examine whether RAC might increase on-topic, small talk conversational exchanges. Results demonstrated that RAC effectively increased small talk skills between participants and a confederate. Upon removal of RAC, all participants still performed above their baselines, with two participants maintaining near mastery levels 2 weeks after the intervention was removed. Limitations and future research are discussed. [ABSTRACT FROM AUTHOR]

The American Psychological Association has identified information literacy as a crucial component to undergraduate education. One major barrier to comprehensive information literacy instruction has been a lack of guidance integrating this into survey courses, particularly with reduced pedagogical resources available.This research evaluates the effectiveness of a scaffolded information literacy curriculum that may be integrated into psychology courses.Students in introductory psychology courses were taught with either an information literacy curriculum or the typical science-focused curriculum. Information literacy knowledge was evaluated using a multiple-choice test.Students who received the specialized curriculum demonstrated significant improvements on an objective information literacy test by the end of the course, while students in the control group did not.Evidence suggests that this easily adaptable information literacy curriculum is effective in meeting psychology information literacy goals, more so than the traditional science-focused curriculum taught in introductory psychology classes.Instructors and faculty should be encouraged to utilize this adaptive curriculum, available on Open Science Framework, as a way of improving information literacy. Other implications, including feasibility and content, are discussed. [ABSTRACT FROM AUTHOR]

A small subset of education studies analyzes school data collected seasonally (separating the summer from the school year). At first, this work was primarily known for documenting learning loss in the summers, but scholars have since recognized that observing how inequality changes between summer and school periods provides leverage for understanding how schools influence inequality. Results based on this analytic technique confirm current views in some ways, but in other ways the patterns challenge existing wisdom. For example, Black/White gaps in math and reading skills often grow faster when school is in versus out, consistent with the view that schools exacerbate racial inequality. But socioeconomic gaps produce the opposite pattern, suggesting that schools are compensatory across this dimension. In this review, I consider the logic behind seasonal research, the empirical patterns it has produced, and the kinds of new questions it motivates. [ABSTRACT FROM AUTHOR]

Students frequently utilize digital devices and applications to assist studying. Past research has yielded mixed results on their effectiveness, and scant research has compared portable technologies with each other or focused on smartphones specifically. We compared college students' learning of vocabulary on paper, laptop, and smartphone. Students were randomly assigned to one platform for reviewing vocabulary flashcards, and then they completed a memory quiz and answered questions regarding perceptions of these technologies. Results showed equivalency in students' learning across platforms, with the only exception being that students spent longer reviewing paper flashcards. Self-reported cognitive load and satisfaction were equal across platforms. Quantitative and qualitative data also suggested that, though students quickly label both laptops and smartphones as helpful for education, they see more educational value in laptops. This research suggests that smartphones present new ways of learning, but care must be taken with how smartphones are utilized in educational settings. [ABSTRACT FROM AUTHOR]

Introduction: Corrected QT (QTc) interval is an essential proarrhythmic risk biomarker, but recent data have identified limitations to its use. The J to T-peak (JTp) interval is an alternative biomarker for evaluating drug-induced proarrhythmic risk. The aim of this study was to evaluate pharmacological effects using spatial magnitude leads and DII electrocardiogram (ECG) leads and common ECG confounders (ie, stress and body temperature changes) on covariate adjusted QT (QTca), covariate adjusted JTp (JTpca), and covariate adjusted T-peak to T-end (Tpeca) intervals. Methods: Beagle dogs were exposed to body hyper- (42 °C) or hypothermic (33 °C) conditions or were administered epinephrine to assess confounding effects on heart rate corrected QTca, JTpca, and Tpeca intervals. Dofetilide (0.1, 0.3, 1.0 mg/kg), ranolazine (100, 140, 200 mg/kg), and verapamil (7, 15, 30, 43, 62.5 mg/kg) were administered to evaluate pharmacological effects. Results: Covariate adjusted QT (slope −12.57 ms/°C) and JTpca (−14.79 ms/°C) were negatively correlated with body temperature but Tpeca was minimally affected. Epinephrine was associated with QTca and JTpca shortening, which could be related to undercorrection in the presence of tachycardia, while minimal effects were observed for Tpeca. There were no significant ECG change following ranolazine administration. Verapamil decreased QTca and JTpca intervals and increased Tpeca, whereas dofetilide increased QTca and JTpca intervals but had inconsistent effects on Tpeca. Conclusion: Results highlight potential confounders on QTc interval, but also on JTpca and Tpeca intervals in nonclinical studies. These potential confounding effects may be relevant to the interpretation of ECG data obtained from nonclinical drug safety studies with Beagle dogs. [ABSTRACT FROM AUTHOR]

Academic undermatching—students enrolling in colleges that are less academically selective than those for which they qualify—is a barrier hindering college degree attainment. Given the many reasons students undermatch, this phenomenon is likely to continue; yet, we know little about the characteristics that may be related to degree attainment for this population of students. Utilizing the ELS: 2002 national dataset, we developed an operationalization of undermatch and then applied this operationalization to the BPS: 04/09 national dataset (N = 11,260). Using logistic regression methods, we identified institutional and student characteristics that are associated with degree attainment for undermatched students. Starting at a 4-year institution, completing at least precalculus, having at least one parent with a college education, being female, and being socially and academically integrated into the institution were positively associated with degree attainment. Our results emphasize the critical influence of nonacademic factors on degree attainment for undermatched students. [ABSTRACT FROM AUTHOR]

Scholars across the social sciences have shown how economic, social, and political changes are weakening local governments and contributing to rising nonprofit activity in urban politics. But these trends could now add up to a new form of decision-making in some American cities. The convergence of public sector austerity and a burgeoning philanthropic and nonprofit sector have created space for what we call "nonprofit governance." In some cities, nonprofit leaders can guide urban policy, sometimes with limited input from elected officials or citizens. First, we apply insights from studies in comparative politics to demonstrate how nonprofit leadership can expand, particularly in the context of a weak state. Next, we assess trends in public sector capacity, based on local government employment in Midwestern U.S. cities. We closely examine Detroit and Flint due to dramatic declines in local government capacity and recent public sector crises in both cities, focusing on the role of nonprofits in each. These leading-edge cases allow us to trace the development of nonprofit governance and explore different forms of nonprofit and local government relationships. [ABSTRACT FROM AUTHOR]

Researchers have sought to understand why cognitive skill disparities between black and white children persist in American society, but the most thorough examinations study school-aged children during a period when the black/white skill gap is already well established. Using the Early Childhood Longitudinal Study–Birth Cohort of 2001, we find trivial black/white differences in cognitive skills at 10 months of age but large disparities at 24 and 48 months, suggesting that the gap emerges in force between 10 months and age four. Although black/white differences in parenting are a powerful predictor, these variations are driven by socioeconomic and related factors that directly and indirectly shape cognitive development gaps between black and white children. [ABSTRACT FROM AUTHOR]

The recent COVID-19 pandemic has significantly disrupted governance. A strong intergovernmental response is critical for stemming the worst damage during the outset of a disaster. Collaborative planning with networks of constituent governments, medical experts, and emergency managers are needed to provide a holistic response to the highly technical and complex issues brought on by the novel coronavirus. This commentary highlights the differences in response by the United States and Australia, provides a comparison of intergovernmental relationships, and sheds light on how these federations vertical and horizontal collaborative efforts were stymied by politics or facilitated by existing intergovernmental forums. [ABSTRACT FROM AUTHOR]