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Introduction Methods Consumer and Community Involvement Results Conclusion The Sensory Processing Measure 2 (SPM2) and the Sensory Profile 2 (SP2) are two sensory processing scales often used by occupational therapists. The SPM2 and SP2 both claim to assess aspects of children's sensory processing. This cross‐sectional study examined the convergent validity of the SPM2‐Home Form (SPM2‐HF) and Child SP2 for school‐aged neurotypical children.Thirty parents/caregivers of neurotypical children aged 7 to 12 completed the SPM2‐HF and the Child SP2 about their child. Spearman rho's correlation coefficient with bootstrapping was used to investigate the correlations among the sensory, behavioural, and quadrant scores of the Child SP2 and SPM2‐HF subscale scores.Given the topic, consumers and community members were not involved in the design, execution, or write up of the study results.Several statistically significant correlations were found between the sensory and quadrant subscales of the Child SP2 with the SPM‐HF. Strong to moderate correlations were established between the sensory subscales of the Child SP2 and the SPM2‐HF, ranging from 0.40 to 0.74 (p < 0.05). Additionally, correlations between the quadrant subscales of the Child SP2 and the subscales of the SPM2‐HF ranged from weak (0.38) to strong (0.77) correlations (p < 0.05).These results provide evidence of convergent validity between the SPM2‐HF and Child SP2 for neurotypical school‐aged children. Further research on the psychometric properties of the SPM2‐HF and Child SP2 is recommended. [ABSTRACT FROM AUTHOR]

This study evaluated the impact of different food residues on the recovery of Listeria monocytogenes and Salmonella Typhimurium from stainless steel surfaces. Food residues tested include lettuce rinsate, blended lettuce, low-fat milk, and whole milk for Listeria monocytogenes, and powdered infant formula, all-purpose flour, and whole milk dairy powder for Salmonella Typhimurium. Bacterial suspensions were inoculated on stainless steel surfaces with or without food residues and held for different time periods. Significant differences (P < 0.0001) in Salmonella Typhimurium recovery were observed between the no food residue control and all food residues over 24 hours. For Listeria monocytogenes, minimal variability in recovery was observed among food residue types, with significant differences from the no food residue control (P < 0.05) observed after 24 hours. The study also found that surface sampling can spread Listeria monocytogenes and Salmonella Typhimurium on stainless steel surfaces, suggesting that food residue type may affect microbial recovery during environmental monitoring. [ABSTRACT FROM AUTHOR]

Training in infant observation, highly valuable in the infant mental health (IMH) field, has an enormous amount to offer family therapists. These two fields of practice, both hold working with the relational world of their clients as central. As two senior family therapists who are also IMH practitioners, we invite those reading this paper to explore the possibilities inherent in undertaking infant observation training as a pathway to enriching and expanding their practice. We provide an overview of infant observation training, how this approach was conceived, and explore the benefits of honouring the subjectivity of the infant, that of bringing the infant's experience alive in the therapeutic space. We provide direct examples from our own practice. We conclude with how infant observation might be incorporated into family therapy training and practice. [ABSTRACT FROM AUTHOR]

This article considers discussions of sexual difference in a range of popular prescriptive texts published between 1920 and 1940 in order to explore the relationship between science and American marital advice literature. It demonstrates the particular role science played in shaping, legitimising and enforcing changing discussions about what 'good sex' should look like in contemporary advice – supporting a hierarchy of sexual activities and desires that privileged a particular version of marital heterosexual expression. Through this, it also interrogates the 'popular' version of sexual science being consumed by the American public at this time. In addition to adding new perspectives to our understanding of contemporary advice and its relationship with science and medicine, it will also act as a provocation for further research into the ways the public engaged with sexual science in early twentieth‐century America. [ABSTRACT FROM AUTHOR]

The gold standard for facioscapulohumeral muscular dystrophy (FSHD) genetic diagnostic procedures was published in 2012. With the increasing complexity of the genetics of FSHD1 and 2, the increase of genetic testing centers, and the start of clinical trials for FSHD, it is crucial to provide an update on our knowledge of the genetic features of the FSHD loci and renew the international consensus on the molecular testing recommendations. To this end, members of the FSHD European Trial Network summarized the evidence presented during the 2022 ENMC meeting on Genetic diagnosis, clinical outcome measures, and biomarkers. The working group additionally invited genetic and clinical experts from the USA, India, Japan, Australia, South‐Africa, and Brazil to provide a global perspective. Six virtual meetings were organized to reach consensus on the minimal requirements for genetic confirmation of FSHD1 and FSHD2. Here, we present the clinical and genetic features of FSHD, specific features of FSHD1 and FSHD2, pros and cons of established and new technologies (Southern blot in combination with either linear or pulsed‐field gel electrophoresis, molecular combing, optical genome mapping, FSHD2 methylation analysis and FSHD2 genotyping), the possibilities and challenges of prenatal testing, including pre‐implantation genetic testing, and the minimal requirements and recommendations for genetic confirmation of FSHD1 and FSHD2. This consensus is expected to contribute to current clinical management and trial‐readiness for FSHD. [ABSTRACT FROM AUTHOR]

In this issue, Schroder I et al. i assess the impacts of mechanical strain and salt on macrophage inflammatory responses I in vitro i . Schröder et al.1 show that both tensile and compressive strain increase TNF and IL-6 production from macrophages, whereas only compression increases levels of secreted PGE2. Broadly, NFAT5 appears to positively regulate TNF and PGE SB 2 sb production in macrophages, whereas it suppresses IL-6 expression. Intriguingly, gene silencing studies suggested a role for NFAT5 in pressure-induced IL-6 production, whereas it inhibited basal IL-6 expression and contributed to the repressive effect of salt on pressure-induced IL-6 production. [Extracted from the article]

As pharmacokinetic modifiers, cell penetrating peptides (CPPs) have proven utility for the delivery of otherwise impermeable cargoes into the discrete intracellular compartments of eukaryotic cells. Methods for the molecular optimisation of CPP sequences can significantly increase the performance of novel vectors matched to a specific delivery function. Moreover, the 'information rich' composition and inherent molecular flexibility of many CPPs can also facilitate their interaction with intracellular proteins and other cellular structures. This proteomimetic property of CPPs has been exploited in the design of bioportides, bioactive CPPs that regulate cellular functions often by binding relatively flat PPI interfaces to achieve a dominant negative action. This new biology of CPPs is rapidly gathering momentum through the design and synthesis of a bewildering variety of peptides that may be, in whole or part, linear, helical, cyclic and/or chimeric in nature. A particular emphasis of contemporary CPP‐centred drug discovery is the unmet medical need of cancer, though the biomedical scope of bioportide applications is impressively broad including cellular signalling and reprogramming. We are hopeful that one or more of the fascinating studies described herein will translate into the clinic to establish bioportide technologies as a viable option for drug discovery. [ABSTRACT FROM AUTHOR]

This chapter explores "haunting" as a way to conceptualize and engage with the traumatic events of the United States Federal Indian Boarding School era. The goal is to create an intersectional and intersubjective approach that does not seek singular explanations, but leaves room for diversity of memory—a core principle in feminist indigenous theory. Bringing together archaeological, archival, and oral data, we tell three stories of perseverance that have come to light from community‐based heritage work. In this manner, archaeology has the power to facilitate community healing and decolonize women's experiences at the Mount Pleasant Indian Industrial Boarding School. [ABSTRACT FROM AUTHOR]

The general utility of the planarian Schmidtea mediterranea, an organism with remarkable regenerative capacity, was investigated as a convenient three‐dimensional model to analyse the import of cell‐penetrating peptides (CPPs) and bioportides (bioactive CPPs) into complex tissues. The unpigmented planarian blastema, 3 days post head amputation, is a robust platform to assess the penetration of red‐fluorescent CPPs into epithelial cells and deeper tissues. Three planarian proteins, Ovo, ZicA and Djeya, which collectively control head remodelling and eye regeneration following decapitation, are a convenient source of novel cationic CPP vectors. One example, Djeya1 (RKLAFRYRRIKELYNSYR), is a particularly efficient and seemingly inert CPP vector that could be further developed to assist the delivery of bioactive payloads across the plasma membrane of eukaryotic cells. Eye regeneration, following head amputation, was utilized in an effort to identify bioportides capable of influencing stem cell‐dependent morphogenesis. These investigations identified the tetradecapeptide mastoparan (INLKALAALAKKIL) as a bioportide able to influence the gross morphology of head development. We conclude that, compared with cellular monolayers, the S. mediterranea system provides many advantages and will support the identification of bioportides able to selectively modify the biology of totipotent neoblasts and, presumably, other mammalian stem cell types. [ABSTRACT FROM AUTHOR]

Objective There has been growing interest in the use of cognitive analytic therapy ( CAT) with those facing experiences of psychosis. However, there is little research on how CAT is best applied to working with psychosis. This study aimed to identify what the key aspects of CAT for psychosis are or whether this approach requires adaptation when applied to those with experiences of psychosis, drawing on expert opinion. Method An adapted Delphi methodology was used. Items were generated during an initial workshop ( N = 24) and then rated for agreement or importance via an online survey by a sample of experts with experience of CAT and working clinically with psychosis ( N = 14). Results Following two rounds of ratings, consensus was reached on most items. Additional comments emphasized the need to be flexible with regard to the varying needs of individual clients. Conclusions Results highlight the specific relational understanding of psychosis provided by CAT as one of the key elements of this approach. Responses emphasized the need for some level of adaptation to work with psychosis, including greater flexibility with regard to the treatment frame. Practitioner Points When working with experiences of psychosis, aspects of the CAT model, such as session length, pacing, and duration of therapy, are open to change and may require modification., When working with experiences of psychosis, narrative reformulation letters and sequential diagrammatic reformulation (SDR) remain essential to the therapy., This Delphi methodology study essentially relies on opinion. Further empirical research could test assumptions about the most important or therapeutically effective components of CAT in psychosis., CAT is still not widely used in the context of psychosis limiting the pool of experts available for the current sample. [ABSTRACT FROM AUTHOR]

Objectives To explore clients' experience of the therapy process in motivational interviewing ( MI) for alcohol abuse. Design A qualitative study using grounded theory. Methods Interviews with nine clients were conducted using interpersonal process recall ( IPR), a methodology which utilizes a video recording as a cue to aid memory recall. Clients watched a videotape of their MI session and were asked to identify and describe the important moments in the therapy session. The transcribed interviews were then analysed using grounded theory. Results A single session of MI is seen by the clients in this study as a complex interpersonal interaction between client and therapist, which impacts on the client's cognitive and affective intrapersonal processes. Conclusions The themes which emerged partly confirm processes of MI previously hypothesized to be important, but also highlight the importance of factors common to all therapeutic approaches. Practitioner points The aspects of therapy which clients in this study felt were important are similar to those hypothesized to underlie the effectiveness of MI, including a non-confrontational approach, affirmation, and developing discrepancies between beliefs and behaviour., These were embedded in aspects common to all therapies, including the qualities of the therapist and the therapeutic relationship., Client's perspectives on therapeutic processes are an important area of research, and IPR is a particularly suitable method. [ABSTRACT FROM AUTHOR]

In the light of recent quantitative data showing a correlation between pregnancy loss (miscarriage or stillbirth) and symptoms of depression and trauma, three theories are explored in relation to miscarriage and stillbirth. Winnicott's primary maternal preoccupation, a 'special psychiatric condition' in which the pregnant woman identifies with her baby, highlights the crisis a woman faces when the baby with whom she is preoccupied and identified dies; the process of grief according to Bowlby and Parkes helps trace the difficult path a woman treads in mourning a miscarriage; and Klein's theory of mourning describes the internal landscape of depression. Published narratives of personal experience are linked with quantified research into miscarriage and mental health, and psychoanalytic case studies are used to trace connections into infancy and childhood, including one clinical vignette from the author's own practice. Experiences of isolation are explored, and also the sometimes unbridgeable gap between the need for support and what is actually available. The possibility of childhood trauma being re-evoked is discussed, and different kinds of identification with the dead baby are presented in the case studies, alongside a resume of Klein's theory of mourning in which there is a 'dread of harbouring dying or dead objects (especially the parents) inside one, and an identification of the ego with objects in this condition' (1935, p. 150), and where the introjection of the maternal object 'miscarries, and the consequence is illness' (1935, p. 146). [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives There is evidence that health and well-being of the National Health Service ( NHS) workforce affects organizational and patient outcomes. A Cochrane review of the effectiveness of clinical audit to improve quality of care has shown great variation between studies, depending on the design and intensity of support offered. This study evaluates the effectiveness of an organizational audit methodology with (1) action-planning workshops and follow-up and (2) audit feedback alone, to support the implementation of the National Institute for Health and Care Excellence ( NICE) workplace guidance. Methods Two rounds of audit using a self-administered online questionnaire were conducted. An overall implementation score was devised for each trust. Following round 1, interviews were conducted with a cohort of trusts with high scores. The interviews used a theory-based framework to identify predictors of and barriers to successful implementation. From this, the content for action-planning workshops was devised and workshops held with lower scoring trusts. The remaining trusts received only written feedback on their audit results. Changes in the implementation score between rounds 1 and 2 were compared within and between cohorts. Results The median improvement in scores between rounds 1 and 2 was statistically significant except where baseline score was high. The improvement for trusts who received workshops was very much better than those who did not ( P < 0.001). This difference remained after adjustment using stratification by baseline score ( P = 0.001). Conclusions Audit, combined with action-planning workshops and follow-up, appears to be more effective in improving implementation of NICE workplace health and well-being guidance than audit with feedback alone. [ABSTRACT FROM AUTHOR]

Key points A correlation was found between in vivo umbilical artery Doppler velocimetry and resistance to fetal-side flow in the human ex vivo dually perfused placenta, highlighting that the fetoplacental vascular bed is a key site of resistance to umbilico-placental flow in pregnancy., We discovered high resistance and poor flow-mediated vasodilatory responses in placentas from pregnancies associated with fetal growth restriction (FGR)., Endothelial cells isolated from the FGR placentas and grown in static and flow culture showed a dysregulated phenotype, with biochemical signalling demonstrating a failed compensatory response to high blood-flow resistance., Abstract Increased vascular resistance and reduced fetoplacental blood flow are putative aetiologies in the pathogenesis of fetal growth restriction (FGR); however, the regulating sites and mechanisms remain unclear. We hypothesised that placental vessels dictate fetoplacental resistance and in FGR exhibit endothelial dysfunction and reduced flow-mediated vasodilatation (FMVD). Resistance was measured in normal pregnancies ( n = 10) and FGR ( n = 10) both in vivo by umbilical artery Doppler velocimetry and ex vivo by dual placental perfusion. Ex vivo FMVD is the reduction in fetal-side inflow hydrostatic pressure (FIHP) following increased flow rate. Results demonstrated a significant correlation between vascular resistance measured in vivo and ex vivo in normal pregnancy, but not in FGR. In perfused FGR placentas, vascular resistance was significantly elevated compared to normal placentas (58 ± 7.7 mmHg and 36.8 ± 4.5 mmHg, respectively; 8 ml min−1; means ± SEM; P < 0.0001) and FMVD was severely reduced (3.9 ± 1.3% and 9.1 ± 1.2%, respectively). In normal pregnancies only, the highest level of ex vivo FMVD was associated with the lowest in vivo resistance. Inhibition of NO synthesis during perfusion (100 μ m l-NNA) moderately elevated FIHP in the normal group, but substantially in the FGR group. Human placenta artery endothelial cells from FGR groups exhibited increased shear stress-induced NO generation, iNOS expression and eNOS expression compared with normal groups. In conclusion, fetoplacental resistance is determined by placental vessels, and is increased in FGR. The latter also exhibit reduced FMVD, but with a partial compensatory increased NO generation capacity. The data support our hypothesis, which highlights the importance of FMVD regulation in normal and dysfunctional placentation. [ABSTRACT FROM AUTHOR]

Health-related quality of life measures have become an important tool in measuring clinical outcomes. Disease-specific health-related quality of life scales, particularly in diseases that might fluctuate, can draw attention to non-motor symptoms and guide symptom management. The following review provides an overview of quality of life ( QOL) with a focus of disease-specific QOL measures for myasthenia gravis. We also review the current understanding of non-motor symptoms in myasthenia gravis and suggest that QOL measures might be a useful way of accounting for these symptoms. After reading the review, the reader will have a better understanding of QOL measures and how they can be used for patient care and clinical research. [ABSTRACT FROM AUTHOR]

Climate change may create risks that, without sufficient adaptation measures in place, endanger lives and damage natural, semi-natural and designed landscapes. This article explores the use of green infrastructure in climate change adaptation in London. A review of the current literature identifies how and where green infrastructure can deliver climate adaptation services and considers the benefits of taking a green infrastructure (or ecosystems services) approach to development. Selected examples are used to demonstrate how green infrastructure is being integrated into London's urban landscape. The article considers how existing mechanisms are facilitating the growth of green infrastructure in the capital and identifies three key focus areas for future research and policy. It concludes by suggesting that a more collaborative and imaginative approach to optimising the potential for green infrastructure benefits is needed. [ABSTRACT FROM AUTHOR]

An idealized scenario of extratropical transition ( ET) is investigated, in which a tropical cyclone interacts with a high-amplitude, upper-level wave pattern and well-developed surface cyclones. Early during the interaction, the external forcing of the upper-level wave by the ET system is quantified based on a metric for the waviness of the midlatitude flow. Local amplification of the wave pattern is diagnosed, associated prominently with the trough downstream of ET. This amplified trough, however, exhibits pronounced anticyclonic breaking and thus, in contrast to many previous ET studies, it is not clear that the amplification of the upper-level wave propagates into the farther downstream region. Subsequently, the ET system merges with the upstream cyclone. The upstream trough undergoes strong deformation and cyclonic breaking associated with straining due to the cyclonic circulation of the ET system. With the decay of this trough, the ET system weakens considerably and the upper-level wave pattern changes locally to a zonal flow orientation. This zonal flow pattern then extends into the downstream region and promotes the decay of the downstream baroclinic systems. As in previous studies, the evolution of ET exhibits large sensitivity to the initial location of the tropical cyclone. Examining the steering flow's topology, i.e. identifying the stagnation points and the streamlines emanating from these points, helps to identify three different regimes: a no- ET regime and two ET regimes reminiscent of the northwest and northeast patterns, respectively, introduced previously by Harr et al.. A stagnation point located on the axis of the upstream trough governs the bifurcation into no- ET and ET regimes. A stagnation point located on the axis of the downstream ridge governs the bifurcation into northwest and northeast patterns. [ABSTRACT FROM AUTHOR]

Extratropical transition (ET) of a tropical cyclone (TC) can modify the midlatitude flow and thus have implications for the weather and predictability in downstream regions such as North America or Europe. Albeit recurving and undergoing ET, the downstream impact of Typhoon Jangmi in September 2008 during the THORPEX Pacific Asian Regional Campaign (T-PARC) was weak. In this study, we explore the physical processes inhibiting the reintensification of Jangmi and governing the forecast uncertainty during ET. The focus is on the relative contribution of the TC and the midlatitude flow. Quasi-geostrophic diagnostics reveal that Jangmi is located south of and in phase with a midlatitude trough. Jangmi does not couple with the region favourable for reintensification ahead of the trough and subsequently decays. Instead, a weak frontal wave-like cyclone develops. The role of the phasing of Typhoon Jangmi and the midlatitude Rossby wave pattern is tested in sensitivity experiments with the COSMO model in which Jangmi has been relocated. The simulations reveal two contrasting groups of scenarios. The first group reflects the weak actual ET and subsequent decay accompanied by a broad ridge over the Pacific. The second group is characterized by a strong ET with extratropical reintensification, the triggering of a pronounced Rossby wave train and downstream cyclogenesis. The displacement of Jangmi's initial position in the two contrasting groups is less than 1.25° (130 km). In the frame moving with the environmental background flow a critical bifurcation point for the track of Jangmi exists. The relative position to this bifurcation point determines whether Jangmi decays or reintensifies and triggers a Rossby wave train. A simple discrimination parameter is derived that allows for classifying the scenarios. The observed behaviour gives a simple explanation for the reduced predictability of the track and of the midlatitude flow in downstream regions during ET. [ABSTRACT FROM AUTHOR]

This study identifies the key physical process that governs the direct impact of the extratropical transition (ET) of Typhoon Jangmi on the midlatitude flow in September 2008. Jangmi was the strongest tropical cyclone (TC) in the western North Pacific in 2008 and occurred during the THORPEX Pacific Asian Regional Campaign (T-PARC). A distinct outflow-jet interaction resulted in ridgebuilding directly downstream of the ET system and a strongly accelerated upper-level jet streak over Japan. A combination of model and observational data is used to investigate the interaction of the transforming TC with the midlatitude flow and a potential vorticity (PV) surgery technique based on PV inversion is developed to further quantify the contribution of the TC to the modification of the midlatitude flow during ET. The joint interaction of the TC circulation with the midlatitude baroclinic zone and of the TC outflow with the upper-level jet is found to be responsible for a substantial diabatically enhanced vertical transport of lower tropospheric air that arrives at jet level with nearly zero PV. This process explains the ridgebuilding and evolution of the jet streak to the northeast of the ET system. The quantification of Jangmi's role in the outflow-jet interaction revealed the diabatic reduction and isentropic transport of upper-tropospheric PV into the jet region as the key physical process responsible for the direct impact of ET. This is manifested in a ridgebuilding with upper-level PV being 6 PVU lower and a midlatitude jet streak being at least 25 m s−1 faster in the presence of Jangmi. The study corroborates the crucial role that ET has on the modification of the midlatitude flow directly downstream of a transforming TC. The remote, downstream impact of the ET of Jangmi is investigated in a companion paper. [ABSTRACT FROM AUTHOR]

Autophagy is a cellular mechanism for the sequestration and degradation of intracellular pathogens and compromised organelles, particularly damaged mitochondria. Autophagy also clears other cellular components, such as inflammasomes and cytokines, thus providing an important means of regulating inflammation. Defects in autophagy have been found by genetic association studies to confer susceptibility to several autoimmune and inflammatory disorders, particularly inflammatory bowel disease. Thus, the manipulation of autophagy in disease situations is of growing interest for therapeutic targeting; however, the involvement of autophagy in cellular homoeostasis, in normal immune function and in inflammation is manifold. An appreciation of the intricacies of the contributions of this process to inflammation, and how these are altered by various immune and environmental stimuli, is essential for the understanding and interpretation of studies of inflammation and the design of therapeutics exploiting the manipulation of autophagy. This review focuses on the known roles of autophagy in the induction and maintenance of inflammation and on its role in the aetiology and regulation of inflammatory and autoimmune disorders. [ABSTRACT FROM AUTHOR]

The study of literature is changing in dramatic ways, stimulated by new opportunities that digital technology presents. Data visualization upends the dynamic for literary analysis, focusing not on questions stemming from a critic's personal viewpoint but on revealing and displaying connections between elements of the literary experience. The dominant association between critic and text is downplayed, replaced with associations within the text and between it and its context. The basis of interpretation shifts from reading to seeing, from qualitative analysis to quantitative. The reader's role is transformed, as well, from following the critic's path of thinking to actively exploring a network of multisensory and interdisciplinary information. The distinction between the authoritative presenter/critic and the learner/explorer is blurred. By inviting literary scholars to ask different questions for computational analysis, digital technology and visualization inspire innovative investigations and enable new insights. [ABSTRACT FROM AUTHOR]

ADP is considered a weak platelet agonist due to the limited aggregation responses it induces in vitro at physiological concentrations of extracellular Ca [(Ca)]. Lowering [Ca] paradoxically enhances ADP-evoked aggregation, an effect that has been attributed to enhanced thromboxane A production. This study examined the role of ectonucleotidases in the [Ca]-dependence of platelet activation. Reducing [Ca] from millimolar to micromolar levels converted ADP (10 μmol/l)-evoked platelet aggregation from a transient to a sustained response in both platelet-rich plasma and washed suspensions. Blocking thromboxane A production with aspirin had no effect on this [Ca]-dependence. Prevention of ADP degradation abolished the differences between low and physiological [Ca] resulting in a robust and sustained aggregation in both conditions. Measurements of extracellular ADP revealed reduced degradation in both plasma and apyrase-containing saline at micromolar compared to millimolar [Ca]. As reported previously, thromboxane A generation was enhanced at low [Ca], however this was independent of ectonucleotidase activity P2Y receptor antagonists cangrelor and MRS2179 demonstrated the necessity of P2Y receptors for sustained ADP-evoked aggregation, with a minor role for P2Y. In conclusion, Ca-dependent ectonucleotidase activity is a major factor determining the extent of platelet aggregation to ADP and must be controlled for in studies of P2Y receptor activation. [ABSTRACT FROM AUTHOR]

The goal of this paper is both modest and ambitious. The modest goal is to show that intercountry adoption should be considered by ethicists and healthcare providers. The more ambitious goal is to introduce the many ethical issues that intercountry adoption raises. Intercountry adoption is an alternative to medical, assisted reproduction option such as in vitro fertilization (IVF), intracytoplasmic sperm injection, third party egg and sperm donation and surrogacy. Health care providers working with assisted reproduction are in a unique position to introduce their clients to intercountry adoption; however, providers should only do so if intercountry adoption is ethically equal or superior to the alternatives. This paper first presents a brief history of intercountry adoption. The second section compares intercountry adoption with medical alternatives. The third section examines the unique ethical challenges that are not shared by other medical alternatives. The final section concludes that it is simplistic for a healthcare provider to promote intercountry adoption unconditionally; however, in situation where intercountry adoption is practiced conscientiously it poses no greater ethical concern than several medical alternatives. This conclusion is preliminary and is intended as a start for further discussion. [ABSTRACT FROM AUTHOR]

A delayed rectifier voltage-gated K+ channel (Kv) represents the largest ionic conductance of platelets and megakaryocytes, but is undefined at the molecular level. Quantitative RT-PCR of all known Kv α and ancillary subunits showed that only Kv1.3 ( KCNA3) is substantially expressed in human platelets. Furthermore, megakaryocytes from Kv1.3−/− mice or from wild-type mice exposed to the Kv1.3 blocker margatoxin completely lacked Kv currents and displayed substantially depolarised resting membrane potentials. In human platelets, margatoxin reduced the P2X1- and thromboxaneA2 receptor-evoked [Ca2+]i increases and delayed the onset of store-operated Ca2+ influx. Megakaryocyte development was normal in Kv1.3−/− mice, but the platelet count was increased, consistent with a role of Kv1.3 in apoptosis or decreased platelet activation. We conclude that Kv1.3 forms the Kv channel of the platelet and megakaryocyte, which sets the resting membrane potential, regulates agonist-evoked Ca2+ increases and influences circulating platelet numbers. [ABSTRACT FROM AUTHOR]

The article discusses the history of the involvement of the Anglican church in the ecumenical movement. It cites that the advocacy of the Anglicans to work for Christian unity dates back even before the Edinburgh World Missionary Conference of 1910. It presents the Lambeth Conferences that produced several resolutions, particularly "The Chicago-Lambeth Quadrilateral," that deal with efforts toward Christian unity.

Introduction There is a lack of assessment tools and empirical data concerning clinician attitudes and behaviors with respect to the health care of older adults with schizophrenia. We develop a survey instrument of physician attitudes, behavior, and inter-office communication, and provide preliminary data on physician-related issues in the provision of health care to this population. Methods A semi-structured 20-item survey instrument was administered to a stratified convenience sample of 24 primary care physicians (PCPs) and 27 psychiatrists working in the New York metropolitan area. Using open ended and multiple choice items, scales, summed scores, and case vignettes, we assessed attitudes, experiences, and procedures in treating medical illnesses in older persons with schizophrenia. All scales had internal consistency reliabilities of >0.70. Results There were no differences between PCPs and psychiatrists in reported and anticipated behavior towards older adults with symptoms of schizophrenia, and both groups displayed favorable views. However, both groups had slightly negative stereotypes and attitudes concerning these patients. PCPs reported receiving information from psychiatrists slightly more than 0 to 10 percent of the time. Conclusions Our preliminary findings indicated more favorable attitudes and behaviors by PCPs than had been anticipated based on earlier research with younger patients. The data suggest that the failure of older schizophrenia patients to receive adequate treatment may not be due primarily to clinicians' negative attitudes and behaviors, and that problems with communication may play a more important role. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This article is concerned with the experience of infants who endure long hospitalisations. It explores the concept of the baby as subject: that is, infants as active, psychic participants in their earliest relationships. It explores therapeutic possibilities with hospitalised infants from an infant mental health perspective. It advocates for family therapists to equip themselves for infant-parent therapeutic work. [ABSTRACT FROM AUTHOR]

Kinetic and thermodynamic (formal potential) data relating to the synthetically useful Li/Li+ couple in tetrahydrofuran (THF) solvent at a range of temperatures (196–295 K) are reported. Formal potentials, $E_{\rm f}^{\rm 0} $ have been measured versus the standard reference electrode, ${\rm Fc}\left( {4\,{\rm mM}} \right)/{\rm Fc}^ + {\rm PF}_6^ - \left( {4\,{\rm mM})} \right)$ in THF. At 295 K the following data have been obtained using a mathematical model to simulate the electro-deposition (metal deposition and growth kinetics) processes of lithium (Li) on a platinum microelectrode; a $E_{\rm f}^0 $ of -3.48 ± 0.005 V, ${\rm d}E_{\rm f}^0 /{\rm d}T$ = -9.2 (±0.5) × 10-4 V K-1, the standard electrochemical rate constant, k0 = 1 (± 0.1) × 10-4 cm s-1, transfer coefficient, α = 0.57 ± 0.03 and diffusion coefficient, D = 8.7 ± 0.1 × 10-6 cm2 s-1. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Despite the rapid growth of research on neighborhood influences on children, little of this research may be useful to prevention scientists. Most studies have ignored processes by which neighborhood conditions influence individual outcomes. To encourage neighborhood research that can better guide the development of preventive interventions, we propose a model that focuses attention on mediating and moderating processes, is appropriate for studies interested in individual differences in outcomes, acknowledges the transactions between residents and neighborhoods, and is sensitive to how neighborhood influences may differ for children at different developmental stages. Furthermore, we argue that greater attention to several methodological issues also can make neighborhood research more useful for the next generation of prevention programs to help low-income urban families and children cope successfully with the challenges posed by their neighborhoods. [ABSTRACT FROM AUTHOR]

Objectives: Chronic lung disease is a recognized complication in children with HIV. Acute respiratory exacerbations (ARE) are common among this group and cause significant morbidity. Exhaled nitric oxide (eNO) is a known marker of local airway inflammation. We investigated the association between eNO and ARE, biomarkers of systemic inflammation, and the effect of azithromycin on eNO levels. Methods: Individuals aged 6–19 years with HIV‐associated chronic lung disease in Harare, Zimbabwe, were enrolled in a placebo‐controlled randomized trial investigating the effect of 48‐week azithromycin treatment on lung function and ARE. eNO levels and biomarkers were measured at inclusion and after treatment in a consecutively enrolled subset of participants. Linear regression and generalized linear models were used to study associations between eNO and ARE, biomarkers, and the effect of azithromycin on eNO levels. Results: In total, 172 participants were included in this sub‐study, 86 from the placebo group and 86 from the azithromycin group. Participants experiencing at least one ARE during follow‐up had significantly higher eNO levels at baseline than participants who did not (geometric mean ratio 1.13, 95% confidence interval [CI] 1.03–1.24, p = 0.015), adjusted for trial arm, age, sex and history of tuberculosis. Matrix metalloproteinase (MMP)‐3, ‐7, and ‐10 were significantly associated with higher baseline eNO levels. At 48 weeks, azithromycin treatment did not affect eNO levels (geometric mean ratio 0.86, 95% CI 0.72–1.03, p = 0.103). Conclusion: Higher baseline eNO levels were a risk factor for ARE. eNO was associated with proinflammatory biomarkers previously found to contribute to the development of chronic lung disease. The potential use of eNO as a marker of inflammation and risk factor for ARE in HIV‐associated chronic lung disease needs further investigation. [ABSTRACT FROM AUTHOR]

The article describes the assessment of the technique of palpation, which is used for manual assessment of skin temperature by a group of medical students from the University of Nottingham Medical School in England and the issue of evidence-based medicine. Of the 209 respondents, 61 per cent preferred to use the back of the hand to test skin temperature. The author explains the important role of medical students and doctors in meeting the demands of a modern evidence-based profession.

Chlorophyll is the major light‐absorbing pigment for plant photosynthesis. While evolution has been selected for high chlorophyll content in leaves, previous work suggests that domesticated crops grown in modern high‐density agricultural environments overinvest in chlorophyll production, thereby lowering light use and nitrogen use efficiency. To investigate the potential benefits of reducing chlorophyll levels, we created ethanol‐inducible RNAi tobacco mutants that suppress Mg‐chelatase subunit I (CHLI) with small RNA within 3 h of induction and reduce chlorophyll within 5 days in field conditions. We initiated chlorophyll reduction later in plant development to avoid the highly sensitive seedling stage and to allow young plants to have full green leaves to maximise light interception before canopy formation. This study demonstrated that leaf chlorophyll reduction >60% during seed‐filling stages increased tobacco seed nitrogen concentration by as much as 17% while canopy photosynthesis, biomass and seed yields were maintained. These results indicate that time‐specific reduction of chlorophyll could be a novel strategy that decouples the inverse relationship between yield and seed nitrogen by utilising saved nitrogen from the reduction of chlorophyll while maintaining full carbon assimilation capacity. Summary statement: Reducing chlorophyll levels in tobacco plants during seed filling stages, without compromising canopy carbon assimilation, increased seed nitrogen concentration by up to 17%, suggesting a potential strategy to improve yield and seed nitrogen content simultaneously. [ABSTRACT FROM AUTHOR]

High‐throughput phenotyping (HTP) with unoccupied aerial systems (UAS), consisting of unoccupied aerial vehicles (UAV; or drones) and sensor(s), is an increasingly promising tool for plant breeders and researchers. Enthusiasm and opportunities from this technology for plant breeding are similar to the emergence of genomic tools ∼30 years ago, and genomic selection more recently. Unlike genomic tools, HTP provides a variety of strategies in implementation and utilization that generate big data on the dynamic nature of plant growth formed by temporal interactions between growth and environment. This review lays out strategies deployed across four major staple crop species: cotton (Gossypium hirsutum L.), maize (Zea mays L.), soybean (Glycine max L.), and wheat (Triticum aestivum L.). Each crop highlighted in this review demonstrates how UAS‐collected data are employed to automate and improve estimation or prediction of objective phenotypic traits. Each crop section includes four major topics: (a) phenotyping of routine traits, (b) phenotyping of previously infeasible traits, (c) sample cases of UAS application in breeding, and (d) implementation of phenotypic and phenomic prediction and selection. While phenotyping of routine agronomic and productivity traits brings advantages in time and resource optimization, the most potentially beneficial application of UAS data is in collecting traits that were previously difficult or impossible to quantify, improving selection efficiency of important phenotypes. In brief, UAS sensor technology can be used for measuring abiotic stress, biotic stress, crop growth and development, as well as productivity. These applications and the potential implementation of machine learning strategies allow for improved prediction, selection, and efficiency within breeding programs, making UAS HTP a potentially indispensable asset. Core Ideas: UAS imagery can be useful in plant breeding programs for routine trait and previously infeasible trait measurement.High‐throughput phenotyping approaches to date differ among crops and each could learn from others.Example applications of UAS imagery are provided for breeding programs of four major crops.The rise of phenomics tools is likely to prove similarly useful to current genomic tools. [ABSTRACT FROM AUTHOR]

Background: On‐demand treatments can treat OFF episodes in Parkinson's disease, however, there is limited information regarding when to prescribe them. Objective: Develop expert consensus to determine appropriate clinical factors for considering on‐demand treatments. Methods: Using a RAND/UCLA modified Delphi panel method, a panel developed consensus on the use of on‐demand treatments for OFF episodes. Results: The panel agreed on‐demand treatments were appropriate when OFF episodes were associated with greater functional impact and interfered with basic daily activities. The panel also agreed on‐demand treatment may be appropriate for patients with morning akinesia and/or delayed ON of first levodopa dose and >1 type of OFF episode (eg, early morning OFF or wearing OFF regardless of frequency). Conclusions: Experts agreed on‐demand treatment is appropriate for many patients with OFF episodes. The greater the functional impact of OFF episodes, the more likely experts agreed that on‐demand treatment is appropriate to prescribe. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to articles published in the previous issue on shortage of experienced veterinarians.

Studies have highlighted a critical role for autophagy in the regulation of multiple cytokines. Autophagy inhibits the release of interleukin (IL)‐1 family cytokines, including IL‐1α, IL‐1β and IL‐18, by myeloid cells. This, in turn, impacts the release of other cytokines by myeloid cells, as well as other cells of the immune system, including IL‐22, IL‐23, IL‐17 and interferon‐γ. Here, we assessed the impact of genetic depletion of the autophagy gene Atg7 in myeloid cells on acute and chronic inflammation. In a model of acute lipopolysaccharide‐induced endotoxemia, loss of autophagy in myeloid cells resulted in increased release of proinflammatory cytokines, both locally and systemically. By contrast, loss of Atg7 in myeloid cells in the Lyn−/− model of lupus‐like autoimmunity resulted in reduced systemic release of IL‐6 and IL‐10, with no effects on other cytokines observed. In addition, Lyn−/− mice with autophagy‐deficient myeloid cells showed reduced expression of autoantibodies relevant to systemic lupus erythematosus, including anti‐histone and anti‐Smith protein. In vitro, loss of autophagy, through pharmacological inhibition or small interfering RNA against Becn1, inhibited IL‐10 release by human and mouse myeloid cells. This effect was evident at the level of Il10 messenger RNA expression. Our data highlight potentially important differences in the role of myeloid cell autophagy in acute and chronic inflammation and demonstrate a direct role for autophagy in the production and release of IL‐10 by macrophages. [ABSTRACT FROM AUTHOR]

The article discusses the career choices and the factors that influenced these choices of small animal veterinarians and nurses.

Objective: To describe the epidemiology of nontraumatic headache in adults presenting to emergency departments (EDs). Background: Headache is a common reason for presentation to EDs. Little is known about the epidemiology, investigation, and treatment of nontraumatic headache in patients attending EDs internationally. Methods: An international, multicenter, observational, cross‐sectional study was conducted over one calendar month in 2019. Participants were adults (≥18 years) with nontraumatic headache as the main presenting complaint. Exclusion criteria were recent head trauma, missing records, interhospital transfers, re‐presentation with same headache as a recent visit, and headache as an associated symptom. Data collected included demographics, clinical assessment, investigation, treatment, and outcome. Results: We enrolled 4536 patients (67 hospitals, 10 countries). "Thunderclap" onset was noted in 14.2% of cases (644/4536). Headache was rated as severe in 27.2% (1235/4536). New neurological examination findings were uncommon (3.2%; 147/4536). Head computed tomography (CT) was performed in 36.6% of patients (1661/4536), of which 9.9% showed clinically important pathology (165/1661). There was substantial variation in CT scan utilization between countries (15.9%–75.0%). More than 30 different diagnoses were made. Presumed nonmigraine benign headache accounted for 45.4% of cases (2058/4536) with another 24.3% classified as migraine (1101/4536). A small subgroup of patients have a serious secondary cause for their headache (7.1%; 323/4536) with subarachnoid hemorrhage (SAH), stroke, neoplasm, non‐SAH intracranial hemorrhage/hematoma, and meningitis accounting for about 1% each. Most patients were treated with simple analgesics (paracetamol, aspirin, or nonsteroidal anti‐inflammatory agents). Most patients were discharged home (83.8%; 3792/4526). In‐hospital mortality was 0.3% (11/4526). Conclusion: Diagnosis and management of headache in the ED is challenging. A small group of patients have a serious secondary cause for their symptoms. There is wide variation in the use of neuroimaging and treatments. Further work is needed to understand the variation in practice and to better inform international guidelines regarding emergent neuroimaging and treatment. [ABSTRACT FROM AUTHOR]

The biochemical properties of the HLA-C antigen differ substantially from those of HLA-A and -B molecules. For this reason, HLA-C diversity and expression at the cell surface are much lower than its counterparts and in consequence HLA-C-restricted responses have been infrequently detected and described. In this review we summarise the key differences between HLA-C and other class I molecules and provide an update on natural killer and T-cell responses restricted by HLA-C. We also discuss the different clinical settings associated with HLA-C alleles which mainly consist of autoimmune disorders, cancers and chronic infections. [ABSTRACT FROM AUTHOR]

This article describes a program of research on effectively transporting the New Beginnings Program (NBP), a university-tested prevention program for divorced families, to community settings. The four steps in this research are described: (1) selecting a community partner, (2) developing effective methods of engaging parents, (3) redesigning the NBP to be easily delivered with high quality and fidelity in community agencies, and (4) adapting the NBP to meet the needs of the full population of divorcing families. The article concludes with a discussion of plans for an effectiveness trial to evaluate the NBP when delivered in community settings. [ABSTRACT FROM AUTHOR]

Macrophage migration inhibitory factor (MIF) is a pleiotropic inflammatory molecule with both cytokine and noncytokine activity. MIF is constitutively released from multiple cell types via an unconventional secretory pathway that is not well defined. Here, we looked at MIF release from human and mouse monocytes/macrophages in response to different stimuli. While MIF release was not significantly altered in response to lipopolysaccharide or heat‐killed Escherichia coli, cytotoxic stimuli strongly promoted release of MIF. MIF release was highly upregulated in cells undergoing necrosis, necroptosis and NLRP3 inflammasome‐dependent pyroptosis. Our data suggest that cell death represents a major route for MIF release from myeloid cells. The functional significance of these findings and their potential importance in the context of autoimmune and inflammatory diseases warrant further investigation. [ABSTRACT FROM AUTHOR]

A B cell culture system using BAFF, IL‐4 and IL‐21 was recently developed that generates B cells with phenotypic and functional characteristics of in vivo‐generated germinal center (GC) B cells. Here, we observe discrete influences of each exogenous signal on the expansion and differentiation of a CD40L‐activated B cell pool. IL‐4 was expressly necessary, but neither BAFF nor IL‐21 was required for B cell acquisition of the GC B cell phenotypes of peanut agglutinin binding and loss of CD38 and IgD expression. Both IL‐4 and IL‐21 enhanced cell cycle entry upon initial activation dose‐dependently, and did so additively. Importantly, while both cytokines acted in concert to increase overall BCL6 expression amounts, IL‐21 exposure uniquely caused a small proportion of cells to attain a higher level of BCL6 expression, reminiscent of in vivo GC B cells. In contrast, BAFF supported survival of a fraction of memory‐like B cells in extended cultures after removal of surrogate T cell‐help signals. Thus, by separably programming proliferation, survival and GC phenotype acquisition, IL‐4, BAFF and IL‐21 drive distinct components of activated B cell fate. [ABSTRACT FROM AUTHOR]

Study Objective: The potential for maternal antidepressant use to influence the risk of spontaneous abortion, one of the most important adverse pregnancy outcomes, is not clear. We aimed to assess whether first trimester antidepressant exposure was associated with an increased risk of spontaneous abortion. Design: Community‐based prospective cohort study (Right from the Start). Setting: Eight metropolitan areas in North Carolina, Tennessee, and Texas. Participants: A total of 5451 women (18 years of age or older) who were planning to conceive or were pregnant (before 12 weeks of completed gestation) and were enrolled in the study between 2000 and 2012; of those women, 223 used antidepressants (selective serotonin reuptake inhibitors [SSRIs] only [170], SSRIs and non‐SSRIs [9], and non‐SSRIs only [44]) during their first trimester, and 5228 did not (never users). Measurements and Main Results: First trimester antidepressant use was determined during a first trimester telephone interview. Spontaneous abortion was self‐reported and verified by medical records. The association of first trimester antidepressant use and spontaneous abortion was assessed by using Cox proportional hazard regression. Among the 5451 women enrolled, 223 (4%) reported first trimester antidepressant use, and 659 (12%) experienced a spontaneous abortion. SSRIs were the most common class of antidepressants used (179 [80%]). Compared with women who never used antidepressants during the first trimester of pregnancy, women who reported antidepressant use were 34% (adjusted hazard ratio [aHR] 1.34, 95% confidence interval [CI] 0.97–1.85) more likely to experience a spontaneous abortion after adjusting for covariates. Women who reported ever using SSRIs were 45% (aHR 1.45, 95% CI 1.02–2.06) more likely to experience a spontaneous abortion compared with never users. When time of loss relative to the time of interview was taken into consideration, the association between first trimester SSRI use and spontaneous abortion was significant only among those with losses before the interview (aHR 1.49, 95% CI 1.04–2.13) but was not significant among those with losses after the interview (aHR 0.43, 95% CI 0.06–3.15). Conclusion: The association between use of first trimester antidepressants, particularly SSRI use, and spontaneous abortion was significant only among women whose exposure status was assessed after loss. In this instance, reporting bias may create a spurious association. Future studies should take the timing of data collection relative to the timing of loss into consideration. [ABSTRACT FROM AUTHOR]

To systematically review and critically evaluate studies reporting alcohol exposure during pregnancy and miscarriage. We searched PubMed, EMBASE, PsycINFO, and ProQuest Theses for publications from January 1970 to January 2019. We identified studies about alcohol exposure during pregnancy and miscarriage. Information about study population, alcohol exposure assessment, outcome definition, covariates, and measures of association was collected. We assessed study quality using an adapted Newcastle‐Ottawa Scale. Data were abstracted by 2 investigators independently. We conducted a random‐effects meta‐analysis to calculate the association between alcohol exposure and miscarriage risk and performed subgroup analyses to determine robustness of results to study differences. For studies reporting dose‐specific effects, a pooled dose–response association was estimated using generalized least squares regression with and without restricted cubic spline terms for number of drinks consumed per week. Of 2,164 articles identified, 24 were eligible for inclusion. Meta‐analysis of data from 231,808 pregnant women finds those exposed to alcohol during pregnancy have a greater risk of miscarriage compared to those who abstained (odds ratio [OR] 1.19, 95% confidence intervals [CI] 1.12, 1.28). Estimates did not vary by study design, study country, or method of alcohol ascertainment. For alcohol use of 5 or fewer drinks per week, each additional drink per week was associated with a 6% increase in miscarriage risk (OR 1.06, 95% CI 1.01, 1.10). Common study limitations reflect challenges inherent to this research, including difficulty recruiting participants early enough in pregnancy to observe miscarriage and collecting and quantifying information about alcohol consumption during pregnancy that accurately reflects use. This review provides evidence that alcohol consumption during pregnancy is associated with a dose‐mediated increase in miscarriage risk. Future studies evaluating change in alcohol use in pregnancy are needed to provide insight into how alcohol consumption prior to pregnancy recognition impacts risk. [ABSTRACT FROM AUTHOR]

The United Kingdom National Health Service (NHS) response to the coronavirus pandemic (COVID-19) involved far-reaching service reconfigurations to release clinical capacity, including staff redeployment and whole department relocations. 4 Kulkarni R. Use of telehealth in the delivery of comprehensive care for patients with haemophilia and other inherited bleeding disorders. A virtual meeting of UK NHS haemophilia physiotherapists took place on 3rd June 2020 to share how services had been affected during the pandemic and review potential implications for physiotherapy in the future. [Extracted from the article]

Cell free hemoglobin impairs vascular function and blood flow in adult cardiovascular disease. In this study, we investigated the hypothesis that free fetal hemoglobin (fHbF) compromises vascular integrity and function in the fetoplacental circulation, contributing to the increased vascular resistance associated with fetal growth restriction (FGR). Women with normal and FGR pregnancies were recruited and their placentas collected freshly postpartum. FGR fetal capillaries showed evidence of erythrocyte vascular packing and extravasation. Fetal cord blood fHbF levels were higher in FGR than in normal pregnancies (P < 0.05) and the elevation of fHbF in relation to heme oxygenase-1 suggests a failure of expected catabolic compensation, which occurs in adults. During ex vivo placental perfusion, pathophysiological fHbF concentrations significantly increased fetal-side microcirculatory resistance (P < 0.05). fHbF sequestered NO in acute and chronic exposure models (P < 0.001), and fHbF-primed placental endothelial cells developed a proinflammatory phenotype, demonstrated by activation of NF-κB pathway, generation of IL-1α and TNF-α (both P < 0.05), uncontrolled angiogenesis, and disruption of endothelial cell flow alignment. Elevated fHbF contributes to increased fetoplacental vascular resistance and impaired endothelial protection. This unrecognized mechanism for fetal compromise offers a novel insight into FGR as well as a potential explanation for associated poor fetal outcomes such as fetal demise and stillbirth. [ABSTRACT FROM AUTHOR]