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The European honey bee, Apis mellifera L., is the single most valuable managed pollinator in the world. Poor colony health or unusually high colony losses of managed honey bees result from a myriad of stressors, which are more harmful in combination. Climate change is expected to accentuate the effects of these stressors, but the physiological and behavioral responses of honey bees to elevated temperatures while under simultaneous influence of one or more stressors remain largely unknown. Here we test the hypothesis that exposure to acute, sublethal doses of neonicotinoid insecticides reduce thermal tolerance in honey bees. We administered to bees oral doses of imidacloprid and acetamiprid at 1/5, 1/20, and 1/100 of LD50 and measured their heat tolerance 4 h post-feeding, using both dynamic and static protocols. Contrary to our expectations, acute exposure to sublethal doses of both insecticides resulted in higher thermal tolerance and greater survival rates of bees. Bees that ingested the higher doses of insecticides displayed a critical thermal maximum from 2 ˚C to 5 ˚C greater than that of the control group, and 67%-87% reduction in mortality. Our study suggests a resilience of honey bees to high temperatures when other stressors are present, which is consistent with studies in other insects. We discuss the implications of these results and hypothesize that this compensatory effect is likely due to induction of heat shock proteins by the insecticides, which provides temporary protection from elevated temperatures., Competing Interests: The authors have declared that no competing interests exist.

Formaldehyde is a well-known industrial material regularly used in fishery, vegetable markets, and fruit shops for maintaining their freshness. But due to its carcinogenic nature and other toxic effects, it is very important to detect it in very low concentrations. In recent years, amine-containing fluorescent probes have gained significant attention for designing formaldehyde sensors. However, the major drawbacks of these small molecular probes are low sensitivity and long exposure time, which limits their real-life applications. In this regard, polymeric probes have gained significant attention to overcome the aforementioned problems. Several polymeric probes have been utilized as a coating material, nanoparticle, quartz crystal microbalance (QCM), etc., for the selective and sensitive detection of formaldehyde. The main objective of this review article is to comprehensively describe the recent advancements in formaldehyde sensors based on small molecules and polymers, and their successful applications in various fields, especially in situ formaldehyde sensing in biological systems., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2022 The Author(s). Published by National Institute for Materials Science in partnership with Taylor & Francis Group.)

Chronic stress exposure causes increased vulnerability to future relapse-like behavior in male, but not female, rats with a history of palatable food self-administration. These effects are mediated by dopamine D 1 -like receptors, but the anatomical location of chronic stress' dopaminergic mechanism is not known. Thus, male rats were trained to respond for palatable food pellets in daily sessions. During subsequent forced abstinence from food self-administration, stress was manipulated (0 or 3 h restraint/day for 7 days). Rats also received bilateral microinjections of the D 1 -like receptor antagonist SCH-23390 (0.25 μg/0.5 μl/side) or vehicle (0.5 μl/side) delivered to either prelimbic or infralimbic medial prefrontal cortex prior to daily treatments. Relapse tests in the presence of food-associated cues were conducted 7 days after the last treatment. Stress caused an increase and a decrease in responding during relapse tests in rats that received prelimbic vehicle and SCH-23390 infusions, respectively, relative to unstressed rats. In rats receiving IL infusions, however, stress caused an increase in responding regardless of whether the infusion was vehicle or SCH-23390. These results establish a specific role for prelimbic D 1 -like receptors in chronic stress-potentiated relapse., (Copyright © 2021 Elsevier B.V. All rights reserved.)

This study uses American Community Survey data to examine the impact of the Great Recession on college graduates majoring in the arts. Arts graduates play important roles in an economy, through both artistic creation and in careers outside of the arts. While the Great Recession took a significant toll on the US economy generally, arts majors faced additional vulnerabilities as industries that rely on discretionary spending, like the arts and entertainment, are especially hard hit in times of economic downturn. This paper assesses the impact of graduating during or shortly after the recession relative to graduating shortly before this period on educational choices, including choice of major, double majoring, and completing an advanced degree, and career outcomes, including employment status, type of employment, hours worked, and earnings, for college graduates majoring in the arts. Graduating before or after the recession is found to have a negative impact on the share of graduates majoring in traditional arts fields, but a positive impact on the share majoring in related creative fields. Using a difference-in-difference estimation strategy, relative to non-art college graduates, traditional arts majors graduating during or after the Great Recession are more likely to complete a double major, be self-employed, be unemployed, work longer hours, and earn less income than those graduating prior to the recession. These impacts are likely to have a negative effect on the pipeline of college-educated artists working in the arts into the future., Competing Interests: Conflict of interestNot applicable., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.)

This article explores a novel methodology in the globalized classroom to face and tackle new challenges across cultures. The new online educational form of international discourse has the potential to make a difference in and outside Academia as it encompasses interpersonal communication across cultures and thus offers a novel framework for interpretation of different sociocultural perspectives to bring about social change. It transcends geographical and physical boundaries as it brings people together for discussion in the online joint event. Our study guides the reader through a collaborative educational framework and offers a methodology that transcends boundaries, exemplifying a tool for 21st century education. It offers techniques that bring on social change and enhances open-mindedness in tackling social problems with valuable methods from the fields of humanities and intercultural, collaborative communication., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2022.)

Globally, nurse educators participate in the three main role activities of teaching, scholarship, and service. Matching for different global locations and career stages, 12 mentor-mentee pairs completed a one-year coordinated virtual program through Sigma Theta Tau International's Global Leadership Mentoring Community and mentees reported building their nurse educator capacities. The authors describe factors that potentially influence international mentoring such as language, time, technology, and key characteristics of mentoring relationships. Growth in educator roles occurred in the contexts of the culture of academe itself and Boyer's definitions of scholarship. Consistent with Sigma's vision statement, nurse educators have a global presence and responsibility to prepare competent nurses who can advance the health of the world's people. Readers may benefit for future planning of mentoring activities to build capacities in nurse educator roles through international interactions., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Romantic partners' communication about sex has been shown to enhance marital satisfaction and well-being, yet is often associated with high levels of uncertainty due to the challenging and potentially face-threatening topics involved in such discussion. While much literature focuses on sexual health information seeking, relational partners' uncertainty management related to sexual satisfaction has not been examined. This study focused on married couples' discussion of sexual satisfaction, tested the theory of motivated information management (TMIM; Afifi & Weiner, 2004) within this context, and examined relational moderators that could influence relational partners' communication about sexual satisfaction. Data from 248 married participants suggested that TMIM effectively predicted five different information management strategies, including direct and indirect information seeking, avoidance, cognitive reappraisal, and disclosure, although the processes through which uncertainty discrepancy influenced information management differed depending on the information management strategy. Furthermore, results indicated relational factors such as marital quality, relational closeness, and communal coping moderated TMIM paths in distinct ways. Theoretical and practical implications for relational partners' uncertainty management about sexual satisfaction are discussed.

Purpose: In recent years more and more students with disabilities are included in general education settings; there is an increased demand for assistive technology application to accommodate their special needs in inclusive settings. This creates an atmosphere for studies on assistive technology applications in K-12 settings., Method: This synthesis study reviewed research articles related to this topic in the past decade. Ten key words were used and relevant databases were searched., Results: Thirty articles were found. After sorting, reviewing and analyzing; the two authors used seven research articles for the study on assistive technology applications in contemporary k-12 schools., Conclusion: The researchers that examined school aged children, all agreed that children with disabilities would benefit from the use of assistive technology. However, they also agree that teachers are not prepared to incorporate advanced technology in the classroom. The results also show that children with physical disabilities in preschool may be too young to independently use advanced technology.Implications for RehabilitationStudents with severe disabilities often have limited interactions with same age peers. Technology can provide a means to increase the quality and quantity of time interacting with young student's peers. Robotic technology has been proven to greatly assist with these interactions.In order for a student to maintain a rehabilitation program, they need to be engaged. Current technology promotes building recreational skills that lead to classroom skills, within entertaining and engaging activities.Daily life skills can be impacted by severe disabilities. Assistive technology has been proven to assist with these issues. Caregivers for children with autism reported improvement for life skills activities using both low- and high-tech methods.

Teaching is inherently connected with specific burdens that may imply stressful situations. The goal of this study was to explore the prevalence of type D (distressed) personality in teachers. This is known to cause depressive episodes and sleep disorders, which not only have direct physical health effects, but can also impact the wellbeing of individuals and hence adversely affect their job performance. The participants consisted of 412 high school teachers from the Silesian Province, located in the south of Poland. Using the following research tools: Type D Scale (DS14), Perceived Stress Scale, Athens Insomnia Scale, and Beck Depression Inventory, it was found that type D personality was observed in a large percentage of teachers (30.1%). It was reported that teachers with distressed personality suffered from insomnia and depression significantly more often. Findings from the current study indicate the need to implement preventive activities focused on reducing psychosocial risk factors in the work environment in order to reduce the frequency of depressive disorders among teachers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Domagalska, Rusin, Razzaghi and Nowak.)

Background Severe patient prosthesis mismatch (sPPM) after surgical aortic valve replacement is associated with worse outcomes. Limited data exists on the impact of sPPM on outcomes after transcatheter aortic valve replacement (TAVR), especially regarding the newer generation valves. The aim of this study was to evaluate the incidence, determinants, and outcomes of sPPM in patients undergoing TAVR with Edwards SAPIEN XT (ES XT) and Edwards SAPIEN 3 (ES3) valves (Edwards Lifesciences, Irvine, CA, USA). Methods We retrospectively reviewed 366 patients who underwent TAVR with ES XT (n = 114) or ES3 (n = 252) valves between July 2012 and June 2018. sPPM was defined as indexed effective orifice area (iEOA) <0.65 cm 2 /m 2 . Kaplan-Meier survival estimates were used to determine outcomes. Results Multivariate linear regression analysis was utilized to determine potential independent effects of PPM on outcomes. sPPM was present in 40 (11%) of the patients [8 (7%) ES XT and 32 (13%) ES3] and was associated with female sex, smaller left ventricular outflow tract (LVOT) diameter and aortic valve annular area, absence of prior coronary artery bypass graft (CABG) surgery, shorter height, higher body mass index, and smaller pre-TAVR valve area (all p < 0.05). Among those with ES3 valves, the incidence of sPPM was inversely proportional to the valve size (50%, 25%, 5% and 3% for 20-, 23-, 26- and 29-mm valve sizes, respectively; p < 0.001). At a mean follow-up period of 3.5 ± 1.5 years, there was no difference in all-cause mortality (22.5% vs. 25.6%, p = 0.89) or a composite endpoint of heart failure, arrhythmias, stroke, and myocardial infarction (30% vs. 34%, p = 0.24) in those with or without sPPM. Conclusion ES3 was associated with a higher incidence of sPPM, particularly with smaller valve sizes. However, the presence of sPPM as defined by iEOA was not an independent predictor of adverse outcomes in patients undergoing TAVR within an intermediate follow-up period., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Vallabhaneni et al.)

In people with normal hearing (NH), speech perception in noise (SPIN) improves when the speech signal is presented not gated with noise but after a delay. The medial olivocochlear reflex (MOCR) was thought to be involved in the neural dynamic range adaptation (NDRA) responsible for this adaptive SPIN; however, some of the recent studies do not support this hypothesis and suggest that adaptive SPIN involves the NDRA to noise-level statistics, irrespective of MOCR activation. A plausible reason for this discrepancy could be the variations and limitations of the experimental designs used in different studies. Using a relatively controlled and comprehensive study design, this study attempts to verify whether a delay between the delivery of speech and the noise improves the SPIN and whether MOCR mediates such effects. The SPIN was estimated by measuring speech reception thresholds (SRT) in noise under simultaneous-onset and delayed-onset (noise precedes speech onset by 300 ms) conditions. The SPIN in both ears was independently examined for ipsilateral, contralateral, and bilateral noise in women with normal hearing (N = 18; age range, 18-25 years). Contralateral suppression of transient-evoked otoacoustic emissions (CSOAEs) was used to estimate the MOCR based cochlear gain reduction. Under all test conditions, SPIN was improved in delayed-onset than in simultaneous-onset conditions, and the mean improvement in the SRT ranged from 0.7±1.7 to 1.8±1.8 dB. No significant correlation was obtained between CSOAEs and the mean temporal improvement in SRT, suggesting that MOCR may not be a predominant mechanism for the temporal improvement in SPIN., Competing Interests: Declaration of Competing Interest There is no conflict of interest to declare., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Context: Preseason testing can be time intensive and cost prohibitive. Therefore, using normative data for postconcussion interpretation in lieu of preseason testing is desirable., Objective: To establish the recovery trajectory for clinical reaction time (RTclin) and assess the usefulness of changes from baseline (comparison of postconcussion scores with individual baseline scores) and norm-based cutoff scores (comparison of postconcussion scores with a normative mean) for identifying impairments postconcussion., Design: Case-control study., Setting: Multisite clinical setting., Patients or Other Participants: An overlapping sample of 99 participants (age = 19.0 ± 1.1 years) evaluated within 6 hours postconcussion, 176 participants (age = 18.9 ± 1.1 years) evaluated at 24 to 48 hours postconcussion, and 214 participants (age = 18.9 ± 1.1 years) evaluated once they were cleared to begin a return-to-play progression were included. Participants with concussion were compared with 942 control participants (age = 19.0 ± 1.0 years) who did not sustain a concussion during the study period but completed preseason baseline testing at 2 points separated by 1 year (years 1 and 2)., Main Outcome Measure(s): At each time point, follow-up RTclin (ie, postconcussion or year 2) was compared with the individual year 1 preseason baseline RTclin and normative baseline data (ie, sex and sport specific). Receiver operating characteristic curves were calculated to compare the sensitivity and specificity of RTclin change from baseline and norm-based cutoff scores., Results: Clinical reaction time performance declined within 6 hours (18 milliseconds, 9.2% slower than baseline). The decline persisted at 24 to 48 hours (15 milliseconds, 7.6% slower than baseline), but performance recovered by the time of return-to-play initiation. Within 6 hours, a change from baseline of 16 milliseconds maximized combined sensitivity (52%) and specificity (79%, area under the curve [AUC] = 0.702), whereas a norm-based cutoff score of 19 milliseconds maximized combined sensitivity (46%) and specificity (86%, AUC = 0.700). At 24 to 48 hours, a change from baseline of 2 milliseconds maximized combined sensitivity (64%) and specificity (61%, AUC = 0.666), whereas a norm-based cutoff score of 0 milliseconds maximized combined sensitivity (63%) and specificity (62%, AUC = 0.647)., Conclusions: Norm-based cutoff scores can be used for interpreting RTclin scores postconcussion in collegiate athletes when individual baseline data are not available, although low sensitivity and specificity limit the use of RTclin as a stand-alone test., (© by the National Athletic Trainers' Association, Inc.)

The purpose of this study was to examine the effect of test sequence on adults' ability to achieve maximal aerobic and anaerobic power during a single assessment visit. Forty-one adults (24 men, 17 women; 22.0 ± 1.8 years) completed two baseline visits in randomized order consisting of either a maximal oxygen consumption (V̇O 2max ) or Wingate anaerobic test (WAnT). The subsequent experimental visit consisted of both V̇O 2max and WAnT in randomized order separated by 20 minutes of rest. Mixed-model ANOVAs compared baseline and experimental performance between and within groups. Chi Squared Goodness of Fit tests determined if test sequence significantly affected V̇O 2max criteria achievement. Significant interaction effects were observed for relative V̇O 2max ( p = 0.005), RER ( p < 0.001), and exercise time ( p = 0.022). Within WAnT/V̇O 2max subjects, these values significantly decreased from baseline to experimental tests. No differences were found for WAnT values. During the experimental session, 50% of subjects who performed WAnt/V̇O 2max and 81% of subjects who performed V̇O 2max /WAnT achieved a valid V̇O 2max . Chi squared analysis found the change to be significant in WAnT/V̇O 2max subjects only. Therefore, performing the WAnT before V̇O 2max sequence significantly reduced the percent of subjects who achieved V̇O 2max criteria. These findings indicate that the sequence of V̇O 2max testing before a WAnT allowed maximal results similar to expected baseline values.

Background: Occupational health professionals (OHPs) are in a unique position to impact the health and well-being of employees at work and outside of work. One way of achieving this holistic health goal is to integrate the concept of Total Worker Health® (TWH) into the organization's culture. It is critical for OHPs to develop the ability to incorporate TWH into their practices, yet there are gaps in our understanding of OHP's attitudes toward change and toward TWH, their level of TWH knowledge, and the number of OHPs who have adopted TWH., Methods: An electronic survey was administered to a national sample of 4,777. This cross-sectional study used Qualtrics to record survey responses measuring knowledge of TWH, attitude toward change, resistance to change, transformational leadership ability, perception of organizational readiness, and leadership commitment., Findings: The total sample size was 253 (5.3%). Most respondents were bachelors prepared nurses (75.1%) with greater than 10 years' experience (71.5%) and employed in manufacturing (42.6%). Approximately 74% ( n = 125) of respondents knew about TWH, but did not have a program in place or were unsure of the existence of one. A high percentage (74.0%) were open to implementing TWH, had favorable attitudes toward change ( M = 3.9 on a 5-point Likert-type scale), but needed education on how to move forward (56.0%)., Conclusions/application to Practice: Findings suggest that most OHPs know about TWH, but generally have not adopted the TWH concept at their worksites. However, they are open to implementing TWH programs and have favorable attitudes toward change.

Proliferation of Schwann cells during peripheral nerve development is stimulated by the heregulin/neuregulin family of growth factors expressed by neurons. However, for neonatal rat Schwann cells growing in culture, heregulins produce only a weak mitogenic response. Supplementing heregulin with forskolin, an agent that elevates cyclic AMP levels, produces a dramatic increase in the proliferation of cultured Schwann cells. The mechanisms underlying this synergistic effect required for Schwann cell proliferation in vivo is not well established. Characterizing the A-kinase anchoring proteins (AKAPs) in Schwann cells might help identify substrates tethered to and phosphorylated by the cAMP-dependent protein kinase A (PKA). Using an RII overlay assay that detects AKAPs that are bound to the type II regulatory subunits of PKA, we identified AKAP150 in Schwann cells. Western blot analysis revealed that additional AKAPs, specifically AKAP95, and yotiao were also present. Disruption of PKA/AKAP interaction with Ht-31 peptide resulted in an increase in luciferase-conjugated cyclin D3 promoter activity. Transfection with sequence-specific AKAP siRNAs for AKAP150 and AKAP95 produced a marked reduction in cell proliferation. Immunoblot analysis revealed that knock down of AKAP95 protein caused a significant decrease in expression of the cell cycle regulatory proteins cyclin D2, cyclin D3 and the cell survival signal Akt/Protein Kinase B (Akt/PKB). Morphological characterization of Schwann cell AKAPs indicated the presence of nuclear (AKAP95), cytoplasm-associated (AKAP150) and perinuclear (yotiao) A-kinase anchoring proteins. These results indicate a role for AKAP95 and AKAP150 in the synergistic response of Schwann cells to treatment with heregulin and forskolin., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Chemical contamination of foods pose a significant risk to consumers. A source of this risk is due to the consumption of products contaminated with heavy metals such as cadmium (Cd) and lead (Pb). The aim of the study was to research the levels of Cd and Pb contamination of selected species of vegetables and fruits in the form of fresh, frozen, dried and processed products. The goal was to verify which of these food groups was more contaminated with heavy metals. The study covered 370 samples of fruits and vegetables including apples, pears, grapes, raspberries, strawberries, cranberries, as well as beetroots, celeries, carrots and tomatoes. The content of Cd and Pb was determined by atomic absorption spectrometry. Quantitative results were analyzed using statistical models: analysis of variance, outlier analysis, post-hoc multiple comparison Tukey test. The tests showed that the levels of Cd and Pb concentration in samples of fresh, processed, frozen and dried fruits and vegetables varied substantially. The highest concentrations were recorded in dried products. Several fruit and vegetable samples exceeded the maximum permissible concentrations of Cd and Pb. The contamination of these products could be a significant source of consumer exposure to heavy metals when these products are a part of the diet.

Eutrophication remains a threat to coastal habitats and water quality worldwide. The U.S. Clean Water Act resulted in reductions of nutrient loading from point sources but management of nonpoint sources (NPS) of nutrients remains challenging despite efforts over at least three decades. The hydrological factors, best management practices (BMPs) and regulatory mechanisms that target nutrient NPS and improve coastal ecosystem function are poorly understood. We identified three case study sites in the U.S. with sufficient NPS management and monitoring history to quantify changes in estuarine habitat and water quality following BMP implementation and regulation targeting nutrient NPS. Utilizing publicly available data, we compared sites that are geographically distant and hydrologically distinct. We found that BMPs targeting NPS loads from surface waters into Roberts Bay (Florida) and Newport Bay (California) significantly reduced nutrient concentrations and harmful algal blooms within ~20 years. Improvements occurred despite concurrent human population growth within both watersheds. Conversely, we found that the majority of BMPs implemented within the Peconic Estuary (New York) watershed targeted surface waters despite a dominance of nitrogen inputs (97%) from groundwater and atmospheric sources. Declines in habitat and water quality in Peconic Estuary may be due to a failure to control the dominant nutrient sources and the long residence time of nitrogen in groundwater. Compared to surface water, reducing groundwater and atmospheric nutrients face greater technical and financial challenges. Improvements to Peconic Estuary may occur with further reductions in surface water inputs and as nutrients leach out of the groundwater. Although the effectiveness of specific NPS BMPs has been examined at small spatial scales, our study is the first to quantify improvements at a watershed scale. We showed that successful NPS management pathways are those which targeted the dominant sources of nutrients to coastal ecosystems and applied multiple BMPs within watersheds.

Abstract: Kollars, JM, Taber, CB, and Beyer, KS. Relative age effects in elite olympic weightlifters. J Strength Cond Res 35(5): 1223-1228, 2021-The time of year in which an athlete is born may provide an advantage developmentally for competition, known as relative age effects (RAEs). The presence of RAEs in sport may result in athletes participating less or leaving the sport early. To determine if RAEs exist in elite Olympic weightlifting, data were examined from the past 5 Olympic Games. Using retrospective competition data, a total of 953 weightlifters (595 men and 358 women) who competed in the Olympic Games between 2000 and 2016 were included in this study. Athletes were divided into lightweight, middleweight, and heavyweight for analysis. Using the subset weight classes, the observed date of birth distribution vs. the expected worldwide date of birth distribution were compared using multiple chi square tests. Relative age effects were present overall for weightlifters (χ2 = 189.428, p < 0.001), with over-representation in January (z = +12.6, 20.9%) and under-representation in June (z = -2.1, 6.3%), September (z = -3.2, 5.7%), and November (z = -3.0, 5.1%). Relative age effects were also present in men lightweight (χ2 = 74.773, p < 0.001), men middleweight (χ2 = 41.786, p < 0.001), men heavyweight (χ2 = 39.395, p < 0.001), and women lightweight (χ2 = 37.251, p < 0.001). Determining that RAEs are present in weightlifting is important because it will help maintain the amount of opportunity for all athletes regardless of when they were born in the year. Coaches should be aware of the possible advantages of training age and the effect of physical maturation as a result of these RAEs. Coaches may use this information for athlete selection, but the presence of RAEs should not discourage athletes from participating in the sport of weightlifting., (Copyright © 2021 National Strength and Conditioning Association.)

Background: Non-invasive determination of mitochondrial capacity via near infrared spectroscopy (NIRS) typically involves voluntary exercise of a single muscle group followed by as many as 26 brief ischemic cuff occlusions to determine a single recovery rate constant (k)., Purpose: To determine the within- and between-visit repeatability of a shortened bilateral NIRS protocol, and to establish the feasibility of hamstring k measurements., Methods: Sixteen young (eight women, eight men; 22 ± 3 years) active adults underwent a bilateral electrical stimulation protocol in which multiple (n = 4) measurements of k for the vastus lateralis (VL) and medial hamstring (MH) muscles were determined on two visits. Repeatability (CV% and intraclass correlations, ICC) and equivalency across visits were assessed for both muscles., Results: Mean k values in the VL were consistent with published values and within-visit ICCs were moderately high for both muscles in both sexes. In men, average k values on visit 2 were within 1% (VL muscle) and 5% (MH muscle) of the values on visit 1 (all p > 0.78). In women, average k values were 10%-15% lower on visit 2 (p = 0.01 and p = 0.15 for MH and VL) with the largest between-visit differences in a subset of participants with the most days between visits., Conclusions: This bilateral NIRS protocol is time efficient and provides valid estimates of k in both sexes and muscle groups with acceptable within-visit repeatability. Lower than expected between-visit repeatability in some participants reinforces the need for further investigation of this newly developed protocol to identify and control for experimental and behavioral sources of variation., (© 2021 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Collisions with buildings cause up to 1 billion bird fatalities annually in the United States and Canada. However, efforts to reduce collisions would benefit from studies conducted at large spatial scales across multiple study sites with standardized methods and consideration of species- and life-history-related variation and correlates of collisions. We addressed these research needs through coordinated collection of data on bird collisions with buildings at sites in the United States (35), Canada (3), and Mexico (2). We collected all carcasses and identified species. After removing records for unidentified carcasses, species lacking distribution-wide population estimates, and species with distributions overlapping fewer than 10 sites, we retained 269 carcasses of 64 species for analysis. We estimated collision vulnerability for 40 bird species with ≥2 fatalities based on their North American population abundance, distribution overlap in study sites, and sampling effort. Of 10 species we identified as most vulnerable to collisions, some have been identified previously (e.g., Black-throated Blue Warbler [Setophaga caerulescens]), whereas others emerged for the first time (e.g., White-breasted Nuthatch [Sitta carolinensis]), possibly because we used a more standardized sampling approach than past studies. Building size and glass area were positively associated with number of collisions for 5 of 8 species with enough observations to analyze independently. Vegetation around buildings influenced collisions for only 1 of those 8 species (Swainson's Thrush [Catharus ustulatus]). Life history predicted collisions; numbers of collisions were greatest for migratory, insectivorous, and woodland-inhabiting species. Our results provide new insight into the species most vulnerable to building collisions, making them potentially in greatest need of conservation attention to reduce collisions and into species- and life-history-related variation and correlates of building collisions, information that can help refine collision management., (© 2020 Society for Conservation Biology.)

Abstract: Herring, CH, Beyer, KS, and Fukuda, DH. Relative age effects as evidence of selection bias in major league baseball draftees (2013-2018). J Strength Cond Res 35(3): 644-651, 2021-The purpose of this study was to examine if relative age effects (RAEs) or the unequal birth-date distribution among a cohort group of individuals exist in Major League Baseball (MLB) draftees. This study comprised 7,078 men drafted in the MLB first-year player draft from 2013 to 2018. Data collected for each draftee included birth date, year drafted, academic-level classification, position, round drafted, batting side, and throwing arm. Draftee's birth dates were categorized into quarters based on the calendar year for baseball in the United States (Q1: August-October; Q2: November-January; Q3: February-April; Q4: May-July). Player birth-date distributions were compared with average expected birth-date distributions and evaluated with the χ2 goodness of fit statistic. Significant χ2 tests were followed up by calculating the standardized residual for each quarter. Differences from the expected frequencies were found for the overall group (p < 0.001) with standardized residuals for baseball athletes born in Q1 (z = +4.45) and Q3 (z = -4.15) exceeding ±2.0. Similar patterns were noted for high schoolers (Q1: z = +3.30; Q3: z = -3.28), pitchers (Q1: z = +2.78; Q3: z = -3.12), early middle rounders (Q1: z = +3.08; Q3: z = -2.67), late rounders (Q1: z = +2.70; Q3: z = -2.61), right-side hitters (Q1: z = +3.23; Q3: z = -2.26), left-handed pitchers (Q1: z = + 2.12; Q3: z = -2.59), and right-handed positional players (Q1: z = +3.12; Q3: z = -2.12). Consistent with the majority of previous research, RAEs are apparent in MLB draftees, with specific patterns of unequal distribution among subsets of athletes., (Copyright © 2021 National Strength and Conditioning Association.)

Background: Just culture has been identified as a vital component of safety culture by national and international organisations. In a just culture, emphasis is not placed on blaming individuals for errors but rather on examining personal and system processes that can best support safety and prevent reoccurrence. Although those in the practice arena have worked to implement the concepts of just culture, the same is not true in nursing education, leaving nursing students lacking the pre-requisite knowledge, skills and attitudes to implement just culture in practice on graduation., Aims: Assessment of this phenomena is the essential first step to align nursing education with practice in promoting just culture as a mechanism for patient safety. The purpose of this paper is to further refine the Just Culture Assessment Tool-Nursing Education through exploratory factor analysis., Methods: The Just Culture Assessment Tool-Nursing Education was adapted from the Just Culture Assessment Tool, an instrument created for the practice setting. Validity and reliability were established for the Just Culture Assessment Tool-Nursing Education in a study of 800 nursing students to assess their perceptions and understanding of just culture with their nursing programmes. Using the previously conducted data, an exploratory factor analysis was conducted., Results: Factor analysis supports six subscales, similar to that of the Just Culture Assessment Tool. However, individual items were loaded into different subscales. All subscales demonstrated good reliability. Factor analysis supported further refinement of two items to improve the instrument's ability to capture data., Conclusions: Perceptions of just culture differ between experienced providers and nursing students; nursing students have less experience with reporting errors. Factor analysis of Just Culture Assessment Tool-Nursing Education items demonstrated these differences, supporting modification of items by the instrument developers. An 'if' statement for students to consider their possible actions rather than experience was added to two items to better capture data from nursing students when completing the assessment., Competing Interests: Declaration of conflicting interest: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article, (© The Author(s) 2020.)

This study investigated the role of uncertainty in information management processes by integrating insights from uncertainty management theory and the theory of motivated information management. Specifically, we examined the extent to which uncertainty appraisals moderated the effects of uncertainty on anxiety and information seeking about family health history (FHH) from spouses. Data from 626 married individuals suggested that desired uncertainty moderated uncertainty's effect on anxiety such that uncertainty led to more anxiety when individuals wanted to be more certain. Uncertainty also exerted stronger effects on anxiety and information seeking when one's actual uncertainty was low. Efficacy remained a predictor of information seeking, consistent with the literature. Findings offer theoretical implications about the interaction effects among different conceptualizations of uncertainty (i.e., actual, desired, and uncertainty discrepancy) and practical applications for encouraging information seeking about FHH.

This study examines the role of college graduates with degrees in the arts, STEM, and other creative fields as entrepreneurs and innovators in the US economy. As creativity is a trait of art students and is important for those acting as entrepreneurs and innovators in an economy, arts majors have the potential to play an important role in these areas. Using American Community Survey data, we look to identify arts, STEM, and other creative majors who are working in entrepreneurial occupations, those where self-employment is common, and innovative industries, those that are copyright intensive. As it is possible that the nature of arts occupations may be inherently more entrepreneurial and innovative, we compare arts majors to STEM and other creative majors also likely to work in such occupations. Using logistic regression, we find that majoring in a core arts field more than doubles an individual's likelihood of working in an entrepreneurial occupation or an innovative industry relative to non-creative majors. Other creative majors, like communications and STEM majors, are also associated with an increased likelihood of working as entrepreneurs or innovators. Relative to STEM and other creative majors, majoring in a core arts field is associated with the greatest increase in the likelihood of working in an entrepreneurial occupation and third greatest increase in the likelihood of working in an innovative industry. While arts graduates play an important role in artistic creation, this paper highlights a role for these graduates as entrepreneurs and innovators in the US economy., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Springer Science+Business Media, LLC, part of Springer Nature 2020.)

Recent work in our lab has shown that chronic stress exposure causes sex-dependent changes in subsequent relapse-like behavior in rats with a history of palatable food self-administration. Although these effects are mediated by dopamine D 1 -like receptors in male rats, such dopaminergic mechanisms have not been investigated in female animals. Thus, male and female rats were trained to respond for highly palatable food reinforcers in daily sessions. During subsequent extinction training, stress was manipulated (0 or 3 h restraint/day for 7 days). To assess dopaminergic involvement, we administered either SCH-23390 (10.0 μg/kg), a dopamine D 1 -like receptor antagonist, or vehicle prior to daily treatments. Rats were then tested for cue- and pellet priming-induced reinstatement. Results showed that a history of chronic stress caused an increase in pellet priming-induced reinstatement in males and a decrease in cue-induced reinstatement in females. SCH-23390 combined with stress prevented those effects in males, but not in females. In females, a history of SCH-23390 administration caused an overall increase in responding that was apparent during cue-, but not pellet priming-, induced reinstatement testing. These results establish that both the effects of chronic stress on reinstatement of food seeking and the involvement of dopamine in those effects are dependent on biological sex. Such findings should inform the development of sex-specific interventions for dietary relapse and other stress-related health problems., (Copyright © 2020 Elsevier B.V. All rights reserved.)

As asynchronous online discussions gain a broader usage due to the COVID-19 epidemic, the need for understanding of students' ideas from unstructured textual data becomes more pressing. In this experimental study, we examine the effects of recommendations on message quality and community formation from voluminous online discussions. Drawing on literature from group cognition, knowledge building discourse, and learning analytics, we calculate message quasi-quality index (QQI) scores based on message lexical complexity and topic-related keyword usage by participants in explaining their ideas. Furthermore, we examine the empirical evidence on the relationship between QQI scores and participants' interactions. Finally, we visualize network structures via sociograms and hierarchically cluster participants to identify subgroups. Our analysis of 281 messages finds that recommendations helped participants to write more messages that compared alternative viewpoints and refined preliminary ideas with higher QQI scores. Results also show that recommendations cultivated a sense of collective agency to increase the opportunity for creativity and reduce the likelihood that peripheral participants will be dissatisfied and fail to identify with a community. Theoretical contributions and practical implications are discussed., (© Springer Science+Business Media, LLC, part of Springer Nature 2020.)

Context: Pre-season testing is often used to establish baseline scores for post-concussion interpretation. However, pre-season testing can be time-intensive and cost-prohibitive, in which case normative data may be used for post-injury interpretation., Objective: To compare change from baseline and normative-based cutoff scores in interpreting clinical reaction time (RTclin) following concussion., Design: Prospective case-control study., Setting: Multi-site study with testing completed in university athletic training rooms., Patients or Other Participants: An overlapping sample of 99 participants (age=19.0±1.1 years) evaluated within 6 hours post injury, 176 participants (age 18.9±1.1 years) evaluated 24-48 hours post injury, and 214 participants (18.9±1.1 years) evaluated at the time they were cleared to begin a return-to-play progression. Concussion participants were compared to 942 control participants (age=19.0±1.0 years) who did not sustain a concussion during the study period but completed preseason baseline testing one year apart., Main Outcome Measures: At each time point, follow-up RTclin (i.e., post injury or year 2) was compared to individualized year 1 preseason baseline RTclin and to normative baseline data (i.e., sex- and sport-specific). Receiver operating characteristic curves were used to compare sensitivity and specificity of RTclin change from baseline and normative-based cutoff scores., Results: Within 6h, change from baseline of 16ms maximized combined sensitivity (52%) and specificity (78%, AUC=0.702), while normative-based cutoff scores of 19ms maximized combined sensitivity (45%) and specificity (86%, AUC=0.700). At 24-48h, change from baseline of 2ms maximized combined sensitivity (64%) and specificity (61%, AUC=0.666), while normative-based cutoff scores of 0ms maximized combined sensitivity (63%) and specificity (62%, AUC=0.647)., Conclusions: Normative-based cutoff scores can be used for interpreting RTclin scores following concussion when individualized baseline data is not available, although low sensitivity and specificity may limit clinical use as a stand-alone test., (© by the National Athletic Trainers' Association, Inc.)

Importance: Population screening for medically relevant genomic variants that cause diseases such as hereditary cancer and cardiovascular disorders is increasing to facilitate early disease detection or prevention. Neuropsychiatric disorders (NPDs) are common, complex disorders with clear genetic causes; yet, access to genetic diagnosis is limited. We explored whether inclusion of NPD in population-based genomic screening programs is warranted by assessing 3 key factors: prevalence, penetrance, and personal utility., Objective: To evaluate the suitability of including pathogenic copy number variants (CNVs) associated with NPD in population screening by determining their prevalence and penetrance and exploring the personal utility of disclosing results., Design, Setting, and Participants: In this cohort study, the frequency of 31 NPD CNVs was determined in patient-participants via exome data. Associated clinical phenotypes were assessed using linked electronic health records. Nine CNVs were selected for disclosure by licensed genetic counselors, and participants' psychosocial reactions were evaluated using a mixed-methods approach. A primarily adult population receiving medical care at Geisinger, a large integrated health care system in the United States with the only population-based genomic screening program approved for medically relevant results disclosure, was included. The cohort was identified from the Geisinger MyCode Community Health Initiative. Exome and linked electronic health record data were available for this cohort, which was recruited from February 2007 to April 2017. Data were collected for the qualitative analysis April 2017 through February 2018. Analysis began February 2018 and ended December 2019., Main Outcomes and Measures: The planned outcomes of this study include (1) prevalence estimate of NPD-associated CNVs in an unselected health care system population; (2) penetrance estimate of NPD diagnoses in CNV-positive individuals; and (3) qualitative themes that describe participants' responses to receiving NPD-associated genomic results., Results: Of 90 595 participants with CNV data, a pathogenic CNV was identified in 708 (0.8%; 436 women [61.6%]; mean [SD] age, 50.04 [18.74] years). Seventy percent (n = 494) had at least 1 associated clinical symptom. Of these, 28.8% (204) of CNV-positive individuals had an NPD code in their electronic health record, compared with 13.3% (11 835 of 89 887) of CNV-negative individuals (odds ratio, 2.21; 95% CI, 1.86-2.61; P < .001); 66.4% (470) of CNV-positive individuals had a history of depression and anxiety compared with 54.6% (49 118 of 89 887) of CNV-negative individuals (odds ratio, 1.53; 95% CI, 1.31-1.80; P < .001). 16p13.11 (71 [0.078%]) and 22q11.2 (108 [0.119%]) were the most prevalent deletions and duplications, respectively. Only 5.8% of individuals (41 of 708) had a previously known genetic diagnosis. Results disclosure was completed for 141 individuals. Positive participant responses included poignant reactions to learning a medical reason for lifelong cognitive and psychiatric disabilities., Conclusions and Relevance: This study informs critical factors central to the development of population-based genomic screening programs and supports the inclusion of NPD in future designs to promote equitable access to clinically useful genomic information.

Vasa previa is a rare but serious medical condition characterized by a velamentous insertion of fetal blood vessels onto the placenta, which places those vessels at high risk of rupturing with rupturing of the membranes. Often vasa previa goes undetected until fetal compromise ensues following rupture of membranes. A recent case report of a 25-year-old pre-eclamptic female demonstrates the emergent and fatal nature of undiagnosed vasa previa., Competing Interests: The authors have declared no financial relationship with any commercial entity to the context of this article. The authors did not discuss off-label use within the article., (Copyright © by the American Association of Nurse Anesthetists.)

Objective: To examine the association between estimated age at first exposure (eAFE) to American football and clinical measures throughout recovery following concussion., Methods: Participants were recruited across 30 colleges and universities as part of the National Collegiate Athletic Association (NCAA)-Department of Defense Concussion Assessment, Research and Education Consortium. There were 294 NCAA American football players (age 19 ± 1 years) evaluated 24-48 hours following concussion with valid baseline data and 327 (age 19 ± 1 years) evaluated at the time they were asymptomatic with valid baseline data. Participants sustained a medically diagnosed concussion between baseline testing and postconcussion assessments. Outcome measures included the number of days until asymptomatic, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores, Balance Error Scoring System (BESS) total score, and Brief Symptom Inventory 18 (BSI-18) subscores. The eAFE was defined as participant's age at the time of assessment minus self-reported number of years playing football., Results: In unadjusted regression models, younger eAFE was associated with lower (worse) ImPACT Visual Motor Speed ( R 2 = 0.031, p = 0.012) at 24-48 hours following injury and lower (better) BSI-18 Somatization subscores ( R 2 = 0.014, p = 0.038) when the athletes were asymptomatic. The effect sizes were very small. The eAFE was not associated with the number of days until asymptomatic, other ImPACT composite scores, BESS total score, or other BSI-18 subscores., Conclusion: Earlier eAFE to American football was not associated with longer symptom recovery, worse balance, worse cognitive performance, or greater psychological distress following concussion. In these NCAA football players, longer duration of exposure to football during childhood and adolescence appears to be unrelated to clinical recovery following concussion., (© 2020 American Academy of Neurology.)

Human trafficking is a form of modern day slavery involving exploitation, abuse, and suffering of victims. Survivors of human trafficking often seek medical care for severe health issues resulting from psychological and physical abuse. Nurses play a critical role in identifying, advocating for, and assisting victims of human trafficking to safety. Sadly, trafficked patients often remain unrecognized due to health care providers' lack of awareness and understanding of human trafficking. Undergraduate nursing programs are uniquely positioned to address this problem; educating nursing students about human trafficking should help improve graduates' ability to help rescue victims. A dearth of knowledge exists in the literature regarding the implementation of human trafficking as a content area in undergraduate nursing curricula. This manuscript provides suggestions for how to deliver human trafficking education to undergraduate nursing students including optimal courses and timing in which to integrate the topic, a review of four key content areas of human trafficking, and creative teaching strategies to consider for classroom use., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Can factors within the Electronic Residency Application Service application be used to predict the success of general surgery residents as measured by the Accreditation Council for Graduate Medical Education (ACGME) general surgery milestones?, Methods: This is a retrospective study of 21 residents who completed training at a single general surgery residency program. Electronic Residency Application Service applications were reviewed for objective data, such as age, US Medical Licensing Examination scores, and authorship of academic publications as well as for letters of recommendation, which were scored using a standardized grading system. These factors were correlated to resident success as measured by ACGME general surgery milestone outcomes using univariate and multivariate analyses. This study was conducted at a single academic tertiary care and level 1 trauma facility. Residents who completed general surgery residency training from the years of 2012-2018 were included in the study., Results: There were few correlations between application factors and resident success determined by the ACGME milestones., Conclusions: Application factors alone do not account for ongoing growth and development throughout residency. Unlike the results presented in the literature for other surgical subspecialties, predicting general surgery resident success based on application factors is not straightforward., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Purpose This study examined factors of language ability that predict consonant production accuracy in young Spanish-English dual language learners (DLLs). Method Participants were 695 Latino DLLs, ages 3;0-6;5 (years;months). Single-word productions were elicited using the Bilingual Phonological Assessment (Miccio & Hammer, 2006). Children's consonant productions were assessed using Percentage of Consonants Correct-Revised (PCC-R; Shriberg et al., 1997a). Vocabulary abilities were assessed using the Woodcock-Muñoz Language Survey-Revised (Woodcock et al., 2005). Multiple linear regression analyses were used to determine the effects of vocabulary abilities and cross-language consonant production abilities on children's consonant production accuracy in each language. Results Large amounts of the variance in PCC-R scores for English ( R 2 = .65) and Spanish ( R 2 = .43) were predicted by children's age, vocabulary scores within the same language, and PCC-R scores across languages. Conclusion Spanish-English DLLs' consonant production abilities in both languages improve with age between 3;0 and 6;5. DLLs' accuracy in each language is also affected by vocabulary abilities within the same language and by their consonant production abilities in the other language. In particular, children's consonant production abilities in each language were highly predictive of their consonant production abilities in the other language, which suggests that shared phonological skills support their development across languages.

Methylenetetrahydrofolate reductase (MTHFR) deficiency is an autosomal recessive disorder that results in hyperhomocysteinemia. Elevated homocysteine levels in the blood can cause arterial and venous thrombosis, atherosclerosis, recurrent pregnancy loss, and neurologic symptoms. Emerging research suggests links to other chronic illnesses as well. Anesthetic management of patients with MTHFR deficiency should focus on decreasing the risk of arterial or venous thrombosis and minimizing elevations in homocysteine levels. Thrombosis prevention includes the use of antiembolism compression stockings, intermittent pneumatic compression sleeves, subcutaneous heparin or low-molecular-weight heparin, early ambulation, and adequate hydration. Nitrous oxide is known to inhibit methionine synthase, a vitamin B12-dependent enzyme responsible for the breakdown of homocysteine, resulting in homocysteine elevation, and should be avoided in these patients. Intravenous vitamin B12 infusion before surgery may help decrease homocysteine levels; however, it is not readily available in most operating rooms. Propofol and sevoflurane do not increase homocysteine levels and are considered safe for patients with MTHFR deficiency. This case study describes a 58-year-old man with known MTHFR deficiency and his subsequent uneventful anesthetic care during a total knee replacement., Competing Interests: The authors have declared no financial relationship with any commercial entity to the context of this article. The authors did not discuss off-label use within the article., (Copyright © by the American Association of Nurse Anesthetists.)

The synthesis, structure, and solid-state UV-vis-NIR spectroscopy of four new f-element squarates, M 2 (C 4 O 4 ) 3 (H 2 O) 4 (M = Eu, Am, Cf) and Sm(C 4 O 4 )(C 4 O 3 OH)(H 2 O) 2 ·0.5H 2 O, four new cationic lanthanide squarate chlorides, [M 4 (C 4 O 4 ) 5 (H 2 O) 12 ]Cl 2 ·5H 2 O (M = Eu, Dy, Ho Er), and two new actinide squarate oxalates, M 2 (C 4 O 4 ) 2 (C 2 O 4 )(H 2 O) 4 (M = Am, Cf), are presented. All of the metal centers are trivalent. Single-crystal X-ray diffraction analysis reveals that M 2 (C 4 O 4 ) 3 (H 2 O) 4 and Sm(C 4 O 4 )(C 4 O 3 OH)(H 2 O) 2 ·0.5H 2 O have a two-dimensional sheet structure constructed from MO 7 (H 2 O) 2 monocapped square-antiprismatic (coordination number (CN) = 9) metal centers and SmO 6 (H 2 O) 2 square-antiprismatic (CN = 8) metal centers, respectively, whereas M 2 (C 4 O 4 ) 2 (C 2 O 4 )(H 2 O) 4 have a three-dimensional (3D) structure constructed from MO 7 (H 2 O) 2 monocapped square-antiprismatic (CN = 9) metal centers. Additionally, the cationic framework materials [M 4 (C 4 O 4 ) 5 (H 2 O) 12 ]Cl 2 ·5H 2 O have a 3D structure constructed from two crystallographically unique MO 5 (H 2 O) 3 square-antiprismatic (CN = 8) metal centers. In these structures, the squarate ligands bind to the metal centers with varying coordination modes and denticities. The results of this study provide another example of the nonparallel chemistry between the lanthanides and transplutonium elements. From the crystallographic data for the isotypic series M 2 (C 4 O 4 ) 3 (H 2 O) 4 (M = La-Nd, Sm, Eu) and the linear regression fit to a plot of the unit cell volume as a function of the cube of the ionic radius, the nine-coordinate ionic radius of Cf  3+ was determined to be 1.127 ± 0.003 Å. Finally, computational analysis of the americium and californium complexes M 2 (C 4 O 4 ) 3 (H 2 O) 4 and M 2 (C 4 O 4 ) 2 (C 2 O 4 )(H 2 O) 4 reveals three important attributes: (i) the 5f orbitals are nonbonding in all cases, with the bonding differences occurring with the empty 6d orbitals; (ii) the Cf complexes exhibit more covalent character than their Am counterparts; and (iii) there is more covalent character in the squarate-oxalate complexes than in the squarate complexes.

A vast amount of literature exists on communication campaign design, implementation, and evaluation, especially in health contexts. Despite recent calls to center the role of local citizens in designing and implementing campaign initiatives, limited literature exists on how to integrate local expertise with the expertise of those external to the local context. Drawing on health communication campaigns literature, peacebuilding literature, and our experiences collaborating on a multi-year communication campaign for peacebuilding and health promotion in Liberia, West Africa, we advance a locally driven communication campaign approach that integrates expertise of local citizens, campaign researchers, and campaign practitioners. We make a critical linkage between health communication and peacebuilding to discuss implications about how a locally driven communication campaign approach can contribute to communication campaigns in general, as well as health and peacebuilding specifically.

Previous research in our lab has established a causal role for chronic stress exposure in subsequent increases in relapse-like behaviors in male rats with a history of palatable food self-administration. Given that many of the neurobehavioral consequences of stress are sex dependent, we aimed to determine whether sex differences exist with regard to the effects of chronic stress on relapse. Additionally, because high trait anxiety confers vulnerability to stress-related disorders, we examined whether individual differences in trait anxiety were related to differences in relapse-like behavior after chronic stress exposure. Following elevated plus maze testing for classification into high- or low-anxiety phenotypes, male and female rats responded for highly palatable food pellets. During subsequent extinction training, stress was manipulated (0 or 90 min restraint/day for 7 days). Rats were then tested for cue- and pellet priming-induced reinstatement of palatable food seeking. Results showed that female rats displayed higher levels of responding during cue-induced reinstatement tests compared to males, and that a history of chronic stress caused an attenuation of cue-induced reinstatement in female, but not male, rats. Regarding pellet priming-induced reinstatement, there was a three-way interaction such that neither stress history nor anxiety phenotype was related to reinstatement in females, but a history of stress in males caused increased and decreased responding in low- and high-anxiety rats, respectively. These results suggest that biological sex and trait anxiety level may help to explain differences in vulnerability to relapse among individuals exposed to chronic stress. Such information may be useful in designing more personalized and effective treatments for obesity and eating disorders., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Context: In the absence of baseline testing, normative data may be used to interpret postconcussion scores on the clinical reaction-time test (RTclin). However, to provide normative data, we must understand the performance factors associated with baseline testing., Objective: To explore performance factors associated with baseline RTclin from among candidate variables representing demographics, medical and concussion history, self-reported symptoms, sleep, and sport-related features., Design: Cross-sectional study., Setting: Clinical setting (eg, athletic training room)., Patients or Other Participants: A total of 2584 National Collegiate Athletic Association student-athletes (n = 1206 females [47%], 1377 males [53%], and 1 unreported (<0.1%); mass = 76.7 ± 18.7 kg; height = 176.7 ± 11.3 cm; age = 19.0 ± 1.3 years) from 3 institutions participated in this study as part of the Concussion Assessment, Research and Education Consortium., Main Outcome Measure(s): Potential performance factors were sex; race; ethnicity; dominant hand; sport type; number of prior concussions; presence of anxiety, learning disability, attention-deficit disorder or attention-deficit/hyperactivity disorder, depression, or migraine headache; self-reported sleep the night before the test; mass; height; age; total number of symptoms; and total symptom burden at baseline. The primary study outcome measure was mean baseline RTclin., Results: The overall RTclin was 202.0 ± 25.0 milliseconds. Female sex (parameter estimate [B] = 8.6 milliseconds, P < .001, Cohen d = 0.54 relative to male sex), black or African American race (B = 5.3 milliseconds, P = .001, Cohen d = 0.08 relative to white race), and limited-contact (B = 4.2 milliseconds, P < .001, Cohen d = 0.30 relative to contact) or noncontact (B = 5.9 milliseconds, P < .001, Cohen d = 0.38 relative to contact) sport participation were associated with slower RTclin. Being taller was associated with a faster RTclin, although this association was weak (B = -0.7 milliseconds, P < .001). No other predictors were significant. When adjustments are made for sex and sport type, the following normative data may be considered (mean ± standard deviation): female, noncontact (211.5 ± 25.8 milliseconds), limited contact (212.1 ± 24.3 milliseconds), contact (203.7 ± 21.5 milliseconds); male, noncontact (199.4 ± 26.7 milliseconds), limited contact (196.3 ± 23.9 milliseconds), contact (195.0 ± 23.8 milliseconds)., Conclusions: Potentially clinically relevant differences existed in RTclin for sex and sport type. These results provide normative data adjusting for these performance factors., (© by the National Athletic Trainers' Association, Inc.)

Purpose The purpose of this study was to compare questionnaire-based and performance-based screening tools as predictors of an auditory processing disorder (APD) diagnosis. The questionnaire-based screening tools used were the Children's Auditory Performance Scale, Fisher's Auditory Problems Checklist, and Buffalo Model Questionnaire-Revised. The performance-based screening tools were from the SCAN-3 screening tests, that is, Auditory Figure Ground, Competing Words Free Recall (CW-FR), and Gap Detection Test. Predictability was ascertained by comparing the scores from screening tools with those from diagnostic APD tests and with the final diagnosis of APD. Research Design This study is a retrospective single-observation study. Method The screening and diagnostic test results were retrospectively analyzed from the medical records of 85 individuals (female = 39) aged 7-23 years who were seen for APD assessment at Bloomsburg University's Clinic for Hearing and Balance. Each participant was assessed with at least two questionnaire-based and at least two performance-based screening tools. Results Spearman correlation coefficient analysis showed a moderate relationship within questionnaire-based screening tools, whereas there was no relationship between questionnaire- and performance-based tools. Notably, the performance-based CW-FR screening tool showed a significant relationship with five diagnostic tests. The questionnaire-based screening tools did not predict APD diagnosis. The performance-based tool CW-FR (φ = 0.33) and the SCAN-3 screening battery (φ = 0.44) predicted the diagnosis of APD. Conclusion A performance-based screening tool or battery can be used to determine whether additional diagnostic APD evaluation is warranted. Referral for diagnostic assessment should not be based solely on questionnaire-based screening tools.

The aim of this study was to determine the heavy metal contents of dietary supplements manufactured from medicinal plants and assess the potential daily burden on their consumers. The study consisted of 41 dietary supplements produced from terrestrial plants or microalgae. The analysis of cadmium, lead, and mercury content was performed using analytical methods. The content of Cd and Pb was determined by flame atomic absorption spectrometry (FAAS). The mercury content was determined using atomic absorption spectrometry with the generation of cold mercury vapor (CVAAS). The presence of at least one of the three analyzed heavy metals was found in 79.2% samples of supplements produced from terrestrial plants and in 88.2% supplement samples produced from microalgae. Hazard quotient was used to calculate noncarcinogenic risk for humans by ingestion of dietary supplements containing heavy metals. From among all supplements, 68.3% of samples were contaminated with Cd and Pb (this does not always apply to the same samples) and 29.3% of samples were contaminated with Hg. The health risk assessment of consumers of dietary supplements showed, in an extreme case, that taking this supplement for only one week poses a health risk associated with exposure to Pb. The health risk associated with the intake of dietary supplements primarily depends on the duration of consumption., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2020 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: While just culture is embraced in the clinical setting, just culture has not been systematically incorporated into nursing education., Purpose: The purpose of this study was to assess prelicensure nursing student perceptions of just culture in academia., Methods: Following a quantitative, descriptive design, the Just Culture Assessment Tool for Nursing Education (JCAT-NE) was used to measure just culture across multiple (N = 15) nursing programs., Results: The majority of JCAT-NE respondents (78%) reported their program has a safety reporting system, 15.4% had involvement in a safety-related event, and 12% submitted an error report. The JCAT-NE mean total score was 127.4 (SD, 23.6), with a statistically significant total score decline as students progressed from the beginning (133.6 [SD, 20.52]) to the middle (129.77 [SD, 23.6]) and end (122.2 [SD, 25.43]) of their programs (χ[2] = 25.09, P < .001)., Conclusions: The results from this study are a call to action for nursing education to emphasize the tenets of just culture, error reporting, and quality improvement.

The purpose of this study was to assess the maturity-related differences in the aerobic and anaerobic adaptations to sprint interval training (SIT) among youth male athletes. Twenty-seven youth male athletes were assessed for years from peak height velocity (PHV) and classified into prepubescent (PRE, n = 7, years from PHV = -2.21 ± 0.47 years), peripubescent (PERI, n = 10, years from PHV = 0.25 ± 0.88 years), and postpubescent (POST, n = 10, years from PHV = 2.81 ± 0.50 years) groups based on their years from estimated peak height velocity. Participants completed a ramp exercise protocol on a cycle ergometer to determine maximal aerobic power, maximal oxygen consumption (VO 2peak ), and fatigue thresholds. Following baseline, all participants completed a 4-week SIT program that consisted of eight total training sessions. During each session, participants completed repeated 20-s sprints on a cycle ergometer against a resistance of 7.5% of body mass. The number of sprints per sessions increased from four in session 1 to seven in session 7, with four sprints in session 8. Peak and mean power from sessions 1 and 8 were recorded. All participants completed a post-testing ramp exercise protocol that mirrored baseline. Maximal aerobic power increased (p < .001) across all groups from baseline (212.61 ± 57.45 W) to post-testing (223.24 ± 58.90 W); however, VO 2peak only increased in POST (3.31 ± 0.43 to 3.54 ± 0.43 L min -1 , p = .003). Similarly, GET, VT, and RCP increased in POST, with no changes in PRE or PERI. In terms of anaerobic performance, PERI and POST had significant increases in peak and mean power. POST improved aerobic and anaerobic performance following SIT, while PERI only experienced improvements in anaerobic performance. Conversely, PRE had no changes in aerobic or anaerobic performance. The adaptations to SIT appear to be influenced by the somatic maturity status., (© 2020 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

This article delineates the theory and framework for an innovative child abuse training program for mandated reporters called ' iLookOut '. iLookOut is an online learning delivery system that utilizes mastery learning and self-determination theory in the Core Training program, along with spaced retrieval and retrieval practice in a follow-up micro-learning program that reinforces learning from the Core Training. A cognitive mapping model provides the structure for documenting and organizing the learning content in both the Core training and the follow-up micro-learning program. The article provides a conceptual framework for designing and implementing effective and efficient online learning programs.

Teachers commonly categorize students as visual or auditory learners. Despite a lack of empirical evidence, teaching to a student's perceived learning style remains common practice in education (Pashler et al., 2009). Having conducted an extensive review of the literature, Pashler et al. (2009) noted, "...very few studies have even used an experimental methodology capable of testing the validity of learning styles applied to education" (p. 105). Rogowsky et al. (2015) published the first study following the experimental design prescribed by Pashler et al. Focusing specifically on the visual/auditory dichotomy, Rogowsky et al. (2015) examined the extent to which learning style predicts comprehension and retention based on mode of instruction. Their study has been noted as "The only study located through the systematic literature search across six different databases and the screening of more than 1000 records that was totally aligned with Pashler's criteria" (Aslaksen and Loras, 2018, p. 3). The caveat to the 2015 study is that it was conducted with adult learners. The current study uses the same design and methodology as its predecessor, but on a school-aged population, making it the first of its kind. Consistent with earlier findings with adults, results failed to find a significant relationship between auditory or visual learning style preference and comprehension. Fifth graders with a visual learning style scored higher than those with an auditory learning style on listening and reading comprehension measures. As such, and counter to current educational beliefs and practices, teachers may actually be doing a disservice to students by using resources to determine their learning style and then tailoring the curriculum to match that learning style., (Copyright © 2020 Rogowsky, Calhoun and Tallal.)

We examined whether individual differences in weight gain during exposure to a "junk-food" diet were related to differences in later relapse-like behavior in a rat model. Following free access to a junk-food diet for 7 weeks, rats were trained to press a lever for palatable food pellets. Following extinction training, rats were tested for cue- and pellet priming-induced reinstatement. Results showed that rats prone to obesity while on the junk-food diet displayed greater pellet priming-, but not cue-, induced reinstatement relative to obesity-resistant rats, suggesting that obesity vulnerability is a factor determining one's chances for some types of relapse., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objectives: The objective of this study was to investigate the ability of a two-stage method of cepstral peak identification to effectively discriminate rough vs breathy vs typical voice in sustained vowel productions. It was hypothesized that a dual-stage search for cepstral peak prominences (CPP's) above and below specified quefrency/F 0 cutoffs would result in a CPP difference that would be characteristic of the rough, diplophonic voice type., Methodology: Central one-second portions of sustained vowel /a/ productions were obtained from 90 subjects (rough, breathy, and normophonic voices). All voice samples were analyzed using a a two-stage cepstral analysis process in which a CPP High-Low difference value was obtained by identifying cepstral peaks above and below a lower limit for expected F 0 (150 Hz for females and 90 Hz for males), called CPP High and CPP Low respectively., Results: The CPP High-Low difference value was observed to be a highly significant predictor, with negative values for this parameter characteristic of a dominant subharmonic in the voice signal and the perception of diplophonic, rough voice. Correct classification of rough vs nonrough voice samples was 82.2% (sensitivity 0.80 and specificity 0.833). In the consideration of three group classification (breathy vs. normophonic vs. rough), models incorporating two predictors (the CPP obtained from a single search through a 60 to 300 Hz frequency range (CPP Default ) and the CPP High-Low difference value) correctly classified 78.88% of the voice samples., Conclusions: Rough, diplophonic voices were consistently observed to have a subharmonic peak that was greater in amplitude than the cepstral peak obtained within the region of the expected F 0 , resulting in a negative value for the CPP High-Low difference. The two-stage cepstral analysis process described herein is visually intuitive from the graphical display of a cepstrum and is a simple extended calculation derived from cepstral analysis procedures that have been recommended as essential in the acoustic description of vocal quality., (Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Traumatic aortic rupture (TAR) is a highly fatal injury mechanism resulting from blunt deceleration forces against the descending aorta. The mechanism of TAR is directly attributed to the aorta suffering damage by indirect shearing forces. The descending aorta remains fixed to the posterior chest wall, while the heart and ascending aorta are exerted forward, thus causing the intimal tear. A characteristic triad presents as increased blood pressure in the upper extremities, decreased blood pressure in the lower extremities, and a widened mediastinum on radiography. Early recognition of signs and symptoms of the mechanism of injury is key to initiating early damage control surgery and ultimately decreasing morbidity and mortality. This case report describes the intraoperative management of an elderly female patient with TAR following a motor vehicle collision in a remote location in rural Pennsylvania., Competing Interests: The authors have declared no financial relationships with any commercial entity related to the content of this article. The authors did discuss off-label use within the article. Disclosure statements are available for viewing upon request., (Copyright© by the American Association of Nurse Anesthetists.)

Hurley, E, Comstock, BA, Haile, L, and Beyer, KS. Relative age effect in collegiate soccer: influence of nationality, playing position, and class. J Strength Cond Res 33(12): 3295-3301, 2019-The purpose of this study was to evaluate the existence of relative age effects (RAEs) in collegiate soccer. In addition, the impact of nationality, position, class, and National Collegiate Athletic Association (NCAA) tournament qualification status on the prevalence of RAEs was assessed. Birth dates from male NCAA Division I soccer athletes (n = 4,082) from the 2017/2018 season were categorized into quarters based on calendar and scholastic quarters. All athlete birth-date distributions were compared with the expected birth-date distributions for the United States. International-born athletes (INT) displayed a significant difference in birth-date distribution when assessed with calendar quarters, whereas American-born athletes (USA) showed a significant difference in birth-date distributions when assessed with scholastic quarters. Furthermore, INT showed significant RAEs for midfielders and defenders, whereas USA showed significant RAEs midfielders and goalkeepers. In terms of class, INT had significant RAEs for all classes, whereas USA had significant RAEs only for freshmen and sophomores. All INT had significant RAEs regardless of tournament qualification status; however, USA had significant RAEs only for nontournament teams. In summary, significant RAEs exist in male Division I college soccer; however, the presence of RAEs is influenced by nationality, position, class, and NCAA tournament qualification status. Coaches should be aware of RAEs during the recruitment process to avoid potential selection bias.

Purpose: There has yet to be a quantitative measurement of communicative resilience processes as outlined in the Communicative Theory of Resilience (CTR). This study aims to determine the structure, reliability, and validity of the Dyadic Communicative Resilience Scale (DCRS) in cancer patients and partners., Method: The DCRS was administered to 584 participants, including 312 cancer patients and 272 partners of cancer patients along with the common coping subscale of the dyadic coping inventory, the cancer-related communication problems with couples scale, and the resilience promoting scale., Results: Exploratory and confirmatory factor analyses revealed nine dimensions of dyadic communicative resilience within the five resilience processes outlined in the CTR. Structure reliability was shown with Cronbach's alphas between .77 and .88 and good to excellent model fit for the nine factors. Convergent and discriminant validities were demonstrated by significant Pearson correlations with relevant, established coping/resilience measures., Conclusions: The DCRS has a clear nine factor structure and demonstrates good reliability. The measure has good convergent and discriminate validity indicating its utility in future research examining resilience in cancer populations.

Objective: To evaluate the proof of concept of an innovative model of physical therapy Rehabilitation Enhancing Aging through Connected Health (REACH) and evaluated its feasibility and effect on physical function and health care utilization., Design: Quasi-experimental 12-month clinical trial., Setting: Two outpatient rehabilitation centers., Participants: Community-dwelling older primary care patients with a treatment arm undergoing the intervention (n=75; mean age=77±5.9y; 54% women) and propensity matched controls derived from a longitudinal cohort study (n=430; mean age=71±7.0y; 68% women) using identical recruitment criteria (N=505)., Intervention: Combined outpatient and home PT augmented with a commercially available app and computer tablet., Measurements: Primary outcomes included a feasibility questionnaire, exercise adherence, self-reported function, and the Short Physical Performance Battery (SPPB). Secondary outcomes included the rates of emergency department (ED) visits and hospitalizations., Results: Among REACH participants, we observed a 9% dropout rate. After accounting for dropouts, with propensity matching, n=68 treatments and n=100 controls were analyzed. Over the 12-month study duration, 85% of participants adhered to the exercise program an average of 2 times a week and evaluated the treatment experience favorably. In comparison to controls, after 1 year of treatment and within multivariable regression models, REACH participants did not manifest a significant difference in patient reported function (group x time effect 1.67 units, P=.10) but did manifest significant differences in SPPB (group x time effect 0.69 units, P=.03) and gait speed (group x time effect .08m/s, P=.02). In comparison to controls, after 1 year, the rate of ED visits (group x time treatment rate=0.27, P<.004) were significantly reduced, but a significant reduction in hospitalizations was not observed., Conclusion: The REACH intervention is feasible and has proof of concept in preventing functional decline and favorably affecting health care utilization. Evaluation on a larger scale is warranted., (Published by Elsevier Inc.)