Search

Purposes: Habitual coffee drinking is ubiquitous and generally considered to be safe despite its transient hypertensive effect. Our purpose was to determine the role of the sympathetic nervous system in the hypertensive response. Methods: In a single-centre crossover study, medical caregivers were studied after consumption of standard coffee (espresso), water and decaffeinated coffee (decaff) given in random order at least 1 month apart. Plasma caffeine levels, mean arterial pressure, heart rate, total peripheral resistance and muscle sympathetic activity were recorded. Baroreflex activity was assessed using burst incidence and RR interval changes to spontaneous blood pressure fluctuations. Results: A total of 16 subjects (mean [± standard error] age 34.4 ± 2 years; 44% female) were recruited to the study. Three agents were studied in ten subjects, and two agents were studied in six subjects. Over a 120-min period following the consumption of standard coffee, mean (± SE) plasma caffeine levels increased from 2.4 ± 0.8 to 21.0 ± 4 µmol/L and arterial pressure increased to 103 ± 1 mmHg compared to water (101 ± 1 mmHg; p = 0.066) and decaff (100 ± 1 mmHg; p = 0.016). Peripheral resistance in the same period following coffee increased to 120 ± 4% of the baseline level compared to water (107 ± 4; p = 0.01) and decaff (109 ± 4; p = 0.02). Heart rate was lower after both coffee and decaff consumption: 62 ± 1 bpm compared to water (64 bpm; p = 0.01 and p = 0.02, respectively). Cardio-vagal baroreflex activity remained stable after coffee, but sympathetic activity decreased, with burst frequency of 96 ± 3% versus water (106 ± 3%; p = 0.04) and decaff (112 ± 3%; p = 0.001) despite a fall in baroreflex activity from – 2.2 ± 0.1 to – 1.8 ± 0.1 bursts/100 beats/mmHg, compared to water (p = 0.009) and decaff (p = 0.004). Conclusion: The hypertensive response to coffee is secondary to peripheral vasoconstriction but this is not mediated by increased sympathetic nerve activity. These results may explain why habitual coffee drinking is safe. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists (SLTs) provide interventions for inducible laryngeal obstruction (ILO) despite a current lack of evidence to inform intervention delivery. This study is the first step to develop an evidence‐based intervention for ILO, using behaviour change theory and the Behaviour Change Technique Taxonomy version 1 (BCTTv1). Outcomes will inform the early development stage of a complex speech and language therapy intervention for ILO, enabling more precise reporting of ILO intervention studies, as per CONSORT guidelines. Aims: (1) To identify whether the BCTTv1 is a useful tool for characterising speech and language therapy interventions for ILO, based on existing literature, current practice and patient interviews. (2) To identify key behaviour change techniques (BCT) used within existing complex speech and language therapy interventions for ILO Methods and Procedures: A five‐phase study was conducted: (1) a systematic literature search of six electronic databases (Medline, EMBASE, CINAHL (EBSCO), Scopus, Trip, Web of Science) and grey literature between 2008 and 2020; (2) observations of six speech and language therapy intervention sessions; (3) a semi‐structured interview with an SLT to validate the observed BCTTs; (4) consensus from four national expert SLTs regarding application of synthesised BCTT data to their own experiences of ILO interventions; and (5) patient engagement to review and comment on findings. Outcomes and Results: Forty‐seven BCTs in total were coded across all three sources. Thirty‐two BCTs were identified in clinical observations; 31 in interviews with SLTs and 18 in the literature. Only six BCT were identified in all three sources. Expert SLTs confirmed clinical application and relevance. Patients reported finding the concept of BCT challenging but highlighted the value of psychoeducation to support their understanding of symptoms and in turn to understand the rationale behind speech and language therapy intervention recommendations. Conclusion: This study indicates that the BCTTv1 is a suitable framework to identify and describe intervention components used within speech and language therapy interventions for ILO. A practice–research gap exists, reinforcing that existing literature does not capture the complexity of speech and language therapy intervention for ILO. Further research is needed to develop our understanding of the BCTs that support optimal behaviour change for this patient group. What this paper adds: What is already known on the subject: There is growing recognition for the value of speech and language therapists (SLTs) in delivering complex interventions for patients with inducible laryngeal obstruction (ILO), including evidence to suggest that their intervention can improve quality of life for patients and reduce excessive healthcare use. There are, however, no randomised controlled trials in this field; thus it is unclear what constitutes the most effective intervention. What this study adds: This study demonstrates the complexity of speech and language therapy interventions for ILO and highlights the practice–research gap. It identifies a range of behaviour change techniques that are used in existing practice and captures patient views relating to the components identified within this study. What are the clinical implications of this work?: Findings highlight the value of providing education about factors that might be driving ILO symptoms and in turn the importance of sharing with patients the rationale for treatment recommendations that necessitate a change in their behaviours. Identified behaviour change techniques can be used when developing and implementing SLT interventions for ILO. [ABSTRACT FROM AUTHOR]

Although the use of airborne molecules as infochemicals is common in terrestrial plants, it has not been shown to occur in an ecologically relevant context in marine seaweeds. Like terrestrial plants, intertidal plants spend part of their lives emersed at low tide and release volatile organic compounds (VOCs) into the air when they are grazed or physiologically stressed. We hypothesized seaweeds could use airborne VOCs as infochemicals and respond to them by upregulating a keystone defensive metabolite, dimethylsulfoniopropionate (DMSP). We conducted laboratory and field experiments in which Ulva fenestrata was exposed to airborne dimethyl sulfide (DMS), a volatile antiherbivore and antioxidant metabolite released when the seaweed is grazed or physiologically stressed. In the laboratory, U. fenestrata exposed to DMS had 43–48% higher DMSP concentrations, relative to controls, 6–9 days after exposure. In the field, U. fenestrata 1 m downwind of DMS emitters had 19% higher DMSP concentrations than upwind seaweeds after 11 days. To our knowledge, this is the first demonstration of a marine plant using an airborne molecule released when damaged to elicit defensive responses. Our study suggests that the ability to detect airborne compounds has evolved multiple times or before the divergence of terrestrial plants and green algae. [ABSTRACT FROM AUTHOR]

Although the image quality from modern distal chip endoscopes is superior, limited mobility of the endoscopic tower prevents this technology from being used in inpatient and emergency departments. In these settings, otolaryngologists commonly use older flexible laryngoscopes with portable light sources. However, these light sources could malfunction. Smartphones are ubiquitous nowadays, and the smartphone's flashlight may be used alternatively to provide illumination when primary light malfunctions. This study compares the ability of flashlights from various smartphone models in providing adequate illumination for flexible laryngoscopy when compared to a commercially available portable light source. White wall and mucosal images were captured using Olympus P4 flexible scope and lights from the Stryker X8000 endoscopy tower light source, Storz 11301D3 portable light source (control), iPhone 4, iPhone 6, iPhone 8, iPhone X, Galaxy S6, and Galaxy S7. ImageJ was used to quantify pixel intensities with white and black standardized as 250 and 0, respectively. Student 2-tailed t test was used for analysis. The endoscopic tower outperformed all other light sources in all categories. The iPhone 4 and iPhone 6 consistently underperformed in comparison to the Storz 11301D3 portable light source (P <.05). Galaxy S6, Galaxy S7, and newer generation iPhone 8 and iPhone X provide comparable pixel intensities to Storz 11301D3 portable light. Smartphones incorporate different types of light-emitting diodes. Newer Galaxy and iPhone provide adequate illumination for the endoscopic assessment of the airway when compared to commercially available portable light source. However, one should always utilize the best commercially available light source in nonemergent cases. [ABSTRACT FROM AUTHOR]

One hundred and ninety‐four patient episodes were audited for response to a standardised 1 g intravenous iron infusion for medical outpatients with iron deficiency anaemia. Patients received either ferric carboxymaltose or iron polymaltose. At 5–7 weeks after infusion, mean increase in Hb was 26.7 g/L and ferritin was 161 mcg/L, and only one patient had Hb <100 g/L. This reassures that 1 g dose of intravenous iron is sufficient for most patients, with benefits for treatment costs and patient convenience. [ABSTRACT FROM AUTHOR]

Presents a study which demonstrated that a high-power backward-wave oscillator's nonlinear saturation properties are dependent on slow-wave structure length. Background on backward-wave oscillator; Description of the experimental setup; Results.

Objective To determine the feasibility of hysteroscopic sterilization in low-income and unauthorized immigrant women when financial barriers to care are removed. Methods Outpatient hysteroscopic sterilization for low-income women at an urban clinic was made possible by grant funding. All procedures were performed by obstetrician/gynecologist attending physicians or supervised trainees. Electronic records were reviewed for cases performed from June 2010 to December 11, 2013. Outcome incidences and complications were determined. Subgroup analyses using demographic and clinical factors were performed. Results Hysteroscopic sterilization was attempted in 197 patients. Most were Hispanic (93%) and undocumented immigrants (83%). Bilateral placement was achieved on first attempt in 92% (181/197). Successful placement was ultimately achieved in 96% (190/197), and 88% (168/190) returned for hysterosalpingogram (HSG). Appropriate tubal occlusion was documented on 96% (161/168) of HSGs with mean time of 3.5 ± 1.3 months. Repeat HSG at 6 months showed 100% occlusion (7/7). Of the initial cohort, 85% (168/197) could ultimately rely on Essure for contraception. One pregnancy was self-reported 9 months after the procedure; the patient had not followed up for HSG. There were no pregnancies among those who completed follow-up. There were no cases of procedural complications. Successful Essure placement was not associated with age, parity, immigration status, or clinical characteristics (analgesics administered, history of cesarean section, vaginal delivery, cervical surgery, ectopic, fibroids, or pelvic inflammatory disease). The only factor positively associated with HSG follow-up was age 35 years or younger (53% vs. 47%; p = .03). Conclusions Successful hysteroscopic sterilization can be achieved in an undocumented, low-income population. Rates of confirmatory HSG follow-up were found to be higher than in the general population. Public funding of programs could decrease unintended pregnancies and pregnancy-related costs. [ABSTRACT FROM AUTHOR]

Managing chronic illness is not just a healthcare issue but is also relevant to workplace communication and relationships. Workers with chronic conditions are faced with the decision of if and how they should disclose the chronic condition to their supervisors and co-workers. These decisions are laden with fears of stigma or other forms of discrimination that are commonly associated with invisible identities. This study used a qualitative questionnaire and thematic analysis techniques to reveal three reasons why workers chose to (or not to) reveal their chronic condition in the work environment:facilitate continued employment, enacting values, andexplaining absence or condition. Viewing the results through social exchange theory showed that employees exchange (or do not exchange) personal information for workplace accommodations. [ABSTRACT FROM AUTHOR]

The most widely used anticancer drugs are platinum-based. Their efficacy might be improved by carriers which can transport large numbers of Pt centres, shield the drug from premature activation, and/or deliver Pt specifically to cancer cells using vectors which recognise specific targets. We describe recent progress using functionalized carbon nanotubes (CNTs) and nanorods, hollow Prussian blue (HPB), magnetic iron oxide and gold nanoparticles, liposomes, nanogels and polymers, as well as active targeting by conjugation to biodegradable proteins and peptides (e.g. EGF, heparin, herceptin, somatostatin and TAT). Spatially targeted activation of PtIV prodrugs using light is also a promising approach. Interestingly, use of these new delivery and targeting systems for platinum drugs can lead to species with unusual reactivity which can kill cancer cells by new mechanisms. [ABSTRACT FROM AUTHOR]

The octahedral PtIV complex trans,trans,trans-[Pt(N3)2(OH)2(py)2] (1) is potently cytotoxic to cancer cells when irradiated with visible (blue) light. We show that the acute photocytotoxicity can be switched off by low doses (500 μM) of the amino acid L-tryptophan. EPR and NMR spectroscopic experiments using spin traps show that L-Trp quenches the formation of azidyl radicals, probably by acting as an electron donor. L-Trp is well-known as a mediator of electron transfer between distant electron acceptor/donor centers in proteins, and such properties may make the free amino acid clinically useful for controlling the activity of photochemotherapeutic azido PtIV drugs. Since previous work has demonstrated the ability of photoactivated 1 to platinate DNA, this suggests that the high potency of such photoactive platinum complexes is related to their dual attack on cancer cells by radicals and PtII photoproducts. [ABSTRACT FROM AUTHOR]

Objective: Manual jet ventilation is a specialized oxygenation and ventilation technique that is not available in all facilities due to lack of technical familiarity and fear of complications. The objective is to review our center's 15 year experience with low pressure low frequency jet ventilation (LPLFJV). Methods: Retrospective review of procedures utilizing LPLFJV from 2005 to 2019 were performed collecting patient demographic, surgery type and complications. Fisher exact test, Chi square, and t -test were used to determine statistical significance. Results: Four hundred fifty-seven patients underwent a total of 891 microlaryngeal surgeries—279 cases for voice disorders, 179 for lesions, and 433 for airway stenosis. The peak jet pressure for all cases did not exceed 20 psi and average peak pressure for the last 100 procedures in this case series was 14.9 ± 4.6 psi. The average lowest oxygen saturation for all cases was 95% ± 0.6%. Brief intubation was required in 154 cases (17%). Surgical duration was significantly longer for cases requiring intubation P <.001. The need for intubation was not associated with smoking or cardiopulmonary disease, but was strongly associated with body mass index (BMI). Intubation rates were 7% for normal weight (BMI < 25, N = 216), 13% for overweight (BMI 25-30, N = 282), 24% for obese (BMI 30-40, N = 342), and 37% for morbidly obese (BMI > 40, N = 52) patients. Three patients developed respiratory distress in the recovery unit and 2 patients required intubation. Conclusion: LPLFJV assisted by intermittent endotracheal intubation is an exceedingly safe and effective intraoperative oxygenation and ventilationmodality for a broad variety of laryngeal procedure. [ABSTRACT FROM AUTHOR]

AREVA NP's U.S. EPR is a 4590-MW(thermal) evolutionary pressurized water reactor that incorporates proven technology with an innovative system architecture to provide an unprecedented level of safety. One of the measures of safety is provided by probability risk assessment (PRA). PRA Level I concerns the evaluation of core damage frequency based on various initiating events and the success or failure of various plant event mitigation features. Determination of this measure requires mission success criteria, which are used to build the logic that makes up the fault trees and event trees of the Level 1 PRA. Developing mission success criteria for the wide variety of accident sequences modeled in the PRA Level I model requires a large number of thermal-hydraulic calculations. AREVA selected the MAAP4 code to perform these calculations because of its fast computation times relative to more sophisticated thermal-hydraulic codes. This is a unique application of the MAAP4 code, which was developed specifically for severe accident and PRA Level 2 analysis. As such, a study was performed to assess MAAP4's thermal-hydraulic response capabilities against AREVA's S-RELAP5 best-estimate integral systems thermal-hydraulic analysis code. [ABSTRACT FROM AUTHOR]

The question of whether metabolic drug clearance is decreased in elderly people has been the subject of considerable debate and is very important because clearance is a determinant of dosing. Drug clearance has been shown to be consistently impaired for flow-limited (high-clearance) drugs, but there have been conflicting results for capacity-limited (low-clearance) drugs. A limitation of the studies of capacity-limited drugs is that most have estimated clearance based on total drug concentrations (protein-bound plus free). Total drug clearance reflects both the intrinsic clearance of free drug and the extent of protein binding. Total clearance is a valid measure for capacity-limited drugs with low protein binding and appears to be consistently impaired in elderly subjects. For phenazone [antipyrine] (fraction unbound [fu] >0.9), seven studies have demonstrated statistical reductions in clearance of 20–52%. For theophylline (fu 0.6), five studies have demonstrated reductions in clearance of 22–35%. For paracetamol [acetaminophen] (fu 0.8), the clearance of which has been quoted as unchanged, four studies have demonstrated reductions in clearance of 19–35%. For highly protein-bound drugs, total clearance is not the appropriate parameter. Free drug clearance is more appropriate since it is independent of changes in protein binding. The literature was reviewed to test the hypothesis that in elderly people, capacity-limited drugs with high protein binding will show decreased free clearance even in the absence of a decrease in total clearance. For these drugs, data for free drug clearance based on measurement of actual free drug concentrations are limited, but suggest that the intrinsic metabolic clearance is impaired in elderly subjects. Four studies of naproxen (fu <0.01) have shown reduced free drug clearance of 50% or more. Two studies of valproic acid (fu 0.1–0.2) have shown reduced free clearance of 39% and 65%. Two studies of ibuprofen (fu <0.01) have shown reduced free clearance of S-ibuprofen of 21% and 28%. There is some indirect evidence for reduced clearance of the highly protein-bound drugs oxaprozin, temazepam, lorazepam, diazepam, phenytoin and warfarin, although studies measuring free concentrations are lacking. Together, the above studies support the hypothesis that the intrinsic metabolic drug clearance is impaired in elderly subjects, in the order of 20–60%, and that this effect is masked if highly protein-bound drugs are assessed using total drug clearance. If the findings are confirmed in future well-designed studies of free drug clearance, there are profound and beneficial implications for dosing of drugs in elderly people. Lower doses are likely to achieve appropriate concentrations, allowing full efficacy but decreased dose-related adverse effects. [ABSTRACT FROM AUTHOR]

Abstract: Transient infrared spectroscopy (or time-resolved infrared spectroscopy, TRIR) on the nanosecond and faster timescales has continued to evolve as a routine and, sometimes, definitive tool both for elucidation of electronic and molecular structures in metal complex excited-states. This review examines examples from the literature since 1998 and discusses experimental methods for performing transient infrared experiments and recent novel applications of TRIR to the excited states of transition metal complexes. While the interrogation of “reporter” ligands such as ν(CO) and ν(CN) modes in metal carbonyl and cyanide complexes and ν(C modes, has grown extensively toward the identification of excited states and important features of their bonding, there have been many exciting extensions of the transient infrared technique in recent years. TRIR has been increasingly applied to many types of excited states, resulting in a well-established methodology for assigning excited-state identities. The usefulness of this method has been demonstrated in the unraveling of the sometimes complicated photophysical behavior associated with the complex interplay of multiple excited states, such as closely-spaced MLCT, intra- (IL) and interligand, and dd (ligand-field (LF)) excited states. In recent years, efforts to relate ground-to-excited state vibrational band shifts with other excited state properties (such as the ground-to-excited state energy gap), and medium effects have brought new insights to the understanding of electronic structure in excited states. Application of electronic structure calculations, such as density functional theory approaches, has proven to be a very powerful tool when combined with TRIR in this regard. Relatively new developments, such as non-linear 2D infrared (T2D-IR) spectroscopy, spectroscopic extension into the near infrared, and time-resolved dynamic imaging methods offer exciting possibilities for future applications, and have already presented new capabilities for providing additional insight into the excited states of transition metal complexes. [Copyright &y& Elsevier]

The chelating ligand (2,2′-C12H8O2)P(CH2CH2O)4P(2,2′-O2C12H8) reacts with both Ru(bpy)2(O3SCF3)2 and Mo(CO)4(C7H8) to form the new metallacrown ether complexes cis-[Ru(bpy)2((2,2′-C12H8O2)P(CH2CH2O)4P(2,2′-O2C12H8))](O3SCF3)2 (1) and cis-[Mo(CO)4((2,2′-C12H8O2)P(CH2CH2O)4P(2,2′-O2C12H8))] (2). The X-ray crystal structures for both complexes indicate that the metallacrown ether ring oxygen atoms point their lone pairs towards the cavity in the cis-metallacrown ether ring. The effect of interactions of the metallacrown ether complex with selected monoatomic cations (Li+, Na+ and Hg2+) on the emissive properties of the Ru(bpy)2 2+ chromophore were studied by steady-state and time-dependent emission spectroscopy. Our results suggest that complex 1 interacts weakly with Li+, Na+ and Hg2+, and subtle changes are observed in its photophysical properties. These changes are discussed in terms of excited-state parameters obtained from a Franck–Condon analysis of the emission spectra. [Copyright &y& Elsevier]

Many hormones activate transcription by raising the level of cAMP within cells. In one well studied pathway, cAMP induces protein kinase A to phosphorylate the transcription factor CREB, which binds to a consensus sequence, the cAMP-regulated enhancer, found in many target genes. A generally accepted model suggests that phosphorylated CREB recruits the histone acetyltransferase CBP to activate transcription. In contrast, histone deacetylases have been linked to the cessation of CREB-dependent transcription. Here we tested this model in the regulation of endogenous CREB target genes. We used a constitutively active CREB mutant and microarray analysis to identify target genes in PC12 cells. We then tested the role of histone deacetylase activity in cAMP activation of four of these genes (c-FOS, ICER, NOR-1, and NUR77) by treating cells with the histone deacetylase inhibitor trichostatin A. Consistent with the generally accepted model, trichostatin A enhanced activation of c-FOS and NUR77 by cAMP. Surprisingly, trichostatin A blocked activation of ICER and NOR-1. The block of ICER and NOR-1 activation persisted in the presence of cycloheximide, indicating that the trichostatin A effect did not depend on new protein synthesis. This unexpected role of histone deacetylases in transcriptional activation of certain endogenous CREB target genes was not apparent in transfected reporter genes. Chromatin immunoprecipitation analysis indicated that the differential roles of histone deacetylases in activating or repressing CREB target genes was manifested at the level of preinitiation complex recruitment. These data indicate that histone deacetylases differentially regulate CREB target genes by contributing to either activation or cessation of transcription. [ABSTRACT FROM AUTHOR]

Lead interferes with cellular energy metabolism by inhibiting ATP (Adenosine triphosphate) synthesis and hydrolysis. This study was conducted to determine in vitro e9ects of lead on Na[SUP+], K[SUP+]-ATPase activity in four regions of adult rat brain: the cerebellum, the hippocampus, the frontal cortex and the brain stem. Male rats (Wistar strain) weighing 125-150 g were sacrificed, whole brain excised and the four regions were isolated. Each tissue was homogenized separately in sucrose (0.25 M) and imidazole (10 mM) buffer (pH 7.5) and P[SUB2] fraction was prepared by following established methods. The activity of ATPase was determined by measuring inorganic phosphate (Pi) liberated from ATP hydrolysis. The delineation of Na[SUP+], K[SUP+]-activated component of ATPase was obtained by the di9erence between total ATPase and Mg[SUP2+]-ATPase using 1 mM ouabain. The P[SUB2] fraction was incubated with 0, 5, 10, 25, 50 and 100 μM of lead at 37°C for 10 min. The enzyme activity was expressed as mmoles of Pi liberated/mg protein/hr. The results indicated a concentration-dependent and region-specific response to lead. In vitro lead at 50 and 100 μM significantly inhibited ATPase activity in all regions of the brain. [ABSTRACT FROM AUTHOR]

Presents a guide in the execution of a laboratory project which introduces several key concepts and skills for biology course at the university level. Procedure for measuring marine mollusk shells; Background reading required prior to measuring genetic drift; Instruction for implementing a case study on leaf variability for the construction of taxonomic keys.

This article reports that the Massachusetts Department of Education responds to a critique of its tests of English Language Arts done by education critic Susan Goldsmith. Having read Goldsmith's thoughtful evaluation of the 2001 Massachusetts Comprehensive Assessment System English Language Arts tests, the Department of Education addressed some of the issues and challenges she raised. In English Language Arts, the learning standards contained in the curriculum framework are organized into sequences that measure language, reading comprehension, writing and revision.

The article highlights the significance of religion in advancing children's rights movements of the United Nations (UN) as of October 2000. Until now, nongovernmental organizations (NGO) has generally consisted of progressive social justice advocates encouraging states to take greater steps to ensure human rights and promote peace and development. Those seeking to advance children's rights will do well to seek to build partnerships with religious organizations if they have not already done so. Fortunately, not all religious organizations agree with the pro-family coalition's stance on children's rights. In fact, a large number of religious groups believe that their faith calls them to support the work of the UN on children's rights. For instance, one of the largest inter-faith organizations, the World Conference on Religion and Peace, has a program devoted to working with religious communities to advance the rights of children. Progressive religious organizations can also educate their constituencies about faith-based reasons for supporting children's rights. Religious traditions shape the values and perceptions of a majority of the world's population. Therefore the ability to explain to religious communities the faith basis for children's and women's rights can increase global support for these values.

In 3 experiments, supportive audiences were associated with unexpected performance decrements (i.e., "choking" under pressure). On a difficult, skill-based task, participants were more likely to fail when observed by supportive audiences than when observed by nonsupportive audiences. When the criterion for success was easy, supportive audiences had no effect. With a difficult criterion, supportive audiences elicited cautious, protective strategies that were associated with poor performance: Speed decreased without improving accuracy. Despite impairments caused by supportive audiences, performers found supportive audiences more helpful and less stressful than neutral or adversarial audiences, and participants believed (wrongly) that they performed better with a supportive audience. Results suggest that people are not aware of debilitating effects of supportive audiences and may opt for emotional comfort rather than objective success. [ABSTRACT FROM AUTHOR]

Although most interpersonal interactions take place between people who know each other, most self-presentation research has focused on self-presentation to strangers. Five studies showed that self-presentational favorability differed as a function of whether the interaction partner was a friend or a stranger. Studies 1 and 2 found that self-presentations to friends were consistently more modest than self-presentations to strangers. In Studies 3 and 4, self-presentations were manipulated by instructing participants to present themselves in either a self-enhancing or modest manner. Modesty with strangers and self-enhancement with friends both resulted in impaired recall for the interaction, consistent with the view that those strategies contradict familiar, overlearned patterns. Study 5 distinguished self-deprecation from modesty. Taken together, the results indicate that people habitually use different self-presentation strategies with different audiences, relying on favorable self-enhancement with strangers but shifting toward modesty when among friends. [ABSTRACT FROM AUTHOR]

Reports on a survey carried out at Dorset House School of Occupational Therapy, Oxford, into the perceived effectiveness of different teaching methods used within the lecture format in the Human Biology courses. How traditional lecture method is ineffective at stimulating thought; Factors contributing to the perceived efficiency of lecture; Methods used in the survey; Results of the survey; Conclusion.

The article discusses the correlations that exist between the sex trade and transmission of the human immunodeficiency virus (HIV). The United Nations Refugee Agency (UNHCR) and the United Nations Population Fund (UNFPA) have conducted studies on the need for multisectoral interventions to address the prevalence of HIV among sex workers in humanitarian settings. Conflicts and disasters facilitate the sell of sex due to factors such as poverty, the separation of families, and breakdowns in community support mechanisms. The author urges that HIV prevention measures need to be extended beyond the healthcare sector.

Introduction: Stop the Bleed (STB), and other trainings that promote health education in basic trauma management techniques, is offered mostly in English and Spanish in the United States. Limited access to injury prevention training may contribute to inequities in health outcomes for individuals with limited English proficiency (LEP). Our study aims to determine the feasibility and effectiveness of STB training in 4 languages spoken in a super diverse refugee settlement community, Clarkston, GA. Methods: Written STB educational materials were culturally adapted, translated, and back translated into 4 languages: Arabic, Burmese, Somali, and Swahili. Four 90-minute in-person STB trainings were conducted by medical personnel with community-based interpreters at a central and familiar location in the Clarkston community. Pre- and post-tests were administered in participant's preferred language to evaluate change in knowledge and beliefs as well as the effectiveness of the training method. Results: A total of 46 community members were trained in STB, the majority of which were women (63%). Participants demonstrated improvement in their knowledge, confidence, and comfort using STB techniques. Participants reported that 2 aspects of the training were particularly beneficial: the presence of language concordant interpreters from the community and small group hands on sessions that allowed for practicing STB techniques. Conclusion: Cultural and linguistic adaptation of STB training is a feasible, cost-effective, and effective method for disseminating life-saving information and trauma education to immigrant populations who have LEP. Expansion of community training and partnerships to support the needs of diverse communities is both necessary and urgent. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented related to the diagnosis of cause of activated partial thromboplastin time in adult patients with beta thalassaemia major, an inherited blood disorder.

Introduction: The British Orthopaedic Association Standards for Trauma (BOAST 12) guidelines for the management of ankle fractures aims to optimize recovery and reduce complications. Within the emergency department (ED), they advised urgent reduction of clinically deformed ankles, with radiographs prior only if this would not cause an unacceptable delay. The primary aim of this study was to assess the effect of time to acceptable reduction on the risk of complications and time to definitive reduction. Methods: This was a retrospective observational study of patients presenting with ankle fracture dislocations between 2013 and 2017. Patients were divided into two groups with and without radiographs prior to reduction of their injury. Results: A total of 242 patients were identified. The time taken from arrival to achieving an acceptable reduction was significantly longer in patients who received pre-reduction radiographs versus patients who did not (184.5 min vs 82, p <.00). The key finding of this follow-up study was that the overall risk of complications and soft tissue complications was not associated with an increased time to reduction (p =.62). Time to definitive operative management was similar between the two sub-groups (immediate reduction 1 day vs 2, p =.72). Conclusion: This study has shown that the use of pre-reduction radiographs in the management of ankle fracture dislocations significantly increases the time to reduction. However, this is not associated with an increased risk of complications or a longer time to definitive management. Further research is needed into the prognostic effect of prolonged ankle dislocation on soft tissues and long-term functional outcome. [ABSTRACT FROM AUTHOR]

An abstract of the article "Empowering School Kitchens With Fresh Produce Skills" by Jennifer H. Butler et al. is presented.

Background: While the conditions in emergency humanitarian and conflict-affected settings often result in significant sex work economies, there is limited information on the social and structural conditions of sex work in these settings, and the impacts on HIV/STI prevention and access to sexual and reproductive health (SRH) services for sex workers. Our objective was to comprehensively review existing evidence on HIV/STI prevention and access to SRH services for sex workers in conflict-affected settings globally. Methods: We conducted a comprehensive review of all peer review (both epidemiological and qualitative) and grey literature published in the last 15 years (2000-2015), focusing on 1) HIV/STI vulnerability or prevention, and/or 2) access to SRH services for sex workers in conflict-affected settings. Five databases were searched, using combinations of sex work, conflict/mobility, HIV/STI, and SRH service terms. Relevant peer-reviewed and grey literature were also hand-searched, and key papers were cross-referenced for additional material. Results: Five hundred fifty one records were screened and 416 records reviewed. Of 33 records describing HIV/STI prevention and/or access to SRH services among sex workers in conflict-affected settings, 24 were from sub-Saharan Africa; 18 studies described the results of primary research (13 quantitative, 3 qualitative, 2 mixed-methods) and 15 were non-primary research (e.g., commentaries, policy reports, programmatic manuals). Available evidence indicated that within conflict-affected settings, SWs’ capacity to engage in HIV/ STI prevention and access SRH services is severely undermined by social and structural determinants including widespread violence and human rights violations, the collapse of livelihoods and traditional social structures, high levels of displacement, and difficulties accessing already scant health services due to stigma, Discussion/Conclusions: This review identified significant gaps in HIV/STI and SRH research, policy, and programming for conflict-affected sex workers, highlighting a critical gap in the humanitarian response. Sex worker-informed policies and interventions to promote HIV/STI prevention and access to HIV and SRH services using a rights-based approach are recommended, and further research on the degree to which conflictaffected sex workers are accessing HIV/STI and SRH services is recommended. A paradigm shift from the behavioural and biomedical approach to a human rights-based approach to HIV/ STI prevention and SRH is strongly recommended. [ABSTRACT FROM AUTHOR]

Introduction Sinonasal melanomas are rare tumors with no comparative survival studies between Europe and the US. Objective To provide a population-based survival analysis between the two continents. Methods The European Cancer Registry (EUROCARE) and the United States Surveillance, Epidemiology, and End Results (SEER) databases were queried to identify patients diagnosed with sinonasal melanoma between 2000 and 2007. Relative survival (RS) data were grouped by age, gender, geographic region, extent of disease, and treatment modality. Results A total of 1,294 cases were identified between 2000 and 2007 (935 from EUROCARE-5 and 359 from SEER). Females were most commonly identified in Europe (56.4%) and in the US (54.9%). Patients over the age of 65 years comprised the greatest proportion of patients in Europe (70%) and in the US (71%). By region, Southern Europe had the highest 5-year RS (31.6%, 95% confidence interval [CI]=[21.3-42.5%]), and Eastern Europe the lowest (16.5%, [7.5-28.5%]). The aggregate European 5-year RSwas 25.4% [21.8-29.1%] and the U.S. was (29.7%, [23.6-36%]). Conclusions Althoughincreasing inincidence, sinonasalmelanomas remain rare. Women were more commonly affected. The most common age group was those older than 65 years, although age did not confer a prognostic value. The most common subsite was the nasal cavity followed by themaxillary sinus. Five-year RSwas similar between continents with an inverse relationship between extent of diseaseand survival. The treatment of choice throughout Europe and the US remains primarily surgical. [ABSTRACT FROM AUTHOR]

The first designed molecular catalyst for water oxidation is the "blue dimer", cis,cis-[(bpy)2(H2O)RuIIIORuIII(OH2)(bpy)2]4+. Although there is experimental evidence for extensive electronic coupling across the μ-oxo bridge, results of earlier DFT and CASSCF calculations provide a model with magnetic interactions of weak to moderately coupled RuIII ions across the μ-oxo bridge. We present the results of a comprehensive experimental investigation, combined with DFT calculations. The experiments demonstrate both that there is strong electronic coupling in the blue dimer and that its effects are profound. Experimental evidence has been obtained from molecular structures and key bond distances by XRD, electrochemically measured comproportionation constants for mixed-valence equilibria, temperature-dependent magnetism, chemical properties (solvent exchange, redox potentials, and pKa values), XPS binding energies, analysis of excitation-dependent resonance Raman profiles, and DFT analysis of electronic absorption spectra. The spectrum can be assigned based on a singlet ground state with specific hydrogen-bonding interactions with solvent molecules included. The results are in good agreement with available experimental data. The DFT analysis provides assignments for characteristic absorption bands in the near-IR and visible regions. Bridge-based dπ → dπ* and interconfiguration transitions at RuIII appear in the near-IR and MLCT and LMCT transitions in the visible. Reasonable values are also provided by DFT analysis for experimentally observed bond distances and redox potentials. The observed temperature-dependent magnetism of the blue dimer is consistent with a delocalized, diamagnetic singlet state (dπ1*)2 with a low-lying, paramagnetic triplet state (dπ1*)1(dπ2*)1. Systematic structural-magnetic-IR correlations are observed between ?sym(RuORu) and ?asym(RuORu) vibrational energies and magnetic properties in a series of ruthenium-based, μ-oxo-bridged complexes. Consistent with the DFT electronic structure model, bending along the Ru-O-Ru axis arises from a Jahn-Teller distortion with Ru-O-Ru dictated by the distortion and electron-electron repulsion. [ABSTRACT FROM AUTHOR]

The article presents a randomized controlled trial to estimate whether a dietary and lifestyle counseling prevents weight gain during pregnancy. Women were randomly assigned to have either an organized and consistent dietary and lifestyle counseling or routine prenatal care. Results revealed that an organized and consistent dietary and lifestyle counseling decreases weight gain during pregnancy but does not increase adherence to Institute of Medicine guidelines.

Complexes trans,trans,trans-[Pt(N3)2(OH)(OCOR)(py)2] where py = pyridine and where OCOR = succinate (1); 4-oxo-4-propoxybutanoate (2) and N-methylisatoate (3) have been synthesized by derivation of trans,trans,trans-[Pt(OH)2(N3)2(py)2] (4) and characterised by NMR and EPR spectroscopy, ESI-MS and X-ray crystallography. Irradiation of 1–3 with green (517 nm) light initiated photoreduction to Pt(II) and release of the axial ligands at a 3-fold faster rate than for 4. TD-DFT calculations showed dissociative transitions at longer wavelengths for 1 compared to 4. Complexes 1 and 2 showed greater photocytotoxicity than 4 when irradiated with 420 nm light (A2780 cell line IC50 values: 2.7 and 3.7 μM) and complex 2 was particularly active towards the cisplatin-resistant cell line A2780cis (IC50 3.7 μM). Unlike 4, complexes 1–3 were phototoxic under green light irradiation (517 nm), with minimal toxicity in the dark. A pKa(H2O) of 5.13 for the free carboxylate group was determined for 1, corresponding to an overall negative charge during biological experiments, which crucially, did not appear to impede cellular accumulation and photocytotoxicity. [ABSTRACT FROM AUTHOR]

Analyzes the effects of seminars on the attitude of junior medical students towards many aspects of the health care system in the U.S. Need for physicians to be actively involved on social issues; Response of students to seminars; Evaluation of changes in the attitudes of the students before and after the seminar.

Objectives: In this study, we characterized the sweet flavor ingredients in 2 internationally popular waterpipe tobaccos, flavored and unflavored. Methods: Tobacco extracts were quantified for humectants, sugars, menthol, nicotine, and sugar alcohols. Qualitative screening of flavor volatiles was performed, and 12 flavor volatiles were quantified. Results: Humectant content was 20 times greater in the flavored brand versus the unflavored, largely due to greater concentration of the glycerol. Sugar content was approximately 1.7 times higher in the flavored tobacco. Vanillin levels were > 200 times greater in the flavored brand. Nicotine content of the unflavored tobacco was 1.5 times greater on a mg/g tobacco basis, which can be explained by the much larger humectant mass content of the flavored tobacco. Conclusions: Flavored waterpipe tobacco may contain significantly greater amounts of humectants and flavor components (the compounds that make up the overall flavor), which may be harmful to users, compared to unflavored. Limiting flavors in waterpipe tobacco could aid in maximizing public health benefits. [ABSTRACT FROM AUTHOR]

l-Tryptophan (Trp), melatonin (MLT) and the Trp-peptide pentagastrin quenched the formation of azidyl radicals generated on irradiation of the anticancer complex trans,trans,trans-[Pt(pyridine)2(N3)2(OH)2] with visible light, giving rise to C3-centred indole radicals which were characterized for Trp and MLT using an EPR spin-trap; indole, together with azidyl and hydroxyl radicals, have potential roles in a multitargeting mechanism of action against resistant cancers. [ABSTRACT FROM AUTHOR]

Mind-sets (aka implicit theories) are beliefs about the nature of human attributes (e.g., intelligence). The theory holds that individuals with growth mind-sets (beliefs that attributes are malleable with effort) enjoy many positive outcomes—including higher academic achievement—while their peers who have fixed mind-sets experience negative outcomes. Given this relationship, interventions designed to increase students’ growth mind-sets—thereby increasing their academic achievement—have been implemented in schools around the world. In our first meta-analysis (k = 273, N = 365,915), we examined the strength of the relationship between mind-set and academic achievement and potential moderating factors. In our second meta-analysis (k = 43, N = 57,155), we examined the effectiveness of mind-set interventions on academic achievement and potential moderating factors. Overall effects were weak for both meta-analyses. However, some results supported specific tenets of the theory, namely, that students with low socioeconomic status or who are academically at risk might benefit from mind-set interventions. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae is a major health threat. Vaccination and passive immunization are considered as alternative therapeutic strategies for managing Klebsiella infections. Lipopolysaccharide O antigens are attractive candidates because of the relatively small range of known O-antigen polysaccharide structures, but immunotherapeutic applications require a complete understanding of the structures found in clinical settings. Currently, the precise number of Klebsiella O antigens is unknown because available serological tests have limited resolution, and their association with defined chemical structures is sometimes uncertain. Molecular serotyping methods can evaluate clinical prevalence ofOserotypes but require a full understanding of the genetic determinants for each O-antigen structure. This is problematic with Klebsiella pneumoniae because genes outside the main rfb (O-antigen biosynthesis) locus can have profound effects on the final structure. Here, we report two new loci encoding enzymes that modify a conserved polysaccharide backbone comprising disaccharide repeat units [33)-β-D-Galp- (133)-β-D-Galf-(13] (O2a antigen). We identified in serotype O2aeh a three-component system that modifies completed O2a glycan in the periplasm by adding 1,2-linked β-Galp side-group residues. In serotype O2ac, a polysaccharide comprising disaccharide repeat units [35)-β-D-Galf-(133)-β-D-GlcpNAc-(13] (O2c antigen) is attached to the non-reducing termini of O2aantigen chains. O2c-polysaccharide synthesis is dependent on a locus encoding three glycosyltransferase enzymes. The authentic O2aeh and O2c antigens were recapitulated in recombinant Escherichia coli hosts to establish the essential gene set for their synthesis. These findings now provide a complete understanding of the molecular genetic basis for the known variations in Klebsiella O-antigen carbohydrate structures based on the O2a backbone. [ABSTRACT FROM AUTHOR]

The lectin DLasiL was isolated from seeds of the Dioclea lasiocarpa collected from the northeast coast of Brazil and characterized for the first time by mass spectrometry, DNA sequencing, inductively coupled plasma-mass spectrometry, electron paramagnetic resonance, and fluorescence spectroscopy. The structure of DLasiL lectin obtained by homology modelling suggested strong conservation of the dinuclear Ca/Mn and sugar-binding sites, and dependence of the solvent accessibility of tryptophan-88 on the oligomerisation state of the protein. DLasiL showed highly potent (low nanomolar) antiproliferative activity against several human carcinoma cell lines including A2780 (ovarian), A549 (lung), MCF-7 (breast) and PC3 (prostate), and was as, or more, potent than the lectins ConBr ( Canavalia brasiliensis ), ConM ( Canavalia maritima ) and DSclerL ( Dioclea sclerocarpa ) against A2780 and PC3 cells. Interestingly, DLasiL lectin caused a G2/M arrest in A2780 cells after 24 h exposure, activating caspase 9 and delaying the on-set of apoptosis. Confocal microscopy showed that fluorescently-labelled DLasiL localized around the nuclei of A2780 cells at lectin doses of 0.5–2 × IC 50 and gave rise to enlarged nuclei and spreading of the cells at high doses. These data reveal the interesting antiproliferative activity of DLasiL lectin, and suggest that further investigations to explore the potential of DLasiL as a new anticancer agent are warranted. [ABSTRACT FROM AUTHOR]

Antiretroviral-based strategies for HIV prevention have shown inconsistent results in women. We investigated whether vaginal microbiota modulated tenofovir gel microbicide efficacy in the CAPRISA (Centre for the AIDS Program of Research in South Africa) 004 trial.Two major vaginal bacterial community types—one dominated by Lactobacillus (59.2%) and the other where Gardnerella vaginalis predominated with other anaerobic bacteria (40.8%)—were identified in 688 women profiled. Tenofovir reduced HIV incidence by 61%(P = 0.013) in Lactobacillus-dominant women but only 18% (P = 0.644) in women with non-Lactobacillus bacteria, a threefold difference in efficacy. Detectible mucosal tenofovir was lower in non-Lactobacillus women, negatively correlating with G. vaginalis and other anaerobic bacteria, which depleted tenofovir by metabolism more rapidly than target cells convert to pharmacologically active drug. This study provides evidence linking vaginal bacteria to microbicide efficacy through tenofovir depletion via bacterial metabolism. [ABSTRACT FROM AUTHOR]

Background: Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder that can substantially impact upon quality of life and everyday functioning. Guidelines recommend pharmacological and psychological treatments, using a cognitive behaviour therapy approach (CBT) including exposure and response prevention, but access has generally been poor. Low intensity psychological interventions have been advocated. The evidence base for these interventions is emerging but there is a paucity of information regarding practitioners' perceptions and experiences of supporting individuals with OCD using this approach. Methods: Qualitative interviews were undertaken with psychological wellbeing practitioners (PWPs) (n = 20) delivering low intensity psychological interventions for adults with OCD within the context of a large pragmatic effectiveness trial. Interviews explored the feasibility and acceptability of delivering two interventions; guided selfhelp and supported computerised cognitive behaviour therapy (cCBT), within Improving Access to Psychological Therapies (IAPT) services in NHS Trusts. Interviews were recorded with consent, transcribed and analysed using thematic analysis. Results: PWPs acknowledged the benefits of low intensity psychological interventions for individuals experiencing OCD symptoms on an individual and population level. Offering low intensity support provided was perceived to have the opportunity to overcome existing service barriers to access treatment, improve patient choice and flexibility. Professional and service relevant issues were also recognised including self-beliefs about supporting people with OCD and personal training needs. Challenges to implementation were recognised in relation to practitioner resistance and intervention delivery technical complications. Conclusions: This study has provided insight into the implementation of new low intensity approaches to the management of OCD within existing mental health services. Benefits from a practitioner, service and patient perspective are identified and potential challenges highlighted. [ABSTRACT FROM AUTHOR]

Introduction and Aims: We developed and evaluated an instrument (DCI-A) to measure the adolescent therapeutic community (TC) treatment process. Design and Methods: Participants were adolescents from one of seven U.S. TC programs (N1 = a76,N2 = a66). We used Sample 1 to identify the instrument’s structure, confirmed this with Sample 2, and generated descriptive statistics for the final solution using the combined sample. Results: We identified and confirmed a 5-factor solution (Treatment Motivation, Personal Development, Problem Recognition, Family Relations, Social Network). Analyses provide preliminary evidence for the instrument’s reliability and validity. Discussion and Conclusions: The DCI-A may be useful for assessing adolescent TC treatment process. [ABSTRACT FROM AUTHOR]

A community empowerment-based response to HIV is a process by which sex workers take collective ownership of programmes to achieve the most effective HIV outcomes and address social and structural barriers to their overall health and human rights. Community empowerment has increasingly gained recognition as a key approach for addressing HIV in sex workers, with its focus on addressing the broad context within which the heightened risk for infection takes places in these individuals. However, large-scale implementation of community empowerment-based approaches has been scarce. We undertook a comprehensive review of community empowerment approaches for addressing HIV in sex workers. Within this effort, we did a systematic review and meta-analysis of the effectiveness of community empowerment in sex workers in low-income and middle-income countries. We found that community empowerment-based approaches to addressing HIV among sex workers were significantly associated with reductions in HIV and other sexually transmitted infections, and with increases in consistent condom use with all clients. Despite the promise of a community-empowerment approach, we identified formidable structural barriers to implementation and scale-up at various levels. These barriers include regressive international discourses and funding constraints; national laws criminalising sex work; and intersecting social stigmas, discrimination, and violence. The evidence base for community empowerment in sex workers needs to be strengthened and diversified, including its role in aiding access to, and uptake of, combination interventions for HIV prevention. Furthermore, social and political change are needed regarding the recognition of sex work as work, both globally and locally, to encourage increased support for community empowerment responses to HIV. INSET: Search strategy and selection criteria.. [ABSTRACT FROM AUTHOR]

Abstract: The 5-factor client-report Dimensions of Change in Therapeutic Communities Treatment Instrument-Adolescent (DCI-A) was developed to assess adolescent substance abuse treatment process in the therapeutic community (TC). The goal of this study was to use bifactor modeling to derive a unidimensional DCI-A short-form (DCI-A-SF) that would represent content from the original DCI-A factors. Data are from 442 adolescents receiving treatment at one of seven residential TC programs. Bifactor analyses suggested selection of seven DCI-A items to comprise the short form. Three items are from the treatment motivation factor, and one item was selected from each of the remaining four factors. Confirmatory factor analysis suggested that the 7-item DCI-A-SF is strongly unidimensional, and unidimensional IRT analysis of the items indicated good internal consistency. A structural equation model that demonstrates the mediating relationship of DCI-A-SF with other measures, including demographic and pre-treatment characteristics, and subsequent treatment completion, provides preliminary evidence of internal validity. [Copyright &y& Elsevier]

The present research was designed to better understand how the magnitude of experienced surprise is affected by both individual difference variables as well as variations in surprise-eliciting stimuli. Eighty-five participants played 5 versions of a slot machine-like game. The five games only differed with respect to the probability of winning each trial-10 % (i.e., wins were highly unusual), 30, 50, 70, and 90 % (i.e., losses were highly unusual). Players were given a fictitious 'bankroll' at the beginning of each game and played up to 25 trials of each game. On each trial, players selected their wager amount, 'pulled' the handle, learned the outcome (win or loss), and reported their surprise level using a 1 (none) to 9 (extremely) Likert scale. Replicating past research, results revealed that self-reported surprise was inversely related to outcome probability and that wins were rated as more surprising than losses, even when wins and losses occurred at the same level of probability. Novel results include finding that larger wagers predicted greater felt surprise (regardless of outcome), and that women reported greater surprise to both wins and losses than men. [ABSTRACT FROM AUTHOR]