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Electrical gradients are fundamental to physiological processes including cell migration, tissue formation, organ development, and response to injury and regeneration. Current electrical modulation of cells is primarily studied under a uniform electrical field. Here we demonstrate the fabrication of conductive gradient hydrogels (CGGs) that display mechanical properties and varying local electrical gradients mimicking physiological conditions. The electrically-stimulated CGGs enhanced human mesenchymal stem cell (hMSC) viability and attachment. Cells on CGGs under electrical stimulation showed a high expression of neural progenitor markers such as Nestin, GFAP, and Sox2. More importantly, CGGs showed cell differentiation toward oligodendrocyte lineage (Oligo2) in the center of the scaffold where the electric field was uniform with a greater intensity, while cells preferred neuronal lineage (NeuN) on the edge of the scaffold on a varying electric field at lower magnitude. Our data suggest that CGGs can serve as a useful platform to study the effects of electrical gradients on stem cells and potentially provide insights on developing new neural engineering applications. [ABSTRACT FROM AUTHOR]

Effective stroke recovery therapeutics remain limited. Stem cell therapies have yielded promising results, but the harsh ischemic environment of the post‐stroke brain reduces their therapeutic potential. Previously, a conductive polymer system that enables stem cell delivery with simultaneous electrical modulation of the cells and surrounding neural environment is developed. This wired conductive polymer system proved efficacious in optimizing ideal conditions for stem cell mediated motor improvements in a rodent model of stroke. To further enable preclinical studies and enhance translational potential, a method to improve this system by eliminating its dependence upon a tethered power source is identified. A wirelessly powered, electrically conductive polymer system that eases therapeutic application and enables full mobility is herein developed. As a proof of concept, it is demonstrated that the wirelessly powered system is able to stimulate neural stem cells in vitro, as well as in vivo in a rodent model of stroke. This system modulates the stroke microenvironment and increases the production of endogenous stem cells. In summation, this novel, wirelessly powered conductive polymer system can serve as a mobile platform for a wide variety of therapeutics involving electrical stimulation. [ABSTRACT FROM AUTHOR]

Key Points: Prognostic understanding among advanced cancer patients is associated with higher levels of engagement in advance care planning (ACP), preference for comfort over aggressive care, and receipt of goal‐concordant care, but few patients have accurate prognostic understanding.Talking about Cancer (TAC) is a communication‐based intervention for advanced cancer patients and their caregivers designed to improve shared accurate prognostic understanding.This case study describes the use of TAC with an interracial friend dyad for whom medical mistrust and experienced bias on the part of the patient significantly impacted interactions with the medical team.Using TAC strategies, this dyad was able to improve communication with the oncology team and each other and engage in ACP. [ABSTRACT FROM AUTHOR]

The present study investigated the relationship between spiritual struggles and various types of psychopathology symptoms in individuals who had and had not suffered from a recent illness. Participants completed self-report measures of religious variables and symptoms of psychopathology. Spiritual struggles were assessed by a measure of negative religious coping. As predicted, negative religious coping was significantly linked to various forms of psychopathology, including anxiety, phobic anxiety, depression, paranoid ideation, obsessive-compulsiveness, and somatization, after controlling for demographic and religious variables. In addition, the relationship between negative religious coping and anxiety and phobic anxiety was stronger for individuals who had experienced a recent illness. These results have implications for assessments and interventions targeting spiritual struggles, especially in medical settings. Keywords: spiritual struggles; negative religious coping; religion; spirituality; psychopathology

The purpose of this study was to compare wound complication rates after total ankle replacement in 3 groups of patients based on tobacco status. The total cohort was divided into 3 groups based on tobacco history. Group 1 included patients who were actively tobacco users. Group 2 included patients with a history of tobacco user. Group 3 served as the control group and included patients who had never used tobacco. Available charts were reviewed for patients who underwent primary total ankle arthroplasty by 1 surgeon. Patient demographics, tobacco history, and postoperative wound complications were recorded. A total of 114 patients with tobacco history were available for follow-up and were included in this study, which ranged from March 2012 to July 2017. Group 1 included 11 active smokers. Group 2 included 38 former smokers, and group 3 had a total of 65 never smokers included. The average follow-up was 28 months for group 1 (range 10-55 months), 34.1 months for group 2 (range 12-60 months), and 32.8 months for group 3 (range 11-60 months). The wound complication rate was noted to be statistically significant when comparing active smokers to never smokers using Fisher's exact test (P = .0223). When comparing former smokers with never smokers, the difference in wound complication rate did not reach statistical significance (P = 0.7631). All patients underwent at least 1 concomitant procedure at the time of initial ankle replacement. Our findings show that total ankle replacement wound healing complication rates are significantly higher in active tobacco users. There was no significant difference in wound healing complications when comparing former tobacco users versus never tobacco users. Levels of Evidence: Level III: Retrospective comparative study. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare complication rates after total ankle replacement in 2 groups of patients based on polyethylene insert size. The total cohort was divided into 2 groups based on insert size. Group 1 included patients with polyethylene insert size less than 10 mm in thickness. Group 2 included patients with polyethylene insert sizes 10 mm and larger. Available charts were reviewed for patients who underwent primary total ankle arthroplasty by one surgeon. Patient demographics, polyethylene insert size, implant used, concomitant procedures, postoperative complications, and patient-reported outcome scores were recorded. One hundred patients were available for follow-up and were included in this study, which ranged from March 2012 to July 2017. The average follow-up was 31.3 months (range = 10-60 months). Forty-eight females and 52 males were included in this study. There were a total of 63 patients in group 1 and 47 patients in group 2. The total complication rate for patients in group 1 was 11.1% (7/63), and in group 2 it was 16.2% (6/32). There was no statistical significance in complication rates when comparing the 2 groups (P = 0.5427). All patients underwent at least one concomitant procedure at the time of initial ankle replacement. Our findings show that total ankle replacement complication rates are equal when comparing large polyethylene inserts commonly utilized to correct deformities, versus small polyethylene inserts commonly utilized in primary resurfacing. Levels of Evidence: Level IV, Retrospective comparative study. [ABSTRACT FROM AUTHOR]

Introductory biology courses for majors are often quite large. The use of peer graders can help instructors use essay exams in large classes without being overwhelmed and still treating students fairly. Describes the procedure used for peer evaluation and explains the advantages for both faculty and students. (Author/PVD)

Increased severity of problematic daytime behavior has been associated with poorer sleep quality in individuals with autism spectrum disorder. In this work, we investigate whether this relationship holds in a real‐time setting, such that an individual's prior sleep can be used to predict their subsequent daytime behavior. We analyzed an extensive real‐world dataset containing over 20,000 nightly sleep observations matched to subsequent challenging daytime behaviors (aggression, self‐injury, tantrums, property destruction and a challenging behavior index) across 67 individuals with low‐functioning autism living in two U.S. residential facilities. Using support vector machine classifiers, a statistically significant predictive relationship was found in 81% of individuals studied (P < 0.05). For all five behaviors examined, prediction accuracy increased up to approximately eight nights of prior sleep used to make the prediction, indicating that the behavioral effects of sleep may manifest on extended timescales. Accurate prediction was most strongly driven by sleep variability measures, highlighting the importance of regular sleep patterns. Our findings constitute an initial step towards the development of a real‐time monitoring tool to pre‐empt behavioral episodes and guide prophylactic treatment for individuals with autism. Autism Res2018, 11: 391–403. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: We analyzed over 20,000 nights of sleep from 67 individuals with autism to investigate whether daytime behaviors can be predicted from prior sleep patterns. Better‐than‐chance accuracy was obtained for 81% of individuals, with measures of night‐to‐night variation in sleep timing and duration most relevant for accurate prediction. Our results highlight the importance of regular sleep patterns for better daytime functioning and represent a step toward the development of ‘smart sleep technologies' to pre‐empt behavior in individuals with autism. [ABSTRACT FROM AUTHOR]

This paper explores the outcomes associated with spirituality following a personal transgression. Personal transgressions differ from externally caused stressful events in various ways. However, the appraisals of and outcomes associated with personal transgressions indicate that such events are often stressful experiences. Many world religions provide their adherents with spiritual methods for addressing their transgressions. Therefore, transgressors may place their transgressions in a spiritual context. This paper describes four spiritual resources available to individuals struggling with personal transgressions: confession, forgiveness, meaning-making, and conversion. The purposes of these resources are to reduce or eliminate distress and stimulate change or transformation. The paper concludes with clinical implications of these spiritual resources illustrated with case vignettes. [ABSTRACT FROM AUTHOR]