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We describe the reproductive health and practices of Hmong immigrants before and after migration to the United States. Data were gathered as part of an ongoing study on the impact of perinatal exposure to environmental chemicals on children's health in Hmong residents of Green Bay, Wisconsin between August 1999 and May 2002. Of the 742 pregnancies reported by 141 reproductive-aged couples, 669 were live births. The Hmong have an average of 5.2 children (range 0-14) and the sex ratio differed by country of birth. Prenatal care began in the first trimester for 60% of US-born infants, up from 12% prior to immigration. Breastfeeding decreased from 94% and 88% in Laos and Thailand to only 11% for Hmong born in the US. Contraceptive use was reported by 25.5% of women; few reported smoking and alcohol consumption. The results suggest that Hmong immigrants may benefit from public health support targeting prenatal care and breastfeeding practices. [ABSTRACT FROM AUTHOR]

No risk factor other than cryptorchidism has been consistently associated with testicular cancer, and the influence of diet on testicular cancer risk has not been extensively explored. A few studies have found increased testicular cancer risk in men whose diets are high in fat, red meats, and milk or low in fruits and vegetables. We evaluated the relationship of dietary factors and risk of testicular cancer and also examined whether this risk varied by type of testicular cancer. We conducted a hospital-based case-control study at The University of Texas M. D. Anderson Cancer Center (Houston, TX) of 160 testicular cancer cases diagnosed between 1990 and 1996 and 136 friend-matched controls. The results of multivariable logistic regression analysis showed that after adjustment for age, education, income, ethnicity, cryptorchidism, and total daily calories, increasing total fat, saturated fat, and cholesterol consumption were associated with increasing risk of nonseminoma testicular cancer, with odds ratios (ORs) for the highest vs. the lowest quartiles of 6.3, 5.3, and 4.6, respectively. The risk for seminoma testicular cancer marginally increased with increasing intake of total fat and saturated fat, with ORs for the highest vs. lowest quartiles of 1.9 and 2.1, respectively. Higher total fat consumption was nearly significantly related to increased mixed germ cell tumor risk, with an OR for highest vs. lowest quartile of 4.2. This study supports the hypothesis that diet (particularly high fat consumption) increases testicular cancer risk in young men. However, the small sample size and the possibility that these observations may be due to bias indicate that the relationship of diet and testicular cancer risk needs to be further examined within a prospective or incident case-control study. [ABSTRACT FROM AUTHOR]

Background/objectives: Family meals have been shown to be an important protective factor for positive health outcomes. This study assessed the associations of parenting factors with family mealtime among overweight African American adolescents over a period of 4 months. It was hypothesized that increases in warm and responsive parenting (parental responsiveness, parental responsibility) would be associated with increased frequency and quality of family mealtimes, while more demanding and controlling parenting (parental demandingness, parental monitoring) would be associated with a reduced frequency and quality of family mealtimes over time., Methods: Data from baseline to 16 weeks were collected from 241 African American adolescent-parent dyads (adolescent: M age = 12.8 ± 1.7 years; 64% female; M BMI% = 96.6 ± 4.2) that participated in the Families Improving Together (FIT) for Weight Loss randomized controlled trial., Results: Multilevel models revealed significant positive main effects of parental responsiveness and parental responsibility ( p < 0.05) on the increased frequency of family meals ( p < 0.01). Significant two-way interactions also showed that parental responsiveness ( p < 0.05) predicted improved quality of family mealtimes, whereas parental demandingness ( p < 0.01) predicted reduced quality of family mealtimes from baseline to 16 weeks., Conclusions: Results from this study have important implications for African American adolescent obesity prevention and future family-based intervention program guidelines.

Background: Previous community-wide physical activity trials have been criticized for methodological limitations, lack of population-level changes, and insufficient reach among underserved communities. Social marketing is an effective technique for community-wide behavior change and can coincide with principles of community-based participatory research (CBPR)., Purpose: A systematic scoping review of community-wide interventions (system-level) targeting physical activity and/or weight loss was conducted to (i) describe and critically discuss how social marketing strategies are implemented; (ii) identify which populations have been targeted, including underserved communities; (iii) evaluate the use of CBPR frameworks; (iv) assess retention rates; and (v) identify gaps in the literature and formulate future recommendations., Methods: Eligible studies included those that: aimed to improve physical activity and/or weight loss on a community-wide level, used social marketing strategies, and were published between 2007 and 2022., Results: Approximately 56% of the studies reported a positive impact on physical activity. All studies described social marketing details in alignment with the five principles of social marketing (product, promotion, place, price, and people). Only two studies explicitly identified CBPR as a guiding framework, but most studies used one (k = 8, 32%) or two (k = 12, 48%) community engagement strategies. Few studies included at least 50% representation of African American (k = 2) or Hispanic (k = 3) participants., Conclusions: This review highlights key gaps in the literature (e.g., lack of fully-developed CBPR frameworks, reach among underserved communities, randomized designs, use of theory), highlights examples of successful interventions, and opportunities for refining community-wide interventions using social marketing strategies., (© Society of Behavioral Medicine 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: This study demonstrates how formative process evaluation was used to assess implementation and improve dose and fidelity in the Together Everyone Achieves More Physical Activity (TEAM-PA) randomized controlled trial. TEAM-PA uses a randomized group cohort design to evaluate the efficacy of a group-based intervention for increasing physical activity among African American women., Methods: Intervention groups met for 10 weeks and were co-led by female African American facilitators, with intervention sessions consisting of group feedback, a health curriculum, group-based physical activity games, and group-based goal-setting. Drawing from a multi-theoretical framework, the intervention targeted social affiliation using collaborative and competitive group strategies, including essential elements focused on group-based behavioral skills, peer-to-peer positive communication, collectivism, optimal challenge, social facilitation, and peer to peer challenges. Formative process evaluation was used to monitor reach, dose, and fidelity, and implement feedback and solutions., Results: Across two cohorts, four groups (n = 54) were randomized to the TEAM-PA intervention. On average 84.8% of participants attended each week, which exceeded the a priori criteria. Results from the systematic observations indicated that on average 93% of the dose items were completed in each session and adequate levels of fidelity were achieved at both the facilitator and group-levels. Participants were compliant with wearing the FitBits (6.73 ± 0.42 days/week) and most participants successfully contributed to meeting the group-based goals. The use of open-ended items also revealed the need for additional modifications to the group-based PA games, including allowing for individuals to take breaks, incorporating a broader range of exercises, minimizing activities that required bending/reaching down without assistance, and providing facilitators with additional training for implementing the games. Initial evidence suggests that these changes were successful in increasing participants' comprehension of the games from Cohort 1 (M = 1.83, SD = 0.71) to Cohort 2 (M = 3.33, SD = 0.69)., Conclusion: Findings from this study demonstrated high levels of reach, dose, and fidelity, while also highlighting strategies for implementing competitive group-based PA games that are accessible across physical fitness levels. Formative process evaluation, including open-ended items and collaborative brainstorming, holds tremendous potential for improving future interventions., Trial Registration: This study was registered on Clinicaltrials.gov (# NCT05519696) on August 22, 2022 prior to the enrollment of the first participant on September 12, 2022 ( https://clinicaltrials.gov/study/NCT05519696?term=NCT05519696&rank=1 )., (© 2024. The Author(s).)

The purpose of the study was to conduct in-depth qualitative interviews to understand the lived experiences of African American parents of overweight adolescents who had previously participated in a family-based weight loss program and to utilize these insights to inform the essential elements of the LEADS trial, an integrated resilience stress management and health promotion intervention. Participants (N = 30) were African American parents and/or caregivers (96.7% female; M age  = 49.73, SD = 10.88; M BMI  = 37.63, SD = 8.21) of adolescents with overweight and/or obesity. Interviews were transcribed and coded using inductive and deductive approaches for themes by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. Prominent stress themes included caregiver responsibilities, work, interpersonal family conflict, and physical and emotional consequences of chronic stress. Participants also noted decreases in physical activity and poor food choices due to stress. Coping mechanisms included prayer/meditation, church social support, and talking with family/partner. Results highlight the importance of mitigating stress among African American parents through stress management and cultural/familial resilience approaches to increase the likelihood of engagement in behavioral strategies in health promotion programs. Future studies should assess the utility of incorporating stress management components and health promotion techniques to improve health outcomes among African American families., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: Delirium is most often reported as present or absent. Patients with symptoms falling short of the diagnostic criteria for delirium fall into 'no delirium' or 'control' groups. This binary classification neglects individual symptoms and may be hindering identification of the pathophysiology underlying delirium. This systematic review investigates which individual symptoms of delirium are reported by studies of postoperative delirium in adults., Methods: Medline, EMBASE and Web of Science databases were searched on 03 June 2021 and 06 April 2023. Two reviewers independently examined titles and abstracts. Each paper was screened in duplicate and conflicting decisions settled by consensus discussion. Data were extracted, qualitatively synthesised and narratively reported. All included studies were quality assessed., Results: These searches yielded 4,367 results. After title and abstract screening, 694 full-text studies were reviewed, and 62 deemed eligible for inclusion. This review details 11,377 patients including 2,049 patients with delirium. In total, 78 differently described delirium symptoms were reported. The most reported symptoms were inattention (N = 29), disorientation (N = 27), psychomotor agitation/retardation (N = 22), hallucination (N = 22) and memory impairment (N = 18). Notably, psychomotor agitation and hallucinations are not listed in the current Diagnostic and Statistical Manual for Mental Disorders-5-Text Revision delirium definition., Conclusions: The 78 symptoms reported in this systematic review cover domains of attention, awareness, disorientation and other cognitive changes. There is a lack of standardisation of terms, and many recorded symptoms are synonyms of each other. This systematic review provides a library of individual delirium symptoms, which may be used to inform future reporting., (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society.)

Objective: Guided by Self-Determination Theory, this study aimed to examine the potential mediating effects of autonomous and controlled motivations on physical activity (PA) experiences of afterschool program (ASP) staff with occupational stress., Method: A total of 58 ASP staff provided full data. Staff occupational stress and self-determination motivations for PA were assessed. Participants' daily moderate-to-vigorous physical activity (MVPA) was measured using accelerometer wear. A path analysis was used to address the research purpose., Results: Occupational stress negatively and indirectly predicted daily MVPA which was mediated by controlled motivation (β = - 4.15, p <.05). Autonomous motivation directly and positively predicted daily MVPA across all types and levels of ASP staff occupational stress (β = 9.93, p =.01)., Conclusions: Autonomous motivation is a powerful predictor of staff PA levels despite the degree to which they experience stress. In contrast, controlled motivations are more vulnerable to occupational stress, and can lead to lower MVPA., Trial Registration: Connect Through PLAY: A Staff-based Physical Activity Intervention for Middle School Youth (Connect). https://clinicaltrials.gov/ct2/show/NCT03732144 . Registered 11/06/2018., Registration Number: NCT03732144., (© 2024. The Author(s).)

Background: Delirium, a common syndrome with heterogeneous etiologies and clinical presentations, is associated with poor long-term outcomes. Recording and analyzing all delirium equally could be hindering the field's understanding of pathophysiology and identification of targeted treatments. Current delirium subtyping methods reflect clinically evident features but likely do not account for underlying biology., Methods: The Delirium Subtyping Initiative (DSI) held three sessions with an international panel of 25 experts., Results: Meeting participants suggest further characterization of delirium features to complement the existing Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision diagnostic criteria. These should span the range of delirium-spectrum syndromes and be measured consistently across studies. Clinical features should be recorded in conjunction with biospecimen collection, where feasible, in a standardized way, to determine temporal associations of biology coincident with clinical fluctuations., Discussion: The DSI made recommendations spanning the breadth of delirium research including clinical features, study planning, data collection, and data analysis for characterization of candidate delirium subtypes., Highlights: Delirium features must be clearly defined, standardized, and operationalized. Large datasets incorporating both clinical and biomarker variables should be analyzed together. Delirium screening should incorporate communication and reasoning., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Background: Guided by Self-Determination Theory (SDT), the purpose of this study was to determine changes in the 16-week moderate-to-vigorous physical activity (MVPA) trajectory of underserved adolescents who participated in the Connect through PLAY afterschool program intervention and the effects of changes in participating adolescents' intrinsic and autonomous extrinsic motivations on their MVPA trajectory over the 16-week intervention., Methods: A subsample of 113 adolescents (56.64% female; 61.06% African American; average age = 11.29) provided complete data throughout the 16-week intervention were examined. Adolescents' objective daily MVPA was measured using 7- day accelerometer data. Changes in adolescents' intrinsic motivation and autonomous extrinsic motivation were assessed using subscales from the Intrinsic Motivation Inventory [1] and the Treatment Self-Regulation Questionnaire [2] respectively. A hierarchical linear model was built and tested to address the research aims., Results: The results of hierarchical linear models showed that, on average, youth daily MVPA increased 6.36 minutes in each 8-week period. Intrinsic motivation change, but not autonomous extrinsic motivation, was a positive and significant level-2 predictor of daily MVPA changes., Conclusion: The findings provide significant evidence suggesting a benefit of integrating SDT-based approaches and further suggest that nurturing intrinsic motivation can be an effective approach to supporting youth daily MVPA in under-resourced afterschool programs., Trial Registration: Connect Through PLAY: A Staff-based Physical Activity Intervention for Middle School Youth (Connect). https://clinicaltrials.gov/ct2/show/NCT03732144 . Registered November 6 th , 2018., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Squids have spherical, gradient index lenses that maximize optical sensitivity while minimizing light scattering and geometric aberration. Previous studies have shown that the constituent lens proteins behave like patchy particles, and that a density gradient of packing fraction ∼0.01 to 1 assembles from a gradient of average particle valence, 〈 M 〉 ≈ 2.1 to 〈 M 〉 > 6. A priori, transparency requires that all regions within the larger gradient must minimize density fluctuations at length scales close to the wavelength of visible light. It is not known how a material can achieve this at all possible packing fractions via attractive interactions. We also observe that the set of proteins making the lens is remarkably polydisperse (there are around 40 isoforms expressed). Why does nature employ so many geometrically similar isoforms when theory suggests a few would suffice, and what, if any, is the physical role of the polydispersity? This study focuses on answering these questions for the sparsest regions of the lens, where the patchy nature of the system will have the largest influence on the final structure. We first simulated mixtures of bi- and trivalent patchy particles and found a strong influence of patch angle on the percolation and gel structure of the system. We then investigated the influence of the interaction polydispersity on the structure of the M = 2.1 system. We find that increasing the variance in patch energies and single-patch angle appears to decrease the length scale of density fluctuations while also moving the percolation line to lower temperature. S -Crystallin geometry and polydispersity appear to promote regular percolation of a gel structure while also limiting density fluctuations to small length scales, thereby promoting transparency in the annealed structure.

Organisms appear opaque largely because their outer tissue layers are strongly scattering to incident light; strongly absorbing pigments, such as blood, typically have narrow absorbances, such that the mean free path of light outside the absorbance peaks can be quite long. As people cannot see through tissue, they generally imagine that tissues like the brain, fat, and bone contain little or no light. However, photoresponsive opsin proteins are expressed within many of these tissues, and their functions are poorly understood. Radiance internal to tissue is also important for understanding photosynthesis. For example, giant clams are strongly absorbing yet maintain a dense population of algae deep in the tissue. Light propagation through systems like sediments and biofilms can be complex, and these communities can be major contributors to ecosystem productivity. Therefore, a method for constructing optical micro-probes for measuring scalar irradiance (photon flux intersecting a point) and downwelling irradiance (photon flux crossing a plane perpendicularly) to better understand these phenomena inside living tissue has been developed. This technique is also tractable in field laboratories. These micro-probes are made from heat-pulled optical fibers that are then secured in pulled glass pipettes. To change the angular acceptance of the probe, a 10-100 µm sized sphere of UV-curable epoxy mixed with titanium dioxide is then secured to the end of a pulled, trimmed fiber. The probe is inserted into living tissue, and its position is controlled using a micromanipulator. These probes are capable of measuring in situ tissue radiance at spatial resolutions of 10-100 µm or on the scale of single cells. These probes were used to characterize the light reaching the adipose and brain cells 4 mm below the skin of a living mouse and to characterize the light reaching similar depths within living algae-rich giant clam tissue.

Background: The Together Everyone Achieves More Physical Activity (TEAM-PA) trial is a randomized controlled trial testing the efficacy of a group-based intervention for increasing physical activity (PA) among insufficiently active African American women., Design: The TEAM-PA trial uses a group cohort design, is implemented at community sites, and will involve 360 African American women. The trial compares a 10-week group-based intervention vs. a standard group-delivered PA comparison program. Measures include minutes of total PA/day using 7-day accelerometer estimates (primary outcome), and body mass index, blood pressure, waist circumference, walking speed, sedentary behavior, light physical activity, and the percentage achieving ≥150 min of moderate to vigorous PA/week (secondary outcomes) at baseline, post-intervention, and 6-months post-intervention., Intervention: The intervention integrates elements from Social Cognitive Theory, Self-Determination Theory, Group Dynamics Theory, and a focus on collectivism to evaluate different components of social affiliation (relatedness, reciprocal support, group cohesion, and collective efficacy). The intervention integrates shared goal-setting via Fitbits, group-based problem-solving, peer-to-peer positive communication, friendly competition, and cultural topics related to collectivism. Compared to the standard group-delivered PA program, participants in the intervention are expected to show greater improvements from baseline to post- and 6-month follow-up on minutes of total PA/day and secondary outcomes. Social affiliation variables (vs. individual-level factors) will be evaluated as mediators of the treatment effect., Implications: The results of the TEAM-PA trial will determine the efficacy of the intervention and identify which aspects of social affiliation are most strongly related to increased PA among African American women., Trial Registration: This study was registered on Clinicaltrials.gov (# NCT05519696) in August 2022 prior to initial participant enrollment., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships what could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Physical activity (PA) plays an integral role in reducing risk for the leading causes of death and has also been shown to buffer stress. Based on the stress-buffering hypothesis, the present study examined whether protective factors (self-efficacy and informal social control) buffered the effects of perceived stress on PA over time. Secondary data analyses of female African American caregivers (N = 143) were conducted using data from the Families Improving Together (FIT) trial. Validated measures of stressors and protective factors were assessed at baseline. Light PA and moderate-to-vigorous PA were assessed using seven-day accelerometry estimates over sixteen weeks. Multilevel growth modeling was used to assess whether protective factors moderated the effects of perceived stress on PA outcomes across 16 weeks. There was a significant two-way interaction between informal social control and time (B = 0.40, SE = 0.17, p = .019) such that higher informal social control was positively associated with MVPA over time. There was a marginal three-way interaction (B = -18.90, SE = 10.31, p = .067) such that stress was associated with greater LPA at baseline under conditions of high but not low self-efficacy. This study provides preliminary support that social factors may be important for maintaining MVPA regardless of stress levels, while cognitive resources may be more important to target for influencing LPA engagement under conditions of high stress., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Data regarding the risk of infection related to reusable bronchoscopes, the global drive toward disposable technology and the COVID-19 pandemic have led to an increase in the use and production of single use or disposable bronchoscopes. An in-depth comparison of all available devices has not been published., Methods: A benchtop comparison of the Ambu ® aScope TM , Boston Scientific ® EXALT TM Model B, the Surgical Company Broncoflex © Vortex, Pentax ® Medical ONE Pulmo™, and Vathin ® H-Steriscope TM (all 2.8 mm inner dimension other than the Pentax single-use flexible bronchoscope (3 mm)) was undertaken including measurement of maximal flexion and extension angles, thumb force required and suction with and without biopsy forceps. Thereafter, preclinical assessment was performed with data collected including experience, gender, hand size, and scope preference., Results: The Vathin single-use flexible bronchoscope had the biggest range of tip movement from flexion to extension with and without forceps. The Boston single-use flexible bronchoscope required the maximal thumb force but had the least reduction of tip movement with forceps. The Boston single-use flexible bronchoscope significantly outperformed all other scopes including the standard Pentax scope and was the only scope capable of suctioning pseudo-mucus around the forceps. Although there was no significant difference in preference in the overall group, females and those with smaller hand size preferred the Pentax and males the Broncoflex single-use flexible bronchoscope., Conclusions: Currently available single-use flexible bronchoscopes differ in several factors other than scope sizes and monitor including suction, turning envelope, and handle size. Performance in the clinical setting will be key to their success.

Background: Web-based tailored interventions offer rich opportunities for improved access to and personalization of behavioral interventions. However, despite the promise of this approach, the engagement and underrepresentation of minority groups remain major issues., Objective: This study evaluated whether engagement (log-in status and log-in duration) with different types of tailored behavioral content from the Families Improving Together for weight loss web-based intervention was associated with changes in moderate to vigorous physical activity (MVPA) among African American families with overweight or obesity., Methods: Parent-adolescent dyads were randomized to a web-based tailored intervention or web-based health education comparison program. The web-based intervention (N=119) was completed by parents and targeted 6 weight-related behaviors to support their adolescent children's weight loss goals (session contents included energy balance, fast food, fruits and vegetables, physical activity [PA], sedentary behavior, and sweetened beverages). MVPA was measured using accelerometers at baseline and after the intervention., Results: Using a hierarchical approach, the log-in status and duration for each web-based session were used to evaluate the additive effects of engagement with different types of tailored behavioral content on MVPA after the web-based intervention. Among parents, logging in to the PA session was not associated with greater MVPA (B=-12.561, 95% CI -18.759 to -6.367), but MVPA increased with greater log-in duration for the PA (B=0.008, 95% CI 0.004-0.012) and sedentary behavior (B= 0.008, 95% CI 0.004-0.012) sessions. These results suggest that parents who logged in to the PA session had lower MVPA, but MVPA increased with greater log-in duration for the PA and sedentary behavior sessions. These associations remained even after accounting for engagement with other content sessions. However, these engagement effects did not translate to the adolescents., Conclusions: The results of this study highlight the need to disentangle the impact of engagement with different tailored content to improve the efficacy of tailored web-based interventions, especially for promoting PA in African American families., Trial Registration: ClinicalTrials.gov NCT01796067; https://clinicaltrials.gov/ct2/show/NCT01796067., (©Allison M Sweeney, Dawn K Wilson, Kenneth Resnicow, M Lee Van Horn, Heather Kitzman. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 12.04.2023.)

The purpose of this study was to investigate the influences of intrinsic motivation, social affiliation orientations and reciprocal social support for physical activity (PA) on underserved youths' afterschool period moderate-to-vigorous (MVPA) changing trajectories across the 16-week Connect through PLAY intervention, a social-motivational climate intervention. A total of 113 youth (61.06% African American, 56.64% girls) provided full data. Youths' intrinsic motivation, social affiliation orientations and social support were measured by youth responses to a set of surveys at baseline and post-intervention. Youths' afterschool period MVPA was measured using data from 7-day ActiGraph accelerometer wear at baseline, midpoint and post-intervention. Hierarchical linear modelling analysis found that youth daily afterschool period (3pm-6pm) MVPA increased, on average, 37.94 min across the 16-week intervention. Increases in intrinsic motivation, social affiliation orientations and social support were positive predictors of youth afterschool MVPA changing trajectory. The findings clarify the contributions that a social-motivational climate intervention can have on youth afterschool period MVPA through increasing youth intrinsic motivation, social affiliation and reciprocal social support.

Objective: In the present report, we have described the technical and clinical outcomes of percutaneous thrombectomy in the deep veins of the upper extremity and thorax using the ClotTriever system (Inari Medical, Irvine, CA)., Methods: Fourteen patients with symptomatic deep venous occlusive disease in the upper extremity deep veins and thoracic central veins who had undergone thrombectomy using the ClotTriever system between October 2020 and January 2022 were reviewed. The technical results, adverse events, imaging follow-up data, and clinical outcomes were recorded., Results: Fourteen patients (seven men and seven women; mean age, 53.6 ± 13.3 years) constituted the study cohort. Of the 14 patients, 9 (64.3%) had had DVT due to intravascular invasion or external compression from known malignancy, 2 (14.3%) had had infected thrombi and/or vegetation due to Staphylococcus aureus refractory to intravenous antibiotic therapy, and 3 (21.4%) had had a benign etiology for thrombus formation. The presenting symptoms included upper extremity and/or facial swelling (n = 14), upper extremity pain (n = 6), fever (n = 2), and dyspnea (n = 1). Thrombectomy with the ClotTriever system was successfully completed in all 14 patients. Seven patients (50.0%) had required additional venous stent reconstruction after thrombectomy to address the underlying stenosis. No major adverse events were noted. All the patients had experienced resolution of the presenting symptoms., Conclusions: For the management of symptomatic deep venous occlusive disease of the upper extremity deep veins and thoracic central veins, thrombectomy using the ClotTriever system was feasible with excellent technical and clinical success., (© 2023 The Author(s).)

Background: Few intervention studies have integrated cultural tailoring, parenting, behavioral, and motivational strategies to address African American adolescent weight loss., Purpose: The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort study testing the efficacy of a cultural tailoring, positive parenting, and motivational intervention for weight loss in overweight African American adolescents (N = 241 adolescent/caregiver dyads)., Methods: The trial tested an 8-week face-to-face group motivational plus family weight loss program (M + FWL) compared with a comprehensive health education control program. Participants were then rerandomized to an 8-week tailored or control online program to test the added effects of the online intervention on reducing body mass index and improving physical activity (moderate-to-vigorous physical activity [MVPA], light physical activity [LPA]), and diet., Results: There were no significant intervention effects for body mass index or diet. There was a significant effect of the group M + FWL intervention on parent LPA at 16 weeks (B = 33.017, SE = 13.115, p = .012). Parents in the group M + FWL intervention showed an increase in LPA, whereas parents in the comprehensive health education group showed a decrease in LPA. Secondary analyses using complier average causal effects showed a significant intervention effect at 16 weeks for parents on MVPA and a similar trend for adolescents., Conclusions: While the intervention showed some impact on physical activity, additional strategies are needed to impact weight loss among overweight African American adolescents., (© Society of Behavioral Medicine 2022. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Motivation is a barrier to physical activity (PA) among African American (AA) women, but past studies have implemented a "one-size-fits-all" approach and have not addressed differences in autonomous motivation. This pilot randomized controlled trial assessed the preliminary efficacy of "Developing Real Incentives and Volition for Exercise," a community- and theory-based intervention, which evaluated whether a motivationally matched (vs. a nonmatched) intervention increases daily total PA., Method: In total, 68 AA women (50.72 ± 13.66 years; 86.8% with obesity) were randomized to an 8-week challenge-focused program (targeted toward high autonomous motivation) or rewards-focused program (targeted toward low autonomous motivation). Randomization was stratified by baseline autonomous motivation. FitBits were used during the intervention to promote self-monitoring (both programs) and social connectedness (challenge program only)., Results: Both programs retained ≥ 80% of participants. Process evaluation revealed high attendance, dose, and fidelity (both programs). However, contrary to expectations, across all motivational levels (low and high autonomous), the challenge-focused intervention resulted in a greater increase in total daily PA (primary outcome), with an average increase of 17.9 min in the challenge-focused intervention versus an average decrease of 8.55 min in the rewards-focused intervention. An exploratory follow-up analysis revealed that engagement with the FitBit mobile app predicted greater PA at postintervention in the challenge-focused program., Conclusions: A team-based approach targeting social connectedness, enjoyment of PA, and positive intragroup competition is a promising approach for promoting PA among AA women. These findings are used to guide a discussion on best practices for engaging AA women in future behavioral interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sponges are animals that inhabit many aquatic environments while filtering small particles and ejecting metabolic wastes. They are composed of cells in a bulk extracellular matrix, often with an embedded scaffolding of stiff, siliceous spicules. We hypothesize that the mechanical response of this heterogeneous tissue to hydrodynamic flow influences cell proliferation in a manner that generates the body of a sponge. Towards a more complete picture of the emergence of sponge morphology, we dissected a set of species and subjected discs of living tissue to physiological shear and uniaxial deformations on a rheometer. Various species exhibited rheological properties such as anisotropic elasticity, shear softening and compression stiffening, negative normal stress, and non-monotonic dissipation as a function of both shear strain and frequency. Erect sponges possessed aligned, spicule-reinforced fibres which endowed three times greater stiffness axially compared with orthogonally. By contrast, tissue taken from shorter sponges was more isotropic but time-dependent, suggesting higher flow sensitivity in these compared with erect forms. We explore ecological and physiological implications of our results and speculate about flow-induced mechanical signalling in sponge cells.

We provide a transactional model of health for understanding the early risk of obesity in youth. This model argues that positive health is construed through the choices and actions that youth take within the range of resources and constraints of their biological and contextual situations across time. Social, cognitive, affective, and behavioral regulatory/motivational processes within the child mediate the relation between life experiences and health outcomes and obesity pathways are influenced by cumulative risk or protective processes for health promotion/compromising behaviors influencing health. We provide evidence-based examples of multilevel approaches to obesity prevention and treatment and highlight recommendations for future health behavior interventions., Competing Interests: Disclosure All authors have nothing to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Perivascular spaces (PVS) drain brain waste metabolites, but their specific flow paths are debated. Meningeal pia mater reportedly forms the outermost boundary that confines flow around blood vessels. Yet, we show that pia is perforated and permissive to PVS fluid flow. Furthermore, we demonstrate that pia is comprised of vascular and cerebral layers that coalesce in variable patterns along leptomeningeal arteries, often merging around penetrating arterioles. Heterogeneous pial architectures form variable sieve-like structures that differentially influence cerebrospinal fluid (CSF) transport along PVS. The degree of pial coverage correlates with macrophage density and phagocytosis of CSF tracer. In vivo imaging confirms transpial influx of CSF tracer, suggesting a role of pia in CSF filtration, but not flow restriction. Additionally, pial layers atrophy with age. Old mice also exhibit areas of pial denudation that are not observed in young animals, but pia is unexpectedly hypertrophied in a mouse model of Alzheimer's disease. Moreover, pial thickness correlates with improved CSF flow and reduced β-amyloid deposits in PVS of old mice. We show that PVS morphology in mice is variable and that the structure and function of pia suggests a previously unrecognized role in regulating CSF transport and amyloid clearance in aging and disease., (© 2022. The Author(s).)

To evaluate the effectiveness of a lecture series in increasing awareness and knowledge about common interventional radiology (IR) procedures amongst emergency medicine and internal medicine residents at a tertiary care academic medical center.A series of two 60-minute lectures was presented at both the Emergency and Internal Medicine weekly didactic conferences for the respective residency programs. The lectures covered the indications, contraindications, imaging, pre-procedure preparation, complications, and follow-up of common IR procedures, including both didactics as well as interactive question and answer segments. The first lecture included central venous access, IVC filters, and image-guided biopsies, and the second lecture covered biliary interventions, genitourinary interventions, and vascular embolization. Pre/post lecture assessments were given evaluating participant knowledge, and paired one-tailed t-tests were elucidated for evaluating differences in the mean scores.A total of 77 emergency and internal medicine resident physicians participated in assessments of the lecture series. There were significantly increased scores (P<0.001) after both of the lectures (36% to 82% on the first lecture and 44% to 65% on the second lecture), suggesting increased knowledge of the common IR procedures discussed in the lecture.This work demonstrated that educational initiatives such as lecture series implementation are effective methods to increase knowledge of common IR procedures and raise awareness of the specialty among referring providers., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Cerebral oedema develops after anoxic brain injury. In two models of asphyxial and asystolic cardiac arrest without resuscitation, we found that oedema develops shortly after anoxia secondary to terminal depolarizations and the abnormal entry of CSF. Oedema severity correlated with the availability of CSF with the age-dependent increase in CSF volume worsening the severity of oedema. Oedema was identified primarily in brain regions bordering CSF compartments in mice and humans. The degree of ex vivo tissue swelling was predicted by an osmotic model suggesting that anoxic brain tissue possesses a high intrinsic osmotic potential. This osmotic process was temperature-dependent, proposing an additional mechanism for the beneficial effect of therapeutic hypothermia. These observations show that CSF is a primary source of oedema fluid in anoxic brain. This novel insight offers a mechanistic basis for the future development of alternative strategies to prevent cerebral oedema formation after cardiac arrest., (© The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: The development of single-use flexible or disposable bronchoscopes (SUFBs) has accelerated in recent years, with the reduced risk of infectious transmission and reduced need for endoscopy staffing particularly advantageous in the COVID-19 pandemic era., Objective: The objective of this study was to assess the performance of a novel single-use bronchoscope in an academic quaternary referral centre with on-site interventional pulmonology programme., Methods: With ethical approval in a quaternary referral centre, we prospectively collected data on sequential bronchoscopy procedures using The Surgical Company Broncoflex© range of SUFBs. Data collected included demographic, procedural, scope performance, user satisfaction, and complication parameters in a tertiary bronchoscopy service., Results: 139 procedures were performed by five pulmonology faculty from January to July 2021. The majority were carried out for infection (45%) and malignancy (32%). Most were performed in the endoscopy suite and 8% were COVID positive or suspected. Most procedures reported the highest score in satisfaction (85%) with technical limitations reported in 15% (predominately related to scope suction or inadequate image quality) reverting to a reusable scope in 2.8 %., Conclusion: In our subset of patients in a bronchoscopy unit, SUFBs are safe, and both routine and advanced bronchoscopy procedures can be performed with high satisfaction reported., (© 2022 S. Karger AG, Basel.)

Background: African American (AA) women experience disproportionate levels of chronic disease, which is theorized to be driven by greater exposure to acute and chronic stress. The coronavirus (COVID-19) pandemic has further exacerbated existing health disparities among AA communities. Understanding how AA women have experienced and responded to stress during the pandemic may help to inform how future interventions can better address physical and mental well-being in AA communities., Aims: Drawing from stress and coping models and an ecological framework, the present study conducted a theory-based qualitative assessment of stress-related experiences during the pandemic among a cohort of AA women, including (1) sources of stress, (2) coping strategies, (3) perceptions of health-related behaviors, (4) the role of community, and (5) recommendations for future interventions., Method: After completing a group-based physical activity intervention program during the COVID-19 pandemic, a cohort of AA women ( N =17, M age = 49.3 ± 11.24) completed individual interviews. Sessions were conducted by phone, audiotaped, transcribed, and coded by independent raters ( r s = .71-.73). Themes were identified using deductive and inductive approaches., Results: Among sources of stress directly related to the pandemic, being at home, getting sick, and homeschooling/parenting were the most frequently discussed themes. Participants engaged in active coping (problem and emotion-focused), with health behaviors, social support, and religion/spirituality, emerging as frequently discussed themes. Although some participants reported passive coping strategies (e.g., avoidance), this approach was less pronounced., Conclusions: These qualitative results are used to guide suggestions for future interventions that jointly address stress and health-related behaviors in order to improve translation of research into practice and policy for future pandemics and disasters.

Background . The purpose of the current article is to demonstrate how formative process evaluation was used in a pilot study to optimize the design and implementation of two motivationally targeted community-based physical activity (PA) interventions for inactive African American women. Method . Fifteen African American women (M age: 41.6 years) were randomized to a challenge-focused program targeted toward high autonomous motivation or a rewards-focused program targeted toward low autonomous motivation. The challenge-focused program targeted enjoyment and valuation of PA and a team-based positive social climate through competitive intergroup activities and team-based goals, whereas the rewards-focused program targeted PA interest, competency, and partner-based social support through a walking program, individual-based goals with financial incentives, and partner-based action-plans. Results . Feedback from participants revealed high levels of acceptability of essential elements. Average weekly attendance exceeded the a priori goal of ≥75% of members in attendance each week. External systematic observation demonstrated that session content dose was ≥93% in both programs. Facilitator-level fidelity exceeded the a priori goal of averaging ≥3 on a 4-point scale for behavioral skills, communication, autonomy support, and session content. The process evaluation also revealed areas for improvement, including facilitator-level social support and behavioral skills at the group-level. Process data collected through FitBits revealed that participants were engaged in self-monitoring PA during the 6-week programs. Conclusions . The formative process evaluation demonstrated adequate levels of feasibility and acceptability and also provided key insights into adjustments needed before proceeding with implementing the motivationally targeted group-based programs in a larger randomized study.

Objective: This study set out to examine the role of parenting practices in protecting or exacerbating the negative effects of parent and adolescent stress on adolescent body mass index (BMI) over time. Separate longitudinal models were conducted to evaluate how parenting practices interacted with parental perceived stress and adolescent perceived stress in predicting adolescent BMI., Methods: Baseline data were collected from 148 African American adolescents (Mage = 12.93, SD = 1.75; Mz-BMI = 0.78, SD = 0.50; MBMI%-ile = 96.7, SD = 3.90) and their caregivers (Mage = 44.45, SD = 8.65; MBMI = 37.63, SD = 8.21) enrolled in the Families Improving Together for Weight Loss trial. Adolescents self-reported their perceptions of caregiver parenting style and feeding practices. Both caregivers and adolescents self-reported their perceptions of chronic stress. BMI for parents and adolescents was assessed objectively at baseline and 16 weeks post-intervention., Results: Hierarchical regression models predicting adolescent BMI z-score (z-BMI) indicated a significant interaction between parental perceived stress and parental pressure to eat. Simple slopes analyses demonstrated that for those parents that exhibit higher pressure to eat, parent stress was positively associated with adolescent z-BMI., Conclusions: These findings provide preliminary support suggesting that certain parenting practices interact with chronic stress on adolescent weight-related outcomes and that future interventions may consider integrating these factors., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This study evaluates whether parental provision of transportation for physical activity is associated with child/adolescent moderate-to-vigorous physical activity, while also evaluating community-level poverty. Self- and parental-reported surveys were administered with parents/caregivers and children in the Healthy Communities Study (N = 5138). Associations between individual-level demographics, community-level poverty, parental provision of transportation for physical activity, and moderate-to-vigorous physical activity were examined in multi-level models. Even when accounting for community-level poverty, which was significantly associated with lower moderate-to-vigorous physical activity, parental provision of transportation for physical activity was positively associated with greater moderate-to-vigorous physical activity. This study provides evidence for the importance of considering multiple systems of influence (e.g., community and individual factors) and considering how gaps in physical activity transportation for youth can be addressed in future health policies., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study evaluated the associations between parenting factors and adolescent weight related outcomes in African American adolescents with overweight and obesity. Baseline heights and weights were collected from 241 African American adolescents (11-16 years) with overweight and obesity. Self-reported adolescent perceptions of caregiver's parenting style (responsiveness, demandingness), parental feeding practices (monitoring, responsibility, weight related concerns, pressure-to-eat, and restriction), and their own dietary self-efficacy for healthy eating were assessed. Results demonstrated that greater parental responsiveness was significantly associated with lower adolescent body mass index (BMI) and higher adolescent dietary self-efficacy. In contrast, parental concern about adolescent weight was significantly associated with greater adolescent BMI, while greater parental responsibility for foods was associated with lower adolescent BMI. Although parental pressure-to-eat was significantly associated with higher dietary self-efficacy, greater parental restriction was associated with lower dietary self-efficacy. The results of this study highlight the importance of parental responsiveness and responsibility in understanding obesity related outcomes in African American adolescents with overweight and obesity., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Understanding determinants of metabolic risk has become a national priority given the increasingly high prevalence rate of this condition among U.S. adults., Purpose: This study's aim was to assess the impact of gene-by-neighborhood social environment interactions on waist circumference (WC) as a primary marker of metabolic risk in underserved African-American adults. Based on a dual-risk model, it was hypothesized that those with the highest genetic risk and who experienced negative neighborhood environment conditions would demonstrate higher WC than those with fewer risk factors., Methods: This study utilized a subsample of participants from the Positive Action for Today's Health environmental intervention to improve access and safety for walking in higher-crime neighborhoods, who were willing to provide buccal swab samples for genotyping stress-related genetic pathways. Assessments were conducted with 228 African-American adults at baseline, 12, 18, and 24 months., Results: Analyses indicated three significant gene-by-environment interactions on WC outcomes within the sympathetic nervous system (SNS) genetic pathway. Two interactions supported the dual-risk hypotheses, including the SNS genetic risk-by-neighborhood social life interaction (b = -0.11, t(618) = -2.02, p = .04), and SNS genetic risk-by-informal social control interaction (b = -0.51, t(618) = -1.95, p = .05) on WC outcomes. These interactions indicated that higher genetic risk and lower social-environmental supports were associated with higher WC. There was also one significant SNS genetic risk-by-neighborhood satisfaction interaction (b = 1.48, t(618) = 2.23, p = .02) on WC that was inconsistent with the dual-risk pattern., Conclusions: Findings indicate that neighborhood and genetic factors dually influence metabolic risk and that these relations may be complex and warrant further study., Trial Registration: NCT01025726., (© Society of Behavioral Medicine 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child's weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; M age = 12.83 ± 1.74; M BMI% = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for Weight Loss trial and an ancillary study. Dietary outcomes (fruit and vegetables (F&Vs), energy intake, sweetened beverage, total fat, and saturated fat) were assessed using random 24-h dietary recalls. Validated surveys were used to assess adolescent-reported EE and parental feeding practices. Results demonstrated a significant interaction between EE and parental monitoring (adjusted analyses; B = 0.524, SE = 0.176, p = 0.004), restriction ( B = -0.331, SE = 0.162, p = 0.043), and concern ( B = -0.602, SE = 0.171, p = 0.001) on F&V intake; under high monitoring, low restriction, and low concern, EE was positively associated with F&V intake. There were no significant effects for the other dietary outcomes. These findings indicate that parental feeding practices and EE may be important factors to consider for dietary interventions, specifically for F&V intake, among overweight African American adolescents.

Few studies have integrated positive parenting and motivational strategies to address dietary outcomes such as frequency of family mealtime. The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort trial ( n = 241 dyads) testing the efficacy of integrating a motivational plus family weight loss (M + FWL) intervention for healthy eating and weight loss in overweight and obese African American adolescents. The current study tested the interaction of parenting styles (responsiveness, demandingness) and parental feeding practices (restriction, concern about child's weight, pressure to eat) and the FIT intervention on frequency of family mealtime over 16 weeks. Multilevel modeling demonstrated significant interactions between the group-based treatment and responsiveness ( p = 0.018) and demandingness ( p = 0.010) on family mealtime. For the group-based M + FWL intervention, increased responsiveness and reduced demandingness were associated with increased frequency of family mealtime from baseline to 16 weeks. There was also a negative association between parental restriction and frequency of family mealtime, but a positive association between parental concerns about their adolescent's weight and frequency of mealtime. These findings are the first to demonstrate that an authoritative or nurturing parenting style moderated intervention effects for improving the frequency of family mealtime in overweight and obese African American adolescents.

Background: African American women participate in less physical activity (PA), have higher rates of chronic disease, and report higher perceived stress relative to other race and sex demographic groups., Purpose: Based on the stress-buffering hypothesis, this study tested the hypothesis that social support would buffer the negative effects of perceived stress on moderate-to-vigorous PA (MVPA) under high, but not low, perceived stress., Methods: Participants were 143 African American women (mean [M] age = 43.94, standard deviation [SD] = 8.62; M body mass index = 37.94, SD = 8.11) enrolled in the Families Improving Together (FIT) for Weight Loss Trial. Average daily minutes of MVPA were obtained via 7 day accelerometer estimates at baseline and 8 and 16 weeks., Results: A multilevel growth model demonstrated a significant three-way interaction between stress, social support, and time (B = -0.31, standard error [SE] = 0.14, p = .03). Simple slopes analyses revealed that, at baseline, among participants with high social support (+1 SD), stress was positively associated with greater MVPA (B = 0.49, SE = 0.18, p = .008), whereas among participants with low social support (-1 SD), stress was not significantly associated with MVPA (B = -0.04, SE = 0.14, p = .81). However, at 8 and 16 weeks, stress was not significantly associated with MVPA for either high or low support groups., Conclusions: Findings highlight the importance of integrating constructs of stress and social support into future physical activity intervention programs for African American women and the need to evaluate changes in stress and social support longitudinally., (© Society of Behavioral Medicine 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The emerging interest in brain fluid transport has prompted a need for techniques that provide an understanding of what factors regulate cerebrospinal fluid (CSF) production. Here, we describe a methodology for direct quantification of CSF production in awake mice. We measure CSF production by placing a catheter in a lateral ventricle, while physically blocking outflow from the 4 th ventricle. Using this methodology, we show that CSF production increases during isoflurane anesthesia, and to a lesser extent with ketamine/xylazine anesthesia, relative to the awake state. Aged mice have reduced CSF production, which is even lower in aged mice overexpressing amyloid-β. Unexpectedly, CSF production in young female mice is 30% higher than in age-matched males. Altogether, the present observations imply that a reduction in CSF production might contribute to the age-related risk of proteinopathies but that the rate of CSF production and glymphatic fluid transport are not directly linked., Competing Interests: Declaration of Interests The authors declare no competing interests., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Inteins, as posttranslational regulatory elements, can tune protein function to environmental changes by conditional protein splicing (CPS). Translated as subdomains interrupting host proteins, inteins splice to scarlessly join flanking sequences (exteins). We used DnaB-intein1 (DnaBi1) from a replicative helicase of Mycobacterium smegmatis to build a k anamycin i ntein s plicing r eporter (KISR) that links splicing of DnaBi1 to kanamycin resistance. Using expression in heterologous Escherichia coli , we observed phenotypic classes of various levels of splicing-dependent resistance (SDR) and related these to the insertion position of DnaBi1 within the kanamycin resistance protein (KanR). The KanR-DnaBi1 construct demonstrating the most stringent SDR was used to probe for CPS of DnaB in the native host environment, M. smegmatis We show here that zinc, important during mycobacterial pathogenesis, inhibits DnaB splicing in M. smegmatis Using an in vitro reporter system, we demonstrated that zinc potently and reversibly inhibited DnaBi1 splicing, as well as splicing of a comparable intein from Mycobacterium leprae Finally, in a 1.95 Å crystal structure, we show that zinc inhibits splicing through binding to the very cysteine that initiates the splicing reaction. Together, our results provide compelling support for a model whereby mycobacterial DnaB protein splicing, and thus DNA replication, is responsive to environmental zinc. IMPORTANCE Inteins are present in a large fraction of prokaryotes and localize within conserved proteins, including the mycobacterial replicative helicase DnaB. In addition to their extensive protein engineering applications, inteins have emerged as environmentally responsive posttranslational regulators of the genes that encode them. While several studies have shown compelling evidence of conditional protein splicing (CPS), examination of splicing in the native host of the intein has proven to be challenging. Here, we demonstrated through a number of measures, including the use of a splicing-dependent sensor capable of monitoring intein activity in the native host, that zinc is a potent and reversible inhibitor of mycobacterial DnaB splicing. This work also expands our knowledge of site selection for intein insertion within nonnative proteins, demonstrating that splicing-dependent host protein activation correlates with proximity to the active site. Additionally, we surmise that splicing regulation by zinc has mycobacteriocidal and CPS application potential., (Copyright © 2020 Woods et al.)

Objective: With the rising incidence of health care emergencies, there has been a considerable burden placed on health care systems worldwide. We aimed to determine the willingness and capacity of medical students in Ireland to volunteer during health care emergencies., Methods: An online, cross-sectional survey of medical students at the National University of Ireland was conducted in 2015., Results: Respondents totaling 274 completed the survey (response rate - 30.1%). Of participants, 69.0% were willing to volunteer in the event of a natural disaster and 59.1% in an event of an infectious epidemic, with altruism being the strongest motivational factor. Only a minority of students (23.7%) felt their current skill level would be useful in an emergency setting., Conclusions: Medical students express a strong interest in actively participating during health care emergencies.

Stroke affects millions each year. Poststroke brain edema predicts the severity of eventual stroke damage, yet our concept of how edema develops is incomplete and treatment options remain limited. In early stages, fluid accumulation occurs owing to a net gain of ions, widely thought to enter from the vascular compartment. Here, we used magnetic resonance imaging, radiolabeled tracers, and multiphoton imaging in rodents to show instead that cerebrospinal fluid surrounding the brain enters the tissue within minutes of an ischemic insult along perivascular flow channels. This process was initiated by ischemic spreading depolarizations along with subsequent vasoconstriction, which in turn enlarged the perivascular spaces and doubled glymphatic inflow speeds. Thus, our understanding of poststroke edema needs to be revised, and these findings could provide a conceptual basis for development of alternative treatment strategies., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Self-Determination Theory proposes that some people are motivated to initiate physical activity by externally-controlled reasons (e.g., physical appearance, approval from others), whereas others feel compelled by more autonomous sources of motivation (e.g., enjoyment, personal importance). This study used qualitative methods to examine whether individual differences in autonomous motivation offers a useful framework for developing targeted intervention programs for African American women. Focus groups (k = 6) were conducted to examine how different levels of autonomous motivation for physical activity related to differences in physical activity barriers and facilitators among African American women (N = 31). Sessions were audiotaped, transcribed, and coded by independent raters (r = 0.70). QSR NVivo 11 was used to analyze data, and themes were identified separately for women with low, medium, or high autonomous motivation. Those with high autonomous motivation focused on themes of wanting novelty, excitement, and competition, whereas those with low autonomous motivation focused on themes of wanting instrumental support and financial incentives for increasing engagement in physical activity. Implications for developing physical activity intervention programs for African American women that are targeted toward differences in autonomous motivation are discussed., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

This paper examines three distinct examples of interventions in nonclinical settings selected to highlight the challenges and opportunities for evaluating cost-effectiveness in the field of health psychology and behavioral medicine. Nonclinical settings are defined as those involving systems outside of traditional medical/clinical settings, and include interventions tested in clinical settings that can also be implemented in nonclinical settings. The examples in this paper reflect the use of a varying degree of existing cost-effectiveness data and previous health economic analyses. First, the Chronic Disease Self-Management Program model reflects an intervention protocol designed to increase patients' confidence and mastery in their ability to manage their conditions that has been shown to be cost effective for a variety of chronic disease conditions. Second, the cost and cost-effectiveness of tobacco quitlines (e.g., National Tobacco Quit Line) has been the subject of several preliminary cost-effectiveness examinations and has proven to have significant reach and impact on tobacco-related behaviors. Finally, environmental interventions for promoting walking and physical activity in community-based contexts (e.g., PATH trial) are presented and have been shown to be highly relevant for demonstrating cost-effectiveness. Overall, the disciplines of health psychology and behavioral medicine are in a unique position to develop, implement, and evaluate a broader range of interventions in more diverse environments than cost-effectiveness applications in more traditional, clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cerebrospinal fluid (CSF) flow in rodents has largely been studied using ex vivo quantification of tracers. Techniques such as two-photon microscopy and magnetic resonance imaging (MRI) have enabled in vivo quantification of CSF flow but they are limited by reduced imaging volumes and low spatial resolution, respectively. Recent work has found that CSF enters the brain parenchyma through a network of perivascular spaces surrounding the pial and penetrating arteries of the rodent cortex. This perivascular entry of CSF is a primary driver of the glymphatic system, a pathway implicated in the clearance of toxic metabolic solutes (e.g., amyloid-β). Here, we illustrate a new macroscopic imaging technique that allows real-time, mesoscopic imaging of fluorescent CSF tracers through the intact skull of live mice. This minimally-invasive method facilitates a multitude of experimental designs and enables single or repeated testing of CSF dynamics. Macroscopes have high spatial and temporal resolution and their large gantry and working distance allow for imaging while performing tasks on behavioral devices. This imaging approach has been validated using two-photon imaging and fluorescence measurements obtained from this technique strongly correlate with ex vivo fluorescence and quantification of radio-labeled tracers. In this protocol, we describe how transcranial macroscopic imaging can be used to evaluate glymphatic transport in live mice, offering an accessible alternative to more costly imaging modalities.

Background: Although weight loss is an important primary outcome in obesity interventions, family-based interventions may have cascading ripple effects that extend to other aspects of health and well-being. Identifying these secondary benefits may be useful for understanding how to best engage underserved African American families in weight loss. The present research examines whether African American adolescents and parents perceive secondary benefits from participating in a family-based weight-loss intervention, including secondary health, social, or cognitive benefits., Methods: Qualitative data were obtained from families participating in the group-based intervention of the Families Improving Together (FIT) for Weight Loss trial. During the final week of the face-to-face motivational and family-based intervention program, families completed a guided open-ended group discussion about changes they experienced from participating (14 groups, N = 41 adolescents and 41 parents). Sessions were audiotaped, transcribed, and coded by independent pairs of raters using both inductive and deductive approaches. Guided by the multi-theoretical framework for the FIT trial, some themes were determined prior to coding using a deductive approach, including: (a) health outcomes (e.g., monitoring strategies for diet and physical activity), (b) social outcomes (e.g., involvement in family support, group support, autonomy support, family bonding, positive communication) and (c) cognitive outcomes (e.g., expression of self-confidence through self-efficacy, self-regulation, establishment of long-term goals). In addition to these pre-determined themes, the coding process included an inductive assessment, allowing for unexpected themes to surface as well around positive self-talk, relapse prevention, and monitoring strategies for different types of weight-related behaviors., Results: Across both adolescents and parents, the cognitive outcomes were the most frequently discussed outcomes, including self-regulation, monitoring strategies for diet, establishing long-term goals, and ultimate relapse prevention. Parents made a greater number of comments about the social outcomes, including family support, group support, self-efficacy, and family connectedness, whereas adolescents made a greater number of comments about positive family communication., Conclusions: The results provide preliminary support for the positive secondary effects of weight loss programs on improving both cognitive and social well-being in underserved African American adolescents., Trial Registration: ClinicalTrials.gov # NCT01796067. https://clinicaltrials.gov/ct2/show/NCT01796067?term=NCT01796067&rank=1 The trial was registered on February 21, 2013 and the first participant was enrolled July 12, 2013.

Effective interventions are needed to increase physical activity (PA) in African American men, but little is known about correlates of PA and exercise motivation in this population. Using an ecological approach that considers cognitive, social, and environmental factors, correlates of moderate-to-vigorous physical activity (MVPA) and exercise motivation in underserved African American men were examined. Greater exercise motivation, greater social support for exercise, and more favorable environmental perceptions were hypothesized to be associated with higher MVPA, and greater social support and environmental perceptions were hypothesized to be associated with higher exercise motivation. This secondary analysis used baseline data from the Positive Action for Today's Health (PATH) trial. African American men ( n = 166, aged 48 ± 15 years) completed surveys that assessed cognitive, social, and environmental factors theoretically relevant to MVPA. Accelerometers were used to obtain a 7-day estimate of MVPA. Hierarchical linear regression analyses showed that exercise motivation was positively associated with MVPA ( B = 1.15, SE = .41, p = .006). Exercise attitudes ( B = .16, SE = .07, p = .037), exercise self-concept ( B = .28, SE = .06, p < .001), exercise support from friends ( B = .12, SE = .06, p = .048), and places for walking and cycling ( B = .13, SE = .06, p = .032) were positively associated with exercise motivation. Interventions that improve exercise motivation and associated variables may be warranted to increase MVPA in underserved African American men. ClinicalTrials.gov # NCT01025726.

Background: Interventions that incorporate behavioral skills training and parental involvement have been effective for promoting weight loss among middle and upper class youth; however, few studies have produced similar weight loss effects in underserved ethnic minority youth., Purpose: This study examined whether online program exposure (in both an online tailored intervention and an online health education comparison program) predicted greater retention among African American youth and their parents in the Families Improving Together (FIT) for Weight Loss trial., Methods: Parent-adolescent dyads (N = 125) were randomized to either an online tailored intervention program (n = 63) or an online health education comparison program (n = 62). Paradata including login data were used to determine the number of sessions viewed (0-8) and the number of minutes spent online per session. Study retention, defined as collection of adolescent anthropometric measures at 6 months postintervention, was the outcome., Results: Logistic regression analyses showed a significant effect for login rate on retention (OR = 1.21, 95% CI [1.04, 1.39]). Total number of sessions viewed, child age, child sex, parent age, and parent sex accounted for 11% of the variance in retention at 6 months post- intervention. Participants who were retained spent a significantly greater number of minutes during each session (M = 12.99, SD = 11.63) than participants who were not retained (M = 7.77, SD = 11.19), t(123) = 2.24, p = .027, d = 0.45., Conclusions: The use of paradata from online interventions is a novel and feasible approach for examining exposure in web-based interventions and program retention in underserved ethnic minority families., Trial Registration: ClinicalTrials.gov NCT01796067. Registered January 23, 2013., (© Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)