Search

Micronutrient interventions can reduce child mortality. By applying Micronutrient Intervention Modeling methods in Senegal, Burkina Faso, and Nigeria, we estimated the impacts of bouillon fortification on apparent dietary adequacy of vitamin A and zinc among children and folate among women. We then used the Lives Saved Tool to predict the impacts of bouillon fortification with ranges of vitamin A, zinc, and folic acid concentrations on lives saved among children 6–59 months of age. Fortification at 250 µg vitamin A/g and 120 µg folic acid/g was predicted to substantially reduce vitamin A– and folate‐attributable deaths: 65% for vitamin A and 92% for folate (Senegal), 36% for vitamin A and 74% for folate (Burkina Faso), and >95% for both (Nigeria). Zinc fortification at 5 mg/g would avert 48% (Senegal), 31% (Burkina Faso), and 63% (Nigeria) of zinc‐attributable deaths. The addition of all three nutrients at 30% of Codex nutrient reference values in 2.5 g bouillon was predicted to save an annual average of 293 child lives in Senegal (3.5% of deaths from all causes among children 6–59 months of age), 933 (2.1%) in Burkina Faso, and 18,362 (3.7%) in Nigeria. These results, along with evidence on program feasibility and costs, can help inform fortification program design discussions. [ABSTRACT FROM AUTHOR]

Purpose: To explore the views of clinicians and researchers about the challenges of measuring health-related quality of life (HRQoL) in children (5–11 years) and to explore whether digital ecological momentary assessment (EMA) could enhance HRQoL measurement. Methods: Semi-structured qualitative interviews with 18 professionals (10 academics/researchers, four clinicians, four with both professional backgrounds) experienced in child HRQoL measurement. We analysed data thematically. Results: Theme One describes the uncertainty around conceptualising HRQoL for children and which domains to include; the greater immediacy and sensitivity of children's reflections on their HRQoL, leading to high variability of the construct; and the wide individual differences across childhood, incongruent with fixed HRQoL measures. Theme Two describes the challenges of proxy reporting, questioning whether proxies can meaningfully report a child's HRQoL and reflecting on discrepancies between child and proxy reporting. Theme Three covers the challenge of interpreting change in HRQoL over time; does a change in HRQoL reflect a change in health, or does this reflect developmental changes in how children report HRQoL. Theme Four discusses digital EMA for HRQoL data capture. In-the-moment, repeated measurement could provide rich data and address challenges of recall, ecological validity and variability; passive data could provide objective markers to supplement subjective responses; and technology could enable personalisation and child-centred design. However, participants also raised methodological, practical and ethical challenges of digital approaches. Conclusion: Digital EMA may address some of the challenges of HRQoL data collection with children. We conclude by discussing potential future research to explore and develop this approach. [ABSTRACT FROM AUTHOR]

Background: We sought to understand which factors are associated with open appendectomy as final operative approach. We hypothesize that higher American Association for the Surgery of Trauma (AAST) Emergency General Surgery (EGS) grade is associated with open appendectomy. Patients and Methods: Post hoc analysis of the Eastern Association for the Surgery of Trauma (EAST) Multicenter Study of the Treatment of Appendicitis in America: Acute, Perforated and Gangrenous (MUSTANG) prospective appendicitis database was performed. All adults (age >18) undergoing appendectomy were stratified by final operative approach: laparoscopic or open appendectomy (including conversion from laparoscopic). Univariable analysis was performed to compare group characteristics and outcomes, and multivariable logistic regression was performed to identify demographic, clinical, or radiologic factors associated with open appendectomy. Results: A total of 3,019 cases were analyzed. One hundred seventy-five (5.8%) patients underwent open appendectomy, including 127 converted from laparoscopic to open. The median age was 37 (25) years and 53% were male. Compared with the laparoscopic group, open appendectomy patients had more comorbidities, higher proportion of symptoms greater than 96 hours, and higher AAST EGS grade. Moreover, on intraoperative findings, the open appendectomy group had a higher incidence of perforated and gangrenous appendicitis with purulent contamination, abscess/phlegmon, and purulent abdominal/pelvic fluid. On multivariable analysis controlling for comorbidities, clinical and imaging AAST grade, duration of symptoms, and intra-operative findings, only AAST Clinical Grade 5 appendicitis was independently associated with open appendectomy (odds ratio [OR], 5.63; 95% confidence interval [CI], 1.24–25.55; p = 0.025). Conclusions: In the setting of appendicitis, generalized peritonitis (AAST Clinical Grade 5) is independently associated with greater odds of open appendectomy. [ABSTRACT FROM AUTHOR]

Jones notes that even birth control reformers such as Marie Stopes were "unable to distinguish between caps that could be used for uterus support and those for contraception" (p. 37). Keywords: Birth control; Technology; Commerce; Medicalization; British history; United States history EN Birth control Technology Commerce Medicalization British history United States history 337 340 4 07/11/23 20230701 NES 230701 With the collapse of abortion rights in the United States, the right to legal contraception may not be far behind. Continued research into the historical and sociological aspects of contraception is now more vital than ever to help us understand the legal and medical context of potential bans, and historians Claire L. Jones and Donna J. Drucker give us two excellent new books to consider. [Extracted from the article]

Our co-authored piece contributes to Black and Indigenous solidarity juxtaposed to our nuanced and convergent lived experiences as racialized people. Lauren and I (Nate)co-explore how our racialized identities and stories may complexify Black-and-Indigenous-led movements. We say "racialized" to acknowledge white supremacists' racecraft to subjugate Black and Indigenous people. Lauren, an Indigenous educator activist, and I, a Black scholar activist, both with white maternal lineage, connected after storying about our journeys to, through, and beyond the teaching profession. Black and Indigenous educators have centered theories of we are not free until we are all free. Our knowledge contributions further complexify freedom-for-all by offering Black and Indigenous knowledge on nuanced ancestry within the U.S. racialization project. Conversational data stemmed from an educator activist collective project where Lauren and I had many conversations about our similar and unique journeys toward our justice orientation. Our conversations yielded many Black and Indigenous solidarity learnings. These co-learnings included: building solidarity through weaving our unique stories, extending nuanced understandings of racialized experiences, and co-regulation in societal spaces not made for us. We conclude with implications in continuing to build solidarity in social science. [ABSTRACT FROM AUTHOR]

Permafrost thaw may increase the production of neurotoxic methylmercury (MeHg) in northern peatlands, but the downstream delivery of MeHg is uncertain. We quantified total mercury (THg) and MeHg concentrations in lakes and streams along a 1700 km permafrost transect in boreal western Canada to determine the influence of regional permafrost extent compared to local lake and catchment characteristics. In lakes, we assessed sediment microbial communities and modeled potential rates of water column photodemethylation (PD). Regardless of permafrost conditions, peatlands were the primary sources of MeHg across the transect as MeHg concentrations in streams increased with aromatic dissolved organic carbon (DOC), iron, and lower pH. Higher DOC and greater catchment peatland extent were further associated with higher stream %MeHg (MeHg/THg). Peatland lakes were potential MeHg sinks, with lower MeHg concentrations than streams (mean ± 1SD: 0.19 ± 0.23 and 0.47 ± 0.77 ng MeHg L−1, respectively), and larger stream catchments had lower %MeHg where PD may occur in abundant small lakes. Microbial communities in lake sediments showed that abundance of Hg reducing genes (merA) predominated over Hg methylating (hgcA) and MeHg demethylating (merB) genes. The effects of permafrost extent on MeHg processes in lakes were secondary to the influence of local catchment characteristics, but lakes in regions with less permafrost had higher DOC concentrations, higher %MeHg, and lower potential rates of PD. Our study highlights a need to understand the impacts of climate change on MeHg source and sink processes, particularly as mediated through changes to peatland DOC, to improve projections of future MeHg concentrations in northern catchments. [ABSTRACT FROM AUTHOR]

Introduction: Anthropometrics and body composition characteristics differentiate many types of athletes and are related to performance on fitness tests and tasks in military personnel. Soldiers competing to enter elite units must demonstrate physical fitness and operational competence across multiple events. Therefore, this study determined whether anthropometrics and body composition predicted physical performance and selection for special forces training among soldiers attending the rigorous Special Forces Assessment and Selection (SFAS) course.Materials and Methods: Soldiers attending the SFAS course between May 2015 and March 2017 were enrolled in a longitudinal, observational study. Anthropometrics (height, body mass, and body mass index [BMI]; n = 795) and body composition measured by dual-energy X-ray absorptiometry (percentage body fat, fat mass, lean mass, bone mineral content [BMC], and bone mineral density [BMD]; n = 117) were assessed before the course start. Associations with physical performance were determined with correlation coefficients. Associations with selection were determined with analyses of variance and t-tests; effect sizes were calculated as Cohen's d. The U.S. Army Research Institute of Environmental Medicine Institutional Review Board (IRB) initially approved this study, and the U.S. Army Medical Research and Development Command IRB approved the continuing review.Results: Lower percentage body fat and fat mass predicted better performance on all assessments: Army Physical Fitness Test (APFT), pull-ups, SFAS run, loaded road march, obstacle course, and land navigation (P ≤ .05). Higher lean mass predicted better performance on the loaded road march (P ≤ .05). Lower body mass and BMI predicted better performance on APFT, pull-ups, run, and obstacle course; higher body mass and BMI predicted better performance on the loaded road march (P ≤ .05). Shorter stature predicted better performance on push-ups (APFT) and pull-ups; taller stature predicted better performance on SFAS run and loaded road march (P ≤ .05). On average, the selected soldiers were taller (179.0 ± 6.6 vs. 176.7 ± 6.7 cm), had higher body mass (85.8 ± 8.8 vs. 82.1 ± 9.6 kg), BMI (26.8 ± 2.2 vs. 26.3 ± 2.6 kg/m2), lean mass (67.2 ± 7.3 vs. 61.9 ± 7.6 kg), BMC (3.47 ± 0.40 vs. 3.29 ± 0.56 kg), and BMD (1.34 ± 0.10 vs. 1.28 ± 0.10 g/cm2), and lower percentage body fat (17.3 ± 3.4 vs. 20.1 ± 4.5%) and fat mass (14.2 ± 3.7 vs. 15.8 ± 4.4 kg) (P ≤ .05). Effect sizes were largest for lean mass (Cohen's d = 0.71) and percentage body fat (d = 0.70), followed by BMD (d = 0.60), body mass (d = 0.40), fat mass (d = 0.39), BMC (d = 0.37), height (d = 0.35), and BMI (d = 0.21). Body mass adjustment attenuated associations between height and selection.Conclusions: Anthropometrics and body composition are predictors of physical performance and SFAS success. Since these measures are modifiable (excluding height), they may be the focus of intervention studies aiming to improve performance in arduous military training courses, sports that require competition in multiple events, and occupations that have varied physical demands, such as firefighting, law enforcement, and construction. [ABSTRACT FROM AUTHOR]

A recent study published in I JAMA Internal Medicine i found that medication abortion is so reliably safe and effective that there is little need for in-person testing prior to the distribution of these pills.[1] Patients are able to safely self-manage medication abortions at home. 2003; 40: 605-20. 14686133 10 Nash E, Dreweke J. The U.S. abortion rate continues to drop: once again, state abortion restrictions are not the main driver. As of May 2022, the overturning of I Roe v. Wade i appears imminent, even as the U.S. Food and Drug Administration has expanded access to medication abortion through the mail. ROOTS OF REPRODUCTIVE CONTROL Abortion was a common practice in early America and most women experienced some combination of menstruation, pregnancy (and its prevention via various contraceptive methods), birth, miscarriage, and abortion over their reproductive life cycle.[3], [4] Unlike today, none of these reproductive processes was necessarily overseen by a physician. [Extracted from the article]

The article discusses fraternization between Union and Confederate soldiers during the U.S. Civil War conflict known as the Siege of Petersburg in Petersburg, Virginia, in 1864 and 1865. It examines the concept of resistance to authority as a method by which soldiers expressed individualism, the concept of the third space, and the trading of goods among soldiers.

Low‐dose methotrexate (MTX) is a first‐line therapy for the treatment of arthritis. However, there is considerable interindividual variability in MTX exposure following standard dosing. Polymorphisms in SLCO1B1 significantly effect MTX clearance, altering therapeutic response. One decreased function variant, rs4149056 (c.521T>C, Val174Ala), slows MTX clearance and in vitro uptake of MTX. This phenotype was recapitulated in a mouse model using a knockout (KO) of the murine orthologue, Slco1b2. Our objective was to investigate the impact of this phenotype on the pharmacokinetics and therapeutic outcomes of low‐dose MTX in a murine model of collagen‐induced arthritis (CIA). We evaluated response to MTX in mice with CIA using wildtype (WT), heterozygous, and KO Slco1b2 mice on a DBA1/J background. Arthritis was macroscopically evaluated daily to quantify disease progression. Mice received 2 mg/kg or a pharmacogenetically guided MTX dose subcutaneously 3 times a week for 2 weeks. MTX concentrations were collected at the end of the study and exposure (day*µM) was estimated using a two‐compartment model. Mice displayed a seven‐fold range in MTX exposure and revealed a significant exposure‐response relationship (p = 0.0027). KO mice receiving the 2 mg/kg dosing regimen had 2.3‐fold greater exposure to MTX (p < 0.0001) and a 66% reduction in overall disease progression (p = 0.011) compared to WT mice. However, exposure and response were equivalent when pharmacogenetically guided dosing was used. These studies demonstrate that an exposure‐response relationship exists for MTX and that Slco1b2 genotype affects MTX exposure and therapeutic response. Such evidence supports the use of SLCO1B1‐pharmacogenetic dosing of low‐dose MTX for patients with arthritis. [ABSTRACT FROM AUTHOR]

The social politics of women's alcohol use is controversial given current debates over maternal-fetal health, fetal alcohol syndrome, and debates about welfare. Exploring the early twentieth century intersections of Prohibition, birth control reform, and alcohol politics reveals the historical roots of current recommendations surrounding women, alcohol, and public assistance. [ABSTRACT FROM AUTHOR]

Background: Major Depressive Disorder (MDD) is a global disorder that negatively affects mood and quality of life. Antidepressant medication and psychotherapy are the most commonly prescribed treatments, but prior research has called their clinical efficacy into question. These treatments may be less effective when the patient has a diagnosed comorbid disorder.Method: A systematic review of the literature was conducted to investigate whether an alternative method of treatment, Transcranial Magnetic Stimulation (TMS), is effective for MDD with a diagnosed comorbidity. 110 articles were identified, of which 8 were included in the current review.Results: Response and remission rates vary. A range of 39.5-70% of participants experienced an antidepressant response to treatment, and 16.6-76.9% of patients achieved remission from MDD. A range of 48.6-84.6% of participants responded to treatment of their comorbid disorder, and 50-84.6% achieved remission of comorbid symptoms.Limitations: Limitations of the current review include small sample sizes, limited statistical power, homogenous samples, and a lack of sham or placebo-controlled studies.Conclusion: Preliminary results support that TMS is effective at treating symptoms of MDD and a comorbid disorder. Additional studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Purpose: This study determined associations between diet quality measured by the Healthy Eating Index (HEI)-2015, physical performance, and successful selection following a U.S. Army Special Forces Assessment and Selection course characterized by arduous cognitive and physical demands. Methods: The HEI-2015 scores were calculated from usual diet assessed with a Block food frequency questionnaire among 782 soldiers attending Special Forces Assessment and Selection. Differences in HEI-2015 scores according to demographics and physical performance were determined with analysis of variance. Differences in likelihood of selection according to HEI-2015 scores were determined with logistic regression. Models were adjusted for potential confounders: age, education, body mass index (BMI), duration and type of resistance training, and smoking. Results: The HEI-2015 total score was higher among older soldiers (≥25 yr), those with more education (≥some college), higher body mass index (≥25), longer duration of resistance training (≥400 min·wk−1), those that reported use of free weights, suspension training, Olympic lifting, and nonsmokers (P < 0.05). The HEI-2015 total score was higher among those with higher Army Physical Fitness Test (APFT) total scores, APFT sit-up score, APFT run score, and faster loaded road march times (P < 0.05). Those with higher HEI-2015 total scores were 75% (quartile 3 vs quartile 1: odds ratio, 1.75; 95% confidence interval, 1.09–2.81) and 65% (quartile 4 vs quartile 1: odds ratio, 1.65, 95% confidence interval, 1.03–2.65) more likely to be selected. Higher scores for total vegetables, greens and beans, seafood and plant protein, and refined grains, but lower sodium scores (indicating more sodium consumed), were associated with better physical performance (P < 0.05). Conclusions: Dietary patterns that conform to federal dietary guidelines (except sodium) are associated with physical performance and Special Forces selection. [ABSTRACT FROM AUTHOR]

Background: Our primary objective was to determine the rate of persistent Trichomonas infection among pregnant women posttreatment. The secondary objective was to determine if oral multidose metronidazole was associated with fewer cases of persistent Trichomonas compared with single-dose treatment.Methods: This is a retrospective cohort study of women diagnosed with genital Trichomonas vaginalis from 2008 to 2017. We calculated the rate of persistent Trichomonas by dividing the number of positive Trichomonas tests collected 21 days or longer posttreatment by the total number of women treated and retested. Bivariate analysis was performed to compare the rates of positive tests after single and multidose metronidazole. Multivariate logistic regression was used to evaluate factors associated with persistent infection.Results: Five hundred forty-two women with 565 pregnancies were diagnosed with Trichomonas infection. The majority of subjects were prescribed either single-dose (n = 352) or multidose metronidazole (n = 74). Posttreatment Trichomonas tests were collected 21 days or longer in 326 subjects and 44% (143) were positive. Rates of positive Trichomonas tests among women receiving single-dose and multidose regimens were similar (45% vs. 40%, P = 0.50). Women who had ≥1 pregnancy affected by Trichomonas infection were more likely to have a positive test posttreatment (adjusted odds ratio, 20.1; 95% confidence interval, 1.9-215.3). Obese women were less likely to have a positive test posttreatment (adjusted odds ratio, 0.3; 95% confidence interval, 0.1-0.9).Conclusions: Given high rates of positive Trichomonas tests and increased detection with nucleic acid amplification tests (NAATs), all pregnant women should be retested with NAATs approximately 3 weeks posttreatment. Further studies are needed to determine the most effective treatment of Trichomonas infection in pregnant women. [ABSTRACT FROM AUTHOR]

This article argues that the postfeminist gender politics of Friends (NBC, 1994–2004) are played out via a series of manipulations and reversals of space and mise-en-scène. Arguing that clearly gendered domestic space forms a stable part of the sitcom’s equilibrium, it analyses instances where the mise-en-scène boldly calls attention to men’s and women’s spaces, puts the gendering of space into flux, and highlights the burden of domestic labor. It reveals through close textual analysis how space in Friends is used to offer the playful promise of freedom from restrictive gender roles, but ultimately maintains a conservative status quo of both space and gender. It also makes a case for paying close attention to the aesthetics of the traditional sitcom to appreciate the expressivity of production design offered in such texts which, although (deliberately) unspectacular, is by no means unremarkable. [ABSTRACT FROM AUTHOR]

Background Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge. Objective To examine 1-year survival trends overall and by rhythm after IHCA. Methods Using Medicare beneficiaries (age ≥ 65 years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival. Results Among 45,567 patients with IHCA, the unadjusted 1-year survival was 9.4%. Unadjusted 1-year survival was 21.8% among the 9,223 (20.2%) of patients with Ventricular Fibrillation or Pulseless Ventricular Tachycardia (VF/VT) and 6.2% among the 36,344 (79.8%) of patients with Pulseless Electrical Activity or asystole (PEA/asystole). After adjustment for patient and arrest characteristics, 1-year survival increased over time for all IHCA from 8.9% in 2000–2001 to 15.2% in 2011 (adjusted rate ratio [RR] per year, 1.05; 95% CI, 1.03–1.06; P < 0.001 for trend). Improvements in 1-year risk adjusted survival were also observed for VF/VT (19.4% in 2000–2001 to 25.6% in 2011 [RR per year, 1.02; 95% CI, 1.01–1.04; P 0.004 for trend]) and PEA/asystole arrests (4.7% in 2000–2001 to 10.2% in 2011 [RR per year, 1.07; 95% CI, 1.05–1.08; P < 0.001 for trend]). Conclusion Among Medicare beneficiaries in the GWTG-Resuscitation registry, 1-year survival after IHCA has increased for over the past decade. Temporal improvements in survival were noted for both shockable and non-shockable presenting arrest rhythms. [ABSTRACT FROM AUTHOR]

An editorial is presented on decisions of U.S. Supreme Court that profoundly shaped the lives of US citizens, clarifying constitutional rights and reshaping cultural norms. It outlines the requirement of citizens across the United States those who lost a fundamental right to bodily autonomy, post‐Dobbs. An overview of the historical and bioethical considerations for a post‐Roe world U.S. is presented.

Rising air temperatures, intensifying wildfire activity, and human disturbance are driving rapid permafrost thaw across the subarctic, particularly for thaw-sensitive discontinuous permafrost. The Taiga Plains and Taiga Shield ecozones of northwestern Canada have experienced rapid and widespread permafrost thaw over recent decades, creating significant community concerns and knowledge gaps. In direct response, this review: (1) outlines the observed thaw-induced changes in landcover, hydrology, and water quality; (2) discusses the underlying drivers and mechanisms of these changes; and (3) identifies knowledge gaps to guide future research in the discontinuous permafrost zone of the Taiga Plains and Shield (study region). In the Taiga Plains, permafrost is mainly associated with peatlands where its thaw increases the extent of thermokarst wetlands at the expense of treed peatlands underlain by permafrost. This thaw-induced landcover change enhances the hydrologic connectivity of the landscape, which increases basin-scale runoff and annual streamflow, and enables wetland drainage such that permafrost-free treed wetlands develop. Thaw-induced landcover changes in the lake- and bedrock-dominated Taiga Shield are not well known but are expected to occur as limited or minor thermokarst pond development and changing lake extent due to the low (<5%) peatland coverage of this ecozone. Permafrost thaw also increases the connectivity between surface water and groundwater, leading to increasing winter baseflows and possibly icing (aufeis) development. Such increases in hydrologic connectivity can enhance the mobilization of parameters of concern for water quality, both in the Taiga Plains and Shield. The thawing of peatlands will likely increase the transport and concentrations of dissolved organic carbon and metals bound to organic compounds, including methylmercury. Further work is needed to fully understand the biogeochemical processes operating in these systems and the degree to which thawing peatlands will impact water quality and quantity at the larger basin scale. The greatest knowledge gaps across the study region surround the evolution of thaw-activated groundwater flow systems and the consequences for wetland biogeochemistry, the rates and patterns of permafrost thaw, contaminant transport, and streamflow of larger river systems. This synthesis not only informs future research directions in the study region but extends to similar subarctic peatland and Shield environments common throughout the circumpolar north. [ABSTRACT FROM AUTHOR]

Background. Our objective was to test whether brief daily activity could increase young students’ physical fitness and compare different forms of intervention delivery. Methods. Two intervention groups were instructed to increase children’s activity by 6 minutes daily. The principal was responsible for the intervention in the first group while classroom teachers were responsible in the second. The third group was a control. Success was defined by changes in student fitness. Results. The principal-led group had a significant increase in the number of 75-foot laps completed after intervention (+0.61 laps) and a significant decrease in after-exercise heart rate (−37.4 beats per minute) as compared with the control group. The teacher-led group experienced no change in either outcome. Conclusions. Our findings demonstrate that a 6-minute increase in activity can produce a significant improvement in student fitness. Administrative support of school-based interventions can have a positive impact on program completion. [ABSTRACT FROM AUTHOR]

Rationale: Acute stress produces behavioral and physiological changes modulated by central catecholamines (CA). Stress increases CA activity, and depletion of CA stores reduces responses to stress. Increasing CA activity by administration of the dietary amino acid CA precursor tyrosine may increase responsiveness to stress. This study determined whether tyrosine enhances the ability of humans to respond to severe stress. Methods: Severe psychological stress was generated during training at Survival, Evasion, Resistance, and Escape (SERE) School. The acute stressor consisted of two mock interrogations conducted during several days of simulated captivity. Seventy-eight healthy male and female military personnel participated in this double-blind, between-subjects study, in which they received either tyrosine (300 mg/kg, N = 36) or placebo ( N = 36). Tyrosine (or placebo) was administered in food bars in two doses of 150 mg/kg each approximately 60 min before each mock interrogation. Mood (Profile of Mood States), saliva cortisol, and heart rate (HR) were assessed prior to stress exposure during a week of academic training preceding mock captivity and immediately following the mock interrogations. Results: The severe stress produced robust effects on mood (i.e., increased tension, depression, anger, fatigue, vigor, and confusion; p < .001), cortisol, and HR ( p < .001). Tyrosine increased anger ( p = .002, ANOVA treatment condition by test session interaction) during stress but had no other effects. Conclusion: Tyrosine did not alter most subjective or physiological responses to severe acute stress, but it increased ratings of anger. The modest increase in anger may be an adaptive emotional response in stressful environments. [ABSTRACT FROM AUTHOR]

Energy deficit and dietary macronutrient intake are thought to independently modulate cognition, mood and sleep. To what extent manipulating the dietary ratio of protein-to-carbohydrate affects mood, cognition and sleep during short-term energy deficit is undetermined. Using a randomized, block design, 39 non-obese young adults (21 ± 1 years, BMI 25 ± 1 kg/m 2 ) consumed diets containing 0.8 g, 1.6 g or 2.4 g protein per kg body weight per day for 31 days. Carbohydrate intake was reduced to accommodate higher protein intakes while dietary fat was maintained at 30% of total energy intake. Cognitive performance, mood, self-reported sleep quality, and plasma amino acid concentrations were periodically assessed during a 10-day energy balance period and a subsequent 21 -day, 40% energy deficit period. Anger, tension and total mood disturbance increased during the initial ten days of energy deficit (P < 0.05), but by the end of the energy deficit returned to levels not different from those measured during energy balance. No effects of dietary protein-to-carbohydrate ratio on cognitive performance, mood or self-reported sleep quality were observed during energy balance or energy deficit. Thus, high-protein, low-carbohydrate, moderate-fat diets do not appear to benefit or impair cognition, mood or sleep in non-obese adults during energy deficit. These findings suggest that energy deficit may initially be psychologically difficult for non-obese individuals attempting to lose weight, but that these changes are transient. Employing strategies that alleviate decrements in mood during this initial period of adaptation may help sustain weight loss efforts. [ABSTRACT FROM AUTHOR]

The article reviews the digital history collection "A Journal of the Plague Year: An Archive of Covid-19," created and maintained by Arizona State University School of Historical, Philosophical, and Religious Studies, and located at https://covid-19archive.org/s/archive/page/Share.

In a conversational exchange, interlocutors use social cues including conversational turn-taking to communicate. There has been attention in the literature concerning how mothers, fathers, boys, and girls converse with each other, and in particular who initiates a conversation. Better understanding of conversational dynamics may deepen our understanding of social roles, speech and language development, and individual language variability. Here we use large-scale automatic analysis of 186 naturalistic daylong acoustic recordings to examine the conversational dynamics of 26 families with children about 30 months of age to better understand communication roles. Families included 15 with boys and 11 with girls. There was no difference in conversation initiation rate by child sex, but children initiated more conversations than mothers, and mothers initiated more than fathers. Results support developmental theories of the different and variable roles that interlocutors play in a social context. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to compared the use and effectiveness of bleeding avoidance strategies (BAS) by sex. Background: Women have higher rates of bleeding following percutaneous coronary intervention (PCI). Methods: Among 570,777 men (67.5%) and women (32.5%) who underwent PCI in the National Cardiovascular Data Registry''s CathPCI Registry between July 1, 2009 and March 31, 2011, in-hospital bleeding rates and the use of BAS (vascular closure devices, bivalirudin, radial approach, and their combinations) were assessed. The relative risk of bleeding for each BAS compared with no BAS was determined in women and men using multivariable logistic regressions adjusted for clinical characteristics and the propensity for receiving BAS. Finally, the absolute risk differences in bleeding associated with BAS were compared. Results: Overall, the use of any BAS differed slightly between women and men (75.4% vs. 75.7%, p = 0.01). When BAS was not used, women had significantly higher rates of bleeding than men (12.5% vs. 6.2%, p < 0.01). Both sexes had similar adjusted risk reductions of bleeding when any BAS was used (women, odds ratio: 0.60, 95% confidence interval [CI]: 0.57 to 0.63; men, odds ratio: 0.62, 95% CI: 0.59 to 0.65). Women and men had lower absolute bleeding risks with BAS; however, these absolute risk differences were greater in women (6.3% vs. 3.2%, p < 0.01). Conclusions: Women continue to have almost twice the rate of bleeding following PCI. The use of any BAS was associated with a similarly lower risk of bleeding for men and women; however, the absolute risk differences were substantially higher in women. These data underscore the importance of applying effective strategies to limit post-PCI bleeding, especially in women. [Copyright &y& Elsevier]

This review considers the potential of certain dietary supplements, including garlic, Ginkgo biloba, ginger, ginseng, fish oil, and vitamin E, to interfere with hemostasis. Dietary supplements are common components of the diet in the United States, with about half the US adult population taking some type of dietary supplement regularly. It has been suggested that some supplements could adversely affect coagulation when taken alone or in combination with antiplatelet medications. Supplements could alter hemostasis by a variety of mechanisms, such as reducing platelet aggregation or inhibiting arachidonic acid, a cellular signaling messenger and inflammatory intermediate. To conduct this review, multiple databases were searched using a variety of search terms to ensure relevant papers were located. Moderate to severe adverse events, such as spinal epidural hematoma, spontaneous intracerebral hemorrhage, retrobulbar hemorrhage, subarachnoid hemorrhage, spontaneous hyphema, and postoperative bleeding, have occasionally been anecdotally associated with consumption of dietary supplements. However, the number of controlled studies in the literature is too limited to demonstrate consistent anticoagulant effects of dietary supplements alone or in combination with drug therapy. [ABSTRACT FROM AUTHOR]

Purpose: Babble Boot Camp (BBC) is a parent-implemented telepractice intervention for infants at risk for speech and language disorders. BBC uses a teach-model-coach-review approach, delivered through weekly 15-min virtual meetings with a speech-language pathologist. We discuss accommodations needed for successful virtual follow-up test administration and preliminary assessment outcomes for children with classic galactosemia (CG) and controls at age 2.5 years. Method: This clinical trial included 54 participants, 16 children with CG receiving BBC speech-language intervention from infancy, age 2 years, five children receiving sensorimotor intervention from infancy and changing to speech-language intervention at 15 months until 2 years of age, seven controls with CG, and 26 typically developing controls. The participants' language and articulation were assessed via telehealth at age 2.5 years. Results: The Preschool Language Scale-Fifth Edition (PLS-5) was successfully administered with specific parent instruction and manipulatives assembled from the child's home. The GFTA-3 was successfully administered to all but three children who did not complete this assessment due to limited expressive vocabularies. Referrals for continued speech therapy based on PLS-5 and GFTA-3 scores were made for 16% of children who received BBC intervention from infancy as compared to 40% and 57% of children who began BBC at 15 months of age or did not receive BBC intervention, respectively. Conclusions: With extended time and accommodations from the standardized administration guidelines, virtual assessment of speech and language was possible. However, given the inherent challenges of testing very young children virtually, in-person assessment is recommended, when possible, for outcome measurements. [ABSTRACT FROM AUTHOR]

BackgroundObjectivesDesignMethodsResultsConclusionsVariation in cognitive, emotional and physical performance in response to stress is attributable to environmental and genetic factors. Ability to adapt to stress is resilience.This study investigated genetic factors associated with resilience in soldiers exposed to severe stress due to intense physical and mental demands at Survive, Evade, Resist and Escape school, a unique environment to study acute stress and resiliency in real-world circumstances.A preliminary correlational study was conducted to identify genetic markers for resilience to stress.Mood state, resiliency and dissociative state of 73 soldiers were assessed using: Connor-Davidson Resilience Scale (CD-RISC); Profile of Mood States (POMS); and Clinician-Administered Dissociative States Scale (CADSS). Change scores for resilience-related stress markers were computed; 116 single nucleotide polymorphisms (SNPs) associated with stress, depression, anxiety, sleep, or psychiatric disorders were assessed.A significant association between change in CD-RISC score and SNP rs4251417, present in an intron of SLC6A4, the serotonin transporter gene, was observed.Individuals with the minor allele of SNP rs4251417 had a greater positive change in CD-RISC, indicating increased self-assessed resilience. This study suggests the minor allele of SNP rs4251417 of SLC6A4 is associated with resilience when individuals are exposed to high stress. [ABSTRACT FROM AUTHOR]

Background: Specialist health services are often organised on a regionalised basis whereby clinical resources and expertise are concentrated in areas of high population. Through a high volume caseload, regionalised facilities may provide improved clinical outcomes for patients. In some cases, regionalisation may be the only economically viable way to organise specialist care. While regionalisation may have benefits, it may also disadvantage some population groups, particularly in circumstances where distance and time are impediments to access.Queensland is a large Australian state with a distributed population. Providing equitable access to specialist healthcare services to the population is challenging. Specialist care for critically ill or injured children is provided by the Queensland Paediatric Intensive Care Service which comprises two tertiary paediatric intensive care units. The two units are located 6 km (3.7 miles) apart by road in the state capital of Brisbane and provide state-wide telephone advice and specialist retrieval services. Services also extend into the northern area of the adjacent state of New South Wales. In some cases children may be managed locally in adult intensive care units in regional hospitals.The aim of this study is to describe the effect of geography and service organisation for children who need intensive care services but who present outside of metropolitan centres in Queensland.Methods/design: Using health services and population data, the availability and spatial accessibility to paediatric intensive care services will be analysed. Retrieval utilisation and the associated costs to the health service will be analysed to provide an indication of service utilisation by non-metropolitan patients.Discussion: While the regionalisation or centralisation of specialist services is recognised as an economical way to provide specialist health services, the extent to which these models serve critically ill children who live some distance from tertiary care has not been described. This study will provide new information on the effect of the regionalisation of specialist healthcare for critically ill children in Queensland and will have relevance to other regionalised health services. This study, which is focussed on describing the organisation, supply and demands on the health service, will provide the foundation for future work to explore clinical outcomes for non-metropolitan children who require intensive care. [ABSTRACT FROM AUTHOR]

Preschoolers' (4- to 7-year-olds) recall and correct rejection rates using the simultaneous, wildcard, elimination, and a new lineup; the elimination with wildcard were compared. The new lineup uses the traditional two judgement procedure inherent to the elimination lineup but modifies Judgement 2 by providing a wildcard rejection. Participants (N = 116) watched a 4-min video of a male target. Each participant was asked to free recall the details of the video and to answer cued recall questions about the target's appearance. Participants were then given one of the four target-absent lineups. Separating by older and younger preschoolers, the 4/5-year-olds reported an average of 1.18 descriptors with an 87% accuracy rate, while the 6/7-year-olds reported an average of 1.93 descriptors with a 91% accuracy rate. For both the older and younger preschoolers, correct rejection rates were highest for the new elimination with wildcard lineup, followed by the simultaneous lineup. [ABSTRACT FROM AUTHOR]

Quantification of the unbound portion of platinum (Pt) in human plasma is important for assessing the pharmacokinetics of the chemotherapeutic drug cisplatin. In this study, we sought to compare the recovery of unbound Pt using Nanosep® filters to 1) traditional filters (Centrifree®, Centrisart ® , Amicon®) or trichloroacetic acid (TCA) protein precipitation, and 2) unbound, bound, and total Pt concentrations in clinical specimens. For the tested filters, the impact of 1) molecular weight cut-offs, 2) centrifugation force, and 3) total Pt concentration on Pt binding in human plasma was evaluated. Pt was quantified using inductively coupled-plasma mass spectrometry. In human plasma spiked with 0.9 μg/mL Pt, the percent of unbound Pt increased at higher centrifugation speeds. By comparison, the percent of unbound Pt was highest (42.1%) following TCA protein precipitation. When total Pt was ≤0.9 μg/mL, unbound Pt (∼20–30%) was consistent across filters. Conversely, when plasma was spiked with Pt exceeding 0.9 μg/mL, the percent of unbound Pt increased from 36.5 to 48% using ultrafiltration, compared to 63.4% to 79% with TCA precipitation. In patients receiving cisplatin-containing chemotherapy, the fraction of unbound Pt at concentrations exceeding 0.9 μg/mL ranged between 35 and 90%. Moreover, the unbound fraction of Pt in plasma correlated with the concentration of unbound (R2 = 0.738) and total Pt (R2 = 0.335). In summary, this study demonstrates that 1) the percent of unbound Pt is influenced by total and unbound Pt levels in vitro and in clinical specimens, and 2) ultrafiltration with Nanosep® filters is a feasible method for quantifying unbound Pt concentrations in human plasma. [ABSTRACT FROM AUTHOR]

This study assessed predictors of successful selection in the very challenging and stressful United States Army Special Forces Assessment and Selection (SFAS) course among 800 Soldiers. A battery of measures were collected during the course and their ability to predict selection were assessed using logistic regression and chi-square tests. Physical performance measures were most predictive, including road march times, land navigation coordinates found, run times, fitness test score, obstacle course score, and pull-ups (p <.05). Soldiers that were officers or 18× enlisted (fast-tracked to SFAS), had <1 year of active duty, ≥ bachelor degree, no children, were not married, and were Ranger school graduates were more likely to be selected (p <.05). Several psychological measures were predictive, including intelligence quotient, grade level equivalents, resilience score, military aptitude score, and grit (p <.05). Basal serum physiological markers weakly predicted selection and were weakly associated with behavioral assessments. Lower C-reactive protein (< 9.5 nmol/L) and higher cortisol and sex-hormone binding globulin (SHBG) predicted selection (p <.05). Higher C-reactive protein (≥ 9.5 nmol/L) was associated with lower fitness test scores and slower road march time (p <.05). Cortisol was correlated with higher grit and resilience scores (p <.05). SHBG correlated with higher grade level equivalents and better performance on pull-ups, land navigation, obstacle course, and the fitness test (p <.05). Testosterone was correlated with faster run and road march times (p <.05). Dehydroepiandrosterone-sulfate (DHEA-S) correlated with lower resilience scores, and DHEA-S, epinephrine, and norepinephrine correlated with worse performance on several physical events (p <.05). These findings suggest measures that could be targeted in interventions to monitor and enhance performance and resilience. • Physical performance is most predictive of successful Special Forces selection. • Demographics and psychological measures are also predictive. • Basal cortisol, sex-hormone binding globulin, and C-reactive protein are weakly predictive. • Physiological markers weakly correlate with physical performance and psychological measures. [ABSTRACT FROM AUTHOR]

Background: Substantial numbers of students in Higher Education (HE) are reporting mental health difficulties, such as mild to moderate symptoms of depression and anxiety. Coupled with academic skills challenges, these difficulties can lead to decreased academic performance, low levels of study satisfaction, and eventually drop out. Student support services are facing budget cuts and can only attend to limited numbers of students, usually the ones who present with more severe mental health problems. Moreover, face-to-face contact may not appeal to those students who feel embarrassed by their problems or are afraid of being stigmatised. To address this important problem, an online psychological wellbeing and study skills support system called MePlusMe, has been developed to provide personalised support to its users. In the present study we investigated the feasibility and acceptability of the contents, design, and functionalities of the system. Methods: An offline version of the system was introduced to 13 postgraduate and undergraduate students (mean age = 31.3 years, SD = 10.25 years; 4 males) in a UK HE Institution, who presented with mild or moderate mental health difficulties. The participants evaluated the design of the system, its functionalities, and contents at Baseline and at Weeks 2, 4, and 8. Results: Participants found the system easy to use, professional, and efficient and its contents non-judgemental and informative. Participants stated that engaging with and practicing the techniques targeted at mental health difficulties led to improvements in positive thinking and self-confidence, while the study skills techniques were practical. Suggestions for further improvement included the development of an app and an option for direct engagement with professionals. Conclusions: The findings confirmed the acceptability of the contents, design and functionalities of the system, while providing useful information to inform its further development. Next steps include a feasibility study, which will test and quantify the effects on everyday functioning, mood, mental wellbeing, and academic self-efficacy after using the system, and subsequently a randomized controlled trial, which will evaluate its effectiveness. [ABSTRACT FROM AUTHOR]

Background: Although rates of survival to hospital discharge after in-hospital cardiac arrest (IHCA) have improved over the last decade, it is unknown if these survival gains are sustained after hospital discharge.Objective: To examine 1-year survival trends overall and by rhythm after IHCA.Methods: Using Medicare beneficiaries (age≥65years) with IHCA occurring between 2000 and 2011 at Get With The Guidelines®-Resuscitation Registry participating hospitals we used multivariable regression, to examine temporal trends in risk-adjusted rates of 1-year survival.Results: Among 45,567 patients with IHCA, the unadjusted 1-year survival was 9.4%. Unadjusted 1-year survival was 21.8% among the 9,223 (20.2%) of patients with Ventricular Fibrillation or Pulseless Ventricular Tachycardia (VF/VT) and 6.2% among the 36,344 (79.8%) of patients with Pulseless Electrical Activity or asystole (PEA/asystole). After adjustment for patient and arrest characteristics, 1-year survival increased over time for all IHCA from 8.9% in 2000-2001 to 15.2% in 2011 (adjusted rate ratio [RR] per year, 1.05; 95% CI, 1.03-1.06; P<0.001 for trend). Improvements in 1-year risk adjusted survival were also observed for VF/VT (19.4% in 2000-2001 to 25.6% in 2011 [RR per year, 1.02; 95% CI, 1.01-1.04; P 0.004 for trend]) and PEA/asystole arrests (4.7% in 2000-2001 to 10.2% in 2011 [RR per year, 1.07; 95% CI, 1.05-1.08; P<0.001 for trend]).Conclusion: Among Medicare beneficiaries in the GWTG-Resuscitation registry, 1-year survival after IHCA has increased for over the past decade. Temporal improvements in survival were noted for both shockable and non-shockable presenting arrest rhythms. [ABSTRACT FROM AUTHOR]