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Presenters Kelly Reeves, BSN, RN, UXC, Hazel Tapp, PhD, Kasey Boehmer, PhD, MPH, Charity Patterson, PhD, MSPH, Katherine O'Hare, MSW, Lindsay Shade, MHS, PA-C, Rebecca Beesley, MD, MPH, Lyn Nuse, [...], Context: Asthma is a prevalent chronic disease that is difficult to manage and associated with marked disparities in outcomes. Among the most visible disparities is the higher rate of visits to the Emergency Department (ED) for uncontrolled asthma involving the most at-risk patients. One promising approach to addressing disparities is Shared Decision Making (SDM), a process by which the patient and provider jointly make a healthcare choice. SDM is associated with improved outcomes for patients; however, time constraints and availability of staff are noted implementation barriers. The use of health IT solutions may increase the adoption of SDM. Coach McLungsSM is an interactive web-based application that engages pediatric patients and their caregivers in a personally tailored experience and collects patient- reported data. The background logic then incorporates the complex asthma guidelines to determine the level of severity or control and pulls forward tailored guideline-based treatment recommendations for both the patient and provider in two respective summaries, which provides decision support for both audiences in developing a shared decision around the treatment plan. Objective: The goal of this study is to evaluate the implementation of the Coach McLungsSM intervention into primary care. Study Design and Analysis: Stepped wedge randomized control study design with a baseline control period and 5 intervention steps over 3 years. Setting: 21 pediatric and family medicine practices within a large, integrated, nonprofit healthcare system based in Charlotte, NC. Population Studied: Patients between 7-17 years old with an asthma diagnosis. Intervention: Implementation will be guided using the Expert Recommendations for Implementing Change (ERIC), a compilation of implementation strategies, and evaluated using CFIR (the Consolidated Framework for Implementation Research) and RE-AIM (Reach Effectiveness, Adoption, Implementation, Maintenance). Outcome Measures: We will measure changes in emergency department visits, hospitalizations, and oral steroid use, which serve as surrogate measures for patient-centered asthma outcomes. Conclusions: We anticipate that the tailored implementation of Coach McLungsSM across primary care practices will lead to a decrease in emergency department visits, hospitalizations, and oral steroid use for patients in the intervention group as compared to the control arm.

Presenters Andrea Price, BS, Barry Make, MD, Hazel Tapp, PhD, Lindsay Shade, MHS, PA- C, Cody Oliver, MPH, Rebecca Beesley, MD, [...], Context: Primary Care Research seeks to "meet our patients where they are" to make research more accessible and inclusive. During the COVID-19 pandemic, recruitment practices shifted. Letters, emails, phone calls took the place of in-person recruitment. Objective: Evaluate the effect of COVID-19 on recruitment demographics across primary care practices within a single health system for "The CAPTURE study: Validating a unique COPD case finding tool in primary care." Study Design and Analysis: Comparative analysis of demographics including race, gender, age from ten urban and rural clinics. The analysis included five practices with in- person recruitment pre-pandemic and 5 with virtual recruitment practices during the pandemic. Setting: Family and Internal Medicine practices, rural and urban. Population Studied: Patients (45-80, male and female) Intervention/Instrument: Before March 2020, pre-pandemic, our team focused on in-person recruitment. Clinicians' schedules were screened for patients who were then consented and enrolled during a clinic visit. After March 2020, our team transitioned to virtual recruit using a population report to identify patients. An email or mailed letter was sent to patients followed by a phone call. Outcome Measures: Percent enrolled relative to total clinic populations (pop). Results: In-person, 31.6% of enrollees were male compared to the clinic pop. of 41.5%. With virtual recruitment, 40.9% of enrollees were male compared to the clinic pop. of 39.9%. This gender difference was statistically significant (t-test p Conclusion: During the COVID-19 pandemic, remote recruitment significantly increased the proportion of male participants but trended toward reduced proportion of AA/Black participants as well as those between the age of 45-64. These results suggest changing recruitment strategies between in person and virtual can alter recruitment outcomes.

Presenters Katherine O'Hare, MSW, Hazel Tapp, PhD, Lindsay Shade, MHS, PA-C, Kelly Reeves, BSN, RN, UXC, Melinda Manning, BS, Jeremy Thomas, MSW, Cheryl Courtlandt, MD, Rebecca Beesley, MD, MPH, Diane [...], Context: Implementing new innovations into healthcare settings is challenging. The Consolidated Framework for Implementation Research (CFIR) can provide guidance on the design, implementation strategies, and evaluation processes. CFIR's versatility offers several advantages: (1) promotes use of a shared language across diverse settings, (2) applicable at various stages of implementation, and (3) ability to map results to the Expert Recommendations for Implementation Change (ERIC) strategies to address barriers. Objective: Here we describe three applications of CFIR for pre and post implementation evaluations. Study Design: Descriptive Setting & Participants: Primary care practices and pediatric emergency departments (ED) within two large healthcare systems based in North Carolina and Georgia. Population studied: Researchers, stakeholders, practice facilitators, administrators, healthcare providers, clinic staff, patients, and caregivers. Intervention/Instrument: First, an early study applied CFIR retrospectively to identify barriers and facilitators to adoption of a shared decision-making intervention. Researchers interviewed practice facilitators to score practices on CFIR constructs. Second, a follow-up study used CFIR to prospectively evaluate readiness for change prior to implementation. Third, as a follow-up study progressed, data from periodic CFIR guided surveys and key informant interviews were used to tailor implementation. Outcome Measure: CFIR Analyses Results: First: Retrospective analysis from the early study distinguished 7 high, 1 medium, and 2 low implementation adopters. Weaknesses, such as little interest in setting performance goals, were consistent among the 2 low adopter practices. Second: Pre-implementation results in the follow-up study revealed comparable high levels of compatibility across ED settings; however, there was less agreement on leadership supporting change efforts. Third: Key facilitators and barriers emerged throughout CFIR survey periods. For example, evaluations at full implementation revealed providers felt initial training waned over time. Mapping identified barriers to ERIC strategies led to the development of re-education resources. Conclusion: CFIR is an effective framework to employ at multiple stages of implementation. While retrospective analysis was useful, the ability to gain insight and provide actionable process improvements during implementation was a key strength to improve outcomes.

During construction, the mobilization of undrained shear strength must be limited to avoid soil failure. Soil strains must be controlled to avoid compromising structural serviceability. To assess foundation performance by strength mobilization, an understanding of soil strains at various levels of strength mobilization is required. In practice, ground investigation data are often limited, and assessment of the expected variation of stress-strain and undrained shear strength is improved with empirical correlations calibrated with a database. The new database RFG/TXCU-278 contains data of 278 consolidated-undrained triaxial tests on reconstituted fine-grained soil samples compiled from the literature. Analysis of the database to evaluate the variability of undrained strength ratio ([c.sub.u]/[[sigma]'.sub.v0]) and a reference shear strain with shear mode is undertaken in this paper. The new database provides evidence that shear strain (like undrained shear strength) is sensitive to the consolidation (isotropic or [K.sub.0]) and shear mode (triaxial compression or extension) applied in the test. For the materials included in the database, the strength mobilization parameters obtained from a triaxial compression test can be used to predict the corresponding triaxial extension parameters to a reasonable accuracy. Key words: databases, stress-strain, fine-grained soils. Pendant la construction, la mobilisation de la resistance au cisaillement non drainee doit etre limitee pour eviter la rupture du sol. Les deformations du sol doivent etre controlees pour eviter de compromettre l'aptitude au service de la structure. Pour evaluer la performance des fondations par la mobilisation de la force, il est necessaire de comprendre les contraintes du sol a differents niveaux de mobilisation de la force. Dans la pratique, les donnees d'investigation au sol sont souvent limitees et l'evaluation de la variation attendue de la resistance aux contraintes et a la traction et de la resistance au cisaillement non drainee est amelioree grace a des correlations empiriques calibrees avec une base de donnees. La nouvelle base de donnees RFG/TXCU-278 contient les donnees de 278 essais triaxiaux non draines consolides sur des echantillons de sol reconstitue a grains fins compiles a partir de la litterature. L'analyse de la base de donnees pour evaluer la variabilite du rapport de resistance non drainee (([c.sub.u]/[[sigma]'.sub.v0]) et d'une contrainte de cisaillement de reference en mode cisaillement est entreprise dans cet article. La nouvelle base de donnees fournit la preuve que la contrainte de cisaillement (comme la resistance au cisaillement non drainee) est sensible a la consolidation (isotrope ou [K.sub.0]) et au mode de cisaillement (compression ou extension triaxiale) appliques dans l'essai. Pour les materiaux inclus dans la base de donnees, les parametres de mobilisation de la force obtenus lors d'un essai de compression triaxiale peuvent etre utilises pour predire les parametres d'extension triaxiale correspondants avec une precision raisonnable. [Traduit par la Redaction] Mots-cles: bases de donnees, contraintes-deformations, sols a grains fins., Introduction Prediction of soil strains at increments of stress ratio or mobilization level (cf. BSI 1994) allows engineers to better evaluate foundation performance. For this purpose, the 'Mobilization Strain Framework' [...]

Introduction Germline-deleterious mutations in BRCA1 and BRCA2 (BRCA1/2) predispose to high lifetime risks of breast and ovarian cancer (1). BRCA1/2 are essential for DNA double-strand break (DSB) repair through homologous [...], Germline mutations in BRCA1 and BRCA2 (BRCA1/2) genes considerably increase breast and ovarian cancer risk. Given that tumors with these mutations have elevated genomic instability, they exhibit relative vulnerability to certain chemotherapies and targeted treatments based on poly (ADP-ribose) polymerase (PARP) inhibition. However, the molecular mechanisms that influence cancer risk and therapeutic benefit or resistance remain only partially understood. BRCA1 and BRCA2 have also been implicated in the suppression of R-loops, triple-stranded nucleic acid structures composed of a DNA:RNA hybrid and a displaced ssDNA strand. Here, we report that loss of RNF168, an E3 ubiquitin ligase and DNA double-strand break (DSB) responder, remarkably protected Brcol-mutant mice against mammary tumorigenesis. We demonstrate that RNF168 deficiency resulted in accumulation of R-loops in BRCA1/2-mutant breast and ovarian cancer cells, leading to DSBs, senescence, and subsequent cell death. Using interactome assays, we identified RNF168 interaction with DHX9, a helicase involved in the resolution and removal of R-loops. Mechanistically, RNF168 directly ubiquitylated DHX9 to facilitate its recruitment to R-loop-prone genomic loci. Consequently, loss of RNF168 impaired DHX9 recruitment to R-loops, thereby abrogating its ability to resolve R-loops. The data presented in this study highlight a dependence of BRCA1/2-defective tumors on factors that suppress R-loops and reveal a fundamental RNF168-mediated molecular mechanism that governs cancer development and vulnerability.

Author(s): Kyriaki Michailidou [1, 2]; Sara Lindstrm [3, 4]; Joe Dennis [1]; Jonathan Beesley [5]; Shirley Hui [6]; Siddhartha Kar [7]; Audrey Lemaon [8]; Penny Soucy [8]; Dylan Glubb [5]; [...]

Bacillus species are typically considered blood culture contaminants, and distinguishing true versus pseudobacteremia requires recognition of the clinical context. Risk factors for infection include prosthetic heart valves, pacemakers, injection drug [...]

Introduction There is a strong link between folate deficiency during pregnancy and neural tube defects and, as a result, many countries have introduced mandatory or voluntary fortification of grain products [...], Background/Objective: Folates are essential for DNA synthesis and methylation, and thus may have a role in carcinogenesis. Limited evidence suggests folate-containing foods might protect against some cancers and may partially mitigate the increased risk of breast cancer associated with alcohol intake, but there is little information regarding ovarian cancer. Our aim was to evaluate the role of folate and related micronutrients, polymorphisms in key folate-metabolising genes and environmental factors in ovarian carcinogenesis. Subjects/Methods: Participants in the Australian Ovarian Cancer Study (1363 cases, 1414 controls) self-completed risk factor and food-frequency questionnaires. DNA samples (1638 cases, 1278 controls) were genotyped for 49 tag single-nucleotide polymorphisms (SNPs) in the methylene tetrahydrofolate reductase (MTHFR), methionine synthase (MTR) and MTR reductase (MTRR) genes. Logistic regression models were used to generate adjusted odds ratios and 95% confidence intervals. Results: We saw no overall association between the intake of folate, B vitamins or other methyl donors and ovarian cancer risk, although increasing folate from foods was associated with reduced risk among current smokers ([P.sub.trend] = 0.03) and folic acid intake was associated with borderline significant increased risks among women who consumed [greater than or equal to] 1 standard alcoholic drinks/ day (odds ratio (OR) = 1.64;95% confidence interval (CI) 1.05-2.54, [P.sub.trend] = 0.05). Two SNPs (rs7365052, rs7526063) showed borderline significant inverse associations with ovarian cancer risk; both had very low minor allele frequencies. There was little evidence for interaction between genotype and micronutrient intake or for variation between different histological subtypes of ovarian cancer. Conclusions: Our data provide little evidence to support a protective role for folate in ovarian carcinogenesis but suggest further evaluation of the joint effects of folic acid and alcohol is warranted. European Journal of Clinical Nutrition (2011) 65, 1133-1140; doi: 10.1038/ejcn.2011.99; published online 1 June 2011 Keywords: ovarian cancer; folate; vitamin B; MTHFR

The present state-of-the-art in chiral capillary gas chromatography (GC) is reviewed by guest columnist, Tom Beesley, one of the pioneers in chiral separations. He will provide a short historical overview [...]

Anthrax, which is caused by the gram-positive, sporulating bacterium Bacillus anthracis, primarily affects herbivorous livestock and wildlife species, but also poses serious public health risks in many parts of the [...]

Dynamic progress in the field of chromatography appears to have begun in the early 1950s when developments began to accelerate first from paper chromatography to TLC and almost simultaneously advances [...]

The development of chiral column technology since the 2008 update (1) is reviewed by Thomas Beesley, a pioneer in the chromatographic separations of enantiomeric compounds. This year, he discusses the [...]

We propose that biases in attitude and stereotype formation might arise as a result of learned differences in the extent to which social groups have previously been predictive of behavioral or physical properties. Experiments 1 and 2 demonstrate that differences in the experienced predictiveness of groups with respect to evaluatively neutral information influence the extent to which participants later form attitudes and stereotypes about those groups. In contrast, Experiment 3 shows no influence of predictiveness when using a procedure designed to emphasize the use of higher level reasoning processes, a finding consistent with the idea that the root of the predictiveness bias is not in reasoning. Experiments 4 and 5 demonstrate that the predictiveness bias in formation of group beliefs does not depend on participants making global evaluations of groups. These results are discussed in relation to the associative mechanisms proposed by Mackintosh (1975) to explain similar phenomena in animal conditioning and associative learning. Keywords: stereotypes, attitudes, associative learning, attention, bias DOI: 10.1037/a0018210

Many previous studies of animal and human learning indicate a processing advantage for cues previously experienced as good predictors of outcomes over those experienced as poorer predictors. Four studies of human associative learning investigated whether learned predictiveness acts at the level of learning (modulating the rate at which cue--outcome associations form), performance (modulating the strength of behavioral responses), or both. In Experiments 1-3, it was found that retrospectively altering the learned predictiveness of cues influenced responding to those cues, demonstrating that learned predictiveness influences performance. Experiment 4 indicates that learned predictiveness also influences learning by demonstrating that the learned predictiveness of a cue affects the acquisition of an association between a novel cue and the outcome with which it is paired. Keywords: human associative learning, cue--outcome association, learned predictiveness

Several theories of associative learning propose that blocking reflects changes in the processing devoted to learning about cues. The results of the only direct test of this suggestion in human learning (Kruschke & Blair, 2000) could equally well be explained in terms of, among others, interference in learning or memory. The present study tested this suggestion in a situation in which processing-change and interference accounts predict opposing results. Results support the idea that blocking in human learning can reflect a change in processing of the cues involved.

Author(s): Douglas F. Easton (corresponding author) [1]; Karen A. Pooley [2]; Alison M. Dunning [2]; Paul D. P. Pharoah [2]; Deborah Thompson [1]; Dennis G. Ballinger [3]; Jeffery P. Struewing [...]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1471-6402.2006.00298.x Byline: Lisa L. Frey (1), Denise Beesley (1), Merle R. Miller (1) Abstract: This study examines relational health, parental attachment, and psychological distress in college men and women from the perspective of the relational-cultural model (Jordan, Kaplan, Miller, Stiver, & Surrey, 1991; Miller, 1984). Peer, mentor, and community relationships, as well as secure parental attachment and year in school, were hypothesized to predict psychological distress, although predictive patterns were expected to differ in women and men. Overall, results supported the hypotheses. Secure parental attachment predicted decreased distress for both women and men. Authentic, empowered, and engaged community relationships significantly predicted decreased distress for women and men. However, for women, peer relational quality was also a significant predictor. The relational-cultural model, which suggests that differentiation and the 'felt sense of self' (Jordan, 1997, p. 15) evolve through meaningful connections with others rather than as a result of the separation-individuation process, is applied as a framework for interpreting the findings. Author Affiliation: (1)University of Oklahoma Article History: Initial submission: May 4, 2005Initial acceptance: September 21, 2005Final acceptance: December 2, 2005 Article note: Address correspondence and reprint requests to: Lisa Frey, University of Oklahoma, Department of Educational Psychology, 820 Van Vleet Oval, Room 321, Norman, OK 73019-2041. E-mail: Melissa.Frey-1@ou.edu

This study examines relational health, parental attachment, and psychological distress in college men and women from the perspective of the relational-cultural model (Jordan, Kaplan, Miller, Stiver, & Surrey, 1991; Miller, 1984). Peer, mentor, and community relationships, as well as secure parental attachment and year in school, were hypothesized to predict psychological distress, although predictive patterns were expected to differ in women and men. Overall, results supported the hypotheses. Secure parental attachment predicted decreased distress for both women and men. Authentic, empowered, and engaged community relationships significantly predicted decreased distress for women and men. However, for women, peer relational quality was also a significant predictor. The relational-cultural model, which suggests that differentiation and the 'felt sense of self' (Jordan, 1997, p. 15) evolve through meaningful connections with others rather than as a result of the separation-individuation process, is applied as a framework for interpreting the findings.

Chiral separations remain high on the priority list of drug developers. Liquid chromatography and supercritical fluid chromatography continue to vie for dominance in the chiral separation market but might be [...]

The study examined the component structure of the Relational Health Indices (B. Liang et al., 2002) with a mixed-sex sample of students seeking services at a university counseling center. In [...]

This study was designed to survey K-12 classroom teachers (N = 188) across the Southwest as to perceptions of the effectiveness of school counseling services in their educational setting. The results revealed that overall teachers reported satisfaction with counseling services, although satisfaction did vary across levels (elementary, middle school/junior high, high school) depending on the specific service area. Also despite rating certain service areas as strengths, teachers still see considerable room for improvement in a variety of specific areas in order for school counselors to work more effectively and successfully with all students in the 21st century. Implications for future research, training, and collaborative teacher/school counselor partnerships are also discussed., As a result of the continued call for increased accountability in education, there is a renewed focus and interest in both school counselor education and comprehensive developmental guidance models designed [...]

Duchenne muscular dystrophy is a fatal muscle disease that is often associated with cognitive impairment. Accordingly, dystrophin is found at the muscle sarcolemma and at postsynaptic sites in neurons. In muscle, dystrophin forms part of a membrane-spanning complex, the dystrophin-associated protein complex (DPC). Whereas the composition of the DPC in muscle is well documented, the existence of a similar complex in brain remains largely unknown. To determine the composition of DPC-like complexes in brain, we have examined the molecular associations and distribution of the dystrobrevins, a widely expressed family of dystrophin-associated proteins, some of which are components of the muscle DPC. (Beta)-Dystrobrevin is found in neurons and is highly enriched in postsynaptic densities(PSDs). Furthermore, (beta)-dystrobrevin forms a specific complex with dystrophin and syntrophin. By contrast, (alpha)-dystrobrevin-1 is found in perivascular astrocytes and Bergmann glia, and is not PSD-enriched. (Alpha)-Dystrobrevin-1 is associated with Dp71, utrophin, and syntrophin. In the brains of mice that lack dystrophin and Dp71, the dystrobrevin-syntrophin complexes are still formed, whereas in dystrophin-deficient muscle, the assembly of the DPC is disrupted. Thus, despite the similarity in primary sequence, (alpha)- and (beta)-dystrobrevin are differentially distributed in the brain where they form separate DPC-like complexes.

Proper dorsal-ventral patterning in the developing central nervous system requires signals from both the dorsal and ventral portions of the neural tube. Data from multiple studies have demonstrated that bone morphogenetic proteins (BMPs) and Sonic hedgehog protein are secreted factors that regulate dorsal and ventral specification, respectively, within the caudal neural tube. In the developing rostral central nervous system Sonic hedgehog protein also participates in ventral regionalization; however, the roles of BMPs in the developing brain are less clear. We hypothesized that BMPs also play a role in dorsal specification of the vertebrate forebrain. To test our hypothesis we implanted beads soaked in recombinant BMP5 or BMP4 into the neural tube of the chicken forebrain. Experimental embryos showed a loss of the basal telencephalon that resulted in holoprosencephaly (a single cerebral hemisphere), cyclopia (a single midline eye), and loss of ventral midline structures. In situ hybridization using a panel of probes to genes expressed in the dorsal and ventral forebrain revealed the loss of ventral markers with the maintenance of dorsal markers. Furthermore, we found that the loss of the basal telencephalon was the result of excessive cell death and not a change in cell fates. These data provide evidence that BMP signaling participates in dorsal-ventral patterning of the developing brain in vivo, and disturbances in dorsal-ventral signaling result in specific malformations of the forebrain.

A novel set of renal outer medulla K+ channel (ROMK) isoforms was identified in the rat kidney using RT-PCR. The ROMK isoforms were generated by the splicing of a region within the ROMK core sequence that is similar to a typical mammalian intron. Results also suggested that the splicing the retained intron generates hydrophilic proteins that are about 33% of the size of native ROMK with COOH termini that lack transmembrane-spanning domains.