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Polycyclic aromatic hydrocarbons (PAHs) are the most widespread xenobiotic pollutants in water and their abatement usually involves expensive and energy-consuming treatments. In this work, anthracene (AN) was selected as the recalcitrant model of PAHs and its solar light-stimulated heterogeneous photocatalytic abatement in aerated aqueous media was investigated using a new TiO derived thermoplastic nanocomposite in thin film form. The results were also compared with the benchmark TiO photocatalyst in slurry form. Finally, the possible contribution of reactive intermediates such as hydroxyl radical, AN radical cation and singlet oxygen, was investigated by using a hydroxyl radical trap and laser flash photolysis. Based on the obtained results, a feasible mechanism for AN photodegradation, which involves hydroxyl radical as the key oxidizing species is proposed., This research was funded by the University of Catania (Piano di incentivi per la ricerca di Ateneo, PIACERI–Linea 2).

Acquired laryngotracheal stenosis (LTS) is a rare condition that causes breathlessness and dyspnoea. Patients have reconstructive airway surgery to improve their breathing difficulties, but both LTS and the surgery can cause voice difficulties. The existing evidence base for management of voice difficulties for adults with LTS focuses on symptoms. There is limited information to provide clinical guidance for speech and language therapists (SLTs) and a limited understanding of the impact of voice changes on adults with LTS.To investigate the lived experience of adults with laryngotracheal stenosis (LTS), who have had reconstructive surgery; here focussing on voice concerns with the aim of guiding clinical care for SLTs.A phenomenological, qualitative study design was used. Focus groups and semi-structured interviews were completed with adults living with LTS who had had reconstructive surgery. Audio recordings were transcribed and inductive thematic analysis was used by the research team to identify themes and sub-themes.A total of 24 participants (five focus groups and two interviews) took part in the study before thematic saturation was identified in analysis. Three main themes were identified specific to the experience of living with LTS: the Medical, Physical and Emotional journey. All participants referenced voice difficulties as they related to each of these overall themes. Sub-themes directly related to voice included experience of surgery, information provision, staff expertise/complacency, symptoms, symptom management, identity, support networks, impact on life and living with a chronic condition.In this qualitative study participants have described the integral part voice difficulties play in their lived experience of LTS and reconstructive surgery. This is considered in the context of their clinical care and the need for individualised management and information provision throughout the course of their condition. The broader research literature relating to voice difficulties is explored with links made to people with LTS and recommendations made for future research into people living with LTS and dysphonia.What is already known on this subject Adults with laryngotracheal stenosis (LTS) experience voice changes as a result of their condition, and the surgeries necessary as a treatment. These changes can lead to altered pitch, vocal fatigue, loss of pitch range and loss of volume control. Although there are known psychosocial implications both to living with a chronic condition and voice difficulties there has been no research exploring this in adults with LTS, and there is minimal clinical guidance for speech and language therapists (SLTs) working with these patients. What this paper adds to existing knowledge This research is the first study to explore the lived experience of adults with LTS who undergo reconstructive surgery, focusing on their voice concerns. This study demonstrates the multifactorial impacts of voice changes on all aspects of the lives of adults with LTS and the need for individualised information provision and clinical care to help support them. What are the potential or actual clinical implications of this work? Adults with LTS want expert SLTs to facilitate their care and support them throughout their LTS journey alongside other support networks. They want to be carefully prepared for reconstructive surgery and given clear information about symptoms and management of their voice difficulties. This has led to the reorganisation of the care pathway at our centre, and the introduction of a patient-led pretreatment session.

This article examines UK newspaper coverage during the first wave of the COVID-19 pandemic March-August 2020. A qualitative framing analysis of public messaging on age in five high circulation newspapers provides a detailed account of who is deemed to be at risk of dying from COVID-19. Newspapers represent older people as most at risk, with disability as a secondary factor. Reports on who is responsible, who is at risk, and who is to blame for deaths from COVID-19 are framed as issues of public health and generational fairness, with individual responsibility occupying a prominent role. We also find two counter-frames. First, in letters to the editor, older people’s pleas for freedom are framed as a fight for their civil liberties. Second, newspapers praise 99-year-old Captain Tom Moore and frame his behaviour as a source of national pride. We identify this as positive ageism. We conclude that reporting across progressive and conservative newspapers reflects age-based stereotypes and paternalism towards older people. Public figures are represented as scapegoats or heroes, offering distraction from the less newsworthy fact that long-term under-investment in social care increased the risk of dying amongst the old and disabled during the pandemic.

This article presents findings from an interdisciplinary project which invited readers to experience the impact of dementia via fictional characters’ narratives. Combining methods from critical gerontology and literary linguistics - a field that examines the language of literature - we undertook an empirical reader response study of dementia fiction. We constructed a large corpus of dementia fiction; selecting twelve extracts, each containing first-hand, focalized accounts of fictional characters’ experiences of living with dementia. Readers (31) were purposively sampled for four separate reading groups – student social workers (9); general public (9); family carers (6); people with dementia (7). Over six weeks they engaged in separate, facilitated, on-line group discussions of extracts. Discussions were independently coded using Atlas.ti. While readers from all four groups reported that fictional characters drew them into the internal life of someone with dementia, some carers questioned whether fictional characters’ experiences were plausible. Readers with dementia recognized themselves in the extracts; viewing fictional characters as eloquent envoys of their lived experiences of diagnosis, social isolation, loss of language and use of humor. Fictional characters offer an entry point for understanding contrasts in caregiver and care-receiver experiences of dementia. Fictional characters are potentially useful for moving dementia narratives beyond monstrous cultural metaphors and onto a disability-based rights agenda.

Chronic nonspecific low back pain (LBP) is a complex and multifaceted problem. The following Perspective piece tries to help make sense of this complexity by describing a model for the development and maintenance of persistent LBP that integrates modifiable factors across the biopsychosocial spectrum. The Fit-for-Purpose model posits the view that chronic nonspecific LBP represents a state in which the person in pain holds strong and relatively intransient internal models of an immutably damaged, fragile, and unhealthy back, and information that supports these models is more available and trustworthy than information that counters them. This Perspective proposes a corresponding treatment framework for persistent pain that aims to shift internal models of a fragile, damaged, unhealthy, and unchangeable self toward the formulation of the back as healthy, strong, adaptable, and fit for purpose and to provide the system with precise and trustworthy evidence that supports this supposition while minimizing information that works against it.

Charged residues on the surface of proteins are critical for both protein stability and interactions. However, many proteins contain binding regions with a high net-charge that may destabilize the protein but are useful for binding to oppositely charged targets. We hypothesized that these domains would be marginally stable, as electrostatic repulsion would compete with favorable hydrophobic collapse during folding. Furthermore, by increasing the salt concentration we predict that these protein folds would be stabilized by mimicking some of the favorable electrostatic interactions that take place during target binding. We varied the salt and urea concentrations to probe the contributions of electrostatic and hydrophobic interactions for the folding of the 60-residue yeast SH3 domain found in Abp1p. The SH3 domain was significantly stabilized with increased salt concentrations according to the Debye-Huckel limiting law. Molecular dynamics and NMR show that sodium ions interact with all 15 acidic residues but do little to change backbone dynamics or overall structure. Folding kinetics experiments show that the addition of urea or salt primarily affects the folding rate, indicating that almost all the hydrophobic collapse and electrostatic repulsion occurs in the transition state. After the transition state formation, modest yet favorable short-range salt-bridges are formed along with hydrogen bonds, as the native state fully folds. Thus, hydrophobic collapse offsets electrostatic repulsion to ensure this highly charged binding domain can still fold and be ready to bind to its charged peptide targets, a property that is likely evolutionarily conserved over one billion years.Statement for broader audienceSome protein domains are highly charged because they are adapted to bind oppositely charged proteins and nucleic acids. However, it is unknown how these highly charged domains fold as during folding there will be significant repulsion between like-charges. We investigate how one of these highly charged domains folds in the presence of salt, which can screen the charge repulsion and make folding easier, allowing us to understand how folding occurs despite the protein’s high charge.Supplementary materialSupplementary material document containing additional details on protein expression methods, thermodynamics and kinetics equations, and the effect of urea on electrostatic interactions, as well as 4 supplemental figures and 4 supplemental data tables. (Supplementary_Material.docx), 15 pagesSupplemental excel file containing covariation data across AbpSH3 orthologs (FileS1.xlsx)

Background/Aims Patients treated with intubation and tracheostomy for COVID-19 infection are at risk of increased incidence of laryngeal injury, dysphagia and dysphonia. Because of the novelty of the SARS-CoV-2 virus, little is known about the type of dysphagia patients experience as a result of infection and critical illness. The aim of this case series report was to progress understanding of COVID-19 and dysphagia following admission to an intensive care unit and to guide speech and language therapy clinical practice in the ongoing pandemic. Methods A retrospective case review was conducted of all patients at Imperial College Healthcare NHS Trust, London who underwent a tracheostomy because of COVID-19 and received an instrumental assessment of swallowing in the early stages of the pandemic. Results A total of 11 patients were identified, and descriptive statistics were used to present demographic data, with a narrative account of their dysphagia profile used to describe presentation. Causes and presentation of dysphagia were heterogenous, with each patient requiring individualised clinical management to maximise outcome. A positive trend was seen in terms of recovery trajectory and progressing to oral intake. Conclusions This study reports on early experience of the presentation of dysphagia in patients with COVID-19 and demonstrates the value of instrumental assessment. It indicates the need for further research to consolidate knowledge and guide clinical practice.

Introduction Experts recommend integrating smoking-cessation treatments within U.S. mental health settings, but the population health benefits of doing so have not been estimated. This study simulates the impact of widespread cessation treatment for patients with depression under best-case treatment and maximum potential cessation scenarios. Methods Cessation interventions were simulated for U.S. adult smokers seeing a health professional for depression from 2020 to 2100. Interventions included (1) Any Treatment (behavioral counseling, pharmacological, combination) and (2) Pharmacological Treatment (including counseling), combined with increased mental health service utilization each. These were compared with a maximum potential cessation scenario where all patients with major depression quit smoking. Analyses were conducted in 2016–2020. Results Widespread uptake of Any Treatment among patients with depression would avert 32,000 deaths and result in 138,000 life-years gained by 2100; Any Treatment combined with 100% mental health service utilization would result in 53,000 and 231,000, respectively. Pharmacological Treatment would avert 125,000 deaths, with 540,000 life-years gained. Pharmacological Treatment combined with 100% mental health service utilization would result in 203,000 deaths averted and 887,000 life-years gained. Health gains under best-case treatment scenarios represent modest fractions of those projected under maximum potential cessation scenarios at current mental health service utilization levels (835,000 deaths averted, 3.73 million life-years gained) and at 100% utilization (1.11 million deaths averted, 5.07 million life years gained). Conclusions Providing smoking-cessation treatment to patients with depression and increasing mental health service utilization would reduce the toll of tobacco on this population. These gains would be considerably larger if cessation treatments were more effective.

Objectives: To investigate how the symptoms of mucus and cough impact adults living with laryngotracheal stenosis, and to use this information to guide future research and treatment plans. Methods: A survey was developed with the support of patient advisors and distributed to people suffering with laryngotracheal stenosis. The survey comprised 15 closed and open questions relating to mucus and cough and included the Leicester Cough Questionnaire (LCQ). Descriptive statistics, X2 and thematic analyses were completed. Results: In total, 641 participants completed the survey, with 83.62% (n = 536) reporting problems with mucus; 79% having daily issues of varying severity that led to difficulties with cough (46.18%) and breathing (20.90%). Mucus affected voice and swallowing to a lesser degree. Respondents described a range of triggers; they identified smoky air as the worst environmental trigger. Strategies to manage mucus varied widely with drinking water (72.26%), increasing liquid intake in general (49.35%) and avoiding or reducing dairy (45.32%) the most common approaches to control symptoms. The LCQ showed a median total score of 14 (interquartile range 11-17) indicative of cough negatively affecting quality of life. Thematic analysis of free text responses identified 4 key themes—the Mucus Cycle, Social impact, Psychological impact, and Physical impact. Conclusion: This study shows the relevance of research focusing on mucus and cough and its negative impact on quality of life, among adults with laryngotracheal stenosis. It demonstrates the inconsistent advice and management strategies provided by clinicians for this issue. Further research is required to identify clearer treatment options and pathways.

Seven siphoviruses were isolated from soil using

Photosensitized thymine<>thymine (Thy<>Thy) formation and repair can be mediated by carbazole (Cbz). The former occurs from the Cbz triplet excited state via energy transfer, while the latter takes place from the singlet excited state via electron transfer. Here, fundamental insight is provided into the role of the topology and excited state multiplicity, as factors governing the balance between both processes. This has been achieved upon designing and synthesizing different isomers of trifunctional systems containing one Cbz and two Thy units covalently linked to the rigid skeleton of the natural deoxycholic acid. The results shown here prove that the Cbz photosensitized dimerization is not counterbalanced by repair when the latter, instead of operating through-space, has to proceed through-bond., Financial support from the Spanish Government (grant SEV-2016-0683), Generalitat Valenciana (PROMETEO/2017/075 and PROMETEO/2021/077), and Technical University of Valencia (Predoctoral FPI fellowship for P.M.) is gratefully acknowledged. G.S. thanks CTI-CSIC for the use of computational facilities.

INTRODUCTION: Improving Access to Psychological Therapies (IAPTs) Services could offer smoking cessation treatment to improve physical and psychological outcomes for service users, but it currently does not. This study aimed to understand participants' views and experiences of receiving a novel smoking cessation intervention as part of the ESCAPE trial (intEgrating Smoking Cessation treatment As part of usual Psychological care for dEpression and anxiety). We used the Capability, Opportunity and Motivation Model of Behaviour (COM-B) to understand the (i) acceptability of the integrated smoking cessation treatment, (ii) views of psychological well-being practitioners' (PWPs) ability to deliver the smoking cessation treatment and (iii) positive and negative impacts of smoking cessation treatment.METHODS: This was a qualitative study embedded within a feasibility randomized-controlled trial (ESCAPE) in primary care services in the United Kingdom (IAPT). Thirty-six participants (53% female) from both usual care and intervention arms of the ESCAPE trial, including both quitters and nonquitters, were interviewed using semi-structured interviews. Data were analysed using a framework approach to thematic analysis, using the COM-B as a theoretical frame.RESULTS: Psychological Capability: Integrated smoking cessation treatment was acceptable and encouraged participants to reflect on their mental health. Some participants found it difficult to understand nicotine withdrawal symptoms.MOTIVATION: Participants were open to change during the event of presenting to IAPT. Some described being motivated to take part in the intervention by curiosity, to see whether quitting smoking would help their mental health. Physical Opportunity: IAPT has a natural infrastructure for supporting integrated treatment, but there were some barriers such as session duration and interventions feeling segmented. Social Opportunity: Participants viewed PWPs as having good interpersonal skills to deliver a smoking cessation intervention.CONCLUSION: People with common mental illness generally accepted integrated smoking cessation and mental health treatment. Smoking cessation treatment fits well within IAPT's structure; however, there are barriers to implementation.PATIENT OR PUBLIC CONTRIBUTION: Before data collection, we consulted with people with lived experience of smoking and/or mental illness and lay public members regarding the aims, design and interview schedules. After analysis, two people with lived experience of smoking and mental illness individually gave feedback on the final themes and quotes.

Monocular vision based road detection methods are mostly based on machine learning methods, relying on classification and feature extraction accuracy, and suffer from appearance, illumination and weather changes. Traditional methods introduce the predictions into conditional random fields or markov random fields models to improve the intermediate predictions based on structure. These methods are optimization based and therefore resource heavy and slow, making it unsuitable for real time applications. We propose a method to detect and segment roads with a random forest classifier of local experts with superpixel based machine-learned features. The random forest takes in machine learnt descriptors from a pre-trained convolutional neural network - VGG-16. The features are also pooled into their respective superpixels, allowing for local structure to be continuous. We compare our algorithm against Nueral Network based methods and Traditional approaches (based on Hand-crafted features), on both Structured Road (CamVid and Kitti) and Unstructured Road Datasets. Finally, we introduce a Road Scene Dataset with 1000 annotated images, and verify that our algorithm works well in non-urban and rural road scenarios., for associated dataset, see https://prassanna-ravishankar.github.io/LandscapeDataset/

Background: Good sleep quantity and quality are essential for patient recovery while in the intensive care unit (ICU). Patients commonly report poor sleep while in the ICU, and therefore, identifying the modifiable factors that patients perceive as impacting their sleep is important to improve sleep and recovery. This study also assessed night-time light and sound levels in an ICU in an effort to find modifiable factors. Methods: A total of 137 patients (51F) aged 58.1 ± 16.8 years completed a survey including questions about their sleep before and during their ICU stay, factors contributing to poor sleep in the ICU, and perceived factors that may have improved their sleep in the ICU. Night-time light and sound levels were measured in patient rooms and nurses’ stations. Results: Patients reported poorer sleep quantity and quality while in the ICU compared to home. Among the most common reasons for poor sleep, easily modifiable factors included noise (50.4%) and lights (45.3%), potentially modifiable factors included pain (46.7%), and non-modifiable factors included IV lines (42.3%). Patients felt their sleep would have been improved with interventions such as dimming lights (58.4%) and closing doors/blinds at night (42.3%), as well as potentially implementable interventions such as a sleeping pill (51.8%). Overnight sound levels in bedrooms were above the recommended levels (40 dB) and light levels averaged over 100 lux. Conclusions: Sleep quality and quantity were both worse in ICU than at home. Modifiable factors such as sound and light are common factors that patients perceive impact their sleep in the ICU. Readily implementable sleep management strategies aimed at minimizing the impacts of sound and light levels in the ICU are ways to improve patients’ sleep in the ICU.

ObjectiveTo critically assess the methodological characteristics and quality of interventional clinical trials investigating the effects of heated tobacco products (HTPs).Data sourcesWeb of Science (Core collection and MEDLINE), Scopus, MedRxiv, ClinicalTrials.gov and ICTRP trial databases and transnational HTP manufacturer online publication libraries were searched for clinical trials on HTPs published between January 2010 and April 2022.Study selectionInterventional clinical trials of any design, in which at least one group of adult participants used a currently marketed HTP, were selected by two reviewers with good or very good agreement.Data extractionData relating to trial characteristics and effects of intervention on primary outcomes were extracted using a predesigned form. Risk of bias was assessed using Cochrane’s Risk of Bias tool v1.Data synthesis40 trials were included, 29 of which were tobacco industry affiliated. Methodological characteristics, such as registration, design, setting, comparator interventions, participants, outcomes and analyses, varied between trials, though there were few significant differences between industry-affiliated and independent trials. Of the 40 trials, 33 were judged to be at high risk of bias and 6 at unclear risk of bias. Trial findings were not significantly associated with either affiliation or risk of bias.ConclusionsThe conduct and reporting of HTP interventional clinical trials were poor in many respects and limited to investigating effects of short-term exposure. These trials fall short of what is needed to determine whether HTPs are beneficial to public health, meaning they may not be a sound basis for tobacco control policy decisions.

Acquired laryngotracheal stenosis (LTS) is a rare condition causing dyspnea and stridor. Patients often require multiple surgical procedures with no guarantee of a definitive outcome. Difficulty swallowing is a recognised problem associated with LTS and the reconstructive surgeries required to manage the condition. The breathlessness patient’s experience impacts on swallowing, and the vulnerable structures of the larynx are implicated during complex surgeries. This leads to dysphagia post-surgery, with some patients experiencing more chronic symptoms depending on the biomechanical impact of the surgery, or a pre-existing dysphagia. Despite this there is limited observational research about the dysphagia associated with LTS, with no exploration of the patient experience. Our aim was to investigate patient experience of living with LTS focussing on dysphagia in order to guide clinical practice. A qualitative study was completed using focus groups and semi-structured interviews with 24 patients who have had reconstructive surgery for LTS. Thematic analysis was used to identify three over-arching themes: The Physical Journey, The Emotional Journey and The Medical Journey. Key sub-themes included the importance of self-management and control, presence of symptoms, benefits of therapy, living with a life-long condition, fear and anxiety, autonomy, medicalisation of normal processes and the dichotomy between staff expertise and complacency. Swallowing was connected to all themes. The results are reviewed with consideration of the wider literature of lived experience particularly in relation to other chronic conditions and those that carry a high symptom burden such as head and neck cancer. Future clinical and research recommendations have been made. Akin to other clinical groups, adults with LTS are keen that management of their swallowing is person-centred and holistic.

Change factors common across psychosocial interventions, including those relating to group treatments, are often not addressed within research into mindfulness-based programmes (MBPs). Here, we present how consideration of these factors can be beneficial for both mindfulness teachers and researchers. This article is a selective review of relevant common factors and small group treatment research and practitioner literature. This encompasses emergent and imposed structure, formal change theory, foundational social processes and emergent process, as well as teacher and client effects. Extant qualitative and quantitative research and key practitioner literature into MBPs is included, and implications for mindfulness teachers both from the wider framework of common and group factors, as well as from MBP research itself, are outlined. Participant expectations and preferences may play a role in supporting good outcomes and course continuation in MBPs, but more research is needed. Participants and practitioners describe the importance of the group crucible, including the experience of common humanity and connection, and group composition may impact this. Group size is under-researched and it is unclear what influence this may have on effectiveness. Surprisingly, research thus far has not found a reliable link between participant outcome and teacher competence, though embodiment is considered key by practitioners, trainers and participants. Future research should focus on the role of expectations, alliance, the group context and group size as well as finding innovative ways to further understand MBP teacher competence.

Mitochondria-targeting drugs and diagnostics are used in the monitoring and treatment of mitochondrial pathologies. In this respect, a great number of functional compounds have been made mitotropic by covalently attaching the active moiety onto a triphenylphosphonium (TPP) cation. Among these compounds, a number of molecular detectors for reactive oxygen species (ROS) are based on fluorescent and chemiluminescent probes. In this regard, luminol (probably the most widely known chemiluminescent molecule) has been employed for a number of biological applications, including ROS detection. Its oxidation under specific conditions triggers a cascade of reactions, ultimately leading to the excited 3-aminophthalate (3AP *), which emits light upon deactivation. Hence, the photophysical interaction between the light-emitting species 3AP * and TPP cations needs to be evaluated, as it can add valuable information on the design of novel emission-based mitotropic systems. We herein investigate the quenching effect of ethyltriphenylphosphonium cation onto substituted 3-aminophthalates. These were prepared in situ upon hydrolysis of the corresponding anhydrides, which were synthesized from 3-aminophthalimides. Steady-state fluorescence and time-resolved experiments were employed for the evaluation of a possible electron transfer quenching by phosphonium ions. Our experimental results confirmed such quenching, suggesting it is mainly dynamic in nature. A minor contribution of static quenching that was also detected is attributed to complex formation in the ground state. Accordingly, the chemiluminescence of luminol was indeed strongly reduced in the presence of phosphonium ions. Our results have to be taken into account during the design of new chemiluminescent mitotropic drugs or diagnostic agents of the luminol family., This project was financially supported by the European Union’s Horizon 2020 framework program for research and innovation under grant agreement no. 712921. T.M. and A.P. would like to thank the State Scholarships Foundation (IKY) for financial support through Ph.D. fellowships through the “Strengthening of Human Resources through Doctoral Research” program of the Operational Program “Human Resource Development, Education and Lifelong Learning” 2014–2020, co-financed by the European Union (European Social Fund ESF) and Greek national funds. M.A.M. and G.M.R.-M. thank the Generalitat Valenciana (Prometeo Program/2017/075) for financial support

IntroductionMindfulness-based programmes (MBPs) have an established, growing evidence base as interventions to optimise health, well-being and performance of individual participants. Emerging evidence suggests that MBPs also enhance prosociality, encouraging individuals to contribute to positive social change. This study focuses on the potential of MBPs to facilitate development of participants’ inner resources that support prosocial shifts. The review seeks to detect shifts in MBP benefit from individual toward ‘bigger than self’, informing and empowering individual and collective responses to complex societal and global issues. The review aims to map current literature on MBPs and social change, into a descriptive overview with commentary on quality, trends, theoretical models and gaps, and on how training in MBPs potentially enables individual and collective responses to societal and global issues. Recommendations for future directions for researchers seeking to advance this evidence base, and practitioners developing innovative MBPs for this purpose will be provided.Methods and analysisA scoping review of peer-reviewed literature will be undertaken and reported on according to the Joanna Briggs Institute (JBI) Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidance. Systematic searches of four scientific databases will be undertaken to identify potentially eligible articles published from all time to current date. Data will be extracted using an extraction template and analysed descriptively using narrative synthesis.Ethics and disseminationThis scoping review involves no human participants, so ethics is not required. Findings will be shared through professional networks, conference presentations and journal publication.

Although there is putative evidence that mindfulness-based programs (MBPs) may contribute to leadership skills, little is known about the direct experience of leaders who attend such programs. It is therefore unknown how MBPs delivered in the corporate environment are experienced by leaders, or how MBPs may facilitate leadership development. This qualitative study explored how leaders experienced an MBP, introduced as a part of a wider leadership development program, and the impact of this intervention on their work lives and leadership role. Participants (N = 10) were leaders who worked for a global manufacturing organization and who had attended a three-day mindfulness-based program as part of a leadership development program. They were interviewed and the data was analysed using thematic analysis. Following the MBP, eight participants reported enhanced emotional awareness, and a greater understanding of the impact of work-related stress, which in turn helped their leadership role. Two did not see how mindfulness could enhance their leadership skills although the MBP was well received by most of the participants. Three superordinate themes were identified: (1) The participant journey: Mixed experiences of the MBP; (2) A clash of cultures: The challenge of integrating mindfulness into the workplace, and (3) Impact on leadership. These results may inform future research, program design, and implementation.

Firefighters are exposed to highly stressful environments, often witnessing multiple traumatic events throughout their careers. The cumulation of stress and traumas firefighters are exposed to have left many in the profession with physical and psychological injuries, and with such injuries left untreated, can lead to lifelong suffering or suicide. The primary objectives for this research investigate firefighter occupational stress, peer support, and attitudes towards help-seeking for mental health in the hopes to fill in gaps understanding why firefighters continue to suffer in silence. Employing a mixed-methods research design, a survey questionnaire was collected from 254 firefighters from a large fire department in British Columbia, Canada. Consistent with the existing literature, findings suggest that the levels of peer support mitigated occupational stress, that is, those who reported higher levels of peer support also reported lower occupational stress levels. Firefighters provided information on what types of support they prefer according to the types and severity of stressors. Suggestions from the respondents provide information on how barriers to receiving help, such as stigma, may be addressed at the organizational level. Implications and recommendations for interventions addressing stigma and help-seeking amongst firefighters are discussed.

Objectives Research concerned with mindfulness-based program (MBP) teacher training has focused on the importance of developing teacher competency and integrity, with little emphasis on the experience of trainees themselves. The aim of this study was to investigate the experiences of trainee MBPs teachers as they delivered their first MBPs, with a focus on how they utilized their personal mindfulness practice to support themselves during this time. Methods We explored the experiences of university-based trainee teachers of Mindfulness-Based Stress Reduction (MBSR) when starting to teach, the ways they negotiated any challenges, and the extent to which they felt supported by their mindfulness practice. Semi-structured interviews were conducted with new MBSR teachers currently on a training course (N = 8). The interview data were analyzed using inductive thematic analysis. Results The key findings of the study were that trainee teachers were deeply motivated to teach MBPs with great integrity; did not anticipate the amount of time and effort needed to deliver their first MBSR courses; had concerns about the viability of the 8-week format of MBSR; needed more development in the area of self-reflection; and do indeed practice what they teach, and used their personal mindfulness practice to work with challenges. Conclusions These findings show that trainee mindfulness teachers are actively engaged with developing their teaching skills, and offer directions for how the pedagogy of MBP teacher training may be further developed. Trainees might benefit from additional pedagogical input on the practicalities of delivering MBSR in community settings, and on the development of reflective skills.

This chapter addresses the emergence of elder abuse as a distinct social problem now that population ageing has become a phenomena we must reckon with. The chapter uses the concept of safeguarding as a framework for examining the role that social work plays in elder abuse and presents different definitions of elder abuse while addressing mental capacity and human rights-based responses. The chapter argues that an effective safeguarding legal or policy framework should aim to give older people equal access to justice whilst promoting their safety, autonomy and confidence. However, developing such a framework engages intrinsic ethical concerns particularly in balancing an older person’s right to autonomy with the responsibility of the State to provide protection. Differences in safeguarding legislation, definitions of abuse and variations in the range of powers and duties afforded to professionals working in this area, are therefore highlighted since these reflect the socially constructed nature of abuse, as well as variations in how governments view their responsibilities towards their older citizens. The chapter stresses the importance of human rights-based approaches to elder abuse while addressing the debates on personalisation, resilience and the complexities of balancing protection with the promotion of autonomy.

Self-assessment is the most common method for monitoring performance and safety in the workplace. However, discrepancies between subjective and objective measures have increased interest in physiological assessment of performance. In a double-blind placebo-controlled study, 23 healthy adults were randomly assigned to either a placebo (n = 11; 5 F, 6 M) or caffeine condition (n = 12; 4 F, 8 M) while undergoing 50 h (i.e. two days) of total sleep deprivation. In previous work, higher salivary alpha-amylase (sAA) levels were associated with improved psychomotor vigilance and simulated driving performance in the placebo condition. In this follow-up article, the effects of strategic caffeine administration on the previously reported diurnal profiles of sAA and performance, and the association between sAA and neurobehavioural performance were investigated. Participants were given a 10 h baseline sleep opportunity (monitored via standard polysomnography techniques) prior to undergoing sleep deprivation (total sleep time: placebo = 8.83 ± 0.48 h; caffeine = 9.01 ± 0.48 h). During sleep deprivation, caffeine gum (200 mg) was administered at 01:00 h, 03:00 h, 05:00 h, and 07:00 h to participants in the caffeine condition (n = 12). This strategic administration of caffeine gum (200 mg) has been shown to be effective at maintaining cognitive performance during extended wakefulness. Saliva samples were collected, and psychomotor vigilance and simulated driving performance assessed at three-hour intervals throughout wakefulness. Caffeine effects on diurnal variability were compared with previously reported findings in the placebo condition (n = 11). The impact of caffeine on the circadian profile of sAA coincided with changes in neurobehavioural performance. Higher sAA levels were associated with improved performance on the psychomotor vigilance test during the first 24 h of wakefulness in the caffeine condition. However, only the association between sAA and response speed (i.e. reciprocal-transform of mean reaction time) was consistent across both days of sleep deprivation. The association between sAA and driving performance was not consistent across both days of sleep deprivation. Results show that the relationship between sAA and reciprocal-transform of mean reaction time on the psychomotor vigilance test persisted in the presence of caffeine, however the association was relatively weaker as compared with the placebo condition. Refereed/Peer-reviewed

Social wasps of the genus Vespula have spread to nearly all landmasses worldwide and have become significant pests in their introduced ranges, affecting economies and biodiversity. Comprehensive genome assemblies and annotations for these species are required to develop the next generation of control strategies and monitor existing chemical control. We sequenced and annotated the genomes of the common wasp (Vespula vulgaris), German wasp (Vespula germanica), and the western yellowjacket (Vespula pensyl- vanica). Our chromosome-level Vespula assemblies each contain 176–179 Mb of total sequence assembled into 25 scaffolds, with 10–200 unanchored scaffolds, and 16,566–18,948 genes. We annotated gene sets relevant to the applied management of invasive wasp populations, including genes associated with spermatogenesis and development, pesticide resistance, olfactory receptors, immunity and venom. These genomes provide evidence for active DNA methylation in Vespidae and tandem duplications of venom genes. Our genomic resources will contribute to the development of next-generation control strategies, and monitoring potential resistance to chemical control.

Objectives Mindfulness-based programs (MBPs) such as the ‘Soles of the Feet’ (SoF) meditation have been shown to be effective for reducing aggressive behavior in people with intellectual disabilities (ID). Research on SoF has shown promising results in the USA but there is an absence of evidence for the approach in the United Kingdom (UK). The aim of this research was to adapt SoF for the UK and to assess the feasibility and cost of implementing the SoF intervention in a UK healthcare setting (UK SoF). Methods The UK SoF intervention consisted of a manualized protocol delivered over a six-week period by National Health Service staff to people with ID and their carers. This was a single-arm study with three measurement time points (baseline and 2- and 6-month follow-ups). Results The UK SoF intervention was shown to be feasible, with recruitment, retention, and adherence figures exceeding the minimum cut-off of 50%. Costs were £2426 per participant, or £2766 when including set-up costs such as therapist training. Although not a primary aim, data suggest that at 6-month follow-up, there was a reduction in scores for anger and aggressive behavior, and depression and anxiety showed improvement. In addition, people with ID were able to self-report on their health-related quality of life. Conclusions This study has indicated areas where the protocol could be further improved, and it is recommended that the research should move to a pilot trial before the development of a full randomized control trial.

Mindfulness-Based Cognitive Therapy (MBCT) was lightly adapted for participants diagnosed with chronic fatigue syndrome (CFS). The aim of the study was to explore participants’ experiences of the MBCT course, with a particular focus on how they applied MBCT to living with and coping with the symptoms of CFS. Nine participants with CFS who completed the MBCT course were interviewed using semi-structured interview methods. Inductive thematic analysis, a methodology designed to generate themes from the “bottom up,” was used. Four superordinate themes were generated from the data: (1) awareness of unhelpful behavioral patterns associated with CFS, (2) benefits of group solidarity, (3) use of mindfulness tools to facilitate shifts in behavioral patterns, and (4) a sense of change and agency. Participants became aware of three specific transformative changes that contributed to a more skillful way of living with CFS: development of acceptance, improved self-care and self-compassion, and reduction in heightened stress response. MBCT appears to enable people with CFS to actively work with their symptoms, and make transformative changes in their behavioral patterns, resulting in benefits to well-being.

There has been an increased interest in the delivery of Mindfulness-Based Programmes (MBPs) in schools yet little is known about how people who deliver MBPs in schools carry out and experience implementation. In this qualitative study, we aimed to examine the experiences of school staff who have a personal mindfulness practice, and who also deliver MBPs to their students. We recruited eight school staff (age range 34–64) who taught students mindfulness, and carried out semi-structured interviews focusing on investigating their positive and negative experiences of delivering mindfulness in schools, how practicing and delivering mindfulness affected their work-life, and their experiences of implementing school-based MBPs. School staff reported that delivering MBPs deepened their own mindfulness practice. The practice enabled them to feel better attuned to others, increased compassion for both themselves and students, helped their emotional regulation, and enhanced resilience to stress. Unexpectedly, half of the participants reported making changes to their work roles and several explicitly linked these changes to the increased self-compassion developed through mindfulness practice. They reported enjoying teaching school students MBPs (and noted that some students embraced mindfulness, and some were reluctant to engage) and sometimes found driving the implementation of MBPs in their school challenging. There appear to be numerous benefits of a personal mindfulness practice for school staff and delivering school-based MBPs can increase feelings of personal accomplishment. Future research is needed into whether MBPs can improve student–teacher relationships, and how some schools have successfully implemented MBPs.

Rationale & Objective More than 50% of hemodialysis patients experience sleep disturbance and most have coexisting sleep apnea. However, how sleep apnea affects sleep and the overall experience of patients with chronic kidney disease treated by hemodialysis has not been evaluated. Study Design A mixed-methods design, incorporating cross-sectional observational and descriptive qualitative methodologies. Setting & Participants Patients receiving maintenance hemodialysis in Newcastle, New South Wales, Australia, with newly diagnosed sleep apnea (apnea-hypopnea index ≥ 5 per hour). Assessments In-laboratory polysomnography to assess sleep apnea and objective sleep parameters. Epworth Sleepiness Scale to assess daytime symptoms. A semi-structured qualitative interview to explore patient experience. Analytical Approach Descriptive and iterative thematic analysis. Results We analyzed 36 patients with newly diagnosed sleep apnea and interviewed 26 (mean age, 62 years, median apnea-hypopnea index, 32 per hour). Severity of sleep apnea did not affect patients’ sleep duration, sleep efficiency, or self-reported Epworth Sleepiness Scale score. From the qualitative interviews, 4 themes emerged: “broken sleep” related to short sleep duration, with waking and dozing off a common sleep cycle, caused by uncontrolled pain and dialysis. Many participants reported regularly “feeling unrefreshed” on waking. “Impact of sleep disturbance” included reduced physical, mental, and self-management capacity. Finally, interviewees described the need to use strategies to “soldier on” with symptoms. Limitations Participants’ views are only transferrable to hemodialysis patients with sleep apnea. Conclusions Our findings suggest that severity of sleep apnea does not affect sleep time or patient-reported daytime sleepiness; however, hemodialysis patients with sleep apnea report disturbed and unrefreshed sleep and the debilitating effects of sleep disturbance is profound. Broken and unrefreshed sleep were the dominant symptoms of sleep apnea and should be assessed routinely to identify patients with sleep apnea and improve quality of life in patients with chronic kidney disease treated with hemodialysis., Graphical abstract

Herein, 9,10-diethynyltriptycene is investigated for its use as a rigid isolating unit in the synthesis of multichromophoric arrays. Sonogashira cross-coupling conditions are utilized to attach various porphyrins and boron dipyrromethenes (BODIPYs) to the triptycene scaffold. While there are previous examples of triptycene porphyrin complexes, this work reports the first example of a linearly connected porphyrin dimer, linked through the bridgehead carbons of triptycene. Symmetric and unsymmetric examples of these complexes are demonstrated and single crystal X-ray analysis of an unsymmetrically substituted porphyrin dimer highlights the evident linearity in these systems. Moreover, initial UV–vis and fluorescence studies show the promise of triptycene as a linker for electron transfer studies, showcasing its isolating nature.

Connecting two porphyrin units in a rigid linear fashion, without any undesired electron delocalization or communication between the chromophores, remains a synthetic challenge. Herein, a broad library of functionally diverse multi‐porphyrin arrays that incorporate the non‐traditional rigid linker groups cubane and bicyclo[1.1.1]pentane (BCP) is described. A robust, reliable, and versatile synthetic procedure was employed to access porphyrin‐cubane/BCP‐porphyrin arrays, representing the largest non‐polymeric structures available for cubane/BCP derivatives. These reactions demonstrate considerable substrate scope, from utilization of small phenyl moieties to large porphyrin rings, with varying lengths and different angles. To control conformational flexibility, amide bonds were introduced between the bridgehead carbon of BCP/cubane and the porphyrin rings. Through varying the orientation of the substituents around the amide bond of cubane/BCP, different intermolecular interactions were identified through single crystal X‐ray analysis. These studies revealed non‐covalent interactions that are the first‐of‐their‐kind including a unique iodine‐oxygen interaction between cubane units. These supramolecular architectures indicate the possibility to mimic a protein structure due to the sp3 rigid scaffolds (BCP or cubane) that exhibit the essential conformational space for protein function while simultaneously providing amide bonds for molecular recognition., Synthesis and characterization of novel porphyrin‐cubane/BCP arrays have been reported. The single crystal analysis revealed supramolecular 3D networks with combined and repetitive inter‐ and intramolecular H‐bonding interactions.

Ductal carcinoma in situ (DCIS) is a non-obligate precursor of invasive ductal carcinoma (IDC), whereby if left untreated, approximately 12% of patients develop invasive disease. The current standard of care is surgical removal of the lesion, to prevent potential progression, and radiotherapy to reduce risk of recurrence. There is substantial overtreatment of DCIS patients, considering not all DCIS lesions progress to invasive disease. Hence, there is a critical imperative to better predict which DCIS lesions are destined for poor outcome and which are not, allowing for tailored treatment. Active surveillance is currently being trialed as an alternative management practice, but this approach relies on accurately identifying cases that are at low risk of progression to invasive disease. Two DCIS-specific genomic profiling assays that attempt to distinguish low and high-risk patients have emerged, but imperfections in risk stratification coupled with a high price tag warrant the continued search for more robust and accessible prognostic biomarkers. This search has largely turned researchers toward the tumor microenvironment. Recent evidence suggests that a spectrum of cell types within the DCIS microenvironment are genetically and phenotypically altered compared to normal tissue and play critical roles in disease progression. Uncovering the molecular mechanisms contributing to DCIS progression has provided optimism for the search for well-validated prognostic biomarkers that can accurately predict the risk for a patient developing IDC. The discovery of such markers would modernize DCIS management and allow tailored treatment plans. This review will summarize the current literature regarding DCIS diagnosis, treatment, and pathology.

The primary role of muscles is to move, and control joints. It is therefore important to understand how degenerative joint disease changes this role with the resulting effect on mechanical joint loading. Muscular control strategies can vary depending on strength and coordination which in turn influences joint control and loading. The purpose of this study was to investigate the variation in neuromuscular control mechanisms and joint biomechanics for three subject groups including those with: uni-compartmental knee osteoarthritis (OA), listed for high tibial osteotomy surgery (pre-HTO, n = 10); multi-compartmental knee OA listed for total knee replacement (pre-TKR, n = 9), and non-pathological knees (NP, n = 11). Lower limb kinematics and electromyography (EMG) data for subjects walking at self-selected speed, were input to an EMG-driven musculoskeletal knee model which was scaled and calibrated to each individual to estimate muscle forces. Compared to NP, the peak gastrocnemius muscle force reduced by 30% and 18% for pre-HTO and pre-TKR respectively, and the peak force estimated for hamstring muscle increased by 25% for pre-HTO. Higher quadriceps and hamstring forces suggest that co-contraction with the gastrocnemius could lead to higher joint contact forces. Combined with the excessive loading due to a high external knee adduction moment this may exacerbate joint destruction. An increased lateral muscle co-contraction reflects the progression from NP to uni-compartmental OA (pre-HTO). Pre-TKR patients adopt a different gait pattern to pre-HTO patients. Increased medial muscle co-activation could potentially differentiate between uni- or multi-compartmental OA.

PurposeRadiopharmaceuticals targeting poly(ADP-ribose) polymerase (PARP) have emerged as promising agents for cancer diagnosis and therapy. PARP enzymes are expressed in both cancerous and normal tissue. Hence, the injected mass, molar activity and potential pharmacological effects are important considerations for the use of radiolabelled PARP inhibitors for diagnostic and radionuclide therapeutic applications. Here, we performed a systematic evaluation by varying the molar activity of [18F]olaparib and the injected mass of [TotalF]olaparib to investigate the effects on tumour and normal tissue uptake in two subcutaneous human glioblastoma xenograft models.Methods[18F]Olaparib uptake was evaluated in the human glioblastoma models: in vitro on U251MG and U87MG cell lines, and in vivo on tumour xenograft-bearing mice, after administration of [TotalF]olaparib (varying injected mass: 0.04-8.0 µg, and molar activity: 1-320 GBq/μmol).ResultsSelective uptake of [18F]olaparib was demonstrated in both models. Tumour uptake was found to be dependent on the injected mass of [TotalF]olaparib (µg), but not the molar activity per sé. An injected mass of 1 μg resulted in the highest tumour uptake (up to 6.9 ± 1.3%ID/g), independent of the molar activity. In comparison, both the lower and higher injected masses of [TotalF]olaparib resulted in lower relative tumour uptake (%ID/g; PEx vivo analysis of U87MG xenograft sections showed that the heterogeneity in [18F]olaparib intratumoural uptake correlated with PARP1 expression. Substantial upregulation of PARP1-3 expression was observed after administration of [TotalF]olaparib (>0.5 µg).Conclusion Our findings show that the injected mass of [TotalF]olaparib has significant effects on tumour uptake. Moderate injected masses of PARP inhibitor-derived radiopharmaceuticals may lead to improved relative tumour uptake and tumour-to-background ratio for cancer diagnosis and radionuclide therapy.

The consumption of caffeine has been linked to osteoporosis, believed to be due to enhanced bone resorption as a result of increased calcium excretion in the urine. However, the amount of calcium in the urine may not necessarily reflect the true effect of caffeine on calcium clearance. This study therefore examined the impact of high-dose, short-term caffeine intake on renal clearance of calcium, sodium and creatinine in healthy adults. In a double-blind clinical study, participants chewed caffeine (n = 12) or placebo (n = 12) gum for 5 minutes at 2-hour intervals over a 6-hour treatment period (800 mg total caffeine). Caffeine increased renal calcium clearance by 77%. Furthermore, the effect was positively correlated with sodium clearance and urine volume, suggesting that caffeine may act through inhibition of sodium reabsorption in the proximal convoluted tubule. This study confirmed that caffeine does increase renal calcium clearance and fosters further investigation into safe consumption of caffeine. Refereed/Peer-reviewed

SUMMARYSmoking rates in people with depression and anxiety are twice as high as in the general population, even though people with depression and anxiety are motivated to stop smoking. Most healthcare professionals are aware that stopping smoking is one of the greatest changes that people can make to improve their health. However, smoking cessation can be a difficult topic to raise. Evidence suggests that smoking may cause some mental health problems, and that the tobacco withdrawal cycle partly contributes to worse mental health. By stopping smoking, a person's mental health may improve, and the size of this improvement might be equal to taking antidepressants. In this article we outline ways in which healthcare professionals can compassionately and respectfully raise the topic of smoking to encourage smoking cessation. We draw on evidence-based methods such as cognitive–behavioural therapy (CBT) and outline approaches that healthcare professionals can use to integrate these methods into routine care to help their patients stop smoking.

The outflow of supercooled Ice Shelf Water from the conjoined Ross and McMurdo ice shelf cavity augments fast ice thickness and forms a thick sub-ice platelet layer in McMurdo Sound. Here, we investigate whether the CryoSat-2 satellite radar altimeter can consistently detect the higher freeboard caused by the thicker fast ice combined with the buoyant forcing of a sub-ice platelet layer beneath. Freeboards obtained from CryoSat-2 were compared with 4 years of drill-hole-measured sea ice freeboard, snow depth, and sea ice and sub-ice platelet layer thicknesses in McMurdo Sound in November 2011, 2013, 2017 and 2018. The spatial distribution of higher CryoSat-2 freeboard concurred with the distributions of thicker ice-shelf-influenced fast ice and the sub-ice platelet layer. The mean CryoSat-2 freeboard was 0.07–0.09 m higher over the main path of supercooled Ice Shelf Water outflow, in the centre of the sound, relative to the west and east. In this central region, the mean CryoSat-2-derived ice thickness was 35 % larger than the mean drill-hole-measured fast ice thickness. We attribute this overestimate in satellite-altimeter-obtained ice thickness to the additional buoyant forcing of the sub-ice platelet layer which had a mean thickness of 3.90 m in the centre. We demonstrate the capability of CryoSat-2 to detect higher Ice Shelf Water-influenced fast ice freeboard in McMurdo Sound. Further development of this method could provide a tool to identify regions of ice-shelf-influenced fast ice elsewhere on the Antarctic coastline with adequate information on the snow layer.

Luminol is a prominent chemiluminescent (CL) agent, finding applications across numerous fields, including forensics, immunoassays, and imaging. Different substitution patterns on the aromatic ring can enhance or decrease its CL efficiency. We herein report a systematic study on the synthesis and photophysics of all possible 6,8-disubstituted luminol derivatives bearing H, Ph, and/or Me substituents. Their CL responses are monitored at three pH values (8, 10, and 12), thus revealing the architecture with the optimum CL efficiency. The most efficient pattern is used for the synthesis of a strongly CL luminol derivative, bearing a functional group for further, straightforward derivatization. This adduct exhibits an unprecedented increase in chemiluminescence efficiency at pH = 12, pH = 10, and especially at pH = 8 (closer to the biologically relevant conditions) compared to luminol. Complementary work on the fluorescence of the emissive species as well as quantum chemistry computations are employed for the rationalization of the observed results., The authors would like to thank Ekaterini Bouga and Christina-Ioanna Vrettou for assisting with certain synthesis steps. This project was financially supported by the European Union’s Horizon 2020 framework program for research and innovation under Grant Agreement No. 712921. T.M. and A.P. would like to thank the State Scholarships Foundation (IKY) for financial support via Ph.D. fellowships through the “Strengthening of Human Resources through Doctoral Research” program of the Operational Program “Human Resource Development, Education and Lifelong Learning” 2014–2020, co-financed by the European Union (European Social Fund ESF) and Greek national funds. The authors would also like to thank Prof. N. Thomaidis and Dr. Maria-Christina for the HRMS analyses. M.A.M. and G.M.R.-M. thank the Generalitat Valenciana (Prometeo Program/2017/075) for financial support. A.G. and D.R.-S. acknowledge Spanish “Ministerio de Ciencia e Innovación (MICINN)” (Project Ref CTQ2017-87054-C2-2-P). A.G. is also thankful to the MICINN for a “Juan de la Cierva” grant (Ref IJC2018-035123-I). D.R.-S. is also thankful to the MICINN for a “Ramón y Cajal” grant (Ref RYC-2015-19234) and to the BBVA Foundation for a 2019 Leonardo Grant for Researchers and Cultural Creators.