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This review evaluates physical activity as a candidate for an adjunct treatment, in conjunction with antiretroviral therapy (ART), for people living with HIV (PLWH). Evidence is summarized that chronic, non-resolving inflammation (a principal feature of immune system dysfunction) and a dysfunctional state of the gut environment are key factors in HIV infection that persist despite treatment with ART. In addition, evidence is summarized that regular physical activity may restore normal function of both the immune system and the gut environment and may thereby ameliorate symptoms and non-resolving inflammation-associated comorbidities that burden PLWH. Physicians who care for PLWH could thus consider incorporating physical activity into treatment plans to complement ART. It is also discussed that different types of physical activity can have different effects on the gut environment and immune function, and that future research should establish more specific criteria for the design of exercise regimens tailored to PLWH. [ABSTRACT FROM AUTHOR]

Background: Irregularities in sleep duration and sleep timing have emerged as potential risk factors for hypertension. This study examined associations between irregularity in sleep duration and timing with hypertension in a large, global sample over multiple months. Methods: Data from 12 287 adults, who used an under-mattress device to monitor sleep duration and timing and also provided blood pressure recordings on ≥5 separate occasions, were analyzed. Sleep duration irregularity was assessed as the SD in total sleep time across the ≈9-month recording period. Sleep timing irregularity was assessed as SDs in sleep onset time, sleep midpoint, and sleep offset time. Logistic regressions were conducted to investigate associations between sleep irregularity and hypertension, defined as median systolic blood pressure ≥140 mm Hg or median diastolic blood pressure ≥90 mm Hg. Results: Participants were middle-aged (mean±SD, 50±12 years), mostly men (88%) and overweight (body mass index, 28±6 kg/m−2). Sleep duration irregularity was consistently associated with an ≈9% to 17% increase in hypertension independently of the total sleep time. A ≈34-minute increase in sleep onset time irregularity was associated with a 32% increase in hypertension (1.32 [1.20–1.45]). A 32-minute increase in sleep midpoint irregularity was associated with an 18% increase in hypertension (1.18 [1.09–1.29]), while a 43-minute increase in sleep offset time irregularity was associated with an 8.9% increase in hypertension (1.09 [1.001–1.18]). Conclusions: These findings support that sleep irregularity, both in duration and timing, is a risk marker for poor cardiovascular health. Further mechanistic investigations of temporal relationships between day-to-day fluctuations in sleep duration and timing, next-day blood pressure, and other cardiovascular outcomes are warranted. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to quantify the organizational commitment of sonographers and determine factors influencing their connection or bond with their employer. Materials and Methods: One thousand nationally credentialed sonographers and vascular technologists in the mid-Atlantic region were surveyed using a systematic sampling model. Measurement tools included the Affective, Continuance, and Normative Commitment Scales. Descriptive and inferential statistics based on stepwise regression were used to define organizational commitment levels and the impact of sociodemographic characteristics on organizational commitment. Results: Of the 1000 surveys mailed, 110 usable surveys were returned (11% response rate). Affective, continuance, and normative commitment scores were 4.30, 4.62, and 3.46 out of 7, respectively. Results showed living in Pennsylvania, years at current organization, being a registered cardiac sonographer, and being unmarried had a statistically significant impact upon the variance in sonographers' organizational commitment scores. Conclusion: Sonographers indicated feeling little obligation to remain with the employer but may do so because of the perceived costs of leaving. As a result, sonographers' performance, work behavior, and attendance may be affected negatively. Factors such as locale, marital status, work tenure, and registration as a cardiac sonographer impact sonographers' organizational commitment. [ABSTRACT FROM AUTHOR]

Although practice by doing is typically regarded to be an effective method to facilitate student learning in a laboratory setting, stretched resources may require alternative approaches to accommodate students and to promote student retention. A portable multipurpose lab bench is presented that facilitates student learning by incorporating demonstration and discussion in a lab environment. In a first course for power electronics, improved student engagement and learning enhancement were targeted through the use of this single bench cohesively with classroom presentations and relevant theory. Laboratory assessments and end of course surveys for two consecutive years were collected to assess the learning experience as well as the effectiveness of the established mobile lab bench concept. [ABSTRACT FROM AUTHOR]

The present systematic review evaluated the efficacy of adjunctive therapies in the treatment of peri-implantitis. Studies comparing the outcome of conventional surgical- or nonsurgical mechanical debridement with the addition of an adjunctive therapeutic modality were identified through an electronic and hand search of available literature. Following data extraction, meta-analyses were performed on the primary outcome measures. The effects of the adjunctive therapies on bleeding on probing (13 studies), probing pocket depth (9 studies), and radiographic bone level changes (7 studies) were analyzed to evaluate potential clinical benefit. Heterogeneity was expressed as the I2 index. Fixed and random effect models were demonstrated. The potential benefit of adjunctive therapies over control procedures was evaluated in 18 studies, representing a total of 773 implants. Quality assessment of the studies found only 3 studies to be at a low risk of bias. Meta-analysis among the different additional modalities revealed chemical therapy demonstrating significant effects in probing pocket depth reduction (0.58 mm; 0.44–0.72) and radiographic bone level gain (0.54 mm; 0.16–0.92). No significant improvements in bleeding on probing reduction were found using any adjunctive therapy. Available evidence on the benefits of adjunctive therapy to nonsurgical or surgical mechanical debridement in the treatment of peri-implantitis is limited by low numbers of standardized, controlled studies for individual therapies, heterogeneity between studies, and a variety of outcome measures. The lack of effect of any adjunctive therapy in reducing bleeding on probing questions the overall effectiveness over conventional treatment. The long-term clinical benefit potential of these therapies is not demonstrated. [ABSTRACT FROM AUTHOR]

Summary: Research with 'good sleepers' is ubiquitous, yet there are no standardised criteria to identify a 'good sleeper'. The present study aimed to create and validate a questionnaire for identifying good sleepers for use in research studies known as the Good Sleeper Scale‐15 items (GSS‐15). Data were derived from a population‐based survey of Australian adults (n = 2,044). A total of 23 items were chosen for possible inclusion. An exploratory factor analysis (EFA) was conducted on ~10% of the survey dataset (n = 191) for factor identification and item reduction. A confirmatory factor analysis (CFA) was conducted on the remaining data (n = 1,853) to test model fit. Receiver operating characteristic curves and correlations were conducted to derive cut‐off scores and test associations with sleep, daytime functioning, health, and quality‐of‐life. The EFA identified six factors: 'Sleep Difficulties', 'Timing', 'Duration', 'Regularity', 'Adequacy', and 'Perceived Sleep Problem'. The CFA showed that model fit was high and comparable to other sleep instruments, χ2 (63) = 378.22, p < 0.001, root mean square error of approximation = 0.05, with acceptable internal consistency (α = 0.76). Strong correlations were consistently found between GSS‐15 global scores and outcomes, including 'a good night′s sleep' (r = 0.7), 'feeling un‐refreshed' (r = −0.59), and 'experienced sleepiness' (r = −0.51), p < 0.001. Cut‐off scores were derived to categorise individuals likely to be a good sleeper (GSS‐15 score ≥40) and those very likely to be a good sleeper (GSS‐15 score ≥45). The GSS‐15 is a freely available, robust questionnaire that will assist in identifying good sleepers for the purpose of sleep research. Future work will test relationships with other sleep measures in community and clinical samples. [ABSTRACT FROM AUTHOR]

Rationale: The combination of noradrenergic and antimuscarinic agents has recently been shown to improve upperairway function and reduce obstructive sleep apnea (OSA) severity in short-term (<1 wk) proof-of-concept studies. Objectives: To determine the safety, tolerability, and potential efficacy of longer term use of different doses of the noradrenergic agent atomoxetine combined with the antimuscarinic oxybutynin (ato-oxy). Methods: Thirty-nine people with predominantly severe OSA received 80/5 mg ato-oxy, 40/5 mg ato-oxy, 40/2.5 mg ato-oxy, or placebo nightly for 30 days in a double-blind, randomized, parallel design. Participants completed three in-laboratory sleep studies (baseline, Night 1, and Night 30) to assess efficacy. Vital signs and objective measures of alertness and memory were assessed. In men, potential effects on prostate function were assessed using the International Prostate Symptom Score at baseline and Night 30. Potential adverse events were assessed during in-laboratory visits and via weekly phone calls. Results: Side effects were generally mild and consistent with known side-effect profiles of each individual drug (i.e., dose-dependent increases in dry mouth with oxybutynin). Heart rate increased by Night 30 in two active drug arms (mean6standard deviation 8610 beats/min [P= 0.01] with 80/5 mg and 9614 beats/min [P=0.02] with 40/2.5 mg vs. placebo). No clinically relevant changes in blood pressure, International Prostate Symptom Score, and measures of alertness and memory were observed between conditions. Apnea–hypopnea index (AHI) with 4% oxygen desaturation and hypoxic burden decreased by (50% with 80/5 mg ato-oxy from baseline but not versus placebo (e.g., AHI with 3% oxygen desaturation and AHI with 4% oxygen desaturation difference at Night 30 was 28.2 [95% confidence interval, 222.5 to 6.2] and 28.5 [95% confidence interval, 218.3 to 1.3] events/h, respectively). Conclusions: One month of nightly noradrenergic and antimuscarinic combination therapy was generally well tolerated, with a side-effect profile consistent with each agent alone, and was associated with an (50% reduction from baseline in a key OSA severity metric, the hypoxic burden with the highest dose combination. These findings highlight the potential to target noradrenergic and antimuscarinic mechanisms for OSA pharmacotherapy development. [ABSTRACT FROM AUTHOR]

Following the 2016 publication of the Association for College and Research Libraries (ACRL) Framework for Information Literacy for Higher Education , information literacy standards evolved to prioritize conceptual understandings and tangible learning skills that students could apply throughout the research process. With these new goals and focuses in mind, in 2018 the Art Libraries Society of North America began an updated and expanded collection of subject-specific core competencies that incorporate both the ACRL Framework , as well as the ACRL Visual Literacy Competency Standards for Higher Education. This article describes the processes used to develop the core competencies for the newest report for historic preservation. [ABSTRACT FROM AUTHOR]