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Background: Saraca asoca (Ashoka, family; Caesalpiniaceae) is an indigenous sacred tree, native to India. It has been used in various traditional medicinal systems and is one such plant that is highly therapeutic but its use in disease management is underrated in today’s era and has lost its importance. Objective: This narrative review is written to provide the information on medicinal importance of S. asoca and the significance of S. asoca in various traditional medicinal systems. Methods: Different databases were searched to gather information. Research articles, abstracts, and reviews are included in this review. Results: Saraca asoca is known for its unique pharmacological role in treating various uterine complications, menstrual disorders, and bacterial infections, bleeding hemorrhoids, urinary and dermatological problems. The stem bark of the tree is the principal constituent for treating menorrhagia and genito-urinary disorders. The stem bark, leaves, and seeds of S. asoca are known to contain flavonoids, tannins, alkaloids, glycosides, polyphenolics, fatty acids, and saponins. The reported major phytoconstituents responsible for its therapeutic uses are epicatechin, procyanidin B2, lyoniside, nudiposide, catechin, leucocyanidin, and leucopelargonidin. Various pharmacological activities of this plant are discussed in this review. Conclusion: It has been proved that Saraca asoca possesses several pharmacological properties and is useful in treating various diseases. More studies on quality control, standardization, and clinical trials on S. asoca should be performed, so that this plant could be utilized as an effective anti-cancer drug which could be a promising source for the herbal and pharmaceutical industry.

The connection between trauma and the development of resiliency is not well understood or agreed upon, especially when examining the link between that relationship and other characteristics defined by adaptability, such as empathy and conscientiousness. In two studies, the relationship between each concept was examined in healthy adults. Study one examined recollected childhood adversity's correlation with total resiliency and empathy. Study two examined recollected childhood adversity and overall lifetime trauma's correlation with resiliency, empathy, and their subconstructs (i.e., intrapersonal and interpersonal resiliency, and cognitive and affective empathy) and compared those to conscientiousness scores. Study one's findings supported positive relationships between recollected childhood adversity, total resiliency, and empathy. Study two's findings showed that cumulative trauma scores were positively associated with interpersonal resiliency and affective empathy. Further, interpersonal resiliency was negatively correlated with conscientiousness, while intrapersonal resiliency was positively correlated with conscientiousness.

Knowledge management is recognized as an important tool for sustaining competitive merit and improving performance of work. It is a means through which law firms can clout their knowledge base and intensify work performance. The assessment of knowledge management performance has become increasingly invaluable since it provides the indicator for guiding organizations to improve their work execution and competitiveness. Many law firms have no documented and planned approach to tap the organization’s knowledge and make it accessible to the staff for enhancement of service delivery. The study was informed by the learning organization theory. The research design for this study was a descriptive and positivism case study that was analysed largely through quantitative methods with a small qualitative component. Purposive sampling design was employed to select 222 law firms, qualitative data was collected using focus group discussions from 12 key informants supported by document review. The results revealed that most of the respondents 86.5% were aware of knowledge management whereas 64.9% indicated that knowledge management contributed to their law firm’s legal practice. From the inferential statistics analysis, there was a significant relationship and influence across different attributes examined that knowledge management is a tool for improving work performance which is, p

The impact of heterogeneous uptake of HO2 on aerosol surfaces on radical concentrations and the O3 production regime in Beijing in summertime was investigated. The uptake coefficient of HO2 onto aerosol surfaces, γHO2, was calculated for the AIRPRO campaign in Beijing, in summer 2017, as a function of measured aerosol soluble copper concentration, [Cu2+]eff, aerosol liquid water content, [ALWC], and particulate matter concentration, [PM]. An average γHO2 across the entire campaign of 0.070±0.035 was calculated, with values ranging from 0.002 to 0.15, and found to be significantly lower than the value of γHO2=0.2, commonly used in modelling studies. Using the calculated γHO2 values for the summer AIRPRO campaign, OH, HO2 and RO2 radical concentrations were modelled using a box model incorporating the Master Chemical Mechanism (v3.3.1), with and without the addition of γHO2, and compared to the measured radical concentrations. The rate of destruction analysis showed the dominant HO2 loss pathway to be HO2 + NO for all NO concentrations across the summer Beijing campaign, with HO2 uptake contributing % to the total loss of HO2 on average. This result for Beijing summertime would suggest that under most conditions encountered, HO2 uptake onto aerosol surfaces is not important to consider when investigating increasing O3 production with decreasing [PM] across the North China Plain. At low [NO], however, i.e. ppb, which was often encountered in the afternoons, up to 29 % of modelled HO2 loss was due to HO2 uptake on aerosols when calculated γHO2 was included, even with the much lower γHO2 values compared to γHO2= 0.2, a result which agrees with the aerosol-inhibited O3 regime recently proposed by Ivatt et al. (2022). As such it can be concluded that in cleaner environments, away from polluted urban centres where HO2 loss chemistry is not dominated by NO but where aerosol surface area is high still, changes in PM concentration and hence aerosol surface area could still have a significant effect on both overall HO2 concentration and the O3 production regime. Using modelled radical concentrations, the absolute O3 sensitivity to NOx and volatile organic compounds (VOCs) showed that, on average across the summer AIRPRO campaign, the O3 production regime remained VOC-limited, with the exception of a few days in the afternoon when the NO mixing ratio dropped low enough for the O3 regime to shift towards being NOx-limited. The O3 sensitivity to VOCs, the dominant regime during the summer AIRPRO campaign, was observed to decrease and shift towards a NOx-sensitive regime both when NO mixing ratio decreased and with the addition of aerosol uptake. This suggests that if [NOx] continues to decrease in the future, ozone reduction policies focussing solely on NOx reductions may not be as efficient as expected if [PM] and, hence, HO2 uptake to aerosol surfaces continue to decrease. The addition of aerosol uptake into the model, for both the γHO2 calculated from measured data and when using a fixed value of γHO2=0.2, did not have a significant effect on the overall O3 production regime across the campaign. While not important for this campaign, aerosol uptake could be important for areas of lower NO concentration that are already in a NOx-sensitive regime.

This paper explores a connection between father parenting traits, guilt and shame proneness, moral identity, and physiological responses to moral shame. In this study, participants answered questionnaires and responded to Kohlberg's (1981) moral dilemma. The researcher read scripted feedback that morally shamed the participants, and cortisol levels were measured following this process. The results were analyzed using multiple linear regression. The father's chaos parenting trait was positively related to increases in cortisol during shaming, and the father's coercion parenting trait was negatively related to increases in cortisol during shaming. The father's structure parenting trait was positively related to guilt-negative behavior evaluations and warmth was negatively related to guilt repair. Finally, the father's warmth was negatively related to moral integrity while chaos was positively related. This research provides insight into the complex process of reacting to moral shame.

For years, there has been a shortage of educators qualified to teach students with disabilities. The effect this has on student outcomes is immeasurable. To overcome this shortage, universities are searching for ways to enroll more students into their special education programs, ensure these graduates are prepared for long-term employment, and arm them with the skills necessary to best prepare their future learners. To this end, special education teacher educators seek ways to instruct most effectively during their limited time with their preservice teachers. This article discusses an instructional method to help teacher educators accomplish this goal, drawing on theoretical frameworks related to active learning techniques. Compared to the traditional method of instruction, the blended learning approach affords teachers more in-class time to actively engage preservice teachers with their course content while maintaining a rigorous learning environment. The authors explain how this model can be incorporated into synchronous and asynchronous courses and share valuable online educational resources for successful implementation. Additionally, the authors discuss active learning strategies and video analysis tools to support preservice teachers in both the classroom and during field supervision. All of these focus on equipping preservice teachers to effectively handle the diverse and constantly evolving demands of the contemporary classroom, which may positively impact teacher retention and create a more stable teaching workforce.

Cardiovascular disease is the leading cause of death worldwide. Cardiac surgery is the main treatment followed by inpatient cardiac rehabilitation (ICR) to prepare patients for recovery.The aim of this study was to describe the delivery, barriers, and enablers to patient participation in ICR programs after cardiac surgery.This integrative review was guided by Whittemore and Knafl's methodology. This process included database searches, data evaluation, data integration, and presentation of results. Searched databases included Medline, CINAHL Complete, PsycINFO, Cochrane Library, and Web of Science. Publications dates included 2000 to 2021. Studies included Phase 1/inpatient phase cardiac rehabilitation following cardiac surgery. The Mixed Method Appraisal Tool (2018) was used to assess the quality of the included studies. Inductive content analysis was used to analyse the textual data.Using the inclusion and the exclusion criteria, 607 articles were screened. Five articles were included in this review, and they were appraised. Categories comprised of the following: i) ICR programs using a multidisciplinary approach beginning in the early postoperative stage; ii) ICR programs including multicomponents that were delivered through an individualised approach; and iii) enablers and barriers to patient participation to ICR. The enablers included religious faith and family support, whereas inconsistent pathways of cardiac rehabilitation referrals and detachment from patients' experiences and needs were barriers to participation in ICR.In some instances, ICR programs were delivered using individualised approaches, but this is an area that needs improvement. A multidisciplinary team including nurses should be involved in the ICR phase after cardiac surgery to provide holistic care and enhance patients' preparedness to participate in subsequent phases of rehabilitation. Only five relevant articles addressing the delivery of inpatient cardiac rehabilitation were identified in this specific topic area.

Several times each year the teaching performance of academics at higher education institutions are evaluated through anonymous, online Student Evaluation of Teaching (SET) surveys. Universities use SET surveys to inform decisions about staff promotion and tenure. But low student participation levels make the surveys impractical for this use. This scoping review aims to explore student motivations, perceptions, and opinions of SET survey completion. Five EBSCO® databases were searched using key words: “student evaluation of teaching” OR “student evaluation*” OR “student rating*” OR “student satisfaction” OR “teach* evaluation” OR “teach* effective*” OR “teach* performance OR “student feedback*” OR “student survey” AND “higher*education” OR university OR college OR tertiary. Thematic analysis of a meta-synthesis of qualitative findings derived from 21 papers identified five themes: (i) The value students’ place on SET, (ii) the knowledge that SET responses are acted upon to improve teaching, (iii) assurance of survey confidentiality and anonymity, (iv) incentives for completing SET, and (v) survey design and timing of survey release. Perceptions, knowledge, and attitudes about the value of SET are essential factors in motivating students to engage and complete SETs, particularly if surveys are easy to interpret, time for completion is incentivised, and responses are valued.

This article provides a bibliography of historical Jesus research from 2000 to 2023 in German and English language publications. In addition to the bibliography, a brief introductory essay identifies trends in historical Jesus research.

Background: Early warning systems (EWS) are used across health care settings as a tool for the early identification of clinical deterioration and to determine the need to escalate care. Early detection of clinical deterioration and appropriate escalation of care in maternity settings is critical to the safety of pregnant women and infants; however, underutilization of EWS tools and reluctance to escalate care have been consistently reported. Little is known about midwives' use of EWS in the Australian context. Methods: Using a cross-sectional approach, we elicited the attitudes, beliefs, and behaviors of a purposive sample of Australian midwives (n = 87) with respect to the Maternal Early Warning Trigger Tool (MEWT). Participants answered a25-question Likert scale survey and one open-ended question. Qualitative answers were analyzed using consensus coding Results: Midwives reported positive attitudes toward the MEWT, describing it as a valuable tool for identifying clinical deterioration, especially when used as an adjunct to clinical judgment. However, midwives also identified training gaps; 25% had received no training, and only half of those who had received training felt it was effective. In addition, professional tension can create a significant barrier to the effective use of the MEWT. Midwives also reported feeling influenced by their peers in their decision-making with respect to use of the MEWT and being afraid they would be chastised for escalating care unnecessarily. Conclusions: Although the MEWT is valued by Australian midwives as a useful tool, barriers exist to its effective use. These include a lack of adequate, ongoing training and professional tension. Improving interdisciplinary collaboration could enhance the use of this tool for the safety of birthing women and their infants. Refereed/Peer-reviewed

Supermassive black holes (SMBHs) are a key catalyst of galaxy formation and evolution, leading to an observed correlation between SMBH mass $M_{\rm BH}$ and host galaxy velocity dispersion $\sigma_{\rm e}$. Outside the local Universe, measurements of $M_{\rm BH}$ are usually only possible for SMBHs in an active state: limiting sample size and introducing selection biases. Gravitational lensing makes it possible to measure the mass of non-active SMBHs. We present models of the $z=0.169$ galaxy-scale strong lens Abell~1201. A cD galaxy in a galaxy cluster, it has sufficient `external shear' that a magnified image of a $z = 0.451$ background galaxy is projected just $\sim 1$ kpc from the galaxy centre. Using multi-band Hubble Space Telescope imaging and the lens modeling software $\texttt{PyAutoLens}$ we reconstruct the distribution of mass along this line of sight. Bayesian model comparison favours a point mass with $M_{\rm BH} = 3.27 \pm 2.12\times10^{10}\,$M$_{\rm \odot}$ (3$\sigma$ confidence limit); an ultramassive black hole. One model gives a comparable Bayesian evidence without a SMBH, however we argue this model is nonphysical given its base assumptions. This model still provides an upper limit of $M_{\rm BH} \leq 5.3 \times 10^{10}\,$M$_{\rm \odot}$, because a SMBH above this mass deforms the lensed image $\sim 1$ kpc from Abell 1201's centre. This builds on previous work using central images to place upper limits on $M_{\rm BH}$, but is the first to also place a lower limit and without a central image being observed. The success of this method suggests that surveys during the next decade could measure thousands more SMBH masses, and any redshift evolution of the $M_{\rm BH}$--$\sigma_{\rm e}$ relation. Results are available at https://github.com/Jammy2211/autolens_abell_1201., Comment: Accepted in MNRAS, 27 pages, 22 figures

Photosynthetic picoeukaryotes (PPEs) are characterized by a reduction in cell and genome size but are free living, in contrast to many other organisms that have undergone such reductions. The relative abundance of PPEs in the oceans remains to be determined, as do the evolutionary imperatives behind their cell and genome reduction. Their enigmatic nature may be deciphered through metagenomics approaches; consequently, we utilized shotgun data from the Tara Oceans database to better understand both their ecological and genomic features. The clustering of meta-metabolomic networks constructed from shotgun data from 10 different sampling sites was influenced by the proportion of PPEs in the data sets. This, along with the relative abundance of RUBISCO sequences belonging to PPEs, indicates that they have a significant effect on oceanic meta-metabolism, emphasizing the evolutionary success of the streamlining strategy. Using rRNA sequences extracted from the shotgun data, a global oceanic distribution of PPEs showed little variation, including those lineages with reduced genome sizes. This indicates that genome and cellular streamlining is not an adaptation to environmental parameters but may rather be a community-driven effect. Lastly, and surprisingly given their role as primary producers, PPEs were found to comprise only 2 to 49% (17% on average) of all picoeukaryotes across 93 metagenomes. We show that contamination of the data set by eukaryotes with larger cell sizes is not responsible for the anomaly, and so the observation remains to be explained. The approaches described here allow us to draw a direct link between taxonomic composition and meta-metabolomic capacity, with implications for better understanding carbon fixation, biogeochemical cycling, and planetary self-regulation.

Observations suggest that the dark matter and stars in early-type galaxies `conspire' to produce a surprisingly simple distribution of total mass, $\rho(r)\propto\rho^{-\gamma}$, with $\gamma\approx2$. We measure the distribution of mass in 48 early-type galaxies that gravitationally lens a resolved background source. By fitting the source light in every pixel of images from the Hubble Space Telescope, we find a mean $\langle\gamma\rangle=2.075_{-0.024}^{+0.023}$ with intrinsic scatter between galaxies of $\sigma_\gamma=0.172^{+0.022}_{-0.032}$ for the overall sample. This is consistent with, and has similar precision to traditional techniques that employ spectroscopic observations to supplement lensing with mass estimates from stellar dynamics. Comparing measurements of $\gamma$ for individual lenses using both techniques, we find a statistically insignificant correlation of $-0.150^{+0.223}_{-0.217}$ between the two, indicating a lack of statistical power or deviations from a power-law density in certain lenses. At fixed surface mass density, we measure a redshift dependence, $\partial\langle\gamma\rangle/\partial z=0.345^{+0.322}_{-0.296}$, that is consistent with traditional techniques for the same sample of SLACS and GALLERY lenses. Interestingly, the consistency breaks down when we measure the dependence of $\gamma$ on the surface mass density of a lens galaxy. We argue that this is tentative evidence for an inflection point in the total-mass density profile at a few times the galaxy effective radius -- breaking the conspiracy., Comment: 14 pages, 11 figures, 5 tables, submitted to MNRAS

Background: Breast cancer is the most diagnosed cancer and the leading cause of mortality among women in India and worldwide. Reprogrammed glucose metabolism is considered as the hallmark of the cancer with immense therapeutic relevance. Withaferin A (WA), a phytocompound isolated from the plant Withania somnifera, commonly known as Ashwagandha has the remarkable anticancer role. However, the mechanism of action of WA in breast cancer metabolism is still unelucidated. Breast cancer cells have metabolic vulnerability and high glucose dependency. Thus targeting glycolysis could be the better therapeutic approach. Chemotherapy and radiotherapy have the side effects, to overcome this natural products can be used to treat cancer. The potential of natural compounds in targeting metabolic vulnerabilities of cancer and highlighting prospective therapeutic benefits that can be determined by improving our understanding of this field. Aims and Objective: To explore the therapeutic effect of WA in breast cancer cell lines and to identify the role of WA in targeting Warburg effect via c-myc. Cancer cells exhibit upregulated Warburg effect, to fulfill the bioenergetics and biosynthetic demands of the rapidly growing cancer cells. Thus targeting the Warburg effect could be the better therapeutic approach. Materials and methods: Breast cancer cell lines (MBA-MB-231, MBA-MB-468, MBA-MB-453 and MCF-7) were procured from NCCS Pune and maintained in DMEM media supplemented with 10% FBS. SRB dye was used for cell viability as it binds to the protein of the cells. Further Colony formation assay (using crystal violet dye) was done to evaluate the effect of WA on colony formation. Metabolic assays \ (lactate production, glucose uptake and ATP generation) were performed using kits (Eton Bioscience). Transient silencing using si-RNA of c-myc was done with lipofectamine 3000. Silencing of c-myc was done for Warburg effect and protein expression. RNA was isolated from breast cancer cells using Qaigen kit and RT-PCR was performed to evaluate the glycolytic gene expression before and after the treatment of the WA in breast cancer cell lines. To check the expression of glycolytic genes at protein level we had done the western blot. Protein isolation was done in RIPA lysis buffer and western blot was performed using primary antibodies of GLUT1, HK2, PKM2, c-myc. Statistical analysis was analyzed in graph pad prism. Breast cancer patient METABRIC data was analyzed and pathway deregulation score was calculated from Pathifier algorithm. Results: Withaferin A decreased the glucose uptake, lactate production and ATP production in different breast cancer cell lines. Further, WA induced suppression of key glycolytic enzymes via c-myc, decreased cell proliferation, biomass and colony formation ability of the breast cancer cells. Silencing of c-myc gene also showed the similar results to WA such as decrease in Warburg effect and reduction in glycolytic proteins expression. Through the LC-MS analysis WA decreases the key glycolytic metabolites and other pathway metabolites, induce metabolic catastrophe in breast cancer cells. Clinical relevance of our experiments was validated in dataset of ~2000 breast tumors (METABRIC) using Pathifier algorithm wherein we calculated deregulation score of glycolysis pathways in each of the tumor and normal sample. Importantly, higher deregulation of glycolysis was observed in breast tumor compared to normal tissues and found to be associated with poor prognosis. Conclusion: Our results highlight the anti- carcinogenic effect of Withaferin A in modulating breast cancer metabolism and the clinical significance of glycolysis in general. WA decreases the glucose metabolism and its flux through key metabolic pathways associated with the glycolytic intermediates. Therefore it could be argued that therapeutic targeting of breast cancer metabolism by WA may improve clinical outcome. Citation Format: Asifa Khan, Shumaila Siddiqui, Sheersh Massey, Daman Saluja, Syed Akhtar Husain, Mohammad Askandar Iqbal. Withaferin A induces metabolic crisis in breast cancer cell lines via decreasing c-myc expression: potential therapeutic implication [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-11-16.

Background: Breast cancer in the recent years has accounted to be most frequently reported cancer across the globe. Nearly 11.7% of total cancer cases were of breast cancer and 6,84,996 deaths were reported in the year 2020. Multiple endocrine neoplasia type 1 gene that encodes for menin protein is known be involved in numerous signaling pathways and is also reported to show its interactions with histone modifiers. MEN1 is frequently reported to be dysregulated in the cancer including neuroendocrine tumors, lung cancer and melanoma. However, the role of MEN1 in case of Breast cancer has not been well understood. Lifestyle, environmental conditions and ethnicity play crucial role in epigenetic modulation of gene expression. In the current scenario with high increase in number of cancer cases, there is need to develop more personalized course of treatment rather than generalized approach. Thus, discovery of new biomarkers will aid in designing better diagnostic and therapeutic strategy to treat cancer. Aims and Objective: In this study we aim to find MEN1 mRNA expression and its connection with the MEN1 promoter methylation in case of Indian breast cancer patients and to correlate our findings with the pathological parameters of the patients to understand the role of MEN1 gene in breast cancer progression. Material and methods: The ethical approval for the study was procured from Institutional ethical committee of AIIMS,New Delhi and Jamia Millia Islamia, New Delhi. The study comprises of 44 pair of Breast tissue samples including cancer and adjacent normal tissue collected at department of surgical oncology AIIMS, New Delhi and were stored in RNA later and PBS at -80˚C for RNA and DNA extraction respectively. DNA was extracted through PCI (Phenol-Chloroform-Isoamyl alcohol) method and was further confirmed by Agarose gel electrophoresis. TRIZOL method was used to extract RNA from tissue samples and was quantified using nanodrop. Moreover, cDNA synthesis was carried out using Verso cDNA synthesis kit. To investigate the MEN1 mRNA expression, RT- PCR was carried out with LightCycler96 SYBR Green I Master (Roche) using specific primers. To analyze the promoter methylation status of MEN1 promoter region, CT- conversion was done and MS-PCR was performed using Methylation and Unmethylation specific primers. Statistical analysis was done using Graph Pad and SPSS to correlate our findings with clinical parameters. Results: In our study we found 27 out of 44 patients to exhibit up-regulation of MEN1 mRNA in the breast cancer tissue as compared with the normal tisuue. MEN1 promoter unmethylation was detected in 25 out of 44 cases, which revealed its significant correlation with the upregulated MEN1 gene. Further on correlation of our data with the clinical parameters, we found its significant association with the estrogen receptor status and age of menopause of the patients. Conclusion: Our results of the MEN1 mRNA expression study and its association with MEN1 promoter methylation in case of breast cancer suggests the tumorigenic role of MEN1 in breast cancer. Our findings thereby indicate the possible role of MEN1 gene in progression of the disease. Further study on large sample size will aid in better understanding the role of MEN1 gene in Breast carcinoma. Citation Format: Sheersh Massey, Aasif Khan, Asifa Khan, SVS Deo, Syed Akhtar Husain. Promoter hypomethylation associated upregulation of MEN1 mRNA expression and its correlation with pathological parameters in Indian breast cancer patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-18-02.

We present the discovery and characterization of six short-period, transiting giant planets from NASA's Transiting Exoplanet Survey Satellite (TESS) -- TOI-1811 (TIC 376524552), TOI-2025 (TIC 394050135), TOI-2145 (TIC 88992642), TOI-2152 (TIC 395393265), TOI-2154 (TIC 428787891), & TOI-2497 (TIC 97568467). All six planets orbit bright host stars (8.9, Comment: 20 Pages, 6 Figures, 8 Tables, Accepted by MNRAS

NEW FINDINGS: What is the central question of this study? Are biomarkers of endothelial function, oxidative stress and inflammation altered by non-freezing cold injury (NFCI)? What is the main finding and its importance? Baseline plasma [interleukin-10] and [syndecan-1] were elevated in individuals with NFCI and cold-exposed control participants. Increased [endothelin-1] following thermal challenges might explain, in part, the increased pain/discomfort experienced with NFCI. Mild to moderate chronic NFCI does not appear to be associated with either oxidative stress or a pro-inflammatory state. Baseline [interleukin-10] and [syndecan-1] and post-heating [endothelin-1] are the most promising candidates for diagnosis of NFCI. ABSTRACT: Plasma biomarkers of inflammation, oxidative stress, endothelial function and damage were examined in 16 individuals with chronic NFCI (NFCI) and matched control participants with (COLD, n = 17) or without (CON, n = 14) previous cold exposure. Venous blood samples were collected at baseline to assess plasma biomarkers of endothelial function (nitrate, nitrite and endothelin-1), inflammation [interleukin-6 (IL-6), interleukin-10 (IL-10), tumour necrosis factor alpha and E-selectin], oxidative stress [protein carbonyl, 4-hydroxy-2-nonenal (4-HNE), superoxide dismutase and nitrotyrosine) and endothelial damage [von Willebrand factor, syndecan-1 and tissue type plasminogen activator (TTPA)]. Immediately after whole-body heating and separately, foot cooling, blood samples were taken for measurement of plasma [nitrate], [nitrite], [endothelin-1], [IL-6], [4-HNE] and [TTPA]. At baseline, [IL-10] and [syndecan-1] were increased in NFCI (P < 0.001 and P = 0.015, respectively) and COLD (P = 0.033 and P = 0.030, respectively) compared with CON participants. The [4-HNE] was elevated in CON compared with both NFCI (P = 0.002) and COLD (P < 0.001). [Endothelin-1] was elevated in NFCI compared with COLD (P < 0.001) post-heating. The [4-HNE] was lower in NFCI compared with CON post-heating (P = 0.032) and lower than both COLD (P = 0.02) and CON (P = 0.015) post-cooling. No between-group differences were seen for the other biomarkers. Mild to moderate chronic NFCI does not appear to be associated with a pro-inflammatory state or oxidative stress. Baseline [IL-10] and [syndecan-1] and post-heating [endothelin-1] are the most promising candidates for diagnosing NFCI, but it is likely that a combination of tests will be required.

Background: For over two decades, nurse-led critical care outreach services have improved the recognition, response, and management of deteriorating patients in general hospital wards, yet variation in terms, design, implementation, and evaluation of such services continue. For those establishing a critical care outreach service, these factors make the literature difficult to interpret and translate to the real-world setting. \ud \ud Aim: The aim of this study was to provide a practical approach to establishing a critical care outreach service in the hospital setting. \ud \ud Method: An international expert panel of clinicians, managers, and academics with experience in implementing, developing, operationalising, educating, and evaluating critical care outreach services collaborated to synthesise evidence, experience, and clinical judgment to develop a practical approach for those establishing a critical care outreach service. A rapid review of the literature identified publications relevant to the study. A modified Delphi technique was used to achieve expert panel consensus particularly in areas where insufficient published literature or ambiguities existed. \ud \ud Findings: There were 502 publications sourced from the rapid review, of which 104 were relevant and reviewed. Using the modified Delphi technique, the expert panel identified five key components needed to establish a critical care outreach service: (i) approaches to service delivery, (ii) education and training, (iii) organisational engagement, (iv) clinical governance, and (v) monitoring and evaluation. \ud \ud Conclusion: An expert panel research design successfully synthesised evidence, experience, and clinical judgement to provide a practical approach for those establishing a critical care outreach service. This method of research will likely be valuable in other areas of practice where terms are used interchangeably, and the literature is diverse and lacking a single approach to practice.

Introduction. A novel BCMH sheet has been shown to achieve improved wound closure rates in chronic and acute wounds when compared with SOC. Objective. This retrospective evaluation assessed chronic wound closure rates with SOC or treatment with the BCMH sheet in an urban hospital wound clinic. Methods. Forty-seven chronic wounds were treated with SOC or the BCMH sheet. The primary endpoint was time to closure. For wounds that did not close, investigations were conducted to determine the reason. Results. Twenty wounds were treated with SOC, which varied in usage of multiple products and/or therapies, and 27 wounds were treated with the BCMH sheet. The average initial wound size was not statistically different between the groups. In both groups, most wounds that were treated did not close. For wounds that did close, the average time to closure was 2× faster in the BCMH group compared with the SOC group (7.4 weeks and 14.8 weeks, respectively; P < .05). Conclusions. This retrospective evaluation showed average time to wound closure to be significantly faster with BCMH compared with SOC in patients who maintained adherence with regular visits.

An artificial neural network (ANN) is trained on moderate or intense low- oxygen dilution (MILD) combustion to predict the sub-grid filtered density function (FDF) in large eddy simulation (LES). For wide usability, a new quantity ψ is calculated by scaling the filtered mixture fraction using the stoichiometric value and a logarithmic function, which is used as an input feature of the ANN. Self-testing on MILD combustion is first conducted for validation and determining the best layout of ANN. An ANN with 4 hidden layers and the activation function of rectified linear unit (ReLU) has the highest accuracy. This ANN is subsequently tested on five different premixed combustion cases. Overall predictions of the progress variable FDF are sat- isfactory, and the filtered chemical source term modelled by the FDFs is in good agreement with the DNS data for each case. However, an underpredic- tion of the filtered reaction rate occurs for the hydrogen–air flames, and the ANN accuracy is lower than that of a presumed β-FDF approach. DNS data of one premixed flame are then added to the training datasets, and newly trained ANNs are tested on remaining premixed flame cases. When the test- ing cases are similar to the added training dataset, improved predictions of marginal FDFs are observed, and the modelled progress variable source terms show good comparisons with the corresponding DNS data. Compared to the presumed β-FDF method, the new ANN shows an improved accuracy and serves as a viable alternative for FDF-based combustion modelling in the LES of turbulent flames.

Chamcheu JC, Siddiqui IA, Adhami VM, et al. Int J Nanomedicine. 2018;13:4189–4206. An error during the preparation of Figures 1 and 5 for publishing led to the inadvertent creation of duplicate regions in images from these figures on pages 4194 and 4199, respectively. The journal wishes to apologise for this error. The correct versions of Figures 1 and 5 are as follows: Figure 1 Size characterization and encapsulation and loading efficiencies of chitosan-based nanoEGCG. (A) Size measurement and distribution of nanoEGCGusing dynamic light scattering. (B) Zeta potential measurement of nanoEGCG. (C) Representative transmission electron microscopy photomicrographs showing the relative homogeneous size and morphology of (i) diluted nanoEGCGand (ii) undiluted nanoEGCG, and (iii) CHI-Void-NPs. Scale bar=200 nm; the insets represent higher magnification. (D) Encapsulation and loading efficiency of EGCG on to chitosan nanoparticles as monitored with UV-vis spectra for free EGCG (not encapsulated) and total EGCG (encapsulated + free). (E) UV-vis spectra used to construct the standard curve, with EGCGconcentrations of 25, 12.5, 6.25, 3.12, and 1.6 μg/mL.Abbreviations: EGCG, (–)-epigallocatechin-3-gallate; nanoEGCG, CHI-EGCG-NPs, chitosan-based polymeric nanoparticle formulation of EGCG; CHI-Void-NPs, chitosan-based void (without EGCG) nanoparticles; UV-vis, ultraviolet–visible. Figure 5 Effect of topically applied free EGCG and nanoEGCG on infiltrating immune cells and expression of differentiation markers in IMQ-treated mouse skin lesions: Mice were treated in 4 groups as described in the legends to Figure 4 and Figure S5. (A–D, F–I, K–N, P–S) Photomicrographs showing immunohistological features of: (A–D) mast cells (toluidine blue staining); (F–I) epidermis/dermis (NE, brown staining), and microabscesses (arrow); (K–N) macrophages (F4/80, red staining); and (P–S) double immunofluorescence staining for loricrin (green) and T-lymphocytes (CD4+, red staining). Nuclei were counterstained blue with DAPI. Magnification for all panels ×200. (E, J, O, T, U) Quantitative analyses of changes in immune cells: (E) mast cells; (J) NE+ cells; (O) F4/80+ cells; and (U) loricrin in the 4 treatment groups. Each data point represents the mean±SD of 4 random fields/mouse from 5 mice/group. *p, 0.05, **p, 0.01, ***p, 0.001, and ****p, 0.0001 for the indicated 2-way comparisons.Abbreviations: EGCG, (–)-epigallocatechin-3-gallate; nanoEGCG, chitosan-based polymeric nanoparticle formulation of EGCG; IMQ, imiquimod; NE, neutrophil elastase; LPV, low-power view.

"This article addresses an approach to explore and tackle some of the existential threats (wicked problems) that face public administration globally. It seeks to build on existing work to suggest some defining traits in terms of ‘wicked’ issues and problems that are being explored again by governments and international organizations such as the OECD in order to develop leadership cadres that are equipped to advance and deliver focused policies that can strategically combat these problems. The paper discusses how and why an innovative and indeed entrepreneurial approach to dealing with these issues requires effective bureaucracies and explores the barriers to public administration academics to getting involved in delivering real world support to policy makers and public servants."

Effective treatments for familial hypercholesterolaemia (FH) offer patients the opportunity of normal life expectancy, but lifelong adherence to both lipid-lowering therapies and lifestyle measures is challenging, and thus, this is rarely achieved. The aim of this systematic review is to identify attributes of educational interventions that promote adherence to treatment in FH. A systematic literature search was undertaken using Medline, CINAHL, HMIC and Embase. Papers were included based upon pre-defined inclusion and exclusion criteria; the quality of each included paper was assessed using the MERSQI scoring system. Relevant data were extracted, and a narrative synthesis was created. Six relevant studies of varying methodological quality were found amongst 2963 papers identified during the search. In total, there were 619 patients with FH in the intervention arm of the relevant studies. All six studies showed a positive effect of education on adherence to FH treatment; however, only two papers observed a statistically significant effect. Assessment was limited to the short-term. Four themes were identified as important when using education to improve treatment adherence: involving family, patient empowerment, practical problem solving and use of information leaflets. Educational interventions improve short term treatment adherence in patients with FH. Successful interventions are those that involve the whole family, set practical problem solving tasks, and that use techniques to increase the patients self-efficacy. This should all be supported by contemporaneous provision of written, age-appropriate information. There were no studies looking at education and long-term adherence in FH patients, and more research is needed in this area. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12687-022-00620-0.

Children and youth with special healthcare needs are at risk for severe consequences during infectious disease emergencies. Messages for parents and caregivers from trusted sources, via preferred channels, that contain the information they need, may improve health outcomes for this population. In this mixed methods study, we conducted a survey (N = 297) and 80 semistructured interviews, with 70 caregivers of children and youth and 10 young adults with special healthcare needs, between April 2018 and June 2019 in Pennsylvania. The survey presented 3 scenarios (ie, storm, disease outbreak, radiation event); the interviews included questions about storms and an outbreak. This article addresses only the disease outbreak data from each set. Participants were recruited through convenience samples from an urban tertiary care children's hospital and practices in a statewide medical home network. In this article, we summarize the preferred information sources, channels, and content needs of caregivers of children and youth with special healthcare needs during an infectious disease emergency. Nearly 84% of caregivers reported that they believe their child's doctor is the best source of information. Other preferred sources include medical experts (31%); the US Centers for Disease Control and Prevention (30%); friends, family, and neighbors (21%); and local or state health and emergency management (17%). Pediatric healthcare providers play an important role in providing information to parents and caregivers of children and youth with special healthcare needs during an infectious disease emergency. Public health agencies can establish health communication plans that integrate medical practices and other reliable sources to promote the dissemination of accurate information from trusted messengers.

Qualitative platelet disorders remain rare and varied. We describe here 2 additional patients with giant platelets, thrombocytopenia, deficiency in alpha granules and the presence of membranous inclusions within the cytoplasm. Collectively known as Medich syndrome, we further elucidated structural and clinical features of this rare syndrome. Platelets obtained from 2 patients with macro-thrombocytopenia were evaluated by electron microscopy. Structural findings were correlated with clinical characteristics. The defining morphologic feature found in the platelets of these patients is the presence of long, tubular inclusions consisting of several layers of membrane wrapped around a core of cytoplasm. These inclusions may deform the discoid shape of the platelet. In addition, abnormal giant alpha granules are present. Clinically all patients in the current report and review of the literature had mucosal bleeding and were often misdiagnosed as having immune related thrombocytopenia. To date five cases of Medich giant platelet syndrome have been reported. The cases are unified by the ultrastructural findings of abnormal alpha granules and unusual cytoplasmic scrolls. All patients experienced mucosal bleeding, however many clinical, biologic and genetic characteristics of this rare disorder remain to be determined.

The study aimed to measure and describe the mental health impact of COVID-19 on Australian pre-registration nursing students.The COVID -19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID-19 on Australian pre-registration nursing students currently.A cross-sectional study was conducted across 12 Australian universities.Using an anonymous, online survey students provided demographic data and self-reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID-19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale-Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS-21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20-188). All participating universities obtained reciprocal approval.Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID-19. Close to half of students (n = 255, 49.4%) reported signs of post-traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID-19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID-19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors.The COVID-19 pandemic has considerably impacted pre-registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce.This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID-19. In this study, we found that students with a pre-existing mental health issue and final-year students were most affected. The changes to education in Australian universities related to COVID-19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce.The study was designed to explore the impact of COVID-19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants.