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BackgroundMobile technologies are increasingly being used in health care and public health practice for patient communication, monitoring, and education. Mobile health (mHealth) tools have also been used to facilitate adherence to chronic musculoskeletal pain (CMP) management, which is critical to achieving improved pain outcomes, quality of life, and cost-effective health care. ObjectiveThe aim of this systematic review was to evaluate the 25-year trend of the literature on the adherence, usability, feasibility, and acceptability of mHealth interventions in CMP management among patients and health care providers. MethodsWe searched the PubMed, Cochrane CENTRAL, MEDLINE, EMBASE, and Web of Science databases for studies assessing the role of mHealth in CMP management from January 1999 to December 2023. Outcomes of interest included the effect of mHealth interventions on patient adherence; pain-specific clinical outcomes after the intervention; and the usability, feasibility, and acceptability of mHealth tools and platforms in chronic pain management among target end users. ResultsA total of 89 articles (26,429 participants) were included in the systematic review. Mobile apps were the most commonly used mHealth tools (78/89, 88%) among the included studies, followed by mobile app plus monitor (5/89, 6%), mobile app plus wearable sensor (4/89, 4%), and web-based mobile app plus monitor (1/89, 1%). Usability, feasibility, and acceptability or patient preferences for mHealth interventions were assessed in 26% (23/89) of the studies and observed to be generally high. Overall, 30% (27/89) of the studies used a randomized controlled trial (RCT), cohort, or pilot design to assess the impact of the mHealth intervention on patients’ adherence, with significant improvements (all P

Premenstrual exacerbation of an existing psychiatric disorder refers to the worsening of symptoms inherent to the condition during the premenstrual phase. Research consistently indicates that hormonal fluctuations during the menstrual cycle present a unique period of vulnerability for the onset or exacerbation of psychiatric symptoms, impacting diagnosis, risk assessment, and treatment. This review sought to elucidate the phenomenon of premenstrual exacerbation and its impact across a spectrum of psychiatric illnesses, including mood, anxiety, psychotic, obsessive-compulsive, personality, and trauma-related disorders. Despite the expanded research in recent years on premenstrual dysphoric disorder and premenstrual syndrome, premenstrual exacerbation remains underexplored and poorly defined. This review offers significant contributions to the diagnosis and management of psychiatric conditions, advocating for heightened awareness and novel treatment approaches in the context of premenstrual exacerbation.

The research presented in this paper delves into the fascinating realm of how temperature, both physical and psychological, can influence human behavior, specifically in the context of charitable donations. It offers valuable insights into the intricate relationship between our sensory experiences and our motivations to engage in prosocial acts. Throughout the four comprehensive studies conducted, the authors shed light on the intricate dance between temperature and our innate need for social warmth and connection. They explore how feeling physically cold or being primed with cold imagery can trigger a desire for social affiliation and empathy, ultimately leading individuals to engage in charitable acts, such as donations. The studies provide robust evidence that when individuals experience the discomfort of cold, whether through physical touch or psychological priming, they are more inclined to seek remedies to rectify their feelings of loneliness and social isolation. This leads to a heightened desire for social connectedness, which, in turn, fosters increased levels of empathy and a greater likelihood of making charitable donations. In essence, the act of donation becomes a compensatory mechanism to counterbalance the perceived social deficit caused by feeling cold. Moreover, the research extends beyond the laboratory setting by conducting a field study in a coffee shop, demonstrating the generalizability of the findings. It reveals that the link between temperature, empathy, and charitable acts holds true in real-world scenarios. These findings offer valuable implications for social marketing and public service announcement campaigns, suggesting that the timing and context of these messages should be carefully considered. In conclusion, this research provides a deeper understanding of the complex interplay between temperature, social warmth, and charitable behavior. It highlights the significance of considering individuals' psychological states when designing campaigns or interventions aimed at promoting prosocial actions. Ultimately, it emphasizes the power of empathy and social connectedness in driving positive social change.

Purpose: To evaluate rates of familial disclosure of hereditary cancer syndrome information. Methods: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines (PROSPERO no.: CRD42020134276). Key electronic databases were searched to identify studies evaluating hereditary cancer syndrome cascade relative disclosure. Eligible studies were subjected to meta-analysis. Results: Thirty-four studies met inclusion criteria. Among 11,711 included relatives, 70% (95% CI 60 - 78%) were informed of their risk of carrying a cancer-associated pathogenic variant; of 2,875 relatives informed of their risk who were evaluated for uptake of cascade testing, 43% (95% CI 27 - 61%) completed testing. Rates of disclosure were higher among female vs male relatives (79% [95% CI 73% - 84%] vs 67% [95% CI 57% - 75%]) and first-degree vs second-degree relatives (83% [95% CI 77% - 88%] vs 58% [95% CI 45 – 69%]). Conclusion: Nearly one-third of at-risk relatives remain uninformed of their risk of carrying a cancer-associated pathogenic variant. Even among those informed, fewer than half subsequently complete genetic testing, representing a critical missed opportunity for precision cancer prevention. Innovation: Five studies evaluating interventions to improve disclosure rates were generally ineffective. Urgent work is needed to elucidate barriers to relative disclosure by probands to develop targeted interventions that can optimize proband-mediated cascade genetic testing rates.

Purpose: To highlight a case series of three pediatric patients who presented with acute ischemic stroke (AIS) in the setting of influenza illness. Methods: Retrospective chart review was performed. Results: Three patients of ages 23 months (patient 1), 2 years (patient 2), and 4 years (patient 3) presented with acute hemiparesis or focal status epilepticus. Two patients had trisomy 21 and trivial cardiac septal defects, and one was previously healthy. All patients tested positive for influenza within a week of symptoms. Neuroimaging showed AIS involving right deep grey matter and bilateral posterior cortex in patient 1, left parietal lobe in patient 2, and right parietotemporal and deep grey matter in patient 3. Vascular abnormalities were found and included moyamoya syndrome in two patients and focal arteriopathy in one patient. For secondary stroke prevention, patients 2 and 3 were started on clopidogrel initially and later transitioned to aspirin after the resolution of the acute influenza infection. Patient 1 was started on aspirin at diagnosis since he was not acutely ill. Conclusions: This case series highlights three pediatric patients with AIS with underlying arteriopathy in the setting of influenza infection. Pediatric AIS is a separate entity from adult stroke. There is limited understanding of its underlying pathophysiology. The most common risk factors described in literature for pediatric AIS are arteriopathy and cardiac disorders. Minor infection may be a significant risk factor in a child that is predisposed to vascular insult. There is some evidence in literature to suggest that vaccination against such illnesses may be protective for AIS.

This article explores how diasporic Chinese video artists present familial histories and tales of cross-cultural exchange in the context of an exhibition I am curating, Another Beautiful Country: Moving Images by Chinese American Artists, at the University of Southern California (USC) Pacific Asia Museum. I discuss projects by featured artists Richard Fung and Patty Chang. These artists’ experimental documentaries and performative videos foster deep personal discoveries that defy the late-capitalist obsession with the new as defined by youth, novelty, and the next trend, providing revelatory insights through recuperative engagements with what has come before. In analyzing artworks by Fung and Chang, I also reference related texts by/about artists and historical figures including Walter Benjamin, Anna May Wong, and Zhang Ailing, who emigrated from the People’s Republic of China to the United States in the 1950s and whose special collections in the USC Libraries helped inform the exhibition’s programming. I also interweave my own related familial histories and share some (not-so-new) curatorial ideas for immersing audiences in intercultural art and reflection.

Abstract Background Postmenopausal breast cancer survivors (PBCS) are at increased risk of bone loss and fractures due to age-related decline of estrogen, and this risk is compounded by aromatase inhibitor cancer therapy. Several patient-level targetable risk factors can mitigate osteoporosis risk; however, adequate health behavior and risk perception in this population are underreported. The goal of this study was to evaluate osteoporosis knowledge and beliefs and assess their association with engagement in osteoporosis preventive behaviors among PBCS. Methods In this cross-sectional descriptive study, early stage I–IIIA PBCS (ages 55–86 years) completed the Facts on Osteoporosis Quiz, Osteoporosis Health Beliefs Scale, and Osteoporosis Preventive Behaviors questionnaires. Participants who were non-English speaking or declined to participate were excluded. Clinical and sociodemographic information were obtained from chart review and baseline questionnaire, respectively. Fisher’s exact test, Student t-test, and Wilcoxon Mann–Whitney tests were used where appropriate to assess the association between knowledge and beliefs with engagement in osteoporosis preventive behaviors. Results The mean participant age was 66.1 years with 20% self-reporting as non-Hispanic White, 40% non-Hispanic Black, 27% Hispanic, and 13% other. Approximately 83% of the cohort had estrogen receptor positive breast cancer and received a bone density scan within the last six years. Osteoporosis knowledge (10.5 ± 3.4), seriousness (14.9 ± 3.8), and susceptibility (14.0 ± 3.5) mean scores were low among PBCS. Most PBCS (75%) were adherent to calcium and vitamin D supplements, but only 47% reported engagement in strength-training exercises. Married/partnered, higher osteoporosis knowledge and health motivation scores were associated with strength-training exercise. After adjustment for marital status and osteoporosis knowledge, only health motivation score remained significantly associated with strength-training exercise (OR 5.56, 95% CI 1.35–22.93). Conclusions PBCS are highly motivated to keep a healthy lifestyle despite limited osteoporosis knowledge, perceived risk, and susceptibility. However,

Background:. Breast pocket irrigation with antiseptic solutions is performed to reduce contamination with breast implants. The optimal antiseptic irrigation solution and the efficacy of individual practices are unclear. Oxychlorosene sodium is frequently used at our institution. Oxychlorosene is bactericidal with a mechanism of action of oxidation and hypochlorination. The purpose of our study was to compare the outcomes of oxychlorosene sodium irrigation with triple antibiotic solution (TAS) in implant-based breast reconstruction. Methods:. All patients who underwent implant-based reconstruction after mastectomy were reviewed. The primary predictive variable was type of solution used for pocket irrigation (TAS or oxychlorosene). Outcome variables included surgical site infection, device removal, and wound complications. Results:. Between 2013 and 2018, 331 implant-based breast reconstructions were performed. Of these, 62% (n = 206) received oxychlorosene for surgical pocket irrigation (group I), and 38% (n = 125) received TAS (group II). Group I had an 11.7% (n = 24) 90-day surgical site infection rate, with 4.9% (n = 10) requiring oral antibiotics, 2.4% (n = 5) requiring intravenous antibiotics without device removal, and 4.4% (n = 9) requiring prosthetic removal. Group II had an 11.2% (n = 14) 90-day infection rate, with 5.6% (n = 7) requiring oral antibiotics, 2.4% (n = 3) requiring intravenous antibiotics without device removal, and 3.2% (n = 4) requiring removal (P = 0.90). When comparing the cost of oxychlorosene irrigation with TAS irrigation, oxychlorosene was less expensive. Conclusions:. Oxychlorosene and TAS have similar surgical site infection rates in prosthetic breast reconstruction. Ease of preparation and cost make oxychlorosene a more favorable option for antibiotic irrigation in reconstructive breast surgery with prosthetic devices.

The literature demonstrates that the quality of cancer family history (CFH) as currently collected in the outpatient setting is inadequate to assess disease risk. Prior to implementation of a web-based application for cancer family history collection, we aimed to review the quality of collected CFH in a gynecologic oncology outpatient clinic and determine contributing patient factors. Medical records were reviewed for 200 new patients presenting between 4/2019–7/2019. CFH was collected during the patient interview and evaluated for inclusion of eight elements based on standards set by the genetics community. Univariate and multivariable linear regression analyses were utilized to evaluate the effect of patient characteristics on the number of relatives included in the CFH. Among our cohort of 200 patients, CFH was documented for 185 patients (92.5%). On univariate analysis, patients with a family history of cancer and prior genetic testing had significantly greater median number of relatives included in the CFH. On multivariable analysis, patients with family members with cancer had significantly more relatives included. Our data are consistent with the literature, suggesting that the current collection methods may not adequately capture all measures of a high quality CFH. Patients reporting no family history of cancer and those without prior genetic testing were least likely to have CFH that included key quality elements and these patients might benefit from health information technology CFH collection tools.

A typical clinical symptom of human norovirus infection is projectile vomiting. Although norovirus RNA and viral particles have been detected in vomitus, infectivity has not yet been reported. We detected replication-competent norovirus in 25% of vomit samples with a 13-fold to 714-fold increase in genomic equivalents, confirming infectious norovirus.

Circadian clocks must maintain their fidelity despite stochasticity arising from finite protein copy numbers. Here, the authors show that a small cyanobacterium relies on an environmentally driven timer likely because its low protein copy numbers cannot support an accurate free-running clock.

OBJECTIVES/GOALS: The aim of this project is to assess the usability and acceptance of a web-based educational resource for early career researchers. The Emerging Investigators website is designed to bring together resources, provide educational support and foster a community of early career researchers throughout the Mount Sinai Health System (MSHS). Locally designed and built, this web-based platform is developed using the principles of Community of Inquiry (COI), which considers how the design of online learning environments might best create and sustain a sense of community among learners. Developing a resource that meets the needs of this cohort of researchers requires an iterative implementation strategy guided by user feedback. A formal website roll-out strategy and accompanied evaluation aims to determine the design, navigability, content, relevance and educational value of this online resource from a user perspective. METHODS/STUDY POPULATION: In order to ensure this resource effectively meets the needs of this cohort of researchers, a mixed process of evaluation and design was utilized. An initial phase 1 survey was conducted with TL1 and KL2 scholars. Surveys consisted of standardized questions with answers arranged as Likert-type scales and additional written responses to collect valuable qualitative data. A convenience sample of early career researchers at Mount Sinai were contacted for initial survey participation (N = 10). A total of 3 junior faculty KL2 scholars, 3 TL1 post-doc and 4 TL1 pre-doc scholars responded to the survey. Participants were initially asked to comment on design, functionality and usefulness of content on a Likert scale with qualitative comments to support the given scores. They were subsequently asked to consider what key topics or resources were missing from the website. Based on the initial survey, changes were made to the format and content of the Emerging Investigators website to improve content relevance and usability. For phase 2, an evaluation rubric was developed to assess design, navigability, content, relevance, along with three key COI criteria to determine the educational value of this online resource. The rubric will be utilized to collect feedback in the wider phase 2 roll out of the website. RESULTS/ANTICIPATED RESULTS: The first phase of survey feedback shaped overall design of the resource. The second phase will comprehensively evaluate the value of the website in the context of teaching and learning for emerging investigators. Ten surveys were captured in the first phase. Data collection is ongoing for the second phase. Phase 1 feedback was primarily qualitative, and valuable in informing overall design choices and content. Overall the website was well received, with participants commenting on the value of the resource in terms of content and educational value. Participants particularly appreciated the regularly updated calendar function and the links provided to a wide range of resources. Functionality issues, such as broken links, were reported by participants and repaired for phase 2. Further topics of content were identified, and additional links and multimedia resources were added to address this feedback. The second phase evaluation is ongoing with data collection being conducted via an evaluation rubric. DISCUSSION/SIGNIFICANCE OF IMPACT: The Emerging Investigators website, developed using the principles of COI provides key learning, reading and resources for early career investigators in a format that is well received by a sample group of early career researchers at Mount Sinai. The website has aimed to address the reported need for communication, collaboration and social interaction with peers and other researchers across the MSHS through the addition of further web-based resources such as a LinkedIn page, a blog to feature research and provide a sounding board for research efforts, and a calendar of events targeted specifically at early career researchers. These were highlighted as areas of particular value by the participants. We anticipate the results of phase 2 rubric-based evaluations will provide actionable data that will lead to further refinement of the website, an optimized interface, and improved usability.

Review of the book "Boys’ Love, Cosplay, and Androgynous Idols: Queer Fan Cultures in Mainland China, Hong Kong, and Taiwan" by Maud Lavin, Ling Yang, and Jing Jamie Zhao (Eds.).

Management of classroom diversity may contribute to creating a structured collaborative learning environment that supports student learning. This research explores whether leveraging students' diverse skills and cultural backgrounds through teamwork improves student performance in finance courses. The study involved seven sections of the Introductory Finance course, offered in a hybrid modality, across two semesters. Results indicate that the classroom intervention effectively generated more culturally diverse groups. Additionally, students in more diverse teams performed significantly better in perceived learning and the actual class performance. [ABSTRACT FROM AUTHOR]

Circadian rhythms are biological oscillations that schedule daily changes in physiology. Outside the laboratory, circadian clocks do not generally free-run but are driven by daily cues whose timing varies with the seasons. The principles that determine how circadian clocks align to these external cycles are not well understood. Here, we report experimental platforms for driving the cyanobacterial circadian clock both in vivo and in vitro. We find that the phase of the circadian rhythm follows a simple scaling law in light-dark cycles, tracking midday across conditions with variable day length. The core biochemical oscillator comprised of the Kai proteins behaves similarly when driven by metabolic pulses in vitro, indicating that such dynamics are intrinsic to these proteins. We develop a general mathematical framework based on instantaneous transformation of the clock cycle by external cues, which successfully predicts clock behavior under many cycling environments.

OBJECTIVES/SPECIFIC AIMS: This project aims to synthesize an angiogenic decorin mimic (VEGFp-DS-SILY) with varying densities of QK and characterize its angiogenic potential and synergism with VEGF by evaluating (1) endothelial cell (EC) migration and proliferation, (2) EC VEGF receptor activation, (3) EC tubule formation in collagen scaffolds, and (4) angiogenesis from a chick chorioallantoic membrane (CAM assay) growing into the scaffold, reflecting the ability of the collagen scaffold to integrate into existing vasculature. The next main goal is to develop and characterize an MMP-degradable nanoparticle system for controlled release of VEGF. Future work will evaluate in vivo effects of VEGFp-DS-SILY bound to a 3D collagen scaffold on ischemic wound repair in a combined excisional wound/bipedical dorsal skin flap rat model. METHODS/STUDY POPULATION: Peptide hydrazides are conjugated to the free carboxylic acid functional groups on dermatan sulfate using EDC chemistry. We added a 3 amino acid spacer (-Gly-Ser-Gly) to the C-terminus of the established QK sequence before the hydrazide functional group and refer to this modified QK as “VEGFp.” VEGFp, SILY, and N-terminal biotinylated versions were synthesized using standard Fmoc solid-phase peptide synthesis protocols and purified using reverse phase HPLC. Coupling efficiencies of peptides to dermatan sulfate were determined spectroscopically at 280 nm measuring the aromatic residues (Trp or Tyr) using a NanoDrop system. Dermatan sulfate with 1 or 4 VEGFp peptides coupled were termed DSV1 and DSV4, respectively. After further conjugation with SILY, we will blend this VEGFp-DS-SILY with unmodified DS-SILY to a total 10 μM to test increasing densities of VEGFp. To verify that the collagen-binding properties of VEGFp-DS-SILY are not compromised by the addition of VEGFp, we will use a streptavidin-HRP system to detect bound biotinylated VEGFp-DS-SILY on collagen-coated plates by established protocols. DSV1 and DSV4 were tested for their effects on endothelial VEGFR2 phosphorylation using an MSD ELISA-type assay and endothelial proliferation using an MTS assay. Cell migration was monitored using an ORIS assay where cells are grown to confluence around a silicone stopper that is then removed to allow cells to migrate inward. Tubulogenesis was evaluated by examining tubule formation on matrigel. Finally, in vivo angiogenesis will be evaluated using a chorioallantoic membrane assay. For extracellular VEGF release, hollow MMP-degradable thermoresponsive nanoparticles [NIPAM, 5 mol% 2-acrylamido-2-methyl-1-propanesulfonic acid (AMPS), 1% Acrylic Acid (AAc), 2 mol% MMP-degradable peptide diacrylate, and potassium persulfate initiator] will be synthesized around noncross-linked polymer cores. The cores will then be diffused out through the shell by dialysis prior to drug loading. SILY (and some biotinylated SILY for visualization) will be conjugated with EDC chemistry for targeting nanoparticles to collagen. NPs size and zeta-potential will be measured on a Malvern Zetasizer. VEGF will be loaded into NPs by co-incubating a loading solution of 1 µg/mL VEGF with 1 mg of NPs, incubating overnight at 4°C. VEGF loading and release will be measured by ELISA. Biological activity of the released VEGF from particles will be determined on ECs using assays similar to those outlined previously. RESULTS/ANTICIPATED RESULTS: Preliminary data have verified the synthesis and purification of SILY and VEGFp (QK-Gly-Ser-Gly-hydrazide), as well as an N-terminal biotinylated version, through mass spectrometry and reverse-phase HPLC, respectively. For proof-of-concept, we have verified binding of VEGFp to the VEGF receptor 2 using a ForteBio Blitz interferometry instrument. In addition to support based on published reports showing retained bioactivity of QK after conjugation using other spacers, our preliminary data suggests that VEGFp still binds to VEGF receptor 2, albeit with decreased affinity like QK as compared with VEGF. Circular dichroism also shows that VEGFp has retained its α-helical structure necessary for bioactivity; however it appears that it has some uncoiling when conjugated to dermatan sulfate. We hypothesize that varying densities of VEGFp conjugated to the decorin mimetic (DS-SILY) will modulate the degree of angiogenic activity and synergy with VEGF. We determined that we can achieve ~70% VEGFp conjugation completion to dermatan sulfate after 3.5 hours. We have quantified VEGFR2 phosphorylation after 5 minute treatments by using phospho-specific antibodies and an ELISA-type protocol in a mesoscale discovery system. Preliminary data with human umbilical vein endothelial cells shows that VEGFp exhibits synergism with VEGF at levels similar to QK. DSV1 and DSV4 data suggests synergy with VEGF, although free-peptides and engineered compounds alone did not show effects similar to VEGF in the conditions tested. Prelminary data with 30 minute treatments suggests that the peptides and compounds may require longer exposures to induce activation, as they may have slower binding rates. In contrast, prolonged stimulation with VEGF causes a sharp increase in receptor activation, peaking around 10 minutes and decreasing significantly by 30 minutes. Peptides QK and VEGFp both slightly increased proliferation of dermal microvascular endothelial cells (HMVECs) after 60 hours incubation. However, incubation with dermatan sulfate and DSV caused significant cell death after 24 hours in reduced growth factor media, likely due to sequestering of growth factors. It is possible that VEGFp-DS-SILY may better stimulate proliferation since it would be presented as a surface bound proteoglycan mimic, rather than as a soluble factor. HMVECs migrated farther for all treatment groups (10 µM QK, 10 µM VEGFp, 1 µM DSV4, and 10 µM DSV4) than the 10 ng/mL VEGF positive control, although more cells migrated in response to VEGF. This may be accounted at least in part by the more pronounced proliferation induced by VEGF. Migration will also be tested in 3D culture within a collagen gel. We are currently testing a 2D matrigel system for tubulogenesis. We have found that 10 µM DSV4 forms qualitatively more well-defined tubules than the untreated control on reduced growth factor matrigel. However, we were not able to quantify the improved tubule formation and are still troubleshooting the tubule analysis. After seeding ECs and culturing for 4, 8, and 12 hours, cells will be fluorescently stained with anti-CD31 and imaged for 3D tubule formation. CAM assay angiogenesis growing into a collagen scaffold. In brief, fertilized chicken embryos are incubated for 2 days before exposing the CAM. VEGFp-DS-SILY bound to a collagen gel will be placed onto the CAM. Some treatment groups will receive additional VEGF to investigate synergistic effects. Light microscope images of angiogenesis into the collagen gel coated with VEGFp-DS-SILY, taken every day from days 10 to 13, will reflect the ability of the collagen scaffold to integrate into existing vasculature and 3D angiogenic potential of VEGFp-DS-SILY with or without VEGF. We expect that VEGFp-DS-SILY treatment will increase the number of vessels formed on the CAM. Preliminary data using a Fluoraldehyde assay indicates that loading of ~300 ng VEGF per mg of nanoparticles can be achieved. We expect that using an MMP-degradable peptide diacrylate crosslinker will allow nanoparticles to degrade in protease-rich environments like the chronic wound bed and release VEGF. Adjustments to the formulation, such as crosslinker density, may need to be modified to control the rate of VEGF release. DISCUSSION/SIGNIFICANCE OF IMPACT: We expect that our angiogenic decorin mimetic will lead to a novel treatment to accelerate healing of ischemic diabetic foot ulcers, thereby reducing the need for limb amputation and mortality rate of diabetic patients. We anticipate that the diabetes research and regenerative medicine communities will (1) gain a platform for targeted delivery of growth factors, (2) understand the dependence of vascularization within 3D collagen constructs on VEGFp densities and VEGF receptor activation in controlling the degree of angiogenesis, and (3) gain the benefits of controlled angiogenesis in ischemic diabetic wound healing.

Background: A voluntary National Healthy Food and Drink Policy (the Policy) was introduced in public hospitals in New Zealand in 2016. This study assessed the changes in implementation of the Policy and its impact on providing healthier food and drinks for staff and visitors in four district health boards between 1 and 5 years after the initial Policy introduction. Methods: Repeat, cross-sectional audits were undertaken at the same eight sites in four district health boards between April and August 2017 and again between January and September 2021. In 2017, there were 74 retail settings audited (and 99 in 2021), comprising 27 (34 in 2021) serviced food outlets and 47 (65 in 2021) vending machines. The Policy's traffic light criteria were used to classify 2652 items in 2017 and 3928 items in 2021. The primary outcome was alignment with the Policy guidance on the proportions of red, amber and green foods and drinks (≥ 55% green 'healthy' items and 0% red 'unhealthy' items). Results: The distribution of the classification of items as red, amber and green changed from 2017 to 2021 (p < 0.001) overall and in serviced food outlets (p < 0.001) and vending machines (p < 0.001). In 2021, green items were a higher proportion of available items (20.7%, n = 815) compared to 2017 (14.0%, n = 371), as were amber items (49.8%, n = 1957) compared to 2017 (29.2%, n = 775). Fewer items were classified as red in 2021 (29.4%, n = 1156) than in 2017 (56.8%, n = 1506). Mixed dishes were the most prevalent green items in both years, representing 11.4% (n = 446) of all items in 2021 and 5.5% (n = 145) in 2017. Fewer red packaged snacks (11.6%, n = 457 vs 22.5%, n = 598) and red cold drinks (5.2%, n = 205 vs 12.5%, n = 331) were available in 2021 compared to 2017. However, at either time, no organisation or setting met the criteria for alignment with the Policy (≥ 55% green items, 0% red items). Conclusions: Introduction of the Policy improved the relative healthiness of food and drinks available, but the proportion of red items remained high. More dedicated support is required to fully implement the Policy. [ABSTRACT FROM AUTHOR]

Premenstrual exacerbation of an existing psychiatric disorder refers to the worsening of symptoms inherent to the condition during the premenstrual phase. Research consistently indicates that hormonal fluctuations during the menstrual cycle present a unique period of vulnerability for the onset or exacerbation of psychiatric symptoms, impacting diagnosis, risk assessment, and treatment. This review sought to elucidate the phenomenon of premenstrual exacerbation and its impact across a spectrum of psychiatric illnesses, including mood, anxiety, psychotic, obsessive-compulsive, personality, and trauma-related disorders. Despite the expanded research in recent years on premenstrual dysphoric disorder and premenstrual syndrome, premenstrual exacerbation remains underexplored and poorly defined. This review offers significant contributions to the diagnosis and management of psychiatric conditions, advocating for heightened awareness and novel treatment approaches in the context of premenstrual exacerbation. [ABSTRACT FROM AUTHOR]

Multicultural interactions bring individuals from varied cultural backgrounds together, leading to situations that either foster or impede social cohesion. This issue is critical as social cohesion significantly influences quality-of-life (QOL), which, together with marketing systems, forms the core of macromarketing. Our research contributes by introducing "boundary interweaving" – a novel concept in boundary-making strategy that aims to improve QOL and cultural well-being within marketing systems. Boundary interweaving is a process wherein two or more cultural boundaries interweave together to create a new, unique cultural boundary. Integrating marketing systems and boundary-making theories, this study on ethnic minority marketing shifts from the traditional single-level focus to explore multi-level interactions among market actors. Employing discourse analysis of a documentary and news articles, particularly focusing on food narratives from wet markets and adjacent hawker stalls, we examine interactions between market actors consisting of government, politicians, mass media, sellers, and consumers. Our findings reveal that interactions among market actors exemplify boundary interweaving within the realms of space, language, and foodways. Rather than delineating us and them among different ethnic groups, this paper demonstrates that joint efforts by market actors across macro-, meso-, and microlevels can facilitate the integration, social inclusion and coexistence of diverse ethnic cultures within the marketing system. Boundary interweaving fosters cultural well-being, promotes a sense of belonging and facilitates social cohesion among different ethnic groups. This study highlights the influence of culture on the functioning, growth, and evolution of a marketing system. [ABSTRACT FROM AUTHOR]

This article analyzes and integrates the 60 nominated articles for the best articles in the Journal of Advertising from its first 50 years, with a focus on the final 15 that were selected as the overall best articles. Hence, the purpose of this article is to highlight the contributions of these articles and their overall influence on advertising research. To this end, the authors synthesize these articles into an organizing framework that is used to analyze the contributions of this research collective. The framework also helps to understand distinct aspects of advertising and identify areas of research that can continue to build on the legacy of the contributions of these articles. [ABSTRACT FROM AUTHOR]

This article explores how diasporic Chinese video artists present familial histories and tales of cross-cultural exchange in the context of an exhibition I am curating, Another Beautiful Country: Moving Images by Chinese American Artists, at the University of Southern California (USC) Pacific Asia Museum. I discuss projects by featured artists Richard Fung and Patty Chang. These artists' experimental documentaries and performative videos foster deep personal discoveries that defy the late-capitalist obsession with the new as defined by youth, novelty, and the next trend, providing revelatory insights through recuperative engagements with what has come before. In analyzing artworks by Fung and Chang, I also reference related texts by/about artists and historical figures including Walter Benjamin, Anna May Wong, and Zhang Ailing, who emigrated from the People's Republic of China to the United States in the 1950s and whose special collections in the USC Libraries helped inform the exhibition's programming. I also interweave my own related familial histories and share some (not-so-new) curatorial ideas for immersing audiences in intercultural art and reflection. [ABSTRACT FROM AUTHOR]

In this article, we first compare adolescents' responses to two formats (easily recognizable versus not easily recognizable) Internet ads. We find that Internet literacy and ad skepticism are necessary for adolescents to effectively apply persuasion knowledge to identify both ad formats. Second, we demonstrate that parental mediation and parents' levels of Internet skills are critical for children's development of Internet literacy. As a result, this article advances our understanding of adolescents' responses to different Internet ad formats and the influential role of parental mediation in facilitating children's development of such skills. [ABSTRACT FROM AUTHOR]

Machine knitting is a well-established fabrication technique for complex soft objects, and both companies and researchers have developed tools for generating machine knitting patterns. However, existing representations for machine knitted objects are incomplete (do not cover the complete domain of machine knittable objects) or overly specific (do not account for symmetries and equivalences among knitting instruction sequences). This makes it difficult to define correctness in machine knitting, let alone verify the correctness of a given program or program transformation. The major contribution of this work is a formal semantics for knitout, a low-level Domain Specific Language for knitting machines. We accomplish this by using what we call the fenced tangle, which extends concepts from knot theory to allow for a mathematical definition of knitting program equivalence that matches the intuition behind knit objects. Finally, using this formal representation, we prove the correctness of a sequence of rewrite rules; and demonstrate how these rewrite rules can form the foundation for higher-level tasks such as compiling a program for a specific machine and optimizing for time/reliability, all while provably generating the same knit object under our proposed semantics. By establishing formal definitions of correctness, this work provides a strong foundation for compiling and optimizing knit programs. [ABSTRACT FROM AUTHOR]

Mothers play a significant role in deciding their adolescents' educational expenditures. They increasingly rely on the Internet for information search and building online support networks to enhance their confidence. Thus, we use the psychological empowerment theory in this study to examine the association between social media use and educational expenditures. Through two studies, we show how a mother's use of social media (active/passive use) significantly impacts adolescent children's educational expenses via dimensions of psychological empowerment. We further demonstrate that the two dimensions of psychological empowerment differentially drive this relationship: intrapersonal (relying on the self) and Interactional (leveraging the community) empowerment. We discover that active (passive) social media use increases mother' intrapersonal (interactional) empowerment. We also find that cross‐cultural differences play a role in psychological empowerment's effect on educational expenditures, where intrapersonal empowerment is vital in the United States, and interactional empowerment is more relevant in India. Our key contributions to literature are three‐fold: we establish the relationship between a mother's social media use and educational expenditures for their adolescent children, identify predictors of different dimensions of psychological empowerment, and present evidence for cross‐cultural differences in the empowering role of social media. [ABSTRACT FROM AUTHOR]

Background: Advancement in breast cancer (BC) diagnosis and treatment have increased the number of long-term survivors. Consequently, primary BC survivors are at a greater risk of developing second primary cancers (SPCs). The risk factors for SPCs among BC survivors including sociodemographic characteristics, cancer treatment, comorbidities, and concurrent medications have not been comprehensively examined. The purpose of this study is to assess the incidence and clinicopathologic factors associated with risk of SPCs in BC survivors. Methods: We analyzed 171, 311 women with early-stage primary BC diagnosed between January 2000 and December 2015 from the Medicare-linked Surveillance Epidemiology and End Results (SEER-Medicare) database. SPC was defined as any diagnosis of malignancy occurring within the study period and at least 6 months after primary BC diagnosis. Univariate analyses compared baseline characteristics between those who developed a SPC and those who did not. We evaluated the cause-specific hazard of developing a SPC in the presence of death as a competing risk. Results: Of the study cohort, 21,510 (13%) of BC survivors developed a SPC and BC was the most common SPC type (28%). The median time to SPC was 44 months. Women who were white, older, and with fewer comorbidities were more likely to develop a SPC. While statins [hazard ratio (HR) 1.066 (1.023–1.110)] and anti-hypertensives [HR 1.569 (1.512–1.627)] increased the hazard of developing a SPC, aromatase inhibitor therapy [HR 0.620 (0.573–0.671)] and bisphosphonates [HR 0.905 (0.857–0.956)] were associated with a decreased hazard of developing any SPC, including non-breast SPCs. Conclusion: Our study shows that specific clinical factors including type of cancer treatment, medications, and comorbidities are associated with increased risk of developing SPCs among older BC survivors. These results can increase patient and clinician awareness, target cancer screening among BC survivors, as well as developing risk-adapted management strategies. [ABSTRACT FROM AUTHOR]

The article explores the legal protection and rights of theater actors with disabilities in the U.S. Topics discussed include the improvements in theater productions which may be attributed to the enforcement of the Americans with Disabilities Act (ADA), the employment discrimination being faced by actors with disabilities, and the statutory interpretation and application of affirmative action in cases involving said actors.

What explains the mismatch between China's vast economic presence, significant diplomatic engagement around the world, and its miniscule global military posture? China's global defense footprint – as measured by overseas deployments and basing – is extremely modest compared to that of many other great powers. While military activity and the construction of military installations in the Asia-Pacific have both expanded noticeably in recent decades, China appears far more reticent to project or station armed forces beyond its immediate neighborhood. Domestic normative factors can explain Chinese hesitancy to increase its global military posture while geostrategic factors can explain the elevated regional activity and clustering of new bases around China's periphery. [ABSTRACT FROM AUTHOR]

Background: Cascade genetic testing for hereditary cancer syndromes offers affected relatives the opportunity to pursue cancer screening and risk‐reducing surgery and thus reduces morbidity and mortality. The purpose of this study was to measure the long‐term utilization of targeted cancer prevention and quality of life among at‐risk relatives offered clinician‐facilitated cascade genetic testing. Methods: In a pilot study, at‐risk relatives of patients with a hereditary cancer syndrome were contacted directly by the clinical team and offered telephone genetic counseling and genetic testing via an at‐home, mailed saliva kit. Two‐year follow‐up results evaluating the use of targeted cancer prevention strategies and the quality of life for enrolled relatives were reported. Quality‐of‐life was measured with validated surveys, and scores were compared to the time of initial contact by the Wilcoxon signed‐rank test. Results: Ninety‐five at‐risk relatives were enrolled in the initial pilot study, and 72 (76%) participated in the 2‐year follow‐up; 57 of these (79%) had completed genetic testing. Twenty‐five of those 57 relatives (44%) were found to harbor an inherited pathogenic variant. Guideline‐based cancer surveillance was recommended to 18 relatives; 13 (72%) completed at least one recommended screening, and six (33%) completed all recommended screenings. Risk‐reducing surgery was recommended to 10 relatives; four (40%) completed a total of eight procedures. Quality‐of‐life surveys demonstrated low levels of anxiety, depression, distress, and uncertainty. Conclusions: The 2‐year follow‐up of the original pilot study revealed that clinician‐facilitated cascade testing resulted in genetically targeted cancer screening and prevention with preserved quality of life. These results, to be confirmed by larger randomized controlled trials, suggest that medical systems should consider supporting clinician‐facilitated cascade testing programs. Cascade testing for cancer syndromes facilitated by the medical team resulted in identification of relatives with pathogenic variants and use of genetically targeted cancer prevention with preserved quality‐of‐life. [ABSTRACT FROM AUTHOR]

The authors examine the influence of olfactory sensitivity on the effectiveness of olfactory imagery in advertising. Findings reveal that the use of olfactory imagery can negatively impact ratings for ads, the product advertised, and likelihood to buy, especially for individuals sensitive to smell. The authors demonstrate that the act of sniffing can reverse the negative effects of olfactory imagery in olfactory sensitive individuals. An event-related potential (ERP) study provides evidence of emotions triggered during sniffing and forming olfactory imagery, explaining the underlying mechanism behind the observed behavioral and perceptual effects. Results show that olfactory imagery has an impact on the evaluation of ads, with a possible negative impact for sensitive individuals. Furthermore, the article demonstrates that these effects can be reversed by introducing sniffing cues in the ad. Thus, the use of a multimethod approach, combining behavioral and neuroscience experiments, provides insight into the effectiveness of advertising strategies in consideration of individual differences in consumer olfactory sensitivity. This article provides support for advertisers to consider incorporating sniffing cues (to trigger positive scent- associated emotions) in the construction of scent-relevant ads to enhance positive ratings of ads. [ABSTRACT FROM AUTHOR]

For a searchable version of these abstracts, please visit www.acrabstracts.org. [ABSTRACT FROM AUTHOR]

Canaliculitis, inflammation of the lacrimal canaliculi, can be caused by numerous pathogens, most commonly bacteria from the genera Actinomyces, Streptococcus, and Staphylococcus. Primary canaliculitis often requires surgical canaliculolith removal and appropriate antibiotic coverage. The authors report a case of a 77-year-old woman with a history of punctal plugs who presented with chronic canaliculitis with canaliculoliths that grew Providencia stuartii. P. stuartii has not previously been described as a cause of primary canaliculitis. This case highlights a new organism that causes canaliculitis with canaliculoliths and stresses the importance of speciation and antibiotic sensitivity testing following canaliculotomy and curettage. P. stuartii should be considered in the differential for bacterial canaliculitis with canaliculoliths, especially in patients with persistent symptoms on topical antibiotic therapy without canaliculotomy. [ABSTRACT FROM AUTHOR]

Using techniques derived from the syntactic methods for visual pattern recognition is not new and was much explored in the area called syntactical or structural pattern recognition. Syntactic methods have been useful because they are intuitively simple to understand and have transparent, interpretable, and elegant representations. Their capacity to represent patterns in a semantic, hierarchical, compositional, spatial, and temporal way have made them very popular in the research community. In this article, we try to give an overview of how syntactic methods have been employed for computer vision tasks. We conduct a systematic literature review to survey the most relevant studies that use syntactic methods for pattern recognition tasks in images and videos. Our search returned 597 papers, of which 71 papers were selected for analysis. The results indicated that in most of the studies surveyed, the syntactic methods were used as a high-level structure that makes the hierarchical or semantic relationship among objects or actions to perform the most diverse tasks. [ABSTRACT FROM AUTHOR]