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Background Racial and ethnic minorities consistently demonstrate disparate post-stroke outcomes. However, there is a paucity of literature related to whether this disparity exists specifically in post-stroke cognitive decline. Objective To determine if racial and ethnic disparities exist in post-stroke subjective cognitive decline (SCD) among non-Hispanic Blacks (Blacks), American Indians or Alaska Natives (AI/ANs), Hispanics, and non-Hispanic Whites (Whites) in the United States using data from the Behavioral Risk Factor Surveillance System (BRFSS). Methods A retrospective analysis was completed using the 2016 BRFSS data in adults who self-reported stroke and SCD. Descriptive statistics were completed for baseline comparisons using chi squared tests for categorical variables. A binary logistic regression controlling for baseline differences was completed to examine racial and ethnic differences in SCD. Results Significant differences in SCD were identified across all racial and ethnic groups. When compared to Whites, Blacks, AI/ANs, and Hispanics more frequently reported worsening confusion or memory loss that interfered with day-to-day activities and the ability to work, volunteer, and engage in social activities outside of the home. AI/ANs who reported SCD were more likely than Whites to have help available. Hispanic persons with SCD or their family members were most likely to discuss SCD with a healthcare provider. Conclusion Although persons from all racial and ethnic groups in this study experienced some degree of SCD, Blacks, AI/ANs, and Hispanics most frequently reported worsening confusion or memory loss impacting engagement in day-to-day activities and the ability to work, volunteer, and engage in social activities outside of the home.

Objective To understand the facilitators and barriers to community reintegration (CR) among injured female veterans. Design Phenomenologic qualitative design. Setting Community. Participants Community-dwelling female veterans with physical and/or psychological injury (N=13). Interventions None. Main Outcome Measures None. Results Conventional content analysis revealed 3 types of facilitators, including (1) strong social support, (2) impactful programs, and (3) protective personal beliefs. Six types of barriers included (1) inadequate services, (2) lack of access to services, (3) poor social support, (4) difficulty trusting others, (5) nonsupportive personal beliefs, and (6) injury factors. Multiple environmental and personal factors acted as facilitators and barriers to CR. Findings are relatively consistent with previous veteran and civilian community reintegration research that indicates the importance of health-related services, attitudes of others, and social support. However, women in this study reported being effected by many of these facilitators and barriers because of their sex. Conclusions This study supports the need to foster social support among injured female veterans throughout the rehabilitation process to promote CR. Long-term social support can be gained by incorporating services (eg, adjunctive therapies, recreation, other social programming) into the rehabilitation repertoire to help with CR for all veterans, particularly women.

Pervasive misinformation about climate change might be reduced if colleges were to include the topic within general education curriculum. This paper analyzes the general education (or “core”) curriculum in the top 100 universities and liberal-arts colleges in the U.S. to assess the proportion of core courses that highlight climate change or climate science. The probability that a student takes at least one climate-change course via the core curriculum is estimated at 0.17 across all schools. The probability is higher at research universities than at liberal arts colleges, in core programs that have more science and social science courses, and at public universities in states with a Democrat-controlled legislature than in states with a Republican-controlled or split legislature. Drawing on cases of best practices in the U.S. identified from the data set, the authors discuss strategies that could ensure a higher likelihood that the core curriculum includes education on climate science and climate change. The study advances the broader research literature on sustainability in higher education programs by bringing it into conversation with research on the college core curriculum and by focusing both on the specific issue of climate-change education.

Research on adult typically-developing (TD) siblings of individuals with developmental disabilities remains limited, and outcomes for TD siblings appear to vary widely. For the current study, 82 adult TD siblings of individuals with autism spectrum disorder (ASD) or intellectual disability (ID) completed questionnaires about themselves and their affected sibling. Results of this study suggest that the attitudes possessed by adult TD siblings are important to consider when understanding adult TD sibling outcomes. Specifically, data indicate that higher levels of positive sibling relationship attitudes are related to TD siblings providing more aid/support to their sibling with a disability, along with having higher levels of general life satisfaction, and negatively related to levels of stress and depressive symptoms among TD siblings. Consistent with previous child research, siblings of individuals with ASD reported fewer positive sibling relationship attitudes compared to siblings of individuals with ID. Finally, group membership related to aid provided, depressive symptoms, and stress of TD siblings indirectly through sibling relationship attitudes. Overall, results indicate that sibling relationship attitudes may be particularly important to consider when conceptualizing sibling relationships when one sibling has an intellectual or developmental disability.

The aim of this study was to examine the impact of an autonomy-supportive yoga intervention on the self-determination of adults with intellectual and developmental disabilities. Research supports the use of autonomy-supportive interventions to increase positive health outcomes with this population. The present study utilized a qualitative approach with eight subjects participating in semi-structured qualitative interviews. Content analysis identified support for three themes related to the impact of yoga: autonomy, relatedness, competence. The results suggested that the yoga intervention may support self-determination for adults with IDD, as the participants’ responses demonstrated increased feelings of autonomy, competence, and relatedness. The results also indicated that an autonomy-supportive yoga intervention can be achieved with adults with intellectual and developmental disabilities by targeting the key constructs of autonomy, relatedness, and competence.

1,3-Amino alcohols were prepared to examine how structure affects the oxidation of tertiary amines in visible light photocatalysis. These substrates were cyclized to produce oxazines following the photooxidative formation of iminium ions using catalytic Ru(bpy)3Cl2. Amino alcohol derivatives of tetrahydroisoquinoline, tetrahydroquinoline, pyrrolidine, and Δ3-piperidine all were found to be viable substrates. In the case of the unsaturated piperidines, cyclization is accompanied by addition of methanol across the alkene; most likely occurring via a conjugate addition to an intermediate α,β-unsaturated iminium ion prior to oxazine formation.

Cytoplasmic lipid droplets (CLD) in mammary epithelial cells undergo secretion by a unique membrane envelopment process to produce milk lipids. Adipophilin (ADPH/Plin2), a member of the perilipin/PAT family of lipid droplet-associated proteins, is hypothesized to mediate CLD secretion through interactions with apical plasma membrane elements. We found that the secretion of CLD coated by truncated ADPH lacking the C-terminal region encoding a putative four-helix bundle structure was impaired relative to that of CLD coated by full-length ADPH. We used homology modeling and analyses of the solution and membrane binding properties of purified recombinant ADPH C terminus to understand how this region possibly mediates CLD secretion. Homology modeling supports the concept that the ADPH C terminus forms a four-helix bundle motif and suggests that this structure can form stable membrane bilayer interactions. Circular dichroism and protease mapping studies confirmed that the ADPH C terminus is an independently folding α-helical structure that is relatively resistant to urea denaturation. Liposome binding studies showed that the purified C terminus binds to phospholipid membranes through electrostatic dependent interactions, and cell culture studies documented that it localizes to the plasma membrane. Collectively, these data provide direct evidence that the ADPH C terminus forms a stable membrane binding helical structure that is important for CLD secretion. We speculate that interactions between the four-helix bundle of ADPH and membrane phospholipids may be an initial step in milk lipid secretion.

Charcot-Marie-Tooth (CMT) is a progressive genetic disorder that produces motor and sensory neuropathy that affects the legs, feet, and hands. A dorsally based closing wedge midfoot osteotomy at the apex of the cavus foot deformity combined with soft tissue and other osseous procedures are procedures performed for CMT patients at The Western Pennsylvania Hospital. The focus of this article is to present a prospective evaluation of 3 patients using radiographic assessment, static biomechanical and the malleolar valgus index (MVI), dynamic alignment, and function results using the F-scan. These results demonstrate that patients have improved function with a plantigrade foot and decreased pain. The Short Form McGill Pain Questionnaire (SF-MPQ) showed that there was a decrease in pain. There was a decrease in the MVI and improved function comparing the preoperative and postoperative F-scan in all patients. The midfoot osteotomy addresses the apex of the progressive cavus foot deformity and provides a plantigrade foot in 3 CMT patients. Level of Clinical Evidence: 4

Vasoactive peptides, such as endothelin-1 and angiotensin II are recognized by specific receptor proteins located in the cell membrane of target cells. Following receptor recognition, the specificity of the cellular response is achieved by G-protein coupling of ligand binding to the regulation of intracellular effectors. These intracellular effectors will be the subject of this brief review on contractile activity initiated by endothelin-1 and angiotensin II.Activation of receptors by endothelin-1 and angiotensin II in smooth muscle cells results in phopholipase C (PLC) activation leading to the generation of the second messengers insitol trisphosphate (IP(3)) and diacylglycerol (DAG). IP(3) stimulates intracellular Ca(2+) release from the sarcoplasmic reticulum and DAG causes protein kinase C (PKC) activation. Additionally, different Ca(2+) entry channels, such as voltage-operated (VOC), receptor-operated (ROC), and store-operated (SOC) Ca(2+) channels, as well as Ca(2+)-permeable nonselective cation channels (NSCC), are involved in the elevation of intracellular Ca(2+) concentration. The elevation in intracellular Ca(2+) is transient and initiates contractile activity by a Ca(2+)-calmodulin interaction, stimulating myosin light chain (MLC) phosphorylation. When the Ca(2+) concentration begins to decline, Ca(2+)-sensitization of the contractile proteins is signaled by the RhoA/Rho-kinase pathway to inhibit the dephosphorylation of MLC phosphatase (MLCP) thereby maintaining force generation. Removal of Ca(2+) from the cytosol and stimulation of MLCP initiates the process of smooth muscle relaxation. In pathological conditions such as hypertension, alterations in these cellular signaling components can lead to an over stimulated state causing maintained vasoconstriction and blood pressure elevation.