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Background: Several studies have previously reported the presence of altered cerebral perfusion during sepsis. However, the role of non-invasive neuromonitoring, and the impact of altered cerebral perfusion, in sepsis patients with delirium remains unclear. Methods: We performed a systematic review of studies that used near-infrared spectroscopy (NIRS) and/or transcranial Doppler (TCD) to assess adults (-18 years) with sepsis and delirium. From study inception to July 28, 2020, we searched the following databases: Ovid MedLine, Embase, Cochrane Library, and Web of Science. Results: Of 1546 articles identified, 10 met our inclusion criteria. Although NIRS-derived regional cerebral oxygenation was consistently lower, this difference was only statistically significant in one study. TCD-derived cerebral blood flow velocity was inconsistent across studies. Importantly, both impaired cerebral autoregulation during sepsis and increased cerebrovascular resistance were associated with delirium during sepsis. However, the heterogeneity in NIRS and TCD devices, duration of recording (from 10 seconds to 72 hours), and delirium assessment methods (e.g., electronic medical records, confusion assessment method for the intensive care unit), precluded meta-analysis. Conclusion: The available literature demonstrates that cerebral perfusion disturbances may be associated with delirium in sepsis. However, future investigations will require consistent definitions of delirium, delirium assessment training, harmonized NIRS and TCD assessments (e.g., consistent measurement site and length of recording), as well as the quantification of secondary and tertiary variables (i.e., Cox, Mxa, MAPOPT), in order to fully assess the relationship between cerebral perfusion and delirium in patients with sepsis. [ABSTRACT FROM AUTHOR]

The similarity between pairs of people is often measured on relatively static traits and at a given point in time. Moving beyond this approach, a burgeoning line of research is investigating temporal dyadic similarity on traits and behaviors, such as health activities. Our study contributes to this line of inquiry by using fine-grained longitudinal data obtained from sensors, mobile devices, and surveys to examine whether we can observe distinct types of dyadic similarity trajectories based on physical activity, and if so, what dyad-level properties predict membership in each trajectory class. Treating daily differences in the steps for dyads as time series, we use k -shape clustering to identify classes of similarity trajectories and logistic regression to examine the link between trajectory class and key dyad-level factors. We identify 21 dyadic trajectory clusters and find that trajectory membership predicts dyadic connectivity in the communication network, as well as racial and religious—but not gender-based—similarity. We conclude by noting how research on dyadic similarity trajectories can be further integrated with ongoing work in social network analysis. [ABSTRACT FROM AUTHOR]

Background: Stress from obstructive sleep apnoea (OSA) stimulates catecholamine release and consequently can exacerbate hypertension, even in the absence of a catecholamine-producing tumour (phaeochromocytoma). As such, a positive screening test for suspected phaeochromocytoma may be misleading. There exists only a handful case reports, and no controlled trials, how continuous positive airway pressure (CPAP) to treat OSA influences catecholamine levels. We examined changes to levels of urinary catecholamine and blood pressure in response to CPAP treatment. Methods: We conducted a meta-analysis of data aggregated from published case reports of individual patient data up to April 2020. The quality of the reports was evaluated using the risk of bias in non-randomized studies of interventions (ROBINS-I) tool. Results: A total of 13 cases (seven men and six women) from seven reports met our search criteria. Patients had mean age of 49.1 years (range = 36–62) and body mass index of 37.4 kg/m2 (range = 27–56). Most had moderate to severe OSA with CPAP treatment. Nine cases had 24-hour urinary noradrenaline assessment before and after CPAP treatment. CPAP treatment led to a 21% reduction (104 nmol/24-hours, 95% credible interval =59 to 148) in 24-hour urinary noradrenaline to within reference ranges, and 25% reduction (from 131 to 100 mmHg) in mean arterial pressure. The risk of overall bias evaluated by the ROBINS-I tool was found to be low in the majority of reports. Conclusions: Investigations of patients suspected of phaeochromocytoma, particularly obese individuals, should exclude OSA and treat this condition if present before performing screening tests to assess for catecholamine levels. [ABSTRACT FROM AUTHOR]

Delirium is common during critical illness and is associated with morbidity and mortality, but its pathophysiology is unknown. We tested whether dysfunctional cerebral autoregulation (CA) contributes to the development of delirium. Adult patients (n = 40) with respiratory failure and/or shock were prospectively enrolled. Continuous recordings of regional cerebral oxygen saturation (rSO2) were obtained by near-infrared spectroscopy (NIRS) during the first 72 h of intensive care unit (ICU) admission. CA function was estimated by the cerebral oximetry index (COx), which is the time-varying correlation between rSO2 and mean arterial pressure (MAP). Delirium was assessed daily. The median ICU stay was seven days (IQR 4–13). Twenty-four patients (60%) screened positive for delirium on at least one day during their stay. Taking positive COx values to reflect periods of CA dysfunction, we found that the cumulative duration of CA dysfunction during the first one to three days in the ICU was significantly associated with the subsequent development of delirium. Additionally, we assessed two alternative methods for estimating optimal MAP targets in individual patients. In summary, early disturbances in CA may contribute to delirium, and NIRS-derived rSO2 may be used to identify individual perfusion targets in critically ill patients. [ABSTRACT FROM AUTHOR]

A long-standing concern in the study of culture is understanding how culture is distributed, often discussed in terms of cultural “coherence.” Cultural diversity, defined as the degree to which people share beliefs or meanings, is one dimension of cultural coherence that has been associated with many social outcomes. This article contributes to this area of research by considering how to measure cultural diversity in text and introducing a simple approach that uses word counts and sets of diversity indices (called “diversity profiles”). Text is useful for social-psychological analysis because as an artifact of individual thought, it provides a way to measure how beliefs and meanings are distributed and made salient across groups. The measurement approach outlined here contrasts to many contemporary computational approaches to measuring culture in text, which employ a relational logic of meaning based on word co-occurrences. While these more sophisticated approaches are well suited to measuring diversity in many instances, I show that there are some cases for which simpler measures based on word counts are ideal. After discussing the measurement of cultural diversity using word counts, I present a computational analysis of interview transcripts of American religious parents discussing the ages at which it is appropriate for children to participate in different practices often considered inappropriate for young children. The analysis points to the homogenizing influence of institutions on discussions of age appropriateness. I conclude by discussing implications for cultural analysis more generally. [ABSTRACT FROM AUTHOR]

A perennial concern in frame analysis is explaining how frames structure perception and persuade audiences. In this article, we suggest that the distinction between personal culture and public culture offers a productive way forward. We propose an approach centered on an analytic contrast between schemas, which we define as a form of personal culture, and frames, which we define as a form of public culture. We develop an “evocation model” of the structure and function of frames. In the model, frames are conceived as material assemblages that activate a network of schemas, thereby evoking a response when people are exposed to them. We discuss how the proposed model extends, and clarifies, extant approaches, and consider new directions for future research. [ABSTRACT FROM AUTHOR]

Describes the case of a patient with dextrocardia who suffered his first myocardial infarction after approximately 26 hours of diagnostic sleep deprivation protocol. Monitoring of sleep deprivation as a risk for myocardial infarction; Cardiac enzyme levels following myocardial infarction; Use of sleep deprivation as a diagnostic tool.

In many fields of research, null hypothesis significance tests and p values are the accepted way of assessing the degree of certainty with which research results can be extrapolated beyond the sample studied. However, there are very serious concerns about the suitability of p values for this purpose. An alternative approach is to cite confidence intervals for a statistic of interest, but this does not directly tell readers how certain a hypothesis is. Here, I suggest how the framework used for confidence intervals could easily be extended to derive confidence levels, or "tentative probabilities," for hypotheses. I also outline four quick methods for estimating these. This allows researchers to state their confidence in a hypothesis as a direct probability, instead of circuitously by p values referring to a hypothetical null hypothesis—which is usually not even stated explicitly. The inevitable difficulties of statistical inference mean that these probabilities can only be tentative, but probabilities are the natural way to express uncertainties, so, arguably, researchers using statistical methods have an obligation to estimate how probable their hypotheses are by the best available method. Otherwise, misinterpretations will fill the void. [ABSTRACT FROM AUTHOR]

When military community closure occurs, it can be challenging for service members and the surrounding community. Given that services and social networks disappear; this is particularly salient in overseas locations. Few studies have systematically assessed the impact of base closure on military community members. In the present study, 743 soldiers, 114 Army civilian employees, and 54 military spouses living in two closing U.S. military communities in Germany were surveyed about transformation stressors, mental health, and factors associated with better adjustment such as individual coping, leadership behaviors, and community cohesion. While individual coping was associated with fewer sleep problems, and individual coping and leadership were associated with less psychological distress, community cohesion generally overrode these effects in the final step of regression models. Thus, while coping and leadership are important, community connection appears to confer benefits to the affected individuals even in the context of base closure. [ABSTRACT FROM AUTHOR]

Introduction: Type 1 diabetes impacts approximately 1.25 m Americans, many of them young children. As a child grows, there is a transition towards independence and they must learn to manage their diabetes independently. The objective of this study was to design, develop and conduct a prototype test to assess the satisfaction and feasibility of a mobile app for adolescents with type 1 diabetes and their parents to aid in this transition.Methods: Ten parent/adolescent groups used MyT1DHero for four weeks. They were given a pre-test/post-test survey regarding family conflict with three tasks of diabetes management and the general tone of family communication. At post-test they were asked questions regarding their satisfaction and perception of ease of use of the app. They also participated in short interviews regarding the app. Additionally, we used server data to examine actual app usage.Results: The parents' perceptions of conflict around the results of the blood sugar tests increased ( t(9) = 2.71, p = .02) as did perceptions of conflict around logging the blood sugar results ( t(9) = 3.67, p = .005). The adolescents perceived increased conflict surrounding the results around logging the blood sugars results ( t(9) = 3.09, p = .01).There was no change in the tone of general family communication. During the prototype testing, we discovered that the app crashed repeatedly and several of the functions were not working properly. In the interview data, three main themes emerged, app-crashing issues, problems with notifications and positive feedback.Discussion: Through this process, all of the reported issues were corrected and new features were planned for subsequent versions. A smartphone application has the potential to be a novel intervention for engaging adolescents and their parents in positive communication to support type 1 diabetes management. [ABSTRACT FROM AUTHOR]

In this paper we introduce the idea of the dual process framework (DPF), an interdisciplinary approach to the study of learning, memory, thinking, and action. Departing from the successful reception of Vaisey (2009), we suggest that intradisciplinary debates in sociology regarding the merits of "dual process" formulations can benefit from a better understanding of the theoretical foundations of these models in cognitive and social psychology. We argue that the key is to distinguish the general DPF from more specific applications to particular domains, which we refer to as dual process models (DPMs). We show how different DPMs can be applied to a variety of analytically distinct issues of interest to cultural sociologists beyond specific issues related to morality, such as culture in learning, culture in memory, culture in thinking, and culture in acting processes. We close by outlining the implications of our argument for relevant work in cultural sociology. [ABSTRACT FROM AUTHOR]

Past research has demonstrated that adolescents with Type 1 diabetes (T1D) typically have a decline in health outcomes as they begin to assume more self-management activities. Mobile app interventions have been suggested as one possible way to improve this behavior.The primary aim of this study was to address declines in health outcomes by pilot testing the satisfaction, use and feasibility of an app-based family communication intervention aimed to assist in adolescent self-management of T1D.Thirty-three adolescent–parent pairs were enrolled in and completed the 12-week pilot study. Participants were randomized 2:1 to intervention (app use) or control group. Pre/post quantitative and qualitative data were collected, including HbA1c and surveys. Paired-sample t-tests and ANOVA statistics were conducted.The parents and adolescents reported high satisfaction with the app, and that it was easy to use. Results showed HbA1c stability in the intervention group and significant worsening in the control group. There were also significant improvements in adherence to diabetes management and quality of life for the parents in the intervention group. The adolescents did not show any improvement in quality-of-life measures.This study suggests that the app intervention is acceptable, shows promise for improving health outcomes for adolescents with T1D, and may improve family communication. The public health implications of this work are that app interventions have a potential role in positively influencing chronic disease outcomes. Additional research with a more extensive and diverse sample is needed to determine generalizability. [ABSTRACT FROM AUTHOR]

Methyl 3-nitrothiophene-2-carboxylate was reduced with bismuth(III) chloride/potassium borohydride to give an unstable hydroxylamine which was oxidised without isolation using iron(III) chloride to give methyl 3-nitrosothiophene-2-carboxylate. Condensation of this with methyl 3-aminothiophene-2-carboxylate furnished the azodiester. This was more conveniently obtained by manganese dioxide oxidation of the aminoester. Hydrolysis of the azodiester to give the diacid followed by decarboxylation gave 3,3′-azothiophene which could be oxidised to 3,3′-azoxythiophene with hydrogen peroxide. The azodiester was oxidised to the corresponding azoxydiester with urea-hydrogen peroxide/trifluoroacetic anhydride and reduced to the related hydrazothiophenediester with diimide. [ABSTRACT FROM AUTHOR]