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Background: Pre-operative rehabilitation aims to improve the functional capacity of the individual to enable him/her to prepare for the period of inactivity associated with the surgical procedure., Objective: To evaluate the impact of preoperative scapular rehabilitation before arthroscopic repair of traumatic rotator cuff injury, regarding pain, range of motion of the shoulder, and functional activity., Study Design: Randomized Clinical Trial (RCT) - pilot., Methods: Twenty adult individuals (age range: 47-69 years), with a diagnosis of traumatic rotator cuff tear and arthroscopic surgical repair, were randomized and allocated into two groups: experimental (EG) (n = 10) and control group (CG) (n = 10). All participants underwent preoperative rehabilitation for six weeks, consisting of mobility exercises of the cervical spine, elbow, wrist, and hand, and analgesics education. The EG also performed scapular and core stabilization exercises, which were not performed by the CG. Exercise instruction was performed by the same physiotherapist and the surgical team was blinded to group participation in the preoperative period. After arthroscopic repair, the patients followed the same protocol of postoperative rehabilitation for 16 weeks, and functional evaluation was conducted after three months and in a follow-up of at least one year., Results: Compared to the CG, the EG presented with a significant decrease in pain between the preoperative period and after one year (p < 0.05). In relation to the preoperative period, flexion and external rotation increased significantly in both groups after three months (p<0.05), and abduction was significantly higher in the EG (p < 0.05). Compared to CG, the EG presented a significantly higher SF-12 physical component after three months (48.47 vs. 40.33, p < 0.05), and a significantly lower Western Ontario Rotator Cuff Index (WORC) total after one year (85.00 vs. 1130.00, p < 0.05)., Conclusion: Preoperative scapular rehabilitation had a positive impact on recovery after arthroscopic repair of traumatic rotator cuff injury, in the assessment of pain, range of motion of the shoulder, and quality of life., Levels of Evidence: Level 1., Competing Interests: The authors have no conflicts of interest to declare that are relevant to the content of this article.

Background : Stroke can result in disabling impairments, affecting functional mobility, balance, and gait. Individualized in-patient rehabilitation interventions improve balance and gait in patients with stroke. Rhythmic pairing of personally-selected music with rehabilitation interventions can be a practical form of personalized therapy that could improve functional outcomes. Objective : To describe an in-patient rehabilitation intervention that rhythmically paired patient-selected music with rehabilitative interventions for a patient with acute stroke. Case Description : The patient was a 48-year old male who sustained a right thalamic hemorrhagic stroke eight days prior to admittance to the in-patient rehabilitation facility. The Berg Balance Scale (BBS) (Balance), Performance Oriented Mobility Assessment-Gait portion (POMA-G) (Gait), and Functional Independence Measure® (FIM) Motor were completed on Day 1, Day 4, and Day 16 (Discharge) during the patient's in-patient rehabilitation stay. Outcomes : From intake to discharge, balance, gait and functional mobility significantly increased by 35, 9, and 31 points, respectively. Likewise, the patient reported positive attitudes toward the novel intervention. Conclusion : Incorporating patient-selected music with in-patient physical rehabilitation may be a feasible intervention for patients with acute stroke. Further research with an adequate sample size that randomly assigns patients to music and control conditions is necessary to confirm the promising findings from this case report.

Background: Neonatal jaundice (NNJ) is a common condition and when not adequately treated leads to acute bilirubin encephalopathy/kernicterus. This largely preventable condition is an important cause of death and disability in low- and middle-income countries. Education, early detection and effective management are key for prevention and require an understanding of community knowledge and practices to foster appropriate behavior to prevent severe NNJ. Therefore, the aim of this study was to identify knowledge, observation for jaundice (both active and passive) and practices related to NNJ in northern Nigeria., Methods: This descriptive, correlational and cross-sectional study enrolled 298 household members with an average age of 29.8 years in Kano, Nigeria. A structured questionnaire regarding knowledge of, potential sequelae and causes and local practices related to NNJ was administered and data were analyzed using descriptive and Chi-square statistics., Results: Participants reported: 85% NNJ to be a sign of illness; 3% understood that NNJ could cause brain damage; 94% did not actively observe for jaundice in their newborns; 56% did not know what causes NNJ; 88% would seek care if their newborn developed jaundice. Significant relationships between educational levels and what study participants would do if a newborn develops jaundice and between occupation, educational level and knowledge about causes of NNJ were noted, consistent with a difference in active jaundice observation between ethnic groups., Conclusion: A public health approach to NNJ with a strong community education program is a crucial next step in the fight to eliminate severe NNJ., (© The Author(s) [2021]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The p75 neurotrophin receptor (p75 NTR ) is a multifunctional protein that regulates cellular responses to pathological conditions in specific regions of the nervous system. Activation of p75 NTR in certain neuronal populations induces proteolytic processing of the receptor, thereby generating p75 NTR fragments that facilitate downstream signaling. Expression of p75 NTR has been reported in neurons of the ventral midbrain, but p75 NTR signaling mechanisms in such cells are poorly understood. Here, we used Lund Human Mesencephalic cells, a population of neuronal cells derived from the ventral mesencephalon, to evaluate the effects of oxidative stress on p75 NTR signaling. Subjection of the cells to oxidative stress resulted in decreased cell-surface localization of p75 NTR and intracellular accumulation of p75 NTR fragments. Oxidative stress-induced p75 NTR processing was reduced by pharmacological inhibition of metalloproteases or γ-secretase, but was unaltered by blockade of the ligand-binding domain of p75 NTR . Furthermore, inhibition of c-Jun N-terminal Kinase (JNK) decreased p75 NTR cleavage induced by oxidative damage. Altogether, these results support a mechanism of p75 NTR activation in which oxidative stress stimulates JNK signaling, thereby facilitating p75 NTR processing via a ligand-independent mechanism involving induction of metalloprotease and γ-secretase activity. These findings reveal a novel role for JNK in ligand-independent p75 NTR signaling, and, considering the susceptibility of mesencephalic neurons to oxidative damage associated with Parkinson's disease (PD), merit further investigation into the effects of p75 NTR on PD-related neurodegeneration., (Copyright © 2020 IBRO. Published by Elsevier Ltd. All rights reserved.)

Currently, 186/188 Re and 99m Tc are widely used radionuclides for cancer detection and diagnosis. New advancements in modalities and targeting strategies of radiopharmaceuticals will provide an opportunity to enhance imagery and detection of smaller colonies of cancer cells while lowering false-positive diagnoses. To understand the chemistry of agents derived from fac-[ 99m Tc(CO) 3 (H 2 O) 3 ] + species, the nonradioactive [Re(CO) 3 (H 2 O) 3 ] + analogue was used. We have designed and synthesized Re-Acdien-LHRH, Re-Acdien-peg-LHRH, and a radiolabeled 99m Tc-Acdien-LHRH (rhenium- and technetium-luteinizing hormone-releasing hormone) conjugates using a tridentate linker to detect cancers overexpressing the LHRH receptor. Re-Acdien-LHRH and Re-Acdien-peg-LHRH were synthesized from non-PEGylated and PEGylated LHRH-Acdien, respectively. Cellular uptake of the compounds 99m Tc-Acdien-LHRH, Re-Acdien-LHRH, and Re-Acdien-peg-LHRH was found to be significantly enhanced compared to that of untargeted 99m Tc alone and unlabeled [Re(CO) 3 (H 2 O) 3 ] + . In addition, the conjugate compounds showed no difference in cellular toxicity compared to untargeted 99m Tc alone or unlabeled [Re(CO) 3 (H 2 O) 3 ] + . Further, a competition assay using LHRH indicated selective targeting of Re-Acdien-peg-LHRH toward the LHRH receptor ( p < 0.05) compared to that of [Re(CO) 3 (H 2 O) 3 ] + alone. Together, our data show the design paradigm and synthesis of targeting radionuclides using the LHRH peptide. Our data suggests that utilizing the LHRH peptide can lead to selective targeting and diagnosis of breast cancers expressing the LHRH receptor., Competing Interests: The authors declare no competing financial interest., (© 2021 The Authors. Published by American Chemical Society.)

Background: Velocity- and power-based training are popular methods of determining training session loads and volumes. One factor that may influence load-velocity and load-power properties of an individual is the myosin heavy chain (MHC) composition of the muscle. The aim of this study was to examine the relationship between MHC composition and both load-velocity and load-power properties of muscle performance., Methods: Forty-two men with a variety of training backgrounds took part in this study (mean±SD; age=22.4±3.5 yrs, hgt=1.78±0.07 m, BW=78.7±13.3 kg). After testing leg extension one repetition maximum (1 RM), subjects performed maximal effort leg extensions at loads from 30% to 90% 1 RM. Muscle biopsies from the vastus lateralis were analyzed via SDS-PAGE electrophoresis technique for MHC content (IIx=13.8±12.9%, IIa=49.4±10.3%, I=36.8±11.3%). Leg extension rotational velocity and power were plotted against relative loads for all subjects., Results: Significant correlations (P<0.05) were observed for MHC IIa with all performance variables (i.e. slopes, intercepts, peaks and relative loads). Relationships indicated that greater %MHC IIa was associated with greater velocity intercepts, more negative load-velocity slopes, greater maximal power, and with maximal power occurring at a lower relative intensity (% 1 RM)., Conclusions: These data indicate that muscle velocity and power characteristics appear to be partially influenced by MHC content in a manner consistent with single muscle fiber contractile properties.

This study aimed to establish the test/re-test reliability of two common interprofessional education (IPE) instruments, the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS), and to compare results based on previous IPE experience. The RIPLS and the IEPS were distributed to 251 students within five academic health science programs at one university. Both instruments were distributed at a second session 10-14 days later. Weighted Kappa, intraclass correlation coefficients (ICC), standard error of measurement, and minimal detectable change were calculated for each instrument's composite scores and subscales. Assessments occurred for all subjects and between students with and without previous IPE experience. Overall and between-group composite score reliability for the RIPLS and IEPS were excellent (ICC≥0.81). RIPLS subscale ICCs were variable per previous IPE experience, ranging from fair-excellent (ICC = 0.56-0.86). IEPS subscale ICCs were excellent for students with previous IPE experience (ICC≥0.76), and fair-excellent for students without previous experience (ICC = 0.64-0.84). Students with previous IPE experience had significantly higher scores within and between sessions for the RIPLS (p ≤ 0.031) but not the IEPS. Both instruments have acceptable measurement consistency; however, the RIPLS varied in repeatability compared to the IEPS. Previous IPE experience should be accounted for when distributing/interpreting the results.

Background: COVID-19 has had a significant effect on all aspects of life and occupational performance most recently., Objective: This aim of this article was to discuss the concept of interference and the role that interference plays in productivity and potential across healthcare settings., Methods: The framework design was the application of Bolea and Atwater's interference framework to probe the COVID-19 pandemic within healthcare organizations., Results: Leadership that focuses on transparency, frequent metric measurement can increase potential and then managing for unintended consequences can foster optimal occupational performance for both the practitioner and client., Conclusion: Interference is a critical concept in understanding organizational behavior. Transparent leadership is needed to adequately support organizations to create resilience in the workplace.

Introduction: Hemorrhagic shock (HS) and resuscitation (RES) cause ischemia-induced intestinal permeability due to intestinal barrier breakdown, damage to the endothelium, and tight junction (TJ) complex disruption between enterocytes. The effect of hemostatic RES with blood products on this phenomenon is unknown. Previously, we showed that fresh frozen plasma (FFP) RES, with or without directed peritoneal resuscitation (DPR) improved blood flow and alleviated organ injury and enterocyte damage following HS/RES. We hypothesized that FFP might decrease TJ injury and attenuate ischemia-induced intestinal permeability following HS/RES., Methods: Sprague-Dawley rats were randomly assigned to groups (n = 8): sham; crystalloid resuscitation (CR) (HS of 40% mean arterial pressure for 60 minutes) and CR (shed blood plus two volumes of CR); CR and DPR (intraperitoneal 2.5% peritoneal dialysis fluid); FFP (shed blood plus one volume of FFP); and FFP and DPR (intraperitoneal dialysis fluid plus two volumes of FFP). Fluorescein isothiocyanate-dextran (molecular weight, 4 kDa; FD4) was instilled into the gastrointestinal tract before hemorrhage; FD4 was measured by UV spectrometry at various time points. Plasma syndecan-1 and ileum tissue TJ proteins were measured using enzyme-linked immunosorbent assay. Immunofluorescence was used to visualize claudin-4 concentrations at 4 hours following HS/RES., Results: Following HS, FFP attenuated FD4 leak across the intestine at all time points compared with CR and DPR alone. This response was significantly improved with the adjunctive DPR at 3 and 4 hours post-RES (p < 0.05). Resuscitation with FFP-DPR increased intestinal tissue concentrations of TJ proteins and decreased plasma syndecan-1. Immunofluorescence demonstrated decreased mobilization of claudin-4 in both FFP and FFP-DPR groups., Conclusion: Fresh frozen plasma-based RES improves intestinal TJ and endothelial integrity. The addition of DPR can further stabilize TJs and attenuate intestinal permeability. Combination therapy with DPR and FFP to mitigate intestinal barrier breakdown following shock could be a novel method of reducing ischemia-induced intestinal permeability and systemic inflammation after trauma., Level of Evidence: Prognostic/Epidemiologic, Level III., (Copyright © 2020 American Association for the Surgery of Trauma.)

The purpose of this study was to explore users' perspectives on power wheelchair service delivery and understand their involvement in the equipment trial and selection process. Five power wheelchair users participated in. Responses and interview data analysis supported four main themes describing variability in the evaluation practices of the provider team, how consumers' participation goals were impacted by equipment usability, consumer involvement in equipment selection influenced satisfaction, and illustrated the complexities in the service delivery process. The conclusion suggests consumer involvement in the trial and selection process may contribute to power wheelchair outcome usability, satisfaction, and occupational engagement.

Our relationship with plastic is complex. While the societal benefits of plastic are undeniable, plastic has also come to occupy a central role within a culture of waste and disposable living that constitutes a significant problem for health and the natural environment. Public awareness of the harms asociated with plastic is high, thanks, in part, to a range of sustained media exposure. This, however, has so far failed to materialize in any significant global reduction in plastic pollution. Meaningful regulatory change that adressess the harms of plastic at the point of production is curiously absent, while some apparent gains have been rolled back-against a backdrop of a global pandemic and a rehabilitation of plastic. This article highlights the assemblage of media, government and corporate interests that performs the role of what we identify as the "Environmental Crisis Industry" ("ECI"), which perpetuates stasis in the face of environmental catastrphe. The ECI manages our anxieties through media discourses of precarity and danger, while at the same time, offering us attainable "solutions" that exist well within the logic of consumer capitalism-in effect, compelling us (at least morally) to become eco-consumers. In this way, the political energy of grassroots climate resistance is "pre-corporated," so to speak, into the product design of major corporations, dissipating the chance of real progressive change in favor of a new green spirit of capitalism., (© The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature 2021.)

We combine experimentally verified constraints on brine thermodynamics along with a global circulation model to develop a new extensive framework of brine stability on the surface and subsurface of Mars. Our work considers all major phase changes (i.e., evaporation, freezing, and boiling) and is consistent, regardless of brine composition, so it is applicable to any brine relevant to Mars. We find that equatorial regions typically have temperatures too high for stable brines, while high latitudes are susceptible to permanent freezing. In the subsurface, this trend is reversed, and equatorial regions are more favorable to brine stability, but only for the lowest water activities (and lowest eutectic temperatures). At locations where brines may be stable, we find that their lifetimes can be characterized by two regimes. Above a water activity of ~0.6, brine duration is dominated by evaporation, lasting at most a few minutes per sol. Below a water activity of 0.6, brine duration is bound by freezing or boiling; such brines are potentially stable for up to several consecutive hours per sol. Our work suggests that brines should not be expected near or on the Martian surface, except for low eutectic water activity salts such as calcium or magnesium perchlorate or chlorate, and their (meta)stability on the surface would require contact with atmospheric water vapor or local ice deposits.

Introduction: Impaired intestinal microvascular perfusion following resuscitated hemorrhagic shock (HS) leads to ischemia-reperfusion injury, microvascular dysfunction, and intestinal epithelial injury, which contribute to the development of multiple organ dysfunction syndrome in some trauma patients. Restoration of central hemodynamics with traditional methods alone often fails to fully restore microvascular perfusion and does not protect against ischemia-reperfusion injury. We hypothesized that resuscitation (RES) with fresh frozen plasma (FFP) alone or combined with direct peritoneal resuscitation (DPR) with 2.5% Delflex solution might improve blood flow and decrease intestinal injury compared with conventional RES or RES with DPR alone., Methods: Sprague-Dawley rats underwent HS (40% mean arterial pressure) for 60 minutes and were randomly assigned to a RES group (n = 8): sham, HS-crystalloid resuscitation (CR) (shed blood + two volumes CR), HS-CR-DPR (intraperitoneal 2.5% peritoneal dialysis fluid), HS-FFP (shed blood + two volumes FFP), and HS-DPR-FFP (intraperitoneal dialysis fluid + two volumes FFP). Laser Doppler flowmeter evaluation of the ileum, serum samples for fatty acid binding protein enzyme-linked immunosorbent assay, and hematoxylin and eosin (H&E) staining were used to assess intestinal injury and blood flow. p Values of <0.05 were considered significant., Results: Following HS, the addition of DPR to either RES modality improved intestinal blood flow. Four hours after resuscitated HS, FABP-2 (intestinal) and FABP-6 (ileal) were elevated in the CR group but reduced in the FFP and DPR groups. The H&E staining demonstrated disrupted intestinal villi in the FFP and CR groups, most significantly in the CR group. Combination therapy with FFP and DPR demonstrated negligible cellular injury in H&E graded samples and a significant reduction in fatty acid binding protein levels., Conclusion: Hemorrhagic shock leads to ischemic-reperfusion injury of the intestine, and both FFP and DPR alone attenuated intestinal damage; combination FFP-DPR therapy alleviated most signs of organ injury. Resuscitation with FFP-DPR to restore intestinal blood flow following shock could be an essential method of reducing morbidity and mortality after trauma.

Objective: Examine the impact of the Summer Food Service Program (SFSP) on the intentions to positively change fruit and vegetable consumption in a rural, low-income adolescent population using the Theory of Planned Behavior., Design: Quantitative data collected via a pre-post intervention survey to determine predictors of positive nutrition behaviors and changes in self-reported fruit and vegetable consumption., Setting: A mid-sized university., Participants: Fifty-seven high school students. Participants were primarily female (n = 36) and white (n = 56)., Intervention: Participants followed the standards of the SFSP for 5 weeks and were provided with mandatory and optional nutrition education sessions., Main Outcome Measure: Intentions to change nutrition behaviors., Analysis: Multiple regression., Results: Paired-sample t test showed a significant increase in knowledge from pretest (mean [M] = 11.18, SD = 1.68) to posttest (M = 12.91, SD = 1.76); t[56] = -8.09, P < 0.001; (t[56] = -8.09, P < 0.001) and in self-reported fruit and vegetable intake from pretest (M = 13.96, SD = 4.23) to posttest (M = 16.80, SD = 5.42); (t[56] = -3.20, P = 0.002). Regression demonstrated that all constructs of the Theory of Planned Behavior were significant (F[4, 52] = 14.56, P < 0.001 with an R 2 of 0.53) for their effects on behavior intentions with perceived behavioral control being the most salient predictor., Conclusions and Implications: Opportunities for shaping adolescent nutrient intake and eating behaviors during enrollment in the SFSP exist. Reinforcing positive attitudes, subjective norms, and perceived behavioral control may help to increase nutrition behavioral intentions and nutrition behaviors., (Copyright © 2020 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To describe trends in hospice social work visits in the last week of life before and after the introduction of the service intensity add-on (SIA) payment reform in 2016. Background: SIA was introduced to compensate hospices for the intensity of caring for individuals at the end of life; it is an hourly rate paid for registered nurse and social worker visits occurring during the last week of a beneficiary's life. Little is known about how hospices responded to this payment incentive. Design: This is a pre-post descriptive study. Setting/Subjects: Subjects were 2015-2016 hospices caring for Medicare beneficiaries. Results: We find a modest increase in social work visits in the last week of life from 2015 (pre-SIA) to 2016 (post-SIA). This modest increase masks significant variation based on organizational characteristics, such as size, facility type, and participation in payment demonstrations. Discussion: Our findings underscore the importance of examining both the overall impact of this type of policy and the change in distribution to identify whether change is being realized uniformly or is associated with certain types of organizations. A number of potential barriers exist to responding to policy incentives that may not be evenly felt across the hospice community.

Little is known about how home health aides (HHAs) perceive the daily physical challenges and risks of injury they face in their line of work. The objectives of this study were to 1) gain detailed information about the daily experiences of HHAs, 2) identify physical challenges of their work, and 3) determine if there is a role for occupational therapists (OTs) in injury prevention through education. A qualitative descriptive approach using semistructured phone interviews that were recorded and transcribed was used. Colaizzi's descriptive phenomenological method was used to guide data analysis. Participants were recruited through convenience sampling and included eight female HHAs with an age range of 35 to 65 years. The following themes were identified: HHAs valued the use of a client-centered approach with their clients (Know the rules and know your clients even better), HHAs assisted their patients with a wide range of activities of daily living and instrumental activities of daily living to support their independence within their home (More than Activities of Daily Living), transferring clients was considered the most physically demanding task (Would you like a hand with your transfer?), and participants believed new HHAs could benefit from training in patient positioning, appropriate use of adaptive equipment, and proper lifting mechanics in various contexts (Let's get physical!). The areas of overlap between HHAs' needs and OTs' skills provide an opportunity for OTs to consult with home care agencies as educators.

Researchers have argued that bilingual speakers experience less emotion in their second language. However, some studies have failed to find differences in emotionality between first and second language speakers. We used computer mouse tracking in an auditory lexical decision task to examine taboo effects - more efficient processing of taboo than neutral words - in first (L1) and second (L2) language speakers of American English. As predicted, we found an effect of language (L1 participants processed words more efficiently than L2 participants did) and a taboo effect (taboo words were processed more efficiently than neutral words). Interestingly, the language by taboo interaction (less emotionality in second language) emerged in number of errors and in the mouse trajectories, but it did not emerge in reaction times. We discuss how different aspects of participants' responses are likely to capture different underlying cognitive processes. We conclude, as other researchers have reported and many bilinguals experience, that language processing in second language is less emotional.

Central Kentucky could be considered a critical source area of nutrients in water ways because of low permeability soils, fast groundwater flow through bedrock fractures, and pervasive agriculture and development. Of particular concern is rising development in rural areas, which creates mixed land cover (MLC) watersheds, i.e., watersheds with development, agriculture, and other land cover types. MLC watersheds add complexity to spatial and temporal releases of dissolved constituents, leading to less predictable water quality patterns. The goal of this research was to examine the export of dissolved substances from a small, upland MLC catchment in central Kentucky with a focus on how the interaction between discharges from developed agricultural land cover and groundwater influence base flow water quality. Our approach was to spatially sample a representative catchment monthly over 1 year, characterize the major dissolved constituents, and evaluate catchment processes with statistical analyses and Piper diagrams. Principal component analysis, factor analysis, and Piper diagrams indicate base flow was composed of groundwater influenced by two different host rocks and an outfall draining a developed region. Base flow nutrient export was dominated by mixing nitrate-sulfate rich groundwater with ammonium-phosphate-chloride rich outfall drainage. High nitrate groundwater dominated nitrogen export in the winter, whereas high ammonium outfall drainage dominated summer export. Spatial analysis revealed that ~ 10% of the basin may have similar land cover and hydrologic processes, suggesting that MLC catchments are small but collectively significant nitrogen sources to river networks due to development and agriculturally impacted groundwater.

A growing body of research has evoked the life-course perspective to understand how experiences in school relate to a wide range of longer term life outcomes. This is perhaps best typified by the notion of the school-to-prison pipeline which refers to a process by which youth who experience punitive punishment in schools are increasingly enmeshed within the criminal justice system. While this metaphor is commonly accepted, few studies have examined the extent to which exclusionary school discipline significantly alters pathways toward incarceration as youth transition into young adulthood. Applying a life-course perspective and leveraging 15 waves of data from the National Longitudinal Survey of Youth 1997, this study examines how school suspensions influence the odds of imprisonment during young adulthood. Mixed-effects longitudinal models demonstrate that receiving a suspension serves as a key turning point toward increased odds of incarceration, even after accounting for key covariates including levels of criminal offending. However, results show that repeated suspensions do not appear to confer additional risk of incarceration. Results carry implications for the ways in which school punishment impacts youths' life-course., Competing Interests: Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Limited descriptions of preoperative education programs for total knee replacement (TKR) surgery are provided in the literature, and the most effective program design is currently unknown., Purpose: The purpose of this qualitative study is to describe orthopaedic nurses' perceptions of preoperative education prior to TKR surgery., Methods: Ten participants completed phone interviews and transcripts were analyzed qualitatively for themes among participants., Results: Participants believed that preoperative education was a significant component impacting patient outcomes following surgery. Interprofessional preoperative education was valued, but pragmatic factors were identified as barriers to the inclusion of other disciplines within these programs. Education programs were constantly evolving on the basis of evidence-based practice and changes to orthopaedic protocols. Pragmatic factors influenced all aspects of program design, such as the timing and length of education sessions., Conclusions: Results from this study provide descriptions of factors that influence program design and can be used to restructure education programs for improved patient outcomes.

The olfactory system serves a vital role in the evolution and survival of insects, being involved in behaviors such as host seeking, foraging, mating, and oviposition. Odorant-binding proteins (OBPs) and chemosensory proteins (CSPs) are involved in the olfactory recognition process. In this study, BtabCSP11 , a CSP11 gene from the whitefly Bemisia tabaci , was cloned and characterized. The open reading frame of BtabCSP11 encodes 136 amino acids, with four highly conserved cysteine residues. The temporal and spatial expression profiles showed that BtabCSP11 was highly expressed in the abdomens of B. tabaci females. Dietary RNA interference (RNAi)-based functional analysis showed substantially reduced fecundity in parthenogenetically reproduced females, suggesting a potential role of BtabCSP11 in B. tabaci reproduction. These combined results expand the function of CSPs beyond chemosensation., (Copyright © 2020 Zeng, Merchant, Wu, Wang, Kong, Zhou, Xie and Zhang.)

The habitat boundaries between crops and seminatural areas influence bee movements and pollination services to crops. Edges also provide favorable conditions for invasive plants, which may usurp pollinators and reduce visitation to native or crop plants. Alternatively, floral displays of alien plants may facilitate, or increase, the pollination success of adjacent plants by attracting more pollinators to the area. Therefore, pollination services of bees from seminatural habitats to crop areas should vary with the presence of invasive floral resources and distance from habitat edges. To test the hypothesis that floral resources of invasive forest shrubs affect the bee community and pollination services in adjacent crop fields, we conducted a 2-yr field experiment along forest-crop edges at five isolated forest remnants. We removed flower buds from a dominant invasive shrub, Lonicera maackii (Amur honeysuckle), along forest-crop edges and paired removals with controls of intact flowers. The bee community, their pollination services, and flower visitation rates were quantified along a 200-m gradient into an adjacent crop field using pan traps and sentinel cucumber plants. Impacts to the bee community were dependent of bee functional traits. Larger bees visited fewer sentinel cucumber flowers in flower removal plots, which corresponded with decreased cucumber pollination compared to plots with honeysuckle flowers at distances >100 m from forest edges. Small-bodied and weaker flying bees visited sentinel plants more frequently closer to the forest edge and increased pollination services to cucumber at distances <100 m from L. maackii shrubs in flower removal plots. After 2 yr, bee abundance and species richness increased within flower removal plots across all distances. High functional diversity of the bee community increased pollination services to sentinel plants and increased cucumber production within 200 m from forest remnants. Our findings suggest that dense floral resources of invasive shrubs suppressed forest-edge bee communities and their pollination services, but also attracted large-bodied generalist bees, which were effective pollinators. This study helps explain how life histories and functional attributes of bees can predict either facilitation or suppression of pollination services to crop or native plants in response to invasive floral resources., (© 2020 by the Ecological Society of America.)

Ovulation is triggered by the gonadotropin surge that induces the expression of two key genes, progesterone receptor (Pgr) and prostaglandin-endoperoxide synthase 2 (Ptgs2), in the granulosa cells of preovulatory follicles. Their gene products PGR and PTGS2 activate two separate pathways that are both essential for successful ovulation. Here, we show that the PGR plays an additional essential role: it attenuates ovulatory inflammation by diminishing the gonadotropin surge-induced Ptgs2 expression. PGR indirectly terminates Ptgs2 expression and PGE2 synthesis in granulosa cells by inhibiting the nuclear factor κB (NF-κB), a transcription factor required for Ptgs2 expression. When the expression of PGR is ablated in granulosa cells, the ovary undergoes a hyperinflammatory condition manifested by excessive PGE2 synthesis, immune cell infiltration, oxidative damage, and neoplastic transformation of ovarian cells. The PGR-driven termination of PTGS2 expression may protect the ovary from ovulatory inflammation., Competing Interests: Declaration of Interests The authors declare no competing interests., (Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)

Statement: Despite increased attention on diversity in medicine and healthcare, heterogeneity in simulation technology has been slow to follow suit. In a nonsystematic review of simulation technology available in 2018 with respect to skin tone, age and sex, we found limited diversity in these offerings, suggesting limitations to educators' abilities to represent the full array of patients, conditions, and scenarios encountered in medicine and training. We highlight these limitations and propose basic strategies by which educators can increase awareness of and incorporate diversity into the simulation arena.

Hypertension in older adults is extremely common. It constitutes the major modifiable risk factor of cardiovascular disease, premature disability, and death. Despite proven benefits of blood pressure (BP) reduction in older individuals, there is a considerable disagreement between major guidelines surrounding the optimal levels of BP treatment and control to be achieved. Given the high prevalence of older adults with hypertension, nurse practitioners should critically examine the overall benefit of treatment, use of antihypertensive therapies, and BP targets to provide high-quality care to this patient population. The purpose of this article is to outline the evidence surrounding the management of BP in older adults and to offer strategies to reconcile conflicting guideline recommendations.

Objective: The objective of this review is to explore and synthesize the evidence on the experience of self-managing multiple sclerosis fatigue among adult patients., Introduction: Multiple sclerosis is a growing neurologic auto-immune disease, and fatigue is considered one of the most common and debilitating side effects. Understanding how multiple sclerosis patients experience fatigue, the cause of their fatigue, as well as how they self-manage their fatigue will better inform healthcare providers and patients., Inclusion Criteria: The review will consider qualitative studies investigating the perceptions, experiences and meaning of fatigue associated with multiple sclerosis, the factors contributing to fatigue and the self-management strategies used to control fatigue in adults. Studies that include adult patients diagnosed with multiple sclerosis and experiencing fatigue, regardless of their participation in pharmacological interventions and non-pharmacological interventions, will be included. Any patients with multiple sclerosis residing in hospital-based care or residential in patient care will not be included., Methods: A three-step search strategy will be utilized in this review. The initial step consists of a limited search in MEDLINE and CINAHL using "multiple sclerosis" and "fatigue" as search terms. Studies will be excluded if they have not been translated into English, but will not be limited by date. Each article will go through a preliminary review based on title and abstract to exclude any articles not pertaining to this study. After the search is completed, two reviewers will individually appraise retrieved qualitative studies for methodological quality prior to inclusion in the review. Findings will be pooled using meta-aggregation, and a ConQual Summary of Findings will be presented.

Background: Direct comparison of 2D images is computationally inefficient due to the need for translation, rotation, and scaling of the images to evaluate their similarity. In many biological applications, such as digital pathology and cryo-EM, often identifying specific local regions of images is of particular interest. Therefore, finding invariant descriptors that can efficiently retrieve local image patches or subimages becomes necessary., Results: We present a software package called Two-Dimensional Krawtchouk Descriptors that allows to perform local subimage search in 2D images. The new toolkit uses only a small number of invariant descriptors per image for efficient local image retrieval. This enables querying an image and comparing similar patterns locally across a potentially large database. We show that these descriptors appear to be useful for searching local patterns or small particles in images and demonstrate some test cases that can be helpful for both assembly software developers and their users., Conclusions: Local image comparison and subimage search can prove cumbersome in both computational complexity and runtime, due to factors such as the rotation, scaling, and translation of the object in question. By using the 2DKD toolkit, relatively few descriptors are developed to describe a given image, and this can be achieved with minimal memory usage., Competing Interests: Competing interestsThe authors declare no competing interest., (© The Author(s) 2020.)

Background: Speech and language therapy (SLT) benefits people with aphasia following stroke. Group level summary statistics from randomised controlled trials hinder exploration of highly complex SLT interventions and a clinically relevant heterogeneous population. Creating a database of individual participant data (IPD) for people with aphasia aims to allow exploration of individual and therapy-related predictors of recovery and prognosis., Aim: To explore the contribution that individual participant characteristics (including stroke and aphasia profiles) and SLT intervention components make to language recovery following stroke., Methods and Procedures: We will identify eligible IPD datasets (including randomised controlled trials, non-randomised comparison studies, observational studies and registries) and invite their contribution to the database. Where possible, we will use meta- and network meta-analysis to explore language performance after stroke and predictors of recovery as it relates to participants who had no SLT, historical SLT or SLT in the primary research study. We will also examine the components of effective SLT interventions., Outcomes and Results: Outcomes include changes in measures of functional communication, overall severity of language impairment, auditory comprehension, spoken language (including naming), reading and writing from baseline. Data captured on assessment tools will be collated and transformed to a standardised measure for each of the outcome domains., Conclusion: Our planned systematic-review-based IPD meta- and network meta-analysis is a large scale, international, multidisciplinary and methodologically complex endeavour. It will enable hypotheses to be generated and tested to optimise and inform development of interventions for people with aphasia after stroke., Systematic Review Registration: The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42018110947).

Background: Preoperative education aids in reducing the incidence of poor outcomes after total knee replacement (TKR) and increasing patient readiness for discharge home but is not well described in the literature., Purpose: The purpose of the study is to describe the current design of preoperative education for TKR across the United States., Methods: A large, national sample of orthopaedic nurses completed an online survey to describe preoperative education at their facilities., Results: Most participants provided preoperative education as part of interprofessional teams in either a group format or combined group and individual education. Verbal instruction was the most common educational delivery method, followed by written instruction. Education typically lasted between 1 and 1.5 hours, was delivered in a single session, and included a variety of topics., Conclusion: Results of this study describe preoperative educational practices and can support future research to improve patient outcomes following TKR surgery.

Despite federal mandates to transition students with disabilities to successful adulthood, outcomes have been poor. Although areas of occupational therapy expertise, such as life and work skills, are effective in improving transition outcomes, occupational therapy personnel rarely provide transition services. The purpose of this study was to examine the effectiveness of occupational therapy transition readiness services for students with disabilities, 14 to 16 years of age, over two academic years of intervention. Forty-two students and 14 occupational therapy personnel from 10 school districts participated. Assessments were provided to transition teams. Peer groups explored work and life skills and completed long-term student-led projects. Pre-post scores of functional behavior were analyzed using a proportional change index. Students receiving occupational therapy transition readiness services demonstrated statistically significant gains. Occupational therapy holds potential to increase the functional readiness of students with disabilities for transition to a successful and productive adult life.

In the "Libet experiment" the onset of movement-related brain activity preceded the reported time of the conscious intention to move, suggesting that conscious intention may not play a role in initiating voluntary movements (Libet, Gleason, Wright, & Pearl, 1983). Dominik et al. (2017) provided evidence that the intention reports employed in the Libet experiment, which Libet et al. (1983) found to precede movement reports, are invalid. In the study by Dominik et al., intention reports preceded movement reports only when participants had prior experience making movement reports. Individuals without such experience reported intention around the same time as movement. These findings suggest that Libet's intention reports do not reflect experiences of intention, but, rather, inferences based on prior experience with movement reports. Our study replicated the core findings of Dominik et al. We argue that Libet's intention reports are invalid and explore the phenomenology of intention in the Libet experiment., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Despite decreases in offending and victimization in schools across the United States, many schools continue to use exclusionary discipline. Although school punishment has been tied to a variety of negative outcomes, the link between suspension and offending remains unclear. Using data from the National Longitudinal Survey of Youth 1997, this study examines the extent to which school punishment contributes to within-individual increases in offending across time and/or amplifies offending between-individuals. Results of a series of cross-lagged dynamic fixed-effects panel models reveal that school suspensions contribute to within-individual increases in offending. This relationship remains even when accounting for the effect of baseline levels of offending on future offending. Further, repeated suspensions amplify offending differences between-individuals., Competing Interests: Disclosure statement No potential conflict of interest was reported by the author(s).

Purpose of Review: This review will outline scapular function in throwing, discuss scapular dyskinesis as an impairment of function that can be associated with throwing injuries and altered performance, and present an algorithm that encompasses guidelines for evaluation and can serve as a basis for treatment., Recent Findings: Optimal scapular function is integral to optimal shoulder function. Multiple roles of the scapula in arm function and throwing have been identified while scapular dysfunction continues to be associated with various shoulder pathologies. Although scapular motion alterations may be common in overhead athletes, various reports have shown that identification and management of the alterations can result in improved rehabilitation and performance outcomes. Baseball throwing occurs as the result of integrated, multisegmented, sequential joint motion, and muscle activation within the kinetic chain. The scapula is a key component link within the chain through its function to maximize the scapulohumeral rhythm and efficient throwing mechanics. Evaluation and management beginning with the scapula can produce improved outcomes related to shoulder pathology in overhead athletes.

Nigeria has the highest number of neonatal and under-five deaths in Africa. Socio-cultural determinants play an important role in disease burden in low-middle income countries. This study aimed to describe knowledge, attitudes and neonatal care practice among household caregivers in a rural community in Nigeria, specifically uvulectomy, female genital mutilation (FGM), failure to routinely immunize and unsafe cord care. Further, relationships between demographic characteristics and knowledge, attitudes and neonatal care practices among caregivers were analyzed. The study design was descriptive correlational and cross-sectional. Consented caregivers (N = 298) were enrolled and interviewed using a structured questionnaire. Data were collected on demographic characteristics of the study participants and practice of uvulectomy, FGM, immunization and cord care. Statistically significant correlations were found between the practice of uvulectomy, FGM and failure to immunize based on occupation (p = 0.0202, p = 0.0290, p = 0.0071) and educational level (p =< 0.0001, p =< 0.0001, p =< 0.0001), with variations by ethnicity. Intense, preventative health measures and maternal education to eliminate harmful care practices are essential to influence outcomes., (© The Author(s) [2019]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Physical therapy (PT) and occupational therapy (OT) professional associations assert the importance that entry-level therapists learn and apply the knowledge and skills necessary for interprofessional collaborative practice; however, the majority of PT and OT programs do not have the other discipline at their university. A challenge exists for the creation of a transparent active learning opportunity promoting interprofessional student engagement when the two professions do not reside in the same university. This case study provides a model for how to feasibly create an interprofessional experience for students in universities that do not include a complementary or collaborative allied health professional program, using various technologies. While creating this collaborative project, we provided opportunities to meet the Interprofessional Education Collaborative's (IPEC) competencies: a) value/ethics for interprofessional practice, b) roles and responsibilities, c) interprofessional communication, and d) teams and teamwork through participation in a breast cancer survivorship research study. Within this demonstration project, the faculty were able to make "micro level" changes to foster interprofessional collaboration among universities with other allied health profession programs, which may lead to improved health outcomes for our clients.

In forensic casework, Y-chromosome short tandem repeats (Y-STRs) are essential for differentiating between unrelated males and resolving the male component of admixed biological evidence. While the majority of Y-STRs are adequate for discriminating between different paternal lineages, rapidly mutating Y-STRs are necessary for improving discrimination between males within populations of low Y-chromosome diversity and between paternal relatives. Alternatively, sequencing of Y-STRs may also improve the discrimination between isometric Y-STR alleles by identifying variation in the repeat unit pattern arrangements and by identifying SNPs in the flanking region or within the STR repeat unit itself. In this report, a total of 153 DNA sequences are presented across the Y-STR loci DYS710, DYS518, DYS385, DYS644, DYS612, DYS626, DYS504, DYS481, DYS447 and DYS449. A total of 94 Y-STR sequences provided herein are reported for the first time, of which 37 sequences represent alleles showing size homoplasy, 34 sequences of known alleles for which sequence data has been unavailable and a total of 23 novel allele sequences across loci DYS644, DS447, DYS710 and DYS504. This study further encountered a rare sequence variant in the 5' flanking region of DYS385 and a total of two SNPs in the repeat structure at DYS481 and DYS449.

Aims and Objectives: To qualitatively evaluate an early mobilisation quality improvement project implemented on a general medicine unit., Background: Early mobility quality improvement projects show promising quantitative results yet have failed to collect data from patient and staff experience associated with physical activity during illness and the impact of this change in clinical practice., Design: A mixed methods case study was used to evaluate a mobility quality improvement project. Quantitative results will be published separately. The qualitative evaluation used a phenomenological lens to explore the patient and staff experience., Methods: Semi-structured interviews with twelve participants (four patients and eight staff) were performed during the project. Data were analysed using open coding, direct interpretation and then categorised into an overarching and four supporting themes. Findings are reported per the Standards for Reporting Qualitative Research., Results: Participants reported that early mobilisation bridged a gap in care. Staff understood the benefits of early mobility. Patients expressed how mobility aligned with personal preferences and their need to prepare for hospital discharge. Greater functional independence and higher mobility levels in patients on the unit reduced staff level of care. When patients were consistently presented with opportunities to be mobile and active, they expected mobility to be a part of their daily care plan., Conclusions: Findings suggest that early mobility quality improvement projects have the potential to transform clinical practice and improve the quality of care for patients in acute care., Relevance to Clinical Practice: All members of the healthcare team, including the patient, recognise the importance of maintaining mobility and function during hospitalisation yet focus on these needs are often delayed or missed. Early mobility quality improvement projects help to set patient expectations and build a culture that promotes patient mobility and function during acute illness., (© 2019 John Wiley & Sons Ltd.)

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) bridges a significant gap in psychiatric nosology by providing trait-based characterizations of psychopathy along with antisocial personality disorder within the Section III alternative model for personality disorders (AMPD). However, the representation of psychopathy in the AMPD has met with some criticisms (Crego & Widiger, 2014; Few, Lynam, Maples, MacKillop, & Miller, 2015). The current study was undertaken to establish an improved means for characterizing psychopathy in DSM-5 Section III terms, by creating scale measures of triarchic psychopathy dimensions using items from the best-established assessment instrument for the AMPD, the Personality Inventory for DSM-5 (PID-5). Using data from a sample of community adults (N = 210), we employed a construct rating and psychometric refinement approach to develop item-based PID-5 Triarchic scales for measuring psychopathy dimensions of boldness, meanness, and disinhibition. The validity of the PID-5 Triarchic scales was then evaluated in relation to criteria including other scale measures of the triarchic constructs and psychopathy, self-reported antisocial behavior and substance use, empathy, internalizing and other clinical problems, and personality within the development sample and a separate independent sample of adults (N = 240) recruited to have elevated psychopathic traits. Results of this work provide a foundation for improved characterization of psychopathy in terms of the AMPD trait system and provide a mechanism for future research oriented toward clarifying the developmental interface between childhood conduct disorder and psychopathy, as well as identifying neurobiological correlates of dimensions of psychopathy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

This study examined whether sleep quality is associated with hand function above and beyond what can be explained by the effect of pain and carpal tunnel syndrome (CTS) severity on hand function in clients with CTS. The sample included 53 adults ages 30-86 yr. The Manual Ability Measure-20, Pittsburgh Sleep Quality Index, visual analog scale for pain, and electromyography for CTS diagnosis and severity level were used to measure outcomes. Sleep quality was significantly associated with manual ability after controlling for CTS severity and pain. In CTS care, attention to sleep is significant because it may promote hand function., (Copyright © 2019 by the American Occupational Therapy Association, Inc.)

A rural community hospital provided a pilot patient deterioration simulation education for new graduate nurses in an attempt to advance the utilization of an existing rapid response team. Pre- and post-intervention self-confidence scores demonstrated a large effect size and a clinically significant eta squared value (.48). The participants successfully completed most of the simulation competencies. This pilot project supports further studies exploring new graduate nurses' self-confidence levels and competency performance with patient deterioration simulation education.

It is important to explore factors that could help or hinder one's wellbeing following a suicide attempt, which could yield not only negative consequences but also posttraumatic growth (PTG; positive changes following a traumatic event). The present study used a multivariate analysis of covariance (MANCOVA) to test the relationship between disclosure, PTG, and posttraumatic depreciation among suicide attempt survivors when controlling for time since attempt and to test whether these effects remained after controlling for quality of support from family and friends. Suicide attempt survivors ( n = 159) completed an online survey about their experiences. Increases in disclosure to family and friends but not to healthcare providers predicted changes in PTG. The effects of family disclosure remained even after controlling for quality of support. Disclosure to healthcare providers demonstrated some statistical effects on PTG, yet in the opposite direction and only after controlling for quality of support. The control variables-time since attempt and quality of support-were the only variables that predicted a change in posttraumatic depreciation. These findings suggest there is value in disclosing one's personal story to family regardless of whether one receives supportive responses and that social support can impact one's PTG.

The current study aimed to examine the effects of inconsistent responding on Psychopathic Personality Inventory-Revised (PPI-R; Lilienfeld & Widows, 2005) scale scores and the utility of the IR scale in detecting such responding in a correctional setting. The study employed an internally controlled method of simulating inconsistent responding by inserting ascending levels of computer-generated random responses into PPI-R protocols. Participants were 218 male inmates from a medium-security prison in central Kentucky in the United States. Results indicated that psychometric properties of PPI-R scores were substantially attenuated at as low as 40% of random responding. Additionally, results indicated that an Inconsistent Responding (IR) Scale cut-off of 40 would provide the best balance between sensitivity and specificity in detecting invalid PPI-R protocols. Overall, this study highlighted the utility of the IR Scale in self-report psychopathy measures and the need to consider such response biases in research and clinical settings.

Direct comparison of three-dimensional (3D) objects is computationally expensive due to the need for translation, rotation, and scaling of the objects to evaluate their similarity. In applications of 3D object comparison, often identifying specific local regions of objects is of particular interest. We have recently developed a set of 2D moment invariants based on discrete orthogonal Krawtchouk polynomials for comparison of local image patches. In this work, we extend them to 3D and construct 3D Krawtchouk descriptors (3DKDs) that are invariant under translation, rotation, and scaling. The new descriptors have the ability to extract local features of a 3D surface from any region-of-interest. This property enables comparison of two arbitrary local surface regions from different 3D objects. We present the new formulation of 3DKDs and apply it to the local shape comparison of protein surfaces in order to predict ligand molecules that bind to query proteins.

Importance: Adults receiving occupational therapy in inpatient rehabilitation are a heterogeneous population with differing needs, outcomes, and rehabilitation processes. Outcome studies based on what works for all clients may obscure the needs of population subgroups who benefit unequally from rehabilitation services., Objective: To identify subgroups on the basis of client satisfaction and progress in functional self-care among a diverse rehabilitation population and to understand subgroup differences in occupational therapy and rehabilitation processes and client discharge status., Design: Using an existing dataset, we used K-means cluster analysis of demographics, status at admission, and the outcomes of satisfaction and change in self-care to identify five homogeneous outcome groups. Occupational therapy and rehabilitation processes and discharge status were compared across subgroups., Setting: Inpatient rehabilitation hospital., Participants: The dataset included 1,099 inpatients age 18 yr and older who received occupational therapy over a 27-mo period., Measures: Admission measures included the Inpatient Rehabilitation Facility-Patient Assessment Instrument and self-care items of the FIM™. The Satisfaction with Continuum of Care-Revised was administered after discharge., Results: Five subgroups showed statistically different patterns of medical complications, functional self-care, rates of progress, satisfaction with intervention, and course of treatment. The profile of each group suggests differing therapeutic needs. Although all groups made significant gains in functional self-care, two groups continued to need physical assistance at discharge., Conclusion: and Relevance: Cluster analysis proved useful in segmenting a typical heterogeneous rehabilitation population into more homogeneous subgroups to enhance understanding of clinical needs and to potentially increase the potency of outcomes research., What This Article Adds: This research identified subgroups within a typical population of rehabilitation clients receiving occupational therapy and identified their unique needs and outcomes using cluster analysis techniques., (Copyright © 2019 by the American Occupational Therapy Association, Inc.)