Search

African American men present at later stages of testicular cancer and have higher mortality rates than Caucasian men. Lack of awareness, beliefs, and access to care may influence this disparity. Guided by the Powe fatalism model, this comparative study assessed knowledge of testicular cancer, perceived risk, and cancer fatalism among African American and Caucasian men who attended selected colleges and universities. Data were collected using the Powe Fatalism Inventory, the Testicular Cancer Knowledge Survey, and the Perceived Cancer Risk Survey. The majority ( n = 190) of men were African American (70%), and the remainder were Caucasian. African American men were significantly younger than Caucasian men. African American men also had lower testicular cancer knowledge scores, higher perceptions of cancer fatalism, and lower perceived risk for the disease. Rates of testicular cancer screening were low for all the men. Research should focus on further understanding the relationship between cancer fatalism and health-promoting behaviors among African American men.

Many traditional approaches to planning and deploying human capital have not been effective. Staffing offices are chaotic, budgets are overrun, staffing is frequently misaligned, a growing number of state legislatures are mandating nurse staffing levels, and dissatisfaction with work schedules abounds. The authors explores methodologies used in the science of logistics management, namely, systems theory and mathematical optimization modeling, which, when applied to human capital planning and deployment, can significantly improve business results. [ABSTRACT FROM AUTHOR]

This bimonthly department, sponsored by the American Organization of Nurse Executives, presents information to assist nurse leaders in shaping the future of healthcare through creative and innovative leadership. The strategic priorities of the American Organization of Nurse Executives anchor the editorial content. They reflect contemporary healthcare and nursing practice issues that challenge nurse executives as they strive to meet the needs of patients. In this article, the author discusses exit interview surveys that identify reasons why employees leave their organization, what may have encouraged them to stay, and what would entice them back to the organization. [ABSTRACT FROM AUTHOR]

Traditionally, nursing has measured job satisfaction by focusing on employees' likes and dislikes. However, job satisfaction is an unsatisfactory construct to assess either the jobs themselves or employees' feelings about work sinceas much as 30% of the variance explained in job satisfaction surveys is a function of personality, something employers can do little to change. Based on socio-technical systems theory, quality of nursing work life (QNWL) assessments focus on identifying opportunities for nurses to improve their work and work environment while achieving the organization's goals. Moreover, some evidence suggests that improvements in work life are needed to improve productivity. Therefore, assessing QNWL reveals areas for improvement where the needs of both the employees and the organization converge. The purpose of this article was to assess the QNWL of staff nurses using Brooks' Quality of Nursing Work Life Survey. [ABSTRACT FROM AUTHOR]

As the largest single employee component of hospitals, nurses are critical to the functioning of the organization, and improving employee productivity continues to be a common theme in the health care literature. However, any increased productivity will be transitory if achieved at the expense of the quality of nurses' work life (QNWL), since improvement in the QNWL is prerequisite to improved productivity. The conceptual components of the concept of QNWL that differentiate QNWL from the concept job satisfaction are explored. [ABSTRACT FROM AUTHOR]

Ten healthy subjects received 10 mg oral enalapril (MK 421) daily for a period of 8 days. Renal clearances of electrolytes, urate and phosphate were monitored and factored for glomerular filtration rate, as measured by creatinine clearance, with particular emphasis on the first and eighth day of treatment. Apart from a fall of around 10% in creatinine clearance between 1-2 h on both days 1 and 8, GFR remained unchanged throughout the study. Fractional sodium excretion increased in a biphasic manner by approximately 50% over control between 1-2 h and 4-8 h on day 1. Significant chloruresis (+39.0 +/- 12.9%) and kaluresis (+26.5 +/- 10.3%) occurred between 4-8 h. Urinary pH increased between 0-1 h (+0.29 +/- 0.12; P less than 0.05), and between 4-8 h (+0.50 +/- 0.08; P less than 0.01). The biphasic saluretic effect was also seen between 1-2 h and 4-8 h on day 8. Enalapril caused significant increases in urate and phosphate excretion on day 8 of therapy. There was a biphasic increase in fractional urate excretion at 1-2 h (+28.1 +/- 6.9%; P less than 0.05) and at 4-8 h (+21.0 +/- 6.0% P less than 0.01). Significant phosphaturia (+36.8 +/- 5.2%; P less than 0.05) was also observed at 4-8 h on day 8. Urinary drug excretion was also biphasic; over the first 2 h the predominant drug form was unchanged enalapril, whilst the peak excretion of the diacid metabolite, enalaprilat, occurred at 4-8 h.(ABSTRACT TRUNCATED AT 250 WORDS) [ABSTRACT FROM AUTHOR]

The effects of indacrinone (IND) have been investigated in a two part study. First, a total of 36 clearance studies have been performed in 14 healthy volunteers, under conditions of either maximal hydration or hydropenia, to compare the renal sites of action of single oral doses of IND, 20 mg, ethacrynic acid (EA), 100 mg, and hydrochorothiazide (HCTZ), 100 mg. Under conditions of maximal water hydration, IND increased fractional Na+ excretion from a mean of 1.19 +/- 0.05 to 4.93 +/- 0.67% of GFR. This was similar to the response seen with HCTZ, which increased fractional Na+ clearance up to 3.16 +/- 0.17% of GFR; EA increased fractional Na+ excretion up to 14.5 +/- 2.5% of GFR. The mean reduction in fractional free-water clearance (CH2O/GFR X 100%) invoked by IND, (delta = −34.8% of control) was similar to that produced by EA, (delta = −27.2% of control), and by HCTZ, (delta = - 26.6% of control). During hydropenia with superimposed mannitol diuresis, both IND and EA caused a fall in fractional free-water reabsorption (TcH2O/GFR X 100%), delta IND = −20.3% of control, delta EA = −70.1% of control. HCTZ produced a significant increase in fractional free-water reabsorption, delta HCTZ = −20.7% of control. In all studies, single doses of IND were both uricosuric and hypouricaemic. Fractional urate excretion increased from a mean 6.7 +/- 0.1 to 15.2 +/- 2.1% of GFR whilst plasma urate concentration fell from a mean of 0.36 +/- 0.03 to 0.34 +/- 0.03 mM (P less than 0.05) within 2- 3 h post drug. HCTZ and EA, in single doses, had little effect on urate excretion. In the second part of the study, a total of 16 healthy volunteers received either IND, 10 mg, or HCTZ 50 mg, orally for 8 days, whilst on a diet of controlled electrolyte content. Both drugs were well tolerated by both sets of subjects with no adverse clinical or pathological findings. Both IND and HCTZ caused a significant reduction in weight and standing systolic blood-pressure during the first 48 h of therapy. At the doses administered, IND and HCTZ displayed similar diuretic responses with respect to water, Na+, Cl-, Ca2+ and PO4(3-) excretion. IND produced less kaliuresis than HCTZ during the first treatment day but cumulative K+ loss was similar for both drugs over the eight days of therapy. Fractional urate excretion after IND remained elevated throughout the 8 days of therapy and the subjects remained isouricaemic for 7 days.(ABSTRACT TRUNCATED AT 400 WORDS) [ABSTRACT FROM AUTHOR]

1 The renal action of indacrinone (MK-196), a phenoxyacetic acid derivative with diuretic and uricosuric properties, has been studied in fifteen male subjects. 2 Increasing single doses of up to 60 mg of oral indacrinone produced a linear increase in urinary volume and excretion of Na+ and Cl-, whilst the responses of urinary K+, Ca2+, Mg2+ and uric acid excretion, rose to a plateau at the 40 mg dose. 3 Indacrinone evoked a rapid diuretic response which reached a maximum of 2-4 h and was largely complete at 8-12 h after administration. 4 During maximal hydration, indacrinone produced a substantial fall in fractional free water clearance (CH2O), from 8.89% to 5.83% of the filtered load of water, associated with an increase in osmolal clearance, from 1.38% to 5.78% of the filtered load of solute. The reduction in CH2O was of the same order as that produced by a dose of ethacrynic acid with comparable saluretic activity and significantly greater than that produced by an equi-saluretic dose of hydrochlorothiazide. These findings imply an action of indacrinone upon solute transport in the diluting segments of the distal tubule. 5 At the time of maximal indacrinone-induced saluresis, which amounted to an increase from 0.48% to 4.61% of the filtered load of NaCl, fractional urate clearance increased from 5.16% to 12.24% of the filtered load of uric acid. 6 Indacrinone is a long acting diuretic, sharing some properties in common with both loop diuretics and benzothiadiazines. The results are discussed in relation to structure-activity amongst derivatives of phenoxyacetic acid. [ABSTRACT FROM AUTHOR]

Twelve healthy male volunteers received single daily oral doses of enalapril (EN) 10 mg for 8 consecutive days. Serum samples for prolactin (PRL) assay were taken on day 0 (baseline) at 12.00 h and 16.00 h, and on days 1 and 8 at 08.00 h (pre-drug), 12.00 h and 16.00 h. The 08.00 h values on day 1 served as the pre-drug baseline. There were no significant changes from baseline in serum PRL levels on days 1 and 8. All mean serum PRL levels on day 8 were significantly (P less than 0.01) lower than the upper limit of the normal range (2-15 ng/ml) found for healthy males in this laboratory. It is concluded that therapeutic doses of EN (10 mg/day, p.o.) for 8 consecutive days do not raise mean serum PRL levels above the normal range in healthy male volunteers. [ABSTRACT FROM AUTHOR]

Health care innovation and entrepreneurship are key drivers of transformation in health care, re-shaping the way care is delivered, managed, and experienced. Innovation in health care spans a range of areas, including digital health, bio-technology, medical devices, tele-health, and health information systems. Entrepreneurs are leveraging technology to create solutions to improve patient outcomes, reduce costs, and address inefficiencies. Nurse inventors and entrepreneurs are blazing new trails that require nursing professional development leaders to consider new opportunities for collaboration. For nursing professional development leaders, fostering relationships with nurse entrepreneurs can unlock numerous benefits, from improving patient safety to enhancing nursing practice and facilitating advisory board appointments. [ J Contin Educ Nurs. 2024;55(11):517-519.] .

Introduction: Reducing cardiopulmonary bypass (CPB) induced inflammatory injury is a potentially important strategy for children undergoing multiple operations for single ventricle palliation. We sought to characterize the soluble receptor for advanced glycation end products (sRAGE), a protein involved in acute lung injury and inflammation, in pediatric patients with congenital heart disease and hypothesized that patients undergoing single ventricle palliation would have higher levels of sRAGE following bypass than those with biventricular physiologies., Methods: This was a prospective, observational study of children undergoing CPB. Plasma samples were obtained before and after bypass. sRAGE levels were measured and compared between those with biventricular and single ventricle heart disease using descriptive statistics and multivariate analysis for risk factors for lung injury., Results: sRAGE levels were measured in 40 patients: 19 with biventricular and 21 with single ventricle heart disease. Children undergoing single ventricle palliation had a higher factor and percent increase in sRAGE levels when compared to patients with biventricular circulations (4.6 vs. 2.4, p = 0.002) and (364% vs. 181%, p = 0.014). The factor increase in sRAGE inversely correlated with the patient's preoperative oxygen saturation (Pearson correlation (r) = -0.43, p = 0.005) and was positively associated with red blood cell transfusion (coefficient = 0.011; 95% CI: 0.004, 0.017; p = 0.001)., Conclusions: Children with single ventricle physiology have greater increase in sRAGE following CPB as compared to children undergoing biventricular repair. Larger studies delineating the role of sRAGE in children undergoing single ventricle palliation may be beneficial in understanding how to prevent complications in this high-risk population., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

CD163, a scavenger receptor with anti-inflammatory function expressed exclusively on monocytes/macrophages, is dysregulated in cases of diabetes complications. This study aimed to characterize circulating CD163+ monocytes in the presence (D +Comps ) or absence (D -Comps ) of diabetes-related complications. RNA-sequencing and mass cytometry were conducted on CD163+ monocytes in adults with long-duration diabetes and D +Comps or D -Comps . Out of 10,868 differentially expressed genes identified between D +Comps and D -Comps , 885 were up-regulated and 190 were down-regulated with a ≥ 1.5-fold change. In D +Comps , 'regulation of centrosome cycle' genes were enriched 6.7-fold compared to the reference genome. MIR27A, MIR3648-1, and MIR23A , the most up-regulated and CD200R1 , the most down-regulated gene, were detected in D +Comps from the list of 75 'genes of interest'. CD163+ monocytes in D +Comps had a low proportion of recruitment markers CCR5, CD11b, CD11c, CD31, and immune regulation markers CD39 and CD86. A gene-protein network identified down-regulated TLR4 and CD11b as 'hub-nodes'. In conclusion, this study reports novel insights into CD163+ monocyte dysregulation in diabetes-related complications. Enriched centrosome cycle genes and up-regulated miRNAs linked to apoptosis, coupled with down-regulated monocyte activation, recruitment, and immune regulation, suggest functionally distinct CD163+ monocytes in cases of diabetes complications. Further investigation is needed to confirm their role in diabetes-related tissue damage.

The shallower portions of subduction zone megathrust faults host Earth's most hazardous tsunamigenic earthquakes, yet understanding how and when they slip remains elusive because of challenges making seafloor observations. We performed Global Navigation Satellite System Acoustic seafloor geodetic surveys before and ~2.5 months after the 29 July 2021 M w (moment magnitude) 8.2 Chignik, Alaska, earthquake and determine ~1.4 meters cumulative co- and post-seismic horizontal displacement ~60 kilometers from the megathrust front. Only for the 2011 M w 9 Tohoku event have closer subduction zone earthquake displacements been observed. We estimate ~2 to 3 meters of megathrust afterslip shallower than 20 kilometers, a portion of the megathrust on which both inter- and co-seismic slip likely had occurred previously. Our analysis demonstrates that by 2.5 months, shallower and deeper moment had effectively equilibrated on the megathrust, suggesting that its tsunamigenic potential remains no more elevated than before the earthquake.

Faults often form through reactivation of pre-existing structures, developing geometries and mechanical properties specific to the system's geologic inheritance. Competition between fault geometry and other factors (e.g., lithology) to control slip at Earth's surface is an open question that is central to our knowledge of fault processes and seismic hazards. Here we use remote sensing data and field observations to investigate the origin of the 2019 M7.1 Ridgecrest, California, earthquake rupture geometry and test its impact on the slip distribution observed at Earth's surface. Common geometries suggest the fault system evolved through reactivation of structures within the surrounding Independence dike swarm (IDS). Mechanical models testing a range of fault geometries and stress fields indicate that the inherited rupture geometry strongly controlled the M7.1 earthquake slip distribution. These results motivate revisiting the development of other large-magnitude earthquake ruptures (1992 M7.3 Landers, 1999 M7.1 Hector Mine) and tectonic provinces within the IDS., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Competing Interests: The authors declare no conflict of interest.

The contemporaneous presentation of transposition of the great arteries and hypertrophic cardiomyopathy is rare and complicates optimal surgical timing. We present a newborn with transposition and severe hypertrophic cardiomyopathy with a postnatal course complicated by persistent pulmonary hypertension who was supported with extracorporeal membrane oxygenation until successful arterial switch operation on the day of life 8.

Background: Although bronchiolitis contributes to substantial acute (eg, intensive care use) and chronic (eg, recurrent wheeze) morbidities in young children, the pathobiology remains uncertain. We examined the associations of serum soluble receptor for advanced glycation end products (sRAGE) with acute and chronic morbidities of bronchiolitis including recurrent wheeze., Methods: A multicenter, multiyear, cohort study of infants hospitalized for bronchiolitis was analyzed. We measured the serum sRAGE level at hospitalization and its association with intensive care use (use of mechanical ventilation and/or admission to the intensive care unit) and development of recurrent wheeze by age 3 years. We performed causal mediation analysis to estimate indirect (mediation) and direct effects of sRAGE on recurrent wheeze., Results: In 886 infants with bronchiolitis, the median age was 2.9 months. Overall, 15% underwent intensive care and 32% developed recurrent wheeze. In multivariable modeling adjusting for 11 confounders, a higher presenting sRAGE level was associated with lower risk of intensive care (odds ratio for each 1-log increment, 0.39; 95% confidence interval [CI], .16 -.91; P = .03) and significantly lower rate of recurrent wheeze (hazard ratio [HR], 0.58; 95% CI, .36 -.94; P = .03). In mediation analysis, the direct effect was significant (HR, 0.60; 95% CI, .37 -.97; P = .04), while the indirect effect was not (P = .30)., Conclusions: Serum sRAGE levels were inversely associated with acute and chronic morbidities of bronchiolitis. The effect of sRAGE on development of recurrent wheeze is potentially driven through pathways other than acute severity of bronchiolitis., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Aims: Delayed healing of diabetes-related foot ulcers (DRFUs) is associated with increased macrophage and matrix metalloproteinases (MMPs) at the wound site. Whether circulating monocyte phenotype and/or MMPs are altered in association with wound healing outcome is unknown, and was investigated in this study., Methods: Blood was obtained from 21 participants with DRFU, at initial visit (V1), week-4 (V2), and week-8 (V3) for measurement of monocyte number (CD14 + ), phenotype (CD16, CD163) and chemokine receptors (CCRs) by flow cytometry, and circulating MMPs and TIMP-1 by ELISA., Results: Six wounds healed during the study. At V1, non-classical CD16 ++ monocytes and MMP-3 were higher in healed vs unhealed (both p < 0.05). At V3, the increased %CD16 ++ persisted and %CCR2 + was decreased in healed, but no other monocyte markers nor MMP/TIMP differed between groups. Increased wound closure rate (WCR) at V3 correlated with increased %CD16 ++ monocytes and decreased MMP-2 at V1 or V1 + V2. Receiver operating characteristic (ROC) curves yielded an area-under-the-curve of %CD16 ++ at V1 of 0.78 to predict ulcer healing at V3., Conclusions: These results indicate that circulating monocyte phenotype and MMPs alter as DRFUs heal. The relationship of %CD16 ++ monocytes with WCR and ROC curve suggest a predictive role of %CD16 ++ monocytes for ulcer healing., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Asthma remains the most common chronic lung disease in childhood in the United States. The receptor for advanced glycation end products (RAGE) has been recognized as both a marker of and participant in pulmonary pathophysiology. While membrane-bound RAGE (mRAGE) perpetuates the type 2 immune response, the soluble form (sRAGE) may act as a decoy receptor for pro-inflammatory ligands. Bronchoalveolar samples from 45 pediatric patients with asthma were obtained. Patients were divided into high and low BAL sRAGE groups using median sRAGE. Descriptive statistical analysis and non-parametric testing were applied. Children in the "high" sRAGE group had a lower median serum eosinophil (0.27 [SE ± 0.04] vs. 0.57 [± 0.06] K/mcl, adjusted p = 0.003) and lower serum IgE level (194.4 [± 60.7] vs. 676.2 ± 140.5) IU/mL, adjusted p = 0.004) as compared to the "low" sRAGE group. When controlling for age and body mass index percentile, absolute eosinophil count ( p = 0.03) and serum IgE ( p = 0.043) remained significantly lower in the "high" sRAGE group. Children with asthma and high levels of BAL sRAGE have lower serum eosinophil and IgE levels. These findings are consistent with the hypothesis that sRAGE may act as a decoy receptor by binding ligands that normally interact with mRAGE.

Poor knowledge of how faults slip and distribute deformation in the shallow crust hinders efforts to mitigate hazards where faults increasingly intersect with the expanding global population at Earth's surface. Here we analyze two study sites along the 2014 M 6.0 South Napa, California, earthquake rupture, each dominated by either co- or post-seismic shallow fault slip. We combine mobile laser scanning (MLS), active-source seismic tomography, and finite element modeling to investigate how deformation rate and mechanical properties of the shallow crust affect fault behavior. Despite four orders-of-magnitude difference in the rupture velocities, MLS-derived shear strain fields are remarkably similar at the two sites and suggest deceleration of the co-seismic rupture near Earth's surface. Constrained by the MLS and seismic data, finite element models indicate shallow faulting is more sensitive to lithologic layering and plastic yielding than to the presence of fault compliant zones (i.e., regions surrounding faults with reduced stiffness). Although both elastic and elastoplastic models can reproduce the observed surface displacement fields within the uncertainty of MLS data, elastoplastic models likely provide the most reliable representations of subsurface fault behavior, as they produce geologically reasonable stress states and are consistent with field, geodetic, and seismological observations.

The population of Hawai'i has traditionally been high in average fish consumption when compared to the national average. However, information is lacking on patterns of fish consumption among subpopulations. Data on fish consumption in the last 30 days from 11,293 adults was collected with the use of the Hawai'i Health Survey (an annual telephone survey of households and household members) during the years 2007 and 2008 and weighted to represent the adult population of Hawai'i. The US Department of Agriculture's, Environmental Protection Agency, and the United States Food and Drug Administration, recommend 8-12 ounces of fish per week for associated health benefits. Present estimates of fish consumption were skewed to the right (mean 10.5 and median 7.9 ounces) with some adults eating large amounts of fish per day and frequently. It may be of concern, given high amounts of methylmercury in select fish, that 13.7% of adults were eating fish 20 or more times per month. In addition, the serving size increased with increasing number of times per week fish was eaten. The subpopulation variables examined included age, sex, marital status, education, ethnicity, poverty, and demographics representing the adults of Hawai'i. The prevalence of adults consuming 8 or more ounces was highest for other than Honolulu counties, men, ages 18-74, married, with at least one year of college, Filipino and Native Hawaiian ethnicities (White, Japanese, Chinese, and All Others were also examined), employed, and adults living with higher income levels (lower poverty). However, only an estimated 46.9% of adults in Hawai'i were eating the eight or more ounces of fish weekly. Prevalence was lowest for women, Chinese, age >74 years, and the City and County of Honolulu. Adults who rated their general health better (excellent/good compared to fair/poor) were more likely to consume 8 or more ounces of fish per week, significantly for men. Men who rated their physical health higher and their mental health higher (via Optum SF™ Health Surveys) were associated with higher prevalence of consuming 8 or more ounces of fish per week. Higher consumption of the beneficial omega-3 fatty acids associated with fish low in methylmercury needs to be encouraged for those not meeting the recommended ounces of fish per week, particularly women, Chinese, older age groups, and adults living below the poverty level., Competing Interests: None of the authors identify any conflict of interest., (©Copyright 2020 by University Health Partners of Hawai‘i (UHP Hawai‘i).)

Deformation associated with plate convergence at subduction zones is accommodated by a complex system involving fault slip and viscoelastic flow. These processes have proven difficult to disentangle. The 2010 M w 8.8 Maule earthquake occurred close to the Chilean coast within a dense network of continuously recording Global Positioning System stations, which provide a comprehensive history of surface strain. We use these data to assemble a detailed picture of a structurally controlled megathrust fault frictional patchwork and the three-dimensional rheological and time-dependent viscosity structure of the lower crust and upper mantle, all of which control the relative importance of afterslip and viscoelastic relaxation during postseismic deformation. These results enhance our understanding of subduction dynamics including the interplay of localized and distributed deformation during the subduction zone earthquake cycle., (Copyright © 2019 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution License 4.0 (CC BY).)

Background: A number of previous studies exploring family history of type 2 diabetes have reported a predominance of maternal diabetes. These studies have not explicitly compared parental history of diabetes across the spectrum of disease onset from youth to later adulthood., Methods: Family history data from 11,467 patients with type 2 diabetes were extracted from the RPA Diabetes Centre database. Parental histories of diabetes were compared across a range of age of diagnosis strata (15-<30, 30-<40, 40-<50, 50-<60 and 60-<70 years). For the young-onset group (diagnosed between 15 and 30 years of age), associations between parental history of diabetes and the presence of cardio-metabolic risk factors and diabetic complications were also explored., Results: For the total cohort and within each age of diagnosis strata, more individuals reported maternal history than paternal history of diabetes. The young-onset group demonstrated the highest prevalence of any parental history of diabetes (60.7%), the highest combined maternal and paternal history (15.8%) and the smallest differential between maternal (25.1%) and paternal (19.7%) history of diabetes. Within the young-onset group, no significant association between parental history and cardio-metabolic risk factors or diabetic complications were identified after a median of 15.0 years of diabetes exposure., Conclusion: Overall, our results demonstrate a consistent maternal excess of diabetes which could be consistent with an underlying epigenetic effect. However, the differential between maternal and paternal history is significantly lower in the young-onset group. Earlier emergence of type 2 diabetes may therefore reflect a different interaction and impact of genetic and environmental factors., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Transition met al catalysis has enabled the highly stereoselective and protecting group-free synthesis of the C14-C23 fragment of the apoptosis-inducing natural products biselyngbyolide A and B. A Pd-catalyzed Stille reaction between a vinyl stannane and a crotyl carbonate formed the skipped diene with complete control of the the trisubstituted bond and excellent control over the branched/linear products. A Cu-catalyzed Stahl oxidation was used to form the requisite aldehyde needed for a Ag-catalyzed asymmetric allylation. The latter provided the final fragment with excellent stereochemical control.

We report experimental findings on how individuals from different cultures solve a repeated coordination game of common interest. The results overturn earlier findings that fixed pairs are almost assured to coordinate on an efficient and cooperative equilibrium. Subjects in the prior experiments were US university students, whereas the subjects in our study are men drawn from high and low castes in rural India. Most low-caste pairs quickly established an efficient and cooperative convention, but most high-caste pairs did not. The largest difference in behavior occurred when a player suffered a loss because he had tried to cooperate but his partner did not: In this situation, high-caste men were far less likely than low-caste men to continue trying to cooperate in the next period. Our interpretation is that for many high-caste men, the loss resulting from coordination failure triggered retaliation. Our results are robust to controls for education and wealth, and they hold by subcaste as well as by caste status. A survey we conducted supports the ethnographic evidence that more high-caste than low-caste men prefer to retaliate against a slight. We find no evidence that caste differences in trust or self-efficacy explain the caste gap in cooperation in our experiment. Our findings are of general interest because many societies throughout the world have cultures that lead individuals to (mis)perceive some actions as insults and to respond aggressively and dysfunctionally., Competing Interests: The authors declare no conflict of interest.

Many others have written about how to prepare a manuscript for publication. Therefore the purpose of this article is to share the experiences of one reviewer and suggest the need for using a theory or conceptual framework to guide research, practice, and publications. Many times while reading a manuscript I feel I am on a journey of discovery without a road map. My sense is authors may be confused about when to include the conceptual framework or the "theory part" in a manuscript if the work being described was not a research study per se. The author shares recommendations from a recent publication on how to use theory or a conceptual framework in manuscript preparation., (© 2018 Wiley Periodicals, Inc.)

Earthquake-related fault slip in the upper hundreds of meters of Earth's surface has remained largely unstudied because of challenges measuring deformation in the near field of a fault rupture. We analyze centimeter-scale accuracy mobile laser scanning (MLS) data of deformed vine rows within ±300 m of the principal surface expression of the M (magnitude) 6.0 2014 South Napa earthquake. Rather than assuming surface displacement equivalence to fault slip, we invert the near-field data with a model that allows for, but does not require, the fault to be buried below the surface. The inversion maps the position on a preexisting fault plane of a slip front that terminates ~3 to 25 m below the surface coseismically and within a few hours postseismically. The lack of surface-breaching fault slip is verified by two trenches. We estimate near-surface slip ranging from ~0.5 to 1.25 m. Surface displacement can underestimate fault slip by as much as 30%. This implies that similar biases could be present in short-term geologic slip rates used in seismic hazard analyses. Along strike and downdip, we find deficits in slip: The along-strike deficit is erased after ~1 month by afterslip. We find no evidence of off-fault deformation and conclude that the downdip shallow slip deficit for this event is likely an artifact. As near-field geodetic data rapidly proliferate and will become commonplace, we suggest that analyses of near-surface fault rupture should also use more sophisticated mechanical models and subsurface geomechanical tests.

Models and data from the North Pacific Ocean indicate that mercury concentrations in water and biota are increasing in response to (global or hemispheric) anthropogenic mercury releases. In the present study, we provide an updated record of mercury in yellowfin tuna (Thunnus albacares) caught near Hawaii that confirms an earlier conclusion that mercury concentrations in these fish are increasing at a rate similar to that observed in waters shallower than 1000 m. We also compiled and reanalyzed data from bigeye tuna (Thunnus obesus) and blue marlin (Makaira nigricans) caught near Hawaii in the 1970s and 2000s. Increases in mercury concentrations in bigeye tuna are consistent with the trend found in yellowfin tuna, in both timing and magnitude. The data available for blue marlin do not allow for a fair comparison among years, because mercury concentrations differ between sexes for this species, and sex was identified (or reported) in only 3 of 7 studies. Also, mercury concentrations in blue marlin may be insensitive to modest changes in mercury exposure, because this species appears to have the ability to detoxify mercury. The North Pacific Ocean is a region of both relatively high rates of atmospheric mercury deposition and capture fisheries production. Other data sets that allow temporal comparisons in mercury concentrations, such as pacific cod (Gadus macrocephalus) in Alaskan waters and albacore tuna (Thunnus alalunga) off the US Pacific coast, should be explored further, to aid in understanding human health and ecological risks and to develop additional baseline knowledge for assessing changes in a region expected to respond strongly to reductions in anthropogenic mercury emissions. Environ Toxicol Chem 2017;36:1365-1374. © 2017 SETAC., (© 2017 SETAC.)

Objective: To determine the effect of sulfonylurea-related hypoglycemia on cardiac repolarization and ectopy in the setting of well-controlled type 2 diabetes., Research Design and Methods: Thirty subjects with sulfonylurea-treated type 2 diabetes underwent 48 h of concurrent continuous glucose monitoring and ambulatory electrocardiography. Ventricular repolarization (QTc) and QT dynamicity were analyzed during periods of hypoglycemia (<3.5 mmol/L for >20 min) and compared with periods of euglycemia and hyperglycemia combined. Cardiac ectopy rates during hypoglycemia were compared with ectopy rates when blood glucose was 4-10 mmol/L., Results: Mean HbA 1c was 6.9% (52 mmol/mol). Hypoglycemia was detected in 9 of 30 subjects (30%); episodes were typically nocturnal (67%) and asymptomatic (73%). Hypoglycemia-associated QTc prolongation was seen in five of nine subjects with a large variation in individual response. Higher QT dynamicity, a poor prognostic factor in cardiac disease, was seen in subjects who experienced hypoglycemia compared with subjects who did not (0.193 vs. 0.159 for the nocturnal period; P = 0.01). This finding persisted after the hypoglycemic event. The rates of ventricular and supraventricular ectopy demonstrated a nonsignificant trend toward an increase during hypoglycemia (median rate ratio 1.58 and 1.33, respectively). Similar, nonsignificant results were observed in a separate insulin-treated cohort., Conclusions: Hypoglycemia, often unrecognized, is a frequent finding in well-controlled sulfonylurea-treated type 2 diabetes. It is associated with the novel finding of increased QT dynamicity and QTc prolongation in some individuals. Our findings suggest sulfonylurea-related hypoglycemia can have detrimental cardiovascular sequelae. Similar effects are also seen in the setting of insulin therapy., (© 2017 by the American Diabetes Association.)

Screening toddlers for autism spectrum disorder (ASD) with the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) has been shown to lower age of diagnosis by 2 years. In order to streamline ASD screening, research is exploring the use of web-based screening during well-child checkups. The current study examined implementation of the web-based M-CHAT-R in an urban pediatric clinic in Atlanta, Georgia. Toddlers (N = 2557; 87% African American) were screened during well-child visits (Mage = 22.43 months, SD = 3.65). Using the web-based version resulted in a 58.5% increase in the number of cases screened per month. A similar proportion of toddlers in each modality screened positive (P = .43), but significantly fewer children were missing "Follow-up" in the web-based administration (P < .001). These results suggest that it is feasible to implement web-based screening in underserved populations. Future research is necessary to understand factors that facilitate successful implementation of web-based ASD screening., Competing Interests: Declaration of Conflicting Interests Diana L Robins, PhD is co-owner of M-CHAT, LLC, which receives royalties from for-profit companies distributing the M-CHAT to users. All of the data collected in this study was from the freely available version., (© The Author(s) 2015.)

This study using simultaneous Holter and continuous glucose monitoring demonstrates that prolongation of QT interval can occur with hypoglycaemia in an ambulatory setting in people with type 1 and type 2 diabetes treated with insulin. This highlights the potential proarrhythmic harms associated with hypoglycaemia., (Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.)

Background: Children with intellectual disability and specific learning disabilities often lack age-appropriate social skills, which disrupts their social functioning. Because of the limited effectiveness of classroom mainstreaming and social skills training for these children, it is important to explore alternative opportunities for social skill acquisition. Participation in social activities is positively related to children's social adjustment, but little is known about the benefits of activity participation for children with intellectual and specific learning disabilities., Methods: This study investigated the association between frequency and type of social activity participation and the social competence of 8-11-year-old children with intellectual disability (n = 40) and specific learning disabilities (n = 53), in comparison with typically developing peers (n = 24)., Results: More time involved in unstructured activities, but not structured activities, was associated with higher levels of social competence for all children. This association was strongest for children with intellectual disability, suggesting that participation in unstructured social activities was most beneficial for these children., Conclusion: Future research on the quality of involvement is necessary to further understand specific aspects of unstructured activities that might facilitate social development., (© 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.)

In light of the fragmentation of health care services and the need for health promotion and disease prevention, it is time to consider the important role community health workers (CHWs) could play as part of the health care team. Globally, CHWs tend to focus on a single patient condition, resulting in fragmented, uncoordinated health care services. Polyvalent (or multimodal) CHWs can provide a comprehensive, patient-centric range of care coordination services with other members of the health care team, ultimately improving patient outcomes and decreasing the cost of care. The potential benefits of the polyvalent CHW to the health care team are not widely understood in the United States. To fill this knowledge gap, a toolkit for nurse leaders in mainstream health care settings was created. The toolkit outlines the key elements essential to a successful CHW program and offers strategies for navigating the various challenges involved when integrating this new role into existing models of care.

This study aims to explore the impact of specific facets of impulsivity as measured by the UPPS Impulsive Behavior Scale (UPPS), as well as reasons for living in predicting suicidal ideation among African American college-aged students. The incremental validity of each facet of the UPPS interacting with reasons for living, a construct meant to buffer against risk for suicide, was explored in a sample of African American students (N = 130; ages 18-24). Results revealed significant interactions between reasons for living and two factors of impulsivity, (lack of) premeditation and sensation seeking. Higher levels of sensation seeking and lack of premeditation in conjunction with lower reasons for living was associated with increased suicidal ideation. Neither urgency nor (lack of) perseverance significantly interacted with reasons for living in association with suicidal ideation. These results suggest including elements of impulsivity, specifically sensation seeking and (lack of) premeditation, when screening for suicidal ideation among African American youth. Future investigations should continue to integrate factors of both risk and protection when determining risk for suicide.

Earthquake early warning (EEW) can reduce harm to people and infrastructure from earthquakes and tsunamis, but it has not been implemented in most high earthquake-risk regions because of prohibitive cost. Common consumer devices such as smartphones contain low-cost versions of the sensors used in EEW. Although less accurate than scientific-grade instruments, these sensors are globally ubiquitous. Through controlled tests of consumer devices, simulation of an M w (moment magnitude) 7 earthquake on California's Hayward fault, and real data from the M w 9 Tohoku-oki earthquake, we demonstrate that EEW could be achieved via crowdsourcing.

Background: A few years ago, when the American Board of Psychiatry and Neurology decided to phase out the patient-based oral examinations in its 3 primary specialties, requirements for assessing clinical skills during residency training were instituted., Objective: The purpose of this report is to describe the experiences of training program directors and graduates with these new credentialing requirements (labeled CSEs) as well as other effects on the specialties., Methods: Surveys were administered electronically in 2012 to all current neurology, child neurology, and psychiatry program directors, and to a convenience sample of graduates who applied for the 2012 certification examinations., Results: Response rates for graduates were similar across the 3 specialties but low (28%-33%). Response rates were higher for program directors (53%-62%) and were similar across the 3 specialties. The results indicated that the CSEs were usually administered early in training, were completed toward the end, were often passed on first attempt, generally took place during routine clinical assignments, were used to assess additional competencies, almost always included feedback to the residents, and did not often lead to remediation. Furthermore, the CSEs were perceived to be useful components in the assessment of clinical skills., Conclusions: The results obtained from the early implementation of the CSEs suggest that they provide an opportunity to assess clinical skills with the additional benefit of feedback to trainees. Other effects included eventual incorporation into training program requirements, milestones, and related faculty development and research efforts.

In the nearly 50 years, since the Medicare Program established funding for nursing education in the United States, there has been a steady migration away from hospital-controlled programs toward those which function as wholly owned subsidiaries within larger health care systems. Private sector health care organizations in particular are under increasing pressure to adapt at the risk of losing all of their funding. However, accomplishing this presents multiple challenges for today's nursing education programs in terms of their regulatory compliance, accreditation, autonomy, and, above all, governance model. The authors outline the journey toward, and specific challenges involved in creating, implementing and administering a new governance model, which sustains the overall mission and vision of the education institution while functioning seamlessly within a modern corporate health care system.

A new phenomenon, the inverted or "flipped" classroom, assumes that students are no longer acquiring knowledge exclusively through textbooks or lectures. Instead, they are seeking out the vast amount of free information available to them online (the very essence of open source) to supplement learning gleaned in textbooks and lectures. With so much open-source content available to nursing faculty, it benefits the faculty to use readily available, technologically advanced content. The nurse content curator supports nursing faculty in its use of such content. Even more importantly, the highly paid, time-strapped faculty is not spending an inordinate amount of effort surfing for and evaluating content. The nurse content curator does that work, while the faculty uses its time more effectively to help students vet the truth, make meaning of the content, and learn to problem-solve. Brooks., (© 2014 Wiley Periodicals, Inc.)

As nursing leaders retire from the nursing workforce, too few nurses are preparing to replace them. The barriers to obtaining the educational credentials necessary to take this important step in a leadership career can appear insurmountable because of cost and time restraints. The authors present an executive format master of science program whose delivery method and content align with the professional and personal needs of emerging nurse leaders.

In this study, we developed and tested the psychometric properties of the Chinese-version Quality of Nursing Work Life Scale along seven subscales: supportive milieu with security and professional recognition, work arrangement and workload, work/home life balance, head nurse's/supervisor's management style, teamwork and communication, nursing staffing and patient care, and milieu of respect and autonomy. An instrument-development procedure with three phases was conducted in seven hospitals in 2010-2011. Phase I comprised translation and the cultural-adaptation process, phase II comprised a pilot study, and phase III comprised a field-testing process. Purposive sampling was used in the pilot study (n = 150) and the large field study (n = 1254). Five new items were added, and 85.7% of the original items were retained in the 41 item Chinese version. Principal component analysis revealed that a model accounted for 56.6% of the variance with acceptable internal consistency, concurrent validity, and discriminant validity. This study gave evidence of reliability and validity of the 41 item Chinese-version Quality of Nursing Work Life Scale., (© 2014 Wiley Publishing Asia Pty Ltd.)

Background: Studies across a range of specialties have consistently yielded positive associations between performance on in-training examinations and board certification examinations, supporting the use of the in-training examination as a valuable formative feedback tool for residents and residency programs. That association to date, however, has not been tested in child and adolescent psychiatry residents., Objective: This is the first study to explore the relationship between performance on the American College of Psychiatrists' Child Psychiatry Resident In-Training Examination (CHILD PRITE) and subsequent performance on the American Board of Psychiatry and Neurology's (ABPN) subspecialty multiple-choice examination (Part I) in child and adolescent psychiatry (CAP)., Methods: Pearson correlation coefficients were used to examine the relationship between performance on the CHILD PRITE and the CAP Part I examination for 342 fellows., Results: Second-year CAP fellows performed significantly better on the CHILD PRITE than did the first-year fellows. The correlation between the CHILD PRITE total score and the CAP Part I examination total score was .41 (P  =  .01) for first-year CAP fellows; it was .52 (P  =  .01) for second-year CAP fellows., Conclusions: The significant correlations between scores on the 2 tests show they assess the same achievement domain. This supports the use of the CHILD PRITE as a valid measure of medical knowledge and formative feedback tool in child and adolescent psychiatry.