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In the current experiment, participants portrayed the role of third-party employees who witnessed a supervisor reprimanding a subordinate for ordering a part from the wrong company. Information was provided to participants conveying whether or not the reprimanded employee was responsible for the ordering error and then participants made ratings related to fairness. Subsequently, employee responsibility either changed or did not change (Time 2) and participants again provided the same ratings. Compared to the no-change condition, observers’ final (Time 2) perceptions of fairness were very extreme for the responsible and the not responsible conditions when participants received contrasting information about employee responsibility. These data suggest that employee reprimands affect the perceptions of their co-workers, such that contrasting information generates dissonance arousal in observers, which can be damaging to work environments. Therefore, supervisors need to establish the facts before they openly reprimand employees or they should take strong steps to avoid such displays.

Complementary and integrative health (CIH) use is diverse and highly prevalent worldwide. Prior research of CIH communication in biomedical encounters address safety, efficacy, symptom management, and overall wellness. Observational methods are rarely used to study CIH communication and avoid recall bias, preserve ecological validity, and contextualize situated clinical communication. Following PRISMA guidelines, we systematically reviewed studies at the intersection of social scientific observational research and findings about CIH communication between clinicians, patients, and caregivers in biomedical settings. We identified international, peer-reviewed publications from seven databases between January 2010 and December 2020. Titles and abstracts were first screened for inclusion, then full studies were coded using explicit criteria. We used a standard checklist was modified to assess article quality. Ten of 11,793 studies examined CIH communication using observational methods for CIH communication in biomedical settings. Studies used a range of observational techniques, including participant and non-participant observation, which includes digital audio or video recordings. Results generated two broad sets of findings, one focused on methodological insights and another on CIH communication. Despite methodological and topic similarities, included studies addressed CIH communication as a process and as proximal and intermediate health outcomes. We recommend how observational studies of CIH communication can better highlight relationships between communication processes and health outcomes. Current research using observational methods offers an incomplete picture of CIH communication in biomedical settings. Future studies should standardize how observational techniques are reported to enhance consistency and comparability within and across biomedical settings to improve comparability.

A better understanding of how communication skills education impacts trainees' communication skills is important for continual improvement in graduate medical education (GME). Guided by the Kirkpatrick Model, this review focused on studies that measured communication skills in either simulated or clinical settings. The aim of this systematic review was to examine the effect of experiential communication skills education on GME trainees' communication behaviors.Five databases were searched for studies published between 2001 and 2021 using terms representing the concepts of medical trainees, communication, training, and skills and/or behaviors. Included studies had an intervention design, focused only on GME trainees as learners, used experiential methods, and had an outcome measure of communication skills behavior that was assessed by a simulated or standardized patient (SP), patient, family member, or outside observer. Studies were examined for differences in outcomes based on study design; simulated versus clinical evaluation setting; outside observer versus SP, patient, or family member evaluator; and length of training.Seventy-seven studies were ultimately included. Overall, 54 (70%) studies reported some positive findings (i.e., change in behavior). There were 44 (57%) single-group pre-post studies, 13 (17%) nonrandomized control studies, and 20 (26%) randomized control studies. Positive findings were frequent in single-group designs (80%) and were likely in nonrandomized (62%) and randomized (55%) control trials. Positive findings were likely in studies evaluating communication behavior in simulated (67%) and clinical (78%) settings as well as in studies with outside observer (63%) and SP, patient, and family member (64%) evaluators.This review demonstrates strong support that experiential communication skills education can impact GME trainees' communication behaviors. Marked heterogeneity in communication trainings and evaluation measures, even among subgroups, did not allow for meta-analysis or comparative efficacy evaluation of different studies. Future studies would benefit from homogeneity in curricular and evaluation measures.

Introduction Recent research has found widespread misperceptions about nicotine. This study tests perceptions among U.S. adults with respect to nicotine addictiveness and cancer harm, while distinguishing between nicotine misperceptions (ie an incorrect response) and “don’t know” (DK) responses. Aims and Methods Data from three cycles of the Health Information National Trends Survey, fielded in 2015, 2017, and 2019 were merged for analysis. Weighted multinominal logistic regression models were conducted where nicotine addictiveness and cancer harm beliefs (DK, incorrect, and correct responses) were regressed on survey year and demographic variables. We also tested for interactions between survey year and demographic variables to assess if previously identified disparities had evolved during these years. Results Analyses showed lower odds of misperceptions about nicotine addictiveness, but higher odds of misperceptions about nicotine cancer harm in 2019 compared to 2015. There was no change in DK responses during these years. Disparities by sociodemographics and tobacco use status were observed, mostly for cancer harm. Survey year significantly interacted with age in the model for cancer harm, which was driven primarily by increased incorrect responses and decreased DK responses over time among the youngest age group (18–34 years). There were no significant interactions between survey year and race and ethnicity or level of educational attainment. Conclusions Disparities in nicotine addictiveness and cancer harm perceptions reflect the uneven distribution of knowledge in the U.S. adult population. Nicotine cancer harm misperceptions are increasing and educational efforts to address this misperception are warranted. Implications Future educational efforts targeting nicotine addictiveness beliefs may benefit by focusing on DK responders. The growing trend of misperceptions of nicotine’s role in cancer harm may negatively impact perceptions about nicotine replacement therapy and low nicotine content cigarettes. Future efforts should focus on correcting nicotine cancer harm misperception, particularly among young adults.

Pyridones are versatile building blocks in organic synthesis and a privileged motif in drug discovery. However, N-substituted 2-pyridones bearing an α-tertiary carbon, cyclopropyl, or heterocycle off of the pyridone nitrogen atom remain challenging to prepare. Herein, we describe the efficient synthesis of a large variety of N-substituted 2-pyridones from ethyl nitroacetate and readily available primary amine building blocks, which can be utilized on a large scale and in parallel medicinal chemistry applications.

Current debate surrounds the promise of neuroscience for education, including whether learning-related neural changes can predict learning transfer better than traditional performance-based learning assessments. Longstanding debate in philosophy and psychology concerns the proposition that spatial processes underlie seemingly nonspatial/verbal reasoning (mental model theory). If so, education that fosters spatial cognition might improve verbal reasoning. Here, in a quasi-experimental design in real-world STEM classrooms, a curriculum devised to foster spatial cognition yielded transfer to improved verbal reasoning. Further indicating a spatial basis for verbal transfer, students’ spatial cognition gains predicted and mediated their reasoning improvement. Longitudinal fMRI detected learning-related changes in neural activity, connectivity, and representational similarity in spatial cognition–implicated regions. Neural changes predicted and mediated learning transfer. Ensemble modeling demonstrated better prediction of transfer from neural change than from traditional measures (tests and grades). Results support in-school “spatial education” and suggest that neural change can inform future development of transferable curricula.

Although the practice of using rapid-acting subcutaneous insulin for the management of mild-to-moderate diabetic ketoacidosis is becoming increasingly popular, the continuous insulin infusion remains widely utilized, and its real-world applicability and safety on a medical surgical unit (Med Surg) and observation level of care are unclear. We assessed whether a continuous insulin infusion protocol for mild-to-moderate diabetic ketoacidosis on Med Surg/observation level of care over a 6.5-year period was associated with adverse outcomes. A retrospective cohort study of adults hospitalized with mild-to-moderate diabetic ketoacidosis was conducted at 2 community hospitals in Northern California, USA, from January 2014 to May 2020. Demographic and clinical variables were collected using an electronic health record. Admission to Med Surg/observation was compared to intensive care unit admission for the outcomes of 30-day readmission, presence of hypoglycemia, rate of hypoglycemic episodes, in-hospital and 30-day mortality, and length of stay using bivariate analysis. Among 227 hospital encounters (mean age 41 years, 52.9% women, 79.3% type 1 diabetes, 97.4% utilization of continuous insulin infusion), 19.4% were readmitted within 30 days, and 20.7% developed hypoglycemia. For Med Surg/observation encounters compared to the intensive care unit, there were no statistically significant differences in the risk of readmission (RR 1.48, 95% CI, 0.86-2.52), hypoglycemia (RR 1.17, 95% CI, 0.70-1.95), or increased length of stay (RR 0.71, 95% CI, 0.55-1.02); there was a lower risk of hypoglycemic events during hospitalization (RR 0.69, 95% CI, 0.54-0.96). Continuous insulin infusion utilization may be a safe option for treatment of mild-to-moderate diabetic ketoacidosis on Med Surg/observation level of care. Further investigation is needed.

Due to logistical and financial barriers that keep many distressed couples from seeking psychotherapy, online relationship education is a more accessible alternative. In the decade since a web-based program showed equivalent effectiveness to traditional marriage education (Duncan et al., 2009), several fully online programs have been developed and evaluated. We reviewed nine studies of four different programs that sampled 2,000 + couples. Specifically, we rated each study’s experimental rigor and compared research designs, theoretical and empirical grounding, average post-intervention and follow-up effect sizes, and differential effectiveness. Across studies, measured outcomes included relational (improved satisfaction, quality, confidence, commitment, communication; reduced conflict and aggression) and individual functioning on various indices of mental and physical health, emotional expression, and quality of life. Finally, we discuss the strengths and limitations of the research evidence, describe the two most evidence-based programs (ePREP and OurRelationship) in some detail and make recommendations for future study of these promising kinds of interventions.

We designed this theory-building study to discover how split alliances are manifested in couple therapy. From an archival database, we selected four cases in which the partners’ self-reported allia...

Curiosity is associated with increased learning, and developing curious individuals is an educational goal in its own right. This review uses Bioecological Systems Theory to examine how students’ curiosity can be supported in educational contexts. Understanding the nature of curiosity as a biopsychosocial characteristic that can change over time and its relation to other characteristics such as knowledge and epistemic beliefs provides insight into why some students may be more curious than others, or more curious in certain subject areas than others. Scaffolding uncertainty and other practices that instigate curiosity are an important means of increasing curiosity for learning. Overall, the development of students’ curiosity should account for the complex, nested structure of learning environments, including the culture of high-stakes testing.

[Image: see text] Phospholipase D (PLD) is a phospholipase enzyme responsible for hydrolyzing phosphatidylcholine into the lipid signaling molecule, phosphatidic acid, and choline. From a therapeutic perspective, PLD has been implicated in human cancer progression as well as a target for neurodegenerative diseases, including Alzheimer’s. Moreover, knockdown of PLD rescues the ALS phenotype in multiple Drosophila models of ALS (amyotrophic lateral sclerosis) and displays modest motor benefits in an SOD1 ALS mouse model. To further validate whether inhibiting PLD is beneficial for the treatment of ALS, a brain penetrant small molecule inhibitor with suitable PK properties to test in an ALS animal model is needed. Using a combination of ligand-based drug discovery and structure-based design, a dual PLD1/PLD2 inhibitor was discovered that is single digit nanomolar in the Calu-1 cell assay and has suitable PK properties for in vivo studies. To capture the in vivo measurement of PLD inhibition, a transphosphatidylation pharmacodynamic LC-MS assay was developed, in which a dual PLD1/PLD2 inhibitor was found to reduce PLD activity by 15–20-fold.

Lentils lower acute glycemic responses and promote satiety, benefits that may aid in chronic disease prevention. However, perceived gastrointestinal (GI) effects may deter inclusion of dietary pulses in the diet. We hypothesized that 8 weeks of lentil-based vs meat-based meals would improve glycemic control and improve satiety in metabolically at-risk, nondiabetic adults. Because GI symptoms are rarely reported, we also explored the temporal effects of symptom severity. Adults with an increased waist circumference (male40 inches, female35 inches) participated in an 8-week dietary intervention that included 5 prepared midday meals each week that were isocaloric but varied in cooked green lentil dosage: 0 g (CON), 300 g (MOD), or 600 g (HI). Assessments included glucose and insulin integrated area under the curve measured during a 75-g carbohydrate tolerance test, hepatic Homeostatic Model of Insulin Resistance (HOMA-IR), and peripheral insulin resistance. On 1 randomized day each week, satiety was assessed at 4:00 pm and GI symptoms at 8:00 pm. A linear model assessed changes in glycemic and GI measures by meal group. Thirty adults (mean ± SD; age, 41.6 ± 11.7 years, body mass index, 35.1 ± 6.3) completed the intervention. HOMA-IR increased in CON (+1.2 units) and decreased in a dose-dependent manner in MOD (-0.9 units, P = .03) and HI (-1.5 units, P.01) relative to CON. Most participants (87.4%) reported no to mild GI symptoms. Of these, flatulence was mild on average with bloating, abdominal discomfort, and cramping severity 0.3, 0.5, and 0.5 units lower (P.001). We observed a dose-dependent reduction on rising hepatic insulin resistance and low GI symptom severity with long-term lentil consumption in metabolically at-risk adults.

The goal of the present study was to characterize high school students’ (n = 338) exposure to geospatial technologies and investigate factors predicting enrollment in a GIS course. Students who rep...

Objective The quality of cancer-related information on social media (SM) is mixed, and exposure to inaccurate information may negatively affect knowledge, attitudes, and behaviors. This study examines SM users’ attention to simulated Facebook posts related to cancer and identifies message features associated with increased attention. Methods SM users (N = 53) participated in a mixed methods experimental study using eye-tracking technology, whereby participants’ dwell time on message components was measured. Stimuli conditions included message format (narrative/non-narrative), information veracity, source (organization/individual), and cancer topic (HPV vaccine and sunscreen safety). Results Pixel-size adjusted analyses revealed that average dwell time was longer on posts attributed to individuals and on narrative-based posts. The source of the message received nearly the same amount of dwell time as the text. Dwell time on other message components did not significantly differ by condition. Conclusion This study found that the source of a message attracted substantial attention, whereas other features were not associated with attention. The study illustrates how communication research can help us understand the processing of ubiquitous cancer-related messages on SM. Practical Implications Health communication practitioners should consider message features that garner attention when developing efforts to facilitate the exchange of evidence-based information and to mitigate the harms of misinformation.

Curiosity and interest have both been regarded as positive motivations for learning. Yet, the boundaries between these constructs are not clarified. Curiosity and interest are used as interchangeable terms by some scholars, while assumed by others to be separable. In an effort to reconcile research on these constructs, this special issue bridges disciplinary boundaries to address three main questions: How do curiosity and interest develop? How can they be supported in classrooms? To what extent do curiosity and interest uniquely predict educational outcomes? Included in this special issue are five articles presenting perspectives on curiosity and interest from educational, developmental, and neuroscientific approaches. The special issue concludes with two commentaries summarizing these perspectives and providing an ambitious agenda for future research and practice.

Although stigma is widely accepted to be a multidimensional construct, the implications of its dimensions for social support warrant greater consideration. We conducted a meta-analysis of 31 conten...

The chemokine Cxcl10 has been associated with poor prognosis in breast cancer, but the mechanism is not well understood. Our previous study has shown that CXCL10 was repressed by the ING4 tumor suppressor, suggesting a potential inverse functional relationship. We thus investigated a role for Cxcl10 in the context of ING4 deficiencies in breast cancer. We first analyzed public gene expression data sets and found that patients with CXCL10-high/ING4-low expressing tumors had significantly reduced disease-free survival in breast cancer. In vitro, Cxcl10 induced migration of ING4-deleted breast cancer cells but not of ING4-intact cells. Using inhibitors, we found that Cxcl10-induced migration of ING4-deleted cells required Cxcr3, Egfr, and the Gβγ subunits downstream of Cxcr3 but not Gαi. Immunofluorescent imaging showed that Cxcl10 induced early transient colocalization between Cxcr3 and Egfr in both ING4-intact and ING4-deleted cells, which recurred only in ING4-deleted cells. A peptide agent that binds to the internal juxtamembrane domain of Egfr inhibited Cxcr3/Egfr colocalization and cell migration. Taken together, these results presented a novel mechanism of Cxcl10 that elicits migration of ING4-deleted cells, in part by inducing a physical or proximal association between Cxcr3 and Egfr and signaling downstream via Gβγ. These results further indicated that ING4 plays a critical role in the regulation of Cxcl10 signaling that enables breast cancer progression.

Assessing whether learning in one domain is transferable to abilities in other domains often eludes traditional testing. Thus, a question with bearing on the promise of neuroscience for education is whether neural changes that accompany in-school curriculum learning can improve prediction of learning transfer. Separately, debate in philosophy and psychology has long concerned whether spatial processes underlie seemingly nonspatial/verbal human reasoning (e.g., mental model theory; MMT). If so, education that fosters spatial cognition might yield transfer to improved verbal reasoning. Here, in real-world classrooms studied in a quasi-experimental design, a STEM curriculum devised to foster spatial cognition yielded improved spatial abilities and-consistent with MMT-transferred beyond the spatial domain to improved verbal reasoning. Further supporting MMT, the more students’ spatial ability improved, the more their verbal reasoning improved, and spatial ability improvement mediated curriculum transfer. At the neural level, longitudinal fMRI detected curriculum-driven changes in activity, connectivity, and representational similarity of brain regions implicated in spatial cognition. Critically, changes in spatial cognition-linked neural activity robustly predicted curriculum transfer-more accurately than testing and grades-and mediated this transfer. Reports by the National Research Council and others note that spatial abilities reliably predict STEM achievement, but that broad adoption of spatial cognition-focused curricula depends on classroom-based evidence of efficacy and mechanisms-of-change. The present findings support the real-world application of MMT to classrooms via “spatial education.” Further, demonstrating that in-school neural change can predict transfer over-and-above performance-based assessment suggests the long-term achievability of neurally-informed curriculum development that leverages neural change to identify and design transferable curricula.

In designing this study, we aimed to obtain a rich, phenomenological understanding of the experiences of couple and family therapists who transitioned their practice to telehealth due to the COVID-19 pandemic. Twelve experienced therapists from the U.S., Spain and Australia were interviewed in depth about their experiences of this transition, particularly how they developed and maintained therapeutic alliances in a virtual context with couples and families suffering pandemic-related hardships. The qualitative analysis identified 40 themes reflecting participants' initial impressions of telehealth and their positive and negative reactions and adjustments to practicing remotely. Upon overcoming some initial wariness about providing services virtually, many participants described advantages to this way of working with families. Indeed, participants were creative in adjusting to this novel therapy modality, finding new ways to connect emotionally with their clients, to work meaningfully with children, to assess in-session dynamics, and to ensure their clients' privacy and safety. Notably, several participants commented on the relatively slower development of alliances with new cases and the challenge of repairing split alliances between family members. Many of these difficulties were described as due to having minimal access to their clients' raw emotions and the inability to use typical systemic interventions, such as moving family members around physically. Participants also reflected on being a "participant observer" to the upheaval caused by the pandemic, a distressing experience they shared with the families in their care.

IntroductionStudies show that tobacco use among sexual and gender minority (SGM) populations is disproportionately higher than heterosexual or cisgender populations. However, few studies have examined tobacco use among SGM subgroups by race/ethnicity or associations between SGM-specific discrimination and connection to SGM identity and tobacco use.MethodsThis study analysed survey data from 11 313 SGM (gay, lesbian, bisexual, other sexual minority or gender minority) young adults in the USA and reported current cigarette, e-cigarette, other tobacco (cigar, smokeless tobacco, hookah) and polytobacco use. We used multinomial logistic regression to estimate associations between (a) SGM subgroup, race/ethnicity, SGM-specific discrimination and SGM identity connection and (b) each tobacco use outcome (vs never use of tobacco). We conducted postestimation testing to assess predicted probabilities of tobacco use against the sample average.ResultsLesbian females (particularly black lesbian females) had higher-than-average probability of polytobacco use. White bisexual and lesbian participants had higher-than-average probability of cigarette and e-cigarette use, respectively. Higher levels of discrimination were associated with polytobacco use. Higher levels of identity connectedness were protective against certain tobacco use behaviours among gender minority participants and participants with high levels of discrimination experience.ConclusionsWe found variations in tobacco use by SGM subgroups overall and by race/ethnicity. Discrimination may be a risk factor for certain tobacco use behaviours. However, SGM identity connectedness may be protective against tobacco use among gender minority individuals and individuals experiencing SGM-specific discrimination. These findings can inform targeted approaches to reach SGM subgroups at greater risk of tobacco use.

Background There is continuing public concern about the safety of COVID-19 vaccination during pregnancy. While there is no compelling biological reason to expect that mRNA COVID-19 vaccination (either preconception or during pregnancy) presents a risk to pregnancy, data are limited. It is, however, well documented that SARS-CoV-2 infection during pregnancy is associated with severe illness and increased risk of adverse pregnancy outcomes. Among recognized pregnancies in high-income countries, 11–16% end in spontaneous abortion (SAB). Methods People enrolled in v-safe, a voluntary smartphone-based surveillance system, who received a COVID-19 vaccine preconception or during pregnancy were contacted by telephone to enroll in the v-safe pregnancy registry. V-safe pregnancy registry participants who received at least one dose of an mRNA COVID-19 vaccine preconception or prior to 20 weeks’ gestation and who did not report a pregnancy loss before 6 completed weeks’ gestation were included in this analysis to assess the cumulative risk of SAB using Life Table methods. Results Among 2,456 pregnant persons who received an mRNA COVID-19 vaccine preconception or prior to 20 weeks’ gestation, the cumulative risk of SAB from 6–19 weeks’ gestation was 14.1% (95% CI: 12.1, 16.1%). Using direct age standardization to the selected reference population, the age-standardized cumulative risk of SAB was 12.8% (95% CI: 10.8–14.8%). Conclusions When compared to the expected range of SABs in recognized pregnancies, these data suggest receipt of an mRNA COVID-19 vaccine preconception or during pregnancy is not associated with an increased risk of SAB. These findings add to accumulating evidence that mRNA COVID-19 vaccines during pregnancy are safe.

Background Information avoidance tendencies have been found to be associated with lower intentions to pursue medically actionable genomic sequencing results, but less so among individuals who engage more in spontaneous self-affirmation. Yet these results were obtained with a largely non-Hispanic White, high-SES cohort. Purpose To assess these variables, their magnitude, and their associations in an African-descent cohort as part of the same ClinSeq® exome sequencing program. Methods Participants reported levels of spontaneous self-affirmation, information avoidance, and intentions to receive three types of results – medically actionable, non-medically actionable, and carrier status as part of a baseline survey. Results Relative to the original, non-Hispanic White cohort, those in the African-descent cohort had higher levels of spontaneous self-affirmation and lower intentions of learning about carrier genomic results; they reported comparable levels of information avoidance and intentions to receive other results. Information avoidance was negatively associated with intention to receive non-actionable results in the African-descent cohort, as found in the initial cohort, with no moderating effect of spontaneous self-affirmation. Information avoidance, spontaneous self-affirmation, and their interaction were not associated with intentions to receive actionable results (contrary to findings in the initial cohort), or carrier results. Conclusions Individuals of African descent may engage in relatively more spontaneous self-affirmation, and do not appear to engage in more information avoidance. Their information avoidance tendencies were associated with pursuit of non-actionable sequencing results, with no moderating effect of self-affirmation, and were not associated with pursuit of actionable results or carrier results.

Epistemic curiosity is a desire for knowledge accompanied by positive emotions, increased arousal, and exploratory behavior (Grossnickle, Educational Psychology Review, 28(1), 23–60, 2016). Although curiosity has typically been characterized as a domain-general construct, domain-general conceptualizations do not acknowledge systematic changes in an individuals’ development (e.g., domain knowledge) as they advance within a domain. Moreover, a domain-general conceptualization of curiosity stands in direct contrast to research on interest, given that interest is typically described as domain-specific (e.g., interest for mathematics). Without a domain-specific conceptualization of curiosity as it relates to development within academic domains, comparisons between curiosity and interest will remain muddled. In the present theoretical review, we put forward a conceptualization of curiosity as domain-specific and examine how the components of curiosity develop within one academic domain: mathematics. In doing so, we juxtapose conceptualizations of epistemic curiosity with literature related to the development of other epistemic factors (i.e., knowledge, epistemic beliefs) in mathematics. Specifically, we build on the knowledge gap theories of epistemic curiosity (Litman, Personality and Individual Differences, 48(4), 397–410, 2010; Loewenstein, Psychological Bulletin, 116(1), 75–98, 1994) to consider developmental shifts in (a) knowledge gaps, (b) heightened arousal, and (c) exploratory behaviors within the domain of mathematics. Understanding the domain-specific and developmental nature of curiosity is critical for distinguishing curiosity from interest and for supporting motivation within mathematics classrooms.