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Francesca Short et al. identify natural polyamines as substrates for a drug efflux pump in the clinically-relevant pathogen, Acinetobacter baumannii. Their results suggest that efflux pumps now known to be involved in drug resistance may have originated as polyamine transporters.

Uzma Zaidi,1 Bushra Kaleem,2 Munira Borhany,1 Sidra Maqsood,2 Naveena Fatima,2 Gul Sufaida,3 Saqib Hussain Ansari,1 Tasneem Farzana,1 Tahir Sultan Shamsi1 1Department of Clinical Hematology, National Institute of Blood Diseases & Bone Marrow Transplantation, Karachi, Pakistan; 2Department of Clinical Research, National Institute of Blood Diseases & Bone Marrow Transplantation, Karachi, Pakistan; 3Department of Molecular Medicine, National Institute of Blood Diseases & Bone Marrow Transplantation, Karachi, Pakistan Background: Nilotinib (Tasigna®) is a second-generation tyrosine kinase inhibitor that shows faster and deeper molecular responses (MR) in comparison to Imatinib as initial therapy in chronic phase chronic myeloid leukemia (CML). Efficacy and safety data for nilotinib in the Asian population is scarce, particularly in Pakistan. We aimed to determine the MR to nilotinib and its safety profile in patients with chronic phase CML.Patients and methods: This observational study was conducted among 173 patients with newly diagnosed CML presenting in the chronic phase. Most patients (50.1%) had a high Sokal score at diagnosis. All patients received nilotinib 600 mg/day. The hematological and molecular responses were assessed at 3 and 6 months respectively and thereafter at 6-monthly intervals. Long-term event free survival (EFS), transformation free survival (TFS), overall survival (OS) and adverse events were observed. Results: Cumulative incidence of major MR (MMR) was 86% and deep MR (DMR ie MR 4.0 and MR4.5) was 39%. Early MMR and DMR after 6 months of therapy were achieved by 74.9% and 37% of patients, respectively. Two-year EFS, TFS and OS rates for all patients were 91.9%, 92% and 92.3%, respectively. At median follow-up of 24 months, 81% and 49% of patients sustained MMR and DMR, respectively. The main adverse events were weight gain (4.6%) and abdominal pain (4%). Conclusion: This study showed promising results in terms of achievement of early and sustained DMR in chronic phase CML, therefore, we recommend nilotinib as frontline treatment in Pakistani population. Keywords: chronic myeloid leukemia, tyrosine kinase inhibitors, nilotinib, molecular response, Sokal Risk Score

Ethnic-racial socialization is one strategy Black parents use to support their children's school engagement and academic achievement given the occurrence and toxic effects of discrimination. Egalitarianism and preparation for bias socialization messages have yielded mixed evidence of promotive and protective effects for Black youth's school outcomes, and effects may vary according to ethnicity. Thus, this research examined associations between ethnic-racial socialization messages and school engagement and achievement, and whether these messages protected against teacher discrimination effects on academic achievement transmitted through school engagement, among a nationally representative sample of Black adolescents who participated in the National Survey of American Life Adolescent supplement study. Ethnic-racial socialization message content and the frequency of communication about race demonstrated different associations with engagement (i.e., school bonding, aspiration-expectation discrepancy, and disciplinary actions) and achievement (i.e., grades) for African American and Caribbean Black youth. However, the benefits were not sufficient to combat the adverse effects of teacher discrimination on school engagement and, in turn, achievement. These findings highlight the utility of integrating ethnic-racial socialization into prevention programs to support Black youth's school experiences; demonstrate the importance of attention to heterogeneity within Black youth; and underscore the critical need for prevention programs to address teacher discrimination.

Youth of color are disproportionately impacted by stressful and traumatic life events, including race-based experiences, which are linked to negative consequences. School is a salient context where youth encounter, witness, and process racial stress and trauma (RST). However, RST is often overlooked within general school-based trauma models. Thus, we propose the School Trauma and Racial Stress (STARS) blueprint, focused on RST across three levels of the school ecology. By building upon and expanding the Substance Abuse and Mental Health Services Administration recommendations regarding trauma-informed approaches (2014), the STARS blueprint applies a multilevel approach to acknowledging and addressing RST within schools. This integrated framework is a call to action across the school ecology, with the goal to increase recognition of RST within school-based trauma-informed approaches and to build racial equity and healing for students of color in K-12 schools. Practical applications for schools are discussed.

Racial socialization is a culturally relevant parenting strategy known to combat the detrimental consequences of racial discrimination for African American youth. Three limitations hinder our developmental understanding of the racial socialization process. Few studies have accounted for the combination of messages that primary caregivers convey, examined how these messages change over time, or investigated how caregivers and adolescents experiences with racial discrimination predict change in the combination of messages conveyed. Given that African American mothers are often the primary socializers in families, the current study used data from a community sample of 497 African American adolescents (52% Female; Time 1 M[subscript age] = 15.69; Time 2 M[subscript age] = 18.74) and their mothers (Time 1 M[subscript age] = 40.43; Time 2 M[subscript age] = 43.39) to identify patterns in mothers' racial socialization messages, identify how mothers' racial socialization patterns change from middle to late adolescence, and investigate whether mother- and adolescent-reported racial discrimination contribute to changes in mothers' racial socialization patterns. Latent profile analysis and latent transition analysis were used to examine these questions. Findings revealed three racial socialization patterns: balanced socializers who mistrust, cultural socialization and preparation for bias emphasizers, and low racial socializers. Most mothers were in the low racial socializers group, and most provided similar messages in middle and late adolescence. Mothers' reports of their own racial discrimination influenced the racial socialization messages mothers delivered; however, adolescent-reported racial discrimination did not. These results have implications for community-based interventions designed to help families manage racial discrimination.

Racial stress and trauma negatively impact the psychological and academic outcomes of Black youth. Riana Elyse Anderson, Farzana Saleem, and James Huguley encourage parents and teachers to explore racial experiences and resulting stress and trauma through racial socialization, or competent conversations and behaviors regarding race and racism, to reduce problematic outcomes. They highlight opportunities for schools, teachers, and families to: 1) create a racial climate at school that affirms discussions about race, racial identity, racism, and coping options; 2) increase teacher training to foster competent classroom practices; and 3) foster safe and supported opportunities for growth for all, including teachers, parents, and students.

Byline: Adil. Abdulla, A. Venugopalan, T. Farzana Continent cutaneous urinary diversion pouches are prone to complications like stoma blockage by mucus, metabolic derangements, infection, renal derangements and urolithiasis. Pouch urolithiasis [...]

Preparation for bias messages (PFB), represent a specific form of racial socialization, used to inform youth about racism and how to cope with racism-related adversity. Although research commonly examines how frequently PFB are delivered to children, few studies have qualitatively explored the heterogeneity in the content of such messages, making it difficult to ascertain how caregivers prepare and coach their children to negotiate incidents of racism-related violence. To address this gap in the literature, the present study qualitatively examined the content of PFB given to Black children from their mothers following high-profile incidents of anti-Black violence. Semistructured interviews were conducted with 12 mothers (Mage = 41.91) of Black children to explore how parental concerns regarding their children's safety inform the content of their PFB. Using thematic analysis, two primary themes emerged. The first theme related to psychosocial factors among caregivers that precipitated PFB (i.e., awareness of anti-Black violence, worry about the child being a victim). The second theme pertained to the different types of PFB that caregivers provided to their children (i.e., awareness of racial biases, strategies to navigate discriminatory encounters). Overall findings support and extend extant racial socialization research and have important implications for how Black youth come to understand the significance of race and racism in the aftermath of racism-related violence. [ABSTRACT FROM AUTHOR]

Introduction Reduced thrombin generation is an important component of post cardiopulmonary bypass (CPB) coagulopathy. To replenish coagulation factors and enhance thrombin generation in bleeding surgical patients, frozen plasma (FP) and four-factor prothrombin complex concentrate (4F-PCC) are used. However, the efficacy–safety balance of 4F-PCC relative to FP in cardiac surgery is unconfirmed.Methods and analysis LEX-211 (FARES-II) is an active-control, randomised, phase 3 study comparing two coagulation factor replacement therapies in bleeding adult cardiac surgical patients at 12 hospitals in Canada and the USA. The primary objective is to determine whether 4F-PCC (Octaplex/Balfaxar, Octapharma) is clinically non-inferior to FP for haemostatic effectiveness. Inclusion criteria are any index (elective or non-elective) cardiac surgery employing CPB and coagulation factor replacement with 4F-PCC or FP ordered in the operating room for bleeding management. Patients will be randomised to receive 1500 or 2000 international units of 4F-PCC or 3 or 4 units of FP, depending on body weight. The primary endpoint of haemostatic treatment response is ‘effective’ if no additional haemostatic intervention is required from 60 min to 24 hours after the first initiation of 4F-PCC or FP; or ‘ineffective’ if any other haemostatic intervention (including a second dose of study drug) is required. An estimated 410 evaluable patients will be required to demonstrate non-inferiority (one-sided α of 0.025, power ≥90%, non-inferiority margin 0.10). Secondary outcomes include transfusions, bleeding-related clinical endpoints, coagulation parameters and safety.Ethics and dissemination The trial has been approved by the institutional review boards of all participating centres. Trial completion is anticipated at the end of 2024, and results will be disseminated via publications in peer-reviewed journals and conference presentations in 2025. The results will advance our understanding of coagulation management in bleeding surgical patients, potentially reducing the need for allogeneic blood products and improving outcomes in surgical patients.Trial registration number NCT05523297.

The aim of this study is to assess the communication apprehension (CA) among the communication students of Bangladesh. The data were collected from 283 students from 10 public universities through the survey method. McCroskey's (1982) Personal Report of Communication Apprehension, also known as the PRCA-24 test was adopted for this study. The data were analyzed using both descriptive and inferential statistics of SPSS 23 software. The study explores that the mean communication apprehension score of communication students of Bangladesh is 68.12 which ascertains the medium level of CA of the students. It also says that 12.6% of students have high CA, 64.7% have medium CA and the rest 13.8% have a low level of communication apprehension. Students are more apprehensive in public communication rather than in group, meeting, and interpersonal communication. Male students have less CA than female students. This research also reveals that those students experience more CA who suffer from depression, prefer loneliness, and spend more time on social media. Communication apprehensive students prefer to sit in the back row or alongside in the classroom setting. Also, CA score is decreased when the age of the student is increased. The study also assesses that students involved with co-curricular activities have less CA than the other students. The study recommends that universities should offer more practical courses in communication to overcome communication apprehension.

Youth of color are disproportionately impacted by stressful and traumatic life events, including race‐based experiences, which are linked to negative consequences. School is a salient context where youth encounter, witness, and process racial stress and trauma (RST). However, RST is often overlooked within general school‐based trauma models. Thus, we propose the School Trauma and Racial Stress (STARS) blueprint, focused on RST across three levels of the school ecology. By building upon and expanding the Substance Abuse and Mental Health Services Administration recommendations regarding trauma‐informed approaches (2014), the STARS blueprint applies a multilevel approach to acknowledging and addressing RST within schools. This integrated framework is a call to action across the school ecology, with the goal to increase recognition of RST within school‐based trauma‐informed approaches and to build racial equity and healing for students of color in K‐12 schools. Practical applications for schools are discussed. Highlights: The School Trauma and Racial Stress (STARS) blueprint builds upon core trauma‐informed elements to explicitly acknowledge and address racial stress and trauma within a multilevel school‐wide approach.The framework is a call to action to build and sustain pathways towards resistance, healing, and resilience. [ABSTRACT FROM AUTHOR]