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The reddish egret Egretta rufescens is the rarest heron in North America, and there are many information gaps in our understanding of its ecology. The population size of the reddish egret is relatively small, and although its range spans from the Gulf Coast of the United States to the northern coast of South America, it is restricted to shallow, coastal lagoon systems. Nest survival and juvenile survival have been examined in the reddish egret; however, adult survival has not. We marked 30 adult reddish egrets with satellite transmitters and used the known-fate model in Program MARK to estimate monthly survival. Monthly survival estimates were high and best explained by season, with a 0.992 (95% CI: 0.974-0.997) survival rate during the breeding season and 0.949 (95% CI: 0.912-0.971) during the nonbreeding season. This is the first study to estimate adult survival of reddish egrets, and it provides new information on the ecology of the species.

Presents a letter to the editor about the publication of the Critically Appraised Papers of the "Australian Occupational Therapy Journal."

There is a dearth of evidence indicating the effectiveness of psychological interventions targeting depression and/or posttraumatic stress disorder (PTSD) for Black women in the United States (US) exposed to intimate partner violence (IPV). We searched PubMed, MEDLINE, PsycINFO, EBSCOhost, Social Sciences, Social Sciences Full Text, Social Work Abstracts, and Cochrane databases between September 2021 and October 2022, for original studies of randomized control trials (RCTs) reporting depression and/or PTSD interventions delivered to US Black women with histories of IPV. Of the 1,276 articles, 46 were eligible and 8 RCTs were ultimately included in the review; interventions for depression (four interventions, n  = 1,518) and PTSD (four interventions, n  = 477). Among Depression and PTSD interventions (one intervention, n  = 208), Beck's Depression Inventory II indicated M  = 35.2, SD  = 12.6 versus M  = 29.5, SD  = 13.1, <.01, and Davidson Trauma Scale indicated M  = 79.4, SD  = 31.5 versus M  = 72.1, SD  = 33.5, <.01, at pre- and post-intervention respectively. Also, some interventions reported severity of depression M  = 13.9 ( SD  = 5.4) versus M  = 7.9 ( SD  = 5.7) < 0.01, and PTSD ( M  = 8.08 vs. M  = 14.13, F (1,117) = 9.93, p  < .01) at pre- and post-intervention respectively. Publication bias was moderate and varied between 12 and 17 via the Downs and Black Checklist for Methodological Rigor for RCTs. Psychological interventions targeting depression and/or PTSD for Black women with histories of IPV reflect moderate improvement. Interventions that account for cultural nuances specific to Black women are fundamental for improving outcomes for survivors presenting with depression and/or PTSD., 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.

Characters play an integral role in animated narratives, but their visual racial presentation has received limited attention. A diverse group of U.S. children watched a 15-min physical activity-promoting animated Sci-Fi narrative. They were randomly assigned to one of three conditions, which varied the lead characters' racial presentation: realistic racially unambiguous (Original: White children, Black mother), realistic racially ambiguous (Ambiguous: All with brown skin without specified race/ethnicity), and fantastical racially ambiguous (Fantastical: All with brown skin with fantastical hair-and-eye color schemes). We assessed narrative engagement, wishful identification, and physical activity intention. Controlling for social desirability and multigroup ethnic identity, children who watched Fantastical characters showed significantly higher narrative engagement than those who watched Original characters, but they did not statistically differ from those who watched Ambiguous characters. Structural equation modeling indicated that narrative engagement and wishful identification fully mediated the racial representation effect (Fantastical vs. Original) on physical activity intention., (© The Author(s) 2023. Published by Oxford University Press on behalf of International Communication Association.)

This research examines the efficacy of self-persuasion narratives (i.e., narratives that describe how a character has changed their mind about the COVID-19 vaccines) in encouraging vaccine uptake among unvaccinated African Americans. A five-condition experiment (N = 394) was conducted in June 2021. Participants viewed one of the three pro-vaccine messages (a self-persuasion narrative, a narrative without self-persuasion, or a non-narrative message) or an irrelevant message or completed a self-persuasion task. Findings supported the persuasive benefits of the self-persuasion narrative compared to the narrative without self-persuasion, actual self-persuasion, and the irrelevant message. Its advantage over the narrative without self-persuasion was mediated by increased self-referencing, affective empathy, and perceived similarity with the character. Moreover, its psychological effects were moderated by participants' trust in science. Unexpectedly, the non-narrative showed persuasive benefits compared to other intervention strategies. The theoretical implications for narrative persuasion and practical implications for vaccine promotion were discussed., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: eHealth interventions using active video games (AVGs) offer an alternative method to help children exercise, especially during a pandemic where options are limited. There is limited data on costs associated with developing and implementing such interventions., Objectives: We quantified the costs of delivering an eHealth RCT intervention among minority children during COVID-19., Methods: We categorized the total trial cost into five subcategories: intervention material development, advertising and recruitment, intervention delivery, personnel salaries, and COVID-19-related equipment costs., Results: The total RCT cost was $1,927,807 (Direct: $1,227,903; Indirect: $699,904) with three visits required for each participant. The average cost per participant completing the RCT (79 participants/237 visits) was $24,403 (Direct: $15,543; Indirect: $8860). Due to no-shows and cancellations (198 visits) and dropouts before study completion (61 visits; 56 participants), 496 visits had to be scheduled to ensure complete data collection on 79 participants. If all 496 visits were from participants completing the three-visit protocol, that would correspond to 165 participants, bringing the average cost per participant down to $11,684 (Direct: $7442; Indirect: $4242). Of the subcategories, intervention material development accounted for the largest portion, followed by personnel salaries. While the direct COVID-19-specific cost constituted <1% of the entire budget, the indirect effects were much larger and significantly impacted the trial., Conclusion: RCTs typically involve significant resources, even more so during a pandemic. Future eHealth intervention investigators should budget and plan accordingly to prepare for unexpected costs such as recruitment challenges to increase flexibility while maximizing the intervention efficacy., 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 © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

We argue that imaginary worlds gain much of their appeal because they fulfill the fundamental need of human beings to feel connected to other humans. Immersion into story worlds provides a sense of social connection to the characters and groups represented in the world. By fulfilling the need to belong, imaginary worlds provide a buffer against rejection and loneliness.

Physics-informed neural networks (PINNs) have enabled significant improvements in modelling physical processes described by partial differential equations (PDEs) and are in principle capable of modeling a large variety of differential equations. PINNs are based on simple architectures, and learn the behavior of complex physical systems by optimizing the network parameters to minimize the residual of the underlying PDE. Current network architectures share some of the limitations of classical numerical discretization schemes when applied to non-linear differential equations in continuum mechanics. A paradigmatic example is the solution of hyperbolic conservation laws that develop highly localized nonlinear shock waves. Learning solutions of PDEs with dominant hyperbolic character is a challenge for current PINN approaches, which rely, like most grid-based numerical schemes, on adding artificial dissipation. Here, we address the fundamental question of which network architectures are best suited to learn the complex behavior of non-linear PDEs. We focus on network architecture rather than on residual regularization. Our new methodology, called physics-informed attention-based neural networks (PIANNs), is a combination of recurrent neural networks and attention mechanisms. The attention mechanism adapts the behavior of the deep neural network to the non-linear features of the solution, and break the current limitations of PINNs. We find that PIANNs effectively capture the shock front in a hyperbolic model problem, and are capable of providing high-quality solutions inside the convex hull of the training set., (© 2022. The Author(s).)

Obesity is increasing worldwide, including in pediatrics. Adequate nutrition is required for initiation of menses, and there is a clear secular trend toward earlier pubertal onset and menarche in females in countries around the globe. Similar findings of earlier pubertal start are suggested in males. However, as individuals and populations have crossed into over-nutritional states including overweight and obesity, the effect of excess weight on disrupting reproductive function has become apparent. Hypothalamic hypogonadism and polycystic ovary syndrome are two conditions where reproductive function appears to directly relate to excess weight. Clinical findings in individuals with certain polygenic and monogenic obesity syndromes, which also have reproductive disruptions, have helped elucidate neurologic pathways that are common to both. Clinical endocrinopathies such as hypothyroidism or panhypopituitarism also aide in the understanding of the role of the endocrine system in weight gain. Understanding the intersection of obesity and reproductive function may lead to future therapies which can treat both conditions., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Thieme. All rights reserved.)

A 6-year-old male undergoing bilateral hydrocelectomy was to receive caudal analgesia after induction of general anesthesia. After insertion of the caudal needle, cerebrospinal fluid was unexpectedly aspirated and the caudal was abandoned. The surgeon performed bilateral ilioinguinal nerve blocks just before incision. Surgery was uneventful. The patient had difficulty ambulating postoperatively, and a detailed neurologic examination revealed quadriceps weakness. A lumbosacral magnetic resonance imaging (MRI) revealed a sacral meningocele. By the next morning, quadriceps function had returned, and he was ambulating normally. The ilioinguinal block was most likely deep to the internal oblique muscle and produced femoral nerve dysfunction., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 International Anesthesia Research Society.)

Background: Although physical activity (PA) has been shown in helping prevent and treat obesity, current PA interventions are still not effective in ameliorating the obesity epidemic. Additional forms of PA need to be investigated to improve PA engagement and outcomes. We hypothesize that pairing a narrative (i.e., story) with an active video game (AVG), a less traditional form of PA, will increase participant engagement in PA. This paper presents the rationale, implementation, and pilot results of a study assessing the effect of narrative's impact on PA and a series of other health outcomes., Objective: This paper presents the rationale, implementation, and pilot results of a study assessing the effect of narrative's impact on PA and a series of other health outcomes., Methods/design: The Active Video Game Study is a six-month randomized controlled single-blind trial projected to include 210 participants. The intervention strategy will pair a narrative to an active video game (AVG). Participants will be randomized into 3 groups: condition A [Narrative + AVG], condition B [AVG Only], and condition C [Control]. Participants will undergo three in-person data collection visits over the course of six months. Inclusion criteria are that children are between the ages of 8-12 and have a BMI ≥ 85%. The primary outcome is change in moderate to vigorous physical activity (MVPA). Secondary outcome measures include change in BMI percentile, fasting insulin and glucose, lipid panel, C-reactive protein, and cognitive function. A pilot trial of n = 6 was conducted to help develop procedures and address problems that could arise in the main trial., Discussion: Successful completion of this study will provide the empirical basis for novel intervention and design strategies to enhance the impact of AVGs on long-term MVPA., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: Games for heath can take the form of interactive narratives, or stories in which readers have the option to make decisions about the direction of the plot. Individual differences may affect the extent to which individuals become engaged in such narratives. Materials and Methods: In two studies, we randomly assigned participants to read either a traditional linear narrative or an interactive version of the same narrative. We examined the influence of need for cognition (NFC) and transportability (the extent to which individuals tend to become immersed in narratives) on transportation, character identification, and perceived realism. Results: Transportability led to higher perceptions of realism in the interactive narrative in Study 1, but this effect was not replicated in Study 2. In Study 1, higher NFC led to greater identification in the interactive narrative; in Study 2, higher NFC led to greater transportation into the interactive narrative. Conclusion: Greater willingness to exert mental effort may lead to greater immersion in interactive narratives.

The popularity of using unmanned aerial vehicles (UAVs) to survey colonial waterbirds has increased in the past decade, but disturbance associated with this bourgeoning technology requires further study. Disturbance was investigated by conducting aerial surveys with a consumer-grade quadcopter (DJI Phantom 3), while concurrently recording behavioural reactions on video. Surveys of mixed-species waterbird colonies (1-6 species per colony) were flown in horizontal transects at heights of 122, 91, 61, and 46 m, which is a typical range for collecting aerial imagery and producing high-resolution mosaicked orthophotos of nesting bird sites. An upper limit of 122 m was used due to local regulations prohibiting higher-altitude flights without federal authorization. Behavioural reactions were tallied every minute and a disturbance score was calculated for each sampling period. When compared to control periods, we found no evidence that colony-wide escape (i.e., flight) behaviour increased during drone flights, at any altitude flown. However, disturbance score increased significantly by 53% for surveys at 46 m. Some species were more sensitive to surveys than others. Laughing Gulls, in particular, exhibited a significant (125%) increase in escape behaviour for surveys at 91 m. Our results indicate when used in a capacity to gather high-resolution imagery for estimating breeding pairs, UAV surveys affected some species more than others, but severe reactions did not appear to increase for mixed-species colonies as a whole. Further study on safe operating thresholds is essential, especially at local and regional scales.

Stories may provide a useful way of communicating about health and promoting engagement for health promotion campaigns. In this study, we examined the effectiveness of a particular type of narrative, restorative narratives (stories that highlight hope and resilience), relative to negative narratives (stories that focus on suffering or challenges). We also tested the effect of labeling the story as fact or fiction. The results suggested that restorative narratives may foster greater prosocial behavior than negative narratives and effectiveness does not differ depending on whether a story is labeled as "factual" or "fictional." Our findings offer encouraging implications for future promotional efforts by health organizations.

Persuasion research often focuses on how source characteristics affect attitude change in response to a message; however, message characteristics may also alter perceptions of the source. The Message-Based Impression Formation effect (M-BIF) suggests that perceivers use features of messages to infer characteristics of the source, and that such inferences may have a variety of consequential outcomes. In particular, the choice of narrative versus statistical evidence may have implications for the perceived warmth and competence of a source. In five experiments, narrative arguments led to greater perceptions of source warmth and statistical arguments led to greater perceptions of source competence. Across the two behavioral studies, a matching effect emerged: participants preferred to work on cooperative tasks with partners who had provided narratives, and competitive tasks with partners who had provided statistical evidence. These results suggest that the evidence type chosen for everyday communications may affect person perception and interpersonal interaction., Competing Interests: The authors have declared that no competing interests exist.

Background: Physical activity is crucial for child obesity prevention and intervention. Narratives embedded in active games can increase children's physical activity., Objective: Little is known about the narrative characteristics that would motivate children to exercise. We attempted to fill the gaps in understanding regarding narrative design for active video games., Methods: In this exploratory study, four animated narratives of different genres were professionally generated. Children (N=41) between the ages of 8 and 12 years were interviewed to identify their preferences. Sessions were digitally recorded, transcribed, and analyzed using exploratory thematic analysis., Results: Findings revealed that the children rated the dystopian science fiction story as their favorite across all weight, race, and gender groups. The physical activity-friendly narrative strategies included virtuous characters, extraordinary character actions, interesting plots, super powers, and engaging cliffhangers. Alternatively, information not related to physical activity, difficult-to-follow plot lines, passive protagonists, and repetitive narrative tropes were less appealing for physical activity., Conclusions: This research provides preliminary evidence that narratives have characteristics that may increase child physical activity when playing active games. Future empirical studies should verify and test these design principles., (©Amy Shirong Lu, Melanie C Green, Debbe Thompson. Originally published in JMIR Serious Games (http://games.jmir.org), 21.11.2019.)

Background: A phase 2 trial showed improved progression-free survival for atezolizumab plus bevacizumab versus sunitinib in patients with metastatic renal cell carcinoma who express programmed death-ligand 1 (PD-L1). Here, we report results of IMmotion151, a phase 3 trial comparing atezolizumab plus bevacizumab versus sunitinib in first-line metastatic renal cell carcinoma., Methods: In this multicentre, open-label, phase 3, randomised controlled trial, patients with a component of clear cell or sarcomatoid histology and who were previously untreated, were recruited from 152 academic medical centres and community oncology practices in 21 countries, mainly in Europe, North America, and the Asia-Pacific region, and were randomly assigned 1:1 to either atezolizumab 1200 mg plus bevacizumab 15 mg/kg intravenously once every 3 weeks or sunitinib 50 mg orally once daily for 4 weeks on, 2 weeks off. A permuted-block randomisation (block size of 4) was applied to obtain a balanced assignment to each treatment group with respect to the stratification factors. Study investigators and participants were not masked to treatment allocation. Patients, investigators, independent radiology committee members, and the sponsor were masked to PD-L1 expression status. Co-primary endpoints were investigator-assessed progression-free survival in the PD-L1 positive population and overall survival in the intention-to-treat (ITT) population. This trial is registered with ClinicalTrials.gov, number NCT02420821., Findings: Of 915 patients enrolled between May 20, 2015, and Oct 12, 2016, 454 were randomly assigned to the atezolizumab plus bevacizumab group and 461 to the sunitinib group. 362 (40%) of 915 patients had PD-L1 positive disease. Median follow-up was 15 months at the primary progression-free survival analysis and 24 months at the overall survival interim analysis. In the PD-L1 positive population, the median progression-free survival was 11·2 months in the atezolizumab plus bevacizumab group versus 7·7 months in the sunitinib group (hazard ratio [HR] 0·74 [95% CI 0·57-0·96]; p=0·0217). In the ITT population, median overall survival had an HR of 0·93 (0·76-1·14) and the results did not cross the significance boundary at the interim analysis. 182 (40%) of 451 patients in the atezolizumab plus bevacizumab group and 240 (54%) of 446 patients in the sunitinib group had treatment-related grade 3-4 adverse events: 24 (5%) in the atezolizumab plus bevacizumab group and 37 (8%) in the sunitinib group had treatment-related all-grade adverse events, which led to treatment-regimen discontinuation., Interpretation: Atezolizumab plus bevacizumab prolonged progression-free survival versus sunitinib in patients with metastatic renal cell carcinoma and showed a favourable safety profile. Longer-term follow-up is necessary to establish whether a survival benefit will emerge. These study results support atezolizumab plus bevacizumab as a first-line treatment option for selected patients with advanced renal cell carcinoma., Funding: F Hoffmann-La Roche Ltd and Genentech Inc., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

A 2-month-old male infant presented for elective repair of inguinal hernias. His preoperative medical history and physical examination were unremarkable. During induction of anesthesia, the infant sustained an adverse cardiac event. The event was characterized by tachycardia, hypotension, and massive ST-segment elevation. Despite vigorous resuscitation, spontaneous hemodynamic stability could not be achieved and extracorporeal membrane oxygenation was required. A transthoracic echocardiogram revealed severe hypoplasia of the ascending aorta. As effective cardiac function did not recover and there was evidence of diffuse ischemic brain injury, life support was withdrawn. Genetic testing performed postoperatively was definitive for Williams syndrome.

Purpose: Concerns regarding anatomical anomalies and worsening neurological symptoms have prevented widespread use of epidural catheters in patients with low level spina bifida. We hypothesize that thoracic epidural placement in the T9 to T10 interspace is safe and decreases narcotic requirements following major open lower urinary tract reconstruction in patients with low level spina bifida., Materials and Methods: We reviewed consecutive patients with low level spina bifida who underwent lower urinary tract reconstruction and received epidurals for postoperative pain control. Controls were patients with low level spina bifida who received single injection transversus abdominis plane blocks and underwent similar procedures. Complications of epidural placement, including changes in motor and sensory status, were recorded. Opioid consumption was calculated using equivalent intravenous morphine doses. Mean and maximum pain scores on postoperative days 0 to 3 were calculated., Results: Ten patients with low level spina bifida who underwent lower urinary tract reconstruction with epidural were matched to 10 controls with low level spina bifida who underwent lower urinary tract reconstruction with transverse abdominis plane block. Groups were demographically similar. All patients had full abdominal sensation and functional levels at or below L3. No epidural complications or changes in neurological status were noted. The epidural group had decreased opioid consumption on postoperative days 0 to 3 (0.75 mg/kg vs 1.29 mg/kg, p = 0.04). Pain scores were similar or improved in the epidural group., Conclusions: Thoracic epidural analgesia appears to be a safe and effective opioid sparing option to assist with postoperative pain management following lower urinary tract reconstruction in individuals with low level spina bifida.

The replacement of the Desert Research Institute (DRI) model 2001 with model 2015 thermal/optical analyzers (TOAs) results in continuity of the long-term organic carbon (OC) and elemental carbon (EC) database, and it adds optical information with no additional carbon analysis effort. The value of multiwavelength light attenuation is that light absorption due to black carbon (BC) can be separated from that of brown carbon (BrC), with subsequent attribution to known sources such as biomass burning and secondary organic aerosols. There is evidence of filter loading effects for the 25% of all samples with the highest EC concentrations based on the ratio of light attenuation to EC. Loading corrections similar to those used for the seven-wavelength aethalometer need to be investigated. On average, nonurban Interagency Monitoring of PROtected Visual Environments (IMPROVE) samples show higher BrC fractions of short-wavelength absorption than urban Chemical Speciation Network (CSN) samples, owing to greater influence from biomass burning and aged aerosols, as well as to higher primary BC contributions from engine exhaust at urban sites. Sequential samples taken during an Everglades National Park wildfire demonstrate the evolution from flaming to smoldering combustion, with the BrC fraction increasing as smoldering begins to dominate the fire event., Implications: The inclusion of seven wavelengths in thermal/optical carbon analysis of speciated PM 2.5 (particulate matter with an aerodynamic diameter ≤2.5 μm) samples allows contributions from biomass burning and secondary organic aerosols to be estimated. This separation is useful for evaluating control strategy effectiveness, identifying exceptional events, and determining natural visibility conditions.

Background: Few options exist for patients with locally advanced or metastatic urothelial carcinoma after progression with platinum-based chemotherapy. We aimed to assess the safety and efficacy of atezolizumab (anti-programmed death-ligand 1 [PD-L1]) versus chemotherapy in this patient population., Methods: We conducted this multicentre, open-label, phase 3 randomised controlled trial (IMvigor211) at 217 academic medical centres and community oncology practices mainly in Europe, North America, and the Asia-Pacific region. Patients (aged ≥18 years) with metastatic urothelial carcinoma who had progressed after platinum-based chemotherapy were randomly assigned (1:1), via an interactive voice and web response system with a permuted block design (block size of four), to receive atezolizumab 1200 mg or chemotherapy (physician's choice: vinflunine 320 mg/m 2 , paclitaxel 175 mg/m 2 , or 75 mg/m 2 docetaxel) intravenously every 3 weeks. Randomisation was stratified by PD-L1 expression (expression on <1% [IC0] or 1% to <5% [IC1] of tumour-infiltrating immune cells vs ≥5% of tumour-infiltrating immune cells [IC2/3]), chemotherapy type (vinflunine vs taxanes), liver metastases (yes vs no), and number of prognostic factors (none vs one, two, or three). Patients and investigators were aware of group allocation. Patients, investigators, and the sponsor were masked to PD-L1 expression status. The primary endpoint of overall survival was tested hierarchically in prespecified populations: IC2/3, followed by IC1/2/3, followed by the intention-to-treat population. This study, which is ongoing but not recruiting participants, is registered with ClinicalTrials.gov, number NCT02302807., Findings: Between Jan 13, 2015, and Feb 15, 2016, we randomly assigned 931 patients from 198 sites to receive atezolizumab (n=467) or chemotherapy (n=464). In the IC2/3 population (n=234), overall survival did not differ significantly between patients in the atezolizumab group and those in the chemotherapy group (median 11·1 months [95% CI 8·6-15·5; n=116] vs 10·6 months [8·4-12·2; n=118]; stratified hazard ratio [HR] 0·87, 95% CI 0·63-1·21; p=0·41), thus precluding further formal statistical analysis. Confirmed objective response rates were similar between treatment groups in the IC2/3 population: 26 (23%) of 113 evaluable patients had an objective response in the atezolizumab group compared with 25 (22%) of 116 patients in the chemotherapy group. Duration of response was numerically longer in the atezolizumab group than in the chemotherapy group (median 15·9 months [95% CI 10·4 to not estimable] vs 8·3 months [5·6-13·2]; HR 0·57, 95% CI 0·26-1·26). In the intention-to-treat population, patients receiving atezolizumab had fewer grade 3-4 treatment-related adverse events than did those receiving chemotherapy (91 [20%] of 459 vs 189 [43%] of 443 patients), and fewer adverse events leading to treatment discontinuation (34 [7%] vs 78 [18%] patients)., Interpretation: Atezolizumab was not associated with significantly longer overall survival than chemotherapy in patients with platinum-refractory metastatic urothelial carcinoma overexpressing PD-L1 (IC2/3). However, the safety profile for atezolizumab was favourable compared with chemotherapy, Exploratory analysis of the intention-to-treat population showed well-tolerated, durable responses in line with previous phase 2 data for atezolizumab in this setting., Funding: F Hoffmann-La Roche, Genentech., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The purpose of this study was to determine whether exposure to a manga comic (Japanese comic art) with messages promoting fruit consumption influenced psychosocial variables associated with increased fruit intake in middle-school youth. A three-group, randomized, single-session study was conducted in two public middle schools in central North Carolina. Participants were randomly assigned to one of three groups: (a) comic (manga comic promoting fruit consumption, (b) newsletter (newsletter about fruit), or (c) attention-control (newsletter about ancient Greece). Participants included N = 263 youth, with a mean age of 13.18 years (SD = 1.12). Outcome expectations, self-efficacy, and knowledge related to fruit intake were measured at baseline and immediately after reading. Secondary outcomes included transportation (degree to which participants are immersed in their media) and enjoyment, measured at posttest. Data were analyzed using regression analyses. Comic group participants tended to have greater change in outcome expectations related to fruit intake compared to the attention-control group and greater transportation and enjoyment than the newsletter and attention-control groups. Study results are promising and suggest that manga comics may be a useful format to promote positive health beliefs in youth.

We propose an extension of the Distancing-Embracing model to the use of stories for prosocial ends. Specifically, audiences may find stories of individuals in need too emotionally overwhelming. Audiences may attempt to regulate or reduce negative emotions, which can reduce empathy and willingness to help. Through distancing, fictionalized accounts may counteract this tendency and thus increase prosocial behavior.

Oxidative stress plays a role in many biological phenomena, but involved mechanisms and individual reactions are not well understood. Correlated electronic structure calculations with the MP2, MP4, and CCSD(T) methods detail thermodynamic and kinetic information for the free radical oxygen protein oxidation pathway studied in a trialanine model system. The pathway includes aerobic, anaerobic and termination reactions. The course of the oxidation process depends on local conditions and availability of specific reactive oxygen species (ROS). A chemical mechanism is proposed for how oxidative stress promotes β-structure formation in the amyloid diseases. The work can be used to aid experimentalists as they explore individual reactions and mechanisms involving oxygen free radicals and oxidative stress in β-structured proteins.

Background: Residual disease (RD) after neoadjuvant chemotherapy carries an increased risk for recurrence. Ixabepilone has activity in anthracycline/taxanes-resistant breast cancer. We explored adjuvant ixabepilone in patients with significant RD HER2-negative breast cancer., Methods: A phase II study in patients with residual cancer burden II or III randomized to ixabepilone versus observation was conducted. Circulating tumor cells (CTCs) were measured at baseline and at 9 and 18 weeks. Survival probabilities were estimated by Kaplan-Meier product limit. Toxicities were reported as proportions in the ixabepilone arm., Results: Accrual was stopped because of ixabepilone toxicity. Sixty-seven patients were registered; 43 were randomized, 19 received ixabepilone, and 24 went to observation. One patient (9.1%) in the observation arm versus 2 patients (18.2%) in the ixabepilone arm had CTCs at 18 weeks (P = 1.0). Three-year recurrence-free survival and overall survival were 94% and 82%, and 100% and 79% in the observation and ixabepilone arms (P = .35 and .18), respectively. Most common adverse events (AEs) included fatigue, pain, neuropathy, constipation, nausea, rash, anorexia, and diarrhea. Serious AEs included pain (63.2%), fatigue (31.6%), and neuropathy (31.6%)., Conclusions: Adjuvant ixabepilone in patients with significant RD after neoadjuvant chemotherapy was difficult to administer because of AEs and did not change the presence of CTC or affect survival outcomes. NCT00877500., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Patients often query in regard to cosmetic outcomes after cutaneous surgery. This study provides information on this topic by surveying preference on 2 skin closure methods, purse and linear. The authors used a novel method to poll opinions by incorporating simulated skin within the context of the survey., Objective: To determine patient's preference for linear or purse string closure. Additional outcomes were to survey patient's opinions regarding which scar characteristics have the highest cosmetic impact, the cosmetic importance of a scar, and the utility of simulators, and patient photographs as methods of understanding closure techniques., Materials and Methods: Participants were prospectively recruited to complete a survey. Data outcomes were analyzed using descriptive statistics and the chi-square test of association., Results: About half of the participants (54.7%) preferred linear closure. Preference was independent of gender (p = .90) or having a prior linear or purse string closure (p = .17). Patient photographs were the most influential for determining preference according to 86.2% of participants; however, 88% of the participants found simulator devices useful for educational purposes., Conclusion: The methods in this survey may represent a venue for educating patients and incorporating their preferences into the choices they will make regarding dermatologic procedures, which they will undergo.

Multiple sclerosis (MS) is a debilitating autoimmune disease with a prominent inflammatory component. There have been strides identifying genetic and environmental MS risk factors, though much of the disease risk remains unknown. Recent large observational studies suggest adverse socioeconomic position increases the risk for MS, however the mediating biological processes are not understood. We hypothesize a prominent role for stress response, both the autonomic nervous system and the hypothalamic-pituitary-adrenal axis, which become maladaptive under frequent or chronic stimulation resulting in a proinflammatory phenotype. Thus, adverse SEP and chronic stress may predispose individuals for MS.

Research has demonstrated the ability of fictional narratives to educate about social and health issues. Although some entertainment-education efforts have used live theater as a mechanism for social change, very few use social science methods to demonstrate exposure effects. This project used live theater to increase understanding and knowledge about intimate partner violence, a pervasive and costly social and health problem. Audiences watched either a play about abusive relationships-emphasizing psychological abuse and the role of coercion and control-or a control play. Compared with controls, those who watched the abuse play were more knowledgeable and less accepting of myths about abusive relationships in a way that mirrored play content. Although both plays were highly transporting, transportation did not explain a significant amount of variance in the attitudes toward intimate partner violence. These results provide rare evidence for theater as a tool for social change.

Mouse models of autistic like behaviors are a valuable tool to use when studying the causes, symptoms, and potential treatments for autism. The inbred C58/J strain is a strain of interest for this model and has previously been shown to possess face validity for some of the core traits of autism, including low social behavior and elevated motor stereotypies. Higher order repetitive behaviors have not been extensively studied in this strain, or in mice in general. In this study, we looked for evidence of higher-order repetitive behaviors in the C58/J strain using a novel object assay. This assay utilized a mouse's natural exploratory behavior among unfamiliar objects to identify potential sequencing patterns in motor activity. The motor stereotypies displayed by the C58/J strain during testing were consistent with past studies. The C58/J strain also displayed a high preference for a single object in the round arena assays and the females demonstrating elevated sequencing patterns in the round arena. Although the C58/J strain did not show pervasive evidence of higher-order repetitive behaviors across all measures, there was evidence of higher order repetitive behaviors in certain situations. This study further demonstrates the potential of the C58/J mouse strains as a model for lower-order and potentially, higher-order repetitive behaviors. This study also demonstrates that the shape of the novel object arena can change the behavior displayed by the test animals. Further studies utilizing the C58/J strain and further validation of the novel object assay are warranted., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Post-translational mechanisms of protein oxidation as a result of reactive oxygen species (ROS) can occur under physiological conditions to yield selective side-chain and backbone modifications including abstractions, donations, additions, substitutions, and fragmentation. In order to characterize the selectivity of radical-mediated fragmentation, quantum mechanical investigations using ab initio and density functional methods were employed to evaluate site, conformation, and pathway trends of small trialanine peptides resembling a β-strand and a β-turn. Comparisons of reaction enthalpies show that the diamide pathway is more energetically favorable than the α-amidation pathway and that both pathways are site and conformationally selective. These findings readily contribute to the understanding of oxidative stress in biochemical processes.

Background: Everolimus synergistically enhances taxane-induced cytotoxicity in breast cancer cells in vitro and in vivo in addition to demonstrating a direct antiproliferative activity. We aim to determine pharmacodynamics changes and response of adding everolimus to standard neoadjuvant chemotherapy in triple-negative breast cancer (TNBC)., Patients and Methods: Phase II study in patients with primary TNBC randomized to T-FEC (paclitaxel 80 mg/m(2) i.v. weekly for 12 weeks, followed by 5-fluorouracil 500 mg/m(2), epirubicin 100 mg/m(2), and cyclophosphamide 500 mg/m(2) every 3 weeks for four cycles) versus TR-FEC (paclitaxel 80 mg/m(2) i.v. and everolimus 30 mg PO weekly for 12 weeks, followed by FEC). Tumor samples were collected to assess molecular changes in the PI3K/AKT/mTOR pathway, at baseline, 48 h, 12 weeks, and at surgery by reverse phase protein arrays (RPPA). Clinical end points included 12-week clinical response rate (12-week RR), pathological complete response (pCR), and toxicity., Results: Sixty-two patients were registered, and 50 were randomized, 27 received T-FEC, and 23 received TR-FEC. Median age was 48 (range 31-75). There was downregulation of the mTOR pathway at 48 h in the TR-FEC arm. Twelve-week RR by ultrasound were 29.6% versus 47.8%, (P = 0.075), and pCR were 25.9% versus 30.4% (P = 0.76) for T-FEC and TR-FEC, respectively. mTOR downregulation at 48 h did not correlate with 12-week RR in the TR-FEC group (P = 0.58). Main NCI grade 3/4 toxicities included anemia, neutropenia, rash/desquamation, and vomiting in both arms. There was one case of grade 3 pneumonitis in the TR-FEC arm. No grade 3/4 stomatitis occurred., Conclusion: The addition of everolimus to paclitaxel was well tolerated. Everolimus downregulated mTOR signaling but downregulation of mTOR at 48 h did not correlate with 12-week RR in the TR-FEC group., Clinical Trial Number: NCT00499603., (© The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Limited clinical data are available regarding the safety of docetaxel in metastatic breast cancer patients with liver dysfunction., Methods: Eligible patients had breast cancer with impaired liver function secondary to hepatic metastases and were candidates for docetaxel therapy. They were assigned to one of five groups on the basis of total bilirubin, alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase levels. All other causes of liver dysfunction were excluded, and bile duct obstruction was corrected, if possible, prior to study entry. Patients received docetaxel every three weeks. The chemotherapy dose was chosen on the basis of the patient's level of hepatic dysfunction and escalated as tolerated. The primary outcome of this study was safety. The secondary outcomes were pharmacokinetic data and efficacy in terms of time to disease progression., Results: Twenty-three patients were enrolled. No unexpected toxicities occurred. Grade 3/4 fatigue (65%), neutropenia (30%), myalgias (26%), neutropenic fever (26%), vomiting (9%), and rash (9%) were the most common serious adverse events. The median time to progression was three months (range 1-18 months). Pharmacokinetic results indicated that patients with more severe hepatic dysfunction may have been underdosed based on our conservative dosing strategy., Conclusions: Docetaxel can be administered to patients with metastatic breast cancer and liver dysfunction after dose attenuation. However, because of a narrow therapeutic index in this clinical setting, therapy should be closely monitored with subsequent dose escalation when possible.

Giant congenital melanocytic nevi (GCMN) are a rare type of melanocytic nevus that covers a large body surface, often with satellite nevi scattered on the rest of the skin. There are several complications associated with GCMN, including malignant melanoma and neurocutaneous melanosis. The management of GCMN is very complex because of the cosmetic appearance and the associated psychological distress, the risk of severe complications, and the need for long-term follow-up. We report a case of a 43-year-old active-duty female with a GCMN reporting new and symptomatic satellite lesions with atypical features on dermoscopy., (Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.)

Attitude change is a critical component of health behavior change, but has rarely been studied longitudinally following extensive exposures to persuasive materials such as full-length movies, books, or plays. We examined changes in attitudes related to food production and consumption in college students who had read Michael Pollan's book The Omnivore's Dilemma as part of a University-wide reading project. Composite attitudes toward organic foods, local produce, meat, and the quality of the American food supply, as well as opposition to government subsidies, distrust in corporations, and commitment to the environmental movement were significantly and substantially impacted, in comparison to students who had not read the book. Much of the attitude change disappeared after 1 year; however, over the course of 12 months self-reported opposition to government subsidies and belief that the quality of the food supply is declining remained elevated in readers of the book, compared to non-readers. Findings have implications for our understanding of the nature of changes in attitudes to food and eating in response to extensive exposure to coherent and engaging messages targeting health behaviors.

Aims: A growing body of research suggests that smoking portrayals in movies influence adolescent tobacco use. However, the mechanism for this influence remains unclear. The aim of this paper is to provide an overview of research on narrative transportation theory, particularly as applied to movies and smoking. We propose that this theory can provide a valuable framework for guiding research on the role of entertainment media in smoking and other addictive behaviors., Methods: We review empirical work on transportation theory and highlight the psychological mechanisms underlying transportation effects. 'Transportation into narrative worlds' refers to cognitive, emotional and imagery engagement into a narrative (including movies and entertainment media). We link this work with research on the effects of movie smoking., Results: Research suggests that individuals who are more highly transported into narratives show greater attitude, belief and behavior change. Transportation effects work through reducing counterarguing, creating connections (identification and liking) with characters and increasing perceptions of realism and emotional involvement. We propose several future directions and research challenges for applying a transportation framework to the issue of entertainment media effects on smoking and tobacco disparities. Understanding factors contributing to transportation may provide a more nuanced view of who will be affected by movie smoking, and understanding the psychological processes underlying narrative persuasion may guide intervention efforts., Conclusions: Narrative transportation theory suggests that individuals' cognitive, emotional and imagery immersion in a narrative is a key mechanism of attitude, belief and behavior change. This theory provides a potentially generative and psychologically grounded framework for increasing knowledge about the boundary conditions and processes underlying the effects of entertainment media on tobacco use., (© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.)

An open-shell extension of the pair interaction energy decomposition analysis (PIEDA) within the framework of the fragment molecular orbital (FMO) method is developed. The open-shell PIEDA method allows the analysis of inter- and intramolecular interactions in terms of electrostatic, exchange-repulsion, charge-transfer, dispersion, and optional polarization energies for molecular systems with a radical or high-spin fragment. Taking into account the low computational cost and scalability of the FMO and PIEDA methods, the new scheme provides a means to characterize the stabilization of radical and open-shell sites in biologically relevant species. The open-shell PIEDA is applied to the characterization of intramolecular interactions in capped trialanine upon hydrogen abstraction (HA) at various sites on the peptide. Hydrogen abstraction reaction is the first step in the oxidative pathway initiated by reactive oxygen or nitrogen species, associated with oxidative stress. It is found that HA results in significant geometrical reorganization of the trialanine peptide. Depending on the HA site, terminal interactions in the radical fold conformers may become weaker or stronger compared to the parent molecule, and often change the character of the non-covalent bonding from amide stacking to hydrogen bonding.