Search

Helping student service members and veterans (SSM/Vs) earn a college degree is central to supporting them post-service. Yet, this generation of SSM/Vs faces challenges in higher education, including problems adapting, poor health, and administrative constraints, contributing to worsened academic outcomes and a sense of isolation on campus. This monograph synthesizes research on the challenges facing SSM/Vs. It also frames common aspects of successful programs aiding SSM/Vs as three areas for intervention: how administrators and faculty can create a welcoming campus for SSM/Vs; ways universities can create support systems for SSM/V social, health, and academic success; and engaging community partnerships to enable these efforts. Whether SSM/Vs overcome their challenges and unlock their strengths is contingent on opportunities provided within the school itself, and by its faculty, administrators, students, and community. Central to these efforts should be the goal of inclusivity enhancement, community building, and reduction of health-related dysfunction among SSM/Vs.

The aim of this research was to establish prevalence estimates for aphantasia, hypophantasia, typical imagery ability, and hyperphantasia in a large multi-national cohort. In Study 1, the Vividness of Visual Imagery Questionnaire was completed by 3,049 participants. Results indicated prevalence estimates of 1.2% for aphantasia, 3% for hypophantasia, 89.9% for typical imagery ability, and 5.9% for hyperphantasia. In Study 2, to replicate these findings in a larger sample, the Study 1 data were combined with openly available data from previous prevalence studies to create a total sample of 9,063 participants. Re-analysis of this data confirmed prevalence estimates of 0.9% for aphantasia, 3.3% for hypophantasia, 89.7% for typical imagery ability, and 6.1% for hyperphantasia. These robust and up-to-date estimates provide enhanced clarity to researchers regarding the prevalence of differing visual imagery abilities and provide a platform for future studies exploring the role of visual imagery in various cognitive and behavioral tasks.

IntroductionInfants with congenital diaphragmatic hernia can suffer severe respiratory insufficiency and pulmonary hypertension after birth. Aerating the lungs before removing placental support (physiologically based cord clamping, PBCC) increases pulmonary blood flow (PBF) and reduces pulmonary vascular resistance (PVR) in lambs with a diaphragmatic hernia (DH). We hypothesized that these benefits of PBCC persist for at least 8 h after birth.MethodsAt ∼138 days of gestation age (dGA), 21 lambs with a surgically induced left-sided DH (∼86 dGA) were delivered via cesarean section. The umbilical cord was clamped either before ventilation onset (immediate cord clamping, ICC, n = 9) or after achieving a tidal volume of 4 ml/kg, with a maximum delay of 10 min (PBCC, n = 12). The lambs were ventilated for 8 h, initially with conventional mechanical ventilation, but were switched to high-frequency oscillatory ventilation after 30 min if required. Ventilatory parameters, cardiopulmonary physiology, and arterial blood gases were measured throughout the study.ResultsPBF increased after ventilation onset in both groups and was higher in the PBCC DH lambs than the ICC DH lambs at 8 h (5.2 ± 1.2 vs. 1.9 ± 0.3 ml/min/g; p

Abstract Actions in social settings are often adapted based on co-actors. This adaptation can occur because one actor “co-represents” the actions and plans of another. Co-representation can result in motor contagion errors, whereby another’s actions unintentionally interfere with (negatively impact) the actor. In sports, practice often takes place simultaneously or alternating with a partner. Co-representation of another’s task could either harm or benefit skill retention and transfer, with benefits due to variable experiences and effortful processes in practice. Here, dyad groups that either alternated or simultaneously practiced golf putting to different (near vs. far) targets were compared to alone groups (n = 30/group). We focused on errors in distance from the target and expected overshooting for near-target partners paired with far-target partners (and undershooting for far-target partners paired with near-target partners), when compared to alone groups. There was evidence of co-representation for near-target partners paired with far-target partners. We also saw trial-to-trial error-based adjustments based on a partner’s outcome in alternating dyads. Despite differences in practice between dyad and alone groups, these did not lead to costs or benefits at retention or transfer. We conclude that the social-context of motor learning impacts behaviours of co-actors, but not to the detriment of overall learning.

Abstract Metastatic dissemination in breast cancer is regulated by specialized intravasation sites called “tumor microenvironment of metastasis” (TMEM) doorways, composed of a tumor cell expressing the actin-regulatory protein Mena, a perivascular macrophage, and an endothelial cell, all in stable physical contact. High TMEM doorway number is associated with an increased risk of distant metastasis in human breast cancer and mouse models of breast carcinoma. Here, we developed a novel magnetic resonance imaging (MRI) methodology, called TMEM Activity-MRI, to detect TMEM-associated vascular openings that serve as the portal of entry for cancer cell intravasation and metastatic dissemination. We demonstrate that TMEM Activity-MRI correlates with primary tumor TMEM doorway counts in both breast cancer patients and mouse models, including MMTV-PyMT and patient-derived xenograft models. In addition, TMEM Activity-MRI is reduced in mouse models upon treatment with rebastinib, a specific and potent TMEM doorway inhibitor. TMEM Activity-MRI is an assay that specifically measures TMEM-associated vascular opening (TAVO) events in the tumor microenvironment, and as such, can be utilized in mechanistic studies investigating molecular pathways of cancer cell dissemination and metastasis. Finally, we demonstrate that TMEM Activity-MRI increases upon treatment with paclitaxel in mouse models, consistent with prior observations that chemotherapy enhances TMEM doorway assembly and activity in human breast cancer. Our findings suggest that TMEM Activity-MRI is a promising precision medicine tool for localized breast cancer that could be used as a non-invasive test to determine metastatic risk and serve as an intermediate pharmacodynamic biomarker to monitor therapeutic response to agents that block TMEM doorway-mediated dissemination.

ABSTRACT The autotransporter protein secretion system has been used previously to target the secretion of heterologous proteins to the bacterial cell surface and the extracellular milieu at the laboratory scale. The platform is of particular interest for the production of “difficult” recombinant proteins that might cause toxic effects when produced intracellularly. One such protein is IrmA. IrmA is a vaccine candidate that is produced in inclusion bodies requiring refolding. Here, we describe the use and scale-up of the autotransporter system for the secretion of an industrially relevant protein (IrmA). A plasmid expressing IrmA was constructed such that the autotransporter platform could secrete IrmA into the culture supernatant fraction. The autotransporter platform was suitable for the production and purification of IrmA with comparable physical properties to the protein produced in the cytoplasm. The production of IrmA was translated to scale-up protein production conditions resulting in a yield of 29.3 mg/L of IrmA from the culture supernatant, which is consistent with yields of current industrial processes. IMPORTANCE Recombinant protein production is an essential component of the biotechnology sector. Here, we show that the autotransporter platform is a viable method for the recombinant production, secretion, and purification of a “difficult” to produce protein on an industrially relevant scale. Use of the autotransporter platform could reduce the number of downstream processing operations required, thus accelerating the development time and reducing costs for recombinant protein production.

Abstract Background As the UK population ages, the prevalence of both dementia and cancer will increase. Family carers of people with dementia who are subsequently diagnosed with cancer are often involved in treatment decisions about cancer. These decisions are uniquely challenging. Objectives To explore the experience of carers involved in cancer treatment decisions for people with dementia. Design A cross‐sectional qualitative interview study with inductive thematic analysis. Setting and Participants Sixteen carers of people with dementia were identified via Primary Care Research Networks and the Join Dementia Research database. Results Three main themes were derived: ‘already at breaking point’, which describes the extreme strain that carers were already under when the cancer diagnosis was made; ‘maintaining the status quo’, which describes how despite the gravity of a cancer diagnosis, avoiding further dementia‐related deterioration was of prime importance; and ‘LPA’, which explores the benefits and frustrations of the use of lasting powers of attorney. Discussion Current services are ill‐equipped to deal with people who have a combination of dementia and cancer. Proxy decisions about cancer care are made in the context of carer stress and exhaustion, which is exacerbated by shortcomings in service provision. Conclusions As the prevalence of comorbid cancer and dementia rises, there is an urgent need to improve services that support carers with proxy health care decision‐making. Patient or Public Contribution The study design was codeveloped with a local dementia‐specific patient and public involvement (PPI) group. A project‐specific PPI group was formed with support from the Alzheimer's Society Research Partnership scheme to provide further bespoke input.

Objectives The impact of a coronavirus disease (COVID-19)-specific professional development programme on the well-being of obstetrics and gynaecology (O&G) doctors in training (DiT) working during the pandemic.Design A mixed-method evaluation of a single group pre–post test design study.Setting Melbourne, Australia between September 2020 and April 2021.Participants 55 O&G DiT working across four healthcare sites of a major tertiary hospital in Victoria, Australia, were included in the programme.Interventions The delivery of a codesigned peer-to-peer programme, which identified and addressed the well-being goals of O&G DiT. Seven interactive workshops were run alongside the implementation of a number of participant-led wellness initiatives.Main outcome measures Repeated-measures analysis of WHO Well-being Index (WHO-5) and Copenhagen Burnout Innovatory (CBI) scores across three time points during the programme. Multilevel generalised linear mixed-effects models with random intercept were fit to the data, both in the entire population (intention-to-treat) and restricted to those who attended the workshop (‘per-protocol’ analysis). Participatory experiences and programme learning were captured using the Most Significant Change (MSC) technique, which included inductive thematic analysis.Results We demonstrated an overall 31.9% improvement in well-being scores (p=0.006). The MSC evaluation captured a shift in workplace culture as a result of the programme, with improvement across the domains of connection, caring, communication, confidence and cooperation.Conclusions We have successfully used a mixed-method approach to contextualise a productive programme to improve the well-being of COVID-19 front-line healthcare workers.

Abstract Background Apps have been shown to be an effective tool in changing patients’ behaviours in orthodontics and can be used to improve their compliance with treatment. The Behaviour Change Techniques (BCTs) and quality (using MARS) within these apps have previously not been published. Objectives 1. To evaluate the quality of these apps aiming to change behaviour. 2. To assess BCTs used in patient focused orthodontic apps. Methods The UK Google Play and Apple App Stores were searched to identify all orthodontic apps and 305 apps were identified. All 305 apps were assessed for the presence of BCTs using an accepted taxonomy of BCTs (Behaviour Change Wheel (BCW)), widely utilised in healthcare. Of those containing BCTs, the quality was assessed using the Mobile App Rating Scale (MARS), a validated and multi-dimensional tool which rates apps according to 19 objective criteria. Data collection was carried out by two calibrated, independent assessors and repeated after 6 weeks for 25% of the apps by both assessors. Results BCTs were found in 31 apps, although only 18 of them were analysed for quality and 13 apps were excluded. Six different BCTs were identified: these were most commonly ‘prompts/cues’, and ‘information about health consequences’. All apps were shown to be of moderate quality (range 3.1–3.7/5). Inter-rater and intra-rater reliability for BCT and quality assessment were excellent. Conclusions The current availability of orthodontic apps of sufficient quality to recommend to patients is very limited. There is therefore a need for high-quality orthodontic apps with appropriate BCTs to be created, which may be utilised to improve patients’ compliance with treatment.

We provide a scoping review of research on athlete development in girls' and women's sports. Our emphasis is on pathways to expertise in the context of deliberate practice theory and associated models, such as the Developmental Model of Sport Participation (DMSP). Despite rationale for sex and gender differences in sport development, there are relatively few studies where the developmental pathways of female elite athletes have been evaluated. We sought to map the scope of the literature on this population over the last 30 years, focusing on measures of practice types and amounts. Following an extensive search of the literature, 32 studies were identified that included all female participants or presented sex/gender disaggregated data. Retrospective methods were commonly used to quantify practice, play and specialization. National-level athletes were the most represented, although there was considerable heterogeneity in sport and expertise-level, making general or comparative judgements challenging. We identified some groups that had accumulated high volumes of practice at a young age, particularly in soccer and gymnastics. Across sports and studies, early majority hours of engagement in the primary sport was the norm. Athletes deviated from predictions in the specialization pathway detailed in the DMSP, by continuing to participate in other sports throughout childhood and adolescence. In addition to highlighting the relative paucity of data pertaining to athlete development pathways in female athletes, we show that the data from these groups deviate from predictions detailed in current models of athlete development.

Abstract Cytoglobin is important in the progression of oral squamous cell carcinoma but the molecular and cellular basis remain to be elucidated. In the current study, we develop a new cell model to study the function of cytoglobin in oral squamous carcinoma and response to cisplatin. Transcriptomic profiling showed cytoglobin mediated changes in expression of genes related to stress response, redox metabolism, mitochondrial function, cell adhesion, and fatty acid metabolism. Cellular and biochemical studies show that cytoglobin expression results in changes to phenotype associated with cancer progression including: increased cellular proliferation, motility and cell cycle progression. Cytoglobin also protects cells from cisplatin-induced apoptosis and oxidative stress with levels of the antioxidant glutathione increased and total and mitochondrial reactive oxygen species levels reduced. The mechanism of cisplatin resistance involved inhibition of caspase 9 activation and cytoglobin protected mitochondria from oxidative stress-induced fission. To understand the mechanism behind these phenotypic changes we employed lipidomic analysis and demonstrate that levels of the redox sensitive and apoptosis regulating cardiolipin are significantly up-regulated in cells expressing cytoglobin. In conclusion, our data shows that cytoglobin expression results in important phenotypic changes that could be exploited by cancer cells in vivo to facilitate disease progression.

Individuals given control over practice variables make practice decisions based on their current performance. When individuals practice in pairs, the question as to if and how a partner's performance impacts these decisions is of theoretical and practical interest. Here, we evaluated this question in a multi-task learning protocol, where individuals and dyads practiced three, differently timed keystroke sequences. Dyad participants alternated turns with a partner so we could study the immediate consequences of the partner's performance on practice choice. Only one of the partners had choice over the sequence order, the other partner practiced the sequences in either a predetermined blocked or random order. Practice with a partner that had a random-schedule promoted more task-switching in the other partner and had some benefit for retention accuracy. Distinct “own-error” and “partner-error” switching strategies were evidenced, with partners choosing to repeat the same sequence on their next turn when they performed poorly or when their partner performed well. These data show that an individual's practice decisions are influenced by their social context, particularly the practice schedule and patterns of errors in a partner's performance.

Continuous monitoring of the glomerular filtration rate (GFR) in the perioperative setting could provide valuable information about acute kidney injury risk for both clinical and research purposes. This pilot study aimed to demonstrate that GFR measurement by a continuous 72 hrs iohexol infusion in patients undergoing colorectal cancer surgery is feasible. Four patients undergoing robot-assisted colorectal cancer surgery were recruited from elective surgery listings. GFR was determined preoperatively by the single-sample iohexol clearance method, and postoperatively at timed intervals by a continuous iohexol infusion for 72 hrs. Plasma concentrations of creatinine and cystatin C were measured concurrently. GFR was calculated as (iohexol infusion rate (mg/min))/(plasma iohexol concentration (mg/mL)). The association of the three different filtration markers and GFR with time were analysed in generalized additive mixed models. The continuous infusion of iohexol was established in all four patients and maintained throughout the study period without interfering with ordinary postoperative care. Postoperative GFR at 2 hours were elevated compared to the preoperative measurements for patients 1, 2, and 3, but not for patient 4. Whereas patients 1, 2, and 3 had u-shaped postoperative mGFR curves, patient 4 demonstrated a linear increase in mGFR with time. We conclude that obtaining continuous measurements of GFR in the postoperative setting is feasible and can detect variations in GFR. The method can be used as a tool to track perioperative changes in renal function.

Visuomotor adaptation to novel environments can occur via non-physical means, such as observation. Observation does not appear to activate the same implicit learning processes as physical practice, rather it appears to be more strategic in nature. However, there is evidence that interspersing observational practice with physical practice can benefit performance and memory consolidation either through the combined benefits of separate processes or through a change in processes activated during observation trials. To test these ideas, we asked people to practice aiming to targets with visually rotated cursor feedback or engage in a combined practice schedule comprising physical practice and observation of projected videos showing successful aiming. Ninety-three participants were randomly assigned to one of five groups: massed physical practice (Act), distributed physical practice (Act+Rest), or one of 3 types of combined practice: alternating blocks (Obs_During), or all observation before (Obs_Pre) or after (Obs_Post) blocked physical practice. Participants received 100 practice trials (all or half were physical practice). All groups improved in adaptation trials and showed savings across the 24-h retention interval relative to initial practice. There was some forgetting for all groups, but the magnitudes were larger for physical practice groups. The Act and Obs_During groups were most accurate in retention and did not differ, suggesting that observation can serve as a replacement for physical practice if supplied intermittently and offers advantages above just resting. However, after-effects associated with combined practice were smaller than those for physical practice control groups, suggesting that beneficial learning effects as a result of observation were not due to activation of implicit learning processes. Reaction time, variable error, and post-test rotation drawings supported this conclusion that adaptation for observation groups was promoted by explicit/strategic processes.

Protein acylation is critical for many cellular functions across all domains of life. In bacteria, lipoproteins have important roles in virulence and are targets for the development of antimicrobials and vaccines. Bacterial lipoproteins are secreted from the cytosol via the Sec pathway and acylated on an N-terminal cysteine residue through the action of three enzymes. In Gram-negative bacteria, the Lol pathway transports lipoproteins to the outer membrane. Here, we demonstrate that the Aat secretion system is a composite system sharing similarity with elements of a type I secretion systems and the Lol pathway. During secretion, the AatD subunit acylates the substrate CexE on a highly conserved N-terminal glycine residue. Mutations disrupting glycine acylation interfere with membrane incorporation and trafficking. Our data reveal CexE as the first member of a new class of glycine-acylated lipoprotein, while Aat represents a new secretion system that displays the substrate lipoprotein on the cell surface.

Background: Physiologic-based cord clamping (PBCC) involves deferring umbilical cord clamping until after lung aeration. It is unclear if infant is at risk of becoming hypothermic during PBCC.Objectives: To test if PBCC would maintain core temperature more effectively than immediate cord clamping (ICC).Design: At 0.93 gestation, fetal lambs were surgically exteriorized and instrumented from pregnant ewes under general anesthesia. Prior to the start of the experiment, lambs were thoroughly dried, placed on hot water bottles, and core temperature was continuously monitored using a rectal thermometer. PBCC lambs (n = 21), received intermittent positive pressure ventilation (iPPV) for ≥5 min prior to umbilical cord clamping. In ICC lambs (n = 23), iPPV commenced within 60 s after umbilical cord clamping. iPPV was provided with heated/humidified gas. Lambs were moved under a radiant warmer after umbilical cord clamping. Additional warmth was provided using a plastic overlay, hairdryer, and extra water bottles, as needed. Two-way mixed and repeated measures one-way ANOVAs were used to compare temperature changes between and within a single group, respectively, over time.Results: Basal fetal parameters including core temperature were similar between groups. ICC lambs had a significant reduction in temperature compared to PBCC lambs (p < 0.001), evident by 1 min (p = 0.002). ICC lambs decreased temperature by 0.51°C (± 0.42) and 0.79°C (± 0.55) at 5 and 10 min respectively (p < 0.001). In PBCC lambs, temperature did not significantly change before or after umbilical cord clamping (p = 0.4 and p = 0.3, respectively).Conclusions: PBCC stabilized core temperature at delivery better than ICC in term lambs. Hypothermia may not be a significant risk during PBCC.

Abstract Background Participant recruitment is an ongoing challenge in health research. Recruitment may be especially difficult for studies of access to health care because, even among those who are in care, people using services least often also may be hardest to contact and recruit. Opt-out recruitment methods (in which potential participants are given the opportunity to decline further contact about the study (opt out) following an initial mailing, and are then contacted directly if they have not opted out within a specified period) can be used for such studies. However, there is a dearth of literature on the effort needed for effective opt-out recruitment. Methods In this paper we describe opt-out recruitment procedures for two studies on access to health care within the U.S. Department of Veterans Affairs. We report resource requirements for recruitment efforts (number of opt-out packets mailed and number of phone calls made). We also compare the characteristics of study participants to potential participants via t-tests, Fisher’s exact tests, and chi-squared tests. Results Recruitment rates for our two studies were 12 and 21%, respectively. Across multiple study sites, we had to send between 4.3 and 9.2 opt-out packets to recruit one participant. The number of phone calls required to arrive at a final status for each potentially eligible Veteran (i.e. study participation or the termination of recruitment efforts) were 2.9 and 6.1 in the two studies, respectively. Study participants differed as expected from the population of potentially eligible Veterans based on planned oversampling of certain subpopulations. The final samples of participants did not differ statistically from those who were mailed opt-out packets, with one exception: in one of our two studies, participants had higher rates of mental health service use in the past year than did those mailed opt-out packets (64 vs. 47%). Conclusions Our results emphasize the practicality of using opt-out methods for studies of access to health care. Despite the benefits of these methods, opt-out alone may be insufficient to eliminate non-response bias on key variables. Researchers will need to balance considerations of sample representativeness and feasibility when designing studies investigating access to care.

Purpose: Our aim was to determine if self-determined motivation (SDM) in elite, men’s soccer changes over time and differs as a function of age, skill-grouping, and engagement in soccer play and practice. We tested predictions from the Developmental Model of Sport Participation (DMSP) regarding relations between practice and play and SDM among both elite and non-elite samples.Methods: Elite youth soccer players in the United Kingdom (n = 31; from the Under 13/U13 and U15 years age groups) completed practice history and motivation questionnaires at time 1 (T1) and ∼2 years later (T2: now U15 and U17 years). Non-elite players (n = 32; from U15 and U17 years) completed the same questionnaires at T2 only.Results: For the elite groups, global SDM decreased over time for the current U17 group (from U15), but no change was seen for the current U15 group (from U13). Age group differences at T2 mirrored these data, with U17 players showing lower global SDM and higher controlled motivation than U15 elites. The non-elite players did not show age group differences, but elites scored higher for global SDM and autonomous motivation than non-elites. The recent hours accumulated in practice negatively correlated with global SDM in elite and non-elite groups, but play was unrelated to measures of motivation.Conclusion: Differences in SDM as a function of age and skill point toward the dynamic nature of these motivations over time, likely a result of proximity to external rewards related to professional status. Although high volumes of practice are related to lower global SDM in both skill groups, the absence of any relations between SDM and soccer play does not support a key prediction related to the DMSP.

Research has shown the effectiveness of observational practice for motor learning, but there continues to be debate about the mechanisms underlying effectiveness. Although cortical processes can be moderated during observation, after both physical and observational practice, how these processes change with respect to behavioural measures of learning has not been studied. Here we compared short-term physical and observational practice during the acquisition and retention of a novel motor task to evaluate how each type of practice modulates EEG mu rhythm (8–13 Hz). Thirty healthy individuals were randomly assigned to one of three groups: (1) physical practice (PP), (2) observational practice (OP), and (3) no practice (NP) control. There were four testing stages: baseline EEG, practice, postpractice observation, and delayed retention. There was significant bilateral suppression of mu rhythm during PP but only left lateralized mu suppression during OP. In the postpractice observation phase, mu suppression was bilateral and larger after PP compared to that after OP. NP control showed no evidence of suppression and was significantly different to both the OP and PP groups. When comparing the three groups in retention, the groups did not differ with respect to tracing times, but the PP group showed fewer errors, especially in comparison to the NP group. Therefore, although the neurophysiological measures index changes in the OP group, which are similar but moderated in comparison to PP, changes in these processes are not manifest in observational practice outcomes when assessed in a delayed retention test.