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Students eager to enter the medical field must develop perspective-taking skills that enhance their ability to connect with patients. Toward this goal, the authors developed a pilot workshop for undergraduate students that included an art activity during which they collaborated to design scalp tattoos to symbolize cancer patients' experiences with chemotherapy and hair loss.A 90-minute, arts-based workshop was held in April 2019. One author selected anonymous excerpts from previously conducted interviews with patients experiencing ovarian and uterine cancer. These excerpts were shared with students to humanize patients' perspectives and give context to the difficulty of coping with chemotherapy-induced alopecia. Students discussed these excerpts and images of scalp tattoos from the internet. Together, they then designed scalp tattoos representing their perspective on the experience of coping with chemotherapy and hair loss and drew them onto mannequin heads.Twenty members of the university community participated in this workshop, including 3 faculty members and 17 undergraduate students. Participants worked together to create 2 sets of scalp tattoos. Of the 20 participants, 75% (n = 15) responded to the postworkshop survey. All respondents were undergraduate students, and 73% (n = 11) reported an increase in empathy toward patients and 87% (n = 13) an increased connection with the patient experience. All respondents agreed that the art activity demonstrated the importance of taking the patient's perspective.This arts-based workshop is effective and can be replicated for other audiences, including undergraduate students, medical students, and practicing clinicians, to encourage perspective-taking and compassion for patients. Further analysis of students' skill development using pre- and postworkshop data is needed.

Objective This article describes a formal ophthalmology residency mentorship program, identifies its strengths and weaknesses over 5 years of implementation, and proposes strategies to improve qualitative outcomes of the mentorship program. Design Cross-sectional anonymous online survey. Subjects All current and former mentees and mentors at the Casey Eye Institute (CEI) residency program from 2016 to 2021. Methods All eligible participants were contacted via email to complete a survey to describe and analyze their experiences with the CEI's formal residency mentorship program. Results Of the 65 surveyed participants, 82% preferred in-person meetings and met up from 2 to 3 times (44%) to 4 to 6 times (38.5%) annually at 15 minutes to 1 hour (48%) or 1 to 2 hours (42%) duration. Sixty-two percent of meetings were initiated by mentors, 8% by mentees, and 32% shared responsibilities equally. Participants also identified the three most important qualities for successful mentor-mentee relationship as personality (33.6%), communication styles (29.2%), and extracurricular interests/hobbies (16.8%). Mentees valued career advising, networking, and wellness support over academic and research mentorship. Subjective outcomes showed 25% of the mentee and 43% of the mentors agreed the mentorship program was a valuable experience. Comparably, 14% of the mentees and 38% of the mentors prioritized the relationship. There was a strong correlation between participants who prioritized the relationship and acknowledged it as a valuable experience (p Conclusion Our survey identified that weaknesses of the mentorship program include ineffective communications, inadequate preparation in their respective roles, and lack of priority focus on the relationship. We propose strategies to strengthen our program through creating workshops to clarify roles and responsibilities, emphasizing accountability with a contract statement, and implementing a new matching algorithm to customize participants' experience. Additional studies from other residencies with formal mentorship programs are warranted to identify, strategize, and foster high-quality mentorship.

We present the ultraviolet to submillimetre spectral energy distributions (SEDs) of the HERschel Ultra Luminous Infrared Galaxy Survey (HERUS) sample of 42 local ultraluminous infrared galaxies (ULIRGs) and fit them with a Markov chain Monte Carlo (MCMC) code using the CYprus models for Galaxies and their NUclear Spectra (CYGNUS) radiative transfer models for starbursts, active galactic nucleus (AGN) tori and host galaxy. The Spitzer IRS spectroscopy data are included in the fitting. Our bayesian SED fitting method takes comparable time to popular energy balance methods but it is more physically motivated and versatile. All HERUS galaxies harbor high rates of star formation but we also find bolometrically significant AGN in all of the galaxies of the sample. We estimate the correction of the luminosities of the AGN in the ULIRGs due to the anisotropic emission of the torus and find that it could be up to a factor of $\sim10$ for nearly edge-on tori. We present a comparison of our results with the smooth torus model of Fritz et al. and the two-phase models of Siebenmorgen et al. and SKIRTOR. We find that the CYGNUS AGN torus models fit significantly better the SEDs of our sample compared to all other models. We find no evidence that strong AGN appear either at the beginning or end of a starburst episode or that starbursts and AGN affect each other. IRAS 01003-2238 and Mrk 1014 show evidence for dual AGN in their SED fits suggesting a minimum dual AGN fraction in the sample of 5%., Published in Monthly Notices of the Royal Astronomical Society. The CYGNUS models used in this paper are available at https://arc.euc.ac.cy/cygnus/

Purpose: Targeting malignant B cells using rituximab (anti-CD20) has improved the efficacy of chemotherapy regimens used to treat patients with non-Hodgkin's lymphoma. Despite the promising clinical results obtained using rituximab, many patients relapse with therapy-resistant disease following rituximab-based treatments. We have created a cell line model of rituximab resistance using three B-cell non-Hodgkin's lymphoma–derived cell lines (Raji, RL, and SUDHL-4). In an attempt to define strategies to overcome rituximab resistance, we sought to determine the chemotherapy sensitivity of our rituximab-resistant cell lines (RRCL).Experimental Design: Parental, rituximab-sensitive cell lines (RSCL) Raji, RL, and SUDHL-4, along with RRCLs derived from them, were exposed to several chemotherapeutic agents with different mechanisms of action and the ability of these agents to induce apoptotic cell death was measured. Expression of multidomain Bcl-2 family proteins was studied as potential mediators of chemotherapy/rituximab resistance.Results: We found that RRCLs are resistant to multiple chemotherapeutic agents and have significantly decreased expression of the Bcl-2 family proteins Bax, Bak, and Bcl-2. RRCLs do not undergo rituximab- or chemotherapy-induced apoptosis but die in a caspase-dependent manner when either wild-type Bax or Bak is exogenously expressed. Furthermore, forced expression of Bak sensitized RRCL to chemotherapy-induced apoptosis.Conclusions: Whereas a single or limited exposure of lymphoma cells to rituximab may lead to a favorable ratio of proapoptotic to antiapoptotic Bcl-2 family proteins, repeated exposure to rituximab is associated with a therapy-resistant phenotype via modulation of Bax and Bak expression.

Supplementary Figures S1-S4 from Acquired Resistance to Rituximab Is Associated with Chemotherapy Resistance Resulting from Decreased Bax and Bak Expression

Searches for phosphine in Venus’ atmosphere have sparked a debate. Cordiner et al. 2022 analyse spectra from the Stratospheric Observatory For Infrared Astronomy (SOFIA) and infer

We examine the origin of molecular gas heating in a sample of 42 infrared-luminous galaxies at z

We present 850um imaging of the XMM-LSS field observed for 170 hours as part of the James Clerk Maxwell Telescope SCUBA-2 Large eXtragalactic Survey (S2LXS). S2LXS XMM-LSS maps an area of 9 square degrees, reaching a moderate depth of 1-sigma ~ 4 mJy/beam. This is the largest contiguous area of extragalactic sky mapped by JCMT at 850um to date. The wide area of the S2LXS XMM-LSS survey allows us to probe the ultra-bright (S_850um > 15 mJy), yet rare submillimetre population. We present the S2LXS XMM-LSS catalogue, which comprises 40 sources detected at >5-sigma significance, with deboosted flux densities in the range of 7 mJy to 48 mJy. We robustly measure the bright-end of the 850um number counts at flux densities >7 mJy, reducing the Poisson errors compared to existing measurements. The S2LXS XMM-LSS observed number counts show the characteristic upturn at bright fluxes, expected to be motivated by local sources of submillimetre emission and high-redshift strongly lensed galaxies. We find that the observed 850um number counts are best reproduced by model predictions that include either strong lensing or source blending from a 15 arcsec beam, indicating that both may make an important contribution to the observed over-abundance of bright single dish 850um selected sources. We make the S2LXS XMM-LSS 850um map and >5-sigma catalogue presented here publicly available., Accepted for publication in MNRAS

The search for life elsewhere in the universe is one of the central aims of science in the 21st century. While most of this work is aimed at planets orbiting other stars, the search for life in our own Solar System is an important part of this endeavour. Venus is often thought to have too harsh an environment for life, but it may have been a more hospitable place in the distant past. If life evolved there in the past then the cloud decks of Venus are the only remaining niche where life as we know it might survive today. The discovery of the molecule phosphine, PH$_3$, in these clouds has reinvigorated research looking into the possibility of life in the clouds. In this review we examine the background to studies of the possibility of life on Venus, discuss the discovery of phosphine, review conflicting and confirming observations and analyses, and then look forward to future observations and space missions that will hopefully provide definitive answers as to the origin of phosphine on Venus and to the question of whether life might exist there., Comment: Invited review, accepted for publication in Contemporary Physics

The assembly of stellar and supermassive black hole (SMBH) mass in elliptical galaxies since $z\sim1$ can help to diagnose the origins of locally-observed correlations between SMBH mass and stellar mass. We therefore construct three samples of elliptical galaxies, one at $z\sim0$ and two at $0.7\lesssim z \lesssim2.5$, and quantify their relative positions in the $M_{BH}-M_*$ plane. Using a Bayesian analysis framework, we find evidence for translational offsets in both stellar mass and SMBH mass between the local sample and both higher redshift samples. The offsets in stellar mass are small, and consistent with measurement bias, but the offsets in SMBH mass are much larger, reaching a factor of seven between $z\sim1$ and $z\sim0$. The magnitude of the SMBH offset may also depend on redshift, reaching a factor of $\sim20$ at $z\sim 2$. The result is robust against variation in the high and low redshift samples and changes in the analysis approach. The magnitude and redshift evolution of the offset are challenging to explain in terms of selection and measurement biases. We conclude that either there is a physical mechanism that preferentially grows SMBHs in elliptical galaxies at $z\lesssim 2$, or that selection and measurement biases are both underestimated, and depend on redshift., Comment: ApJ, accepted

Objective The purpose of this study was to develop and test a tool to monitor a nursing orientee's progress to competence. Background The literature suggests that, during orientation, consistent documentation and communication among educators, preceptors, and nurse leaders facilitate a timely progression to independent practice for new nurses. Methods A 2-phase methodological study was conducted. Nurse educators clarified goals, identified essential competencies, and developed the Baptist Health Lexington Nursing Orientation Progression Tool (OPT). The tool was used to monitor orientees' progression through orientation. Results Content validity assessment of the OPT (content validity index = 0.98) demonstrated strong validity. Testing of the tool revealed 31 nurses completed orientation early, 12 completed orientation on time, and 18 nurses required extended orientation time. All requiring an extension were new graduates. Conclusion The OPT guided preceptors to facilitate timely completion of orientation among newly hired nurses. Findings suggest that new graduates may need more assistance than experienced nurses.

Malaria remains a global driver of morbidity and mortality. To generate new antimalarials, one must elucidate the fundamental cell biology of Plasmodium falciparum , the parasite responsible for the deadliest cases of malaria. A membranous and proteinaceous scaffold called the inner membrane complex (IMC) supports the parasite during morphological changes, including segmentation of daughter cells during asexual replication and formation of transmission-stage gametocytes. The basal complex lines the edge of the IMC during segmentation and likely facilitates IMC expansion. It is unknown, however, what drives IMC expansion during gametocytogenesis. We describe the discovery of a basal complex protein, PfBLEB, which we find to be essential for gametocytogenesis. Parasites lacking PfBLEB harbor defects in IMC expansion and are unable to form mature gametocytes. This article demonstrates a role for a basal complex protein outside of asexual division, and, importantly, highlights a potential molecular target for the ablation of malaria transmission.

PurpleAir sensors, which measure particulate matter (PM), are widely used by individuals, community groups, and other organizations including state and local air monitoring agencies. PurpleAir sensors comprise a massive global network of more than 10 000 sensors. Previous performance evaluations have typically studied a limited number of PurpleAir sensors in small geographic areas or laboratory environments. While useful for determining sensor behavior and data normalization for these geographic areas, little work has been done to understand the broad applicability of these results outside these regions and conditions. Here, PurpleAir sensors operated by air quality monitoring agencies are evaluated in comparison to collocated ambient air quality regulatory instruments. In total, almost 12 000 24 h averaged PM2.5 measurements from collocated PurpleAir sensors and Federal Reference Method (FRM) or Federal Equivalent Method (FEM) PM2.5 measurements were collected across diverse regions of the United States (US), including 16 states. Consistent with previous evaluations, under typical ambient and smoke-impacted conditions, the raw data from PurpleAir sensors overestimate PM2.5 concentrations by about 40 % in most parts of the US. A simple linear regression reduces much of this bias across most US regions, but adding a relative humidity term further reduces the bias and improves consistency in the biases between different regions. More complex multiplicative models did not substantially improve results when tested on an independent dataset. The final PurpleAir correction reduces the root mean square error (RMSE) of the raw data from 8 to 3 µg m−3, with an average FRM or FEM concentration of 9 µg m−3. This correction equation, along with proposed data cleaning criteria, has been applied to PurpleAir PM2.5 measurements across the US on the AirNow Fire and Smoke Map (https://fire.airnow.gov/, last access: 14 May 2021) and has the potential to be successfully used in other air quality and public health applications.

We study stellar and black hole mass assembly in a sample of 42 infrared-luminous galaxy mergers at z, Comment: MNRAS Accepted

Adequate pain management is one of the biggest challenges of the modern healthcare system. Physician perception of patient subjective pain, which is crucial to pain management, is susceptible to a host of potential biases. Here we explore the timing of physicians’ work as a previously unrecognized source of systematic bias in pain management. We hypothesized that during night shifts, sleep deprivation, fatigue, and stress would reduce physicians’ empathy for others’ pain, leading to underprescription of analgesics for patient pain relief. In study 1, 67 resident physicians, either following a night shift or not, performed empathy for pain assessment tasks and simulated patient scenarios in laboratory conditions. As predicted, following a night shift, physicians showed reduced empathy for pain. In study 2, we explored this phenomenon in medical decisions in the field. We analyzed three emergency department datasets from Israel and the United States that included discharge notes of patients arriving with pain complaints during 2013 to 2020 ( n = 13,482). Across all datasets, physicians were less likely to prescribe an analgesic during night shifts (compared to daytime shifts) and prescribed fewer analgesics than generally recommended by the World Health Organization. This effect remained significant after adjusting for patient, physician, type of complaint, and emergency department characteristics. Underprescription for pain during night shifts was particularly prominent for opioids. We conclude that night shift work is an important and previously unrecognized source of bias in pain management, likely stemming from impaired perception of pain. We consider the implications for hospitals and other organizations employing night shifts.

Some police departments are responding to changing community needs by promoting a departmental cultural shift, which may involve their training programs. Reliable evaluation tools are needed to cap...

Parental stress is high when infants are admitted to a neonatal intensive care unit in community-based hospital. This quasi-experimental study explored the effect of implementing the "Creating Opportunities for Parent Empowerment" (COPE) program on parental stress, postpartum depression, parental satisfaction with care, and length of stay in a community-based hospital. A cohort of nurses completed a 1-day "COPE for HOPE" parent empowerment training session. A nurse implemented the COPE parent training at the bedside soon after birth and extended throughout hospitalization. The following instruments were used to collect data: a demographic data sheet, Parental Stress Scale: Neonatal Intensive Care Unit, Edinburgh Postnatal Depression Scale, and an investigator-designed parent satisfaction survey. Forty-nine parent sets participated in the study (29 in the intervention group, 20 in the comparison group). A significant difference was found between the groups related to lower parental stress. There was no difference in terms of parental depression scores or length of hospital stay. However, clear trends revealed that parents in the COPE group exhibited lower depression scores. Parents in both groups reported being greater than 95% satisfied with care across all items. These findings may motivate administrators in other community-based hospitals to implement this intervention.

Purpose To describe the intraoperative and early postoperative complications using preloaded Descemet membrane endothelial keratoplasty (DMEK) grafts with intraocular injection of the graft in Optisol-GS and omission of trypan blue restaining. Methods This is a retrospective case series of 132 consecutive eyes with Fuchs endothelial dystrophy or endothelial failure who underwent DMEK using preloaded donor tissue prepared as previously described. The graft was not restained with trypan blue by the surgeon, and Optisol-GS was injected with the graft into the eye instead of being rinsed from the injector. Early postoperative complications (0-8 wk) including intraoperative fibrin formation, intraocular inflammation, elevated intraocular pressure, partial graft detachment requiring rebubble, and early graft failure were recorded. Results No eyes developed intraoperative fibrin formation or postoperative inflammation (such as toxic anterior segment syndrome) or elevated intraocular pressure. For eyes with Fuchs corneal dystrophy, our rebubble rate was 21% (22/106 eyes). Early graft failure was noted in 2% (3/132 eyes), which is similar to previous reports. Conclusions Our results suggest that injection of Optisol-GS into the anterior chamber during DMEK graft injection does not lead to increases in intraoperative or early postoperative complications. Trypan blue restaining is not necessary for intraoperative visualization. This simplification can reduce graft manipulation and save time and resources for this procedure.

PURPOSE To examine the effect of education on nursing personnel's knowledge and attitudes regarding the use of hand massage, breathing techniques, and essential oils with hospice and palliative care patients. BACKGROUND Unrelieved, end of life pain is common among hospitalized patients on hospice and palliative care units. Integrative care techniques such as hand massage, breathing techniques, and essential oils can be available to use with these individuals. Nursing personnel are often unaware of other techniques that are not a traditional pharmacology approach to pain. METHODS A quasi-experiment was conducted to evaluate the effect of an educational intervention on nursing personnel's knowledge and attitudes regarding the use of three integrative care techniques (hand massage, breathing techniques, and essential oils) with hospice and palliative care patients in an acute care setting. Data on knowledge and attitudes were collected pre- and postintervention. RESULTS Following the intervention, improvements in nursing personnel's attitudes and knowledge toward the use of the three techniques were found. CONCLUSION Results of this study suggest that education of nursing personnel may positively influence knowledge and attitudes toward providing hand massage, breathing techniques, and essential oil for end of life patients.

While climate change and sea level rise threaten species across the globe, species in low-lying coastal regions, such as South Florida, are projected to face particularly severe threats. One such species is the Florida reef gecko (Sphaerodactylus notatus), the only gecko native to the eastern U.S., and a highly understudied species that persists in heavily fragmented habitats of only three coastal Florida counties. To assess the conservation status of this species, we conducted surveys throughout South Florida to determine potential extirpations from historic localities and to delimit S. notatus’ current distribution. We also estimated the level of threat S. notatus faces from sea level rise relative to other species by analyzing sea level risk of all herpetofauna in the U.S. We detected geckos in only 41% of sites with appropriate habitat, and in only 65% of historic localities. Geckos were only present within 1.2 km from the coast, and the minimum 2.2 m of sea level rise already expected based on current carbon emissions will place 85% of suitable S. notatus habitat under water. Our findings were used to update the conservation risk of S. notatus according to IUCN and Florida guidelines for listing threatened and endangered species, and suggest this species now fits the criteria to warrant listing. In comparison to all other U.S. herpetofaunal species, we found that S. notatus is the most at risk from sea level rise due its fidelity to low-lying coastal habitats.

Measurements of trace gases in planetary atmospheres help us explore chemical conditions different to those on Earth. Our nearest neighbour, Venus, has cloud decks that are temperate but hyperacidic. Here we report the apparent presence of phosphine (PH3) gas in Venus’s atmosphere, where any phosphorus should be in oxidized forms. Single-line millimetre-waveband spectral detections (quality up to ~15σ) from the JCMT and ALMA telescopes have no other plausible identification. Atmospheric PH3 at ~20 ppb abundance is inferred. The presence of PH3 is unexplained after exhaustive study of steady-state chemistry and photochemical pathways, with no currently known abiotic production routes in Venus’s atmosphere, clouds, surface and subsurface, or from lightning, volcanic or meteoritic delivery. PH3 could originate from unknown photochemistry or geochemistry, or, by analogy with biological production of PH3 on Earth, from the presence of life. Other PH3 spectral features should be sought, while in situ cloud and surface sampling could examine sources of this gas. The detection of ~20 ppb of phosphine in Venus clouds by observations in the millimetre-wavelength range from JCMT and ALMA is puzzling, because according to our knowledge of Venus, no phosphine should be there. As the most plausible formation paths do not work, the source could be unknown chemical processes—maybe even life?

Observations have found black holes spanning ten orders of magnitude in mass across most of cosmic history. The Kerr black hole solution is however provisional as its behavior at infinity is incompatible with an expanding universe. Black hole models with realistic behavior at infinity predict that the gravitating mass of a black hole can increase with the expansion of the universe independently of accretion or mergers, in a manner that depends on the black hole's interior solution. We test this prediction by considering the growth of supermassive black holes in elliptical galaxies over $0, Comment: 10 pages, 3 figures, published in ApJ Letters

The 2mm Mapping Obscuration to Reionization with ALMA (MORA) Survey was designed to detect high redshift ($z\gtrsim4$), massive, dusty star-forming galaxies (DSFGs). Here we present two, likely high redshift sources, identified in the survey whose physical characteristics are consistent with a class of optical/near-infrared (OIR) invisible DSFGs found elsewhere in the literature. We first perform a rigorous analysis of all available photometric data to fit spectral energy distributions and estimate redshifts before deriving physical properties based on our findings. Our results suggest the two galaxies, called MORA-5 and MORA-9, represent two extremes of the "OIR-dark" class of DSFGs. MORA-5 ($z_{\rm phot}=4.3^{+1.5}_{-1.3}$) is a significantly more active starburst with a star-formation rate of 830$^{+340}_{-190}$M$_\odot$yr$^{-1}$ compared to MORA-9 ($z_{\rm phot}=4.3^{+1.3}_{-1.0}$) whose star-formation rate is a modest 200$^{+250}_{-60}$M$_\odot$yr$^{-1}$. Based on the stellar masses (M$_{\star}\approx10^{10-11}$M$_\odot$), space density ($n\sim(5\pm2)\times10^{-6}$Mpc$^{-3}$, which incorporates two other spectroscopically confirmed OIR-dark DSFGs in the MORA sample at $z=4.6$ and $z=5.9$), and gas depletion timescales ($, Comment: 18 pages, 7 figures, accepted for publication in ApJ