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The monoammonium salt of glycyrrhizic acid (AGA) is known to form fibrillar hydrogels and few studies regarding self-assembly of AGA have been published. Yet, the understanding of the fibrillar microstructures and the gelation remains vague. Thus, we attempt to achieve a deeper understanding of the microstructures and the gelation process of binary solutions of AGA in water. Further, we examine the effect of ethanol on the microstructures to pave the way for potential enhancement of drug loading in AGA hydrogels.A partial room temperature phase map of the ternary system AGA/ethanol/water was recorded. Small-angle X-ray and neutron scattering experiments were performed over wide ranges of compositions in both binary AGA/water and ternary AGA/ethanol/water mixtures to get access to the micro-structuring.Binary aqueous solutions of AGA form birefringent gels consisting of a network of long helical fibrils. 'Infinitely' long negatively charged fibrils are in equilibrium with shorter fibrils (≈25 nm), both of which have a diameter of about 3 nm and are made of around 30 stacks of AGA per helical period (≈9nm), with each stack consisting of two AGA molecules. The interaxial distance (order of magnitude ≈20 nm) varies with an almost two-dimensional swelling law. Addition of ethanol reduces electrostatic repulsion and favors the formation of fibrillar end caps, reducing the average length of shorter fibrils, as well as the formation of small, swollen aggregates. While the gel network built by the long fibrils is resilient to a significant amount of ethanol, all fibrils are finally dissolved into small aggregates above a certain threshold concentration of ethanol (≈30 wt%).

Traditional methods for the assembly of functionalised DNA structures, involving enzyme restriction and modification, present difficulties when working with small DNA fragments (

This study examined whether stressful life events were associated with weight loss, central adiposity, and health behavior changes of African American breast cancer survivors (AABCS) participating in a weight loss intervention. We conducted a secondary-data analyses of Moving Forward, a weight loss efficacy trial for AABCS conducted in 2011–2014. Two-hundred forty-six eligible women were randomized to a 6-month interventionist-guided (IG) or self-guided (SG) weight loss intervention. Data was collected on height, weight, self-reported diet, and self-reported physical activity. Stress (e.g., financial, legal, employment, relationships, safety, prejudice) was measured using an abbreviated version of the Crisis in Family Systems (CRISYS) urban life stress measure. Generalized linear models stratified by group examined the degree to which stress was associated with weight loss or changes in central adiposity, physical activity, and diet during the intervention (Months 1–6) or maintenance (Months 7 to 12) phases. Participants reported a median of 3.0 life stressors (range 0 to 22) mostly relating to relationships, safety concerns, and financial problems. In the IG group during the intervention phase, exposure to life stressors was not associated with weight loss (p = 0.15) or change in central adiposity (p = 0.69), physical activity (p = 0.15), or diet (p = 0.26). We found similar associations for the maintenance phase and in the SG group. Despite facing stress across a myriad of domains (e.g., relationships, safety, finances), AABCS were successful at initiating and maintaining behaviors to achieve weight loss, reductions in central adiposity, and behavioral changes. Future randomized controlled trials are warranted that include more strategies to address the challenges that AABCS face, to determine whether AABCS in particular might benefit from interventions that address barriers (e.g., stress management) to weight loss. Such strategies are critical for improving quality of life and lowering the risk of cancer recurrence.

PURPOSE: To explore the feasibility, adherence, safety and potential efficacy of Every Day Counts; a randomized pilot trial designed for women with metastatic breast cancer (MBC) framed by the American Cancer Society nutrition and physical activity (PA) guidelines METHODS. Women with clinically stable MBC were recruited to complete an interview, dual energy x-ray absorptiometry imaging and phlebotomy at baseline and post-intervention. Multidimensional quality of life, symptom burden, lifestyle behaviors (nutrition and PA) and biomarkers of prognosis were procured and quantified. Women were randomized to the immediate intervention or a waitlist control arm. The 12-week intervention included a curriculum binder, lifestyle coaching (in-person and telephone-based sessions) and intervention support (activity monitor, text messaging, cooking classes.) Women in the waitlist control were provided monthly text messaging. RESULTS. Forty women were recruited within 9 months (feasibility). Women in the immediate intervention attended 86% of all 12 weekly coaching sessions (adherence) and showed significant improvements in general QOL (p=0.001), and QOL related to breast cancer (p=0.001), endocrine symptoms (p=0.002) and fatigue (p=0.037), whereas the waitlist control did not (all p values ≥ 0.05) (efficacy). PA significantly increased for women in the intervention compared to control (p

Background The interventional radiology (IR) trainee recruitment in the UK is lagging behind the pace of service expansion and is potentially hindered by underrepresented undergraduate curricula. Understanding the contributing factors that encourage junior doctors and medical students to consider an IR career will help the IR community to better focus the efforts on recruiting and nurturing the next generation. Methods Anonymised questionnaires on undergraduate and postgraduate IR exposure were distributed to attendees of five UK IR symposia between 2019 and 2020. Results 220 responses were received from 103 (47%) junior doctors and 117 (53%) medical students. Prior IR exposure strongly correlates with individuals’ positive views towards an IR career (Pearson’s R = 0.40, p < 0.001), with involvement in clinical activities as the most important independent contributor (OR 3.6, 95%CI 1.21–10.50, p = 0.021). Longer time spent in IR (especially as elective modules) and IR-related portfolio-building experiences (such as participating in research, attending conferences and obtaining career guidance) demonstrate strong association with willingness to pursue an IR career for the more motivated (p values < 0.05). The symposia had overall positive effects on subjective likelihood to pursue an IR career, particularly among junior doctors who face near-term career choices (p < 0.001). Conclusion Our study, focusing on a self-selected cohort, identified contributing factors to individuals’ willingness to pursue an IR career. Symposia have additional recruitment effects in extra-curricular settings. Active engagement with junior doctors and medical students through clinical activities and non-clinical portfolio-related experiences are key to generate informed and motivated candidates for the future of IR. Electronic supplementary material The online version of this article (10.1007/s00270-020-02655-7) contains supplementary material, which is available to authorised users.

YouTube has emerged as a growing educational resource for medical learners and educators; yet, its broad implementation may lack guidance from evidence-based evaluations. This article presents a scoping review of the utility, effectiveness, and validity of YouTube video resources in medical education. Of the 113 articles identified, 31 articles met inclusion criteria that focused on use of YouTube in medical education. Only 19.4% of the articles (n = 6) reported evaluative outcomes related to the use of YouTube for instructional purposes. Recommendations are offered for improving the usefulness and quality of YouTube videos as an educational resource in medical education. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40670-020-01016-w) contains supplementary material, which is available to authorized users.

Background: Representation of Black individuals with cancer in biospecimen research remains disproportionately low compared to white counterparts. Clinicians and research staff are responsible for informing, inviting, and consenting patients to participate in such research. We sought to understand clinician and research staff perspectives on engaging Black patients in biospecimen research. Methods: We conducted 10 in-depth interviews with purposively sampled clinicians and research staff at a large academic cancer center in North Carolina between January and August 2022. Participants underwent semi-structured interviews (duration 45-60 minutes) and were asked open ended questions about biospecimen research barriers in general, barriers specific to people who identify as Black or African American, and considerations when discussing biospecimen research with Black patients. Interview transcripts were analyzed using thematic analysis. Results: Perceived patient related barriers to biospecimen donation included pain from sample collection, invasive sample collection, lack of to time or transportation, medical research mistrust, health literacy, and limited knowledge of opportunities for involvement. Many felt that these barriers were faced by both Black and non-Black patients. However, some felt for Black patients, these barriers existed within the context of historical injustices in medicine, current bias in health care and socioeconomic inequities, while others felt socioeconomic status not race was more of a concern. Clinician and research staff identified barriers to discussing biospecimen research included lack of time given busy clinical practice and concern with patients’ physical and emotional state. Patients’ race was not considered a barrier. When asked about considerations for discussing biospecimen research specifically with Black patients, participants felt time to establish rapport and trust, readiness to discuss historical injustices in biomedical research, reminding participants research is voluntary, and having in person discussions were important. Few felt that patient race was not relevant to these discussions. Conclusion: Some clinicians and research staff acknowledge that historical injustices and current racial bias in biomedical research and health care contribute to low representation of Black individuals in biospecimen research, while others did not. Further research is needed to assess whether race and/or racism agnostic approaches versus acknowledgement of structural racism’s influence on biomedical research and health care have an impact on fair representation of Black individuals in biospecimen research. Sponsored by the Lung Cancer Research Foundation Research Grant on Disparities in Lung Cancer Citation Format: Aaron Carpenter, Hayley N. Morris, Annabella Opoku, Alison Hilton, Jessica Carda-Auten, Randall Teal, Jeenn A. Barreiro-Rosado, Lauren Matthews, Oluwatumilara Akeke, Ashley Rankin Collins, Marjory Charlot. Research team perspectives on engaging Black patients with cancer in biospecimen research. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5535.

Background: Participation of racially diverse populations in research is necessary to advance cancer care. However, representation of Black individuals in biospecimen cancer research remains low and requires being asked to engage in research. We sought to understand the experiences, beliefs, and knowledge about biospecimen research among Black patients with lung cancer. Methods: Semi-structured interviews with a purposive sample of 15 Black patients diagnosed with lung cancer were conducted between January and August 2022 at a large academic center in North Carolina. Interviews were digitally recorded and transcribed and analyzed using thematic analysis. Results: Themes related to who should initiate discussions about biospecimen donation, what should be considered before donation, and communication strategies to increase participation of Black patients with cancer in biospecimen research emerged from the interviews. Most participants indicated that discussions about biospecimen donation should be initiated by trusted and knowledgeable members of the medical team and most expressed trusting their providers. Some also expressed the importance of including family members in discussions about medical and research decisions. Some participants felt it was important to consider if donating specimens would cause pain or would require additional procedures. Recommended communication strategies to facilitate participation included use of simple and easily understood language in addition to messaging related to how biospecimen donation would benefit others. Participants also felt cultural humility, respect, and empathy during research recruitment would help enhance enrollment of Black participants in biospecimen research. Of note, all participants reported never being asked to participate in biospecimen research and felt that underrepresentation of Black participants may be due to not being asked. Conclusion: Black participants in this study have not been asked to participate in biospecimen research but are willing to be engaged in conversations about research from their medical team. Simply being asked, trusting their medical provider, cultural humility, and framing the message on how the research will benefit others are some of the recommended strategies to enhance research participation among Black patients. Future research should incorporate these strategies into an intervention to assess the impact on recruiting Black individuals in biomedical research. Sponsored by the Lung Cancer Research Foundation Research Grant on Disparities in Lung Cancer Citation Format: Jeenn A. Barreiro-Rosa, Oluwatumilara Akeke, Annabella Opoku, Alison Hilton, Jessica Carda-Auten, Randall Teal, Aaron Carpenter, Hayley N. Morris, Lauren Matthews, Ashley Rankin Collins, Marjory Charlot. “Simply ask and explain”: perspectives from Black patients with lung cancer on strategies to address racial disparities in biospecimen research participation. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5534.

Colloidal gels are out of equilibrium soft solids composed of attractive Brownian particles that form a space-spanning network at low volume fractions. The elastic properties of these systems result from the network microstructure, which is very sensitive to shear history. Here, we take advantage of such sensitivity to tune the viscoelastic properties of a colloidal gel made of carbon black nanoparticles. Starting from a fluidized state under an applied shear rate $\dot \gamma_0$, we use an abrupt flow cessation to trigger a liquid-to-solid transition. We observe that the resulting gel is all the more elastic when the shear rate $\dot \gamma_0$ is low and that the viscoelastic spectra can be mapped on a master curve. Moreover, coupling rheometry to small angle X-ray scattering allows us to show that the gel microstructure is different from gels solely formed by thermal agitation where only two length scales are observed: the dimension of the colloidal and the dimension the fractal aggregates. Competition between shear and thermal energy leads to gels with three characteristic length scales. Such gels structure in a percolated network of fractal clusters that interpenetrate each other. Experiments on gels prepared with various shear histories reveal that cluster interpenetration increases with decreasing values of the shear rate $\dot \gamma_0$ applied before flow cessation. These observations strongly suggest that cluster interpenetration drives the gel elasticity, which we confirm using a structural model. Our results, which are in stark contrast with previous literature, where gel elasticity was either linked to cluster connectivity or to bending modes, highlight a novel local parameter controlling the macroscopic viscoelastic properties of colloidal gels.

Abstract: Skin is the largest non–parenchymal organ of the human body. It constitutes a natural barrier against pathogens and harmful environmental exposures and contributes to the human body's homeostasis. Conditions affecting the skin range from infections and injury to autoimmune diseases and cancer. Herbs have been used to treat dermatological conditions for a long time. Traditional approaches to delivering herbs to the skin include ointments, gels, creams, and lotions. However, poor lipophilicity or hydrophilicity in most herbal preparations results in limited bioavailability and poor penetration, restricting their effectiveness. Nanotechnology-based approaches have major potential, showing more promising results in enhancing transdermal penetration than traditional approaches. This review article summarizes such advances and sheds light on future directions in using nanotechnology-based strategies.

Self-assembled lyotropic phases are important in a variety of applications, in particular microemulsions are essential for formulation science. A spectacular situation arises when microemulsions are made to swell by systematically increasing the bending modulus of the surfactant film separating the oil and water regions. In an attempt to realize such extremely swollen microemulsion phases, Peter et al. [Phys. Rev. Lett., 76 (1996) 3866] found a variety of lyotropic phases including a long-range ordered three-dimensional cubic phase over a narrow section of the complex phase diagram of a pseudo-quaternary system composed of decane, brine, octanol, and sodium dodecyl sulfate. In this work, the same region of the phase diagram was reinvestigated using high-resolution small-angle X-ray scattering (HR-SAXS) and rheo-SAXS, which is an important technical aspect for homogenizing the sample and orienting the structural units. Whilst the formation of a swollen two-dimensional hexagonal phase was observed, the structural features of a cubic phase were not detected. The long correlation lengths noted prior were also seen here, over 2000 nm for the hexagonal phase, taken from rheo-SAXS measurements. Based on the measurements covering more than three orders of magnitude in scattering vector, the structure appeared to be an organization of elongated swollen emulsion droplets, which could form an interconnected structure, dense liquid-like order, or further order into a hexagonal morphology with unusually large lattice spacings for a surfactant system.

Auditory challenges are both common and disruptive for autistic children and evidence suggests that listening difficulties may be linked to academic underachievement (Ashburner, ZivianiRodger, 2008). Such deficits may also contribute to issues with attention, behavior, and communication (Ashburner et al., 2008; Riccio, Cohen, GarrisonSmith, 2005). The present study aims to summarize the auditory challenges of autistic children with normal pure-tone hearing thresholds, and perceived listening difficulties, seen at auditory-ASD clinics in the US and Australia.Data were compiled on a comprehensive, auditory-focused test battery in a large clinical sample of school-age autistic children with normal pure-tone hearing to date (N = 71, 6-14 years). Measures included a parent-reported auditory sensory processing questionnaire and tests of speech recognition in noise, binaural integration, attention, auditory memory and listening comprehension. Individual test performance was compared to normative data from children with no listening difficulties.Over 40% of patients exhibited significantly reduced speech recognition in noise and abnormal dichotic integration that were not attributed to deficits in attention. The majority of patients (86%) performed abnormally on at least one auditory measure, suggesting that functional auditory issues can exist in autistic patients despite normal pure-tone sensitivity.Including functional listening measures during audiological evaluations may improve clinicians' ability to detect and manage the auditory challenges impacting this population. Learner Outcomes: 1) Readers will be able to describe the auditory difficulties experienced by some autistic patients (ASD). 2) Readers will be able to describe clinical measures potentially useful for detecting listening difficulties in high-functioning autistic children.

Correction for ‘Interpenetration of fractal clusters drives elasticity in colloidal gels formed upon flow cessation’ by Noémie Dagès et al., Soft Matter, 2022, 18, 6645–6659, https://doi.org/10.1039/D2SM00481J.

Glyceline, a deep eutectic solvent comprising glycerol and choline chloride, is a green nonaqueous solvent with potential industrial applications. Molecular mechanisms of surfactant self-assembly in deep eutectic solvents are expected to differ from those in their constituent polar components and are not well understood. Here we report the observation of self-assembled SDS fractal dendrites with dimensions up to ∼mm in glyceline at SDS concentrations as low as cSDS ∼ 0.1 wt%. The prevalence of these dendritic fractal aggregates led to the formation of a gel phase at SDS concentrations above ≥1.9 wt% (the critical gelation concentration cCGC). The gel microscopic structure was visualised using polarised light microscopy (PLM); rheology measurements confirmed the formation of a colloidal gel, where the first normal stress difference was negative and the elastic modulus was dominant. Detailed nano-structural characterisation by small-angle neutron scattering (SANS) further confirmed the presence of fractal aggregates. Such SDS aggregation or gelation has not been observed in water at such low surfactant concentrations, whereas SDS has been reported to form lamellar aggregates in glycerol (a component of glyceline). We attribute the formation of the SDS fractal dendrites to the condensation of counterions (i.e. the choline ions) around the SDS aggregates - a diffusion-controlled process, leading to the aggregate morphology observed. These unprecedented results shed light on the molecular mechanisms of surfactant self-assembly in deep eutectic solvents, important to their application in industrial formulation.

Glyceline, a deep eutectic solvent comprising glycerol and choline chloride, is a green nonaqueous solvent with potential industrial applications. Molecular mechanisms of surfactant self-assembly in deep eutectic solvents are expected to differ from those in their constituent polar components and are not well understood. Here we report the observation of self-assembled SDS fractal dendrites with dimensions up to ∼mm in glyceline at SDS concentrations as low as cSDS ∼ 0.1 wt%. The prevalence of these dendritic fractal aggregates led to the formation of a gel phase at SDS concentrations above ≥1.9 wt% (the critical gelation concentration cCGC). The gel microscopic structure was visualised using polarised light microscopy (PLM); rheology measurements confirmed the formation of a colloidal gel, where the first normal stress difference was negative and the elastic modulus was dominant. Detailed nano-structural characterisation by small-angle neutron scattering (SANS) further confirmed the presence of fractal aggregates. Such SDS aggregation or gelation has not been observed in water at such low surfactant concentrations, whereas SDS has been reported to form lamellar aggregates in glycerol (a component of glyceline). We attribute the formation of the SDS fractal dendrites to the condensation of counterions (i.e. the choline ions) around the SDS aggregates - a diffusion-controlled process, leading to the aggregate morphology observed. These unprecedented results shed light on the molecular mechanisms of surfactant self-assembly in deep eutectic solvents, important to their application in industrial formulation.

Treatments for metastatic breast cancer (MBC) improve survival but often impose prolonged symptom burden. We performed molecular characterization of 84 miRNAs in the circulating serum of women with MBC to explore possible early indicators of intervention response. Expression levels of miR-10a-5p and miR-211-5p were downregulated in nonresponders, but upregulated in responders (miR-10a-5p: 0.40-fold and eightfold; miR 211-5p: 0.47-fold and fourfold). miR-205-5p expression was upregulated in both nonresponders and responders, but to a greater extent in responders (1.8-fold and sixfold). Additionally, levels of miR-10a-5p were negatively correlated with expression levels of IL-6 (r = -0.412). Exploration of these pathways may reveal mechanisms of action in lifestyle interventions aimed at improving quality of life and impacting disease progression for women with MBC., Lay abstract As treatment for women with metastatic breast cancer improves survival rates, interventions are needed that relieve symptom burden. We examined the serum of women with metastatic breast cancer who participated in a lifestyle intervention that improved diet and increased physical activity. Three miRNAs were discovered that may serve as early indicators of the ability of lifestyle interventions to improve quality of life and impact disease progression., Tweetable abstract Three miRNAs may predict how women with metastatic breast cancer respond to lifestyle interventions.

This report presents a case of Lemierre syndrome caused by Fusobacterium necrophorum in a healthy young adult who presented atypically with shortness of breath and jaundice but no clinical or diagnostic evidence of thrombophlebitis. Due to this unusual presentation with jaundice, diagnosis was challenging and delayed. However, the patient was successfully initiated on a prolonged course of intravenous antibiotics; he required a period in the intensive care unit and was discharged without significant complications. This report aims to raise awareness of the diagnosis and treatment of this rare condition and to highlight both common and unusual presentations of the syndrome.

Understanding morphological transformations upon temperature-induced mesophase transitions offers mechanistic insights into the self-assembly process. We have recently reported the unexpected formation of a microfibrillar lamellar gel in SDS-glycerol mixtures above a critical gelation concentration (CGC) as low as ~2 wt%. The gel phase comprised a fibrillar structure on the microscale and a lamellar structure on the nanoscale. Here, the nanoscopic structure of the gel as a function of temperature was probed with small-angle neutron scattering (SANS). The gel underwent a gel-to-fluid transition at a critical gelation temperature, TGC = 45 °C, forming cylindrical micelles at elevated temperatures. Upon cooling, a hexagonal phase formed at ~TGC, evident from the SANS Bragg peaks. This hexagonal phase upon the fluid-to-gel transition sheds light on the gelation mechanism, in which self-assembled SDS micelles undergo a cylindrical-to-lamellar morphological transition via a hexagonal phase. This unprecedented observation also highlights the complexity of self-assembly in nonaqueous hydrogen-bonding rich media.

HypothesisHydrogen-bonding capacities of polar nonaqueous media significantly affect self-assembly behaviours of surfactants in these media.IntroductionGlycerol, a nonaqueous hydrogen-bonding solvent, is widely used in industrial formulations due to its desirable physical properties. Surfactants are ubiquitous in such applications; however, surfactant self-assembly in glycerol is not well understood.MethodsThe microscopic structure of the gel phase was studied using a series of imaging techniques: polarised light microscopy (PLM), confocal laser scanning microscopy (CLSM), and environmental scanning electron microscopy (ESEM). The rheological properties of the gel were studied using viscometry and oscillation rheology measurements. Further nano-structural characterisation was carried out using small-angle neutron scattering (SANS).ResultsWe have observed the unexpected formation of a microfibrillar gel in SDS and glycerol mixtures at a critical gelation concentration (CGC) as low as ∼ 2 wt%; such SDS gelation has not been observed in aqueous systems. The microscopic structure of the gel consisted of microfibres some mm in length and with an average diameter of D ∼ 0.5 μm. The fibres in the gel phase exhibited shear-induced alignment in the viscometry measurements, and oscillation tests showed that the gel was viscoelastic, with an elastic-dominated behaviour. Fitting to SANS profiles showed lamellar nano-structures in the gel microfibres at room temperature, transforming into cylindrical-micellar solutions above a critical gelation temperature, TCG ∼ 45 oC.ConclusionsThese unprecedented observations highlight the markedly different self-assembly behaviours in aqueous and nonaqueous H-bonding solvents, which is not currently well understood. Deciphering such self-assembly behaviour is key to furthering our understanding of self-assembly on a fundamental level.

While child protection social workers (CPSWs) make decisions about which children with an injury need a medical examination, we do not know how they make these decisions. We aimed to ascertain the knowledge, attitudes and training of CPSWs in regards to assessing childhood bruising. Paediatricians' views on the bruising knowledge and training of CPSWs were also explored, as well as the relationship and communication between the two professions. ‘Aimed to ascertain the knowledge, attitudes and training of CPSWs in regards to assessing childhood bruising’ Semi-structured, face-to-face interviews were conducted with 39 CPSWs and 16 paediatricians across South Wales and South West England. Interviews were recorded and transcribed until data saturation was reached. Using NVivo, two independent assessors conducted a thematic analysis, identifying themes emerging from the data with group comparisons where appropriate. CPSWs lack confidence in assessing bruising with knowledge gaps regarding bruise patterns and the lack of evidence for ageing bruises. This appears to be linked to an almost complete lack of training. An important theme was that CPSWs regard the clinician's view as paramount, yet paediatricians feel that there is an over-expectation of what a child protection medical can conclude; this exemplified some of the communication issues between the professions. Evidence-based training of CPSWs is needed jointly by health and social care professionals, including an understanding of the respective roles. Copyright © 2017 John Wiley & Sons, Ltd. Key Practitioner Messages CPSWs lack confidence in assessing bruising characteristics associated with physical abuse, largely due to their lack of training. CPSWs' decisions to refer for medical examinations are strongly influenced by an exploration of history and key social factors, including chastisement strategies and the home environment. Paediatricians are unaware of CPSWs' training or knowledge, and thus have unrealistic expectations of their assessment of bruising characteristics. Communication between professionals could be improved by joint professional training in this area, providing current scientific evidence relating to bruises and an explicit explanation of the role of each in this assessment. ‘Paediatricians are unaware of CPSWs' training or knowledge, and thus have unrealistic expectations of their assessment of bruising characteristics’

We investigate the reversible gelation of poly(N-isopropylacrylamide) (pNIPAM) microgels in the presence of triblock-copolymer (PEO-PPO-PEO type) surfactant. We demonstrate that the association of these polymers with the microgel particles at elevated temperature is responsible for the gelation, due to the temperature responsive nature of the components. This is highlighted by an increase in the apparent hydrodynamic diameter of the particles in dynamic light scattering experiments, which only occurs above the volume phase transition temperature of pNIPAM. The gels that result shrink over a time period much larger than that of the collapse of pNIPAM microgels, and retain the shape of the container they form in. We investigate the mechanism that leads to this gelation and the structure of the gels that result. Confocal microscopy experiments show that both polymers are present in the gel network, indicating that an associative mechanism is responsible for the gelation. We vary the pNIPAM particle architecture to further investigate the gelation process, and find that the cross-link distribution plays a key role in the gelation mechanism, where for uniformly cross-linked particles the gelation is not observed. This shows that the fuzzy corona of the pNIPAM microgels is involved in the association of the polymers, allowing the triblock-copolymer to penetrate the outer corona of the microgels and bridge the particles. The phase transition observed is close to physiological conditions, so these gels have the potential for use in biomedical applications, including tissue engineering.

This paper reports work aimed at extending previous studies of the sonochemical method for forming microspheres. It shows that a previously reported method for encapsulating and delivering hydrophilic species using a ‘double emulsion’ method can be used with chitosan or thiolated poly(methacrylic acid), PMAA SH , based systems. One particular application involves targeted catalysis where gold nanoparticles are incorporated into chitosan microspheres and can be released to catalyse the borohydride reduction of 4-nitrophenol. Also reported is the use of ultrasound to ‘trigger’ the reduction reaction of 4-nitrophenol by rupturing nanoparticle-containing microspheres to release the catalyst. We also demonstrate that more sustainable and potentially lower environmental impact processes can be prepared by substituting commercial vegetable oil for the hydrocarbons used previously. We also report for the first time the use of responsive block copolymers to form microspheres. The copolymers consist of PMAA SH blocks around a central, responsive block of poly(ethylene glycol), poly(4-vinylphenyl boronic acid) or poly(N-isopropylacrylamide) to give systems that potentially respond to pH, sugar concentrations or temperature.

Understanding interactions between nanoparticles and model membranes is relevant to functional nano-composites and the fundamentals of nanotoxicity. In this study, the effect of polyamidoamine (PAMAM) dendrimers as model nanoparticles (NP) on the mesophase behaviour of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphoethanolamine (POPE) has been investigated using high-pressure small-angle X-ray scattering (HP-SAXS). The pressure-temperature ( p − T ) diagrams for POPE mesophases in excess water were obtained in the absence and presence of G2 and G4 polyamidoamine (PAMAM) dendrimers (29 A and 45 A in diameter, respectively) at varying NP-lipid number ratio (ν = 0.0002–0.02) over the pressure range p = 1–3000 bar and temperature range T = 20–80 °C. The p − T phase diagram of POPE exhibited the Lβ, Lα and HII phases. Complete analysis of the phase diagrams, including the relative area pervaded by different phases, phase transition temperatures (Tt) and pressures (pt), the lattice parameters (d-spacing), the pressure-dependence of d-spacing (Δd/Δp), and the structural ordering in the mesophase as gauged by the Scherrer coherence length (L) permitted insights into the size- and concentration-dependent interactions between the dendrimers and the model membrane system. The addition of dendrimers changed the phase transition pressure and temperature and resulted in the emergence of highly swollen lamellar phases, dubbed Lβ-den and Lα-den. G4 PAMAM dendrimers at the highest concentration ν = 0.02 suppressed the formation of the HII phase within the temperature range studied, whereas the addition of G2 PAMAM dendrimers at the same concentration promoted an extended mixed lamellar region in which Lα and Lβ phases coexisted. Statement of Significance Using high pressure small angle X-ray scattering in the pressure range 1–3000 bar and temperature range 20–60 °C, we have studied interactions between PAMAM dendrimers (as model nanoparticles) and POPE lipid mesophases (as model membranes). We report the pressure-temperature phase diagrams for the dendrimer-lipid mesophases for the first time. We find that the dendrimers alter the phase transition temperatures (Tt) and pressures (pt), the lattice parameters (d-spacing), and the structural order in the mesophase. We interpret these unprecedented results in terms of the fluidity of the lipid membranes and the interactions between the dendrimers and the membranes. Our findings are of fundamental relevance to the field of nanotoxicity and functional nanomaterials that integrate nanoparticles and organized lipid structures.

Prostate cancer incidence and mortality rates are highest among African-American men. Comorbidity burden and quality of life (QOL) challenges are also high. Many factors drive these differences; health behaviors are important modifiable contributors. Studies document positive results for lifestyle interventions targeting NHW prostate cancer survivors, but inclusion of African-Americans is limited. We conducted an exploratory mixed-methods study with AAPCS to inform the development of a culturally relevant lifestyle intervention. Twenty-two AAPCS completed questionnaires and a discussion group on dietary and physical activity patterns, QOL, and unmet needs related to lifestyle changes. Seventy-five percent of the participants were overweight or obese, 82% had physical activity patterns considered insufficiently active and only 10% did resistance training at least twice weekly in accordance with current survivorship guidelines. Diets were high in saturated fat and sugar, low in fiber, fruit, and vegetable intake. PROMIS-29 scores indicated that AAPCS had worse physical functioning, pain interference, and sexual functioning, but less social isolation compared to the general population. Compared to other prostate cancer survivors, participants reported poorer status on all domains. Qualitative data highlighted barriers to healthy lifestyles including access, knowledge, and skills, as well as motivators including health benefits and building strength to feel more “manly.” Participants shared high interest in programs to exercise, learn about affordable healthy eating, and bring survivors together to discuss survivorship issues. Lifestyle interventions targeting AAPCS are warranted. To increase impact of these efforts, consideration of environmental, cultural, and survivor contexts will be key.

Interprofessional education (IPE) is an educational requirement for many health care professions, including speech-language pathology and audiology. Interprofessional approaches to education may be a valuable asset for improving services provided to older adults due to their complex and unique needs required over a longer period of time compared to a younger individual. Studies have also shown that IPE activities may elicit positive changes in student perceptions toward older adults and other professions. However, research describing the best educational practices for conducting IPE aimed at preparing professionals to work with older adults is limited, and many educational programs lack exposure and practice for IPE as their focus is on a single profession. Educators can use information related to the IPE Competency Domains and outcome measurement tools provided in this article to develop IPE experiences. Evaluation of IPE experiences will increase the evidence base and address a critical need in health care for older adults.

Objective Brief interventions for adolescent marijuana users offered in schools reach users who would not otherwise present for treatment. The current study builds on previous trials of a school-based, 2-session motivational enhancement therapy (MET) intervention by adding periodic, brief motivational check-ins to reinforce gains and bolster motivation. Method Adolescent participants were randomly assigned to a motivational check-in (MCI; n = 128) or assessment-only check-in (ACI; n = 124) comparison condition. Both conditions received 2 sessions of MET. Participants in the MCI condition then attended 3 MET-based check-in sessions at 4, 7, and 10 months after baseline, whereas the ACI condition participants attended assessment-only check-ins at the same time points. Optional cognitive behavior therapy (CBT) sessions were available as needed for 12 months from baseline in both conditions. Results Outcomes were assessed at 6, 9, 12, and 15 months after baseline. Participants (59% Caucasian; 68% male; mean age = 15.84) reported using marijuana on an average of 37 of the last 60 days, and 70% met diagnostic criteria for a marijuana use disorder. Both conditions were associated with reduced use and negative consequences that were sustained throughout the 15 months of follow-up. The MCI condition resulted in greater reductions at the 6 months follow-up, but differences between conditions were not found at later follow-ups, and MCI participation did not increase engagement in CBT as predicted. Conclusions Results replicated the efficacy of the brief intervention for adolescent marijuana use and provided mixed evidence on the utility of adding repeated check-in sessions. (PsycINFO Database Record

African American men are disproportionally affected by high prostate cancer incidence and mortality, and also comorbidities. African American prostate cancer survivors (AAPCS) report lower quality of life (QOL) relative to Non-Hispanic white (NHW) survivors. Many factors drive these differences, including weight status and health behaviors. The American Cancer Society has nutrition and physical activity guidelines to help cancer survivors achieve optimal health and QOL. AAPCS are more likely than NHW survivors to be non-adherent. Poor diet and physical inactivity often result in adverse body composition (high adiposity, low lean muscle) leading to hormonal changes, increased systemic inflammation and insulin resistance theorized to promote carcinogenesis and chronic diseases. Studies document positive results for lifestyle interventions focusing on NHW prostate cancer survivors, but inclusion of AAPCS is limited. We conducted an exploratory mixed methods study with AAPCS to inform the development and implementation of Men Moving Forward, a lifestyle intervention currently being tested in a randomized efficacy trial. Methods: 22 AAPCS completed a focus group and validated questionnaires on diet, physical activity patterns, QOL, and unmet needs related to lifestyle changes. Results: 75% of the participants were overweight/obese, 82% were considered insufficiently active, only 10% engaged in resistance training. Diets were high in saturated fat and sugar, low in fiber, fruits and vegetables. Compared to other prostate cancer survivors, AAPCS reported lower rankings on all QOL domains. Compared to the general population, men had worse physical functioning, pain interference, and sexual functioning. Qualitative data reflected high interest in a lifestyle intervention that would provide opportunities to build strength, learn about healthy eating, and bring men together to talk about relevant survivorship issues. Conclusions: Interventions are needed to address the lifestyle and QOL needs of AAPCS. The community-based Men Moving Forward trial will examine the feasibility and effects of a 4-month lifestyle program with 200 AAPCS. Outcomes include body composition (adiposity, lean muscle mass), behavior (diet, physical activity), strength, biomarkers of general health (lipids, blood pressure, glucose, and insulin) and prostate cancer recurrence (inflammation, insulin resistance, hormones) and QOL. This study is being conducted in partnership with the Milwaukee Public Recreation system which increases the potential for program sustainability. Citation Format: Jamal A. Jarrett, Lauren Matthews, Patricia Sheean, Kathryn Flynn, Kathryn Bylow, Deepak Kilari, Paula Papanek, Tina Johnson, Melinda Stolley. Developing Men Moving Forward, a lifestyle intervention for African American prostate cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B006.

Digital, social, and mobile technologies (DSMTs) can support a wide range of self-directed learning activities, providing learners with diverse resources, information, and ways to network that support their learning needs. DSMTs are increasingly used to facilitate learning across the continuum of health professional education (HPE). Given the diverse characteristics of DSMTs and the formal, informal, and nonformal nature of health professional learning, a review of the literature on DSMTs and HPE could inform more effective adoption and usage by regulatory organizations, educators, and learners.A scoping review of the literature was performed to explore the effectiveness and implications of adopting and using DSMTs across the educational continuum in HPE. A data extraction tool was used to review and analyze 125 peer-reviewed articles. Common themes were identified by thematic analysis.Most articles (56.0%) related to undergraduate education; 31.2% to continuing professional development, and 52.8% to graduate/postgraduate education. The main DSMTs described include mobile phones, apps, tablets, Facebook, Twitter, and YouTube. Approximately half of the articles (49.6%) reported evaluative outcomes at a satisfaction/reaction level; 45.6% were commentaries, reporting no evaluative outcomes. Most studies reporting evaluative outcomes suggest that learners across all levels are typically satisfied with the use of DSMTs in their learning. Thematic analysis revealed three main themes: use of DSMTs across the HPE continuum; key benefits and barriers; and best practices.Despite the positive commentary on the potential benefits and opportunities for enhancing teaching and learning in HPE with DSMTs, there is limited evidence at this time that demonstrates effectiveness of DSMTs at higher evaluative outcome levels. Further exploration of the learning benefits and effectiveness of DSMTs for teaching and learning in HPE is warranted.

Purpose African American women with breast cancer have higher cancer-specific and overall mortality rates. Obesity is common among African American women and contributes to breast cancer progression and numerous chronic conditions. Weight loss interventions among breast cancer survivors positively affect weight, behavior, biomarkers, and psychosocial outcomes, yet few target African Americans. This article examines the effects of Moving Forward, a weight loss intervention for African American breast cancer survivors (AABCS) on weight, body composition, and behavior. Patients and Methods Early-stage (I-III) AABCS were randomly assigned to a 6-month interventionist-guided (n = 125) or self-guided (n = 121) weight loss program supporting behavioral changes to promote a 5% weight loss. Anthropometric, body composition, and behavioral data were collected at baseline, postintervention (6 months), and follow-up (12 months). Descriptive statistics and mixed models analyses assessed differences between groups over time. Results Mean (± standard deviation) age, and body mass index were 57.5 (± 10.1) years and 36.1 (± 6.2) kg/m2, respectively, and 82% had stage I or II breast cancer. Both groups lost weight. Mean and percentage of weight loss were greater in the guided versus self-guided group (at 6 months: 3.5 kg v 1.3kg; P < .001; 3.6% v 1.4%; P < .001, respectively; at 12 months: 2.7 kg v 1.6 kg; P < .05; 2.6% v 1.6%; P < .05, respectively); 44% in the guided group and 19% in the self-guided group met the 5% goal. Body composition and behavioral changes were also greater in the interventionist-guided group at both time points. Conclusion The study supports the efficacy of a community-based interventionist-guided weight loss program targeting AABCS. Although mean weight loss did not reach the targeted 5%, the mean loss of > 3% at 6 months is associated with improved health outcomes. Affordable, accessible health promotion programs represent a critical resource for AABCS.

Objective: This treatment development study provides summary data for standard Dialectical Behavior Therapy (DBT) with minimal adaptation for 8 women with binge-eating disorder (BED) (5) or bulimia nervosa (BN) (3) and Borderline Personality Disorder (BPD). Method: DBT involved 6 months of weekly skills group, individual DBT, therapist consultation team meeting, and 24-hour telephone coaching. Assessments were conducted at pre-, post-treatment, and 6-months follow-up and utilized standardized clinical interviews including the Eating Disorders Examination (EDE), Personality Disorders Exam, and the Structured Clinical Interview for DSM-IV. Results: From pre- to post-treatment, effect sizes for objective binge eating, total EDE scores and global adjustment were large and for number of non-eating disorder axis I disorders and for suicidal behavior and self-injury were medium. From pre- to 6-months follow-up, effect sizes were large for all these outcomes. Conclusion: This provides promising pilot data for larger studies utilizing DBT for BED or BN and BPD. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008

This article reviews the current state of the literature pertaining to the neuropsychological dysfunctions that are found in children and adults with attention-deficit/hyperactivity disorder (ADHD). Be-cause considerable controversy has existed about the nature and validity of adult ADHD, this article will aid clinicians in develop-ing a better understanding of the empirical literature on neuropsychological function in ADHD throughout the lifespan.

Molecular materials formed from aggregated TDBC dye and PVA have been shown to have high, metal-like reflectivity. This property enables them to support a surface exciton polariton mode, despite their inherent disorder [1]. Here we build on this work, showing first that several dyes have these properties, and second that these properties can be controlled in fabrication. These new materials could be used to create novel nanophotonic modes [2], with choice of dye and method of fabrication giving control over the guided mode. The quantum behaviour of these materials is also of interest. The strong intermolecular coupling present in J-aggregates produces a delocalised exciton ground state that could facilitate coherent energy transport [3].