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This study was pre-registered before participant data collection began, but after research assistant coding began. The registration includes two documents: the pre-registration document containing methodological details and the content coding scheme.

This is an addendum to our initial pre-registration (“Pre-registration diversity dilution 1Oct2021.pdf”) after we have already collected data. The addendum document ("Pre-registration ADDENDUM diversity dilution 25Oct2021") contains extra analyses not included in the original pre-registration.

ED health care professionals are at the frontline of evaluation and management of patients with acute, and often undifferentiated, illness. During the initial phase of the SARS-CoV-2 outbreak, there were concerns that ED health care professionals may have been at increased risk of exposure to SARS-CoV-2 due to difficulty in early identification of patients. This study assessed the seroprevalence of SARS-CoV-2 antibodies among ED health care professionals without confirmed history of COVID-19 infection at a quaternary academic medical center.This study used a cross-sectional design. An ED health care professional was deemed eligible if they had worked at least 4 shifts in the adult emergency department from April 1, 2020, through May 31, 2020, were asymptomatic on the day of blood draw, and were not known to have had prior documented COVID-19 infection. The study period was December 17, 2020, to January 27, 2021. Eligible participants completed a questionnaire and had a blood sample drawn. Samples were run on the Roche Cobas Elecsys Anti-SARS-CoV-2 antibody assay.Of 103 health care professionals (16 attending physicians, 4 emergency residents, 16 advanced practice professionals, and 67 full-time emergency nurses), only 3 (2.9%; exact 95% CI, 0.6%-8.3%) were seropositive for SARS-CoV-2 antibodies.At this quaternary academic medical center, among those who volunteered to take an antibody test, there was a low seroprevalence of SARS-CoV-2 antibodies among ED clinicians who were asymptomatic at the time of blood draw and not known to have had prior COVID-19 infection.

The anti-Müllerian hormone (AMH) plays an essential role in sex determination in early embryonic development. Through a series of sequential steps that follows inheriting an XY chromosome, Sertoli cell differentiation upregulates the expression of AMH-suppressing Müllerian duct development and maintains the AMH at a high level until puberty. In females, the AMH is produced by granulosa cells of follicles beginning in the second half of fetal life and continues through adulthood, with a steady decline through the reproductive years and severe decline at menopause, until levels eventually become undetectable. The AMH is essential for the regulation of follicular maturation via the recruitment of primordial follicles throughout folliculogenesis. AMH serum concentration in women strongly correlates with ovarian reserve quantity and reflects ovulation potential. Because the AMH is expressed almost exclusively by growing follicles before FSH-dependent selection, it commonly serves as a marker for ovarian function in various clinical situations, including in the diagnosis and pathogenesis of polycystic ovarian syndrome, artificial reproductive technology, and predictions of menopause or premature ovarian failure.

SARS-CoV-2 can cause acute respiratory distress and death in some patients(1). Although severe COVID-19 is linked to substantial inflammation, how SARS-CoV-2 triggers inflammation is not clear(2). Monocytes and macrophages are sentinel cells that sense invasive infection to form inflammasomes that activate caspase-1 and gasdermin D, leading to inflammatory death (pyroptosis) and the release of potent inflammatory mediators(3). Here we show that about 6% of blood monocytes of patients with COVID-19 are infected with SARS-CoV-2. Monocyte infection depends on the uptake of antibody-opsonized virus by Fcγ receptors. The plasma of vaccine recipients does not promote antibody-dependent monocyte infection. SARS-CoV-2 begins to replicate in monocytes, but infection is aborted, and infectious virus is not detected in the supernatants of cultures of infected monocytes. Instead, infected cells undergo pyroptosis mediated by activation of NLRP3 and AIM2 inflammasomes, caspase-1 and gasdermin D. Moreover, tissue-resident macrophages, but not infected epithelial and endothelial cells, from lung autopsies from patients with COVID-19 have activated inflammasomes. Taken together, these findings suggest that antibody-mediated SARS-CoV-2 uptake by monocytes and macrophages triggers inflammatory cell death that aborts the production of infectious virus but causes systemic inflammation that contributes to COVID-19 pathogenesis.

Today’s college student is endowed with enormous pressure to succeed; to graduate within four years, to work part-time, to be involved in extracurricular activities, curate friendships, pursue internships, and maintain a competitive grade point average. These pressures can wreak havoc on the physical, mental, psychological, and emotional well-being of students. Eurocentric and patriarchal ideals shape American values and standards exacerbate the social pressures faced by minoritized groups who are already distanced from the status quo. The university campus is no exception to this exacerbation. College and university campuses can be viewed as microcosms of society; which means the same types of social discrimination, racial privileges, and racial oppression observable in the greater society are also observable on a university campus and influence peer-to-peer interactions, student self-perception, students’ relationship with professors, and ability to succeed. College and university campuses that are comprised of a predominately White student body, with students of color comprising a smaller group, are often referred to as Predominantly White Institutions (PWIs). While some PWIs strive to create a diverse and inclusive campus culture, many university campuses are deemed as unresponsive to the needs to racial minorities (Gomer & White). Unresponsive colleges and universities exhibit the effects of institutional racism: equating success with cultural conformity through campus culture, maintaining a racially homogenous faculty, and exclusionary practices which lead minorities to feel excluded, inferior, or forced to assimilate. In these environments, minorities are pressured to meet societal standards, assimilate and defy stereotypes which decreases their mental bandwidth and limits their capacity to learn and succeed on a university campus (Verschelden, 2017). Institutional racism, which reduces the cognitive bandwidth of Black and Latino students, can be noted as a contributing factor to the discrepancies in retention and graduation rates of Blacks and Latino students compared to White students. Bandwidth can be reclaimed by decentering Whiteness and empowering marginalized students to define their own identities, name their own challenges, validate their own experiences, find community, and develop strategies to dismantle oppression through rejecting assimilation, cultural expectations, and master-narratives (Verschelden, 2017). These efforts of resisting the assimilation and marginalization are collectively referred to as counter-narrative storytelling, a form of self-actualization which validates the identities, experiences, and capabilities of traditionally oppressed groups. Counter-narrative storytelling has historically been used to uplift and encourage minoritized groups through validating their identities, dismantling stereotypes and stereotype threat and by providing community by creating space for sharing commonalities between individual experiences. Counter-narrative storytelling can help empower marginalized individuals to set and achieve the goals they set for themselves personally, professionally, academically or otherwise. Counter-narrative storytelling is grounded in Critical Race Theory (CRT). CRT provides a critical means of evaluating the relationships between the success of Black and Latino/a students and their ability to construct a counter-narratives and achieve collegiate success. CRT is referenced in the included research as it. CRT will also provide a framework for evaluating what university practices are most effective in promoting the success of Black and Latino students. This paper will examine the influence of counter-narrative storytelling on the success collegiate success Black and Latino students at PWIs. The phrase “success” shall be operationalized to mean college retention, feeling included and supported within the university, and graduation from college. The referenced articles examine the experiences of Blacks and Latino/a students enrolled in colleges and universities across the United States and the influence counter-narrative storytelling had on their experience.

Aims, Objectives and BackgroundPenetrating trauma remains a leading cause of mortality in the United Kingdom with major haemorrhage a potentially preventable cause of death.KnifeSavers, a not-for-profit healthcare professional led organisation based at a regional major trauma centre, launched in 2019 to educate and empower the public how to manage a bleeding wound. There are three pillars of the campaign; an education programme, distribution of bleeding control packs and a public awareness campaign all focused on stopping major bleeding at scene.The aim of this review is to evaluate the response to the education programme and improvement in confidence and ability of the attendees to control major bleeding.Method and DesignAdult public members attending KnifeSavers education sessions between July 2021 and March 2022 were recruited to partake in pre and post event surveys.Utilising a 5-point Likert scale participants willingness and preparedness to manage bleeding knife related wounds were assessed.The data was comparatively measured, without accounting for attrition, to evaluate a change in response.Abstract 1674 Figure 1Comparison of pre and post survey 5-point Likert scale dataResults and ConclusionThere were 137 responses to the pre survey and 74% retention rate for the post session survey (n=101).Despite a consistently high willingness in participants to intervene (93% pre session and 96% post), only 28% felt prepared to manage a bleeding wound prior to the education session, and 27% felt prepared to use a bleeding control kit.Following the session an increase to 98% of participants were prepared to deal with a bleeding wound, and 96% prepared use a bleeding control kit.Of note 97% of attendees stated it was important that training was delivered by health care professionals.This data suggests that the KnifeSavers education programme is an effective strategy in increasing public preparedness to manage life-threatening bleeding wounds and supports further expansion of the programme.A further mixed methods qualitative assessment including paired t-test statistical analysis is underway.

SARS-CoV-2 causes acute respiratory distress that can progress to multiorgan failure and death in some patients. Although severe COVID-19 disease is linked to exuberant inflammation, how SARS-CoV-2 triggers inflammation is not understood. Monocytes are sentinel blood cells that sense invasive infection to form inflammasomes that activate caspase-1 and gasdermin D (GSDMD) pores, leading to inflammatory death (pyroptosis) and processing and release of IL-1 family cytokines, potent inflammatory mediators. Here we show that ~10% of blood monocytes in COVID-19 patients are dying and infected with SARS-CoV-2. Monocyte infection, which depends on antiviral antibodies, activates NLRP3 and AIM2 inflammasomes, caspase-1 and GSDMD cleavage and relocalization. Signs of pyroptosis (IL-1 family cytokines, LDH) in the plasma correlate with development of severe disease. Moreover, expression quantitative trait loci (eQTLs) linked to higherGSDMDexpression increase the risk of severe COVID-19 disease (odds ratio, 1.3, pOne sentence summaryAntibody-mediated SARS-CoV-2 infection of monocytes activates inflammation and cytokine release.

Keloids negatively impact the health and quality of life of many affected dermatologic patients. Treating keloids is often difficult, and suboptimal responses are frequent. Fortunately, there are many treatment options available to the clinician that may lead to improved clinical outcomes. We present a review of currently available therapeutic options. Intralesional steroid injection remains the first-line treatment for keloids. Imiquimod, direct interferon therapy, or intralesional 5-flurouracil may alleviate the need for excessive corticosteroid therapy. Radiation and laser therapy are emerging therapeutic options that have demonstrated efficacy in reviewed studies. Given the unsatisfactory outcomes associated with pressure dressings, vitamin E, ablative laser, and surgical excision, these options should be avoided in keloid management. Further research is needed to evaluate the efficacy and recurrence associated with the reviewed therapeutics.

Background: Deficits of executive function (EF) have been proposed as all or part of the underlying mechanisms of language impairment in at least some types of aphasia. Executive functions also play a role in the recovery process. There is evidence that bilingual persons have some executive functioning advantages compared to monolingual persons. In this paper we combine two lines of recent investigation in order to explore the relationship between executive function and conversational strategies in bilingual aphasia. Aims: The aim of this preliminary research was to compare the executive functioning profiles of bilingual individuals to those of monolingual participants with aphasia. A further aim was to examine evidence in the conversational samples of the participants in relation to the application of a range of executive skills and to link cognitive and conversational profiles using Barkley's (1997) model of executive functions. Methods & Procedures: The performance of two bilingual individuals with aph...

Vitiligo is a depigmenting disorder characterized by the progressive loss of melanocytes. In cases of extensive vitiligo that is unresponsive to treatment and involves noticeable areas, such as the face and hands, total depigmentation is a clinical option. The choice to depigment is a difficult one for the patient given the irreversible nature of treatment and the psychosocial implications of skin color change. This issue can be particularly complex for black patients. Depigmentation has been practiced for decades and documented in the literature, but the practice in Fitzpatrick skin type VI is not well-documented. We present a case of depigmentation in a patient with Fitzpatrick skin type VI, as well as technical options for depigmentation, the clinical approach, patient preparation, and psychosocial issues involved with this treatment option.

Low rates of help seeking and poor access to health care for Australian adolescents areproblems particularly in rural areas (Booth et al., 2004). Adolescents indicate that they are notlikely to seek help for health concerns (Booth et al., 2004) and are particularly reluctant to seekprofessional help for mental health problems (Wilson, Deane, & Ciarrochi, 2005). Rural andsmall regional communities often have greater structural barriers such as limited numbers ofproviders and longer wait times which reduce access to health care professionals (Quine et al.,2003). However, there are also individual factors such as heightened concerns about anonymityand confidentiality, stronger ethos of self reliance and stoicism that may be barriers to helpseeking in rural settings (e.g., Quine et al., 2003).In order to improve access to primary health care, general practitioners in rural Australia reportwanting greater opportunities to consult and to promote their services to young people outside ofthe usual office consultation setting (Kang et al., 2003). They also want training in collaborativeapproaches and outreach strategies. In addition, youth health workers want improvedrelationships with other service providers such as GPs and especially with schools (Kang et al.,2003). Young people themselves say they prefer to see professionals that they know and trust(Booth et al., 2004).