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The current study investigated how foundational conversations about the body and sexuality begin, how they develop longitudinally, and whether parental body talk varies as a function of characteristics of both the parent and child. Participants included 442 mothers ( M age = 32.50, SD  = 5.61, 93% heterosexual, 85% White) and 337 available father-figures ( M age = 33.99, SD  = 5.68, 98% heterosexual, 80% White), who were the parents of infants (age at Time 1 = 28.13 months, SD  = 6.85, 52% male). Factor analyses suggested that parents engaged in positive, avoidant, and scolding body talk with their young children, and growth curve analyses suggested that frequency of positive body talk increased from when the child was age two to when they were age four for both mother- and father-figures. Results also suggested that the most consistent predictors of body talk included parents' perceptions of whether their child was too young to discuss sexuality, and the child's own questions and behaviors about their bodies and sexuality. The discussion focuses on the frequency of parental body talk and the active role of the child in the early socialization of healthy sexuality.

Research has found that media is associated with children's prosocial behavior (PB) from an early age, and that parents play a key role in children's media use and behavior. However, few studies explore these relations as early as infancy while also controlling for well-established predictors of PB (e.g., empathic concern). Thus, the present study examined longitudinal associations between parents' PB and media use, and prosocial development during early childhood, mediated by children's own media use. Participants were 519 children (M age at Time 1 = 17.77 months) and parents who participated in three timepoints of an ongoing, longitudinal study. A longitudinal path model suggested that children's media use was still significantly associated with PB 1 year later after accounting for factors such as parents' PB, media use, and empathy. These findings have important implications for the early development of behaviors that serve as a foundation for social and moral development., (© 2023 International Congress of Infant Studies.)

Purpose: Guidelines recommend considering an initial trial of continuous positive airway pressure (CPAP) to treat central sleep apnea (CSA). However, practice patterns vary widely. This study investigated predictors for an initial trial of CPAP in patients with central apneas and whether those factors predict adequate treatment response in patients receiving an initial CPAP trial., Methods: Charts of patients receiving a diagnostic code for CSA following a sleep study during 2016-2018 at a single center were reviewed. Patient factors, initial treatment prescriptions, and subsequent changes to therapy were extracted from electronic health records. Regression models were used to estimate factors associated with an initial CPAP prescription and the likelihood of an adequate CPAP response (no subsequent therapy change and no discontinuation of therapy) among patients prescribed CPAP., Results: 429/588 (73%) patients with central apneas received an initial trial of CPAP. Younger age, diagnosis by home sleep testing, non-opiate etiology of central apneas, and a lower proportion of central apneas at diagnosis were independently associated with a higher likelihood of an initial CPAP trial. A lower proportion of central apneas was associated with a higher probability of adequate response, while current smoking and opiate-related central apneas predicted an unsuccessful CPAP trial. A new finding was that older age predicted a lower likelihood of an initial CPAP prescription but did not predict an unsatisfactory response to CPAP., Conclusion: Clinicians may incorrectly weigh certain clinical and sleep study characteristics when deciding whether to trial CPAP for patients with central apneas., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Hair loss is a common complaint among both men and women and is associated with significant psychologic distress. Due to the varied causes, it is important to correctly diagnose the type of alopecia a patient is experiencing to ensure tailoring of treatment. This continuing medical education article describes the approach to diagnose alopecia based on current clinical practice and standards., (Copyright © 2023. Published by Elsevier Inc.)

Infants can help and share in the second year of life. However, there is limited knowledge as to variability in these behaviors as a function of target (e.g., caregiver vs. unfamiliar adult) and the influence of caregiver support on infant prosocial behavior. Infants ( N = 268, 124 female) at 1-2 years of age ( M = 1.47, SD = .27) and again at 2-3 years of age ( M = 2.48, SD = .26) participated in a helping task (with the caregiver or unfamiliar experimenter), a sharing task (with either target), and a free-play observation with their primary caregiver from which caregiver support was coded. The racial and ethnic composition of the sample consisted of 3% Asian, 10% Black, 20% Hispanic, 59% White, 1% mixed race, and 6% "other." Median family annual income was $50,000 to $59,000, and median caregiver education level was "some college." Infant helping favored caregivers at both time points. However, infant sharing did not differ by target for 1-2-year-olds, but 2-3-year-olds shared more with their caregivers than an unfamiliar experimenter. Additionally, infants' behaviors antecedent to the act of helping or sharing (e.g., latency to respond, checking behaviors, and looking duration toward the target) differed by target. Concurrent relations between caregiver support and helping and sharing were moderated by age and differed by time point. Caregiver support for 1-2-year-olds also longitudinally predicted an age-moderated relation with 2-3-year-olds' helping toward an unfamiliar experimenter. Theoretical implications for the role of socialization in the emergence of helping and sharing behaviors are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background: Elective culinary medicine education has become popular to help fill important gaps in physician nutrition training. The implementation and outcomes among the inaugural cohort of medical students who received culinary medicine training as a required component of medical school curriculum at the University of Maryland School of Medicine are described. Methods: Following a series of elective pilot sessions, culinary medicine training was provided to all first-year medical students in the 2019-2020 academic year. The 3-hour training included evidence-based nutrition lecture, cooking simple recipes, and group discussion of the application to personal and patient care. Pre-/postsession questionnaires assessed nutrition knowledge, skills, and attitudes as well as nutritional counseling confidence. Paired t -tests estimated mean differences in outcomes pre- and posttraining. Qualitative data were subjected to thematic analysis. Results: Overall, 119 of 125 (95.2%) students provided pre- and posttraining outcomes data. All nutritional and patient counseling outcomes improved ( P < .05). Themes of being better prepared to address healthy eating barriers in patient care and personal ability to make healthy dietary changes were noted in qualitative analysis. Conclusion: One session of culinary medicine training in core medical student curriculum was feasible and improved medical student nutrition knowledge, skills, and attitudes and confidence in patient nutrition counseling., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2021 The Author(s).)

Synthetic biology allows us to bioengineer cells to synthesize novel valuable molecules such as renewable biofuels or anticancer drugs. However, traditional synthetic biology approaches involve ad-hoc engineering practices, which lead to long development times. Here, we present the Automated Recommendation Tool (ART), a tool that leverages machine learning and probabilistic modeling techniques to guide synthetic biology in a systematic fashion, without the need for a full mechanistic understanding of the biological system. Using sampling-based optimization, ART provides a set of recommended strains to be built in the next engineering cycle, alongside probabilistic predictions of their production levels. We demonstrate the capabilities of ART on simulated data sets, as well as experimental data from real metabolic engineering projects producing renewable biofuels, hoppy flavored beer without hops, fatty acids, and tryptophan. Finally, we discuss the limitations of this approach, and the practical consequences of the underlying assumptions failing.

Hospital lengths of stay for orthopaedic procedures are declining internationally. Discharge home from hospital following total joint replacement surgery can be stressful due to pain and physical restrictions. Thus, many patients report experiencing increased anxiety and feeling a sudden withdrawal of support from their medical team. The Coach Program maximizes human resources and family-centred care by formally integrating an individual whom the patient identifies as their primary support into their health care team. This unique and innovative program was designed to decrease patient anxiety, increase patient confidence, enhance coping with shorter hospital lengths of stay, and smooth the discharge planning process. Anecdotal feedback from patients and staff has been overwhelmingly positive. A pilot self-reported patient survey was conducted. Future steps include distribution and analysis of a more detailed survey to a broader patient population and finding ways to address the needs of patients with limited social support., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Native American women in the Northern Plains have a high prevalence of human papillomavirus (HPV) and high incidence of cervical disease and cervical cancer. HPV vaccination coverage is shown to be lower among nonwhite populations and disparity populations. We assessed HPV knowledge, attitudes, and beliefs towards HPV and HPV vaccination during a community-based participatory research project among tribal youth, young adults, parents, and health professionals. In 2009, we recruited a total of 73 individuals to participate in four tribal focus groups: tribal health providers, (n=10), Indian Health Service providers (n=7), young adult women ages 19-26 (n=22), girls (14-18) (n=18), and parents (n=16). Of these, 62 (84.93 %) completed a survey, which included 10 healthcare providers, 22 young adults, 14 teens, and 16 parents. We employed a qualitative thematic analysis of focus group transcript data and conducted frequency analysis of survey data, which were both reviewed and triangulated by a Community Advisory Board. Based on the results of this study, the tribal community advisory board identified local tribal settings for interventions to increase HPV vaccination coverage through health education classes and a school-based vaccination clinic. In addition to tribal community-wide education events to increase awareness of HPV disease, the HPV vaccine, provider-specific training was identified as a potential intervention. These community-based focus group findings underscore the importance of locally and cultural tailored educational interventions to further increase HPV knowledge and HPV vaccination among disparate populations like American Indian adolescent and young adult women.

We examine how structured reflection through after-event reviews (AERs) promotes experience-based leadership development and how people's prior experiences and personality attributes influence the impact of AERs on leadership development. We test our hypotheses in a time-lagged, quasi-experimental study that followed 173 research participants for 9 months and across 4 distinct developmental experiences. Findings indicate that AERs have a positive effect on leadership development, and this effect is accentuated when people are conscientious, open to experience, and emotionally stable and have a rich base of prior developmental experiences.

To determine the long-term impact of Lyme disease, we evaluated 84 randomly selected, original study patients from the Lyme, Connecticut, region who had erythema migrans, facial palsy, or Lyme arthritis 10-20 years ago and 30 uninfected control subjects. The patients in the 3 study groups and the control group did not differ significantly in current symptoms or neuropsychological test results. However, patients with facial palsy, who frequently had more widespread nervous system involvement, more often had residual facial or peripheral nerve deficits. Moreover, patients with facial palsy who did not receive antibiotics for acute neuroborreliosis more often now had joint pain and sleep difficulty and lower scores on the body pain index and standardized physical component sections of the Short-Form 36 Health Assessment Questionnaire than did antibiotic-treated patients with facial palsy. Thus, the overall current health status of each patient group was good, but sequelae were apparent primarily among patients with facial palsy who did not receive antibiotics for acute neuroborreliosis.

Cysticercosis is a disease caused by encysted larvae of the tapeworm Taenia solium. Most muscular disease presents with central nervous system involvement or multiple cysts or both. The authors report a 25-year-old woman with a rare single muscle cyst presenting as a tender hard triceps mass. Results of clinical examination and magnetic resonance imaging were indicative of a soft tissue tumor. Excision of the mass revealed purulence, and the histologic diagnosis was cysticercosis. In the differential diagnosis of isolated muscular masses, a rare isolated cysticercus presenting as a pseudotumor should be considered.

It is necessary to prescribe the mechanical properties of tumor tissue when modeling the metastatically involved skeleton for clarifying the mechanisms of fracture. This study provides mechanical property data for lytic bone metastases. Specimens of human lytic tumor were tested under a confined compression uniaxial creep protocol and the mechanical behavior of the tumor tissue was modeled using linear biphasic theory. The tumor tissue was found to have an aggregate modulus (HA) of 3.6 +/- 1.6 kPa and a hydraulic permeability (k) of 0.59 +/- 0.46mm4 N(-1) s(-1). Tumors with a higher percentage of stromal content were found to be stiffer and more permeable than those with a more cellular composition. No significant differences in aggregate modulus or hydraulic permeability were found between lytic metastases of different types. These data are useful for the development of models to simulate the behavior of the metastatically involved skeleton using theoretical or finite-element analysis techniques and also have significance for developing effective tumor-drug-transport models. We anticipate that specification of the mechanical behavior of this tissue may help to better focus future treatment of lytic bony metastases through better assessment of fracture risk and improved drug delivery.

A small percentage of Lyme patients develop mild to moderate encephalopathic symptoms months to years after diagnosis and treatment. Their symptoms typically include fatigue, memory loss, sleep disturbance, and depression. However, the etiology of this syndrome remains controversial. It is generally thought that Lyme patients with abnormal cerebral spinal fluid (CSF) have a neurological basis to their illness. To further examine this question, we compared Lyme patients with evidence of abnormal CSF, intrathecal antibody to Borrelia burgdorferi, elevated protein, or a positive polymerase chain reaction for B. burgdorferi DNA (n = 14); Lyme patients with normal CSF (n = 18); and healthy controls (n = 15) on a battery of neuropsychological and personality tests. Although both Lyme groups reported memory problems, only the Lyme group with abnormal CSF had measurable memory deficits. Both Lyme groups had higher depression scores than the normal control group, although depression was not correlated with memory scores. It appears that Lyme patients with abnormal CSF may have a neurological basis to their illness, whereas affective symptoms, common to many chronic disorders, may predispose other Lyme patients to the perception of cognitive dysfunction.

Since 1989, 78 patients have had Implantable Cardioverter Defibrillator (ICD) systems implanted in the Electrophysiology Laboratory (EPS) at the Charleston Area Medical Center. Between June 1993 and December 1994, 28 patients (21 males, 7 females) had new transvenous ICD systems successfully implanted in the Electrophysiology Laboratory. Coronary artery disease was present in 22 patients (76%). The mean left ventricular ejection fraction measured 28 percent (range 19%-45%), and the mean follow-up was 159 +/- 112 days (5.3 months). Twelve patients (43%) experienced shock, with an average of three per patient. The implantation of transvenous ICD systems in an electrophysiology laboratory is feasible, efficacious, safe, and associated with rapid patient recovery. With advances in technology, the procedure is becoming more comparable to a pacemaker implantation.

The substantial variation in birth weight-adjusted mortality among neonatal intensive care units (NICUs) may reflect differences in population illness severity. Development of an illness severity measure is essential for comparisons of outcomes. The Score for Neonatal Acute Physiology (SNAP) was developed and validated prospectively on 1643 admissions (114 deaths) in three NICUs. SNAP scores the worst physiologic derangements in each organ system in the first 24 hours. SNAP showed little correlation with birth weight and was highly predictive of neonatal mortality even within narrow birth weight strata. It was capable of separating patients into groups with 2 to 20 times higher mortality risk. It also correlated highly with other indicators of severity including nursing workload (r = .59), therapeutic intensity (r = .78), physician estimates of mortality risk (r = .65), and length of stay (R2 = .59). SNAP is an important new tool for NICU research.

This study was conducted in partial fulfillment of the requirements of the U.S. Army-Baylor University Graduate Program in Physical Therapy, Academy of Health Sciences, Fort Sam Houston, TX. The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or representing the views of the Department of the U.S. Army or the Department of Defense. The purpose of this study was to investigate the effects of 30-minute ice treatments to the quadriceps femoris muscle and subsequent recovery time on involuntary isometric torque production (the dependent variable) using the Electrostim 180-2. Twenty healthy, male subjects (age 18-35) on active military duty completed the study. Each subject served as his own control. Collected data included maximum current tolerated during electrical stimulation and maximum involuntary isometric torque production pretreatment, immediately posttreatment, and 90 minutes posttreatment. From the statistical analysis, it was concluded that ice application did not significantly affect an individual's ability to tolerate more electrical current or to produce higher maximum involuntary isometric contraction (MIIC) torque values. Results showed a wide variation in subjective response to electrical stimulation. Suggestions for further research and implications for the clinical use of ice in combination with electrical stimulation modalities are discussed. J Orthop Sports Phys Ther 1991;13(5):240-248.

A study of 114 male and female alcoholics was conducted to evaluate the validity of information obtained by means of self-report questionnaires. Factor analysis was used to derive composite measures of alcohol dependence, withdrawal symptomatology, pathological intoxication, and alcoholic psychosis. Validation was conducted by comparing these measures with independent and external criteria; that is drinking estimates made by collateral informants, measures of general alcohol involvement, and drinking behavior 6 months after treatment. The results support each type of validity, and thereby contradict the assumption that the alcoholics' self-reports were not accurate. The question of unreliable self-report data due to the demand characteristics of the situation under which the information is obtained is also addressed.