A cohort study examining the association between children's symptoms of inattention and hyperactivity, internalizing symptoms, and mindful parenting during the COVID-19 pandemic.

Objectives: Increased mental health difficulties have been reported in Canadian children as a result of the COVID-19 pandemic, and emerging research suggests that children with high levels of symptoms of inattention and hyperactivity have been disproportionately impacted. Accordingly, the pandemic has impacted families as well. The purpose of this study was the following: (1) to examine whether children's symptoms of inattention and hyperactivity at the beginning of the 2020 and 2021 academic year were associated with mindful parenting at the end of the academic year and (2) to examine whether children's depressive and anxiety symptoms at the end of the year moderated this relationship. Methods: Parents of 114 young children in a large Canadian city participated in this study in the Winter of 2020 and the Spring of 2021. Parents completed several self-report scales used to measure children's mental health symptomatology and mindfulness in parenting. Results: Children's symptoms of inattention and hyperactivity were significantly, negatively associated with mindful parenting across the pandemic year, and children's depressive symptoms moderated this relationship. Specifically, when children's depressive symptoms were low or average it was found that higher symptoms of inattention and hyperactivity were associated with lower levels of mindful parenting. However, when children's depressive symptoms were high their symptoms of inattention and hyperactivity were not predictive of mindful parenting. Conclusions: Children's mental health, namely symptoms of inattention/hyperactivity and depression, are related to challenges in mindful parenting during COVID-19. These results may inform practitioners about which families require additional support during the pandemic.

Constructing Within-City Neighborhood Health Rankings in Philadelphia by Using Data From the 500 Cities Project.

INTRODUCTION: Profound geographic disparities in health exist in many US cities. Most reporting on these disparities is based on predetermined administrative districts that may not reflect true neighborhoods. We undertook a ranking project to describe health at the neighborhood level and used Philadelphia, Pennsylvania, as our case study. METHODS: To create neighborhood health rankings, we first divided the city into neighborhoods according to groups of contiguous census tracts. Modeling our ranking methods and indicators on the Robert Wood Johnson Foundation County Health Rankings, we gathered census tract-level data from the Centers for Disease Control and Prevention's 500 Cities Project and local sources and aggregated these data, as needed, to each neighborhood. We assigned composite scores and rankings for both health outcomes and health factors to each neighborhood. RESULTS: Scores for health outcomes and health factors were highly correlated. We found clusters of neighborhoods with low rankings in Philadelphia's northern, lower northeastern, western, and southwestern regions. We disseminated information on rankings throughout the city, including through a comprehensive webpage, public communication, and a museum exhibit. CONCLUSION: The Philadelphia neighborhood health rankings were designed to be accessible to people unfamiliar with public health, facilitating education on drivers of health in communities. Our methods can be used as a model for other cities to create and communicate data on within-city geographic health disparities.

Long-term trajectories of self-reported cognitive function in a cohort of older survivors of breast cancer: CALGB 369901 (Alliance).

BACKGROUND: The number of survivors of breast cancer aged ≥65 years ("older") is growing, but to the authors' knowledge, little is known regarding the cognitive outcomes of these individuals. METHODS: A cohort of cognitively intact older survivors with nonmetastatic, invasive breast cancer was recruited from 78 sites from 2004 through 2011; approximately 83.7% of the survivors (1280 survivors) completed baseline assessments. Follow-up data were collected at 6 months and annually for up to 7 years (median, 4.1 years). Cognitive function was self-reported using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30); scores ranged from 0 to 100, with a higher score indicating better function. Group-based trajectory modeling determined trajectories; women were assigned to a trajectory group based on the highest predicted probability of membership. Multinomial logistic regression evaluated the association between receipt of chemotherapy (with or without hormonal treatment) and trajectory group. RESULTS: Survivors were aged 65 to 91 years; approximately 41% received chemotherapy. There were 3 cognitive trajectories: "maintained high" (42.3% of survivors); "phase shift" (50.1% of survivors), with scores slightly below but parallel to maintained high; and "accelerated decline" (7.6% of survivors), with the lowest baseline scores and greatest decline (from 71.7 [standard deviation, 19.8] to 58.3 [standard deviation, 21.9]). The adjusted odds of being in the accelerated decline group (vs the maintained high group) were 2.1 times higher (95% confidence interval, 1.3-3.5) for survivors who received chemotherapy (with or without hormonal therapy) versus those treated with hormonal therapy alone. Greater comorbidity and frailty also were found to be associated with accelerated decline. CONCLUSIONS: Trajectory group analysis demonstrated that the majority of older survivors maintained good long-term self-reported cognitive function, and that only a small subset who were exposed to chemotherapy manifested accelerated cognitive decline. Future research is needed to determine factors that place some older survivors at risk of experiencing cognitive decline. Cancer 2016;122:3555-3563. © 2016 American Cancer Society.

Assessing What Matters Most in Older Adults With Multicomplexity.

BACKGROUND AND OBJECTIVES: Abilities and activities that are often simultaneously valued may not be simultaneously achievable for older adults with multicomplexity. Because of this, the Geriatrics 5Ms framework prioritizes care on "what matters most." This study aimed to evaluate and refine the What Matters Most-Structured Tool (WMM-ST). RESEARCH DESIGN AND METHODS: About 105 older adults with an average of 4 chronic conditions completed the WMM-ST along with open-ended questions from the Serious Illness Conversation Guide. Participants also provided demographic and social information, completed cognitive screening with the Telephone-Montreal Cognitive Assessment-Short and frailty screening with the Frail scale. Quantitative and qualitative analyses aimed to (a) describe values; (b) evaluate the association of patient characteristics with values; and (c) assess validity via the tool's acceptability, educational bias, and content accuracy. RESULTS: Older adults varied in what matters most. Ratings demonstrated modest associations with social support, religiosity, cognition, and frailty, but not with age or education. The WMM-ST was rated as understandable (86%) and applicable to their current situation (61%) independent of education. Qualitative analyses supported the content validity of WMM-ST, while revealing additional content. DISCUSSION AND IMPLICATIONS: It is possible to assess what matters most to older adults with multicomplexity using a structured tool. Such tools may be useful in making an abstract process clearer but require further validation in diverse samples.

Membranoproliferative Glomerulonephritis Associated with Nivolumab Therapy.

Nivolumab is an immune checkpoint inhibitor that targets programmed death-1 on T cells and is designed to amplify an immunologic reaction against cancer cells. However, upregulation of the immune system with checkpoint inhibition is nonspecific, and it can be associated with certain renal side effects, the best documented of which is acute tubulointerstitial nephritis. We present a unique case of a patient with acute kidney injury associated with nephrotic syndrome shortly after starting nivolumab therapy for metastatic anal carcinoma. Subsequent renal biopsy revealed membranoproliferative glomerulonephritis (MPGN). We believe this represents the first reported direct case of nivolumab-associated MPGN. As immunotherapy becomes more widely used in cancer treatment, particular attention must be paid to possible consequences of immune checkpoint inhibitors.

An engineered virus as a bright fluorescent tag and scaffold for cargo proteins--capture and transport by gliding microtubules.

We have demonstrated substantial capture and transport of fluorescently-labeled engineered cowpea mosaic virus (CPMV) using Drosophila kinesin-driven microtubules (MTs). The capture occurred through both NeutrAvidin (NA)-biotin and antibody (IgG)-antigen interactions. The MTs were derivatized with rabbit anti-chicken IgG or biotin, and the virus was conjugated with chicken IgG or NA. The CPMV conjugate was introduced into standard MT motility assays via convective flow at concentrations as high as 1.36 nM, and became bound to the MTs in densities as high as one virus per microm of MT length. When the CPMV conjugate was present at 17 pM, the average speed of the MTs bearing the NA-virus was 0.59 +/- 0.08 microm/sec, and that of those bearing IgG-virus was 0.52 +/- 0.15 microm/sec. These speeds are comparable to those of the unladen MTs (0.61 +/- 0.09 microm/sec), the presence of the virus on the MT causing only a small decrease in MT gliding speeds. The fluorescent CPMV appears to be superior to fluorescent polystyrene spheres of the same size, as both a reporter tag and a scaffold for MT-transported cargo proteins, because of its negligible non-specific adsorption and superior brightness. This work is important for the development of sensors based on nanolocomotion and biological recognition, or new strategies for the nanoassembly of biological structures.

Development and validation of the College Life Alcohol Salience Scale: a measure of beliefs about the role of alcohol in college life.

This article reports the development and validation of the College Life Alcohol Salience Scale (CLASS), which assesses college students' beliefs about the centrality of alcohol to the college experience. Developed using procedures designed to increase its ecological validity, the CLASS was administered to three samples of college students (total N = 571). Its unidimensional factor structure was first established via exploratory factor analysis and parallel analysis on one sample and then verified via confirmatory factor analysis on a separate sample. Scores on the CLASS were predictably related to a nomological network of drinking and personality variables and it provided incremental validity in accounting for drinking frequency and amount, when added to drinking motive scores. The importance of assessing and developing interventions to target the types of beliefs measured by the CLASS is discussed.

Long term storage of virus templated fluorescent materials for sensing applications.

Wild type, mutant, and chemically modified Cowpea mosaic viruses (CPMV) were studied for long term preservation in the presence and absence of cryoprotectants. Viral complexes were reconstituted and tested via fluorescence spectroscopy and a UV/vis-based RNase assay for structural integrity. When viruses lyophilized in the absence of cryoprotectant were rehydrated and RNase treated, UV absorption increased, indicating that the capsids were damaged. The addition of trehalose during lyophilization protected capsid integrity for at least 7 weeks. Measurements of the fluorescence peak maximum of CPMV lyophilized with trehalose and reconstituted also indicate that the virus remained intact. Microarray binding assays indicated that CPMV particles chemically modified for use as a fluorescent tracer were intact and retained binding specificity after lyophilization in the presence of trehalose. Thus, we demonstrate that functionalized CPMV nanostructures can be stored for the long term, enabling their use in practical sensing applications.

A hybrid quantum dot-antibody fragment fluorescence resonance energy transfer-based TNT sensor.

We demonstrate the use of luminescent QDs conjugated to antibody fragments to develop solution-phase nanoscale sensing assemblies, based on fluorescence resonance energy transfer (FRET) for the specific detection of the explosive 2,4,6-trinitrotoluene (TNT) in aqueous environments. The hybrid sensor consists of anti-TNT specific antibody fragments attached to a hydrophilic QD via metal-affinity coordination. A dye-labeled TNT analogue prebound in the antibody binding site quenches the QD photoluminescence via proximity-induced FRET. Analysis of the data collected at increasing dye-labeled analogue to QD ratios provided an insight into understanding how the antibody fragments self-assemble on the QD. Addition of soluble TNT displaces the dye-labeled analogue, eliminating FRET and resulting in a concentration-dependent recovery of QD photoluminescence. Sensor performance and specificity were evaluated.