Validation of the cognitive section of the Penn computerized adaptive test for neurocognitive and clinical psychopathology assessment (CAT-CCNB).

BACKGROUND: The Penn Computerized Neurocognitive Battery is an efficient tool for assessing brain-behavior domains, and its efficiency was augmented via computerized adaptive testing (CAT). This battery requires validation in a separate sample to establish psychometric properties. METHODS: In a mixed community/clinical sample of N = 307 18-to-35-year-olds, we tested the relationships of the CAT tests with the full-form tests. We compared discriminability among recruitment groups (psychosis, mood, control) and examined how their scores relate to demographics. CAT-Full relationships were evaluated based on a minimum inter-test correlation of 0.70 or an inter-test correlation within at least 0.10 of the full-form correlation with a previous administration of the full battery. Differences in criterion relationships were tested via mixed models. RESULTS: Most tests (15/17) met the minimum criteria for replacing the full-form with the updated CAT version (mean r = 0.67; range = 0.53-0.80) when compared to relationships of the full-forms with previous administrations of the full-forms (mean r = 0.68; range = 0.50-0.85). Most (16/17) CAT-based relationships with diagnostics and other validity criteria were indistinguishable (interaction p > 0.05) from their full-form counterparts. CONCLUSIONS: The updated CNB shows psychometric properties acceptable for research. The full-forms of some tests should be retained due to insufficient time savings to justify the loss in precision.

Relationships Between Physical Ability Test Performance and Fitness in Recruits From a Southeastern U.S. Police Department.

ABSTRACT: Lockie, RG, Orr, RM, Sanchez, KJ, Gonzales, SM, Viramontes, E, Kennedy, K, and Dawes, JJ. Relationships between physical ability test performance and fitness in recruits from a southeastern U.S. police department. J Strength Cond Res 38(8): 1472-1478, 2024-Police recruit occupational ability may be predicted by a physical ability test (PAT). This study determined relationships between a department-specific PAT and fitness test performance among police recruits. Retrospective analysis was conducted on recruit data (1,069 men and 404 women) from one department collected during 2005-2009 and 2016-2020. The following data were provided: grip strength; sit-and-reach; 60-second push-ups; 60-second sit-ups; 2.4-km run; and the PAT. The PAT involved exiting a vehicle and opening the trunk; running ∼201 m; completing an obstacle course; dragging a 68-kg dummy 31 m; completing an obstacle course and running ∼201 m; dry firing a weapon 6 times with each hand; and trunk item placement and vehicle reentry. Relationships between the PAT and fitness tests were measured by partial correlations and stepwise linear regression, both controlling for sex. The PAT was completed in a mean time of 4:16 ± 1:07 minutes:seconds. The PAT significantly ( p < 0.001) related to all fitness tests. Moderate relationships were found for push-ups ( r = -0.35), sit-ups ( r = -0.41), and the 2.4-km run ( r = -0.43). Small relationships were found with grip strength ( r = -0.19) and the sit-and-reach ( r = -0.17). The final regression model, which included sex and all fitness tests except the sit-and-reach, explained ∼53% of the variance. Sex and the 2.4-km run explained ∼47% of the variance. Aerobic fitness appeared to have the greatest impact on PAT performance, which may have related to the PAT design and duration. Tasks completed in succession, and the use of a relatively light dummy, may stress aerobic fitness and muscular endurance to a greater extent.

A Retrospective Analysis of Southeastern U.S. Police Recruit Health and Fitness From 4 Points in Time Within a 16-Year Period: Implications for Physical Fitness Training.

ABSTRACT: Gonzales, SM, Orr, RM, Coburn, JW, Hoffmann, MD, Kennedy, K, Dawes, JJ, and Lockie, RG. A retrospective analysis of southeastern U.S. police recruit health and fitness from 4 points in time within a 16-year period: Implications for physical fitness training. J Strength Cond Res 38(6): 1118-1126, 2024-Drawing from the general population for its recruiting needs, police departments often employ academy curricula to improve a recruit's fitness so they can perform occupational tasks. Recently, obesity and physical inactivity have increased in the general population, potentially influencing the health and fitness of incoming recruits. This study involved a retrospective, cross-sectional analysis of health and fitness data of police recruits. Data from 1 police department in southeastern United States were analyzed at 4 specific time points, splitting the recruits into natural immerging groups; 2003 (n = 93), 2006 (n = 137), 2009 (n = 74), and 2019 (n = 242). Health and fitness data for all recruits included age, height, body mass, and body mass index (BMI); systolic and diastolic blood pressure (BP); sit-and-reach; combined grip strength; push-ups and sit-ups completed in 60 seconds; physical ability test time; and 2.4-km run time. Several univariate analyses, with sex and age as covariates (analyses of covariance), and a Bonferroni's post hoc, determined whether there were significant between-group differences. Effect sizes (d) were also calculated. Key results demonstrated that 2019 recruits were heavier than the recruits in 2006 and 2009 (p ≤ 0.032; d = 0.14-0.38); had a greater BMI (p ≤ 0.028; d = 0.24-0.75) and systolic BP (p < 0.001; d = 0.47-0.65), and lesser sit-and-reach distance (p ≤ 0.020; d = 0.26-0.46), than all recruit groups; completed fewer sit-up repetitions than the recruits in 2006 and 2009 (p ≤ 0.025; d = 0.42-0.48); and were slower in the 2.4-km run than the recruits in 2006 (p = 0.009; d = 0.36). Police training staff may need to address lesser health (BMI, BP) and fitness (hamstring flexibility, abdominal endurance, aerobic fitness) in incoming recruits.

Vaccine Hesitancy Among Canadian Mothers: Differences in Attitudes Towards a Pediatric COVID-19 Vaccine Among Women Who Experience Intimate Partner Violence.

OBJECTIVES: Vaccine hesitancy (VH) in maternal decision-making is important to understand to achieve community immunity targets and optimize pediatric COVID-19 vaccine adoption. COVID-19 is exacerbating the risk of intimate partner violence (IPV) for women in abusive relationships, a known risk factor for maternal VH. This project aimed to: (1) determine if IPV impacts maternal VH in Canada; and (2) understand maternal attitudes towards routine childhood vaccines and a pediatric COVID-19 vaccine in Canada. METHODS: As part of a cross-sectional, quantitative study, 129 women completed an online survey. IPV was assessed using the Abuse Assessment Screen and the revised, short-form Composite Abuse Scale. The Parent Attitudes about Childhood Vaccines scale evaluated maternal attitudes towards routine vaccinations and a COVID-19 vaccine. Questions informed by the World Health Organization's Increasing Vaccination Model (IVM) evaluated perceived barriers and facilitators to COVID-19 vaccination. RESULTS: In total, 14.5% of mothers were hesitant towards routine childhood vaccines, while 97.0% were hesitant towards a COVID-19 vaccine. Experiencing IPV was significantly associated with maternal COVID-19 VH (W = 683, p < 0.05). Social processes were identified as instrumental barriers and facilitators to COVID-19 vaccination, meaning that social norms and information sharing among social networks are critical in maternal vaccination decision-making. CONCLUSIONS FOR PRACTICE: This study provides novel evidence of maternal IPV significantly impacting VH and the presence of strong maternal VH specific to a COVID-19 vaccine in the Canadian context. Further research is required to fully understand the factors that build confidence and mitigate hesitancy in mothers, especially mothers who have experienced IPV.

Effects of orthognathic surgery on quality of life compared with nonsurgical controls in an American population.

INTRODUCTION: To determine the psychosocial effects of a facial skeletal mal-relationship with its subsequent surgical correction in a group of patients treated using surgical orthodontics compared with a matched group of nontreated controls. METHODS: This study was approved by The Ohio State University Institutional Review Board. Subjects were patients presenting with facial skeletal mal-relationships whose proposed treatment plans included orthognathic surgery. This study used valid and reliable questionnaires: Orthognathic Quality of Life Questionnaire (OQLQ), Beck Depression Inventory II (Children's Depression Inventory - 2), Satisfaction with Life Scale, and State Trait Anxiety Inventory (State Trait Anxiety Inventory for Children), administered at 3 different stages of treatment (time 1 = initial pretreatment, time 2 = before oral surgery, and time 3 = at completion of treatment). Matched controls recruited at each time point completed the same questionnaires. RESULTS: A total of 267 subjects were recruited to participate in this study. There were no significant differences between treatment and control groups in age, sex, education level, or employment status at any of the 3 time points. The randomization test was used to compare values for all outcome variables between groups at the 3 stages of treatment. For the pretreatment period, T1, there were significant differences between patients and controls in domains 1 (P = 0.0126), 2 (P = 0.0000), and 3 (P = 0.0000) of the OQLQ (social aspects, facial esthetics, and oral function, respectively) as well as total OQLQ (P = 0.0000). For the presurgery period, T2, there were significant differences between patients and controls in domains 2 (P = 0.0136) and 3 (P = 0.0001) of the OQLQ (facial esthetics and oral function) as well as total OQLQ (P = 0.0291). Finally, for the posttreatment period, T3, there was a significant difference between patients and controls only in domain 3 (P = 0.0196) of the OQLQ (oral function). CONCLUSIONS: The psychosocial profile of patients with a facial skeletal mal-relationship does not differ from the general population in depression, anxiety, and overall satisfaction with life. However, these patients do report a reduced quality of life based on condition-specific measures in social aspects, facial esthetics, and oral function. Concerns about oral function remain even up to 2 years after treatment is completed.

You Do What You Got To Do: African-American Women's Perspectives of Managing Breast Cancer.

The purpose of this study is to build a grounded theory of the process of diagnosis, treatment, and coping in African-American women diagnosed with stage 1-3 breast cancer, and identifying factors that may lead to resiliency in these women. Factors promoting resiliency identified by the participants included having a voice, self-attunement, spirituality, pragmatism, and keeping positive. Based on the findings, the researchers suggest health care providers work to create patient-centered healthcare,facilities for cancer treatment, validate patient self-agency, encourage communion, and hire staff that have been previously diagnosed with breast cancer to act as mentors.

The Well-Defined Pediatric ICU: Active Surveillance Using Nonmedical Personnel to Capture Less Serious Safety Events.

BACKGROUND: Adverse events, diverse and often costly, commonly occur in pediatric intensive care units (PICUs). Serious safety events (SSEs) are captured through well-developed systems, typically by voluntary reporting. Less serious safety events (LSSEs), including close calls, however, occur at a higher frequency than those that result in immediate harm or death but are underestimated by standard reporting systems. LSSEs can reveal system defects and precede serious events resulting in patient or provider harm. METHODS: A unique active surveillance program was created at Children's Hospitals and Clinics of Minnesota to quantify and categorize, and, ultimately reduce, LSSEs, in PICUs. Premedical college graduates without formal health care training daily canvassed the PICUs and facilitated reporting of LSSEs at the point of care. Events were recorded on a Web application and stored in a relational database management system. Events were enumerated and categorized according to distinctive characteristics (Theme Index) and real or potential harm (Harm Index). RESULTS: Some 1,980 PICU patients, representing 10,766 PICU patient-days in a 15-month period (June 1, 2013- August 31, 2014) experienced 2,465 LSSEs-5.4 LSSEs/ day or 0.23 LSSEs/patient-day. Such events resulted in a patient intervention 38% of the time. Some 158 quality/safety improvement projects were initiated during the observation period, 74 of which have been completed. Quality/safety information was broadcasted to providers, local leadership, and hospital management. CONCLUSIONS: LSSEs occur frequently in our PICUs. Non-health care providers can cost-effectively facilitate reporting by actively canvassing PICU providers on a daily basis and can contribute to quality/safety improvement projects and local safety culture. Reported events can serve as a focus for quality/safety improvement projects. A Web application and mobile tablet interfaces are efficient tools to record events.

Establishing a critical-size mandibular defect model in growing pigs: characterization of spontaneous healing.

PURPOSE: A large animal model is desired for preclinical studies aimed at reconstructing severe mandibular skeletal defects using tissue engineering techniques. To identify the size and location requirements for a mandibular critical-size bone defect in growing pigs, the present study investigated the spontaneous healing of surgically created mandibular defects. MATERIALS AND METHODS: Six 4-month-old domestic pigs were used. In pigs 1 and 2, a 3-, 5-, or 7-cm(3) subperiosteal mandibular defect was created. In pigs 3 to 6, 3- to 5-cm(3) bilateral defects were randomly created at the anterior (apical to the molars) and posterior (mandibular angle) mandibular regions. Spontaneous healing of these defects was assessed by serial computed tomography scans (postoperative week 1, 6, and 12) and histologic analyses. RESULTS: In pigs 1 and 2, regardless of defect size, the anterior, but not posterior, defects had largely healed. Systematic analyses of pigs 3 to 6 revealed, first, the extent of defect regeneration from spontaneous healing was significantly less in the posterior than in the anterior defects, with about two thirds and one third of the original defect volume remaining, respectively. Second, histologically, the posterior defects had considerably less regeneration and more evident tapering of the new bone than did the anterior defects. Finally, the buccal periosteum had completely regenerated in the anterior defects, but had only partially done so in the posterior defects. Also, the buccal surface contour was moderately concave in the anterior defects, but it was severely concave in the posterior defects. CONCLUSIONS: Despite robust spontaneous healing of mandibular defects in growing pigs, 5-cm(3) defects in the mandibular angle region without buccal periosteum would be a reasonable critical-size defect model relevant to mandibular defects in adolescent humans.

Introduction of an applicant Job-Related Task Assessment (JTA) and the effects on the health and fitness of police recruits.

BACKGROUND: In 2020, a police department in the south-eastern USA introduced a Job-Related Task Assessment (JTA). The JTA included running, climbing, crawling, balance, direction changes, stair climbing, dragging, pushing, and simulated controlling of a struggling subject and needed to be completed by applicants in 6 : 57 min:s. It is not known whether introducing the JTA in the hiring process affected the health and fitness of hired recruits. OBJECTIVE: To compare the health and fitness of recruits hired prior to, and following, the JTA introduction. METHODS: Analysis was conducted on recruit data split into academy training year: 2016 (n = 91), 2017 (n = 129), 2018 (n = 167), 2019 (n = 242), and 2020 (n = 37). The 2020 group was hired after the JTA introduction and included one academy class. The following were recorded for all recruits: age, height, body mass, and body mass index; systolic and diastolic blood pressure (BP); sit-and-reach; grip strength; push-ups; sit-ups; 2.4-km run; and a physical ability test (PAT). A univariate ANOVA, with sex and age as covariates and Bonferroni post hoc, determined between-year differences. RESULTS: The recruits from 2020 were significantly lighter than 2018 recruits (p < 0.031), had higher systolic and diastolic BP than recruits from 2016-2018 (p≤0.006), completed the 2.4-km run faster than recruits from all years (p < 0.001), and completed the PAT faster than the 2016 and 2019 (p = 0.006-0.007) recruits. CONCLUSION: The JTA introduction led to the selection of recruits with lower body mass, and better aerobic (2.4-km run) and job-specific fitness (PAT). However, 2020 recruits also had higher BP which should be monitored.

Validation of the structured interview section of the penn computerized adaptive test for neurocognitive and clinical psychopathology assessment (CAT GOASSESS).

Large-scale studies and burdened clinical settings require precise, efficient measures that assess multiple domains of psychopathology. Computerized adaptive tests (CATs) can reduce administration time without compromising data quality. We examined feasibility and validity of an adaptive psychopathology measure, GOASSESS, in a clinical community-based sample (N = 315; ages 18-35) comprising three groups: healthy controls, psychosis, mood/anxiety disorders. Assessment duration was compared between the Full and CAT GOASSESS. External validity was tested by comparing how the CAT and Full versions related to demographic variables, study group, and socioeconomic status. The relationships between scale scores and criteria were statistically compared within a mixed-model framework to account for dependency between relationships. Convergent validity was assessed by comparing scores of the CAT and the Full GOASSESS using Pearson correlations. The CAT GOASSESS reduced interview duration by more than 90 % across study groups and preserved relationships to external criteria and demographic variables as the Full GOASSESS. All CAT GOASSESS scales could replace those of the Full instrument. Overall, the CAT GOASSESS showed acceptable psychometric properties and demonstrated feasibility by markedly reducing assessment time compared to the Full GOASSESS. The adaptive version could be used in large-scale studies or clinical settings for intake screening.

Bone ingrowth and initial stability of titanium and porous tantalum dental implants: a pilot canine study.

PURPOSE: To investigate if a dental implant system with a midsection covered by 3-dimensionally porous tantalum material would exhibit stability comparable with a traditional threaded titanium alloy implant system and whether bone would grow into the porous section. METHODS: Three experimental and 3 control implants were placed in the individual mandibles of 8 dogs. Resonance frequency analysis assessed implant stability at 0, 2, 4, 8, and 12 weeks of healing. Histomorphometric and backscattered scanning electron microscopic analyses examined the presence of bone ingrowth into the experimental implant's porous section and bone-to-implant contact along the titanium surfaces of both implants. RESULTS: Implant stability did not significantly differ during 0 to 12 weeks of healing. Progressive tissue mineralization developed inside porous sections from weeks 2 to 12. Porous implants exhibited a combination of progressive osseointegration along their titanium surfaces and bone ingrowth inside their porous tantalum sections. CONCLUSIONS: Cortical and apical implant threads, combined with the porous section, were able to stabilize the experimental implant to the same degree as the fully threaded control implant.

In-person Versus Virtual Interviews in the Oral & Maxillofacial Surgery Residency Application Process: An Applicant Perspective.

PURPOSE: The purpose of this study is to determine whether in-person vs virtual interviews in the Oral & Maxillofacial Surgery (OMS) residency application process affects an applicant's perspective on a program and his/her comfort level in ranking a program. This study will also look to assess if the continuation of virtual interviews has any socioeconomic impacts on the application pool. METHODS: This cross-sectional study used a descriptive survey sent to all applicants in the 2022 to 2023 OMS residency application cycle to The Ohio State University OMS Residency Program (OSU OMS). The survey involved both scaled and comparative questions aimed to deduce applicant's preferences on the mode of interview process. Questions were designed to both target an applicant's ability to differentiate programs as well uncover any socioeconomic impacts that the reinstatement of in-person interviews caused. All obtained statistics were computed for data analysis. RESULTS: There were 187 applicants to the OSU OMS program in the 2022 to 2023 cycle. Fifty-four applicants completed responses (response rate = 28.9%). A total of 84.4% of respondents preferred in-person interviews. CONCLUSIONS: In-person interviews are the preferred modality for OMS interviews. The ability to experience a program and its faculty and residents in-person proved favorable despite the financial and logistical benefits of virtual interviews.

Shame and guilt for alcohol-related transgressions and hazardous drinking among male and female college students.

Objective: Shame and guilt are often present prior to and consequent to alcohol use among college students. Little is known about the propensity to experience these emotions in the context of transgressions that occur while drinking alcohol. We examined the association between shame and guilt propensity for alcohol-related transgressions with hazardous drinking, and the role of gender in these relationships. Participants: College student drinkers (N = 130; Mage=19.39; 68% females; 86% White) from a Mid-south college. Methods: An online confidential survey included measures of hazardous drinking, guilt and shame propensity, and guilt and shame propensity specific to alcohol-related transgressions. Results: Our preliminary findings suggest that experiencing guilt (but not shame) after alcohol-related transgressions was related to less hazardous drinking when controlling for general guilt and shame propensity for male and female students. Conclusions: Targeting components of guilt (e.g., reparative behaviors) after alcohol-related transgressions may help to reduce problematic drinking among college students.

Trauma-Informed Approaches in the Context of Cancer Care in Canada and the United States: A Scoping Review.

Cancer is predominantly understood as a physical condition, but the experience of cancer is often psychologically challenging and has potential to be traumatic. Some people also experience re-traumatization during cancer because of previous, non-cancer-related trauma, such as intimate partner violence or adverse childhood experiences. A trauma-informed approach to care (TIC) has potential to enhance care and outcomes; however, literature regarding cancer-related TIC is limited. Accordingly, the objective of this scoping review was to identify what is known from existing literature about trauma-informed approaches to cancer care in Canada and the United States. A scoping review (using Arksey and O'Malley's (2005) framework) was conducted. The PsycINFO, CINAHL, MEDLINE (Ovid), Embase (Ovid), and Scopus databases, key journals, organizations, and reference lists were searched in February 2022. In total, 124 sources met the review criteria and 13 were included in the final review. Analysis included a basic descriptive summary and deductive thematic analysis using conceptual categories. Theorizations, applications, effectiveness, and feasibility of TIC were compiled, and gaps in TIC and recommendations for TIC were identified. TIC appeared to be growing in popularity and promising for improving cancer outcomes; however, gaps in the theorization, effectiveness, and feasibility of TIC persisted. Many recommendations for the application of TIC were not issued based on a strong body of evidence due to a lack of available literature. Further research is required to develop evidence-based recommendations regarding TIC related to cancer. A systematic review and meta-analysis would be warranted upon literature proliferation.

Breastfeeding experiences of patients in baby-friendly certified hospital settings: protocol for a scoping review.

INTRODUCTION: The Baby-friendly Hospital Initiative is a global programme that is meant to support breastfeeding within organisations. Most of the current literature is focused on implementation and uptake of the programme; however, little is known about the patient experience of breastfeeding within these settings. By exploring this current gap in the literature, we may discover important contextual elements of the breastfeeding experience. The objective of this protocol is to provide a framework for a scoping review where we aim to understand the extent and type of evidence in relation to the patient experience of breastfeeding in Baby-friendly Hospital Initiative (BFHI)-certified settings. METHODS AND ANALYSIS: The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. The databases to be searched for relevant literature include MEDLINE, Embase, PsycINFO, CINAHL and Scopus in April 2023. A grey literature scan will include reviewing documents from professional organisations/associations. For all sources of evidence that meet the inclusion criteria, data will be extracted and presented in a table format. The results of the search and the study inclusion process will be reported in full in the final scoping review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Participants in this review will include any individual who delivered their baby in a BFHI-certified setting. Exploring the patient experience will involve reviewing their subjective perceptions of events related to breastfeeding. These events must occur in a BFHI-certified hospital, and therefore, home births and other outpatient settings will be excluded. ETHICS AND DISSEMINATION: Ethical approval is not required for this scoping review protocol or the final review. Knowledge gained from this research will be disseminated through the primary author's PhD dissertation work, as well as manuscript publications and conference presentations.

Enhanced transformation efficiency in Treponema denticola enabled by SyngenicDNA-based plasmids lacking restriction-modification target motifs.

Oral spirochetes are among a small group of keystone pathogens contributing to dysregulation of tissue homeostatic processes that leads to breakdown of the tissue and bone supporting the teeth in periodontal disease. Additionally, our group has recently demonstrated that Treponema are among the dominant microbial genera detected intracellularly in tumor specimens from patients with oral squamous cell carcinoma. While over 60 species and phylotypes of oral Treponema have been detected, T. denticola is one of the few that can be grown in culture and the only one in which genetic manipulation is regularly performed. Thus, T. denticola is a key model organism for studying spirochete metabolic processes, interactions with other microbes, and host cell and tissue responses relevant to oral diseases, as well as venereal and nonvenereal treponematoses whose agents lack workable genetic systems. We previously demonstrated improved transformation efficiency using an Escherichia coli-T. denticola shuttle plasmid and its utility for expression in T. denticola of an exogenous fluorescent protein that is active under anaerobic conditions. Here, we expand on this work by characterizing T. denticola Type I and Type II restriction-modification (R-M) systems and designing a high-efficiency R-M-silent "SyngenicDNA" shuttle plasmid resistant to all T. denticola ATCC 35405 R-M systems. Resequencing of the ATCC 33520 genome revealed an additional Type I R-M system consistent with the relatively low transformation efficiency of the shuttle plasmid in this strain. Using SyngenicDNA approaches, we optimized shuttle plasmid transformation efficiency in T. denticola and used it to complement a defined T. denticola ΔfhbB mutant strain. We further report the first high-efficiency transposon mutagenesis of T. denticola using an R-M-silent, codon-optimized, himarC9 transposase-based plasmid. Thus, use of SyngenicDNA-based strategies and tools can enable further mechanistic examinations of T. denticola physiology and behavior.

Carbohydrate restriction and lactate transporter inhibition in a mouse xenograft model of human prostate cancer.

UNLABELLED: What's known on the subject? and What does the study add? It is known that both lactate inhibition and carbohydrate restriction inhibit tumour growth. What is unknown is whether the two work synergistically together. This study adds that though the combination of lactate inhibition and carbohydrate restriction did not synergistically slow tumour growth in our model, we confirmed that carbohydrate restriction started after tumour inoculation slowed tumour growth. Moreover, lactate inhibition resulted in changes in the tumour microenvironment that may have implications for future metabolic targeting of prostate cancer growth. OBJECTIVE: To determine if a no-carbohydrate ketogenic diet (NCKD) and lactate transporter inhibition can exert a synergistic effect on delaying prostate tumour growth in a xenograft mouse model of human prostate cancer. MATERIALS AND METHODS: 120 nude athymic male mice (aged 6-8 weeks) were injected s.c. in the flank with 1.0 × 10(5) LAPC-4 prostate cancer cells. • Mice were randomized to one of four treatment groups: Western diet (WD, 35% fat, 16% protein, 49% carbohydrate) and vehicle (Veh) treatment; WD and mono-carboxylate transporter-1 (MCT1) inhibition via α-cyano-4-hydroxycinnamate (CHC) delivered through a mini osmotic pump; NCKD (84% fat, 16% protein, 0% carbohydrate) plus Veh; or NCKD and MCT1 inhibition. • Mice were fed and weighed three times per week and feed was adjusted to maintain similar body weights. • Tumour size was measured twice weekly and the combined effect of treatment was tested via Kruskal-Wallis analysis of all four groups. Independent effects of treatment (NCKD vs WD and CHC vs Veh) on tumour volume were tested using linear regression analysis. • All mice were killed on Day 53 (conclusion of pump ejection), and serum and tumour sections were analysed for various markers. Again, combined and independent effects of treatment were tested using Kruskal-Wallis and linear regression analysis, respectively. RESULTS: There were no significant differences in tumour volumes among the four groups (P= 0.09). • When testing the independent effects of treatment, NCKD was significantly associated with lower tumour volumes at the end of the experiment (P= 0.026), while CHC administration was not (P= 0.981). However, CHC was associated with increased necrotic fraction (P < 0.001). CONCLUSIONS: Differences in tumour volumes were observed only in comparisons between mice fed a NCKD and mice fed a WD. • MCT1 inhibition did not have a significant effect on tumour volume, although it was associated with increased necrotic fraction.

Elucidation of a lingual detection mechanism for high-viscosity solutions in humans.

While perception of high-viscosity solutions (η > 1000 cP) is speculated to be linked to filiform papillae deformation, this has not been demonstrated psychophysically. Presently, just-noticeable-viscosity-difference thresholds were determined using the forced-choice staircase method and high-viscosity solutions (η = 4798-12260 cP) with the hypotheses that the tongue would be chiefly responsible for viscosity perception in the oral cavity, and that individuals with more, longer, narrower filiform papillae would show a greater acuity for viscosity perception. Subjects (n = 59) evaluated solutions in a normal, "unblocked" condition as well as in a "palate blocked" condition which isolated the tongue so that only perceptual mechanisms on the lingual tissue were engaged. Optical profiling was used to characterize papillary length, diameter, and density in tongue biopsies of a subset (n = 45) of participants. Finally, psychophysical and anatomical data were used to generate a novel model of the tongue surface as porous media to predict papillary deformation as a strain-detector for viscosity perception. Results suggest that viscosity thresholds are governed by filiform papillae features. Indeed, anatomical characterization of filiform papillae suggests sensitivity to high-viscosity solutions is associated with filiform papillae length and density (r = 0.68, p < 0.00001), but not with diameter. Modelling indicated this is likely due to a reciprocal interaction between papillae diameter and fluid shear stress. Papillae with larger diameters would result in higher viscous shear stress due to a narrower gap and stronger fluid-structure interaction, but a larger-diameter papilla would also deform less easily.

Women's experiences of navigating chronic pain within the context of living with an episodic disability.

OBJECTIVES: Of the 6.2 million Canadians aged 15 years or older who live with disability, 61% have disabilities that are not static or continuous. These dynamic conditions are known as episodic disabilities and many disproportionately experienced by women. Chronic pain is also a common feature associated with many episodic disabilities. The purpose of this article is to explore the experience of chronic pain for women living with episodic disabilities. METHODS: This qualitative study draws on the tenets of interpretive description. Thirty women, with one or more episodic disabilities and chronic pain, participated in a semi-structured interview and answered questions about their chronic pain levels, using Von Korff et al.'s graded chronic pain scale. RESULTS: Women experienced gendered treatment within the healthcare system and reported that they were frequently dismissed by their healthcare providers, most often physicians. Healthcare professionals' practices around pain assessment were another common challenge for women. Women who were able to access financial support from government disability programs were more likely to access allied health professionals. Many of the holistic strategies that women researched and used to treat chronic pain were self-enacted. While diet, exercise, and other self-care activities are general health promotion strategies for all, they were seen as essential aspects of living that helped women have control over chronic pain and modifying the course of their episodic disability. CONCLUSION: Living with chronic pain and an episodic disability is complex. The findings of this study present the impact that gendered treatment in the healthcare system has on women who live with an episodic disability and experience chronic pain. It is evident that the current system did not meet the needs of the women in our study and system changes could result in better experiences, more disclosure of alternative therapies, and increase women's agency in their care.

Surgical advances in the management of placenta accreta spectrum: establishing new expectations for operative blood loss.

OBJECTIVE: To evaluate whether the implementation of our surgical approach, referred to in the text as Linear Cutter Vessel Sealing System (LCVSS) technique, will improve perioperative outcomes in patients with placenta accreta spectrum (PAS), specifically by reducing blood loss and blood transfusion rates at the time of cesarean hysterectomy (C-HYST). The LCVSS technique integrates the following: (1) hysterotomy performed using the Linear Cutter, (2) no placental manipulation, (3) cauterization of anatomically prominent vascular anastomosis using the handheld vessel sealing system, and (4) completion of bladder dissection until the cervico-vaginal junction before ligation and division of uterine arteries. MATERIALS AND METHODS: This is a retrospective cohort study that analyzed perioperative outcomes in patients undergoing C-HYST for PAS at a tertiary care center from 1 July 2014 to 1 December 2019. Comparisons were performed between cases managed with the use of the LCVSS technique (designated as LCVSS cohort) and those managed without the use of the LCVSS technique (designated as no technique cohort). The primary outcomes were cumulative blood loss (CBL) and total perioperative blood transfusion of ≥4 and ≥6 units of PRBCs. The secondary outcomes were intra- and postoperative complications. Continuous and categorical variables were compared according to the sample size and distribution. Binary logistic regression analysis was performed to predict confounders for blood transfusion of ≥4 units of PRBCs. RESULTS: A total of 69 prenatally diagnosed PAS cases underwent C-HYST at the time of delivery. Forty-four cases that were performed using the LCVSS technique comprised the LCVSS cohort. The remaining 25 were marked as no technique cohort. CBL was significantly lower in the LCVSS cohort (1124 ml [300-4100] vs 3500 ml [650-10600]; p < .001). The rate of urinary tract injuries was similar (16%). The rate of postoperative complications and reoperation for intra-abdominal bleeding were lower but not significantly different in LCVSS cohort (9 vs 20% and 0 vs 8%, p = .26 and p = .12, respectively). There were no differences in neonatal outcomes. CONCLUSION: Implementation of this advanced surgical approach for PAS management resulted in reduced blood loss and blood transfusion rates in comparison with no technique cohort.