TrueNTH sexual recovery study protocol: a multi-institutional collaborative approach to developing and testing a web-based intervention for couples coping with the side-effects of prostate cancer treatment in a randomized controlled trial.

BACKGROUND: Over half of men who receive treatment for prostate suffer from a range of sexual problems that affect negatively their sexual health, sexual intimacy with their partners and their quality of life. In clinical practice, however, care for the sexual side effects of treatment is often suboptimal or unavailable. The goal of the current study is to test a web-based intervention to support the recovery of sexual intimacy of prostate cancer survivors and their partners after treatment. METHODS: The study team developed an interactive, web-based intervention, tailored to type of treatment received, relationship status (partnered/non-partnered) and sexual orientation. It consists of 10 modules, six follow the trajectory of the illness and four are theme based. They address sexual side effects, rehabilitation, psychological impacts and coaching for self-efficacy. Each includes a video to engage participants, psychoeducation and activities completed by participants on the web. Tailored strategies for identified concerns are sent by email after each module. Six of these modules will be tested in a randomized controlled trial and compared to usual care. Men with localized prostate cancer with partners will be recruited from five academic medical centers. These couples (N = 140) will be assessed prior to treatment, then 3 months and 6 months after treatment. The primary outcome will be the survivors' and partners' Global Satisfaction with Sex Life, assessed by a Patient Reported Outcome Measure Information Systems (PROMIS) measure. Secondary outcomes will include interest in sex, sexual activity, use of sexual aids, dyadic coping, knowledge about sexual recovery, grief about the loss of sexual function, and quality of life. The impact of the intervention on the couple will be assessed using the Actor-Partner Interaction Model, a mixed-effects linear regression model able to estimate both the association of partner characteristics with partner and patient outcomes and the association of patient characteristics with both outcomes. DISCUSSION: The web-based tool represents a novel approach to addressing the sexual health needs of prostate cancer survivors and their partners that-if found efficacious-will improve access to much needed specialty care in prostate cancer survivorship. TRIAL REGISTRATION: Clinicaltrials.gov registration # NCT02702453 , registered on March 3, 2016.

XUV-induced reactions in benzene on sub-10 fs timescale: nonadiabatic relaxation and proton migration.

Unraveling ultrafast dynamical processes in highly excited molecular species has an impact on our understanding of chemical processes such as combustion or the chemical composition of molecular clouds in the universe. In this article we use short (<7 fs) XUV pulses to produce excited cationic states of benzene molecules and probe their dynamics using few-cycle VIS/NIR laser pulses. The excited states produced by the XUV pulses lie in an especially complex spectral region where multi-electronic effects play a dominant role. We show that very fast τ ≈ 20 fs nonadiabatic processes dominate the relaxation of these states, in agreement with the timescale expected for most excited cationic states in benzene. In the CH3+ fragmentation channel of the doubly ionized benzene cation we identify pathways that involve structural rearrangement and proton migration to a specific carbon atom. Further, we observe non-trivial transient behavior in this fragment channel, which can be interpreted either in terms of propagation of the nuclear wavepacket in the initially excited electronic state of the cation or as a two-step electronic relaxation via an intermediate state.

Communication: XUV transient absorption spectroscopy of iodomethane and iodobenzene photodissociation.

Time-resolved extreme ultraviolet (XUV) transient absorption spectroscopy of iodomethane and iodobenzene photodissociation at the iodine pre-N4,5 edge is presented, using femtosecond UV pump pulses and XUV probe pulses from high harmonic generation. For both molecules the molecular core-to-valence absorption lines fade immediately, within the pump-probe time-resolution. Absorption lines converging to the atomic iodine product emerge promptly in CH3I but are time-delayed in C6H5I. We attribute this delay to the initial π → σ(*) excitation in iodobenzene, which is distant from the iodine reporter atom. We measure a continuous shift in energy of the emerging atomic absorption lines in CH3I, attributed to relaxation of the excited valence shell. An independent particle model is used to rationalize the observed experimental findings.

Spatial and temporal variation in the diet of the Pacific sand lance Ammodytes hexapterus in waters off the coast of British Columbia, Canada.

Variation in the diet of the Pacific sand lance Ammodytes hexapterus was examined in three years (2009-2011) at four sites in British Columbia, Canada. There were 12 major taxa of prey in diets, eight of which were Crustacea, with copepods being by far the dominant taxon in all 12 site-years. Of the 22 copepod taxa recorded, only Calanus marshallae and Pseudocalanus spp. occurred in all collections, and these two calanoid species dominated diets in terms of frequency of occurrence and total numbers of prey (Pseudocalanus spp. in most collections), and total prey biomass (C. marshallae in all collections). Based on an index of relative importance, C. marshallae was the primary prey at the two southerly sampling sites (Pine and Triangle Islands) and Pseudocalanus spp. at the two northerly sites (Lucy Island and S'Gang Gwaay). Based on an index of dietary overlap, the species composition of the copepod component of A. hexapterus diets overlapped very strongly at the northerly and the southerly pairs of sites in both a cold-water La Niña year (2009) and a warm-water El Niño year (2010), but overall there was more homogeneity amongst all four sites in the La Niña year.

Makisterone A:a 28-carbon hexahydroxy molting hormone from the embryo of the milkweed bug.

Makisterone A is the predominant ecdysone in the 96 +/- 4-hour-old embryo of the large milkweed bug and it is the first molting hormone with a C-24 alkyl substituent of the side chain to be isolated and identified from an insect. In addition, unknown compounds that may represent other C28 ecdysones were detected in very low concentrations. The milkweed bug could well possess a biosynthetic-metabolic pathway for C28 molting hormones instead of or in addition to known pathways for the C27 ecdysones.

Low incidence of plastics in food loads delivered to nestlings by a zooplanktivorous seabird over a 21-year period.

We quantified the amount of plastic found in food loads delivered to nestlings in Cassin's Auklet (Ptychoramphus aleuticus), a small, zooplanktivorous seabird, on Triangle Island, British Columbia, in 1996-2016. The density of plastic in surrounding waters is moderately high, yet few food loads contained any plastic (3 of 850), and none more than two pieces. That result accords well with previous observations on the other four North Pacific auklets (Aethia spp.), leading us to conclude that true auklets rarely transfer plastic to nestlings. However, many hatch-year Cassin's Auklets found dead in coastal British Columbia, Washington and Oregon during the mass mortality event of fall and winter 2014-15 had plastic in their ventriculi. We suggest that these plastic particles would have been obtained at sea after fledging, perhaps while the birds transited south through a region of high plastic density off the west coast of Vancouver Island, Washington and Oregon.

Few-femtosecond passage of conical intersections in the benzene cation.

Observing the crucial first few femtoseconds of photochemical reactions requires tools typically not available in the femtochemistry toolkit. Such dynamics are now within reach with the instruments provided by attosecond science. Here, we apply experimental and theoretical methods to assess the ultrafast nonadiabatic vibronic processes in a prototypical complex system-the excited benzene cation. We use few-femtosecond duration extreme ultraviolet and visible/near-infrared laser pulses to prepare and probe excited cationic states and observe two relaxation timescales of 11 ± 3 fs and 110 ± 20 fs. These are interpreted in terms of population transfer via two sequential conical intersections. The experimental results are quantitatively compared with state-of-the-art multi-configuration time-dependent Hartree calculations showing convincing agreement in the timescales. By characterising one of the fastest internal conversion processes studied to date, we enter an extreme regime of ultrafast molecular dynamics, paving the way to tracking and controlling purely electronic dynamics in complex molecules.

Selective reduction of human tumor cell populations by human granulocytes in vitro.

Human peripheral blood granulocytes at a 10:1 effector cell:target cell ratio were shown by an in vitro semiquantitative staining procedure to reduce the number of human tumor cells, but not that of normal cells. Microscopic observations revealed that this selective reduction of tumor cells by granulocytes was a function of both detachment and cytolysis. The cytotoxic effect of granulocytes on the tumor cells was confirmed by a quantitative 5-[125I]iodo-2-deoxyuridine release assay. The data indicate that human granulocytes at a relatively low effector:target cell ratio (10:1) have the capacity to recognize and destroy human tumor cells in vitro.

Rumen Microorganisms Decrease Bioavailability of Inorganic Selenium Supplements.

Despite the availability of selenium (Se)-enriched trace mineral supplements, we have observed low Se status in cattle and sheep offered traditional inorganic Se supplements. Reasons for this may include inadequate intake or low bioavailability of inorganic Se sources. The objective of this study was to determine whether rumen microorganisms (RMO) alter the bioavailability of Se sources commonly used in Se supplements. Rumen microorganisms were isolated from ewes (n = 4) and incubated ex vivo with no Se (control), with inorganic Na selenite or Na selenate, or with organic selenomethionine (SeMet). Total Se incorporated into RMO and the amount of elemental Se formed were determined under equivalent conditions. Incorporation of Se from Na selenite, Na selenate, or SeMet into RMO was measured as fold change compared with control (no added Se). Incorporation of Se into microbial mass was greater for SeMet (13.2-fold greater than no-Se control) compared with inorganic Se supplements (P = 0.02); no differences were observed between inorganic Na selenate (3.3-fold greater than no-Se control) and Na selenite (3.5-fold greater than no-Se control; P = 0.97). Formation of non-bioavailable, elemental Se was less for RMO incubated with SeMet compared with inorganic Se sources (P = 0.01); no differences were observed between Na selenate and Na selenite (P = 0.09). The clinical importance of these results is that the oral bioavailability of organic SeMet should be greater compared with inorganic Se sources because of greater RMO incorporation of Se and decreased formation of elemental Se by RMO.

Attosecond Hole Migration in Benzene Molecules Surviving Nuclear Motion.

Hole migration is a fascinating process driven by electron correlation, in which purely electronic dynamics occur on a very short time scale in complex ionized molecules, prior to the onset of nuclear motion. However, it is expected that due to coupling to the nuclear dynamics, these oscillations will be rapidly damped and smeared out, which makes experimental observation of the hole migration process rather difficult. In this Letter, we demonstrate that the instantaneous ionization of benzene molecules initiates an ultrafast hole migration characterized by a periodic breathing of the hole density between the carbon ring and surrounding hydrogen atoms on a subfemtosecond time scale. We show that these oscillations survive the dephasing introduced by the nuclear motion for a long enough time to allow their observation. We argue that this offers an ideal benchmark for studying the influence of hole migration on molecular reactivity.

XUV excitation followed by ultrafast non-adiabatic relaxation in PAH molecules as a femto-astrochemistry experiment.

Highly excited molecular species are at play in the chemistry of interstellar media and are involved in the creation of radiation damage in a biological tissue. Recently developed ultrashort extreme ultraviolet light sources offer the high excitation energies and ultrafast time-resolution required for probing the dynamics of highly excited molecular states on femtosecond (fs) (1 fs=10(-15) s) and even attosecond (as) (1 as=10(-18) s) timescales. Here we show that polycyclic aromatic hydrocarbons (PAHs) undergo ultrafast relaxation on a few tens of femtoseconds timescales, involving an interplay between the electronic and vibrational degrees of freedom. Our work reveals a general property of excited radical PAHs that can help to elucidate the assignment of diffuse interstellar absorption bands in astrochemistry, and provides a benchmark for the manner in which coupled electronic and nuclear dynamics determines reaction pathways in large molecules following extreme ultraviolet excitation.

Injury prevention counseling by pediatricians: a benefit-cost comparison.

OBJECTIVES: The American Academy of Pediatrics believes that health education, through office-based counseling, can contribute to childhood injury prevention. This report extends previously published work on the effectiveness of primary care-based counseling and compares the costs and estimated monetary value of the benefits of safety counseling targeting children ages 0 to 4 years. METHODS: We estimate the savings achievable with comprehensive childhood injury prevention counseling organized around the three Framingham Safety Surveys used in The Injury Prevention Program (TIPP) developed by the American Academy of Pediatrics. We verify the estimated savings by comparing them with the effects of pediatrician counseling from separate analyses of the most fully evaluated interventions--in child motor vehicle occupant injuries, burns, and falls. RESULTS: TIPP pediatrician injury counseling sessions between the ages of 0 and 4 years can achieve estimated savings of $880 per child or $80 per visit. If all 19.2 million children ages 0 to 4 years completed TIPP, we estimate that $230 million would be saved annually in medical spending, and injury costs would decline $3.4 billion. each dollar spent on TIPP childhood injury prevention targeting children ages 0 to 4 years returns nearly $13. CONCLUSION: TIPP pediatrician injury counseling is a cost-effective method of preventing childhood injuries and should be more widely adopted.

Human immunodeficiency virus/acquired immunodeficiency syndrome in pregnant women.

A pregnant woman experiences selective immunosuppression as a physiologic response to the presence of a genetically heterologous fetus. Case reports early in the acquired immunodeficiency syndrome (AIDS) epidemic suggested that adverse human immunodeficiency virus (HIV)-related clinical outcomes might be causally associated with pregnancy. A review of relevant published data indicates that: (1) Adverse clinical outcomes of pregnancy are common among HIV-infected pregnant women, but no studies to date have fully disentangled the many confounding factors. (2) HIV-related complications are common in pregnancy only among immunosuppressed (< 300 CD4+ cells/mm3) women. (3) The distinct effect of pregnancy on the expression of HIV infection cannot be evaluated in the absence of appropriately controlled observations. (4) Cofactors for perinatal transmission are poorly understood. (5) Research into the motives for reproductive decisions and behaviors is of critical importance for improving our health education and outreach efforts for high-risk women. (6) Adequate clinical treatment and prophylactic health care services must be made easily accessible and available to women at high risk of HIV disease. (7) Treatment with available antiviral and anti-Pneumocystis drugs is advisable for HIV-infected pregnant women with fewer than 300 to 350 CD4+ cells/mm3, though data to definitively guide therapeutic decision making are not available. (8) Large multicenter studies are needed to recruit patients and to retain them in sufficient numbers, allowing for better evaluation of the many variables determining clinical outcomes for HIV-infected mothers and their infants. The natural history of HIV in pregnant women must be studied to facilitate clinical decision making, and to design and implement interventions, including prevention (behavior change, vaccines) and treatment (chemotherapy, immunotherapy).

Patterns of childhood medical spending.

OBJECTIVE: To provide data on childhood medical spending. METHODS: This article is based on data released in 1991 through 1993 from the 1987 National Medical Expenditure Survey. The data were analyzed for 14 diagnostic categories. They excluded spending on nursing home and dental care. We inflated the National Medical Expenditure Survey expenditures to December 1993 dollars by means of annual medical spending per capita as a price index. RESULTS: Medical spending on children aged 0 to 21 years totaled $86 billion per year, 15% of all US medical care spending. The largest source of child medical spending was on live birth and pregnancy, at $19 billion, followed by injury, at $12 billion, and respiratory conditions, at $10 billion. Live birth and pregnancy were the largest contributor of hospital inpatient spending for children 0 to 21 years old. Injury accounted for more than half of the spending in emergency departments. One quarter of prescription spending was the result of respiratory conditions. CONCLUSIONS: Childhood medical spending for the three largest categories can be reduced through proved preventive measures. These analyses also show that prevention priorities differ by age group.

In vitro metabolism of 3beta-hydroxy-, and 3beta,14alpha-dihydroxy-[3alpha-3H]-5beta-cholest-7-en-6-one by the prothoracic glands of Manduca sexta.

alpha-Ecdysone (2beta,3beta,14alpha,22R,25-pentahydroxy-5beta-cholest-7-en-6-one) has been identified as the metabolism product of 3beta,14alpha-dihydroxy-5beta-cholest-7-en-6-one in isolated prothoracic glands of the tobacco hornworm, Manduca sexta. In contrast, 3beta-hydroxy-5beta-cholest-7-en-6-one is metabolized to 14-deoxy-alpha-ecdysone and a variety of intermediates all lacking the 14-hydroxy group. The results suggest that either the normal precursor for the synthesis of alpha-ecdysone by prothoracic glands is a sterol more highly oxygenated than cholesterol or that hydroxylation of a minimally oxygenated precursor at C-14 must precede introduction of the C-6 ketone and/or delta7 bond. The data further suggest that several alternative hydroxylation routes may exist for the latter steps of alpha-ecdysone biosynthesis.

In vitro metabolism of possible ecdysone precursors by the prothoracic glands of the tobacco hornworm, Manduca sexta.

3 beta, 14 alpha-Dihydroxy-5 alpha-7-en-6-one (5 alpha-ketodiol) (1) is metabolized by the prothoracic glands to 2,22-dideoxy-5 alpha-ecdysone (4) and 2-deoxy-5 alpha-ecdysone (3) but not to ecdysone (5) or any other 5 beta-metabolites. Similarly, 3 beta,5 alpha,14 alpha-trihydroxy-cholest-7-en-6-one (5 alpha-ketotriol) (8) is hydroxylated at C-22 and C-25 (9,10) of the side chain. However, 3 beta,14 alhpa-dihydroxy-cholesta-4,7-diene-6-one (ketodienediol) (11) is not metabolized. The absence of 2 beta-hydroxymetabolites for substrates (1) and (8) implies that hydroxylation at C-2 can occur only when the A-B rings are cis fused (5 beta-configuration). By contrast, the enzyme complexes that introduce hydroxyls at C-22 and C-25 do not exhibit a preference for cis over trans fusion and appraently cannot recognize the planar A-B ring configuration.

Maintaining perceptions of control: finding perceived control in low-control circumstances.

Three questions about the role of perceived control in coping with a major life stressor were addressed in a sample of 71 cancer patients. As expected, those with greater perceptions of control were less depressed, even when physical functioning, marital satisfaction, and negative affectivity were controlled for. Consistent with a compensatory model of control, it was more important for patients to believe that they could control daily emotional reactions and physical symptoms than the course of the disease. Patients who endorsed irrational beliefs had lower overall perceptions of control. The results indicated that even patients who were physically or psychosocially worse off were better adjusted if they had higher perceptions of control.

Reproductive hormone responses to resistance exercise.

To investigate if changes in circulating testosterone levels during isokinetic resistance exercise in women were similar to those during intense aerobic exercise and to examine concomitant changes in hemoconcentration, specific binding protein (sex hormone binding globulin-binding capacity), non-sex hormone binding globulin bound testosterone, luteinizing hormone, follicle-stimulating hormone, cortisol, and lactate, blood samples were obtained through an indwelling cannula at 30 and 15 min before exercise, after each of six exercises on upper and lower body muscle groups, and at 15 and 30 min after exercise in seven normal menstruating women. Investigations lasting approximately 60 min were performed in the early follicular phase beginning at 3.30 p.m. after two months of training with isokinetic ("Nautilus") equipment. Baseline testosterone and non-sex hormone binding globulin bound testosterone levels were significantly higher in subjects than in a control group. Increased total and non-sex hormone binding globulin bound testosterone was observed immediately prior to exercise with further increases late in exercise, then with proportional increases in cortisol and lactic acid. Sex hormone binding globulin-binding capacity increased before exercise. The testosterone increments exceeded hemoconcentration. Luteinizing hormone and follicle-stimulating hormone levels increased during exercise. The data suggest that origins of the exercise-associated testosterone increment are complex, resulting from hemoconcentration and specific gonadal and adrenal responses.

Negative recall bias and neuroticism: state vs trait effects.

Incidental recall of positive and negative trait adjectives was assessed in high and low N (neuroticism) Ss in whom depressed or neutral mood had been induced. Results indicated that the negative recall bias is an interactive function of trait vulnerability (as reflected by N scores) and current mood state. In the depressed mood condition, there was a trend for high N to be associated with relatively better recall of negative material, as expected. However, in neutral mood, high levels of N predicted relatively poorer recall of negative information. This unexpected finding was discussed in relation to previous research into mood-incongruent recall effects and sex differences.