The Effect of Pulling and Twisting Forces on Chameleon Sequence Peptides.

Chameleon sequences are amino acid sequences found in several distinct configurations in experiment. They challenge our understanding of the link between sequence and structure, and provide insight into structural competition in proteins. Here, we study the energy landscapes for three such sequences, and interrogate how pulling and twisting forces impact the available structural ensembles. Chameleon sequences do not necessarily exhibit multiple structural ensembles on a multifunnel energy landscape when we consider them in isolation. The application of even small forces leads to drastic changes in the energy landscapes. For pulling forces, we observe transitions from helical to extended structures in a very small span of forces. For twisting forces, the picture is much more complex, and highly dependent on the magnitude and handedness of the applied force as well as the reference angle for the twist. Depending on these parameters, more complex and more simplistic energy landscapes are observed alongside more and less diverse structural ensembles. The impact of even small forces is significant, confirming their likely role in folding events. In addition, small forces exerted by the remaining scaffold of a protein may be sufficient to lead to the adoption of a specific structural ensemble by a chameleon sequence.

Development of an audio and computer cognitive behavioral therapy for depression in older adults.

Background: The purpose of this paper is to discuss the development of two novel technology-based interventions for depression in older adults while comparing older adults' preferences for audio-based and computer-based cognitive behavioral therapy for depressive symptoms. The audio program consisted of eight compact discs and a workbook while the computer program consisted of 11 modules of similar duration provided on a tablet PC. Both interventions consisted of the following topics: 1) introduction, 2) identifying and changing unhelpful thoughts, 3) addressing feelings, 4) relaxation, 5) engaging in pleasant events, 6) assertiveness, and 7) problem-solving. Methods: Fifty-one older adults were recruited from medical settings and rural communities and randomly assigned to an immediate treatment group (computer or audio) with minimal contact or a four-week minimal contact delayed treatment control condition. Results: Participants rated computer-based and audio-based cognitive behavioral therapy fairly equally, with 75% of those who received audio treatment and 85% of those who received computer-based treatment indicating benefits to their mood.Discussion: Computer-based or audio-based cognitive behavioral treatments may be valuable, low-cost modalities to deliver psychotherapy to older adults with depressive symptoms within a health care setting. Both modalities seem to be accepted by older adults.

Use of the Field-Based Silica Monitoring Technique in a Coal Mine: A Case Study.

Exposure to respirable crystalline silica (RCS) can cause serious and irreparable negative health effects, including silicosis and lung cancer. Workers in coal mines have the potential of being exposed to RCS found in dust generated by various mining processes. The silica content of respirable dust in one single mine can vary substantially over both time and location. The current monitoring approach for RCS relies on the use of traditional air sampling followed by laboratory analysis. Results generated using this approach are generally not available for several days to several weeks after sampling, and this delay prevents timely and effective intervention if needed. An alternate analytical method is needed to reduce the time required to quantify the RCS exposure of mine workers. The National Institute for Occupational Safety and Health (NIOSH) has developed a new method using commercially available portable infrared spectrometers for measuring RCS at the end of the sampling shift. This paper will describe the application of the new field-based RCS analytical process for coal mines, including the use of the new method with the existing Coal Mine Dust Personal Sampler Unit. In a case study conducted by NIOSH with a coal mine operator in West Virginia, field-based RCS analysis was completed at a mine site to evaluate the new technique. The RCS analysis results obtained by the field-based method in this case study showed sufficiently strong correlation with results obtained by the MSHA standard laboratory analysis method to allow the mine operator to use the field-based method for evaluating process improvements.

Gerontological social work and cardiac rehabilitation.

Cardiac rehabilitation is a setting in which integrating social work services can benefit older adults. Many cardiac rehabilitation patients endorse symptoms of stress and depression following a cardiac event, impeding their ability to participate fully in cardiac rehabilitation services or recover from a heart attack. Gerontologically trained social workers can improve the care of older adults with heart disease in a variety of ways and this paper discusses the potential roles social workers can play in enhancing care. Two examples demonstrating how community academic partnerships can lead to improved options for older adults following a heart attack are discussed. First, using a microsystems approach, social workers embedded within cardiac rehabilitation may improve patient quality of life, address social service needs, provide mental health treatment, and assist in the completion of standard cardiac rehabilitation assessments. Second, using a macrosystems approach, social workers can help communities by developing partnerships to establish infrastructure for new cardiac rehabilitation clinics that are integrated with mental health services in rural areas. Social workers can serve an important role in addressing the psychological or social service needs of cardiac rehabilitation patients while increasing access to care.

Clinical and Sonographic Evaluation of Bicortical Button for Proximal Biceps Tenodesis.

Use of a cortical button for proximal biceps tenodesis has demonstrated strength comparable to that of other types of fixation in biomechanical models, but few studies have evaluated the clinical outcome of such fixation. In the study reported here, 18 patients who underwent open subpectoral biceps tenodesis with a bicortical button were assessed, at minimum 12-month follow-up, with the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, a pain scale, physical examination, biceps supination strength testing, and ultrasonographic evaluation (to determine tenodesis integrity and proximity of the button to the axillary nerve). No patient had symptoms of axillary nerve damage, clinical deformity, or tenodesis failure. Mean DASH score was 15.15 (scale range: 0, none to 100, extreme difficulty), and mean pain score was 12.6 (scale range: 0, none to 100, worst pain). Seventy-eight percent of patients had no bicipital groove tenderness, 89% had full elbow range of motion, and 94% had full shoulder range of motion. Mean forearm supination strength of the operated arm (125.04 lb) was significantly (P = .01) less than that of the nonoperated arm (134.39 lb). Mean (SD) distance from button to posterior circumflex humeral artery was 18.17 (9.0) mm. The study results suggest that subpectoral biceps tenodesis with a bicortical button is a safe, stable procedure that results in excellent functional outcomes.

Lower extremity nerve entrapments in athletes.

Nerve entrapments are a potential cause of lower extremity pain in athletes. Signs and symptoms suggestive of nerve entrapment include anesthesia, dysesthesias, paresthesias, or weakness in the distribution of a peripheral nerve. The physical examination may reveal an abnormal neurologic examination finding in the distribution of a peripheral nerve, positive nerve provocative testing, and positive Tinel sign over the area of entrapment. Electrodiagnostic studies, radiographs, magnetic resonance imaging studies, and sonographic evaluation may assist with the diagnosis of these disorders. Initial treatment usually involves conservative measures, but surgical intervention may be required if conservative treatment fails. This article discusses the diagnosis and treatment of common lower extremity nerve entrapments in athletes. A high index of suspicion for nerve entrapments enables the clinician to identify these conditions in a timely manner and institute an appropriate management program, thus improving patient outcomes.