Social media engagement amongst 2017 colorectal surgery Tripartite Meeting attendees: updates on contemporary social media use.

AIM: Engagement by medical professionals with social media (SM) is increasing. Variation is noted in engagement between SM platforms and between surgical specialities and geographical regions. We aimed to study SM engagement by colorectal surgeons attending an international conference. METHOD: Surgeons were identified from the delegate list of the 2017 Annual Meeting of the American Society of Colon and Rectal Surgeons (ASCRS) and Tripartite Meeting (Seattle, Washington, USA). Delegates were searched on Twitter and LinkedIn for the presence of a matching profile. SM presence, activity, gender and geographical region were analysed. RESULTS: Two hundred and seventy (13.2%) surgeons had Twitter accounts and 994 (44.3%) had LinkedIn profiles. UK surgeons were more likely to be on Twitter than surgeons from elsewhere (23.4% vs 12.7%, P = 0.0072). Significant variation in SM membership between each geographical region was noted, with usage rates for Twitter of 18.1% in Europe, 14.4% in North America, 12.9% in South America, 4.3% in Oceania, 3.7% in Asia and 0% in Africa. A similar picture for LinkedIn is seen. The #ASCRS17 meeting saw the highest participation of users to date (979 participants, over 7000 individual tweets and nearly 14 million impressions). CONCLUSION: SM engagement by colorectal surgeons continues to increase. Significant geographical variation is noted, suggesting that SM's unique potential for education and networking may not yet be widely appreciated globally. Future work should include further analysis into tweet contents to gain insights and optimize the use of SM as an educational adjunct.

Contemporary use of social media by consultant colorectal surgeons.

AIM: There is evidence of significant growth in the engagement of UK health-care professionals with 'open' social media platforms, such as Twitter and LinkedIn. Social media communication provides many opportunities and benefits for medical education and interaction with patients and colleagues. This study was undertaken to evaluate the uptake of public social media membership and the characteristics of use of such media channels amongst contemporary UK consultant colorectal surgeons. METHOD: Colorectal surgeons were identified from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) national registry of colorectal mortality outcomes and were cross-referenced with the General Medical Council (GMC) register. Individuals were identified by manual searching on a number of social media platforms. Matching accounts were then examined to confirm ownership and to evaluate key markers of use. RESULTS: Six-hundred and eighteen individual consultant colorectal surgeons from 142 health authorities were studied (79.5% were ACPGBI members and 90.8% were male). Two-hundred and twenty-nine (37.1%) had LinkedIn profiles (37.7% male surgeons, 29.8% female surgeons; P = 0.2530). LinkedIn membership was significantly higher in ACPGBI members (P < 0.001) and in those with GMC registration before 1997 vs after this date (39% before 1997 vs 30% after 1997; P = 0.03). LinkedIn members had a mean of 62 connections (median = 22), and 19 (3.1%) surgeons had Twitter profiles with a mean of 82 (median = 16; range: 0-914) followers and their accounts were followed by a mean of 87 (median = 27; range: 0-642) persons. CONCLUSION: UK consultant colorectal surgeons are less engaged with social media than reported studies from other health-care professional groups. Further education and appropriate guidance on usage may encourage uptake and confidence, particularly in younger consultants.

Contemporary engagement with social media amongst hernia surgery specialists.

PURPOSE: Healthcare professional engagement is increasing. This study aims to identify levels of adoption and engagement of several social media platforms by a large international cohort of hernia surgery specialists. METHODS: Hernia specialists attending the 38th International Congress of the European Hernia Society were identified. A manual search was then performed on Twitter, ResearchGate, and LinkedIn to identify those who had named accounts. Where accounts were identified, data on markers of utilisation were assessed. RESULTS: 759 surgeons (88.5% male) from 57 countries were identified. 334 surgeons (44%) engaged with a social media platform. 39 (5.1%) had Twitter accounts, 189 (24.9%) had ResearchGate accounts and 265 (34.9%) had LinkedIn accounts. 137 surgeons (18.1%) had accounts on 2 or more social media platforms. There was no gender association with social media account ownership (p > 0.05). Engagement in one social media platform was associated with increased engagement and utilisation on other platforms; LinkedIn users were more likely to have Twitter accounts (p < 0.001) and ResearchGate profiles (p < 0.001). Surgeons on all three SM platforms were more likely to have high markers of engagement across all SM platforms (multiple outcomes, p < 0.05). Geographical variation was noted with UK and South American Surgeons being more likely to be present on Twitter than their counterparts (p = 0.031). CONCLUSIONS: The level of engagement with social media amongst Hernia surgeons is similar to other surgical specialities. Geographical variation in SM engagement is seen. Engagement with one SM platform is associated with presence on multiple platforms.

3-Hydroxyxanthine: transplacental effects and ontogeny of related sulfate metabolism in rats and mice.

The ontogeny of sulfate metabolism related to the metabolic activation of the carcinogenic purine N-oxide 3-hydroxyxanthine (3-OH-X) was studied in noninbred Sprague-Dawley rats. Sulfotransferase activity toward 3-OH-X was detectable in most fetal livers near term at about 25% of adult values and increased slowly after birth. This activity was also present in placentas. Compared to 3-OH-X sulfotransferase, sulfotransferase activity toward p-nitrophenol was lower in fetal livers and was not detected in placentas. Sulfohydrolase activity toward 3'-phosphoadenosine-5'-phosphosulfate was higher in fetal and newborn livers and in placentas than in adult liver. In a parallel transplacential carcinogenicity assay, a low but significant percentage of male rats exposed as fetuses to multiple high doses of 3-OH-X developed single liver carcinomas. After the lowest transplacental dose, the incidence of degenerative kidney disease in old male offspring was significantly higher than that in controls. In an assay with mice, (C57BL/6 X BALB/c)F1 mice exposed transplacentally to 3-OH-X experienced significantly greater perinatal morality and fewer lung adenomas among the surviviors at 20 months of age than did the controls.

Conversion of the oncogenic 1-methylguanine 3-oxide to 3-hydroxy-1-methylxanthine.

Deamination of the oncogenic 1-methylguanine 3-oxide occurs to a significant extent in rats to yield 3-hydroxy-1-methylxanthine and its metabolites. When 3-hydroxy-1-methylxanthine is administered, 1-methyl-8-methylthioxanthine can be recovered from urine and released from hepatic protein. No 1-methyl-8-methylthioguanine was detected in urine or bound to protein. There is no evidence of significant activation of 1-methylguanine 3-oxide by sulfotransferase, but deamination to the oncogenic 3-hydroxy-1-methylxanthine suffices to explain its oncogenicity.

Reduced P300 responses in criminal psychopaths during a visual oddball task.

BACKGROUND: Clinicians have long recognized that psychopaths show deficits in cognitive function, but there have been few experimental studies exploring these deficits. We present here the first in a series of event-related potential (ERP) experiments designed to elucidate and characterize the neural correlates of cognitive processes of psychopaths. METHODS: We recorded ERPs from a topographic array from 11 psychopathic and 10 nonpsychopathic prison inmates, assessed with the Hare Psychopathy Checklist-Revised, during performance of a visual oddball task. ERPs to target (25% of trials) and nontarget (75% of trials) visual stimuli were analyzed. RESULTS: Consistent with previous research, there were no group differences in the latency or amplitude of the ERPs for the nontarget stimuli. For nonpsychopaths, the P300 amplitude was larger when elicited by the target stimuli than when elicited by the nontarget stimuli. In contrast, psychopaths failed to show reliable P300 amplitude differences between the target and nontarget conditions. Psychopaths had a smaller amplitude P300 to target stimuli than did nonpsychopaths. In addition, the amplitude of the P300 was less lateralized in psychopaths than in nonpsychopaths. Psychopaths also had a larger centrofrontal negative wave (N550) during the target condition than did nonpsychopaths. CONCLUSIONS: The results of this study indicate that there are substantial differences between psychopaths and others in the processing of even simple cognitive tasks and provide support for information processing models of psychopathy.

An analysis of audio-visual crossmodal integration by means of event-related potential (ERP) recordings.

Crossmodal integration was studied in humans by presenting random sequences of auditory (brief noise bursts), visual (flashes), and audiovisual (simultaneous noise bursts and flashes) stimuli from a central location at irregular intervals between 600 and 800 ms. The subjects' task was to press a button to infrequent and unpredictable (P=0.15) target stimuli that could be either a more intense noise burst, a brighter flash, or a combination of the two. In accordance with previous studies, behavioral data showed that bimodal target stimuli were responded to much faster and were identified more accurately than the unimodal target stimuli. The neural basis of this crossmodal interaction was investigated by subtracting the ERPs to the auditory (A) and the visual (V) stimuli alone from the ERP to the combined audiovisual (AV) stimuli (i.e. interaction=AV-(A+V)). Using this approach, we replicated previous reports of both early (at around 40 ms) and late (after 100 ms) ERP interaction effects. However, it appears that the very early interaction effects can be largely accounted for by an anticipatory ERP that precedes both the unimodal and bimodal stimuli. In calculating the ERP interaction this slow shift is subtracted twice, resulting in an apparent shift of the opposite polarity that may be confounded with actual crossmodal interactions.

Transient spatial attention modulates distinct components of the auditory ERP.

We recorded ERPs to pairs of externally presented tones, T1 and T2, in the absence of attentional cues to determine whether attention is momentarily sustained at the location of a behaviourally relevant sound, and what effect this focusing of attention might have on the neural response to target stimuli. ERPs to T2 were more negative when the preceding T1 was presented on the same side of fixation than when T1 was presented on the opposite side of fixation. This negative difference consisted of an early, parietal phase and a later, frontocentral phase. These results confirm and extend previously reported effects of transient spatial attention on auditory ERPs, and they demonstrate that transient spatial attention has a distinct and robust effect on the early stages of stimulus processing in the auditory system.

Forensic aspects of sexual harassment.

Sexual harassment law presents a complex set of issues not only for lawyers but also for psychiatrists in their roles both as evaluators and clinicians. Judge Reinhardt of the US Court of Appeals for the 9th Circuit, summed up these complexities: "We tend these days, far more than in earlier times, to find our friends, lovers, and even mates in the workplace. We ... often discover that our interests and values are closer to those of our colleagues or fellow employees than to those of people we meet in connection with other activities. In short, increased proximity breeds increased volitional sexual activity." On the other hand, he notes that Title VII "entitles individuals to a workplace that is free from the evil of sexual intimidation or repression. It is frequently difficult to reconcile the two competing values." He goes on to ask, "When does a healthy constructive interest in romance become sexual harassment? To what extent is pursuit of a co-worker proper but of a subordinate forbidden? Is wooing or courting a thing of the past? Must a suitor cease his attentions at the first sign of disinterest or resistance? Must there be an express agreement before the person seeking romance may even hold the hand of the subject of his affection? Is it now verboten to steal a kiss? In the workplace? Everywhere? Under all circumstances or only some? Has the art of romantic persuasion lost its charm? Questions relating to love and sex are among the most difficult for society to answer." The US Supreme Court has stressed the need for common sense in evaluating cases of sexual harassment. Perhaps psychiatrists can play a sobering role in developing answers to these questions.

A stereochemical model of the transpeptidation complex.

Molecular models are proposed to describe the relative arrangement of aminoacyl and peptidyl tRNAs when bound to their respective A and P sites on the ribosome. The crystallographically determined structures of tRNAasp and tRNAphe have served as the models for these bound structures, while the imposed steric constraints for the model complexes were based on the results of published experimental data. The constructed models satisfy the stereochemical requirements needed for codon-anticodon interaction and for peptide bond formation. In this paper, the results of the complex containing tRNAphe as the A and P site bound transfer RNAs, is compared to a similarly constructed model which uses tRNAasp as the ribosome-bound transfer RNAs. The models have the following three major features: 1) the aminoacyl and peptidyl transfer RNAs assume an angle of approximately 45 degrees relative to each other; 2) in providing the proper stereochemistry for peptide bond condensation, a significant kink must be present in the messenger RNA between the A site and P site codons; and 3) a comparison of the two model complexes indicates that structural variations between the tRNAs or any allosteric transitions of the transfer RNAs associated with codon-anticodon recognition may be accommodated in the model by way of freedom of rotation about the phosphate backbone bonds in the mRNA between consecutive codons.

Synthesis and disposition of 14C-labelled gentian violet in F344 rats and B6C3F1 mice.

The synthesis of [phenyl-U-14C]gentian violet from [U-14C]benzene is described. The 14C-labelled dye was administered by gavage to groups of male and female F344 rats which were killed at 2, 4, 14, 24 or 36 hr after the single dose. Radioactivity was measured in urine, and determined in faeces, liver, kidney, fatty tissue, gonads and muscle by combustion analysis. Residues were maximal at 4 hr in liver, kidney, muscle and gonads, and in fat they reached a plateau after 24 hr. Depletion half-lives for male and female livers were 14.5 and 17.0 hr, respectively. The 14C-labelled dye was also administered in multiple doses by gavage to both sexes of F344 rats and B6C3F1 hybrid mice for 7 days. The highest residue level was found in fatty tissue of females of both species, with a highly significant sex difference (P less than 0.01). Significant sex differences were also noted for residue levels in kidney and muscle tissue from both species and in mouse liver. Bile collected from cannulated rats contained 5.7-6.4% of a single oral dose of the dye. The results suggest that gentian violet is absorbed from the gastro-intestinal tract to a greater extent than has been reported for other triphenylmethane dyes.

Neutral location cues and cost/benefit analysis of visual attention shifts.

The effects of location cuing on target responses can be examined by comparing informative and neutral cuing conditions. In particular, the magnitudes of costs of invalid location cuing and of benefits of valid location cuing can be determined by comparing invalid and valid cue responses to location-nonspecific neutral cue responses. Cost/benefit analysis is based on the assumption that neutral baseline measures reflect a general warning effect about the impending target's onset but no other specific target information. The experiments we report were carried out to determine the appropriateness of two baseline measures for cost/benefit analyses of direct (nonsymbolic) location cuing effects. We found that a multiple-cue baseline attenuated the benefits of valid cuing, and that a background-flash baseline arbitrarily attenuated costs or benefits depending on flash intensity. It is proposed that a background flash is the more suitable neutral cue because it is target-location-nonspecific, but that its intensity should be adjusted to elicit a target-onset warning signal of the same magnitude as the location cues with which it will be compared.

Electrophysiological evidence for the "missing link" in crossmodal attention.

Orienting attention involuntarily to the location of a sensory event influences responses to subsequent stimuli that appear in different modalities with one possible exception: orienting attention involuntarily to a sudden light sometimes fails to affect responses to subsequent sounds (e.g., Spence & Driver, 1997). Here we investigated the effects of involuntary attention to a brief flash on the processing of subsequent sounds in a design that eliminates stimulus-response compatibility effects and criterion shifts as confounding factors. In addition, the neural processes mediating crossmodal attention were studied by recording event-related brain potentials. Our data show that orienting attention to the location of a spatially nonpredictive visual cue modulates behavioural and neural responses to subsequent auditory targets when the stimulus onset asynchrony is short (between 100 and 300 ms). These findings are consistent with the hypothesis that involuntary shifts of attention are controlled by supramodal brain mechanisms rather than by modality-specific ones.

Posture in patients with shoulder overuse injuries and healthy individuals.

Assessment of posture is an integral component of patient evaluation with shoulder overuse injuries. However, the professional literature contains relatively few studies that have assessed the relationship between posture, function, and injury. The purpose of this study was to determine the relationship and differences in postural variables within and between subjects with overuse injuries to the shoulder of healthy subjects. Thirty patient subjects and 30 healthy subjects matched for age and gender were recruited. Scapular protraction and rotation, forward head position, midthoracic curvature, and passive humeral elevation in the plane of the scapula were measured randomly in standing. All measurement techniques were standardized and validated. Intrarater and interrater reliability for all clinical measures were established before data collection. Forward head position was significantly greater (p < .001) in the patient group than the healthy group; humeral elevation was significantly greater (p < .001) in the healthy group than in the patient group and in the uninvolved shoulders (p < .01) than the involved shoulders within the patient group. Scapular protraction, rotation, midthoracic curvature, and scapular symmetry were not significantly different between groups. Scapula protraction and rotation were significantly related (p < .05) in the patient group. No other postural variables were related. Conclusions regarding the influence of posture to shoulder injury are inconclusive based on several confounding variables that may have affected the outcome.

EEOC guidance on psychiatric disabilities: many problems, few workable solutions.

The EEOC recently issued "Enforcement Guidance" on psychiatric disabilities under the Americans with Disabilities Act. Although the Guidance provides clarification of a few issues involving mental disabilities under the ADA, in most respects the Guidance is problematic. For example, the Guidance suggests that the inability to get along with a supervisor or coworkers may constitute a disability under the ADA, that an employer may have to "accommodate" a disabled employee's misconduct, that an employer cannot require an employee to follow doctor's orders as a condition of employment, and that an employer may be obligated to modify work rules and procedures to accommodate a mentally disabled employee but is prohibited from explaining to coworkers why it is making such modifications. As the EEOC's Guidance exceeds or conflicts with the ADA in some respects and is largely unworkable in many respects, it remains to be seen how many courts will actually follow it.

Mental disabilities under the ADA: a management rights approach.

While numerous sources have focused on employee rights and employer obligations under the Americans with Disabilities Act, this article will emphasize employer rights with respect to mental disabilities under the ADA. Specifically, it addresses the ADA's definition of "mental disability," the right of employers to screen job applicants in spite of the ADA, the conditions under which an employer may require an employee to undergo a "fitness for duty" examination, and the limits of the duty to "reasonably accommodate" an employee with a mental disability.