Rosindone revisited: a computational and photophysical study of 7-phenylbenzo[a]phenazine-5(7H)-one (PBP).

A reasonable gram quantity of the crystalline red dye 7-phenylbenzo[a]phenazine-5(7H)-one (PBP) was synthesised by the condensation of N-phenylbezene-1,2-diamine with 2-hydroxynaphthalene-1,4-dione in acetic acid (58% yield). The molecular structure of the dye, as determined by single-crystal X-ray crystallography, reveals a near planar phenazinone-like core, and an N-phenyl group twisted out of this plane by around 85°. The CO bond length of 1.241(2) Å is consistent with double bond character, which supports minor ground state zwitterionic character to the compound. The wavelength maximum for the observed partially structured low-energy absorption band is relatively insensitive to changes in the solvent polarity and polarizability. TD-DFT calculations predict that the long wavelength absorption envelope originates from localised π-π* transitions with no contribution from an n-π* state. The fluorescence quantum yield and singlet lifetime of the dye in MeCN are 0.12 and 3.0 ns, respectively. Fluorescence maxima are slightly sensitive to the solvent and changes in the Stokes shifts for a small series of alkanols were fitted to the Lippert-Mataga equation to afford a change in dipole moment of 8 ± 2 D. Calculations also reveal that full rotation of the N-phenyl group is severely restricted in the ground state (ΔEGS = 29 kcal mol-1) and in the first-excited singlet state (ΔEES = 34 kcal mol-1). The rocking back and forth of the phenyl group distorts the phenazinone-like backbone as it becomes co-planar and a minor solvent viscosity effect was observed in hydrogen bonding alkanol solvents.

Social hair pulling in captive rhesus macaques (Macaca mulatta).

Alopecia is common among captive populations of nonhuman primates. There are many potential causes of alopecia, including physiological conditions such as hormonal imbalance and infection, features of the captive environment such as housing type, ground substrate, and group density, as well as behavioral abnormalities such as self-plucking. A potential behavioral cause of alopecia in group-housed primates is social hair pulling, where one animal pulls hair from a conspecific. While social hair pulling has been conflated with overgrooming in some of the alopecia literature, other authors have categorized it as a form of aggression rather than a form of excessive grooming. In this study, we examined social hair pulling, grooming, and aggression within seven groups of rhesus macaques (Macaca mulatta) (N = 319). We took weekly 30-min behavioral observations on each group for one year to assess the patterns of hair pulling and grooming, which monkeys were receiving and initiating these behaviors, as well as aggression and other behaviors indicating dominance. We also assessed the amount of alopecia on each individual monthly. While grooming tended to be directed "up" the hierarchy (i.e., monkeys were more likely to groom animals of a higher rank than lower rank), most hair pulling was directed "down" the hierarchy. Further, hair pulling seldom co-occurred with aggressive behaviors, suggesting that it was not a form of aggression. Hair pulling also usually resulted in ingestion of the pulled hair. Hair pulling was correlated with alopecia; monkeys who were frequent recipients of hair pulling scored higher on monthly alopecia ratings than those who were less often observed having hair pulled. Our results suggest that social hair pulling is a behavior distinct from either grooming or aggressive behavior, and that it may contribute to alopecia in socially housed macaques.

Return of voiding function after greenlight photovaporisation of the prostate for a patient with giant bladder.

Giant bladder is a rare condition with varied definitions and causes. It can lead to complications such as urinary tract infections, retrograde urine reflux, pyelonephritis, renal damage and occasionally vascular obstruction. In this case report, we present a man in his 70s with massive urinary retention >7 L and severe bilateral hydronephrosis. The patient underwent a successful Greenlight photovaporisation of the prostate to address underlying bladder outlet obstruction. The surgical procedure resulted in significant improvement in urinary function, enabling the patient to live catheter and infection free, and without renal damage. This case demonstrates that bladder outlet surgery can be useful in selected cases of giant bladder to avoid complications of chronic catheterisation or ongoing retention.

Effects of Seasonality and Pregnancy on Hair Loss and Regrowth in Rhesus Macaques.

Several studies have examined the etiology of alopecia, or hair loss, in rhesus macaques. While outcomes differ across studies, some commonalities have emerged. Females, particularly pregnant females, show more alopecia than males, and alopecia follows a seasonal pattern. Much research has explored causes of hair loss; however, alopecia can result from lack of hair growth in addition to hair loss. To better understand how sex, reproductive state, and season affect alopecia, we followed 241 rhesus macaques (Macaca mulatta) in outdoor breeding groups over one year, recording both alopecia severity and presence of hair regrowth. We found that both alopecia and hair regrowth followed a seasonal pattern; alopecia was highest in spring and lowest in late summer, while regrowth started in spring and peaked in late summer. Reproductive state also correlated with both alopecia and hair growth. Females in their third trimester had the highest average level of alopecia and the lowest amount of hair regrowth. Regrowth resumed postpartum, regardless of whether females were rearing an infant. Results indicate that the seasonal pattern of alopecia is due in part to the seasonal limitations on hair regrowth, and that breeding, which also occurs seasonally in rhesus macaques, may further suppress hair regrowth.

Impact of Catheter-Drawn Blood Cultures on Patient Management: A Multicenter, Retrospective Cohort Study.

Background: Nosocomial bloodstream infections associated with intravascular catheters pose significant financial burden, morbidity, and mortality. There is much debate about whether or not blood cultures should be drawn through central venous catheters, and while guidelines advocate for catheter-drawn cultures when catheter infection is suspected, there is variable practice in this regard. Methods: We performed a retrospective cohort study assessing episodes of positive catheter-drawn blood cultures with concomitant negative percutaneously-drawn cultures in tertiary care hospitals in the United States and Spain. Results: We identified 143 episodes in 122 patients meeting inclusion criteria. Thirty percent of such episodes revealed growth of potential pathogens such as Staphylococcus aureus. Overall, 21% of follow-up percutaneously-drawn blood cultures obtained within 48 hours revealed growth of the same microbe after an episode of positive catheter-drawn blood cultures with negative concomitant percutaneously-drawn cultures (33% when potential pathogens were isolated; 16% when common skin contaminants were isolated). Patients with cultures growing pathogenic organisms were more likely to receive targeted antimicrobial therapy and have their catheters removed sooner. Conclusions: Many episodes of positive catheter-drawn blood cultures with concomitant negative percutaneously-drawn cultures lead to growth from percutaneously-drawn follow-up blood cultures. Thus, such initial discordant results should not be disregarded. Our findings advocate for a nuanced approach to blood culture interpretation, emphasizing the value of catheter-drawn blood cultures in clinical decision making and management.

"Shared decision-making" for prostate cancer screening: Is it a marker of quality preventative healthcare?

BACKGROUND: "Shared decision-making" (SDM) is a cornerstone of prostate cancer (PCa) screening guidelines due to tradeoffs between clinical benefits and concerns for over-diagnosis and over-treatment. SDM requires effort by primary-care-providers (PCP) in an often busy clinical setting to understand patient preferences with the backdrop of patient risk factors. We hypothesized that SDM for PCa screening, given its prominence in guidelines and practical challenges, may be associated with quality preventative healthcare in terms of other appropriate cancer screening and encouragement of other preventative health behaviors. METHODS: From the 2020 Behavioral Risk Factor Surveillance Survey, 50-75 year old men who underwent PSA screening were assessed for their participation in SDM, PCa and colorectal cancer (CRC) screening, and other preventative health behaviors, like vaccination, exercise, and smoking status. Adjusted odds ratio of likelihood of PSA testing as a function of SDM was calculated. Likelihoods of SDM and PSA testing as a function of preventative health behaviors were also calculated. RESULTS: Screening rates were 62 % for PCa and 88 % for CRC. Rates of SDM were 39.1 % in those with PSA screening, and 16.2 % in those without. Odds of PSA screening were higher when SDM was present (AOR = 2.68). History of colonoscopy was associated with higher odds of SDM (AOR = 1.16) and PSA testing (AOR = 1.94). Health behaviors, like regular exercise, were associated with increased odds of SDM (AOR = 1.14) and PSA testing (AOR = 1.28). History of flu vaccination (AOR = 1.29) and pneumonia vaccination (AOR = 1.19) were associated with higher odds of SDM. Those who received the flu vaccine were also more likely to have PSA testing (AOR = 1.36). Smoking was negatively associated with SDM (AOR = 0.86) and PSA testing (AOR = 0.93). Older age was associated with higher rates of PSA screening (AOR = 1.03, CI = 1.03-1.03). Black men were more likely than white men to have SDM (AOR = 1.6, CI = 1.59 - 1.6) and decreased odds of PSA testing (AOR = 0.94, CI = 0.94 - 0.95). CONCLUSIONS: SDM was associated with higher odds of PSA screening, CRC screening, and other appropriate preventative health behaviors. Racial disparities exist in both SDM and PSA screening usage. SDM may be a trackable metric that can lead to wider preference-sensitive care and improved preventative care.

The Surgical Management of Urolithiasis: A Review of the Literature.

The incidence of stone disease has increased significantly in the past 30 years, with a reported prevalence of 11% of the U.S. population in 2022, up from 9% in 2012 and 5.2% in 1994.1 While prevention is a vital aspect of management, many patients present with symptomatic urolithiasis requiring surgical management. Emerging advances in endoscopy and technology has led to a dynamic shift in the surgical management of stone disease. This paper will serve as a comprehensive review to inform urologic and non-urologic medical professionals alike, as well as the layperson, on the surgical treatment of nephrolithiasis, starting from the initial evaluation, laboratory and radiographic studies, and various surgical options. Additionally, the nuances of managing the pediatric and pregnant patient with nephrolithiasis will be explored. Using the most up-to-date urologic data, our aim is to provide a comprehensive resource for readers who interact with patients experiencing acute episodes of urolithiasis.

The Course of ADHD during Pregnancy.

OBJECTIVE: The aim of this study was to characterize the course of ADHD during pregnancy. METHOD: Women ages 18 to 45 were followed prospectively at <20 weeks, 24 weeks, and 36 weeks pregnant. Three groups emerged: women who discontinued, maintained, or adjusted their ADHD medications. ADHD symptoms were recorded using the AISRS. Anxiety, depression, stress, and functional impairment were monitored. RESULTS: A total of 25 women with ADHD were eligible for analysis. No significant difference observed between three groups in AISRS scores. Significant differences found between medication discontinuers vs adjusters for both mood and family functioning (EPDS, 5.3, p < .0001; WFIRS, 3.3, p = .0309). Significant differences also found between discontinuers vs maintainers for mood and family functioning (EPDS, 4.98, p = .0009; WFIRS, 3.09, p = .0197). CONCLUSION: This preliminary study provides novel insight into the course of ADHD during pregnancy, underscoring mood and family functioning as critical domains that may contribute to growing use of psychostimulants during pregnancy.

Perinatal depression screening using smartphone technology: Exploring uptake, engagement and future directions for the MGH Perinatal Depression Scale (MGHPDS).

Women may experience new-onset or worsening depressive disorders during pregnancy and the postpartum. If untreated, there may be detrimental consequences to the health and wellbeing of the woman and to her baby. There is a need for improved tools and approaches that can be easily and broadly implemented to effectively detect depression during the perinatal period. Early identification of depression during pregnancy is an important first step towards connecting women to treatment and preventing continued depression into the postpartum or beyond. This report provides preliminary findings from a pilot study of a digital screening app for perinatal depression expiring potential for app reach, engagement, and user demographics and mental health symptoms. With mainly passive recruitment efforts, we collected cross-sectional mental health data on over 700 women during the perinatal period, including women across over 30 countries. We report on mean depression scores among women during pregnancy and the postpartum as well as on constructs that are commonly comorbid with depression, including anxiety, sleep dysregulation, and perceived stress. Over half of the women during pregnancy and over 70% of women in the postpartum had a depression score indicative of clinical depression. Future research directions for this work and potential for public health impact are discussed, including longitudinal data collection and analyses of symptomology over time and embedding evidence-based digital therapeutics into the app as a means to increase access to mental health services.