The use of experimentally evolved coral photosymbionts for reef restoration.

The heat tolerance of corals is largely determined by their microbial photosymbionts (Symbiodiniaceae, colloquially known as zooxanthellae). Therefore, manipulating symbiont communities may enhance the ability of corals to survive summer heatwaves. Although heat-tolerant and -sensitive symbiont species occur in nature, even corals that harbour naturally tolerant symbionts have been observed to bleach during summer heatwaves. Experimental evolution (i.e., laboratory selection) of Symbiodiniaceae cultures under elevated temperatures has been successfully used to enhance their upper thermal tolerance, both in vitro and, in some instances, following their reintroduction into corals. In this review, we present the state of this intervention and its potential role within coral reef restoration, and discuss the next critical steps required to bridge the gap to implementation.

Describing the decision process of post-operative opioid and pain prescribing patterns in orthopedic and general surgeons.

OBJECTIVE: To describe the post-operative opioid prescribing behaviors of orthopedic and general surgeons through the use of the Integrated Behavioral Model (IBM), and subsequently the steps and logic used by providers in determining post-operative pain prescriptions. DESIGN: This study was a prospective, cross-sectional, cohort study utilizing qualitative methods consisting of semistructured interviews. Data were analyzed using thematic analysis to categorize and identify themes to describe prescriber behavior. SETTING: All participants were from a regional health system in central Appalachia. PATIENTS AND PARTICIPANTS: Mixed population of orthopedic and general surgeons who completed residency training and performed nontraumatic procedures. MAIN OUTCOME MEASURE: Categorization and identification of themes within the constructs of the IBM that described surgeon opioid prescribing. RESULTS: Fifteen surgeons participated in this study. Themes were identified within the context of the IBM. Attitudes by surgeons consisted of blame toward the government, a lack of personal screening of patients, and a theme of the abusing population of patients only being a small group. Norms were identified that included prescribing based on a standard prescribing set, realization of patient fear, and the idea of past mentality. Surgeons believed in their ability to prescribe responsibly and conservatively. CONCLUSIONS: The prescribing patterns of surgeons and their keenness to assess patients for opioid abuse vary. Most surgeons did not actively participate in screening activities but rely on ancillary staff. Surgeons utilize federal and state laws to back prescribing patterns and thwart patient attempts for additional medications. Prescribers maintain a sense of self-confidence with their own knowledge and ability to taper and keep patients from becoming reliant on opioid prescribing.

Impact of state legislation in Tennessee on opioid prescribing practices of orthopedic surgeons.

OBJECTIVE: Post-operative patients are at increased risk of becoming chronic users of opioids, and overprescribing can lead to abuse and diversion. Though data have shown a decrease in opioid prescriptions nationally, limited studies have specifically evaluated the influence of state legislation on this trend. This study aimed to assess the impact of legislation in the state of Tennessee on opioid prescribing amongst orthopedic surgeons. DESIGN: This retrospective cohort analysis evaluated patients who received opioids post-orthopedic surgery before and after the state legislation was passed. SETTING: A community teaching hospital. PATIENTS AND PARTICIPANTS: Two hundred and three post-orthopedic surgery patients were included, with 101 in the preleg-islation and 102 in the post-legislation groups. INTERVENTIONS: State legislation in Tennessee limiting amounts of prescribed opioids went into effect in July 2018. MAIN OUTCOME MEASURE(S): The primary outcome was total morphine milligram equivalents (MMEs) prescribed, with secondary outcomes of days' supply, dosage units, and MME per day. RESULTS: Orthopedic surgery patients in the post-legislation arm were prescribed significantly fewer MME than those in the prelegislation arm (median MME 375 vs. 562.5; p < 0.001). Prescription days' supply, number of dosage units, and MME per day were also significant lower in the post-legislation group. CONCLUSIONS: After orthopedic surgery, patients in the post-legislation arm were prescribed a median 187.5 MME less than those in the prelegislation arm. Our findings suggest that state opioid legislation is associated with a reduction in the amount of opioids prescribed in certain orthopedic surgery patients, though further studies evaluating adequacy of pain control are warranted.

Tandem postsynthetic modification of metal-organic frameworks using an inverse-electron-demand Diels-Alder reaction.

A postsynthetic modification (PSM) scheme for metal-organic frameworks (MOFs) has been developed using a tetrazine-based "Click" reaction. It was found that the efficacy of this modification procedure was dependent on the MOF topology and, in the case of an isoreticular MOF (IRMOF) system, required the formation of a mixed-ligand IRMOF with a suitable ratio of 1,4-benzenedicarboxylate (BDC) and an olefin-tagged BDC derivative. On the basis of the versatile use of tetrazine "Click" chemistry in bioconjugate chemistry, we expect that this scheme will prove to be a useful reaction for preparing functionalized materials, including MOFs.

Engaging student pharmacists to improve Hospital Consumer Assessment of Health Care Providers and Systems scores.

INTRODUCTION: Student pharmacists have historically served in shadowing roles for their experiential training at our institution. However, engaging students through active learning assignments has the potential to benefit both the student and the institution. The purpose of this project was to evaluate the impact of student pharmacists on Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) scores, a direct reflection of patient satisfaction within the hospital. METHODS: In a four-month quality-improvement pilot project, student pharmacists were given active learning assignments directed at helping patients understand the purpose and side effects of their medications. Patients with hospital-initiated medications were provided with medication cards via student pharmacist-run counseling programs. The primary outcome was top response ("always") in medication-related HCAHPS scores. Secondary outcomes included scores on individual questions, number of medication education encounters, number of interventions, cost savings, and student feedback. RESULTS: There were 482 medication education encounters. The top response for all medication-related HCAHPS scores improved by 14% (49% to 63%). Top response regarding medication indication increased 23% (63% to 86%). There were 552 interventions accepted, projecting a savings of $135,658. The top score on student evaluations of the practice site increased 20% (69% to 89%). CONCLUSIONS: Student pharmacists can have a meaningful impact on medication-related HCAHPS scores. Additionally, student pharmacists benefit from active learning opportunities by providing and improving patient care leading to a more meaningful experience.

Chemically crosslinked isoreticular metal-organic frameworks.

Herein we report the synthesis of canonical isoreticular metal-organic frameworks (IRMOFs) containing interligand crosslinks. Chemically crosslinking two molecules of 2-amino-1,4-benzene dicarboxylic acid (NH2-BDC) gives ligands that readily form IRMOF-1 analogs, producing crosslinked MOFs that may be designed to have novel properties.

Relations between Short-term Memory Deficits, Semantic Processing, and Executive Function.

BACKGROUND: Previous research has suggested separable short-term memory (STM) buffers for the maintenance of phonological and lexical-semantic information, as some patients with aphasia show better ability to retain semantic than phonological information and others show the reverse. Recently, researchers have proposed that deficits to the maintenance of semantic information in STM are related to executive control abilities. AIMS: The present study investigated the relationship of executive function abilities with semantic and phonological short-term memory (STM) and semantic processing in such patients, as some previous research has suggested that semantic STM deficits and semantic processing abilities are critically related to specific or general executive function deficits. METHOD AND PROCEDURES: 20 patients with aphasia and STM deficits were tested on measures of short-term retention, semantic processing, and both complex and simple executive function tasks. OUTCOME AND RESULTS: In correlational analyses, we found no relation between semantic STM and performance on simple or complex executive function tasks. In contrast, phonological STM was related to executive function performance in tasks that had a verbal component, suggesting that performance in some executive function tasks depends on maintaining or rehearsing phonological codes. Although semantic STM was not related to executive function ability, performance on semantic processing tasks was related to executive function, perhaps due to similar executive task requirements in both semantic processing and executive function tasks. CONCLUSIONS: Implications for treatment and interpretations of executive deficits are discussed.

Functional tolerance in an isoreticular series of highly porous metal-organic frameworks.

A series of highly porous University of Michigan Crystalline Material (UMCM-1) type Zn-based metal-organic frameworks (MOFs) were synthesized from mono- and bi-functionalized benzenedicarboxylate (BDC) ligands. In total, 16 new functionalized UMCM-1 derivatives were obtained by a combination of pre- and postsynthetic functionalization. Through postsynthetic modification (PSM), amino-halo bifunctional MOFs were converted into amide-halo materials via solid-state acylation reactions. A series of bifunctional MOFs containing Cl, Br, and I groups revealed that PSM conversion is not affected by the size of the halide, only by the steric bulk of the reagent used in these solid-state organic transformations.

A disorder of executive function and its role in language processing.

R. Martin and colleagues have proposed separate stores for the maintenance of phonological and semantic information in short-term memory. Evidence from patients with aphasia has shown that damage to these separable buffers has specific consequences for language comprehension and production, suggesting an interdependence between language and memory systems. This article discusses recent research on aphasic patients with limited-capacity short-term memories (STMs) and reviews evidence suggesting that deficits in retaining semantic information in STM may be caused by a disorder in the executive control process of inhibition, specific to verbal representations. In contrast, a phonological STM deficit may be due to overly rapid decay. In semantic STM deficits, it is hypothesized that the inhibitory deficit produces difficulty inhibiting irrelevant verbal representations, which may lead to excessive interference. In turn, the excessive interference associated with semantic STM deficits has implications for single-word and sentence processing, and it may be the source of the reduced STM capacity shown by these patients.