Understanding Myeloma-Related Information Needs and Communication Preferences Within Black American Communities: An Exploratory Study.

Myeloma is the third most common blood cancer and one of the most complex and expensive cancers to treat. Black Americans face health disparities related to myeloma incidence, age at diagnosis, access to novel treatments, and mortality. To help reduce health disparities among Black Americans through education and outreach, the Leukemia & Lymphoma Society has implemented its Myeloma Link initiative. In 2022, a formative, qualitative evaluation was conducted across the 15 U.S. cities that implemented Myeloma Link to better understand the information and communication needs and preferences of three groups: patients, community members, and primary care providers (PCPs). Data collection included interviews with eight patients, two focus groups with a total of ten community members, and interviews with six PCPs. Patients expressed wanting information about treatment experiences, including clinical trials, and emotional and peer support services, particularly from other Black American patients. Community members were largely unfamiliar with myeloma and desired outreach via trusted community organizations about disease signs and symptoms. Both groups discussed the importance of self-advocacy within the current healthcare system and wanted actionable messaging, rather than messaging leading with disparities statistics. PCPs described systemic capacity and time challenges in the context of needing to address more frequently encountered health conditions; nonetheless, PCPs welcomed information and brief trainings about myeloma diagnosis and treatment options, referrals to specialists, and how to improve care, prognosis, and caregiver support. Findings underscore the importance of outreach initiatives such as Myeloma Link to help meet these needs and reduce health disparities.

Development and validation of a new vision screening test algorithm for public use mobile application- A pilot study.

OBJECTIVES: To design and develop a simple vision test algorithm for mobile application and perform a pilot study to determine its validity and reliability as a tool for vision test in the community. METHODS: A simple visual acuity test algorithm in the form of a single letter E display was designed as the optotype for development of a mobile application. The standardised optotype is presented at random to test visual acuity for corresponding level of 3/60, 6/60, 6/18, and 6/12. The final result is auto-generated based on the classification of the WHO for visual impairment and blindness. The Snellen chart was used as the gold standard to determine its validity while five different users were involved to determine its inter-rater reliability. A pilot study was performed between April till November 2019, in the Universiti Sultan Zainal Abidin Medical Centre (UMC) at Kuala Nerus and Mooris Optometrist Centre at Marang, Terengganu. A total of 279 participants aged four years old and above were involved in this study. RESULTS: The highest sensitivity was found at the vision level cut-off point of 6/12 with the percentage of 92.7% and 86.8% for the right and left eye, respectively. The specificity was more than 89% for all vision levels in both eyes. The Krippendorff's alpha value for the inter-rater reliability was 0.87 and 0.83. CONCLUSION: The relatively high level of validity and reliability obtained indicate the feasibility of using the designed optotype to develop a valid and reliable mobile app for vision test. The app can be used to screen vision by nonmedical persons, at anytime and anywhere to help improve public awareness and capability to correctly determine their visual status.

Well-differentiated papillary mesothelioma of tunica vaginalis testis of unknown malignant potential: Sonographic appearance.

Paratesticular mesothelioma is a rare differential diagnosis in the presence of scrotal hydrocele. A 17-year-old boy presented with a 3-year history of progressive hydrocele. Sonography revealed a large left paratesticular mass within the hydrocele. Serum tumor markers were negative. Left hydrocelectomy was performed and pathological analysis of the epididymal mass revealed a well-differentiated papillary mesothelioma. We discuss the sonographic and pathological findings of this rare neoplasm.

Disrupted seasonal biology impacts health, food security and ecosystems.

The rhythm of life on earth is shaped by seasonal changes in the environment. Plants and animals show profound annual cycles in physiology, health, morphology, behaviour and demography in response to environmental cues. Seasonal biology impacts ecosystems and agriculture, with consequences for humans and biodiversity. Human populations show robust annual rhythms in health and well-being, and the birth month can have lasting effects that persist throughout life. This review emphasizes the need for a better understanding of seasonal biology against the backdrop of its rapidly progressing disruption through climate change, human lifestyles and other anthropogenic impact. Climate change is modifying annual rhythms to which numerous organisms have adapted, with potential consequences for industries relating to health, ecosystems and food security. Disconcertingly, human lifestyles under artificial conditions of eternal summer provide the most extreme example for disconnect from natural seasons, making humans vulnerable to increased morbidity and mortality. In this review, we introduce scenarios of seasonal disruption, highlight key aspects of seasonal biology and summarize from biomedical, anthropological, veterinary, agricultural and environmental perspectives the recent evidence for seasonal desynchronization between environmental factors and internal rhythms. Because annual rhythms are pervasive across biological systems, they provide a common framework for trans-disciplinary research.

Intramolecular direct aldol reactions of sugar 2,7-diketones: syntheses of hydroxylated cycloalka(e)nones.

A regio- and stereoselective intramolecular direct aldol reaction of 2,7-diketones derived from carbohydrates has been developed to construct cycloalkanones , which were dehydrated to obtain heavily oxygenated cycloalkenones .

Endocrine phenotype, reproductive success and survival in the great tit, Parus major.

A central goal in evolutionary ecology is to characterize and identify selection patterns on the optimal phenotype in different environments. Physiological traits, such as hormonal responses, provide important mechanisms by which individuals can adapt to fluctuating environmental conditions. It is therefore expected that selection shapes hormonal traits, but the strength and the direction of selection on plastic hormonal signals are still under investigation. Here, we determined whether, and in which way, selection is acting on the hormones corticosterone and prolactin by characterizing endocrine phenotypes and their relationship with fitness in free-living great tits, Parus major. We quantified variation in circulating concentrations of baseline and stress-induced corticosterone and in prolactin during the prebreeding (March) and the breeding season (May) for two consecutive years, and correlated these with reproductive success (yearly fledgling number) and overwinter survival in female and male individuals. In both years, individuals with high baseline corticosterone concentrations in March had the highest yearly fledgling numbers; while in May, individuals with low baseline corticosterone had the highest yearly reproductive success. Likewise, individuals that displayed strong seasonal plasticity in baseline corticosterone concentrations (high in March and low in May) had the highest reproductive success in each year. Prolactin concentrations were not related to reproductive success, but were positively correlated to the proximity to lay. Between-year plasticity in stress-induced corticosterone concentrations of males was related to yearly variation in food abundance, but not to overall reproductive success. These findings suggest that seasonally alternating directional selection is operating on baseline corticosterone concentrations in both sexes. The observed between-year consistency in selection patterns indicates that a one-time hormone sample in a given season can allow the prediction of individual fitness.

An alternative synthesis of 1,1'-bis-valienamine from D-glucose.

An alternative synthesis of 1,1'-bis-valienamine 5, which was demonstrated to be a potent trehalase inhibitor, has been achieved from d-glucose in 12 steps with 15% overall yield via enone 12 as the key intermediate, involving a direct aldol reaction of a glucose-derived diketone and a palladium-catalyzed allylic coupling reaction as the key steps.

Facile syntheses of (+)-gabosines A, D, and E.

(+)-Gabosines A (12), D (4), and E (5), which share the same trihydroxycyclohexenone skeleton, were synthesized from enone 11 as the common intermediate. The key building block 11 was accessed by an intramolecular aldol cyclization of a diketone derived from D-glucose (8).

Enantiospecific synthesis of pseudoacarviosin as a potential antidiabetic agent.

A pseudo-1,4'- N-linked disaccharide, pseudoacarviosin 5, was constructed via a key palladium-catalyzed coupling reaction of pseudoglycosyl chloride 8 (prepared from d-glucose via a novel direct intramolecular aldol addition in 12 steps) and pseudo-4-amino-4,6-dideoxy-alpha- d-glucose 9 (prepared from l-arabinose via an unusual trans-fused isoxazolidine-selective intramolecular nitrone-alkene cycloaddition in 11 steps). Pseudoacarviosin 5 has been shown to be a potent inhibitor of alpha-glucosidases, particularly the intestinal mucosal enzymes sucrase and glucoamylase of relevance to blood glucose control.

Intramolecular nitrile oxide-alkene cycloaddition of sugar derivatives with unmasked hydroxyl group(s).

[reaction: see text] Intramolecular nitrile oxide-alkene cycloaddition (INOC) of sugar derivatives with one to four free hydroxyl group(s) is reported. The INOC reaction, using chloramine-T, in the presence of silica gel, to generate nitrile oxides from oximes, proceeded smoothly to afford five- or six-membered carbocycles in good to excellent yields. This new methodology alleviates protection/deprotection steps and makes the synthetic route shorter and more efficient.

Cutaneous immune activity varies with physiological state in female house sparrows (Passer domesticus).

Many vertebrates show seasonality in immune defenses, perhaps because of trade-offs with other physiological processes. Trade-offs between reproduction and immune function have been well studied, but how other life cycle events such as molt affect immune function remains unclear. Here, we hypothesize that one possible explanation is that accumulative dissociated processes (e.g., resource deficits generated over the long term by physiological processes) can have delayed effects on immune activity. To test this hypothesis, we compared cutaneous immune responses in groups of captive female house sparrows (Passer domesticus) photoperiodically induced into six different life cycle stages. We predicted that if delayed trade-offs occur, immune activity would be reduced after a mature life state was reached (e.g., postmolt) and not just compromised when other tissues were actively growing (instantaneous trade-off). We found evidence for both types of trade-offs: immune responses were weakest in sparrows that had just completed postnuptial molt, but they were also weak in birds growing reproductive tissues or feathers. Birds in mature reproductive states or light molt had strong immune responses comparable with birds in a nonbreeding/nonmolting state. Altogether, our results indicate that immune activity in female house sparrows can be influenced by both instantaneous and delayed trade-offs.

Femoral overgrowth following plate fixation of the fractured femur in children.

INTRODUCTION: The purpose of this study is to determine the overgrowth phenomenon of the affected femur following plate fixation of femoral fractures in children. METHODS: 15 patients (aged between eight and 14 years old), who underwent open reduction and plate fixation for fractures of the femur, were assessed at two years postoperation for limb length discrepancy. Measurements were made using a computed tomography (CT) scanogram. Its association with age, limb dominancy and site of fracture were analysed. RESULTS: There were 12 boys and three girls. All children had femoral overgrowth of the injured femur, ranging from 0.1 cm to 2.0 cm with a mean of 1.15 cm. There was a significant correlation between age and bone overgrowth. Limb dominancy and site of fracture had no significant influence on femoral overgrowth. CONCLUSION: The amount of femoral overgrowth following fracture stabilisation with plate in children was minimal. It could still occur even without fracture overlapping during the healing process. The overgrowth was less in older subjects.

Food as a circadian Zeitgeber for house sparrows: the effect of different food access durations.

House sparrows (Passer domesticus) can synchronize their circadian rhythms of locomotion and feeding with times of periodic food availability. In contrast to most mammals, which synchronize only a specific part of their circadian system with feeding cycles and thus express two distinct activity components, house sparrows synchronize their circadian activity rhythms as a whole with the food zeitgeber. Previous results had indicated that feeding cycles act as comparatively weak zeitgebers for house sparrows. In the present study, therefore, we investigate whether feeding schedules are weak zeitgebers in general or whether their impact on the circadian system of the birds depends on the degree of food restriction. A detailed analysis of the synchronization pattern under the different experimental conditions should help to clarify whether house sparrows use a different mechanism for food-synchronization than mammals. House sparrows were kept in continuous dim light and exposed to different feeding schedules with daily food access durations ranging from 8 to 20 h. Many birds lost synchronization and exhibited free-running rhythms in locomotor and feeding activity when the daily food access duration was lengthened but became synchronized when the feeding duration was shortened. The interpretation that short food access durations represent stronger zeitgebers than long food access durations was supported by the occurrence of large negative phase-angle differences during long daily feeding schedules, contrasting with small and sometimes positive phase-angle differences under short food access durations. There were no indications that house sparrows possess a specific food-entrainable circadian oscillator as mammals do. Rather, periodic food availability seems to be a zeitgeber for the whole circadian system, which, hence, can be synchronized both by light and food. An explanation for such different mechanisms of food-synchronization is offered in the feeding ecology of these animals. Birds may evaluate the importance of a specific feeding schedule as a zeitgeber either from temporal information on the duration of the daily food access time or from energetic considerations. The phase-angle differences associated with the different feeding schedules and the maintenance of daily activity times may ensure an appropriate temporal integration of behavior with specific conditions. Non-synchronized birds exhibited masking-induced feeding activity, which might represent an alternative means of adjusting to feeding cycles when synchronization cannot occur.

Is there an endogenous tidal foraging rhythm in marine iguanas?

As strictly herbivorous reptiles, Galápagos marine iguanas graze on algae in the intertidal areas during low tide. Daily foraging rhythms were observed on two islands during 3 years to determine the proximate factors underlying behavioral synchrony with the tides. Marine iguanas walked to their intertidal foraging grounds from far-off resting areas in anticipation of the time of low tide. Foraging activity was restricted to daytime, resulting in a complex bitidal rhythm including conspicuous switches from afternoon foraging to foraging during the subsequent morning when low tide occurred after dusk. The animals anticipated the daily low tide by a maximum of 4 h. The degree of anticipation depended on environmental parameters such as wave action and food supply. "Early foragers" survived in greater numbers than did animals arriving later at foraging sites, a result indicating selection pressure on the timing of anticipation. The timing of foraging trips was better predicted by the daily changes in tabulated low tide than it was by the daily changes in actual exposure of the intertidal foraging flats, suggesting an endogenous nature of the foraging rhythms. Endogenous rhythmicity would also explain why iguanas that had spontaneously fasted for several days nevertheless went foraging at the "right" time of day. A potential lunar component of the foraging rhythmicity of marine iguanas showed up in their assemblage on intertidal rocks during neap tide nights. This may indicate that iguanas possessed information on the semi-monthly rhythms in tide heights. Enclosure experiments showed that bitidal foraging rhythms of iguanas may free run in the absence of direct cues from the intertidal areas and operate independent of the light:dark cycle and social stimuli. Therefore, the existence of a circatidal oscillator in marine iguanas is proposed. The bitidal foraging pattern may result from an interaction of a circadian system with a circatidal system. Food intake or related stimuli may be used as tidal zeitgebers in synchronizing the foraging rhythms of these reptiles under natural conditions.

Melatonin: generation and modulation of avian circadian rhythms.

The pineal organ and its hormone melatonin are significant components of avian circadian pacemaking systems. In songbirds, pinealectomy results in the abolition or destabilization of overt circadian rhythms such as the rhythm of locomotor activity, feeding, or body temperature. A stable rhythmicity can be restored either by reimplanting a pineal organ, by periodic injections or infusions of melatonin, or by applying melatonin rhythmically through the drinking water. Several results suggest that the pineal melatonin rhythm acts on at least one other oscillator within the circadian pacemaking system, presumably the SCN, which in turn, feeds back to the pineal. As described by the "Neuroendocrine Loop" and "Internal Resonance" models, overall pacemaker output thus depends on the relative strengths of the oscillations in the pineal and the SCN. Investigations on migratory birds have shown that the amplitude of the 24-h plasma melatonin rhythm is reduced during the migratory seasons compared with the nonmigratory seasons. According to the models mentioned above, such a reduced melatonin amplitude should result in a reduction in the degree of self-sustainment of the pacemaker as a whole. This, in turn, should facilitate adjustment to the altered Zeitgeber conditions encountered by these birds as a result of their own migratory flights. A seasonal reduction in melatonin amplitude also occurs in some high-latitude birds during midsummer and midwinter. Under such conditions a less self-sustained circadian pacemaker may enhance entrainability to weak zeitgeber conditions. These examples suggest that the properties of the circadian system may be adjusted to match the changing requirements for synchronization, and that this is achieved by altering the melatonin amplitude.

Adjustment of house sparrow circadian rhythms to a simultaneously applied light and food zeitgeber.

Periodic food availability has been shown to be an effective circadian zeitgeber in many vertebrates. It is still unclear, however, i) whether light-active species like most birds can synchronize with food cycles in the presence of a strong light-dark (LD) cycle and ii) whether it is common among non-mammalian vertebrates to use a separate circadian oscillator to synchronize with food cycles as most mammals do. We investigated these questions experimentally by exposing house sparrows simultaneously to two zeitgebers: light and food. The LD cycle was set at 1410 h; food was always available for 12 hour per day, but at different phases of the LD cycle. The effects of the two zeitgebers were analyzed by observing two behavioral outputs of the birds' circadian system, the rhythms of locomotion and feeding. The data revealed that light acted as the dominant zeitgeber in most conditions. Food cycles affected the phase of the behavioral rhythms of the birds only when the food was presented no later than 3 h after the onset of light. Apart from their synchronizing actions both light and food cycles also exerted direct (masking) effects on the behavioral rhythms of the birds. The results suggest that the circadian system of house sparrows can indeed adjust to two simultaneous environmental periodicities, i.e. light and food. We propose that light is the stronger zeitgeber and plays a 'permissive' role in determining the phases at which synchronization with food cycles comes into effect. We did not find evidence that the house sparrows' behavioral rhythms are controlled by a food-entrainable circadian oscillator that is distinct from the light-entrainable system as is the case in most mammals. The differences in the patterns of food synchronization and organization of the circadian system that appear to exist between different species can be interpreted in two ways: i) species of different phylogenetic origin (e.g., mammals versus birds) evolved different circadian system or ii) regardless of phylogeny, species with different ecological requirements show a specialization in their circadian organization which is adjusted to the importance of zeitgebers in nature.

Continuous melatonin administration accelerates resynchronization following phase shifts of a light-dark cycle.

Circadian rhythms of most passerine birds and some reptiles depend to a considerable extent on the presence of periodic melatonin, which is considered to be part of the central pacemaking system. Recent results on house sparrows have suggested that melatonin, apart from its periodic effects on the circadian system, may also exert effects derived from a constant action: Continuous melatonin applied through subcutaneously implanted silastic tubing enhanced the synchronization response to a low-amplitude light-dark zeitgeber, indicating some kind of sensitization to zeitgeber stimuli. In the present study we tested the prediction derived from these results, that speed of resynchronization after a phase shift of a light-cycle should be enhanced if melatonin is continuously administered. We found that, indeed, house sparrows required less time to resynchronize to an 8 h advance or delay phase shift of a low-amplitude light-dark cycle while carrying a silastic implant filled with melatonin than while carrying an empty implant. The effect is suggested to result from either one or a combination of the following mechanisms: (i) An increased circadian visual sensitivity, (ii) a diminished amplitude of the circadian oscillation, iii) an altered feedback of the locomotor activity to the oscillatory system.

Ignition of combustible/air mixtures by small radiatively heated surfaces.

Optical radiation as an ignition source in potentially explosive atmospheres was investigated for a number of explosive mixtures with respect to the most important case occurring in practice, i.e., absorption of the radiation by a solid target. Iron oxide was used as the target material. The combustibles were selected in compliance with the well-known temperature classes and apparatus groups to allow a useful graduation of the power limits to be applied.

Ten common mistakes to avoid as an independent consultant.

1. Enthusiasm, dedication, and hard work will not guarantee success as an independent consultant. 2. Careful market research, selecting a venture that promises clients and profit, should be the basis for deciding to start a consultant business, not just enthusiasm and emotional drive. 3. Business management practices of developing a business plan, careful price setting, and managing cash flow are essential for business survival. 4. Legal considerations, including the form of the business, contracts, and essential recordkeeping, must not be overlooked.