"It's not safe for me and what would it achieve?" Acceptability of patient-referral partner notification for sexually transmitted infections to young people, a mixed methods study from Zimbabwe.

Partner notification (PN) is considered integral to the management of sexually transmitted infections (STI). Patient-referral is a common PN strategy and relies on index cases notifying and encouraging their partners to access treatment; however, it has shown limited efficacy. We conducted a mixed methods study to understand young people's experiences of PN, particularly the risks and challenges encountered during patient-referral. All young people (16-24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. PN slip uptake and partner treatment were recorded. Among 1807 young people (85.0% female) offered PN slips, 745 (41.2%) took up ≥1 PN slip and 103 partners (5.7%) returned for treatment. Most participants described feeling ill-equipped to counsel and persuade their partners to seek treatment. Between June and August 2021, youth researchers conducted in-depth interviews with 41 purposively selected young people diagnosed with an STI to explore their experiences of PN. PN posed considerable social risks, threatening their emotional and physical safety. Except for a minority in long-term, publicly acknowledged relationships, participants did not expect PN would achieve successful outcomes. Public health discourse, which constructs PN as "the right thing to do", influenced participants to adopt narratives that concealed the difficulties of PN and their unmet needs. Urgent interrogation is needed of whether PN is a suitable or constructive strategy to continue pursuing with young people. To improve the outcomes of preventing reinfection and onward transmission of STIs, we must consider developing alternative strategies that better align with young people's lived experiences.Plain language summary Partner notification is a public health strategy used to trace the sexual partners of people who have received a sexually transmitted infection (STI) diagnosis. It aims to interrupt the chains of STI transmission and prevent reinfection by treating both the person diagnosed and their sexual partners. The least effective but most common partner notification strategy used in many resource-limited settings is called "patient referral". This involves a sexual healthcare provider encouraging the person diagnosed to give a "partner notification slip" to their potentially exposed sexual partner/s and persuading them to access treatment. This research sought to better understand young people's experiences of partner notification, particularly the risks and challenges they faced during patient-referral.All young people (16-24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. Young people trained as researchers interviewed 41 young people who had received a STI diagnosis to explore their experiences of partner notification.Only a small number (5.7%) of the partners of those who took a slip attended the service for treatment. Most participants felt they did not have the preparation, skills, or resources to persuade their partners to seek treatment. Many described negative experiences during and after partner notification, including relationship breakdown, reputation damage, and physical violence.These findings suggest that we should reconsider if partner notification is suitable or effective for use with young people. We should explore alternative approaches that do not present risks to young people's social, emotional, and physical safety and well-being.

Newly diagnosed patients with advanced non-small cell lung cancer: A clinical description of those with moderate to severe depressive symptoms.

OBJECTIVES: The aims of this observational study were to 1) accrue newly diagnosed patients with advanced-stage non-small cell lung cancer (NSCLC) awaiting the start of first-line treatment and identify those with moderate to severe depressive symptoms and, 2) provide a clinical description of the multiple, co-occurring psychological and behavioral difficulties and physical symptoms that potentially exacerbate and maintain depressive symptoms. MATERIALS AND METHODS: Patients with stage IV NSCLC (N = 186) were enrolled in an observational study (ClinicalTrials.gov Identifier: NCT03199651) and completed the American Society of Clinical Oncology-recommended screening measure for depression (Patient Health Questionnaire-9 [PHQ-9]). Individuals with none/mild (n = 119; 64 %), moderate (n = 52; 28 %), and severe (n = 15; 8 %) depressive symptoms were identified. Patients also completed measures of hopelessness, generalized anxiety disorder (GAD) symptoms, stress, illness perceptions, functional status, and symptoms. RESULTS: Patients with severe depressive symptoms reported concomitant feelings of hopelessness (elevating risk for suicidal behavior), anxiety symptoms suggestive of GAD, and traumatic, cancer-specific stress. They perceived lung cancer as consequential for their lives and not controllable with treatment. Pain and multiple severe symptoms were present along with substantial functional impairment. Patients with moderate depressive symptoms had generally lower levels of disturbance, though still substantial. The most salient differences were low GAD symptom severity and fewer functional impairments for those with moderate symptoms. CONCLUSIONS: Depressive symptoms of moderate to severe levels co-occur in a matrix of clinical levels of anxiety symptoms, traumatic stress, impaired functional status, and pain and other physical symptoms. All of the latter factors have been shown, individually and collectively, to contribute to the maintenance or exacerbation of depressive symptoms. As life-extending targeted and immunotherapy use expands, prompt identification of patients with moderate to severe depressive symptoms, referral for evaluation, and psychological/behavioral treatment are key to maximizing treatment outcomes and quality of life for individuals with advanced NSCLC.

Emotion dysregulation in multiple sclerosis: Impact on symptoms of depression and anxiety.

BACKGROUND: There is consistent evidence for higher prevalence of affective disorders, specifically mood and anxiety disorders, in people with MS (PwMS). PURPOSE: The goal of this study was to examine the role of emotion dysregulation in explaining symptoms of depression and anxiety in PwMS. METHODS: Data from 100 PwMS and 98 community controls (CC) were analyzed. Participants completed survey measures assessing symptoms of depression and anxiety, difficulties in emotion regulation, general and health-related quality of life, and use of emotion regulation strategies during emotionally evocative situations in the previous two weeks. RESULTS: PwMS had higher scores on depression, endorsed greater difficulty regulating emotions, and reported lower health-related quality of life compared with CC. Higher scores on both measures of depression and anxiety were associated with difficulties in emotion regulation and greater use of maladaptive emotion regulation strategies. Additionally, emotion dysregulation - quantified via use of maladaptive strategies and difficulties in regulating emotions - mediated the effect of MS on symptoms of depression. CONCLUSIONS: Emotion dysregulation is associated with symptoms of depression and anxiety in PwMS. Given the malleability of this construct, this study underscores the importance of further investigating emotion dysregulation, and possibly adopting it as a surrogate endpoint in interventions targeting affective disorders in PwMS.

Towards a characterisation of the wild legume bitter vetch (Lathyrus linifolius L. (Reichard) Bässler): heteromorphic seed germination, root nodule structure and N-fixing rhizobial symbionts.

Lathyrus linifolius L. (Reichard) Bässler (Fabiaceae, bitter vetch) is a nitrogen (N) fixing species. A coloniser of low nutrient (N) soils, it supports biodiversity such as key moth and butterfly species, and its roots are known for their organoleptic and claimed therapeutic properties. Thus, the species has high potential for restoration, conservation, novel cropping and as a model species. The last because of its genetic synteny with important pulse crops. However, regeneration and functional attributes of L. linifolius remain to be characterised. Seeds of L. linifolius were characterised using physical, colorimetric and chemical data. Ultrastructural and functional characterisation of the N-fixing root nodules included immunolabelling with nifH protein antibodies (recognising the N-fixing enzyme, nitrogenase). Endosymbiotic bacteria were isolated from root nodules and characterised phylogenetically using 16S rRNA, nodA and nodD gene sequences. L. linifolius yielded heteromorphic seed of distinct colour classes: green and brown. Seed morphotypes had similar C:N ratios and were equally germinable (ca. 90%) after scarification at differing optimal temperatures (16 and 20 °C). Brown seeds were larger and comprised a larger proportion of the seed batch (69%). L. linifolius root nodules appeared indeterminate in structure, effective (capable of fixing atmospheric N) and having strains very similar to Rhizobium leguminosarum biovar viciae. The findings and rhizobial isolates have potential application for ecological restoration and horticulture using native seeds. Also, the data and rhizobial resources have potential applications in comparative and functional studies with related and socio-economically important crops such as Pisum, Lens and Vicia.

Experimental and computational modeling of interaction of kolaviron-kolaflavanone with aldehyde dehydrogenase.

Aldehyde dehydrogenases (ALDHs) are a diverse family of enzymes that catalyze the NAD(P)+-dependent detoxification of toxic aldehyde compounds. ALDHs are also involved in non-enzymatic ligand binding to endobiotics and xenobiotics. Here, the enzyme crucial non-canonical and non-catalytic interaction with kolaflavanone, a component of kolaviron, and a major bioflavonoid isolated from Garcinia kola (Bitter kola) was characterized by various spectroscopic and in silico approaches under simulated physiological condition. Kolaflavanone quenched the intrinsic fluorescence of ALDH in a concentration dependent manner with an effective quenching constant (Ksv) of 1.14 × 103 L.mol-1 at 25 °C. The enzyme has one binding site for kolaflavanone with a binding constant (Ka) of 2.57 × 104 L.mol-1 and effective Forster resonance energy transfer (FRET) of 4.87 nm. The bonding process was enthalpically driven. The reaction was not spontaneous and was predominantly characterized by Van der Waals forces and hydrogen bond. The flavonoid bonding slightly perturbed the secondary and tertiary structures of ALDH that was 'tryptophan-gated'. The interaction was regulated by both diffusion and ionic strength. Molecular docking showed the binding of kolaflavanone was at the active site of ALDH and the participation of some amino acid residues in the complex formation with -9.6 kcal mol-1 binding energy. The profiles of atomic fluctuations indicated the rigidity of the ligand-binding site during the simulation. With these, ALDH as a subtle nano-particle determinant of kolaviron bioavailability and efficacy is hereby proposed.

Characterization of compact-toroid injection during formation, translation, and field penetration.

We have developed a compact toroid (CT) injector system for particle refueling of the advanced beam-driven C-2U field-reversed configuration (FRC) plasma. The CT injector is a magnetized coaxial plasma gun (MCPG), and the produced CT must cross the perpendicular magnetic field surrounding the FRC for the refueling of C-2U. To simulate this environment, an experimental test stand has been constructed. A transverse magnetic field of ∼1 kG is established, which is comparable to the C-2U axial magnetic field in the confinement section, and CTs are fired across it. On the test stand we have been characterizing and studying CT formation, ejection/translation from the MCPG, and penetration into transverse magnetic fields.

Absolute calibration of neutron detectors on the C-2U advanced beam-driven FRC.

In the C-2U fusion energy experiment, high power neutral beam injection creates a large fast ion population that sustains a field-reversed configuration (FRC) plasma. The diagnosis of the fast ion pressure in these high-performance plasmas is therefore critical, and the measurement of the flux of neutrons from the deuterium-deuterium (D-D) fusion reaction is well suited to the task. Here we describe the absolute, in situ calibration of scintillation neutron detectors via two independent methods: firing deuterium beams into a high density gas target and calibration with a 2 × 107 n/s AmBe source. The practical issues of each method are discussed and the resulting calibration factors are shown to be in good agreement. Finally, the calibration factor is applied to C-2U experimental data where the measured neutron rate is found to exceed the classical expectation.

Development of a magnetized coaxial plasma gun for compact toroid injection into the C-2 field-reversed configuration device.

A compact toroid (CT) injector was developed for the C-2 device, primarily for refueling of field-reversed configurations. The CTs are formed by a magnetized coaxial plasma gun (MCPG), which consists of coaxial cylindrical electrodes and a bias coil for creating a magnetic field. First, a plasma ring is generated by a discharge between the electrodes and is accelerated by Lorenz self-force. Then, the plasma ring is captured by an interlinkage flux (poloidal flux). Finally, the fully formed CT is ejected from the MCPG. The MCPG described herein has two gas injection ports that are arranged tangentially on the outer electrode. A tungsten-coated inner electrode has a head which can be replaced with a longer one to extend the length of the acceleration region for the CT. The developed MCPG has achieved supersonic CT velocities of ∼100 km/s. Plasma parameters for electron density, electron temperature, and the number of particles are ∼5 × 10(21) m(-3), ∼40 eV, and 0.5-1.0 × 10(19), respectively.

Challenges and opportunities for quantifying roots and rhizosphere interactions through imaging and image analysis.

The morphology of roots and root systems influences the efficiency by which plants acquire nutrients and water, anchor themselves and provide stability to the surrounding soil. Plant genotype and the biotic and abiotic environment significantly influence root morphology, growth and ultimately crop yield. The challenge for researchers interested in phenotyping root systems is, therefore, not just to measure roots and link their phenotype to the plant genotype, but also to understand how the growth of roots is influenced by their environment. This review discusses progress in quantifying root system parameters (e.g. in terms of size, shape and dynamics) using imaging and image analysis technologies and also discusses their potential for providing a better understanding of root:soil interactions. Significant progress has been made in image acquisition techniques, however trade-offs exist between sample throughput, sample size, image resolution and information gained. All of these factors impact on downstream image analysis processes. While there have been significant advances in computation power, limitations still exist in statistical processes involved in image analysis. Utilizing and combining different imaging systems, integrating measurements and image analysis where possible, and amalgamating data will allow researchers to gain a better understanding of root:soil interactions.

Dwarf alleles differentially affect barley root traits influencing nitrogen acquisition under low nutrient supply.

Sustainable food production depends critically on the development of crop genotypes that exhibit high yield under reduced nutrient inputs. Rooting traits have been widely advocated as being able to influence optimal plant performance, while breeding-based improvements in yield of spring barley suggest that this species is a good model crop. To date, however, molecular genetics knowledge has not delivered realistic plant ideotypes, while agronomic trials have been unable to identify superior traits. This study explores an intermediate experimental system in which root traits and their effect on plant performance can be quantified. As a test case, four modern semi-dwarf barley varieties, which possess either the ari-e.GP or the sdw1 dwarf allele, were compared with the long-stemmed old variety Kenia under two levels of nutrient supply. The two semi-dwarf types differed from Kenia, exhibiting smaller stem mass and total plant nitrogen (N), and improved partitioning of mass and N to grain. Amongst the semi-dwarfs, the two ari-e.GP genotypes performed better than the two sdw1 genotypes under standard and reduced nutrient supply, particularly in root mass, root investment efficiency, N acquisition, and remobilization of N and mass to grain. However, lack of between-genotype variation in yield and N use efficiency indicated limited potential for exploiting genetic variation in existing varieties to improve barley performance under reduced nutrient inputs. Experimental approaches to test the expression of desirable root and shoot traits are scrutinized, and the potential evaluated for developing a spring barley ideotype for low nutrient conditions.

Root elongation, water stress, and mechanical impedance: a review of limiting stresses and beneficial root tip traits.

Root elongation in drying soil is generally limited by a combination of mechanical impedance and water stress. Relationships between root elongation rate, water stress (matric potential), and mechanical impedance (penetration resistance) are reviewed, detailing the interactions between these closely related stresses. Root elongation is typically halved in repacked soils with penetrometer resistances >0.8-2 MPa, in the absence of water stress. Root elongation is halved by matric potentials drier than about -0.5 MPa in the absence of mechanical impedance. The likelihood of each stress limiting root elongation is discussed in relation to the soil strength characteristics of arable soils. A survey of 19 soils, with textures ranging from loamy sand to silty clay loam, found that ∼10% of penetration resistances were >2 MPa at a matric potential of -10 kPa, rising to nearly 50% >2 MPa at - 200 kPa. This suggests that mechanical impedance is often a major limitation to root elongation in these soils even under moderately wet conditions, and is important to consider in breeding programmes for drought-resistant crops. Root tip traits that may improve root penetration are considered with respect to overcoming the external (soil) and internal (cell wall) pressures resisting elongation. The potential role of root hairs in mechanically anchoring root tips is considered theoretically, and is judged particularly relevant to roots growing in biopores or from a loose seed bed into a compacted layer of soil.

Neutron cross section measurements at ORELA for improved nuclear data and their application.

To support the Nuclear Criticality Safety Program, the Oak Ridge Electron Linear Accelerator (ORELA) has been used to measure the total and capture neutron cross sections of several nuclides in the energy range from 100 eV to -600 keV. Concerns about the use of existing cross section data in nuclear criticality calculations have been a prime motivator for the new cross-section measurements. Our new capture cross sections of aluminium, silicon, chlorine, fluorine and potassium in the energy range from 100 eV to 600 keV are substantially different from the cross sections in evaluated nuclear data files of ENDF/B-VI and JENDL-3.2.

Inhibition of tobacco mosaic virus replication in lateral roots is dependent on an activated meristem-derived signal.

Viral invasion of the root system of Nicotiana benthamiana was studied noninvasively with a tobacco mosaic virus (TMV) vector expressing the green-fluorescent protein (GFP). Lateral root primordia, which developed from the pericycle of primary roots, became heavily infected as they emerged from the root cortex. However, following emergence, a progressive wave of viral inhibition occurred that originated in the lateral-root meristem and progressed towards its base. Excision of source and sink tissues suggested that the inhibition of virus replication was brought about by the basipetal movement of a root meristem signal. When infected plants were inoculated with tobacco rattle virus (TRV) expressing the red-fluorescent protein, DsRed, TRV entered the lateral roots and suppressed the host response, leading to a reestablishment of TMV infection in lateral roots. By infecting GFP-expressing transgenic plants with TMV carrying the complementary GFP sequence it was possible to silence the host GFP, leading to the complete loss of fluorescence in lateral roots. The data suggest that viral inhibition in lateral roots occurs by a gene-silencing-like mechanism that is dependent on the activation of a lateral-root meristem.

Proper-name processing: are proper names pure referencing expressions?

Theoretical models of proper-name processing have been primarily derived from studies of people's names; however, they are thought to generalize to all classes of proper name. Five experiments are reported that use repetition priming to compare different classes of proper names. It was found that for people's names and landmark names, (a) production of a name in response to seeing a picture primed a subsequent familiarity decision to the same item's written name and (b) similarly, making a familiarity decision to an auditory presentation of a name primed a familiarity decision to the same item's written name. No comparable facilitation was found for the country-name stimuli. The presence of this specific facilitation was attributed to the nature of connectivity between conceptual and lexical representations. Theoretical views that proper names are unique, meaningless labels and that they are pure referencing expressions are evaluated.

Face recognition and emotional valence: processing without awareness by neurologically intact participants does not simulate covert recognition in prosopagnosia.

Covert face recognition in neurologically intact participants was investigated with the use of very brief stimulus presentation to prevent awareness of the stimulus. In Experiment 1, skin conductance response (SCR) to photographs of celebrity and unfamiliar faces was recorded; the faces were displayed for 220 msec and for 17 msec in a within-participants design. SCR to faces presented for 220 msec was larger and more likely to occur with familiar faces than with unfamiliar faces. Face familiarity did not affect the SCR to faces presented for 17 msec. SCR was larger for faces of good than for faces of evil celebrities presented for 17 msec, but valence did not affect SCR to faces displayed for 220 msec. In Experiment 2, associative priming was found in a face familiarity decision task when the prime face was displayed for 220 msec, but no facilitation occurred when primes were presented for 17 msec. In Experiment 3, participants were able to differentiate evil and good faces presented without awareness in a two-alternative forced-choice decision. The results provide no evidence of familiarity detection outside awareness in normal participants and suggest that, contrary to previous research, very brief presentation to neurologically intact participants is not a useful model for the types of covert recognition found in prosopagnosia. However, a response based on affective valence appears to be available from brief presentation.

The development of competency standards for specialist critical care nurses.

In defining the contemporary role of the specialist nurse it is necessary to challenge the concept of nursing as merely a combination of skills and knowledge. Nursing must be demonstrated and defined in the context of client care and include the broader notions of professional development and competence. This qualitative study sought to identify the competency standards for nurse specialists in critical care and to articulate the differences between entry-to-practice standards and the advanced practice of specialist nurses. Over 800 hours of specialist critical care nursing practice were observed and grouped into 'domains' or major themes of specialist practice using a constant comparison qualitative technique. These domains were further refined to describe attributes of the registered nurses which resulted in effective and/or superior performance (competency standards) and to provide examples of performance (performance criteria) which met the defined standard. Constant comparison of the emerging domains, competency standards and performance criteria to observations of specialist critical care practice, ensured the results provided a true reflection of the specialist nursing role. Data analysis resulted in 20 competency standards grouped into six domains: professional practice, reflective practice, enabling, clinical problem solving, teamwork, and leadership. Each of these domains is comprised of between two and seven competency standards. Each standard is further divided into component parts or 'elements' and the elements are illustrated with performance criteria. The competency standards are currently being used in several Australian critical care educational programmes and are the foundation for an emerging critical care credentialling process. They have been viewed with interest by a variety of non-critical care specialty groups and may form a common precursor from which further specialist nursing practice assessment will evolve.

Age-of-acquisition and cumulative frequency have independent effects.

Lewis (1999) argued that effects of age of acquisition (AoA) are entirely attributable to cumulative frequency. He reported an instance-based model in which the number of instances of the stimulus stored in memory predicts reaction time. We note four aspects of the literature on AoA that cannot be explained by this instance-based approach. Firstly, an effect of AoA has been observed in the absence of an effect of frequency. Secondly, an effect of AoA has been observed when cumulative frequency has been controlled. Thirdly, the effect of AoA is dependent on task. Fourthly, the effect of word frequency is dependent on stimulus modality. Lewis reported an experiment in which participants make a decision based on identity-specific semantic information to celebrity faces to demonstrate an effect of the number of instances in memory, which he interpreted as an effect of AoA. We note that effects of AoA have been found in lexical and perceptual tasks, but to date all attempts to demonstrate an advantage for early-acquired items in semantic classification tasks have failed. We conclude that the effects of AoA cannot be attributed solely to the effects of cumulative frequency.

Recognizing unfamiliar faces: the effects of distinctiveness and view.

Three experiments are reported in which the effects of viewpoint on the recognition of distinctive and typical faces were explored. Specifically, we investigated whether generalization across views would be better for distinctive faces than for typical faces. In Experiment 1 the time to match different views of the same typical faces and the same distinctive faces was dependent on the difference between the views shown. In contrast, the accuracy and latency of correct responses on trials in which two different faces were presented were independent of viewpoint if the faces were distinctive but were view-dependent if the faces were typical. In Experiment 2 we tested participants' recognition memory for unfamiliar faces that had been studied at a single three-quarter view. Participants were presented with all face views during test. Finally, in Experiment 3, participants' were tested on their recognition of unfamiliar faces that had been studied at all views. In both Experiments 2 and 3 we found an effect of distinctiveness and viewpoint but no interaction between these factors. The results are discussed in terms of a model of face representation based on an inter-item similarity in which the representations are view specific.

Contrasting effects of age of acquisition and word frequency on auditory and visual lexical decision.

In four experiments, we examined the effects of frequency and age of acquisition on auditory and visual lexical decision. Word frequency affected visual, but not auditory, lexical decision speed (Experiments 1 and 3). Age of acquisition affected lexical decision speed in both modalities (Experiments 2 and 4). We suggest that previous reports of effects of frequency on auditory lexical decision may be due to a confounding of frequency with age of acquisition, and we discuss the implications of these findings for theories of auditory and visual word recognition.