A thiol-ene mediated approach for peptide bioconjugation using 'green' solvents under continuous flow.

Flow chemistry has emerged as an integral process within the chemical sector permitting energy efficient synthetic scale-up while improving safety and minimising solvent usage. Herein, we report the first applications of the photoactivated, radical-mediated thiol-ene reaction for peptide bioconjugation under continuous flow. Bioconjugation reactions employing deep eutectic solvents, bio-based solvents and fully aqueous systems are reported here for a range of biologically relevant peptide substrates. The use of a water soluble photoinitiator, Irgacure 2959, permitted synthesis of glycosylated peptides in fully aqueous conditions, obviating the need for addition of organic solvents and enhancing the green credentials of these rapid, photoactivated, bioconjugation reactions.

Double click macrocyclization with Sondheimer diyne of aza-dipyrrins for B-Free bioorthogonal imaging.

Sequential azide/diyne cycloadditions proved highly effective for the macrocyclization of a bis-azido aza-dipyrrin. Macrocyclic aza-dipyrrin could be produced in 30 min at rt in water with changes in fluorescence intensity and lifetimes measurable upon reaction. Live cell microscopy showed that aza-dipyrrins were suitable for confocal and STED super-resolution imaging and a bioorthogonal response to macrocyclization could be detected in cellular compartments. These results will encourage a broader examination of the sensing and imaging uses of aza-dipyrrins.

Continuous Flow Bioconjugations of NIR-AZA Fluorophores via Strained Alkyne Cycloadditions with Intra-Chip Fluorogenic Monitoring.

The importance of bioconjugation reactions continues to grow for cell specific targeting and dual therapeutic plus diagnostic medical applications. This necessitates the development of new bioconjugation chemistries, in-flow synthetic and analytical methods. With this goal, continuous flow bioconjugations were readily achieved with short residence times for strained alkyne substituted carbohydrate and therapeutic peptide biomolecules in reaction with azide and tetrazine substituted fluorophores. The strained alkyne substrates included substituted 2-amino-2-deoxy-α-D-glucopyranose, and the linear and cyclic peptide sequences QIRQQPRDPPTETLELEVSPDPAS-OH and c(RGDfK) respectively. The catalyst and reagent-free inverse electron demand tetrazine cycloadditions proved more favourable than the azide 1,3-dipolar cycloadditions. Reaction completion was achieved with residence times of 5 min at 40 °C for tetrazine versus 10 min at 80 °C for azide cycloadditions. The use of a fluorogenic tetrazine fluorophore, in a glass channelled reactor chip, allowed for intra-chip reaction monitoring by recording fluorescence intensities at various positions throughout the chip. As the Diels-Alder reactions proceeded through the chip, the fluorescence intensity increased accordingly in real-time. The application of continuous flow fluorogenic bioconjugations could offer an efficient translational access to theranostic agents.

The Role of Agonistic Striving in the Association Between Cortisol and High Blood Pressure.

OBJECTIVE: A social action theory of chronic stress proposes that agonistic striving (seeking to influence or control others) impairs cardiovascular health by magnifying the impact of high adversity-induced cortisol levels on blood pressure. We tested three predictions of social action theory: (1) the social action theory taxonomy of regulatory strivings characterizes young adults from high-adversity neighborhoods; (2) high cortisol levels predict high blood pressure more reliably in the subgroup with the agonistic striving profile than in subgroups with other profiles; (3) the association of higher cortisol and higher blood pressure with agonistic striving is not explained by negative affect (depressive symptoms/dysphoria, anger, hostility). METHODS: Participants were young adults (N = 198, mean [SD] age = 32 [3.4] years); 71% female; 65% black) from disadvantaged urban neighborhoods. Motive profiles (including agonistic strivings) were assessed using the Social Competence Interview. Cortisol levels were derived from saliva samples; blood pressure level was obtained during two days of ambulatory monitoring. Psychological measures of negative affect were assessed using questionnaires. RESULTS: The predicted taxonomy of regulatory strivings was replicated in this sample; the interaction between cortisol and motive profile was significant (F(2, 91) = 6.72, p = .002); analyses of simple effects disclosed that higher cortisol levels predicted higher ambulatory blood pressure only in individuals who exhibited agonistic striving. Depressive symptoms/dysphoria, trait anger, and hostility were not correlated with agonistic striving, cortisol, or blood pressure. CONCLUSIONS: Agonistic striving may represent a distinctive (and novel) social-cognitive mechanism of toxic stress and cardiovascular risk.

Investigating the Occupational Challenges of Corner Store Workers Operating in Baltimore City Food Deserts.

A qualitative pilot study was conducted in Baltimore City with the aim of documenting specific occupational safety challenges of small-scale urban retailers, or "corner store" owners. Semistructured interviews with a small sample ( n = 4) revealed significant challenges for owners and workers, and revealed potential areas for occupational health intervention.

Connecting Hispanic Women in Baltimore to the Mercy Medical Center Sexual Assault Forensic Examiners/Forensic Nurse Examiners Program: A Preliminary Assessment of Service Utilization and Community Awareness.

Sexual violence and gender-based violence represent a major public health problem causing significant negative mental, physical, and social outcomes for victims. The rapidly growing population of Hispanic women in Baltimore are both more vulnerable to sexual assault and less able to access postassault services. In an effort to assess service utilization and community awareness of the Mercy Medical Center Sexual Assault Forensic Examiners/Forensic Nurse Examiners Program, we conducted a retrospective chart review of 2,322 women who were seen by the program between 2010 and 2013 and found that only 2.5% of the women were identified as Hispanic, about half of what Baltimore City demographic data would predict. This exploratory pilot project, augmented by key informant interviews, reveals that Hispanic women are underutilizing sexual assault services. Multiple barriers exist for Hispanic women in obtaining victim services, including lack of awareness within the community that the services exist, cultural factors, language barriers, lack of awareness of legal rights, and a fear of deportation.

Racial and ethnic differences in factors related to workplace violence victimization.

Workplace violence (WPV) is a significant public health concern affecting all racial or ethnic groups. This study examined whether different racial/ethnic groups differed in vulnerability to WPV exposure and utilization of resources at the workplace. This cross-sectional research focused on White, Black, and Asian nursing employees (N = 2,033) employed in four health care institutions in a mid-Atlantic U.S. metropolitan area. Whereas childhood physical abuse was significantly related to risk of WPV among workers from all racial/ethnic backgrounds, intimate partner abuse was a significant factor for Asians and Whites. Blacks and Asians were found to be less likely than Whites to be knowledgeable about WPV resources or use resources to address WPV. Services to address past trauma, and education and training opportunities for new workers may reduce risk of WPV and promote resource utilization among minority workers.

White house executive order protects transgender workers in the federal government.

Occupational and environmental health nurses should be aware of the unique challenges and potential discrimination faced by transgender workers.

Intensified case-finding for latent tuberculosis infection among the Baltimore City Hispanic population.

Foreign-born immigrants are at high risk for latent TB infection (LTBI). In conjunction with the Baltimore City Health Department (BCHD), student volunteers conducted intensified LTBI case-finding (ICF) using tuberculin skin testing (TST) in the Hispanic community from 2006-2010. We sought to determine the yield of ICF and estimate the LTBI prevalence. Retrospective cross-sectional study. Among 478 individuals screened, 164 (34.3 %) had a positive TST, 227 (47.5 %) had a negative TST, and 87 (18.2 %) did not return. Among those who completed screening, the prevalence of LTBI was 164/391 (41.9, 95 % CI 0.37-0.47). ICF referrals accounted for 4.4 % of all LTBI referrals to BCHD and for 41 % of referrals among Hispanics. We found a high rate of undiagnosed LTBI within the Hispanic community. This student-run ICF program accounted for almost half of all LTBI cases among Hispanics. Community resources are needed to target this high-risk population.

Patterns of Violence Against Women: A Latent Class Analysis.

This study examined patterns of nine types of violence against women (VAW) and associated mental health problems. The following self-reported, lifetime violence victimization was examined among 1424 employed women: (1) childhood physical abuse, (2) childhood sexual abuse, (3) physical abuse between parents/guardians during childhood, (4) psychological intimate partner violence (IPV), (5) physical IPV, (6) sexual IPV, (7) adult physical or sexual assault by a non-intimate partner, (8) physical workplace violence, and (9) psychological workplace violence. Latent class analysis was used to identify homogenous patterns, called "classes," of women's "yes/no" responses to experiencing these types of violence. The best model consisted of 4-classes characterized by the following probabilities: low violence (class 1: 63.1%), high psychological and physical IPV (class 2: 15.6%), high physical and psychological workplace violence (class 3: 12.4%), and moderate to high childhood abuse (class 4: 9.0%). When compared to class 1 (low violence), membership in classes 2 (IPV) and 4 (childhood abuse) was associated with screening positive for depression in the past week at baseline after controlling for the influence of demographic characteristics on class membership. Also, when compared to class 1 (low all), membership in class 2 (IPV) was associated with greater odds of screening positive for posttraumatic stress disorder in the past month at the six month follow-up assessment. Findings document distinct patterns of VAW and associated proximal and distal mental health outcomes. Implications for interventions aimed to improve employed women's health are discussed.

Images in surgical radiology: an unusual case of acute appendicitis within a femoral hernia.

We present a rare case of acute appendicitis within a femoral hernia, which was diagnosed preoperatively on CT scan.

Primary prevention among working age USA adults with and without disabilities.

PURPOSE: Health promotion and disease prevention among people with disabilities are often overlooked. The objective of this article is to determine if working age adults with disabilities differ in healthy behaviours from those without disabilities. METHOD: Behavioural Risk Factor Surveillance System data (2003) were used to assess healthy behaviours among 201,840 community dwelling working age adults. RESULTS: People who reported activity limitation irrespective of assistive device use were more likely to be overweight and to smoke than people without a disability. The prevalence of heavy alcohol and insufficient fruit and vegetable consumption was significantly lower among those who used an assistive device irrespective of activity limitation compared to the No Disability Group. Adults in all disability groups were significantly more likely to report physical inactivity compared to the No Disability Group. Lower alcohol consumption and physical inactivity findings were accentuated when the disabled were not working. CONCLUSIONS: There is evidence that people with a disability report poor lifestyle behaviours that increase disease risk and may need assistance with smoking cessation, weight loss and adoption of a physical activity routine. Screening for unhealthy behaviours and advice should be incorporated into routine health care visits for working age adults with disabilities.

Workplace violence: prevalence and risk factors in the safe at work study.

OBJECTIVE: Nurses face one of the highest rates of reported workplace violence (WPV). This research examined the prevalence of WPV and demographic, work-related, and adult and childhood abuse histories as risk factors for WPV among 2166 nurses/nursing personnel across four health care institutions in one US metropolitan area. METHODS: Using data from an online cross-sectional survey, multivariate logistic regression was utilized to determine risk factors for physical and psychological WPV. RESULTS: Almost one-third (30%) of nurses/nursing personnel experienced WPV (19.4% physical, 19.9% psychological). Risk factors included being a nurse, white, male, working in the emergency department, older age, longer employment, childhood abuse, and intimate partner violence. CONCLUSIONS: Adult and childhood abuse histories have not been considered in previous large-scale investigations, but were significant risk factors along with other previously identified risk factors for WPV.

Assessment of "gene-environment" interaction in cases of familial and sporadic pancreatic cancer.

INTRODUCTION: Pancreatic cancer (PC) is the fourth leading cause of cancer death in the United States. This study characterizes one of the largest national registries of familial PC (FPC) and sporadic PC (SPC), focusing on demographics, clinical factors, self-reported environmental and occupational lifetime exposures, and survival status. BACKGROUND: Reported risk factors for PC include advancing age, a family history of PC, high-risk inherited syndromes, cigarette, cigar, and pipe smoking, exposure to occupational and environmental carcinogens, African-American race, high fat/high cholesterol diet, obesity, chronic pancreatitis, and diabetes mellitus. PATIENTS AND METHODS: This retrospective cross-sectional, case-only analysis includes cases of FPC (n = 569) and SPC (n = 689) from the Johns Hopkins National Familial Pancreas Tumor Registry (NFPTR) enrolled between 1994 and 2005. RESULTS: FPC smokers with environmental tobacco smoke (ETS) exposure were diagnosed at a significantly younger mean age (63.7 years) as compared to FPC non-smokers without ETS exposure (66.6 years; p = 0.05). Non-smoker ETS-exposed cases were diagnosed with PC at a significantly younger mean age (64.0 years) compared to non-smoker non-ETS-exposed cases (66.5 years) (p < 0.0004). The mean age at diagnosis for Ashkenazi Jewish SPC subjects was significantly younger (by 2.1 years) than Ashkenazi Jewish FPC cases (p = 0.05). In addition, Ashkenazi Jewish FPC subjects who smoked were diagnosed 5.9 years earlier than Ashkenazi Jewish FPC non-smokers (p = 0.05). The median length of survival for unresected FPC cases was significantly shorter (168 days) as compared to unresected SPC cases (200 days) (p = 0.04). Survival was improved in resected cases, 713 days for FPC cases and 727 days for SPC cases, but was not significantly different between the groups (p = 0.4). Mild to moderate multiplicative interaction was found between a family history of PC and exposure to asbestos, environmental radon, and environmental tobacco smoke (ETS), as evidenced by odds ratios >1.0. CONCLUSIONS: These are the first data to show that occupational and environmental exposures may act synergistically with inherited or acquired genetic polymorphisms, resulting in earlier occurrence of PC. Exposure to cigarette smoking and ETS exposure in non-smokers when younger than 21 years of age are associated with a younger mean age of diagnosis in FPC and SPC cases and Ashkenazi Jewish smokers, when compared to non-exposed cases. Risk prediction models which take into account environmental exposures as well as family history may more accurately predict the risk of PC. High-risk individuals will likely benefit from early identification of pre-malignant lesions and molecular profiling, as methods of early detection, prevention, and personalized therapy.

Measuring emotional labor among young workers: refinement of the Emotions at Work Scale.

This analysis examines the applicability of the emotional labor scale from the Emotions at Work Scale (EWS) through the assessment of its psychometric properties in a sample of young workers. Factor analysis and test-retest reliability were conducted on a 13-item scale measuring emotional labor. The EWS 13-item emotional labor scale was refined to 9 items. Two subscales were delineated: 5 items measured surface acting and 4 items measured deep acting, each with a mean inter-item correlation of 0.33. Cronbach's alpha was .96 for the 9-item scale, and .71 and .67 for the surface acting and deep acting subscales, respectively. Test-retest reliability was 0.64 for surface acting and 0.51 for deep acting during a mean interval of 3 months. Emotional labor can be quantitatively measured among young workers using the derived 9-item scale, although additional studies further evaluating its use should be conducted.

The youth work force: unique occupational health considerations and challenges.

During the past decade, the characteristics and number of adolescent workers has changed little. Several studies were conducted during this time documenting the patterns, scope, and effect of work among young individuals in the United States. Part-time employment may benefit youth by imparting positive work values, reinforcing the importance of academic skills for future career success, providing a better understanding of the workplace, increasing contact with adults, and building character. Negative aspects of youth employment include threats to completion of developmental tasks and education, injury, toxic exposure, and illness. The enactment of regulations and resulting change in the nature of youth employment has contributed to a substantial decrease in youth-related occupational fatality and injury. However, youth workers continue to suffer fatal and nonfatal occupational injuries with most injuries occurring in the retail industry. Efforts should be made to develop innovative interventions tailored to young workers that focus on surveillance, advocacy, education, and research to decrease workplace injury and illness.

Assessing cardiovascular reactivity in working women with the social competence interview.

The Social Competence Interview (SCI), an interview to induce cardiovascular reactivity through recounting a stressful life experience, was used with a sample of 120 working women employed as childcare providers. Women recounted their most stressful work factor while cardiovascular reactions were monitored at 2-minute intervals (data points included 4 baseline, 6 SCI, and 3 recovery). Increases were found when comparing mean baseline and SCI measures: systolic blood pressure (SBP) increased 10.00 mmHg; diastolic blood pressure (DBP)increased 10.63 mmHg; and heart rate increased 4.57 beats per minute. Consistent with the literature SBP and DBP were higher for some subgroups of women (those who were 50 years or older, were obese, or had 4 or more risk factors) across all data points. There were no time by individual difference interactions, indicating that the patterns of change over time were the same across groups. In a logistic regression, comparing women who reached SBP > or = 140 mmHg and/or DBP > or = 90 mmHg during the SCI versus those who did not, higher BP was associated with being older and obese, having a higher level of acceptance coping, and a lower level of suppression of competing activities coping.

Early antecedents of adult work stress: social-emotional competence and anger in adolescence.

We hypothesized that youth with elevated coronary heart disease (CHD) risk who exhibit diminished social-emotional competence and frequent anger in adolescence experience increased occupational stress after becoming adults. Perceived job control and support from coworkers in 57 young Black and White men and women were regressed on measures of social problem-solving skill (SPS) and anger arousal (AR) obtained 5 years earlier when participants were in high school. In models controlling for grade point average (GPA), SPS and GPA independently predicted coworker support in adulthood; anger in high school predicted diminished job control. These findings suggest that occupational stress may have identifiable social-emotional antecedents early in life.

Urban sprawl and you: how sprawl adversely affects worker health.

Urban sprawl, once thought of as just an environmental issue, is currently gaining momentum as an emerging public health issue worthy of research and political attention. Characteristics seen in sprawling communities include increasing traffic volumes; inadequate public transportation; pedestrian unfriendly streets; and the division of businesses, shops, and homes. These characteristics can affect health in many ways. Greater air pollution contributes to higher asthma and other lung disorder rates. An increased dependence on the automobile encourages a more sedentary lifestyle and can potentially contribute to obesity. The increased danger and stress of long commutes can lead to more accidents, anxiety, and social isolation. Occupational health nurses can become involved by promoting physical activity in the workplace, creating programs for injury prevention and stress management, becoming involved in political smart growth measures, and educating and encouraging colleagues to become active in addressing this issue.