Relationship Between Diet Quality and Statin Use Among Adults With Metabolic Syndrome From the CARTaGENE Cohort.

Background: In metabolic syndrome (MetS), cardiovascular disease (CVD) risk reduction relies on the complementary use of diet and lipid-lowering medication. Evidence suggests that initiating such medication may impede diet quality. The objective of this study was to evaluate the relationship between diet quality and statin use among adults with MetS and free of CVD from the Province of Québec. Methods: This cross-sectional study included 2481 adults with MetS (40-69 years of age) from the CARTaGENE Québec population-based cohort, of whom 463 self-reported using statin monotherapy. Diet was assessed using the Canadian Dietary History Questionnaire II, a food- frequency questionnaire, and diet quality was assessed using the Alternative Healthy Eating Index (AHEI). Results: In multivariable-adjusted linear regression models, statin users had lower AHEI (%) compared with nonusers (users: 40.0; 95% confidence interval [CI], 38.9, 41.2 vs nonusers: 41.2; 95% CI, 40.4, 42.0; P = 0.03] because of a lower consumption of vegetables and whole grains. Stratified interaction analyses showed that the lower diet quality among statin users was mostly prevalent among men aged ≥ 50 years and women aged ≥ 60 years, among individuals with annual household incomes of < $50,000 and persons who self-reported history of high blood pressure. Conclusions: In this cohort of adults with MetS from Quebéc, the use of statin monotherapy in primary prevention of CVD was associated with a slightly lower diet quality. These data suggest suboptimal complementarity between diet quality and use of cholesterol-lowering medication in primary prevention of CVD in MetS.

Contexte: Dans le syndrome métabolique, la réduction du risque de maladie cardiovasculaire repose sur la complémentarité entre une saine alimentation et l'utilisation d'hypolipidémiants. Des évidences suggèrent que l'initiation d'un traitement médicamenteux hypolipémiant influencerait négativement la qualité de l'alimentation. Cette étude avait pour objectif de déterminer la relation entre la qualité de l'alimentation et l'utilisation de statines chez des adultes avec un syndrome métabolique, mais sans maladie cardiovasculaire, au Québec. Méthodologie: Cette étude transversale comptait 2481 adultes avec un syndrome métabolique (âgés de 40 à 69 ans) provenant de la cohorte CARTaGENE, représentative de la population du Québec, dont 463 sujets ayant autodéclaré qu'ils prenaient une statine en monothérapie. L'alimentation des sujets a été évaluée à l'aide du Canadian Dietary History Questionnaire II, un questionnaire de fréquence alimentaire, et la qualité de l'alimentation a été évaluée à l'aide de l'Alternative Healthy Eating Index (AHEI). Résultats: Dans des modèles de régression linéaire multivariée, les utilisateurs de statines ont présenté un indice AHEI (%) plus faible en comparaison aux non-utilisateurs (utilisateurs : 40,0; intervalle de confiance [IC] à 95 % : 38,9-41,2 vs non-utilisateurs : 41,2; IC à 95 % : 40,4-42,0; p = 0,03), en raison d'une plus faible consommation de légumes et de grains entiers. Selon des analyses d'interaction stratifiées, la plus faible qualité nutritionnelle chez les utilisateurs de statines était particulièrement prévalente chez les hommes de ≥ 50 ans et les femmes de ≥ 60 ans, chez les personnes dont le revenu annuel du ménage était < 50 000 dollars et chez les personnes ayant autodéclaré des antécédents d'hypertension. Conclusions: Dans cette cohorte d'adultes du Québec avec un syndrome métabolique, l'utilisation de statines en monothérapie dans la prévention des maladies cardiovasculaires était associée à une alimentation dont la qualité était légèrement plus faible. Ces données suggèrent une complémentarité sous-optimale entre la qualité de l'alimentation et l'utilisation d'hypocholestérolémiants en prévention des maladies cardiovasculaires chez les personnes avec un syndrome métabolique.

Relationship Between Diet Quality and Glucose-Lowering Medication Intensity Among Adults With Type 2 Diabetes: Results From the CARTaGENE Cohort.

Background: In real-world settings, whether diet and medication are used as complements for glycemic management in type 2 diabetes (T2D) remains unclear. This study assessed the relationship between diet quality and intensity of glucose-lowering medication among adults with T2D. Methods: This cross-sectional study included 352 adults with T2D from the CARTaGENE Québec population-based cohort. Diet quality was assessed using the Healthful Plant-Based Diet Index (hPDI). Glucose-lowering medication intensity was graded according to self-reported information on the type and number of drugs: no medication; oral monotherapy; oral polytherapy; and insulin with and without oral medication. In the subsample of 239 individuals who reported the medication dosages, intensity was also graded using the Medication Effect Score (MES). Results: In multivariable-adjusted models, we found no evidence of a relationship between the hPDI and medication intensity, assessed using the categorical approach (Pbetween-group = 0.25) or the MES (P = 0.43). However, the hPDI was inversely associated with the MES among men < 50 years of age and women < 60 years (ß1-point MES = -2.24 [95% confidence interval, -4.46, -0.02] hPDI points), but not among older individuals (ß = -0.03 [-1.28, 1.21] hPDI points). Evidence of a nonsignificant inverse relationship between the hPDI and HbA1c was observed (ß10-point hPDI = -0.23% [-0.63, 0.17]), whereas a positive and significant association between the MES and hemoglobin (Hb)A1c was found (ß1-point MES = 0.30% [0.10, 0.51]). Conclusions: In this cohort of adults with T2D, there was an overall lack of complementarity between diet quality and intensity of glucose-lowering medication. The issue was particularly important among younger adults for whom diet quality was inversely associated with intensity of medication.

Introduction: Il n'a jamais été étudié, en contexte réel, si la qualité de l'alimentation et la médication sont utilisées de façon complémentaire dans la gestion de la glycémie chez des personnes avec le diabète de type 2 (DT2). La présente a évalué la relation entre la qualité de l'alimentation et l'intensité de la médication hypoglycémiante chez des adultes avec DT2. Méthodes: Cette étude transversale portait sur 352 adultes avec DT2 participant à la cohorte populationnelle québécoise CARTaGENE. Nous avons évalué la qualité du régime à l'aide du Healthful Plant-based Diet Index (hPDI, soit l'indice d'un régime alimentaire à base de plantes). Nous avons évalué l'intensité des médicaments hypoglycémiants à partir des renseignements fournis sur le type et le nombre de médicaments : aucun médicament, monothérapie orale, polythérapie orale, insuline avec ou sans médicaments par voie orale. Dans le sous-échantillon de 239 individus qui ont mentionné les posologies de médicaments, nous avons aussi évalué l'intensité au moyen du Medication Effect Score (MES). Résultats: Dans les modèles multivariés, nous n'avons observé aucune évidence de relation entre le hPDI et l'intensité des médicaments au moyen de l'approche catégorielle (Pentre les groupes = 0,25) ou du MES (P = 0,43). Toutefois, le hPDI était inversement associé au MES chez les hommes < 50 ans et chez les femmes < 60 ans (ßMES 1 point = ­2,24 [intervalle de confiance à 95 %, ­4,46, ­0,02] points hPDI), mais non chez les personnes plus âgées (ß = ­0,03 [­1,28, 1,21] point hPDI). Nous avons observé une relation inverse non significative entre le hPDI et l'hémoglobine (Hb)A1c (ßhPDI 10 points = ­0,23 % [­0,63, 0,17]) et une association positive et significative entre le MES et l'HbA1c (ßMES 1 point = 0,30 % [0,10, 0,51]). Conclusions: Au sein de cette cohorte d'adultes avec DT2, nous avons constaté une absence globale de complémentarité entre la qualité de l'alimentation et l'intensité des médicaments hypoglycémiants. Cet enjeu était d'autant plus important chez les personnes plus jeunes pour lesquels la qualité du régime était inversement associée à l'intensité des médicaments.

Moral identity goal characteristics: Age-related trends from early adolescence to old age.

The study investigated age-related trends in moral identity goal characteristics, as proposed in previous research (Krettenauer, 2022a), by modifying the Self-Importance of Moral Identity Questionnaire (Aquino & Reed, 2002). Internally and externally motivated moral identity was assessed on varying levels of abstractness for promotion orientation as well as prevention orientation in Canadian participants from three different age groups: early adolescence (13-14 years, n = 248, 119 female), late adolescence to early adulthood (17-20 years, n = 251, 160 female), and mid to old age (50-76 years, n = 129, 76 female). Findings demonstrate that the self-importance of abstract moral identity characteristics increased with age relative to concrete identity characteristics, while the relationship between the two characteristics weakened. The same trend was found for internal moral identity motivation in comparison to external motivation. The study demonstrates that moral identity does not only reflect stable individual differences but is also an important developmental construct. Merging developmental and individual difference perspectives on moral identity opens new and promising avenues for future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

New Insight into Nanoscale Identification of the Polar Axis Direction in Organic Ferroelectric Films.

Ferroelectric poly(vinylidene fluoride-co-trifluoroethylene) [P(VDF-co-TrFE)] thin films have been deposited by spin-coating onto the Bi0.5Na0.5TiO3(BNT)/LNO/SiO2/Si heterostructure. The copolymer microstructure investigated by using grazing-incidence wide-angle X-ray diffraction (GIWAXD) and deduced from the (200)/(110) reflections demonstrates that the b-axis in the P(VDF-co-TrFE) orthorhombic unit cell is either in the plane or out of the plane, depending on the face-on or on the two types of edge-on (called I and II) lamellar structures locally identified by atomic force microscopy (AFM). For edge-on I lamellae regions, the electroactivity (dzzeff ∼ -50.3 pm/V) is found to be twice as high as that measured for both edge-on II or face-on crystalline domains, as probed by piezoresponse force microscopy (PFM). This result is directly correlated to the direction of the ferroelectric polarization vector in the P(VDF-co-TrFE) orthorhombic cell: larger nanoscale piezoactivity is related to the b-axis which lies along the normal to the substrate plane in the case of the edge-on I domains. Here, the ability to thoroughly gain access to the as-grown polar axis direction within the edge-on crystal lamellae of the ferroelectric organic layers is evidenced by combining the nanometric resolution of the PFM technique with a statistical approach based on its spectroscopic tool. By the gathering of information at the nanoscale, two orientations for the polar b-axis are identified in edge-on lamellar structures. These findings contribute to a better understanding of the structure-property relationships in P(VDF-co-TrFE) films, which is a key issue for the design of future advanced organic electronic devices.

Are Lipid-Lowering and Antihypertensive Medications Used as Complements to Heart-Healthy Diets? A Scoping Review.

In cardiovascular disease (CVD) prevention, whether antihypertensive and lipid-lowering medications are used as complements to heart-healthy diets has not been thoroughly assessed. This scoping review aimed to 1) analyze observational studies that assessed the relationship between diet and antihypertensive/lipid-lowering medication use and 2) evaluate whether medication was used as a complement to heart-healthy dietary intakes. We searched MEDLINE, Embase, Web of Science, and CINAHL through 14 January, 2023, for studies that assessed either 1) intraindividual changes in diet associated with lipid-lowering/antihypertensive medication initiation or use or 2) interindividual differences in diet between users and nonusers of these medications. A total of 17 studies were included. Of those, 3 prospectively assessed the intraindividual changes in diet associated with medication initiation or use, but none documented potential changes in diet prior to medication initiation. The 14 other studies compared dietary intakes of medication users and nonusers, most of which also relied on an incomplete assessment of the temporal dynamics between diet and medication use as they employed cross-sectional (n = 12) or repeated cross-sectional (n = 2) designs. Data from 8 studies, including 4 of the 5 studies from Europe, suggested that medication was used as a complement to heart-healthy diets, whereas data from the 9 other studies, including the 4 conducted in the United States, provided no such evidence, indicating potential between-country differences in this relationship. Finally, no studies investigated how the dynamics between diet and medication use influenced the long-term CVD risk. This scoping review suggests that the current literature on the relationship between lipid-lowering/antihypertensive medication use and diet provides an incomplete perspective on how medication may influence diet in CVD prevention. Prospective studies assessing intraindividual changes in diet associated with medication initiation and use and how these dynamics influence the CVD risk are thus needed.

Mechanical Behavior of Thermoplastic Starch: Rationale for the Temperature-Relative Humidity Equivalence.

This paper aimed at understanding and rationalizing the influence of both temperature and relative humidity on the mechanical behavior of thermoplastic starch (TPS). DMA experiments revealed that water molecules impact the crosslinking network by reducing the intermolecular hydrogen bond density, resulting in a less dense entanglement network. In addition, the in-situ X-ray characterization during hydration of starch revealed structural changes, which were ascribed to conformational changes in the starch chain, due to their interaction with the uptake water molecules. Finally, the study of TPS uniaxially stretched at different temperatures and humidity showed that the mechanical behavior of TPS could be rationalized by considering the ΔT parameter, which corresponds to the temperature difference between the drawing temperature and the glass transition temperature of TPS.

Sleep Medication in Older Adults: Identifying the Need for Support by a Community Pharmacist.

Many older adults take benzodiazepines and sedative-hypnotics for the treatment of sleep disorders. With a view to considering the possible discontinuation of hypnotics, the objectives of the present study were to describe bedtime habits and sleep patterns in older adults and to identify the sleep medications taken. An expert group developed a structured interview guide for assessing the patients' bedtime habits, sleep patterns, and medications. During an internship in a community pharmacy, 103 sixth-year pharmacy students conducted around 10 interviews each with older adults (aged 65 or over) complaining of sleep disorders and taking at least one of the following medications: benzodiazepines, benzodiazepine derivatives ("Z-drugs"), antihistamines, and melatonin. A prospective, observational study was carried out from 4 January to 30 June 2016. The pharmacy students performed 960 interviews (with 330 men and 630 women; mean ± standard deviation age: 75.1 ± 8.8). The most commonly taken hypnotics were the Z-drugs zolpidem (n = 465, 48%) and zopiclone (n = 259, 27%). The vast majority of patients (n = 768, 80%) had only ever taken a single hypnotic medication. The median [interquartile range] prescription duration was 120 (48-180) months. About 75% (n = 696) of the patients had at least 1 poor sleep habit, and over 41% (n = 374) had 2 or more poor sleep habits. A total of 742 of the patients (77%) reported getting up at night-mainly due to nycturia (n = 481, 51%). Further, 330 of the patients (35%) stated that they were keen to discontinue their medication, of which 96 (29%) authorized the pharmacist to contact their family physician and discuss discontinuation. In France, pharmacy students and supervising community pharmacists can identify problems related to sleep disorders by asking simple questions about the patient's sleep patterns. Together with family physicians, community pharmacists can encourage patients to discuss their hypnotic medications.

The interpersonal nature of self-talk: Variations across individuals and occasions.

This research addressed the hypothesis that self-talk conveys a variety of interpersonal styles, representing different ways of addressing oneself, and that these different styles can be conceptualized with the interpersonal circumplex. Using a diary-like method for 14 days, 232 undergraduates were asked, toward the end of each day, to reflect on one positive and one negative event from that day and write down their self-talk about each. Using an instrument based on the interpersonal circumplex, participants and later independent judges rated the interpersonal qualities of each self-talk statement. Ratings showed a reasonably high degree of consistency over days, and averages over days for each participant showed reasonably good circumplex structure, consistent with an interpersonal conception of self-talk style. Multilevel modeling revealed that the interpersonal qualities of self-talk also showed substantial variance at the occasion level. There were synergistic interactions of self-talk dominance and affiliation in the prediction of post-self-talk affect, with higher positive and lower negative affect following self-talk that was relatively high in both dominance and affiliation. Conceptualizing self-talk styles in terms of the interpersonal circumplex offers a promising framework for further research on inner experience and its effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Daily moral identity: Linkages with integrity and compassion.

OBJECTIVE: The present study investigated how much variability in moral identity scores is attributable to individual differences that are stable over time and how much variability reflects daily fluctuations. METHOD: Participants (N = 138, M age = 25.11 years, SD = 10.77; 82% female) were asked to report the self-importance of three moral attributes (being honest, fair, and caring) once a day for 50 consecutive days. Ratings were decomposed into between- and within-person variability and analyzed in relation to individuals' self-reported feelings of integrity and compassion using hierarchical linear modelling. RESULTS: Daily measures of moral identity exhibited more between- than within-person variability (64% vs. 36%). Furthermore, feelings of integrity and compassion were more strongly positively correlated with moral identity on the inter-individual level than the intra-individual level. CONCLUSION: Overall, findings suggest that moral identity has both trait- and state-like characteristics and might be best conceptualized as a characteristic adaptation evidencing both stability and change.

Impact of Airway Humidification Strategy in Mechanically Ventilated COVID-19 Patients.

BACKGROUND: Humidification of inspiratory gases is mandatory in all mechanically ventilated patients in ICUs, either with heated humidifiers (HHs) or with heat and moisture exchangers (HMEs). In patients with COVID-19, the choice of the humidification device may have relevant impact on patients' management as demonstrated in recent studies. We reported data from 2 ICUs using either HME or HH. METHODS: Data from patients with COVID-19 requiring invasive mechanical ventilation during the first wave in 2 ICUs in Québec City were reviewed. In one ICU, HMEs were used, whereas heated-wire HHs were used in the other ICU. We compared ventilator settings and arterial blood gases at day one after adjustment of ventilator settings. Episodes of endotracheal tube occlusions (ETOs) or subocclusions and a strategy to limit the risk of under-humidification were reported. On a bench test, we measured humidity with psychrometry with HH at different ambient temperature and evaluated the relation with heater plate temperature. RESULTS: We reported data from 20 subjects positive for SARS-Cov-2, including 6 in the ICU using HME and 14 in the ICU using HH. In the HME group, PaCO2 was higher (48 vs 42 mm Hg) despite higher minute ventilation (171 vs 145 mL/kg/min predicted body weight [PBW]). We also reported 3 ETOs occurring in the ICU using HH. The hygrometric bench study reported a strong correlation between heater plate temperatures of the HH and humidity delivered. After implementation of measures to avoid under-humidification, including heater plate temperature monitoring, no more ETOs occurred. CONCLUSIONS: The choice of the humidification device used in subjects with COVID-19 had a relevant impact on ventilation efficiency (increased CO2 removal with lower dead space) and on complications related to low humidity, including ETOs that may be present with heated-wire HHs when used with high ambient temperatures.

Determining the impact of unknown individuals in criminality using network analysis of DNA matches.

Criminal offenders missing from police files limit the capacity to reconstruct criminal networks for criminological research and operational purposes. Recent studies show that forensic DNA databanks offer potential to address this problem, through large-scale analysis of DNA matches, many of which involve unidentified offenders. Applying social network analysis (SNA) to 18 years of DNA match data from Québec, Canada, we found that 1400 unknowns do not occupy more marginal positions in the network than 13,000 known offenders, and explain up to 18% of SNA values (e.g., betweenness centrality) for the latter while supporting 46% of their clustering values. Our results contrast with previous studies, showing moreover that unknown individuals who are positioned centrally in a network may have a larger impact than previously expected on investigation policing with implications for forensic intelligence.

Hydrogen-deuterium exchange mass spectrometry reveals three unique binding responses of mAbs directed to the catalytic domain of hCAIX.

Human carbonic anhydrase (hCAIX), an extracellular enzyme that catalyzes the reversible hydration of CO2, is often overexpressed in solid tumors. This enzyme is instrumental in maintaining the survival of cancer cells in a hypoxic and acidic tumor microenvironment. Absent in most normal tissues, hCAIX is a promising therapeutic target for detection and treatment of solid tumors. Screening of a library of anti-hCAIX monoclonal antibodies (mAbs) previously identified three therapeutic candidates (mAb c2C7, m4A2 and m9B6) with distinct biophysical and functional characteristics. Selective binding to the catalytic domain was confirmed by yeast surface display and isothermal calorimetry, and deeper insight into the dynamic binding profiles of these mAbs upon binding were highlighted by bottom-up hydrogen-deuterium exchange mass spectrometry (HDX-MS). Here, a conformational and allosterically silent epitope was identified for the antibody-drug conjugate candidate c2C7. Unique binding profiles are described for both inhibitory antibodies, m4A2 and m9B6. M4A2 reduces the ability of the enzyme to hydrate CO2 by steric gating at the entrance of the catalytic cavity. Conversely, m9B6 disrupts the secondary structure that is necessary for substrate binding and hydration. The synergy of these two inhibitory mechanisms is demonstrated in in vitro activity assays and HDX-MS. Finally, the ability of m4A2 to modulate extracellular pH and intracellular metabolism is reported. By highlighting three unique modes by which hCAIX can be targeted, this study demonstrates both the utility of HDX-MS as an important tool in the characterization of anti-cancer biotherapeutics, and the underlying value of CAIX as a therapeutic target.

Does hip or knee joint replacement decrease chances to complete an ultra-trail race? Study in participants at the Ultra-Trail du Mont Blanc®.

INTRODUCTION: The number of patients with hip or knee joint replacements is increasing. Some of these patients want to practice sport, including in high-impact sports such as ultra-trails. Is the proportion of drop-out higher among runners after a hip or knee replacement? What are the symptoms of these patients? HYPOTHESIS: Hip or knee joint replacements are associated with a higher drop-out rate during an ultra-trail. MATERIAL AND METHODS: We conducted a monocentric retrospective epidemiological study. A questionnaire translated into French, English and Spanish were sent to all runners registered for one or more of the 5 races of the 2015 to 2017 Ultra-Trail du Mont-Blanc® (UTMB®) editions. There were no exclusion criteria. The drop-out rate of patients who responded to the questionnaire was calculated among patients with and without hip or knee joint replacement. Specific symptoms related to these joint replacements were identified before, during and after the race. RESULTS: Out of the 24,855 participants having run at least one of the 3 editions, 2,469 responded. Some of them ran several races: these 2469 runners were on 3171 start lines and 2548 finish lines (drop-out rate of 19.6%). Among these 2469 runners, 18 had hip and/or knee replacement and were on 27 start lines and 17 finish lines (drop-out rate of 37%). The race was finished by 3 of the 6 runners with a total hip arthroplasty (THA), all of the 8 runners with a hip resurfacing arthroplasty (HRA) and 3 of the 4 runners with a total knee arthroplasty (TKA). Among runners with THA, pubalgia or groin pain was described by one of them before the race, 3 during the race and 2 after the race. Among runners with HRA, pygalgia or groin pain was described by 2 of them during the race. As for the TKA, there was no specific symptom. No answering runner had a unicompartmental knee prosthesis. DISCUSSION: Running ultra-trail is possible after a hip or knee joint replacement. All of the 8 runners with HRA finished the race. We may remain cautious about the long-term survival of prostheses. LEVEL OF PROOF: IV; monocentric retrospective epidemiological study.

Historical human remains identification through maternal and paternal genetic signatures in a founder population with extensive genealogical record.

OBJECTIVES: We describe a method to identify human remains excavated from unmarked graves in historical Québec cemeteries by combining parental-lineage genetic markers with the whole-population genealogy of Québec contained in the BALSAC database. MATERIALS AND METHODS: The remains of six men were exhumed from four historical cemeteries in the province of Québec, Canada. DNA was extracted from the remains and genotyped to reveal their mitochondrial and Y-chromosome haplotypes, which were compared to a collection of haplotypes of genealogically-anchored modern volunteers. Maternal and paternal genealogies were searched in the BALSAC genealogical record for parental couples matching the mitochondrial and the Y-chromosome haplotypic signatures, to identify candidate sons from whom the remains could have originated. RESULTS: Analysis of the matching genealogies identified the parents of one man inhumed in the cemetery of the investigated parish during its operating time. The candidate individual died in 1833 at the age of 58, a plausible age at death in light of osteological analysis of the remains. DISCUSSION: This study demonstrates the promising potential of coupling genetic information from living individuals to genealogical data in BALSAC to identify historical human remains. If genetic coverage is increased, the genealogical information in BALSAC could enable the identification of 87% of the men (n = 178,435) married in Québec before 1850, with high discriminatory power in most cases since >75% of the parental couples have unique biparental signatures in most regions. Genotyping and identifying Québec's historical human remains are a key to reconstructing the genomes of the founders of Québec and reinhuming archeological remains with a marked grave.

2-D Modeling of Rosen-Type Piezoelectric Transformer by Means of a Polynomial Approach.

A 2-D semianalytical model using the Legendre polynomial approach was applied for modeling the piezoelectric transformer (PT). In the model, the mechanical displacements and the electric potential were expanded in a double series of orthonormal polynomials with an appropriate analytical form. Series and parallel resonance frequencies, input electrical admittance, and voltage gain were obtained for the PT. The results are in excellent agreement with both the numerical results calculated with a 3-D finite-element analysis and experimental ones. The approach is able to predict the behavior of a wide and a long PT.

Substitution degree and fatty chain length influence on structure and properties of fatty acid cellulose esters.

A series of fatty acid cellulose esters (FACEs) with both various degrees of substitution (from DS = 1.7 to 3) and side chain length were obtained by grafting aliphatic acid chlorides (from C10 to C16) onto cellulose backbone, in a homogeneous LiCl/DMAc medium. These materials were characterized by Fourier Transformed InfraRed (FTIR) and Nuclear Magnetic Resonance of Proton (1H NMR) spectroscopies, as well as Wide Angle X-ray Scattering (WAXS), Differential Scanning Calorimetry (DSC), mechanical analyses and chemical resistance to concentrated acid and alkali solutions. Whatever the alkyl chains length and the DS, all samples displayed a layered structure composed of a planar arrangement of parallel cellulosic backbones with fully extended flexible side chains oriented perpendicular to the planar structure without interdigitation. The alkyl chains were able to crystallize as soon as they are long enough. As the DS decreased, the plasticizing effect of the alkyl chains was less pronounced and their ability to crystallize was improved. Regarding the mechanical behavior and the chemical resistance, similar results were observed whatever the DS is.

Is the true self truly moral? Identity intuitions across domains of sociomoral reasoning and age.

Adults intuit that positive moral characteristics (e.g., being caring, being honest) reflect a person's true self. The current work aimed to extend research on the true self phenomenon (a) by directly comparing how moral and nonmoral norms are implicated in intuitions about the true self and (b) by examining intuitions about the true self across various age groups (children, adolescents, and adults). Participants from three age groups were presented with scenarios describing people undergoing change and reported the impact of that change on identity. The nature of the change varied in the type of characteristic (moral belief, social-conventional belief, or personal preference), the direction (positive change or negative change), and the target (self or other). Children and adolescents, like adults, judged that changes to moral beliefs were more disruptive to identity continuity than changes to social-conventional beliefs or personal preferences. All three age groups shared the intuition that negative moral change was more disruptive to identity than positive moral change, which is consistent with an understanding of the central role that morally good characteristics play in perceptions of the true self. Although these results suggest continuity between late childhood and early adulthood in understanding of the true self, age-related differences did emerge with regard to the target of the change. Children and adolescents reported that moral changes in others were more disruptive to identity than moral changes in themselves, unlike adults, whose intuitions were perspective invariant.

Polypharmacy in older patients: identifying the need for support by a community pharmacist.

BACKGROUND: The community pharmacist is a key player in medication reviews of older outpatients. However, it is not always clear which individuals require a medication review. The objective of the present study was to identify high-priority older patients for intervention by a community pharmacist. METHODS: As part of their final-year placement in a community pharmacy, pharmacy students conducted 10 interviews each with older adults (aged 65 or over) taking at least five medications daily. The student interviewer also offered to examine the patient's home medicine cabinet. An interview guide was developed by an expert group to assess the difficulties in managing and taking medications encountered by older patients. RESULTS: The 141 students interviewed a total of 1370 patients (mean age: 81.5; mean number of medications taken daily: 9.3). Of the 1370 interviews, 743 (54.2%) were performed in the patient's home, and thus also included an examination of the home medicine cabinet. Adverse events were reported by 566 (42.0%) patients. A total of 378 patients (27.6%) reported difficulties in preparing, administering and/or swallowing medications. The inspections of medicine cabinets identified a variety of shortcomings: poorly located cabinets (in 15.0% of inspections), medication storage problems (21.7%), expired medications (40.7%), potentially inappropriate medications (15.0%), several different generic versions of the same drug (19.9%), and redundant medications (20.4%). CONCLUSIONS: In a community pharmacy setting, high-priority older patients for intervention by a community pharmacist can be identified by asking simple questions about difficulties in managing, administering, taking or storing medications.