Effectiveness of an evidenced-based cognitive behavioral therapy intervention for adolescents in a school setting.

PROBLEM: The adolescent years are a formative time when rapid hormonal and physical changes stimulate the developing mind. Exposure to poverty, abuse, violence, and lack of peer and social support causes an increase in vulnerability to the development of mental health problems. The COVID-19 pandemic has also exacerbated symptoms of depression and anxiety. Regardless of the risk factors, anxiety and depression continue to be significant health problems, affecting thousands of adolescents yearly in the United States. The first-line treatment recommendation for managing anxiety and depression symptoms is cognitive behavioral therapy (CBT). However, access to a provider for CBT treatment is not always an option for many reasons. METHODS: This pilot evidenced-based practice project aims to increase access to skills acquired through CBT and improve adolescents' mental health by implementing a brief and evidenced-based CBT program in a school setting. The CBT program for this project is the Creating Opportunities for Personal Empowerment (COPE) for Teens program consisting of seven 50-55-min sessions. The COPE program was delivered to 22 students in a 7th-grade health class. The Generalized Anxiety Disorder 7-Item and Patient Health Questionnaire-9 Modified for Adolescents measured anxiety and depression scores at baseline, post-intervention, and 2-month follow-up. FINDINGS: Results indicate clinically significant improvements in anxiety and depression scores and showed participant satisfaction. CONCLUSIONS: COPE in the school setting offers a low-risk solution to improving behaviors and emotional intelligence. COPE is a cost-effective solution to the mental health provider shortage.

A homeschool-based cognitive behavioral program to improve adolescent mental health.

PROBLEM: Anxiety and depression are prevalent in the adolescent population and can have significant consequences. Treatment recommendations are established but rates of utilization remain low, often due to a lack of access to mental health providers. Availability of mental health services in a school-based setting may increase access, but homeschooled children do not have access to these services. Additionally, the COVID-19 pandemic has increased the number of homeschooled children and compounded the problem of adolescent mental health disorders. METHODS: This pilot evidence-based practice project aimed to increase access to cognitive behavioral therapy (CBT) in adolescents. Eight students from a local homeschool cooperative participated in the Creating Opportunities for Personal Empowerment (COPE) program. A Friedman test was used to evaluate median differences on anxiety and depression screening instruments at baseline, program completion, and 1 month after the program. Students also completed an adapted COPE program evaluation. RESULTS: Median scores on screening instruments decreased from pre-COPE to 1 month after, although results were not statistically significant. Students reported that the COPE program was helpful, and they learned new ways to deal with their thoughts, feelings, and behaviors. CONCLUSION: COPE is a feasible option to increase access to CBT in a homeschool setting.

Minimal effects of reduced teaching hours on undergraduate medical student learning outcomes and course evaluations.

Introduction: Various pressures exist for curricular change, including economic forces, burgeoning knowledge, broadening learning outcomes, and improving quality and outcomes of learning experiences. In an Australian 5-year undergraduate medical course, staff were asked to reduce teaching hours by 20% to alleviate perceived overcrowded preclinical curriculum, achieve operating efficiencies and liberate time for students' self-directed learning.Methods: A case study design with mixed methods was used to evaluate outcomes.Results: Teaching hours were reduced by 198 hours (14%) overall, lectures by 153 hours (19%) and other learning activities by 45 hours (7%). Summative assessment scores did not change significantly after the reductions: 0.4% increase, 1.5% decrease and 1.7% increase in Years 1, 2 and 3, respectively. The percentage of students successfully completing their academic year did not change significantly: 94.4% before and 93.3% after the reductions. Student evaluations from eVALUate surveys changed little, except workload was perceived to be more reasonable.Conclusions: Teaching hours, particularly lectures, can be moderately reduced with little impact on student learning outcomes or satisfaction with an undergraduate medical course.

Transmission of Amblyomma maculatum-Associated Rickettsia spp. During Cofeeding on Cattle.

Amblyomma maculatum is the primary vector for the spotted fever group rickettsiae, Rickettsia parkeri, a known pathogen, and "Candidatus Rickettsia andeanae," currently considered nonpathogenic. Spotted fever group rickettsiae are typically endothelial cell associated and rarely circulate in the blood. Horizontal transmission to naïve ticks through blood feeding from an infected host is likely rare. Cofeeding provides an opportunity for rickettsial transmission to naïve ticks in the absence of circulating rickettsiae. We evaluated R. parkeri transmission through cofeeding between A. maculatum adults and nymphs on beef calves. Six calves in each of two trials were infested with A. maculatum that had been capillary fed R. parkeri. Four days later, calves each received recipient A. maculatum that were either capillary fed "Ca. R. andeanae" or not capillary fed before infestation. Trials differed by whether we included a barrier to minimize adjacent feeding between recipient and donor ticks. After cofeeding, we detected R. parkeri in 27% of "Ca. R. andeanae"-free recipient ticks, whereas R. parkeri was not detected in any recipient ticks that were capillary fed "Ca. R. andeanae." Rickettsia parkeri transmission efficiency to naïve ticks was greater when ticks freely cofed in proximity. No rickettsial DNA was detected in calf blood. Results confirm cofeeding as a method of horizontal transmission of R. parkeri in the absence of host rickettsemia and suggest no evidence of transmission by cofeeding when recipient ticks are first exposed to "Ca. R. andeanae" through capillary feeding. While cofeeding may provide an opportunity for maintaining the pathogen, R. parkeri, the mechanisms driving any potential effect of "Ca. R. andeanae" on R. parkeri transmission are unclear.

Role of vitamin D3 in modulation of ΔNp63α expression during UVB induced tumor formation in SKH-1 mice.

ΔNp63α, a proto-oncogene, is up-regulated in non-melanoma skin cancers and directly regulates the expression of both Vitamin D receptor (VDR) and phosphatase and tensin homologue deleted on chromosome ten (PTEN). Since ΔNp63α has been shown to inhibit cell invasion via regulation of VDR, we wanted to determine whether dietary Vitamin D3 protected against UVB induced tumor formation in SKH-1 mice, a model for squamous cell carcinoma development. We examined whether there was a correlation between dietary Vitamin D3 and ΔNp63α, VDR or PTEN expression in vivo in SKH-1 mice chronically exposed to UVB radiation and fed chow containing increasing concentrations of dietary Vitamin D3. Although we observed differential effects of the Vitamin D3 diet on ΔNp63α and VDR expression in chronically irradiated normal mouse skin as well as UVB induced tumors, Vitamin D3 had little effect on PTEN expression in vivo. While low-grade papillomas in mice exposed to UV and fed normal chow displayed increased levels of ΔNp63α, expression of both ΔNp63α and VDR was reduced in invasive tumors. Interestingly, in mice fed high Vitamin D3 chow, elevated levels of ΔNp63α were observed in both local and invasive tumors but not in normal skin suggesting that oral supplementation with Vitamin D3 may increase the proliferative potential of skin tumors by increasing ΔNp63α levels.

Has vertebrate chemesthesis been a selective agent in the evolution of arthropod chemical defenses?

Arthropods use a variety of chemical substances to repel potential predators, but how did they arrive at the suite of chemicals that they use? One way to explore this question is to map chemically defended arthropod species in a multidimensional "compound" space. Clustering within this space indicates species that share similar combinations of chemical compounds and can reflect a phylogenetic signal, common biochemical pathways, or both. More important for this study, clustering can help to identify allomone targets. We herein compare common arthropod allomones with known vertebrate trigeminal irritants. We argue that the degree of overlap between these two groups of compounds indicates that chemesthesis was an important determining factor in the evolution of many arthropod allomones. The multidimensional scaling methods used may also allow the identification of new irritant receptors.

Metal core bonding motifs of monodisperse icosahedral Au13 and larger Au monolayer-protected clusters as revealed by X-ray absorption spectroscopy and transmission electron microscopy.

The atomic metal core structures of the subnanometer clusters Au13[PPh3]4[S(CH2)11CH3]2Cl2 (1) and Au13[PPh3]4[S(CH2)11CH3]4 (2) were characterized using advanced methods of electron microscopy and X-ray absorption spectroscopy. The number of gold atoms in the cores of these two clusters was determined quantitatively using high-angle annular dark field scanning transmission electron microscopy. Multiple-scattering-path analyses of extended X-ray absorption fine structure (EXAFS) spectra suggest that the Au metal cores of each of these complexes adopt an icosahedral structure with a relaxation of the icosahedral strain. Data from microscopy and spectroscopy studies extended to larger thiolate-protected gold clusters showing a broader distribution in nanoparticle core sizes (183 +/- 116 Au atoms) reveal a bulklike fcc structure. These results further support a model for the monolayer-protected clusters (MPCs) in which the thiolate ligands bond preferentially at 3-fold atomic sites on the nanoparticle surface, establishing an average composition for the MPC of Au180[S(CH2)11CH3]40. Results from EXAFS measurements of a gold(I) dodecanethiolate polymer are presented that offer an alternative explanation for observations in previous reports that were interpreted as indicating Au MPC structures consisting of a Au core, Au2S shell, and thiolate monolayer.

Sub-nanometer Au monolayer-protected clusters exhibiting molecule-like electronic behavior: quantitative high-angle annular dark-field scanning transmission electron microscopy and electrochemical characterization of clusters with precise atomic stoichiometry.

The synthesis and characterization of the clusters Au13[PPh3]4[S(CH2)11CH3]2Cl2 (1) and Au13[PPh3]4[S(CH2)11CH3]4 (2) are described. These mixed-ligand, sub-nanometer clusters, prepared via exchange of dodecanethiol onto phosphine-halide gold clusters, show enhanced stability relative to the parent. The characterization of these clusters features the precise determination of the number of gold atoms in the cluster cores using high-angle annular dark-field scanning transmission electron microscopy, allowing the assignment of 13 gold atoms (+/-3 atoms) to the composition of both cluster molecules. Electrochemical and optical measurements reveal discrete molecular orbital levels and apparent energy gaps of 1.6-1.7 eV for the two cluster molecules. The electrochemical measurements further indicate that the Au13[PPh3]4[S(CH2)11CH3]2Cl2 cluster undergoes an overall two-electron reduction. The electrochemical and spectroscopic properties of the two Au13 cluster molecules are compared with those of a secondary synthetic product, which proved to be larger Au thiolate-derivatized monolayer-protected clusters with an average core of Au180. The latter shows behavior fully consistent with the adoption of metallic-like properties.

Ligand heterogeneity on monolayer-protected gold clusters.

This paper describes the effects of oxidative electronic charging of the Au cores of the monolayer-protected clusters (MPCs), Au140(S(CH2)5CH3)53 and Au38(SCH2CH2Ph)24, on nuclear magnetic resonance (NMR) spectra of their monolayer ligand shells. Previously unresolved fine structure in the 13C NMR hexanethiolate methyl and C5 methylene resonances is seen in spectra of solutions of monodisperse Au140(S(CH2)5CH3)53 MPCs, reflecting magnetically inequivalent ligand sites. Incremented increases in positive cluster core charge, effected by electrochemical charging, cause the spectral fine structure of the methyl resonance to coalesce, becoming a single peak at the Au140(3+) charge state. The spectral changes are reversible; charging back to the original core charge state regenerates the methyl 13C resonance fine structure. Adding an equimolar quantity of a Au(I) thiolate complex, Au(I)[SCH2(C6H4)C(CH3)3], to an uncharged Au140(S(CH2)5CH3)53 MPC solution in d2-methylene chloride causes partial spectral coalescence. 13C NMR spectra of Au38(SCH2CH2Ph)24 MPCs exhibit roughly comparable spectral changes upon positive core charging to the '0', '+1', and '+2' states. The NMR results indicate that exchange between magnetically inequivalent sites occurs at rates of 100 to 400 s(-1), a rate believed to be too fast to be accountable by actual exchanges of ligands between different sites on the Au core. We also describe changes in core electronic spectra of Au140(S(CH2)5CH3)53 induced by positive charging, measured using spectroelectrochemistry.

Ion atmosphere relaxation controlled electron transfers in cobaltocenium polyether molten salts.

A room-temperature redox molten salt for the study of electron transfers in semisolid media, based on combining bis(cyclopentadienyl)cobalt with oligomeric polyether counterions, [Cp2Co](MePEG350SO3), is reported. The transport properties of the new molten salt can be varied (plasticized) by varying the polyether content. The charge transport rate during voltammetric reduction of the ionically conductive [Cp2Co](MePEG350SO3) molten salt exceeds the actual physical diffusivity of [Cp2Co]+ because of rapid [Cp2Co](+/0) electron self-exchanges. The measured [Cp2Co](+/0) electron self-exchange rate constants (k(EX)) are proportional to the diffusion coefficients (D(CION)) of the counterions in the melt. The electron-transfer activation barrier energies are also close to those of ionic diffusion but are larger than those derived from optical intervalent charge-transfer results. Additionally, the [Cp2Co](+/0) rate constant results are close to those of dissimilar redox moieties in molten salts where D(CION) values are similar. All of these characteristics are consistent with the rates of electron transfers of [Cp2Co](+/0) (and the other donor-acceptor pairs) being controlled not by the intrinsic electron-transfer rates but by the rate of relaxation of the ion atmosphere around the reacting pair. In the low driving force regime of mixed-valent concentration gradients, the ion atmosphere relaxation is competitive with electron transfer. The results support the generality of the recently proposed model of ionic atmosphere relaxation control of electron transfers in ionically conductive, semisolid materials.

Hexanethiolate monolayer protected 38 gold atom cluster.

The nucleation-growth-passivation Brust reaction has been modified so as to enrich the product in useful quantities of a 38-atom gold nanoparticle coated with a hexanethiolate monolayer. Two modifications are described, using -78 degrees C reduction temperature and a hyperexcess of thiol. Compositional evidence is presented that establishes the product as a Au38(C6)24 hexanethiolate monolayer protected cluster (MPC), based on transmission electron microscopy, laser ionization-desorption mass spectrometry, thermogravimetric analysis, and elemental analysis. Reverse phase HPLC confirms the relatively good monodispersity of the MPC products, but high-resolution double-column HPLC reveals that the MPCs are a mixture of closely related but chromatographically distinct products. Voltammetry, low energy spectrophotometry, and spectroelectrochemistry reveal, respectively, a 1.6 eV electrochemical energy gap between the first oxidation and the first reduction, an optical HOMO-LUMO energy absorbance edge at 1.3 eV, and a bleaching of optical absorbance near the 1.3 eV band edge that accompanies electrochemical oxidation of the nanoparticle.

Electrochemistry and optical absorbance and luminescence of molecule-like Au38 nanoparticles.

This paper describes electrochemical and spectroscopic properties of a well-characterized, synthetically accessible, 1.1 nm diam Au nanoparticle, Au(38)(PhC(2)S)(24), where PhC(2)S is phenylethylthiolate. Properties of other Au(38) nanoparticles made by exchanging the monolayer ligands with different thiolate ligands are also described. Voltammetry of the Au(38) nanoparticles in CH(2)Cl(2) reveals a 1.62 V energy gap between the first one-electron oxidation and the first reduction. Based on a charging energy correction of ca. 0.29 V, the indicated HOMO-LUMO gap energy is ca. 1.33 eV. At low energies, the optical absorbance spectrum includes peaks at 675 nm (1.84 eV) and 770 nm (1.61 eV) and an absorbance edge at ca. 1.33 eV that gives an optical HOMO-LUMO gap energy that is consistent with the electrochemical estimate. The absorbance at lowest energy is bleached upon electrochemical depletion of the HOMO level. The complete voltammetry contains two separated doublets of oxidation waves, indicating two distinct molecular orbitals, and two reduction steps. The ligand-exchanged nanoparticle Au(38)(PEG(135)S)(13)(PhC(2)S)(11), where PEG(135)S is -SCH(2)CH(2)OCH(2)CH(2)OCH(3), exhibits a broad (1.77-0.89 eV) near-IR photoluminescence band resolvable into maxima at 902 nm (1.38 eV) and 1025 nm (1.2 eV). Much of the photoluminescence occurs at energies less than the HOMO-LUMO gap energy. A working model of the energy level structure of the Au(38) nanoparticle is presented.

Ion atmosphere relaxation control of electron transfer dynamics in a plasticized carbon dioxide redox polyether melt.

The sorption of CO(2) into the highly viscous, semisolid hybrid redox polyether melt, [Co(phenanthroline)(3)](MePEG-SO(3))(2), where MePEG-SO(3) is a MW 350 polyether-tailed sulfonate anion, remarkably accelerates charge transport in this molten salt material. Electrochemical measurements show that as CO(2) pressure is increased from 0 to 800 psi (54 atm) at 23 degrees C, the physical diffusion coefficient D(PHYS) of the Co(II) species, the rate constant k(EX) for Co(II/I) electron self-exchange, and the physical diffusion coefficient of the counterion D(COUNTERION) all increase, from 4.3 x 10(-10) to 6.4 x 10(-9) cm(2)/s, 4.1 x 10(6) to 1.6 x 10(7) M(-1) s(-1), and 3.3 x 10(-9) to 1.6 x 10(-8) cm(2)/s, respectively. Plots of log(k(EX)) versus log(D(PHYS)) and of log(k(EX)) versus log(D(COUNTERION)) are linear, showing that electron self-exchange rate constants are closely associated with processes that also govern D(PHYS) and D(COUNTERION). Slopes of the plots are 0.68 and 0.98, respectively, indicating a better linear correlation between k(EX) and D(COUNTERION). The evidence indicates that k(EX) can be controlled by relaxation of the counterion atmosphere about the Co complexes in the semisolid redox polyether melts. Because the counterion relaxation is in turn controlled by polyether "solvent" fluctuations, this is a new form of solvent dynamics control of electron transfer.