Evaluating a school-based science program that teaches the physiological effects of nicotine.

School-based drug prevention programs represent a widely endorsed public health goal, with an important aspect of knowledge-based curricula being education about the physiological effects of drugs. Nicotine is one of the world's most addictive substances and in this program we have used nicotine-induced mammalian-like behaviors in flatworms called planarians to successfully teach students (4th-12th grade; n = 1,616 students) about the physiological and addictive effects of nicotine. An initial study tested the change in knowledge about addictive substances in 6th-12th grade students after they completed a lab examining the effects of two concentrations of nicotine on the number of stereotypies (C-shaped spasms) planarians demonstrate in a 5-minute period of time. Lab discussion focused on developing and testing hypotheses, measurement reliability, and mechanisms of nicotine action. Surveys given pre- and post-lab experience showed that 6th grade students have significantly lower knowledge about nicotine than 7th-12th grade students (6th grade: 40.65 ± 0.78% correct, 7th-12th grade: 59.29 ± 1.71%, p < 0.001) pre-lab, but that students in all grades showed a significant increase in knowledge post-lab (p < 0.001). In 6th grade the lab was effective in improving knowledge about nicotine in urban, suburban and rural schools, p < 0.001, with students in suburban schools showing significantly greater knowledge both pre-test (urban: 37.62 ± 1.45%; suburban: 48.78 ± 1.62%; rural: 37.33 ± 0.99%; p < 0.001) and post-test (urban:60.60 ± 1.85%; suburban: 67.54 ± 1.82%; urban: 61.66 ± 1.18%; p < 0.001). A second study, modifying the lab so that the time spent observing the planarians is reduced to a 1-minute period, showed that students in both 4th and 5th grades had a significant increase in knowledge about the physiological and addictive effects of nicotine post-lab (p < 0.001).

The PI3K/AKT Pathway Inhibitor ISC-4 Induces Apoptosis and Inhibits Growth of Leukemia in Preclinical Models of Acute Myeloid Leukemia.

Acute myeloid leukemia is a heterogeneous disease with a 5-year survival rate of 28.3%, and current treatment options constrained by dose-limiting toxicities. One of the key signaling pathways known to be frequently activated and dysregulated in AML is PI3K/AKT. Its dysregulation is associated with aggressive cell growth and drug resistance. We investigated the activity of Phenybutyl isoselenocyanate (ISC-4) in primary cells obtained from newly diagnosed AML patients, diverse AML cell lines, and normal cord blood cells. ISC-4 significantly inhibited survival and clonogenicity of primary human AML cells without affecting normal cells. We demonstrated that ISC-4-mediated p-Akt inhibition caused apoptosis in primary AML (CD34+) stem cells and enhanced efficacy of cytarabine. ISC-4 impeded leukemia progression with improved overall survival in a syngeneic C1498 mouse model with no obvious toxic effects on normal myelopoiesis. In U937 xenograft model, bone marrow cells exhibited significant reduction in human CD45+ cells in ISC-4 (~87%) or AraC (~89%) monotherapy groups compared to control. Notably, combination treatment suppressed the leukemic infiltration significantly higher than the single-drug treatments (~94%). Together, the present findings suggest that ISC-4 might be a promising agent for AML treatment.

Parental Perception of the Perioperative Experience for Children With Autism.

Children with autism spectrum disorders (ASDs) face unique challenges when preparing for and undergoing surgery in the perioperative setting. Our goal was to describe this experience via the qualitative evaluation of interviews with parents whose children with ASD had recently undergone surgery in a tertiary medical center. Twelve parents or guardians participated in these interviews. Two independent researchers recorded interviews and analyzed transcripts. The researchers analyzed the interview transcripts using qualitative software to determine the categories of frequent answers to interview questions. Important categories that emerged included behavioral triggers (ie, response to sounds, expression of anxiety and pain), objects used for comfort, communication issues, important people, and advice. We found that children with ASD have specific and unique needs for reassurance and comfort during a perioperative visit. We created a tool, included in this article, to provide a patient-centered framework for interactions with children with ASD in the perioperative environment.

Decisional regret following ventilation tube insertion.

OBJECTIVE: The purpose of this study was to see if parental regret following ventilation tube (VT) insertion was related to non-resolution of ear infections and thus ongoing need for otolaryngological care and VT reinsertion. MATERIALS AND METHODS: All consecutive parents presenting with children who had VT in place were given a validated regret survey and asked the reason for their visit. Chart review was used for medical history. RESULTS: Two hundred and ten respondents were included. The children involved had a mean age of 5.2 years, 63.3% were male, and mean number of years since first VT insertion was 1.12 with a range of 0.04-9.28 years. 70.5% had a regret score of 0, with mean score 6.98 (95%CI 5.11-8.85). Scores were significantly higher for parents who presented their child with an ear complaint such as otorrhea (15.52, 95%CI 7.67-23.37, p = 0.004). Parents whose children had a history of reflux had significantly lower regret scores than parents whose children did not have a history of reflux (3.33 versus 7.89, p = 0.007). Parental regret was unrelated to patient age, other comorbidities, indication for initial tube insertion, hearing status on the day of inquiry, number of sets of tubes, visits for otorrhea, prescriptions given for eardrops, clinic visits, or length of follow-up. CONCLUSION: Transient factors may influence decisional regret at any given time. For parents whose children receive VT, regret is not related to prolonged specialized ear care and need for VT reinsertion.