An evaluation of the diagnostic validity of the structured questionnaires of the adult Asperger's Assessment.

The Adult Autism Quotient (AQ), the Empathy Quotient (EQ) and the Relative's Questionnaire (RQ) were used as part of the Adult Asperger's Assessment (AAA) by a diagnostic service for adults without an intellectual disability with suspected autism spectrum disorder (ASD). This service is part of the National Health Service (NHS) in England. Little is known about the utility of these structured questionnaires despite wide use in clinical practice. It was investigated whether the questionnaires could discriminate between individuals with and without a diagnosis of ASD. Receiver Operating Curve analysis showed good levels of sensitivity to detect a positive diagnosis, but the specificity to exclude those without a diagnosis was poor. A binary logistic regression showed that a combination of the questionnaires also showed limited diagnostic validity. These findings have clinical implications in reviewing the efficiency of the assessment process.

The diversity officer: Police officers' and black women civilians' epistemologies of race and racism in policing.

Diversifying police forces has been suggested to improve "police-minority relations" amidst national uprisings against police violence. Yet, little research investigates how police and black civilians-two groups invoked in discourse on "police-minority relations"-understand the function of diversity interventions. We draw on 100 in-depth interviews with 60 black women civilians and 40 police from various racial and ethnic backgrounds to explore how they understand the function of racial diversity in policing. Findings highlight discrepancies in how these two groups frame the utility of racial diversity in policing, revealing conflicting epistemologies of race and racism. Police draw on an epistemology of racial ignorance (Mills 1997, 2007, 2015) to selectively accommodate race-conscious critique while denying the history and power dynamics between the institution and minority communities. Conversely, black women civilians, grounded in a standpoint epistemology (Collins 1986, 2009), emphasize the historical roots of policing, along with collective memories and lived experiences to understand the relationship between the institution and minority communities. Through a comparative analysis of these frames, we theorize dominant/state-sponsored discourse on diversity and police-minority relations as form of racecraft (Fields and Fields 2012, 2014) that serves to legitimize negligible institutional change to policing in an era of renewed scrutiny of police racism.

Outcomes of Alvimopan Use in Laparoscopic Intra-abdominal Surgery: A Retrospective Review.

Background: Postoperative ileus is a transient cessation of bowel motility, occurring after bowel resection, characterized by abdominal distension and pain, nausea, vomiting, and an accumulation of gas/fluids in the bowel. It is associated with a greater incidence of postoperative morbidity and increased length of stay or readmission. Alvimopan, a novel peripheral mu receptor antagonist, is indicated for preventing postoperative ileus in patients undergoing intra-abdominal surgery or bowel resection. The objective of this study was to assess the impact of alvimopan use in laparoscopic abdominal surgeries. Objective: To assess alvimopan use's impact in laparoscopic abdominal surgeries. Methods: A retrospective chart review was conducted of 84 patients who underwent laparoscopic procedures that received alvimopan (September 1, 2018 to October 31, 2018) and compared to patients that did not receive alvimopan (May 1, 2018 to June 30, 2018, due to a national shortage of the medication). The primary outcome was the rate of postoperative ileus. Secondary outcomes included rate of 30-day readmission, length of stay (LOS), postoperative opioid and laxative use, time to initiation of oral diet, and return of bowel function (ROBF) as demonstrated by recorded bowel movement. Results: There was no statistical difference observed in primary outcome of postoperative ileus between alvimopan and no alvimopan groups (2.7% vs 4.3%, p=1). Secondary outcomes such as length of stay (5.4 days vs 5.4 days, p=0.49), length of postoperative stay (5 vs 4.9, p=0.44), days to oral diet (0.9 vs 0.4, p=0.16), time to BM (1.8 vs 2.2, p=0.32), and 30-day readmission were also similar between the two groups. Conclusion: The similar outcome profiles in all primary and secondary outcomes do not support the use of alvimopan in the setting of laparoscopic intra-abdominal surgery.

Plant science decadal vision 2020-2030: Reimagining the potential of plants for a healthy and sustainable future.

Plants, and the biological systems around them, are key to the future health of the planet and its inhabitants. The Plant Science Decadal Vision 2020-2030 frames our ability to perform vital and far-reaching research in plant systems sciences, essential to how we value participants and apply emerging technologies. We outline a comprehensive vision for addressing some of our most pressing global problems through discovery, practical applications, and education. The Decadal Vision was developed by the participants at the Plant Summit 2019, a community event organized by the Plant Science Research Network. The Decadal Vision describes a holistic vision for the next decade of plant science that blends recommendations for research, people, and technology. Going beyond discoveries and applications, we, the plant science community, must implement bold, innovative changes to research cultures and training paradigms in this era of automation, virtualization, and the looming shadow of climate change. Our vision and hopes for the next decade are encapsulated in the phrase reimagining the potential of plants for a healthy and sustainable future. The Decadal Vision recognizes the vital intersection of human and scientific elements and demands an integrated implementation of strategies for research (Goals 1-4), people (Goals 5 and 6), and technology (Goals 7 and 8). This report is intended to help inspire and guide the research community, scientific societies, federal funding agencies, private philanthropies, corporations, educators, entrepreneurs, and early career researchers over the next 10 years. The research encompass experimental and computational approaches to understanding and predicting ecosystem behavior; novel production systems for food, feed, and fiber with greater crop diversity, efficiency, productivity, and resilience that improve ecosystem health; approaches to realize the potential for advances in nutrition, discovery and engineering of plant-based medicines, and "green infrastructure." Launching the Transparent Plant will use experimental and computational approaches to break down the phytobiome into a "parts store" that supports tinkering and supports query, prediction, and rapid-response problem solving. Equity, diversity, and inclusion are indispensable cornerstones of realizing our vision. We make recommendations around funding and systems that support customized professional development. Plant systems are frequently taken for granted therefore we make recommendations to improve plant awareness and community science programs to increase understanding of scientific research. We prioritize emerging technologies, focusing on non-invasive imaging, sensors, and plug-and-play portable lab technologies, coupled with enabling computational advances. Plant systems science will benefit from data management and future advances in automation, machine learning, natural language processing, and artificial intelligence-assisted data integration, pattern identification, and decision making. Implementation of this vision will transform plant systems science and ripple outwards through society and across the globe. Beyond deepening our biological understanding, we envision entirely new applications. We further anticipate a wave of diversification of plant systems practitioners while stimulating community engagement, underpinning increasing entrepreneurship. This surge of engagement and knowledge will help satisfy and stoke people's natural curiosity about the future, and their desire to prepare for it, as they seek fuller information about food, health, climate and ecological systems.

Multidisciplinary approach to low-dose CT screening for lung cancer in a metropolitan community.

BACKGROUND: Lung cancer is the primary cause of cancer death in men and women in the USA, led by Kentucky. In 2015, the Centers for Medicare and Medicaid Services initiated annual lung cancer screening with a low-dose computed tomography (LDCT) scan. This observational cohort study evaluated the multidisciplinary approach to this screening in our metropolitan community. METHODS: We present the prospective findings of patients who underwent a screening lung LDCT scan over a 2-year period at our institution in Kentucky. Patients who fulfilled the screening criteria were identified during an office visit with their primary care provider. RESULTS: Of the 4170 patients who underwent a screening lung LDCT scan, a total of 838 (20.9%) patients had nodules >4 mm. Of the 70 patients diagnosed with lung cancer, Stage 1 non-small cell lung cancer was most commonly detected [38 cases (54.3%)]. A follow-up lung LDCT scan (n = 897), pulmonary function test (n = 157), positron emission tomography scan (n = 12) and a lung biopsy (n = 53) were performed for certain individuals who had anomalies observed on the screening lung LDCT scan. A total of 42% of patients enrolled in group tobacco cessation classes quit smoking. CONCLUSIONS: This study provides a unique perspective of a lung LDCT scan screening program driven by primary care providers in a state plagued by cigarette smoking and lung cancer deaths and offers a valuable message into the prevention, high-risk screening and diagnosis of lung cancer.

Atypical APC/C-dependent degradation of Mcl-1 provides an apoptotic timer during mitotic arrest.

The initiation of apoptosis in response to the disruption of mitosis provides surveillance against chromosome instability. Here, we show that proteolytic destruction of the key regulator Mcl-1 during an extended mitosis requires the anaphase-promoting complex or cyclosome (APC/C) and is independent of another ubiquitin E3 ligase, SCFFbw7 Using live-cell imaging, we show that the loss of Mcl-1 during mitosis is dependent on a D box motif found in other APC/C substrates, while an isoleucine-arginine (IR) C-terminal tail regulates the manner in which Mcl-1 engages with the APC/C, converting Mcl-1 from a Cdc20-dependent and checkpoint-controlled substrate to one that is degraded independently of checkpoint strength. This mechanism ensures a relatively slow but steady rate of Mcl-1 degradation during mitosis and avoids its catastrophic destruction when the mitotic checkpoint is satisfied, providing an apoptotic timer that can distinguish a prolonged mitotic delay from normal mitosis. Importantly, we also show that inhibition of Cdc20 promotes mitotic cell death more effectively than loss of APC/C activity through differential effects on Mcl-1 degradation, providing an improved strategy to kill cancer cells.

The effect of exercise intensity and excess postexercise oxygen consumption on postprandial blood lipids in physically inactive men.

Reductions in postprandial lipemia have been observed following aerobic exercise of sufficient energy expenditure. Increased excess postexercise oxygen consumption (EPOC) has been documented when comparing high- versus low-intensity exercise. The contribution of EPOC energy expenditure to alterations in postprandial lipemia has not been determined. The purpose of this study was to evaluate the effects of low- and high-intensity exercise on postprandial lipemia in healthy, sedentary, overweight and obese men (age, 43 ± 10 years; peak oxygen consumption, 31.1 ± 7.5 mL·kg-1·min-1; body mass index, 31.8 ± 4.5 kg/m2) and to determine the contribution of EPOC to reductions in postprandial lipemia. Participants completed 4 conditions: nonexercise control, low-intensity exercise at 40%-50% oxygen uptake reserve (LI), high-intensity exercise at 70%-80% oxygen uptake reserve (HI), and HI plus EPOC re-feeding (HI+EERM), where the difference in EPOC energy expenditure between LI and HI was re-fed in the form of a sports nutrition bar (Premier Nutrition Corp., Emeryville, Calif., USA). Two hours following exercise participants ingested a high-fat (1010 kcals, 99 g sat fat) test meal. Blood samples were obtained before exercise, before the test meal, and at 2, 4, and 6 h postprandially. Triglyceride incremental area under the curve was significantly reduced following LI, HI, and HI+EERM when compared with nonexercise control (p < 0.05) with no differences between the exercise conditions (p > 0.05). In conclusions, prior LI and HI exercise equally attenuated postprandial triglyceride responses to the test meal. The extra energy expended during EPOC does not contribute significantly to exercise energy expenditure or to reductions in postprandial lipemia in overweight men.

Facile Use of Cationic Hydrogel Particles for Surface Modification of Planar Substrates Toward Multifunctional Neural Permissive Surfaces: An in Vitro Investigation.

Synthetic materials such as silicon have been commonly used for neural interfacing applications but are intrinsically noninteractive with neurons. Here, a facile approach has been developed to integrate both chemical and topographical cues to impart neural permissiveness for such materials. The approach simply exploits the basic phenomenon of electrostatically driven adsorption of colloidal particles onto a solid material and applies it to a cationic hydrogel particle system that we have developed recently based on "click" reaction of epoxide and amine. The particle adsorption process can be tuned by varying the adsorption time and the concentration of the original colloidal suspension, both of which directly control the surface densities of the adsorbed hydrogel particles. Using the PC12 cell line and primary cortical neurons derived from chick embryo, we demonstrate that the particle-adsorbed surface readily supports robust cell adhesion and differentiation. Although the extent of neural permissiveness exhibited by such particle-adsorbed surface was comparable to the cationic polyethylenimine-coated control surface, the adsorbed hydrogel particles offer a unique reservoir function to the modified surface that is unparalleled by the control. The successful loading of hydrophobic dye of nile red to the surface adsorbed hydrogel particles indicates that the modified surface not only provides physical support of neurons, but also can be explored in the future to exert localized therapeutic actions favorable for neural interfacing.

Occupational Needs and Goals of Survivors of Domestic Violence.

This study's purpose was to describe the occupational needs and goals of women residing in a domestic violence shelter and their self-perceived changes in satisfaction and occupational performance. Using a retrospective design, data from 68 occupational therapy evaluations from two domestic violence shelter settings were examined. Data were analyzed by coding problem areas and occupational goals and calculating frequencies for these variables. Where data were available, we also analyzed changes in pre- and postscores for self-perceived satisfaction and occupational performance (n = 25). The most common problem areas were leisure, education, work, child rearing, and health management. The most common goals were in the areas of education, work, health management, child rearing, and home management. Retrospective pre- and postchange scores in performance and satisfaction for 25 women were statistically significant. Findings provide direction for, and highlight the importance of occupational therapy services within domestic violence shelters as women regain their life skills.

Developing information leaflets for parents of children with cancer.

Information aids parents' understanding of and adjustment to their child's disease and treatment, and their ability to care for their child safely at home. This article describes the development of a leaflet on conditions, treatments, side effects, management advice and contacts for parents of children receiving treatment for cancer using an Ommaya reservoir. Health professionals should be aware of developments in health care, to ensure that current evidence-based information for families is provided.