Teaching during COVID-19: Relational-Cultural Theory in the Online Classroom

The sudden conversion from face-to-face to online instruction in Spring semester 2020 due to the COVID-19 pandemic was unprecedented. During this time instructors in helping professional training programs were engaged in the duality of being impacted in various degrees while simultaneously training students to assist clients in dealing with the resulting stress and emotional impact. Relational-Cultural Theory (RCT) is a framework that can be used within online counselor education to consider the impact of the larger socio-cultural context on student learning, prioritizing fostering relational connections. In this article, online teaching approaches aligned with the video conferencing tool, Zoom, are described

Early (Days 1–4) post-treatment serum hCG level changes predict single-dose methotrexate treatment success in tubal ectopic pregnancy

Acknowledgements S.C.M. was supported by the South-East Scotland Academic Foundation Programme. Medical Research Council (MRC) Centre grants to the Centre for Reproductive Health (CRH) (G1002033 and MR/N022556/1) are also gratefully acknowledged. Funding This project was supported by funding from the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research partnership (grant reference number 14/150/03).Peer reviewedPublisher PD

Subsequent pregnancy outcomes among women with tubal ectopic pregnancy treated with methotrexate

An ectopic pregnancy occurs when an embryo implants outside of the uterus, usually in a fallopian tube. When detected early, treatment is often with a medication called methotrexate. When methotrexate does not work, surgery is required. A recent clinical trial of ectopic pregnancy treatment (called GEM3) found that adding a drug called gefitinib to methotrexate did not reduce the need for surgery. We have used data from the GEM3 trial, combined with data collected 12 months after the trial finished, to investigate post-methotrexate pregnancy outcomes. We found no difference in pregnancy rates, pregnancy loss rates and recurrent ectopic pregnancy rates between those treated medically only and those who subsequently also needed surgery. The surgical technique used also did not affect pregnancy rates. This research provides reassurance that women with ectopic pregnancies treated medically who need surgery have similar post-treatment pregnancy outcomes to those treated successfully medically

Genetic variation in TLR genes in Ugandan and South African populations and comparison with HapMap data

Genetic epidemiological studies of complex diseases often rely on data from the International HapMap Consortium for identification of single nucleotide polymorphisms (SNPs), particularly those that tag haplotypes. However, little is known about the relevance of the African populations used to collect HapMap data for study populations conducted elsewhere in Africa. Toll-like receptor (TLR) genes play a key role in susceptibility to various infectious diseases, including tuberculosis. We conducted full-exon sequencing in samples obtained from Uganda (n = 48) and South Africa (n = 48), in four genes in the TLR pathway: TLR2, TLR4, TLR6, and TIRAP. We identified one novel TIRAP SNP (with minor allele frequency [MAF] 3.2%) and a novel TLR6 SNP (MAF 8%) in the Ugandan population, and a TLR6 SNP that is unique to the South African population (MAF 14%). These SNPs were also not present in the 1000 Genomes data. Genotype and haplotype frequencies and linkage disequilibrium patterns in Uganda and South Africa were similar to African populations in the HapMap datasets. Multidimensional scaling analysis of polymorphisms in all four genes suggested broad overlap of all of the examined African populations. Based on these data, we propose that there is enough similarity among African populations represented in the HapMap database to justify initial SNP selection for genetic epidemiological studies in Uganda and South Africa. We also discovered three novel polymorphisms that appear to be population-specific and would only be detected by sequencing efforts

The Sloan Digital Sky Survey Reverberation Mapping Project: Investigation of Continuum Lag Dependence on Broad-Line Contamination and Quasar Properties

This work studies the relationship between accretion-disk size and quasar properties, using a sample of 95 quasars from the SDSS-RM project with measured lags between the $g$ and $i$ photometric bands. Our sample includes disk lags that are both longer and shorter than predicted by the \citet{SS73} model, requiring explanations which satisfy both cases. Although our quasars each have one lag measurement, we explore the wavelength-dependent effects of diffuse broad line region (BLR) contamination through our sample's broad redshift range, $0.1<z<1.2$. We do not find significant evidence of variable diffuse \FeII\ and Balmer nebular emission in the root-mean-square (RMS) spectra, nor from Anderson-Darling tests of quasars in redshift ranges with and without diffuse nebular emission falling in the observed-frame filters. Contrary to previous work, we do not detect a significant correlation between measured continuum and BLR lags in our luminous quasar sample, similarly suggesting that our continuum lags are not dominated by diffuse nebular emission. Similar to other studies, we find that quasars with larger-than-expected continuum lags have lower 3000~\AA\ luminosity, and we additionally find longer continuum lags with lower X-ray luminosity and black hole mass. Our lack of evidence for diffuse BLR contribution to the lags indicates that the anti-correlation between continuum lag and luminosity is not likely to be due to the Baldwin effect. Instead, these anti-correlations favor models in which the continuum lag increases in lower-luminosity AGN, including scenarios featuring magnetic coupling between the accretion disk and X-ray corona, and/or ripples or rims in the disk.Comment: 15 pages, 10 figure

The Sloan Digital Sky Survey Reverberation Mapping Project : investigation of continuum lag dependence on broad-line contamination and quasar properties

Funding: H.W.S., J.R.T., M.C.D., and L.B.F. acknowledge support from NSF grant CAREER-1945546, and with C.J.G. acknowledge support from NSF grants AST-2009539 and AST-2108668. C.R. acknowledges support from Fondecyt Regular grant 1230345 and ANID BASAL project FB210003. M.L.M.-A. acknowledges financial support from Millenium Nucleus NCN19-058 (TITANs).This work studies the relationship between accretion-disk size and quasar properties, using a sample of 95 quasars from the Sloan Digital Sky Survey Reverberation Mapping Project with measured lags between the g and i photometric bands. Our sample includes disk lags that are both longer and shorter than predicted by the Shakura and Sunyaev model, requiring explanations that satisfy both cases. Although our quasars each have one lag measurement, we explore the wavelength-dependent effects of diffuse broad-line region (BLR) contamination through our sample’s broad redshift range, 0.1 < z < 1.2. We do not find significant evidence of variable diffuse Fe ii and Balmer nebular emission in the rms spectra, nor from Anderson–Darling tests of quasars in redshift ranges with and without diffuse nebular emission falling in the observed-frame filters. Contrary to previous work, we do not detect a significant correlation between the measured continuum and BLR lags in our luminous quasar sample, similarly suggesting that our continuum lags are not dominated by diffuse nebular emission. Similar to other studies, we find that quasars with larger-than-expected continuum lags have lower 3000 Å luminosities, and we additionally find longer continuum lags with lower X-ray luminosities and black hole masses. Our lack of evidence for diffuse BLR contribution to the lags indicates that the anticorrelation between continuum lag and luminosity is not likely to be due to the Baldwin effect. Instead, these anticorrelations favor models in which the continuum lag increases in lower-luminosity active galactic nuclei, including scenarios featuring magnetic coupling between the accretion disk and X-ray corona, and/or ripples or rims in the disk.Publisher PDFPeer reviewe

A broad distribution of the alternative oxidase in microsporidian parasites

Microsporidia are a group of obligate intracellular parasitic eukaryotes that were considered to be amitochondriate until the recent discovery of highly reduced mitochondrial organelles called mitosomes. Analysis of the complete genome of Encephalitozoon cuniculi revealed a highly reduced set of proteins in the organelle, mostly related to the assembly of ironsulphur clusters. Oxidative phosphorylation and the Krebs cycle proteins were absent, in keeping with the notion that the microsporidia and their mitosomes are anaerobic, as is the case for other mitosome bearing eukaryotes, such as Giardia. Here we provide evidence opening the possibility that mitosomes in a number of microsporidian lineages are not completely anaerobic. Specifically, we have identified and characterized a gene encoding the alternative oxidase (AOX), a typically mitochondrial terminal oxidase in eukaryotes, in the genomes of several distantly related microsporidian species, even though this gene is absent from the complete genome of E. cuniculi. In order to confirm that these genes encode functional proteins, AOX genes from both A. locustae and T. hominis were over-expressed in E. coli and AOX activity measured spectrophotometrically using ubiquinol-1 (UQ-1) as substrate. Both A. locustae and T. hominis AOX proteins reduced UQ-1 in a cyanide and antimycin-resistant manner that was sensitive to ascofuranone, a potent inhibitor of the trypanosomal AOX. The physiological role of AOX microsporidia may be to reoxidise reducing equivalents produced by glycolysis, in a manner comparable to that observed in trypanosome

The Sloan Digital Sky Survey Reverberation Mapping project : photometric g and i light curves

Funding: P.H. acknowledges the support of the Natural Sciences and Engineering Research Council of Canada (NSERC), funding reference number 2017-05983. C.J.G., W.N.B., and D.P.S. acknowledge support from NSF grant AST-1517113. Y.S. acknowledges support from an Alfred P. Sloan Research Fellowship and NSF grant AST-1715579. L.C.H. acknowledges the National Key R&D Program of China (2016YFA0400702) and the National Science Foundation of China (11721303, 11991052). J.V.H.S. and K.H. acknowledge support from a STFC grant ST/R000824/1. C.S.K. is supported by NSF grants AST-1814440 and AST-1908570.The Sloan Digital Sky Survey (SDSS) Reverberation Mapping program monitors 849 active galactic nuclei (AGNs) both spectroscopically and photometrically. The photometric observations used in this work span over 4 yr and provide an excellent baseline for variability studies of these objects. We present the photometric light curves from 2014 to 2017 obtained by the Steward Observatory's Bok telescope and the Canada-France-Hawaii telescope with MegaCam. We provide details on the data acquisition and processing of the data from each telescope, the difference imaging photometry used to produce the light curves, and the calculation of a variability index to quantify each AGN's variability. We find that the Welch-Stetson J index provides a useful characterization of AGN variability and can be used to select AGNs for further study.PostprintPeer reviewe

A multi-centre, double-blind, placebo-controlled, randomised trial of combination methotrexate and gefitinib versus methotrexate alone to treat tubal ectopic pregnancies (GEM3): trial protocol

Background Tubal ectopic pregnancy (tEP) is the most common life-threatening condition in gynaecology. Treatment options include surgery and medical management. Stable women with tEPs with pre-treatment serum human chorionic gonadotrophin (hCG) levels  1000 IU/L can take significant time to resolve with methotrexate and require multiple outpatient monitoring visits. In pre-clinical studies, we found that tEP implantation sites express high levels of epidermal growth factor receptor. In early-phase trials, we found that combination therapy with gefitinib, an orally active epidermal growth factor receptor antagonist, and methotrexate resolved tEPs without the need for surgery in over 70% of cases, did not cause significant toxicities, and was well tolerated. We describe the protocol of a randomised trial to assess the efficacy of combination gefitinib and methotrexate, versus methotrexate alone, in reducing the need for surgical intervention for tEPs. Methods and analysis We propose to undertake a multi-centre, double-blind, placebo-controlled, randomised trial (around 70 sites across the UK) and recruit 328 women with tEPs (with pre-treatment serum hCG of 1000–5000 IU/L). Women will be randomised in a 1:1 ratio by a secure online system to receive a single dose of intramuscular methotrexate (50 mg/m2) and either oral gefitinib or matched placebo (250 mg) daily for 7 days. Participants and healthcare providers will remain blinded to treatment allocation throughout the trial. The primary outcome is the need for surgical intervention for tEP. Secondary outcomes are the need for further methotrexate treatment, time to resolution of the tEP (serum hCG ≤ 15 IU/L), number of hospital visits associated with treatment (until resolution or scheduled/emergency surgery), and the return of menses by 3 months after resolution. We will also assess adverse events and reactions until day of resolution or surgery, and participant-reported acceptability at 3 months. Discussion A medical intervention that reduces the need for surgery and resolves tEP faster would be a favourable treatment alternative. If effective, we believe that gefitinib and methotrexate could become standard care for stable tEPs

GaPP2, a multicentre randomised controlled trial of the efficacy of gabapentin for the management of chronic pelvic pain in women:study protocol

Introduction: Chronic pelvic pain (CPP) affects more than 1 million UK women with associated healthcare costs of £158 million annually. Current evidence supporting interventions when no underlying pathology is identified is very limited and treatment is frequently inadequate. Gabapentin (a GABA analogue) is efficacious and often well tolerated in other chronic pain conditions. We have completed a successful pilot randomised controlled trial (GaPP1) and here describe the protocol for the definitive multicentre trial to assess the efficacy of gabapentin in the management of CPP in women (GaPP2).Methods and analysis: We plan to perform a double blind placebo controlled randomised multi-centre clinical trial, recruiting 300 women with CPP from more than 8 NHS hospitals within the UK. After randomisation, women will titrate their medication (gabapentin or placebo) over a 4-week period to a maximum of 2700mg or placebo equivalent and will then maintain a stable dose for a 12 week period. Response to treatment will be monitored with validated questionnaires and co-primary outcome measures of average and worst pain scores will be employed. The primary objective is to test the hypothesis that treatment with gabapentin has the potential to provide an effective oral treatment to alleviate pain in women with CPP in the absence of any obvious pelvic pathology.Ethics and dissemination: Ethical approval has been obtained from the Coventry and Warwick Research Ethics Committee (REC 15/WM/0036). Data will be presented at international conferences and published in peer-reviewed journals. We will make the information obtained from the study available to the public through national bodies and charities.Trial registration number: ISRCTN7745176