Comparative Analyses of Pain, Depressed Mood and Sleep Disturbance Symptoms in Women before and after Hysterectomy

Hysterectomy affects several aspects of a woman’s health, and persons considering a surgery should be aware of its effectiveness for relief of symptoms and long term effects on quality of life. The aims of the study were to examine pain, depressed mood, and sleep disturbance symptoms of women before and six weeks after hysterectomy; compare the physiological and social variables related to the symptoms, and examine the levels of symptom severity between abdominal vs vaginal hysterectomy. A pre and post measures study collected data from a prospective sample of 26 of the 36 culturally diverse women who were scheduled for hysterectomy using subjective questionnaires and objective wrist actigraphy monitoring for sleep and wake time. Results indicated that the majority of participants reported moderate amounts of pain before surgery however an average pain score did not vary over time. Depressed mood scores in women with laparoscopic vaginal hysterectomy significantly decreased from the baseline to six weeks after surgery, showing less severity of depression after surgery. Compared to the baseline measures, wrist actigraphy recordings showed increases in the numbers of awakening, wake after sleep onset and day time sleep during six weeks after surgery indicating that women had more sleep disturbance postoperatively. However, compared to women who had the abdominal surgery, those with vaginal hysterectomy reported a significantly severe sleep disturbance at six weeks after surgery; and younger women experienced more wake time at night. Evidence based findings indicated that hysterectomy relieved pain however women continued to experience disturbed sleep patterns six weeks after surgery, suggesting further research is needed in light of women’s health

Association of Prenatal Urinary Concentrations of Phthalates and Bisphenol A and Pubertal Timing in Boys and Girls.

BackgroundAnimal studies suggest that phthalates and bisphenol A (BPA), endocrine-disrupting chemicals found in many consumer products, may impact the timing of puberty.ObjectivesWe aimed to determine the association of prenatal exposure to high-molecular-weight phthalates and BPA with pubertal timing in boys and girls participating in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) longitudinal cohort study.MethodsWe quantified urinary concentrations of eight phthalate metabolites and BPA at two time points during pregnancy among participating mothers ([Formula: see text]) and conducted clinical Tanner staging of puberty on their children every 9 months between 9 and 13 y of age. We conducted accelerated failure time models and examined the role of child overweight/obese status in this association.ResultsThe sum of urinary metabolites of di(2-ethylhexyl) phthalate [Formula: see text], monobenzyl phthalate (MBzP), and BPA were associated with later onset of at least one of the three outcomes assessed in girls (thelarche, pubarche, or menarche) and with earlier onset of at least one of the two outcomes assessed in boys (gondarche and pubarche). We found that monocarboxynonyl phthalate, monocarboxyoctyl phthalate, mono(3-carboxypropyl) phthalate, and BPA were associated with later pubarche and menarche mostly among normal-weight girls but not overweight/obese girls. MBzP was associated with later thelarche in all girls, and [Formula: see text] was associated with later thelarche and menarche in all girls. BPA and all phthalate biomarkers were associated with earlier gonadarche and pubarche in all boys as well as in overweight/obese boys when stratified by weight. Among normal-weight boys, associations with BPA were also inverse, whereas associations with phthalate metabolites were close to the null or positive.ConclusionsSeveral high-molecular-weight phthalates and BPA were associated with later puberty in girls and earlier puberty in boys included in the CHAMACOS cohort study. Childhood overweight/obesity may modify these associations. https://doi.org/10.1289/EHP3424

The Emerging Epigenetic Landscape in Melanoma

Melanoma is the deadliest form of skin cancer. The disease is driven by molecular alterations in oncogenic signaling pathways, such as mitogen‐activated protein kinase (MAPK) and phosphatidylinositol 3‐kinase (PI3K). Activating mutations in oncogenes, such as BRAF and NRAS, and inactivating mutations in tumor suppressors genes, such as PTEN, promote this disease by altering cellular processes involved in growth, survival, and migration. Therapies targeting critical nodes in these pathways have demonstrated efficacy in clinical trials, but their therapeutic potential has been limited by the rapid onset of drug resistance. Durable therapeutic responses have also been observed in patients receiving immunotherapy. However, this activity appears to be confined to a subset of patients, and combinations with targeted therapies have raised safety concerns. Accumulating evidence strongly suggests that the pathogenesis of melanoma is also shaped by the aberrant activity of epigenetic factors that regulate gene expression through the modification of DNA and chromatin. This chapter provides a comprehensive review of the epigenetic alterations in melanoma and highlights the roles played by specific chromatin regulators during disease progression. We also discuss the clinical utility of both first and second generation epigenetic therapies in the melanoma setting, placing emphasis on the potential to overcome resistance to targeted therapies and to serve as priming agents for immunotherapies

Knowledge of Cardiovascular Medications in a Culturally Diverse Elderly Community: Health Assessment Outcomes by Nursing Students

Lack of knowledge in medication use appears a major hindrance in managing cardiovascular diseases. The cross-sectional study examined the determinants of knowledge of cardiovascular medications in elderly community, using the survey questionnaire and structured interviews to collect data from 99 culturally-diverse elderly people at independent-living facilities in California. Results indicate that the majority of participants was women (82.8%), living alone with an educational level of high-school or higher. Sixty-six participants took at least one cardiovascular medication, and the average number of cardiovascular medications taken was 2.02 (±1.10). The most frequently used cardiovascular medications were lipid-lowering agents and aspirin. Thirtyeight participants demonstrated a lack of knowledge of cardiovascular medication use. After adjusting for age, gender, education, and living status, it was found that having a BMI higher than 25 (OR: 5.46; 95% CI; 1.12, 26.52), drinking alcohol beverages (OR: 0.075; 95% CI: 0.01, 0.83), and having a history of ever-smoking (OR: 54.90; 95% CI: 4.39, 686.29) were statistically significant, independent predictors of a lack of knowledge about cardiovascular medications

Occupational Therapy and Allied Health Interventions to Promote and Support Client Self-Advocacy: A Systematic Review of the Literature

Background: Despite occupational therapy’s focus on optimizing participation in society for individuals with disability, self-advocacy has only recently (2008) become an official client factor in the Occupational Therapy Practice Framework (OTPF). Method: This study examined the current evidence in allied health professions addressing self-advocacy skills through exploring the quality, characteristics, and effectiveness of interventions designed to promote client self-advocacy. Multiple electronic databases were used for the literature search, including: PubMed, Ebscohost, PsycINFO, Google Scholar, and Sagepub. Select professional journals were also searched. Key words used in literature review were: self-advocacy, self-determination, occupational therapy, advocacy, empowerment, interventions, allied health, and people with disabilities. The Feasibility, Appropriateness, Meaningfulness, and Effectiveness (FAME) scale (Pearson et al., 2007) was used to determine the quality of current self-advocacy interventions. Results: The studies included in this systematic review showed successful self-advocacy interventions conducted in group and community-based settings that allowed for peer support. Self-advocacy skills have been shown to positively affect clients’ quality of life, participation, well-being, and occupational justice. Conclusion: Our study indicates that although literature on self-advocacy interventions has been published in the last 15 years, research on self-advocacy interventions in occupational therapy and other allied health disciplines is still lacking

Understanding Perceptions of Problematic Facebook Use: When People Experience Negative Life Impact and a Lack of Control

While many people use social network sites to connect with friends and family, some feel that their use is problematic, seriously affecting their sleep, work, or life. Pairing a survey of 20,000 Facebook users measuring perceptions of problematic use with behavioral and demographic data, we examined Facebook activities associated with problematic use as well as the kinds of people most likely to experience it. People who feel their use is problematic are more likely to be younger, male, and going through a major life event such as a breakup. They spend more time on the platform, particularly at night, and spend proportionally more time looking at profiles and less time browsing their News Feeds. They also message their friends more frequently. While they are more likely to respond to notifications, they are also more likely to deactivate their accounts, perhaps in an effort to better manage their time. Further, they are more likely to have seen content about social media or phone addiction. Notably, people reporting problematic use rate the site as more valuable to them, highlighting the complex relationship between technology use and well-being. A better understanding of problematic Facebook use can inform the design of context-appropriate and supportive tools to help people become more in control.Comment: CHI 201

Primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphomas: reappraisal of a provisional entity in the 2016 WHO classification of cutaneous lymphomas.

Primary cutaneous CD8-positive aggressive epidermotropic T-cell lymphoma is a rare and poorly characterized variant of cutaneous lymphoma still considered a provisional entity in the latest 2016 World Health Organization Classification of Cutaneous lymphomas. We sought to better characterize and provide diagnostic and therapeutic guidance of this rare cutaneous lymphoma. Thirty-four patients with a median age of 77 years (range 19-89 years) presented primarily with extensive annular necrotic plaques or tumor lesions with frequent mucous membrane involvement. The 5-year survival was 32% with a median survival of 12 months. A subset of 17 patients had a prodrome of chronic patches prior to the development of aggressive ulcerative lesions. We identified cases with lack of CD8 or αβ T-cell receptor expression yet with similar clinical and pathological presentation. Allogeneic stem cell transplantation provided partial or complete remissions in 5/6 patients. We recommend the term primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphoma as this more broad designation better describes this clinical-pathologic presentation, which allows the inclusion of cases with CD8 negative and/or αβ/γδ T-cell receptor chain double-positive or double-negative expression. We have identified early skin signs of chronic patch/plaque lesions that are often misdiagnosed as eczema, psoriasis, or mycosis fungoides. Our experience confirms the poor prognosis of this entity and highlights the inefficacy of our standard therapies with the exception of allogeneic stem cell transplantation in selected cases

Submm/mm Galaxy Counterpart Identification Using a Characteristic Density Distribution

We present a new submm/mm galaxy counterpart identification technique which builds on the use of Spitzer IRAC colors as discriminators between likely counterparts and the general IRAC galaxy population. Using 102 radio- and SMA-confirmed counterparts to AzTEC sources across three fields (GOODS-N, GOODS-S, and COSMOS), we develop a non-parametric IRAC color-color characteristic density distribution (CDD), which, when combined with positional uncertainty information via likelihood ratios, allows us to rank all potential IRAC counterparts around SMGs and calculate the significance of each ranking via the reliability factor. We report all robust and tentative radio counterparts to SMGs, the first such list available for AzTEC/COSMOS, as well as the highest ranked IRAC counterparts for all AzTEC SMGs in these fields as determined by our technique. We demonstrate that the technique is free of radio bias and thus applicable regardless of radio detections. For observations made with a moderate beamsize (~18"), this technique identifies ~85 per cent of SMG counterparts. For much larger beamsizes (>30"), we report identification rates of 33-49 per cent. Using simulations, we demonstrate that this technique is an improvement over using positional information alone for observations with facilities such as AzTEC on the LMT and SCUBA-2 on JCMT.Comment: 30 pages, 9 figures, 5 tables. Accepted for publication in MNRA

Effect of the Electrolyte Solvent on Redox Processes in Mg–S Batteries

Mg–S batteries are attractive for next-generation energy storage because of their high theoretical capacity and low cost. The foremost challenge in Mg–S batteries is designing electrolytes that support reversible electrochemistry at both electrodes. Here, we target a solution-mediated reduction pathway for the S_8 cathode by tailoring the electrolyte solvent. Varying the solvent in Mg-based systems is complicated because of the active nature of the solvent in solvating Mg^(2+) and the complex dynamics of electrolyte–Mg interfaces. To understand the effect of the solvent on the S_8 reduction processes in the Mg–S cell, the magnesium–aluminum chloride complex (MACC) electrolyte was prepared in different ethereal solvents. Reversible Mg electrodeposition is demonstrated in the MACC electrolyte in several solvent systems. The electrodeposition overpotentials and current densities are found to vary with the solvent, suggesting that the solvent plays a noninnocent role in the electrochemical processes at the Mg interface. Mg–S cells are prepared with the electrolytes to understand how the solvent affects the reduction of S_8. A reductive wave is present in all linear-sweep voltammograms, and the peak potential varies with the solvent. The peak potential is approximately 0.8 V versus Mg/Mg^(2+), lower than the expected reduction potential of 1.7 V. We rule out passivation of the Mg anode as the cause for the low voltage peak potential, making processes at the S8 cathode the likely culprit. The ability to oxidize MgS with the MACC electrolyte is also examined, and we find that the oxidation current can be attributed to side reactions at the C–electrolyte interface

Effect of the Electrolyte Solvent on Redox Processes in Mg–S Batteries

Mg–S batteries are attractive for next-generation energy storage because of their high theoretical capacity and low cost. The foremost challenge in Mg–S batteries is designing electrolytes that support reversible electrochemistry at both electrodes. Here, we target a solution-mediated reduction pathway for the S_8 cathode by tailoring the electrolyte solvent. Varying the solvent in Mg-based systems is complicated because of the active nature of the solvent in solvating Mg^(2+) and the complex dynamics of electrolyte–Mg interfaces. To understand the effect of the solvent on the S_8 reduction processes in the Mg–S cell, the magnesium–aluminum chloride complex (MACC) electrolyte was prepared in different ethereal solvents. Reversible Mg electrodeposition is demonstrated in the MACC electrolyte in several solvent systems. The electrodeposition overpotentials and current densities are found to vary with the solvent, suggesting that the solvent plays a noninnocent role in the electrochemical processes at the Mg interface. Mg–S cells are prepared with the electrolytes to understand how the solvent affects the reduction of S_8. A reductive wave is present in all linear-sweep voltammograms, and the peak potential varies with the solvent. The peak potential is approximately 0.8 V versus Mg/Mg^(2+), lower than the expected reduction potential of 1.7 V. We rule out passivation of the Mg anode as the cause for the low voltage peak potential, making processes at the S8 cathode the likely culprit. The ability to oxidize MgS with the MACC electrolyte is also examined, and we find that the oxidation current can be attributed to side reactions at the C–electrolyte interface