Ozanimod: A Practical Review for Nurses and Advanced Practice Providers

Ozanimod is the first sphingosine 1-phosphate (S1P) receptor modulator approved for the treatment of moderately to severely active ulcerative colitis (UC). In clinical trials, participants with moderately to severely active UC who received once-daily oral ozanimod demonstrated significantly improved rates of clinical, endoscopic, and histologic outcomes than participants receiving placebo. Ozanimod is also approved for the treatment of relapsing forms of multiple sclerosis (MS). This review summarizes safety data from UC and MS clinical trials and discusses treatment considerations when using ozanimod in clinical practice. Ozanimod is an oral, small molecule agent with a novel mechaism of action that differentiates it from other UC therapies. Ozanimod was generally well tolerated in clinical trials, and the incidence of adverse events of special interest based on prior associations with S1P receptor modulation was low overall. Of note, the risk for clinically significant bradycardia upon treatment initiation was mitigated by gradual dose titration, few patients experienced lymphopenia or serious infections, macular edema and malignancy occurred infrequently, and most hepatic events were transient and did not require treatment discontinuation. Given the safety and efficacy profile of ozanimod, it may be an early treatment option in patients with moderate disease or in those hesitant to use biologics, and it could also be beneficial after other treatments have failed. Further investigation is needed to determine the positioning of ozanimod within the UC treatment armamentarium

Coaching Teachers of English Language Learners

The following qualitative study examined how Reading First Literacy Coaches refined their literacy coaching to meet the cultural and linguistic needs of Hispanic English language learners (ELLs) in 30 elementary schools located along the US Mexico Border. Data were gathered from the coaches through written surveys and a focus group. Findings from the coaches’ practices identified three themes: 1) Coaches understood bilingual programs and the theory underlying such instruction; 2) Coaches supported teachers of ELLs by sharing their knowledge and experiences about ELLs; and 3) Coaches faced challenges in meeting the needs of teachers of Hispanic ELLs. This study is an addition to the literature that describes and contextualizes the work of instructional coaches. It has practical implications for schools seeking to build the capacity of teachers of ELLs. Guidance is suggested related to hiring coaches with special dispositions and the professional development of existing coaches

Introducing Berry phase gradients along the optical path via propagation-dependent polarization transformations

Abstract As a classical or quantum system undergoes a cyclic evolution governed by slow change in its parameter space, it acquires a topological phase factor known as the geometric or Berry phase. One popular manifestation of this phenomenon is the Gouy phase which arises when the radius of curvature of the wavefront changes adiabatically in a cyclic manner, for e.g., when focused by a lens. Here, we report on a new manifestation of the Berry phase in 3D structured light which arises when its polarization state adiabatically evolves along the optical path. We show that such a peculiar evolution of angular momentum, which occurs under free space propagation, is accompanied by an accumulated phase shift that elegantly coincides with Berry's prediction. Unlike the conventional dynamic phase, which accumulates monotonically with propagation, the Berry phase observed here can be engineered on demand, thereby enabling new possibilities; such as spin-dependent spatial frequency shifts, and modified phase matching in resonators and nonlinear interactions. Our findings expand the laws of wave propagation and can be applied in optics and beyond

Physical Activity in Children with Prader-Willi Syndrome: A Parents’ Perspective

Background. Physical activity (PA) is vital for the management of weight among those with Prader Willi Syndrome (PWS). However, little is known about characteristics of PA in individuals with PWS. Objective/Hypothesis. To assess from the parent’s perspective, PA levels among individuals with PWS, their preferences for specific activities, and perceived benefits, barriers, and resources needed to participate in PA. Methods. Participants were 90 parents and caregivers of a child with PWS, predominantly in California. Survey questions included their child’s participation in different PAs, perceived benefits and barriers to enrolling their child in a PA program, and perceived needs to facilitate their child being physically active. Results. Walking was the predominant PA, representing 66% of the activity time across all age groups. Children 10-17 years old engaged in more moderate intensity PA per week than children 5-10 years old. Children 5-10 years old engaged in more vigorous PA than those 18+ years old. Parents reported that they would be encouraged to enroll their child in a PA program if it would improve their children’s motor skills and balance (78.2%) as well as stamina and strength (74.4%). Time commitment and travel were most common barriers. Less financial constraints (70.1%) and having more time (54.7%) were listed as needs. Conclusions. Similar to individuals without PWS, vigorous PA declines with age. It is recommended that caregivers and health care providers emphasize the role of vigorous and bone-strengthening PA as children with PWS approach adolescence

Polariton Nanophotonics using Phase Change Materials

Polaritons formed by the coupling of light and material excitations such as plasmons, phonons, or excitons enable light-matter interactions at the nanoscale beyond what is currently possible with conventional optics. Recently, significant interest has been attracted by polaritons in van der Waals materials, which could lead to applications in sensing, integrated photonic circuits and detectors. However, novel techniques are required to control the propagation of polaritons at the nanoscale and to implement the first practical devices. Here we report the experimental realization of polariton refractive and meta-optics in the mid-infrared by exploiting the properties of low-loss phonon polaritons in isotopically pure hexagonal boron nitride (hBN), which allow it to interact with the surrounding dielectric environment comprising the low-loss phase change material, Ge$_3$Sb$_2$Te$_6$ (GST). We demonstrate waveguides which confine polaritons in a 1D geometry, and refractive optical elements such as lenses and prisms for phonon polaritons in hBN, which we characterize using scanning near field optical microscopy. Furthermore, we demonstrate metalenses, which allow for polariton wavefront engineering and sub-wavelength focusing. Our method, due to its sub-diffraction and planar nature, will enable the realization of programmable miniaturized integrated optoelectronic devices, and will lay the foundation for on-demand biosensors.Comment: 15 pages, 4 figures, typos corrected in v

Constraining the Size of the Circumgalactic Medium Using the Transverse Autocorrelation Function of C IV Absorbers in Paired Quasar Spectra

The circumgalactic medium (CGM) plays a vital role in the formation and evolution of galaxies, acting as a lifeline between galaxies and the surrounding intergalactic medium (IGM). In this study we leverage a unique sample of quasar pairs to investigate the properties of the CGM with absorption line tomography. We present a new sample of medium resolution Keck/ESI, Magellan/MagE, and VLT/XSHOOTER spectra of 29 quasar pairs at redshift $2 < z < 3$. We supplement the sample with additional spectra of 32 pairs from the literature, creating a catalog of 61 quasar pairs with angular separations between 1.7" and 132.9" and projected physical separations ($r_\perp$) between 14 kpc and 887 kpc. We construct a catalog of 906 metal-line absorption doublets of C IV ($\lambda\lambda 1548, 1550$) with equivalent widths ranging from 6 m{\AA} $\leq W_{r, 1550} \leq 2053$ m{\AA}. The best fit linear model to the log-space equivalent width frequency distribution ($\log f(W_r) = m\log(W_{r}) + b$) of the sample yields coefficients of $m=-1.44\pm0.16$ and $b=-0.43\pm0.16$. To constrain the projected extent of C IV, we calculate the transverse autocorrelation function. The flattening of the autocorrelation function at low $r_\perp$ provides a lower limit for the coherence length of the metal enriched CGM - on the order of 200 $h^{-1}$ comoving kpc. This physical size constraint allows us to refine our understanding of the metals in the CGM, where the extent of C IV in the CGM depends on gas flows, feedback, timescale of metal injection and mixing, and the mass of the host galaxies.Comment: 19 pages, 8 figures, 2 tables, Accepted for publication by The Astronomical Journa

Endometriosis Among Women Exposed to Polybrominated Biphenyls

We examined the association between endometriosis and exposure to polybrominated biphenyls (PBBs) and polychlorinated biphenyls (PCBs) among women inadvertently exposed to PBBs in 1973

A frame-shift mutation in COMTD1 is associated with impaired pheomelanin pigmentation in chicken

Author summaryVertebrates possess two types of melanin, red/yellow pheomelanin and black/brown eumelanin. In this study, we report that the recessive Inhibitor of gold phenotype in chicken, which causes a severe defect in pheomelanin pigmentation, is associated with a mutation that most likely inactivates the COMTD1 gene. This gene encodes an O-methyltransferase enzyme and is present throughout vertebrate evolution, but is one of the many genes in vertebrate genomes for which the biological function is still poorly understood. This is the first report of a COMTD1 mutation associated with a phenotypic effect. We show that the COMTD1 protein is present in mitochondria in pigment cells. Furthermore, inactivation of the gene in a mouse pigment cell line results in a significant reduction in metabolites that are important for the synthesis of pheomelanin. We hypothesize that COMTD1 activity protects pigment cells from oxidative stress and that inactivation of this function impairs the production of pheomelanin. It is likely that COMTD1 has a similar function in other cell types. This study establishes this chicken mutation as a model for further studies of COMTD1 function.The biochemical pathway regulating the synthesis of yellow/red pheomelanin is less well characterized than the synthesis of black/brown eumelanin. Inhibitor of gold (IG phenotype) is a plumage colour variant in chicken that provides an opportunity to further explore this pathway since the recessive allele (IG) at this locus is associated with a defect in the production of pheomelanin. IG/IG homozygotes display a marked dilution of red pheomelanin pigmentation, whilst black pigmentation (eumelanin) is only slightly affected. Here we show that a 2-base pair insertion (frame-shift mutation) in the 5(th) exon of the Catechol-O-methyltransferase containing domain 1 gene (COMTD1), expected to cause a complete or partial loss-of-function of the COMTD1 enzyme, shows complete concordance with the IG phenotype within and across breeds. We show that the COMTD1 protein is localized to mitochondria in pigment cells. Knockout of Comtd1 in a mouse melanocytic cell line results in a reduction in pheomelanin metabolites and significant alterations in metabolites of glutamate/glutathione, riboflavin, and the tricarboxylic acid cycle. Furthermore, COMTD1 overexpression enhanced cellular proliferation following chemical-induced transfection, a potential inducer of oxidative stress. These observations suggest that COMTD1 plays a protective role for melanocytes against oxidative stress and that this supports their ability to produce pheomelanin

Factors that contribute to a NANDA nursing diagnosis of risk for frail elderly syndrome

Objective: Identify the risk factors that contribute to a NANDA-I nursing diagnosis of risk for frail elderly system.Method: Cross-sectional study with 395 elderly subjects, conducted from November 2010 to January 2013, in a university hospital in South of Brazil. Sociodemographic data were collected and levels of frailty were identified according to the Edmonton Frail Scale.Results: A total of 177 (44.81%) participants were classified as frail. There was a significant association between frailty and being female (p=0.031), nonwhite (p=0.008), having no romantic partner (p=0.014), no schooling (p=0.001), a monthly income lower than the minimum wage (p=0.034), and preexisting morbidities for respiratory diseases (p=0.003) as well as infectious and parasitic diseases (p=0.040). Diseases of the tracts genitourinary (p = 0.035), respiratory (p = 0.001) and blood (p = 0.035) were the primary reasons for hospitalization.Conclusion: The results contribute to the development and implementation of the nursing diagnosis in the hospital setting.Keywords: Frail elderly. Nursing diagnosis. Aged. Nursing