The Army Chaplain as Counselor: An Exploration of Self-Reflexivity and Denominational Particularities

Army chaplain reflects on his experience of providing spiritual care while serving in the Army

Description, Utilisation and Results from a Telehealth Primary Care Weight Management Intervention for Adults with Obesity in South Carolina

Introduction: In the US, obesity rates are higher in rural areas than in urban areas. Rural access to treatment of obesity is limited by a lack of qualified clinicians and by transportation and financial barriers. We describe a telemedicine weight management programme, Wellness Connect, developed through a partnership of academic clinicians and rural primary care providers in South Carolina, and present utilisation and weight outcomes from seven patient cohorts. Methods: Eight bi-weekly sessions were provided via telemedicine videoconferencing for groups of patients at these rural primary care clinics. Protocol-based sessions were led by registered dietitians, exercise physiologists and clinical psychologists at a central urban location. Results: Of 138 patients who started the programme, 62% (N ¼ 86) of patients met the criteria for completion. Completers lost an average of 3.5% (standard deviation (SD) ¼ 3.9%) body weight, which was statistically significant (p \u3c.001) and corresponded with an average loss of 3.8 kg (SD ¼ 4.5 kg). There were no differences in weight change among clinics (p ¼.972). Overall, patients and providers reported satisfaction with the programme and identified several challenges to sustainability. Discussion: The use of innovative telemedicine interventions continues to be necessary to alleviate barriers to accessing evidence-based services to reduce chronic diseases and decrease obesity rates among rural populations

Disease Extent at Secondary Cytoreductive Surgery is Predictive of Progression-free and Overall Survival in Advanced Stage Ovarian Cancer: an NRG Oncology/Gynecologic Oncology Group study

Purpose GOG 152 was a randomized trial of secondary cytoreductive surgery (SCS) in patients with suboptimal residual disease (residual tumor nodule >1 cm in greatest diameter) following primary cytoreductive surgery for advanced stage ovarian cancer. The current analysis was undertaken to evaluate the impact of disease findings at SCS on progression-free survival (PFS) and overall survival (OS). Methods Among the 550 patients enrolled on GOG-152, two-hundred-sixteen patients were randomly assigned following 3 cycles of cisplatin and paclitaxel to receive SCS. In 15 patients (7%) surgery was declined or contraindicated. In the remaining 201 patients the operative and pathology reports were utilized to classify their disease status at the beginning of SCS as; no gross disease/microscopically negative N= 40 (19.9%), no gross disease/microscopically positive N= 8 (4.0%), and gross disease N=153 (76.1%). Results The median PFS for patients with no gross disease/microscopically negative was 16.1 months, no gross disease/microscopically positive was 13.5 months and for gross disease was 11.7 months, p=0.002. The median OS for patients with no gross disease/microscopically negative was 51.5 months, no gross disease/microscopically positive was 42.6 months and for gross disease was 34.9 months, p=0.018. Conclusion Although as previously reported SCS did not change PFS or OS, for those who underwent the procedure, their operative and pathologic findings were predictive of PFS and OS. Surgical/pathological residual disease is a biomarker of response to chemotherapy and predictive of PFS and OS

Continuous positive airway pressure for children with undifferentiated respiratory distress in Ghana: an open-label,cluster, crossover trial

Background In low-income and middle-income countries, invasive mechanical ventilation is often not available for children at risk of death from respiratory failure. We aimed to determine if continuous positive airway pressure (CPAP), a form of non-invasive ventilation, decreases all-cause mortality in children with undifferentiated respiratory distress in Ghana. Methods This open-label, cluster, crossover trial was done in two Ghanaian non-tertiary hospitals where invasive mechanical ventilation is not routinely available. Eligible participants were children aged from 1 month to 5 years with a respiratory rate of more than 50 breaths per min in children 1–12 months old, or more than 40 breaths per min in children older than 12 months, and use of accessory muscles or nasal flaring. CPAP machines were allocated to one hospital during each study block, while the other hospital served as the control site. The initial intervention site was randomly chosen using a coin toss. 5 cm of water pressure was delivered via CPAP nasal prongs. The primary outcome measure was all-cause mortality rate at 2 weeks after enrolment in patients for whom data were available after 2 weeks. We also did post-hoc regression analysis and subgroup analysis of children by malaria status, oxygen saturation, and age. This study is registered with ClinicalTrials.gov, number NCT01839474. Findings Between Jan 20, 2014, and Dec 5, 2015, 2200 children were enrolled: 1025 at the intervention site and 1175 at the control site. Final analysis included 1021 patients in the CPAP group and 1160 patients in the control group. 2 weeks after enrolment, 26 (3%) of 1021 patients in the CPAP group, and 44 (4%) of 1160 patients in the control group, had died (relative risk [RR] of mortality 0·67, 95% CI 0·42–1·08; p=0·11). In children younger than 1 year, all-cause mortality was ten (3%) of 374 patients in the CPAP group, and 24 (7%) of 359 patients in the control group (RR 0·40, 0·19–0·82; p=0·01). After adjustment for study site, time, and clinically important variables, the odds ratio for 2-week mortality in the CPAP group versus the control group was 0·4 in children aged up to 6 months, 0·5 for children aged 12 months, 0·7 for children aged 24 months, and 1·0 for those aged 36 months. 28 patients (3%) in the CPAP group and 24 patients (2%) in the control group had CPAP-related adverse events, such as vomiting, aspiration, and nasal, skin, or eye trauma. No serious adverse events were observed. Interpretation In the unadjusted analysis the use of CPAP did not decrease all-cause 2-week mortality in children 1 month to 5 years of age with undifferentiated respiratory distress. After adjustment for study site, time, and clinically important variables, 2-week mortality in the CPAP group versus the control group was significantly decreased in children 1 year of age and younger. CPAP is safe and improves respiratory rate in a non-tertiary setting in a lowermiddle- income country

Quantifying HIV-1 Viral Load with Fluorescence Correlation Spectroscopy

The DVD team is working to develop a cost-effective technique for measuring HIV load in resource-restricted regions. Our client is Dr Phil Thuma and the Macha Research Centre in Zambia. Our design utilizes a fluorescence correlation spectroscopy (FCS) approach, including a protein-engineered probe, custom optics, a field programmable gate array (FPGA), and a graphical display to assess viral load in a patient blood sample. In this talk we will present on the design and testing of our optical FCS system, the method of processing and analyzing the signal, and creation of the user interface display. Our team is currently finalizing the design of each device component and looking towards device integration and prototyping in the Fall of 2020.https://mosaic.messiah.edu/engr2020/1015/thumbnail.jp

The TRIM-NHL protein NHL-2 is a Novel Co-Factor of the CSR-1 and HRDE-1 22G-RNA Pathways [preprint]

Proper regulation of germline gene expression is essential for fertility and maintaining species integrity. In the C. elegans germline, a diverse repertoire of regulatory pathways promote the expression of endogenous germline genes and limit the expression of deleterious transcripts to maintain genome homeostasis. Here we show that the conserved TRIM-NHL protein, NHL-2, plays an essential role in the C. elegans germline, modulating germline chromatin and meiotic chromosome organization. We uncover a role for NHL-2 as a co-factor in both positively (CSR-1) and negatively (HRDE-1) acting germline 22G-small RNA pathways and the somatic nuclear RNAi pathway. Furthermore, we demonstrate that NHL-2 is a bona fide RNA binding protein and, along with RNA-seq data point to a small RNA independent role for NHL-2 in regulating transcripts at the level of RNA stability. Collectively, our data implicate NHL-2 as an essential hub of gene regulatory activity in both the germline and soma

Strengths and Limitations of Nitrogen Rate Recommendations for Corn and Opportunities for Improvement

Nitrogen fixation by the Haber–Bosch process has more than doubled the amount of fixed N on Earth, significantly influencing the global N cycle. Much of this fixed N is made into N fertilizer that is used to produce nearly half of the world’s food. Too much of the N fertilizer pollutes air and water when it is lost from agroecosystems through volatilization, denitrification, leaching, and runoff. Most of the N fertilizer used in the United States is applied to corn (Zea mays L.), and the profitability and environmental footprint of corn production is directly tied to N fertilizer applications. Accurately predicting the amount of N needed by corn, however, has proven to be challenging because of the effects of rainfall, temperature, and interactions with soil properties on the N cycle. For this reason, improving N recommendations is critical for profitable corn production and for reducing N losses to the environment. The objectives of this paper were to review current methods for estimating N needs of corn by: (i) reviewing fundamental background information about how N recommendations are created; (ii) evaluating the performance, strengths, and limitations of systems and tools used for making N fertilizer recommendations; (iii) discussing how adaptive management principles and methods can improve recommendations; and (iv) providing a framework for improving N fertilizer rate recommendations

Gender Differences in Russian Colour Naming

In the present study we explored Russian colour naming in a web-based psycholinguistic experiment (http://www.colournaming.com). Colour singletons representing the Munsell Color Solid (N=600 in total) were presented on a computer monitor and named using an unconstrained colour-naming method. Respondents were Russian speakers (N=713). For gender-split equal-size samples (NF=333, NM=333) we estimated and compared (i) location of centroids of 12 Russian basic colour terms (BCTs); (ii) the number of words in colour descriptors; (iii) occurrences of BCTs most frequent non-BCTs. We found a close correspondence between females’ and males’ BCT centroids. Among individual BCTs, the highest inter-gender agreement was for seryj ‘grey’ and goluboj ‘light blue’, while the lowest was for sinij ‘dark blue’ and krasnyj ‘red’. Females revealed a significantly richer repertory of distinct colour descriptors, with great variety of monolexemic non-BCTs and “fancy” colour names; in comparison, males offered relatively more BCTs or their compounds. Along with these measures, we gauged denotata of most frequent CTs, reflected by linguistic segmentation of colour space, by employing a synthetic observer trained by gender-specific responses. This psycholinguistic representation revealed females’ more refined linguistic segmentation, compared to males, with higher linguistic density predominantly along the redgreen axis of colour space