Exploring Communication Between Staff and Clinicians on an Inpatient Adolescent Psychiatric Unit

This dissertation explored interdisciplinary team functioning on a long-term adolescent inpatient psychiatric unit. It compared staff perceptions (MHCs, clinicians, and nurses) of interdisciplinary coherence and unit effectiveness. This study was particularly focused on understanding MHCs perceptions of team functioning and how satisfied team members are with their level of input and involvement in team decision-making. Additionally, this study explored possible barriers to effective team functioning in this setting. Eighty-four participants in this study completed the Interdisciplinary Team Process and Performance Survey (ITPPS) to assess perceptions of team functioning. Participants answered additional questions assessing barriers to communication and collaboration and levels of satisfaction with their input in the team’s decision-making process. A one-way ANOVA was conducted to compare perceptions of team cohesion and team effectiveness across occupations. Results suggest that there is a significant difference among the three occupational groups regarding their perceptions of how their team functions, with MHCs having more negative perceptions of team processes than nurses and clinicians. This team ranked the three highest barriers to communication and collaboration: (a) Differences in accountability, payment, and rewards; (b) Hierarchy; and (c) Lack of training for MHCs. Regarding levels of satisfaction, results showed that MHCs reported the lowest levels of satisfaction, while clinicians rated the highest levels of satisfaction. With these findings, recommendations were made for ways in which long-term inpatient adolescent psychiatric hospitals can work to improve their interdisciplinary team functioning to increase job satisfaction and improve patient care

Discrete CO2-System Measurements in the Chesapeake Bay Mainstem between 2016 and 2018

These are discrete observations of total dissolved inorganic carbon (DIC) and alkalinity (TA), and associated computed CO2-system parameters, from samples collected throughout the Chesapeake Bay mainstem between 2016 and 2018. Samples were collected on board the R/V Kerhin in Maryland and the R/V Fay Slover in Virginia at a subset of fixed stations in collaboration with the Chesapeake Bay Water Quality Monitoring Program. Samples were analyzed following standard procedures at the Virginia Institute of Marine Science. The DIC and TA data were then used to compute the remaining CO2-system parameters (pH, CO2 partial pressure (pCO2), and carbonate saturation state). A detailed description of sample collection and analytical methods is given Friedman et al., 2019

Negation of protein-protein interactions: analysis and extraction

Sanchez Graillet O, Poesio M. Negation of protein-protein interactions: analysis and extraction. Bioinformatics. 2007;23(13):i424--i432.**Motivation**: Negative information about protein–protein interactions—from uncertainty about the occurrence of an interaction to knowledge that it did not occur—is often of great use to biologists and could lead to important discoveries. Yet, to our knowledge, no proposals focusing on extracting such information have been proposed in the text mining literature. **Results**: In this work, we present an analysis of the types of negative information that is reported, and a heuristic-based system using a full dependency parser to extract such information. We performed a preliminary evaluation study that shows encouraging results of our system. Finally, we have obtained an initial corpus of negative protein–protein interactions as basis for the construction of larger ones. **Availability**:The corpus is available by request from the authors

Seasonal Variability of the CO2 System in a Large Coastal Plain Estuary

The Chesapeake Bay, a large coastal plain estuary, has been studied extensively in terms of its water quality, and yet, comparatively less is known about its carbonate system. Here we present discrete observations of dissolved inorganic carbon (DIC) and total alkalinity from four seasonal cruises in 2016–2017. These new observations are used to characterize the regional CO2 system and to construct a DIC budget of the mainstem. In all seasons, elevated DIC concentrations were observed at the mouth of the bay associated with inflowing Atlantic Ocean waters, while minimum concentrations of DIC were associated with fresher waters at the head of the bay. Significant spatial variability of the partial pressure of CO2 was observed throughout the mainstem, with net uptake of atmospheric CO2 during each season in the upper mainstem and weak seasonal outgassing of CO2 near the outflow to the Atlantic Ocean. During the time frame of this study, the Chesapeake Bay mainstem was (1) net autotrophic in the mixed layer (net community production of 0.31‐mol C m−2·year−1) and net heterotrophic throughout the water column (net community production of −0.48‐mol C m−2·year−1), (2) a sink of 0.38‐mol C m−2·year−1 for atmospheric CO2, and (3) significantly seasonally and spatially variable with respect to biologically driven changes in DIC. DATA available at: https://doi.org/10.25773/rntn‐ez1

High-frequency CO2-system variability over the winter-to-spring transition in a large coastal plain estuary

Understanding the vulnerability of estuarine ecosystems to anthropogenic impacts requires a quantitative assessment of the dynamic drivers of change to the carbonate (CO2) system. Here we present new high‐frequency pH data from a moored sensor. These data are combined with discrete observations to create continuous time series of total dissolved inorganic carbon (TCO2), CO2 partial pressure (pCO2), and carbonate saturation state. We present two deployments over the winter‐to‐spring transition in the lower York River (where it meets the Chesapeake Bay mainstem) in 2016/2017 and 2017/2018. TCO2 budgets with daily resolution are constructed, and contributions from circulation, air‐sea CO2 exchange, and biology are quantified. We find that TCO2 is most strongly influenced by circulation and biological processes; pCO2 and pH also respond strongly to changes in temperature. The system transitions from autotrophic to heterotrophic conditions multiple times during both deployments; the conventional view of a spring bloom and subsequent summer production followed by autumn and winter respiration may not apply to this region. Despite the dominance of respiration in winter and early spring, surface waters were undersaturated with respect to atmospheric CO2 for the majority of both deployments with mean fluxes ranging from −9 to −5 mmol C·m−2·day−1. Deployments a year apart indicate that the seasonal transition in the CO2 system differs significantly from one year to the next and highlights the necessity of sustained monitoring in dynamic nearshore environments

A Pilot Study of Dietary Counseling in Kidney Transplant Recipients

Long-term management strategies to preserve graft function in post-renal transplant patients have largely remained stagnant. Whole-food plant-based dietary counseling has beenshown to reduce the incidence of comorbidities(diabetes, dyslipidemia, and hypertension) that post-transplant patients are at increased risk for developing. It is not yet standard-of-care to offer post-transplant patients long-term dietary counseling. Whole-food plant-based dietary counseling is a cost-effective and safe intervention that can be widely distributed.This examines if three months of whole-food plant-based dietary counseling in post-renal transplant patients can reduce the incidence of comorbidities thus improving graft & patient outcome

AI Driven Analysis of MRI To Measure Health and Disease Progression in FSHD

Facioscapulohumeral muscular dystrophy (FSHD) affects roughly 1 in 7500 individuals. While at the population level there is a general pattern of affected muscles, there is substantial heterogeneity in muscle expression across- and within-patients. There can also be substantial variation in the pattern of fat and water signal intensity within a single muscle. While quantifying individual muscles across their full length using magnetic resonance imaging (MRI) represents the optimal approach to follow disease progression and evaluate therapeutic response, the ability to automate this process has been limited. The goal of this work was to develop and optimize an artificial intelligence-based image segmentation approach to comprehensively measure muscle volume, fat fraction, fat fraction distribution, and elevated short-tau inversion recovery signal in the musculature of patients with FSHD. Intra-rater, inter-rater, and scan-rescan analyses demonstrated that the developed methods are robust and precise. Representative cases and derived metrics of volume, cross-sectional area, and 3D pixel-maps demonstrate unique intramuscular patterns of disease. Future work focuses on leveraging these AI methods to include upper body output and aggregating individual muscle data across studies to determine best-fit models for characterizing progression and monitoring therapeutic modulation of MRI biomarkers

Dietary flavonoid intake and risk of incident depression in midlife and older women

Background: The impact of dietary flavonoid intakes on risk of depression is unclear. Objective: We prospectively examined associations between estimated habitual intakes of dietary flavonoids and depression risk. Design: We followed 82,643 women without a previous history of depression at baseline from the Nurses’ Health Study [(NHS) aged 53–80 y] and the Nurses’ Health Study II [(NHSII) aged 36–55 y]. Intakes of total flavonoids and subclasses (flavonols, flavones, flavanones, anthocyanins, flavan-3-ols, polymeric flavonoids, and proanthocyanidins) were calculated from validated food-frequency questionnaires collected every 2–4 y. Depression was defined as physician- or clinician-diagnosed depression or antidepressant use and was self-reported in response to periodic questionnaires. Cox proportional hazards models were performed to examine associations. Results: A total of 10,752 incident depression cases occurred during a 10-y follow-up. Inverse associations between flavonol, flavone, and flavanone intakes and depression risk were observed. Pooled multivariable-adjusted HRs (95% CIs) were 0.93 (0.88, 0.99), 0.92 (0.86, 0.98), and 0.90 (0.85, 0.96) when comparing the highest (quintile 5) with the lowest (quintile 1) quintiles, respectively, with evidence of linear trends across quintiles (P-trend = 0.0004–0.08). In flavonoid-rich food-based analyses, the HR was 0.82 (95% CI: 0.74, 0.91) among participants who consumed ≥2 servings citrus fruit or juices/d compared with <1 serving/wk. In the NHS only, total flavonoids, polymers, and proanthocyanidin intakes showed significant (9–12%) lower depression risks. In analyses among late-life NHS participants (aged ≥65 y at baseline or during follow-up), for whom we were able to incorporate depressive symptoms into the outcome definition, higher intakes of all flavonoid subclasses except for flavan-3-ols were associated with significantly lower depression risk; flavones and proanthocyanidins showed the strongest associations (HR for both: 0.83; 95% CI: 0.77, 0.90). Conclusions: Higher flavonoid intakes may be associated with lower depression risk, particularly among older women. Further studies are needed to confirm these associations

BRCA2 polymorphic stop codon K3326X and the risk of breast, prostate, and ovarian cancers

Background: The K3326X variant in BRCA2 (BRCA2*c.9976A&gt;T; p.Lys3326*; rs11571833) has been found to be associated with small increased risks of breast cancer. However, it is not clear to what extent linkage disequilibrium with fully pathogenic mutations might account for this association. There is scant information about the effect of K3326X in other hormone-related cancers. Methods: Using weighted logistic regression, we analyzed data from the large iCOGS study including 76 637 cancer case patients and 83 796 control patients to estimate odds ratios (ORw) and 95% confidence intervals (CIs) for K3326X variant carriers in relation to breast, ovarian, and prostate cancer risks, with weights defined as probability of not having a pathogenic BRCA2 variant. Using Cox proportional hazards modeling, we also examined the associations of K3326X with breast and ovarian cancer risks among 7183 BRCA1 variant carriers. All statistical tests were two-sided. Results: The K3326X variant was associated with breast (ORw = 1.28, 95% CI = 1.17 to 1.40, P = 5.9x10- 6) and invasive ovarian cancer (ORw = 1.26, 95% CI = 1.10 to 1.43, P = 3.8x10-3). These associations were stronger for serous ovarian cancer and for estrogen receptor–negative breast cancer (ORw = 1.46, 95% CI = 1.2 to 1.70, P = 3.4x10-5 and ORw = 1.50, 95% CI = 1.28 to 1.76, P = 4.1x10-5, respectively). For BRCA1 mutation carriers, there was a statistically significant inverse association of the K3326X variant with risk of ovarian cancer (HR = 0.43, 95% CI = 0.22 to 0.84, P = .013) but no association with breast cancer. No association with prostate cancer was observed. Conclusions: Our study provides evidence that the K3326X variant is associated with risk of developing breast and ovarian cancers independent of other pathogenic variants in BRCA2. Further studies are needed to determine the biological mechanism of action responsible for these associations

SPACA3gene variants in a New Zealand cohort of infertile and fertile couples

SPRASA (also referred to as SLLP1) is a protein identified in the acrosome of human sperm and encoded by the gene SPACA3. SPRASA is associated with sperm-oocyte recognition and binding, and may play a role in fertility. In order to determine whether variants in the SPACA3 gene are associated with human infertility, we undertook a genetic analysis of 102 infertile and 104 fertile couples. Three gene variants were identified using PCR-based DNA sequencing; 1) an insertion of TGC within a quadruple tri-nucleotide (TGC) repeat region in the 5’ untranslated region (UTR) (g.–22TGC(4_5), 2) a guanine to adenosine transition at position 239 (c.239G> A) resulting in a non-synonymous amino acid substitution from cysteine to tyrosine (p.C80Y) at position 80 in the putative transmembrane region, and 3) a novel nucleotide variant (c.691G> C) located in the 3’UTR. A functional effect of the g.–22TGC (4_5) was confirmed by a luciferase expression assay, while the effects of the variants c.239G> A and c.691G> C were predicted using in silico analysis. Although the frequencies of these variants were not significantly different between the infertile and fertile populations, we present evidence that the variants could affect the expression levels or function of SPRASA, thereby affecting a couple's fertility. Larger populations, especially individuals/couples with unexplained infertility, need to be screened for these variants to validate a relationship with fertility