High pressure chemical reactivity and structural study of the Na-P and Li-P systems

Pressure enables the synthesis of (Na/Li)3P compounds at RT bypassing established chemical methods while at higher pressure, both undergo a pressure-induced phase transition.</p

High pressure chemical reactivity and structural study of the Na-P and Li-P systems

Pressure enables the synthesis of (Na/Li)3P compounds at RT bypassing established chemical methods while at higher pressure, both undergo a pressure-induced phase transition.</p

Disruptive moments as opportunities towards justice-oriented pedagogical practice in Informal Science Learning

Despite the promise of Informal Science Learning settings (ISLs) in supporting youth science engagement in ways that value their experiences and communities, in practice, such opportunities are limited. While some ISLs promote more culturally relevant approaches to science engagement, many still reflect White supremacist and patriarchal worldviews in discourse and practice. In Research Practice Partnerships, we engaged eight ISL educators from two partner sites—a community center and science center, and youth from across their six programs. Using participatory ethnography we explore how educators' pedagogical practices supported youth in codeveloping more justice-oriented ISL experiences—experiences which disrupt these dominant and oppressive norms. Our analysis pays attention, in particular, to those fraught moments when youth, in interaction with peers and educators, sought to disrupt their ISL experience in ways that centered and amplified their lives, hopes, and desires for being and learning in ISL and humanized the ISL learning community. Two kinds of pedagogical response patterns emerged that we report on in our findings: (1) collaborative critique and (2) critically being with each other towards new relationalities. We discuss how these two practices centered political and ethical dimensions of teaching and learning, fundamentally shifting power and relationalities towards new ISL possibilities. We also discuss how these practices involved leveraging specific moments to resee youths' activities in new ways, making visible how an ISL space limited opportunities for youth visibility of presence in science—a kind of pausing for justice

Application of the Aquifer Impact Model to support decisions at a CO2 sequestration site

The National Risk Assessment Partnership (NRAP) has developed a suite of tools to assess and manage risk at CO sequestration sites. The NRAP tool suite includes the Aquifer Impact Model (AIM), which evaluates the potential for groundwater impacts from leaks of CO and brine through abandoned wellbores. There are two aquifer reduced-order models (ROMs) included with the AIM tool, a confined alluvium aquifer, and an unconfined carbonate aquifer. The models accept aquifer parameters as a range of variable inputs so they may have broad applicability. The generic aquifer models may be used at the early stages of site selection, when site-specific data is not available. Guidelines have been developed for determining when the generic ROMs might be applicable to a new site. This paper considers the application of the AIM to predicting the impact of CO or brine leakage were it to occur at the Illinois Basin Decatur Project (IBDP). Results of the model sensitivity analysis can help guide characterization efforts; the hydraulic parameters and leakage source term magnitude are more sensitive than clay fraction or cation exchange capacity. Sand permeability was the only hydraulic parameter measured at the IBDP site. More information on the other hydraulic parameters could reduce uncertainty in risk estimates. Some non-adjustable parameters are significantly different for the ROM than for the observations at the IBDP site. The generic ROMs could be made more useful to a wider range of sites if the initial conditions and no-impact threshold values were adjustable parameters. © 2017 Society of Chemical Industry and John Wiley &amp; Sons, Ltd. 2 2

P-ANCA vasculitic neuropathy with 12-year latency between onset of neuropathy and systemic symptoms

BACKGROUND: The differential diagnosis of chronic progressive multifocal asymmetric neuropathies is challenging. Vasculitic neuropathies, multifocal forms of chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathies, and asymmetric lower motor neuron disorders are important considerations. CASE PRESENTATION: We report a patient with an unusually long 12-year course of nonsystemic vasculitic neuropathy prior to the development of systemic manifestations. CONCLUSION: We discuss some of the difficulties involved in the diagnosis of chronic progressive multifocal asymmetric neuropathies

Extragingival pyogenic granuloma: a case report

The pyogenic granuloma is thought to represent an exuberant tissue response to local irritation or trauma

Specific Cognitive Deficits in ADHD: A Diagnostic Concern in Differential Diagnosis

We present a critical account of existing tools used to diagnose children with Attention Deficit Hyperactivity Disorder and to make a case for the assessment of cognitive impairments as a part of diagnostic system. Surveys have shown that clinicians rely almost entirely upon subjective reports or their own clinical judgment when arriving at diagnostic decisions relating to this prevalent disorder. While information from parents and teachers should always be carefully considered, they are often influenced by a host of emotional and perceptual factors. It increases the possibility for misdiagnosis of a condition like ADHD. Recent experimental literature on ADHD has identified unique underlying cognitive dysfunction, specific to ADHD. Therefore, we propose that there is a need to incorporate information on cognitive mechanisms underlying ADHD and inculcate such information in the diagnostic system, which will provide a more sensitive as well as specific tool in differential diagnosis of ADHD

Metabolic control of BRISC–SHMT2 assembly regulates immune signalling

Serine hydroxymethyltransferase 2 (SHMT2) regulates one-carbon transfer reactions that are essential for amino acid and nucleotide metabolism, and uses pyridoxal-5′-phosphate (PLP) as a cofactor. Apo SHMT2 exists as a dimer with unknown functions, whereas PLP binding stabilizes the active tetrameric state. SHMT2 also promotes inflammatory cytokine signalling by interacting with the deubiquitylating BRCC36 isopeptidase complex (BRISC), although it is unclear whether this function relates to metabolism. Here we present the cryo-electron microscopy structure of the human BRISC–SHMT2 complex at a resolution of 3.8 Å. BRISC is a U-shaped dimer of four subunits, and SHMT2 sterically blocks the BRCC36 active site and inhibits deubiquitylase activity. Only the inactive SHMT2 dimer—and not the active PLP-bound tetramer—binds and inhibits BRISC. Mutations in BRISC that disrupt SHMT2 binding impair type I interferon signalling in response to inflammatory stimuli. Intracellular levels of PLP regulate the interaction between BRISC and SHMT2, as well as inflammatory cytokine responses. These data reveal a mechanism in which metabolites regulate deubiquitylase activity and inflammatory signalling

Analysis of patient safety event report categories at one large academic hospital

Given the persistent safety incidents in operating rooms (ORs) nationwide (approx. 4000 preventable harmful surgical errors per year), there is a need to better analyze and understand reported patient safety events. This study describes the results of applying the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) supported by the Teamwork Evaluation of Non-Technical Skills (TENTS) instrument to analyze patient safety event reports at one large academic medical center. Results suggest that suboptimal behaviors stemming from poor communication, lack of situation monitoring, and inappropriate task prioritization and execution were implicated in most reported events. Our proposed methodology offers an effective way of programmatically sorting and prioritizing patient safety improvement efforts

A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity

BACKGROUND: Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. METHODS: Providers in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI), the Center for Epidemiological Studies-Depression Scale scale (CESD) and the Pain Disability Index (PDI). Patients were monitored for substance misuse. RESULTS: Eighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73%) completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003). The mean PDI score improved to 39.3 (p < 0.001). Mean CESD score was reduced to 18.0 (p < 0.001), and the proportion of depressed patients fell from 79% to 54% (p = 0.003). Substance misuse was identified in 27 patients (32%). CONCLUSIONS: A primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up