Treadmill exercise within lower body negative pressure protects leg lean tissue mass and extensor strength and endurance during bed rest.

Leg muscle mass and strength are decreased during reduced activity and non-weight-bearing conditions such as bed rest (BR) and spaceflight. Supine treadmill exercise within lower body negative pressure (LBNPEX) provides full-body weight loading during BR and may prevent muscle deconditioning. We hypothesized that a 40-min interval exercise protocol performed against LBNPEX 6 days week(-1) would attenuate losses in leg lean mass (LLM), strength, and endurance during 6° head-down tilt BR, with similar benefits for men and women. Fifteen pairs of healthy monozygous twins (8 male and 7 female pairs) completed 30 days of BR with one sibling of each twin pair assigned randomly as the non-exercise control (CON) and the other twin as the exercise subject (EX). Before and after BR, LLM and isokinetic leg strength and endurance were measured. Mean knee and ankle extensor and flexor strength and endurance and LLM decreased from pre- to post-BR in the male CON subjects (P < 0.01), but knee extensor strength and endurance, ankle extensor strength, and LLM were maintained in the male EX subjects. In contrast, no pre- to post-BR changes were significant in the female subjects, either CON or EX, likely due to their lower pre-BR values. Importantly, the LBNPEX countermeasure prevents or attenuates declines in LLM as well as extensor leg strength and endurance. Individuals who are stronger, have higher levels of muscular endurance, and/or have greater LLM are likely to experience greater losses during BR than those who are less fit

Decision-making regarding place of birth in high-risk pregnancy: a qualitative study

Introduction: Women consider factors including safety and the psychological impact of their chosen location when deciding whether to give birth in hospital or at home. The same is true for women with high-risk pregnancies who may plan homebirths against medical advice. This study investigated women’s decision-making during high-risk pregnancies. Half the participants were planning hospital births and half were planning homebirths. Methods: A qualitative study using semi-structured interviews set in a hospital maternity department in the UK. Twenty-six participants with high-risk pregnancies, at least 32 weeks pregnant. Results were analysed using systematic thematic analysis. Results: Three themes emerged: perceptions of birth at home and hospital; beliefs about how birth should be; and the decision process. Both groups were concerned about safety but they expressed different concerns. Women drew psychological comfort from their chosen birth location. Women planning homebirths displayed faith in the natural birth process and stressed the quality of the birth experience. Women planning hospital births believed the access to medical care outweighed their misgivings about the physical environment. Discussion: Although women from both groups expressed similar concerns about safety they reached different decisions about how these should be addressed regarding birth location. These differences may be related to beliefs about the birth process. Commitment to their decisions may have helped reduce cognitive stress

Buspirone for the treatment of dementia with behavioral disturbance

Behavioral disturbances are common but serious symptoms in patients with dementia. Currently there are no FDA approved drugs for this purpose. There have been case reports and small case series of the use of buspirone. In this retrospective study, we review 179 patients prescribed buspirone for treatment of behavioral disturbance in dementia to better characterize the efficacy and potential side effects. All patients prescribed buspirone for behavioral disturbance due to dementia from a geropsychiatric outreach program were reviewed. Data was collected and analyzed using SPSS. One hundred-seventy-nine patients met criteria for the study with a mean age of 83.8 + 7. Alzheimer’s dementia was the most common dementia (n=111; 62%) followed by vascular type (n=81; 45.5%). Behavioral disturbances were mainly verbal aggression (n= 125; 72.3%), and physical aggression (n=116; 47.5%). Using the Clinical Global Impression scale, 72.8% of patients responded to buspirone, with 30.8% being moderately to markedly improved. The mean dose of buspirone was 25.7 mg ±12.50. Buspirone appears to be effective in treating behavioral disturbances in dementia. Future prospective and double blinded studies are needed

P50 addressing the vocational development of young people with long-term health conditions in health care settings:a systematic review and mixed methods synthesis

INTRODUCTION/BACKGROUND: Long term health conditions (LTHC) such as rheumatic conditions have significant impact on the biopsychosocial development of young people (YP) including vocational development. Educational transitions are prominent during adolescence and young adulthood yet not all transitional care programmes in rheumatology address this area [1]. The aim of this study was to identify and synthesise the benefits and experiences of addressing the vocational development of YP with LTHC in health care settings. DESCRIPTION/METHOD: A mixed methods synthesis approach [2] was employed. We systematically searched 10 bibliographic databases. Restrictions were applied on publication date (1996-2020) and publication language (English). Articles reporting quantitative and/or qualitative primary research on addressing vocational needs/issues of YP with LTHC in health care settings were included. YP was defined as 10-24 years [3]. Two reviewers independently screened records using predetermined inclusion/exclusion criteria [4]. Quality appraisal was undertaken following study selection. Qualitative data were synthesised thematically. Quantitative data were synthesised narratively, given that a pooled synthesis was not considered appropriate. A cross-study synthesis integrated findings from both the qualitative and quantitative syntheses. DISCUSSION/RESULTS: 43 articles were included. The quality of qualitative evidence was good; however, the quality of quantitative evidence was poor. The thematic synthesis of stakeholders’ perspectives (n = 23 qualitative studies) resulted in seven recommendations for interventions: provide skills training; provide psychological support; offer to liaise with key stakeholders in educational/workplace settings; provide specialist career advice; provide information, signposting and facilitate access to supporting services; provide/facilitate access to social support; provide flexible care and optimal disease management to support education/employment transitions. The narrative synthesis summarised the results of 17 interventions. The cross-study synthesis mapped interventions against the set of recommendations arising from stakeholders’ perspectives: four interventions met five recommendations; two interventions met four recommendations; five interventions met three recommendations; six interventions met two recommendations. Transitional care interventions were the type of intervention that most comprehensively met the recommendations. The way in which interventions addressed vocational issues was not always clear, with some interventions addressing them directly and others indirectly. No interventions had vocational issues as the core, defining component of the intervention. KEY LEARNING POINTS/CONCLUSION: Existing stakeholder evidence highlights that vocational development is an important area to address in the care of YP with LTHC such as rheumatic diseases. The resulting set of recommendations provides guidance for future research in this area and transitional care developments in rheumatology. Further work in this area should address these aspects to enable better quality evidence and ensure consistency. References [1] Clemente D et al. Pediatr Rheumatol Online J. 2017 Jun 9;15(1):49. [2] Kavanagh, J et al Synthesizing Qualitative Research: Choosing the Right Approach. Wiley-Blackwell, Chichester, UK, pp. 113–136 [3] World Health Organization, 2001. The second decade: improving adolescent health and development. Geneva. [4] Farre A et al. PROSPERO 2016 CRD42016051359

[\u3csup\u3e3\u3c/sup\u3eH]‑Raffinose, a Novel Radioactive Label for Determining Organ Sites of Catabolism of Proteins in the Circulation

The primary tissue sites of catabolism of plasma proteins with long circulating half-lives are unknown. It has been difficult to identify these sites because plasma proteins are delivered to tissues at relatively slow rates but are rapidly degraded intracellularly within lysosomes. Therefore, a tracer attached to protein is lost from the site of uptake before an amount sufficient for quantitation can accumulate. We hypothesized that sucrose (Glupal-2 /3Fruf) would be a useful label to circumvent this difficulty because of the stability of sucrose in lysosomes; and thus, sucrose should remain in tissue long after the protein to which it was attached had been degraded to products released from the lysosome. [G-3HJRaffinose (RAF, Galpal- Glupcwl- 2flFruf) was selected as the vehicle for attaching sucrose to protein. [31XjRAF was converted to the C-6 aldehydogalactose form with galactose oxidase and then covalently coupled to protein by reductive amination using NaBH3CN. [‘H]RAF was coupled first to two relatively long lived plasma proteins, bovine serum albumin and fetuin. The half-lives of these proteins in the rat circulation (&,* = -24 h) was unchanged, suggesting that RAF did not alter the normal mechanisms of protein clearance. When attached to short lived proteins with known sites of catabolism, such as asialofetuin, RNase B, and heatdenatured albumin, neither the tissue nor cellular sites of uptake of the proteins were altered. Thus, 13H]RAFasialofetuin was recovered almost exclusively (\u3e90%) in the liver parenchymal cell fraction, while both [JHJRAF-labeled RNase B and heat-denatured albumin were recovered primarily (\u3e85%) in nonparenchymal cells. In addition, the RAF label was observed to reside stably (tl,2 \u3e 100 h) in the liver following degradation of the carrier protein; in contrast, radioactivity from “‘Ilabeled asialofetuin or RNase B was rapidly (tl,z \u3c 30 min) lost from liver. Radioactivity from 13H]RAF-proteins was recovered in a lysosomally enriched subcellular fraction in liver and consisted of a low molecular weight species (-llOO), containing both glucose and fructose in a ratio similar to that in the original protein. The results of these studies establish that 13H]RAF useful radioactive tracer for detecting the tissue and cellular sites of catabolism of long lived circulating proteins

The Landscape of Noncredit Workforce Education: State Policies and Community College Practices

Postsecondary noncredit education has become increasingly common in recent years, and at many community colleges, noncredit programs enroll more students than do credit programs (Bailey et al., 2003). Courses connected with workforce instruction and contract training account for much of this growth (Dougherty and Bakia, 1999), and such courses are noted for their important role in responding flexibly to shifting workforce demands. Still, the growth in community college noncredit workforce education raises questions about whether the colleges are keeping pace with student and industry needs, using resources efficiently, and providing adequate access to all students. The answers to these questions may challenge current state policies and college practices

Prospective Teachers\u27 Use of Representations in Solving Statistical Tasks with Dynamic Statistical Software

This study examined a random stratified sample (n=62) of prospective teachers\u27 work across eight institutions on three tasks that utilized dynamic statistical software. Our work was guided by considering how teachers may utilize their statistical knowledge and technological statistical knowledge to engage in cycles of investigation. Although teachers did not tend to take full advantage of dynamic linking capabilities, they utilized a large variety of graphical representations and often added statistical measures or other augmentations to graphs as part of their analysis

Gene expression profile of cervical tissue compared to exfoliated cells: Impact on biomarker discovery

BACKGROUND: Exfoliated cervical cells are used in cytology-based cancer screening and may also be a source for molecular biomarkers indicative of neoplastic changes in the underlying tissue. However, because of keratinization and terminal differentiation it is not clear that these cells have an mRNA profile representative of cervical tissue, and that the profile can distinguish the lesions targeted for early detection. RESULTS: We used whole genome microarrays (25,353 unique genes) to compare the transcription profiles from seven samples of normal exfoliated cells and one cervical tissue. We detected 10,158 genes in exfoliated cells, 14,544 in the tissue and 7320 genes in both samples. For both sample types the genes grouped into the same major gene ontology (GO) categories in the same order, with exfoliated cells, having on average 20% fewer genes in each category. We also compared microarray results of samples from women with cervical intraepithelial neoplasia grade 3 (CIN3, n = 15) to those from age and race matched women without significant abnormalities (CIN1, CIN0; n = 15). We used three microarray-adapted statistical packages to identify differential gene expression. The six genes identified in common were two to four fold upregulated in CIN3 samples. One of these genes, the ubiquitin-conjugating enzyme E2 variant 1, participates in the degradation of p53 through interaction with the oncogenic HPV E6 protein. CONCLUSION: The findings encourage further exploration of gene expression using exfoliated cells to identify and validate applicable biomarkers. We conclude that the gene expression profile of exfoliated cervical cells partially represents that of tissue and is complex enough to provide potential differentiation between disease and non-disease

Delay/Disruption Tolerant Networking for the International Space Station (ISS)

Disruption Tolerant Networking (DTN) is an emerging data networking technology designed to abstract the hardware communication layer from the spacecraft/payload computing resources. DTN is specifically designed to operate in environments where link delays and disruptions are common (e.g., space-based networks). The National Aeronautics and Space Administration (NASA) has demonstrated DTN on several missions, such as the Deep Impact Networking (DINET) experiment, the Earth Observing Mission 1 (EO-1) and the Lunar Laser Communication Demonstration (LLCD). To further the maturation of DTN, NASA is implementing DTN protocols on the International Space Station (ISS). This paper explains the architecture of the ISS DTN network, the operational support for the system, the results from integrated ground testing, and the future work for DTN expansion

How Does Thermal Scattering Shape the Infrared Spectra of Cloudy Exoplanets? A Theoretical Framework and Consequences for Atmospheric Retrievals in the JWST era

Observational studies of exoplanets are suggestive of a ubiquitous presence of clouds. The current modelling techniques used in emission to account for the clouds tend to require prior knowledge of the cloud condensing species and often do not consider the scattering effects of the cloud. We explore the effects that thermal scattering has on the emission spectra by modelling a suite of hot Jupiter atmospheres with varying cloud single-scattering albedos (SSAs) and temperature profiles. We examine cases ranging from simple isothermal conditions to more complex structures and physically driven cloud modelling. We show that scattering from nightside clouds would lead to brightness temperatures that are cooler than the real atmospheric temperature if scattering is unaccounted for. We show that scattering can produce spectral signatures in the emission spectrum even for isothermal atmospheres. We identify the retrieval degeneracies and biases that arise in the context of simulated JWST spectra when the scattering from the clouds dominates the spectral shape. Finally, we propose a novel method of fitting the SSA spectrum of the cloud in emission retrievals, using a technique that does not require any prior knowledge of the cloud chemical or physical properties.Comment: Accepted to MNRA