Common Strategy Research Articles

Molecular Design of Functional Polymers for Silica Scale Inhibition.

Silica polymerization, which involves the condensation reaction of silicic acid, is a fundamental process with wide-ranging implications in biological systems, material synthesis, and scale formation. The formation of a silica-based scale poses significant technological challenges to energy-efficient operations in various industrial processes, including heat exchangers and water treatment membranes. Despite the common strategy of applying functional polymers for inhibiting silica polymerization, the underlying mechanisms of inhibition remain elusive. In this study, we synthesized a series of nitrogen-containing polymers as silica inhibitors and elucidated the role of their molecular structures in stabilizing silicic acids. Polymers with both charged amine and uncharged amide groups in their backbones exhibit superior inhibition performance, retaining up to 430 ppm of reactive silica intact for 8 h under neutral pH conditions. In contrast, monomers of these amine/amide-containing polymers as well as polymers containing only amine or amide functionalities present insignificant inhibition. Molecular dynamics simulations reveal strong binding between the deprotonated silicic acid and a polymer when the amine groups in the polymer are protonated. Notably, an extended chain conformation of the polymer is crucial to prevent proximity between the interacting monomeric silica species, thereby facilitating effective silica inhibition. Furthermore, the hydrophobic nature of alkyl segments in polymer chains disrupts the hydration shell around the polymer, resulting in enhanced binding with ionized silicic acid precursors compared to monomers. Our findings provide novel mechanistic insights into the stabilization of silicic acids with functional polymers, highlighting the molecular design principles of effective inhibitors for silica polymerization.

Understanding Pseudophosphatase Function Through Biochemical Interactions.

Pseudophosphatases have been solidified as important signaling molecules that regulate signal transduction cascades. However, their mechanisms of action remain enigmatic. Reflecting this mystery, the prototypical pseudophosphatase STYX (phospho-serine-threonine/tyrosine-binding protein) was named with allusion to the river of the dead in Greek mythology to emphasize that these molecules are "dead" phosphatases. Although proteins with STYX domains do not catalyze dephosphorylation, this does not preclude their having other functions, including as integral elements of signaling networks. Thus, understanding their roles may mark them as potential novel drug targets. This chapter outlines common strategies used to characterize the functions of pseudophosphatases, using as an example MK-STYX [MAPK (mitogen-activated protein kinase) phospho-serine-threonine/tyrosine-binding], which has been linked to tumorigenesis, hepatocellular carcinoma, glioblastoma, apoptosis, and neuronal differentiation. We start with the importance of "restoring" (when possible) phosphatase activity in a pseudophosphatase, so the active mutant may be used as a comparison control throughout immunoprecipitation and mass spectrometry analyses. To this end, we provide protocols for site-directed mutagenesis, mammalian cell transfection, co-immunoprecipitation, phosphatase activity assays, and immunoblotting that we have used to investigate MK-STYX and the active mutant MK-STYXactive. We also highlight the importance of utilizing RNA interference (RNAi) "knockdown" technology to determine a cellular phenotype in various cell lines. Therefore, we outline our protocols for introducing short hairpin RNA (shRNA) expression plasmids into mammalian cells and quantifying knockdown of gene expression with real-time quantitative PCR (qPCR). We also provide a bioinformatic approach to investigating MK-STYX and MK-STYX(active mutant). These bioinformatic approaches can stand alone experimentally but also complement and enhance "wet" bench approaches such as binding assays and/or activity assays. A combination of cellular, molecular, biochemical, proteomic, and bioinformatic techniques has been a powerful tool in identifying novel functions of MK-STYX. Likewise, the information provided here should be a helpful guide to elucidating the functions of other pseudophosphatases.

Mesoporous Silica Nanoparticles Mediate SiRNA Delivery for Long-Term Multi-Gene Silencing in Intact Plants.

RNA interference (RNAi) is a powerful tool for understanding and manipulating signaling pathways in plant science, potentially facilitating the accelerated development of novel plant traits and crop yield improvement. The common strategy for delivering siRNA into intact plants using agrobacterium or viruses is complicated and time-consuming, limiting the application of RNAi in plant research. Here, a novel delivery method based on mesoporous silica nanoparticles (MSNs) is reported, which allows for the efficient delivery of siRNA into mature plant leaves via topical application without the aid of mechanical forces, achieving transient gene knockdown with up to 98% silencing efficiency at the molecular level. In addition, this method is nontoxic to plant leaves, enabling the repeated delivery of siRNA for long-term silencing. White spots and yellowing phenotypes are observed after spraying the MSN-siRNA complex targeted at phytoene desaturase and magnesium chelatase genes. After high light treatment, photobleaching phenotypes are also observed by spraying MSNs-siRNA targeted at genes into the Photosystem II repair cycle. Furthermore, the study demonstrated that MSNs can simultaneously silence multiple genes. The results suggest that MSN-mediated siRNA delivery is an effective tool for long-term multi-gene silencing, with great potential for application in plant functional genomic analyses and crop improvement.

When Corporations Care: A Reassessment of the Debunking Paradigm in Environmental Communication

ABSTRACT When corporations, particularly those in the fossil fuel industry, profess to care about their audience, how should we analyze and evaluate this care? The common strategy by scholars and journalists is to debunk, or expose, fake or inauthentic messaging. In this essay, I argue that debunking prevents us from articulating the coordinates of care in environmental communication. I propose the adoption of a different critical stance toward corporate “green” communication, and offer some resources for achieving the objective of situating environmental communication as a care discipline.

Niobate Anodes for High Rate Lithium-Ion Batteries

Fast charging is one of the key performance requirements for next generation lithium ion batteries, and is directly related to the ease of ionic and electronic transport. However, lithium ion diffusion rates of promising anode materials, such as Li4Ti5O12, anatase TiO2, T-Nb2O5 and Nb18W16O93, are still insufficient. Therefore, nanosizing of the active electrode material is a common strategy to increase the effective lithium ion diffusion transport rate, which unfortunately also decreases the volumetric energy/power density and stability of the battery.Recently, we demonstrated nickel niobate, NiNb2O6, for the first time as a new intrinsic high-rate electrode material,[1] which exhibits an intrinsic high rate performance enabled by its suitable host crystal structure without the requirement of realizing nano-architectures. The NiNb2O6 host crystal structure exhibits only a single type of channel for lithium ion intercalation and can be fully lithiated up to Li3NiNb2O6 with a capacity of about 244 mAh/g at low current densities. Interestingly, a high diffusion coefficient of 10-12 cm2/s at 300 K enables fast (dis)charging at high current densities resulting in high capacities of 140 and 50 mAh/g for respectively 10C and 100C. The minimal volume change during lithiation is the origin of the stable reversible lithiation process in NiNb2O6 and leads to a capacity retention of 81% after 20.000 cycles at 100C. The structural stability and electrochemical behaviour were investigated by various experimental techniques and confirmed by density functional theory (DFT) calculations. Finally, full cell systems against LiFePO4 and NCM811 cathodes demonstrate the promising energy storage performance of nickel niobate anodes in practical battery devices.Our results strongly suggest that niobate-based materials are intrinsic high-rate anode materials without the requirement of realizing nano-architectures as typical for numerous titanium- and niobium-based oxides through complex synthesis procedures to minimize the length scales for lithium diffusion. Recently, we have replaced nickel by other transition metal ions to widen the exploration of niobate compounds for fast lithium ion diffusion. Large variations in electrochemical performance are observed, and the latest results will be presented. This will provide a new perspective on the role of intrinsic high-rate electrode materials for realizing ultrafast anode materials for future energy storage devices.[1] R. Xia et al., Advanced Energy Materials 12 (2022) 2102972.

Effect of Backbone Selection on the Enhanced Electrocatalytic Activity of Pr2Ni0.6Cu0.4O4 Infiltrated Oxygen Electrodes

Infiltration is proved to be a highly efficient technique for increasing the electrocatalytic activity of oxygen electrodes in solid oxide fuel/electrolysis cells (SOFC/SOEC). One of the main advantages of this technique is the flexibility of choosing various backbone/surface-decoration combinations. The selection of correct backbone/surface-decoration combination is one of the challenges in developing the infiltrated oxygen electrodes. It is suggested that via choosing the correct combination, one can synergistically improve the electrochemical performance. Pr-based-Ruddlesden-Popper-nickelates such as Pr2Ni0.6Cu0.4O4 (PNCO) was recently demonstrated to be an efficient Cobalt-free and Alkaline earth-free electrocatalyst for oxygen reduction/evolution reaction (ORR/OER) when used as a surface decoration phases. Here, in this study, PNCO as a model electrocatalyst is infiltrated into various porous backbones of La0.6Sr0.4Co0.2Fe0.8O3 (LSCF), Ce0.9Gd0.1O2 (CGO), La0.6Sr0.4Co0.2Fe0.8O3/Ce0.9Gd0.1O2 (LSCF/CGO) and LaNi0.6Fe0.4O3/Ce0.9Gd0.1O2 (LNF/CGO) with various levels of ionic and electronic conductivity, and effect of infiltration loading on polarization and series resistance of symmetrical cells was investigated. The results showed that to achieve high performances via surface decoration of ionic conductor backbones, such as CGO, usually very high infiltration loadings as high as 15-30 wt% is required. The reason behind such high loadings is the fact that the surface decoration phases are the only sources of electronic conduction, and therefore high infiltration loadings are necessary to attain sufficient percolation of the electronic conducting phase. However, if the surface decoration phase does not possess high electronic conduction, which is the case for oxides such as PNCO, then additional paths for electronic conduction must be created in the electrode network to prevent current constriction effects. This additional path can be generated via replacing some fraction of the ionic conductor phase in the backbone with the electronic conductor phases such as LNF and LSCF. The other common strategy for developing efficient infiltrated oxygen electrode is the surface decoration of a mixed-ionic-electronic-conductor MIEC backbone (such as LSCF) with another MIEC phase (PNCO). The best performances in these types of infiltrated electrodes are achieved with significantly less infiltration loading compared to infiltrated ionic conductor backbones with values as low as 10 wt%. In this study, marked performance improvements were achieved with 10 wt% infiltration loading of PNCO, including a reduction by a factor of 2 of the polarization resistance at 650 °C for both LSCF (0.22 Ω.cm2 to 0.1 Ω.cm2) and the LSCF/CGO (0.15 Ω.cm2 to 0.06 Ω.cm2) state of the art electrodes. In CGO as well as LNF/CGO composite backbone, infiltration with 30 wt% of PNCO led to enhanced electrode performance improvement, reaching 0.24 Ω.cm2 and 0.1 Ω.cm2 at 650 °C, faster than the state-of-the-art LSCF-CGO (0.15 Ω.cm2) at same temperature, which shows the potential of these highly efficient cobalt-free and alkaline earth-free oxygen electrodes for (SOFC/SOEC) application. Figure 1

Peptide Gel Electrolytes for Stabilized Zn Metal Anodes.

The rechargeable aqueous Zn ion battery (AZIB) is considered a promising candidate for future energy storage applications due to its intrinsic safety features and low cost. However, Zn dendrites and side reactions (e.g., corrosion, hydrogen evolution reaction, and inactive side product (Zn hydroxide sulfate) formation) at the Zn metal anode have been serious obstacles to realizing a satisfactory AZIB performance. The application of gel electrolytes is a common strategy for suppressing these problems, but the normally used highly cross-linked polymer matrix (e.g., polyacrylamide (PAM)) brings additional difficulties for battery assembly and recycling. Herein, we have developed a gel electrolyte for Zn metal anode stabilization, where a peptide matrix, a highly biocompatible material, is used for gel construction. Various experiments and simulations elucidate the sulfate anion-assisted self-assembly gel formation and its effect in stabilizing Zn metal anodes. Unlike polymer gel electrolytes, the peptide gel electrolyte can reversibly transform between gel and liquid states, thus facilitating the gel-involved battery assembly and recycling. Furthermore, the peptide gel electrolyte provides fast Zn ion diffusion (comparable to conventional liquid electrolyte) while suppressing side reactions and dendrite growth, thus achieving highly stable Zn metal anodes as validated in various cell configurations. We believe that our concept of gel electrolyte design will inspire more future directions for Zn metal anode protection based on gel electrolyte design.

Joint optimization of task scheduling and computing resource allocation for VR video services in 5G‐advanced networks

AbstractWith the development of 5G networks and related hardware equipment, the demand for various VR video services including panoramic video live broadcast and immersive game is increasing day by day. Due to the explosive growth of data volume and the trend toward lightweight VR equipment, traditional local computing architecture faces problems of insufficient computing power and high cost. As an emerging computing paradigm, the remote computing architecture of cloud‐edge collaboration frees users from cumbersome local restrictions. However, edge computing resources are often limited, and the remote cloud has inconsistent network latency. Therefore, how to adaptively schedule and allocate computing resources is the key to determining VR service quality. Based on an in‐depth analysis of the characteristics of VR video services and network environments, this article first builds a cloud‐edge‐network coorperation computing and transmission architecture for VR video services. This architecture can adaptively offload concurrent computing tasks and allocate computing power to them in VR scenes based on network conditions provided by the 5G‐Advanced networks via network information exposure interface. This paper proposes a general optimization problem to maximize user experience. And a single‐slot delay optimization model was constructed. Combining convex optimization theory and deep learning algorithms, this paper designs a task scheduling and computing power allocation strategy based on deep reinforcement learning. The policy gradually learns optimal task scheduling and resource allocation decisions to maximize delay‐related rewards in the long run. This article further introduces the graph neural network under the attention mechanism to solve the problem of changes in the number of concurrent tasks. Finally, through Cloudsim simulation, this article verifies the superiority of task scheduling and computing power allocation strategies based on deep reinforcement learning compared to other common strategies in terms of resource utilization, client latency, scalability and decision time.

A PILOT FAMILY COACHING INTERVENTION FOR PEOPLE WITH TYPE 2 DIABETES AND A FAMILY MEMBER

Abstract Type 2 diabetes is a common chronic condition in later life that requires substantial lifestyle changes. Most diabetes management occurs at home with the help – and sometimes hindrance – of family members. Although coaching has become a common strategy in healthcare to supplement diabetes education, few interventions have prepared family members to be coaches, despite the documented benefit of including family members in chronic disease management interventions. The overall goal of our pilot intervention was to develop and test a family coaching approach to enhance patients’ diabetes self-management while preserving relationship quality and both individuals’ well-being. Participants were recruited from local diabetes education classes and through provider referrals, and included 20 dyads in the intervention group (patient Mage=59.12) and 20 dyads in the control group (patient Mage=57.06). The intervention, involving 5 interactive group sessions (in-person or virtual) led by a facilitator, covered evidence-based material developed by the investigators on diabetes education and coaching strategies. Behavioral, clinical, emotional, and relational metrics were assessed via a survey at baseline, post-intervention, and 3 months later; intervention participants also completed a program evaluation survey and participated in a focus group. Survey findings revealed some positive effects for diabetes self-management behaviors, no effects for short-term clinical markers, negative effects for emotional well-being, and both positive and negative effects for relational well-being. Participants reported being satisfied with the program overall; they indicated learning a lot and having a positive experience. A translation and cultural adaptation of this program for Spanish-speaking populations is currently underway.

PAIN ASSESSMENT AND MANAGEMENT FOR OLDER ADULTS WITH DEMENTIA IN LONG-TERM CARE: A SCOPING REVIEW

Abstract Self-reporting is essential for assessing pain. However, owing to their cognitive impairment, older adults with dementia may not always express pain. As such, older adults with dementia are at risk of living with undertreated pain. This scoping review aimed to explore and identify current publication trends and strategies regarding pain assessment and management for older adults with dementia in long-term care. Using the scoping review method of Arksey and O’Malley, two reviewers conducted structured searches for articles published from 2012 to 2022 on four databases (CINAHL, Cochrane, PubMed, RISS) and then independently reviewed the full text for eligibility criteria. The review included 40 articles for analysis and identified 20 observational pain tools used in the studies. A few studies assessed pain in older adults with dementia using facial expression recognition technology and electroencephalography. A common pain management strategy identified for older adults with dementia was the application of protocols or clinical guidelines that included a pain assessment and treatment phase. In addition to pharmacological and non-pharmacological treatment, a therapeutic robot (PARO) and play activities were investigated to determine whether the pain was alleviated in older adults with dementia. Although studies have been conducted to assess and manage pain in older adults with dementia in long-term care, the review highlighted the need for education and training on pain tools and treatment approaches, as well as for the development of pain management strategies and non-pharmacological interventions.

NEIGHBORHOOD DISADVANTAGE AND PHYSICAL FUNCTIONING: EXPLORING GENDER-SPECIFIC MECHANISMS

Abstract The relationship between poverty status and functional limitation among late middle age and older adults is well-established. However, the contextual effect of neighborhood disadvantage on physical functioning is less clear. First, the potential pathways linking the two are largely unexplored. Extant evidence shows that perceived neighborhood safety and order are significant predictors of physical functioning. Moreover, stress eating is a common coping strategy for stressful life events and contexts. These three explanations potentially mediate the relationship between poverty rate and physical functioning. Second, even though existing evidence finds stark gender difference in physical functioning, the explanations for the gender difference remains largely unknown. We propose that gender-specific mechanisms can explain the gender difference in physical functioning. The goal of the study was to test the gender-specific mechanism thesis based on a nationally representative sample of adults 55 to 93 years of age in the MIDUS 2 and 3 data (N = 2099). We employed Multilevel Generalized Structural Equation Modeling to test the gender-specific mediating roles of the three mediators. Results showed that county-level poverty rate is significantly associated with instrumental activities of daily living (IADL) among women and men. In contrast, perceived neighborhood safety and stress eating significantly mediate the relationship between poverty rate and physical functioning among women but not men. Furthermore, the indirect effect among women is significantly larger than among men. The important findings support gender-specific mechanisms linking neighborhood disadvantage and health and highlight the role of subjective neighborhood indicators among older women.

The spatialization of social capital in the collective management of natural resources, a theoretical and methodological model

ABSTRACT The importance of studying the commons lies in the fact that the best-preserved ecosystems are found in areas managed and owned by the community. However, the capitalist mode of production, which depends on the excessive exploitation of natural resources, has undermined the fundamental elements of the communal system. Despite this, some territories have been able to maintain and strengthen common strategies related to the characteristics of their social capital, transforming it into a localized resource. With these objectives in mind, the study was conducted to, (1) Perform a literature review of theoretical, methodological, and empirical works related to social capital and territorialization to examine collective strategies for the conservation and management of natural resources. (2) Develop a theoretical and methodological framework that incorporates the territorialization of social capital as an explanatory factor in the collective appropriation of commons, using general concepts. The methodological approach was based on a literature review of articles, complemented by the co-occurrence method. The results show that the conceptual model consists of five theoretical categories and eleven categories of analysis, which interact to identify six thematic areas.

Refinement of Drug Regulation and Russian Pharmaceutical Export

Strategy on development of the pharmaceutical industry for the period up to 2030 (Pharma-2030 Strategy), adopted in the Russian Federation this year, includes tasks to further saturate the national market with domestic medicines and to “realize the export potential of the pharmaceutical industry”. National drug regulation has a significant stimulating effect on the export of medicines. To identify the most important elements of this regulation related to the development and maintenance of sustainable pharmaceutical export, different aspects of national drug regulatory systems were studied. Countries belonging to different segments of the global pharmaceutical export market were included in the research. The results of the analysis of drug regulation in top export countries were published earlier. This article presents the results for pharmerging countries with a fastgrowing pharmaceutical sector and formulated common strategies for these countries that are aimed at achieving leadership positions of the national pharmaceutical industry in both the domestic and foreign markets. Several measures have been proposed for inclusion in the implementation plan for the Pharma-2030 Strategy, which, in our opinion, will contribute to achieving the goals set both to stimulate exports and to saturate the Russian market with domestic medicines.

CHALLENGES AND STRATEGIES TO IMPLEMENTING THE TRANSITIONAL CARE MODEL: LESSONS LEARNED FROM THE MIRROR-TCM TRIAL

Abstract The Transitional Care Model (TCM) is an advanced practice registered nurse-led, team-based, care management strategy which has repeatedly been shown to improve outcomes for older adults transitioning from hospital to home. The MIRROR-TCM randomized controlled trial was implemented at three healthcare systems (7 hospitals) in four states. Older adults, hospitalized with heart failure, chronic obstructive pulmonary disease, or pneumonia, were enrolled between September 2020 and January 2023. A parallel evaluation study of “what it takes” to implement the TCM was launched to explore the challenges and strategies necessary to implement the Model’s 10 components, especially in the context of COVID-19. A qualitative descriptive analysis of 167 meetings (clinical, community, leadership) from June 2020 (Pre-Implementation) through January 2023 (implementation/evaluation) was conducted. Codes were developed inductively over the first year of the study. The most common challenges were patient and caregiver factors (e.g., engagement, preferences, medical complexity), staffing coverage (e.g., time off, absences), and collaboration with multidisciplinary teams (e.g., poor or reluctant collaboration/communication). Common strategies to address challenges included: clarifying and adapting TCM processes, establishing an appropriate plan of care, building and engaging networks and relationships across healthcare and community settings, and trialing alternative strategies (e.g., telehealth in place of in-person visits). While some challenges were more common across sites such as patients refusing visits or no weekend coverage, strategies to resolve them tended to be site-specific. Findings provide important insights into what it takes to successfully implement complex evidence-based interventions such as the TCM.

Self-employment and disability

In many countries, self-employment has become a common strategy for achieving inclusion in the labour market. Studies show that the occurrence of self-employment depends not only on individual motives, but also on existing policies and support. In Sweden, labour market measures to include people with disabilities are primarily organized to achieve inclusion through traditional forms of employment, though one tool offered by the Swedish Public Employment Service is Support to Start a Business. One part of this support is exclusive to people with disabilities. Although the Swedish Public Employment Service is responsible for this specific support, they collaborate with both external state-funded and non-profit actors who assess applicants’ business ideas. Drawing on the methodological approach of institutional ethnography, this article explores how the in-house frontline workers and external actors describe their professional roles, how they make decisions and what the chain of action looks like at multiple sites. Nine representatives from the various organizations that people can meet with when trying to start and run their own business have taken part in semi-structured interviews. The analysis identifies different institutional practices that overlap when people with disabilities apply for support to start their own business: one focusing on the efficient allocation of resources, and the other on the individual’s social and financial welfare by protecting the individuals these organizations meet with from risks connected to economy and health. These two practices reflect a long-standing conflict between control and support in objectives within both labour market policy and social work. This support of self-employment for people with disabilities is organized by actors who traditionally have not been studied in research on social work.

KIAA0101 promotes cisplatin resistance through regulating cell apoptosis in lung cancer cells.

Lung cancer is one of the most server mortality in the world and remains a huge threat to human health. Recently, cisplatin-based chemotherapy represented a common therapeutic strategy, however, cisplatin resistance greatly limits the therapy efficacy. We investigated whether KIAA0101 plays a role in cisplatin resistance of lung cancer cells and its mechanisms of action. The expression of KIAA0101 was evaluated based on comprehensive bioinformatic analysis. KIAA0101 knockdown and overexpression A549 cells were constructed to investigate its effects on cell proliferation and apoptosis induced by cisplatin treatment. Western blot analysis was performed to measure the levels of p53-related apoptosis proteins. We found that KIAA0101 was greatly increased in lung cancer tissues and cells. Knockdown of KIAA0101 suppressed cell proliferation and increased cisplatin-induced apoptosis. Knockdown of KIAA0101 also augmented the cisplatin-induced cell apoptosis signaling pathway. Then p53 was found to account for the role of KIAA0101 in cisplatin resistance. In conclusion, our findings provide a novel factor of KIAA0101 in lung cancer resistance, which suggests as a novel target for lung cancer therapy.

Stress Levels and Coping Strategies in Medical Students and its Association with Salivary IL-6 Levels

BACKGROUND: Medical students experience stress throughout their training period, to which they have built their own coping mechanisms. Stress alters various physiological processes, including markers like IL-6, a pro-inflammatory marker. The present study was conducted to assess the stress levels and coping strategies in medical students and its association with salivary IL-6 levels. METHODS: This descriptive study was conducted after obtaining institutional ethical clearance. Total of 76 undergraduate medical students who gave their consent, answered the Cohen’s perceived stress scale and BriefCOPE questionnaire. Unstimulated saliva was used to assess salivary IL-6 levels using Diaclone human IL-6 ELISA kit and data obtained was analyzed. RESULTS: Out of the 76 participants, 59(77.6%) were females and 17(22.4%) were males. Mild stress was perceived by 9 students, moderate and severe stress by 53 and 14 students respectively. Based on Kruskal-Wallis p test, in all grades of stress, approach method of coping had a higher score. Approach is form of active coping strategy where the students deal with the stressor in order to solve the issue and plan for the future. Approach coping has shown better responses for adversity, physical health and emotional responsiveness. Most commonly used coping strategies in mild and medium stress was acceptance, positive-refrain and planning. Students with severe stress adopted planning, self-distraction and self-blame. In spite of the perceived stress, there was no significant difference in the salivary IL-6 levels among the three categories. CONCLUSION: The common coping strategies employed by students to handle stress was ‘approach’. As described in the BriefCOPE, it has been shown to be associated with better outcomes. In spite of this, a vast number of students have reported to experience stress. Therefore, more effective coping strategies are needed to handle stress and demands of the profession. The study also emphasizes on need for further research with a large sample size to assess the relation between salivary IL-6 and stress levels.

A growing battlefield in the war against biofilm-induced antimicrobial resistance: insights from reviews on antibiotic resistance.

Biofilms are a common survival strategy employed by bacteria in healthcare settings, which enhances their resistance to antimicrobial and biocidal agents making infections difficult to treat. Mechanisms of biofilm-induced antimicrobial resistance involve reduced penetration of antimicrobial agents, increased expression of efflux pumps, altered microbial physiology, and genetic changes in the bacterial population. Factors contributing to the formation of biofilms include nutrient availability, temperature, pH, surface properties, and microbial interactions. Biofilm-associated infections can have serious consequences for patient outcomes, and standard antimicrobial therapies are often ineffective against biofilm-associated bacteria, making diagnosis and treatment challenging. Novel strategies, including antibiotics combination therapies (such as daptomycin and vancomycin, colistin and azithromycin), biofilm-targeted agents (such as small molecules (LP3134, LP3145, LP4010, LP1062) target c-di-GMP), and immunomodulatory therapies (such as the anti-PcrV IgY antibodies which target Type IIIsecretion system), are being developed to combat biofilm-induced antimicrobial resistance. A multifaceted approach to diagnosis, treatment, and prevention is necessary to address this emerging problem in healthcare settings.

Timing of Pediatric Incarcerated Inguinal Hernia Repair: A Review of Nationwide Readmissions Data

IntroductionIn pediatric patients, incarcerated inguinal hernias are often repaired on presentation. We hypothesize that in appropriate patients, repair may be safely deferred. MethodsThe Nationwide Readmissions Database was used to identify pediatric patients (aged < 18 y) with incarcerated inguinal hernia from 2010 to 2014. Patients were stratified by management approach (Early Repair versus Deferral). Overall frequencies of these operative strategies were calculated. Propensity score matching was then performed to control for patient age, comorbidities, perinatal conditions, and congenital anomalies. Outcomes including complications, surgical procedures, and readmissions were compared. Outpatient surgeries were not assessed. ResultsAmong 6148 total patients with incarcerated inguinal hernia, the most common strategy was to perform Early Repair (88% versus 12% Deferral). Following propensity score matching, the cohort included 1288 patients (86% male, average age 1.7 ± 4.1 years). Deferral was associated with equivalent rates of readmission within one year (13% versus 15%, P = 0.143), but higher readmissions within the first 30 days (7% versus 3%, P = 0.002) than Early Repair. Deferral patients had lower rates of orchiectomy (2% versus 5%, P = 0.001), wound infections (< 2% versus 2%, P = 0.020), and other infections (7% versus 15%, P < 0.001). The frequency of other complications including bowel resection, oophorectomy, testicular atrophy, sepsis, and pneumonia were equivalent between groups. Three percent of Deferrals had a diagnosis of incarceration on readmission. ConclusionsDeferral of incarcerated inguinal hernia repair at index admission is associated with higher rates of hospital readmissions within the first 30 days but equivalent readmission within the entire calendar year. These patients are at risk of repeat incarceration but have significantly lower rates of orchiectomy than their counterparts who undergo inguinal hernia repair at the index admission. We propose that prospective studies be performed to identify good candidates for Elective Deferral following manual reduction and overnight observation. Such studies must capture outpatient surgical outcomes.

Visualization of the chemical defense molecule formoside binding to sensory structures in a model fish predator.

Sensory perception of chemical threats coming from an organism's environment relies on the coordination of numerous receptors and cell types. In many cases, the physiological processes responsible for driving behavioral responses to chemical cues are poorly understood. Here, we investigated the physiological response of fish to an unpalatable compound, formoside, which is employed as a chemical defense by marine sponges. Construction of fluorescent probe derivatives of formoside allowed visualization of this chemical defense molecule in vivo, interacting with the cells and tissues of the early larvae of a model predator, the zebrafish (Danio rerio). This revealed the precise chemosensory structures targeted by formoside to be in the taste buds and olfactory epithelium of developing zebrafish. Mechanosensory neuromasts were also targeted. This study supports the involvement of a previously identified co-receptor in detection of the chemical defense and provides a springboard for the long-term goal of identification of the cellular receptor of formoside. Extension of this approach to other predators and chemical defenses may provide insight into common mechanisms of chemoreception by predators as well as common strategies of chemical defense employed by prey.