Just as there was a transition to remote teaching because of the COVID pandemic, many universities are in the process of transitioning back to in person classrooms. Case in point, Clinical Physiology ...I is the first semester of a 5000 level two‐semester course that is offered as a flipped class. Even with the transition to fully online teaching in the Spring of 2020, the robust breakout room feature of the video teleconferencing software, Zoom, permitted small group work that occurs with the flipped to continue.
As the fall 2021 semester approached, the University approved a return to in person classes, however several students emailed the course instructor (L.C. Anderson) expressing concern and asking if an online option would be available. Students completed a pre‐class survey in which they committed to attend class in person or remotely via zoom. The instructor continued the flipped classroom with some students in small groups in person and some students in zoom breakout rooms. The students scored lower than expected on the first exam. Traditionally, the average of the first exam is approximately 80%, however the Fall 2021 Exam 1 average was 70%. Of 40 students, 13 scored less than 70%; this statistic was concerning given that students must earn a 70% to pass the course. To address the difficulty of the exam and to make sure students had learned the material, the course instructor flagged 13 questions (of 40 test questions total) with questionable testing statistics. Student submitted reflective essays on three of the exam questions but could write about all 13 questions for extra credit. From the student writings, the instructor ascertained that 3 of the test questions were flawed and all students were given credit for those 3 questions. Post exam reflections and adjustments raised the course average to 85%.
Sensing continued anxiety within class, the instructor surveyed the students. The survey results suggested that remote students were less satisfied with class and perceived that they, as a group, had done poorly on the exam. Remote students reported feeling unfairly disadvantaged by the flipped classroom model online and reported a lack of trust in their online group members. This led the instructor to ask the questions: 1) Did the remote students score worse than the in‐person students? 2) If there is a performance difference, are there other factors that could explain the difference? In‐person students answered an average of 29.9 + 4.8 questions (about 75%) correctly whereas remote students answered an average of 25.7 + 5.8 (about 64%) correctly which was significantly different (Student’s T test, p=0.015). There was no significant difference between the performance of males and females, however BIPOC students averaged 23.6 + 6.0 with white students averaging 29.7 + 4.5 (Student's T Test, p= 0.001). This difference was lessened but persisted after the exam correction. This was an alarming observation; furthermore, more BIPOC students were participating remotely. The instructor invited students to meet one on one to review exam 1, added office hours and used student feedback to adjust class activities. The class performance improved on exam 2; furthermore, there were no significant differences between 1) in person versus remote students, 2) male versus female students and 3) BIPOC versus white students.
Individuals with eating disorders (EDs) are at significant risk for increases in symptomatology and diminished treatment access during the COVID-19 pandemic. Environmental precautions to limit ...coronavirus spread have affected food availability and access to healthy coping mechanisms, and have contributed to weight-stigmatizing social media messages that may be uniquely harmful to those experiencing EDs. Additionally, changes in socialization and routine, stress, and experiences of trauma that are being experienced globally may be particularly deleterious to ED risk and recovery. This paper presents a brief review of the pertinent literature related to the risk of EDs in the context of COVID-19 and offers suggestions for modifying intervention efforts to accommodate the unique challenges individuals with EDs and providers may be experiencing in light of the ongoing public health crisis.
Disordered eating behaviors (DEB) are highly prevalent and are associated with negative long-term health outcomes. Extant research on DEB prevalence trajectories has predominantly focused on white ...women, thereby lacking both gender and ethnic/racial diversity, which may lead to preventive interventions that are not optimally timed for socially minoritized groups. The purpose of this study was to identify patterns in DEB trajectories from adolescence to adulthood across intersecting gender and ethnic/racial identities.
Participants (n = 1314) were from Project EAT (Eating and Activity in Teens and Young Adults), a population-based sample in the United States. Unhealthy weight control behaviors and binge eating were assessed across four waves at 5-year intervals. Gender-stratified generalized estimating equations (GEE) analyses were applied to examine ethnic/racial and gender differences in the prevalence trajectories of two forms of DEB (unhealthy weight control behaviors and binge eating).
Hispanic/Latina young women reported heightened prevalence of unhealthy weight control behaviors and binge eating during adolescence (82.4% and 31.1%) relative to women with other ethnic/racial identities (44–70.2% and 8.8–18.2%) at any other developmental time point. Black/African American women reported linear increases in unhealthy weight control behaviors from adolescence (46.6%) to adulthood (65.5%), with nearly 20% greater prevalence relative to white women (44.6%) during adulthood. Among men, prevalence of unhealthy weight control behaviors was higher among Hispanic/Latinos (60.7–68.0%) and Asian Americans (41.9–56.7%) relative to Black/African American (24.6–36.9%) and white men (25.7–34.9%). Similarly, Hispanic/Latino young men reported up to ten or more times higher prevalence of binge eating during adolescence (22.8%) and adulthood (26.8%) relative to men from other ethnic/racial identities at any other time point (1.7–12.3%).
Ethnic/racial disparities in DEB prevalence vary across development, DEB subtype, and by gender. Targeted preventive interventions, or interventions that address these different trajectories, that are optimally timed may reduce these disparities.
•Ethnic/racial differences in DEB trajectories were more prominent among women.•Ethnic/racial differences in DEB trajectories differed by developmental time period.•Black/African American women were the only group with linearly increasing UWCBs.•Hispanic/Latina women and men may be particularly vulnerable to both forms of DEB.•Asian American women and men may be particularly vulnerable to UWCBs.
Colorectal cancers with
BRAF
mutations have an aggressive natural history and are often resistant to therapy. A treatment regimen that combined BRAF inhibition, MET inhibition, and blocking of EGFR ...signaling resulted in a response rate of 26% and a median overall survival of 9 months.
We conduct a large-scale economics experiment paired with a survey to examine the association between individual risk preference and health-related behaviors among adults aged 18–87 years. Risk ...preference is measured by the lottery choice experiment designed by Holt and Laury Holt, C.A., Laury, S.K., 2002. Risk aversion and incentive effects. The American Economic Review 92(5), 1644–1655. Controlling for subject demographic and economic characteristics, we find that risk aversion is negatively and significantly associated with cigarette smoking, heavy drinking, being overweight or obese, and seat belt non-use. In additional specifications, we find that risk aversion is negatively and significantly associated with the likelihood a subject engaged in any of five risky behaviors and the number of risky behaviors reported.
Objectives This study was devised to describe the different cardiac magnetic resonance (CMR) appearances in light chain amyloid (AL) and transthyretin-related amyloidosis (ATTR). Background CMR is ...increasingly used to investigate patients with suspected amyloidosis. Global subendocardial late gadolinium enhancement (LGE) has been reported as typical of AL amyloidosis, whereas different patterns have been noted in ATTR amyloidosis. Methods We performed de novo analyses on original DICOM magnetic resonance imaging in 46 patients with cardiac AL amyloidosis and 51 patients with ATTR type who had been referred to a specialist amyloidosis center between 2007 and 2012 after CMR. Histological examination was performed in all cases, with immunohistochemistry, to confirm systemic amyloidosis. Results Patients' median age was 68 ± 10 years, and 74% were male. Left ventricular mass was markedly increased in ATTR amyloidosis (228 g 202 to 267 g) compared with AL type (167 g 137 to 191 g) (p < 0.001). LGE was detected in all but 1 cardiac amyloidosis patient (AL type) and was substantially more extensive in ATTR compared with AL amyloidosis. Ninety percent of ATTR patients demonstrated transmural LGE compared with 37% of AL patients (p < 0.001). Right ventricular LGE was apparent in all ATTR patients but in only 33 AL patients (72%) (p < 0.001). Despite these findings, survival was significantly better in cardiac ATTR amyloidosis compared with AL type. We derived an LGE scoring system (Query Amyloid Late Enhancement) that independently differentiated ATTR from AL amyloidosis and, when incorporated into a logistic regression model with age and wall thickness, detected ATTR type with 87% sensitivity and 96% specificity. Conclusions Transmural patterns of LGE distinguished ATTR from AL cardiac amyloidosis with high accuracy in this real-world analysis of CMR. Precise diagnosis of cardiac amyloidosis is crucial given the role of chemotherapy in AL type and with novel therapies for ATTR type currently in development.
Idiographic research methods can provide rich information regarding the process of change in specific treatments. Objective: Adopting an idiographic, exploratory approach, this study examined (a) ...temporal patterns of 3 transdiagnostic change constructs (mindfulness, cognitive reappraisal, and emotion avoidance), (b) the relationships between these constructs and depression and anxiety symptom severity over time, and (c) changes in these constructs in relation to the introduction of specific transdiagnostic intervention strategies in a single case. Method: The case was a 64-year-old, White, female patient with principal major depressive disorder and secondary generalized anxiety disorder being treated with the Unified Protocol (UP). Univariate and multivariate time series analyses were applied to symptom and change construct data. Results: (a) Clinically significant decreases in depression and anxiety from baseline to posttreatment were observed, as well as clinically significant increases in mindfulness and reappraisal; (b) changes in mindfulness were associated with changes in depression and anxiety, and changes in mindfulness temporally preceded changes in depression and anxiety; (c) changes in reappraisal were associated with changes in depression, and changes in reappraisal temporally preceded changes in depression; (d) the UP module designed to increase present-focused emotion awareness exerted the strongest influence on mindfulness ratings, although other modules had an impact; (e) reappraisal ratings were most strongly influenced by the emotion monitoring and functional analysis module, although subsequent modules continued to have a measureable impact. Conclusions: Although specific to this case, these results begin to elucidate important processes of change in transdiagnostic cognitive-behavioral therapy for principal depression with comorbid anxiety.
Effector-triggered immunity (ETI), the major host defense mechanism in plants, is often associated with programmed cell death (PCD). Plants lack close homologs of caspases, the key mediators of PCD ...in animals. So although the NB-LRR receptors involved in ETI are well studied, how they activate PCD and confer disease resistance remains elusive. We show that the Arabidopsis nuclear envelope protein, CPR5, negatively regulates ETI and the associated PCD through a physical interaction with cyclin-dependent kinase inhibitors (CKIs). Upon ETI induction, CKIs are released from CPR5 to cause overactivation of another core cell-cycle regulator, E2F. In cki and e2f mutants, ETI responses induced by both TIR-NB-LRR and CC-NB-LRR classes of immune receptors are compromised. We further show that E2F is deregulated during ETI, probably through CKI-mediated hyperphosphorylation of retinoblastoma-related 1 (RBR1). This study demonstrates that canonical cell-cycle regulators also play important noncanonical roles in plant immunity.
Display omitted
•The nuclear membrane protein CPR5 inhibits effector-triggered immunity (ETI)•CPR5 inhibits ETI via interaction with cyclin-dependent kinase inhibitors (CKIs)•CKIs are released from CPR5 upon ETI induction and are required for PCD and immunity•CKIs induce immunity through RB hyperphosphorylation and E2F overactivation
Effector-triggered immunity (ETI) in plants is often associated with programmed cell death (PCD), but the mechanisms are unclear. Wang et al. report that upon ETI induction, core cell-cycle regulators CKIs are released from the nuclear-membrane protein CPR5 and function noncanonically through RBR1 and E2F to induce PCD and immunity.
This essay argues that N. K. Jemisin’s award-winning Broken Earth science fiction trilogy engages the concepts of freedom, enslavement, and marronage through the stories of her orogene narrators ...Essun and Nessun. Through the complexity of the trilogy, Jemisin challenges her readers to consider the nature of enslavement and freedom, and the challenges and necessity of radical transformation to create new ways of being.
Social support is a known protective factor against the negative psychological impact of natural disasters. Most past research has examined how the effects of exposure to traumatic events influences ...whether someone meets diagnostic criteria for depression and posttraumatic stress disorder (PTSD); it has also suggested sequelae of disaster exposure depends on whether survivors are displaced from their homes. To capture the full range of the psychological impact of natural disasters, we examined the buffering effects of social support on depressive symptoms and cluster‐specific PTSD symptoms, with consideration of displacement status. In a survey conducted 18 to 24 months after Hurricane Katrina, 810 adults exposed to the disaster reported the number of Katrina‐related traumatic events experienced, perceived social support 2 months post‐Katrina, and cluster‐specific PTSD and depressive symptoms experienced since Katrina. Analyses assessed the moderating effects of social support and displacement and the conditional effects of displacement status. Social support significantly buffered the negative effect of Katrina‐related traumatic events on depressive symptoms, B = −0.10, p = .001, and avoidance and arousal PTSD symptoms, B = −0.02, p = .035 and B = −0.02, p = .042, respectively. Three‐way interactions were nonsignificant. Conditional effects indicated social support buffered development of depressive symptoms across all residents; however, the moderating effects of support on avoidance and arousal symptoms only appeared significant for nondisplaced residents. Results highlight the protective effects of disaster‐related social support among nondisplaced individuals, and suggest displaced individuals may require more formal supports for PTSD symptom reduction following a natural disaster.
Resumen
Spanish s by the Asociación Chilena de Estrés Traumático (ACET)
El Apoyo Social Modera los Efectos de la Exposición a Desastres Naturales sobre los Síntomas de Depresión y Trastorno de Estrés Postraumático: Efectos para Residentes Trasladados y No‐Trasladados
APOYO SOCIAL MODERA LOS EFECTOS DE LOS DESASTRES NATURALES
El apoyo social es un factor protector conocido contra el impacto psicológico negativo de los desastres naturales. La mayoría de la investigación previa ha examinado cómo la exposición a eventos traumáticos influencia la posibilidad de cumplir los criterios diagnósticos para depresión y trastorno de estrés postraumático (TEPT); también se ha sugerido que las secuelas de la exposición a desastres dependen de si los sobrevivientes son trasladados de sus hogares. Para capturar el rango completo del impacto psicológico de los desastres naturales, examinamos los efectos de amortiguadores que ejerce el apoyo social en síntomas depresivos y los dominios sintomáticos dentro del TEPT, considerando el estado de Trasladado o No‐Trasladado. En una encuesta realizada 18 a 24 meses tras el huracán Katrina, 810 adultos expuestos a ese desastre reportaron el número de eventos traumáticos experimentados relacionados con Katrina, apoyo social percibido dos meses después de Katrina, y dominios sintomáticos de TEPT y síntomas de depresión sufridos desde Katrina. El análisis examinó los efectos moderadores del apoyo social y de la situación de traslado, así como los efectos condicionales del estatus de trasladado. El apoyo social mitigó significativamente los efectos negativos de los eventos traumáticos relacionados con Katrina en síntomas depresivos, B = ‐0.10, p = .001, así como los dominios sintomáticos de evitación e hiperactivación en TEPT (B = ‐0.02, p = .035 y B = ‐0.02, p = .042, respectivamente). Las interacciones en tres direcciones fueron no significativas. Los efectos condicionales mostraron que el apoyo social amortiguó el desarrollo de síntomas depresivos en todos los individuos; sin embargo, los efectos moderadores del apoyo sobre los síntomas de evitación e hiperactivación sólo alcanzaron significancia para personas no‐trasladadas. Estos resultados enfatizan los efectos protectores del apoyo social en desastres en individuos no trasladados, y sugieren que individuos trasladados podrían requerir apoyos más formales para reducir los síntomas de TEPT después de un desastre natural.
抽象
Traditional and Simplified Chinese s by AsianSTSS
Social Support Moderates Effects of Natural Disaster Exposure on Depression and PTSD Symptoms: Effects for Displaced and Non‐Displaced Residents
Traditional Chinese
標題: 社會支持會調節天災經歷對抑鬱症及PTSD症狀的影響:在有和無跟家園分離的人的效應
撮要: 我們已知社會支持是天災導致的負面心理影響的保護因素。過往大部分研究亦檢視創傷經歷怎樣影響當事人是否符合患抑鬱症和創傷後壓力症(PTSD)的標準;亦指出天災經歷的後遺症如何, 視乎生還者是否跟家園分離。為了解天災構成的全面心理影響, 本研究檢視社會支持對於抑鬱症狀及PTSD症狀的特殊聚類構成的緩衝效應, 亦考慮到樣本與家園分離的狀況。在颶風卡特里娜發生18 至24月後, 810名經歷此天災的成人接受調查, 報告了他們經歷與此颶風相關的創傷事件數目、颶風發生兩個月後的社會支持感知、以及他們在颶風後的PTSD特殊症狀聚類和抑鬱症狀。我們分析社會支持及跟家園分離產生的調節效應, 以及跟家園分離的狀況產生的制約效應。社會支持顯著地緩衝了與颶風卡特里娜相關的創傷事件對抑鬱症狀(B = ‐0.10, p = .001)、和PTSD裡的迴避與警覺症狀(分別為B = ‐0.02, p = .035 與B = ‐0.02, p = .042)構成的負面影響。三向的交互作用並不顯著。制約效應反映, 在所有居民中社會支持都緩衝了抑鬱症狀的發展。然而, 社會支持對迴避和警覺症狀的調節效應, 卻只在沒與家園分離的樣本中顯著。結果凸顯出天災相關的社會支持對沒與家園分離的人產生保護效應, 並反映與家園分離的人可能需要更多專業支持, 以減輕天災後的PTSD症狀。
Simplified Chinese
标题: 社会支持会调节天灾经历对抑郁症及PTSD症状的影响:在有和无跟家园分离的人的效应
撮要: 我们已知社会支持是天灾导致的负面心理影响的保护因素。过往大部分研究亦检视创伤经历怎样影响当事人是否符合患抑郁症和创伤后压力症(PTSD)的标准;亦指出天灾经历的后遗症如何, 视乎生还者是否跟家园分离。为了解天灾构成的全面心理影响, 本研究检视社会支持对于抑郁症状及PTSD症状的特殊聚类构成的缓冲效应, 亦考虑到样本与家园分离的状况。在飓风卡特里娜发生18 至24月后, 810名经历此天灾的成人接受调查, 报告了他们经历与此飓风相关的创伤事件数目、飓风发生两个月后的社会支持感知、以及他们在飓风后的PTSD特殊症状聚类和抑郁症状。我们分析社会支持及跟家园分离产生的调节效应, 以及跟家园分离的状况产生的制约效应。社会支持显著地缓冲了与飓风卡特里娜相关的创伤事件对抑郁症状(B = ‐0.10, p = .001)、和PTSD里的回避与警觉症状(分别为B = ‐0.02, p = .035 与B = ‐0.02, p = .042)构成的负面影响。三向的交互作用并不显著。制约效应反映, 在所有居民中社会支持都缓冲了抑郁症状的发展。然而, 社会支持对回避和警觉症状的调节效应, 却只在没与家园分离的样本中显著。结果凸显出天灾相关的社会支持对没与家园分离的人产生保护效应, 并反映与家园分离的人可能需要更多专业支持, 以减轻天灾后的PTSD症状。