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Bacterial vaginosis (BV) is the most frequently occurring vaginal infection worldwide, yet it remains significantly underdiagnosed as a majority of patients are asymptomatic. Untreated BV poses a serious threat as it increases one’s risk of STI acquisition, pregnancy complications, and infertility. We aim to minimize these risks by creating a low-cost disposable sensor for at-home BV diagnosis. A clinical diagnosis of BV is most commonly made according to the Amsel criteria. In this method, a fish-like odor, caused by increased levels of trimethylamine (TMA) in vaginal fluid, is used as a key diagnostic. This paper outlines the development of a Home-Based Electrochemical Rapid Sensor (HERS), capable of detecting TMA in simulated vaginal fluid (sVF). Instead of odor-based detection of volatilized TMA, we identify TMA in trimethylammonium form by utilizing HERS and a potentiometric readout. We fabricated the ion selective electrode using a carbon-black-coated cotton string and a TMA-selective membrane consisting of calix[4]arene and sodium tetrakis[3,5-bis(trifluoromethyl)phenyl]borate. When paired with a standard reference electrode, our device was able to quantify TMA concentration in deionized (DI) water, as well as sVF samples at multiple pH levels with a clinically relevant limit of detection (8.66 µM, and theoretically expected Nernstian slope of 55.14 mV/decade).

Metastatic neuroendocrine tumors secrete serotonin and other vasoactive substances that are responsible for carcinoid syndrome and carcinoid heart disease. We sought to evaluate the discriminatory utility of diagnostic biomarkers in determining the presence and severity of carcinoid heart disease in patients with metastatic neuroendocrine tumors. A cross-sectional study of patients with neuroendocrine tumors with documented liver metastases and/or carcinoid syndrome between April 2009-October 2012 in 5 tertiary referral centers. Serum was analyzed for Chromogranin A, Chromogranin B and N-terminal pro Brain Natriuretic Peptide (NT-proBNP). Plasma was analyzed for Neurokinin A and 5-Hydroxyindoleacetic acid (5HIAA). Echocardiography was used to determine the presence and severity of carcinoid heart disease. Non-parametric receiver operating characteristic curves were constructed for biomarkers, and the area under the curve determined. The severity of cardiac involvement was correlated with the concentration of each biomarker. A total of 187 patients were identified of whom 37 (20%) had carcinoid heart disease. Significantly higher median values of all biomarkers were found in the patients with cardiac involvement. NT-proBNP and plasma 5HIAA had the highest areas under the curve for the prediction of carcinoid heart disease [NT-proBNP 0.82 (95% confidence interval 0.74-0.90, p<0.0001) and 5HIAA 0.85 (95% confidence interval 0.78-0.92, p<0.0001]. NT-proBNP was moderately correlated (r = 0.48, p<0.001) whereas plasma 5HIAA was only weakly correlated (r = 0.34, p<0.001) with the echocardiographic severity score. NT-proBNP and plasma 5HIAA are both sensitive and specific biomarkers for the presence of carcinoid heart disease whereas only NT-proBNP is moderately correlated with disease severity.

Acetaminophen is the most common cause of acute liver failure in the United States. The transfer of drugs to breast milk poses risks to infants, yet dosing guidelines are based on limited data from small studies. Currently, drug levels in milk are simply estimated through invasive blood draws. We present a new low-cost, textile-based electrochemical sensor for detecting acetaminophen at the point of use in breast milk. An embroidered conductive yarn (steel and silver) is used, which eliminates the need for complex microfabrication processes. A gold-nanoparticle-doped carbon ink-modified steel yarn serves as the working electrode, with pristine steel and silver yarns as counter and reference electrodes, respectively. Using square wave voltammetry, the sensor achieves a linear detection range of 9.9–166.4 μ M in undiluted breast milk, with a limit of detection of 1.15 μ M. This platform provides a simple and accessible alternative for drug monitoring

Antiepileptic medications are the frontline treatment for seizure conditions. However, these medications are not without cognitive side effects. Previously, our laboratory reported learning deficits in phenytoin and carbamazepine-treated rats. In the experiment reported here, the effects of valproic acid (VPA) have been studied using the same instrumental training tasks. VPA-treated rats displayed a severe deficit in acquiring a tone-signaled avoidance response. This deficit was attenuated in animals that had prior training in an appetitive context. Thus, this deficit is specific to learning in an aversive context, and does not result from difficulties in transferring associations from an appetitive to aversive context. Learning transfer deficits were previously observed in rats treated with phenytoin, and to a lesser extent, carbamazepine. On the other hand, rats treated with VPA fail to suppress inappropriate responsiveness across aversive training whether they had undergone prior appetitive training or not.

This dissertation study examines the effects of negative media depictions of Black men on leadership self-efficacy as adults. This study is a cross-sectional survey design. The research design is quantitative/correlational and involves multiple regression analyses. Internet surveys were collected from a Qualtrics survey panel. The hypothesis that, among Black men, there is an effect of their recollections of childhood experiences of negative media portrayals of Black men on their current levels of leadership self-efficacy as adults was not supported. The current study solely tested for direct effects, and discusses the need for more complex considerations of how Black men’s remembrances of negative media depictions and messages as children effect their leadership as adults. Testing more complex models would include tests of mediators as part of indirect effects. Limitations of the study and other considerations were also addressed.

PurposeAppendiceal goblet cell carcinomas (aGCCs) are rare but aggressive tumours associated with significant mortality. We retrospectively reviewed the outcomes of aGCC patients treated at our tertiary referral centre.MethodsWe analysed aGCC patients, diagnosed between 1990–2016, assessing the impact of completion surgery and tumour factors on survival. Survival was assessed using Kaplan–Meier analysis.ResultsWe identified 41 patients (23 F, 18 M); median age 61 (range 27–79) years. Mean tumour size was 10.5 (range 0.5–50) mm; most tumours were located in the appendiceal tip (n = 18, 45%). Appendicectomy was the index surgery in 32 patients, 24 of whom subsequently underwent completion surgery at median 3 (range 1.3–13.3) months later. Histology from completion surgery showed residual disease in 8 patients: nodal disease (n = 2) or residual tumour (n = 6). Index surgery for the rest was either colectomy (n = 7) or cytoreductive surgery plus intraperitoneal chemotherapy (CRS-HIPEC) (n = 1). Index and completion surgery had 0% mortality and 2.5% morbidity. Overall and recurrence-free survival were not significantly affected by tumour grade or completion surgery. Disease recurred in 9 patients after a median follow-up of 57.0 (4.6–114.9) months; 7 of these patients died during follow-up. Recurrences were treated with CRS-HIPEC (n = 1), palliative chemotherapy (n = 3) or supportive care (n = 5). Five- and ten- year overall survival were 85.3% and 62.3% respectively; 5-year and 10-year recurrence-free survival were 73.6% and 50.6%.ConclusionThe prognosis of aGCCs remains relatively poor. Completion surgery did not prevent recurrence or improve survival, but this needs to be verified with a larger patient cohort. The high mortality associated with tumour recurrence questions current treatment recommendations.

IntroductionSmall intestinal neuroendocrine tumors (SI-NETs) often present with metastatic disease. An ongoing debate exists on whether to perform primary tumor resection (PTR) in patients with stage IV SI-NETs, without symptoms of the primary tumor and inoperable metastatic disease. ObjectiveThe aim of this study was to compare a treatment strategy of upfront surgical resection versus a surveillance strategy of watch and wait. MethodsThis was a retrospective cohort study of patients with stage IV SI-NETs at diagnosis, between 2000 and 2018, from two tertiary referral centers (Netherlands Cancer Institute [NKI] and Aintree University Hospital [AUH]) who had adopted contrasting treatment approaches: upfront surgical resection and watch and wait, respectively. Patients without symptoms related to the primary tumor were included. Multivariable intention-to-treat (ITT), per-protocol (PP), and instrumental variable (IV) analyses using ‘institute’ as an IV were performed to assess the influence of PTR on disease-specific mortality (DSM).ResultsA total of 557 patients were identified, with 145 patients remaining after exclusion of stage I–III disease or symptoms of the primary tumor (93 from the NKI and 52 from AUH). The cohorts differed in performance status (PS; p = 0.006) and tumor grade (p < 0.001). PTR was independently associated with reduced DSM irrespective of statistical methods employed: ITT hazard ratio [HR] 0.60, p = 0.005; PP HR 0.58, p < 0.001; and IV HR 0.07, p = 0.019. Other factors associated with DSM were age, PS, high chromogranin A, and somatostatin analog treatment.ConclusionTaking advantage of contrasting institutional treatment strategies, this study identified PTR as an independent predictor of DSM. Future prospective studies should aim to validate these results.

In the current pandemic, available evidence to date is that higher education institutions and their partners were able to bring the majority of mobile students home safely, while the remainder were able to shelter in place under the auspices of their host universities or study abroad providers. Providing for the physical well-being of mobile students begins with clear communication and planning prior to departure and continues throughout the program. Finally, sexual and racialized violence and assault pose specific risks to marginalized students when they travel. Although the field of global education has dealt with major public health crises in our recent past, the authors have not faced a truly global and systemic threat like the current coronavirus pandemic. Increased alcohol consumption is also associated with two additional risks college students face: sexual harassment and assault.

Libraries and fire stations become life-protecting emergency shelters in the face of power outages, pandemics, and natural disasters. Equipping these facilities with reliable power through contingency resources like energy storage helps to ensure these shelters have power to continue supporting the community 24/7 - even if a disaster collapses other power sources. Using an energy saving performance contract, capital improvement and facilities modernization projects can be funded using future energy savings over the term of the contract.