Magnetic resonance imaging-guided focused ultrasound thalamotomy for essential tremor in a patient with von Willebrand disease: perioperative optimization for patients with coagulopathies. Illustrative case.

BACKGROUND: Essential tremor (ET) is one of the most common movement disorders worldwide. In medically refractory ET, deep brain stimulation (DBS) of the ventral intermediate nucleus of the thalamus is the current standard of care. However, DBS carries an inherent 2% to 3% risk of hemorrhage, a risk that can be much higher in patients with concomitant coagulopathy. Magnetic resonance imaging-guided focused ultrasound (MRgFUS) thalamotomy is a surgical alternative that is highly effective in treating ET, with no reports of intracranial hemorrhage to date. OBSERVATIONS: This is the first documented case of successful MRgFUS thalamotomy in a patient with von Willebrand disease (VWD). A 60-year-old left-handed male had medically refractory ET, VWD type 2B, and a family history of clinically significant hemorrhage after DBS. He underwent right-sided MRgFUS thalamotomy and received a perioperative course of VONVENDI (recombinant von Willebrand factor) to ensure appropriate hemostasis. Postprocedure imaging confirmed a focal lesion in the right thalamus without evidence of hemorrhage. The patient reported 90% improvement of his left-hand tremor and significant improvement in his quality of life without obvious side effects. LESSONS: MRgFUS thalamotomy with peri- and postoperative hematological management is a promising alternative to DBS for patients with underlying coagulopathies.

Optimization of non-endorectal prostate MR image quality using PI-QUAL: A multidisciplinary team approach.

PURPOSE: To evaluate the utility of the PI-QUAL score in assessing protocol changes aimed to improve image quality from a non-endorectal coil prostate MR imaging protocol during a 9-month quality improvement (QI) project and to quantify the inter-reader agreement of PI-QUAL scores between radiologists, technologists, and physicists. METHODS: This retrospective study audited 1,012 multiparametric prostate MRI examinations as part of a national QI project according to the PI-QUAL standard. PI-QUAL scores were used to inform MR protocol changes. Following the project, 4 radiologists, 2 technologists, and 1 medical physicist collectively audited an additional set of 150 examinations to identify statistical improvements in image quality using the two-tailed Wilcoxon rank sum test. The improvements due to individual protocol changes were assessed among subsets of the 1,012 examinations which compared examinations occurring before and after the isolated protocol change. Inter-reader variability was assessed using the percent majority agreement and the average standard deviation of PI-QUAL scores between evaluators. RESULTS: During this QI project, PI-QUAL scores improved from 3.67 ± 0.75 to 4.16 ± 0.59 (p < 0.01) after implementing a series of protocol changes. Among a subset of 451 cases, we found that adopting R/L rather than A/P phase encoding reduced distortion in diffusion-weighted imaging (DW) from 21.6% (41/190 A/P phase encoded cases) to 11.5% (30/261 R/L phase encoded cases) (p < 0.01). Similarly, in the same 451 cases, adopting R/L phase encoding in T2WI reduced breathing motion artifacts from 34.6% (94/272 A/P phase encoding cases) to 12.8% (23/179 R/L phase encoding cases) (p < 0.01). DWI wraparound artifact was mitigated by employing a full-pelvis shim and enabling the abdomen shim option. The occurrence of low signal-to-noise ratio was reduced from 19.4% (19/98 cases without a weight-based threshold) to 6.3% (10/160) by instituting a weight-based threshold for using an endorectal coil (p < 0.01). The percent majority agreement was similar between radiologists, technologists and physicists, and all evaluators combined (72%, 77%, and 67%, respectively). CONCLUSIONS: PI-QUAL can evaluate image quality changes resulting from protocol optimizations at both the exam- and series-levels. With training, radiologists, technologists, and physicists can perform PI-QUAL scoring with similar performance. Broadening the scope of the quality improvement team can result in meaningful and lasting change.

Incarceration history and ethnic bias in hiring perceptions: An experimental test of intersectional bias & psychological mechanisms.

This study seeks to better understand mechanisms of bias against formerly incarcerated and ethnically minoritized job applicants as well as the interactive effects of those two identities. In a sample of 358 hiring managers in the United States, the 2 (incarceration history) x 4 (ethnicity) experiment will manipulate incarceration history and ethnicity through job application materials, and measure hireability, and perception of job applicants along dimensions of sociability/warmth, competence, and morality. We will use a moderated mediation model to test hypotheses regarding a main effect of prior incarceration and an interaction effect of incarceration history and ethnicity on judgments of hireability, as well as whether such effects are mediated through perception of job applicants. We expect results to inform both research and practice related to employment practices.

The Involvement in Alcoholics Anonymous Scale - Short Form: Factor Structure & Validation.

Background: The aim of this research was to examine the psychometrics of a short form version of the multidimensional Involvement in Alcoholics Anonymous scale (IAA-SF) by assessing the factor structure, internal consistency, and predictive validity. While there are several existing measures of involvement in Alcoholics Anonymous, many are either unidimensional or are limited in their ability to gather variation in the level of involvement in the different dimensions of 12-step programs. Objective: To achieve our aim, we used exploratory and principal axis factor analysis, correlation, and logistic regression with two unique and diverse samples. Longitudinal data were collected from a northern Illinois sample of 110 post-treatment adults, and cross-sectional data were from a random sample of 296 recovery home residents in the United States. Results: Results from the first sample suggested three exploratory factors (Principles Involvement, Social Involvement, and Spiritual Involvement) that were concordant with the proposed conceptualization and were then confirmed in the second sample. A 2nd order factor of global involvement was also found. All subscales demonstrated good to excellent internal consistency and were moderately associated with AA affiliation. Global and social involvement predicted greater odds of abstinence 2 years later, but principles and spiritual involvement did not. Conclusion: Overall results suggest the IAA- SF is a valid and reliable 12-item instrument for assessing involvement in the AA program, and the differential prediction suggests potential utility for a multidimensional approach to 12-step involvement.

Correction to: Oxford House Residents' Attitudes Toward Medication Assisted Treatment Use in Fellow Residents.

The original version of this article unfortunately contained a mistake in the author group, where co-authors Isabel Dovale, Noah Gelfman and Sarah Callahan were missed to include and Brandon Isler should be removed from the author group.

Oxford House Residents' Attitudes Toward Medication Assisted Treatment Use in Fellow Residents.

Methadone and buprenorphine/naloxone are medication assisted treatment (MAT) options for treating opioid use disorder, yet attitudes regarding their use within abstinence-based recovery homes have not been assessed. The present investigation examined attitudes regarding MAT utilization among residents living in Oxford Houses. This cross-sectional investigation compared residents (n = 87) receiving MAT whose recent drug use involved opioids, and two groups not receiving MATs; those who had used opioids and those who had used substances other than opioids. The vast majority of residents were not receiving MAT, yet 32% reported MAT histories. Negative attitudes regarding MAT were observed among residents who were not receiving MAT. Those presently receiving MAT reported mixed attitudes regarding the use of methadone and buprenorphine/naloxone, and two of these residents reported they had never been prescribed MAT. Findings suggest that abstinence-based recovery homes such as Oxford Houses may not be optimal resources for persons receiving MATs.

Payload hardware and experimental protocol development to enable future testing of the effect of space microgravity on the resistance to gentamicin of uropathogenic Escherichia coli and its σs-deficient mutant.

Human immune response is compromised and bacteria can become more antibiotic resistant in space microgravity (MG). We report that under low-shear modeled microgravity (LSMMG), stationary-phase uropathogenic Escherichia coli (UPEC) become more resistant to gentamicin (Gm), and that this increase is dependent on the presence of σs (a transcription regulator encoded by the rpoS gene). UPEC causes urinary tract infections (UTIs), reported to afflict astronauts; Gm is a standard treatment, so these findings could impact astronaut health. Because LSMMG findings can differ from MG, we report preparations to examine UPEC's Gm sensitivity during spaceflight using the E. coli Anti-Microbial Satellite (EcAMSat) as a free-flying "nanosatellite" in low Earth orbit. Within EcAMSat's payload, a 48-microwell fluidic card contains and supports study of bacterial cultures at constant temperature; optical absorbance changes in cell suspensions are made at three wavelengths for each microwell and a fluid-delivery system provides growth medium and predefined Gm concentrations. Performance characterization is reported here for spaceflight prototypes of this payload system. Using conventional microtiter plates, we show that Alamar Blue (AB) absorbance changes can assess the Gm effect on E. coli viability, permitting telemetric transfer of the spaceflight data to Earth. Laboratory results using payload prototypes are consistent with wellplate and flask findings of differential sensitivity of UPEC and its ∆rpoS strain to Gm. if σs plays the same role in space MG as in LSMMG and Earth gravity, countermeasures discovered in recent Earth studies (aimed at weakening the UPEC antioxidant defense) to control UPEC infections would prove useful also in space flights. Further, EcAMSat results should clarify inconsistencies from previous space experiments on bacterial antibiotic sensitivity and other issues.

Suicide Attempts and Personal Need for Structure Among Ex-Offenders.

Suicide attempts were examined in relation to sociodemographic (age, gender, ethnicity), psychopathological (prior psychiatric hospitalizations, physical and sexual abuse histories), and cognitive (personal need for structure) variables among a sample of ex-offenders with substance use disorders ( N = 270). Hierarchical logistic regression was conducted to determine whether personal need for structure would significantly predict whether participants reported past suicide attempts beyond sociodemographic and psychopathological predictors. Personal need for structure and prior psychiatric hospitalizations were the only significant predictors, with higher values of these predictors increasing the likelihood of suicide attempts. Findings are consistent with a cognitive model for understanding suicide behavior, suggesting that persons with a high need for cognitive structures operate with persistent and rigid thought processes that contribute to their risk of suicide.

Income Generation in Recovering Heroin Users: A Comparative Analysis of Legal and Illegal Earnings.

Research has shown employment to be a central mediator to sustained recovery and community reentry for substance abusers; however, heroin users have lower employment rates and report lower mean incomes than other drug users. The authors of the present study assessed income generating behaviors of substance users recruited from substance abuse treatment facilities (N=247). Heroin users had higher mean incomes from illegal sources. Further, logistic regression analysis found heroin use to increase the likelihood of engagement in illegal income generating behaviors. As these results increase the likelihood of involvement in the criminal justice system, the implications for heroin specific treatment and rehabilitation are discussed.

Engagement and disengagement in mutual-help addiction recovery housing: a test of affective events theory.

This study tested an affective events theory (AET) model in the Oxford House network of recovery homes. Residents' congruence with their home (P-E fit) was hypothesized to directly influence behavior that supported the house and other residents-citizenship behavior. We further hypothesized P-E fit would be related to member intentions to leave, with attitudes toward the home mediating that relationship. To assess this, we administered a cross-sectional national survey to 296 residents of 83 randomly selected Oxford Houses. Although the AET model demonstrated good fit with the data, an alternative model fit better. This alternative model suggested an additional indirect relationship between P-E fit and citizenship mediated by attitudes. Results suggested affective experiences such as feeling like one fits with a community may influence engagement and disengagement. There appears to be a direct influence of fit on citizenship behavior and an indirect influence of fit through recovery home attitudes on both citizenship and intentions to leave the home. We conclude affective experiences could be important for community engagement and disengagement but AET may need to integrate cognitive dissonance theory.

Special section on LGBT resilience across cultures: introduction.

This special section addresses a gap area of resilience and LGBT well-being. Although comprehensive global diversity regarding LGBT resilience was challenging to find, the special section includes representation from outside the US (Israel and Hong Kong), ethnic/racially diverse domestic populations, immigration, and one population for which LGBT identities might be considered marginalized-Christians in the US. The full range of LGBT identities are represented in the issue along with persons identifying as queer or questioning, although transgendered people were less well represented than lesbian, gay or bisexual identities.

Investigation of Electron Transfer by Geobacter sulfurreducens Biofilms by using an Electrochemical Quartz Crystal Microbalance.

Both the short- and long-term electron-transfer processes of electrode-respiring Geobacter sulfurreducens biofilms are demonstrated by using an electrochemical quartz crystal microbalance (QCM). The QCM monitors the frequency shift from the initial resonant frequency (background) in real time, while the current increases, because of biofilm growth. In the short term, the frequency shift is linear with respect to current for the biofilm. In long-term biofilm growth up to the exponential phase, a second linear region of frequency shift with respect to current is observed. In addition to the frequency shift response at constant polarization, the frequency shift response is coupled to cyclic voltammetry experiments. During cyclic voltammetry, a reproducible, negative increase in frequency shift is observed at oxidizing potentials. The results suggest that a QCM can be used in applications in which it is useful to find the most efficient current producer.

Person-environment interactions among residents of Oxford Houses.

The continued struggle of addiction recovery support systems suggest that the paradigm of this field needs to continue its evolution, which has increasingly emphasized environments. Field Theory suggests that the products of individual and environmental characteristics be considered rather than a summation of the two. This study examined such interactions in Oxford Houses, a network of democratic, and self-governed addiction recovery homes. This study examined sobriety in experienced houses (average length of residency > six months) compared to less experienced houses (average length of residency ≤ six months) in relation to individual resident characteristics (age, length of residence in an Oxford House, and referral from the criminal justice system). Using multilevel modeling, findings indicated that older residents living in an experienced Oxford Houses were more likely to remain abstinent over time than those in inexperienced homes. Additionally, for inexperienced houses, residents who had been in the Oxford House for a longer period had a higher the probability of abstinence than those that had been in the house for a shorter period of time. Finally, legal referral was related to a lower probability of one-year abstinence but only for those in experienced homes. These types of person-environment interactions point to the need for more research to better understand how person variables interact with environmental variables in the processes of recovery and adaptation to settings, as well as for treatment professionals' consideration of both person and environment when making recovery home referrals.

Hope as a Predictor of Reincarceration Among Mutual-Help Recovery Residents.

Given the rates of reincarceration in the U.S., it is important to understand criminal justice risk and protective factors. Hope is a potentially important factor with two components-agency (goal-directed determination) and pathways (planning to meet goals) (Snyder et al., 1991). We conducted a secondary data analysis (n = 45) of a longitudinal survey of mutual-help recovery home residents. As hypothesized, greater global hope and agency significantly predicted lower odds for reincarceration, and lower levels of pathways was not predictive. We relate these findings to hope theory and potential community applications.

The "Virtual" Panel: A Computerized Model for LGBT Speaker Panels.

Recent societal trends indicate more tolerance for homosexuality, but prejudice remains on college campuses. Speaker panels are commonly used in classrooms as a way to educate students about sexual diversity and decrease negative attitudes toward sexual diversity. The advent of computer delivered instruction presents a unique opportunity to broaden the impact of traditional speaker panels. The current investigation examined the influence of an interactive "virtual" gay and lesbian speaker panel on cognitive, affective, and behavioral homonegativity. Findings suggest the computer-administered panel is lowers homonegativity, particularly for affective experiential homonegativity. The implications of these findings for research and practice are discussed.

The general environment fit scale: a factor analysis and test of convergent construct validity.

Person-environment fit (P-E fit) was initially espoused as an important construct in the field of community psychology; however, most of the theoretical and empirical development of the construct has been conducted by the industrial/organizational (I/O) psychologists and business management fields. In the current study, the GEFS-a P-E fit measure that was developed from organizational perspectives on fit-was administered to 246 attendees of an annual convention for residents and alumni of Oxford House, a network of over 1,400 mutual-help addiction recovery homes. The authors conducted confirmatory factor and convergent construct validity analyses with the GEFS. The results suggested that the theoretical factor structure of the measure adequately fit the data and provided limited support for the measure's validity. Sufficient supply of resident needs by the Oxford House and similarity between residents and their housemates predicted satisfaction with the recovery home, but only perceived similarity to housemates predicted how long residents intended to stay in the Oxford Houses.

The O/OREOS mission: first science data from the Space Environment Survivability of Living Organisms (SESLO) payload.

We report the first telemetered spaceflight science results from the orbiting Space Environment Survivability of Living Organisms (SESLO) experiment, executed by one of the two 10 cm cube-format payloads aboard the 5.5 kg Organism/Organic Exposure to Orbital Stresses (O/OREOS) free-flying nanosatellite. The O/OREOS spacecraft was launched successfully to a 72° inclination, 650 km Earth orbit on 19 November 2010. This satellite provides access to the radiation environment of space in relatively weak regions of Earth's protective magnetosphere as it passes close to the north and south magnetic poles; the total dose rate is about 15 times that in the orbit of the International Space Station. The SESLO experiment measures the long-term survival, germination, and growth responses, including metabolic activity, of Bacillus subtilis spores exposed to the microgravity, ionizing radiation, and heavy-ion bombardment of its high-inclination orbit. Six microwells containing wild-type (168) and six more containing radiation-sensitive mutant (WN1087) strains of dried B. subtilis spores were rehydrated with nutrient medium after 14 days in space to allow the spores to germinate and grow. Similarly, the same distribution of organisms in a different set of microwells was rehydrated with nutrient medium after 97 days in space. The nutrient medium included the redox dye Alamar blue, which changes color in response to cellular metabolic activity. Three-color transmitted intensity measurements of all microwells were telemetered to Earth within days of each of the 48 h growth experiments. We report here on the evaluation and interpretation of these spaceflight data in comparison to delayed-synchronous laboratory ground control experiments.

Interfacial ion transfers between a monolayer phase of cationic Au nanoparticles and contacting organic solvent.

The highly cationic nanoparticle [Au(225)(TEA-thiolate(+))(22)(SC6Fc)(9)] adsorbs so strongly on Pt electrodes from CH(3)CN/Bu(4)NClO(4) electrolyte solutions that films comprised of 1-2 monolayers of nanoparticles can be transferred to nanoparticle-free electrolyte solutions without desorption and ferrocene voltammetry stably observed. (TEA-thiolate(+) = -S(CH(2))(11)N(CH(2)CH(3))(3)(+); SC6Fc = S(CH(2))(6)-ferrocene; Fc = ferrocene). The Fc(+/0) redox couple's voltammetry is used to detect the adsorption. The apparent formal potential (E(o)'(APP)) of the Fc(+/0) couple depends on the electrolyte--its anion, cation, and concentration--in the contacting nanoparticle-free solution. A 10-fold change in electrolyte concentration shifts the Fc(+/0) E(o)'(APP) by 48-67 mV, depending on the electrolyte. The dependency is interpreted to reflect the energetics of transfer of charge-compensating anions from the electrolyte solution to the monolayer nanoparticle "phase", promoted by the formation of Fc(+) sites in the nanoparticle film. This interpretation is supported by electrochemical quartz crystal microbalance results. Some further aspects of the results suggest adsorption of electrolyte cations at the nanoparticle film/electrolyte solution interface. The interface mimics a liquid/liquid interface between immiscible electrolyte solutions, in which the ion transfer approaches permselective behavior. The experimental results show that even 1-2 monolayers of highly ionic nanoparticles can behave as a polyelectrolyte "phase".

Electrospray ionization mass spectrometry of intrinsically cationized nanoparticles, [Au(144/146)(SC(11)H(22)N(CH(2)CH(3))(3)(+))(x)(S(CH(2))(5)CH(3))(y)](x+).

Electrospray ionization triple-quadrupole mass spectrometry of ca. 1.6 nm diameter thiolate-protected gold nanoparticles has been achieved at higher resolution than in previous reports. The results reveal the presence of nanoparticles with formulas Au(144)L(60) and Au(146)L(59), present in the sample as a mixture. The improved resolution is based on lowering m/z by exchanging multiple [-SC(11)H(22)N(CH(2)CH(3))(3)(+)] ligands into the original [-S(CH(2))(5)CH(3)] ligand shell. The nanoparticles are thus intrinsically cationized and appear as a series of 10+ to 15+ mass spectral peaks. The assigned state of charge was confirmed by a collision-induced dissociation measurement.

Voltammetry and redox charge storage capacity of ferrocene-functionalized silica nanoparticles.

We describe the electrochemistry of 15 nm diameter silica nanoparticles densely functionalized with ferrocene (FcSiO(2)) through siloxane couplings. Each nanoparticle bears approximately 600 Fc sites, as measured by potentiometric titration (590 Fc) and diffusion-controlled voltammetry (585 Fc) and estimated by XPS (630 Fc). The nanoparticle ferrocene coverage amounts to ca. a complete monolayer of ferrocene sites, which react electrochemically without mutual interactions and which are apparently fully accessible for diffusion-controlled electrode reactions. Diffusion-controlled voltammetry of the FcSiO(2) nanoparticles was observed in dilute methanol dispersions and in more concentrated slurry phases formed in methanol/acetonitrile mixtures. Electrochemical studies reveal interesting behavior in the dilute and more concentrated solutions. Because of the large nanoparticle surface area/volume ratio, the ferrocene-coated silica nanoparticles are capable of storing up to 5 x 10(7) C/m(3) of redox charge as dry phases and 6 x 10(5) C/m(3) in the concentrated slurries.