On the uniform stress/uniform stretch states of prestressed arteries.

This work examines the mechanics of the circumferentially prestressed N-layer artery, subject to axial tethering force and the internal pressure of blood, focusing on the uniform stretch state, the uniform circumferential stress states and the transitional states between them. Under increasing pressure the ith layer is shown to experience five distinct stages, two of which are the uniform stretch state and the uniform circumferential stress state. For arbitrary strain energy density, simple analytical expressions are presented for the stress distributions and the internal pressure at these specialized states. For the 1-layer, uniform tubular model of an artery without axial tethering force, the results coincide with those of Destrade et al. (2012). For the 2-layer composite tube, which models the mechanically significant medial and adventitial layers of large elastic arteries, numerical solutions are obtained employing two microstructurally based constitutive models for medial and adventitial arterial tissues, respectively. These results indicate that the uniform stretch state, the uniform circumferential stress state of the medial layer, and the uniform circumferential stress state of the adventitial layer occur at the diastolic blood pressure, the mean blood pressure, and the systolic blood pressure, respectively.

Characteristics Associated with Depression and Suicidal Thoughts Among Medical Residents: Results from the DEPRESS-Ohio Study.

OBJECTIVE: This study describes the characteristics that are associated with depression in residents and also examines resident perception of available mental health support. METHODS: Residents and their program directors from each of 10 specialties across all academic training institutions in Ohio were electronically surveyed over a 2-month period. Generalized logistic regression was used to test for association between risk factors and depression and, among depressed residents, with suicidal thoughts. RESULTS: Using the PHQ-9, 19% of residents met criteria for at least moderate depression and 31.1% of depressed residents had suicidal thoughts. Over 70% of depressed residents were not receiving treatment, including 70% of depressed residents with suicidal thoughts. Residents who were unaware of wellness programming or did not believe their program director would be supportive of a depressed resident were significantly more likely to be depressed. Residents who believed depression treatment would negatively impact medical licensure were significantly more likely to be depressed. Male program directors and those in their position for fewer than 5 years were significantly more likely to have depressed residents in their program. CONCLUSIONS: A substantial proportion of depressed residents have suicidal thoughts, and most are not receiving treatment. Depressed residents may perceive the availability of support from their program director differently than their non-depressed colleagues, and may perceive greater risk to medical licensure if they seek treatment.

Perceptions of Residents and Their Training Directors Regarding Wellness Education, Program Support, and Access to Depression Treatment: the DEPRESS-Ohio Study.

OBJECTIVE: This study determines the extent to which residents and their program directors have discordant perceptions regarding wellness, support, and treatment opportunities for trainees. In addition, the authors examined whether psychiatry residents differed in their perceptions compared with residents in other specialties. METHODS: Residents and their program directors from each of 10 specialties were electronically surveyed after IRB approval and giving informed consent. RESULTS: Of 42 program directors responding, over 92% indicated they provided wellness education and programming; however, a significantly lower percentage of 822 trainees were aware of this (81.2% and 74.9%, respectively). A similar disparity existed between program directors (PDs) who knew where to refer depressed residents for help (92.9%) and residents who knew where to seek help (71%). Moreover, 83.3% of program directors believed they could comfortably discuss depression with a depressed resident, but a lower percentage of their trainees (69.1%) felt their training directors would be supportive. A significantly greater percentage of program directors (40.5%) believed seeking treatment for depression might compromise medical licensure than did residents (13.0%). Psychiatry residents were significantly more aware of wellness, support, and access than were residents from other specialties. CONCLUSIONS: The availability of wellness education, programming, program director accessibility, and knowing where to ask for help if depressed does not seem to be adequately communicated to many residents. Moreover, program directors disproportionately see depression treatment as a risk to medical licensure compared with their residents. Psychiatry residents seem to be more aware of program director support and access to care than their colleagues.

Spectroscopic and Computational Insights on Catalytic Synergy in Bimetallic Aluminophosphate Catalysts.

A combined electronic structure computational and X-ray absorption spectroscopy study was used to investigate the nature of the active sites responsible for catalytic synergy in Co-Ti bimetallic nanoporous frameworks. Probing the nature of the molecular species at the atomic level has led to the identification of a unique Co-O-Ti bond, which serves as the loci for the superior performance of the bimetallic catalyst, when compared with its analogous monometallic counterpart. The structural and spectroscopic features associated with this active site have been characterized and contrasted, with a view to affording structure-property relationships, in the wider context of designing sustainable catalytic oxidations with porous solids.

Neutrophilic panniculitis developing after treatment of metastatic melanoma with vemurafenib.

Vemurafenib is an inhibitor of BRAF and is used to treat patients with metastatic melanoma who carry a V600E BRAF mutation. Recently, four patients have been described in the literature who developed a neutrophilic panniculitis following treatment with a BRAF inhibitor. We present an additional case and review the clinical findings of the cases reported to date.

Trends in U.S. consumers' safe handling and consumption of food and their risk perceptions, 1988 through 2010.

Although survey results measuring the safety of consumers' food handling and risky food consumption practices have been published for over 20 years, evaluation of trends is impossible because the designs of published studies are not comparable. The Food Safety Surveys used comparable methods to interview U.S. adults by telephone in 1988, 1993, 2001, 2006, and 2010 about food handling (i.e., cross-contamination prevention) and risky consumption practices (eating raw or undercooked foods from animals) and perceived risk from foodborne illness. Sample sizes ranged from 1,620 to 4,547. Responses were analyzed descriptively, and four indices measuring meat, chicken, and egg cross-contamination, fish cross-contamination, risky consumption, and risk perceptions were analyzed using generalized linear models. The extent of media coverage of food safety issues was also examined. We found a substantial improvement in food handling and consumption practices and an increase in perceived risk from foodborne illness between 1993 and 1998. All indices were stable or declined between 1998 and 2006. Between 2006 and 2010, the two safe food handling practice indices increased significantly, but risk perceptions did not change, and safe consumption declined. Women had safer food handling and consumption practices than men. The oldest and youngest respondents and those with the highest education had the least safe food handling behaviors. Changes in safety of practices over the survey years are consistent with the change in the number of media stories about food safety in the periods between surveys. This finding suggests that increased media attention to food safety issues may raise awareness of food safety hazards and increase vigilance in food handling by consumers.

The mechanics of atherosclerotic plaque rupture by inclusion/matrix interfacial decohesion.

Histological investigation along with finite element analysis of arterial wall/atherosclerotic plaque geometries indicates the paradoxical result that ruptures often occur at sites with predicted stresses of half the plaque cap strength. Recent experiments have revealed calcified cells within the cap suggesting that these inclusions, situated close to the cap/luminal blood surface, precipitate rupture at low nominal loads by concentrating stress. In this paper, we investigate the proposition that rupture at low nominal loads occurs by (possibly brittle) decohesion of the calcification/cap interface followed by tearing of cap tissue. A novel boundary value problem is analyzed consisting of a remotely loaded linear elastic layer (extracellular matrix cap) containing a rigid spherical inclusion (calcified cell) that interacts with it through a nonlinear structural interface which models the binding of the calcified cell to the extracellular matrix via integrin receptor proteins. Equilibrium solutions are obtained from equations derived from the Boussinesq potentials for spherical domains. Results indicate a brittle character to the rupture process with the size of the domains between the inclusion center and the matrix surfaces determining the concentration of stress. For an inclusion close to a surface the abrupt unloading of the interface during brittle decohesion produces a sharp spike in circumferential stress. We conjecture that when this dynamic stress exceeds the cap strength, tearing occurs followed by thrombus formation and possibly infarction.

Primary cutaneous B-cell lymphoma, leg type restricted to the subcutaneous fat arising in a patient with dermatomyositis.

Until now, cutaneous lymphoma limited to the subcutaneous fat has been described as being derived only from T cells. Subcutaneous panniculitis-like T-cell lymphoma has been reported as a rare, postthymic neoplasm with various associations, including dermatomyositis. Furthermore, primary cutaneous B-cell lymphoma of the leg is defined by a diffuse dermal infiltrate of neoplastic B cells with extension to both the papillary dermis and the subcutaneous fat. We report a case of a patient with dermatomyositis who developed a cutaneous lymphoma of B-cell origin restricted to the subcutis, the first of its kind reported in the literature. This malignancy spared the dermis and epidermis, and we suggest that this is a unique variant of primary cutaneous B-cell lymphoma of the leg.

Practice-specific risk perceptions and self-reported food safety practices.

The relationship between risk perception and risk avoidance is typically analyzed using self-reported measures. However, in domains such as driving or food handling, the validity of responses about usual behavior is threatened because people think about the situations in which they are self-aware, such as when they encounter a hazard. Indeed, researchers have often noted a divergence between what people say about their behavior and how they actually behave. Thus, in order to draw conclusions about risk perceptions and risk avoidance from survey data, it is important to identify particular cognitive elements, such as those measured by questions about risk and safety knowledge, risk perceptions, or information search behavior, which may be effective antecedents of self-reported safety behavior. It is also important to identify and correct for potential sources of bias that may exist in the data. The authors analyze the Food and Drug Administration's 1998 Food Safety Survey to determine whether there are consistent cognitive antecedents for three types of safe food practices: preparation, eating, and cooling of foods. An assessment of measurement biases shows that endogeneity of food choices affects reports of food preparation. In addition, response bias affects reports of cooling practices as evidenced by its relation to knowledge and information search, a pattern of cognitive effects unique to cooling practices. After correcting for these biases, results show that practice-specific risk perceptions are the primary cognitive antecedents of safe food behavior, which has implications for the design of effective education messages about food safety.

Early diffuse alopecia in a neonate with congenital syphilis.

Neonatal alopecia has been described in many circumstances but never as a part of the constellation of signs in congenital syphilis. Common clinical features of early congenital syphilis include hepatosplenomegaly, skeletal deformities, hematologic disturbances, and mucocutaneous features such as rhinitis and maculopapular rash. Syphilitic alopecia has previously been described only in conjunction with secondary syphilis. In this article, we describe the first occurrence of alopecia in a neonate with congenital syphilis.

l-DOPA improves odor discrimination learning in rats.

Using a forced-choice odor discrimination task in rats, we show here that intraperitoneal injections of l-DOPA improve rats' odor discrimination performance in comparison to control rats injected with saline. Although the exact mechanism of l-DOPA and potential action on dopamine receptors remains unclear, the present results indicate that rats injected with the 20-50 mg/kg of l-DOPA performed significantly better in an odor discrimination task than did control rats. In addition, we observed a significant correlation between the concentration of l-DOPA and odor discrimination performance.

A camera's view of consumer food-handling behaviors.

OBJECTIVE: To compare consumer food-handling behaviors with the Fight BAC! consumer food-safety recommendations. DESIGN: Subjects were videotaped in their home while preparing a meal. Videotapes were coded according to Fight BAC! recommendations. A food-safety survey was administered and temperature data was collected. SUBJECTS/SETTING: A market research company randomly recruited subjects by telephone. Ninety-nine consumers participated (92 women, seven men). STATISTICAL ANALYSIS PERFORMED: Descriptive statistics were used. RESULTS: Overall, subjects did not follow the Fight BAC! recommendations for safe food handling. Handwashing was inadequate. The average hand wash length was significantly lower than the 20-second recommendation. Only one-third of subjects' hand wash attempts were with soap. Surface cleaning was inadequate with only one-third of surfaces thoroughly cleaned. Moreover, one-third of subjects did not attempt to clean surfaces during food preparation. Nearly all subjects cross-contaminated raw meat, poultry, seafood, eggs, and/or unwashed vegetables with ready-to-eat foods multiple times during food preparation. Unwashed hands were the most common cross-contamination agent. Many subjects undercooked the meat and poultry entrees. Very few subjects used a food thermometer. APPLICATIONS/CONCLUSIONS: Consumers make many food-handling errors during food preparation, increasing their risk of foodborne illness. Dietetics professionals need to familiarize themselves with the Fight BAC! consumer food-safety recommendations; understand where consumers are making food-handling errors; increase food safety awareness; and educate consumers, especially those in high-risk populations, about safe food handling at home.

Prevalence of Selected Food Consumption and Preparation Behaviors Associated with Increased Risks of Food-borne Disease.

Although not well quantified, a portion of food-borne illnesses results from voluntary behaviors that are entirely avoidable, such as eating raw foods of animal origin or engaging in unsafe food preparation practices. A telephone survey of 1,620 respondents was conducted to assess the prevalence of selected self-reported food consumption and preparation behaviors associated with increased risks of food-borne illness and the demographic characteristics related to such behaviors. The percentages of survey respondents who reported consuming raw foods of animal origin were 53%, raw eggs; 23%, undercooked hamburgers; 17%, raw clams or oysters; and 8%, raw sushi or ceviche. A fourth of the respondents said that after cutting raw meat or chicken, they use the cutting board again without cleaning it. Safer food consumption and preparation behaviors were consistently reported by persons who were female, were at least 40 years old, and had a high-school education or less. These findings suggest that risky food consumption and preparation behaviors are common in the United States and that educational campaigns aimed at changing these behaviors may need to be targeted to specific groups of persons.

Foodborne Illness: Perceptions, Experience, and Preventive Behaviors in the United States.

Data from national telephone surveys conducted in 1988 and 1993 were used to describe consumer perceptions of foodborne illness. The 1993 data were also used to assess the relationship between the perception that a foodborne illness had recently been experienced and awareness, concern, knowledge, and behavior related to food safety. Respondents described foodborne disease primarily as a minor illness without fever that occurs within a day of eating a contaminated food prepared in a restaurant. However, several common pathogens have a latency period longer than a day, and experts on foodborne disease estimate that most cases of foodborne illness originate from foods prepared at home. In both surveys, people 18 to 39 years of age were more likely than those in other age groups to believe they had experienced a foodborne illness. In 1993, people with at least some college education were more likely to believe they had experienced foodborne illness than were people with less education. People who believed they had experienced foodborne illness had greater awareness of foodborne microbes and concern about food safety issues, were more likely to eat raw protein foods from animals, and were less likely to practice safe food handling than were those who did not perceive that they had experienced such an illness.