What you don't know can hurt you: adverse psychologic effects in members of BRCA1-linked and BRCA2-linked families who decline genetic testing

PURPOSE: To identify members of hereditary breast and ovarian cancer families who are at risk for adverse psychologic effects of genetic testing. PATIENTS AND METHODS: A prospective cohort study with baseline (preeducation) assessments of predictor variables (ie, sociodemographic factors, cancer history, and cancer-related stress symptoms) was performed. The primary outcome variable (presence of depressive symptoms) was assessed at baseline and at 1- and 6-month follow-up evaluations. Participants were 327 adult male and female members of BRCA1- and BRCA2-linked hereditary breast and ovarian cancer families, who were identified as carriers, noncarriers, or decliners of genetic testing. RESULTS: The presence of cancer-related stress symptoms at baseline was strongly predictive of the onset of depressive symptoms in family members who were invited but declined testing. Among persons who reported high baseline levels of stress, depression rates in decliners increased from 26% at baseline to 47% at 1-month follow-up; depression rates in noncarriers decreased and in carriers showed no change (odds ratio [OR] for decliners v noncarriers=8.0; 95% confidence interval [CI], 1.9 to 33.5; P=.0004). These significant differences in depression rates were still evident at the 6-month follow-up evaluation (P=.04). CONCLUSION: In BRCA1/2-linked families, persons with high levels of cancer-related stress who decline genetic testing may be at risk for depression. These family members may benefit from education and counseling, even if they ultimately elect not to be tested, and should be monitored for potential adverse effects.     

Anesthesia for neonatal surgical emergencies

In this review of the anesthetic considerations for the neonate who requires anesthesia for emergency surgery, the authors discuss preoperative, intraoperative, and postoperative management from an anesthetic perspective. Monitoring the cardiorespiratory and metabolic status of neonates during anesthesia is usually difficult because the neonate is not physically accessible. Specific monitoring techniques that provide accurate measurements are discussed. General anesthesia is usually required for the surgery, the airway must be secured and anesthesia managed with a combination of inhalational and intravenous agents. Regional anesthesia and opioids may be included to decrease the intraoperative anesthetic requirements and prevent pain in the postoperative period. The pharmacology of specific anesthetic and adjuvant agents are discussed.     

Depression and self-medication with nicotine: The modifying influence of the dopamine D4 receptor gene.

This study evaluated whether there are genetic subgroups of depressed individuals who are more or less predisposed to engage in self-medication smoking practices. Smokers (N?=?231) completed self-report questionnaires of depression and smoking practices and were genotyped for the dopamine D4 (DRD4) gene. A significant interaction (DRD4 Genotype?×?Depression) was found for stimulation smoking and negative-affect reduction smoking. Specifically, these smoking practices were significantly heightened in depressed smokers homozygous for the short alleles of DRD4 but not in those heterozygous or homozygous for the long alleles of DRD4. These preliminary results suggest that the rewarding effects of smoking and the beneficial effects of nicotine replacement therapy for depressed smokers may depend, in part, on genetic factors involved in dopamine transmission. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Time-based approach to obtain quantitative measures for ergonomics hazard analysis

The paper describes a methodology for conducting an ergonomic analysis that allows ergonomists to gather data while off site. The analysis described is carried out on portable computing devices, using common computer applications. It includes data collection via a camera on the manufacturing floor and conversion into a digital format. Software is suggested for playback and semi-automatic work sampling of work cycles while recording observations to electronic form, to generate rapidly the analysis of results. Snapshot observations are made on frozen video frames that are categorized into work elements, upper body joint posture and static/dynamic effort. Using two case studies, it is shown how the approach may be implemented as a procedure of choice to complete a quantitative work analysis.     

Is Swedish snus associated with smoking initiation or smoking cessation?

Nicotine replacement therapies (NRT) are an effective treatment for tobacco dependence, yet most smokers do not quit or remain abstinent. We investigated whether Swedish snus (snuff) use was associated with smoking cessation among males participating in a large population based twin study in Sweden. Snus use was associated with smoking cessation but not initiation. Given that snus delivers comparable nicotine concentrations but carries lesser cancer risk than cigarettes, snus may be a widely used, non-medical form of NRT. Evaluation of the efficacy of snus for smoking cessation should be evaluated in randomised clinical trials.     

A training curriculum for professional psychologists in primary care.

Primary care psychology is a growing field that requires specific training opportunities for successful practice. The knowledge and skills that practitioners need for work in this setting are outlined here in detail. This curriculum integrates literature and experience in family psychology, health psychology, and pediatric psychology; considers multiple levels of education and training; and provides illustrative examples. It is a first attempt in an evolving process of integrating historical and cutting edge literature from many areas of psychology and other disciplines to contribute to comprehensive primary care psychology training. It can be used by programs and individual practitioners alike in designing education and training experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accurate determination of plasmonic fields in molecular junctions by current rectification at optical frequencies

Current rectification, i.e., induction of dc current by oscillating electromagnetic fields, is demonstrated in molecular junctions at an optical frequency. The magnitude of rectification is used to accurately determine the effective oscillating potentials in the junctions induced by the irradiating laser. Since the gap size of the junctions used in this study is precisely determined by the length of the embedded molecules, the oscillating potential can be used to calculate the plasmonic enhancement of the electromagnetic field in the junctions. With a set of junctions based on alkyl thiolated molecules with identical HOMO-LUMO gap and different lengths, an exponential dependence of the plasmonic field enhancement on gap size is observed.     

Modeling Stress Responses of Multilayer Capacitors Using Varying Termination Geometries

Environmental regulations and increasingly challenging design objectives have prompted the search for alternative materials in microelectronics. Employing these materials alters the reliability profile and performance characteristics of the electronic components into which they are integrated. This article explores how mechanical stresses impact the reliability of ceramic dielectric bodies of multilayer ceramic capacitors (MLCCs) when the material, shape, and thickness of the MLCC terminations were varied. The termination material, termination geometry, and thickness of the ceramic were varied. Results were obtained using finite element analysis, and a reliability model was developed and validated. A preliminary investigation indicated a relationship between the selection of materials used for capacitor termination and the emergence of cracks. Stresses that occurred when boards were subjected to conditions including cyclic bending, vibrations, temperature cycling, and high-g loading correlated to the appearance of cracks on the bottom of the capacitor in proximity to the termination.     

On Constructing One-Way Permutations from Indistinguishability Obfuscation

We prove that there is no black-box construction of a one-way permutation family from a one-way function and an indistinguishability obfuscator for the class of all oracle-aided circuits, where the construction is “domain invariant” (i.e., where each permutation may have its own domain, but these domains are independent of the underlying building blocks). Following the framework of Asharov and Segev (FOCS ’15), by considering indistinguishability obfuscation for oracle-aided circuits we capture the common techniques that have been used so far in constructions based on indistinguishability obfuscation. These include, in particular, non-black-box techniques such as the punctured programming approach of Sahai and Waters (STOC ’14) and its variants, as well as sub-exponential security assumptions. For example, we fully capture the construction of a trapdoor permutation family from a one-way function and an indistinguishability obfuscator due to Bitansky, Paneth, and Wichs (TCC ’16). Their construction is not domain invariant, and our result shows that this, somewhat undesirable property, is unavoidable using the common techniques. In fact, we observe that constructions which are not domain invariant circumvent all known negative results for constructing one-way permutations based on one-way functions, starting with Rudich’s seminal work (PhD thesis ’88). We revisit this classic and fundamental problem and resolve this somewhat surprising gap by ruling out all such black-box constructions—even those that are not domain invariant.