Training for the future of the genetic counseling profession: Exploring the assessment and adaptation of graduate programs' didactic curriculum.

Since the first genetic counseling program (GCP) was established in 1969, there has been a proliferation of growth and demand for genetic counselors. Advances in technology, affordable access to genetic testing, public genomic health initiatives, and diversifying clinical and non-clinical roles comprise a dynamic environment that GCPs must respond to. While there is extensive literature regarding how other health professions adapt their curricula to changing environments, this has yet to be documented and explored for genetic counseling.

Automated determination of transport and depositional environments in sand and sandstones.

As sand moves across Earth's landscapes, the shapes of individual grains evolve, and microscopic textures accumulate on their surfaces. Because transport processes vary between environments, the shape and suite of microtextures etched on sand grains provide insights into their transport histories. For example, previous efforts to link microtextures to transport environments have demonstrated that they can provide important information about the depositional environments of rocks with few other indicators.

Clinical Bootcamp: Moving toward competency outside of the clinic.

The COVID-19 Pandemic placed many challenges on the healthcare system. As healthcare providers were stretched thin and clinics were closed to any non-essential personnel, including learners, educational programs across the country scrambled to meet the needs of their students. In response to restrictions placed on traditional in-person clinical training, the University of Michigan Genetic Counseling Program (UMGCP) designed a Clinical Bootcamp (Bootcamp); a two-weeklong, blended educational activity using a framework of case-based learning (CBL) (McLean, 2016).

Entrustment decision-making in genetic counseling supervision: Exploring supervisor and student perspectives to enhance training practices.

Entrustment decisions are an essential part of genetic counseling supervision and have the potential to influence a student's progression toward autonomy. However, there is often uncertainty among supervisors regarding how and when to make these decisions and very few studies have examined the impact of these decisions on students. This study utilized a mixed methods approach including surveys of genetic counseling supervisors (n = 76) and students (n = 86) as well as qualitative interviews with genetic counseling supervisors (n = 20) and students (n = 20) that explored factors that influence the entrustment decisions of genetic counseling supervisors and their effect on genetic counseling students.

Motivational interviewing for genetic counseling: A unified framework for persuasive and equipoise conversations.

Genetic counselors (GCs) have traditionally been trained to adopt a position of equipoise or clinical neutrality. They provide information, answer questions, address barriers, and engage in shared decision-making, but generally, they do not prescribe a genetic test. Historically, GCs have generally been trained not to persuade the ambivalent or resistant patient.

Nocturnal survival of isoprene linked to formation of upper tropospheric organic aerosol.

Isoprene is emitted mainly by terrestrial vegetation and is the dominant volatile organic compound (VOC) in Earth's atmosphere. It plays key roles in determining the oxidizing capacity of the troposphere and the formation of organic aerosol. Daytime infrared satellite observations of isoprene reported here broadly agree with emission inventories, but we found substantial differences in the locations and magnitudes of isoprene hotspots, consistent with a recent study.

Microsoft OneNote provides continuity for undergraduate biochemistry lab during a pandemic.

This article illustrates the use of Microsoft OneNote as an Electronic Notebook for undergraduate biochemistry lab reports as well as student opinions of this use both before and during the online coursework shift during the pandemic.

Reflective functioning and empathy among mothers of school-aged children: Charting the space between.

Parental child-focused (RF)-understanding children's behavior as a function of mental states-and parental -understanding, resonating with, and feeling concern for children's emotions-have each been linked to sensitive caregiving and children's attachment security in separate studies, but they have been neither directly compared nor have researchers tested whether they interact in predicting child outcomes. In this article, we offer theoretical perspectives regarding differences between the constructs, potential points of connection, and ways in which these constructs may function together. Then we test these ideas empirically with 2 samples of mothers of school-age children, exploring their unique and interactive associations with parenting sensitivity, children's attachment security, and children's emotion regulation.

Optimizing efficiency and skill utilization: Analysis of genetic counselors' attitudes regarding delegation in a clinical setting.

This study assessed genetic counselors' (GCs) perceptions of delegation as a tool to increase workforce efficiency and help meet the current gap between the number of genetic service providers and the number of patients. GCs were recruited to participate via an online survey that assessed activities (categorized as typical genetic counseling, administrative, or professional development) performed by a clinical genetic counselor. Respondents indicated which activities represent their largest time consumers, their willingness to delegate these activities, and barriers to and perceived outcomes of delegation.

Use of rapid Model for End-Stage Liver Disease (MELD) increases for liver transplant registrant prioritization after MELD-Na and Share 35, an evaluation using data from the United Network for Organ Sharing.

The Model for End-Stage Liver Disease (MELD) score has been successfully used to prioritize patients on the United States liver transplant waiting list since its adoption in 2002. The United Network for Organ Sharing (UNOS)/Organ Procurement Transplantation Network (OPTN) allocation policy has evolved over the years, and notable recent changes include Share 35, inclusion of serum sodium in the MELD score, and a 'delay and cap' policy for hepatocellular carcinoma (HCC) patients. We explored the potential of a registrant's change in 30-day MELD scores (ΔMELD30) to improve allocation both before and after these policy changes.

Ring polymer dynamics and tumbling-stretch transitions in planar mixed flows.

The properties of dilute polymer solutions are governed by the conformational dynamics of individual polymers which can be perturbed in the presence of an applied flow. Much of our understanding of dilute solutions comes from studying how flows manipulate the molecular features of polymer chains out of equilibrium, primarily focusing on linear polymer chains. Recently there has been an emerging interest in the dynamics of nonlinear architectures, particularly ring polymers, which exhibit surprising out-of-equilibrium dynamics in dilute solutions.

Improving access to cancer genetic services: perspectives of high-risk clients in a community-based setting.

Cancer genetic services are underutilized by high-risk clients in community-based health settings. To understand this disparity, 108 Planned Parenthood high-risk clients completed a utilization-focused survey. Clients expressed interest (78.

Prenatal opioid exposure heightens sympathetic arousal and facial expressions of pain/distress in term neonates at 24-48 hours post birth.

The rising issue of opioid use during pregnancy poses an increased risk of fetal exposure to opioids and the development of neonatal abstinence syndrome (NAS). The cessation of exposure to opioids upon birth causes elevated levels of norepinephrine in the circulation enhancing sympathetic arousal. Skin conductance (SC) detects sympathetic-mediated sweating while the Neonatal Facial Coding System (NFCS) depicts facial expressions of stress and pain.

Conformationally averaged iterative Brownian dynamics simulations of semidilute polymer solutions.

The dynamics of semidilute polymer solutions are important to many polymer solution processing techniques such as fiber spinning and solution printing. The out-of-equilibrium molecular conformations resulting from processing flows directly impact material properties. Brownian dynamics (BD) simulations are a standard technique for studying this connection between polymer conformations in solution and processing flows because they can capture molecular-level polymer dynamics.

Increased Frequency of Skin-to-Skin Contact Is Associated with Enhanced Vagal Tone and Improved Health Outcomes in Preterm Neonates.

Objective: An estimation of the individual's ability to cope with environmental adversity, that is, stress resiliency, can be extrapolated by measuring cardiac vagal tone, that is, high-frequency heart rate variability (HF-HRV); indeed, higher HF-HRV is associated with health and developmental advantages for preterm neonates. Previous studies show skin-to-skin contact (SSC) improves stress resiliency; however, linkages between SSC and HF-HRV on outcomes have not been assessed. We aimed to test the hypothesis that increased SSC frequency would enhance HF-HRV, reduce neonatal morbidity, and improve developmental outcomes.

A human MUTYH variant linking colonic polyposis to redox degradation of the [4Fe4S] cluster.

The human DNA repair enzyme MUTYH excises mispaired adenine residues in oxidized DNA. Homozygous MUTYH mutations underlie the autosomal, recessive cancer syndrome MUTYH-associated polyposis. We report a MUTYH variant, p.

Evaluating and improving the implementation of a community-based hereditary cancer screening program.

Healthcare disparities exist in the provision of cancer genetic services including genetic counseling and testing related to BRCA1/2 mutations. To address this in a community health setting a screening tool was created to identify high-risk women. This study evaluates the implementation of the tool and identifies opportunities for improved cancer genetic screening, including regular clinician education.

Hemodynamically Directed Two-Person Chest Compressions: A Case Report.

Cardiopulmonary resuscitation has a low success rate both in and out of the hospital setting. Return of spontaneous circulation, however, is considerably higher for intraoperative cardiac arrests. Chest compressions remain of utmost importance.

The relationship between dynamic and pseudo-thermodynamic measures of the glass transition temperature in nanostructured materials.

Despite decades of research on the effects of nanoconfinement on the glass transition temperature T, apparent discrepancies between pseudothermodynamic and dynamic measurements of these effects have raised questions regarding the presence of long-ranged interfacial dynamic gradients in glass-forming liquids. Here we show that these differences can be accounted for based on disparities in these methods' weightings over local T's within an interfacial gradient. This finding suggests that a majority of experimental data are consistent with a broad interfacial dynamic interphase in glass-forming liquids.

Comparison of two equivalent model for end-stage liver disease scores for hepatocellular carcinoma patients using data from the United Network for Organ Sharing liver transplant waiting list registry.

Patients with hepatocellular carcinoma (HCC) have been advantaged on the liver transplant waiting list within the United States, and a 6-month delay and exception point cap have recently been implemented to address this disparity. An alternative approach to prioritization is an HCC-specific scoring model such as the MELD Equivalent (MELD ) and the mixed new deMELD. Using data on adult patients added to the UNOS waitlist between 30 September 2009 and 30 June 2014, we compared projected dropout and transplant probabilities for patients with HCC under these two models.

Does fragility of glass formation determine the strength of T-nanoconfinement effects?

Nanoscale confinement has been shown to alter the glass transition and associated mechanical and transport properties of glass-forming materials. Inspired by expected interrelations between nanoconfinement effects, cooperative dynamics in supercooled liquids, and the "fragility" (or temperature-abruptness) of the glass transition, it is commonly expected that nanoconfinement effects on T should be more pronounced for more fragile glass formers. Here we employ molecular dynamics simulations of glass formation in the bulk and under nanoconfinement of model polymers in which we systematically tune fragility by several routes.

Mother-child language style matching predicts children's and mothers' emotion reactivity.

Co-regulation of behavior occurring within parent-child attachment relationships is thought to be the primary means through which children develop the capacity to regulate emotion, an ability that is protective across development. Existing research on parent-child co-regulation focuses predominantly on parent-infant dyads, and operationalizes co-regulation as the matching of facial expressions; however, matching can occur on other behaviors, including vocal tone, body movement, and language. Studies with young children find that greater matching is associated with children's lower emotion reactivity, but with unknown impacts on parents.

Projected outcomes of 6-month delay in exception points versus an equivalent Model for End-Stage Liver Disease score for hepatocellular carcinoma liver transplant candidates.

The United Network for Organ Sharing (UNOS) recently implemented a 6-month delay before granting exception points to liver transplantation candidates with hepatocellular carcinoma (HCC) to address disparity in transplantation access between HCC and non-HCC patients. An HCC-specific scoring scheme, the Model for End-Stage Liver Disease equivalent (MELDEQ ), has also been developed. We compared projected dropout and transplant probabilities and posttransplant survival for HCC and non-HCC patients under the 6-month delay and the MELDEQ using UNOS data from October 1, 2009, to June 30, 2014, and multistate modeling.

Telomere Dysfunction Triggers Palindrome Formation Independently of Double-Strand Break Repair Mechanisms.

Inverted chromosome duplications or palindromes are linked with genetic disorders and malignant transformation. They are considered by-products of DNA double-strand break (DSB) repair: the homologous recombination (HR) and the nonhomologous end joining (NHEJ). Palindromes near chromosome ends are often triggered by telomere losses.