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The aim of this article is to address how conceptualizations of addiction shape the lived experiences of people who use drugs (PWUDs) during the current opioid epidemic. Using a discourse analytic approach, we examine interview transcripts from 27 PWUDs in rural Appalachian Ohio. selleck chemical We investigate the ways in which participants talk about their substance use, what these linguistic choices reveal about their conceptions of self and other PWUDs, and how participants' discursive caches might be constrained by or defined within broader social discourses. We highlight three subject positions enacted by participants during the interviews addict as victim of circumstance, addict as good Samaritan, and addict as motivated for change. We argue participants leverage these positions to contrast themselves with a reified addict-other whose identity carries socially ascribed characteristics of being blameworthy, immoral, callous, and complicit. We implicate these processes in the perpetuation of intragroup stigma and discuss implications for intervention.

Trans-catheter aortic valve replacement is a commonplace procedure for patients with aortic valvular stenosis who are at a high risk for surgery, evidenced by the 34,892 trans-catheter aortic valve replacements performed in 2016. Trans-catheter aortic valve replacement's rate of major vascular complications with second-generation closure devices is 4.5% according to a meta-analysis of 10,822 patients. To manage those complications, percutaneous approaches to arterial repairs show shorter length of stay, higher rate of direct to home discharge and equivalent outcomes at long-term follow-up. This study's goal is to show that one center's vascular access strategy can decrease open repairs and improve patient outcomes.

Our team began accessing the mid-common femoral artery at least 1-2 cm proximal to the takeoff of the profunda femoris. This allowed an endovascular stent to be deployed if necessary via contralateral femoral access. We performed a completion angiogram following every trans-catheter aortic valveplacement, activation of surgical resources, and possibly the length of stay.

This strategy is safe and feasible to implement and reduces the number of open repairs following trans-catheter aortic valve replacement, activation of surgical resources, and possibly the length of stay.In two experiments, we examined younger and older participants' appraisals of memory failures in fictitious characters portrayed as younger (in their 20's to 30's) or older (in their 60's to 70's) adults. Participants read vignettes where forgetful behavior had minor or more severe consequences for the target character (Experiment 1) or for the character and others in the social environment (Experiment 2). Participants rated potential causes of the forgetfulness and opinions concerning the target character's cognitive health. In Experiment 1, an age-based double standard was observed, where both age groups rated ability as a cause of forgetting more often for older than younger characters. Ratings of forgetfulness as a sign of mental difficulty, need for memory training, and professional evaluation were also higher for older compared to younger characters. In Experiment 2, the Attribution Type by Target Age interaction effect was replicated. Ability and effort contributed to the significance of the interaction, confirming the reliability and generalizability of the age-based double standard. Forgetfulness was rated as a sign of mental difficulty more often for the older than younger characters, replicating Experiment 1. In both experiments, the consequences of the forgetting had a large impact on the attribution and opinion ratings for younger and older forgetful characters. These data suggest that people of all ages evaluate forgetful characters in light of situational outcomes as well as ageist presumptions of cognitive frailty in later life.Objective To investigate impedance change of cochlear implant (CI) electrodes from CochlearTM in patients with straight and precurved electrodes, and to determine if impedance change of the basal electrodes are indicative for cochlear electrode migration. Methods Retrospective case series at an academic tertiary referral center. Five hundred sixty patients (414 precurved, 146 straight) received a CI from CochlearTM between January 2010 and August 2018. Electrode impedance measured intraoperatively and during follow-up has been assessed. In case of impedance change of the 3 most basal electrodes a computer tomography (CT) scan has been performed. Cochlear position of the electrode array has been determined and compared to the one day postoperative electrode position (plain radiography). Results Changes in electrode impedance in the basal electrodes occurred in 2.1% ears (n = 12). CT scan was available in 9 patients and revealed a migration of the electrode array in 6 patients. Straight electrode types showed a significantly higher migration rate than precurved electrode types (4.1% vs 0%). Conclusions Electrode impedance is a useful tool to investigate electrode array integrity as well as to raise suspicion of possible electrode migration. Patients implanted with a straight electrode from CochlearTM array might benefit from lead wire fixation.Inhalation of particles results in pulmonary inflammation; however, treatments are currently lacking. Docosahexaenoic acid (DHA) is an omega-3 polyunsaturated fatty acid shown to exhibit anti-inflammatory capabilities. The impact of DHA on particle-induced inflammation is unclear; therefore, the aim of this study was to examine the hypothesis that DHA downregulates macrophage inflammatory responses by altering phagolysosomal membrane permeability (LMP) and shifting macrophage phenotype. Isolated Balb/c alveolar macrophages (AM) were polarized into M1, M2a, M2b, or M2c phenotypes in vitro, treated with DHA, and exposed to a multi-walled carbon nanotube (MWNCT) or crystalline silica (SiO2). Results showed minimal cytotoxicity, robust effects for silica particle uptake, and LMP differences between phenotypes. Docosahexaenoic acid prevented these effects to the greatest extent in M2c phenotype. To determine if DHA affected inflammation similarly in vivo, Balb/c mice were placed on a control or 1% DHA diet for 3 weeks, instilled with the same particles, and assessed 24 hr following instillation.