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This research investigated the predictors of satisfaction for parents of pediatric patients after a clinical consultation. Specifically, we assessed whether perceptions of their provider's communication quality influenced the degree to which their (dis)satisfaction with consultation length associated with their provider rating and intent to recommend the provider's office. Using patient satisfaction survey data collected after initial clinical visits to a pediatric hospital (N = 12,004), we found that communication quality was a stronger predictor for those who were dissatisfied with their consultation length, whereas communication quality made a relatively smaller difference for those who were satisfied with their consultation length. Put another way, parents' dissatisfaction with their child's consultation length mattered little when they perceived their provider to be high in communication quality, but it reduced their ratings and intentions to recommend when they perceived their provider to be low in communication quality. These results suggest that providers' communication behaviors have the capacity to buffer patients' negative evaluations otherwise incurred from shorter than desired consultations. [ABSTRACT FROM AUTHOR]

Eomysticetidae are a clade of early diverging functionally toothless, longirostrine and likely baleen-bearing stem mysticete whales. Eomysticetid fossils are rare but known worldwide from Oligocene strata. The richest assemblage of eomysticetids has been uncovered in New Zealand from the Kokoamu Greensand and Otekaike Limestone (North Otago and South Canterbury regions, South Island). This includes some of the largest known eomysticetids, Tokarahia kauaeroa and Tokarahia lophocephalus, some older and more archaic forms such as Matapanui waihao, the fragmentary Tohoraata raekohao and Tohoraata waitakiensis, and the well-known Waharoa ruwhenua represented by several well-preserved skulls and mandibles of adults and juveniles. Studies of these New Zealand fossils strongly indicates monophyly of Eomysticetidae and suggest possible skim feeding behaviour, possession of non-functional teeth and baleen, extreme rostral lengthening during growth and peramorphic evolution, rostral kinesis, use of Zealandia as a calving ground, and probable extinction at or near the Oligo-Miocene boundary. [ABSTRACT FROM AUTHOR]

ABSTRACT It is intuitively wrongful to deceive people into forming a false belief. It is especially intuitively wrongful to deceive people into forming the false belief that you are their friend. Despite these intuitions, this article argues that in a surprising number of cases, deceiving people into believing you are their friend is not only permitted, but required. The article uses this result to make some important revisions and suggestions for the emergent social rights literature: (i) it shows that social rights are feasible in a wider range of cases than previously thought, and (ii) it casts doubt on whether grounding such rights on the impersonal value of genuine intimate relationships is their most fruitful grounding. [ABSTRACT FROM AUTHOR]

Nature-based solutions (NbS) offer an exciting opportunity to work with nature to conserve heritage sites and objects. Soft capping is a novel form of NbS used commonly in Britain and Ireland to help conserve ruined and free-standing walls; soil and vegetation is placed on the wall head to help reduce deterioration by buffering thermal fluctuations and regulating moisture. While this conservation practice has proved cheaper and more effective at reducing deterioration than traditional hard capping, soft caps need to be resilient to future environmental changes. Previous research has shown that the sedum species commonly used in soft caps are vulnerable to climate change. Thus, following feedback from an interactive webinar with practicing heritage professionals, here we assess the climate resilience of four grass species commonly found in western Europe as possible soft-capping species: Festuca rubra (red fescue), Poa pratensis (smooth meadow-grass), Catapodium rigidum (fern-grass) and Poa annua (annual meadow-grass). We use species distribution modelling (Maxent) to assess the likelihood of species survival by mid and end century based on presence probabilities derived using three climate models (HadGEM3-GC31-LL, IPSL-CM6A-LR, and MIROC6). Results show that all four species are resilient under mid-century projections, and P. annua proved resilient under all scenarios. Therefore, using turf-based soft caps incorporating one or more of these grass species could enhance the future resilience of this conservation technique. Given the growing interest in the use of nature-based approaches to heritage conservation, our study represents an important attempt to account for and adapt to a changing climate. [ABSTRACT FROM AUTHOR]

The rise in Africans involvement in cybercrimes globally due to increased access to the internet has prompted some African governments to enact ICT and Cybercrime related Laws. Unfortunately, some provisions of these laws, criminalize some expressions and are likely to stifle and restrict online activities and freedom of expression of Africans. This paper argues that the criminalization of certain expressions by these laws are contrary to the expectations of international and regional instruments on freedom of expression. It recommends the adaptation of the experiences and jurisprudence of the European and Inter-American Courts. [ABSTRACT FROM AUTHOR]

Fear‐related psychopathologies, such as post‐traumatic stress disorder, are linked to dysfunction in neural circuits that govern fear memory and arousal. The lateral hypothalamus (LH) and zona incerta (ZI) regulate fear, but our understanding of the precise neural circuits and cell types involved remains limited. Here, we examined the role of relaxin family peptide receptor 3 (RXFP3) expressing cells in the LH/ZI in conditioned fear expression and general arousal in male RXFP3‐Cre mice. We found that LH/ZI RXFP3+ (LH/ZIRXFP3) cells projected strongly to fear learning, stress, and arousal centres, notably, the periaqueductal grey, lateral habenula, and nucleus reuniens. These cells do not express hypocretin/orexin or melanin‐concentrating hormone but display putative efferent connectivity with LH hypocretin/orexin+ neurons and dopaminergic A13 cells. Following Pavlovian fear conditioning, chemogenetically activating LH/ZIRXFP3 cells reduced fear expression (freezing) overall but also induced jumping behaviour and increased locomotor activity. Therefore, the decreased freezing was more likely to reflect enhanced arousal rather than reduced fear. Indeed, stimulating these cells produced distinct patterns of coactivation between several motor, stress, and arousal regions, as measured by Fos expression. These results suggest that activating LH/ZIRXFP3 cells generates brain‐wide activation patterns that augment behavioural arousal. [ABSTRACT FROM AUTHOR]

Major power outages have risen over the last two decades, largely due to more extreme weather conditions. However, there is a lack of knowledge on the distribution of power outages and its relationship to social vulnerability and co-occurring hazards. We examined the associations between localized outages and social vulnerability factors (demographic characteristics), controlling for environmental factors (weather), in Washington State between 2018–2021. We additionally analyzed the validity of PowerOutage.us data compared to federal datasets. The population included 27 counties served by 14 electric utilities. We developed a continuous measure of daily outage burden using PowerOutage.us data and operationalized social vulnerability using four factors: poverty level, unemployment, disability, and limited English proficiency. We applied zero-altered lognormal generalized additive mixed-effects models to characterize the relationship between social vulnerability and daily power outage burden, controlling for daily minimum temperature, maximum wind speed, and precipitation, from 2018 to 2021 in Washington State. We found that social vulnerability factors have non-linear relationships with outages. Wind and precipitation are consistent drivers of outage occurrence and duration. There are seasonal effects that vary by county-utility area. Both PowerOutage.us and federal datasets have missing and inaccurate outage data. This is the first study evaluating differential exposure to localized outages as related to social vulnerability that has accounted for weather and temporal correlation. There is a lack of transparency into power outage distribution for those most vulnerable to climate impacts, despite known contributions by electric utilities to climate change. For effective public health surveillance of power outages and transparency, outage data should be made available at finer spatial resolution and temporal scales and/or utilities should be required to report differential exposure to power outages for socially vulnerable populations. [ABSTRACT FROM AUTHOR]

Practitioners interested in the process of helping people change are confronted today with such a burgeoning array of perspectives, theories, and treatment modalities that even the most diligent can feel overwhelmed by the number of choices. This plethora of approaches calls into question whether there is anything that can tie them together. Asking if the psychoanalytic field is destined to be splintered into fragments that defy cohesion or if it is possible to generate a way of thinking and working that is more inclusive, this paper takes a historical and integrationist approach, grounded in a clinical focus on mental organization and Leo Rangell's total composite theory. It discusses trends in the development of psychoanalysis and argues for the importance of integration of the findings from neuropsychology and neuropsychoanalysis into psychoanalytic clinical work. [ABSTRACT FROM AUTHOR]

Carbon black, a key ingredient in ancient inks, is used today to make the porous electrodes found in many rechargeable batteries. Understanding how to control its microstructure can pave the way to better-performing batteries. [ABSTRACT FROM AUTHOR]

The article outlines the strategy used by social work researchers to navigate a university institutional review board (IRB) to develop a youth-centered research ethics training for youth participatory action research. It outlines the training components and examples of interactive youth-focused research activities. It discusses lessons learned from working with IRBs to prepare and engage youth as research partners, as well as the implications of the study for research and practice.

The article reviews the exhibition "Africa Fashion" at the Victoria & Albert Museum in London from July 2, 2022, to April 16, 2023, and at the Brooklyn Museum in New York from June 23 to October 22, 2023, including a celebration of African historical and contemporary fashion.

This article provides a detailed exploration of the geography, mining history, and mineralogy of the Elkhorn Mountains in southwestern Montana. It focuses on the Elkhorn and Radersburg mining districts and discusses the specific mines and minerals found in the area. The article also delves into the concept of epitaxy, which involves the growth of crystals on preexisting crystals, and explains the different types of oriented intergrowths. The authors conducted a study on the epitactic relationship between quartz and hemimorphite minerals, observing their structural similarities and suggesting a shared framework as the reason for this relationship. The article concludes with acknowledgments to mine owners and individuals who assisted in the research. [Extracted from the article]

Over the last two decades, the growth and development of the fields of Dance Science and Pedagogy, as practice, research and area of study, has changed the landscape of 21st Century training and performance. The aim of this paper is to stimulate thinking and initiate dialogue between practitioners and academics in the exploration of new solutions to ongoing pedagogical tensions within the vocational training environment. In recognising the challenge which an interdisciplinary approach brings to dance (integrating the science of content and the art of delivery), this paper explores the integration of coaching pedagogical concepts and practices, to inform an innovative approach to dancer empowerment, placing the dancer central to the learning environment. The paper proposes an empowered dancer focused framework for coaching with the emphasis being placed on the development of the dancer displaying the skills of self-determined, decision-making and are empowered across the life cycle of their career(s). [ABSTRACT FROM AUTHOR]

In recent studies we have reported on the near-UV light-induced degradation of iron complexes of various pharmaceutical excipients, such as Fe(III)-citrate and Fe(III)-amino acid complexes. Mechanistic studies revealed a common photo-degradation pattern, i.e. the formation of carbon dioxide radical anion, a potent reducing agent, via an alkoxyl/amino radical intermediate generated by light-induced ligand-to-metal charge transfer (LMCT) involving α-hydroxycarboxylates or amino acids. Herein, we confirm the proposed general photo-degradation pathways through the study of the iron complexes of other α-hydroxycarboxylates that may be present in protein formulations, such as lactate and glycolate. The results indicate that lactate generates even higher yields of •CO 2 − as compared to citrate, suggesting a significant potential of lactate for the promotion of photo-degradation in pharmaceutical formulations. [Display omitted] [ABSTRACT FROM AUTHOR]

Glioblastoma (GBM) is a lethal brain tumor. Standard-of-care treatment comprising surgery, radiation, and chemotherapy results in median survival rates of 12 to 15 months. Molecular-targeted agents identified using conventional 2-dimensional (2D) in vitro models of GBM have failed to improve outcome in patients, rendering such models inadequate for therapeutic target identification. A previously developed 3D GBM in vitro model that recapitulates key GBM clinical features and responses to molecular therapies was investigated for utility for screening novel radiation-drug combinations using gold-standard clonogenic survival as readout. Patient-derived GBM cell lines were optimized for inclusion in a 96-well plate 3D clonogenic screening platform, ClonoScreen3D. Radiation responses of GBM cells in this system were highly reproducible and comparable to those observed in low-throughout 3D assays. The screen methodology provided quantification of candidate drug single agent activity (half maximal effective concentration or EC 50) and the interaction between drug and radiation (radiation interaction ratio). The poly(ADP-ribose) polymerase inhibitors talazoparib, rucaparib, and olaparib each showed a significant interaction with radiation by ClonoScreen3D and were subsequently confirmed as true radiosensitizers by full clonogenic assay. Screening a panel of DNA damage response inhibitors revealed the expected propensity of these compounds to interact significantly with radiation (13/15 compounds). A second screen assessed a panel of compounds targeting pathways identified by transcriptomic analysis and demonstrated single agent activity and a previously unreported interaction with radiation of dinaciclib and cytarabine (radiation interaction ratio 1.28 and 1.90, respectively). These compounds were validated as radiosensitizers in full clonogenic assays (sensitizer enhancement ratio 1.47 and 1.35, respectively). The ClonoScreen3D platform was demonstrated to be a robust method to screen for single agent and radiation-drug combination activity. Using gold-standard clonogenicity, this assay is a tool for identification of radiosensitizers. We anticipate this technology will accelerate identification of novel radiation-drug combinations with genuine translational value. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate how teachers' socialization experiences influence their perceptions of and responses to bullying. Methods: Thirty in-service physical education teachers were recruited to participate. One semi-structured, individual interview was conducted with each participant lasting approximately 60 minutes. Data analysis employed inductive and deductive techniques. Results: Two themes emerged that described teachers' perceptions of and responses to bullying. These themes included: (a) socialization experiences and socializing agents influence teachers' perceptions and behaviors in relation to bullying, and (b) teachers have developed strategies to address bullying but also experience significant challenges. Discussion: The current study suggests that while enrolled in a physical education teacher education program, preservice teachers should be provided greater knowledge about and strategies for addressing bullying. In-service teachers are encouraged to pursue professional development that increases their self-efficacy in managing bullying. [ABSTRACT FROM AUTHOR]

Termites are important ecosystem engineers in many ecosystems globally. Hence, surveys of termite species composition, abundance and activity can be important for understanding ecosystem function—especially in biomes where they tend to be abundant, such as tropical savannas. However, comprehensively surveying termites can be challenging due to their cryptic nature and varied feeding and nesting habits, which strongly influence the effectiveness of different survey methods. Baiting and active searches of reduced transects are two methods commonly used to sample termites, and while these methods have been evaluated in the savannas of South Africa, this has not occurred in the extensive tropical savannas of northern Australia. Thus, this study evaluated the effectiveness of baits and reduced transects to assess termite species richness and activity across 18 × 1 ha experimental plots in a tropical savanna near Darwin, Australia. Surveys in each plot consisted of two 60 × 2 m transects and a 9 × 3 baiting grid of alternating buried wood and paper baits and surface straw baits. Baits were checked three times: at 4‐, 7‐ and 10‐week intervals following placement. Upon survey completion, the sampling effort, efficacy and costs of each method were compared. Reduced transects detected all 32 species recorded in this study, representing four feeding groups (from undecayed wood to highly decayed organic material in the soil). Baiting detected 20 species, but failed to detect some of the species that fed on decayed materials. Paper baits, checked only twice (at 4 and 10 weeks following placement), were required to detect all species sampled at both wood and paper baits. Therefore, overall baiting costs could be reduced (without data loss) by using paper baits only and reducing the number of bait checks. Compared with baiting using all three bait types, reduced transects detected the most species and had the lowest per‐species cost. Consequently, reduced transect surveys are the most effective method in these northern Australian savannas when assessing species composition. However, if the abundance of species that feed on undecayed wood or levels of termite activity are being assessed, then reduced baiting is a more appropriate method. [ABSTRACT FROM AUTHOR]

The UK’s new social security benefit, Universal Credit, is driving up food insecurity. Particularly problematic is the five-week wait for the first payment. Meanwhile, low wages and insecure contracts mean many food sector workers rely on Universal Credit. This qualitative study explores the effects of the five-week wait on food security among these workers. The findings show this is forcing them to depend on family, friends and foodbanks, inducing shame and isolation, and negatively impacting their physical and mental health. Meanwhile, working in the food sector offers little or no protection from these effects and, in some cases, exacerbates them. [ABSTRACT FROM AUTHOR]

We describe two new species of the microhylid frog genus Choerophryne Van Kampen, 1914 from the mountains of Papua New Guinea. The first is a scansorial species known only from foothill forest at altitudes of 440-950 m a.s.l. on the northern slopes of Papua New Guinea's Central Cordillera. It is a moderately large member of the genus (males 16.8-20.6 mm snout-urostyle length) that utters long series of short whistling calls each lasting 77-125 ms. The second species is arboreal and known only from a small area of montane forest at altitudes of 2060-2300 m a.s.l. on the southern edge of the Central Cordillera. It is also moderately large for the genus (three males with snout-urostyle lengths of 19.3-20.6 mm) and produces long series of short buzzing calls, each lasting 124-173 ms. Descriptions of these two species bring the number of recognised Choerophryne to 39, and at least 18 additional species in the genus await formal description. [ABSTRACT FROM AUTHOR]

Frogs have a highly conserved body plan, yet they employ a diverse array of locomotor modes, making them ideal organisms for investigating the relationships between morphology and locomotor function, in particular whether anatomical complexity is a prerequisite for functional complexity. We use diffusible iodine contrast‐enhanced microCT (diceCT) imaging to digitally dissect the gross muscle anatomy of the pelvis and hindlimbs for 30 species of frogs representing five primary locomotor modes, including the first known detailed dissection for some of the world's smallest frogs, forming the largest digital comparative analysis of musculoskeletal structure in any vertebrate clade to date. By linking musculoskeletal dissections and phylogenetic comparative methods, we then quantify and compare relationships between anatomy and function across over 160 million years of anuran evolution. In summary, we have found that bone lengths and pelvic crest sizes are generally not reliable predictors of muscle sizes, which highlights important implications for future palaeontological studies. Our investigation also presents previously unreported differences in muscle anatomy between frogs specialising in different locomotor modes, including several of the smallest frog hindlimb muscles, which are extremely difficult to extract and measure using traditional approaches. Furthermore, we find evidence of many‐to‐one and one‐to‐many mapping of form to function across the phylogeny. Additionally, we perform the first quantitative analysis of how the degree of muscle separation can differ between frogs. We find evidence that phylogenetic history is the key contributing factor to muscle separation in the pelvis and thigh, while the separation of shank muscles is influenced more strongly by locomotor mode. Finally, our anatomical 3D reconstructions are published alongside this manuscript to contribute towards future research and serve as educational materials. [ABSTRACT FROM AUTHOR]

Perinatal depression (PND) affects up to 20% of women and is associated with significant impairment and disability in affected women. In addition, perinatal depression is associated with broader public health and multigenerational consequences. Innovative approaches are needed to reduce the burden of perinatal depression through identification, tracking, and treatment of depressive symptoms during the perinatal period. This study is a randomized clinical trial comparing the relative efficacy of a multi-tiered system of care, Screening and Treatment of Anxiety and Depression (STAND) to perinatal care delivered by a reproductive psychiatrist in reducing symptoms of depression and anxiety. A sample of 167 individuals was randomized between week 28 of pregnancy and 6 months postpartum. A secondary aim compares the original online therapy intervention used in the first half of the study to a newer online therapy program used in the second half of the study for individuals assigned to the STAND treatment. The study measures, intervention groups, and analysis methods are described, as well as expected implications. The findings from this study may improve the methods for tracking symptom changes over time, monitoring treatment response, and providing personalized care for individuals with PND. As such, this study may improve the lives of patients with PND and their families and lower the related health care costs to society. Trial registration NCT: 9/24/2021 NCT direct link: https://www.clinicaltrials.gov/study/NCT05056454?term=NCT05056454&rank=1&a=1. [ABSTRACT FROM AUTHOR]

In this paper, we build on a growing body of research on practical measurement for educational improvement, contributing a conceptualization of the organizational functions of measurement in processes of persistence and change. Our work is grounded in theoretical understandings of micro‐institutional change that foreground processes of reproduction and disruption of organizational categories, priorities, assumptions, and practices. Drawing together measurement discourses from multiple fields of study, we identify four metaphors for organizational functions that measures can serve: carriers, windows, exercises, and drivers. We propose a conceptual framework illustrating relationships and pathways among these functions as they operate in context. We then apply the framework in the context of co‐designing three practical measures of science teacher learning in a large urban district, illustrating varied pathways through which the practical measures seemed to function, and documenting their respective affordances and constraints in driving reproduction and/or disruption in the organization's work to support science teacher learning. This line of work extends prior research on practical measurement through its focus on measures of science teacher learning and its attention to how practical measures can function to shape broader processes of organizational transformation and stability. This paper is part of the special issue on Teacher Learning and Practice within Organizational Contexts. [ABSTRACT FROM AUTHOR]

The mangrove forest in Palawan has the most extensive distribution in the Philippines. The fisher community's perception of the mangrove forest as a known habitat for saltwater crocodiles (Crocodylus porosus) and its fishery benefits in Bugsuk Island were gathered using a participatory systems mental modeling framework for the coastal social-ecological system. From the causal loop diagram, six reinforcing and one balancing feedback loop were derived. The respondents observed a positive growth in the interaction between mangroves and crocodiles in Bugsuk Island, with both populations expanding and providing support to fishery resources. Bugsuk Island represents a unique diversity with great potential for resource conservation and economic benefit. [ABSTRACT FROM AUTHOR]

This paper examines the theological concept of 'ark' as a useful metaphor for assessing the potential of cathedrals for effective mission and social action. The popular concept of ark as shelter and means of salvation is but one way of thinking about cathedrals, but the paradoxical and complex nature of what it means to be 'ark' for others in Scripture and tradition provides other ways of assessing and developing mission potential. These different ways of thinking about the cathedral will be set against stories obtained from talking to people seeking different forms of help from cathedrals, in order to show in what ways the cathedral was 'ark' for them and to test what the limits of that perspective might be. The paper concludes with some suggestions for strategic action within cathedrals to maximise this particular mission and social justice lens. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to investigate the neuromuscular contributions to enhanced fatigue resistance with carbohydrate (CHO) ingestion and to identify whether fatigue is associated with changes in interstitial glucose levels assessed using a continuous glucose monitor (CGM). Methods: Twelve healthy participants (six males, six females) performed isokinetic single-leg knee extensions (90°·s-1) at 20% of the maximal voluntary contraction (MVC) torque until MVC torque reached 60% of its initial value (i.e., task failure). Central and peripheral fatigue were evaluated every 15 min during the fatigue task using the interpolated twitch technique and electrically evoked torque. Using a single-blinded crossover design, participants ingested CHO (85 g sucrose per hour), or a placebo (PLA), at regular intervals during the fatigue task. Minute-by-minute interstitial glucose levels measured via CGMand whole blood glucose readings were obtained intermittently during the fatiguing task. Results: CHO ingestion increased time to task failure over PLA (113 ± 69 vs 81 ± 49min, mean±SD; P < 0.001) and was associated with higher glycemia asmeasured byCGM(106 ± 18 vs 88 ± 10mg·dL-1, P<0.001) and whole blood glucose sampling (104 ± 17 vs 89 ± 10 mg·dL-1,P<0.001). When assessing the values in the CHO condition at a similar time point to those at task failure in the PLA condition (i.e., ~81 min), MVC torque, percentage voluntary activation, and 10 Hz torque were all better preserved in the CHO versus PLA condition (P < 0.05). Conclusions: Exogenous CHO intakemitigates neuromuscular fatigue at both the central and peripheral levels by raising glucose concentrations rather than by preventing hypoglycemia. [ABSTRACT FROM AUTHOR]

Social difficulties and mental health are primary behavioral health concerns in autistic young adults, perhaps especially during key life transitions such as entering college. This study evaluated how dissatisfaction with social connectedness may predict and/or maintain depression and anxiety symptoms in neurodiverse, first-semester, undergraduate students (N = 263; n = 105 with diagnosed or suspected autism). Participation included a baseline survey battery, a brief survey completed twice per week across 12 weeks, and an endpoint survey battery. Social dissatisfaction at baseline was prospectively associated with biweekly ratings of depression symptoms, when controlling for baseline depressive symptoms. Social dissatisfaction was synchronously related to elevated sadness, anhedonia, and anxiety throughout the semester. These relationships were generally consistent across levels of baseline social motivation; however, there was one significant moderation effect—the negative relationship between baseline social satisfaction and anxiety was strongest for more socially motivated participants. More autistic traits were related to lower social satisfaction at baseline and greater mood concerns across timepoints. In contrast, greater autistic traits at baseline were related to greater satisfaction with social connectedness throughout the semester. Results support ongoing efforts to address mental health in autistic college students by highlighting the importance of social satisfaction. How satisfied people feel with their social connections and support is related to mental health outcomes for many different types of people. People may feel less socially connected at some times in their life—like when they start college. Feeling disconnected from others could lead to depression or anxiety. The transition to college may be especially difficult for autistic students as they are more likely to have difficulties adjusting socially. In our study, we asked 263 college students to answer questions about their emotions and social satisfaction twice per week during their first semester of college. We found that students who reported being less satisfied with their social connectedness (either at the beginning or throughout the semester) tended to express more symptoms of depression and anxiety. This relationship between social satisfaction and anxiety was even stronger for people who had a strong desire for social interaction (i.e. were more socially motivated). Students with more autistic traits tended to report more mood concerns, and they also reported being less satisfied with friendships at the beginning of the semester. This information may help to support ongoing efforts to better address mental health in autistic college students by encouraging efforts to improve social satisfaction. [ABSTRACT FROM AUTHOR]

The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. Finite natural resources, rising human population, and climate change pose challenges to traditional crop production. Hydroponically grown fodder (i.e., sprouted grains) can be an alternative feed source for dairy cows; however, only sprouted barley has been investigated in low-producing cows. We aimed to evaluate the effect of replacing conventional concentrates with sprouted barley or wheat, grown using hydroponics, on milk production, nutrient digestibility, and milk fatty acid profile in high-producing cows. Twenty-four multiparous Holstein cows (3.25 ± 1.33 lactations; 102 ± 23 DIM; 49 ± 4 kg/d of milk) were used in a replicated 3 × 3 Latin square design with 21-d experimental periods. Following a 2-wk covariate period, cows were fed 1 of 3 experimental diets: a TMR (1) without sprouted grains (control), or with (2) 10% sprouted barley, or (3) 10% sprouted wheat on a DM basis. Experimental diets were formulated to be isoenergetic and isonitrogenous with sprouted grains that replaced ground corn, soybean meal, canola meal, and dextrose. Sprouted grains were grown using a semi-automatic hydroponic system and harvested after 6 d of growth. Data and sample collection occurred during the last 3 d of the covariate and experimental periods. Wide ranges were observed for the DM percent of sprouted grains (12.1%–22.9% and 13.3%–25.7% for barley and wheat, respectively) and the ratio of sprouted fodder to seed (0.67–1.07 for both barley and wheat). Feeding sprouted grains did not modify the yield of milk or ECM; however, DMI were lower for barley, relative to control. Feed efficiencies were greater for barley than for control (1.49 ± 0.03 vs. 1.43 ± 0.03 for milk yield/DMI; 1.85 ± 0.03 vs. 1.73 ± 0.04 for ECM/DMI). Yields and concentrations of milk components (i.e., fat, true protein, and lactose) were not affected by treatment. Milk urea N concentrations were greater for wheat, relative to control or barley. Body weight (752 ± 3 vs. 742 ± 3 kg) and BW gains (6.53 ± 2.99 vs. −9.33 ± 2.91 kg/21 d) were higher for wheat than for control. Apparent total-tract digestibility of organic matter was greater for wheat relative to barley. Digestibilities of NDF and starch were higher for wheat and control, relative to barley, and CP digestibility was greater for wheat, relative to barley and control. Rumination and physical activity were not affected by treatment. In summary, replacing traditional concentrates with sprouted grains grown using hydroponics improved milk production efficiency (barley sprouts) or enhanced body weight gain (wheat sprouts). A life-cycle assessment needs to be conducted to determine the net effect of this feeding strategy for the dairy industry. [ABSTRACT FROM AUTHOR]

Although rare, injury to the internal carotid artery (ICA) during pituitary surgery may result in serious morbidity such as stroke or death. This case series explores a single centre's incidence and outcomes of ICA injury during endoscopic transsphenoidal pituitary surgery, discusses the current management options, and introduces the 'muscle wonton' (morcellised muscle wrapped in a single sheet of Surgicel®) as being a viable repair option. All patients undergoing pituitary operations from January 2010 to December 2019 at the Queen Elizabeth Hospital, Birmingham, UK were included. Primary outcome was number of internal carotid artery injuries during pituitary surgery. Secondary outcome measures included pre-operative (demographic, risk factors such as previous radiotherapy, number of previous operations, imaging available), operative (intra-operative image guidance, intra-operative doppler ultrasound, which side ICA was damaged, repair technique) and post-operative result (death, cranial nerve VI palsy, or stroke). 7 out of 893 patients (0.8%) were identified as having an ICA injury. Four of the injuries were left sided. Average age was 54 years old, five were male. In four of the ICA injuries intra-operative navigation imaging was used, and a further two concurrently used ultrasound doppler. Three of the seven cases resulted in permanent morbidity (stroke). There were no other consistent demographic, pre-operative, operative, or post-operative similarities. The two patients with muscle wonton repair suffered no permanent serious complication of ICA injury (i.e. death, abducens nerve palsy, stroke). Our findings resemble the current literature, with left sided ICA injury being more common. Different methods for repairing ICA injury exist, however morcellised muscle patches have shown significant promise in animal models, and the perforated Surgicel® helps create an easy delivery method. The muscle wonton is a viable surgical option for repairing ICA injuries during pituitary surgery. [ABSTRACT FROM AUTHOR]

Background: Kaiser Permanente Southern California began offering a 4‐week supplemental benefit of home‐delivered meals to Medicare Advantage members after discharge from a hospitalization for heart failure and other medical conditions in 2021. The purpose of this study is to explore the associations between socioeconomic disadvantage and food insecurity with patient uptake of and satisfaction with the meals. Methods: Data for this cross‐sectional study were drawn from survey and electronic medical record data for members referred for the meals benefit (n = 6169) and linked to a hospitalization encounter (n = 2254) between January and December 2021. Uptake was assessed using vendor records; measures of socioeconomic status included the neighborhood deprivation index (NDI) and prior receipt of medical financial assistance (MFA) from the health system. Patients were invited to complete an email or phone survey about their satisfaction with the meals and food insecurity. Multivariable log‐binomial regression models were used to examine the association between socioeconomic disadvantage and food insecurity with meals uptake and satisfaction. Results: Sixty‐two percent of patients referred for the benefit accepted the meals (mean age: 79 ± 9, 59% people of color). While there was no significant relationship between NDI and meals uptake (RR: 0.99, 95% CI: 0.92–1.07, p = 0.77), patients who received prior MFA were more likely to accept the meals (RR: 1.09, 95% CI: 1.02–1.16, p < 0.01). Sixty‐nine percent of patients who completed the survey (23% response rate) reported that meals were very or extremely helpful. Patients with food insecurity (29% of survey respondents) were more likely to report that the meals were helpful for their recovery compared to food secure patients (RR: 1.21, 95% CI: 1.09–1.35, p < 0.01). Conclusions: The home‐delivered meals appeared to be particularly utilized by and helpful to patients with greater financial strain and/or food insecurity, suggesting that supplemental benefits could be more targeted toward addressing unmet needs of vulnerable adults. See related Editorial by Amit Kumar. [ABSTRACT FROM AUTHOR]

Objective: This study aims to examine how variation in physicians' treatment decisions for newborn deliveries responds to changes in the hospital‐level norms for obstetric clinical decision‐making. Data Sources: All hospital‐based births in Florida from 2003 through 2017. Study Design: Difference‐in‐differences approach is adopted that leverages obstetric unit closures as the source of identifying variation to exogenously shift obstetricians to a new, nearby hospital with different propensities to approach newborn deliveries less intensively. Data Extraction: Births attributed to physicians continuously observed 2 years before the closure event and 2 years after the closure event (treatment group physicians) or for identical time periods around a randomly assigned placebo closure date (control group physicians). Principal Findings: All of the physicians meeting our inclusion criteria shifted their births to a new hospital less than 20 miles from the hospital shuttering its obstetric unit. The new hospitals approached newborn births more conservatively, and treatment group physicians sharply became less aggressive in their newborn birth clinical management (e.g., use of C‐section). The immediate 11‐percentage point (33%) increase in delivering newborns without any procedure behavior change is statistically significant (p value <0.01) and persistent after the closure event; however, the physicians' payer and patient mix are unchanged. Conclusions: Obstetric physician behavior change appears highly malleable and sensitive to the practice patterns of other physicians delivering newborns at the same hospital. Incentives and policies that encourage more appropriate clinical care norms hospital‐wide could sharply improve physician treatment decisions, with benefits for maternal and infant outcomes. [ABSTRACT FROM AUTHOR]

Jets from active nuclei may supply the heating which moderates cooling and accretion from the circum-galactic medium. While steady overpressured jets can drive a circulatory flow, lateral energy transfer rarely exceeds 3 per cent of jet power, after the initial bow shock has advanced. Here, we explore if pulses in high-pressure jets are capable of sufficient lateral energy transfer into the surrounding environment. We answer this by performing a systematic survey of numerical simulations in an axisymmetric hydrodynamic mode. Velocity pulses along low Mach jets are studied at various overpressures. We consider combinations of jet velocity pulse amplitude and frequency. We find three flow types corresponding to slow, intermediate, and fast pulsations. Rapid pulsations in light jets generate a series of travelling shocks in the jet. They also create ripples which propagate into the ambient medium while a slow convection flow brings in ambient gas which is expelled along the jet direction. Long period pulses produce slowly evolving patterns which have little external effect, while screeching persists as in non-pulsed jets. In addition, rapid pulses in jets denser than the ambient medium generate a novel breathing cavity analogous to a lung. Intermediate period pulses generate a series of bows via a bellows action which transfer energy into the ambient gas, reaching power efficiencies of over 30 per cent when the jet overpressure is sufficiently large. This may adequately inhibit galaxy gas accretion. In addition, such pulses enhance the axial out-flow of jet material, potentially polluting the circum-galactic gas with metal-enriched interstellar gas. [ABSTRACT FROM AUTHOR]

Founded in 1997 by arts and community workers, the Feast Festival in Adelaide is one of the major LGBTQIA+ festivals held in Australia. 2022 marked the 25th year of the Feast Festival and, as such, was an opportunity to reflect upon the importance of community-driven festivals, especially those that explicitly services and advocates for social and cultural minorities. Researching this queer history required multimodal strategies. We interviewed past participants, organizers and performers, which contributed to a short documentary film that was exhibited as part of Feast’s 25th programme. This project has also been supported by extensive archival research. We investigated the role that archives play in research and in documenting the history of a community arts festival, and how archives can actively contribute to the research process at various stages of data collection and creative artefact creation. Further, we explored the festival organizers’ careful engagement with both open-access and curatorial approaches to festival management, including engaging with the South Australian LGBTQIA+ community to encourage participation and develop special events for the programme. [ABSTRACT FROM AUTHOR]

Introduction: The suicide crisis syndrome (SCS) has demonstrated efficacy in predicting suicide attempts, showing potential utility in detecting at‐risk individuals who may not be willing to disclose suicidal ideation (SI). The present international study examined differences in intentions to utilize mental health and suicide prevention resources among community‐based adults with varying suicide risk (i.e., presence/absence of SCS and/or SI). Methods: A sample of 16,934 community‐based adults from 13 countries completed measures about the SCS and SI. Mental health and suicide prevention resources were provided to all participants, who indicated their intentions to use these resources. Results: Individuals with SCS (55.7%) were just as likely as those with SI alone (54.0%), and more likely than those with no suicide‐related symptoms (45.7%), to report willingness to utilize mental health resources. Those with SI (both with and without SCS) were more likely to seek suicide prevention resources (52.6% and 50.5%, respectively) than those without SI (41.7% and 41.8%); however, when examining endorsements for personal use, those with SCS (21.6%) were more likely to use resources than individuals not at risk (15.1%). Conclusions: These findings provide insight into individuals' willingness to use resources across configurations of explicitly disclosed (SI) and indirect (SCS) suicide risk. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had both short- and long-term impacts on the institution of schooling, as well as on teachers and students who experienced it. While much has been learned about the impact of the pandemic, including in physical education, less is known about how physical education teachers navigated the sociopolitical realities of their work as they were socialized through the pandemic. Adopting occupational socialization theory, the purpose of this study was to examine the experiences of Midwestern US physical educators during the COVID-19 pandemic and the lasting implications for their careers. Participants were 30 in-service physical education teachers (20 female and 10 male) from one state in the US Midwest who each participated in a semi-structured interview. Semi-structured interviews were audio-recorded and analyzed using a multiphase collaborative qualitative analysis method grounded in analytic induction and deduction and focused on thematic development. Data analysis resulted in four themes: (a) changing instructional modalities was challenging but prompted creativity and growth; (b) resources were scarce, and marginalization was intensified through the pandemic; (c) recognizing and responding to changes in teacher and student health; and (d) stressors associated with COVID-19 may influence teachers' career trajectories. This study not only adds to the literature related to COVID-19 but also is important for understanding how the schools' culture changes through times of crisis. It is likely that other local, regional, national, or international events will cause disruptions in teachers' work and the nature of student learning in the future. [ABSTRACT FROM AUTHOR]

The protection of heritage from a changing climate has been of increasing interest over the last few decades, which creates a need for a systematic approach to the impacts of climate on tangible and intangible heritage. We present heritage climatology as an applied, interdisciplinary field of science that examines aspects of climate that affect heritage and provides data, statistics, well-tuned climate parameters and projections that can aid interpreting past changes and future management of heritage. It must consider the impact of extreme events, cyclic processes and the gradual accumulation of damage. Climate threats to heritage need to be represented at the appropriate temporal and spatial scales, and transferred using dose–response functions such that they can be interpreted in terms of management decisions yet be resistant to errors from both the representation of the climate threat and its translation into policy. [ABSTRACT FROM AUTHOR]

Background: Individuals with high risk for lung cancer may benefit from lung cancer screening, but there are associated risks as well as benefits. Shared decision‐making (SDM) tools with personalized information may provide key support for patients. Understanding patient perspectives on educational tools to facilitate SDM for lung cancer screening may support tool development. Aim: This study aimed to explore patient perspectives related to a SDM tool for lung cancer screening using a qualitative approach. Methods: We elicited patient perspectives by showing a provider‐facing SDM tool. Focus group interviews that ranged in duration from 1.5 to 2 h were conducted with 23 individuals with high risk for lung cancer. Data were interpreted inductively using thematic analysis to identify patients' thoughts on and desires for a patient‐facing SDM tool. Results: The findings highlight that patients would like to have educational information related to lung cancer screening. We identified several key themes to be considered in the future development of patient‐facing tools: barriers to acceptance, preference against screening and seeking empowerment. One further theme illustrated effects of patient–provider relationship as a limitation to meeting lung cancer screening information needs. Participants also noted several suggestions for the design of technology decision aids. Conclusion: These findings suggest that patients desire additional information on lung cancer screening in advance of clinical visits. However, there are several issues that must be considered in the design and development of technology to meet the information needs of patients for lung cancer screening decisions. Patient or Public Contribution: Patients, service users, caregivers or members of the public were not involved in the study design, conduct, analysis or interpretation of the data. However, clinical experts in health communication provided detailed feedback on the study protocol, including the focus group approach. The study findings contribute to a better understanding of patient expectations for lung cancer screening decisions and may inform future development of tools for SDM. [ABSTRACT FROM AUTHOR]

Background: Depression is common in patients with cancer and is associated with lower treatment adherence and reduced quality of life. Antidepressants and psychotherapy have limited success in improving depression among patients with cancer. This study explored the safety, feasibility, and efficacy of psilocybin‐assisted therapy in patients with cancer and major depressive disorder. Methods: This phase 2, open‐label trial enrolled patients with curable and noncurable cancer and major depressive disorder at a single community oncology practice site. A single 25‐mg dose of psilocybin was administered simultaneously to cohorts of three to four participants with individual (4.25 hours in 1:1 therapist‐to‐patient ratio) and group therapeutic support (3.75 hours) before, during, and after psilocybin administration. Outcomes included depression severity, anxiety, pain, demoralization, and disability. Results: Thirty participants completed the study. No psilocybin‐related serious adverse events occurred; treatment‐related adverse events (e.g., nausea, headache) were generally mild and expected. There were no laboratory or electrocardiogram abnormalities. No suicidality was reported. Efficacy was suggested with a robust reduction in depression severity scores from baseline to posttreatment of 19.1 points (95% CI, 22.3 to –16.0; p <.0001) by week 8. Eighty percent of participants demonstrated a sustained response to psilocybin treatment; 50% showed full remission of depressive symptoms at week 1, which was sustained for 8 weeks. Conclusions: Psilocybin‐assisted therapy in group cohort administration was safe and feasible in patients with cancer and depression. Efficacy was suggested based on clinically meaningful reductions in depressive symptoms. The novel, group‐oriented format, compact delivery time, community cancer center setting, and one‐to‐one therapist‐to‐patient ratio could also add to therapeutic gains and efficiency of administration. Trial Registration: NCT04593563. Plain Language Summary: Depression is common in patients with cancer and associated with lower treatment adherence, reduced quality of life, and limited response to antidepressants and psychotherapy.We conducted a phase 2 trial to study a single dose of psilocybin administered in a group therapy setting with one‐to‐one therapist‐to‐participant psychological support to patients with curable and noncurable cancer and major depressive disorder.Findings of the study showed safety (no treatment‐related serious adverse events or suicidality) with psilocybin and suggested efficacy, with a significant reduction in depression severity scores from baseline to posttreatment. Further investigation is warranted. A phase 2 study explored the safety, feasibility, and efficacy of psilocybin‐assisted therapy in a community cancer setting in 30 patients with cancer and major depressive disorder. Psilocybin‐assisted therapy in group cohort administration was safe and feasible, as demonstrated by a robust reduction in depression severity scores from baseline to posttreatment of 19.1 points (95% CI, 22.3 to –16.0; p <.0001) by week 8. [ABSTRACT FROM AUTHOR]

School administrators represent key agents of socialization for teachers within their schools, including adapted physical educators who design and implement instruction for youth with disabilities, often across multiple school sites. The purpose of this study was to understand how adapted physical educators navigate and build relationships with administrators in the schools where they teach. Data were collected through semistructured interviews with 24 adapted physical educators from the U.S. state of California and analyzed using a multiphase approach. Analysis suggested both the importance of and challenges with building effective relationships with administrators. Themes included the following: (a) Administrators do not understand adapted physical education, which impacts programs and students; (b) the importance of relationship building in cultivating principal support; and (c) relationship development requires intentionality, but results in trust and motivation. Results are discussed using role socialization theory, and recommendations for the preparation of both adapted physical educators and school principals are discussed. [ABSTRACT FROM AUTHOR]

Introduction Materials and Methods Results Conclusion Local anaesthesia (LA) is fundamental to successful dental treatment. Graduating hygienists, therapist and dentists should be confident and proficient in delivering LA. There is one previously published article reviewing LA teaching in United Kingdom (UK) dental schools in 2016, and at this time 10 out of 14 schools allowed peer‐to‐peer administration. The method of teaching LA administration has become an area of debate in terms of legality and morality given the potential complications and issues with valid consent. The aim of the study was to explore current teaching practices and assessment of LA in UK dental schools.Two national surveys (2020 and 2023) were sent out via the ABAOMS Education Committee to all 16 dental schools in the United Kingdom with dental and/or hygiene and therapy programmes.There was a 100% response rate from all schools. There has been a significant shift from peer‐to‐peer administration of local anaesthesia, with only 4 schools now allowing peer‐to‐peer administration. The majority of schools use simulation methods to deliver the teaching, including LA models, cadavers and ‘cap‐on’ simulation with a peer. When comparing the timing of teaching between 2020 and 2023, BDS students now administer their first LA injection to a patient later in the programme, and there has been a reduction in intra‐professional teaching.Due to the large shift away from practicing LA on peers, there is a need for further development of simulation methods given the drawbacks with current models and the limited development of haptic technology in relation to LA. [ABSTRACT FROM AUTHOR]

Premise Methods Results Conclusions Polypodium pellucidum, a fern endemic to the Hawaiian Islands, encompasses five ecologically and morphologically variable subspecies, suggesting a complex history involving both rapid divergence and rampant hybridization.We employed a large target‐capture data set to investigate the evolution of genetic, morphological, and ecological variation in P. pellucidum. With a broad sampling across five Hawaiian Islands, we deciphered the evolutionary history of P. pellucidum, identified nonhybrid lineages and intraspecific hybrids, and inferred the relative influence of geography and ecology on their distributions.Polypodium pellucidum is monophyletic, dispersing to the Hawaiian archipelago 11.53–7.77 Ma and diversifying into extant clades between 5.66 and 4.73 Ma. We identified four nonhybrid clades with unique morphologies, ecological niches, and distributions. Additionally, we elucidated several intraspecific hybrid combinations and evidence for undiscovered or extinct “ghost” lineages contributing to extant hybrid populations.We provide a foundation for revising the taxonomy of P. pellucidum to account for cryptic lineages and intraspecific hybrids. Geologic succession of the Hawaiian Islands through cycles of volcanism, vegetative succession, and erosion has determined the available habitats and distribution of ecologically specific, divergent clades within P. pellucidum. Intraspecific hybrids have likely arisen due to ecological and or geological transitions, often persisting after the local extinction of their progenitors. This research contributes to our understanding of the evolution of Hawai'i's diverse fern flora and illuminated cryptic taxa to allow better‐informed conservation efforts. [ABSTRACT FROM AUTHOR]

AbstractAn increasing focus of recent research is on the role of technology in support of teaching, learning and renewal or revitalization of endangered languages. The potential roles of a given piece of technology logically depend, at least to some extent, on the features built into the technology at design stage. Since most language revitalization and renewal efforts are local, community-based initiatives, the preferences and insights of community members are critical to build into the design, to maximize the relevance and appeal of the technology to those who might use it to maintain and increase knowledge and skills in their language. Recognizing this, the project reported on here incorporated co-design into the development of a mobile app, Warrma Mangarrayi (“Listen to Mangarrayi”). The app design also drew on a model of language revitalization, which offers a conceptualization of how technology can be a resource for a language revitalization team whose goals include everyday phrase-based communication in the endangered language. In this article we discuss the iterative user-centered co-design process adopted for the research and the improvements resulting from community user feedback on different versions and how the resulting resource, Warrma Mangarrayi, responded to community needs and aspirations. [ABSTRACT FROM AUTHOR]

Background Methods Findings Conclusions Inclusive research has sidelined discussion of theoretical issues with researchers with intellectual/learning disabilities. This is a situation which the Big Ideas initiative sought to change. Between 2021 and 2023, the Open University, Leipzig University and the University of Koblenz organised nine workshops to explore influential theories in disability research. The objective was to share a theory (Big Idea) that sheds light on disability with self‐advocates and discuss how it relates to their experience. By making theories accessible and discussing how they relate to lived experience, we aimed to inform self‐advocates and activist researchers about key concepts in disability, deepen their capacity for research and campaigning, and better equip them to activate for change.The online workshops were evaluated by observers. These observations were used by an inclusive group of activist researchers as the basis for an overall evaluation of the project.People with learning disabilities can engage with complex theories if these are presented accessibly alongside opportunities for reflective discussion. Input from self‐advocates helps to broaden and deepen theoretical understanding.An unanticipated but important finding was that the Big Ideas workshops created a new space in which academics and self‐advocates could learn together as equals.Making theory accessible and easier to understand is both possible and valuable. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions Emergency medicine (EM) doctors are often required to manage a diverse set of complex challenges; navigating direct patient care, systemic issues and inter‐professional interactions. Leadership is well recognised as crucial in optimising both the delivery and the quality of patient care. There is a clear need to gain greater understanding of the reality of EM leadership through exploring doctors' experience and perception of leadership in EM, yet there is a paucity of research focusing on this area. The objective of the present study was to explore the research question: ‘What are the experiences and perceptions of leadership by EM doctors?’This single‐site qualitative study was undertaken using semi‐structured in‐depth individual interviews to collect data. Interviews were audio recorded, transcribed and de‐identified. Reflexive thematic analysis was performed by the research team with the aid of DelveTool software.Our sample included nine participants incorporating consultants and registrars. Three major themes were identified: (i) situational tensions, (ii) relational tensions and (iii) leadership style tensions. Each of these was further explored with subthemes discussed separately.Leadership within the ED is complex and multifaceted, with doctors required to navigate many competing tensions. The present study highlighted key areas for future leadership development, including situational awareness, emotional intelligence and a fluid approach to leadership styles. The present study provides an important step towards enhancing the development of targeted leadership training for EM doctors. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal circulation causes a systemic inflammatory response, that may cause postoperative haemodynamic instability and end-organ dysfunction. This study aimed to investigate the impact of minimal invasive extracorporeal circulation (MiECC) on the systemic inflammatory response compared with conventional extracorporeal circulation (CECC). Methods: Patients undergoing coronary artery bypass grafting were randomized to MiECC (n = 30) and CECC (n = 30). Primary endpoint was tumor necrosis factor-α. Secondary endpoints were other biochemical markers of inflammation (IL1β, IL6 and IL8, C-reactive protein, leukocytes), and markers of inadequate tissue perfusion and tissue damage (lactate dehydrogenase, lactate and creatine kinase-MB). In addition, we registered signs of systemic inflammatory response syndrome, haemodynamic instability, atrial fibrillation, respiratory dysfunction, and infection. Results: Patients treated with MiECC showed significantly lower levels of tumor necrosis factor-α than CECC during and early after extracorporeal circulation (median: MiECC 3.4 pg/mL; CI 2.2–4.5 vs. CECC 4.6 pg/mL; CI 3.4–5.6; p = 0.01). Lower levels of creatine kinase-MB and lactate dehydrogenase suggested less tissue damage. However, we detected no other significant differences in any other markers of inflammation, tissue damage or in any of the clinical outcomes. Conclusions: Lower levels of TNF-α after MiECC compared with CECC may reflect reduced inflammatory response, although other biochemical markers of inflammation were comparable. Our results suggest better end-organ protection with MiECC compared with CECC. Clinical parameters related to systemic inflammatory response were comparable in this study. Clinical registration number: NCT03216720. [ABSTRACT FROM AUTHOR]

This study tested two opposing hypotheses on the continuity of psychopathology throughout adolescence and young adulthood; differentiation versus dynamic mutualism. Differentiation predicts that co-occurrence decreases, while dynamic mutualism predicts that co-occurrence increases due to causal interactions amongst mental health problems. Using data from the Dutch TRacking Adolescents' Individual Lives Survey (n = 2228, 51% female), we studied the development of self-reported internalizing, externalizing, and attention problems at ages 11 to 26 across six waves. Random-intercept cross-lagged panel modeling was employed to distinguish within-person development from stable between-person processes. Large stable between-person associations indicated that adolescents with internalizing problems tended to have both externalizing and attention problems as well. On a within-person level, mental health problems showed partial stability and strong cross-sectional co-occurrence. Within-wave associations of internalizing with externalizing or attention problems decreased between age 11 and 16 years, after which they increased again. Little heterotypic continuity was found: age 11 externalizing predicted age 13 attention, which in turn predicted age 16 externalizing problems, and internalizing predicted externalizing problems across ages 22 to 26. Findings were similar for males and females. Our findings suggest co-occurrence decreases during early and middle adolescence, supporting differentiation. While co-occurrence increased again into young adulthood, this could not be labeled as dynamic mutualism because little evidence for heterotypic continuity was found in this phase of life. The strong stable links between internalizing, externalizing, and attention problems stress the importance of targeting these mental health problems and their shared risk factors together. [ABSTRACT FROM AUTHOR]

Histones organize DNA within cellular nuclei, but they can be released from damaged cells. In peripheral tissues extracellular histones act as damage-associated molecular patterns (DAMPs) inducing pro-inflammatory activation of immune cells. Limited studies have considered DAMP-like activity of histones in the central nervous system (CNS); therefore, we studied the effects of extracellular histones on microglia, the CNS immunocytes, and on neuronal cells. Both the linker histone H1 and the core histone H3 induced pro-inflammatory activation of microglia-like cells by upregulating their secretion of NO and cytokines, including interferon-γ-inducible protein 10 (IP-10) and tumor necrosis factor-α (TNF). The selective inhibitors MMG-11 and TAK-242 were used to demonstrate involvement of toll-like receptors (TLR) 2 and 4, respectively, in H1-induced NO secretion by BV-2 microglia. H1, but not H3, downregulated the phagocytic activity of BV-2 microglia. H1 was also directly toxic to all neuronal cell types studied. We conclude that H1, and to a lesser extent H3, when released extracellularly, have the potential to act as a CNS DAMPs. Inhibition of the DAMP-like effects of extracellular histones on microglia and their neurotoxic activity represents a potential strategy for combating neurodegenerative diseases that are characterized by the adverse activation of microglia and neuronal death. • Extracellular histones were hypothesized to be DAMPs of the central nervous system. • H1 or H3 histones were applied directly to cultured microglial and neuronal cells. • Pro-inflammatory activation of murine and human microglia-like cells was observed. • H1-induced NO secretion by BV-2 microglia was reduced by TLR4 and TLR2 inhibitors. • H1, but not H3, was directly toxic to murine primary neurons and neuronal cell lines. [ABSTRACT FROM AUTHOR]

Humanitarian practitioners, specifically emergency aid and relief workers, disaster responders, social workers, and crisis clinicians, are at elevated risk of experiencing trauma as a result of their professions. Approaches for responding to the silent pandemic of reactive traumatic stress, including secondary traumatic stress and vicarious traumatization among humanitarian practitioners continue to be inadequate. The current model of self‐care, emphasizing internal regulation and processes to promote positive health, wellbeing, and the ability to continue to support others, is insufficient to best equip humanitarian practitioners with protective factors to stave off reactive traumatic responses to their work. We therefore propose our theory to extend the current self‐care model to include the external focus of compassion resilience and conclude with recommendations. [ABSTRACT FROM AUTHOR]

Psoriasis is an autoimmune cutaneous condition that significantly impacts quality of life and represents a burden on society due to its prevalence. Genome-wide association studies (GWASs) have pinpointed several psoriasis-related risk loci, underlining the disease's complexity. Functional genomics is paramount to unveiling the role of such loci in psoriasis and disentangling its complex nature. In this review, we aim to elucidate the main findings in this field and integrate our discussion with gold-standard techniques in molecular biology—i.e., Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)—and high-throughput technologies. These tools are vital to understanding how disease risk loci affect gene expression in psoriasis, which is crucial in identifying new targets for personalized treatments in advanced precision medicine. [ABSTRACT FROM AUTHOR]

Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians use them and if OTAs themselves modify clinician prescribing practices. To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. Our analysis identified three main themes: (1) OTAs did not influence clinicians' decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians' decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs' purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. [ABSTRACT FROM AUTHOR]

The undergraduate mental health nursing course is an optimal time to address stigma and prejudice, while developing positive student attitudes toward those who live with mental health conditions. A quasi-experimental, pretest-posttest, nonequivalent-group study with a sample of undergraduate nursing students in New York City (N = 126) was conducted to determine the impact of an undergraduate mental health nursing course on attitudes toward people living with a general mental illness, depression, or schizophrenia. The intervention resulted in a significant reduction in total prejudice scores toward those with a general mental illness when compared to the control (p = 0.033, partial η2 = 0.062). The intervention had no significant impact on total prejudice scores regarding those with depression, or schizophrenia. Subscale analysis revealed the intervention significantly reduced attitudes of fear/avoidance regarding general mental illness (p = 0.040, partial η2 = 0.058) and schizophrenia (p < 0.001, partial η2 = 0.164). There was no impact on authoritarian or malevolent attitudes. Though some attitudes were not amenable to change, this study provides evidence that positive attitudes can be cultivated through undergraduate nursing education. Curricular reform is needed to reduce all facets of prejudice and best prepare future nurses to care for those with mental health conditions. [ABSTRACT FROM AUTHOR]