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• Tested the effect of witness opinions and background information in investigation. • Witness opinions biased judgments of event cause and witness confidence. • Background information biased judgments of cause and the value of evidence. • Background information biased participants to misclassify more opinions as facts. • Paper provides bias mitigation suggestions for professionals in the field. Introduction : A unique feature of workplace investigations is the familiarity that investigators and witnesses have with the factors involved in the adverse incident. Familiarity creates expectations that can shape investigators' and witnesses' assumptions and opinions. The current research examined the biasing effect of non-factual witness claims on investigators' judgments. These claims, which we call 'uncheckable,' included opinions about factors involved in the event and the future. We also examined how participants' a priori knowledge of an employee's history influenced their judgments. Method: This experiment used a 2 (background information: control or unsafe) × 2 (uncheckable content: neutral or unsafe) between-subjects design. Participants were provided with background information about a worker (control or unsafe history) and a witness statement about a workplace event that contained uncheckable claims (neutral or worker as unsafe). We tested how our manipulations biased participants' judgments of: (i) the cause of the event, (ii) the witness's confidence and credibility, and (iii) the diagnosticity of the witness's account. We also tested if biasing background information affected how factual participants found the witness's statement. Results: Biasing uncheckable information (i.e., opinions) affected participants' judgments of event cause (ηp2 = 0.033) and increased their ratings of witness confidence (ηp2 = 0.074). Biasing background information about a worker affected participants' judgments of the cause of the event (ηp2 = 0.088), the diagnostic value of the witness statement (ηp2 = 0.054), and the number of factual claims in the witness statement, resulting in more uncheckable claims being misclassified as potential facts (ηp2 = 0.18). Conclusion: This experiment demonstrated the significant effect that non-factual witness statements and irrelevant background information can have on the interpretation of evidence and judgments about the cause of events. Practical Application: Understanding how contextual information can bias investigative judgment helps workplace investigators manage its influence in their judgment practices. [ABSTRACT FROM AUTHOR]

Adenosine A2A receptor (A2AR) antagonists are the leading nondopaminergic therapy to manage Parkinson's disease (PD) since they afford both motor benefits and neuroprotection. PD begins with a synaptic dysfunction and damage in the striatum evolving to an overt neuronal damage of dopaminergic neurons in the substantia nigra. We tested if A2AR antagonists are equally effective in controlling these two degenerative processes. We used a slow intracerebroventricular infusion of the toxin MPP+ in male rats for 15 days, which caused an initial loss of synaptic markers in the striatum within 10 days, followed by a neuronal loss in the substantia nigra within 30 days. Interestingly, the initial loss of striatal nerve terminals involved a loss of both dopaminergic and glutamatergic synaptic markers, while GABAergic markers were preserved. The daily administration of the A2AR antagonist SCH58261 (0.1 mg/kg, i.p.) in the first 10 days after MPP+ infusion markedly attenuated both the initial loss of striatal synaptic markers and the subsequent loss of nigra dopaminergic neurons. Strikingly, the administration of SCH58261 (0.1 mg/kg, i.p. for 10 days) starting 20 days after MPP+ infusion was less efficacious to attenuate the loss of nigra dopaminergic neurons. This prominent A2AR-mediated control of synaptotoxicity was directly confirmed by showing that the MPTP-induced dysfunction (MTT assay) and damage (lactate dehydrogenase release assay) of striatal synaptosomes were prevented by 50 nM SCH58261. This suggests that A2AR antagonists may be more effective to counteract the onset rather than the evolution of PD pathology. [ABSTRACT FROM AUTHOR]

Increasing survivorship in kidney cancer patients has shifted treatment strategies to optimize renal function preservation. In 2010, the College of American Pathologists (CAP) updated their synoptic reporting guidelines for tumor nephrectomies to require evaluation of the nonneoplastic kidney parenchyma. We conducted this study to understand current practice behaviors regarding the evaluation of the nonneoplastic kidney parenchyma in tumor nephrectomy specimens. We emailed a 14-item multiple-choice survey to members of the Renal Pathology Society and Genitourinary Pathology Society. We also emailed a 12-item survey to program and associate program directors of American pathology residencies to assess the current state of renal pathology education. Ninety-eight genitourinary and 104 renal pathologists responded to the survey on the nonneoplastic kidney parenchyma. Ninety-five percent of respondents who examine tumor nephrectomies reported evaluating the nonneoplastic kidney parenchyma. Seventy-five percent of genitourinary pathologists and 67% of renal pathologists use synoptic reporting, and 81% use the CAP protocol. Thirty-nine percent of respondents report always contacting the clinician when they find evidence of medical renal disease. Forty-two program leaders responded to our renal pathology education survey, and 64% of them have a mandatory renal pathology rotation that on average lasts about 2 to 4 weeks. The majority of pathologists examine the nonneoplastic kidney parenchyma of tumor nephrectomies and frequently report incidences of new medical renal disease directly to clinicians, but there remains room for improvement and educational gaps during residency training. Further efforts to standardize both this evaluation and renal pathology education will improve patient care. [ABSTRACT FROM AUTHOR]

• Application of deformable slice-to-volume reconstruction is feasible for MRI characterisation of preterm lung development. • Mean T2* values were lower in the preterm cohort than in controls. • Alterations in pulmonary development associated with preterm birth may commence in the antenatal period. To compare mean pulmonary T2* values and pulmonary volumes in fetuses that subsequently spontaneously delivered before 32 weeks with a control cohort with comparable gestational ages and to assess the value of mean pulmonary T2* as a predictor of preterm birth < 32 weeks' gestation. MRI datasets scanned at similar gestational ages were selected from fetuses who spontaneously delivered < 32 weeks of gestation and a control group who subsequently delivered at term with no complications. All women underwent a fetal MRI on a 3 T MRI imaging system. Sequences included T2-weighted single shot fast spin echo and T2* sequences, using gradient echo single shot echo planar sequencing of the fetal thorax. Motion correction was performed using slice-to-volume reconstruction and T2* maps generated using in-house pipelines. Lungs were manually segmented and volumes and mean T2* values calculated for both lungs combined and left and right lung separately. Linear regression was used to compare values between the preterm and control cohorts accounting for the effects of gestation. Receiver operating curves were generated for mean T2* values and pulmonary volume as predictors of preterm birth < 32 weeks' gestation. Datasets from twenty-eight preterm and 74 control fetuses were suitable for analysis. MRI images were taken at similar fetal gestational ages (preterm cohort (mean ± SD) 24.9 ± 3.3 and control cohort (mean ± SD) 26.5 ± 3.0). Mean gestational age at delivery was 26.4 ± 3.3 for the preterm group and 39.9 ± 1.3 for the control group. Mean pulmonary T2* values remained constant with increasing gestational age while pulmonary volumes increased. Both T2* and pulmonary volumes were lower in the preterm group than in the control group for all parameters (both combined, left, and right lung (p < 0.001 in all cases). Adjusted for gestational age, pulmonary volumes and mean T2* values were good predictors of premature delivery in fetuses < 32 weeks (area under the curve of 0.828 and 0.754 respectively). These findings indicate that mean pulmonary T2* values and volumes were lower in fetuses that subsequently delivered very preterm. This may suggest potentially altered oxygenation and indicate that pulmonary morbidity associated with prematurity has an antenatal antecedent. Future work should explore these results correlating antenatal findings with long term pulmonary outcomes. [ABSTRACT FROM AUTHOR]

During the 2023-24 respiratory virus season, the Advisory Committee on Immunization Practices recommends influenza and COVID-19 vaccines for all persons aged =6 months, and respiratory syncytial virus (RSV) vaccine is recommended for persons aged =60 years (using shared clinical decisionmaking), and for pregnant persons. Data from the National Immunization Survey-Adult COVID Module, a random-digit-dialed cellular telephone survey of U.S. adults aged =18 years, are used to monitor influenza, COVID-19, and RSV vaccination coverage. By December 9, 2023, an estimated 42.2% and 18.3% of adults aged =18 years reported receiving an influenza and updated 2023-2024 COVID-19 vaccine, respectively; 17.0% of adults aged =60 years had received RSV vaccine. Coverage varied by demographic characteristics. Overall, approximately 27% and 41% of adults aged =18 years and 53% of adults aged =60 years reported that they definitely or probably will be vaccinated or were unsure whether they would be vaccinated against influenza, COVID-19, and RSV, respectively. Strong provider recommendations for and offers of vaccination could increase influenza, COVID-19, and RSV vaccination coverage. Immunization programs and vaccination partners are encouraged to use these data to understand vaccination patterns and attitudes toward vaccination in their jurisdictions to guide planning, implementation, strengthening, and evaluation of vaccination activities. [ABSTRACT FROM AUTHOR]

Summary: The bacterial strain SF857 was isolated from the entomopathogenic nematode, Steinernema bakwenae SF857, found in soil samples of St Lucie cherry, a species of cherry tree, from the Muriti farm, close to Kroondal (25°44′E, 59°99′S) in the northwest province of South Africa. Strain SF857 is Gram-negative, catalase and oxidase-negative, and lecithinase-positive. Strain SF857 shared the highest 16S rRNA gene sequence similarity (97.7%) with the type strain of Xenorhabdus ishibashii. However, a comparison of housekeeping gene sequences showed that strain SF857 grouped closer to X. griffiniae , X. ehlersii and X. thuongxuanensis than to X. ishibashii. Digital DNA-DNA hybridisation (dDDH) between strain SF857 and all Xenorhabdus spp. is less than the 70% species threshold, confirming that the strain belongs to a separate species. Furthermore, the biochemical characteristics of strain SF857 differ from other Xenorhabdus spp. Based on these findings, strain SF857 represents a novel species within the genus Xenorhabdus , for which the name Xenorhabdus bakwenae sp. n. (type strain SF857T) is proposed. Pathogenicity bioassays with last-instar Cydia pomonella showed S. bakwenae to be highly virulent, with potential use as a biocontrol agent in apple orchards. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is a shared experience for diagnosed mothers and their young adult caregiving daughters (YACDs). They struggle to talk about cancer and receive no guidance for navigating challenging but critical care conversations. Daughters in young adulthood also tend to avoid cancer-related talk, which is associated with poorer biopsychosocial outcomes, whereas openness between mothers and daughters is tied to better biopsychosocial outcomes. We sought to determine mothers' and YACDs' most challenging topics as well as their preferred strategies that help them engage in these discussions, while also exploring associations between openness/avoidance and their psychosocial outcomes. Results highlight how mother–daughter communication approaches (i.e., avoidance and openness) intersect with their psychological distress and relational satisfaction. Collectively, findings demonstrate that if we are to promote better psychosocial outcomes for diagnosed mothers and their caregiving daughters, we must recognize the influential role their communication plays in their well-being. For many diagnosed mothers and their daughters, breast cancer is a shared experience. However, they struggle to talk about cancer. This is particularly true when the daughter is in adolescence or young adulthood, as they tend to be more avoidant, which is associated with poorer biopsychosocial outcomes. When daughters are their mother's caregivers, daughters' burden and distress are heightened. Young adult caregiving daughters (YACDs) are the second most common family caregiver and encounter more distress and burden than other caregiver types. Yet, YACDs and their diagnosed mothers receive no guidance on how to talk about cancer. Thirty-nine mother/YACD pairs participated in an online survey to identify challenging topics and strategies for talking about cancer, and to explore associations between openness/avoidance and psychosocial outcomes. YACDs and mothers reported the same challenging topics (death, treatment-related issues, negative emotions, relational challenges, YACDs' disease risk) but differed on why they avoided the topic. YACDs and mothers identified the same helpful approaches to navigate conversations (openness, staying positive, third-party involvement, avoidance). Avoidance was correlated with more distress whereas openness was correlated with better psychosocial outcomes. These results provide a psychosocial map for a mother-YACD communication skills intervention, which is key to promoting healthy outcomes. [ABSTRACT FROM AUTHOR]

Cardiac arrest is an uncommon but serious maternal complication. This article describes the rate of cardiac arrest among hospitalized women who were pregnant in the United States in 2017 to 2019 and examines factors associated with those who had cardiac arrest and those who survived. Visual Abstract. Cardiac Arrest During Delivery Hospitalization.: Cardiac arrest is an uncommon but serious maternal complication. This study describes the rate of cardiac arrest among hospitalized women who were pregnant in the United States in 2017 to 2019 and examines factors associated with those who had cardiac arrest and those who survived. Background: Estimates of cardiac arrest occurring during delivery guide evidence-based strategies to reduce pregnancy-related death. Objective: To investigate rate of, maternal characteristics associated with, and survival after cardiac arrest during delivery hospitalization. Design: Retrospective cohort study. Setting: U.S. acute care hospitals, 2017 to 2019. Participants: Delivery hospitalizations among women aged 12 to 55 years included in the National Inpatient Sample database. Measurements: Delivery hospitalizations, cardiac arrest, underlying medical conditions, obstetric outcomes, and severe maternal complications were identified using codes from the International Classification of Diseases, 10th Revision, Clinical Modification. Survival to hospital discharge was based on discharge disposition. Results: Among 10 921 784 U.S. delivery hospitalizations, the cardiac arrest rate was 13.4 per 100 000. Of the 1465 patients who had cardiac arrest, 68.6% (95% CI, 63.2% to 74.0%) survived to hospital discharge. Cardiac arrest was more common among patients who were older, were non-Hispanic Black, had Medicare or Medicaid, or had underlying medical conditions. Acute respiratory distress syndrome was the most common co-occurring diagnosis (56.0% [CI, 50.2% to 61.7%]). Among co-occurring procedures or interventions examined, mechanical ventilation was the most common (53.2% [CI, 47.5% to 59.0%]). The rate of survival to hospital discharge after cardiac arrest was lower with co-occurring disseminated intravascular coagulation (DIC) without or with transfusion (50.0% [CI, 35.8% to 64.2%] or 54.3% [CI, 39.2% to 69.5%], respectively). Limitations: Cardiac arrests occurring outside delivery hospitalizations were not included. The temporality of arrest relative to the delivery or other maternal complications is unknown. Data do not distinguish cause of cardiac arrest, such as pregnancy-related complications or other underlying causes among pregnant women. Conclusion: Cardiac arrest was observed in approximately 1 in 9000 delivery hospitalizations, among which nearly 7 in 10 women survived to hospital discharge. Survival was lowest during hospitalizations with co-occurring DIC. Primary Funding Source: None. [ABSTRACT FROM AUTHOR]

Motivated by growing trends to require doctoral students to be supervised by panels rather than single supervisors, our study investigates how these resulting structural changes affect students' and supervisors' agency and the co-construction of their identity. Using role theory as a framework to analyze the narratives of a matched sample of students and supervisors, findings reveal the effect of socially enacted roles on members' engagement, with purposed conformance evident in their goal-directed agency. Besides the pivotal role of primary supervisors in ensuring a common purpose to achieve timely completion of the required research, findings demonstrate the importance of developing members' shared understanding of the adjustments to structure and agency required to achieve diversity and excellence. [ABSTRACT FROM AUTHOR]

Breast cancer survivors' (BCSs') sexual health (SH) clinical conversations are rarely studied from a dyadic perspective let alone from a triadic perspective. Using a triadic approach, we evaluated BCSs' comfort discussing SH with partners present and identified factors that can contribute to their comfort level. Qualitative approach using in-depth interviews. 93 BCSs, partners, and providers involved in BCS care. In-depth interviews with BCSs, partners, and providers explored triadic perspectives to understand factors informing BCSs' comfort level. Thematic analysis was used to analyze data. Four themes characterize potential benefits of partner presence: 1) partner facilitates information exchange, 2) partner realizes BCS's SH concerns are "a real thing," 3) partner better understands SH challenges, and 4) partner presence encourages relational communication about SH. Five themes illustrate potential complications of partner presence: 1) partner feels/becomes embarrassed, 2) partner is/becomes defensive, 3) partner presence constrains BCS's agency in clinical conversations, 4) partner presence threatens partner's view of BCS as a sexual being, and 5) partner presence increases partner burden. Providers should (1) initiate conversations about BCS comfort with partner presence, (2) be aware of the interaction between BCS primary and secondary goals, (3) consider how BCS/partner goal conflicts obstruct BCS agency and sexual/relational health, and (4) offer opportunities to clarify goals and expectations, and coordinate therapeutic options. [ABSTRACT FROM AUTHOR]

The frequent activation of the PI3K/AKT/mTOR pathway and its crucial role in estrogen receptor-positive (ER+) breast cancer tumorigenesis and drug resistance has made it a highly attractive therapeutic target in this breast cancer subtype. Consequently, the number of new inhibitors in clinical development targeting this pathway has drastically increased. Among these, the PIK3CA isoform-specific inhibitor alpelisib and the pan-AKT inhibitor capivasertib were recently approved in combination with the estrogen receptor degrader fulvestrant for the treatment of ER+ advanced breast cancer after progression on an aromatase inhibitor. Nevertheless, the clinical development of multiple inhibitors of the PI3K/AKT/mTOR pathway, in parallel with the incorporation of CDK4/6 inhibitors into the standard of care treatment in ER+ advanced breast cancer, has led to a multitude of available therapeutic agents and many possible combined strategies which complicate personalizing treatment. Here, we review the role of the PI3K/AKT/mTOR pathway in ER+ advanced breast cancer, highlighting the genomic contexts in which the various inhibitors of this pathway may have superior activity. We also discuss selected trials with agents targeting the PI3K/AKT/mTOR and related pathways as well as the rationale supporting the clinical development of triple combination therapy targeting ER, CDK4/6 and PI3K/AKT/mTOR in ER+ advanced breast cancer. [ABSTRACT FROM AUTHOR]

Lupinus mutabilis Sweet (Fabaceae), "tarwi" or "chocho", is an important grain legume in the Andean region. In Peru, studies on tarwi have mainly focused on morphological features; however, they have not been molecularly characterized. Currently, it is possible to explore the genetic parameters of plants with reliable and modern methods such as genotyping by sequencing (GBS). Here, for the first time, we used single nucleotide polymorphism (SNP) markers to infer the genetic diversity and population structure of 89 accessions of tarwi from nine Andean regions of Peru. A total of 5922 SNPs distributed along all chromosomes of tarwi were identified. STRUCTURE analysis revealed that this crop is grouped into two clusters. A dendrogram was generated using the UPGMA clustering algorithm and, like the principal coordinate analysis (PCoA), it showed two groups that correspond to the geographic origin of the tarwi samples. AMOVA showed a reduced variation between clusters (7.59%) and indicated that variability within populations is 92.41%. Population divergence (Fst) between clusters 1 and 2 revealed low genetic difference (0.019). We also detected a negative Fis for both populations, demonstrating that, like other Lupinus species, tarwi also depends on cross-pollination. SNP markers were powerful and effective for the genotyping process in this germplasm. We hope that this information is the beginning of the path towards a modern genetic improvement and conservation strategies of this important Andean legume. [ABSTRACT FROM AUTHOR]

Work at the intersection of blockchain technology and law suffers from a distinct linguistic disadvantage. As a highly interdisciplinary area of inquiry, legal researchers, lawmakers, researchers in the technical sciences, and the public all talk past each other, using the same words, but as different terms of art. Evidence of these language wars largely derives from anecdote. To better assess the nature and scope of the problem, this Article uses corpus linguistics to reveal the inherent value conflicts embedded in definitional differences and debates related to developing regulation in one specific area of the blockchain technology ecosystem: cryptocurrency. Using cryptocurrency as a case study reveals the delicate balance necessary to develop law in even the best popularly understood area of blockchain technology. In doing so, the Article demonstrates that corpus linguistics offers a tool for identifying specific linguistic ambiguities before they are embedded in law, ultimately enhancing the clarity, predictability, and coherency of the regulatory regimes to which cryptocurrency is subject. [ABSTRACT FROM AUTHOR]

• Quantified the magnitude of the human error bias in professional investigators. • Meta-analyses showed professionals had a stronger human error bias than students. • Professionals wrongly, but confidently, believed that they were objective. • Recommendations for mitigating bias in workplace investigation are presented. Introduction: This study explored the magnitude of professional industrial investigators' bias to attribute cause to a person more readily than to situational factors (i.e., human error bias). Such biased opinions may relieve companies from responsibilities and liability, as well as compromise efficacy of suggested preventative measures. Method: Professional investigators and undergraduate participants were given a summary of a workplace event and asked to allocate cause to the factors they found causal for the event. The summary was crafted to be objectively balanced in its implication of cause equally between two factors: a worker and a tire. Participants then rated their confidence and the objectivity of their judgment. We then conducted an effect size analysis, which supplemented the findings from our experiment with two previously published research studies that used the same event summary. Results: Professionals exhibited a human error bias, but nevertheless believed that they were objective and confident in their conclusions. The lay control group also showed this human error bias. These data, along with previous research data, revealed that, given the equivalent investigative circumstances, this bias was significantly larger with the professional investigators, with an effect size of d unb = 0.97, than the control group with an effect size of only d unb = 0.32. Conclusions: The direction and strength of the human error bias can be quantified, and is shown to be larger in professional investigators compared to lay people. Practical Applications: Understanding the strength and direction of bias is a crucial step in mitigating the effects of the bias. The results of the current research demonstrate that mitigation strategies such as proper investigator training, a strong investigation culture, and standardized techniques, are potentially promising interventions to mitigate human error bias. [ABSTRACT FROM AUTHOR]

Cells from glioblastoma multiforme (GBM) feature up-regulation of the mechanistic Target of Rapamycin (mTOR), which brings deleterious effects on malignancy and disease course. At the cellular level, up-regulation of mTOR affects a number of downstream pathways and suppresses autophagy, which is relevant for the neurobiology of GBM. In fact, autophagy acts on several targets, such as protein clearance and mitochondrial status, which are key in promoting the malignancy GBM. A defective protein clearance extends to cellular prion protein (PrPc). Recent evidence indicates that PrPc promotes stemness and alters mitochondrial turnover. Therefore, the present study measures whether in GBM cells abnormal amount of PrPc and mitochondrial alterations are concomitant in baseline conditions and whether they are reverted by mTOR inhibition. Proteins related to mitochondrial turnover were concomitantly assessed. High amounts of PrPc and altered mitochondria were both mitigated dose-dependently by the mTOR inhibitor rapamycin, which produced a persistent activation of the autophagy flux and shifted proliferating cells from S to G1 cell cycle phase. Similarly, mTOR suppression produces a long-lasting increase of proteins promoting mitochondrial turnover, including Pink1/Parkin. These findings provide novel evidence about the role of autophagy in the neurobiology of GBM. [ABSTRACT FROM AUTHOR]

BACKGROUND: Observational studies have improved our understanding of the risk factors for sudden infant death syndrome, but separate examination of risk for sleep-related suffocation and unexplained infant deaths has been limited. We examined the association between unsafe infant sleep practices and sudden infant deaths (sleep-related suffocation and unexplained causes including sudden infant death syndrome). METHODS: We conducted a population-based case-control study using 2016 to 2017 Centers for Disease Control and Prevention data. Controls were liveborn infants from the Pregnancy Risk Assessment Monitoring System; cases were from the Sudden Unexpected Infant Death Case Registry. We calculated risk factor prevalence among cases and controls and crude and adjusted odds ratios. RESULTS: We included 112 sleep-related suffocation cases with 448 age-matched controls and 300 unexplained infant death cases with 1200 age-matched controls. Adjusted odds for sleeprelated suffocation ranged from 18.7 (95% confidence interval [CI]: 6.8--51.3) among infants not sharing a room with their mother or caregiver to 1.9 (95% CI: 0.9--4.1) among infants with nonsupine sleep positioning. Adjusted odds for unexplained death ranged from 7.6 (95% CI: 4.7--12.2) among infants not sharing a room with their mother or caregiver to 1.6 (95% CI: 1.1--2.4) among nonsupine positioned infants. COCLUSIONS: We confirmed previously identified risk factors for unexplained infant death and independently estimated risk factors for sleep-related suffocation. Significance of associations for suffocation followed similar patterns but was of larger magnitude. This information can be used to improve messaging about safe infant sleep. [ABSTRACT FROM AUTHOR]

Our study examined novice urban teachers' abilities to impact student learning and development. We interviewed 19 graduates, collecting narratives of critical teaching incidents. Analysis revealed the importance of (a) connecting with learners and of (b) receiving support. Teacher education programs were helpful in preparing graduates to set high expectations, use culturally responsive strategies, and develop relationships to meet diverse learners' needs. Graduates also identified induction supports that helped or hindered effectiveness. [ABSTRACT FROM AUTHOR]

The concept of Use of Self is one of the foundational building blocks of the field of Organization Development (OD). It is the “conscious use of one’s whole being in the intentional execution of one’s role.” Though Use of Self is becoming increasingly well-known as a competency of organization development practitioners, it is less understood as an application for leaders who are primarily responsible for the organization’s health. This article provides insights on how OD practitioners can partner with leaders to integrate the concepts of Use of Self into an organization’s culture. [ABSTRACT FROM AUTHOR]

Some public health professionals have expressed concern that the COVID-19 pandemic has increased vaccine hesitancy about routine childhood vaccines; however, the differential prevalence of vaccine hesitancy about specific vaccines has not been measured. Data from the National Immunization Survey-Child COVID-19 Module (NIS-CCM) were analyzed to assess the proportion of children ages 6 months–17 years who have a parent with hesitancy about: COVID-19, influenza, human papillomavirus (HPV) (for children ≥ 9 years) vaccines, and "all other childhood shots." Interviews from October 2022 through April 2023 were analyzed. The percentage of children with a vaccine-hesitant parent varied by vaccine. 55.9% of children had a parent hesitant about COVID-19 vaccine, 30.9% hesitant about influenza vaccine, 30.1% hesitant about HPV vaccine, and 12.2% had a parent hesitant about other vaccines such as measles, polio, and tetanus. The study findings suggest that differential interventions and communications to parents be used to educate about COVID-19, influenza, HPV, and routine childhood vaccinations because the hesitancy levels differ widely. [ABSTRACT FROM AUTHOR]

Knowing the settings where children ages 5–17 years received COVID-19 vaccination in the United States, and how settings changed over time and varied by socio-demographics, is of interest for planning and implementing vaccination programs. Data from the National Immunization Survey-Child COVID-19 Module (NIS-CCM) were analyzed to assess place of COVID-19 vaccination among vaccinated children ages 5–17 years. Interviews from July 2021 thru May 2022 were included in the analyses for a total of n = 39,286 vaccinated children. The percentage of children receiving their COVID-19 vaccine at each type of setting was calculated overall, by sociodemographic characteristics, and by month of receipt of COVID-19 vaccine. Among vaccinated children ages 5–11 years, 46.9 % were vaccinated at a medical place, 37.1 % at a pharmacy, 8.1 % at a school, 4.7 % at a mass vaccination site, and 3.2 % at some other non-medical place. Among vaccinated children ages 12–17 years, 35.1 % were vaccinated at a medical place, 47.9 % at a pharmacy, 8.3 % at a mass vaccination site, 4.8 % at a school, and 4.0 % at some other non-medical place. The place varied by time among children ages 12–17 years but minimally for children ages 5–11 years. There was variability in the place of COVID-19 vaccination by age, race/ethnicity, health insurance, urbanicity, and region. Children ages 5–17 years predominantly received their COVID-19 vaccinations at pharmacies and medical places. The large proportion of vaccinated children receiving vaccination at pharmacies is indicative of the success in the United States of expanding the available settings where children could be vaccinated. Medical places continue to play a large role in vaccinating children, especially younger children, and should continue to stock COVID-19 vaccine to keep it available for those who are not yet vaccinated, including the newly recommended group of children < 5 years. [ABSTRACT FROM AUTHOR]

Background. The mother-daughter relationship can be central to women who are coping with breast cancer and provide a key source of support. However, the adolescent and young adult (AYA) daughters of diagnosed mothers have been known to exhibit notable distress during this time, withdrawing and avoiding communication, further challenging their ability to cope together. Objective. We sought to identify challenging topics that contribute to this avoidant mother–daughter communication pattern, as a first step in helping mothers and AYA daughters facilitate health-promoting communication. Methods. We examined thematically analyzed transcripts of one-on-one, in-depth, semi-structured interviews with 27 women (12 mother–daughter dyads). Results. We to identified 3 broad topics that were challenging to discuss: daughters' future breast cancer risk; emotionally related concerns; and clinical and physical aspects of disease. Thematic properties illustrate the challenging nature of each topic that informed their ability to communally cope together. Implications. Findings provide an initial roadmap for developing communication skills interventions that help mothers and AYA daughters navigate challenging conversations and facilitate communal coping. [ABSTRACT FROM AUTHOR]

Introduction: CDC estimates that influenza resulted in 9-41 million illnesses, 140,000-710,000 hospitalizations, and 12,000-52,000 deaths annually during 2010-2020. Persons from some racial and ethnic minority groups have historically experienced higher rates of severe influenza and had lower influenza vaccination coverage compared with non-Hispanic White (White) persons. This report examines influenza hospitalization and vaccination rates by race and ethnicity during a 12-13-year period (through the 2021-22 influenza season).Methods: Data from population-based surveillance for laboratory-confirmed influenza-associated hospitalizations in selected states participating in the Influenza-Associated Hospitalization Surveillance Network (FluSurv-NET) from the 2009-10 through 2021-22 influenza seasons (excluding 2020-21) and influenza vaccination coverage data from the Behavioral Risk Factor Surveillance System (BRFSS) from the 2010-11 through 2021-22 influenza seasons were analyzed by race and ethnicity.Results: From 2009-10 through 2021-22, age-adjusted influenza hospitalization rates (hospitalizations per 100,000 population) were higher among non-Hispanic Black (Black) (rate ratio [RR] = 1.8), American Indian or Alaska Native (AI/AN; RR = 1.3), and Hispanic (RR = 1.2) adults, compared with the rate among White adults. During the 2021-22 season, influenza vaccination coverage was lower among Hispanic (37.9%), AI/AN (40.9%), Black (42.0%), and other/multiple race (42.6%) adults compared with that among White (53.9%) and non-Hispanic Asian (Asian) (54.2%) adults; coverage has been consistently higher among White and Asian adults compared with that among Black and Hispanic adults since the 2010-11 season. The disparity in vaccination coverage by race and ethnicity was present among those who reported having medical insurance, a personal health care provider, and a routine medical checkup in the past year.Conclusions and Implications for Public Health Practice: Racial and ethnic disparities in influenza disease severity and influenza vaccination coverage persist. Health care providers should assess patient vaccination status at all medical visits and offer (or provide a referral for) all recommended vaccines. Tailored programmatic efforts to provide influenza vaccination through nontraditional settings, along with national and community-level efforts to improve awareness of the importance of influenza vaccination in preventing illness, hospitalization, and death among racial and ethnic minority communities might help address health care access barriers and improve vaccine confidence, leading to decreases in disparities in influenza vaccination coverage and disease severity. [ABSTRACT FROM AUTHOR]

The number of U.S. births has been declining. There is also concern about rural obstetric units closing. To better understand the relationship between births and obstetric beds during 2000–2019, we examined changes over time in births, birth hospital distributions (i.e., hospital birth volume, ownership, and urban–rural designation), and the ratio of births to obstetric beds. We analyzed American Hospital Association Annual Survey data from 2000 to 2019. We included U.S. hospitals with at least 25 reported births during the year and at least 1 reported obstetric bed. We categorized birth volume to identify and describe hospitals with maternity services using seven categories. We calculated ratios of number of births to number of obstetric beds overall, by annual birth volume category, by three categories of hospital ownership, and by six urban–rural categories. The ratio of births to obstetric beds, which may represent need for maternity services, has stayed relatively consistent at 65 over the past two decades, despite the decline in births and changes in birth hospital distributions. The ratios were smallest in hospitals with < 250 annual births and largest in hospitals with ≥ 7000 annual births. The largest ratios of births to obstetric beds were in large metro areas and the smallest ratios were in noncore areas. At a societal level, the reduction in obstetric beds corresponds with the drop in the U.S. birth rate. However, consistency in the overall ratio can mask important differences that we could not discern, such as the impact of closures on distances to closest maternity care. [ABSTRACT FROM AUTHOR]

Background: Delirium, poor performance status, and dyspnea predict short survival in the palliative care setting.Objective: Our goal was to determine whether these three conditions, which we refer to as a "triple threat," also predict mortality among patients with advanced cancers in the emergency department (ED).Methods: The study sample included 243 randomly selected, clinically stable patients with advanced cancer who presented to our ED. The analysis included patients who had delirium (Memorial Delirium Assessment Scale score ≥ 7), poor performance status (Eastern Cooperative Oncology Group performance status score of 3 or 4), or dyspnea as a presenting symptom. We obtained survival data from medical records. We calculated predicted probability of dying within 30 days and association with number of symptoms after the ED visit using logistic regression analysis.Results: Twenty-eight patients died within 30 days after presenting to the ED. Death within 30 days occurred in 36% (16 of 44) of patients with delirium, 28% (17 of 61) of patients with poor performance status, and 14% (7 of 50) of patients with dyspnea, with a predicted probability of 30-day mortality of 0.38 (95% confidence interval [CI] 0.25-0.53), 0.28 (95% CI 0.18-0.40), and 0.15 (95% CI 0.07-0.29), respectively. The predicted probability of death within 30 days for patients with two or three of the conditions was 0.49 (95% CI 0.34-0.66) vs. 0.05 (95% CI 0.02-0.09) for patients with none or one of the conditions.Conclusions: Patients with advanced cancers who present to the ED and have at least two triple threat conditions have a high probability of death within 30 days. [ABSTRACT FROM AUTHOR]

Triple-negative breast cancer (TNBC) is a heterogeneous disease that accounts for 10–15% of all breast cancer cases. Within TNBC, the treatment of basal B is the most challenging due to its highly invasive potential, and thus treatments to suppress metastasis formation in this subgroup are urgently needed. However, the mechanisms underlying the metastatic ability of TNBC remain unclear. In the present study, we investigated the role of Aurora A and Bcl-xL in regulating basal B cell invasion. We found gene amplification and elevated protein expression in the basal B cells, which also showed increased invasiveness in vitro, compared to basal A cells. Chemical inhibition of Aurora A with alisertib and siRNA-mediated knockdown of BCL2L1 decreased the number of invading cells compared to non-treated cells in basal B cell lines. The analysis of the correlation between AURKA and BCL2L1 expression in TNBC and patient survival revealed significantly decreased relapse-free survival (n = 534, p = 0.012) and distant metastasis-free survival (n = 424, p = 0.017) in patients with primary tumors exhibiting a high combined expression of AURKA and BCL2L1. Together, our findings suggest that high levels of Aurora A and Bcl-xL promote metastasis, and inhibition of these proteins may suppress metastasis and improve patient survival in basal B TNBC. [ABSTRACT FROM AUTHOR]

Objective: We examined the effects of the family communication environment (conversation orientation) on adult child caregivers' burden and clinical interactions and if the effects are mediated by openness to communicate about cancer, avoidant cancer communication, and social support (SS). Method: Caregivers of a parent diagnosed with a blood cancer (N = 121) completed an online survey of validated measures of conversation orientation (i.e., the extent to which families openly communicate), SS, cancer openness, avoidance, caregiver burden, clinical communication skills, and quality of clinical interactions (QCI). Results: Conversation orientation had significant indirect effects on caregiver burden, mediated by SS (β = −0.11, p < 0.001), as well as cancer openness and avoidance (β = −0.07, p < 0.001). Conversation orientation also had significant indirect effects on caregivers' communication skills with a parent's clinician, mediated by avoidance (β = 0.08, p < 0.01) and SS (β = 0.06, p < 0.001). Finally, conversation orientation had significant indirect effects on caregivers' QCI mediated by avoidance (β = 0.71, p < 0.05). Conclusions: Adult child caregivers whose families communicate more openly exhibit less caregiver burden and report better clinical interaction skills and perceived quality of the clinical interaction. Avoidance emerged as a key mediating factor. Caregivers from less open communication environments may benefit from interventions that help them navigate challenging but critical caregiving conversations. [ABSTRACT FROM AUTHOR]

Freshwater mussels are important for nutrient cycling and ecosystem health as they filter feed on their surrounding water. This filter feeding makes these bivalves especially sensitive to conditions in their environment. Gut microbial communities (microbiomes) have been recognised as important to both host organism and ecosystem health; however, how freshwater mussel microbiomes are organised and influenced is unclear.In this study, the gut bacterial microbiome of Threeridge mussel, Amblema plicata, was compared across two river basins, five rivers, and nine local sites in the south‐eastern U.S.A. Mussel gut tissue was dissected, DNA extracted, and the microbiome characterised by high throughput sequencing of the V4 region of the 16S ribosomal RNA gene.Planctomycetes, Firmicutes, and Cyanobacteria were the most common bacterial phyla within the guts of all sampled A. plicata. However, the relative abundances of these major bacterial phyla differed between mussels sampled from different rivers and river basins, as did the relative abundance of specific bacterial operational taxonomic units (OTUs). Despite these differences, a core microbiome was identified across all mussels, with eight OTUs being consistent members of the A. plicata microbiome at all sites, the most abundant OTU identifying as a member of the family Planctomycetaceae. Geographic distance between sites was not correlated with similarity in the structure of the gut microbiome, which was more related to site physicochemistry.Overall, these results suggest that while physicochemical conditions affect the composition of transient bacteria in the Threeridge mussel gut microbiome, the core microbiome is largely unaffected, and a portion of the A. plicata microbiome is retained regardless of the river system.How long transient bacteria remain in the gut, and to what extent these transient microbes aid in host function is still unknown. Core microbiota have been found to aid in multiple functions within animal hosts, and within freshwater mussels this core microbiome may aid in nutrient processing and cycling. Therefore, it is important to look at both transient and core microbes when studying the structure of freshwater invertebrate microbiomes. [ABSTRACT FROM AUTHOR]

Simple Summary: Around 30% of children with Down Syndrome (DS) will develop Transient Abnormal Myelopoiesis (TAM) and 20% of them will progress to Acute Myeloid Leukemia (AML), mostly Megakaryoblastic Leukemia (AMKL). The optimal balance between treatment intensity and treatment-related toxicity has not yet been defined; neither the prognostic factors that determine the risk of developing AML nor the outcome. The aims of our retrospective study were to analyze the demographic/biological features of this population, identify possible risk factors and the optimal treatment. We observed that early intervention in TAM is effective to prevent a dismal outcome. The strongest poor-prognostic factor of DS-AML was sporadic DS-AML (non-AMKL immunophenotype), as well as complex karyotype and young age. Classical Myeloid Leukemia associated with DS (ML-DS) good outcome is mainly related to their low relapse rate. Even though the augmented sensitivity to chemotherapy seen in DS patients must be kept in mind, our data do not support the omission of high doses of cytarabine in ML-DS. Children with Down syndrome (DS) are at an increased risk of developing clonal myeloproliferative disorders. The balance between treatment intensity and treatment-related toxicity has not yet been defined. We analyzed this population to identify risk factors and optimal treatment. This single-center retrospective study included 78 DS patients <16 years-old with Transient Abnormal Myelopoiesis (TAM, n = 25), Acute Myeloblastic Leukemia (DS-AML, n = 41) of which 35 had classical Myeloid Leukemia associated with DS (ML-DS) with megakaryoblastic immunophenotype (AMKL) and 6 sporadic DS-AML (non-AMKL). Patients with DS-AML were treated according to four BFM-based protocols. Classical ML-DS vs. non-DS-AMKL were compared and the outcome of ML-DS was analyzed according to treatment intensity. Only four patients with TAM required cytoreduction with a 5-year Event-Free Survival probability (EFSp) of 74.4 (±9.1)%. DS-AML treatment-related deaths were due to infections, with a 5-year EFSp of 60.6 (±8.2)%. Megakaryoblastic immunophenotype was the strongest good-prognostic factor in univariate and multivariate analysis (p = 0.000). When compared ML-DS with non-DS-AMKL, a better outcome was associated with a lower relapse rate (p = 0.0002). Analysis of administered treatment was done on 32/33 ML-DS patients who achieved CR according to receiving or not high-dose ARA-C block (HDARA-C), and no difference in 5-year EFSp was observed (p = 0.172). TAM rarely required treatment and when severe manifestations occurred, early intervention was effective. DS-AML good outcome was associated with AMKL with a low relapse-rate. Even if treatment-related mortality is still high, our data do not support the omission of HDARA-C in ML-DS since we observed a trend to detect a higher relapse rate in the arm without HDARA-C. [ABSTRACT FROM AUTHOR]

Some state health departments in the United States are in the process of increasing access to immediate postpartum long-acting reversible contraception (LARC), an evidence based approach to preventing unintended pregnancy. Changing state Medicaid policies for immediate postpartum LARC reimbursement has proven insufficient for overcoming access barriers, so states developed implementation strategies to conduct multiple, coordinated systems changes. This research was conducted to understand the roles of social networks in implementing a complex health systems change. In 2015 and 2018, semi-structured telephone interviews were conducted with state teams engaged in increasing access to immediate postpartum LARC. Transcriptions of interviews were coded based on the Consolidated Framework for Implementation Research and implementation strategies, then themes were refined through discussion. A web-based assessment in 2018 evaluated degree of implementation accomplishment. Teams found that increased formal or informal social engagement among members aided timeliness, resource coordination, accountability, and enthusiasm, and over the course of 2 years, reduced disruptions due to staff turnover. The composition of the team influenced the social ties it could draw upon. Preexisting relationships were the most common source of social networking. Bridging social ties connected state teams to novel information and instrumental aid used to seek funding, conduct consumer awareness activities, and train healthcare providers. Cultivating and maintaining relationships among agencies and organizations as part of routine operations enables them to be available for future implementation efforts. Multi-agency teams may benefit from prioritizing time for internal and external relationship-building to enhance implementation progress. [ABSTRACT FROM AUTHOR]

The Increasing Access to Contraception Learning Community was established to disseminate strategies and best practices to support 27 jurisdictions in the development of policies and programs to increase access to the full range of reversible contraceptives. We describe Learning Community activities and identify those that were most useful to participants. Although participation in Learning Community provided jurisdictional teams with structured activities such as virtual learning and peer networking opportunities, some teams struggled with full participation because of staffing turnover and shifts in priorities. (Am J Public Health. 2022;112(S5):S523–S527. https://doi.org/10.2105/AJPH.2022.306823) [ABSTRACT FROM AUTHOR]

Neonatal chest-Xray (CXR)s are commonly performed as a first line investigation for the evaluation of respiratory complications. Although lung area derived from CXRs correlates well with functional assessments of the neonatal lung, it is not currently utilised in clinical practice, partly due to the lack of reference ranges for CXR-derived lung area in healthy neonates. Advanced MR techniques now enable direct evaluation of both fetal pulmonary volume and area. This study therefore aims to generate reference ranges for pulmonary volume and area in uncomplicated pregnancies, evaluate the correlation between prenatal pulmonary volume and area, as well as to assess the agreement between antenatal MRI-derived and neonatal CXR-derived pulmonary area in a cohort of fetuses that delivered shortly after the antenatal MRI investigation. Fetal MRI datasets were retrospectively analysed from uncomplicated term pregnancies and a preterm cohort that delivered within 72 h of the fetal MRI. All examinations included T2 weighted single-shot turbo spin echo images in multiple planes. In-house pipelines were applied to correct for fetal motion using deformable slice-to-volume reconstruction. An MRI-derived lung area was manually segmented from the average intensity projection (AIP) images generated. Postnatal lung area in the preterm cohort was measured from neonatal CXRs within 24 h of delivery. Pearson correlation coefficient was used to correlate MRI-derived lung volume and area. A two-way absolute agreement was performed between the MRI-derived AIP lung area and CXR-derived lung area. Datasets from 180 controls and 10 preterm fetuses were suitable for analysis. Mean gestational age at MRI was 28.6 ± 4.2 weeks for controls and 28.7 ± 2.7 weeks for preterm neonates. MRI-derived lung area correlated strongly with lung volumes (p < 0.001). MRI-derived lung area had good agreement with the neonatal CXR-derived lung area in the preterm cohort [both lungs = 0.982]. MRI-derived pulmonary area correlates well with absolute pulmonary volume and there is good correlation between MRI-derived pulmonary area and postnatal CXR-derived lung area when delivery occurs within a few days of the MRI examination. This may indicate that fetal MRI derived lung area may prove to be useful reference ranges for pulmonary areas derived from CXRs obtained in the perinatal period. • Refrence ranges were derived from segmentation of fetal lung areas on AIP-MRI images and correlates with CXR-derived data in preterm infants • Fetal MRI-derived lung area correlated well with fetal MR pulmonary volume and postnatal CXR-lung area. This may prove to be a useful reference range for pulmonary areas derived from CXRs obtained in the perinatal period. • The findings suggest that fetal MRI measurements can serve as useful reference points for assessing lung area in high-risk neonatal CXRs. [ABSTRACT FROM AUTHOR]

There is an urgent need for novel antidepressants, given that approximately 30% of those diagnosed with depression do not respond adequately to first-line treatment. Additionally, monoaminergic-based antidepressants have a substantial therapeutic time-lag, often taking months to reach full therapeutic effect. Ketamine, an N -methyl- d -aspartate receptor (NMDAR) antagonist is the only current effective rapid-acting antidepressant, demonstrating efficacy within hours and lasting up to two weeks with an acute dose. Reelin, an extracellular matrix glycoprotein, has demonstrated rapid-acting antidepressant-like effects at 24 h, however the exact timescale of these effects has not been investigated. To determine the short and long-term effects of reelin, female Long Evans rats (n = 120) underwent a chronic corticosterone (CORT; or vehicle) paradigm (40 mg/kg, 21 days). On day 21, rats were treated with reelin (3μg; i.v.), ketamine (10 mg/kg; i.p.), both reelin and ketamine (same doses), or vehicle (saline). Behavioural and biological effects were then evaluated at 1 h, 6 h, 12 h, and 1 week after treatment. The 1-week cohort continued CORT injections to ensure the effect of chronic stress was not lost. Individually, both reelin and ketamine significantly rescued CORT-induced behaviour and hippocampal reelin expression at all timepoints. Ketamine rescued a decrease in dendritic maturity as induced by CORT. Synergistic effects of reelin and ketamine appeared at 1-week, suggesting a potential additive effect of the antidepressant-like actions. Taken together, this study provides further support for reelin-based therapeutics to develop rapid-acting antidepressant. • Reelin and ketamine rescue behavioural indicators of chronic stress across multiple timepoints. • Hippocampal reelin expression increased as fast as 1 h after reelin and ketamine treatment. • Ketamine rescued decreases in dendritic maturity after chronic stress. • Synergistic effects of reelin and ketamine appeared at 1 week after treatment. • Reelin, similar to ketamine, may have promise as a rapid-acting antidepressant. [ABSTRACT FROM AUTHOR]

Turning Point Analysis (TPA) is a methodological approach that allows scholars to retrospectively capture change over time by identifying instances of critical change (i.e., turning points) encountered across a given time period. While TPA has been used to examine time as a variable in health and illness experiences, the use of the method in behavioral medicine scholarship may be limited by the lack of understanding of TPA procedures and applicability. To describe how TPA has been used and enhance its accessibility by identifying and synthesizing methods of TPA data collection and analysis. A systematic search of electronic databases, including Academic Source Premier, Psychology and Behavioral Sciences Collection, APA PsycInfo, and ProQuest Dissertation and Theses Database, was conducted in May 2020. In July 2020, we used hand searching to identify additional articles, including forward and back tracking seminal articles on TPA. Studies were screened in duplicate. Of the 1184 studies screened for this review, we included 52. Studies used TPA to examine relational (k = 40), organizational (k = 6), and individual (k = 6) variables and included an analysis of either turning points (k = 28), the trajectories of change over time created by the turning points (k = 3), or both (k = 21). Turning points and trajectories were captured and analyzed using qualitative and quantitative analytic approaches, with most studies using either purely qualitative (k = 26) or mixed methods (k = 21). The findings of this review provide insight into the varied applications of TPA and suggest the potential value of this methodological approach in better understanding health experiences across time. By synthesizing the procedural and analytic steps to conducting a TPA, this review could also increase the accessibility and use of TPA in behavioral medicine research. • Turning point analysis (TPA) captures change over time in social contexts. • TPA has utility in health research as time is integral in illness experiences. • The TPA methodological approach be customized to fit different research contexts. [ABSTRACT FROM AUTHOR]

Simple Summary: Genetic animal models are a valuable tool for understanding how human pathologies develop. The type of animal model chosen is important for uncovering effects specific to certain behaviours and neurobiological functions. A polymorphism in the brain-derived neurotrophic factor (BDNF) has been linked with various clinical conditions in human subjects and with mouse models of anorectic behaviour. This study investigated for the first time the role of the BDNF Val66Met allelic substitution in a rat model of anorexia nervosa (AN), known as activity-based anorexia (ABA). Contrary to reports of altered BDNF signaling in patients with AN and increased anorectic behaviour in a mouse model containing the same allelic variation, it showed that 66Met did not alter susceptibility to weight loss or aspects of energy balance, including feeding and exercise in the rat model. It highlights the need to consider species–specific differences when evaluating animal models of human pathologies. Brain-derived neurotrophic factor (BDNF) is abundantly expressed in brain regions involved in both homeostatic and hedonic feeding, and it circulates at reduced levels in patients with anorexia nervosa (AN). A single nucleotide polymorphism in the gene encoding for BDNF (Val66Met) has been associated with worse outcomes in patients with AN, and it is shown to promote anorectic behaviour in a mouse model of caloric restriction paired with social isolation stress. Previous animal models of the Val66Met polymorphism have been in mice because of the greater ease in modification of the mouse genome, however, the most widely-accepted animal model of AN, known as activity-based anorexia (ABA), is most commonly conducted in rats. Here, we examine ABA outcomes in a novel rat model of the BDNF Val66Met allelic variation (Val68Met), and we investigate the role of this polymorphism in feeding, food choice and sucrose preference, and energy expenditure. We demonstrate that the BDNF Val68Met polymorphism does not influence susceptibility to ABA or any aspect of feeding behaviour. The discrepancy between these results and previous reports in mice may relate to species–specific differences in stress reactivity. [ABSTRACT FROM AUTHOR]

Animals can have pervasive effects on ecosystems as they modify their biogeochemical and physical environments. In particular, when animals occur in high densities these effects can result in dramatic changes in the physical environment and biogeochemical hotspots or hot moments. While most research to date has focused on the direct role of animals in biogeochemical cycles, few have examined how animals indirectly influence biogeochemical cycles across scales.Freshwater mussels occur as spatially heterogeneous, dense and species‐rich aggregations in many river ecosystems world‐wide. Here we examined how mussel communities (a) directly influence the flux of particulate and dissolved nutrients and (b) indirectly effect the flux of N2 production, via denitrification, across a gradient of mussel biomass and differences in community composition at the patch‐ (0.25 m2) and stream reach‐scales (60–80 m).We combined measurements of ammonia (N) and soluble reactive phosphorous (P) excretion and C, N and P biodeposition rates for 10 species with biomass and distribution estimates for seven mixed‐species aggregations to quantify direct mussel contributions to biogeochemical cycling and the spatial heterogeneity of their impact. Additionally, we sampled sediments at a fine spatial scale to determine how mussel biomass and richness influence potential denitrification (indirect flux) rates at the patch‐ and reach‐scales.We predicted that increasing mussel biomass would lead to greater direct and indirect fluxes of nutrients, manifesting in heterogeneous nutrient redistribution within and among stream reaches. We also predicted that variation in community composition would result in differential nutrient excretion and egestion stoichiometries.Our results indicate that mussel aggregations directly influence soluble and particulate nutrient fluxes with community composition, particularly phylogenetic tribe composition, controlling the stoichiometry. Mussel aggregations also indirectly influenced nutrient fluxes as greater mussel biomass and species richness resulted in higher denitrification rates as mediated by their interactions with the sediments and enhancement of nutrient availability. Our results underscore the importance of patchy communities in acting as biogeochemical control points. A free Plain Language Summary can be found within the Supporting Information of this article. [ABSTRACT FROM AUTHOR]

Objectives: The Utah Study of Associated Risks of Stillbirth (SOARS) collects data about stillbirths that are not included in medical records or on fetal death certificates. We describe the design, methods, and survey response rate from the first year of SOARS. Methods: The Utah Department of Health identified all Utah women who experienced a stillbirth from June 1, 2018, through May 31, 2019, via fetal death certificates and invited them to participate in SOARS. The research team based the study protocol on the Pregnancy Risk Assessment Monitoring System surveillance of women with live births and modified it to be sensitive to women's recent experience of a stillbirth. We used fetal death certificates to examine survey response rates overall and by maternal characteristics, gestational age of the fetus, and month in which the loss occurred. Results: Of 288 women invited to participate in the study, 167 (58.0%) completed the survey; 149 (89.2%) responded by mail and 18 (10.8%) by telephone. A higher proportion of women who were non-Hispanic White (vs other races/ethnicities), were married (vs unmarried), and had ≥high school education (vs

Several states have recently changed their business organization law to accommodate autonomous businesses--businesses operated entirely through computer code. A variety of international civil society groups are also actively developing new frameworks--and a model law--for enabling decentralized, autonomous businesses to achieve a corporate or corporate-like status that bestows legal personhood. Meanwhile, various jurisdictions, including the European Union, have considered whether and to what extent artificial intelligence (AI) more broadly should be endowed with personhood to respond to AI's increasing presence in society. Despite the fairly obvious overlap between the two sets of inquiries, the legal and policy discussions between the two only rarely overlap. As a result of this failure to communicate, both areas of personhood theory fail to account for the important role that socio-technical and socio-legal context plays in law and policy development. This Article fills the gap by investigating the limits of artificial rights at the intersection of corporations and artificial intelligence. Specifically, this Article argues that building a comprehensive legal approach to artificial rights--rights enjoyed by artificial people, whether corporate entity, machine, or otherwise--requires approaching the issue through a systems lens to ensure that the legal system adequately considers the varied socio-technical contexts in which artificial people exist. To make these claims, this Article begins by establishing a terminology baseline, and emphasizing the importance of viewing AI as part of a socio-technical system. Part I then concludes by reviewing the existing ecosystem of autonomous corporations. Parts II and III then examine the existing debates around artificially intelligent persons and corporate personhood, arguing that the socio-legal needs driving artificial personhood debates in both contexts include: protecting the rights of natural people, upholding social values, and creating a fiction for legal convenience. Parts II and III also explore the extent to which the theories from either set of literature fits the reality of autonomous businesses, illuminating gaps and using them to demonstrate that the law must consider the socio-technical context of AI systems and the socio-legal complexity of corporations to decide how autonomous businesses will interact with the world. Ultimately, the Article identifies and leverages links between both areas of legal personhood to demonstrate the Article's core claim: developing law for artificial systems in any context should use the systems nature of the technical artifact to tie its legal treatment directly to the system's socio-technical reality. [ABSTRACT FROM AUTHOR]

Robustness and resilience are widely used in the biological sciences and related disciplines to describe how systems respond to change. Robustness is the ability to tolerate change without adapting or moving to another state. Resilience refers to the ability for a system to sustain a perturbation and maintain critical functions. Robustness and resilience transcend levels of biological organization, though they do not scale directly across levels. We live in an era of novel stressors and unprecedented change, including climate change, emerging environmental contaminants, and changes to the Earth's biogeochemical and hydrological cycles. We envision a common framework for developing models to predict the robustness and resilience of biological functions associated with complex systems that can transcend disciplinary boundaries. Conceptual and quantitative models of robustness and resilience must consider cross-scale interactions of potentially infinite complexity, but it is impossible to capture everything within a single model. Here, we discuss the need to balance accuracy and complexity when designing models, data collection, and downstream analyses to study robustness and resilience. We also consider the difficulties in defining the spatiotemporal domain when studying robustness and resilience as an emergent property of a complex system. We suggest a framework for implementing transdisciplinary research on robustness and resilience of biological systems that draws on participatory stakeholder engagement methods from the fields of conservation and natural resources management. Further, we suggest that a common, simplified model development framework for describing complex biological systems will provide new, broadly relevant educational tools. Efficient interdisciplinary collaboration to accurately develop a model of robustness and resilience would enable rapid, context-specific assessment of complex biological systems with benefits for a broad range of societally relevant problems. [ABSTRACT FROM AUTHOR]

We investigated the impact of stressful life events (SLEs) for males and females on transitions in problematic alcohol involvement, both progression and recovery, over a 3-year interval. Participants of both Wave 1 (2001–2002) and Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were stratified by sex (14,233 males and 19,550 females). Latent transition analysis estimated the impact of experiencing ≥3 SLE in the year preceding the Wave 1 interview on the probability of transitioning between three empirically-derived stages of alcohol involvement (patterns of alcohol use disorder [AUD] symptoms), across waves. Propensity score methods adjusted for confounding. For males, three or more SLEs were associated with progression from the moderate to the severe problem stage (odds ratio [OR] = 2.23, 95% confidence interval [CI] = 1.17, 4.26). Among those in the severe problem stage, SLEs negatively impacted recovery regardless of sex. Employment/Financial SLEs were associated with a higher odds of transition from the moderate to the no problem stage (OR = 1.60, 95% CI = 1.03, 2.46) and lower odds of transitions from the severe to the moderate problem stage (OR = 0.40, 95% CI = 0.16, 0.99) among males, and from the severe to the no problem stage (OR = 0.26, 95% CI = 0.07, 0.88) among females. Stressful life events appear to affect transitions in alcohol involvement over time among those who already have alcohol problems, rather than impacting a transition among those without AUD problems. [ABSTRACT FROM AUTHOR]

Pregnant women are at increased risk for severe COVID-19-related illness, and COVID-19 is associated with an increased risk for adverse pregnancy outcomes and maternal and neonatal complications (1-3). To date, studies assessing whether COVID-19 during pregnancy is associated with increased risk for stillbirth have yielded mixed results (2-4). Since the B.1.617.2 (Delta) variant of SARS-CoV-2 (the virus that causes COVID-19) became the predominant circulating variant,* there have been anecdotal reports of increasing rates of stillbirths in women with COVID-19.† CDC used the Premier Healthcare Database Special COVID-19 Release (PHD-SR), a large hospital-based administrative database,§ to assess whether a maternal COVID-19 diagnosis documented at delivery hospitalization was associated with stillbirth during March 2020-September 2021 as well as before and during the period of Delta variant predominance in the United States (March 2020-June 2021 and July-September 2021, respectively). Among 1,249,634 deliveries during March 2020-September 2021, stillbirths were rare (8,154; 0.65%): 273 (1.26%) occurred among 21,653 deliveries to women with COVID-19 documented at the delivery hospitalization, and 7,881 (0.64%) occurred among 1,227,981 deliveries without COVID-19. The adjusted risk for stillbirth was higher in deliveries with COVID-19 compared with deliveries without COVID-19 during March 2020-September 2021 (adjusted relative risk [aRR] = 1.90; 95% CI = 1.69-2.15), including during the pre-Delta (aRR = 1.47; 95% CI = 1.27-1.71) and Delta periods (aRR = 4.04; 95% CI = 3.28-4.97). COVID-19 documented at delivery was associated with increased risk for stillbirth, with a stronger association during the period of Delta variant predominance. Implementing evidence-based COVID-19 prevention strategies, including vaccination before or during pregnancy, is critical to reducing the impact of COVID-19 on stillbirths. [ABSTRACT FROM AUTHOR]

The aims of the current project included to (a) describe the use of connectives in written language samples by fifth grade students, (b) examine differences in connective use between groups who differed in English proficiency and exceptionalities, and (c) examine the predictive relationship between connective measures and writing quality ratings. Investigators utilized written expository responses of 1,128 students in fifth grade who differed in English proficiency and language ability. The sample included 214 English learners and 144 students with language learning disabilities (LLD). Group differences were examined in the use of advanced connective words in academic writing. Regression analysis was used to examine connective measures as predictors of overall writing quality rating. Students with LLD used advanced connectives less frequently than their peers and demonstrated less variety in their connective word use. Two connective measures (total number of advanced connectives and the ratio of connectives) were significant predictors of writing quality. Findings support the need for additional efforts to improve the use of cohesive devices in academic writing for students with LLD to minimize achievement gaps. [ABSTRACT FROM AUTHOR]

A contract generally only binds its parties. Security agreements, which create a security interest in specific personal property, stand out as a glaring exception to this rule. Under certain conditions, security interests not only bind the creditor and debtor, but also third-party creditors seeking to lend against the same collateral. To receive this extraordinary benefit, creditors must put the world on notice, usually by filing a financing statement with the state in which the debtor is located. Unfortunately, the Uniform Commercial Code (U.C.C.) Article 9 filing system fails to provide actual notice to interested parties and introduces risk of heavy financial losses. To solve this problem, this Article introduces a smart-contract-based U.C.C.-1 form built using Lexon, an innovative new programming language that enables the development of smart contracts in English. The proposed “Lexon U.C.C. Financing Statement” does much more than merely replicate the financing statement in digital form; it also performs several U.C.C. rules so that, for the first time, the filing system works as intended. In demonstrating that such a system remains compatible with existing law, the Lexon U.C.C. Financing Statement also reveals important lessons about the interaction of technology and commercial law. This Article brings cryptolaw to the U.C.C. in three parts. Part I examines the failure of the U.C.C. Article 9 filing system to achieve actual notice and argues that blockchain technology and smart contracts can help the system function as intended. Part II introduces the Lexon U.C.C. Financing Statement, demonstrating how the computer code implements U.C.C. provisions. Part II also examines the goals that influenced the design of the Lexon U.C.C. Financing Statement, discusses the new programming language used to build it, and argues that the prototype could be used now, under existing law. Part III proposes five innovations for the Article 9 filing system enabled by the Lexon U.C.C. Financing Statement. Part III then considers the broader implications of the project for commercial law, legal research around smart contracts, and the interplay between technology-neutral law and a lawyer’s increasingly important duty of technological competence. Ultimately, by providing the computer code needed to build the Lexon U.C.C. Financing Statement, this Article demonstrates not only that crypto-legal structures are possible, but that they can simplify the law and make it more accessible. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the relationship between urbanization and upper respiratory health in two early modern populations from the Netherlands. For this purpose, we analyzed the prevalence of chronic maxillary sinusitis in the adult urban population of Arnhem (n = 83) and in the rural village of Middenbeemster (n = 74). A slightly higher prevalence of chronic maxillary sinusitis was observed in the Arnhem sample (55.4%) compared with the Middenbeemster sample (51.3%), and these variations were not statistically significantly different. Although historical sources attest to the fact that life in the postmedieval settlements of Arnhem and Middenbeemster greatly differed, our results suggest that both environments exposed people to certain respiratory hazards. Furthermore, sinusitis prevalence was also investigated in correlation to sex, as urbanization in the Netherlands often involved women in factory work in direct contrast to the traditional domestic role they kept covering in rural environments. No significant differences were observed between males and females, both in an intersite (Arnhem males vs. Middenbeemster males; Arnhem females vs. Middenbeemster females) and in an intrasite (males vs. females at Arnhem; males vs. females at Middenbemster) comparison. As men and women in Arnhem worked on similar tasks, our results confirm that they were both exposed to similar risk factors. In Middenbeemster, where women mainly stayed inside taking care of the house while men worked the fields, the adverse weather conditions and continuous exposure to pollens and allergens may have enhanced men's chances of contracting chronic maxillary sinusitis. This study suggests that urbanization in the early modern Netherlands was in fact not inherently more detrimental than rural living. Future research incorporating a larger sample from other Dutch sites is being considered to better frame the complex etiology of sinusitis within the present understanding of historic regional variation in urbanization patterns. [ABSTRACT FROM AUTHOR]

Background: During October 2016 through May 2018, a learning community was convened to focus on policies and programs to increase access to the full range of contraceptive options for women of reproductive age. The Increasing Access to Contraception (IAC) Learning Community included 27 jurisdictions, with teams from each jurisdiction consisting of state health department leaders, program staff, and provider champions. At the kick-off meeting, teams from each jurisdiction created action plans that outlined their goals. Methods: We contacted jurisdictions during May–June 2019, 1 year after the learning community ended, and invited them to complete a post-assessment of goal achievement and sustainment through semi-structured interviews over the telephone or via email. Results: Follow-up information was collected from 26 jurisdictions (96%) that participated in the learning community. The teams from these jurisdictions had created 79 total goals. At the time of the learning community closing meeting in May 2018, 35 goals (44%) had been achieved. Three jurisdictions achieved all their goals by the close of the learning community. At the time of the post-assessment 1 year later, jurisdictions were sustaining efforts for 69 (87%) of the total goals. In every jurisdiction, work on at least one goal that originated in the learning community was sustained. Conclusions: The jurisdictions that participated in the IAC Learning Community continued the work of their action plan goals 1 year after the formal closure of the learning community, indicating sustainability of the learning community activities, beyond what jurisdictions accomplished during formal participation. [ABSTRACT FROM AUTHOR]

We consider random perturbations of a topologically transitive local diffeomorphism of a Riemannian manifold. We show that if an absolutely continuous ergodic stationary measures is expanding (all Lyapunov exponents positive), then there is a random Gibbs–Markov–Young structure which can be used to lift that measure. We also prove that if the original map admits a finite number of expanding invariant measures then the stationary measures of a sufficiently small stochastic perturbation are expanding. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Prior studies of patients treated for breast cancer during pregnancy (PrBC) report mixed outcomes and are limited by substandard treatment, small cohorts, and short follow‐up. This study compared survival outcomes of PrBC patients treated with chemotherapy during pregnancy with nonpregnant patients matched by age, year of diagnosis, stage, and subtype.PrBC patients treated from 1989 to 2022 on prospective institutional protocols were eligible. Disease‐free survival (DFS), overall survival (OS), and progression‐free survival (PFS) were estimated using the Kaplan–Meier method and multivariable Cox proportional hazards regression.Among 143 PrBC and 285 nonpregnant patients, median follow‐up was 11.4 years. Survival differences were statistically significant, with median DFS and OS not attained for PrBC patients versus 5.6 years (95% confidence interval [CI], 3.6–15.4; p = .0001) and 19.3 years (95% CI, 14.1–not estimated; p = .0262) for nonpregnant patients, respectively. Median PFS was 24.1 years (95% CI, 15.8–not estimated) for PrBC patients versus 8.4 years (95% CI, 6.4–10.9) for the nonpregnant cohort (p = .0008). Study cohort was associated with DFS, PFS, and OS in multivariable analyses, with the nonpregnant cohort having increased risks of disease recurrence (hazard ratio [HR], 1.91; 95% CI, 1.33–2.76; p = .0005) and disease progression or death (HR, 1.68; 95% CI, 1.19–2.39; p = .0035), and shorter OS (HR, 1.52; 95% CI, 1.01–2.29; p = .0442).These data suggest that PrBC patients treated with chemotherapy during pregnancy have at least comparable, if not superior, outcomes than nonpregnant patients with similar age, cancer stage, and subtype. Analyses excluding patients with postpartum breast cancer were unable to be performed and are a priority for future confirmatory studies. [ABSTRACT FROM AUTHOR]

Cytopathology induced by methamphetamine (METH) is reminiscent of degenerative disorders such as Parkinson's disease, and it is characterized by membrane organelles arranged in tubulo-vesicular structures. These areas, appearing as clusters of vesicles, have never been defined concerning the presence of specific organelles. Therefore, the present study aimed to identify the relative and absolute area of specific membrane-bound organelles following a moderate dose (100 µM) of METH administered to catecholamine-containing PC12 cells. Organelles and antigens were detected by immunofluorescence, and they were further quantified by plain electron microscopy and in situ stoichiometry. This analysis indicated an increase in autophagosomes and damaged mitochondria along with a decrease in lysosomes and healthy mitochondria. Following METH, a severe dissipation of hallmark proteins from their own vesicles was measured. In fact, the amounts of LC3 and p62 were reduced within autophagy vacuoles compared with the whole cytosol. Similarly, LAMP1 and Cathepsin-D within lysosomes were reduced. These findings suggest a loss of compartmentalization and confirm a decrease in the competence of cell clearing organelles during catecholamine degeneration. Such cell entropy is consistent with a loss of energy stores, which routinely govern appropriate subcellular compartmentalization. [ABSTRACT FROM AUTHOR]

Background Evidence on risk for adverse outcomes from coronavirus disease 2019 (COVID-19) among pregnant women is still emerging. We examined the association between COVID-19 at delivery and adverse pregnancy outcomes, maternal complications, and severe illness, and whether these associations differ by race/ethnicity, and describe discharge status by COVID-19 diagnosis and maternal complications. Methods Data from 703 hospitals in the Premier Healthcare Database during March–September 2020 were included. Adjusted risk ratios (aRRs) overall and stratified by race/ethnicity were estimated using Poisson regression with robust standard errors. Proportion not discharged home was calculated by maternal complications, stratified by COVID-19 diagnosis. Results Among 489 471 delivery hospitalizations, 6550 (1.3%) had a COVID-19 diagnosis. In adjusted models, COVID-19 was associated with increased risk for acute respiratory distress syndrome (aRR, 34.4), death (aRR, 17.0), sepsis (aRR, 13.6), mechanical ventilation (aRR, 12.7), shock (aRR, 5.1), intensive care unit admission (aRR, 3.6), acute renal failure (aRR, 3.5), thromboembolic disease (aRR, 2.7), adverse cardiac event/outcome (aRR, 2.2), and preterm labor with preterm delivery (aRR, 1.2). Risk for any maternal complications or for any severe illness did not significantly differ by race/ethnicity. Discharge status did not differ by COVID-19; however, among women with concurrent maternal complications, a greater proportion of those with (vs without) COVID-19 were not discharged home. Conclusions These findings emphasize the importance of implementing recommended prevention strategies to reduce risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and further inform counseling and clinical care for pregnant women during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

• Expert regulatory safety inspectors' judgments were biased by background information. • Professionals reported being unaware that information biased their judgments. • Judgments lacked consistency and this was not explained by experience. • Findings are discussed in relation to safety inspection and professional judgment. • Article provides useful suggestions regarding bias mitigation in safety inspection. Introduction: A critical aspect of occupational safety is workplace inspections by experts, in which hazards are identified. Scientific research demonstrates that expectation generated by context (i.e., prior knowledge and experience) can bias the judgments of professionals and that individuals are largely unaware when their judgments are affected by bias. Method: The current research tested the reliability and biasability of expert safety inspectors' judgments. We used a two-study design (Study 1, N = 83; Study 2, N = 70) to explore the potential of contextual, task-irrelevant, information to bias professionals' judgments. We examined three main issues: (1) the effect that biasing background information (safe and unsafe company history) had on professional regulatory safety inspectors' judgments of a worksite; (2) the reliability of those judgments amongst safety inspectors and (3) inspectors' awareness of bias in their judgments and confidence in their performance. Results: Our findings establish that: (i) inspectors' judgments were biased by historical contextual information, (ii) they were not only biased, but the impact was implicit: they reported being unaware that it affected their judgments, and (iii) independent of our manipulations, inspectors were inconsistent with one another and the variations were not a product of experience. Conclusion: Our results are a replication of findings from a host of other professional domains, where honest, hardworking professionals underappreciate the biasing effect of context on their decision making. The current paper situates these findings within the relevant research on safety inspection, cognitive bias and decision making, as well as provides suggestions for bias mitigation in workplace safety inspection. Practical Application: Our results have implications for occupational health and safety given that inspection is an integral aspect of an effective safety system. In addition to our findings, this study contributes to the literature by providing recommendations regarding how to mitigate the effect of bias in inspection. [ABSTRACT FROM AUTHOR]