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IntroductionMethodResultsConclusionThis study sought to explore the lived experiences of college students with intellectual and developmental disabilities (IDD) and their understanding and access of mental health resources, as well as potential barriers to accessing these resources.Fourteen college students with IDD enrolled in an inclusive postsecondary education (IPSE) program completed a semi-structured interview about their experiences with mental health resources. The research team utilized interpretative phenomenological analysis (IPA) and generated group experiential themes from exploratory notes and individual experiential statements.Following data analysis, six themes emerged that describe the participants’ experience with the phenomena (i.e. understanding, accessing, and barriers to mental health resources). The themes are: (a) using resources and services provided by an IPSE program; (b) using resources and services provided by their Institute of Higher Education (IHE); (c) satisfaction with current IHE resources available; (d) family and friends as a mental health resource; (e) recognizing importance of and attuning to emotions; and (f) navigating barriers to mental health resources.These themes highlight potential practices and policies that the Institutes of Higher Education (IHE) and IPSE programs may consider as they strive to make higher education and mental health resources more accessible to individuals with IDD. Limitations and future research suggestions are also provided. [ABSTRACT FROM AUTHOR]

Non-Functioning Pituitary Adenomas (pituitary neuroendocrine tumours) (NFPA) have a profound detrimental effect of patient-reported health-related quality of life (QOL). Elucidating the underlying mechanisms by which NFPA influence patients' emotional physical and psychosocial wellbeing would provide the foundation for therapeutic strategies to optimise patient outcomes. A systematic review of the literature was performed in accordance with the PRISMA statement. Studies that utilised validated metrics to report QOL in NFPA were included. Patients with NFPA exhibit worse QOL than healthy controls across both mental and physical domains. Surgery provides significant improvements in QOL within 3 months, and QOL can normalise years after successful treatment. Compared with functioning adenomas, QOL is favourable. The underlying mechanisms for QOL detriment in NFPA is multifactorial and includes visual failure, hypopituitarism, headache, sleep dysfunction, pain, the sick role, treatment-related anxiety, and the morbidity of surgical and radiotherapy treatment. The effects of NFPA on QOL are global, with deficits in physical, psychosocial, and cognitive function. With successful treatment, QOL can return to that of the general population. Targeting hypopituitarism, sleep dysfunction, headache, pain, and disease-related anxiety are paths to improve QOL in NFPA. [ABSTRACT FROM AUTHOR]

A virtual model of the rhesus macaque inner ear was created in the present study. Rhesus macaques have been valuable in cochlear research; however, their high cost prompts a need for alternative methods. Finite Element (FE) analysis offers a promising solution by enabling detailed simulations of the inner ear. This study employs FE analysis to create a virtual model of the rhesus macaque's inner ear, reconstructed from MRI scans, to explore how cochlear implants (CIs) impact residual hearing loss. Harmonic-acoustic simulations of sound wave transmission indicate that CIs have minor effects on the displacement of the basilar membrane and thus minimally impact residual hearing loss post-implantation, but stiffening of the round window membrane worsens this effect. While the rhesus macaque FE model presented in this study shows some promise, its potential applications will require further validation through additional simulations and experimental studies. [ABSTRACT FROM AUTHOR]

The Panel on Food Additives and Flavourings (FAF) provides a scientific opinion re‐evaluating the safety of the two food additives argon (E 938) and helium (E 939). Argon (Ar) and helium (He) are two noble gases, highly stable single atoms. Their chemical inertness is well known. Their physicochemical properties have served as a basis for their previous evaluations by SCF and JECFA, which have considered the use of these food additives safe even in the absence of a toxicological evaluation. No business operator or other interested party provided information in response to the call for data published by EFSA to support the re‐evaluation of these two food additives with respect to their identity and specifications, manufacturing process (including the identification and quantification of potential impurities) and how they are applied to food to exert their technological function. One business operator replied to the call for data issued by EFSA reporting use levels of E 938 as a packaging gas in one food category. Based on their physicochemical properties, both gases are considered by the Panel to be of low toxicological concern when used as food additives. No information was available on the potential presence of impurities of toxicological concern resulting from the manufacturing process(es) applied to the production of the food additives E 938 and E 939. The Panel however noted that a minimum purity of 99.0% is required to comply with existing specifications. The Panel concluded that the use of argon (E 938) and helium (E 939) as food additives does not raise a safety concern. The Panel recommended an amendment of the existing EU specifications to introduce the respective CAS numbers. [ABSTRACT FROM AUTHOR]

We prove the characteristic zero case of Zilber's Restricted Trichotomy Conjecture. That is, we show that if \mathcal M is any non-locally modular strongly minimal structure interpreted in an algebraically closed field K of characteristic zero, then \mathcal M itself interprets K; in particular, any non-1-based structure interpreted in K is mutually interpretable with K. Notably, we treat both the 'one-dimensional' and 'higher-dimensional' cases of the conjecture, introducing new tools to resolve the higher-dimensional case and then using the same tools to recover the previously known one-dimensional case. [ABSTRACT FROM AUTHOR]

Despite the introduction of Pap testing for screening to prevent cervical cancer in the mid-20th century, cervical cancer remains a common cause of cancer-related mortality and morbidity globally. This is primarily due to differences in access to screening and care between low-income and high-income resource settings, resulting in cervical cancer being one of the cancers with the greatest health disparity. The discovery of human papillomavirus (HPV) as the near-obligate viral cause of cervical cancer can revolutionize how it can be prevented: HPV vaccination against infection for prophylaxis and HPV testing-based screening for the detection and treatment of cervical pre-cancers for interception. As a result of this progress, the World Health Organization has championed the elimination of cervical cancer as a global health problem. However, unless research, investments, and actions are taken to ensure equitable global access to these highly effective preventive interventions, there is a real threat to exacerbating the current health inequities in cervical cancer. In this review, the progress to date and the challenges and opportunities for fulfilling the potential of HPV-targeted prevention for global cervical cancer control are discussed. [ABSTRACT FROM AUTHOR]

The EFSA Panel on Food Additives and Flavourings was requested to evaluate 14 flavouring substances assigned to the Flavouring Group Evaluation 80 (FGE.80), using the Procedure as outlined in the Commission Regulation (EC) No 1565/2000. Thirteen substances have already been considered in FGE.80 and its revision and in FGE.96 [FL‐no: 10.005, 10.024, 10.025, 10.050, 10.061, 10.069, 10.070, 10.072, 10.169, 13.009, 13.012, 13.161 and 16.055]. The remaining flavouring substance 3a,4,5,7a‐tetrahydro‐3,6‐dimethylbenzofuran‐2(3H)‐one [FL‐no: 10.057] has been cleared with respect to genotoxicity in FGE.217Rev3 and it is considered in this revision 2 of FGE.80. The substance [FL‐no: 10.057] was evaluated through a stepwise approach that integrates information on the structure–activity relationships, intake from current uses, threshold of toxicological concern (TTC) and available data on metabolism and toxicity. The Panel concluded that [FL‐no: 10.057] does not give rise to safety concerns at its levels of dietary intake, when estimated on the basis of the 'Maximised Survey‐derived Daily Intake' (MSDI) approach. Besides the safety assessment of the flavouring substance, the specifications for the material of commerce have also been considered and the information provided was complete for [FL‐no: 10.057]. However, for the flavouring substance [FL‐no: 10.057] in the present revision and for eight substances evaluated in previous revisions, the 'modified Theoretical Added Maximum Daily Intakes' (mTAMDIs) values are above the TTC for their structural class (III). For four substances previously evaluated in FGE.80Rev1 and in FGE.96, use levels are still needed to calculate the mTAMDI estimates. Therefore, in total for 13 flavouring substances, data on uses and use levels should be provided to finalise their safety evaluations. For [FL‐no: 10.050, 10.069 and 13.161], information on the composition of stereoisomeric mixtures is needed. [ABSTRACT FROM AUTHOR]

Background: Growing evidence suggests that chronic inflammation caused by tuberculosis (TB) may increase the incidence of diabetes. However, the relationship between post-TB pulmonary abnormalities and diabetes has not been well characterized. Methods: We analyzed data from a cross-sectional study in KwaZulu-Natal, South Africa, of people 15 years and older who underwent chest X-ray and diabetes screening with hemoglobin A1c testing. The analytic sample was restricted to persons with prior TB, defined by either (1) a self-reported history of TB treatment, (2) radiologist-confirmed prior TB on chest radiography, and (3) a negative sputum culture and GeneXpert. Chest X-rays of all participants were evaluated by the study radiologist to determine the presence of TB lung abnormalities. To assess the relationships between our outcome of interest, prevalent diabetes (HBA1c ≥6.5%), and our exposure of interest, chest X-ray abnormalities, we fitted logistic regression models adjusted for potential clinical and demographic confounders. In secondary analyses, we used the computer-aided detection system CAD4TB, which scores X-rays from 10 to 100 for detection of TB disease, as our exposure interest, and repeated analyses with a comparator group that had no history of TB disease. Results: In the analytic cohort of people with prior TB (n = 3,276), approximately two-thirds (64.9%) were women, and the average age was 50.8 years (SD 17.4). The prevalence of diabetes was 10.9%, and 53.0% of people were living with HIV. In univariate analyses, there was no association between diabetes prevalence and radiologist chest X-ray abnormalities (OR 1.23, 95%CI 0.95–1.58). In multivariate analyses, the presence of pulmonary abnormalities was associated with an 29% reduction in the odds of prevalent diabetes (aOR 0.71, 95%CI 0.53–0.97, p = 0.030). A similar inverse relationship was observed for diabetes with each 10-unit increase in the CAD4TB chest X-ray scores among people with prior TB (aOR 0.92, 95%CI 0.87–0.97; p = 0.002), but this relationship was less pronounced in the no TB comparator group (aOR 0.96, 95%CI 0.94–0.99). Conclusions: Among people with prior TB, pulmonary abnormalities on digital chest X-ray are inversely associated with prevalent diabetes. The severity of radiographic post-TB lung disease does not appear to be a determinant of diabetes in this South African population. [ABSTRACT FROM AUTHOR]

This article challenges the mainstream view on functional neurological disorders (FND) by arguing that psychological factors play a significant role in their causation. It criticizes the agnostic stance adopted by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), which fails to acknowledge the importance of psychological mechanisms in FND. The document emphasizes the need for respect and resources for individuals suffering from these disorders and calls for a psychological/psychiatric engine model to better understand and treat FND. Additionally, a list of references and citations related to FND is provided, offering various perspectives and approaches to the topic. [Extracted from the article]

Over the last fifty years, a number of higher energy X‐ray sources have been suggested as alternatives for the usual AlKα source found in the first commercial XPS systems and still the standard anode material for XPS today. This paper reviews the development of a number of such sources, predominantly in the authors' laboratory, and the rationale behind the desire to extend the binding energy range of the technique. The achromatic sources SiKα, ZrLα and TiKα are described along with monochromatic sources AgLα and CrKβ, both based on the standard quartz monochromator geometry but taking higher orders of diffraction. The driving force for much of this development was the desire to probe deeper core levels and CCC Auger transitions. These could be combined into initial or final state Auger parameters as described in much of the work cited in this review. The highest energy source considered is the CuKα source based around an external X‐ray tube, which provides much insight into the electronic structure of steels by measurement of the Fe1s and FeKLL peaks. The last decade or so has seen a significant increase of interest in HAXPES, and all manufacturers of turn‐key XPS instruments offer HAXPES options of one form or another, there are three dedicated HAXPES systems commercially available, which are very briefly described. [ABSTRACT FROM AUTHOR]

Background: Digital imaging combined with deep-learning-based computational image analysis is a growing area in medical diagnostics, including parasitology, where a number of automated analytical devices have been developed and are available for use in clinical practice. Methods: The performance of Parasight All-in-One (AIO), a second-generation device, was evaluated by comparing it to a well-accepted research method (mini-FLOTAC) and to another commercially available test (Imagyst). Fifty-nine canine and feline infected fecal specimens were quantitatively analyzed by all three methods. Since some samples were positive for more than one parasite, the dataset consisted of 48 specimens positive for Ancylostoma spp., 13 for Toxocara spp. and 23 for Trichuris spp. Results: The magnitude of Parasight AIO counts correlated well with those of mini-FLOTAC but not with those of Imagyst. Parasight AIO counted approximately 3.5-fold more ova of Ancylostoma spp. and Trichuris spp. and 4.6-fold more ova of Toxocara spp. than the mini-FLOTAC, and counted 27.9-, 17.1- and 10.2-fold more of these same ova than Imagyst, respectively. These differences translated into differences between the test sensitivities at low egg count levels (< 50 eggs/g), with Parasight AIO > mini-FLOTAC > Imagyst. At higher egg counts Parasight AIO and mini-FLOTAC performed with comparable precision (which was significantly higher that than Imagyst), whereas at lower counts (> 30 eggs/g) Parasight was more precise than both mini-FLOTAC and Imagyst, while the latter two methods did not significantly differ from each other. Conclusions: In general, Parasight AIO analyses were both more precise and sensitive than mini-FLOTAC and Imagyst and quantitatively correlated well with mini-FLOTAC. While Parasight AIO produced lower raw counts in eggs-per-gram than mini-FLOTAC, these could be corrected using the data generated from these correlations. [ABSTRACT FROM AUTHOR]

The proliferation of novel psychoactive substances (NPSs) continues to challenge toxicology laboratories. In particular, the United Nations Office on Drugs and Crime considers designer benzodiazepines to be a current primary threat among all NPSs. Herein, we report detection of a new emerging designer benzodiazepine, clobromazolam, using high-resolution mass spectrometry and untargeted data acquisition in combination with a "suspect screening" method built from the crowd-sourced HighResNPS.com database. Our laboratory first detected clobromazolam in emergency department presenting intoxications included within the Emerging Drugs Network of Australia—Victoria project in the state of Victoria, Australia, from April 2022 to March 2023. Clobromazolam was the most frequent designer benzodiazepine detected in this cohort (100/993 cases, 10%). No patients reported intentional administration of clobromazolam, although over half reported exposure to alprazolam, which was detected in only 7% of cases. Polydrug use was prevalent (98%), with phenazepam (45%), methylamphetamine (71%) and other benzodiazepines (60%) most frequently co-detected. This is the first case series published in the literature concerning clobromazolam in clinical patients. The identification of clobromazolam in patients presenting to emergency departments in Victoria demonstrates how high-resolution mass spectrometry coupled with the HighResNPS.com database can be a valuable tool to assist toxicology laboratories in keeping abreast of emerging psychoactive drug use. [ABSTRACT FROM AUTHOR]

Objective and study design: This is a retrospective, descriptive study of consecutive patients undergoing novel preoperative pushable coil localization for spinal surgery, in order to evaluate its feasibility, safety and accuracy. Methods: Consecutive patients who underwent pre‐operative coil marking for spinal surgery at our institution from May 2018 to July 2021 were included. Data were collected for coil placement, accuracy, complications and fluoroscopy usage. Patient demographic and relevant perioperative and procedural data were also collected. Results: A total of 34 patients were identified of which 32 (94%) had complete data and imaging at last clinical follow up, with a mean duration of 13.9 months. There were no incorrect level surgeries performed. There were no coil‐related complications found in our cohort. Conclusions: Preoperative coil placement is an accurate, safe and well‐tolerated method for level localization in spinal surgeries. [ABSTRACT FROM AUTHOR]

This article presents a case study of an 8-year-old male with multiple café-au-lait macules, axillary freckling, and hypopigmented macules. The patient's sister also had similar features and a history of T-cell lymphoblastic lymphoma. Although the patient initially met the clinical criteria for neurofibromatosis type 1 (NF1), further assessment suggested a diagnosis of constitutional mismatch repair deficiency (CMMRD). Genetic testing confirmed a homozygous pathogenic variant in the PMS2 gene. CMMRD is a rare autosomal recessive syndrome associated with an increased risk of cancer, and early diagnosis is crucial for initiating appropriate surveillance and management. [Extracted from the article]

The advent of dopamine (D2) receptor-blocking medications over 70 years ago, ushered in a new era of biological treatment for schizophrenia. However, we argue that little subsequent progress has been made in translating this into fulfilled and fulfilling lives for people with schizophrenia. This Viewpoint asks why this is the case, and suggests ways forward for capitalising on extant and emerging new treatments for psychotic disorders, to the betterment of the lives of people living with schizophrenia. [ABSTRACT FROM AUTHOR]

This qualitative grounded theory study uses the voices of current and former law enforcement officers to consider the problems that can arise with police administration when there exists ineffective civilian oversight. The n = 10 participants in this study serve or served as professional uniformed and sworn police officers from different municipalities throughout the United States. The findings of this study seemingly spotlight the notion that ineffective civilian oversight promotes a culture of corruption in the police subculture and fuels the distrust of the communities they are sworn to protect and serve. The implication of this study is forming a foundation for law enforcement agencies to grow on in order to improve community policing so as to benefit the officers and the civilians they serve. [ABSTRACT FROM AUTHOR]

What is arts–research collaboration and how does it work? What does arts–research collaboration as method for qualitative inquiry do? What is the effect of collaboration on creative practice and academic research? Drawing on a collaboration between an anthropologist and an artist, this article addresses a surprising lack of qualitative inquiry into collaboration between creative practitioners and academic researchers. By recounting how the authors developed and used collaboration as method, the article identifies and analyzes underpinning qualities of how they worked together through arts–research activities. It advances existing debate by agitating for more theoretically grounded accounts of collaboration, including those that take a processual view on making and creativity to argue for considering collaboration, itself, to be materials from which creative practice and outputs emerge. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 70-year-old woman with advanced human immunodeficiency virus (HIV) infection in KwaZulu-Natal, South Africa, experiencing cough, shortness of breath, and malaise. Topics discussed include the patient's HIV treatment history, co-infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Mycobacterium tuberculosis, and the challenges in managing her symptoms.

Patient quality of life (QOL) is an important metric of surgical success. To guide therapeutic advances in pituitary adenoma surgery, a validated, comprehensive instrument to quantify QOL is required. We aim to evaluate the validity of the 35 item anterior skull base questionnaire (ASBQ-35) in patients undergoing pituitary adenoma surgery. A total of 168 patients undergoing endoscopic resection of pituitary adenomas underwent longitudinal QOL assessment using the ASBQ-35 and the 22-item Sinonasal Outcomes Test (SNOT-22) over the first postoperative year. Validity of the ASBQ-35 was assessed by internal consistency, test–retest reliability, responsiveness to clinical change, and concurrent validity with the SNOT-22. Internal consistency of the ASBQ-35 was excellent, with a Cronbach’s alpha > 0.95 across all timepoints. Test–retest reliability between 3 and 6 months (ICC = 0.82, p < 0.001) and 6 months and 12 months (ICC = 0.78, p < 0.001) was robust. Concurrent validity with SNOT-22 was strong across all timepoints (absolute Pearson r ≥ 0.63, p < 0.001). Mean ASBQ-35 scores were significantly worse at 3 weeks compared to preoperative baseline (mean difference − 0.28, p < 0.01); however, by 12 months, scores had significantly improved (mean difference + 0.24, p < 0.01), indicating that the scale is responsive to clinical change. Each of the 6 domains of the ASBQ, and all 35 component questions, contributed to the discriminative of the ASBQ to measure QOL during the first postoperative year. The ASBQ-35 is a valid, comprehensive tool for assessing QOL after endoscopic pituitary adenoma surgery. Each component of the ASBQ-35 contributed to the overall assessment of QOL during the first postoperative year. [ABSTRACT FROM AUTHOR]

Schizophrenia is a severe psychiatric disorder associated with significant comorbidities and early mortality. People with schizophrenia have a greater predisposition to the top 6 modifiable global mortality (cardiometabolic) risk factors as defined by the World Health Organization (compared with the general population). These are driven by genetic, lifestyle and disease factors, and obesogenic antipsychotic medications. Smoking, obesity and type 2 diabetes are the most important modifiable cardiometabolic risk factors for cardiovascular disease in people with schizophrenia. Enhanced physical health screening, especially for cardiometabolic risk factors, is recommended for people with schizophrenia. Enhanced physical health screening, especially for cardiometabolic risk factors, is recommended for people with schizophrenia. [ABSTRACT FROM AUTHOR]

Religious music served a political function in the southern United States during the antebellum period. This article examines catechisms and hymnbooks used by white evangelical missionaries and slaveowners in the antebellum South, arguing that the planter elite deployed hymns as a medium to assert white supremacy. The term sonic domination identifies processes whereby sound functioned as a social tool to maintain discipline and order among the enslaved population. Black and white people sang hymns in church, at interracial revivals, and during civic services; they were also heard on bells and cited in poetry. English texts and tunes included in slave catechisms and white portrayals of Black singing highlight the role of evangelical hymns in maintaining plantation order in the Old South. At the same time, enslaved Black Christians found creative ways to circumvent the oppressive power of the white elite through song. African Americans employed English hymns in their own religious rituals and used them to convey hidden meanings on the plantation. Both genres, which interacted and ultimately influenced each other, contributed to an eventual codification of American evangelical hymnody. [ABSTRACT FROM AUTHOR]

Background: Efficient transfer of adult trauma patients to the intensive care unit (ICU) is associated with decreased emergency department (ED) length of stay (ED LOS) and improved patient outcomes. While well studied in adults, quality improvement (QI) initiatives focused on the rapid transfer of pediatric trauma patients are lacking. We report the effect of institutional system changes directed at expediting the transfer of pediatric trauma patients to the pediatric ICU (PICU). Methods: This initiative commenced in 2013. Preliminary data regarding ED LOS for pediatric trauma patients were collected from January through December 2012 as the pre-implementation cohort. Using the plan-do-study-act (PDSA) framework of QI, the first PDSA cycle was implemented in January 2013. In subsequent PDSA cycles, we implemented the mandatory attendance of the PICU charge nurse and the PICU attending physician to all highest-level pediatric trauma activations. Throughout, ED LOS was collected and mapped on a run chart. ED LOS and variance were compared between all cycles of implementation. Results: One hundred and fifty-one pediatric patients arrived or were upgraded to the highest-level pediatric trauma activation and admitted to the PICU from 2012 through 2019. We observed a decrease in median ED LOS of 105 minutes between the pre- and post-implementation groups. With each PDSA cycle, we observed a decrease in median ED LOS and variation. Conclusion: The inclusion of the PICU charge nurse and attending physician at highest-level pediatric trauma activations facilitated more rapid access to the PICU with decreased ED LOS. [ABSTRACT FROM AUTHOR]

The current scientific enquiry of deep brain stimulation (DBS) does not capture the breadth of DBS-induced changes to an individual's life. Considering that DBS is applied in severe and complex cases, it is ethically and clinically necessary to consider the patient perspective and personally relevant outcomes. This lived experience investigation of people with obsessive compulsive disorder (OCD) undergoing DBS aims to provide a comprehensive evaluation of DBS-induced effects associated with OCD psychopathology. Six patients and six carers completed semi-structured open-ended interviews. A blended approach of interpretative phenomenological, inductive, and thematic analysis techniques was employed. Profound psychopathological changes were expressed; individuals felt more alive, had improved cognitive affective control, greater engagement in the world, and were able to manage their OCD. Through suppression of the condition, self-constructs were able to re-emerge and develop. A framework describing the progression of phenomenological changes, and a theoretical model describing changes in the cognitive appraisal of intrusions influencing recovery are proposed. This is the first identified qualitative investigation of DBS-induced changes in psychiatric patients and carers. Findings have implications for patient education and recovery models of OCD, and scientific understanding of DBS effects. [ABSTRACT FROM AUTHOR]

Background: Poor quality of care in nursing homes (NHs) with high proportions of Black residents has been a problem in the US and even more pronounced during the COVID‐19 pandemic. Federal and state agencies are devoting attention to identifying the best means of improving care in the neediest facilities. It is important to understand environmental and structural characteristics that may have led to poor healthcare outcomes in NHs serving high proportions of Black residents pre‐pandemic. Methods: We conducted a cross‐sectional observational study using multiple 2019 national datasets. Our exposure was the proportion of Black residents in a NH (i.e., none, <5%, 5%–19.9%, 20–49.9%, ≥50%). Healthcare outcomes examined were hospitalizations and emergency department (ED) visits, both observed and risk‐adjusted. Structural factors included staffing, ownership status, bed count (0–49, 50–149, or ≥150), chain organization membership, occupancy, and percent Medicaid as a payment source. Environmental factors included region and urbanicity. Descriptive and multivariable linear regression models were estimated. Results: In the 14,121 NHs, compared to NHs with no Black residents, NHs with ≥50% Black residents tended to be urban, for‐profit, located in the South, have more Medicaid‐funded residents, and have lower ratios of registered‐nurse (RN) and aide hours per resident per day (HPRD) and greater ratios of licensed practical nurse HPRD. In general, as the proportion of Black residents in a NH increased, hospitalizations and ED visits also increased. Discussion/Implications: As lower use of RNs has been associated with increased ED visits and hospitalizations in NHs generally, it is likely low RN use largely drove the differences in hospitalizations and ED visits in NHs with greater proportions of Black residents. Staffing is an area in which state and federal agencies should take action to improve the quality of care in NHs with larger proportions of Black residents. [ABSTRACT FROM AUTHOR]

The article discusses concerns about a clinical memorandum on deep brain stimulation (DBS) therapy for obsessive-compulsive disorder (OCD). It criticizes the memorandum for not adequately reporting the scientific evidence and clinical efficacy of DBS for OCD. The authors argue that recent systematic reviews have shown significant improvements in OCD symptoms with DBS, suggesting that it meets the criteria for an established therapy for OCD.

The article focuses on the profound consequences of the Dobbs v. Jackson Women's Health Organization ruling, particularly on maternal and infant mortality rates, ethical considerations surrounding bodily autonomy, and the ongoing challenges faced by marginalized communities in accessing reproductive healthcare. It highlights the discriminatory practices within the healthcare system.

The 'digital plumber' is a conceptualisation in ubicomp research that describes the work of installing and maintaining IoT devices. But an important and often understated element of commercial IoT solutions is their long-term socio-technical infrastructural nature, and therefore long-term installation and maintenance needs. This adds complexity to both the practice of digital plumbing and to the work of design that supports it. In this paper we study a commercial company producing and installing IoT alarm systems. We examine video recordings that capture how a digital plumbing representative and software development team members make changes to both the installation process and supporting technology. Our data enables us to critically reflect on concepts of infrastructuring, and uncover the ways in which the team methodically foreground hidden elements of the infrastructure to address a point of failure experienced during field trials of a new version of their product. The contributions from this paper are twofold. Firstly, our findings build on previous examples of infrastructuring in practice by demonstrating the use of notions of elemental states to support design reasoning through the continual foregrounding and assessment of tensions identified as key factors at the point of failure. Secondly, we build on current notions of digital plumbing work. We argue that additional responsibilities of 'reporting failure' and 'facilitation of change' are part of the professional digital plumbing role and that commercial teams should support these additional responsibilities through collaborative troubleshooting and design sessions alongside solid communication channels with related stakeholders within the product team. [ABSTRACT FROM AUTHOR]

Water balance is fundamental to all homeostasis. The hypothalamic-pituitary-adrenal axis influences water balance through the effects of corticotropin-releasing hormone and cortisol on arginine vasopressin secretion and the peripheral effects of cortisol on hemodynamics and renal water handling. In this review, we explored the complex interplay of glucocorticoids with water balance, with particular attention to hyponatremia and pituitary surgery. [ABSTRACT FROM AUTHOR]

Background/Aim: Clotting factors promote cancer development. We investigated if coagulation proteins promote proliferation and migration in colorectal cancer (CRC) cell lines and whether their direct inhibitors can attenuate these effects. Materials and Methods: DLD‐1 and SW620 cells were treated with tissue factor (0, 50, 100 and 500 pg/mL ± 10 μg/mL 10H10 [anti‐tissue factor antibody]), thrombin (0.0, 0.1, 1.0 and 10.0 U/mL ± 0.5 μM dabigatran [thrombin inhibitor]) and Factor Xa, FXa (0.0, 0.1, 1.0 and 10.0 U/mL ± 100 ng/mL rivaroxaban [FXa inhibitor]) and their effects on proliferation and migration were quantified using the PrestoBlue® and transwell migration assays, respectively. Results: Thrombin increased proliferation from 48 h treatment compared to its control (48 h 6.57 ± 1.36 u vs. 2.42 ± 0.13 u, p = 0.001, 72 h 9.50 ± 1.54 u vs. 4.50 ± 0.47 u, p = 0.004 and 96 h 10.77 ± 1.72 u vs. 5.57 ± 0.25 u, p = 0.008). This increase in proliferation was attenuated by dabigatran at 72 h (2.23 ± 0.16 u vs. 3.26 ± 0.43 u, p = 0.04). Tissue factor (0 pg/mL 20.7 ± 1.6 cells/view vs. 50 pg/mL 32.4 ± 1.9 cells/view, p = 0.0002), FXa (0.0 U/mL 8.9 ± 1.1 cells/view vs. 10.0 U/mL 17.7 ± 1.7 cells/view, p < 0.0001) and thrombin (0.0 U/mL 8.9 ± 1.3 cells/view vs. 10.0 U/mL 20.2 ± 2.0 cells/view, p < 0.0001) all increased migration compared to their controls. However, their direct inhibitors did not attenuate these increases. Conclusion: Thrombin, FXa and TF all increase migration in CRC in vitro. Thrombin induced increase in proliferation is abrogated by dabigatran. Dabigatran may have potential as an anti‐cancer therapy in CRC. [ABSTRACT FROM AUTHOR]

This study compares documentation and reimbursement rates before and after provider education in nutritional status documentation. Our study aimed to evaluate accurate documentation of nutrition status between registered dietitian nutritionists and licensed independent practitioners before and after the implementation of a dietitian-led Nutrition-Focused Physical Exam intervention at an academic medical center in the southeastern US. ICD-10 codes identified patients from 10/1/2016-1/31/2018 with malnutrition. The percentage of patients with an appropriate diagnosis of malnutrition and reimbursement outcomes attributed to malnutrition documentation were calculated up to 24 months post-intervention. 528 patients were analyzed. Pre-intervention, 8.64% of patients had accurate documentation compared to 46.3% post-intervention. Post-intervention, 68 encounters coded for malnutrition resulted in an estimated $571,281 of additional reimbursement, sustained at 6, 12, 18, and 24 months. A multidisciplinary intervention improved physician documentation accuracy of malnutrition status and increased reimbursement rates. [ABSTRACT FROM AUTHOR]

How do global trade rules evolve? This article argues that agreements create precedent that shapes subsequent negotiations, and policymakers exploit this precedent. Specifically, states sequence agreements, using negotiations with likeminded or relatively less important partners to establish model rules for subsequent use where negotiations will be more challenging. By institutionalizing negotiating positions where stakes are low, negotiators seek to improve the odds of replicating preferred terms in later, more challenging deals. A two-stage regression analysis on trade agreement design from 1965 to 2016 and qualitative probes from the UK and New Zealand support the argument: agreements with less important partners are presented as strategic opportunities to innovate and set precedent. Legal language has a way of sticking around, and states know it. States sign agreements with an eye to the future. [ABSTRACT FROM AUTHOR]

Since the US Food and Drug Administration first approved robotic surgery for clinical use in 2000, it has gained widespread adoption across multiple surgical domains. While pediatric surgery has had a relatively slower adoption rate, robotic surgery has nonetheless grown in this context. This work traces the historical and regulatory aspects of pediatric robotic surgery, showing how it incorporated an existing robotic surgical system developed for adults; situates the technology within ethical frameworks for analyzing surgical innovation; and advocates for combined surgeon self-regulation and institutional oversight. Finally, the argument is made that there are key unmet technological needs pertaining to instrument size and adaptability secondary to pediatric robotic surgery's smaller market share and that clinicians and producers of robotic surgical systems should work to address these needs. [ABSTRACT FROM AUTHOR]

Background: Mechanisms by which alcohol increases the risk of esophageal squamous cell carcinoma remain undefined. Human esophageal myofibroblasts (HEMFs) subjacent to the squamous epithelium are exposed directly to these agents via epithelial barrier defects and indirectly via factors derived from the exposed epithelium. Our aim was to investigate the cellular biology of HEMFs and HEMF‐esophageal epithelial cell interactions in response to alcohol and its toxic metabolite acetaldehyde. Methods: An immortalized HEMF and a human esophageal epithelial cell line (Epi) were treated with alcohol (0 to 200 mM) or acetaldehyde (0 to 100 μM) in a cyclic fashion or incubated with supernatants collected from treated cells. Healthy cell %, reactive oxygen species (ROS), and proliferation were assessed via flow cytometry, luminescence, scratch wound, and colorimetric assays, respectively. A 15‐plex multiplex assay was performed on cell supernatants, followed by IL‐6 and IL‐8 qRT–PCR and ELISA. Results: Healthy HEMF decreased to less than 80% at 30 mM alcohol and 70 μM acetaldehyde, with microscopic changes at 40 μM acetaldehyde. HEMF ROS was detected at 100 mM alcohol and 80 μM acetaldehyde. Supernatants from 30 mM alcohol‐ or 40 μM acetaldehyde‐treated HEMFs increased Epi proliferation more than two‐fold that of lower doses. In the complementary studies, healthy Epi cells decreased to less than 80% at 50 mM and 70 μM acetaldehyde, with microscopic changes at 40 μM. Supernatants from Epi treated with 50 mM alcohol or 40 μM acetaldehyde increased HEMF proliferation more than two‐fold that of lower doses. A multiplex assay of supernatants showed the greatest increase in concentrations of IL‐6 and IL‐8 in HEMFs and in Epi treated with higher doses of alcohol or acetaldehyde. Neutralization of IL‐6 and IL‐8 in supernatants of HEMFS and esophageal epithelial cells inhibited the proliferation of Epi and HEMFs, respectively. Conclusions: Alcohol and acetaldehyde doses in which the majority of HEMFs and epithelial cells are healthy, elicit the production of paracrine mediators with pro‐proliferative effects on neighboring cells. Understanding the effect of alcohol and acetaldehyde on HEMFs and HEMF‐epithelial interactions could help to identify the molecular basis by which alcohol increases the risk for esophageal cancer. [ABSTRACT FROM AUTHOR]

Use of body mass index (BMI) as a health care metric is controversial, especially in candidacy assessments for gender-affirming surgery. When considering experiences of fat trans individuals, it is important to advocate for equitable divisions of responsibility for and recognition of systemic fat phobia. This commentary on a case suggests strategies for increasing equitable access to safe surgery for all body types. If surgeons use BMI thresholds, simultaneous effort must be made to advocate for data collection so that surgical candidacy criteria are evidence-based and equitably applied. [ABSTRACT FROM AUTHOR]

Neurofibromatosis Type 1 (NF1) is a neurocutaneous syndrome characterized by multiple café-au-lait macules, neurofibromas, and predisposition to malignancies, including rhabdomyosarcomas (RMS). Somatic NF1 mutations occur in RMS and other cancers, and ∼1% of patients with RMS have NF1. We describe three patients who presented prior to one year of age with RMS and were subsequently diagnosed with NF1. Compared to sporadic RMS, patients with this cancer predisposition syndrome are diagnosed younger, genitourinary sites are more common, and tumors are almost exclusively the embryonal subtype. Genomic sequencing of the tumor was initiated in one patient, and we identified a second sequence variant in NF1. The identification of molecular drivers in tumors is changing the nature of pediatric oncology by informing therapeutics targeted to specific molecular pathways and selecting patients who are likely to harbor germline variants in cancer predisposition genes who would benefit from a Medical Genetics assessment. [ABSTRACT FROM AUTHOR]

Digital technologies enable the dissemination of multimedia resources to support adults with serious mental illness in their self-management and personal recovery. However, delivery needs to accommodate engagement and accessibility challenges. We examined how a digital resource, designed for mental health workers and consumers to use together in session, would be used in routine practice. Thirty consumers and their workers participated. The web-based resource, Self-Management And Recovery Technology (SMART), was available to use within and between sessions, for a 6-month period. Workers initiated in-session use where relevant. Feasibility was explored via uptake and usage data; and acceptability and impact via questionnaires. A pre-post design assessed recovery outcomes for consumers and relationship outcomes for consumers and workers. In participating mental health practitioner-consumer dyads, consumers gave strong acceptability ratings, and reported improved working relationships. However, the resource was typically used in one-third or fewer appointments, with consumers expressing a desire for greater in-session use. Improvements in self-rated personal recovery were not observed, possibly contributed to by low usage. In-session use was found helpful by consumers but may be constrained by other demands in mental health care delivery: collaborative use may require dedicated staff time or more formal implementation. [ABSTRACT FROM AUTHOR]

Simple Summary: Rhabdomyosarcomas are soft tissue tumors more commonly found in children than adults. The diagnosis and management of these tumors continues to change as our knowledge of how they behave and how they respond to previously used treatments has improved. We treat these tumors differently based on where they develop. Rhabdomyosarcomas of the genitourinary tract are the second most common, arising from the bladder, prostate, vagina/uterus, and paratesticular regions. Advancements in treatment options, including chemotherapy and radiation, have led to improved outcomes and have allowed, in many instances, for less drastic surgical resections. In this review, we discuss how to approach rhabdomyosarcomas in general, with an emphasis on the presentation, diagnosis, treatment, and outcomes of those arising from the different organs in the genitourinary tract. Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric and adolescent population, with 350 new cases diagnosed each year. While they can develop anywhere in the body, the genitourinary tract is the second most common primary location for an RMS to develop. Overall survival has improved through the increased use of protocols and multidisciplinary approaches. However, the guidelines for management continue to change as systemic and radiation therapeutics advance. Given the relative rarity of this disease compared to other non-solid childhood malignancies, healthcare providers not directly managing RMS may not be familiar with their presentation and updated management. This review aims to provide foundational knowledge of the management of RMSs with an emphasis on specific management paradigms for those arising from the genitourinary tract. The genitourinary tract is the second most common location for an RMS to develop but varies greatly in symptomology and survival depending on the organ of origin. As the clinical understanding of these tumors advances, treatment paradigms have evolved. Herein, we describe the breadth of presentations for genitourinary RMSs with diagnostic and treatment management considerations, incorporating the most recently available guidelines and societal consensus recommendations. [ABSTRACT FROM AUTHOR]

Group 4 tumours (MBGrp4) represent the majority of non-WNT/non-SHH medulloblastomas. Their clinical course is poorly predicted by current risk-factors. MBGrp4 molecular substructures have been identified (e.g. subgroups/cytogenetics/mutations), however their inter-relationships and potential to improve clinical sub-classification and risk-stratification remain undefined. We comprehensively characterised the paediatric MBGrp4 molecular landscape and determined its utility to improve clinical management. A clinically-annotated discovery cohort (n = 362 MBGrp4) was assembled from UK-CCLG institutions and SIOP-UKCCSG-PNET3, HIT-SIOP-PNET4 and PNET HR + 5 clinical trials. Molecular profiling was undertaken, integrating driver mutations, second-generation non-WNT/non-SHH subgroups (1–8) and whole-chromosome aberrations (WCAs). Survival models were derived for patients ≥ 3 years of age who received contemporary multi-modal therapies (n = 323). We first independently derived and validated a favourable-risk WCA group (WCA-FR) characterised by ≥ 2 features from chromosome 7 gain, 8 loss, and 11 loss. Remaining patients were high-risk (WCA-HR). Subgroups 6 and 7 were enriched for WCA-FR (p < 0·0001) and aneuploidy. Subgroup 8 was defined by predominantly balanced genomes with isolated isochromosome 17q (p < 0·0001). While no mutations were associated with outcome and overall mutational burden was low, WCA-HR harboured recurrent chromatin remodelling mutations (p = 0·007). Integration of methylation and WCA groups improved risk-stratification models and outperformed established prognostication schemes. Our MBGrp4 risk-stratification scheme defines: favourable-risk (non-metastatic disease and (i) subgroup 7 or (ii) WCA-FR (21% of patients, 5-year PFS 97%)), very-high-risk (metastatic disease with WCA-HR (36%, 5-year PFS 49%)) and high-risk (remaining patients; 43%, 5-year PFS 67%). These findings validated in an independent MBGrp4 cohort (n = 668). Importantly, our findings demonstrate that previously established disease-wide risk-features (i.e. LCA histology and MYC(N) amplification) have little prognostic relevance in MBGrp4 disease. Novel validated survival models, integrating clinical features, methylation and WCA groups, improve outcome prediction and re-define risk-status for ~ 80% of MBGrp4. Our MBGrp4 favourable-risk group has MBWNT-like excellent outcomes, thereby doubling the proportion of medulloblastoma patients who could benefit from therapy de-escalation approaches, aimed at reducing treatment induced late-effects while sustaining survival outcomes. Novel approaches are urgently required for the very-high-risk patients. [ABSTRACT FROM AUTHOR]

Cochlear implant (CI) surgery is one of the most utilized treatments for severe hearing loss. However, the effects of a successful scala tympani insertion on the mechanics of hearing are not yet fully understood. This paper presents a finite element (FE) model of the chinchilla inner ear for studying the interrelationship between the mechanical function and the insertion angle of a CI electrode. This FE model includes a three-chambered cochlea and full vestibular system, accomplished using µ-MRI and µ-CT scanning technologies. This model's first application found minimal loss of residual hearing due to insertion angle after CI surgery, and this indicates that it is a reliable and helpful tool for future applications in CI design, surgical planning, and stimuli setup. [ABSTRACT FROM AUTHOR]

Intradural lumbar disk herniation (ILDH) is a rare variant and accounts for 0.33%–1.5% of lumbar disk herniations. Although clues exist on preoperative imaging, they remain subtle and most cases of ILDH are diagnosed intraoperatively. Intraoperative ultrasound is a useful adjunct in diagnosing and managing ILDH. We present a case to demonstrate the features of an intradural herniated disk on ultrasound imaging and highlight the utility of intraoperative ultrasonography in establishing diagnosis, guiding dural opening, and confirming adequate nerve root decompression following diskectomy. [ABSTRACT FROM AUTHOR]

Rumen degradable protein (RDP) is required for cattle consuming low-quality forage to ensure adequate fiber digestion. However, in situations where cattle are not supplemented daily, supplementing RDP could overwhelm the nitrogen recycling mechanisms, leading to increased nitrogen excretion. The objective of this experiment was to determine the effect of rumen degradability and frequency of supplemental protein in beef cattle consuming low-quality forage. Treatments were arranged in a 2 × 2 factorial with protein degradability (68.5% or 32.8% RDP) and supplementation frequency (daily or biweekly) as the two factors. Ruminally cannulated Angus steers [n = 8; body weight (BW) = 328 ± 12.2 kg] were used in a Latin rectangle. The low RDP treatment was composed of 50% soybean hulls and 50% corn gluten meal (40.3% CP; 32.8% RDP), and the high RDP treatment consisted of 45.4% soybean hulls, 41.4% soybean meal, 4.1% urea, and 9.1% molasses (40% CP; 68.5% RDP). The biweekly steers were supplemented on d 0, 4, 7, 11, 14, 18, and 21 of each period. Steers were given ad libitum access to low-quality (7.4% CP) native grass hay. Daily blood samples were collected from d 14 to 17 at 0630 h and d 21 at -2, 3, and 7 h relative to supplementation. Rumen fluid samples were collected every 4 h on d 18 to 21. Daily NEFA concentrations decreased (P < 0.001) postsupplementation in the biweekly supplemented steers and then returned to baseline values, while the daily supplemented steers had no change. Hourly NEFA concentrations in steers supplemented with high RDP biweekly increased from 2 h pre-supplementation to 3 h post-supplementation (P < 0.001), then decreased at 7 h post-supplementation back to pre-supplementation concentrations. Plasma urea nitrogen (PUN) increased in biweekly high RDP supplemented steers 1 d after supplementation (P < 0.001) and decreased from d 15 to d 17. PUN concentrations increased from 2 h presupplementation through 7 h post-supplementation in both high RDP treatments, while low RDP treatments did not change (P < 0.001). Rumen fluid lactate and ammonia concentrations rapidly increased in the biweekly high RDP-supplemented steers in response to each supplementation (P < 0.001). There were spikes in ammonia concentrations for the daily high RDP treatment post-supplementation; however, they were smaller in magnitude compared with the biweekly high RDP. The low RDP treatments remained steady across all hours of ammonia sampling, where daily and biweekly supplemented steers decreased slightly in the time points following supplementation and then gradually increased. Rumen pH displayed drastic changes in the biweekly high RDP-supplemented group with values ranging from 6.99 to 5.97 (P < 0.001), but the low RDP treatments remained consistent. Supplementing biweekly with high RDP resulted in fluctuations in metabolites not observed in the other treatments, which could reduce forage utilization and increase nitrogen excretion. [ABSTRACT FROM AUTHOR]

Objective: Tuberculosis (TB) may predispose individuals to the development of diabetes. Such a relationship could have an outsized impact in high-prevalence TB settings. However, few studies have explored this relationship in populations heavily burdened by diabetes and TB. Methods: We analyzed data from a community-based population cohort that enrolled adults in rural South Africa. Individuals were considered to have prior TB if they self-reported a history of TB treatment. We fitted sex-specific logistic regression models, adjusted for potential clinical and demographic confounders, to estimate relationships between dysglycemia (HBA1c ≥6.5%) and prior TB. Propensity score-matched cohorts accounted for the differential age distributions between comparator groups. We examined the interactions between sex, prior TB, and HIV status. Results: In the analytic cohort (n = 17,593), the prevalence of prior TB was 13.8% among men and 10.7% among women. Dysglycemia was found in 9.1% of the population, and HIV prevalence was 34.0%. We found no difference in dysglycemia prevalence by prior TB (men OR 0.96, 95% CI 0.60–1.56: women OR 1.05, 95% CI 0.79–1.39). However, there was a qualitative interaction by HIV serostatus, such that among men without HIV, those with a history of TB had a greater prevalence of dysglycemia than those without prior TB (10.1% vs. 4.6%, p = 0.0077). An inverse relationship was observed among men living with HIV (prior TB 3.3% vs. no TB 7.3%, p = 0.0073). Conclusions: Treated TB disease was not associated with dysglycemia in an HIV-endemic, rural South African population. However, we found a significant interaction between prior TB and HIV status among men, suggesting distinct pathophysiological mechanisms between the two infections that may impact glucose metabolism. Longitudinal studies are needed to better establish a causal effect and underlying mechanisms related to resolved TB, HIV, and diabetes. [ABSTRACT FROM AUTHOR]

Appropriate prescribing practices are imperative to ensure adequate pain control, without excess opioid dispensing across colorectal patients. National Surgical Quality Improvement Program, Kentucky All Scheduled Prescription Electronic Reporting, and patient charts were queried to complete a retrospective study of elective colorectal resections, performed by a fellowship-trained colorectal surgeon, from January 2013 to December 2020. Opioid use at 14 d and 30 d posthospital discharge converted into morphine milligram equivalents (MMEs) were analyzed and compared across preadmission and inpatient factors. One thousand four hundred twenty seven colorectal surgeries including 56.1% (N = 800) partial colectomy, 24.1% (N = 344) low anterior resection, 8.3% (N = 119) abdominoperineal resection, 8.4% (N = 121) sub/total colectomy, and 3.0% (N = 43) total proctocolectomy. Abdominoperineal resection and sub/total colectomy patients had higher 30-day postdischarge MMEs (P < 0.001, P = 0.041). An operative approach did not affect postdischarge MMEs (P = 0.440). Trans abdominal plane blocks do not predict postdischarge MMEs (0.616). Epidural usage provides a 15% increase in postdischarge MMEs (P = 0.020). Age (P < 0.001), smoking (P < 0.001), chronic obstructive pulmonary disease (P = 0.006, < 0.001), dyspnea (P = 0.001, < 0.001), albumin < 3.5 (P = 0.085, 0.010), disseminated cancer (P = 0.018, 0.001), and preadmission MMEs (P < 0.001) predict elevated 14-day and 30-day postdischarge MMEs. We conclude that perioperative analgesic procedures, as enhanced recovery pathway suggests, are neither predictive nor protective of postoperative discharge MMEs in colorectal surgery. Provider should account for preoperative risk factors when prescribing discharge opioid medications. Furthermore, providers should identify appropriate adjunct procedures to improve discharge opioid prescription stewardship. • This study evaluates preoperative risk factors that may predict postdischarge opioid prescriptions in colorectal resection patients. • Study reviewed 1427 colorectal surgeries from January 2013 to December 2020 linked with state-tracked opioid data. • Few studies identify patient inherent risk factors for postdischarge opioid prescribed morphine milligram equivalents following colorectal resections. • Enhanced recovery pathway suggested perioperative analgesic procedures are not protective of postoperative discharge needs in colorectal surgery. [ABSTRACT FROM AUTHOR]

The collateral consequences of incarceration and prison visitation, transcend the boundaries of prison and transform women's lives. Through an intersectional approach, this research uncovers in what capacity degradation and secondary prisonization shape women's lives, and what coping mechanisms women form in response to the difficulties of visitation. Existing research has yet to identify visitors' relationships to one another and how these relationships aid in fostering coping strategies and resilience within the carceral realm. To fill the gaps, I employed qualitative research to explore the process of visitation, processing procedures, challenges of visitation, staff relations, and women's support systems. Findings indicated visitors are subject to an environment of gendered, racist, and classist oppression that varies in degree depending on social heirarchy and status. However, as a manifestation of resilience, women construct coping mechanisms in the form of information and support networks that aid in the dismantling the prevailing culture of scarcity of information and the degradation of free women by prison staff. These marginalized women habitually resist carceral domination through informal interpersonal support systems. [ABSTRACT FROM AUTHOR]

The cellular prion protein (PrPC) converts to alternatively folded pathogenic conformations (PrPSc) in prion infections and binds neurotoxic oligomers formed by amyloid-ß a-synuclein, and tau. ß-Endoproteolysis, which splits PrPC into N- and C-terminal fragments (N2 and C2, respectively), is of interest because a protease-resistant, C2-sized fragment (C2Sc) accumulates in the brain during prion infections, seemingly comprising the majority of PrPSc at disease endpoint in mice. However, candidates for the underlying proteolytic mechanism(s) remain unconfirmed in vivo. Here, a cell-based screen of protease inhibitors unexpectedly linked type II membrane proteins of the S9B serine peptidase subfamily to PrPC ß-cleavage. Overexpression experiments in cells and assays with recombinant proteins confirmed that fibroblast activation protein (FAP) and its paralog, dipeptidyl peptidase-4 (DPP4), cleave directly at multiple sites within PrPC's N-terminal domain. For wild-type mouse and human PrPC substrates expressed in cells, the rank orders of activity were human FAP ~ mouse FAP > mouse DPP4 > human DPP4 and human FAP > mouse FAP > mouse DPP4 >> human DPP4, respectively. C2 levels relative to total PrPC were reduced in several tissues from FAP-null mice, and, while knockout of DPP4 lacked an analogous effect, the combined DPP4/FAP inhibitor linagliptin, but not the FAP-specific inhibitor SP-13786, reduced C2Sc and total PrPSc levels in two murine cell-based models of prion infections. Thus, the net activity of the S9B peptidases FAP and DPP4 and their cognate inhibitors/modulators affect the physiology and pathogenic potential of PrPC. [ABSTRACT FROM AUTHOR]

Immigration and forced migration have been on the rise globally because of a variety of political, social and economic factors. The association between forced migration and poor mental health is well documented, with many families and youth experiencing violence, loss of identity or status, racism, and discrimination. Despite these adversities, families and youth have leveraged individual and collective resources that have assisted in their integration, and overall well-being as they have acculturated to the United States (US). To explore the phenomenon of what refugee youth viewed as a healthy community during their transition to the US, a community based participatory research photovoice study was conducted with youth between 13-18 years of age. Through the photovoice process three main themes were identified by refugee youth that they felt were critical in making a healthy, thriving community, with thematic analysis revealing additional subthemes. Participants described how these themes were not only intertwined, but necessary for their social, emotional, and mental stability and the stability of members of their community. Implications regarding how to apply these results in both the clinical and human service fields are discussed. [ABSTRACT FROM AUTHOR]