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• Use of glucagon-like peptide 1 receptor agonists improves outcomes in patients with coronary artery disease. • The benefits of beta blockers after acute myocardial infarction in patients with normal systolic function remain questionable. • Aggressive multimodal lipid lowering is needed for secondary prevention of atherosclerotic cardiovascular disease with target LDL-C < 70 mg/dL. • Use of single antiplatelet therapy in patient 1-6 months elective percutaneous coronary intervention is reasonable to reduce risk of bleeding. The 2023 American Heart Association (AHA)/American College of Cardiology (ACC) Multisociety Guideline for the Management of Patients with Chronic Coronary Disease presents important updates to the care of patients with chronic coronary disease. The recommendations of these guidelines inform the care for patients with 1) asymptomatic coronary artery disease, 2) stable angina or equivalent symptoms (e.g., dyspnea upon exertion), 3) symptomatic nonobstructive coronary disease including coronary microvascular dysfunction and vasospasm, and 4) left ventricular (LV) systolic dysfunction with known coronary artery disease. In this review, we aim to demonstrate key recommendations in the 2023 guideline using the following four hypothetical cases. [ABSTRACT FROM AUTHOR]

Arctic ecosystems are affected by accelerated warming as well as the intensification of the hydrologic cycle, yet understanding of the impacts of compound climate extremes (e.g., simultaneous extreme heat and rainfall) remains limited, despite their high potential to alter ecosystems. Here, we show that the aquatic ecosystems in historically arid West Greenland have undergone an ecological transformation after a series of atmospheric rivers that simultaneously produced record heat and rainfall hit the region in autumn 2022. We analyzed a unique, long-term lake dataset and found that compound climate extremes pushed Arctic lakes across a tipping point. As terrestrial-aquatic linkages were strengthened, lakes synchronously transformed from "blue" lakes with high transparency and low pelagic primary production to "brown" in less than a year, owing to a large influx of dissolved organic material and metals, with iron concentrations increasing by more than two orders of magnitude. The browning of lake waters reduced light penetration by 50% across lakes. The resulting light limitation altered plankton distributions and community structure, including a major reduction in prokaryotic diversity and an increase in algal groups capable of metabolizing organic carbon sources. As a result, lakes shifted from being summer carbon sinks to sources, with a >350% increase in carbon dioxide flux from lakes to the atmosphere. The remarkably rapid, coherent transformation of these Arctic ecosystems underscores the synergistic and unpredictable impacts of compound extreme events and the importance of their seasonal timing, especially in regions with negative moisture balance. [ABSTRACT FROM AUTHOR]

Androgens are pleiotropic and play pivotal roles in the formation and variation of sexual phenotypes. We show that differences in circulating androgens between the three male mating morphs in ruff sandpipers are linked to 17-beta hydroxysteroid dehydrogenase 2 (HSD17B2), encoded by a gene within the supergene that determines the morphs. Low-testosterone males had higher HSD17B2 expression in blood than high-testosterone males, as well as in brain areas related to social behaviors and testosterone production. Derived HSD17B2 isozymes, which are absent in high-testosterone males but preferentially expressed in low-testosterone males, converted testosterone to androstenedione faster than the ancestral isozyme. Thus, a combination of evolutionary changes in regulation, sequence, and structure of a single gene introduces endocrine variation underlying reproductive phenotypes. [ABSTRACT FROM AUTHOR]

Despite significant research efforts, pancreatic cancer remains a formidable foe. To address the critical need for improved diagnostics, this study presents a novel approach that integrates expert guidance with computer-aided imaging for fine needle aspiration (FNA). A meticulously curated computed tomography (CT) dataset of ground truth images, focusing on key subregions of the pancreas, was established in collaboration with medical professionals. The images provided the training ground for a novel diagnostic model equipped with the gradual moment approximation (GMAp) optimization algorithm, designed to enhance the precision of cancer detection. By efficiently transferring knowledge from pre-trained models, the proposed model achieved remarkable accuracy (98.16%) in classifying CT images across distinct cancerous pancreatic subregions (head, body, and tail) and healthy pancreas. Extensive evaluations against diverse pre-trained models and benchmark medical databases: medical segmentation decathlon, clinical proteomic tumor analysis consortium pancreatic ductal adenocarcinoma, and pancreas-computed tomography proved the model's robustness and superior F1-scores compared to existing approaches. The experiment demonstrates that the deep learning-based 4-class classification outperforms state-of-the-art machine learning-based method by 3.66% in terms of accuracy. This efficiency, coupled with rigorous testing, paves the way for seamless integration into clinical workflows, potentially enabling earlier and more accurate pancreatic cancer diagnoses. [ABSTRACT FROM AUTHOR]

Background: Despite equality and quality being the core of good healthcare, racial and ethnic inequalities continue to persist. Racialized groups, including racialized migrant women, experience various forms of discrimination—particularly during maternal care encounters, where intersectional forms of discrimination may occur. Experiences of discrimination in maternal care have been associated with poor health-seeking behavior and adverse maternal health outcomes. However, research on racialized migrant women's discrimination in maternal care is limited. This scoping review aims to give an overview of the state of current research on the discriminatory experiences of racialized migrant women when utilizing maternal healthcare and its gaps to ensure equity in global maternal healthcare. Methodology: This scoping review mapped out all available English-language scientific empirical literature published between 2012 and 2023. All authors agreed on the inclusion criteria. Collecting, charting, and reviewing the included material were done using the 2018 Preferred Reporting Items for reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The search strategy included electronic databases, such as Pubmed, CINAHL, MEDLINE, Web of Science, and PsycInfo. Results: A total of 57 articles were included and analyzed. The majority were qualitative and conducted in European and North American countries. None of the included article's aims originally intended to focus on discrimination. However, their findings exposed the many ways racialized migrant women experienced discrimination when using maternal healthcare services—from accessibility problems, non-utilization of interpreters, and untimely and delayed care to disrespect, abuse, and differential care. Racialized migrant women's discrimination resulted in a lack of agency and being excluded from decision-making. Conclusions: While the included articles allude to some issues related to discrimination in maternal healthcare experienced by racialized migrant women, this review delineated knowledge gaps warranting discussion. Few articles focus on and conceptualize discrimination from a racialized lens in maternal healthcare. A limited geographical scope in research and knowledge generation on discrimination and racialization exist in this field as does a lack of sufficient articles on discrimination and racism from healthcare personnel. Lastly, many of the existing studies lack an intersectional lens in exploring discrimination in maternal care against racialized migrant women. [ABSTRACT FROM AUTHOR]

Arsenic (As) is a risk factor for non-melanoma skin cancer (NMSC). From a six-year follow-up study on 7000 adults exposed to As, we reported the associations of single-nucleotide variation in tumor tissue and gene expression. Here, we identify the associations of small deletions (DELs) and transcriptomic profiles in NMSC. Comparing the (a) NMSC tissue (n = 32) and corresponding blood samples from each patient, and (b) an independent set of non-lesional, healthy skin (n = 16) and paired blood, we identified NMSC-associated DELs. Differential expressions of certain gene pathways (TGF-β signaling pathway, IL-17 pathway, PD-L1 pathway, etc.) showed significant interactions with these somatic DELs and As exposure. In low-As-exposure cases, the DELs in APC were associated with the up-regulation of inflamed T-Cell-associated genes by a fold change (FC) of 8.9 (95% CI 4.5–17.6), compared to 5.7 (95% CI 2.9–10.8) without APC DELs; in high-As-exposure cases, the APC DELs were associated with an FC of 5.8 (95% CI 3.5–9.8) compared to 1.2 (95% CI −1.3 to 1.8) without APC DELs. We report, for the first time, the significant associations of somatic DELs (many in STR regions) in NMSC tissue and As exposure with many dysregulated gene pathways. These findings may help in selecting groups of patients for potential targeted therapy like PD-L1 inhibitors, IL-17 inhibitors, and TGF-β inhibitors in the future. [ABSTRACT FROM AUTHOR]

Examination of the host‐associated microbiome in wildlife can provide critical insights into the eco‐evolutionary factors driving species diversification and response to disease. This is particularly relevant for isolated populations lacking genomic variation, a phenomenon that is increasingly common as human activities create habitat 'islands' for wildlife. Here, we characterised the gut and otic microbial communities of one such species: Channel Island foxes (Urocyon littoralis). The gut microbiome provided evidence of phylosymbiosis by reflecting the host phylogeny, geographic proximity, history of island colonisation and contemporary ecological differences, whereas the otic microbiome primarily reflected geography and disease. Santa Catalina Island foxes are uniquely predisposed to ceruminous gland tumours following infection with Otodectes cynotis ear mites, while San Clemente and San Nicolas Island foxes exhibit ear mite infections without evidence of tumours. Comparative analyses of otic microbiomes revealed that mite‐infected Santa Catalina and San Clemente Island foxes exhibited reduced bacterial diversity, skewed abundance towards the opportunistic pathogen Staphylococcus pseudintermedius and disrupted microbial community networks. However, Santa Catalina Island foxes uniquely harboured Fusobacterium and Prevotella bacteria as potential keystone taxa. These bacteria have previously been associated with colorectal cancer and may predispose Santa Catalina Island foxes to an elevated cancer risk. In contrast, mite‐infected San Nicolas Island foxes maintained high bacterial diversity and robust microbial community networks, suggesting that they harbour more resilient microbiomes. Considered together, our results highlight the diverse eco‐evolutionary factors influencing commensal microbial communities and their hosts and underscore how the microbiome can contribute to disease outcomes. [ABSTRACT FROM AUTHOR]

Households are a significant source of SARS-CoV-2 transmission, even during periods of low community-level spread. Comparing household transmission rates by SARS-CoV-2 variant may provide relevant information about current risks and prevention strategies. This investigation aimed to estimate differences in household transmission risk comparing the SARS-CoV-2 Delta and Omicron variants using data from contact tracing and interviews conducted from November 2021 through February 2022 in five U.S. public health jurisdictions (City of Chicago, Illinois; State of Connecticut; City of Milwaukee, Wisconsin; State of Maryland; and State of Utah). Generalized estimating equations were used to estimate attack rates and relative risks for index case and household contact characteristics. Data from 848 households, including 2,622 individuals (median household size = 3), were analyzed. Overall transmission risk was similar in households with Omicron (attack rate = 47.0%) compared to Delta variant (attack rate = 48.0%) circulation. In the multivariable model, a pattern of increased transmission risk was observed with increased time since a household contact's last COVID-19 vaccine dose in Delta households, although confidence intervals overlapped (0–3 months relative risk = 0.8, confidence interval: 0.5–1.2; 4–7 months relative risk = 1.3, 0.9–1.8; ≥8 months relative risk = 1.2, 0.7–1.8); no pattern was observed in Omicron households. Risk for household contacts of symptomatic index cases was twice that of household contacts of asymptomatic index cases (relative risk = 2.0, 95% confidence interval: 1.4–2.9), emphasizing the importance of symptom status, regardless of variant. Uniquely, this study adjusted risk estimates for several index case and household contact characteristics and demonstrates that few characteristics strongly dictate risk, likely reflecting the complexity of the biological and social factors which combine to impact SARS-CoV-2 transmission. [ABSTRACT FROM AUTHOR]

Background: Glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment reduces cardiovascular events in type 2 diabetes. Yet, the impact of GLP-1RA treatment before ST-segment elevation myocardial infarction (STEMI) on long-term prognosis in patients with type 2 diabetes remains unclear. In patients with STEMI and type 2 diabetes, we aimed to investigate the association between long-term prognosis and GLP-1RA treatment before STEMI. Methods: This nationwide cohort study included consecutive patients admitted with type 2 diabetes and STEMI in Denmark from 2010 to 2016. All data were retrieved from nationwide Danish registries. Type 2 diabetes was defined by prior hospital admission with type 2 diabetes or anti-diabetic prescriptions within one year before STEMI. Dispensed GLP-1RA medication was retrieved within one year before STEMI. Results: Of 1421 patients with STEMI and diabetes, 7% were treated with GLP-1RA before STEMI and 93% were not. Patients treated with GLP-1RA were younger, had more comorbidities, and more often treated with other anti-diabetics. During 8.4 years, 36% patients treated with GLP-1RA died whereas 52% died in the no GLP-1RA group (p = 0.002). In adjusted Cox analysis, GLP-1RA was associated with lower long-term mortality (hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.43–0.84). There was no association between GLP-1RA and ischemic stroke (adjusted HR 1.05, 95% CI 0.57–1.94), recurrent myocardial infarction (adjusted HR 0.74, 95% CI 0.48–1.15), or hospitalisation for heart failure (adjusted HR 0.71, 95% CI 0.48–1.05). Conclusions: In patients with diabetes and STEMI, GLP-1RA treatment prior to STEMI admission was associated with significantly lower long-term mortality. [ABSTRACT FROM AUTHOR]

Focusing on queer female fan labor within the K-pop realm, this study explores how fans engage with female-centered media texts and the role of fan labor in shaping collective queer female identity. By examining the phenomenon of “girl crush” groups, particularly Mamamoo, and how fan-created content surrounding their queerness functions, I reveal how affect-based queer networks emerge through free fan labor, complicating fans’ relationships with identity and constructing online spaces for queer female fans. This article thus emphasizes the transcultural nature of these interpretations and the significance of fan labor in fostering subversive, community-focused engagement within “girl crush” groups. [ABSTRACT FROM AUTHOR]

Labial hypertrophy, which lacks an accepted definition, is generally understood to refer to morphological and aesthetic characteristics of the labia believed to deviate from a perceived norm. Such ostensive deviation has the potential to affect many domains of a person's well-being, as does its surgical treatment, labiaplasty. Nearly 24,000 labiaplasty procedures were performed in the United States in 2022, representing a greater than three-fold increase since numbers were first reported in 2013. Nearly 20% of these procedures were performed on minors, and cases have been reported in children well before complete pubertal development or the age of personal consent. In this article, we explore the indications that are used to designate labiaplasty as "medically necessary" in minors, a status that, we argue, is required for such procedures to avoid fitting the definition of "medicalized FGM" (i.e., "female genital mutilation") according to the World Health Organization. As a part of this, we consider the particular ways in which outcomes are measured in this population. We shed light on persistent methodological shortcomings in the research on labiaplasty, discuss ethical and legal implications, and make recommendations to improve the relevance, reliability, and generalizability of future investigations into this increasingly common, controversial surgical procedure. [ABSTRACT FROM AUTHOR]

This report illustrates the Food and Drug Administration (FDA) approval of first-in-its-class activin A receptor IIA inhibitor, sotatercept (Winrevair™), for the treatment of pulmonary arterial hypertension (PAH). Sotatercept is used to increase exercise capacity, improve WHO functional class, and decrease the risk of clinical worsening events in adults with PAH. One phase 2 trial, one phase 3 trial, and an ongoing open-label extension study is described in detail within the current text. Sotatercept significantly improved the 6-min walk distance in patients with PAH after 24 weeks with a mean change increase of 40.1 meters in the experimental group versus 1.4 meters decrease in the placebo group. Epistaxis, telangiectasia, increased hemoglobin, hematocrit, red blood cell levels, and dizziness were adverse events more frequently observed in the sotatercept group than in the placebo group. Sotatercept has shown significant benefits in the reduction of pulmonary vascular resistance and N-terminal pro b-type natriuretic peptide in patients with PAH. However, more studies are needed to evaluate the reduction in mortality. Limitations in practice include high cost and unknown long-term effects. [ABSTRACT FROM AUTHOR]

Purpose: There is an expanding body of research interrogating lesbian, gay, bisexual, transgender, queer, asexual and other gender and sexuality diverse (LGBTQA+) persons' experiences of domestic and family violence (DFV). However, few studies have considered LGBTQA+ persons' specific experiences of 'coercive control' and none have considered legal help-seeking behaviours and decisions within this context. This article addresses this gap, through an examination of LGBTQA+ Australians' experiences of legal help-seeking behaviours when experiencing coercive control from an intimate partner and/or family member. Method: The article draws on the qualitative responses of a sample of 137 LGBTQA+ victim-survivors who participated in a survey on Australians' experiences of coercive control. The analysis considers the reasons why some participants did not report abuse to the police, and the impact of police reporting for those who did. Results: The study found that many of the concerns about the impact of reporting held by those who did not report to the police, were actualized in the experiences of those who did. Further, the study found that LGBTQA+ persons experience similar barriers to help-seeking compared to heterosexual and cisgender women, in addition to barriers that speak specifically to LGBTQA+ communities. Conclusion: The findings of this study highlight the shortcomings of the law's response to domestic and family violence and the need for intersectional responses to coercive control in Australia and beyond. The emerging findings presented in this article reinforce the importance and further need for research that specifically examines LGBTQA+ experiences of coercive control. [ABSTRACT FROM AUTHOR]

Background/Objectives: Glioblastoma multiforme (GBM) is the most common high-grade primary brain cancer in adults. Despite efforts to advance treatment, GBM remains treatment resistant and inevitably progresses after first-line therapy. Induced neural stem cell (iNSC) therapy is a promising, personalized cell therapy approach that has been explored to circumvent challenges associated with the current GBM treatment. Methods: Herein, we developed a chitosan-based (CS) injectable, biodegradable, in situ forming thermo-responsive hydrogel as a cell delivery vehicle for the treatment of GBM. Tumoricidal neural stem cells were encapsulated in the injectable CS hydrogel as stem cell therapy for treatment of post-surgical GBM. In this report, we investigated the safety of the injectable CS hydrogel in an immune-competent mouse model. Furthermore, we evaluated the persistence and efficacy of iNSC-laden CS hydrogels in a post-surgical GBM mouse model. Results: The injectable CS hydrogel was well tolerated in mice with no signs of chronic local inflammation. Induced neural stem cells (iNSCs) persisted in the CS hydrogels for over 196 days in comparison to 21 days for iNSCs (cell injection) only. GBM recurrence was significantly slower in mice treated with iNSC-laden CS hydrogels with a 50% increase in overall median survival in comparison to iNSCs (cell injection) only. Conclusions: Collectively, we demonstrated the ability to encapsulate, retain, and deliver iNSCs in an injectable CS hydrogel that is well tolerated with better survival rates than iNSCs alone. [ABSTRACT FROM AUTHOR]

Simple Summary: Melanoma is an aggressive malignancy defined by significant intratumoral heterogeneity, driving its capacity for therapeutic resistance and recurrence. This study adopts a systems-level approach to dissect the melanoma microenvironment, focusing on intricate interactions between malignant cells and immune infiltrates. We identified critical regulatory networks and intercellular communication pathways that appear to influence disease progression. These findings highlight the dynamic interplay between tumor-intrinsic factors and the surrounding microenvironment, revealing potential mechanisms underlying immune evasion and therapy resistance. By mapping these complex interactions, the present study builds on our foundation for precision-based therapeutic strategies tailored to the unique biological landscape of melanoma, offering promise for improved clinical outcomes. Background: Despite significant strides in anti-melanoma therapies, resistance and recurrence remain major challenges. A deeper understanding of the underlying biology of these challenges is necessary for developing more effective treatment paradigms. Methods: Melanoma single-cell data were retrieved from the Broad Single Cell Portal (SCP11). High-dimensional weighted gene co-expression network analysis (hdWGCNA), CellChat, and ligand-receptor relative crosstalk (RC) scoring were employed to evaluate intercellular and intracellular signaling. The prognostic value of key regulatory genes was assessed via Kaplan-Meier (KM) survival analysis using the 'SKCM-TCGA' dataset. Results: Twenty-seven (27) gene co-expression modules were identified via hdWGCNA. Notable findings include NRAS Q61L melanomas being enriched for modules involving C19orf10 and ARF4, while BRAF V600E melanomas were enriched for modules involving ALAS1 and MYO1B. Additionally, CellChat analysis highlighted several dominant signaling pathways, namely MHC-II, CD99, and Collagen-receptor signaling, with numerous significant ligand-receptor interactions from melanocytes, including CD99-CD99 communications with cancer-associated fibroblasts, endothelial cells, NK cells, and T-cells. KM analysis revealed that higher expression of SELL, BTLA, IL2RG, PDGFA, CLDN11, ITGB3, and SPN improved overall survival, while higher FGF5 expression correlated with worse survival. Protein-protein interaction network analysis further indicated significant interconnectivity among the identified prognostic genes. Conclusions: Overall, these insights underscore critical immune interactions and potential therapeutic targets to combat melanoma resistance, paving the way for more personalized and effective treatment strategies. [ABSTRACT FROM AUTHOR]

Introduction Blood transfusions are common during combat casualty care, aiming to address the loss of blood volume that often accompanies severe battlefield injuries. This scoping review delves into the existing military combat casualty data to analyze the efficacy, challenges, and advances in the use of massive and super-massive transfusions in the management of critically injured warfighters. Materials and Methods We performed a scoping review of combat-related literature published between 2006 and 2023 pertaining to massive transfusions used during combat deployments. We utilized PubMed to identify relevant studies and utilized the PRISMA-ScR Checklist to conduct the review. Results We identified 53 studies that met the inclusion criteria with the majority being retrospective studies from registries used by the United States, British, French, and Dutch Militaries. Most of the studies focused on transfusion ratios, the movement of blood transfusions to more forward locations, implementation of massive transfusions with different fibrinogen-to-red blood cell ratios, the addition of recombinant factor VII, and the use of predictive models for transfusion. Lastly, we identified reports of improved survival for casualties with the rapid implementation of various blood products (warm fresh whole blood, cold-stored low titer group O blood, freeze-dried plasma, and component therapy) and literature relating to pediatric casualties and submassive transfusions. Notable findings include the establishment of hemodynamic and cell blood count parameters as predictors of the requirement for massive transfusions and the association of higher fibrinogen-to-red blood cell ratios with decreased mortality. Conclusions We identified 53 studies focused on blood transfusions from the Global War on Terrorism conflicts. The majority were related to transfusion ratios and the movement of blood transfusions to more forward locations. We highlight key lessons learned on the battlefield that have been translated into scientific developments and changes in civilian trauma methods. [ABSTRACT FROM AUTHOR]

BACKGROUND: Primary aldosteronism (PA) is the most common cause of secondary hypertension, yet screening remains startlingly infrequent. We describe (1) PA screening practices in a large, diverse health system, (2) the development of a computable phenotype for PA screening, and (3) the design and pilot deployment of an electronic health record (EHR)-based active choice nudge to recommend PA screening. STUDY DESIGN: A multidisciplinary team developed a multipronged intervention to improve PA screening informed by guidelines, expertise, and multivariable analyses of factors associated with screening. The intervention included EHR-based tools to automatically identify screen-eligible patients, an active choice nudge recommending screening for these patients, and screening result interpretation. The intervention was piloted across 2 primary care practices for 7 months. Screening frequencies were compared with clinics not receiving the intervention. RESULTS: The baseline frequency of screening of eligible patients within 1 year was 1.4%. Higher mean systolic blood pressure (odds ratio [OR] 1.4; p < 0.001), more antihypertensive medications (OR 1.3; p = 0.002), lower minimum serum potassium (OR 2.0; p = 0.001), specialist care (OR 3.0; p < 0.001), and Black race (OR 1.5; p = 0.001) were associated with a higher likelihood of screening. The refined computable phenotype identified a subcohort with a higher frequency of positive screening (8.6% vs 4.1%; p = 0.03). In a pilot study of an active choice nudge, a greater proportion of eligible patients were screened in the intervention clinics (16.4%) than in the nonintervention clinics (1.8%; p < 0.001). CONCLUSIONS: PA screening rates are low. This pilot study suggests an EHR-based nudge leveraging a precise computable phenotype can dramatically increase appropriate PA screening. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionsTo report host-related and environmental factors associated with otitis media (OM), and compare the prevalence of OM in 12-month-old infants reported by parents with that predicted from audiological assessment results.A non-randomised, cross-sectional design was used. Data were collected via a parental questionnaire during children’s audiology appointment at 12 months of age. Audiological assessments were performed on all participants.Participants were 237 infants whose parents had completed a questionnaire at the audiology appointment.The results of the logistic regressions with univariate model showed that attendance at day-care centres, upper respiratory tract infections (URTI) and siblings’ history of OM were statistically significant variables with an odds ratio of 1.91, 2.87 and 3.56, respectively. The results of the multivariate logistic regression highlighted siblings’ history of OM as the significant associated factor. The prevalence of parent-reported OM was 22.3% whereas the prevalence predicted from audiological findings was at least 39.7%.The present study identified three associated factors for OM: day-care attendance, frequent URTI and siblings’ history of OM in infants. The prevalence of OM predicted from audiologic measures was about twice of that reported by parents. Preventive measures to mitigate the effects of OM have been suggested. [ABSTRACT FROM AUTHOR]

Circadian neurons within animal brains orchestrate myriad physiological processes and behaviors, but the contribution of these neurons to the regulation of sleep is not well understood. To address this deficiency, we leveraged single-cell RNA sequencing to generate a comprehensive census of transcriptomic cell types of Drosophila clock neurons. We focused principally on the enigmatic DN3s, which constitute most fly brain clock neurons and were previously almost completely uncharacterized. These DN3s are organized into 12 clusters with unusual gene expression features compared to the more well-studied clock neurons. We further show that previously uncharacterized DN3 subtypes promote sleep through a G protein-coupled receptor, TrissinR. Our findings indicate an intricate regulation of sleep behavior by clock neurons and highlight their remarkable diversity in gene expression and functional properties. [ABSTRACT FROM AUTHOR]

Ecological restoration often requires exotic invasive plant control. In many ecosystems, reestablishment of biological soil crusts (biocrusts) is a desired restoration outcome because biocrusts enhance ecosystem function and may favor native plants over exotics. We sought to pair exotic plant suppression with biocrust restoration using a novel restoration material: biocrust‐covered weed barriers. We tested five different barriers, including three biodegradable weed barriers, one synthetic weed barrier commonly used in the study area, and burlap cloth, because it has previously been shown to be useful in biocrust establishment. We grew biocrust moss over the surface of each barrier type in a fog chamber. Each barrier type was attached to the ground in the field with moss on the underside of the barrier (moss‐down), the top, or not present. We monitored the establishment of moss biocrusts and exotic plants and the durability of the barriers. The most successful barrier type for biocrust establishment was burlap, but one biodegradable weed barrier made of maize‐derived polylactic acid (corn) promoted biocrusts, especially in the moss‐down position. Only the synthetic weed barrier suppressed exotic plants for two growing seasons. The corn barrier only partially suppressed exotic plants for one growing season. Less durable weed barriers were less able to suppress exotic plants. Though we failed to identify a biodegradable barrier that both stimulates biocrust recovery and suppresses exotic plants beyond one growing season, our results suggest that our goal may be attainable if more durable biodegradable weed barriers were used or created. [ABSTRACT FROM AUTHOR]

This study comprehensively assesses the predictive capabilities of the Monsoon Mission Coupled Forecasting System (MMCFS) output for El Niño-Southern Oscillation (ENSO) conditions and its transitions in the various phases. The MMCFS model is being run for the operational seasonal forecast at the India Meteorological Department (IMD), and understanding the model skill for different seasons and various leads is imperative for informed decision-making in various climate-sensitive sectors. This analysis reveals various aspects of the model’s skill for the forecast of Niño 3.4 index by quantifying deterministic and probabilistic verifications across seven leads during all the three-month running seasons throughout the year for the period 1991–2020. Analysis indicates predominant cold bias across the Niño 3.4 region. The results highlight that the root mean square error (RMSE) is always less than the observed standard deviation (SD) regardless of the season for lead 1. The lowest RMSE for the JJA season using lead 1 is about 0.35℃, while the observed SD for the same season is approximately 0.61. Reliability and receiver operating characteristic (ROC) curve suggest higher forecasting skills for shorter leads. This study also analyses the performance of the MMCFS model on the four types of ENSO transitions, such as from El Niño (La Niña) to Neutral ENSO and Neutral ENSO to El Niño (La Niña), to enhance the understanding and provide insights for improved seasonal forecasting. Lead 1 shows significant skill in predicting ENSO transitions compared to other leads. Results reveal that the MMCFS captures four transitions of ENSO with a 95% level of significance pattern correlation coefficient (PCC) values. The acquired insights in this study deepen our understanding of ENSO forecasting, which is pivotal in facilitating informed decision-making processes across diverse climate-sensitive sectors, vulnerable to the multifaceted impacts of ENSO-related phenomena. [ABSTRACT FROM AUTHOR]

Background and Aims: Postoperative sleep disturbances are associated with delayed recovery and increased incidences of complications. This systematic review aims to determine the impact of perioperative pharmacological therapies on postoperative sleep quality in the hospital. Material and Methods: We searched MEDLINE, MEDLINE ePubs and In-Process Citations (Daily), Embase Classic + Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and PubMed for randomized controlled trials (RCTs) from inception to May 2022, with continued literature surveillance until August 2023. Studies included consisted of noncardiac surgical patients aged ≥18 years with postoperative sleep in the hospital. The primary outcome was improvement in postoperative sleep outcomes such as sleep quality, duration, efficiency, architecture, and insomnia ratings after pharmacological treatment. Additional outcomes included postoperative pain scores and opioid consumption. Results: The search strategy yielded 21 studies (n = 3276), and 18 reported improved sleep outcomes using eight validated sleep measurement tools. Eight of 10 studies using dexmedetomidine via patient-controlled analgesia or intravenous infusion reported better sleep quality versus controls. Opioids (nalbuphine, tramadol plus sufentanil), nonopioids (zolpidem, midazolam, pregabalin), propofol total intravenous anesthesia (TIVA), S -ketamine, and ropivacaine nerve blocks were superior to controls in enhancing postoperative sleep quality. Eleven studies (52%) which included the combination of dexmedetomidine with opioids reported concurrent improvements in postoperative pain and sleep. Dexmedetomidine also decreased postoperative opioid analgesia consumption. Conclusions: Evidence for the effects of perioperative pharmacological approaches on postoperative sleep are limited. High-quality RCTs of adequate power and methodology on the effects of pharmacology interventions on postoperative sleep are warranted. [ABSTRACT FROM AUTHOR]

The growing mental health needs and constrained resources in low- and middle-income countries necessitate scalable solutions. Single Session Therapy (SST) is a global trend in brief and cost-effective options for mental health interventions. It involves a single planned session between mental health service provider and client. This study aims to present a protocol to develop and evaluate a culture specific web-based training program to equip mental health support providers with the skills and confidence to deliver SST. The study protocol uses a mixed-methods evaluation design through three phases—need assessment – where psychologists and social workers collaborate to identify training needs and co-create the program; development and expert validation of the web-based training program; and randomized control trial to evaluate the training, followed by in-depth discussions with participants. This study breaks new ground by empirically designing and evaluating a training program for SST. It uniquely co-designs and validates a culturally sensitive SST training program, leveraging the expertise of a renowned international panel. This protocol goes beyond a blueprint for replicating this study, it serves as a foundational guide for nations seeking to implement effective SST training for their mental health professionals, preventing duplication of efforts. [ABSTRACT FROM AUTHOR]

Background: The declining trend in the number of primary care physicians worldwide has led to shortages especially within socioeconomically deprived areas. Socioeconomically deprived areas in the context of this review are defined by regions where there are lower levels of income and access to essential services such as primary healthcare compared to other areas. This shortage contributes to a higher incidence of preventable hospital admissions, unnecessarily straining healthcare infrastructure and negatively affecting patient outcomes. Previous studies have often been limited in scope, focusing on isolated factors or specific regions. Therefore, the objective of this systematic review is to synthesise current research to provide a better understanding of the underlying causes of this high turnover, ultimately informing strategies to address the global shortage of primary care physicians. Methods: This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Refer to S1 Table for the PRISMA 2020 checklist. A comprehensive search was conducted across PubMed (1970 to September 2024) and Embase (1974 to September 2024). The eligibility criteria included quantitative empirical studies that included a measurement of at least one of the factors behind increased primary care physician turnover or retention within socio-economically deprived or disadvantaged areas. However, the included studies were required to employ a specific methodology for classifying or defining socioeconomic deprivation. The references were screened, the studies selected, the data extracted, and the risk of bias assessed using the ROBINS-I tool, with both reviewers in agreement. Results: Thirteen studies were identified. The factors measured in the studies driving increased turnover in deprived areas included region of work (n = 7), income (n = 2), burnout (n = 2) and social values (n = 2). Some studies found additional challenges specific to socioeconomically deprived areas, such as familial concerns about regional safety, limited employment opportunities for spouses, or personal career development challenges. However, some studies identified increased hours and sickness presenteeism as stronger contributors to burnout. However, this link can be presumed to be stronger in deprived areas due to staffing shortages, though none of the studies in this systematic review have directly measured this correlation. Though longer-term methods of retention within socioeconomically deprived areas included more collaborative working environments and flexible working hours, this can also be applied to benefit healthcare settings across all regions. Conclusions: The studies reviewed have consistently highlighted the repeating cycle of persistent staff shortages contributing to an increased turnover rate within disadvantaged areas internationally. Therefore, implementation of targeted policies by governments and healthcare organisations is required to retain primary care physicians within these areas to ultimately improve and standardise patient care. [ABSTRACT FROM AUTHOR]

This qualitative study examines how Latina mothers with multilingual children institutionally designated as English Learners negotiated dominant notions of competence in their dual language bilingual program. Findings demonstrated that Latina mothers reclaimed competence for themselves and their children by interrogating intersecting, hegemonic constitutions of competence while employing various forms of motherwork to support their children’s learning and well-being. Specifically, they sustained their children’s expansive, historicized identities and language practices, advocated for their children’s access to interdisciplinary, multimodal learning experiences, and asserted their children’s right to wellness and personal agency in utilizing bilingual educational spaces. Findings from this study have implications for how to contest problematic institutional conceptualizations of families in schools, and how to create programming and leadership structures that elevate Latina mothers as critical leaders of collective mobilization efforts aimed at equity and justice in bilingual educational programs. [ABSTRACT FROM AUTHOR]

Background: The construct of social vulnerability attempts to understand social circumstances not merely as a descriptor, but as a predictor of adverse health events. It can be measured by aggregating social deficits in a social vulnerability index (SVI). We describe a standard procedure for constructing a multi-level SVI using two working examples. Methods: First, we describe a six-step approach to constructing a SVI. Then, we conducted a secondary analysis of a clinical dataset (Canadian Immunization Research Network's Serious Outcomes Surveillance Network (SOS)) and a population-based dataset (Canadian Longitudinal Study on Aging (CLSA)). In both datasets, we construct SVIs, use descriptive statistics to report distributions by age and sex, and perform a multivariable linear regression of social vulnerability on frailty. Results: Procedures for drafting a list of candidate social items, selecting deficits for inclusion, and screening deficits to meet inclusion criteria were applied to yield a 18-deficit SVI for the SOS and 74-deficit SVI for the CLSA. Deficits in each SVI were re-scored between 0 and 1, where 1 indicates the greater risk. Finally, the sum of all deficits is calculated into an index. In the SOS, SVI was associated with age only for females and was weakly associated with frailty (r = 0.26, p<0.001). In the CLSA, SVI was associated with age for both sexes and moderately associated with frailty (r = 0.41, p<0.001). Conclusion: We present a standard method of constructing a SVI by incorporating factors from multiple social domains and levels in a social-ecological model. This SVI can be used to improve our understanding of social vulnerability and its impacts on the health of communities and individuals. [ABSTRACT FROM AUTHOR]

Background: The importance of replication in the social and behavioural sciences has been emphasized for decades. Various frequentist and Bayesian approaches have been proposed to qualify a replication study as successful or unsuccessful. One of them is meta-analysis. The focus of the present study is on the way meta-analysis functions as a replication success metric. To investigate this, original and replication studies that are part of two large-scale replication projects were used. For each original study, the probability of replication success was calculated using meta-analysis under different assumptions of the underlying population effect when replication results were unknown. The accuracy of the predicted overall replication success was evaluated once replication results became available using adjusted Brier scores. Results: Our results showed that meta-analysis performed poorly when used as a replication success metric. In many cases, quantifying replication success using meta-analysis resulted in the conclusion where the replication was deemed a success regardless of the results of the replication study. Discussion: We conclude that when using meta-analysis as a replication success metric, it has a relatively high probability of finding evidence in favour of a non-zero population effect even when it is zero. This behaviour largely results from the significance of the original study. Furthermore, we argue that there are fundamental reasons against using meta-analysis as a metric for replication success. [ABSTRACT FROM AUTHOR]

ABSTRACT Despite the persistence of breastfeeding racial and ethnic disparities in the United States, little is known about Black fathers' perceptions of breastfeeding and breastfeeding support services (e.g., maternity hospital‐based care and lactation management care). This qualitative, community‐based participatory research study reports Black fathers' perceptions of barriers and facilitators to breastfeeding, including the provision of breastfeeding support services in Connecticut. A focus group guide was co‐developed with community partners and adapted from the Barrier Analysis Tool to identify breastfeeding facilitators, barriers, and service improvement areas. Four focus groups were conducted with 30 Black fathers who were Connecticut residents with a child under 3 years old. Qualitative data were analyzed using rapid template analysis involving deductive and inductive coding. We identified factors influencing breastfeeding and fathers' ability to support breastfeeding across all levels of the Socio‐Ecological Model. Facilitators included high paternal breastfeeding knowledge, paternal breastfeeding involvement, parents' shared decision‐making, extensive maternity hospital discharge support, ongoing breastfeeding support into the postnatal period, availability of community breastfeeding resources, and designated spaces for public breastfeeding. Barriers included low paternal breastfeeding knowledge, familial discouragement, insufficient prenatal breastfeeding education, exclusion of the father from breastfeeding support services, and stigma against breastfeeding in public. Understanding breastfeeding perceptions among members of a mother's support network, including their partners, is key for developing effective person‐ and family‐centered breastfeeding education and counseling services that are well coordinated from the prenatal to postnatal periods with strong direct engagement from fathers. [ABSTRACT FROM AUTHOR]

Here, we sequenced rearranged TCRβ and TCRα chain sequences in CD4+CD8+ double positive (DP), CD4+CD8- single positive (SP4) and CD4-CD8+ (SP8) thymocyte populations from the foetus and young adult mouse. We found that life-stage had a greater impact on TCRβ and TCRα gene segment usage than cell-type. Foetal repertoires showed bias towards 3'TRAV and 5'TRAJ rearrangements in all populations, whereas adult repertoires used more 5'TRAV gene segments, suggesting that progressive TCRα rearrangements occur less frequently in foetal DP cells. When we synchronised young adult DP thymocyte differentiation by hydrocortisone treatment the new recovering DP thymocyte population showed more foetal-like 3'TRAV and 5'TRAJ gene segment usage. In foetus we identified less influence of MHC-restriction on α-chain and β-chain combinatorial VxJ usage and CDR1xCDR2 (V region) usage in SP compared to adult, indicating weaker impact of MHC-restriction on the foetal TCR repertoire. The foetal TCRβ repertoire was less diverse, less evenly distributed, with fewer non-template insertions, and all foetal populations contained more clonotypic expansions than adult. The differences between the foetal and adult thymus TCR repertoires are consistent with the foetal thymus producing aβT-cells with properties and functions that are distinct from adult T-cells: their repertoire is less governed by MHC-restriction, with preference for particular gene segment usage, less diverse with more clonotypic expansions, and more closely encoded by genomic sequence. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic exacerbated socioeconomic and racial disparities. Because of the institution's commitment to health equity, Morehouse School of Medicine, one of four Historically Black College and University (HBCU) medical schools, took the leadership role in addressing disparities by becoming a community vaccination provider. With vaccines registered, ordered, and received from the Georgia Department of Public Health through the mobile community vaccine initiative, the Medical School vaccinated more than 2700 people in the metropolitan Atlanta area. The initiative took place from January 2021, shortly after the COVID-19 vaccines were initially released, until April 2022 when vaccinations became part of routine health maintenance and preventive health measures at the school. Eighty-six percent of the individuals vaccinated were African American or Hispanic/Latino. Our efforts highlighted the importance of addressing vaccine access barriers and providing culturally sensitive care. (Am J Public Health. 2024;114(S9): S714–S717. https://doi.org/10.2105/AJPH.2024.307768) [ABSTRACT FROM AUTHOR]

Conservatorship, though viewed as a private law device, has always operated as a tool of public governance, social control, and resource extraction through the manipulation of the legal category of disability. This Article places a well-accepted Anglo-American history of conservatorship in probate law in conversation with its historical deployment by states, the federal government, and government-empowered private actors to control and extract resources from Native and Black Americans. By recognizing the inherent instability and malleability of disability as a legal concept, I unearth and interrogate its use in the United States in three key moments of political and economic subordination: (1) guardianship of Native Americans in colonial New England; (2) guardianship of free Black Americans in the South during the antebellum period; and (3) guardianship of Native Americans during the allotment period. In isolation, these histories may be familiar to some readers. This Article’s contribution derives from linking them. Doing this shows how conservatorship was and continues to be a formidable legal tool of political and economic subordination, made possible because of how powerful actors have been able to manipulate the concept of disability. To advance this argument, this Article mines legislation, cases, and original conservatorship petitions submitted to county probate courts during the relevant historical periods to show how the design of conservatorship laws offered a way to create economic indebtedness and servitude, while also shifting valuable resources out of conservatees’ hands. This Article then turns to recent examples of conservatorship cases to show how elements from this institution’s early history have shaped the design and operation of conservatorship law today. Seeing this throughline allows us to look upon conservatorship with fresh eyes and ask different questions—questions that may ultimately push us beyond reformist solutions and toward a more radical reimagining of this legal institution. [ABSTRACT FROM AUTHOR]

This study presents a comprehensive numerical computation of heat‐mass transfer characteristics of single‐walled carbon nanotube (SWCNT)/multi‐walled carbon nanotube (MWCNT)‐water suspension flow over a porous stretching sheet with an inclined magnetic field. The governing equations for fluid flow characteristics are formulated using the Sisko fluid model to capture the Newtonian and non‐Newtonian behavior of the nanotube‐water mixture. The nonlinear coupled partial differential equations are converted into nonlinear dimensionless coupled ordinary differential equations using suitable similarity transformations. These equations are solved using MATLAB by implementing the four‐stage Lobatto IIIa formula. The comprehensive set of computations is performed to explore the influence of pertinent parameters, including Sisko fluid parameters, concentration of nanotubes, stretching sheet velocity, and porous medium characteristics on the flow, heat, and mass transfer profiles. From the graphs and statistical analysis, it is clear that the volume fraction of SWCNT and MWCNTs are strongly correlated. The investigation reveals that increasing the inclination angle affects the fluid velocity. The variation in all flow features is negligible for volume fractions of CNTs between 0% and 10% but a significant effect is observed only beyond 10%. Higher volume fractions of CNTs result in enhanced local heat transfer coefficient. This can be attributed due to the outstanding heat transfer capabilities of CNTs owing to their high thermal conductivity. However, Shear thickening fluids exhibit high heat transfer phenomena when compared to shear‐thinning and Newtonian fluids. This research provides valuable insights into the optimization of CNT‐based nanofluids for efficient heat and mass transfer applications in electronics cooling, heat exchangers, and solar energy systems, offering opportunities to enhance energy efficiency and device performance. [ABSTRACT FROM AUTHOR]

Background: Gallstones are a common diagnosis in the United States; though many patients remain asymptomatic, others develop symptoms. Standard of care for symptomatic cholelithiasis is cholecystectomy, but many do not undergo surgery. The purpose of this study is to identify factors that influence receipt of cholecystectomy for symptomatic cholelithiasis at a safety net hospital. Methods: This is a retrospective study performed at a large, academic, tertiary care and safety net state hospital. Patients who presented with symptomatic cholelithiasis were included. Same admission cholecystectomy and elective outpatient cholecystectomy were considered success/standard of care, and readmission cholecystectomy or no cholecystectomy were considered failures/not standard of care. Results: Of 376 patients, a substantial minority were Spanish speaking, and almost half had public insurance. 23.7% were successfully treated, and 76.3% had failure in management. A larger number of patients in the group that had successful treatment had surgery consultation, 67.4%. Only 28.5% of patients saw a surgeon as an outpatient within 30 days of their visit. On multivariable analysis, patients who were provided a surgery consultation were more likely to receive standard of care. Age, sex, language, smoking status, lack of insurance, and alcohol use were not associated. Conclusion: Surgery consultation during presentation for symptomatic cholelithiasis was associated with receipt of same admission, or outpatient elective cholecystectomy, or successful management. There should be a low threshold to involve a surgeon for symptomatic cholelithiasis. [ABSTRACT FROM AUTHOR]

Background: Arsenic present in underground water affects the overall health. The therapeutic effects of Allium sativum was investigated for ameliorating the toxic effects of arsenic exposed ducks. Even though, heavy metals especially arsenic toxicity and ameliorative effects of Allium sativum has been largely studied, yet the histopathological cardiac lesion grading and its correlation with oxidative stress and biochemical parameters is scarce. This study is aimed at evaluating cardiotoxic lesions due to arsenic and ameliorative effects of Allium sativum in accordance with histopathological grading with respect to oxidative and biochemical parameters. Methods: In the present study, 105 birds were randomly distributed in 5 groups. GRP II was given arsenic @ 30 ppm whereas GRP III, IV, V were given Allium sativum @ 0.5 gm/kg feed, 1 gm/kg feed and 2 gm/kg feed respectively along with arsenic to study the ameliorative effects. At the end of 42 days, 6 birds from each group were slaughtered after blood collection and the extend of arsenic toxicity with Allium sativum effects were studied as biochemical and oxidative parameters with histopathological grading of lesions. The extent of lesions was graded as mild (+), moderate (++) and severe (+++). Result: Grossly, heart revealed dilatation and thickening of ventricular wall in GRP II along with congestion in coronary vessels. In GRP V, grossly heart revealed no congestion and comparatively reduced enlargement. Whereas microscopically, myocardial and epicardial oedema, disruption of muscle fiber and hemorrhage was observed. Along with this, there was increase in cardiac biomarkers - Total serum creatinine kinase (CK), creatine kinase-MB (CK-MB) levels and tissue oxidative parameters (LPO), with decrease in GSH, CAT, total antioxidant and SOD levels in GRP II which was comparably restored in GRP V. [ABSTRACT FROM AUTHOR]

Introduction: Suicide risk is substantially elevated following discharge from a psychiatric hospitalization. Caring Contacts (CCs) are brief communications delivered post‐discharge that can help to improve mental health outcomes. Method: This three‐phase, mixed‐method quality‐improvement study revised an existing CC intervention using iterative patient and community feedback. Inpatients (n = 2) and community members (n = 13) participated in focus groups to improve existing CC messages (phases 1 and 2). We piloted these messages among individuals with a suicide‐related concern following discharge from an inpatient psychiatric hospitalization (n = 27), sending CCs on days 2 and 7 post‐discharge (phase 3). Phase 3 participants completed mental health symptom measures at baseline and day 7, and provided feedback on these messages. Results: Phase 1 and 2 focus group participants indicated preferences for shorter, more visually appealing messages that featured personalized, recovery‐focused content. Phase 3 participants demonstrated reductions in depressive symptoms at day‐7 post‐discharge (−6.4% mean score on Hopkins‐Symptom‐Checklist, −9.0% mean score on Entrapment‐Scale). Most participants agreed that CC messages helped them feel more connected to the hospital and encouraged help‐seeking behavior post‐discharge. Conclusion: This study supports the use of an iterative process, including patient feedback, to improve CC messages and provides further pilot evidence that CC can have beneficial effects. [ABSTRACT FROM AUTHOR]

Background: Disorders of primary peristalsis are associated with a higher percent time pH <4 in the esophagus suggesting poor acid clearance. However, there are no studies of secondary peristalsis and its relationship to microscopic or erosive esophagitis. The goal of this study was to determine the relationship between secondary peristalsis using functional luminal imaging probes (EndoFLIP) and the presence or absence of esophagitis. Methods: We reviewed the endoscopic and EndoFLIP 2.0 tracings for 103 consecutive patients including those with a history of upper gastrointestinal surgery undergoing upper endoscopy. Esophagogastric junction (EGJ) distensibility and diameter, repetitive antegrade contraction (RACs) presence and frequency, and occlusive diameters were measured. Measurements were then compared between patients with and without microscopic and/or erosive esophagitis. Means were compared using t‐tests. Proportions were compared using Chi‐Squared analyses. Key Results: One hundred and three patients were included (mean age: 14.4 + 6.4 years). Ten patients had erosive esophagitis and 28 patients had microscopic esophagitis. Erosive and microscopic esophagitis were associated with abnormal or absent of RACs (p < 0.001). Occlusive diameters were higher in patients with esophagitis compared to those without (p < 0.001). There was no relationship between EGJ distensibility and the presence of erosive or microscopic esophagitis (p = 0.4). The absence of RACs was the only independent predictor of esophagitis (erosive and microscopic), after controlling for age, proton pump inhibitors (PPI) use and EGJ distensibility (p < 0.001). Conclusions & Inferences: Abnormal secondary peristalsis is associated with microscopic and gross esophagitis, suggesting that EndoFLIP should be part of the diagnostic algorithm for esophagitis. [ABSTRACT FROM AUTHOR]

Tineola bisselliella , the webbing clothes moth, is an economically important, globally distributed synanthropic pest species and member of the basal moth lineage Tineidae. These moths are facultatively keratinophagous, and their larvae can cause extensive damage, particularly to clothing, textiles, and museum specimens. Despite the economic and phylogenetic importance of T. bisselliella , there is a lack of quality genomic resources for this, or for other species within the Tineidae family. The T. bisselliella genome assembly presented here consists of 30 pseudochromosomes (29 autosomes and 1 Z chromosome) produced using synteny alignment of a preliminary contig-level assembly (256 contigs) to a closely related species, Tinea pellionella. The resulting final pseudochromosome-level assembly is 243.630 Mb and has an N50 length of 8.708 Mb. The assembly is highly contiguous and has similar or improved quality compared to other available Tineidae genomes, with 93.1% (91.8% single copy and 1.3% duplicated) of lepidopteran orthologs complete and present. Annotation of the pseudochromosome-level genome assembly with the transcriptome we produced ultimately yielded 11,259 annotated genes. Synteny alignments between the T. bisselliella genome assembly and other Tineidae genomes revealed evidence for numerous small rearrangements with high synteny conservation. In contrast, a synteny alignment performed between T. bisselliella and Melitaea cinxia , which is thought to have retained the ancestral karyotype (n = 31), revealed a fusion of the ancestral autosome 30 and Z chromosome that led to a reduction in T. bisselliella karyotype size. The reference quality annotated genome for T. bisselliella presented here will advance our understanding of the evolution of the lepidopteran karyotype by providing a chromosome-level genome for this basal moth lineage and provide future insights into the mechanisms underlying keratin digestion in T. bisselliella. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore women's preferences and experiences of degree of control in decision making when planning an induction of labor (IOL). This multi‐method study was conducted using semi‐structured individual interviews and the completion of two Control Preferences Scales by eight postnatal women from a metropolitan health service in Melbourne, Australia. Four themes were generated from the interview data: "shared decision making"; "changing expectations"; "IOL experience"; and "informed consent." Women's expectations of, and preferences for, an IOL changed during pregnancy and were influenced by their perception of risk to the fetus, indication for the procedure, and trust in clinicians. Information that was personalized to the woman to include practical aspects, risks, and alternative options was rarely provided. Overall, women reported that they did not experience the degree of control they preferred when planning an IOL. Clinician understanding of decision making preferences of women when planning an IOL can assist with care that is individualized and aligned to women's values, which is crucial to improving the quality of care provided. [ABSTRACT FROM AUTHOR]

Considerable investment has been made in recent years to address sexual exploitation, abuse and harassment by aid workers in the humanitarian sector. However, such sexual misconduct remains a persistent, complex challenge with wide-ranging impacts, including on sexual health, for individuals and communities hosting humanitarian responses. This article considers the state of research regarding sexual exploitation, abuse and harassment in humanitarian contexts, and identifies gaps in the evidence base necessary for reinforcing prevention and response efforts. We first report what we know about sexual exploitation, abuse and harassment, including its impacts on sexual health, risk factors and the permissive enabling organizational cultures. We then identify several critical knowledge gaps that must be addressed for more effective future strategies and approaches to prevent and respond to sexual exploitation, abuse and harassment. We discuss system-wide knowledge gaps, such as lack of evidence on programming approaches and effectiveness of prevention and accountability mechanisms. We explore potential options that health-care programming provides for preventing and responding to sexual exploitation, abuse and harassment. We also describe population-level knowledge gaps, including in patterns of perpetration and specific challenges faced by marginalized groups. We conclude with reflections for a future integrated research and policy agenda. [ABSTRACT FROM AUTHOR]

Objectives The impact of mild autonomous cortisol secretion (MACS) on cognition is incompletely characterized. We aimed to assess cognition in patients with MACS, identify factors associated with lower cognition, and determine the impact of adrenalectomy on cognition. Methods We conducted a cross-sectional study (4/2019 to 10/2022) and a longitudinal cohort study (10/2021 to 9/2023) of adults with MACS and referent subjects. Cognition was assessed with National Institute of Health Toolbox Cognition Battery and reported as standardized T scores (adjusted for age, sex, race/ethnicity, and education) for fluid, crystallized, and total composite cognition. Participants were assessed with urine steroid profiling (liquid chromatography-tandem mass spectrometry), frailty index, Beck's Depression Inventory (BDI), and Short Form-36 (SF-36). Results A total of 84 patients (median age 57 years, 67% women) and 201 referent subjects (median age 63 years, 58% women) were included. Patients with MACS demonstrated lower mean (SD) total composite (50.9 [9.3] vs 55.4 [8.9], P <.001) and fluid composite T score (49.3 [10.6] vs 55.2 [10.2], P <.001), but not crystallized composite T score (52.3 [8.4] vs 54.0 [8.4], P =.130) when compared with referent subjects. Multivariable analysis adjusted for age, sex, BDI, SF-36, frailty index, total glucocorticoids, and androgens demonstrated that MACS status was associated with lower cognition. When cognition was reassessed in 37 patients post-adrenalectomy and 31 referent subjects, adjusted group differences of cognition change were similar except for a higher comparative increase in attention and executive functioning in patients with MACS. Conclusion Patients with MACS demonstrate lower cognition than referent subjects. Adrenalectomy for MACS had a minor positive impact on cognition. [ABSTRACT FROM AUTHOR]

Ice-coring auger machines can cost thousands of dollars and are generally made for vertical extraction from sea ice or glaciers. This project required specimens from ice accreted onto vertical piles at the Port of Alaska (POA) in Anchorage, Alaska, which meant the extraction was horizontal and had to be completed during the short low-tide window. In this paper, we describe the development of a method for economically harvesting and processing the accreted ice from the POA into cylindrical cores and shear beams. The ice was harvested by cutting large cubes out of the in situ mass with a chainsaw and then lifting these onto the port deck using a crane. The cubes were then transported to a laboratory walk-in freezer to be processed. Ice cores were drilled from the cubes using a custom-fabricated core bit made from metal tubing and hole saws. This simple core bit quickly produced smooth ice surfaces, provided there was a mechanism for evacuating the cut ice chips during drilling. To facilitate this, an alignment template was used to locate and drill two adjoining evacuation holes prior to coring. These evacuation holes had to be precisely located to be adjacent, parallel, and connected with the outside diameter of the forthcoming core, but were not allowed to impinge on the core. With this new method, an ice block can be converted into up to a dozen test-ready compression ice cores within a few hours. The variability in the diameter of the ice cores was found to be small, with a coefficient of variation of < 0.4%. [ABSTRACT FROM AUTHOR]

Women remain underrepresented in tennis coaching roles in Australia. This study aimed to examine the factors (barriers and facilitators) that may underlie gendered experiences in sport coaching and their links to retention in the profession, through the lens of Self-determination Theory. An online survey assessed barriers to coaching (individual, interpersonal, organisational and socio-cultural levels), coaching motivation and social support for coaching. Participants also completed measures of coach retention (coaching commitment, intentions to continue coaching). The survey was completed by 243 Australian tennis coaches (Mage = 49.5 ± 16.4 years, 35.8% women). The findings indicated that women coaches perceived experiencing significantly more socio-cultural barriers (e.g. discrimination, marginalisation) than their men counterparts. Fewer women (41.4%) than men (55.8%) intended to remain in the profession long-term (>10 years). Regression analyses did not reveal any predictors of retention among women coaches. In men, integrated regulation (β = 0.22, p =.036) and amotivation (β = -0.24, p =.010) predicted coaching commitment. Interpersonal barriers (OR = 0.27, p =.038), external regulation (OR = 0.68, p =.023) and amotivation (OR = 0.72, p =.040) predicted male's intentions to exit the profession sooner. This study sheds light on the factors that shape the experiences of sport coaches. Ongoing efforts to support the retention of women in sport coaching are necessary and may include challenging socio-cultural barriers. [ABSTRACT FROM AUTHOR]

This qualitative study explored the influence of implementing a virtual culturally responsive and equity-centered trauma-informed professional development series with seven urban educators in the U.S. The study's findings suggest that a culturally responsive, equity-centered trauma-informed professional development series can enrich educators' knowledge and awareness regarding racial trauma. Furthermore, the series has the potential to improve interpersonal interactions between teachers and students and increase student engagement. Lastly, the professional development series can help prepare educators to become confident and assertive social change agents advocating for racial equity in schools. Implications are provided for practice, research, and policy. [ABSTRACT FROM AUTHOR]

Sleep is essential and highly conserved, yet its regulatory mechanisms remain largely unknown. To identify sleep drive neurons, we imaged Drosophila brains with calcium-modulated photoactivatable ratiometric integrator (CaMPARI). The results indicate that the activity of the protocerebral bridge (PB) correlates with sleep drive. We further identified a key three-layer PB circuit, EPG-SpsP-PEcG, in which the four SpsP neurons in the PB respond to ellipsoid body (EB) signals from EPG neurons and send signals back to the EB through PEcG neurons. This circuit is strengthened by sleep deprivation, indicating a plasticity response to sleep drive. SpsP neurons also receive inputs from the sensorimotor brain region, suggesting that they may encode sleep drive by integrating sensorimotor and navigation cues. Together, our experiments show that the four SpsP neurons and their sleep regulatory circuit play an important and dynamic role in sleep regulation. [ABSTRACT FROM AUTHOR]

Kink and BDSM can have healing and liberatory potential for practitioners, whether kink-identified or not, particularly Black women and those who are members of alternative sexual communities. This study presents data from N = 22 kink/BDSM-identified, experienced, and non-kinky/BDSM Black ciswomen on their awareness of and engagement in kink and BDSM (bondage and discipline, sadism and masochism, dominance, and submission). Qualitative data were from Phase Two of The Big Sex Study, a #HotGirlScience participatory action project. Reflexive thematic analysis resulted in four themes: (1) Kink/BDSM Introductions, (2) Identity Within/Outside of Kink/BDSM, (3) Kink/BDSM in Action (subthemes: Principles and Values, Sexual Practices, Partner Compatibility, and Digital Spaces), and (4) Liberation and Healing. Participants reported 49 kink/BDSM activities and demonstrated an awareness of kink/BDSM identities, values, and behaviors regardless of their experience or identification with kink/BDSM. We conclude with implications for research and practice. [ABSTRACT FROM AUTHOR]

Restoring seagrasses provides habitat for animals, many of which play vital roles in the maintenance, persistence, and resilience of seagrass habitat. Understanding how the maturity of restored seagrass habitats influences the colonization and condition of associated animal communities can provide insights to inform restoration methods and improve outcomes. We surveyed mobile fauna at 132 sites in Vejle fjord, Denmark, in natural seagrass, bare sand, and restored seagrass (Zostera marina; eelgrass). Seagrass was transplanted 1, 2, 3, or 4 years ago (2019–2022). In addition to abundance and diversity metrics, we quantified individual condition metrics, and conducted metabolomic analysis on lesser pipefish (Syngnathus rostellatus). Seagrass‐associated species rapidly colonized restored habitats, such as common periwinkles and Baltic prawns. Bare sites and 1‐year‐old sites harbored very similar communities. A distinct shift thereafter saw restored communities converge irrespective of habitat age, and were similar to natural sites. We observed species‐specific trends in abundance related to seagrass cover that were positive, negative, or unimodal; abundance was highest when seagrass cover was intermediate (approximately 45–70%). Morphometric indices for three fish species, and metabolomic profiles for lesser pipefish, did not differ among sites. Our study adds to the growing body of literature showing rapid faunal colonization of restored Z. marina habitats, particularly when restored in close proximity to natural eelgrass. This provides impetus for continued investments in eelgrass restoration and suggests little need for building in time lags when including biodiversity benefits of seagrass restoration in natural capital assessments for this species. [ABSTRACT FROM AUTHOR]

Non-pharmacological therapies play an essential role in the management of heart failure, complementing pharmacological treatments to mitigate disease progression and improve patient outcomes. This review provides an updated perspective on non-pharmacological interventions with a focus on lifestyle modifications, device therapies, and the management of heart failure in special populations, such as the elderly, women, and patients with comorbid conditions like renal dysfunction and diabetes. Key lifestyle interventions, including sodium and fluid restriction, dietary changes, and physical activity, are explored for their impact on symptom reduction, hospital readmissions, and quality of life. Device therapies like cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillators (ICD) are also evaluated for their effectiveness in reducing mortality in patients with advanced HF. Special attention is given to vulnerable populations, emphasizing the need for individualized approaches tailored to specific pathophysiological mechanisms and socioeconomic factors. By integrating these strategies, healthcare providers can optimize care and enhance patient adherence, reducing the overall burden of heart failure. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death globally and a serious public health concern. Childhood trauma has been found to be associated with adult suicide vulnerability. Recent research has turned attention to investigating the role of attachment in the context of the childhood trauma-adult suicide relationship. The current study investigated for the first time whether attachment influences and moderates the childhood trauma-suicidality relationship, using a daily diary design, in the general population. 481 participants completed questionnaires assessing experiences of childhood trauma, attachment patterns, and history of suicidality. 243 participants continued to a daily diary phase where measures of daily stress, defeat and entrapment were completed for 7 consecutive days. Higher levels of childhood trauma were associated with a history of suicide ideation and attempt and also higher levels of daily defeat, entrapment and stress during the 7 day study. Similarly, higher levels of attachment anxiety and avoidance were associated with a history of suicide ideation and attempt together with higher levels of daily defeat, entrapment and stress. However, the effects of childhood trauma on suicide history and on daily suicide vulnerability factors were not moderated by attachment anxiety or avoidance. The measure of childhood trauma was a retrospective self-report tool that may be influenced by memory biases. Childhood trauma and insecure attachment are implicated in adult suicide risk. Interventions aimed at mitigating the negative effects of childhood trauma and insecure attachment should also incorporate components that target modifiable risk factors such as defeat, entrapment and stress. • Childhood trauma and insecure attachment are implicated in suicide risk. • Childhood trauma is associated with higher daily defeat, entrapment and stress. • Insecure attachment is associated with higher daily defeat, entrapment and stress. [ABSTRACT FROM AUTHOR]

Although the globalization of international migration is commonly accepted as a general tendency in contemporary migration patterns (de Haas, Castles, and Miller 2020, 9), the corresponding body of empirical evidence is mixed and fragmented. Our review of global migration patterns over the past half‐century highlights how the theories, expectations, and ultimately findings may vary depending on the specific definitions, vantage points, and measures being used. In this paper, we provide a simpler and integrated account of the globalization of international migration that includes a corresponding empirical template to quantify the relative importance of two processes at work: the intensity and connectivity of international migration. Using recent estimates of country‐to‐country migration flows every five years from 1990–1995 to 2015–2020, our analysis using demographic decomposition and group‐based multitrajectory modeling highlights the dynamic relationship between intensity and connectivity from both the global and country vantage points. Our work in this paper provides a starting point in the form of a much‐needed empirical template, one that is also highly flexible and customizable, for future research on the globalization of international migration to coalesce around and use going forward. [ABSTRACT FROM AUTHOR]