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Summary Advances in antibody technologies have resulted in the development of potent antibody‐based therapeutics with proven clinical efficacy against infectious diseases. Several monoclonal antibodies (mAbs), mainly against viruses such as SARS‐CoV‐2, HIV‐1, Ebola virus, influenza virus, and hepatitis B virus, are currently undergoing clinical testing or are already in use. Although these mAbs exhibit potent neutralizing activity that effectively blocks host cell infection, their antiviral activity results not only from Fab‐mediated virus neutralization, but also from the protective effector functions mediated through the interaction of their Fc domains with Fcγ receptors (FcγRs) on effector leukocytes. Fc‐FcγR interactions confer pleiotropic protective activities, including the clearance of opsonized virions and infected cells, as well as the induction of antiviral T‐cell responses. However, excessive or inappropriate activation of specific FcγR pathways can lead to disease enhancement and exacerbated pathology, as seen in the context of dengue virus infections. A comprehensive understanding of the diversity of Fc effector functions during infection has guided the development of engineered antiviral antibodies optimized for maximal effector activity, as well as the design of targeted therapeutic approaches to prevent antibody‐dependent enhancement of disease. [ABSTRACT FROM AUTHOR]

Background and Objective: Systemic corticosteroids have a long history of use in the treatment of autoimmune and inflammatory diseases. Both efficacy and safety show large interindividual variability (IIV), suggesting that corticosteroids may have the potential for individualised dosing strategies to optimise therapy. This systematic review aims to provide an overview of current evidence on the pharmacokinetic (PK) and pharmacodynamic (PD) relationships of systemic corticosteroids in patients with autoimmune and inflammatory diseases. Methods: A systematic literature search was conducted in PubMed and Embase for PK/PD studies of systemic corticosteroids in autoimmune and inflammatory diseases in humans published until December 2023. Studies were scored from 1 to 5 according to criteria for the levels of evidence, as inspired by the Oxford Centre for Evidence-Based Medicine. Results: Twelve studies (1981–2016) were included. The majority of these studies had a small sample size. The corticosteroids involved were prednisone, prednisolone, methylprednisolone and budesonide. Substantial IIV of corticosteroid PK was described in all studies. Evidence for a relationship between the PK of corticosteroids and efficacy was inconclusive and limited. However, there was some evidence for a relationship between the PK of prednisolone and the severity of Cushingoid features. Conclusion: There is insufficient evidence to draw firm conclusions on the potential associations between PK and clinical outcome of systemic corticosteroid treatment in autoimmune and inflammatory diseases. This is remarkable given the many decades that steroid drugs have been used in clinical care. Prospective research is recommended with robust and well-defined cohorts to fully quantify the PK/PD associations of corticosteroids. [ABSTRACT FROM AUTHOR]

The article "Reframing African ecology: Challenging bias and celebrating contribution" discusses the bias and marginalization faced by African ecological studies in Western discourse and scientific research. It highlights the rich scientific heritage of African ecosystems and the contributions of both native and foreign scientists. The article emphasizes the need for collaborative efforts and inclusive scholarship to challenge biases and elevate African ecological research on a global scale. It also explores the significant role of African ecology in shaping our understanding of ecological processes, conservation biology, and other scientific disciplines. The article provides examples of groundbreaking research in Africa, such as Dr. Christiaan N. Barnard's heart transplant and Louis Leakey's work in paleoanthropology. It also discusses the contributions of African ecosystems to evolutionary biology, genetics, and conservation science. The article concludes by calling for a more transparent and open discussion in journals like the African Journal of Ecology to promote and recognize African talent in the international scientific community. The article discusses the importance of African ecological research in understanding various topics such as predation, population dynamics, optimal foraging theory, resource stoichiometry, and the composition of food webs. It also highlights the significance of studying bushmeat and its impact on conservation, public health, and local communities. The emergence of zoonotic diseases like Ebola and COVID-19 has further emphasized the need for interdisciplinary research in wildlife ecology, epidemiology, and socio-cultural studies. The article acknowledges the challenges faced in conducting ecological research in Africa, including logistical [Extracted from the article]

Birds are widely used as indicators of environmental contamination because they integrate signals across space and time. However, this advantage also means that locating the source of pollution can be challenging, especially for species that migrate large distances. Historically, the assignment of contaminant burden to particular life stages or locations has been made by sampling tissues with varying time signals and associating those signals with locations assigned from band recoveries or stable isotope analyses. Unfortunately, these assignments are geographically coarse. More recently, tracking devices have been increasingly used to determine more precisely where and when contamination is likely to occur. Here, we review current knowledge on using tracking devices to examine the relationship between avian movements and contaminant loads. We found 42 published articles with samples collected from 1986 to 2021 that used tracking devices to examine the relationship between avian movement and contaminant loads, where studies were primarily concentrated in the northern hemisphere, notably in the North Atlantic. Tracking methodology varied widely across studies to date, but the use of radiotransmitters and satellite tags generally decreased as newer technologies, such as global positioning systems and geolocation sensors, were developed. Blood and feathers were the most commonly used tissues to assess contaminant concentrations, but sample sizes were often low (<40, the recommended sample size for some tracking or contaminant studies), and one-quarter of studies did not statistically test the relationship between tracking data and contaminant concentrations. Moving forward, studies should (1) consider statistical power; (2) consider tissue turnover rates, contaminant turnover rates, and tracking device resolution; (3) examine tissues that inform different time scales; 4) explore the impacts of contaminants on behaviour and movement; and 5) increase collaboration, standardization, and information sharing across existing tracking or contaminant monitoring programs. Focusing on these aspects will enhance our ability to identify the source, transport, and fate of contaminants in avian species across the globe. [ABSTRACT FROM AUTHOR]

Purpose: Bone marrow stimulation is a common treatment for full‐thickness cartilage defects in the hip joint. However, common procedures may result in poor fibrous repair tissue and changes to the subchondral anatomy. This study investigated the clinical outcome of a cohort of International Cartilage Repair Society (ICRS) grades 3 and 4 cartilage defects treated with bone marrow stimulation compared to those who received simple debridement/chondroplasty. Methods: In this retrospective registry study, 236 patients with uni‐focal acetabular chondral lesions of the hip up to 400 mm² (mean 177.4 ± 113.4 mm²) and of ICRS grade ≥3 with follow‐up of at least 12 months (mean 33.2 ± 15.3 months) were included. Eighty‐one patients underwent bone marrow stimulation (microfracture: n = 44, abrasion: n = 37) besides treatment of the underlying pathology, 155 patients underwent defect debridement/chondroplasty. The patient‐reported outcome was measured using the International Hip Outcome Tool 33 (iHOT33) score and the Visual Analogue Scale (VAS) for pain. Results: iHOT33 and VAS both improved highly statistically significantly (p < 0.001) in the debridement group after 6, 12, 24, 36 and 60 months compared to the preoperative scores, whereas iHOT33 and VAS after microfracture or abrasion did not show statistically significant changes over time. Twenty‐four and sixty months postsurgery the debridement group revealed significant higher scores in the iHOT33 compared to the bone marrow stimulation groups. Conclusion: Patients with chondral lesions of the hip ≤400 mm2 sustainably benefit from arthroscopic debridement under preservation of the subchondral bone plate in terms of functional outcome and pain in contrast to patients treated with bone marrow stimulation. These findings discourage the currently recommended use of microfracture in the hip joint. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Background: Robotic suturing training is in increasing demand and can be done using suture-pads or robotic simulation training. Robotic simulation is less cumbersome, whereas a robotic suture-pad approach could be more effective but is more costly. A training curriculum with crossover between both approaches may be a practical solution. However, studies assessing the impact of starting with robotic simulation or suture-pads in robotic suturing training are lacking. Methods: This was a randomized controlled crossover trial conducted with 20 robotic novices from 3 countries who underwent robotic suturing training using an Intuitive Surgical® X and Xi system with the SimNow (robotic simulation) and suture-pads (dry-lab). Participants were randomized to start with robotic simulation (intervention group, n = 10) or suture-pads (control group, n = 10). After the first and second training, all participants completed a robotic hepaticojejunostomy (HJ) in biotissue. Primary endpoint was the objective structured assessment of technical skill (OSATS) score during HJ, scored by two blinded raters. Secondary endpoints were force measurements and a qualitative analysis. After training, participants were surveyed regarding their preferences. Results: Overall, 20 robotic novices completed both training sessions and performed 40 robotic HJs. After both trainings, OSATS was scored higher in the robotic simulation-first group (3.3 ± 0.9 vs 2.5 ± 0.8; p = 0.049), whereas the median maximum force (N) (5.0 [3.2–8.0] vs 3.8 [2.3–12.8]; p = 0.739) did not differ significantly between the groups. In the survey, 17/20 (85%) participants recommended to include robotic simulation training, 14/20 (70%) participants preferred to start with robotic simulation, and 20/20 (100%) to include suture-pad training. Conclusion: Surgical performance during robotic HJ in robotic novices was significantly better after robotic simulation-first training followed by suture-pad training. A robotic suturing curriculum including both robotic simulation and dry-lab suturing should ideally start with robotic simulation. [ABSTRACT FROM AUTHOR]

Internal circadian phase assessment is increasingly acknowledged as a critical clinical tool for the diagnosis, monitoring, and treatment of circadian rhythm sleep−wake disorders and for investigating circadian timing in other medical disorders. The widespread use of in‐laboratory circadian phase assessments in routine practice has been limited, most likely because circadian phase assessment is not required by formal diagnostic nosologies, and is not generally covered by insurance. At‐home assessment of salivary dim light melatonin onset (DLMO, a validated circadian phase marker) is an increasingly accepted approach to assess circadian phase. This approach may help meet the increased demand for assessments and has the advantages of lower cost and greater patient convenience. We reviewed the literature describing at‐home salivary DLMO assessment methods and identified factors deemed to be important to successful implementation. Here, we provide specific protocol recommendations for conducting at‐home salivary DLMO assessments to facilitate a standardized approach for clinical and research purposes. Key factors include control of lighting, sampling rate, and timing, and measures of patient compliance. We include findings from implementation of an optimization algorithm to determine the most efficient number and timing of samples in patients with Delayed Sleep−Wake Phase Disorder. We also provide recommendations for assay methods and interpretation. Providing definitive criteria for each factor, along with detailed instructions for protocol implementation, will enable more widespread adoption of at‐home circadian phase assessments as a standardized clinical diagnostic, monitoring, and treatment tool. [ABSTRACT FROM AUTHOR]

Despite problem posing's prominence in mathematics education research, its implementation in classrooms is limited. Therefore, teacher educators should incorporate problem posing tasks into preparation programs to help prospective teachers gain confidence in their abilities. One approach to teaching problem posing includes providing examples. The Common Core State Standards Initiative provides taxonomies with examples of one‐step word problems for all four basic operations. Through this mixed‐methods study, preservice teachers (N = 44) regularly identified and posed word problems within the addition and subtraction taxonomy. Before and after the intervention, the preservice teachers answered survey questions and posed problems to model given equations. The researchers analyzed the preservice teachers' abilities to pose logical word problems and to match given equations before and after instruction. They also quantitatively analyzed Likert‐style survey responses on perceptions of posing the various types of word problems and integrated the results with a qualitative analysis of open‐ended responses expanding on the same questions. Results showed participants' abilities to pose problems increased after the intervention. Additionally, participants felt problems with the unknown information at the beginning or middle were harder to pose than those with the unknown information at the end. [ABSTRACT FROM AUTHOR]

Objectives Self-compassion has been identified as a psychological resource for aging well. To date, self-compassion among older adults has typically been conceptualized as a trait variable. This study examined whether day-to-day (state) variability in self-compassion was associated with negative affective reactivity to daily stressors. Methods Daily diary assessment methods were used to examine the potential moderating role of between- and within-person self-compassion on the relationship between daily stressors and negative affect. A community-based sample of 107 older adults aged 65+ completed questionnaires once daily over 14 days. Results Multilevel modeling revealed that 37% of the variance in self-compassion occurred within persons. Daily self-compassion moderated the relationship between daily stressor exposure and daily negative affect. On days with greater stressor exposure than usual, older adults showed less negative affective reactivity on days when self-compassion was higher, compared with days when self-compassion was lower. No moderating effects were observed for between-person (trait) self-compassion. Discussion These findings suggest that self-compassion in older adults should be conceptualized as both state and trait variables and that state self-compassion may be protective in the stress–reactivity pathway. Future research should investigate whether brief self-compassion interventions might help older adults to avoid or downregulate negative emotions in response to stressors. [ABSTRACT FROM AUTHOR]

Congenital interventricular septal aneurysms (IVSA) of the muscular septum are rare and can be associated with other familial abnormalities of the ventricular septum, arrhythmias, additional congenital heart disease, and chromosomal abnormalities. IVSA is also linked to ventricular dysfunction and non-compaction, although there are limited reports of this association presenting in utero. We describe a case of fetal ventricular septal aneurysm associated with ventricular dysfunction and pericardial effusion. [ABSTRACT FROM AUTHOR]

Simple Summary: While dogs will rescue their owners in distress, no study has investigated whether or not dogs may do the same for strangers. This study explores this question by recording dogs' behaviors, heart rate variability, and approach in response to a trapped calm or distressed stranger. The results show that whether the unfamiliar human was distressed or not did not affect whether the dog opened the door. Additionally, there was no difference in heart rate variability, how they approached the stranger through the door, or time near the door between dogs who were presented with a distressed or calm stranger. Dogs that did open the door to approach the unfamiliar human were described as less fearful by their owners. Dogs that opened also showed less aggression and fear when they approached the human behind the trapped door compared to dogs that did not open. These results show that dogs may not be able to show emotional contagion or respond differentially to distressed unknown humans. It also may be vital for dog owners to be present in order for complex behaviors such as emotional contagion and helping to occur towards strangers. Empathy is a complex cognitive ability that has been studied in many social animals, including dogs. Previous studies have found that dogs would rescue their distressed owner more quickly than a calm owner and that dogs respond physiologically and behaviorally to the sound of crying strangers. However, no studies have explored the empathetic and emotional contagion capabilities of dogs towards strangers in rescue paradigms. In the present study, a stranger was placed behind a clear door and was told to cry (distress) or hum (neutral). The dogs' door opening, stress behaviors, tone of approach, and physiological responses were measured. Dogs did not open more frequently or more quickly for the stranger in the distressed condition compared to the neutral condition. Additionally, there was no significant difference between the behavioral or physiological indicators of stress across conditions. It was also found that non-openers were reported by owners to have more fear and, in the empathy test, were more aggressive and fearful in their tone of approach. These results suggest that dogs may be less likely to exhibit empathy-like behaviors to unknown humans in an unfamiliar environment and that owners may be necessary to moderate a dog's stress to show empathetic behaviors. [ABSTRACT FROM AUTHOR]

Background: Lack of physical activity is a concern for children across diverse backgrounds, particularly affecting those in rural areas who face distinct challenges compared to their urban counterparts. Community-derived interventions are needed that consider the unique context and additional physical activity barriers in under-resourced rural settings. Therefore, a prospective pre-post pilot/feasibility study of Hoosier Sport was conducted over 8-weeks with 6th and 7th grade children in a low-socioeconomic rural middle school setting. The primary objective of the present study was to assess trial- and intervention-related feasibility indicators; and the secondary objective was to collect preliminary assessment data for physical activity levels, fitness, psychological needs satisfaction, and knowledge of physical activity and nutrition among participating youth. Methods: This prospective 8-week pilot/feasibility study took place in the rural Midwestern United States where twenty-four middle school students participated in a mixed-methods pre-post intervention during physical education classes. The intervention included elements like sport-based youth development, individualized goal setting, physical activity monitoring, pedometer usage, and health education. Data were collected at baseline (T1) and post-intervention (T3), with intermediate measures during the intervention (T2). Qualitative data were integrated through semi-structured interviews. Analytical methods encompassed descriptive statistics, correlations, repeated measures ANOVA, and thematic analysis. Results: Key findings indicate robust feasibility, with intervention-related scores (FIM, AIM, and IAM) consistently surpassing the "good" threshold and 100% retention and recruitment success. Additionally, participants showed significant physical performance improvement, shifting from the 25th to the 50th percentile in the 6-minute walk test (p < 0.05). Autonomy and competence remained high, reflecting positive perceptions of program practicality. Nutrition knowledge, initially low, significantly improved at post-intervention (p < 0.01), highlighting the efficacy of targeted nutritional education in Hoosier Sport. Conclusions: This study pioneers a community-engaged model for physical activity intervention in under-resourced rural settings. Positive participant feedback, coupled with improvements in physical fitness and psychosocial factors, highlights the potential of the co-design approach. The findings offer valuable insights and a practical template for future community-based research, signaling the promising impact of such interventions on holistic well-being. This research lays the foundation for subsequent phases of the ORBIT model, emphasizing collaborative, community-driven approaches to address the complex issue of declining physical activity levels among adolescents. [ABSTRACT FROM AUTHOR]

Repetitive head impacts (RHIs) from football are associated with the neurodegenerative tauopathy chronic traumatic encephalopathy (CTE). It is unclear whether a history of traumatic brain injury (TBI) is sufficient to precipitate CTE neuropathology. We examined the association between TBI and CTE neuropathology in 580 deceased individuals exposed to RHIs from football. TBI history was assessed using a modified version of the Ohio State University TBI Identification Method Short Form administered to informants. There were 22 donors who had no TBI, 213 who had at least one TBI without loss of consciousness (LOC), 345 who had TBI with LOC, and, of those with a history of TBI with LOC, 36 who had at least one moderate-to-severe TBI (msTBI, LOC >30 min). CTE neuropathology was diagnosed in 405. There was no association between CTE neuropathology status or severity and TBI with LOC (odds ratio [OR] = 0.95, 95% confidence interval [CI] = 0.64–1.41; OR = 1.22, 95% CI = 0.71–2.09) or msTBI (OR = 0.70, 95% CI = 0.33–1.50; OR = 1.01, 95% CI = 0.30–3.41). There were no associations with other neurodegenerative or cerebrovascular pathologies examined. TBI with LOC and msTBI were not associated with CTE neuropathology in this sample of brain donors exposed to RHIs from American football. [ABSTRACT FROM AUTHOR]

Background: Low-dose weekly methotrexate (MTX) is the mainstay of treatment in juvenile idiopathic arthritis. Unfortunately, a substantial part of patients has insufficient efficacy of MTX. A potential cause of this inadequate response is suboptimal drug adherence. The aim of this study was to assess MTX adherence in juvenile idiopathic arthritis patients by quantification of MTX concentrations in plasma. Secondly, the association between MTX concentrations and either self-reported adherence issues, or concomitant use of biologics was examined. Methods: This was a retrospective, observational study using plasma samples from juvenile idiopathic arthritis patients. An ultrasensitive liquid chromatography-tandem mass spectrometry method was developed for quantification of MTX and its metabolite 7-hydroxy-MTX in plasma. The determined MTX plasma concentrations in juvenile idiopathic arthritis patients were compared with corresponding adherence limits, categorising them as either adherent or possibly non-adherent to MTX therapy. Results: Plasma samples of 43 patients with juvenile idiopathic arthritis were analysed. Adherence to MTX in this population was 88% shortly after initiation of MTX therapy and decreased to 77% after one year of treatment. Teenagers were more at risk for non-adherence (p = 0.002). We could not find an association between MTX adherence with either self-reported adherence issues, nor with the use of concomitant biological treatment (p = 1.00 and p = 0.27, respectively; Fisher's Exact). Conclusions: Quantification of MTX in plasma is a feasible and objective method to assess adherence in patients using low-dose weekly MTX. In clinical practice, the use of this method could be a helpful tool for physicians to refute or support suspicion of non-adherence to MTX therapy. [ABSTRACT FROM AUTHOR]

Background and Objective: High variability in tacrolimus pharmacokinetics directly after lung transplantation (LuTx) may increase the risk for acute kidney injury (AKI) and transplant rejection. The primary objective was to compare pharmacokinetic variability in patients receiving tacrolimus orally versus intravenously early after LuTx. Methods: Pharmacokinetic and clinical data from 522 LuTx patients transplanted between 2010 and 2020 in two university hospitals were collected to compare orally administered tacrolimus to intravenous tacrolimus early post-transplantation. Tacrolimus blood concentration variability, measured as intrapatient variability (IPV%) and percentage of time within the therapeutic range (TTR%), was analyzed within the first 14 days after LuTx. Secondary outcomes were AKI, acute rejection, length of stay in the intensive care unit (ICU), and mortality in the ICU and during hospital admission. Results: We included 224 patients in the oral and 298 in the intravenous group. The mean adjusted IPV% was 10.8% (95% confidence interval [CI] 6.9–14.6; p < 0.001) higher in the oral group (27.2%) than the intravenous group (16.4%). The mean TTR% was 7.3% (95% CI − 11.3 to − 3.4; p < 0.001) lower in the oral group (39.6%) than in the intravenous group (46.9%). The incidence of AKI was 46.0% for oral and 42.6% for intravenous administration (adjusted odds ratio [OR] 1.2; 95% CI 0.8–1.8; p = 0.451). The frequencies of clinically diagnosed acute rejection in the oral and intravenous groups were nonsignificant (24.6% vs 17.8%; OR 1.5 [95% CI 1.0–2.3; p = 0.059]). ICU and hospital mortality rate and ICU length of stay were similar. Conclusions: Administering tacrolimus orally directly after LuTx leads to a higher variability in blood concentrations compared to intravenous administration. There was no difference in the occurrence of AKI or transplant rejection. [ABSTRACT FROM AUTHOR]

In the past 2 decades, health care has witnessed technological and pharmacological advancements leading to innovations in diabetes management. Despite these advances, published guidelines, and treatment algorithms, most people with diabetes remain above glycemic targets. Thus, the authors designed a novel care model aimed at improving several causative factors, including therapeutic inertia, limited access to endocrinology and cardiovascular specialists, time constraints, and complexity in incorporating clinical practice guidelines. The model involves collaboration between the diabetes specialty team and primary care providers (PCPs). The intervention reviewed uncontrolled diabetes data and the patient's electronic medical record (EMR) and sent personalized, evidence-based recommendations to the provider using the task function in the EMR. Other services (eg, diabetes education) were utilized to optimize patient care to achieve optimal glycemic targets and address cardiometabolic risk. The overall mean hemoglobin A1c (HbA1c) decreased pre-post intervention by almost 1%, and 52.1% (347 of 666) of the cohort had ≥−0.5% change in HbA1c post-intervention. All pathways exhibited a decrease in HbA1c. Team-based approaches to managing diabetes patient care were the most effective. The interventions effectively utilized the resources across the health system without placing additional load or burden on primary care or diabetes specialty care teams. In the future, the authors hope to address the limitations of the current gap caused by increasing diabetes numbers, decreasing availability of PCPs and endocrinologists, and fee-for-service models using the innovative specialty consultant–primary care connection and knowledge exchange offered by this novel model, which can only be sustained with payer's support. [ABSTRACT FROM AUTHOR]

The NaZr2P3O12 family of materials have shown low and tailorable thermal expansion properties. In this study, SrZr4P6O24 (SrO·4ZrO2·3P2O5), CaZr4P6O24 (CaO·4ZrO2·3P2O5), MgZr4P6O24 (MgO·4ZrO2·3P2O5), NaTi2P3O12 [½(Na2O·4TiO2·3P2O5)], NaZr2P3O12 [½(Na2O·4ZrO2·3P2O5)], and related solid solutions were synthesized using the organic–inorganic steric entrapment method. The samples were characterized by in‐situ high‐temperature X‐ray diffraction from 25 to 1500°C at the Advanced Photon Source and National Synchrotron Light Source II. The average linear thermal expansion of SrZr4P6O24 and CaZr4P6O24 was between −1 × 10−6 per °C and 6 × 10−6 per °C from 25 to 1500°C. The crystal structures of the high‐temperature polymorphs of CaZr4P6O24 and SrZr4P6O24 with R3c symmetry were solved by Fourier difference mapping and Rietveld refinement. This polymorph is present above ∼1250°C. This work measured thermal expansion coefficients to 1500°C for all samples and investigated the differences in thermal expansion mechanisms between polymorphs and between compositions. [ABSTRACT FROM AUTHOR]

Background Nontuberculous mycobacteria (NTM) are environmental bacteria which may cause chronic lung disease. The prevalence of NTM pulmonary infection and disease has been increasing in the United States and globally. The predominant clinically relevant species of NTM in the United States are Mycobacterium avium complex (MAC) species and Mycobacterium abscessus. With the development of rapid species identifcation methods for NTM (e.g. PCR probes), more testing for NTM is being conducted through commercial labs, such as Laboratory Corporation of America (Labcorp), which provides deidentifed real-time testing data to the Centers for Disease Control (CDC) pursuant to a data sharing agreement. Because NTM lung infections are not reportable in most states, other data sources are key to understanding NTM testing patterns, positivity rates, and species distributions to track infection trends and identify clinical care needs. Methods We obtained national Labcorp data for the period January 2019 through mid-April 2022. We subset the data to only respiratory samples sent for Acid Fast Bacilli (AFB) cultures. NTM positive results were defned as those which identifed an NTM species and are not Mycobacterium tuberculosis, Mycobacterium bovis, or Mycobacterium gordonae. Results Overall, 112,528 respiratory samples were sent for AFB testing during the study period; 26.3% were from the Southeast U.S., identifed as HSS Region IV in the Labcorp dataset, and 23.0% were from the Pacifc and South Pacifc region (Region IX). The culture positive prevalence ranged from 20.2% in the Southeast to 9.2% in the East North Central region (Region V). In the Southeast US, M. abscessus prevalence was 4.0%. For MAC, the highest prevalence was observed in the Mountain region (Region VII) (13.5%) and the lowest proportion was in the East South Central region (7.3%, Region III). Among positive tests, the proportion which was MAC varied from 61.8% to 88.9% and was highest in the Northeast U.S. The proportion of positive samples which were M. abscessus ranged from 3.8% to 19.7% and was highest in the Southeast. Conclusions The Southeastern region of the U.S. has the highest rate of culture positivity in Labcorp tests for total NTM and, of all positive tests, the highest proportion of M. abscessus. These estimates may underrepresent the true number of M. abscessus infections because M. absesscus-specifc probes are not commercially available and not all NTM testing in the United States is done by Labcorp. Analysis of real-time testing data from commercial laboratories may provide insights into risk factors for NTM culture positivity in‘hotspot’ areas. [ABSTRACT FROM AUTHOR]

Background: Antibiotic overuse at hospital discharge is common, costly, and harmful. While discharge-specific antibiotic stewardship interventions are effective, they are resource-intensive and often infeasible for hospitals with resource constraints. This weakness impacts generalizability of stewardship interventions and has health equity implications as not all patients have access to the benefits of stewardship based on where they receive care. There may be different pathways to improve discharge antibiotic prescribing that vary widely in feasibility. Supporting hospitals in selecting interventions tailored to their context may be an effective approach to feasibly reduce antibiotic overuse at discharge across diverse hospitals. The objective of this study is to evaluate the effectiveness of the Reducing Overuse of Antibiotics at Discharge Home multicomponent implementation strategy ("ROAD Home") on antibiotic overuse at discharge for community-acquired pneumonia and urinary tract infection. Methods: This 4-year two-arm parallel cluster-randomized trial will include three phases: baseline (23 months), intervention (12 months), and postintervention (12 months). Forty hospitals recruited from the Michigan Hospital Medicine Safety Consortium will undergo covariate-constrained randomization with half randomized to the ROAD Home implementation strategy and half to a "stewardship as usual" control. ROAD Home is informed by the integrated-Promoting Action on Research Implementation in Health Services Framework and includes (1) a baseline needs assessment to create a tailored suite of potential stewardship interventions, (2) supported decision-making in selecting interventions to implement, and (3) external facilitation following an implementation blueprint. The primary outcome is baseline-adjusted days of antibiotic overuse at discharge. Secondary outcomes include 30-day patient outcomes and antibiotic-associated adverse events. A mixed-methods concurrent process evaluation will identify contextual factors influencing the implementation of tailored interventions, and assess implementation outcomes including acceptability, feasibility, fidelity, and sustainment. Discussion: Reducing antibiotic overuse at discharge across hospitals with varied resources requires tailoring of interventions. This trial will assess whether a multicomponent implementation strategy that supports hospitals in selecting evidence-based stewardship interventions tailored to local context leads to reduced overuse of antibiotics at discharge. Knowledge gained during this study could inform future efforts to implement stewardship in diverse hospitals and promote equity in access to the benefits of quality improvement initiatives. Trial registration: Clinicaltrials.gov NCT06106204 on 10/30/23 [ABSTRACT FROM AUTHOR]

Circadian rhythmicity is associated to clinical variables that play an important role in both schizophrenia (SZ) and substance use disorders (SUD), although the characteristics of the coexistence of these two diagnoses (SZ +) remain mostly unknown. Hence, we studied a sample of 165 male patients divided in three groups each of 55, according to their diagnoses (SZ + , SZ, and SUD), as well as a healthy control (HC; n = 90) group. Alongside with sociodemographic and clinical variables, circadian rhythms were registered through a sleep–wake data structured interview, a circadian typology questionnaire, and distal skin temperature (DST) using the Thermochron iButton every 2 min during 48 h. Analyses showed that SZ + and SZ patients presented a longer sleep (delay in wake-up time) and mostly an intermediate circadian typology, while SUD patients slept less hours, displaying a morning typology. The DST showed the highest daily activation and stability for the SUD group, even when compared with the HC group. The presence of schizophrenia (SZ + and SZ) was related to a DST pattern with a reduced amplitude determined by a wakefulness impairment, which was more pronounced for SZ patients whose sleep period was adequate. The assessment of circadian rhythms in under treatment male patients with SZ should be focused on the diurnal period as a possible marker of either treatment adherence or patient's recovery, irrespective of the presence of a comorbid SUD. Further research with additional objective measures may provide knowledge transferable to therapeutic strategies and could be useful to establish possible endophenotypes in the future. [ABSTRACT FROM AUTHOR]

Background: Precision medicine approaches aim to improve treatment outcomes by identifying which treatments work best for specific individual phenotypes. In the treatment of alcohol use disorder (AUD), precision medicine approaches have been proposed based on phenotypes characterized by individuals who drink primarily to enhance rewarding experiences (i.e., reward drinking) or those who drink primarily to relieve negative states (i.e., relief drinking). This study examined these phenotypes across treatment‐ and nontreatment‐seeking individuals and the stability of the phenotypes over time. Methods: We used latent profile and latent transition analyses to identify and assess longitudinal stability (over 3 or 4 months) of reward and relief drinking subgroups within a nontreatment‐seeking community sample that engaged in hazardous drinking (n = 189) and two treatment‐seeking samples of individuals with AUD enrolled in two large clinical trials (n = 1726, n = 1383). We examined prospective associations with alcohol consumption and consequences at long‐term follow‐up (15 or 18 months). Results: Results supported four subgroups: low reward/low relief, low reward/high relief, high reward/low relief, and high reward/high relief. The community sample contained more individuals classified within the high reward/low relief subgroup than treatment‐seeking samples. Subgroups were generally more stable over time in the community sample than in the treatment‐seeking samples. Alcohol consumption and consequences decreased over time for the treatment‐seeking samples, with consequences and drinking frequency decreasing for the community sample. Participants classified within the high reward/high relief and low reward/high relief groups reported the most consequences and consumption at long‐term follow‐up. Conclusion: Reward and relief drinking phenotypes can be identified within community and treatment‐seeking samples of individuals who drink heavily. The phenotypic subgroups appear to be stable over time in the absence of treatment, change somewhat during treatment, and provide utility in predicting alcohol consumption and consequences. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Preschool-aged children with mild community-acquired pneumonia (CAP) routinely receive antibiotics even though most infections are viral. We sought to identify barriers to the implementation of a "no antibiotic" strategy for mild CAP in young children. METHODS: Qualitative study using semistructured interviews conducted in a large pediatric hospital in the United States from January 2021 to July 2021. Parents of young children diagnosed with mild CAP in the previous 3 years and clinicians practicing in outpatient settings (pediatric emergency department, community emergency department, general pediatrics offices) were included. RESULTS: Interviews were conducted with 38 respondents (18 parents, 20 clinicians). No parent heard of the no antibiotic strategy, and parents varied in their support for the approach. Degree of support related to their desire to avoid unnecessary medications, trust in clinicians, the emotional difficulty of caring for a sick child, desire for relief of suffering, willingness to accept the risk of unnecessary antibiotics, and judgment about the child's illness severity. Eleven (55%) clinicians were familiar with guidelines specifying a no antibiotic strategy. They identified challenges in not using antibiotics, including diagnostic uncertainty, consequences of undertreatment, parental expectations, follow-up concerns, and acceptance of the risks of unnecessary antibiotic treatment of many children if it means avoiding adverse outcomes for some children. CONCLUSIONS: Although both parents and clinicians expressed broad support for the judicious use of antibiotics, pneumonia presents stewardship challenges. Interventions will need to consider the emotional, social, and logistical aspects of managing pneumonia, in addition to developing techniques to improve diagnosis. [ABSTRACT FROM AUTHOR]

Der globale Tourismus ist derzeit für 8% der weltweiten Treibhausgasemissionen verantwortlich (Lenzen et al. 2018) und trägt dadurch bedeutend zum anthropogenen Klimawandel bei (Strasdas & Zeppenfeld, 2016). Zukünftig wird der tourismusbedingte CO₂ Fußabdruck durch das rasante Wachstum der Tourismusindustrie noch größer werden, da die Nachfrage nach Reisen zunehmen wird und die Dekarbonisierung der Branche gleichzeitig nur langsam voranschreitet (Lenzen et al. 2018). Im Rahmen des vorliegenden Beitrags wird vor diesem Hintergrund ein Tourismusklimabudget als eine mögliche Emissionsreduktionsmaßnahme entwickelt und dessen hypothetische Wirkung auf nachfragerseitige Reiseentscheidungen untersucht. Dieses Budget zielt darauf ab, die CO₂ Emissionen für die Urlaubsreisen der Deutschen zu begrenzen, um so sicherzustellen, dass nicht mehr Emissionen ausgestoßen werden, als mit den Pariser Klimazielen vereinbar sind. Global tourism is currently responsible for 8% of global greenhouse gas emissions (Lenzen et al. 2018) and therefore makes a significant contribution to anthropogenic climate change (Strasdas & Zeppenfeld, 2016). In the future, the tourism-related carbon footprint will become even larger due to the rapid growth of the tourism industry, as the demand for travel will increase and the decarbonisation of the industry will only progress slowly at the same time (Lenzen et al. 2018). Against this background, this article develops a tourism climate budget as a possible emissions reduction measure and analyses its hypothetical effect on demand-side travel decisions. The budget aims to limit CO₂ emissions for German holiday trips in order to ensure that no more emissions are emitted than are compatible with the Paris climate targets. [ABSTRACT FROM AUTHOR]

This Note seeks to contribute to scholarship on the growing tension between secularism and religion in the United States by considering the claim, made by some commentators, that secular liberalism should be considered a religion for the purposes of the First Amendment. Part I explains the historical background of the First Amendment's Religion Clauses and surveys what little jurisprudence there is from the U.S. Supreme Court and lower courts regarding secular liberalism's potential status as a religion. Part II lays out the landscape of current scholarship on the status of secularism, secular liberalism, and adjacent nontheistic belief systems as religions, including: (1) arguments made by some conservative Christians who maintain that secular liberalism is a religion; (2) related but distinct arguments made by scholars who argue that non-theistic beliefs should be accorded respect equal to that granted religions under the First Amendment; and (3) arguments from scholars who believe religion should continue to be treated as "special" and separate from non-religious, secular belief systems. Part III argues that, even if secular liberalism could be defined as a religion, it should not be, for two reasons. First, the proposition that secular liberalism is a religion is conceptually incoherent because it conflates strong moral conviction with religious belief. Advocates of this position misconstrue passion as transcendent commitment and treat "religion" as a functionalist label. Second, if accepted as true, this proposition would be problematic for legal theory and for the Constitution. This Note argues that the answer to the question of whether secular liberalism is a religion implicates the legitimacy of our government, because without a neutral principle of governance a democracy cannot justify its use of force against its citizens. [ABSTRACT FROM AUTHOR]

Primary amebic meningoencephalitis (PAM) is a necrotizing and hemorrhagic inflammation of the brain and meninges caused by Naegleria fowleri, a free-living thermophilic ameba of freshwater systems. PAM remains a neglected disease that disproportionately affects children in tropical and subtropical climates, with an estimated mortality rate of 95–98%. Due to anthropogenic climate change, the average temperature in the USA has increased by 0.72 to 1.06 °C in the last century, promoting the poleward spread of N. fowleri. PAM is often misdiagnosed as bacterial meningitis or viral encephalitis, which shortens the window for potentially life-saving treatment. Diagnosis relies on the patient’s history of freshwater exposure and the physician’s high index of suspicion, supported by cerebrospinal fluid studies. While no experimental trials have been conducted to assess the relative efficacy of treatment regimens, anti-amebic therapy with adjunctive neuroprotection is standard treatment in the USA. We performed a literature review and identified five patients from North America between 1962 and 2022 who survived PAM with various degrees of sequelae. [ABSTRACT FROM AUTHOR]

Habitat fragmentation is one of the main threats to biodiversity in Africa. In this article, we highlight the importance of conserving the Guinean forests of West Africa, which are rich in biodiversity and endemism but threatened by habitat loss, degradation and fragmentation. The size of forest patches is critical, with larger fragments containing more species than smaller ones. The protection of intact, dense forest patches is vital for any conservation strategy in West Africa, but improving the management of forests that are already used for logging and hunting is also essential. Community forests (CFs) can play a crucial role in conservation, especially if there is a substantial network that can promote ecological connectivity. However, biomonitoring in CFs remains a challenge due to inadequate resources. By developing standardised, easy-to-apply and inexpensive methods for biomonitoring, communities can be involved in biomonitoring instead of relying solely on scientists and expensive equipment. We present a monitoring framework here where we suggest local communities should become the main agents for biomonitoring in their own forests; we highlight a five-step scheme. The importance of the various CFs in terms of conservation should be made through a combination of accurate, standardised face-to-face interviews with selected persons in the target communities and biomonitoring be based on the RAPELD scheme. The latter will be implemented after specifically training local 'wise' persons. We are proposing a kind of 'citizen science' scheme, applied to enhance the ability of local communities to monitor their own biodiversity. [ABSTRACT FROM AUTHOR]

Spontaneous sorption of proteins on the nanoparticles' surface leads to the fact that nanoparticles in biological media are always enveloped by a layer of proteins—the protein corona. Corona proteins affect the properties of nanoparticles and their behavior in a biological environment. In this regard, knowledge about the composition of the corona is a necessary element for the development of nanomedicine. Because proteins have different sorption efficacy, isolating particles with a full corona and characterizing the full corona is challenging. In this study, we propose a photo-activated cross-linker for full protein corona fixation. We believe that the application of our proposed approach will make it possible to capture and visualize the full corona on nanoparticles coated with a lipid shell. [ABSTRACT FROM AUTHOR]

Cefiderocol is a broad‐spectrum cephalosporin antibiotic and is indicated in patients with difficult‐to‐treat Gram‐negative bacterial infections. Cefiderocol is applied as a 2–4‐times daily prolonged 3‐h infusion. The therapeutic target of cefiderocol suggests that continuous infusion (CI) may be advantageous, since it is more likely to achieve 100% of time of the unbound concentration above the minimal inhibitory concentration (MIC). However, limited information on cefiderocol as CI has been assessed. We present a case of a critically ill 37‐year‐old woman with continuous venovenous haemofiltration (CVVH) treated with a CI of cefiderocol for multidrug‐resistant Pseudomonas aeruginosa. She received 4 g per 24 h, in accordance with the recommendations for the total daily dose during CVVH with an effluent flow rate of 2.1–3 L/h. We evaluated intraperitoneal, plasma arterial pre‐ and postfilter and ultrafiltrate (urine) total cefiderocol concentrations and discussed the pharmacokinetics in respect to the CVVH settings. The predicted unbound plasma concentrations during CI resulted in 6.8–9.5‐fold higher concentrations than the adopted MIC of 2 mg/L for cefiderocol against P. aeruginosa. The optimal time of the unbound concentration >MIC target of cefiderocol was met during the sampling period, suggesting adequate exposure during the total treatment period. The obtained intraperitoneal concentration indicated adequate cefiderocol exposure at the site of infection. Continuous infusion of 4 g cefiderocol per 24 h led to sufficient plasma concentrations in our anuric critically ill patient treated with CVVH. This case is supportive to the use of cefiderocol as continuous infusion. [ABSTRACT FROM AUTHOR]

This essay responds to and reflects on the arguments made by Charles Bosk in the introduction to The Price of Perfection: The Cost of Error, written from the perspective of a former sociology doctoral student of his who now works in academic medicine. The author highlights two innovative and persuasive threads running through Bosk's work critiquing the patient safety social movement: (1) the consequence of the social constructedness of medical error and safety solutions, and (2) the importance of the personal, relational, and social dimensions of occupational rituals in clinical practice. The legacy of Bosk's work and impact beyond sociology is considered. The author demonstrates the enduring value of his insights and the impact they can have on current debates about how to transform clinical practice to reduce patient harm. [ABSTRACT FROM AUTHOR]

Therapeutic bacteriophages (phages) are primarily chosen based on their in vitro bacteriolytic activity. Although anti-phage antibodies are known to inhibit phage infection, the influence of other immune system components is less well known. An important anti-bacterial and anti-viral innate immune system that may interact with phages is the complement system, a cascade of proteases that recognizes and targets invading microorganisms. In this research, we aimed to study the effects of serum components such as complement on the infectivity of different phages targeting Pseudomonas aeruginosa. We used a fluorescence-based assay to monitor the killing of P. aeruginosa by phages of different morphotypes in the presence of human serum. Our results reveal that several myophages are inhibited by serum in a concentration-dependent way, while the activity of four podophages and one siphophage tested in this study is not affected by serum. By using specific nanobodies blocking different components of the complement cascade, we showed that activation of the classical complement pathway is a driver of phage inhibition. To determine the mechanism of inhibition, we produced bioorthogonally labeled fluorescent phages to study their binding by means of microscopy and flow cytometry. We show that phage adsorption is hampered in the presence of active complement. Our results indicate that interactions with complement may affect the in vivo activity of therapeutically administered phages. A better understanding of this phenomenon is essential to optimize the design and application of therapeutic phage cocktails. [ABSTRACT FROM AUTHOR]

Secondary visual arts education provides learners with opportunities to develop critical thinking, and their creative potential, as part of their personal growth. This development happens when visual arts teachers actively integrate creative pedagogies to target creative thinking in learners. Ghana's 2019 National Pre‐tertiary Curriculum Framework has added creativity as one goal for all learners. This research study explores teachers' perceptions and use of creative pedagogies as part of implementing this creativity into their teaching. A multi‐site qualitative case study was conducted in government secondary schools within Sekondi‐Takoradi, Ghana, and data were gathered from interviews and participant observations. The 16 cases specifically examined creative pedagogies in practice in the secondary visual arts programme, as the subject of visual arts is commensurate with developing creativity. The study revealed that teachers' pedagogical perceptions of developing creativity do not align with the actual pedagogies they employ, with teachers being observed to emphasise teacher‐centred pedagogies. It is suggested that the integration of creative pedagogies should be contextualised in Ghana's secondary visual arts programme, in order to support teachers to meet the goal of creativity development for all learners. [ABSTRACT FROM AUTHOR]

Toll‐Like Receptors (TLRs) play a pivotal role in immunity by recognising conserved structural features of pathogens and initiating the innate immune response. TLR signalling is subject to complex regulation that remains poorly understood. Here we show that two small type I transmembrane receptors, TMED2 and 7, that function as cargo sorting adaptors in the early secretory pathway are required for transport of TLRs from the ER to Golgi. Protein interaction studies reveal that TMED7 interacts with TLR2, TLR4 and TLR5 but not with TLR3 and TLR9. On the other hand, TMED2 interacts with TLR2, TLR4 and TLR3. Dominant negative forms of TMED7 suppress the export of cell surface TLRs from the ER to the Golgi. By contrast TMED2 is required for the ER‐export of both plasma membrane and endosomal TLRs. Together, these findings suggest that association of TMED2 and TMED7 with TLRs facilitates anterograde transport from the ER to the Golgi. [ABSTRACT FROM AUTHOR]

Antibody responses against highly conserved epitopes on the stalk domain of influenza virus hemagglutinin (HA) confer broad protection; however, such responses are limited. To effectively induce stalk-specific immunity against conserved HA epitopes, sequential immunization strategies have been developed based on chimeric HA (cHA) constructs featuring different head domains but the same stalk regions. Immunogenicity studies in small animal models, as well as in humans, revealed that cHA immunogens elicit stalk-specific IgG responses with broad specificity against heterologous influenza virus strains. However, the mechanisms by which these antibodies confer in vivo protection and the contribution of their Fc effector function remain unclear. To characterize the role of Fc-FcγR (Fcγ receptor) interactions to the in vivo protective activity of IgG antibodies elicited in participants in a phase I trial of a cHA vaccine candidate, we performed passive transfer studies of vaccine-elicited IgG antibodies in mice humanized for all classes of FcγRs, as well as in mice deficient for FcγRs. IgG antibodies elicited upon cHA vaccination completely protected FcγR humanized mice against lethal influenza virus challenge, while no protection was evident in FcγR-deficient mice, suggesting a major role for FcγR pathways in the protective function of vaccine-elicited IgG antibodies. These findings have important implications for influenza vaccine development, guiding the design of vaccination approaches with the capacity to elicit IgG responses with optimal Fc effector function. [ABSTRACT FROM AUTHOR]

Solution processing of metal halide perovskites offers the potential for efficient, high‐speed roll‐based manufacturing of emerging optoelectronic devices such as lightweight photovoltaics and light emitting diodes at lower cost than achievable with incumbent technologies (e.g., Silicon). However, current perovskite fabrication methods are limited in their speed, uniformity, and patterning resolution, relying on subtractive postdeposition scribing for integration of modules and device arrays. Here, a method for flexographic printing of MA0.6FA0.4PbI3 at 60 m min−1, the fastest reported perovskite absorber deposition and the first report of inline drying integrated with roll‐based printing, is presented. This process delivers high‐resolution patterning (< 3 µm line edge roughness) and precise thickness control through rheological design of precursor inks, allowing scalably printed 50 µm features over large areas (140 cm2), while obviating damaging scribing steps. 2D scanning photoluminescence (PL) is applied to resolve correlations between ink leveling dynamics and optoelectronic quality. Integrating these highly uniform printed perovskite absorbers into n‐i‐p planar perovskite solar cells, photovoltaic conversion efficiency up to 20.4% (0.134 cm2), the highest performance yet reported for any roll‐printed perovskite cells is achieved. This study, thus, establishes flexography as a scalable approach to deposit precisely‐patterned high‐quality perovskites extensible to applications in emitter and detector arrays. [ABSTRACT FROM AUTHOR]

• BD+SUD showed more cognitive impairment than each disorder separately. • Improvement in depression could enhance cognitive functioning in DD patients. • Attention and executive functions were the most impaired functions in both DD groups. • Memory seems to be more clearly impaired in MDD+SUD group. • Cognitive impairment may influence clinical variables like abstinence and relapses. Major depression disorder (MDD) and bipolar disorder (BD) are usual comorbidities in patients with substance use disorders (SUD), a condition known as dual disorder (DD). MDD, BD and SUD are associated with cognitive impairment, potentially leading to a greater functional impairment in the context of DD. Objectives: To review the existing data on the cognitive impairment in DD patients with comorbid MDD or BD, considering the influence of the depressive symptomatology. Methods: Following the PRISMA protocol 19 studies were selected from the last 17 years, 13 of which focused on BD, five on MDD and one included both diagnoses. Results: Studies based in BD+SUD showed that the most affected cognitive domains were attention and executive functions, but not all of them found a greater impairment due to the comorbidity. While fewer studies were found for depression, MDD+SUD works point to a similar impairment cognitive pattern. Furthermore, depression improvement could be associated to better cognitive performance. Limitations: More standardized research is needed regarding the influence of depression on cognitive performance of DD patients, especially on those with comorbid MDD. Factors such as main substance, abstinence, or MDD/BD-related variables should be considered. Unstudied factors, like gender or circadian rhythms, are proposed to improve knowledge in this area. Conclusions: Current studies suggest that DD could potentiate cognitive impairment in BD, MDD and SUD. However, additional research is needed to improve the understanding of comorbidity to apply more individualized therapies in the treatment of these patients, considering the interference of their neurocognitive functioning. [ABSTRACT FROM AUTHOR]

This collection of texts explores the intersection of wine and culinary tourism, focusing on three research projects. The first project investigates the role of culinary excellence in destination marketing, specifically looking at the presence and perception of culinary artists in international marketing. The second project examines the use of motorhome pitches as an income opportunity for wineries, studying the motivations and expectations of motorhome owners who stay at wineries. The third project explores the potential synergies between hiking tourism and local wine producers, examining how wine producers can benefit from hikers as additional consumers. The texts emphasize the importance of collaboration between the wine and tourism industries, highlight the combination of wine and hiking tourism as a growing trend, and stress the need to understand customer motivations and expectations to create valuable wine tourism experiences. [Extracted from the article]

This participatory action research case study describes how one secondary school aimed to improve staff culture. Although pre-test data showed the school as performing consistently well in terms of their organisational health, the school chose to implement a line management intervention over 12 months to target three low-rating factors: appraisal and recognition, professional growth, and supportive leadership. Quantitative evaluation showed that while the improvement strategy had no effect on the intended targets, there were unanticipated effects on other factors. Staff reported a mixture of positive and negative effects from the intervention; however, a core issue was its impact on teachers' workloads. Participants reported burnout and stress as a consequence of school leaders driving continuous change. This case study argues that quality school improvement needs to be supported by a clear vision, with due consideration and attention to sustainable work practices. [ABSTRACT FROM AUTHOR]

Background: Dilated cardiomyopathy (DCM) is a life-threatening heart disease and a common cause of heart failure due to systolic dysfunction and subsequent left or biventricular dilatation. A significant number of cases have a genetic etiology; however, as a complex disease, the exact genetic risk factors are largely unknown, and many patients remain without a molecular diagnosis. Methods: We performed GWAS followed by whole-genome, transcriptome, and immunohistochemical analyses in a spontaneously occurring canine model of DCM. Canine gene discovery was followed up in three human DCM cohorts. Results: Our results revealed two independent additive loci associated with the typical DCM phenotype comprising left ventricular systolic dysfunction and dilatation. We highlight two novel candidate genes, RNF207 and PRKAA2, known for their involvement in cardiac action potentials, energy homeostasis, and morphology. We further illustrate the distinct genetic etiologies underlying the typical DCM phenotype and ventricular premature contractions. Finally, we followed up on the canine discoveries in human DCM patients and discovered candidate variants in our two novel genes. Conclusions: Collectively, our study yields insight into the molecular pathophysiology of DCM and provides a large animal model for preclinical studies. [ABSTRACT FROM AUTHOR]

Growing small seedling tubers from true seed, comparable with mini tubers, in controlled conditions could be a method to multiply healthy starting material of potato. In indoor farming systems, the conditions can be optimised for high production. In field trials, it is impossible to investigate the effects of environmental factors such as temperature and light separately. In this study, we performed three climate room experiments in which the effects of light intensity, temperature and percentage of far‐red light in the light spectrum on tuber production were assessed. We found that increasing the average temperature reduced tuber number and tuber weight. Increasing the diurnal temperature variation while keeping the average temperature equal resulted in increased tuber size. The light treatments on the other hand only affected the number of tubers per plant: increasing light intensity and increasing the percentage of far‐red light in the spectrum enhanced the number of tubers. Moreover, interaction in tuber production between inbred lines and temperature was significant, with some inbred lines being relatively tolerant to high temperature. These findings will help breed for heat tolerant varieties and optimise growing conditions for tuber production in indoor farming systems. [ABSTRACT FROM AUTHOR]

The article presents a case study of a child with pediatric opsoclonus-myoclonus-ataxia syndrome (OMAS), a rare inflammatory neurological disorder characterized by ataxia, myoclonus, and random eye movements. The case involves a patient with severe paraneoplastic OMAS associated with neurobehavioral abnormalities and a history of neuroblastoma in remission.

3D printing has the promising capability to fabricate engineered lattice structures with broadly tunable surface area and optimal geometries for maximizing structural and functional properties. This study characterizes the electrical conductivity of 3D lattices of varying size, structure, and porosity to guide additively manufactured electrode design in energy storage devices. Graph theory‐based calculations and experiments comparing the conductivity of multiple strut lattice structures and illustrating the scaling laws governing architectures with either coated or solid conductive struts are presented. The lightweight lattices explored here show higher conductivity than random foams that lack a periodic mesostructure. It is experimentally demonstrated that the 3D lattice type influences the specific capacity when employed in supercapacitors, outperforming 2D supercapacitor counterparts, and other 3D printed electrodes while allowing for optimization of the design for different energy storage applications. Additionally, it is shown that tuning the physical structure of the lattices allows for precise control over the electrical response to mechanical loading, as confirmed through experimental measurements. The lattice structure programs the electrodes' mechanical stiffness, with higher relative density samples showing higher Young's modulus. These results can serve to guide the design of 3D printed electrodes in a variety of electrochemical and electromechanical device applications. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has emerged as a worldwide public health crisis, leading to significant disruptions in societal behaviors and norms. Within the affected population, individuals with mental health disorders are considered a vulnerable group, experiencing higher infection rates and poorer outcomes. These adverse outcomes can be attributed to various factors, including inadequate adherence to vaccination and other preventive measures. To address this issue, this study aims to present the research protocol for a scoping review that will comprehensively examine the literature on the adherence of individuals with mental disorders to preventive behaviors during the COVID-19 pandemic. The scoping review will adhere to the methodological guidelines outlined by the Joanna Briggs Institute and will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A comprehensive search for published literature containing original data will be conducted in the Embase, MEDLINE, PsycINFO, and Web of Science databases. The search strategy will be developed based on the Population, Concept, and Context inclusion criteria. Two authors will independently screen titles, abstracts, and full texts for inclusion and extract relevant data. The findings of the review will be presented using descriptive statistics, including tables, charts, and flow diagrams, to elucidate the key concepts of interest. [ABSTRACT FROM AUTHOR]

Turbulence is ubiquitous within space plasmas, where it is associated with numerous nonlinear interactions. Magnetospheric Multiscale (MMS) provides the unique opportunity to decompose the electric field (E) dynamics into contributions from different linear and nonlinear processes via direct measurements of the terms in generalized Ohm's law. Using high-resolution multipoint measurements, we compute the magnetohydrodynamic ( E MHD ), Hall ( E Hall ), electron pressure ( E P e ), and electron inertia ( E inertia ) terms for 60 turbulent magnetosheath intervals, to uncover the varying contributions to the dynamics as a function of scale for different plasma conditions. We identify key spectral characteristics of the Ohm's law terms: the Hall scale, k Hall , where E Hall becomes dominant over E MHD ; the relative amplitude of E P e to E Hall , which is constant in the sub-ion range; and the relative scaling of the nonlinear and linear components of E MHD and of E Hall , which are independent of scale. We find expressions for the characteristics as a function of plasma conditions. The underlying relationship between turbulent fluctuation amplitudes and ambient plasma conditions is discussed. Depending on the interval, we observe that E MHD and E Hall can be dominated by either nonlinear or linear dynamics. We find that E P e is dominated by its linear contributions, with a tendency for electron temperature fluctuations to dominate at small scales. The findings are not consistent with existing linear kinetic Alfvén wave theory for isothermal fluctuations. Our work shows how contributions to turbulent dynamics change in different plasma conditions, which may provide insight into other turbulent plasma environments. [ABSTRACT FROM AUTHOR]

Quantum chemistry simulations of some industrially relevant molecules are reported, employing variational quantum algorithms for near-term quantum devices. The energies and dipole moments are calculated along the dissociation curves for lithium hydride (LiH), hydrogen sulfide, lithium hydrogen sulfide, and lithium sulfide. In all cases, we focus on the breaking of a single bond to obtain information about the stability of the molecular species being investigated. We calculate energies and a variety of electrostatic properties of these molecules using classical simulators of quantum devices, with up to 21 qubits for lithium sulfide. Moreover, we calculate the ground-state energy and dipole moment along the dissociation pathway of LiH using IBM quantum devices. This is the first example, to the best of our knowledge, of dipole moment calculations being performed on quantum hardware. [ABSTRACT FROM AUTHOR]

Background: Nontuberculous mycobacteria (NTM) are ubiquitous, environmental bacteria that can cause chronic lung disease. Persons with cystic fibrosis (pwCF) are at high risk for NTM. Approximately 1 in 5 pwCF in the United States (U.S.) is affected by pathogenic NTM species, and incidence rates of NTM have been increasing among pwCF as well as in the general population. Prevalence of NTM pulmonary infections (PI) varies widely across the United States because of geographic variation in environmental exposures. This study will present updated region-level incidence of NTM infections in the cystic fibrosis (CF) population in the U.S. Methods: We used the Cystic Fibrosis Foundation Patient Registry (CFFPR) data for the period 2010 through 2019. Our study population comprised persons with CF ≥ 12 years of age who had been tested for NTM PI. We included only registry participants with NTM culture results. We defined incident cases as persons with one positive mycobacterial culture preceded by ≥ two negative mycobacterial cultures. We defined non-cases as persons with ≥ two negative mycobacterial cultures. We estimated average annual NTM PI incidence by region. Using quasi-Poisson models, we calculated annual percent change in incidence by region. Results: We identified 3,771 incident NTM infections. Of these cases, 1,816 (48.2%) were Mycobacterium avium complex (MAC) infections and 960 (25.5%) were Mycobacterium abscessus infections. The average annual incidence of NTM PI among pwCF in the U.S. was 58.0 cases per 1,000 persons. The Northeast had the highest incidence of MAC (33.5/1,000 persons tested) and the South had the highest incidence of M. abscessus (20.3/1,000 persons tested). From 2010 to 2019, the annual incidence of total NTM PI increased significantly by 3.5% per year in the U.S. Conclusions: NTM PI incidence is increasing among pwCF. Identifying high risk areas and increasing trends is important for allocating public health and clinical resources as well as evaluating interventions. [ABSTRACT FROM AUTHOR]

Tailoring treatments to individual needs may be beneficial for treatment adherence and treatment effects. However, individualizing a group-based Social Skills Training (SST) may be complicated. Therefore, in this feasibility study, we examined outcomes after engagement in an individualized SST provided to 33 children aged 7–11 years (M = 9.39, SD = 1.09; 13 girls), who were referred to a mental health care center for various psychosocial problems. To analyze outcomes, we combined a top-down (including researcher-chosen measures: Questionnaires on pro-social, socially inadequate, and problem behavior) and a bottom-up (including participant-driven measures: Ratings of personal goals and evaluation reports) approach and used a mixed-methods design. After the SST, personal goals and pro-social behavior increased (large and small effects respectively). Also, socially inadequate behavior and problem behavior decreased (both small effects). Evaluation reports mainly showed improvements in social responsiveness, emotion regulation, and internalizing problems. At the same time, however, most parents also reported limitations (e.g., a lack of generalization). Altogether, we can conclude that (1) tailoring a group-based SST to the individual needs of children, as well as measuring progress on personal goals, is feasible and (2) mixed-method designs to study intervention effectiveness should be encouraged. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, reports of domestic violence across the United States increased from 21% to 35%. Stay-at-home orders, designed to protect the public against the spread of COVID-19, along with heightened societal stressors as a result of the global pandemic, inadvertently increased rates of illicit drug and alcohol use, job loss, and isolation, resulting in increased stress and nonphysical (e.g., psychological, emotional, economic, technological) abuse that often escalated to physical violence. These processes were exacerbated in marginalized communities. These risks were heightened among Black women and Latinas, who experience high rates of domestic violence, long-standing distrust in law enforcement, and compromised self-reporting or anonymous reporting of abuse. We make recommendations for training key stakeholders (e.g., law enforcement, mental health clinicians, and public health care professionals) to facilitate the safety and well-being of domestic violence survivors and to better manage prevention or intervention efforts targeted at domestic violence. We make public health policy suggestions for individuals, communities, and governing structures. (Am J Public Health. 2023;113(S2):S149–S156. https://doi.org/10.2105/AJPH.2023.307289) [ABSTRACT FROM AUTHOR]

Studies have demonstrated the importance of the gut microbiota during pregnancy, and there is emerging literature on the postpartum maternal gut microbiota. The primary objective of this paper was to synthesize the literature on the postpartum gut microbiome composition and diversity measured in stool samples from healthy mothers of predominantly term infants. The secondary objectives were (1) to identify biological and environmental factors that influence postpartum maternal gut microbiota and (2) to assess health conditions and clinical intermediate measures associated with postpartum gut microbiota changes in all mothers. Electronic searches were conducted November 9, 2020 and updated July 25, 2021 without publication time limits on PubMed, Embase, CINHAL, Scopus, Cochrane Library, BioArchives, and OpenGrey.eu. Primary research on maternal gut microbiota in the postpartum (up to one year after childbirth) were eligible. Postpartum gut microbiota comparisons to pregnancy or non-pregnancy gut microbiota were of interest, therefore, studies examining these in addition to the postpartum were included. Studies were excluded if they were only conducted in animals, infants, pregnancy, or microbiome of other body locations (e.g., vaginal). Data extraction of microbial composition and diversity were completed and synthesized narratively. Studies were assessed for risk of bias. A total of 2512 articles were screened after deduplication and 27 were included in this review. Of the 27 included studies, 22 addressed the primary objective. Firmicutes was the predominant phylum in the early (<6 weeks) and late postpartum (6 weeks to 1 year). In early postpartum, Bacteroides was the predominant genus. Findings from longitudinal assessments of alpha and beta diversity from the early to the late postpartum varied. Nineteen of the 27 studies assessed biological and environmental factors influencing the postpartum gut microbial profile changes. Timing of delivery, probiotic supplementation, triclosan exposure, and certain diets influenced the postpartum gut microbiota. Regarding health conditions and intermediate clinical measures assessed in 8 studies; inflammatory bowel disease, postpartum depression, early-onset preeclampsia, gestational diabetes, excessive gestational weight gain, and anthropometric measures such as body mass index and waist-to-hip ratio were related to gut microbiota changes. There is limited data on the maternal postpartum gut microbiota and how it influences maternal health. We need to understand the postpartum maternal gut microbiome, establish how it differs from non-pregnancy and pregnancy states, and determine biological and environmental influencers. Future research of the gut microbiome's significance for the birthing parent in the postpartum could lead to a new understanding of how to improve maternal short and long-term health. [ABSTRACT FROM AUTHOR]

This article traces the course of the Elbe River from Czechoslovakia through the German Democratic Republic (GDR) into the Federal Republic, where it flows into the North Sea. As the GDR's main water artery, the Elbe's border crossings became a site of security concern for the GDR. Traversing the GDR's border with fellow communist state Czechoslovakia as well as its rival West German state, the river linked the GDR to a larger ecological system as well as transnational sociopolitical dynamics. These connections illuminated the GDR's crucial position in central Europe and beyond. Yet the Elbe also presented challenges for the GDR in terms of controlling information, people, and pollution that streamed into—and out of—the country. The river thus was a precious and contested resource that revealed the communist dictatorship's limited ability to control nature, humans, or interactions between the two. Ultimately, the Elbe's border crossings were a site of transnational and global connection that called into question the GDR's domestic legitimacy and international standing. [ABSTRACT FROM AUTHOR]