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Objective Cognitive changes are heterogeneous in Parkinson's disease (PD). This study compared whether anticholinergic burden drives differences in cognitive domain performance and empirically-derived PD-cognitive phenotypes. Method A retrospective chart review contained participants (n  = 493) who had idiopathic PD without dementia. Participants' medications were scored (0–3) and summed based on the anticholinergic cognitive burden scale (ACBS). We examined the ACBS' relationship to five cognitive domain composites (normative z-scores) and three (K-means clustering based) cognitive phenotypes: cognitively intact, low executive function (EF), and predominately impaired EF/memory. Analyses included Spearman correlations, analysis of covariance, and Pearson chi-squared test. Results Overall, phenotypes did not differ in anticholinergic burden, and (after false-discovery-rate corrections) no cognitive domains related. When comparing those above and below the clinically relevant ACBS cutoff (i.e. score ≥3), no significant phenotype or domain differences were found. Conclusions Anticholinergic medication usage did not drive cognitive performance in a large clinical sample of idiopathic PD without dementia. [ABSTRACT FROM AUTHOR]

PURPOSE: Limited studies have used natural language processing (NLP) in the context of non–small cell lung cancer (NSCLC). This study aimed to validate the application of an NLP model to an NSCLC cohort by extracting NSCLC concepts from free-text medical notes and converting them to structured, interpretable data. METHODS: Patients with a lung neoplasm, NSCLC histology, and treatment information in their notes were selected from a repository of over 27 million patients. From these, 200 were randomly selected for this study with the longest and the most recent note included for each patient. An NLP model developed and validated on a large solid and blood cancer oncology cohort was applied to this NSCLC cohort. Two certified tumor registrars and a curator abstracted concepts from the notes: neoplasm, histology, stage, TNM values, and metastasis sites. This manually abstracted gold standard was compared with the NLP model output. Precision and recall scores were calculated. RESULTS: The NLP model extracted the NSCLC concepts with excellent precision and recall with the following scores, respectively: Lung neoplasm 100% and 100%, NSCLC histology 99% and 88%, histology correctly linked to neoplasm 98% and 79%, stage value 98.8% and 92%, stage TNM value 93% and 98%, and metastasis site 97% and 89%. High precision is related to a low number of false positives, and therefore, extracted concepts are likely accurate. High recall indicates that the model captured most of the desired concepts. CONCLUSION: This study validates that Optum's oncology NLP model has high precision and recall with clinical real-world data and is a reliable model to support research studies and clinical trials. This validation study shows that our nonspecific solid tumor and blood cancer oncology model is generalizable to successfully extract clinical information from specific cancer cohorts. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods and Results Conclusions Companion animals, like household dogs, are an overlooked transmission point for zoonotic pathogens such as nontyphoidal Salmonella (NTS). Given the proximity of dogs to humans and the use of critically important antibiotics in companion animal medicine, household dogs represent a risk for the spread of antimicrobial‐resistant (AMR) Salmonella.To this end, we aimed to leverage existing biosurveillance infrastructure to investigate AMR and the zoonotic potential of NTS isolated from dogs and humans. We identified all NTS strains isolated from domestic dogs via the Veterinary Laboratory Investigation and Response Network between May 2017 and March 2023 (N = 87), and spatiotemporally matched strains isolated from humans in the NCBI Pathogen Isolate Browser (N = 77). These 164 strains, collected from 17 states in the United States, formed the basis of our analysis. Strains isolated from dogs comprised diverse serovars, with most being clinically relevant to human health. All strains possessed AMR determinants for drug classes deemed critically or highly important by the World Health Organization. We identified sixteen NTS isolates from humans closely related to ≥1 of six dog‐associated strains.Collectively, our data emphasize the importance of antimicrobial stewardship and sustained biosurveillance beyond human‐ and agriculture‐associated veterinary medicine, using a One‐Health framework that accounts for all transmission points including companion animals. [ABSTRACT FROM AUTHOR]

Aware of the power of platform firms and the risks of the platform economy, governments are reconsidering the dominant laissez faire approach in favour of strategies that regulate the power of platform firms. transnational dynamics play an important role in shaping emerging national regimes, but we argue that governments are also influenced by three factors that operate primarily at domestic level: the agency of platform firms, the impact of first-mover US platforms, and domestic politics. We illustrate our approach through an analysis of the trajectories and regulatory measures of four economies: the US, the EU, China, and India. As governance efforts expand to emerging technologies such as AI, our analysis presages broader changes to the structure of what was, with a few important exceptions, a relatively borderless global online economy. [ABSTRACT FROM AUTHOR]

Hepatitis E virus (HEV) is an important emerging pathogen producing significant morbidity in immunosuppressed patients. HEV has been detrimental to solid organ transplant (SOT) patients, cancer patients, and HIV-positive patients, where chronic HEV infections occur. Blood-borne transfusions and multiple cases of chronic HEV infection in transplant patients have been reported in the past few decades, necessitating research on HEV pathogenesis using immunosuppressed animal models. Numerous animal species with unique naturally occurring HEV strains have been found, several of which have the potential to spread to humans and to serve as pathogenesis models. Host immunosuppression leads to viral persistence and chronic HEV infection allows for genetic adaptation to the human host creating new strains with worse disease outcomes. Procedures necessary for SOT often entail blood transfusions placing immunosuppressive patients into a "high risk group" for HEV infection. This scenario requires an appropriate immunosuppressive animal model to understand disease patterns in these patients. Hence, this article reviews the recent advances in the immunosuppressed animal models for chronic HEV infection with emphasis on pathogenesis, immune correlates, and the liver pathology associated with the chronic HEV infections. [ABSTRACT FROM AUTHOR]

PURPOSE: Limited studies have used natural language processing (NLP) in the context of non–small cell lung cancer (NSCLC). This study aimed to validate the application of an NLP model to an NSCLC cohort by extracting NSCLC concepts from free-text medical notes and converting them to structured, interpretable data. METHODS: Patients with a lung neoplasm, NSCLC histology, and treatment information in their notes were selected from a repository of over 27 million patients. From these, 200 were randomly selected for this study with the longest and the most recent note included for each patient. An NLP model developed and validated on a large solid and blood cancer oncology cohort was applied to this NSCLC cohort. Two certified tumor registrars and a curator abstracted concepts from the notes: neoplasm, histology, stage, TNM values, and metastasis sites. This manually abstracted gold standard was compared with the NLP model output. Precision and recall scores were calculated. RESULTS: The NLP model extracted the NSCLC concepts with excellent precision and recall with the following scores, respectively: Lung neoplasm 100% and 100%, NSCLC histology 99% and 88%, histology correctly linked to neoplasm 98% and 79%, stage value 98.8% and 92%, stage TNM value 93% and 98%, and metastasis site 97% and 89%. High precision is related to a low number of false positives, and therefore, extracted concepts are likely accurate. High recall indicates that the model captured most of the desired concepts. CONCLUSION: This study validates that Optum's oncology NLP model has high precision and recall with clinical real-world data and is a reliable model to support research studies and clinical trials. This validation study shows that our nonspecific solid tumor and blood cancer oncology model is generalizable to successfully extract clinical information from specific cancer cohorts. This non-specific oncology NLP model generalizes to successfully extract insights for specific cancer cohorts. [ABSTRACT FROM AUTHOR]

Summary: Background: The prevalence of childhood obesity in the U.S. has increased, likely due to decreased physical activity, increased sedentary behaviour and unhealthy diets. Little is known about the relationships between these factors and weight gain in those under the age of three. Objectives: This study aimed to understand the longitudinal associations of weight gain over 6‐month intervals with child and parent characteristics as children develop from 6 to 36 months. Methods: Mother and infant data were collected at 6‐month intervals from 6 to 36 months. Weight (kg) was the primary outcome variable, and potential explanatory variables included child and parent characteristics, physical activity, motor development, diet and sleep. Structural equation modelling was used to assess associations between explanatory variables and 6‐month weight gain. Results: Weight increased ~1 kg per 6‐month interval (p < 0.001) from 6 to 36 months. Childcare outside of the home at 12 months was associated with 0.272 kg (p = 0.002) greater weight gain at 18 months, while children's physical activity was associated with 0.228 kg (per 2 SD, p = 0.051) less weight gain during the same time period. Mother's TV and screen media use (0.102 kg per hour/day, p = 0.046) and child's intake of high‐energy beverages at 18 months (0.387 kg, p = 0.037) were both associated with greater weight gain at 24 months. Conclusion: Childcare, physical activity, screen media use and high‐energy beverage consumption might affect weight gain at different time points in early childhood. These insights can inform efforts to prevent excessive weight gain and childhood obesity effectively. [ABSTRACT FROM AUTHOR]

Background: The prognosis of surgically treated subjects with early onset scoliosis (EOS) into adulthood has been lacking. We aimed to investigate the patients’ perspectives on satisfaction with surgical treatment. Methodology: We included all surgical candidates with EOS who had undergone index spinal surgery for scoliosis correction between 2009 and 2013. The minimum duration of postoperative follow-up was 10 years at the time of survey completion. Three questionnaires were used in this study, comprising the revised Scoliosis Research Society questionnaire (SRS-22r), the Patient-Reported Outcomes Measurement Information System (PROMIS-29), and the World Health Organization Quality of Life (WHOQOL-BREF). Measures of treatment satisfaction were retrieved from SRS-22r. Results: There were 29 participants who completed the survey, and thereby included in the study (i.e., a response rate of 43% and a dropout rate of 6%). Amongst them, 14, 11, and 4 individuals received posterior spinal fusion (PSF), magnetically controlled growing rods (MCGR), and traditional growing rods, respectively. The average duration after the index spinal surgery was 12.6 ± 2.2 years. Our findings revealed that self-image (across all treatment groups), sleep disruption (only in PSF), and social aspects (in both PSF and MCGR) were significantly worse when compared to the normative values. According to the multivariable linear regression model (R-square = 0.690, p <.001), an increase in SRS-22r mental health (p =.008) and PROMIS-29 social participation scores (p =.004) corresponded to 0.511 and 0.055 points increases in satisfaction. Every unit increase in PROMIS-29 fatigue (p =.043) and WHOQOL-BREF physical domain scores (p =.007) was in conjunction with 0.019 and 0.040 points decreases in satisfaction. SRS-22r self-image (p =.056) and WHOQOL-BREF environmental domain scores (p =.076) were included in the model but did not reach statistical significance. Conclusions: To improve the long term quality of life in surgical candidates with EOS, we demonstrated that mental health, social participation, fatigue, and physical health were significant factors associated with treatment satisfaction. Interestingly, demographic and radiographic parameters did not have a significant effect in our cohort. [ABSTRACT FROM AUTHOR]

Background: Almost half of acute ischemic stroke patients present with mild symptoms and there are large practice variations in their treatment globally. Individuals with an intracranial occlusion who present with minor stroke are at an increased risk of early neurological deterioration and poor outcomes. Individual patient data meta-analysis in the subgroup of patients with minor deficits showed benefit of alteplase in improving outcomes; however, this benefit has not been seen with intravenous alteplase in published randomized trials. Design: TEMPO-2 (A Randomized Controlled Trial of Tenecteplase Versus Standard of Care for Minor Ischemic Stroke With Proven Occlusion) is a prospective, open label with blinded outcome assessment, randomized controlled trial, designed to test the superiority of intravenous tenecteplase (0.25 mg/kg) over nonthrombolytic standard of care, with an estimated sample size of 1274 patients. Adult patients presenting with acute ischemic stroke with the National Institutes of Health Stroke Scale (NIHSS) ⩽ 5 and visible arterial occlusion or perfusion deficit within 12 h of onset are randomized to receive either tenecteplase (0.25 mg/kg) or standard of care. The primary outcome is return to baseline neurological functioning, measured by the modified Rankin scale (mRS) at 90 days. Safety outcomes include death and symptomatic hemorrhage (intra or extra-cranial). Other secondary outcomes include mRS 0–1, mRS 0–2, ordinal shift analysis of the mRS, partial, and full recanalization on follow-up computed tomography angiogram. Conclusion: Results of this trial will aid in determining whether there is benefit of using tenecteplase (0.25 mg/kg) in treating patients presenting with minor stroke who are at high risk of developing poor outcomes due to presence of an intracranial occlusion. Data access statement: Data will be available upon reasonable request. [ABSTRACT FROM AUTHOR]

Despite impressive advances in the broad field of innate immunity, our understanding of the molecules and signaling pathways that control the host immune response to nematode infection remains incomplete. We have shown recently that Transforming Growth Factor-β (TGF-β) signaling in the fruit fly Drosophila melanogaster is activated by nematode infection and certain TGF-β superfamily members regulate the D. melanogaster anti-nematode immune response. Here, we investigate the effect of an entomopathogenic nematode infection factor on host TGF-β pathway regulation and immune function. We find that Heterorhabditis bacteriophora serine carboxypeptidase activates the Activin branch in D. melanogaster adults and the immune deficiency pathway in Activin-deficient flies, it affects hemocyte numbers and survival in flies deficient for Activin signaling, and causes increased intestinal steatosis in Activin-deficient flies. Thus, insights into the D. melanogaster signaling pathways and metabolic processes interacting with H. bacteriophora pathogenicity factors will be applicable to entomopathogenic nematode infection of important agricultural insect pests and vectors of disease. [ABSTRACT FROM AUTHOR]

Background: Development of reliable disease activity biomarkers is critical for diagnostics, prognostics, and novel drug development. Although computed tomography (CT) is the gold-standard for quantification of bone erosions, there are no consensus approaches or rationales for utilization of specific outcome measures of erosive arthritis in complex joints. In the case of preclinical models, such as sexually dimorphic tumor necrosis factor transgenic (TNF-Tg) mice, disease severity is routinely quantified in the ankle through manual segmentation of the talus or small regions of adjacent bones primarily due to the ease in measurement. Herein, we sought to determine the particular hindpaw bones that represent reliable biomarkers of sex-dependent disease progression to guide future investigation and analysis. Methods: Hindpaw micro-CT was performed on wild-type (n = 4 male, n = 4 female) and TNF-Tg (n = 4 male, n = 7 female) mice at monthly intervals from 2–5 (females) and 2-8-months (males) of age, since female TNF-Tg mice exhibit early mortality from cardiopulmonary disease at approximately 5-6-months. Further, 8-month-old WT (n = 4) and TNF-Tg males treated with anti-TNF monoclonal antibodies (n = 5) or IgG placebo isotype controls (n = 6) for 6-weeks were imaged with micro-CT every 3-weeks. For image analysis, we utilized our recently developed high-throughput and semi-automated segmentation strategy in Amira software. Synovial and osteoclast histology of ankle joints was quantified using Visiopharm. Results: First, we demonstrated that the accuracy of automated segmentation, determined through analysis of ~9000 individual bones by a single user, was comparable in wild-type and TNF-Tg hindpaws before correction (79.2±8.9% vs 80.1±5.1%, p = 0.52). Compared to other bone compartments, the tarsal region demonstrated a sudden, specific, and significant bone volume reduction in female TNF-Tg mice, but not in males, by 5-months (4-months 4.3± 0.22 vs 5-months 3.4± 0.62 mm3, p<0.05). Specifically, the cuboid showed significantly reduced bone volumes at early timepoints compared to other tarsals (i.e., 4-months: Cuboid -24.1±7.2% vs Talus -9.0±5.9% of 2-month baseline). Additional bones localized to the anterolateral region of the ankle also exhibited dramatic erosions in the tarsal region of females, coinciding with increased synovitis and osteoclasts. In TNF-Tg male mice with severe arthritis, the talus and calcaneus exhibited the most sensitive response to anti-TNF therapy measured by effect size of bone volume change over treatment period. Conclusions: We demonstrated that sexually dimorphic changes in arthritic hindpaws of TNF-Tg mice are bone-specific, where the cuboid serves as a reliable early biomarker of erosive arthritis in female mice. Adoption of automated segmentation approaches in pre-clinical or clinical models has potential to translate quantitative biomarkers to monitor bone erosions in disease and evaluate therapeutic efficacy. [ABSTRACT FROM AUTHOR]

Men's negative attitudes toward women represent a known risk factor for sexual aggression perpetration. Sexual aggression is a widespread public health concern, especially among emerging adults, and is associated with a multitude of negative consequences. The current study evaluated whether pornography-related perceived peer norms, own approval, and self-reported use are associated with negative attitudes toward women in a sample of college men. Types of pornography examined included pornography (in general); pornography that included portrayals of bondage, whipping, and spanking but without explicit dissent (i.e., pornography that depicted bondage/physical aggression); as well as pornography consisting of sexually explicit rape depictions in which force is used. Self-report measures assessing the frequency of pornography exposure, self-acceptance of pornography use, and perceived peer norms were collected from 283 college men. A multiple linear regression model revealed that only perceived peer norms for acceptance of pornography that depicted rape was positively associated with negative attitudes toward women. Findings highlight the importance of better understanding and addressing perceived peer norms in sexual assault prevention programs for college men. [ABSTRACT FROM AUTHOR]

Pacing guides are commonplace yet controversial in American public schools. For teachers who question their usefulness, one means to circumvent them is to exercise autonomy in pedagogical decision-making, though doing so comes with challenges. Through interviews, we examined how 87 gifted and general education 4th and 5th grade math and reading/language arts teachers in one large, diverse public school district expressed their autonomy and reported enacting it in their classrooms. Findings indicated teachers' perceptions of autonomy differed, and their reported pacing guide deviations also differed accordingly. We discuss implications for those in environments where use of pacing guides is mandated. [ABSTRACT FROM AUTHOR]

The unculturable bacterium 'Candidatus Liberibacter soianacearum' (CLso) is responsible for a growing number of emerging crop diseases. However, we know little about the diversity and ecology of CLso and its psyllid vectors outside of agricultural systems, which limits our ability to manage crop disease and understand the impacts this pathogen may have on wild plants in natural ecosystems. In North America, CLso is transmitted to crops by the native potato psyllid (Bactericera cockerelli). However, the geographic and host plant range of the potato psyllid and CLso beyond the borders of agriculture are not well understood. A recent study of historic herbarium specimens revealed that a unique haplotype of CLso was present infecting populations of the native perennial Solanum umbelliferum in California decades before CLso was first detected in crops. We hypothesized that this haplotype and other potentially novel CLso variants arc still present in S. umbelliferum populations. To test this, we surveyed populations of S'. umbelliferum in Southern California for CLso and potato psyllid vectors. We found multiple haplotypes of CLso and the potato psyllid associated with these populations, with none of these genetic variants having been previously reported in California crops. These results suggest that CLso and its psyllid vectors are much more widespread and diverse in North American natural plant communities than suggested by data collected solely from crops and weeds in agricultural fields. Further characterization of these apparently asymptomatic haplotypes will facilitate comparison with disease-causing variants and provide insights into the continued emergence and spread of CLso. [ABSTRACT FROM AUTHOR]

Objectives: Randomized controlled trials (RCTs) are the gold standard for evaluating the comparative efficacy and safety of new cancer therapies. However, enrolling patients in control arms of clinical trials can be challenging for rare cancers, particularly in the context of precision oncology and targeted therapies. External Control Arms (ECAs) are a potential solution to address these challenges in clinical research design. We conducted a scoping review to explore the use of ECAs in oncology. Methods: We systematically searched four databases, namely MEDLINE, EMBASE, Web of Science, and Scopus. We screened titles, abstracts, and full texts for eligible articles focusing on patients undergoing therapy for cancer, employing ECAs, and reporting clinical outcomes. Results: Of the 629 articles screened, 23 were included in this review. The earliest included studies were published in 1996, while most studies were published in the past 5 years. 44% (10/23) of ECAs were employed in blood‐related cancer studies. Geographically, 30% (7/23) of studies were conducted in the United States, 22% (5/23) in Japan, and 9% (2/23) in South Korea. The primary data sources used to construct the ECAs involved pooled data from previous trials (35%, 8/23), administrative health databases (17%, 4/23) and electronic medical records (17%, 4/23). While 52% (12/23) of the studies employed methods to align treatment and ECAs characteristics, 48% (11/23) lacked explicit strategies. Conclusion: ECAs offer a valuable approach in oncology research, particularly when alternative designs are not feasible. However, careful methodological planning and detailed reporting are essential for meaningful and reliable results. [ABSTRACT FROM AUTHOR]

We evaluated the proportion of patients with trichomoniasis and chlamydial infections who received recommended versus nonrecommended antibiotic therapy after the updated 2021 Sexually Transmitted Infections Guideline. Of 712 patients, 473 (66%) received recommended therapy. Receipt of emergency department care was independently associated with recommended therapy (adjusted odds ratio, 2.1; 95% confidence interval, 1.5–2.9). [ABSTRACT FROM AUTHOR]

The article analyzes exercise patterns among individuals with type 1 diabetes (T1D) using the Hedia Diabetes Assistant app. Topics discussed include the comparison of physical activity (PA) between users who utilized the app's PA module and those who did not, glucose management during exercise, and the implications of exercise patterns on insulin dosing strategies.

The article focuses on the critical reassessment of Sydney Owenson, also known as Lady Morgan, and Rosa Mulholland, highlighting their contributions to the Irish novel. Topics include the historical dismissal of Owenson's literary significance, the unjust comparisons made between Mulholland's "Marcella Grace" and Owenson's "The Wild Irish Girl," and the complexities of Mulholland's portrayal of gender and national identity in the context of 19th-century Irish literature.

Effective teamwork is essential in almost every job, and can even mean life, death, or disability in some jobs. Intraoperative neurophysiological monitoring (IONM) is a career in which effective teamwork and accurate communication are of utmost importance, yet it comes with a unique set of challenges in which to achieve those goals. Operating rooms can be very stressful environments, even if a surgical neurophysiologist (SNP) works in the same hospital every day. Often an SNP is required to travel from hospital to hospital and work with different teams each day. In addition, communication with the IONM oversight professional (IONM-P) can be challenging by nature of the telemedicine model which is becoming the most commonly applied IONM model in the United States. It is unfortunate that such critical skills are assumed and are rarely formally trained. In this article, we present evidence-based recommendations for establishing effective team function. We also provide several tools designed to help create effective and efficient teams. Teams cannot function at their best without outstanding communication, so improving teamwork also means improving communication. This article also provides several techniques for excellent communication, regardless of the situation or context. [ABSTRACT FROM AUTHOR]

Existing healthcare systems face finite resource allocation and budgetary constraints, resulting in a substantial need for innovative solutions to enhance service delivery at reduced costs. A novel, user-friendly on-body delivery system (OBDS) was developed which enables administration of large-volume subcutaneous (SC) drugs in both clinical and home-based settings (at-home healthcare professional [HCP] administration or at-home self-administration). This research sought to evaluate the potential economic impact of at-home self- or HCP- administration with the OBDS through a comprehensive review of published literature and semi-structured interviews with 17 US payers representing approximately 227 million covered lives. Published literature on OBDS remains limited, but available research highlights the cost-savings of SC administration due to reduced healthcare resource utilization, particularly with home-based care, and improved patient compliance. In interviews, payers identified several attributes that would help address unmet clinical and economic needs. Clinically, the hidden needle and ease-of-use compared to SC syringe pumps was deemed valuable to improve patient compliance and, as OBDS required minimal training, reduce the risk of administration errors. The flexibility to administer drugs at home (self-administration or HCP-administration) or in-clinic was identified as the most impactful attribute on coverage decision making as it has the greatest potential to reduce costs associated with HCP administration for several therapeutic areas. Given the ability to help address critical unmet needs for the patient and healthcare system, a large proportion of the payers stated that the novel OBDS would warrant a price premium versus the cost of the standalone SC vial and certainly over the IV counterpart. Future research to quantify the value that OBDS efficiencies could bring to healthcare delivery are warranted. [ABSTRACT FROM AUTHOR]

Motion‐sensitive cameras are commonly used to monitor wildlife occupancy rates; however, few studies have assessed whether data from cameras are correlated with density estimates obtained from more traditional labor‐intensive methods such as those based on capture‐mark‐recapture. We used data from a boreal forest community to test whether camera data were correlated with densities estimated from independent monitoring methods. We placed 72 covert cameras in the forest around Lhù'ààn Mân' (Kluane Lake), Yukon, Canada, for 7 years and tracked changes in population densities by camera hit rates. We independently estimated population densities of snowshoe hares (Lepus americanus) and red squirrels (Tamiasciurus hudsonicus) using capture‐mark‐recapture via live trapping, and Canada lynx (Lynx canadensis), coyotes (Canis latrans), and moose (Alces americanus) by snow track transects. Density estimates obtained from conventional aerial surveys were also periodically available for moose. Except for red squirrels, camera hit rates were highly correlated with population density estimates obtained by traditional methods, including across a large range of estimated densities corresponding to cyclic population dynamics in several species. Accordingly, we infer that motion‐sensitive cameras could supplement or replace traditional methods for monitoring key species in boreal forest food webs. Using cameras to monitor population change has several advantages; they require less effort in the field, are non‐invasive compared to live‐trapping, include multiple species at the same time, and rely less on weather than either aerial surveys or snow track transects. Tracking changes across the vast boreal forest is becoming increasingly necessary because of climate and landscape change and our data validate the use of motion‐sensitive cameras to provide a useful quantitative method for state‐of‐the‐environment reporting. [ABSTRACT FROM AUTHOR]

Aging is associated with a wide range of physiological and behavioral changes in many species. Zebrafish, like humans, rodents, and birds, exhibits gradual senescence, and thus may be a useful model organism for identifying evolutionarily conserved mechanisms related to aging. Here, we compared behavior in the novel tank test of young (6-month-old) and middle aged (12-month-old) zebrafish from two strains (TL and TU) and both sexes. We find that this modest age difference results in a reduction in locomotor activity in male fish. We also found that background strain modulated the effects of age on predator avoidance behaviors related to anxiety: older female TL fish increased bottom dwelling whereas older male TU fish decreased thigmotaxis. Although there were no consistent effects of age on either short-term (within session) or long-term (next day) habituation to the novel tank, strain affected the habituation response. TL fish tended to increase their distance from the bottom of the tank whereas TU fish had no changes in bottom distance but instead tended to increase thigmotaxis. Our findings support the use of zebrafish for the study of how age affects locomotion and how genetics interacts with age and sex to alter exploratory and emotional behaviors in response to novelty. [ABSTRACT FROM AUTHOR]

Background: Sexual assault and heavy alcohol use are prevalent and interrelated public health concerns on university campuses. Surprisingly, however, few alcohol harm reduction interventions address this intersection to help students reduce both personal and community risks for sexual assault in college drinking contexts. Objectives: In the current study, students (ages 18–24) shared strategies they use to protect themselves and others from sexual assault in college drinking contexts, as well as challenges to implementing these strategies. A series of six focus groups were conducted across two universities in the U.S. (N = 35). Participants responded to open-ended questions focused on drinking and sexual assault (e.g., What are some of the things students might do to avoid or address situations where they feel pressured of coerced to hook up or have sex when they do not want to?). Results: Thematic analyses demonstrated students' awareness of protective behavioral and bystander intervention strategies that could help reduce vulnerability to experience sexual assault for themselves or others in drinking contexts. Perceived barriers to using bystander intervention strategies included student's own and friends' heavy drinking (decreased inhibitions, loss of autonomy), ambiguity in deciphering risk (lack of familiarity, minimization, diffusion of responsibility), and gender (gender norms, power imbalances). Conclusions: This study informs the development of interventions that help students identify strategies and overcome barriers to reduce risks for sexual assault in college drinking contexts. [ABSTRACT FROM AUTHOR]

Bacteriophage therapy is a rapidly growing field of study. Narrow host ranges, bacterial resistance, and limited antibiotic availability make lytic phages a feasible therapeutic potential. Phage discovery, a critical step in developing phage therapy, is a pathway to accessible treatment. This has always been a laborious, time-consuming and resource-intensive process. In this paper, we describe a 96-well plate low-volume bacteriophage enrichment method with concentrated environmental sources to rapidly discover and isolate phages targeting multiple organisms simultaneously. Samples from natural water sources, wastewater influent, and activated sludge were tested in large volume enrichment cultures and low-volume 96-well plate format. Each plate has the capacity to run as many as 48 different combinations with multiple bacterial hosts. The time to identify the presence of phage in a sample was 5 to 10 hours in the low-volume format versus a minimum of 2 days in the traditional enrichment method. The labor and expense involved also favor the 96-well plate format. There was some loss of discovered phages using this technique, primarily targeting bacterial species less prevalent in the environment. This is an easily modifiable method that is amenable to automation and a variety of potential phage sources. [ABSTRACT FROM AUTHOR]

AbstractObjective: During young adulthood, drinking and sexual behaviors are both normative and inextricably linked. While this association is well documented, little is known about how students define positive and negative drinking-related sexual experiences. Methods: Thirty-five undergraduates participated in a focus group about sexual experiences in the context of drinking. Thematic analysis was utilized to identify themes in the data. Results: Students’ descriptions of positive drinking-related sexual encounters included having a good time, feeling safe, maintaining control over alcohol, as well as feeling safe in drinking contexts where sexual partners are located. Students’ perceptions of negative experiences included specific consequences such as a damaged reputation, loss of control due to alcohol, and concern of engagement in sex when they or a partner was too intoxicated to consent. Conclusion: Gaining a better understanding of how college students view positive and negative drinking-related sexual experiences could inform interventions aimed at promoting student well-being. [ABSTRACT FROM AUTHOR]

Radio-frequency capacitively coupled plasmas (CCPs) are one of the key technologies enabling the latest etching processes in 3D NAND and FinFET manufacturing. These processes rely crucially on the precise control of the uniformity of ion/radical fluxes and ion angular and energy distribution function (IAEDF) in CCPs. The plasma behavior and scaling properties are dependent on the plasma chemistry in these processes, e.g., electro-positive Ar plasmas vs highly electro-negative O2 plasmas. With the large number of process and design parameters influencing the plasma properties, computational modeling has become an important tool in conjunction with experimental diagnostics in understanding the intricate physical mechanisms in CCPs. In this paper, a 2D particle-in-cell plasma model is used to study the kinetic behavior of low-pressure (<5 Pa) CCPs in two different representative chemistries: Ar and O2. The low-frequency RF source is at 1.356 MHz while 27.12 MHz is used for the high frequency. Simulations show a shift of the peak in the plasma density from the center of the chamber to the edge as the pressure increases from 0.3 to 2.6 Pa. The computed magnitude and spatial profile of electron density compare reasonably with experimental measurements over a range of pressure. Comparison between electro-positive and electro-negative plasmas are discussed. Modeling results for the dual frequency CCP highlight the effect of plasma uniformity on the IAEDF, especially near the outer edge of the electrodes. Collisions in the sheath increase the population of low-energy ions as the pressure is increased to 2.6 Pa. [ABSTRACT FROM AUTHOR]

The U.S. Military uses handwritten documentation throughout the continuum of combat casualty care to document from point-of-injury, during transport and at facilities that provide damage control resuscitation and surgery. Proven impractical due to lack of durability and legibility in arduous tactical environments, we hypothesized that mobile applications would increase accuracy and completeness of documentation in combat casualty simulations. We conducted simulations across this continuum utilizing 10 two-person teams consisting of a Medic and an Emergency or Critical Care Nurse. Participants were randomized to either the paper group or BATDOK and T6 Health Systems mobile application group. Simulations were completed in both the classroom and simulated field environments. All documentation was assessed for speed, completeness, and accuracy. Participant demographics averaged 10.8 ± 5.2 y of military service and 3.9 ± 0.6 h of training on both platforms. Classroom testing showed a significant increase in completeness (84.2 ± 8.1% versus 77.2 ± 6.9%; P = 0.02) and accuracy (77.6 ± 8.1% versus 68.9 ± 7.5%; P = 0.01) for mobile applications versus paper with no significant difference in overall time to completion (P = 0.19). Field testing again showed a significant increase in completeness (91.6 ± 5.8 % versus 70.0 ± 14.1%; P < 0.01) and accuracy (87.7 ± 7.6% versus 64.1 ± 14.4%; P < 0.01) with no significant difference in overall time to completion (P = 0.44). In deployed environments, mobile applications have the potential to improve casualty care documentation completeness and accuracy with minimal additional training. These efforts will assist in meeting an urgent operational need to enable our providers. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) prevents food insecurity and supports nutrition for more than 3 million low-income young children. Our objectives were to determine the cost-effectiveness of changes to WIC's nutrition standards in 2009 for preventing obesity and to estimate impacts on socioeconomic and racial/ethnic inequities. METHODS We conducted a cost-effectiveness analysis to estimate impacts from 2010 through 2019 of the 2009 WIC food package change on obesity risk for children aged 2 to 4 years participating in WIC. Microsimulation models estimated the cases of obesity prevented in 2019 and costs per quality-adjusted-life year gained. RESULTS An estimated 14.0 million 2- to 4-year old US children (95% uncertainty interval (UI), 13.7--14.2 million) were reached by the updated WIC nutrition standards from 2010 through 2019. In 2019, an estimated 62 700 (95% UI, 53 900--71 100) cases of childhood obesity were prevented, entirely among children from households with low incomes, leading to improved health equity. The update was estimated to cost $10 600 per quality-adjusted-life year gained (95% UI, $9760--$11 700). If WIC had reached all eligible children, more than twice as many cases of childhood obesity would have been prevented. CONCLUSIONS Updates to WIC's nutrition standards for young children in 2009 were estimated to be highly cost-effective for preventing childhood obesity and contributed to reducing socioeconomic and racial/ethnic inequities in obesity prevalence. Improving nutrition policies for young children can be a sound public health investment; future research should explore how to improve access to them. [ABSTRACT FROM AUTHOR]

The open data movement represents a major advancement for informed water management. Data that are findable, accessible, interoperable, and reusable—or FAIR—are now prerequisite to responsible data stewardship. In contrast to FAIR, accessibility and usability case studies and guidelines designed around human access and understanding are lacking in the literature, especially for water resources. Such decision support guidelines are critical because (i) inherent visual design trade‐offs are not best made using intuition or feedback (perceived preference), and (ii) choosing designs requires a nuanced understanding of why and how the design works (revealed effectiveness). Thus, the goal of this commentary is to highlight knowledge gaps and discuss a general usability testing method which can be applied to any water resources decision support product. The user‐testing approach includes (i) interviews about visualization goals, audiences, and the uses and decisions made with the data products, (ii) diagnosis of usability challenges, and (iii) redesign of decision support products given best practices and control versus treatment with intended end‐user audiences. We illustrate the method using high‐profile U.S. Geological Survey water science products. In sum, optimizing and testing for usability and understandability are as central to stakeholder use as FAIR standards are, and warrant being part of the development of data products and geovisualizations. [ABSTRACT FROM AUTHOR]

Objectives Over 50% of adults living with sickle cell disease (SCD) have chronic pain, but the underlying mechanisms of chronic pain in this population remain unclear. Quantitative sensory testing is an important measurement tool for understanding pain and sensory processing. This scoping review summarizes quantitative sensory testing methodologies used in sickle cell studies and the evidence for central sensitization in this population. Methods We conducted a systematic search of PubMed, Embase, and CINAHL to identify studies using quantitative sensory testing in individuals living with sickle cell disease. Search strategies were based on variations of the terms "sickle cell disease," and "quantitative sensory testing." Eligible studies were observational or experimental studies in human participants living with SCD that reported findings and detailed methodology for at least 1 quantitative sensory testing modality. Results Our search yielded a total of 274 records; 27 of which are included in this scoping review. Of the 27 studies, 17 were original studies (with combined total of 516 adult and 298 pediatric participants), and 10 were secondary or subgroup analyses of these prior studies. Significant variation existed in quantitative sensory testing methodologies across studies, including testing locations, type and intensity of stimuli, and interpretation of findings. Of the identified studies, 22% (2/9 studies) reported sensory abnormalities in mechanical sensitivity and thresholds, 22% (2/9 studies) reported abnormal pressure pain thresholds, 46% (6/13 studies) reported sensory abnormalities in thermal pain thresholds and tolerance (cold and warm), and 50% (2/4 studies) reported abnormalities in temporal summation. Conclusion Future studies should use standardized quantitative sensory testing protocols with consistent and operationalized definitions of sensitization to provide clear insight about pain processing and central sensitization in sickle cell disease. [ABSTRACT FROM AUTHOR]

Baseline studies of small rodent populations in undisturbed ecosystems are rare. We report here 50 years of monitoring and experimentation in Yukon of a dominant rodent species in the North American boreal forest, the red‐backed vole Clethrionomys rutilus. These voles breed in summer, weigh 20–25 g, and reach a maximum density of 20 to 25 per ha. Their populations have shown consistent 3–4‐year cycles for the last 50 years with the only change being that peak densities averaged 8/ha until 2000 and 18/ha since that year. During the last 25 years, we have measured food resources, predator numbers, and winter weather, and for 1‐year social interactions, to estimate their contribution to changes in the rate of summer increase and the rate of overwinter decline. All these potential limiting factors could contribute to changes in density, and we measured their relative contributions statistically with multiple regressions. The rate of winter decline in density was related to both food supply and winter severity. The rate of summer increase was related to summer berry crops and white spruce cone production. No measure of predator numbers was related to winter or summer changes in vole abundance. There was a large signal of climate change effects in these populations. There is no density dependence in summer population growth and only a weak one in winter population declines. None of our results provide a clear understanding of what generates 3–4‐year cycles in these voles, and the major missing piece may be an understanding of social interactions at high density. [ABSTRACT FROM AUTHOR]

Background: Families of children with medical complexity (CMC) have been negatively affected by the COVID‐19 pandemic, experiencing challenges such as decreased access to services, increased financial hardship and increased isolation. However, there are few qualitative studies which explore parental experiences. The aim of the present study was to describe the impact of the COVID‐19 pandemic on families of CMC. Methods: Caregivers of CMC were recruited from a large hospital in the Midwestern United States. They completed a semistructured qualitative interview assessing the impact of COVID‐19 on their child's care, which was analysed using interpretive phenomenological analysis. Results: Twenty caregivers who were predominantly White, married and female participated. Emergent themes included the importance of protecting their child's health to ensure their physical safety, greater social isolation and missed medical services related to concerns about exposure, clinic closures and/or other logistical changes. Participants noted that the convenience of telehealth was a positive outcome of COVID‐19 that facilitated care while reducing time and resource challenges. Conclusions: This study highlights the importance of protecting the health of CMC through continued safe access to in‐person or telehealth services. It is important to prioritise emotional support services for families of CMC as they have experienced increased stress and social isolation during and after the COVID‐19 pandemic. This topic should be explored among diverse families with CMC across multiple healthcare systems. [ABSTRACT FROM AUTHOR]

Differentiation is an instructional practice teachers employ to modify their classroom content, process, and products based on student readiness, interest, and learning profile. Many school districts recognize the benefits of differentiated instruction and thus mandate allotted classroom time for its implementation. In this article, we investigate how teachers in one such district resolved differentiation policy to practice in a high-stakes testing environment. We found, during the designated time for differentiation, teachers regularly remediated small groups but did not similarly address the academic needs of advanced students, thus not enacting the disciplinary standard for differentiation. We suggest teachers are recoupling practice and policy but misaligning it to the disciplinary definition of differentiation, which we contend has broader implications for instructional policymaking. [ABSTRACT FROM AUTHOR]

Background: Predictors of virologic failure in those receiving long-acting injectable (LAI) cabotegravir/rilpivirine (CAB/RPV) have been evaluated; however, factors associated with low-level viremia, including blips and persistent low-level viremia (pLLV), are not well-described. Methods: A retrospective cohort study was performed using data from April 2021 through December 2022. Inclusion criteria included treatment with CAB/RPV for at least 3 months, availability of pre- and postswitch HIV RNA values, HIV RNA value of <200 copies/mL (cpm) at the time of switch to CAB/RPV, and at least 1 postswitch HIV RNA collected >21 days after the start of CAB/RPV. Outcomes included incidence of HIV RNA ≥20, ≥50, and ≥200 cpm after switch and factors associated with detectable HIV RNA after switch. Results: The median duration of follow-up among 144 participants was 287 days. After switching to CAB/RPV, occurrences of at least 1 HIV RNA ≥20, ≥50, and ≥200 cpm after switch were 34.7%, 15.3%, and 2.8%, respectively. Those with pLLV before switch were significantly more likely to have detectable HIV RNA after switch [hazard ratio 24.39 (8.71–68.34)], and 44.4% of those with pLLV before switch continued with pLLV after switch to LAI CAB/RPV. Body mass index, late injection, and monthly versus every two-month dosing were not associated with detectable viremia after switch. Conclusions: Despite virologic suppression at the time of switch and the perceived adherence benefits, participants still experienced blips or pLLV after switch to LAI CAB/RPV. Having detectable HIV RNA on oral therapy before switch was associated with detectable HIV RNA after switching. [ABSTRACT FROM AUTHOR]

Since idiopathic scoliosis is a multifactorial disorder, the proprioceptive defect is considered one of its etiological factors. Genetic studies have separately revealed this relationship, yet it remains indeterminate which specific genes that related to proprioception contributed to the initiation, progression, pathology, and treatment outcomes of the curvature. A systematic search was conducted on four online databases, including PubMed, Web of Science, Embase, and Academic search complete. Studies were included if they involved human or animal subjects with idiopathic scoliosis and evaluated with proprioceptive genes. The search period was the inception of the database to February 21, 2023. Four genes (i.e., Ladybird homeobox 1 [LBX1], Piezo type mechanosensitive ion channel component 2 [PIEZO2], Runx family transcription factor 3 [RUNX3], and neurotrophin 3 [NTF3]) investigated in 19 studies were included. LBX1 has confirmed the correlation with the development of idiopathic scoliosis in 10 ethnicities, whereas PIEZO2 has shown a connection with clinical proprioceptive tests in subjects with idiopathic scoliosis. However, curve severity was less likely to be related to the proprioceptive genes. The potential pathology took place at the proprioceptive neurons. Evidence of proprioception‐related gene mutations in association with idiopathic scoliosis was established. Nevertheless, the causation between the initiation, progression, and treatment outcomes with proprioceptive defect requires further investigation. [ABSTRACT FROM AUTHOR]

Mutations in the DYNC1H1 gene have been linked to multiple neurologic syndromes with a multitude of clinical manifestations, both ocular and non-ocular. Previous case reports have outlined various ocular phenotypes, including cataracts of congenital onset, infantile onset, and adult onset with lack of further ophthalmologic detail. Our case report outlines, in more detail, a 24-month-old male with a heterozygous mutation in the DYNC1H1 gene who developed a white, intumescent cataract in his left eye and a posterior subcapsular cataract in his right eye with evidence of progressive axial myopia. Based on the findings outlined in our case we suggest eye exams at regular intervals during early childhood in patients with DYNC1H1 mutations to screen for amblyogenic ocular pathology and potential rapidly developing cataracts. [ABSTRACT FROM AUTHOR]

Context The Child and Adult Care Food Program (CACFP) is a federal nutrition program that supports young children's nutrition. Its potential impacts on child well-being have not been summarized. Objective The objective of this review was to summarize the evidence for the impact of CACFP on children's diet quality, weight status, food insecurity, and cognitive development. Data Sources Databases searched included MEDLINE, CAB Abstracts, Web of Science Core Collection, ERIC, PsycInfo, Dissertations & Theses Global (Proquest), EconLit, NBER, and the USDA's Economic Research Service (ERS), from database inception to November 12, 2021. Studies were included if the sample drew from child care programs serving children between the ages of 2 years and 18 years and if a comparison group of nonparticipating programs was included. Data Extraction Two reviewers independently extracted data on study design, year(s) of data collection, region, sample size, participant demographics, outcomes, and risk of bias. Data Analysis Due to the heterogeneity of the studies, a narrative synthesis was used. Results Nineteen articles were reviewed, most of which had been published since 2012. Seventeen used cross-sectional designs. Twelve evaluated foods and beverages served; 4 evaluated dietary intake; 4 evaluated the child care nutrition environment; 2 evaluated food insecurity, 1 evaluated weight status; none evaluated cognitive outcomes. Studies typically found either a small beneficial association with CACFP or no significant association. Conclusion Currently, evidence for an association between CACFP and children's health is inconclusive, though it is slightly suggestive of a benefit for some dietary quality outcomes. More research, with stronger study designs, is needed. Systematic Review Registration A protocol for this systematic review was registered with the PROSPERO systematic review protocol registry (PROSPERO 2021 CRD42021254423). [ABSTRACT FROM AUTHOR]

Background: Back pain occurs commonly in adults and is multifactorial in nature. This study aimed to assess the prevalence and intensity of back pain during young adulthood in subjects with adolescent idiopathic scoliosis (AIS), as well as factors that may be associated with its prognosis. Methods: Subjects with AIS aged 20–39 treated conservatively were included in this study. Patient-reported outcome measures in adulthood involved episodes of back pain, and scales of self-image, depression, anxiety, and stress. Additionally, pain, self-image, and mental health scores were retrieved at the first clinic consultation. Occurrence of back pain was defined as a numeric pain rating scale ≥ 6. Results: 101 participants were enrolled. The prevalence of back pain in the lifetime, past 12 months, past 6 months, past 1 month, past 7 days, and past 24 h were 37%, 35%, 31%, 27%, 23%, and 20%, respectively. Male, self-image, and depression were significant associated factors for the development of back pain at all time points. Furthermore, the analyses of the initial presentation of participants have shown that participants with back pain in adulthood were characterised by poor self-image and mental health during their adolescence. Conclusion: The present study addressed the natural history of back pain in young adults with conservatively treated AIS. Psychological makeup has been shown to constitute the development of back pain and is strongly hinted as an early sign of having back pain in adulthood among subjects with AIS. [ABSTRACT FROM AUTHOR]

In this Research Commentary, we address a call to translate qualitative educational research into practice by highlighting the potential of the qualitative synthesis methodology, which thus far has had limited guidelines and exemplars in mathematics education research. We contribute methodological guidance on one qualitative synthesis approach, meta-aggregation, by sharing experiences and lessons learned from using this approach in mathematics education. We discuss how and why researchers can normalize the use of this synthesis approach to influence policies and practices in mathematics teaching and learning. By sharing our experiences and insights on meta-aggregation components, we aim to support and motivate future development and application of qualitative synthesis in mathematics education research. [ABSTRACT FROM AUTHOR]

Law enforcement officers are the primary individuals called and who respond to situations of heightened concern. They make split-second observations and decisions based on how best to react to given safety situations and those involved. Characteristics of autism spectrum disorders (ASD), if not properly understood and reacted to, may quickly escalate a law enforcement officer call in a negative way, making autism training for law enforcement officers imperative. To ascertain what is known about autism training for law enforcement officers, a scoping review was conducted. Five studies met final inclusion criteria. The trainees, context and development of the training, evaluation procedures, and training outcomes are synthesized to provide guidance for future training implementation teams. Areas for future research are presented. [ABSTRACT FROM AUTHOR]

The transcriptional regulator SsrB acts as a switch between virulent and biofilm lifestyles of non-typhoidal Salmonella enterica serovar Typhimurium. During infection, phosphorylated SsrB activates genes on Salmonella Pathogenicity Island-2 (SPI-2) essential for survival and replication within the macrophage. Low pH inside the vacuole is a key inducer of expression and SsrB activation. Previous studies demonstrated an increase in SsrB protein levels and DNA-binding affinity at low pH; the molecular basis was unknown (Liew et al., 2019). This study elucidates its underlying mechanism and in vivo significance. Employing single-molecule and transcriptional assays, we report that the SsrB DNA-binding domain alone (SsrBc) is insufficient to induce acid pH-sensitivity. Instead, His12, a conserved residue in the receiver domain confers pH sensitivity to SsrB allosterically. Aciddependent DNA binding was highly cooperative, suggesting a new configuration of SsrB oligomers at SPI-2-dependent promoters. His12 also plays a role in SsrB phosphorylation; substituting His12 reduced phosphorylation at neutral pH and abolished pH-dependent differences. Failure to flip the switch in SsrB renders Salmonella avirulent and represents a potential means of controlling virulence. [ABSTRACT FROM AUTHOR]

Since 2006, the government of Laos has pursued a policy of "Turning Land into Capital", which broadly refers to the generation of economic value from the marketization of land, producing not only profit but also government revenue and economic development. The policy's ambiguity raises questions regarding the precise political-economic processes at work and what exactly the transformation of land into capital might mean. Building on Marxist theorizations of land, value, capital, and rent, this paper argues that land under capitalism does not only operate as a rent-bearing asset, in which value is extracted from elsewhere. Land can also be treated as a real form of capital, or capitalized, when its social relations are transformed to facilitate value expansion and act as a store of value mobilized for further investment. It is imperative to investigate how land is used to expand value as capital, extract value as rent, or do both. This paper examines four manifestations of the Turning Land into Capital policy to outline the contours of struggles and contestations over the production and distribution of value in the Lao political economy. [ABSTRACT FROM AUTHOR]

Historically, subject matter experts and healthcare professionals have played a pivotal role in driving oncology clinical trials. Although patients have been key participants, their deliberate and active contribution to the design and decision-making process has been limited. This scoping review aimed to examine the existing literature to scope the extent of active patient engagement in the design of oncology clinical trials and its corresponding influence on trial outcomes. We conducted a systematic search using two databases, namely MEDLINE (Ovid) and EMBASE, to identify relevant studies exploring patient engagement in cancer-related clinical research design. We identified seven studies that met the eligibility criteria. The studies highlighted the benefits of active patient involvement, such as improved recruitment strategies, and the attainment of more patient-centered trial outcomes. The influence of patient involvement varied from tangible developments like patient-friendly resources to indirect impacts like improved patient experiences and potentially higher adherence to trial intervention. The future of clinical trials should prioritize patients' values and perspectives, with regulatory bodies fostering these practices through clear guidelines. As the concept of patient centricity takes root in oncology research, the involvement of patients should evolve beyond mere participation. [ABSTRACT FROM AUTHOR]

[Display omitted] Understanding the behaviour of uranium waste, for disposal purposes, is crucial due to the correlation between pH values and the disposal of distinct types of waste, with low level waste typically associated with acidic pH values, and higher and intermediate level waste commonly related to alkaline pH values. We studied the adsorption of U(VI) on sandstone and volcanic rock surfaces at pH 5.5 and 11.5 in aqueous solutions with and without bicarbonate (2 mM HCO 3 –) using XAS and FTIR. In the sandstone system, U(VI) adsorbs as a bidentate complex to Si at pH 5.5 without bicarbonate and as uranyl carbonate species with bicarbonate. At pH 11.5 without bicarbonate, U(VI) adsorbs as monodentate complexes to Si and precipitates as uranophane. With bicarbonate at pH 11.5, U(VI) precipitated as a Na-clarkeite mineral or remained as a uranyl carbonate surface species. In the volcanic rock system, U(VI) adsorbed to Si as an outer sphere complex at pH 5.5, regardless of the presence of bicarbonate. At pH 11.5 without bicarbonate, U(VI) adsorbed as a monodentate complex to one Si atom and precipitated as a Na-clarkeite mineral. With bicarbonate at pH 11.5, U(VI) sorbed as a bidentate carbonate complex to one Si atom. These results provide insight into the behaviour of U(VI) in heterogeneous, real-world systems related to the disposal of radioactive waste. [ABSTRACT FROM AUTHOR]

Objectives: Approximately 25% of patients with Clostridioides difficile infection (CDI) will experience recurrence, which is greater in immunocompromised patients. We report experience with an institutional guideline targeting high-risk immunocompromised patients. Methods: This was a retrospective cohort of consecutive patients with CDI who met institutional criteria for bezlotoxumab due to high risk for recurrent CDI between June 1, 2017, and November 30, 2018. The primary endpoint of recurrent CDI within 12 weeks was compared between patients who received the standard of care (SoC) plus or minus bezlotoxumab. Results: Twenty-three patients received bezlotoxumab infusion plus SoC and were compared to 30 SoC patients. 84% of patients were immunocompromised and 54.7% were transplant recipients. The primary endpoint occurred in 13% of bezlotoxumab patients compared to 23.3% of SoC patients. No serious adverse effects were identified. Conclusion: Bezlotoxumab was associated with a meaningful reduction in recurrent CDI in this cohort largely comprising immunocompromised and transplant patients. Larger studies are warranted to evaluate bezlotoxumab in this population. [ABSTRACT FROM AUTHOR]

Site visits are common in evaluation plans but there is a dearth of guidance about how to conduct them. This paper revisits site visit standards published by Michael Patton in 2017 and proposes a framework for evaluative site visits. We retrospectively examined documents from a series of site visits for examples of Patton's standards. Through this process, we identified additional standards and organized them into four categories and fourteen standards that can guide evaluation site visits: team competencies and knowledge (interpersonal competence, cultural humility, evaluation competence, methodological competence, subject matter knowledge, site specific knowledge), planning and coordination (project design, resources, data management), engagement (team engagement, sponsor engagement, site engagement), and confounding factors (neutrality, credibility). In the paper, we provide definitions and examples from the case of meeting, and missing, the standards. We encourage others to apply the framework in their contexts and continue the discussion around evaluative site visits. [ABSTRACT FROM AUTHOR]

Gabapentin (GBP) is a structural analog of gamma-aminobutyric acid (GABA) that is commonly used in palliative care for symptom management indications including neuropathic pain syndromes, hiccups, cough, and anxiety. An uncommon adverse effect of GBP is urinary incontinence (UI). We report the case of a 61-year-old male with metastatic non-small cell lung cancer who developed probable overflow UI while receiving 1200 mg/day of GBP for chemotherapy-induced peripheral neuropathy. The patient self-tapered GBP to 600 mg/day which resolved the overflow UI, but resulted in poorly controlled bilateral foot pain. The palliative care physician rotated the patient to pregabalin 150 mg/day and his bilateral foot pain improved after his regimen was titrated to 200 mg/day. The patient did not experience overflow UI while taking pregabalin despite the similar pharmacology and comparable doses to GBP. We believe this is the first case report to describe subsequent achievement of pain control by substituting pregabalin without recurrence of UI. Healthcare professionals should consider GBP as a potential cause when evaluating patients presenting with new onset overflow UI. [ABSTRACT FROM AUTHOR]