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Context: Blood flow restriction resistance exercise studies often require caffeine abstinence to avoid cardiovascular effects that could change the blood flow restriction stimulus. However, effects may be attenuated for habituated users. Objective: To compare cardiovascular responses to blood flow restriction resistance exercise when habituated users consume or abstain from caffeine. Design: Thirty participants completed a 3-visit within-subject study beginning with familiarization and caffeine intake questionnaire. Methods: Visits 2 and 3 consisted of blood flow restriction resistance exercise (3 sets bicep curls to failure, 30% 1-repetition max, 40% arterial occlusion pressure [AOP]), following participants' normal caffeine consumption (CAFF) or abstaining (ABS). AOP, systolic (SBP) and diastolic (DBP) blood pressure, and heart rate were measured preexercise and postexercise. Prevalues and preexercise to postexercise change scores for SBP, DBP, AOP (all millimeters of mercury), heart rate (in beats per minute), and repetitions were compared between conditions. Results are represented as mean (SD). Results: Preexercise AOP was similar for CAFF (137.8 [14.4]) and ABS (137.1 [14.9], BF10 = 0.2), although pre-SBP was higher for CAFF (115.4 [9.8]) than ABS (112.3 [9.4], BF10 = 1.9). Pre-DBP was similar between conditions. The exercise-induced change in AOP was greater for CAFF (18.4 [11.2]) than ABS (13.2 [14.9]), though evidence was anecdotal (BF10 = 0.7). Exercise-induced changes in SBP, DBP, and heart rate were similar between conditions (all BF10 ≤ 0.40). More repetitions were completed for CAFF (63 [26]) than ABS (57 [17], BF10 = 2.1). Conclusions: The findings of this study suggest that for habituated users, maintaining daily caffeine habits will not have substantial effects on common cardiovascular variables relevant to blood flow restriction. [ABSTRACT FROM AUTHOR]

Challenge and threat (C/T) states have been shown to predict sport performance under pressure. Nevertheless, only one study has examined whether preseason C/T states are associated with season-long performance, yielding promising findings. Despite promising findings, this work is not without limitations that warrant addressing. We aimed to address these limitations and contribute to the scarce literature which tests the effect of anticipatory C/T states on longer term performance. Thirty-eight amateur cricketers prepared and delivered two counterbalanced speeches: a control speech and a speech about an important cricket batting situation approximately 16 weeks prior to the start of their competitive season. Regression analysis showed that cardiovascular reactivity in anticipation of delivering a speech about an important cricket batting scenario the next season did not predict season-long batting performance. The findings have potential to challenge the role C/T states play in predicting longer term performance in the sport domain. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discusses articles within the issue on topics including worker agency and resistance of the Black refugee community in postwar Virginia, threat to the freedom of freedpeople due to competing interest of planters, Northern reformers and federal agencies, and application of the concept of elite capture to Chicago Republican, abolitionist and Union soldier Henry Frisbie and his expression of antilabor politics.

We have performed classical molecular dynamics simulations using the fully polarizable Atomic Multipole Optimized Energetics for Biomolecular Applications (AMOEBA) forcefield implemented within the Tinker package to determine whether a more adequate treatment of electrostatics is sufficient to correctly describe the mixing of methane with water under high pressure conditions. We found a significant difference between the ability of AMOEBA and other classical, computationally cheaper forcefields, such as TIP3P, simple point charge–extended, TIP4P, and optimized potentials for liquid simulations–all atom. While the latter models fail to detect any effect of pressure on the miscibility of methane in water, AMOEBA qualitatively captures the experimental observation of the increased solubility of methane in water with pressure. At higher temperatures, the solubility of water in methane also increases; this seems to be associated with the breakdown of the fourfold hydrogen-bonded water network structure: bonding in water is weaker, so the energy cost of solution is lowered. [ABSTRACT FROM AUTHOR]

A stability criterion is derived for mode transitions in the discharge current oscillations of a magnetically shielded Hall thruster. The two-equation model evaluated in Paper I for these large-amplitude (> --> 100 % background), low-frequency (< 25 kHz) current oscillations is generalized and then validated with measurements from a 9 kW class test article. It is shown that the model can re-create quantitatively trends in both oscillation amplitude and frequency with discharge voltage and current. The validated model is non-dimensionalized and applied to derive an analytical stability criterion for the onset of large-amplitude oscillations. The resulting expression depends on several properties, including discharge current, discharge voltage, neutral transit time in the channel, length of the acceleration zone, magnetic field strength, and channel area. The criterion is leveraged to inform two mitigation strategies—changing magnetic field strength and controlling anode temperature— for adjusting the stability margin of the thruster. The criterion is also employed to motivate a physical explanation for why mode transitions occur and, in turn, why the stability margin differs between shielded and unshielded thrusters. [ABSTRACT FROM AUTHOR]

Combined use of action observation and motor imagery (AOMI) is an increasingly popular motor-simulation intervention, which involves observing movements on video while simultaneously imagining the feeling of movement execution. Measuring and reporting participant imagery-ability characteristics are essential in motor-simulation research, but no measure of AOMI ability currently exists. Accordingly, the AOMI Ability Questionnaire (AOMI-AQ) was developed to address this gap in the literature. In Study 1, two hundred eleven participants completed the AOMI-AQ and the kinesthetic imagery subscales of the Movement Imagery Questionnaire-3 and Vividness of Motor Imagery Questionnaire-2. Following exploratory factor analysis, an 8-item AOMI-AQ was found to correlate positively with existing motor-imagery measures. In Study 2, one hundred seventy-four participants completed the AOMI-AQ for a second time after a period of 7–10 days. Results indicate a good test–retest reliability for the AOMI-AQ. The new AOMI-AQ measure provides a valid and reliable tool for researchers and practitioners wishing to assess AOMI ability. [ABSTRACT FROM AUTHOR]

Recent studies have shown that proximity effects are able to substantially modulate the superconducting properties of various quasi-two-dimensional layered materials such as FeSe, FeSeTe, NbSe2, and NbS2. Due to their high surface charge concentration and high dielectric constants, ferroelectric materials provide an interesting avenue for inducing proximity effects in layered superconductors. In this study, we explore the interactions between FeSeTe and the two-dimensional ferroelectrics CuInP2S6 and CuInP2Se6. We found that contrary to the normal behavior of FeSeTe, FeSeTe/CuInP2S6, and FeSeTe/CuInP2Se6 heterostructures display a peculiar two-step superconducting transition. Further testing revealed a hysteresis loop in the IV curves of these samples when measured below the critical temperature indicating the presence of disorder and domains within FeSeTe. We conclude that these domains are responsible for the two-step transition in FeSeTe and hypothesize that they are induced by the domain structure of the aforementioned ferroelectric materials. [ABSTRACT FROM AUTHOR]

Confrontation on Borneo tests a thesis on counterinsurgency: winning hearts and minds succeeds if object place/people win over the hearts and minds of subject counterinsurgency soldiers. This psychological transformation depends on fixed objects that counterinsurgency cannot easily change: the counterinsurgency destination and the counterinsurgents' place of origin that formed soldiers' unconscious selves. Soldiers encountered on Borneo a transformative, attractive, alien destination that changed their behavior. Soldiers then ratified unconscious behavior by asserting that the cause was their innate decency and official hearts and minds policy. But Borneo had formed the unconscious self that gave form to hearts and minds. This article argues that altered states of being shape counterinsurgency. [ABSTRACT FROM AUTHOR]

We outline a surface scattering kernel for rarefied gas flows through ideally ordered nanomaterials, such as high aspect ratio carbon nanotubes. The derived model allows for a comparison of the tangential momentum accommodation coefficient, and, hence, the total effective friction, for different species of gases as a function of the particle diameter. This surface kernel is incorporated with a Fokker–Planck model as an approximation to transport of a rarefied gas through ideally ordered carbon nanotubes. The results of this analysis predict that H 2 experiences higher friction in such systems in comparison with larger molecules such as C H 4 . The results are proposed as a potential explanation of the reduced gas transport of hydrogen gas in nanoporous systems. [ABSTRACT FROM AUTHOR]

This study employed Rasch analyses to validate a novel measure of sport experience: the Sport Experience Measure: Children and Youth (SEM:CY). Analyses were applied to self-reported data of n = 503 young people (age 9–18 years, M = 12.91, 50% female) in Canada who were engaging in sport during the previous 12 months. The revised measure, consisting of 24 items on a 3-point response scale, demonstrated good fit statistics (e.g., item fit residual: M = −0.50, SD = 0.94 and person fit residual: M = −0.62, SD = 2.33), an ability to reliably discriminate between levels of sport experience, and an absence of differential item functioning for various groups (males and females, older and younger individuals, solo and team sports, and those playing at various competitive levels, including recreation). The SEM:CY is a succinct tool that can serve as a valuable means to gauge the quality of an individual's sport experience, which can facilitate positive youth development and sustain participation across the life span. [ABSTRACT FROM AUTHOR]

Case conceptualization is an important stage in the sport and performance psychology (SPP) consulting process. The conceptualization of a case can influence a consultant's understanding of the underpinning mechanisms contributing to a presenting concern, interventions selected to help a client, and the effectiveness of provided services. Guidelines for case conceptualization have been developed for SPP professionals, but little is known about how this activity is undertaken in practice. The purpose of this study was to investigate the case-conceptualization methods and approaches of certified SPP professionals. Fifty-two certified mental performance consultants completed an online qualitative survey exploring how they conceptualized cases. Our findings suggested that SPP consultants viewed case conceptualization as an ongoing process, something that helps a consultant understand a client's presenting concerns and guide any intervention plans, a collaboration between client and consultant, and a way to evaluate the effectiveness of their practice. [ABSTRACT FROM AUTHOR]

HORTON is a free and open-source electronic-structure package written primarily in Python 3 with some underlying C++ components. While HORTON's development has been mainly directed by the research interests of its leading contributing groups, it is designed to be easily modified, extended, and used by other developers of quantum chemistry methods or post-processing techniques. Most importantly, HORTON adheres to modern principles of software development, including modularity, readability, flexibility, comprehensive documentation, automatic testing, version control, and quality-assurance protocols. This article explains how the principles and structure of HORTON have evolved since we started developing it more than a decade ago. We review the features and functionality of the latest HORTON release (version 2.3) and discuss how HORTON is evolving to support electronic structure theory research for the next decade. [ABSTRACT FROM AUTHOR]

This work outlines conditions suitable for the heteroepitaxial growth of Cr2O3(0001) films (1.5–20 nm thick) on a Ru(0001)-terminated substrate. Optimized growth is achieved by sputter deposition of Cr within a 4 mTorr Ar/O2 20% ambient at Ru temperatures ranging from 450 to 600 °C. The Cr2O3 film adopts a 30° rotated honeycomb configuration with respect to the underlying Ru(0001) substrate and exhibits a hexagonal lattice parameter consistent with that for bulk Cr2O3(0001). Heating to 700 °C within the same environment during film preparation leads to Ru oxidation. Exposure to temperatures at or above 400 °C in a vacuum, Ar, or Ar/H2 3% leads to chromia film degradation characterized by increased Ru 3d XPS intensity coupled with concomitant Cr 2p and O 1s peak attenuations when compared to data collected from unannealed films. An ill-defined but hexagonally well-ordered RuxCryOz surface structure is noted after heating the film in this manner. Heating within a wet Ar/H2 3% environment preserves the Cr2O3(0001)/Ru(0001) heterolayer structure to temperatures of at least 950 °C. Heating an Ru–Cr2O3–Ru heterostacked film to 950 °C within this environment is shown by cross-sectional scanning/transmission electron microscopy (S/TEM) to provide clear evidence of retained epitaxial bicrystalline oxide interlayer structure, interlayer immiscibility, and epitaxial registry between the top and bottom Ru layers. Subtle effects marked by O enrichment and O 1s and Cr 2p shifts to increased binding energies are noted by XPS in the near-Ru regions of Cr2O3(0001)/Ru(0001) and Ru(0001)/Cr2O3(0001)/Ru(0001) films after annealing to different temperatures in different sets of environmental conditions. [ABSTRACT FROM AUTHOR]

Hear from a public library director of a small library in Michigan. The author assumed the role as a first-time library director. This column explores the opportunities and challenges of taking on a directorship of a small public library. An emphasis on customer service and building the library into a community player is a key theme. The library's relationship to the city and other city departments is also discussed. Leading a public library through the COVID pandemic is touched on as well. This column is a glimpse into the operation of municipal government and public libraries. Smaller public libraries are special places in a community and this column helps you understand how they function. [ABSTRACT FROM AUTHOR]

Noncovalent bonding between atmospheric molecules is central to the formation of aerosol particles and cloud condensation nuclei and, consequently, radiative forcing. While our understanding of O–H⋯B interactions is well developed, S–H⋯B hydrogen bonding has received far less attention. Sulfur- and nitrogen-containing molecules, particularly amines, play a significant role in atmospheric chemistry, yet S–H⋯N interactions are not well understood at a fundamental level. To help characterize these systems, H2S and methyl-, ethyl-, n-propyl-, dimethyl-, and trimethylamine (MA, EA, n-PA, DMA, and TMA) have been investigated using matrix isolation Fourier transform infrared spectroscopy and high-level theoretical methods. Experiments showed that H2S forms hydrogen bonded complexes with each of the amines, with bond strengths following the trend MA ≈ EA ≈ n-PA < TMA ≤ DMA, in line with past experimental work on H2SO4·amine complexes. However, the calculated results indicated that the trend should be MA < DMA < TMA, in line with past theoretical work on H2SO4·amine complexes. Evidence of strong Fermi resonances indicated that anharmonicity may play a critical role in the stabilization of each complex. The theoretical results were able to replicate experiment only after binding energies were recalculated to include the anharmonic effects. In the case of H2SO4·amine complexes, our results suggest that the discrepancy between theory and experiment could be reconciled, given an appropriate treatment of anharmonicity. [ABSTRACT FROM AUTHOR]

A practical quantitative model is presented to account for the I–V characteristics of pin diodes based on epitaxial Ge-like materials. The model can be used to quantify how the different material properties and recombination mechanisms affect the diode performance. The importance of dislocations, non-passivated defects, and residual intrinsic layer doping in determining the qualitative shape of the I–V curves is discussed in detail. Examples are shown covering literature diodes as well as diodes fabricated with the purpose of validating the theoretical effort. [ABSTRACT FROM AUTHOR]

Nuclear receptors regulate transcriptional programs in response to the binding of natural and synthetic ligands. These ligands modulate the receptor by inducing dynamic changes in the ligand binding domain that shift the C-terminal helix (H12) between active and inactive conformations. Despite decades of study, many questions persist regarding the nature of the inactive state and how ligands shift receptors between different states. Here, we use molecular dynamics (MD) simulations to investigate the timescale and energetic landscape of the conformational transition between inactive and active forms of progesterone receptor (PR) bound to a partial agonist. We observe that the microsecond timescale is insufficient to observe any transitions; only at millisecond timescales achieved via accelerated MD simulations do we find the inactive PR switches to the active state. Energetic analysis reveals that both active and inactive PR states represent energy minima separated by a barrier that can be traversed. In contrast, little or no transition is observed between active and inactive states when an agonist or antagonist is bound, confirming that ligand identity plays a key role in defining the energy landscape of nuclear receptor conformations. [ABSTRACT FROM AUTHOR]

The nucleation of ice from aqueous solutions is a process essential to myriad environmental and industrial processes, but the physical factors affecting the capacity of different solutes to depress the homogeneous nucleation temperature of ice are yet poorly understood. In this work, we demonstrate that for many binary aqueous solutions of non-ionic solutes, this depression is dominated by the entropy of the liquid phase. Employing the classic Turnbull interpretation of the interfacial free energy γ ∼ T S l i q u i d − S s o l i d and estimating solution entropies with a Flory-style modification of the ideal entropy of mixing that accounts for solute size effects, we demonstrate that mixing entropy alone predicts experimental homogeneous nucleation temperatures across a wide variety of non-ionic solutions. We anticipate that this physical insight will not only enhance a fundamental understanding of homogeneous nucleation processes across fields but also open new avenues to the rational design of aqueous solutions for desired nucleation behaviors. [ABSTRACT FROM AUTHOR]

Despite perceived postracial ideologies of American sport, players, coaches, fans, and media have been complicit in reaffirming racial hierarchies through racist microaggressions and remarks. Such racist violations are commonly exposed in the current moment of widespread social media engagement and social justice activism. Subsequently, many violators issue apologies—often employing the conjunction "if"—which hinges the apology on the condition of the targeted group taking offense. We call these conditional apologies nonapology apologies and argue that they fall within a racializing apologia framework, devaluing and questioning the place of those offended in American society and sport, and reinforcing White supremacy. In this paper, we examine apology statements by sports figures and explore the implications of nonapology apologies. [ABSTRACT FROM AUTHOR]

We study heat exchange in temperature-biased metal–molecule–metal molecular junctions by employing the molecular dynamics simulator LAMMPS. Generating the nonequilibrium steady state with Langevin thermostats at the boundaries of the junction, we show that the average heat current across a gold–alkanedithiol–gold nanojunction behaves physically, with the thermal conductance value matching the literature. In contrast, the full probability distribution function for heat exchange, as generated by the simulator, violates the fundamental fluctuation symmetry for entropy production. We trace this failure back to the implementation of the thermostats and the expression used to calculate the heat exchange. To rectify this issue and produce the correct statistics, we introduce single-atom thermostats as an alternative to conventional many-atom thermostats. Once averaging heat exchange over the hot and cold thermostats, this approach successfully generates the correct probability distribution function, which we use to study the behavior of both the average heat current and its noise. We further examine the thermodynamic uncertainty relation in the molecular junction and show that it holds, albeit demonstrating nontrivial trends. Our study points to the need to carefully implement nonequilibrium molecular dynamics solvers in atomistic simulation software tools for future investigations of noise phenomena in thermal transport. [ABSTRACT FROM AUTHOR]

Traditionally, physical models of associative memory assume conditions of equilibrium. Here, we consider a prototypical oscillator model of associative memory and study how active noise sources that drive the system out of equilibrium, as well as nonlinearities in the interactions between the oscillators, affect the associative memory properties of the system. Our simulations show that pattern retrieval under active noise is more robust to the number of learned patterns and noise intensity than under passive noise. To understand this phenomenon, we analytically derive an effective energy correction due to the temporal correlations of active noise in the limit of short correlation decay time. We find that active noise deepens the energy wells corresponding to the patterns by strengthening the oscillator couplings, where the more nonlinear interactions are preferentially enhanced. Using replica theory, we demonstrate qualitative agreement between this effective picture and the retrieval simulations. Our work suggests that the nonlinearity in the oscillator couplings can improve memory under nonequilibrium conditions. [ABSTRACT FROM AUTHOR]

Much has been written about the demographic make-up of librarianship, which remains overwhelmingly white and female, but little has been discussed about the socioeconomic background of folks entering the field. In this column, I explore some of the ways that coming from a financially disadvantaged background can impact both entering the profession and the experience of working within it. A mix of practical and aspirational action items are provided. [ABSTRACT FROM AUTHOR]

Transferrin, a central player in iron transport, has been recognized not only for its role in binding iron but also for its interaction with other metals, including titanium. This study employs solid-state nanopores to investigate the binding of titanium ions [Ti(IV)] to transferrin in a single-molecule and label-free manner. We demonstrate the novel application of solid-state nanopores for single-molecule discrimination between apo-transferrin (metal-free) and Ti(IV)-transferrin. Despite their similar sizes, Ti(IV)-transferrin exhibits a reduced current drop, attributed to differences in translocation times and filter characteristics. Single-molecule analysis reveals Ti(IV)-transferrin's enhanced stability and faster translocations due to its distinct conformational flexibility compared to apo-transferrin. Furthermore, our study showcases solid-state nanopores as real-time monitors of biochemical reactions, tracking the gradual conversion of apo-transferrin to Ti(IV)-transferrin upon the addition of titanium citrate. This work offers insights into Ti(IV) binding to transferrin, promising applications for single-molecule analysis and expanding our comprehension of metal–protein interactions at the molecular level. [ABSTRACT FROM AUTHOR]

In 2021, New York City passed some of the most progressive nuclear disarmament legislation of any major city in the United States, supported by local activists from the New York Campaign to Abolish Nuclear Weapons (NYCAN). In this essay, two of the people behind this effort share some details of their success with local government as an example of what others can do to bring nuclear abolitionist activism home. They also give a sense of New York's long history as a nuclear city—and as a locus of action for disarmament. [ABSTRACT FROM AUTHOR]

We present a deep X-Shooter rest-frame ultraviolet (UV) to optical spectral analysis of the heavily reddened quasar, ULASJ2315+0143 at |$z=2.566$|⁠ , known to reside in a major-merger host galaxy. The rest-frame optical is best fit by a dust-reddened quasar (E (B – V) |$^{\rm QSO}= 1.55$|⁠) with black-hole mass |$\rm log_{10}(H\beta , M{\small BH} [{\rm M}_{\odot }]) = 10.26 \pm 0.05$|⁠ , bolometric luminosity |$\rm L_{Bol}$|  = |$\rm 10^{48.16}\, erg\,\,s^{-1}$| and Eddington-scaled accretion rate log |$_{10}(\rm \lambda _{Edd}) = -0.19$|⁠. We find remarkable similarities between ULASJ2315+0143 and the high-redshift little red dots (LRDs). The rest-frame UV cannot be explained by a dusty quasar component alone and requires an additional blue component consistent with either a star-forming host galaxy or scattered AGN light. We detect broad high-ionization emission lines in the rest-UV, supporting the scattered light interpretation for the UV excess. The scattering fraction represents just 0.05  per cent of the total luminosity of ULASJ2315+0143 . Analysis of the mid-infrared SED suggests an absence of hot dust on torus-scales similar to what is observed for LRDs. The obscuring medium is therefore likely on galaxy scales. We detect narrow, blueshifted associated absorption-line systems in C  iv , N  v , Si  iv , and Si  iii. There is evidence for significant high-velocity (>1000  |$\rm km\, s^{-1}$|⁠) outflows in both the broad- and narrow-line regions as traced by C  iv and [O  iii ] emission. The kinetic power of the [O  iii ] wind is |$\dot{\epsilon }_{k}^{ion} = 10^{44.61} \rm erg\, s^{-1} \sim 0.001\, L_{Bol}$|⁠. ULASJ2315+0143 is likely in an important transition phase where star formation, black-hole accretion and multiphase gas flows are simultaneously occurring. [ABSTRACT FROM AUTHOR]

New gambling products have been developed over time as technology permits. For example, early mechanical slot machines were later replaced by electronic gaming machines (EGMs), which enabled a faster speed of play and more immersive experience. EGMs have in the decades since their invention become one of the main drivers of gambling expenditure worldwide and are one of the gambling products most strongly associated with harm. This literature review considers research relevant to a new subcategory of EGM, 'skill-based' EGMs, termed 'SGMs' here. SGMs can be highly varied in content, with some representing a minimal departure from EGMs, where the typical bonus round is replaced by some skill-based activity, such as a simple video game, which could increase the machine's appeal. Other SGMs feature more radical departures from conventional EGMs, such as multiplayer games using intellectual property from popular TV shows or video games. These skill-based elements could tap into common gambling fallacies such as the illusion of control, and therefore facilitate harmful engagement. SGMs could also be less harmful than current EGMs, if skill-based elements break the dissociative states associated with EGM gambling. The intellectual property used in SGMs may increase their appeal among people who generally do not gamble, and the skill-based elements could increase their interest among gamblers who predominately prefer skill-based gambling formats such as sports betting. The novelty and varied content of SGMs present many open questions, which research should aim to address in future. [ABSTRACT FROM AUTHOR]

To investigate the association between resilience and outcomes of pain and neck-related disability after single- and double-level anterior cervical discectomy and fusion (ACDF). Patients who underwent single- or double-level ACDF were sent a survey between 6 months and 2 years after surgery. The survey included the Brief Resilience Scale (BRS), visual analogue scale (VAS) for pain, Neck Disability Index (NDI), and Pain Self-Efficacy Questionnaire (PSEQ-2). Patients completed the VAS and NDI twice, once describing preoperative pain and disability and once describing current pain and disability. Respondents were classified as high resilience (HR), medium resilience (MR), or low resilience (LR). Demographics, PSEQ-2 scores, pre- and postoperative VAS and NDI scores, and change in VAS (ΔVAS) and NDI (ΔNDI) scores were compared between groups. Thirty-three patients comprised the HR group, 273 patients comprised the MR group, and 47 patients comprised the LR group. All groups demonstrated postoperative improvement in VAS and NDI scores that exceeded previously established MCID values. The HR group demonstrated greater improvement in pain compared with the LR group (ΔVAS: –5.8 for HR vs. –4.4 for LR, P = 0.05). Compared with the MR group, the LR group demonstrated greater postoperative pain (VAS: 3.2 for LR vs. 2.5 for MR, P = 0.02) and disability (NDI: 11.9 for LR vs. 8.6 for MR, P = 0.02). Patients demonstrated improvement in pain and neck-related disability after single- and double-level ACDF, regardless of resilience score. Patients with greater resilience may be expected to demonstrate more improvement in pain after ACDF. [ABSTRACT FROM AUTHOR]

Colony collapse disorder (CCD) has caused widespread death of honeybees, but the exact causes are not understood. Many scientists agree that pathogenic threats most likely contribute to CCD. Due to the integral ecosystem role bees fulfill, it is important to understand how honeybees respond immunologically to different factors to better inform practices to combat CCD. Quantifying the immunological cost of two different beekeeping approaches allows us to better understand how beekeeping practices affect bees' susceptibility to CCD. Within colonies, a plastic frame foundation provides structural support for the creation of honeycomb. Production of beeswax is energetically costly for colonies to produce, possibly causing energetic stress that may affect the colony's ability to fight pathogens. Two colonies were maintained, one with an internal plastic foundation on their frames and one without. We collected bees from each colony and extracted their hemolymph to quantify both their basal and activated immunological protein levels. Protein levels were higher in bees from the no foundation colony. Prophenoloxidase (PPO) activity trended toward higher levels in the no foundation colony, although this was not statistically significant. This suggests that lack of foundation causes the bees to have a higher protein turnover based on their energetic requirements, increasing their ability to fight off immunological threats. [ABSTRACT FROM AUTHOR]

Internships are widely promoted high-impact practices that can have positive impacts on students' academic and post-graduate success, yet how specific features facilitate these outcomes is understudied. Instead, internships are often studied in terms of mere participation, without recognizing that these experiences are complex pedagogic spaces shaped by professional cultures and decisions about instructional design. In this sequential mixed-methods study we use sociocultural learning theory to interpret data from online surveys (n = 435) and focus groups (n = 52) with students at five institutions. Stepwise linear regression analyses of demographic and programmatic variables associated with intern satisfaction, developmental value, and career adaptability indicated that first-generation status, sex, race and income level, and supervisor behaviors were significantly associated with satisfaction and development. Analyses of qualitative data revealed that features of positive (clear communication, availability, feedback) and negative (unavailability, inattention to learning) supervision impacted student experiences. These findings reveal that internships should be designed with careful attention to task scaffolding, student autonomy and supervisor assistance, depending on the professional context and situation. These results highlight the need for colleges and employers to design internships as mentored and culturally shaped learning spaces, provide supervisor training, and consider the cultural backgrounds of students when matching them to internships. [ABSTRACT FROM AUTHOR]

The last decade has given rise to substantial concern about democratic backsliding in the U.S. Manifestations include decreased trust in government, conspiratorial beliefs, contentious protests, and support for political violence. Surprisingly, prior work has not explored how these attitudes and behaviors relate to gun-buying, an action that provides people with the means to challenge the state. We address this topic by focusing on the unprecedented gun-buying surge during the COVID-19 pandemic. Using a survey with over 32,000 respondents, we find that—relative to pre-existing gun owners (who did not buy during the pandemic) and the non-gun-owning public—pandemic gun-buyers are more likely to distrust government, believe in conspiracies, protest, and support political violence. These anti-government views and protest behaviors are especially likely among those who bought guns for political reasons. Our findings highlight a crucial dynamic underlying the recent spike in gun sales with consequences for American democracy. [ABSTRACT FROM AUTHOR]

This study is aimed at the synthesis of nanoparticles (NPs) and nanocomposite (NC) using maize leave as precursor. Silver NPs (AgNPs) and AgNCs were synthesized from silver nitrate and maize leave extract using green approach. The maize leave NPs (AgNPs) and the maize leave NCs (AgNCs) were characterized using Fourier Transform infrared (FTIR), scanning electron microscopy (SEM), energy dispersion x-ray (EDX), Brunauer–Emmett–Teller (BET) surface area measurement, and dynamic light scattering (DLS) particle size analysis. The phytochemical analysis revealed the presence of tannin, oxalate, and flavonoids in appreciable quantity, which have proven to be a powerful reducing agent that facilitates the reduction of silver ions for the synthesis of silver NPs and silver nano composites. FTIR revealed that all the peaks identified in AgNPs and AgNCs belong to the characteristic bands of reducing compounds such as flavonoid compounds. The SEM-EDX results showed that the peaks observed from 2.9 to 3.1 Kev in the spectra indicate the presence of elemental silver as it is reduced from Ag+ to Ag. DLS analysis results showed that the average size and polydispersity index (PdI) of the synthesized AgNPs and AgNCs were 42.30 and 68.29 nm, 0.691 and 0.270, respectively. The single point BET surface area (m2/g) obtained for AgNPs and AgNCs were 223.3 and 209.5, respectively. The results showed maize leave as a potential precursor for the preparation of NPs and NCs. [ABSTRACT FROM AUTHOR]

Aim: The assembly of species into communities and ecoregions is the result of interacting factors that affect plant and animal distribution and abundance at biogeographic scales. Here, we empirically derive ecoregions for mammals to test whether human disturbance has become more important than climate and habitat resources in structuring communities. Location: Conterminous United States. Time Period: 2010–2021. Major Taxa Studied: Twenty‐five species of mammals. Methods: We analysed data from 25 mammal species recorded by camera traps at 6645 locations across the conterminous United States in a joint modelling framework to estimate relative abundance of each species. We then used a clustering analysis to describe 8 broad and 16 narrow mammal communities. Results: Climate was the most important predictor of mammal abundance overall, while human population density and agriculture were less important, with mixed effects across species. Seed production by forests also predicted mammal abundance, especially hard‐mast tree species. The mammal community maps are similar to those of plants, with an east–west split driven by different dominant species of deer and squirrels. Communities vary along gradients of temperature in the east and precipitation in the west. Most fine‐scale mammal community boundaries aligned with established plant ecoregions and were distinguished by the presence of regional specialists or shifts in relative abundance of widespread species. Maps of potential ecosystem services provided by these communities suggest high herbivory in the Rocky Mountains and eastern forests, high invertebrate predation in the subtropical south and greater predation pressure on large vertebrates in the west. Main Conclusions: Our results highlight the importance of climate to modern mammals and suggest that climate change will have strong impacts on these communities. Our new empirical approach to recognizing ecoregions has potential to be applied to expanded communities of mammals or other taxa. [ABSTRACT FROM AUTHOR]

Shallow-water platform carbonate δ13C may provide a record of changes in ocean chemistry through time, but early marine diagenesis and local processes can decouple these records from the global carbon cycle. Recent studies of calcium isotopes (δ44/40Ca) in shallow-water carbonates indicate that δ44/40Ca can be altered during early marine diagenesis, implying that δ13C may also potentially be altered. Here, we tested the hypothesis that the platform carbonate δ13C record of the Kinderhookian–Osagean boundary excursion (KOBE), ∼353 m.y. ago, reflects a period of global diagenesis using paired isotopic (δ44/40Ca and clumped isotopes) and trace-element geochemistry from three sections in the United States. There is little evidence for covariation between δ44/40Ca and δ13C during the KOBE. Clumped isotopes from our shallowest section support primarily sediment-buffered diagenesis at relatively low temperatures. We conclude that the δ13C record of the KOBE as recorded in shallow-water carbonate is consistent with a shift in the dissolved inorganic carbon reservoir and that, more generally, ancient shallow-water carbonates can retain records of primary seawater chemistry. [ABSTRACT FROM AUTHOR]

Summary: Background: There are concerns that airway management in patients with suspected or confirmed cervical spine injury may exacerbate an existing neurological deficit, cause a new spinal cord injury or be hazardous due to precautions to avoid neurological injury. However, there are no evidence‐based guidelines for practicing clinicians to support safe and effective airway management in this setting. Methods: An expert multidisciplinary, multi‐society working party conducted a systematic review of contemporary literature (January 2012–June 2022), followed by a three‐round Delphi process to produce guidelines to improve airway management for patients with suspected or confirmed cervical spine injury. Results: We included 67 articles in the systematic review, and successfully agreed 23 recommendations. Evidence supporting recommendations was generally modest, and only one moderate and two strong recommendations were made. Overall, recommendations highlight key principles and techniques for pre‐oxygenation and facemask ventilation; supraglottic airway device use; tracheal intubation; adjuncts during tracheal intubation; cricoid force and external laryngeal manipulation; emergency front‐of‐neck airway access; awake tracheal intubation; and cervical spine immobilisation. We also signpost to recommendations on pre‐hospital care, military settings and principles in human factors. Conclusions: It is hoped that the pragmatic approach to airway management made within these guidelines will improve the safety and efficacy of airway management in adult patients with suspected or confirmed cervical spine injury. [ABSTRACT FROM AUTHOR]

Objectives: The use of nebulized tranexamic acid (TXA) in massive pulmonary hemorrhage is well-described. Published utilization in post-tonsillectomy bleeding (PTB) is limited to a single case. This study examines whether TXA resulted in change of operative intervention necessity and narcotic utilization. Methods: This was a retrospective cohort study at a single, urban academic medical center in the United States. Chart review was conducted of all patients who presented to the hospital for post-tonsillectomy bleed (PTB) between 3/1/2018 and 7/1/2020. Demographic data, intervention modality, need for control under general anesthesia, and opioid use were collected and analyzed. Results: Twenty-one patients underwent a total of 23 visits for PTB over the study period. Control of hemorrhage without need for operating room intervention for PTB was 100% (6/6) for patients receiving TXA nebulizer and 53% (9/17) for those receiving other treatment modalities. Opioid usage in hospital and on discharge was also lower in patients receiving TXA nebulizers. All results were statistically significant. Conclusions: Our study supports nebulized TXA as an effective, non-invasive mode of hemostasis in patients presenting to the emergency department for post-tonsillectomy hemorrhage. Nebulized TXA may prevent the need for general anesthesia and operative intervention. Otolaryngologists should consider addition of this novel treatment appropriation of TXA to their management options for postoperative tonsillar hemorrhage. [ABSTRACT FROM AUTHOR]

Advancements in genome sequencing and assembly techniques have increased the documentation of structural variants in wild organisms. Of these variants, chromosomal inversions are especially prominent due to their large size and active recombination suppression between alternative homokaryotypes. This suppression enables the 2 forms of the inversion to be maintained and allows the preservation of locally adapted alleles. The Barramundi Perch (BP; Lates calcarifer) is a widespread species complex with 3 main genetic lineages located in the biogeographic regions of Australia and New Guinea (AUS + NG), Southeast Asia (SEA), and the Indian Subcontinent (IND). BP are typically considered to be a protandrous sequential hermaphrodite species that exhibits catadromy. Freshwater occupancy and intraspecific variation in life history (e.g. partially migratory populations) exist and provide opportunities for strongly divergent selection associated with, for example, salinity tolerance, swimming ability, and marine dispersal. Herein, we utilize genomic data generated from all 3 genetic lineages to identify and describe 3 polymorphic candidate chromosomal inversions. These candidate chromosomal inversions appear to be fixed for ancestral variants in the IND lineage and for inverted versions in the AUS + NG lineage and exhibit variation in all 3 inversions in the SEA lineage. BP have a diverse portfolio of life history options that includes migratory strategy as well as sexual system (i.e. hermaphroditism and gonochorism). We propose that the some of the life history variabilities observed in BP may be linked to inversions and, in doing so, we present genetic data that might be useful in enhancing aquaculture production and population management. [ABSTRACT FROM AUTHOR]

This document explores the use of mechanical ventilation and the titration of inspired oxygen in critically ill adults. It discusses various randomized trials comparing lower versus higher oxygenation targets and their effects on patient outcomes. The results of these trials have been conflicting, with some showing no significant difference and others showing better outcomes with either lower or higher oxygenation targets. The document also examines potential explanations for these conflicting results, including the possibility of heterogeneity of treatment effect. It suggests that machine learning models may provide more accurate predictions of individualized treatment effects, but further validation and a randomized clinical trial are needed before implementing individualized oxygenation targets in clinical practice. [Extracted from the article]

Background: The Area Deprivation Index (ADI) approximates a patient's relative socioeconomic deprivation. The ADI has been associated with increased healthcare use after TKA, but it is unknown whether there is an association with patient-reported outcome measures (PROMs). Given that a high proportion of patients are dissatisfied with their results after TKA, and the large number of these procedures performed, knowledge of factors associated with PROMs may indicate opportunities to provide support to patients who might benefit from it. Questions/purposes: (1) Is the ADI associated with achieving the minimum clinically important difference (MCID) for the Knee Injury and Osteoarthritis Outcome Score (KOOS) for pain, Joint Replacement (JR), and Physical Function (PS) short forms after TKA? (2) Is the ADI associated with achieving the patient-acceptable symptom state (PASS) thresholds for the KOOS pain, JR, and PS short forms?. Methods: This was a retrospective study of data drawn from a longitudinally maintained database. Between January 2016 and July 2021, a total of 12,239 patients underwent unilateral TKA at a tertiary healthcare center. Of these, 92% (11,213) had available baselinePROM data and were potentially eligible. An additional 21% (2400) of patients were lost before the minimum study follow-up of 1 year or had incomplete data, leaving 79% (8813) for analysis here. The MCID is the smallest change in an outcome score that a patient is likely to perceive as a clinically important improvement, and the PASS refers to the threshold beyond which patients consider their symptoms acceptable and consistent with adequate functioning and well-being. MCIDs were calculated using a distributionbased method. Multivariable logistic regression models were created to investigate the association of ADI with 1-year PROMs while controlling for patient demographic variables. ADI was stratified into quintiles based on their distribution in our sample. Achievement of MCID and PASS thresholds was determined by the improvement between preoperative and 1-year PROMs. Results: After controlling for patient demographic factors, ADI was not associated with an inability to achieve the MCID for the KOOS pain, KOOS PS, or KOOS JR. A higher ADI was independently associated with an increased risk of inability to achieve the PASS for KOOS pain (for example, the odds ratio of those in the ADI category of 83 to 100 compared with those in the 1 to 32 category was 1.34 [95% confidence interval 1.13 to 1.58]) and KOOS JR (for example, the OR of those in the ADI category of 83 to 100 compared with those in the 1 the 32 category was 1.29 [95% CI 1.10 to 1.53]), but not KOOS PS (for example, the OR of those in the ADI category of 83 to 100 compared with those in the 1 the 32 category was 1.09 [95% CI 0.92 to 1.29]). Conclusion: Our findings suggest that social and economic factors are associated with patients' perceptions of their overall pain and function after TKA, but such factors are not associated with patients' perceptions of their improvement in symptoms. Patients from areas with higher deprivation may be an at-risk population and could benefit from targeted interventions to improve their perception of their healthcare experience, such as through referrals to nonemergent medical transportation and supporting applications to local care coordination services before proceeding with TKA. Future research should investigate the mechanisms underlying why socioeconomic disadvantage is associated with inability to achieve the PASS, but not the MCID, after TKA. [ABSTRACT FROM AUTHOR]

Background: Associations of plasma total tau levels with future risk of AD have been described. Objective: To examine the extent to which plasma tau reflects underlying AD brain pathology in cognitively healthy individuals. Methods: We examined cross-sectional associations of plasma total tau with 11C-Pittsburgh Compound-B (PiB)-PET and 18F-Flortaucipir (FTP)-PET in middle-aged participants at the community-based Framingham Heart Study. Results: Our final sample included 425 participants (mean age 57.6± 9.9, 50% F). Plasma total tau levels were positively associated with amyloid-β deposition in the precuneus region (β±SE, 0.11±0.05; p = 0.025). A positive association between plasma total tau and tau PET in the rhinal cortex was suggested in participants with higher amyloid-PET burden and in APOEɛ4 carriers. Conclusions: Our study highlights that plasma total tau is a marker of amyloid deposition as early as in middle-age. [ABSTRACT FROM AUTHOR]

Parturition timing has long been a topic of interest in ungulate research. However, few studies have examined parturition timing at fine scale (e.g., <1 day). Predator activity and environmental conditions can vary considerably with diel timing, which may result in selective pressure for parturition to occur during diel times that maximize the likelihood of neonate survival. We monitored parturition events and early‐life survival of elk (Cervus canadensis) and mule deer (Odocoileus hemionus) in Utah, USA to better understand diel timing of parturition in temperate ungulates. Diel timing of parturition was moderately synchronous among conspecifics and influenced by environmental variables on the date of parturition. For elk, parturition events were most common during the morning crepuscular period and generally occurred later (i.e., closer to 12:00) when a relatively large proportion of the moon was illuminated. For mule deer, parturition events were most common during the diurnal period and generally occurred later (i.e., closer to 15:00) on cold, wet dates. Diel timing of parturition did not influence neonate survival, but larger datasets may be required to verify the apparent lack of influence. Although additional work could evaluate alternative variables that might affect parturition timing, our data provide an improved and finer scale understanding of reproductive ecology and phenology in ungulates. [ABSTRACT FROM AUTHOR]

This study was designed to evaluate the classification accuracy of the Memory module for the Inventory of Problems (IOP-M) in a sample of real-world patients. Archival data were collected from a mixed clinical sample of 90 adults clinically referred for neuropsychological testing. The classification accuracy of the IOP-M was computed against psychometrically defined invalid performance. IOP-M ≤30 produced a good combination of sensitivity (.46-.75) and specificity (.86-.95). Lowering the cutoff to ≤29 improved specificity (.94-1.00) at the expense of sensitivity (.29-.63). The IOP-M correctly classified between 73% and 91% of the sample. Given its low cost, ease of administration/scoring in combination with robust classification accuracy, the IOP-M has the potential to expand the existing toolkit for the evaluation of performance validity during neuropsychological assessments. [ABSTRACT FROM AUTHOR]

Objective: The aim was to determine the impact of consolidation of two rural level 1 trauma centers on adult trauma patients presenting to the remaining level 1 trauma center. To our knowledge, a study assessing the impact of trauma center consolidation on adult trauma patients had yet to be performed. Methods: A single institution, retrospective study was conducted at a rural level 1 trauma center. Adult trauma patients who presented to our center from January 2017 to January 2022 were included. The cohorts spanned 33 months pre- and post-consolidation. Multiple demographic and outcome measures were gathered. Data were analyzed using the student's t-test and Chi-squared testing. Results: There was a 33% increase in overall trauma activations and 9% increase in transfers from outside facilities post-consolidation. The post-consolidation group was significantly older, had higher mean injury severity score, and decreased hospital-free days. The post-consolidation group also saw an increase in ICU admission and surgical intervention. While there were no significant differences in ICU-free days or ventilator days, patients in the post-consolidation group with the highest level of activation who required both surgical intervention and ICU admission experienced decreased mortality. Conclusion: The consolidation of trauma services to a single level 1 trauma center in a rural Appalachian health system led to higher trauma volume and acuity, but most importantly decreased mortality for the most severely injured trauma patients. [ABSTRACT FROM AUTHOR]

Testicular malignancies commonly affect adolescent and young adult males. Although they tend to respond well to cisplatin-based chemotherapy with excellent overall survival, complications such as inferior vena cava tumor thrombus are rare and can be associated with high morbidity and mortality. We present a case of tumor thrombus in a 21-year-old active duty male with a newly diagnosed stage IIIB non-seminomatous germ cell tumor presenting with extensive left lower extremity swelling. Ultrasound with Doppler was notable for significant thrombus of the left common femoral, femoral, and popliteal vein. Computed tomography imaging revealed extensive thrombus of the inferior vena cava, left iliac veins, and left gonadal vein with sparing of the left renal vein. Endovascular thrombectomy was performed with pathologic analysis confirming the presence of malignant cells consistent with tumor thrombus. The patient continued subsequent non-seminomatous germ cell tumor treatment without complications. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer is the second most common cause of cancer mortality in Australia (1). The National Bowel Cancer Screening Program (NBCSP) aims to reduce mortality through early detection with a biennial faecal occult blood test for Australians aged 50–74 years (2). Modelling predicted COVID‐19 would reduce participation and delay colonoscopies despite the NBCSP continuing during the pandemic (3). This study analyses the realized impact of COVID‐19 related disruptions on the NBCSP and the effect on mortality. Methods: NBCSP participation, time to colonoscopy and annualized mortality were compared before and during COVID‐19. The effect on mortality was determined using a validated microsimulation model (4, 5). Results: From 1 January 2018 to 31 December 2019, 2 497 317 people participated in the NBCSP and 168 390 received a colonoscopy, compared to 2 490 265 and 162 573 from 1 January 2020 to 31 December 2021. Relative participation decreased 6 % and the proportion of colonoscopies performed within the recommended 120 days increased 14.5%. A disproportionally greater impact was observed outside major cities and in lower socioeconomic areas. An estimated 98–111 additional colorectal cancer deaths resulted from 3 % fewer colonoscopies performed during the pandemic. Conclusion: This study presents the most comprehensive analysis of the realized impact of COVID‐19 on the NBCSP. Catch‐up screening would be best targeted at Australians from rural and lower socioeconomic areas where participation remains low. Streamlined referral pathways and additional colonoscopy provisioning is required as less than two thirds of screen positive patients receive a colonoscopy within the recommended 120 days. [ABSTRACT FROM AUTHOR]

An in‐depth technical examination and conservation treatment of paintings by William Williams (Bristol 1727–1791 Bristol) has shed light on the artist's materials and technique. This investigation centered primarily on Williams's two 1766 portraits of William and David Hall. The paintings are considered the earliest life‐sized, full‐length portraits executed in the Philadelphia area. The analysis of the artist's palette indicated deliberate choices in the use of orpiment (As2S3). The mineral's tendency to oxidize to colorless and water‐soluble arsenic oxides likely caused color changes and degraded organic binder in the orpiment‐rich areas. μ‐XANES revealed orpiment photodegradation to arsenate species at the paint surface, with migration to the ground layers. Just below the paint surface, arsenic remains bound primarily as arsenite, with some associated with sulfur as orpiment. This As distribution suggests that the paint is liable to further degradation by photooxidation and use of moisture would be detrimental. Given this treatment‐critical degradation phenomenon, it was important to identify all arsenic‐containing areas of both portraits. Scanning XRF allowed rapid and accurate collection of maps from both portraits. Elemental maps of arsenic identified the orpiment‐rich areas of the painting, which would be susceptible to further degradation upon exposure to water during treatment. An aqueous adhesive was necessary to consolidate the cupped paint of the glue‐paste lined paintings. The arsenic maps guided the use of two different consolidants–BEVA 371 for the water‐sensitive orpiment‐rich paint and sturgeon glue for all other areas, striking a compromise between esthetic improvement and long term preservation. [ABSTRACT FROM AUTHOR]

Increasing demand for high‐quality STEM education calls for the formation and retention of effective educators with STEM expertise; yet endeavors to meet this demand require organizational structures and supports that can overcome the lack of collective understanding around STEM education, limited STEM knowledge by leadership, and mounting teacher attrition. STEM teacher leadership is one mechanism for addressing this challenge by empowering excellent classroom teachers with opportunities to institutionally shape STEM learning, without extracting them from their instructional role. This paper offers a STEM teacher leadership framework that targets teachers' identity development toward an equity‐focused, transformational STEM teacher leader. First, we examine the field of teacher leadership (both STEM‐specific and generally) to provide a foundation for the areas of potential impact by STEM teacher leaders, as well as dispositions and stances that support their emergent leadership. Complementing the literature, we explore and elevate aspiring STEM teacher leaders' perspectives, drawn from baseline surveys and interviews of a multi‐year professional development program for middle grade teachers in STEM disciplines. The framework, iteratively informed by these sources, includes our stance on equity in STEM education, eight dispositions, and four domains of knowledge and practices that shape STEM teacher leadership in K‐8 school settings. [ABSTRACT FROM AUTHOR]

Background: Early evidence suggests long-acting injectable cabotegravir and rilpivirine (LA-CAB/RPV) may be beneficial for people with HIV (PWH) who are unable to attain viral suppression (VS) on oral therapy. Limited guidance exists on implementation strategies for this population. Setting: Ward 86, a clinic serving publicly insured PWH in San Francisco. Methods: We describe multilevel determinants of and strategies for LA-CAB/RPV implementation for PWH without VS, using the Consolidated Framework for Implementation Research. To assess patient and provider-level determinants, we drew on preimplementation qualitative data. To assess inner and outer context determinants, we undertook a structured mapping process. Results: Key patient-level determinants included perceived ability to adhere to injections despite oral adherence difficulties and care engagement challenges posed by unmet subsistence needs; strategies to address these determinants included a direct-to-inject approach, small financial incentives, and designated drop-in days. Providerlevel determinants included lack of time to obtain LA-CAB/RPV, assess injection response, and follow-up late injections; strategies included centralizing eligibility review with the clinic pharmacist, a pharmacy technician to handle procurement and monitoring, regular multidisciplinary review of patients, and development of a clinic protocol. Ward 86 did not experience many outer context barriers because of rapid and unconstrained inclusion of LA-CAB/ RPV on local formularies and ability of its affiliated hospital pharmacy to stock the medication. Conclusions: Multilevel strategies to support LA-CAB/RPV implementation for PWH without VS are required, which may necessitate additional resources in some settings to implement safely and effectively. Advocacy to eliminate outer-context barriers, including prior authorizations and specialty pharmacy restrictions, is needed. [ABSTRACT FROM AUTHOR]