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Context: There is a well-established increased risk of lower-extremity (LE) musculoskeletal (MSK) injury following a sport-related concussion (SRC). Neuromuscular training programs improve biomechanics associated with LE MSK injury and reduce LE MSK injury incidence, but their relative effectiveness in athletes with history of SRC is unknown. The purpose of this study was to evaluate LE MSK injury incidence in female adolescent athletes with history of SRC following a neuromuscular training intervention. Design: Prospective case-control. Methods: Seventy-seven adolescent female athletes aged 12–18 years who participated in soccer, volleyball, or basketball were recruited from a single institutional sports medicine research and performance center to complete a 6-week neuromuscular training program prior to competitive athletic season. Group (Control, History of SRC) comparisons of athlete exposure and relative LE MSK injury risk and rates during the competitive athletic season were assessed. Results: Ten injuries were recorded by 9 athletes. Female athletes who reported history of SRC had increased injury risk (Risk Ratio 3.9, 95% CI, 1.1–13.8, P =.01) and increased injury rate (rate ratio 4.1, 95% CI, 1.1–15.8, P =.03) compared with female athletes without history of SRC. Conclusions: Female adolescent athletes with history of SRC showed a greater risk of LE MSK injury compared with athletes with no history of SRC. Future work is still needed to understand the underlying mechanisms associated with future LE MSK injury following SRC and interventions that ameliorate elevated injury risk. [ABSTRACT FROM AUTHOR]

• fMRI bilateral motor control task was used to evaluate longitudinal changes in brain activity. • Neuromuscular training induced movement adaptations in MC and HxSRC groups. • MCs demonstrate increased cerebellar activity associated with improved frontal plane ROM. • HxSRCs demonstrate increased somatosensory activity associated with improved frontal plane ROM. Sports-related concussion (SRC) in adolescent athletes is associated with an increased risk of subsequent lower extremity injury. Neuromuscular training (NMT) has shown promise for reducing lower extremity injuries following SRC, however, neural adaptations in response to changes in lower extremity biomechanics following NMT in athletes with a history of SRC (HxSRC) remains poorly understood. Therefore, the purpose of this study was to identify changes in neural activity associated with lower extremity movement adaptations following a six-week NMT intervention in athletes with a HxSRC. Thirty-two right-hand/foot-dominant female adolescent athletes (16 with self-reported HxSRC, 16 age- and anthropometrically-matched controls) completed a bilateral leg press task with 3D motion analysis during functional magnetic resonance imaging (fMRI). Movement adaptations were defined as a change in frontal and sagittal plane range of motion (ROM) during the fMRI bilateral leg press task. Significant pre- to post-NMT reductions were observed in the non-dominant (left) mean frontal plane ROM. Whole-brain neural correlate analysis revealed that increased cerebellar activity was significantly associated with reduced mean left-knee frontal ROM for matched controls. Exploratory within group analyses identified neural correlates in the postcentral gyrus for the HxSRC group which was associated with reduced mean left-knee frontal plane ROM. These distinct longitudinal changes provide preliminary evidence of differential neural activity associated with NMT to support knee frontal plane control in athletes with and without a HxSRC. [ABSTRACT FROM AUTHOR]

Background: The TrialNet Oral Insulin (OI) prevention trial showed no overall treatment effect, using the diagnosis of type 1 diabetes as an endpoint. A significant delay in onset was only found in a high‐risk stratum (termed secondary stratum 1) of participants with low first‐phase insulin release (FPIR). Methods: Since trials with an endpoint of type 1 diabetes take years to complete, in this post hoc analysis, we assessed whether a novel combination of glucose and C‐peptide markers could identify a therapeutic benefit after 1 year of follow‐up (trial participants followed for a median 2.7 years). Results: Participants were relatives with multiple islet autoantibodies and low FPIR (n = 40). Glucose rose, and C‐peptide declined in the placebo group, whereas glucose rose minimally, and C‐peptide increased in the OI group. When glucose and C‐peptide were plotted on two‐dimensional grids using 30–120‐min oral glucose tolerance test (OGTT) time points, changes in ratios of their central points (centroid ratio) differed between groups (p = 0.037 adjusted for age, BMI, and baseline C‐peptide and glucose). Conclusions: These findings support a favorable early effect of OI on combined glucose and C‐peptide endpoints in high‐risk individuals, indicating metabolic benefit. With further study, these measures may allow for shorter trials compared to the standard endpoint of type 1 diabetes diagnosis. [ABSTRACT FROM AUTHOR]

Regulation of ion channel expression on the plasma membrane is a major determinant of neuronal excitability, and identifying the underlying mechanisms of this expression is critical to our understanding of neurons. Here, we present two orthogonal strategies to label extracellular sites of the ion channel TRPV1 that minimally perturb its function. We use the amber codon suppression technique to introduce a non-canonical amino acid (ncAA) with tetrazine click chemistry, compatible with a transcyclooctene coupled fluorescent dye. Additionally, by inserting the circularly permutated HaloTag (cpHaloTag) in an extracellular loop of TRPV1, we can incorporate a fluorescent dye of our choosing. Optimization of ncAA insertion sites was accomplished by screening residue positions between the S1 and S2 transmembrane domains with elevated missense variants in the human population. We identified T468 as a rapid labeling site (~5 min) based on functional and biochemical assays in HEK293T/17 cells. Through adapting linker lengths and backbone placement of cpHaloTag on the extracellular side of TRPV1, we generated a fully functional channel construct, TRPV1exCellHalo, with intact wild-type gating properties. We used TRPV1exCellHalo in a single molecule experiment to track TRPV1 on the cell surface and validate studies that show decreased mobility of the channel upon activation. The application of these extracellular label TRPV1 (exCellTRPV1) constructs to track surface localization of the channel will shed significant light on the mechanisms regulating its expression and provide a general scheme to introduce similar modifications to other cell surface receptors. [ABSTRACT FROM AUTHOR]

Objectives. To determine whether geographic prioritization of limited COVID-19 vaccine supply was effective for reducing geographic disparities in case rates. Methods. Rhode Island allocated a portion of the initial COVID-19 vaccine supply to residents of Central Falls, a community already affected by structural policies and inadequate systems that perpetuate health inequities and experiencing disproportionately high COVID-19 morbidity and mortality. The policy was implemented with a culturally and linguistically appropriate community engagement plan and was intended to reduce observed disparities. Using a Bayesian causal analysis with population surveillance data, we evaluated the impact of this prioritization policy on recorded cases over the subsequent 16 weeks. Results. Early geographic prioritization of Central Falls accelerated vaccine uptake, averting an estimated 520 cases (95% confidence interval = 22, 1418) over 16 weeks and reducing cases by approximately 34% during this period (520 averted vs 1519 expected without early prioritization). Conclusions. Early geographic prioritization increased vaccine uptake and reduced cases in Central Falls, thereby reducing geographic disparities. Public Health Implications. Public health institutions should consider geographic prioritization of limited vaccine supply to reduce geographic disparities in case rates. (Am J Public Health. 2024;114(S7):S580–S589. https://doi.org/10.2105/AJPH.2024.307741) [ABSTRACT FROM AUTHOR]

'Design thinking' necessitates that we challenge our core beliefs to reframe our understanding and generate innovative solutions. The noun 'design' may also connote cunning. Mêtis (mῆτις) is such a form of thought and knowledge. Through wise application of prudence, vigilance and opportunism, it operates in unstable and uncertain environments. While the nature of crime is enduring, its character is transitory. If forensic science is to remain a valuable force-multiplier, it must co-adapt with a policing model that is orienting towards proactivity and disruption. 'Forensic intelligence (FORINT) is intelligence derived from technical and forensic information and expertise', and is the epitome of forensic science agility and a manifestation of mêtis in design. It is transdisciplinary, operating in different phases of the (pre-)investigative workflow, across the tactical-operational-strategic continuum. FORINT may emerge readily from a consultative/integrative forensic organization. Alternatively, its establishment may be a 'Trojan Horse' (consider Odysseus, master of mêtis): in design parlance this refers to an artefact that also is a vehicle for strategic change. Countering polymorphic transnational serious and organized crime requires us to be more multiple, more polyvalent, without compromise of ethics or integrity – leveraging mêtis in designing the future of forensic science through FORINT. [ABSTRACT FROM AUTHOR]

A new technique called generalized additive spatial smoothing (GASS) is introduced for modeling neighborhood effects within a regression framework. GASS has a number of desirable features, namely that it provides a data-driven mechanism for endogenously selecting neighborhoods based on a spatial scale hyperparameter. By allowing different scale hyperparameters to be selected for different relationships in the model, the technique is inherently multiscale and allows neighborhoods to vary by relationship. In addition, GASS includes a measure of uncertainty associated with each scale hyperparameter. These characteristics make it attractive for modeling phenomena where proximity might be an important aspect of a process, especially when a clear definition of proximity is not immediately available. Through multiscale data-driven spatial smoothing, GASS conducts a form of change of support and therefore also facilitates the incorporation of data from diverse sources. Finally, the technique is flexible and can be adapted and expanded with relative ease because it builds on generalized additive modeling. After providing an overview of the methodology, including a modified backfitting algorithm for calibration, a simulation experiment is described and an empirical example modeling bike-share usage is presented. The simulation results indicate that GASS can generally produce reliable results pertaining to both the regression coefficients and scale hyperparameters, and the results from the empirical example demonstrate that the GASS approach provides a better model fit and captures relationships that might otherwise be obfuscated. Overall, these results highlight the potential of the GASS framework and the importance of measuring multiscale neighborhood effects. [ABSTRACT FROM AUTHOR]

In 2021, the structural determinants of health (SDOH) were added to the Accreditation Council of Graduate Medical Education common program requirements for all accredited residency programs, including general surgery. In this study, we sought to explore the current scope of, and concepts used in, health disparities curricula for general surgery residents, specifically investigating how general surgery residents learn about health disparities and the SDOH. We searched PubMed, EMBASE, Education Research Complete (EBSCOhost), and Web of Science Core Collection using keywords related to health disparities and the SDOH. Inclusion criteria consisted of all studies published after 2005 that discussed health disparities curricula for Accreditation Council of Graduate Medical Education–accredited general surgery residency programs. Five thousand three hundred seventeen articles were screened using a two-phase process. Data extraction and analysis was performed using critical review methods. Seventeen articles were identified. Within these articles, seven unique health disparities curricula were found. All seven of the identified curricula employed cultural frameworks as methods to mitigate health disparities. Three curricula, all published after 2011, included education on the SDOH. A wide variety of educational methods were utilized; in-person didactics was the most common. In the current literature, culture continues to play a large role in health disparities training for general surgery residents. Though further efforts are needed to understand the methods used in programs that have not published scholarly work, it is imperative to ensure that residents are provided with the sociopolitical perspective needed to understand the SDOH and serve all patients, including those affected by health disparities. [ABSTRACT FROM AUTHOR]

Restoration researchers and practitioners alike advocate for novel restoration approaches, informed by ecological theories and principles, to enhance the likelihood of meeting restoration goals. Forested wetland restoration has historically focused on creating abiotic conditions that support the tolerance thresholds of desired species, but the stress gradient hypothesis provides guidance for potential new strategies that use biotic interactions to ameliorate stressful abiotic conditions. In this study, we tested whether multi‐species planting approaches can be used to enhance the survival and growth of a target restoration tree species, Bald cypress, along multiple abiotic gradients. We conducted a fully factorial controlled greenhouse experiment which manipulated above‐ and belowground interactions between two species (Bald cypress and Soft rush), as well as light availability and depth of inundation. Our findings showed that co‐planting Bald cypress seedlings with Soft rush did not increase tree biomass production or growth metrics (e.g. stem height and leaf area) under any exposed stress combination. Importantly, we found that full‐sun irradiance negatively impacted functional traits associated with the tree seedlings' health and ability to photosynthesize. Our findings are important for consideration by practitioners as light is rarely the focus of wetland ecosystem restoration and degraded forested wetlands or restoration sites often have open canopies. [ABSTRACT FROM AUTHOR]

For Black students in the United States, attending schools with a higher proportion of White students is associated with worse mental and physical health outcomes in adolescence/early adulthood. To our knowledge, no prior studies have evaluated the association between school racial/ethnic composition from kindergarten through grade 12 and later-life mental health. In a cohort of Black adults aged ≥50 years in Northern California who retrospectively reported (2017-2020) school racial/ethnic composition for grades 1, 6, 9, and 12, we assessed the association between attending a school with mostly Black students versus not and mid-/late-life depressive symptoms (8-item Patient-Reported Outcomes Measurement Information System (PROMIS) depression score, standardized to the 2000 US adult population) using age-, sex/gender-, southern US birth–, and parental education–adjusted generalized estimating equations, and assessed effect modification by the presence of a caring teacher/staff member. Levels of later-life depressive symptoms were lower among those who attended schools with mostly Black students in grades 1 and 6 (β = −0.12 [95% CI, −0.23 to 0.00] and β = −0.11 [95% CI, −0.22 to 0.00], respectively). In grade 6, this difference was larger for students without an adult at school who cared about them (β = −0.29 [95% CI, −0.51 to −0.07] vs β = −0.04 [95% CI, −0.17 to 0.09]). Among Black Americans, experiencing early schooling with mostly Black students may have later-life mental health benefits; this protective association appears more important for students without the presence of caring teachers/staff. This article is part of a Special Collection on Mental Health. [ABSTRACT FROM AUTHOR]

Following the emergence of the Black Lives Matter movement, a new wave of progressive athlete activism emerged. While a section of sport media members supported these athletes and their causes, a subset of anti-progressive pundits and critics emerged resisting the new wave of politically active Black athletes. I argue that sport media pundits like Clay Travis at Fox Sports represent sport media monetizing white male backlash to “woke” Black athletes. By promoting these voices, these outlets committed to amplifying white male grievance politics and emboldened anti-Black racism in sport media, all while increasing polarization and partisanship, paralleling conservative political news pundits during the Trump era. This essay critically and closely reads and contextualizes the increasingly rightward rhetoric of Travis, explaining how he connects Trumpian rhetoric to sports punditry more broadly and allows major sport media an opportunity to advance overtly conservative, racist, and sexist dialogues. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study utilized structural equation modeling to examine effects of COVID-19 stress on food insecurity and fruit and vegetable consumption mediated through personal agency and behavioral intention. Participants: Students (n = 749) enrolled at one federally designated Hispanic-serving public university during the fall 2020 semester. Methods: A 34-item survey was developed and administered. Results: COVID-19 stress had a statistically significant impact on food insecurity (B =.341; p <.001) and an inverse impact on personal agency to consume fruit and vegetables (B = −.283; p <.001). Personal agency (B =.389; p <.001) and behavioral intention to consume fruit and vegetables were directly associated while food insecurity inversely impacted behavioral intention (B = −.076; p =.034). Conclusions: Pandemic-related stress impacts nutrition behaviors among the student population already at risk of poor fruit and vegetable intake. During periods of high pandemic-related stress, college students need adequate access to fruits and vegetables and health promotion programs emphasizing stress management and healthy dietary behaviors. [ABSTRACT FROM AUTHOR]

Quantitative methods to characterize bone contusions and associated cartilage injury remain limited. We combined standardized voxelwise normalization and 3D mapping to automate bone contusion segmentation post‐anterior cruciate ligament (ACL) injury and evaluate anomalies in articular cartilage overlying bone contusions. Forty‐five patients (54% female, 26.4 ± 11.8 days post‐injury) with an ACL tear underwent 3T magnetic resonance imaging of their involved and uninvolved knees. A novel method for voxelwise normalization and 3D anatomical mapping was used to automate segmentation, labeling, and localization of bone contusions in the involved knee. The same mapping system was used to identify the associated articular cartilage overlying bone lesions. Mean regional T1ρ was extracted from articular cartilage regions in both the involved and uninvolved knees for quantitative paired analysis against ipsilateral cartilage within the same compartment outside of the localized bone contusion. At least one bone contusion lesion was detected in the involved knee within the femur and/or tibia following ACL injury in 42 participants. Elevated T1ρ (p = 0.033) signal were documented within the articular cartilage overlying the bone contusions resulting from ACL injury. In contrast, the same cartilaginous regions deprojected onto the uninvolved knees showed no ipsilateral differences (p = 0.795). Automated bone contusion segmentation using standardized voxelwise normalization and 3D mapping deprojection identified altered cartilage overlying bone contusions in the setting of knee ACL injury. [ABSTRACT FROM AUTHOR]

Individuals with neuromuscular disorders display a combination of motor control deficits and lower limb weakness contributing to knee extension deficiency characterized by exaggerated stance phase knee flexion. There is a lack of evidence for long-term improvement of knee extension deficiency with currently available clinical treatment programs. Our previous work testing a wearable robotic exoskeleton with precisely timed assistive torque applied at the knee showed immediate increases in knee extension during walking for children with cerebral palsy, which continued to improve over an acute practice period. When we applied interleaved assistance and resistance to knee extension, we observed improvements in knee extension and increased muscle activation indicating the potential for muscle strengthening when used over time. There is a need for additional, high-quality trials to assess the impact of dosage, intensity and volume of training necessary to see persistent improvement in lower limb function for these patient populations. This randomized crossover study (ClinicalTrials.gov: NCT05726591) was designed to determine whether 12 weeks of overground gait training with a robotic exoskeleton outside of the clinical setting, following an initial in clinic accommodation period, has a beneficial effect on walking ability, muscle activity and overall motor function. Participants will be randomized to either complete the exoskeleton intervention or continue their standard therapy for 12 weeks first, followed by a crossover to the other study component. The primary outcome measure is change in peak knee extension angle during walking; secondary outcome measures include gait speed, strength, and validated clinical scales of motor function and mobility. Assessments will be completed before and after the intervention and at 6 weeks post-intervention, and safety and compliance will be monitored throughout. We hypothesize that the 12-week exoskeleton intervention outside the clinical setting will show greater improvements in study outcome measures than the standard therapy. [ABSTRACT FROM AUTHOR]

Autistic students are a growing subgroup within post-secondary schooling; however, little is known about barriers to their success in that context. Research suggests autistic students face more challenges to completing post-secondary education than neurotypical students, but findings often rely on expert opinion and fail to incorporate first-hand perspectives. To address this gap, a qualitative inquiry into barriers to success for autistic post-secondary students was conducted. Thematic Analysis yielded 10 themes in three categories, while two separate cross-cutting themes emerged; themes interact with one another, intensifying concerns of autistic students. Findings can support post-secondary institutions to reflect on the extent to which these barriers are present for their autistic students and modify support services accordingly. [ABSTRACT FROM AUTHOR]

Predation is an important species interaction to monitor when assessing an invasive species' impact on a particular ecosystem, but it can be difficult to observe and thus, fully understand. On Kaua'i island, invasive Barn Owls (Tyto alba) predate native seabirds, but difficult terrain in this region and the cryptic nature of owl predation make traditional monitoring of predation quite challenging. Using Barn Owls collected as part of removal efforts on Kaua'i and Lehua islands, we conducted DNA metabarcoding of owl digestive tracts to detect and determine seabird species they predate. We used a seabird-targeted 12s marker to sequence 112 swabs from 55 owls and detected 6 seabird taxa, including 2 ESA-listed seabirds—Hawaiian Petrel (Pterodroma sandwichensis) and Newell's Shearwater (Puffinus newelli), in 12 swabs from 11 owls (20% of sampled owls). Corresponding morphological assessment of owl stomach contents detected seabird species as prey items in only 2% (1/55) of sampled owls, highlighting the utility of molecular approaches for detecting diet items, especially degraded or visually absent items. Additionally, this approach has proven very useful in revealing cryptic trophic interactions in inaccessible seabird populations. For the most comprehensive analysis of diet, the use of both esophageal and cloacal swabs for metabarcoding is recommended. Supplementing metabarcoding with other methods that can provide complementary prey information, such as stable isotope analysis, would help to characterize trophic interactions more fully. The method described here has proven to be a reliable tool for investigating diet in invasive owls and may be used to investigate cryptic predation in living birds as a minimally invasive technique, as well. [ABSTRACT FROM AUTHOR]

Reduction of the previously reported Iron (III) complex PhCC4MeFeCl with sodium naphthalide forms the square pyramidal complex PhCC4MeFe (1), cleanly in moderate yield with short reaction times. The related diamagnetic complex PhCC4MeFe(CNtBu) (2) was prepared by addition of an equivalent of tert‐butylisocyanide to a solution of 1. XRD of 2 reveals a rare bent form of the isocyanide moiety with a C−N−C bond angle of 142.67(18)° consistent with sp2 hybridization at the N‐atom while IR spectroscopy reveals an atypically broadened isocyanide stretch at νCNR=1981 cm−1; taken together these metrics are demonstrative of the excellent donor ability of the dianionic penta‐carbene framework and point to a degree of metal‐to‐ligand π‐backbonding rarely seen at isocyanide complexes of iron. [ABSTRACT FROM AUTHOR]

Many faculty perform work as public intellectuals, producing essays, op-eds, interviews, and other forms of media to amplify their academic work. However, educational research has not examined how faculty conceptualize non-academic audiences, influencing who faculty address in their public scholarship and what they work on as public intellectuals. This study engaged with 14 education faculty members to explore how these individuals conceptualized the audiences for their public scholarship. Findings suggest faculty often conceptualize audiences of public scholarship as larger, non-academic audiences, speaking to the constraints of academic audiences. However, faculty often described their audiences as being educated, being educators, and being passionate about education—identities that they held—possibly perpetuating a public echo chamber between education faculty and educators in the public sphere. Implications for faculty development and public scholarship are addressed. [ABSTRACT FROM AUTHOR]

Summary: Mornings are salient times for disrupted affect that may be impacted by prior sleep. The current study extends work linking sleep disruptions with negative affect by examining how nightly changes in sleep duration, timing, and quality relative to a person's average impact morning affect. We further tested whether depression severity moderated the relationship between nightly variations in sleep and morning affect. This is a secondary analysis of participants ages 18–65 years with varying levels of depression (N = 91) who wore an Actiwatch for 3–17 days (n = 73) while reporting morning affect using a visual analogue scale. Multilevel models tested the previous night's sleep duration, timing, or quality as a predictor of morning affect. Sleep measures were group‐mean centred to account for nightly variation in participants' sleep. A cross‐level interaction between depression severity and nightly sleep was entered. Sleeping longer (b = 0.1; p < 0.001) and later (b = 1.8; p = 0.01) than usual were both associated with better morning mood. There was a significant interaction between nightly actigraphic sleep duration and depression severity on morning affect (b = 0.003; p = 0.003). Participants with higher depression severity reported worse affect upon waking after sleeping less than their usual. In comparison, sleeping less than usual did not affect morning affect ratings for participants with lower depression. A similar interaction was found for sleep quality (b = 0.02; p < 0.001). There was no interaction for midsleep timing. Sleeping less than usual impacted morning affect in individuals with greater depression, potentially suggesting a pathway by which sleep disturbances perpetuate depression. [ABSTRACT FROM AUTHOR]

Taxon‐specific quantitative PCR (qPCR) assays are commonly used for environmental DNA sampling‐based inference of animal presence. These assays require thorough validation to ensure that amplification truly indicates detection of the target taxon, but a thorough validation is difficult when there are potentially many non‐target taxa, some of which may have incomplete taxonomies. Here, we use a previously published, quantitative model of cross‐amplification risk to describe a framework for assessing qPCR assay specificity when there is missing information and it is not possible to assess assay specificity for each individual non‐target confamilial. In this framework, we predict assay specificity against unsampled taxa (non‐target taxa without sequence data available) using the sequence information that is available for other confamilials. We demonstrate this framework using four case study assays for: (1) An endemic, freshwater arthropod (meltwater stonefly; Lednia tumana), (2) a globally distributed, marine ascidian (Didemnum perlucidum), (3) a continentally distributed freshwater crustacean (virile crayfish; Faxonius virilis, deanae and nais species complex) and (4) a globally distributed freshwater teleost (common carp; Cyprinus carpio and its close relative C. rubrofuscus). We tested the robustness of our approach to missing information by simulating application of our framework for all possible subsamples of 20—all non‐target taxa. Our results suggest that the modelling framework results in estimates which are largely concordant with observed levels of cross‐amplification risk using all available sequence data, even when there are high levels of data missingness. We explore potential limitations and extensions of this approach for assessing assay specificity and provide users with an R Markdown template for generating reproducible reports to support their own assay validation efforts. [ABSTRACT FROM AUTHOR]

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California, USA, is home to 3 subspecies of North American elk (Cervus canadensis): Roosevelt (C. c. roosevelti), Rocky Mountain (C. c. nelsoni), and tule (C. c. nannodes). Effective management requires a baseline understanding of each subspecies' range, admixture zones, and geographic patterns of genetic diversity. To address these questions, we genotyped 1,271 individual elk from California (n = 1,204) and reference populations of Rocky Mountain and Roosevelt elk from Nevada (n = 32) and Oregon (n = 35), USA. Using 19 polymorphic microsatellite loci, we detected admixture between Roosevelt and Rocky Mountain elk at a contact zone in northern California, and between Roosevelt and tule elk in north-coastal California and centralcoastal California. We identified a genetically distinct population of Roosevelt elk in northwestern California, likely reflecting the remnant population that survived a large demographic decline from overhunting during the 1800s. Tule elk exhibited lower levels of heterozygosity (0.44 ± 0.03 [SD]) and allelic richness (2.9±0.2) than Rocky Mountain (0.58±0.05, 4.9±0.4, respectively) and Roosevelt (0.50 ± 0.06, 4.4 ± 0.6, respectively) elk. Among tule elk populations, heterozygosity varied, with the lowest heterozygosity (0.23 ± 0.05) corresponding to the oldest enclosed herd used over the past century as a source of translocations. Among tule elk populations, genetic structure revealed several cases of successful and unsuccessful reintroduction or augmentation attempts. Results provide an essential baseline for future monitoring and decisions about harvest management, translocations to preserve genetic diversity, and landscape-level conservation planning to maintain, enhance, or obstruct connectivity of elk populations. Genome-wide sequencing and analyses are needed to quantify inbreeding absolutely and assess genetic load and the age of admixture where subspecies currently exchange genes. [ABSTRACT FROM AUTHOR]

This study examines changes in college students' relationships with their grandparents during the COVID-19 pandemic and lockdown, and whether these relationship changes were associated with college students' coping with the pandemic and mental health. 441 college students (76% female) completed an online survey. The majority of participants reported changes to the grandparent-grandchild relationship. Reduced contact and closeness was the most commonly reported change and was related to greater participant COVID-19 concerns and anticipatory grief for grandparents. A small number of participants reported increased closeness, which was related to their lower anxiety and depression. For younger students, grandparent contracting COVID-19 was associated with lower COVID-19 concerns and greater negative reactions to lockdown restrictions. [ABSTRACT FROM AUTHOR]

Medical students value the opportunity to learn from patients as a supplement to traditional faculty-led education; however, long-term follow-up to understand the educational impact of these experiences is lacking. We surveyed medical students who conducted non-medical virtual encounters with transplant recipients or living donors to understand the impact on students' patient care approach after 1-2 y. Students who completed their surgery clerkship from July 2020 to September 2021 were surveyed about this nonmedical patient encounter in January 2023. Quantitative and qualitative survey data were analyzed using descriptive statistics and inductive thematic analysis, respectively. Of the 27 respondents (46% response rate), 44.4% completed the experience 1 y ago and 55.6% completed the experience 2 y ago. Nearly all respondents (96.3%) agreed that this experience was an effective way to learn about organ donation and transplantation and that learning from patients was beneficial to their development as a doctor. Over 50% felt this experience changed how they provide care to patients. Qualitatively, students reported that this activity cultivated their empathy for patients, provided unique insight into patients' illness experiences, and enhanced their understanding of the longitudinal patient-surgeon relationship. Utilizing patients as teachers in transplant surgery not only taught medical students more about organ donation and transplantation but also built empathy and highlighted unique, non-clinical aspects of the patient experience that persisted over time. This is one of the first studies to evaluate patient-led teaching of this type over a year later and assess its unique influence on medical student development. [ABSTRACT FROM AUTHOR]

Background Evaluating the National Institute's Health's (NIH's) response to the coronavirus disease 2019 (COVID-19) pandemic via grants and clinical trials is crucial to determining the impact they had on aiding US citizens. We determined how the NIH's funding for COVID-19 research was disbursed and used by various institutions across the United States. Methods We queried NIH RePORTER and isolated COVID-19–related grants from January 2020 to December 2021. We analyzed grant type, geographical location, and awardee institution. Manuscripts published from these grants were quantitatively analyzed. COVID-19 clinical trials were mapped and distances from counties to clinical trial sites were calculated using ArcGis. Results A total of 2401 COVID-19 NIH grants resulted in 14 654 manuscripts from $4.2 billion and generated more than 150 000 citations. R01s make up 32% of grants (763/2401) and 8% of funding ($329 million). UM1 grants account for the majority of funding (30.8%; $1.3 Billion). Five states received 50.6% of funding: North Carolina, Washington, New York, California, and Massachusetts. Finally, of the 1806 clinical trials across 1266 sites in the United States, the majority were in metropolitan areas in close proximity to areas of high COVID-19 disease burden. Conclusions and Relevance Evaluating the outcome of the NIH's response to the COVID-19 pandemic is of interest to the general public. The present study finds that the NIH disbursed more than $4 billion in funding to large consortiums and clinical trials to develop diagnostics, therapeutics, and vaccines. Approximately 8% of funding was used for R01 grants. Clinical trial sites were generally located in areas of high COVID-19 burden. [ABSTRACT FROM AUTHOR]

Environmental DNA (eDNA) sampling is a powerful tool for rapidly characterizing biodiversity patterns for specious, cryptic taxa with incomplete taxonomies. One such group that are also of high conservation concern are North American freshwater gastropods. In particular, springsnails of the genus Pyrgulopsis (Family: Hydrobiidae) are prevalent throughout the western United States where >140 species have been described. Many of the described species are narrow endemics known from a single spring or locality, and it is believed that there are likely many additional species which have yet to be described. The distribution of these species across the landscape is of interest because habitat loss and degradation, climate change, groundwater mining, and pollution have resulted in springsnail imperilment rates as high as 92%. Determining distributions with conventional sampling methods is limited by the fact that these snails are often <5 mm in length with few distinguishing morphological characters, making them both difficult to detect and to identify. We developed an eDNA metabarcoding protocol that is both inexpensive and capable of rapid, accurate detection of all known Pyrgulopsis species. When compared with conventional collection techniques, our pipeline consistently resulted in detection at sites previously known to contain Pyrgulopsis springsnails and at a cost per site that is likely to be substantially less than the conventional sampling and individual barcoding that has been done historically. Additionally, because our method uses eDNA extracted from filtered water, it is non‐destructive and suitable for the detection of endangered species where "no take" restrictions may be in effect. This effort represents both a tool which is immediately applicable to taxa of high conservation concern across western North America and a case study in the broader application of eDNA sampling for landscape assessments of cryptic taxa of conservation concern. [ABSTRACT FROM AUTHOR]

BACKGROUND: While more than 2.5 million U.S. high students worked in 2020, data to assess how work affects this group are sparse. To facilitate such research, a set of occupational safety and health questions for inclusion on the Youth Risk Behavior Surveillance System (YRBSS) and other youth‐focused surveys was developed. METHODS: Survey questions about occupational experiences of young workers were adapted from other surveys or created de novo. Key audiences were engaged to define priority topic areas and develop draft questions, which were further refined through cognitive interviews with working youth. RESULTS: Twenty‐one resulting questions spanned multiple work‐related topics: employment status; health outcomes; psychosocial exposures; and safety climate. Cognitive testing revealed that youth (aged 14‐19) had difficulty with temporal concepts. Some difficulties reflected the propensity of youth to engage in multiple, online, and informal jobs. During 3 rounds of interviews, questions were adjusted to better reflect youth employment circumstances and language. Four states added at least 1 work‐related question to their 2023 Youth Risk Behavior Survey questionnaire, and the full set of questions has been disseminated to federal agencies and partners. CONCLUSION: Including tailored questions about employment in surveys of youth will facilitate occupational health surveillance for this group. Analysis of resulting data can help to close knowledge gaps, provide current prevalence data, inform policy, and allow development of focused prevention and intervention strategies to reduce adverse outcomes among young workers. [ABSTRACT FROM AUTHOR]

The resources for carrying out and analyzing microbial evolution experiments have become more accessible, making it possible to expand these studies beyond the research laboratory and into the classroom. We developed five connected, standards‐aligned yeast evolution laboratory modules, called "yEvo," for high school students. The modules enable students to take agency in answering open‐ended research questions. In Module 1, students evolve baker's yeast to tolerate an antifungal drug, and in subsequent modules, investigate how evolved yeasts adapted to this stressful condition at both the phenotype and genotype levels. We used pre‐ and post‐surveys from 72 students at two different schools and post‐interviews with students and teachers to assess our program goals and guide module improvement over 3 years. We measured changes in student conceptions, confidence in scientific practices, and interest in STEM careers. Students who participated in yEvo showed improvements in understanding of activity‐specific concepts and reported increased confidence in designing a valid biology experiment. Student experimental data replicated literature findings and has led to new insights into antifungal resistance. The modules and provided materials, alongside "proof of concept" evaluation metrics, will serve as a model for other university researchers and K − 16 classrooms interested in engaging in open‐ended research questions using yeast as a model system. [ABSTRACT FROM AUTHOR]

Performance on the psychomotor vigilance test (PVT; Dinges & Powell, 1985)—a common index of sustained attention—is affected by the opposing forces of fatigue and sustained effort, where reaction times and error rates typically increase across trials and are sometimes offset by additional efforts deployed toward the end of the task (i.e., an "end‐spurt"; cf. Bergum & Klein, 1961). In ACT‐R (Adaptive Control of Thought‐Rational; Anderson et al., 2004), these influences on task performance have been modeled as latent variables that are inferred from performance (e.g., Jongman, 1998; Veksler & Gunzelmann, 2018) without connections to directly observable variables. We propose the use of frontal gamma (γ) spectral power as a direct measure of vigilant effort and demonstrate its efficacy in modeling performance on the PVT in both the aggregate and in individuals. Performance decrements across time‐on‐task during sustained attention tasks are difficult to simulate in computational frameworks, as are the relationships between behavioral and neural outcomes related to fatigue. We propose the use of frontal gamma spectral power computed from EEG data as a direct measure of both positive (i.e., compensatory) and negative (i.e., fatigue‐related) changes in vigilant attention and introduce a method for incorporating these estimates into ACT‐R models of the psychomotor vigilance test (PVT). Simulations using gamma power successfully recover observed response patterns in both the aggregate and within individual participants. [ABSTRACT FROM AUTHOR]

The basic timescales governing animal life are generally determined by body size. Pauses in naturally occurring human speech were investigated to determine if pause timescales are also sensitive to body size. Reported is an analysis of pause duration allometry in recorded interviews of 61 athletes. Pauses were divided into three classes based on whether they occurred during fluid speech or whether they preceded or followed a filled pause (i.e., "um"). Allometric laws relating body size to pause size were found for all three classes--larger people take longer pauses. The derived allometric exponents were used to evaluate a theory of how people experience the passage of time. The theory associates the experience of time passage with the distal flow of time through the mathematics of bounded exponential growth. Nonlinearities inherent in the theory are shown to predict, in detail, the way body size interacts with linguistic context in the deployment of pauses. The theory provides a meaningful framework for understanding how time is experienced as a felt quantity and how pauses are negotiated in everyday speech. [ABSTRACT FROM AUTHOR]

Research in modifiable behaviors, like exercise, on risk for dementia is increasing. Although many studies focus on older adults, brain pathology for Alzheimer's Disease can begin in middle age, suggesting an ideal target for intervention. We conducted a systematic review from exercise intervention studies on cognitive function among healthy, middle-aged participants (45-65). We searched multiple databases (PubMed, PsycINFO, MEDLINE, Cochrane Central Register of Controlled Trials, Google Scholar) for studies using standard, validated, neuropsychological measures following either single- or multi-session interventions in cognitively-unimpaired, middle-aged adults. We identified 13 eligible studies. There was notable heterogeneity across studies, with varying design, measures, interventions, and results. Results from single-session studies showed improvement in response inhibition, while results for cognitive flexibility were mixed. No significant changes were found on measures of attention, working memory, or processing speed. Results from multi-session studies were more varied. Verbal memory was found to improve while performance on tests of attention and working memory, processing speed, and executive function were mixed. Importantly, for both single-session and multi-session studies, there was no standard set of neuropsychological tests administered, making it more difficult to synthesize the findings into a single narrative. We end with a discussion on future directions and implementation. [ABSTRACT FROM AUTHOR]

* Context.--The use of immunohistochemical stains in breast and gynecologic pathology has become increasingly complex, with various diagnostic, prognostic, and predictive applications. Objective.--To provide an update and review of immunohistochemical stains used in the practice of breast and gynecologic pathology. Established and new entities are reviewed, with descriptions of histomorphology and immunohistochemical staining patterns and discussion of interpretive pitfalls. Data Sources.--Data were obtained from review of the English-language literature and firsthand experience of the authors in breast and gynecologic pathology. Conclusions.--Many entities in breast and gynecologic pathology benefit from evaluation with various immunohistochemical stains. These studies not only aid in the diagnosis and staging of tumors but also can provide prognostic and predictive information. Updated guidelines for recommended ancillary studies such as mismatch repair, p53, and human epidermal growth factor receptor 2 (HER2) studies in endometrium, as well as estrogen and progesterone receptors and HER2 in breast, are discussed. Finally, the use and interpretation of established and novel immunohistochemical stains are discussed in various breast and gynecologic malignancies. [ABSTRACT FROM AUTHOR]

Determining the relative importance of sexual and asexual reproduction is critical for determining how genetic diversity is partitioned within and among populations. Macroalgae exhibit reproductive system variability, with many species capable of both sexual and asexual reproduction. Thus, rates of fragmentation (asexual) versus sporic recruitment (sexual) must be quantified. This is critical during range expansions when shifts to uniparental reproduction are common. Chondria tumulosa is a cryptogenic red alga that was discovered forming thick mats at Manawai, in the Northwestern Hawaiian Islands, during opportunistic sampling in 2019. It reduced the biodiversity and abundance of associated coral reef organisms. To characterize the reproductive system of C. tumulosa in this atoll, we visually assessed 124 thallus clumps for reproductive structures and used five microsatellite loci to genotype 41 thalli. All thalli bearing reproductive structures (20%) and all thalli that were genotyped were tetrasporophytes. No gametophytic thalli were observed using microscopy or microsatellite genotyping, though 80% of thalli observed under the microscope were vegetative. We observed in situ thallus fragmentation supported by the presence of 17 repeated genotypes and other genetic signatures, suggesting high rates of asexual reproduction. These results suggest that C. tumulosa is partially clonal in this atoll and has the potential for spreading to other nearby atolls. Rapid establishment, thallus fragmentation and tetrasporophytic dominance are consistent with other red macroalgal invasions studied to date. Understanding the reproductive system is an important component of developing management strategies for this alga and expanding our understanding of the population genetics of partially clonal taxa. [ABSTRACT FROM AUTHOR]

Biofilms are widely recognized as a prominent mode of microbial growth and strategy of antimicrobial tolerance in many environments. Characteristics that are often overlooked in biofilm investigations include the examination of metabolic pathways as the assumption might be that interference with central pathways such as glycolysis would only reduce growth and thus not be meaningful. Using the Keio collection of Escherichia coli mutants, we investigated the influence of biofilm formation and planktonic growth in full-strength and diluted Luria–Bertani (LB) broths using strains with a disruption of glycolysis (Δpgi), the Entner–Doudoroff pathway (Δedd), or the pentose phosphate pathway (Δgnd). Unexpectedly, in contrast to the E. coli Keio parent strain (BW25113), planktonic growth was enhanced in full strength and diluted LB broths in the metabolic mutants. Using a microtiter biofilm assay, the E. coli parent strain showed the highest crystal violet staining. However, when analyzed by culture assays, there was an increase in biofilm populations in the mutants in comparison to the parent strain. Fluorescence microscopy showed differences in colonization patterns in the strains. Given the availability of mutant collections in many model organisms, similar metabolic studies are warranted for biofilms, given their importance in nature. [ABSTRACT FROM AUTHOR]

Background: The gut microbiome is a salient contributor to the development of obesity, and diet is the greatest modifier of the gut microbiome, which highlights the need to better understand how specific diets alter the gut microbiota to impact metabolic disease. Increased dietary fiber intake shifts the gut microbiome and improves energy and glucose homeostasis. Dietary fibers are found in various plant-based flours which vary in fiber composition. However, the comparative efficacy of specific plant-based flours to improve energy homeostasis and the mechanism by which this occurs is not well characterized. Methods: In experiment 1, obese rats were fed a high fat diet (HFD) supplemented with four different plant-based flours for 12 weeks. Barley flour (BF), oat bran (OB), wheat bran (WB), and Hi-maize amylose (HMA) were incorporated into the HFD at 5% or 10% total fiber content and were compared to a HFD control. For experiment 2, lean, chow-fed rats were switched to HFD supplemented with 10% WB or BF to determine the preventative efficacy of flour supplementation. Results: In experiment 1, 10% BF and 10% WB reduced body weight and adiposity gain and increased cecal butyrate. Gut microbiota analysis of WB and BF treated rats revealed increases in relative abundance of SCFA-producing bacteria. 10% WB and BF were also efficacious in preventing HFD-induced obesity; 10% WB and BF decreased body weight and adiposity, improved glucose tolerance, and reduced inflammatory markers and lipogenic enzyme expression in liver and adipose tissue. These effects were accompanied by alterations in the gut microbiota including increased relative abundance of Lactobacillus and LachnospiraceaeUCG001, along with increased portal taurodeoxycholic acid (TDCA) in 10% WB and BF rats compared to HFD rats. Conclusions: Therapeutic and preventative supplementation with 10%, but not 5%, WB or BF improves metabolic homeostasis, which is possibly due to gut microbiome-induced alterations. Specifically, these effects are proposed to be due to increased concentrations of intestinal butyrate and circulating TDCA. [ABSTRACT FROM AUTHOR]

There is conflicting evidence regarding the prevalence and magnitude of exercise-induced muscle damage (EIMD) following low-load resistance exercise with blood flow restriction (LL + BFR) that may be related to exercise protocols. The purpose of this investigation was to examine the effects of 75-repetition (BFR-75) (1 × 30, 3 × 15) and 4 sets to failure (BFR-4x) protocols on indices of EIMD among untrained women. Thirteen women completed this investigation. One leg was randomly assigned to BFR-75 and the other to BFR-4x. Each leg performed isokinetic, unilateral, concentric-eccentric, leg extension muscle actions at 30% of maximal strength. Indices of EIMD (muscle soreness, range of motion [ROM], limb circumference, pain pressure threshold [PPT], and maximal voluntary isometric contraction [MVIC]) were recorded before exercise, 0-, 24-, 48-, 72-, and 96-hours post-exercise. There were no changes for ROM, circumference, or PPT. Muscle soreness increased similarly in both conditions 0-, 24-, and 48-hours post-exercise and MVIC increased 24-, 48-, 72-, and 96-hours post-exercise. These findings suggested BFR-75 and BFR-4x were not associated with EIMD and elicited similar physiological responses. The increases in muscle soreness may be due to metabolic stress associated with LL + BFR protocols apart from EIMD. There was no evidence of significant exercise-induced muscle damage following low-load resistance exercise with blood flow restriction completed failure and non-failure. Muscle function was not impaired 24-96 h post-exercise for either protocol. Low-load resistance exercise with blood flow restriction using a 75-repetition and 4 sets to volitional failure protocol resulted in similar physiological responses to exercise. There may be higher levels of metabolic stress which may increase muscle soreness following low-load resistance exercise with blood flow restriction. [ABSTRACT FROM AUTHOR]

Can emancipatory, decolonial histories of science be extracted from objects collected from—or made visible to history by—the archives of colonialism? To answer this question, this essay presents the case study of a rhinoceros horn amulet (qarn al-khartit), an ethnographic object collected by the British anthropologist Winifred Blackman during her fieldwork in Egypt in the late 1920s. Markedly decentering the traditional colonial history of how the rhinoceros horn was collected and displayed as an object in European museums, the essay follows the trail of the rhinoceros horn back to the site of its collection in Egypt to reveal a strikingly different story: one of non-Western histories of science/magic/medicine, gender, race, and enslavement, all set against the backdrop of Egypt's imperial pursuits in East Africa. The essay proposes the method of decolonial materialism to "read" objects, like the rhinoceros horn, as archives of scientific knowledge otherwise. [ABSTRACT FROM AUTHOR]

Sports‐related concussions (SRCs) are associated with neuromuscular control deficits in athletes following return to play. However, the connection between SRC and potentially disrupted neural regulation of lower extremity motor control has not been investigated. The purpose of this study was to investigate brain activity and connectivity during a functional magnetic resonance imaging (fMRI) lower extremity motor control task (bilateral leg press) in female adolescent athletes with a history of SRC. Nineteen female adolescent athletes with a history of SRC and nineteen uninjured (without a history of SRC) age‐ and sport‐matched control athletes participated in this study. Athletes with a history of SRC exhibited less neural activity in the left inferior parietal lobule/supramarginal gyrus (IPL) during the bilateral leg press compared to matched controls. Based upon signal change detected in the brain activity analysis, a 6 mm region of interest (seed) was defined to perform secondary connectivity analyses using psychophysiological interaction (PPI) analyses. During the motor control task, the left IPL (seed) was significantly connected to the right posterior cingulate gyrus/precuneus cortex and right IPL for athletes with a history of SRC. The left IPL was significantly connected to the left primary motor cortex (M1) and primary somatosensory cortex (S1), right inferior temporal gyrus, and right S1 for matched controls. Altered neural activity in brain regions important for sensorimotor integration and motor attention, combined with unique connectivity to regions responsible for attentional, cognitive, and proprioceptive processing, indicate compensatory neural mechanisms may underlie the lingering neuromuscular control deficits associated with SRC. Our research provides a new perspective on motor control alterations in female adolescent athletes with a history of sports‐related concussion (SRC), by identifying neural alterations via functional magnetic resonance imaging during lower extremity movement. This work complements previous evidence of neuromuscular control impairments in athletes following a concussion and identifies a potential underlying mechanism for lower extremity injury risk in female adolescent athletes with a history of SRC. [ABSTRACT FROM AUTHOR]

Improved oxidation kinetics for a polycrystalline Ni-based superalloy used in turbine disc applications has been shown to be possible by controlling the heating rate of the first thermal exposure to 5 °C min−1. The beneficial effect arises from the formation of a protective layer of NiCr2O4, instead of the more usually formed doped Cr2O3. This study shows that it was possible to form the NiCr2O4 at temperatures up to 725 °C, within the operational conditions for this alloy, and that at higher temperatures Cr2O3 formed. The improvements in alloy performance extended to the internal oxidation processes where reduced depths of degradation were observed. It is demonstrated here that Al2O3 formation is less thermodynamically stable when the highly protective NiCr2O4 oxide is present at the alloy surface compared to the doped Cr2O3. Synchrotron XRD was performed on samples removed during the heating stage and provided evidence of the oxidation sequence occurring, enabling refinement in the thermodynamic calculations and suggesting an additional route to the formation of the NiCr2O4. [ABSTRACT FROM AUTHOR]

Cardiac magnetic resonance (CMR) incorporates a field of view that has the potential to capture clinically relevant extracardiac findings (ECF); however, there has been minimal investigation of ECF prevalence in children's hospitals, where the patient population varies in age and diagnosis. We retrospectively reviewed consecutive, clinically indicated, CMR studies performed at a tertiary care children's hospital during a 1-year period from January 1 to December 31, 2019. ECFs were classified as significant or non-significant based on whether they were described in the final impression of the CMR report. A total of 851 distinct patients had a CMR study during the 1-year period. Mean age was 19.5 (range 0.2; 74.2) years. A total of 254 ECFs were present in 158 of the 851 studies (18.6%) with 9.8% of all studies having significant ECFs. A total of 40.2% of ECFs were previously unknown and 9.1% (23/254) of ECFs included further recommendations (2.1% of all studies). ECFs were most often found in the chest (48%) or abdomen/pelvis (46%). Three patients were incidentally found to have malignancy (renal cell, thyroid, and hepatocellular carcinoma). Comparing studies with significant ECFs to the group without, CMR indications for biventricular CHD (43% vs 31%, p = 0.036), single ventricle CHD (12% vs 3.9%, p = 0.002), and aortopathy/vasculopathy (16% vs 7.6%, p = 0.020) were more common. The odds of significant ECF increased with increasing age (OR 1.82, 95% CI 1.10–3.01) and increased most notably between ages 14 to 33 years old. Recognition of the high percentage of ECFs remains important for timely diagnosis of these incidental findings. [ABSTRACT FROM AUTHOR]

Next, child illness appraisals were examined as predictors of caregiver perceptions of FA management and burden to better understand how child perceptions of their FA may impact caregiver outcomes. FA reactions can include a range of symptoms and families are often recommended to avoid the food allergen to manage the illness.[1] FA burden is defined as caregivers' perceived strain and difficulties due to their child's FA. Caregiver-child dyads reported similar perceptions of illness uncertainty and illness intrusiveness, but not illness stigma. After controlling for child age, regression results indicated that child perceptions of important cognitive illness appraisals (i.e., FA-related stigma, illness uncertainty and illness intrusiveness) were unrelated to illness-related management or burden that is experienced by caregivers. [Extracted from the article]

Rectal small cell carcinoma is a rare and aggressive cancer subtype for which a consensus of optimal treatment has not yet been reached. This cancer presents a difficult surgical problem, and thus, the mainstay of treatment tends to mirror that of small cell carcinoma of the lung (chemotherapy, radiation therapy, and immune modulators). This brief report highlights current treatment options available for this rare and difficult entity. There is a significant need for large-center clinical trials and prospective studies to help determine the best treatment regimen to effectively care for patients with small cell carcinoma of the rectum. [ABSTRACT FROM AUTHOR]

The book "Woman between Two Kingdoms: Dara Rasami and the Making of Modern Thailand" by Leslie Castro-Woodhouse explores the formation of modern Thailand through the lens of Dara Rasami, a consort to King Chulalongkorn and daughter of the king of Chiang Mai. The author highlights the often overlooked role of women and those on the peripheries of the nation-state in Thai history. The book delves into Dara's political influence, her role as a hostage and diplomat, and her promotion of "northern" culture. It also examines the legacy of Dara in Chiang Mai and the political implications of her actions. The conclusion reflects on the demise of polygyny and the continued importance of women in embodying identity in post-1932 Siam. Overall, the book provides a nuanced understanding of modernity, nation, and identity in Thailand and Southeast Asia. [Extracted from the article]

Background: Type 1 diabetes mellitus (T1DM) is a lifelong diagnosis that involves immune-mediated damage of pancreatic beta cells and subsequent hyperglycemia, manifesting as: polyuria, polydipsia, polyphagia, and weight loss. Treatment of type 1 diabetes centers on insulin administration to replace or supplement the body's own insulin with the goal of achieving euglycemia and preventing or minimizing complications. Patients with T1DM are at risk for developing other autoimmune conditions, most commonly thyroid or celiac disease. Case presentation: A 20-year-old African American female with T1DM was referred by her endocrinologist to pediatric gastroenterology for 2 months of nocturnal, non-bloody diarrhea, left lower quadrant pain, and nausea; she was also being followed by neurology for complaints of lower extremity paresthesias and pain. The patient's initial lab-workup was remarkable for a low total Immunoglobulin A (IgA) level of < 6.7 mg/dL. As IgA deficiency is associated with an increased risk of celiac disease, the patient underwent upper and lower endoscopy, which was grossly unremarkable; however, histology revealed a pattern consistent with autoimmune gastritis. Subsequent serum evaluation was remarkable for an elevated fasting gastrin level and an elevated parietal cell antibody level without macrocytic anemia, iron deficiency, or vitamin B12 depletion. The patient was diagnosed with autoimmune gastritis (AIG) and subsequently initiated on parenteral B12 supplementation therapy with improvement in her neurologic and gastrointestinal symptoms. Conclusion: This case illustrates the importance of recognition of red flag findings in a patient with known autoimmune disease. Following well-established health maintenance recommendations for individuals with T1DM ensures that common comorbidities will be detected. Autoimmune gastritis, while a rarer pathology in the pediatric population, deserves consideration in patients with pre-existing autoimmune conditions and new gastrointestinal or neurologic symptoms, as AIG can be associated with poor outcomes and risk of malignancy. Initial lab findings associated with an eventual diagnosis of AIG typically include anemia, iron deficiency, or Vitamin B12 deficiency. However, as demonstrated in this case, symptoms of AIG can rarely present before anemia or Vitamin B12 deficiency develops. To prevent permanent neurological damage, parenteral Vitamin B12 therapy must be considered even in the absence of Vitamin B12 deficiency, especially in those patients already experiencing neurological symptoms. [ABSTRACT FROM AUTHOR]

Abstract Objective: Investigate the sleep hygiene and quality of emerging adults with a CMC compared to healthy peers as well as potential predictors of sleep quality. Participants: College students with and without a CMC (n = 137 per group; aged 18–23 years) at a Midwestern university. Methods: Participants reported on anxious and depressive symptoms, sleep quality, sleep hygiene, and illness uncertainty. Results: College students with a CMC reported poorer sleep quality (Adolescent Sleep Quality Scale-Revised) and hygiene (Adolescent Sleep Hygiene Scale-Revised) than the non-CMC group. The indirect effect of internalizing symptoms on sleep quality via cognitive-emotional arousal was only significant in the CMC. Illness uncertainty demonstrated a significant indirect effect on sleep quality though the consecutive influence of internalizing symptoms and cognitive-emotional arousal. Conclusions: Emerging adults with CMCs may experience poorer sleep outcomes than peers. Illness uncertainty, internalizing symptoms, and cognitive-emotional arousal appear relevant to sleep outcomes, suggesting clinical implications for these constructs. [ABSTRACT FROM AUTHOR]

In the United States, venous thromboembolisms (VTE) and acute coronary syndrome (ACS) are significant causes of morbidity and mortality. Anticoagulant medicines, such as heparin, are often indicated to stop or prevent clot formation, and early administration of heparin has been associated with reduced mortality. There is no literature evaluating whether administration of heparin is expedited when pharmacists are involved in patient care in the emergency department (ED). The purpose of this study was to determine whether the presence of an ED pharmacist decreased time to heparin administration for patients with VTE or ACS. This study was approved by the institutional review board at the Sisters of Charity of Leavenworth (SCL) Health Institutional Review Board (reference number: 2021‐047). This retrospective cohort analysis evaluated patients who presented to the ED between 1 January 2019 and 30 May 2022 and received an order for unfractionated heparin with a confirmed diagnosis of VTE or ACS. The chi‐square test and Wilcoxon ranked‐sum test were used to detect differences between groups. A total of 65 patients were included in the analyses. Comparison of the median time between order and administration of heparin revealed that patients with an order placed while a pharmacist was present in the ED received heparin sooner than patients without an ED pharmacist present (32 min vs 50 min, p = 0.02). Time to administration of heparin was significantly shorter when a pharmacist was present in the ED at the time the order was placed by the care team. Findings suggest that the presence of an ED pharmacist expedites time to heparin administration. [ABSTRACT FROM AUTHOR]

OBJECTIVE: While continuous glucose monitors (CGMs), insulin pumps, and hybrid closed-loop (HCL) systems each improve glycemic control in type 1 diabetes, it is unclear how the use of these technologies impacts real-world pediatric care. RESEARCH DESIGN AND METHODS: We found 1,455 patients aged <22 years, with type 1 diabetes duration >3 months, and who had data from a single center in between both 2016–2017 (n = 2,827) and 2020–2021 (n = 2,731). Patients were grouped by multiple daily injections or insulin pump, with or without an HCL system, and using a blood glucose monitor or CGM. Glycemic control was compared using linear mixed-effects models adjusting for age, diabetes duration, and race/ethnicity. RESULTS: CGM use increased from 32.9 to 75.3%, and HCL use increased from 0.3 to 27.9%. Overall A1C decreased from 8.9 to 8.6% (P < 0.0001). CONCLUSIONS: Adoption of CGM and HCL was associated with decreased A1C, suggesting promotion of these technologies may yield glycemic benefits. [ABSTRACT FROM AUTHOR]

Recent research has demonstrated the many benefits of human-animal interaction through traditional modalities, such as service dogs and pets, to more recent initiatives designated as Animal-Assisted Interventions (AAIs). AAIs are quite varied ranging in setting--educational, therapeutic, residential; as well as process--group vs individual, and ongoing vs single dose. Even a single dose of Animal-Assisted Activities (AAAs) has been shown to provide relief from anxiety and stress. Individuals recovering from substance abuse often experience stress and anxiety associated with social isolation and difficulty with self-regulation. A residential facility for men in recovery introduced an AAA to help alleviate anxiety. In 2 of 3 separate sessions a comparison of pre and post measures showed a significant reduction in state anxiety. The success of the program is further reflected in its continuation as well as the enthusiasm of staff and participants. Step-by-step suggestions are provided for facilities interested in implementing AAAs. [ABSTRACT FROM AUTHOR]

The article discusses the prevalence of disability among different occupation groups in the U.S. It highlights that in 2020, approximately 21.5 million employed adults in the U.S. had some form of disability, It examines the prevalence of disability by occupation group, using data from 35 states and Guam, and It identifies three major occupation groups with the highest adjusted disability prevalences including food preparation.