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Context: Contusion and soft tissue injuries are common in sports. Photobiomodultion, light and laser therapy, is an effective aid to increase healing rates and improve function after various injury mechanisms. However, it is unclear how well photobiomodulation improves function after a contusion soft tissue injury. This study aimed to determine the effects of a pulsed red and blue photobiomodulation light patch on muscle function following a human thigh contusion injury. Design: Single-blinded randomized control trial design. Methods: We enrolled 46 healthy participants. Participants completed 5 visits on consecutive days. On the first visit, participants completed a baseline isokinetic quadriceps strength testing protocol at 60°/s and 180°/s. On the second visit, participants were struck in the rectus femoris of the anterior thigh with a tennis ball from a serving machine. Immediately following, participants were treated for 30 minutes with an active or placebo photobiomodulation patch (CareWear light patch system, CareWear Corp). Following the treatment, participants completed the same isokinetic quadriceps strength testing protocol. Participants completed the treatment and isokinetic quadriceps strength test during the following daily visits. We normalized the data by calculating the percent change from baseline. We used a mixed model analysis of covariance, with sex as a covariate, to determine the difference between treatment groups throughout the acute recovery process. Results: We found the active photobiomodulation treatment significantly increased over the placebo group, quadriceps peak torque during the 180°/s test (P =.030), and average power during both the 60°/s (P =.041) and 180°/s (P ≤.001) assessments. The mean peak torque and average power of 180°/s, at day 4, exceeded the baseline levels by 8.9% and 16.8%, respectively. Conclusions: The red and blue photobiomodulation light patch improved muscle strength and power during the acute healing phase of a human thigh contusion injury model. [ABSTRACT FROM AUTHOR]

Introduction: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of myocardial infarction. Migraine headache has been reported to be common among patients with SCAD, but the degree of migraine-related disability has not been quantified. Methods: Clinical data and headache variables were obtained from the baseline assessment of the prospective, multicenter iSCAD Registry. Migraine-related disability was quantified using the self-reported Migraine Disability Assessment (MIDAS). Demographic, clinical, psychosocial, and medical characteristics from data entry forms were compared between patients with and without migraine. Results: Of the 773 patients with available data, 46% reported previous or current migraines. Those with migraines were more likely to be women (96.9% vs 90.3%, p = 0.0003). The presence of underlying carotid fibromuscular dysplasia was associated with migraine (35% vs 27%, p = 0.0175). There was not a significant association with carotid artery dissection and migraine. Current migraine frequency was less than monthly (58%), monthly (24%), weekly (16%), and daily (3%). Triptan use was reported in 32.5% of patients, and 17.5% used daily migraine prophylactic medications. Using the MIDAS to quantify disability related to migraine, 60.2% reported little or no disability, 14.4% mild, 12.7% moderate, and 12.7% severe. The mean MIDAS score was 9.9 (mild to moderate disability). Patients with SCAD had higher rates of depression and anxiety (28.2% vs 17.7% [ p = 0.0004] and 35.3% vs 26.7% [ p = 0.0099], respectively). Conclusions: Migraines are common, frequent, and a source of disability in patients with SCAD. The association between female sex, anxiety, and depression may provide some insight for potential treatment modalities. [ABSTRACT FROM AUTHOR]

Background: Type 1 diabetes, an autoimmune disorder leading to the destruction of pancreatic β-cells, requires lifelong insulin therapy. Islet transplantation offers a promising solution but faces challenges such as limited availability and the need for immunosuppression. Induced pluripotent stem cells (iPSCs) provide a potential alternative source of functional β-cells and have the capability for large-scale production. However, current differentiation protocols, predominantly conducted in hybrid or 2D settings, lack scalability and optimal conditions for suspension culture. Methods: We examined a range of bioreactor scaleup process parameters and quality target product profiles that might affect the differentiation process. This investigation was conducted using an optimized High Dimensional Design of Experiments (HD-DoE) protocol designed for scalability and implemented in 0.5L (PBS-0.5 Mini) vertical wheel bioreactors. Results: A three stage suspension manufacturing process is developed, transitioning from adherent to suspension culture, with TB2 media supporting iPSC growth during scaling. Stage-wise optimization approaches and extended differentiation times are used to enhance marker expression and maturation of iPSC-derived islet-like clusters. Continuous bioreactor runs were used to study nutrient and growth limitations and impact on differentiation. The continuous bioreactors were compared to a Control media change bioreactor showing metabolic shifts and a more β-cell-like differentiation profile. Cryopreserved aggregates harvested from the runs were recovered and showed maintenance of viability and insulin secretion capacity post-recovery, indicating their potential for storage and future transplantation therapies. Conclusion: This study demonstrated that stage time increase and limited media replenishing with lactate accumulation can increase the differentiation capacity of insulin producing cells cultured in a large-scale suspension environment. [ABSTRACT FROM AUTHOR]

Background: Type 1 diabetes, an autoimmune disorder leading to the destruction of pancreatic β-cells, requires lifelong insulin therapy. Islet transplantation offers a promising solution but faces challenges such as limited availability and the need for immunosuppression. Induced pluripotent stem cells (iPSCs) provide a potential alternative source of functional β-cells and have the capability for large-scale production. However, current differentiation protocols, predominantly conducted in hybrid or 2D settings, lack scalability and optimal conditions for suspension culture. Methods: We examined a range of bioreactor scaleup process parameters and quality target product profiles that might affect the differentiation process. This investigation was conducted using an optimized High Dimensional Design of Experiments (HD-DoE) protocol designed for scalability and implemented in 0.5L (PBS-0.5 Mini) vertical wheel bioreactors. Results: A three stage suspension manufacturing process is developed, transitioning from adherent to suspension culture, with TB2 media supporting iPSC growth during scaling. Stage-wise optimization approaches and extended differentiation times are used to enhance marker expression and maturation of iPSC-derived islet-like clusters. Continuous bioreactor runs were used to study nutrient and growth limitations and impact on differentiation. The continuous bioreactors were compared to a Control media change bioreactor showing metabolic shifts and a more β-cell-like differentiation profile. Cryopreserved aggregates harvested from the runs were recovered and showed maintenance of viability and insulin secretion capacity post-recovery, indicating their potential for storage and future transplantation therapies. Conclusion: This study demonstrated that stage time increase and limited media replenishing with lactate accumulation can increase the differentiation capacity of insulin producing cells cultured in a large-scale suspension environment. [ABSTRACT FROM AUTHOR]

Around midnight on 1/2 November 2023, Jersey (Channel Islands) was impacted by a supercell storm which produced both a tornado, rated T6/IF3, and very large hail. This article presents details of that remarkable hailstorm and places it into context by investigating severe hail events during the October–March cool season in the UK and Crown Dependencies of Jersey, Guernsey, and the Isle of Man. The storm is compared to previous ‘dual‐hazard’ events during the cool season, where both a tornado and severe hail were produced. [ABSTRACT FROM AUTHOR]

Background and Aims Freshwater nitrogen inputs are increasing globally, altering the structure and function of wetland ecosystems adapted to low nutrient conditions. Carnivorous wetland plants of the genus Utricularia are hypothesized to reduce their reliance on carnivory and increase their assimilation of environmental nutrients when the supply of ambient nutrients increases. Despite success in using stable isotope approaches to quantify carnivory of terrestrial carnivorous plants, quantifying carnivory of aquatic Utricularia requires improvement. Methods We developed stable isotope mixing models to quantify aquatic plant carnivory and used these models to measure dietary changes of three Utricularia species, Utricularia australis , U. gibba and U. uliginosa , in 11 wetlands across a 794-km gradient in eastern Australia. Diet was assessed using multiple models that compared variations in the natural-abundance nitrogen isotope composition (δ15N) of Utricularia spp. with that of non-carnivorous plants, and environmental and carnivorous nitrogen sources. Key Results Carnivory supplied 40–100 % of plant nitrogen. The lowest carnivory rates coincided with the highest availability of ammonium and dissolved organic carbon. Conclusions Our findings suggest that Utricularia populations may adapt to high nutrient environments by shifting away from energetically costly carnivory. This has implications for species conservation as anthropogenic impacts continue to affect global wetland ecosystems. [ABSTRACT FROM AUTHOR]

Background: Identifying priority challenges of older adults with chronic obstructive pulmonary disease (COPD) is critical to designing interventions aimed at improving their well‐being and independence. Objective: To prioritize challenges of older adults with COPD and those who care for them to guide refinement of a telephonic nurse coach intervention for patients with COPD and their family caregivers (EPIC: Empowering People to Independence in COPD). Design: Multiphase study guided by Baltes Theory of Successful Aging and the 5Ms Framework: Phase 1: Nominal group technique (NGT), a structured process of prioritizing responses to a question through group consensus. Phase 2: Rapid qualitative analysis. Phase 3: Intervention mapping and refinement. Setting: Ambulatory, virtual. Participants: Older adults with COPD, family caregivers, clinic staff (nurses, respiratory therapists), clinicians (physicians, nurse practitioners), and health system leaders. Results: NGT sessions were conducted by constituency group with 37 participants (n = 7 patients, n = 6 family caregivers, n = 8 clinic staff, n = 9 clinicians, n = 7 health system leaders) (Phase 1). Participants generated 92 statements across five themes (Phase 2): (1) "Barriers to care", (2) "Family caregiver needs", (3) "Functional status and mobility issues", (4) "Illness understanding", and (5) "COPD care complexities". Supplemental oxygen challenges emerged as a critical problem, and prioritized challenges differed by group. Patients and clinic staff prioritized "Functional status and mobility issues", family caregivers prioritized "Family caregiver needs", and clinicians and health system leaders prioritized "COPD care complexities". Intervention mapping (Phase 3) guided EPIC refinement focused on meeting patient priorities of independence and mobility but accounting for all priorities. Conclusions: Diverse constituency groups identified priority challenges for older adults with COPD. Functional status and mobility issues, particularly related to supplemental oxygen, emerged as patient prioritized challenges. Implications: Patient‐centered interventions for older adults with COPD must account for their prioritized functional and supplemental oxygen needs and explore diverse constituent perspectives to facilitate intervention enrichment. [ABSTRACT FROM AUTHOR]

Introduction: Given the increasing incidence of chronic degenerative diseases related to changes in tissues, the availability of diagnostic tools with greater accuracy in the estimation of body composition (BC) has become necessary. Interpreting the BC values of individuals requires reference data obtained from a healthy population with the same ethnicity, to identify individuals at risk for the development of negative health outcomes. Objective: Generate reference values (RV) of body composition (BC) for Mexican children and adolescents. Methods: This was an urban-population-based cross-sectional study of healthy Mexican children and adolescents. BC estimations by anthropometry, multifrequency bioimpedance analysis (MF-BIA) and dual-energy X-ray absorptiometry (DXA) where used to create sex- and age-specific RV by means of generalized additive models for location, scale and shape (GAMLSS). Results: We assessed 2104 subjects, and after confirming a clinically and metabolically healthy status, we measured 1659 subjects aged 5–20 years, [806 females (49%) and 853 males (51%)] by anthropometry, MF-BIA and DXA to create sex- and age- smoothed reference centiles, lambda (L), mu (M), and sigma (S) values. We also built sex- and age-smoothed graphic curves for each variable of interest. Conclusions: We present valid RV and curves for BC variables estimated by anthropometry, MF-BIA and DXA from clinically and metabolically healthy urban Mexican children and adolescents. These RV are different from those reported for other populations, and therefore, should be used for clinical and research purposes involving urban Mexican children and adolescents. [ABSTRACT FROM AUTHOR]

Following the Grand Bargain, there has been increasing focus on aid localisation and partnerships between international and local aid agencies. Yet there has been less scholarly attention on how and why international agency policies and partnerships can cause unintended harm to civil society organisations and their staff. Drawing on James Scott's seminal work Seeing like a State, and interviews with Myanmar civil society organisation leaders in 2023, this article argues that international agencies often attempt to render civil society "legible" through processes of systematisation and codification. However, these processes can in turn sideline accrued experiential and contextual knowledge, or metis, which is necessary for local organisations' survival, especially in times of instability. The article highlights several instances in Myanmar where the marginalisation of this more contextual knowledge results in unintended harms. The article concludes that international agencies' acknowledgement of metis is a crucial and yet still under-recognised pillar of aid localisation. [ABSTRACT FROM AUTHOR]

Background: Neuroendocrine tumors (NET) constitute a heterogeneous group of malignancies whose incidence has been on the rise over the past two decades, currently documented at 5.25 per 100,000. Liver metastasis develops in over 60% of NET patients. Even after resection recurrence rates are high, underscoring the importance of parenchymal-sparing interventions. In this study, we conducted 105 surgical microwave ablations and examined outcomes related to survival and local recurrence. Methods: Retrospective review of patients who underwent a surgical microwave ablation (MWA) at a single-center, high-volume institution from September 2007 through December 2022 using a prospective database. Primary outcome was overall survival. Results: A total of 105 operations were performed on 94 patients, with 397 tumors undergoing MWA. Median tumor size was 1.3 cm (range 0.3–8.0), and the median number of tumors ablated was 2 (range 1–12). Laparoscopic approach was utilized 69.5% of the time. The most common concomitant procedure performed was hepatectomy (33.3%) and cholecystectomy (23.8%). Clavien–Dindo grade III or IV complications occurred in 9 patients (9.6%). Mortality within 30 days occurred in 1 patient (1.1%). The rate of incomplete ablation was 0.3% per tumor. Local recurrence occurred in 2.8% of tumors. Median OS was 9.43 years [95% CI 4.23–14.63 years], with a 5- and 10-year survival probability of 70.2% and 48.2%, respectively. Conclusion: Surgical MWA offers an efficacious, parenchymal-sparing treatment of hepatic metastasis of NET, with low rates of incomplete ablation and local recurrence per tumor. [ABSTRACT FROM AUTHOR]

Computational models are powerful tools to quantify physical phenomena to gain valuable insights into a manufacturing process. Their accuracy is hindered, however, by uncertainty in the input data. Furthermore, when calibrating models with plant measurements, it helps to understand which variables have greatest effect on the critical model outputs. This work applies uncertainty quantification and sensitivity analysis to determine the most influential input parameters in the CON1D model of heat transfer and solidification in steel continuous casting with slag. Results show that the slag rim greatly affects heat flux near the meniscus, so control of its size is important. Heat flux and temperature down the mold depend greatly on velocity of the solid slag layer, and slag solidification temperature, which control the slag layer thickness, which in turn affects the interfacial resistance that controls heat transfer in the process. Scale formation on the mold coldface greatly increases mold temperatures. Based on the results presented here, models of heat transfer in continuous casting such as CON1D would benefit from plant measurements such as slag rim size and solid slag velocity, and lab measurements such as slag viscosity at lower temperatures, to better characterize this important slag property. [ABSTRACT FROM AUTHOR]

AbstractIntroductionObjectiveMethodsResultsConclusion\nCONTRIBUTIONS OF PAPERHealthcare requires new technologies to deliver hybrid services. Before embedding health-delivery transformations including physiotherapy in asthma clinics, it is essential to give young people and their carers a voice to facilitate co-designing of services.To co-design hybrid telehealth physiotherapy services and online resources for, and in partnership with, young people with asthma and dysfunctional breathing, and their families.Experience based co-design study undertaken at a specialist paediatric difficult asthma clinic, including online service user focus groups and electronic questionnaires for service providers. Eight children aged between 11 and 17 years and their families and 11 members of the multi-disciplinary team (MDT) managing children with difficult asthma were recruited purposively.A series of seven online videos were created, topics included: how to support a breathless child, education on how we breathe, breathing patterns, symptom differentiation, breathlessness, rescue breathing techniques, and exercise. Each video has downloadable resources. Five children and four parents wrote blogs to share their experiences. A live online 12-week physiotherapy program was developed on a web-based platform www.beamfeelgood.com called Asthma Kids.Co-design enabled partnership working to develop hybrid telehealth physiotherapy services and prototype interventions to support home practice for children with asthma and dysfunctional breathing.Service provider and service user insight into experiences of using digital healthcare technologies.Novel co-designed physiotherapy-based 12-week program of interventions for children and young people with asthma and dysfunctional breathing.Novel co-designed online resources to support physiotherapy home practice for children and young people with asthma and dysfunctional breathing.Service provider and service user insight into experiences of using digital healthcare technologies.Novel co-designed physiotherapy-based 12-week program of interventions for children and young people with asthma and dysfunctional breathing.Novel co-designed online resources to support physiotherapy home practice for children and young people with asthma and dysfunctional breathing. [ABSTRACT FROM AUTHOR]

Background: Australia's clinical trials sector is highly productive with continued sector investment needed to enhance research impact. Generating economic evidence alongside trials has the potential to facilitate the implementation of trial results into practice. Ascertaining the use of health economic evaluations alongside clinical trials can assist in determining whether clinical trials fully realize and operationalize their potential to change policy and practice. The aims of this study were to ascertain the uptake of health economic evaluations alongside Australian-led clinical trials and explore associations between uptake and trial characteristics. Methods: This observational study comprised a descriptive analysis of clinical trials registries, a cross-sectional survey of Australian Clinical Trials Alliance (ACTA) networks, and a subgroup analysis of completed acute care trials. Descriptive analyses of trial registrations were conducted, with logistic regressions used to identify predictors of proposing and subsequently publishing a health economic evaluation alongside acute care trials. Results: Few randomized Australian-led clinical trials (11% of 9251) and ACTA network trials (43% of 227) proposed a health economic evaluation. In the subgroup analysis, 22% of the 324 acute care trials and 53% of the 38 ACTA network acute care trials proposed a health economic evaluation. Acute care trials funded by government bodies were significantly more likely to propose and publish a health economic evaluation than those funded by hospitals, universities, and other funders, after adjusting for phase, registration year, primary sponsor type, and comparator. Conclusions: Current uptake of health economic evaluations alongside Australian-led clinical trials is low, with uptake higher among the subset of ACTA network trials. This is despite economic evidence playing an increasingly prominent role in health system management, as well as rising health expenditure, limited budgets, and competing demands. There is significant opportunity to embed health economic evaluations alongside clinical trials, particularly phase 3 trials, to increase research outputs and optimize research translation. Investing in clinical trial networks that support funding for a health economist or a health economic evaluation may be an effective strategy to increase the uptake of health economic evaluations alongside trials. [ABSTRACT FROM AUTHOR]

We present a sensor that utilizes a modified single-frequency split beam metasurface reflector to measure the refractive index of materials ranging from one to three. Samples are placed into a cavity between a PCB-etched dielectric and a reflecting ground plane. It is illuminated using a 10.525 GHz free-space transmit horn with reflecting angles measured by sweeping a receiving horn around the setup. Predetermined changes in measured angles determined through simulations will coincide with the material's index. The sensor is designed using the Fourier transform method of array synthesis and verified with FEM simulations. The device is fabricated using PCB milling and 3D printing. The quality of the sensor is verified by characterizing 3D printed dielectric samples of various infill percentages and thicknesses. Without changing the metasurface design, the sensing performance is extended to accommodate larger sample thicknesses by including a modified 3D printed fish-eye lens mounted in front of the beam splitter; this helps to exaggerate changes in reflected angles for those samples. All the methods presented are in agreement and verified with single-frequency index measurements using Snell's law. This device may offer a viable alternative to traditional index characterization methods, which often require large sample sizes for single-frequency measurements or expensive equipment for multi-frequency parameter extraction. [ABSTRACT FROM AUTHOR]

Thermoplastic elastomers (TPEs) based on styrenic block copolymers constitute excellent examples of self‐networking macromolecules that are employed in a wide range of contemporary technologies as molded parts. In such applications, these TPEs exist as dense (nonporous) films or other shapes. Here, it is first demonstrated that a series of commercial TPEs possessing comparable compositions can be electrospun from solution to form microfibers that are arranged into nonwoven mats that are breathable. An important consideration for microfiber formation is the copolymer molecular weight, which regulates i) the viscosity of the parent solution prior to electrospinning, ii) the ability of these copolymers to self‐assemble during electrospinning, iii) the microfiber morphology, and iv) the mechanical properties of the resultant microfibers. The addition of a midblock‐selective aliphatic oil to these TPEs yields thermoplastic elastomer gels (TPEGs), wherein the copolymer morphology and mechanical properties become highly composition‐tunable. Electrospinning TPEGs from a binary oil+solvent solution introduces a micelle inversion mechanism that begins with an oil‐rich micellar core and ends with a styrene‐rich micellar core, required for network stabilization, as the solvent dries during microfiber solidification. This work has implications for the production of controllably low‐modulus microfibrous materials possessing modestly improved toughness but exceptional extensibility and enhanced optical transparency. [ABSTRACT FROM AUTHOR]

This paper discusses the opportunities and policy levers to increase the use of low-temperature geothermal resources in New Zealand for decarbonising primary industries, in particular, covered crops. Geothermal heat (geoheat) is a local, reliable, resilient and sustainable energy source. Low-temperature geothermal energy (220°C) is available in the Taupō Volcanic Zone with low awareness of the nationwide availability of lower temperature resources. Covered crop growers in New Zealand, needing to decarbonise their operations, are investigating the potential of utilising geoheat, following the example of the Netherlands. The Netherlands has strategically invested in low-temperature geothermal energy, utilising 80 °C water resources, from ∼ 2 to 3 km below the surface to heat greenhouses. Internationally, risk mitigation schemes and insurance programmes have proven pivotal policy instruments for fostering geothermal adoption. This paper discusses the opportunities that the adoption of using low-temperature geothermal provides to New Zealand drawing upon successful models from other countries. [ABSTRACT FROM AUTHOR]

"La casa inundada" (1960) presents a peculiar, meditative, and uncanny short story by the Uruguayan writer, Felisberto Hernández. The story is narrated via the memories (and the male fantasies) of a writer who once took on the odd job of rowing a large woman around the inside of her flooded house day after day in a small boat. Throughout most of the story, the woman, Margarita, remains a mystery to the narrator and to the reader, as do the reasons for her taciturn disposition and for having purposefully flooded her own house. In this article, rather than rescue what is unknown so that the mysterious woman's apparent '"dirty little secret'" can be recovered from the swell, I explore the ontological, epistemological, and affective attributes of water itself. In so doing, I build on Felisberto's expanding bibliography, calling particular attention to his understudied motifs of "pereza" and "deslizarse." Unlike most critics of Felisberto, I utilize concepts that both come from and critique psychoanalysis; additionally, the underappreciated theories of Gaston Bachelard regarding water as a "true mother substance" serve as a vital source of theoretical interpretation. In the course of Felisberto's story, the narrator comes to believe that, for the motherly—and tantalizing—character of Margarita, "lo que más quería [ella], era comprender el agua." Ultimately, as I demonstrate, "La casa inundada," similarly helps readers to better think, understand, and sense water and its myriad ways. [ABSTRACT FROM AUTHOR]

Background and aims: Young people accessing alcohol and other drug (AOD) treatment experience high rates of treatment disengagement, contributing to poorer outcomes. To improve outcomes, it is important to identify factors associated with treatment retention. This study measured the relationships between client characteristics, treatment characteristics, clinical severity measures and completion of treatment among young people. Design, setting and participants: This study was a retrospective analysis of routinely collected data set in residential‐ and community‐based AOD services in New South Wales, Australia. Routinely collected data from the Network of Alcohol and Other Drug Agencies' (NADA) database were used. Included individuals were aged 10–24 years and accessed treatment between 2012 and 2023 (n = 17 474). Measurements: Variables included client‐related characteristics, service characteristics and baseline measures of clinical severity [Kessler‐10 (K10), EUROHIS–QoL, severity of dependence scale (SDS)]. Multivariable binary logistic regression models assessed the relationships between these characteristics and treatment completion. Findings Rates of treatment completion were highest among adolescents in community‐based treatment (57%) and lowest among young adults in residential treatment (35%). Polysubstance use was negatively associated with treatment completion among adolescents [adjusted odds ratio (adjOR) = 0.71, P < 0.001] and adults (adjOR = 0.70, P < 0.001) in community‐based treatment, and adolescents in residential treatment (adjOR = 0.62, P = 0.006), as was housing insecurity (adolescents in community treatment, adjOR = 0.61, P = 0.001; adults in community treatment, adjOR = 0.77, P = 0.002; adolescents in residential treatment, adjOR = 0.42, P = 0.005). Attending youth‐specific services was associated with higher treatment completion rates among adults in community‐based (adjOR = 1.81, P < 0.001) and residential treatment (adjOR = 1.72, P < 0.001). Varying correlates of treatment completion were identified throughout treatment groups, reflecting the differences in population and/or needs across contexts. Conclusions: In New South Wales, Australia, fewer than half of young people accessing alcohol and other drug treatment between 2012 and 2023 completed treatment, and completion rates were lower among those facing barriers such as polysubstance use and housing insecurity. [ABSTRACT FROM AUTHOR]

ABSTRACT Hepatitis C virus (HCV) elimination requires treatment access expansion, especially for underserved populations. Telehealth has the potential to improve HCV treatment access, although data are limited on its incorporation into standard clinical practice. We conducted a cross‐sectional, email survey of 598 US HCV treatment providers who had valid email addresses and (1) were located in urban areas and had written ≥ 20 prescriptions for HCV treatment to US Medicare beneficiaries in 2019–2020 or (2) were located in non‐urban areas and wrote any HCV prescriptions in 2019–2020. Through email, we notified providers of a self‐administered electronic 28‐item survey of clinical strategies and attitudes about telemedicine for HCV. We received 86 responses (14% response rate), of which 75 used telemedicine for HCV in 2022. Of those 75, 24% were gastroenterologists/hepatologists, 23% general medicine, 17% infectious diseases and 32% non‐physicians. Most (82%) referred patients to commercial laboratories, and 85% had medications delivered directly to patients. Overwhelmingly, respondents (92%) felt that telehealth increases healthcare access, and 76% reported that it promotes or is neutral for treatment completion. Factors believed to be ‘extremely’ or ‘very’ important for telehealth use included patient access to technology (86%); patients' internet access (74%); laboratory access (76%); reimbursement for video visits (74%) and audio‐only visits (66%). Non‐physician licensing and liability statutes were rated ‘extremely’ or ‘very’ important by 43% and 44%, respectively. Providers felt that telehealth increases HCV treatment access. Major limitations were technological requirements, reimbursement, and access to ancillary services. These findings support the importance of digital equity and literacy to achieve HCV elimination goals. [ABSTRACT FROM AUTHOR]

Objectives: With high disease and disability burden in rural and remote regions, student-assisted clinics can be an effective workforce development tool to meet community health needs and workforce shortages. This research sought to identify the conditions under which student-assisted clinics can be successfully utilised as a workforce development strategy, with specific application to remote Queensland, Australia. Methods: A rapid review of the international literature in English was conducted. This was the most appropriate type of review because the results of the review were time-sensitive, with the student-assisted clinic model being trialled in Queensland soon. A mixed methods design was applied, with the search strategy piloted with one database. Results: Eleven studies met the inclusion criteria. Seven reported data on participant experiences, including consumers, students, services/clinics, and educators/supervisors/health professionals. Each of the studies operationalised student-assisted clinics through practice models (university-driven learning need), service delivery models (service driven need addressed through a student workforce), community need models (student delivered services primarily addressing a community health need), and blended models (practice need and community need). Some studies reported concerns about fragmentation of services, referral pathways and issues with follow-up, while others reported concerns about sustainable funding. All models reported successful outcomes when focused on service or consumer health outcomes, or student learning outcomes. Conclusions: Student-assisted clinics make an important contribution to the development of the rural and remote health workforce. Student-assisted clinics can complement and extend existing services, supporting workforce development in an overstretched health system impacted by an ongoing pandemic. [ABSTRACT FROM AUTHOR]

Context. Investigating the flow of material along filamentary structures towards the central core can help provide insights into high-mass star formation and evolution. Aims. Our main motivation is to answer the question of what the properties of accretion flows are in star-forming clusters. We used data from the ALMA Evolutionary Study of High Mass Protocluster Formation in the Galaxy (ALMAGAL) survey to study 100 ALMAGAL regions at a ∼1″ resolution, located between ∼2 and 6 kpc. Methods. Making use of the ALMAGAL ∼1.3 mm line and continuum data, we estimated flow rates onto individual cores. We focus specifically on flow rates along filamentary structures associated with these cores. Our primary analysis is centered around position velocity cuts in H2CO (30, 3–20, 2), which allow us to measure the velocity fields surrounding these cores. Combining this work with column density estimates, we were able to derive the flow rates along the extended filamentary structures associated with cores in these regions. Results. We selected a sample of 100 ALMAGAL regions, covering four evolutionary stages from quiescent to protostellar, young stellar objects (YSOs), and HII regions (25 each). Using a dendrogram and line analysis, we identify a final sample of 182 cores in 87 regions. In this paper, we present 728 flow rates for our sample (4 per core), analysed in the context of evolutionary stage, distance from the core, and core mass. On average, for the whole sample, we derived flow rates on the order of ∼10−4 M⊙ yr−1 with estimated uncertainties of ±50%. We see increasing differences in the values among evolutionary stages, most notably between the less evolved (quiescent and protostellar) and more evolved (YSO and HII region) sources and we also see an increasing trend as we move further away from the centre of these cores. We also find a clear relationship between the calculated flow rates and core masses ∼M2/3, which is in line with the result expected from the tidal-lobe accretion mechanism. The significance of these relationships is tested with Kolmogorov–Smirnov and Mann-Whitney U tests. Conclusions. Overall, we see an increasing trend in the relationships between the flow rate and the three investigated parameters, namely: evolutionary stage, distance from the core, and core mass. [ABSTRACT FROM AUTHOR]

Coronavirus genomes have evolutionary histories shaped extensively by recombination. Yet, how often recombination occurs at a cellular level, or the factors that regulate recombination rates, are poorly understood. Utilizing experimental co-infections with pairs of genetically distinct coronaviruses, we found that recombination is both frequent and rare during coinfection. Recombination occurred in every instance of co-infection yet resulted in relatively few recombinant RNAs. By integrating a discrete-time Susceptible-Infected-Removed (SIR) model, we found that rates of recombination are determined primarily by rates of cellular co-infection, rather than other possible barriers such as RNA compartmentalization. By staggering the order and timing of infection with each virus we also found that rates of co-infection are themselves heavily influenced by genetic and ecological mechanisms, including superinfection exclusion and the relative fitness of competing viruses. Our study highlights recombination as a potent yet regulated force: frequent enough to ensure a steady influx of mutations but also infrequent enough to maintain genomic integrity. As recombination is thought to be an important driver of host-switching and disease emergence, our study provides new insights into the factors that regulate coronavirus recombination and evolution more broadly. Author summary: Recombination is a key driver of coronavirus evolution and disease emergence. However, our understanding of this mechanism or the factors that regulate it is extremely limited. Despite advances in sequencing technology, experimental studies on the frequency and drivers of recombination have been sparse. In fact, this issue hasn't been closely studied in over 30 years. Our study takes a novel look at the factors that influence the rate of coronavirus recombination. By integrating experimental data with mathematical models, we show that the timing and order of viral infections significantly impact recombination rates. These findings shed light on the ecological and cellular dynamics that govern recombination, offering new insights into how coronaviruses evolve and adapt. By understanding the conditions that drive recombination, we can better predict the emergence of new viral strains, which is critical for forecasting spillover events and mitigating future outbreaks. Our study underscores the importance of recombination as a key process in viral evolution and highlights the need for continued research to fully understand its role in disease emergence. [ABSTRACT FROM AUTHOR]

Anger can adversely impact functioning in veterans. Psychological aggression, which is related to but distinct from anger, is particularly detrimental to veterans’ mental health. Research examining anger and psychological aggression following individual therapy for posttraumatic stress disorder (PTSD) has demonstrated small effect sizes. Treatments that directly target conflict management and interpersonal functioning, both regarding content and delivery to veterans and their loved ones (e.g., couples‐based PTSD treatments), may be more effective in alleviating anger symptoms. This study examined whether larger reductions in anger and psychological aggression would be observed in a couples‐based intervention compared to an active comparator at posttreatment and follow‐up. Data were derived from a randomized trial comparing brief cognitive–behavioral conjoint therapy for PTSD (bCBCT) and PTSD family education (PFE). Participants were 137 veterans and their intimate partners (bCBCT: n = 92, PFE: n = 45). We observed within‐condition significant reductions in angry temperament, d = ‐0.47, p < .001, and angry reaction, d = −0.26, p = .004, among veterans in bCBCT but not PFE, |d|s = 0.13–0.17, ps = .166–.268. Veterans and partners in both conditions reported reductions in psychological aggression, |d|s = 1.09–1.46, ps < .001. There were no significant differences between the treatment conditions on any outcome, ps = .103–.443, and there were no significant changes in anger between posttreatment and follow‐up, |d|s = 0.07–0.24, ps = .052–.582. Couples‐based interventions for PTSD, including bCBCT and PFE, can be effective in improving aspects of anger among veterans and their intimate partners. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Location Methods Results Conclusions Changing biodiversity and environmental conditions may allow multi‐host pathogens to spread among host species and affect prevalence. There are several widely acknowledged theories about mechanisms that may influence variation in pathogen prevalence, including the controversially debated dilution effect and abundance‐occupancy relationship hypotheses. Here, we explore such abundance‐occupancy relationships for unique lineages of three vector‐borne avian blood parasite genera (the avian malaria parasite Plasmodium and the related haemosporidian parasites Parahaemoproteus and Leucocytozoon) across biogeographical regions.Nearctic‐Neotropical and Palearctic‐Afrotropical regions.We compiled a cross‐continental dataset of 17,116 bird individuals surveyed from 46 bird assemblages across the Nearctic‐Neotropical and Palearctic‐Afrotropical regions and explored relationships between local parasite lineage prevalence and host assemblage metrics in a Bayesian random regression framework.Most lineages from these three genera infected ≥ 5 host species and exhibited clear phylogenetic or functional host specificity. Lineage prevalence from all three genera increased with host range, but also with higher degrees of specialisation to phylogenetically or functionally related host species. Local avian community features were also found to be important drivers of prevalence. For example, bird species richness was positively correlated with lineage prevalence for Plasmodium and Leucocytozoon, whereas higher relative abundances of the main host species were associated with lower prevalence for Plasmodium and Parahaemoproteus but higher prevalence for Leucocytozoon.Our results broadly support several of the leading hypotheses about mechanisms that influence pathogen prevalence, including the niche breadth hypothesis in that higher avian host species diversity and broader host range amplify prevalence through increasing ecological opportunities and the trade‐off hypotheses in that specialisation among subsets of available host species may increase prevalence. Furthermore, the three studied avian haemosporidian genera exhibited different abundance‐occupancy relationships across the major global climate gradients and in relation to host availability, emphasising that these relationships do not strictly follow common rules for vector‐borne parasites with different life histories. [ABSTRACT FROM AUTHOR]

We assess the UK Biobank (UKB) Polygenic Risk Score (PRS) Release, a set of PRSs for 28 diseases and 25 quantitative traits that has been made available on the individuals in UKB, using a unified pipeline for PRS evaluation. We also release a benchmarking software tool to enable like-for-like performance evaluation for different PRSs for the same disease or trait. Extensive benchmarking shows the PRSs in the UKB Release to outperform a broad set of 76 published PRSs. For many of the diseases and traits we also validate the PRS algorithms in a separate cohort (100,000 Genomes Project). The availability of PRSs for 53 traits on the same set of individuals also allows a systematic assessment of their properties, and the increased power of these PRSs increases the evidence for their potential clinical benefit. [ABSTRACT FROM AUTHOR]

AbstractTypically, students view classroom assessments like tests, exams, reports, and essays as a major stressor in higher education. However, it is also plausible that students have experienced instances in which the purposes, format, and design of classroom assessment actually supports their well-being. We used a qualitative descriptive design to explore students’ experiences of assessment and wellness. Based on thematic analysis, three low-inference themes emerged all of which showed how any given assessment practice can be experienced differently in terms of student well-being. First, students described how tangible assessment practices including types, grading methods, and assessment design were associated with wellness. Second, participants explained how factors related to their professor such as skills and sensitivity to student stress impacted well-being. Third, students described a wide range of systemic factors associated with assessment that nearly unanimously hindered their wellness. Our results imply that well-being in assessment is a psychological experience that depends on the students’ perceptions more so than the exact assessment practice. Based on our results, we recommend that instructors apply psychological principles known to support well-being to high-quality assessment practices to more predictably influence wellness. [ABSTRACT FROM AUTHOR]

An approximately 26‐year‐old, suspected female, red‐tailed hawk (Buteo jamaicensis) was presented with a history of chronic ocular changes of the left eye likely secondary to blunt trauma resulting in blindness and phthisis bulbi. Ophthalmic evaluation of OS revealed a large intraocular mass, 3+ aqueous flare indicating anterior uveitis, and severely decreased intraocular pressure measuring 5 mmHg. Ocular ultrasound revealed an abnormal, spherical shaped and hyperechoic lens, as well as hyperechoic material or a mass lesion in the posterior segment. An enucleation procedure was performed, and histopathology of the eye revealed no signs of neoplasia but instead intraocular osseous metaplasia with bone marrow and adipose tissue replacing the lens. Similar mass lesions were found in the retina and choroid. Multiple fractures in the scleral ossicle and cartilage correlated the intraocular lesions with a blunt traumatic event. A bioresorbable disk of porcine small intestine submucosa (BioSIS Vetrix®) was incorporated to relieve tension during closure. The graft sloughed during healing process, revealing a healed wound underneath. The BioSIS was not incorporated into the wound as designed but may have facilitated healing. This is the first report of intraocular osseous metaplasia in a raptor and the use of BioSIS Vetrix® with enucleation in an avian species. [ABSTRACT FROM AUTHOR]

Understanding biotic interactions is a crucial goal in community ecology and species distribution modelling, and large strides have been made towards improving multivariate computational methods with the aim of quantifying biotic interactions and improving predictions of species occurrence. Yet, while considerable attention has been given to computational approaches and the interpretation of these quantitative tools, the importance of sampling design to reveal these biotic interactions has received little consideration. This study explores the influential role of priority effects, that is, the order of habitat colonisation, in shaping our ability to detect biotic interactions. Using a simple set of simulations, we demonstrate that commonly used cross‐sectional co‐occurrence data alone cannot be used to make reliable inferences on asymmetric biotic interactions, even if they perform well in predicting the occurrence of species. We then show how sampling designs that consider priority effects can recover the asymmetric effects that are lost when priority effects are ignored. Based on these findings, we urge for caution when drawing inferences on biotic interactions from cross‐sectional binary co‐occurrence data, and provide guidance on sampling designs that may provide the necessary data to tackle this longstanding challenge. [ABSTRACT FROM AUTHOR]

Two experiments were conducted to assess the efficiency of including the novel protein ingredient Arthrospira platensis or improved soybean meal in a broiler diet. The first experiment aimed to determine the feeding value of soybean meal produced from varieties of soybeans bred for increased amino acid content (SBAA) and improved oil content (SBO) compared to a conventional soybean variety in an ANOVA design fed to Cobb 500 female broilers for 28–42 d. The SBAA and SBO soybeans contained overall higher amino acid content and lower oligosaccharide content compared to the conventional soybean variety in addition to improved oil quality. The second experiment assessed the novel protein ingredient microalgae, Arthrospira platensis (algae), and was conducted to evaluate algae and corn distillers' grain (DDGS) inclusion on broiler performance for a 28–42 d feeding period in Cobb CF05 male broilers with a 2 × 2 factorial treatment array. Prior to the experimental period, all birds were reared on common feeds. In Experiment 1, birds were fed a diet containing 20% inclusion of an experimental soybean source in the form of full-fat soybean meal. In Experiment 2, the four dietary treatments consisted of diets containing algae at inclusion levels of either 0 or 2% and DDGS at inclusion levels of 0% and 8%. Diets were fed to 288 female broilers (Experiment 1) and 384 male broilers (Experiment 2), placed in eight replicate pens of twelve birds, and live performance was assessed from d 28 to 42. At d 42, six birds from each pen were randomly selected and processed for evaluation of carcass traits and incidence of woody breast. For Experiment 1, all performance data were analyzed using a one-way ANOVA using JMP Pro 16 software with diet as the fixed effect and block as a random effect. Statistical significance was considered at p ≤ 0.05. No significant responses were observed for any recorded measurement for live performance, carcass traits, or woody breast. All data in Experiment 2 were analyzed as a full factorial with a mixed model using JMP software with algae, DDGS, and algae × DDGS as fixed effects and block as a random effect. The F-protected Fisher's LSD test was used to separate means when p ≤ 0.05. No significant responses were observed for the algae, DDGS, and algae × DDGS influences on BWG, FI, and FCR or processing characteristics; the ingredient source did not affect bird performance. Experimental soybean lines developed at the University of Arkansas were able to be incorporated into broiler diets without decreasing performance. Algae has the potential to be a protein-contributing ingredient for broilers. [ABSTRACT FROM AUTHOR]

Background Shared decision-making (SDM) is increasingly expected in healthcare systems prioritising patient autonomy. Treatment escalation plans (TEPs) outline contingency for medical intervention in the event of patient deterioration. This study aimed to understand clinicians' perspectives on SDM in TEP for older patients in the acute medical setting. Methods This was a qualitative study following a constructivist approach. Semistructured interviews with vignettes were conducted with 26 consultant and registrar doctors working in emergency medicine, general internal medicine, intensive care medicine and palliative care medicine. Reflexive thematic analysis was performed. Results There were three themes: 'An unequal partnership', 'Options without equipoise' and 'Decisions with shared understanding'. Clinicians' expertise in synthesising complex, uncertain clinical information was contrasted with perceived patient unfamiliarity with future health planning and medical intervention. There was a strong sense of morality underpinning decision-making and little equipoise about appropriate TEP decisions. Communication around the TEP was important, and clinicians sought control over the high-stakes decision whilst avoiding conflict and achieving shared understanding. Conclusions Clinicians take responsibility for securing a 'good' TEP decision for older patients in the acute medical setting. They synthesise clinical data with implicit ethical reasoning according to their professional predictions of qualitative and quantitative success following medical intervention. SDM is seldom considered a priority for this context. Nonetheless, avoidance of conflict, preserving the clinical relationship and shared understanding with the patient and family are important. [ABSTRACT FROM AUTHOR]

Continuous, ambulatory perioperative monitoring using wearable devices has shown promise for earlier detection of physiological deterioration and postoperative complications, preventing 'failure-to-rescue'. This study aimed to compare the accuracy of vital signs measured by wrist-based wearables with gold standard measurements from vital signs monitors or nurse assessments in major abdominal surgery. Adult patients were eligible for inclusion in this prospective observational study validating the Empatica E4 wrist sensor intraoperatively and postoperatively. The primary outcomes were the 95% limits of agreement (LoA) between manual and device recordings of heart rate (HR) and temperature evaluated via Bland-Altman analysis. Secondary analysis was conducted using Clarke-Error grid analysis. Overall, 31 patients were recruited, and 27 patients completed the study. The median duration of recording per patient was 70.3 h, and a total of 2112 h of data recording were completed. Wrist-based HR measurement was accurate and moderately precise (bias: 0.3 bpm; 95% LoA −15.5 to 17.1), but temperature measurement was neither accurate nor precise (bias −2.2°C; 95% LoA −6.0 to 1.6). On Clarke-Error grid analysis, 74.5% and 29.6% of HR and temperature measurements, respectively, fell within the acceptable range of reference standards. Continuous perioperative monitoring of HR and temperature after major abdominal surgery using wrist-based sensors is feasible but was limited in this study by low precision. While wrist-based devices offer promise for the continuous monitoring of high-risk surgical patients, current technology is inadequate. Ongoing device hardware and software innovation with robust validation is required before such technologies can be routinely adopted in clinical practice. [ABSTRACT FROM AUTHOR]

Drawing on research conducted with platform delivery workers in Washington D.C., this paper builds on the work of scholars committed to both describing and challenging the degrading conditions that so often define the gig economy. Acknowledging the importance of both employee classification and citizenship status to understanding the plight of platform-based migrant workers, this paper directs attention to the distinction that platform companies draw between what counts as work and what counts as waiting. This distinction is not only central to understanding the degrading nature of gig work, but to understanding the logic of what we describe as the fulfilment city – a city organized around the promise and potential of one-click, same day, or even same hour, delivery services. We end by arguing that questions of waiting and fulfillment are important for migration scholars concerned with the formation of 'immigrant counterpublics'. [ABSTRACT FROM AUTHOR]

What kind of writing, criticism and photography theory is needed today? Photographies, since 2008 the leading UK-based theory journal, includes research articles, practice-led photo-essays, and critical debates. Journal editors curate diverse articles to cluster papers that inter-relate. Yet readers search online for single articles or named authors. Should we envisage a future within which editors are redundant? In addition, use of artificial intelligence in partially or entirely generating submissions begs questions relating to anonymous peer review principles but may also herald experiments in generative practices, perhaps in the form of 'live' authorial content synthesized with AI contributions. [ABSTRACT FROM AUTHOR]

Purpose This report describes the step-by-step process that led to expansion of ambulatory care pharmacy services at a newly established internal medicine clinic within a patient-centered medical home in North Carolina. Summary Implementation of clinical pharmacist services at the clinic was led by a postgraduate year 2 (PGY2) pharmacy resident and guided by the 9 steps described in the book Building a Successful Ambulatory Care Practice: A Complete Guide for Pharmacists. After a needs assessment and review of the demographics and insurance status of the clinic's target population, it was determined that pharmacist services would focus on quality measures including diabetes nephropathy screening, diabetes eye examination, blood glucose control in diabetes, discharge medication reconciliation, annual wellness visits, and medication adherence in diabetes, hypercholesterolemia, and hypertension. Clinic appointments were conducted under 3 models: a pharmacist-physician covisit model, a "floor model" of pharmacist consultation on drug information or medication management issues during medical resident sign-out sessions with supervising physicians (medical residents could also see patients along with the pharmacist at a covisit appointment), and a covisit model of stacked physician and pharmacist appointments. The pharmacist's services were expanded from 2 half-day clinic sessions per week initially to 5 or 6 half-day clinic sessions by the end of the residency year. Conclusion By the fourth quarter of the first PGY2 residency year in which ambulatory care pharmacy services were provided in the clinic, the clinical and financial impact of those services justified the addition of a second full-time pharmacist to the clinic team. [ABSTRACT FROM AUTHOR]

BACKGROUND: Colorectal cancer (CRC) is the third most common cause of cancer mortality worldwide. Of these, approximately 25% will have liver metastasis. We performed 394 microwave ablations (MWAs) and analyzed outcomes for survival and ablation failure. STUDY DESIGN: We conducted a retrospective review of patients who underwent a surgical MWA at a single-center high-volume institution from October 2006 to September 2022 using a prospectively maintained database. The primary outcome was overall survival. RESULTS: A total of 394 operations were performed on 328 patients with 842 tumors undergoing MWA. Median tumor size was 1.5 cm (range 0.4 to 7.0 cm), with the median number of tumors ablated per operation being 1 (range 1 to 11). A laparoscopic approach was used 77.9% of the time. Concomitant procedures were performed 63% of the time, most commonly hepatectomy (22.3%), cholecystectomy (17.5%), and colectomy (6.6%). Clavien-Dindo grade III or IV complication occurred in 12 patients (3.6%), and all of these patients had undergone concomitant procedures. Mortality within 30 days occurred in 4 patients (1.2%). The rate of incomplete ablation was 1.5% per tumor. Local recurrence occurred at a rate of 6.3% per tumor. Black patients were found to have a higher incidence of incomplete ablation and local recurrence. One-year survival probability was 91% (95% CI 87.9 to 94.3), with a mean overall survival of 57.6 months (95% CI 49.9 to 65.4 months). CONCLUSIONS: Surgical MWA offers a low-morbidity approach to treatment of colorectal liver metastasis, with low rate of failure. This large series reviews the outcomes of MWA as definitive treatment for colorectal liver metastasis. [ABSTRACT FROM AUTHOR]

Recently, layered rare-earth hydroxides (LRHs) have received growing attention in the field of theranostics. We have previously reported the hydrothermal synthesis of layered terbium hydroxide (LTbH), which exhibited high biocompatibility, reversible uptake of a range of model drugs, and release-sensitive phosphorescence. Despite these favourable properties, LTbH particles produced by the reported method suffered from poor size-uniformity (670 ± 564 nm), and are thus not suitable for therapeutic applications. To ameliorate this issue, we first derive an optimised hydrothermal synthesis method to generate LTbH particles with a high degree of homogeneity and reproducibility, within a size range appropriate for in vivo applications (152 ± 59 nm, n = 6). Subsequently, we apply this optimised method to synthesise a selected range of LRH materials (R = Pr, Nd, Gd, Dy, Er, Yb), four of which produced particles with an average size under 200 nm (Pr, Nd, Gd, and Dy) without the need for further optimisation. Finally, we incorporate Gd and Tb into LRHs in varying molar ratios (1 : 3, 1 : 1, and 3 : 1) and assess the combined magnetic relaxivity and phosphorescence properties of the resultant LRH materials. The lead formulation, LGd1.41Tb0.59H, was demonstrated to significantly shorten the T2 relaxation time of water (r2 = 52.06 mM−1 s−1), in addition to exhibiting a strong phosphorescence signal (over twice that of the other LRH formulations, including previously reported LTbH), therefore holding great promise as a potential multi-modal medical imaging probe. [ABSTRACT FROM AUTHOR]

Along with its broader impact in the country, Myanmar's 2021 coup and subsequent revolution have brought an upheaval amongst international aid agencies. As they have pivoted their programmes in the new context, international agencies have faced criticism from many Myanmar humanitarian and advocacy organisations. Drawing on interviews from 2022, this article argues that the way in which aid is given – in relation to context-specific conventions of reciprocity – is significant in creating meaning in partnerships. Engaging with Myanmar studies literature, the article contends that well-known overlapping values of sedana (goodwill), parahita (charity), and metta (loving kindness) inform Myanmar organisation leaders' expectations of reciprocity in their relationship with international aid agencies in the context of Myanmar's revolution. There is often a moral overlay on interpretations of aid partnerships, beyond the project-organised and contractual relationship that characterises the formal realm. Criticism of international aid is not new in Myanmar, yet the revolution has increased the stakes for local organisations and exposed new fractures in their relationships with their international partners. Transnational support is crucial amid the country's revolution and many Myanmar organisation leaders seek relationships of solidarity with international agencies, yet diverging assumptions about reciprocity in partnerships fuel ongoing frustration. [ABSTRACT FROM AUTHOR]

Fire agencies across the United States must make complex resource allocation decisions to manage wildfires using a national network of shared firefighting resources. Firefighters play a critical role in suppressing fires and protecting vulnerable communities. However, they are exposed to health and safety risks associated with fire, smoke inhalation, and infectious disease transmission. The COVID-19 pandemic further complicated these risks, prompting fire agencies to propose resource management adaptations to minimize COVID-19 exposure and transmission. It is unclear if and how the pandemic may have operationally influenced wildland firefighting personnel resource use given compounding wildfire and COVID-19 risks. Therefore, we developed generalized linear mixed models that were fit using multiple integrated datasets to detect changes in personnel resource use for years prior to and during the COVID-19 pandemic, while controlling for historical fire and landscape conditions, societal risks, and management objectives. Analyses of observed and predicted firefighting resource use revealed reductions in the mean personnel resources used per wildfire per day during the pandemic for models developed across the western U.S. and for various western U.S. fire regions. Notably, the Northern California and the Great Basin Coordination Centers showed statistically significant reductions in ground personnel use during the COVID-19 pandemic. Learning from wildland fire management strategies and resource use trends that occurred during the COVID-19 pandemic, fire agencies can better anticipate resource constraints that may arise during the compounding threats of severe wildland fire activity and infectious disease outbreaks to proactively prepare and adapt suppression management strategies. [ABSTRACT FROM AUTHOR]

Background: Whole blood host transcript signatures show great potential for diagnosis of infectious and inflammatory illness, with most published signatures performing binary classification tasks. Barriers to clinical implementation include validation studies, and development of strategies that enable simultaneous, multiclass diagnosis of febrile illness based on gene expression. Methods: We validated five distinct diagnostic signatures for paediatric infectious diseases in parallel using a single NanoString nCounter® experiment. We included a novel 3-transcript signature for childhood tuberculosis, and four published signatures which differentiate bacterial infection, viral infection, or Kawasaki disease from other febrile illnesses. Signature performance was assessed using receiver operating characteristic curve statistics. We also explored conceptual frameworks for multiclass diagnostic signatures, including additional transcripts found to be significantly differentially expressed in previous studies. Relaxed, regularised logistic regression models were used to derive two novel multiclass signatures: a mixed One-vs-All model (MOVA), running multiple binomial models in parallel, and a full-multiclass model. In-sample performance of these models was compared using radar-plots and confusion matrix statistics. Results: Samples from 91 children were included in the study: 23 bacterial infections (DB), 20 viral infections (DV), 14 Kawasaki disease (KD), 18 tuberculosis disease (TB), and 16 healthy controls. The five signatures tested demonstrated cross-platform performance similar to their primary discovery-validation cohorts. The signatures could differentiate: KD from other diseases with area under ROC curve (AUC) of 0.897 [95% confidence interval: 0.822–0.972]; DB from DV with AUC of 0.825 [0.691–0.959] (signature-1) and 0.867 [0.753–0.982] (signature-2); TB from other diseases with AUC of 0.882 [0.787–0.977] (novel signature); TB from healthy children with AUC of 0.910 [0.808–1.000]. Application of signatures outside of their designed context reduced performance. In-sample error rates for the multiclass models were 13.3% for the MOVA model and 0.0% for the full-multiclass model. The MOVA model misclassified DB cases most frequently (18.7%) and TB cases least (2.7%). Conclusions: Our study demonstrates the feasibility of NanoString technology for cross-platform validation of multiple transcriptomic signatures in parallel. This external cohort validated performance of all five signatures, including a novel sparse TB signature. Two exploratory multi-class models showed high potential accuracy across four distinct diagnostic groups. [ABSTRACT FROM AUTHOR]

In fewer than fifteen years, the study of Ni stable isotopes has advanced from early method development to application of a powerful tool for resolving a long-standing question: why does it appear that output fluxes of Ni from the global oceans far exceed input fluxes? The seawater concentration of Ni, a bioessential trace metal, is almost certainly at steady state on timescales comparable to its residence time of ∼20 kyr, so some of the current flux estimates must be inaccurate. Just as the input and output fluxes should balance, so should the flux-weighted isotopic compositions of the inputs and outputs. Thus, isotopic characterization of inputs and outputs provide an additional constraint on a balanced model of the marine Ni budget. Here, we report on experiments designed to elucidate fractionation mechanisms and magnitudes for sorption of Ni to Mn oxyhydroxide (birnessite), because Mn-rich sediments accumulating on abyssal plains represent the largest sink flux of Ni from seawater to marine sediments. Our results show remarkably large fractionations at low ionic strength (average Δ60/58Ni dissolved-sorbed = +1.38 ‰). Neither closed-system equilibrium trends nor Rayleigh curves fit the data well. Fractionations are even larger at high ionic strength (Δ60/58Ni dissolved-sorbed ranging from +2.0 to +4.0 ‰), and they decrease with experimental duration from 2 d (49 h) to 27 d. The high ionic strength data fit Rayleigh trends well. Here, we use X-ray absorption fine-structure spectroscopy (EXAFS) and results from previous studies to support interpretation of our data as combinations of kinetic and equilibrium isotope effects that vary in their proportional contributions to the total fractionation with time and with surface loading. One important consequence of this study is that none of the experimental results reported thus far, including ours, are directly applicable to building steady-state models of the Ni cycle. Even our longest duration experiments did not achieve equilibrium, which is likely to be manifest in the very slowly accumulating sediments on abyssal plains. Our work constrains further the mechanisms of Ni sorption to birnessite and clearly indicates that determination of equilibrium fractionation in this system, although challenging, will be a crucial step toward resolving the apparent marine Ni imbalance. [ABSTRACT FROM AUTHOR]

Fairytales may represent a unique genre of media well-suited to depict feminine traits as valuable to characters of all genders by positioning traditionally feminine-coded traits as sources of strength and power to characters in fairytale plots. To examine this theoretical supposition, this study examines the association between indices of female empowerment (United States), modern audience ratings of films, and gendered depictions within 31 film adaptations of Cinderella produced over the span of 100 years. Results indicate Cinderella was consistently depicted as more feminine and the Prince more masculine, but both Cinderella and the Prince consistently displayed both masculine and feminine traits—providing mixed evidence of the renegotiation of gender in fairytales. Cinderella's femininity was negatively related to indices of female empowerment, but positively related to modern audience ratings, suggesting possible tension between the production and consumption of gendered media in this context. [ABSTRACT FROM AUTHOR]

This article explores the process of becoming a feminist educator as the author employed feminist theory in her pedagogy for the first time. This self-study answered the research question: 'What would a feminist pedagogy look like in a music history classroom?' Throughout a ten-week undergraduate music history course, the author employed a research design based on autoethnography and autobiography in which data was collected from research journals, class sessions, dialogues with a critical friend, and student feedback. This self-study both illuminated and improved the author's pedagogical practice as a newly conscious feminist educator. The author re-imagined knowing and being through a feminist lens as she experienced epistemological and ontological shifts in her pedagogy. The author's feminist pedagogy unfolded through knowing herself as an educator, knowing the curriculum differently, and knowing through experience. Feminist pedagogy was also enacted through being in relationship with herself, being in relationship with others, and being in community. This self-study provides an example to educators in self-study of practice and in-service teachers of feminist pedagogy moving from theory to practice. It provides a discipline-specific example of resisting oppressive ways of knowing and being that exclude gendered experiences from educational spaces. [ABSTRACT FROM AUTHOR]

Background: Animal and owner quality‐of‐life (QoL) is pivotal in treatment decisions. Accurate measurement of owner‐reported QoL and treatment satisfaction (TS) supports disease burden and treatment benefit evaluation. Objectives: Develop and evaluate an owner‐completed canine dermatitis QoL and TS questionnaire (CDQoL‐TSQ) in allergic dogs. Materials and Methods: The CDQoL‐TSQ was drafted following review of existing measures and expert input. Content validity was assessed through interviews with owners of allergic dogs. Psychometric properties of the QoL domains (Canine QoL, Owner QoL) were evaluated. Score interpretation was derived. Results: Twenty dog owners were interviewed. Item wording was amended following the first 10 interviews. Data from 211 owners were used in the psychometric evaluation. The Canine QoL domain demonstrated strong internal consistency (α = 0.89), test–retest reliability (ICC2,1 = 0.844), moderate convergent validity (r = 0.41) and moderate‐high known‐groups validity (effect size 0.37–0.64). The Owner QoL domain demonstrated strong internal consistency (α = 0.73), high convergent validity (r = 0.63) and moderate‐high known‐groups validity (0.43–0.63). Test–retest reliability approached moderate strength (ICC2,1 = 0.490). Group‐level interpretation analysis showed minimal important difference of 7.0–13.6 points for dogs and 13.0–13.6 for owners. For individual dogs a change of 6.3 or 12.5 points for dogs, and 12.5 or 18.8 for owners indicates a response. Conclusions and Clinical Relevance: The CDQOL‐TSQ is a two‐part assessment to evaluate QoL and TS in canine allergic dermatitis. The QoL questionnaire demonstrated validity and reliability, and interpretation of scores was derived, making it suitable for use in research and practice. The TS module is suitable for clinical setting use to improve owner–veterinarian communication. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia predicts morbidity and mortality in end‐stage chronic liver disease (ESCLD). Here, we describe changes in body composition in children with ESCLD before and after liver transplantation (LT). Methods: Retrospective analysis of whole body DXA scans performed before and after LT over 4 years. Appendicular and whole‐body fat mass and lean mass were expressed as fat mass (FMI) and lean mass (LMI) index z‐scores. Sarcopenia was defined as leg LMI z‐score <−1.96. Results: Eighty‐three DXA scans of children before or after LT were studied. Sarcopenia had a positive correlation with weight (0.8, p <.01), height (0.48, p <.05), and BMI z‐score (0.77, p <.01), as well as arm, trunk, and total mean mass indices. It correlated negatively with indices of hypersplenism: PLTs (−0.57, p <.01), Neu (−0.50, p <.05), WCC (−0.44, p <.05), and days to discharge (−0.46, p <.05). At baseline: 13/25 (52%) children were sarcopenic and stayed in the hospital after LT for longer. Eight were stunted with a higher WCC and Ne/Ly ratio. All had normal FM indices. One year after LT, 12/26 children remained sarcopenic. Seven were stunted. Two years after LT, 5/15 were sarcopenic, and 5 were stunted. Three years after LT, 1/10 was sarcopenic, and 2 were stunted. By 4 years after LT, 1/7 was sarcopenic, and the same one was stunted. FM indices remained normal. Conclusions: Sarcopenic patients stayed longer in the hospital after LT. Lean mass indices were mostly within the normal range by 4 years after LT. 32% of children were stunted, and markers of inflammation were correlated with stunting. Fat mass was preserved at the cost of lean mass. [ABSTRACT FROM AUTHOR]