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The article analyzes trends in pharmacological management of pediatric patients with type 2 diabetes in German-speaking countries from 2000 to 2023 based on the Diabetes Prospective Follow-up Registry. The study shows changes in treatment regimens over the years, with an increase in the use of oral antidiabetic drugs (OADs) and glucagon-like peptide-1 receptor agonists (GLP1-RAs), and a decrease in insulin monotherapy or lifestyle intervention alone. Despite the availability of new treatment options, significant improvements in metabolic control and body mass index (BMI) are challenging to achieve in real-world settings. The study highlights the need for further research to determine the impact of expanded therapeutic options on pediatric patients with type 2 diabetes. [Extracted from the article]

Antagonist and mutualist organisms mediate the long‐standing, classical Janzen‐Connell effects and yet they are rarely investigated, especially when they share plant species hosts. Here, we propose that plant species create an “antagonists‐ and mutualist‐scape” which, coupled with seed dispersal mechanisms, will govern the relative survival rates of juveniles within the landscape and influence their later life stages. We combined data on fully stem mapped plots of woody plant species in two Mediterranean forests (Mixed Forest of Segura [MFS] and Mixed Forest of Jaen [MFJ]) with data on the associated communities of leaf epiphytic fungi, leaf pathogens, sap‐sucking insects and chewer insects hosted by each woody plant species. This allowed us to indirectly test the Janzen‐Connell hypothesis by investigating the placement of plant species with contrasting seed dispersal mechanisms (fleshy fruited vs. dry‐fruited plant) within the antagonists‐ and mutualist‐scapes. More specifically, we determined the degree of host‐specificity of plant‐associated organisms and defined the antagonist‐ or mutualist‐scapes for focal plants as the mean number of antagonist‐ or mutualist species the focal plant shares with its (sapling or adult) plant neighbours, respectively. We then applied multivariate spatial point pattern analysis to test whether saplings and adults of the focal species tended to be located in favourable sites of the antagonist‐scapes (i.e. were neighboured by fewer antagonist species than expected) or were distributed independently of the antagonist‐scapes. A substantial proportion of organisms was associated with more than one plant species, with organisms at MFJ being more “host‐specific” than organisms at MFS. Our spatial analyses revealed spatial patterns that differed strongly between fleshy‐fruited and dry‐fruited species and were, in most cases, consistent with our expectations. For example, saplings of dry‐fruited species were placed in favourable sites in the saplings antagonist‐scapes, whereas saplings of fleshy‐fruited species were independently placed with respect to the saplings antagonist‐scapes. Our results show how the placement of plant species within the antagonist‐scapes changes during the ontogeny, and how this is influenced by Janzen‐Connell effects and the seed dispersal mechanisms. We provide a new approach and indications about the importance of generalist antagonists and mutualists as drivers of the spatial assembly of plant communities. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Diagnostic disparities are preventable differences in diagnostic errors or opportunities to achieve diagnostic excellence. There is a need to summarize solutions with explicit considerations for addressing diagnostic disparities. We aimed to describe potential solutions to diagnostic disparities, organize them into an action-oriented typology with illustrative examples, and characterize these solutions to identify gaps for their further development. During four human-centered design workshops composed of diverse expertise, participants ideated and clarified potential solutions to diagnostic disparities and were supported by environmental literature scan inputs. Nineteen individual semi-structured interviews with workshop participants validated identified solution examples and solution type characterizations, refining the typology. Our typology organizes 21 various types of potential diagnostic disparities solutions into four primary expertise categories needed for implementation: healthcare systems' internal expertise, educator-, multidisciplinary patient safety researcher-, and health IT-expertise. We provide descriptions of potential solution types ideated as focused on disparities and compare those to existing examples. Six types were characterized as having diagnostic-disparity-focused examples, five as having diagnostic-focused examples, and 10 as only having general healthcare examples. Only three solution types had widespread implementation. Twelve had implementation on limited scope, and six were mostly hypothetical. We describe gaps that inform the progress needed for each of the suggested solution types to specifically address diagnostic disparities and be suitable for the implementation in routine practice. Numerous opportunities exist to tailor existing solutions and promote their implementation. Likely enablers include new perspectives, more evidence, multidisciplinary collaborations, system redesign, meaningful patient engagement, and action-oriented coalitions. [ABSTRACT FROM AUTHOR]

In temperate mixed forests, dominant ectomycorrhizal (EM) tree species usually coexist with diverse arbuscular mycorrhizal (AM) understorey tree species. Here, we investigated the spatial associations between AM and EM trees in two > 20 ha temperate forest mega‐plots to better understand the observed 'EM‐dominant versus AM‐diverse' coexistence. Overall, we found that positive spatial associations (e.g., facilitation) were mostly related to EM trees, while negative spatial associations (e.g., inhibition) were mainly related to AM trees. Because adult EM trees tended to facilitate surrounding AM and EM saplings and other EM adults in these two forests, facilitation hotspots that stabilize AM‐EM tree coexistence should be centred around EM tree species rather than around AM tree species. Together, we propose a novel EM‐stabilization mechanism, which emphasises how, despite some species‐specific variation, EM tree species foster 'EM‐dominant versus AM‐diverse' coexistence in temperate mixed forests by facilitating other trees. [ABSTRACT FROM AUTHOR]

In the absence of antiretroviral therapy (ART), a subset of individuals, termed HIV controllers, have levels of plasma viremia that are orders of magnitude lower than non-controllers (NC) who are at higher risk for HIV disease progression. In addition to having fewer infected cells resulting in fewer cells with HIV RNA, it is possible that lower levels of plasma viremia in controllers are due to a lower fraction of the infected cells having HIV-1 unspliced RNA (HIV usRNA) compared with NC. To directly test this possibility, we used sensitive and quantitative single-cell sequencing methods to compare the fraction of infected cells that contain one or more copies of HIV usRNA in peripheral blood mononuclear cells (PBMC) obtained from controllers and NC. The fraction of infected cells containing HIV usRNA did not differ between the two groups. Rather, the levels of viremia were strongly associated with the total number of infected cells that had HIV usRNA, as reported by others, with controllers having 34-fold fewer infected cells per million PBMC. These results reveal that viremic control is not associated with a lower fraction of proviruses expressing HIV usRNA, unlike what is reported for elite controllers, but is only related to having fewer infected cells overall, maybe reflecting greater immune clearance of infected cells. Our findings show that proviral silencing is not a key mechanism for viremic control and will help to refine strategies toward achieving HIV remission without ART. [ABSTRACT FROM AUTHOR]

Background: Matrix-induced autologous chondrocyte implantation (MACI), the third-generation of the technique, is an established procedure for the treatment of focal cartilage defects in the knee. However, the literature lacks long-term results of MACI with good statistical power. Purpose: To determine long-term survival and patient-reported outcomes (PROs) in a representative cohort and to identify patient- and surgery-related parameters that may influence long-term clinical outcomes. Study Design: Case series; Level of evidence, 4. Methods: A total of 103 patients were clinically evaluated at the current follow-up of 8.1 years (range, 5-11.9 years). PRO measures (PROMs) included the Knee injury and Osteoarthritis Outcome Score (KOOS), EQ-5D, visual analog scale for pain, and Tegner Activity Scale. Magnetic resonance imaging results were evaluated by using the AMADEUS (area measurement and depth and underlying structures) and MOCART (magnetic resonance observation of cartilage repair tissue) 2.0 knee score classification systems. Potential factors influencing PROs were first identified univariately and investigated in a multivariate regression model. Results: The defects had a mean size of 4.8 cm2 (range, 1.2-12 cm2) and were predominantly femorotibial (66%). The mean Kaplan-Meier survival rate of revision for any reason was 97.2% ± 1.6% at 10 years. In comparison to preoperative values, all PROMs were significantly improved at the current follow-up (P <.05). The MOCART 2.0 score peaked at 12 months (mean, 80.2 ± 15.3 months) and showed no significant change at 96 months (mean, 76.1 ± 19.5 months; P =.142). The linear multivariate regression model identified an association of body mass index (BMI), MOCART 2.0 score, and number of previous knee surgeries with KOOS (R 2 = 0.41; f 2 = 0.69). Further analysis of the individual determinants revealed an optimal BMI range of 20 to 29 for favorable PROs at 96 months. Significant correlations of MOCART subscores with the overall KOOS were found for graft surface and structure, bony reaction, and subchondral detectable changes. Only 30% of patients with2 previous surgeries and 20% of patients with 3 previous surgeries achieved a Patient Acceptable Symptom State (χ2 = 10.93; P =.012). Conclusion: The present study shows consistently good long-term clinical outcomes after MACI with a low revision rate and high patient satisfaction. BMI and number of previous knee surgeries may influence clinical outcomes and should be considered in patient selection and education. There is a correlation between graft structure, subchondral bone changes on magnetic resonance imaging, and long-term PROMs. [ABSTRACT FROM AUTHOR]

Novelty search is a powerful tool for finding diverse sets of objects in complicated spaces. Recent experiments on simplified versions of novelty search introduce the idea that novelty search happens at the level of the archive space, rather than individual points. The sparseness measure and archive update criterion create a process that is driven by a two measures: (1) spread out to cover the space while trying to remain as efficiently packed as possible, and (2) metrics inspired by k nearest neighbor theory. In this paper, we generalize previous simplifications of novelty search to include traditional population (μ , λ) dynamics for generating new search points, where the population and the archive are updated separately. We provide some theoretical guidance regarding balancing mutation and sparseness criteria and introduce the concept of saturation as a way of talking about fully covered spaces. We show empirically that claims that novelty search is inherently objectiveless are incorrect. We leverage the understanding of novelty search as an optimizer of archive coverage, suggest several ways to improve the search, and demonstrate one simple improvement—generating some new points directly from the archive rather than the parent population. [ABSTRACT FROM AUTHOR]

Background: Marginal zone lymphomas of mucosa-associated lymphatic tissues (MZL of MALT) are a group of indolent B-cell neoplasms, which are thought to arise from chronic antigenic stimulation of B-cells either due to underlying chronic infection or autoimmune disease. Little is known about potential causative pathogens in pulmonary MZL (PMZL), although some data suggests a potential role of Achromobacter (A.) xylosoxidans. Methods: An index case of chronic pulmonary colonisation with Tropheryma (T.) whipplei and subsequent development of PMZL was identified by T. whipplei specific PCR and metagenomic next genome sequencing (mNGS). This case prompted a retrospectively conducted analysis of T. whipplei-specific PCRs in lung tissue from PMZL patients (n = 22), other pulmonary lymphomas, and normal controls. Positive results were confirmed by mNGS. A systematic search for T. whipplei and A. xylosoxidans in our in-house mNGS dataset comprising autopsy lungs, lung biopsies and lung resection specimens (n = 181) was subsequently performed. Results: A 69-year-old patient presented with weight loss and persistent pulmonary consolidation. Subsequent mNGS analysis detected T. whipplei in the resected lung specimen. An antibiotic regimen eventually eliminated the bacterium. However, the consolidation persisted, and the diagnosis of PMZL was made in a second lung resection specimen. A second case of T. whipplei-associated PMZL was subsequently detected in the retrospectively analysed PMZL cohort. Both cases showed comparatively few mutations and no mutations in genes encoding for NF-κB pathway components, suggesting that T. whipplei infection may substitute for mutations in these PMZL. None of the samples in our in-house dataset tested positive for T. whipplei. In contrast, A. xylosoxidans was frequently found in both autopsy lungs and lung biopsy / resection specimens that were not affected by PMZL (> 50%). Conclusions: Our data suggests that T. whipplei colonisation of lungs may trigger PMZL as a potential driver. Systematic analyses with larger cohorts should be conducted to further support this hypothesis. The frequent detection of A. xylosoxidans in lung tissue suggests that it is a common component of the pulmonary microbiome and therefore less likely to trigger lymphomas. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions Level of Evidence The purpose of this study was to evaluate long‐term survival, patient‐reported outcomes (PROs) and radiographic results of matrix‐associated autologous chondrocyte implantation (M‐ACI) in adolescents with immature cartilage and compare them to adult controls.A retrospective matched‐pair analysis was performed comparing the PRO after M‐ACI for focal cartilage defect of the knee in cartilaginous immature adolescents to mature adults. Groups were matched for sex, body mass index, defect site and size, symptom duration and the number of previous knee surgeries. Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART 2.0) scores were assessed at least 60 months postoperatively. Patient acceptable symptomatic state (PASS) and clinical response rate in KOOS and KOOS subscores were calculated.A total of 54 patients were matched. At a mean of 96 months (65–144 months), no surgical complications, graft hypertrophy or reoperations were noted in the cohorts studied. Adolescents showed superior PROs at the final follow‐up (76.9 ± 14.1 vs. 66.4 ± 15.0, p = 0.03) and were significantly more likely to achieve PASS (74.1% vs. 55.6%; p = 0.02) compared to the adult cohort. The KOOS subscale analysis showed long‐term benefits for adolescents in terms of symptom improvement, pain reduction, activities of daily living, sports and quality of life (p < 0.05). None of the patients in the adolescent group showed graft hypertrophy on magnet resonance imaging or signs of osteoarthritis on radiographs at long‐term follow‐ups.M‐ACI is an effective treatment for chondral defects of the knee in patients with immature cartilage with low revision rates and high patient satisfaction over the long term. Adolescents showed comparable clinical and radiographic results in the short and medium term, with slightly more favourable, clinically relevant functional results in adolescents in the long term. M‐ACI can be safely used in adolescents, and consideration should be given to expanding the indication to include these patients.Level III. [ABSTRACT FROM AUTHOR]

Objective To determine if the prevalence of schistosomiasis in children aged 9--12 years is associated with the prevalence in 5--8-year-olds and adults after preventive chemotherapy in schools or the community. Methods We combined data from four community-randomized, preventive chemotherapy trials in treatment-naïve populations in Côte d'Ivoire, Kenya and the United Republic of Tanzania during 2010--2016 according to the number of praziquantel treatments and the delivery method. Schistosoma mansoni infection was sought on two slides prepared from each participant's first stool using the Kato--Katz technique. We assessed associations between S. mansoni prevalence in 9--12-year-olds and 5--8-year-olds and adults in the community before and after treatment using Bayesian regression models. Findings Stool samples from 47 985 5--8-year-olds, 81 077 9--12-year-olds and 20 492 adults were analysed. We found associations between the prevalence in 9--12-year-olds and that in 5--8-year-olds and adults after preventive treatment, even when only school-age children were treated. When the prevalence in 9--12-year-olds was under 10%, the prevalence in 5--8-year-olds was consistently under 10%. When the prevalence in 9--12-year-olds was under 50%, the prevalence in adults after two or four rounds of preventive chemotherapy was 10%--15% lower than before chemotherapy. Post-chemotherapy age-group associations were consistent with pre-chemotherapy associations in this analysis and previous studies. Conclusion The prevalence of S. mansoni infection in 9--12-year-olds was associated with the prevalence in other age groups and could be used to guide community treatment decisions. [ABSTRACT FROM AUTHOR]

Question: Species‐specific habitat associations are one of several processes that lead to a clustered spatial pattern of plant populations. This pattern occurs in tropical and temperate forests. To analyze species–habitat associations, four methods are commonly used when determining species–habitat associations from spatial point pattern and environmental raster data. Two of the methods randomize the spatial point pattern of plants, and two randomize the raster data of habitat patches. However, the strengths and weaknesses of the four methods have never been analyzed in detail. Methods: We conducted a simulation study to analyze the strengths and weaknesses of the four most used methods. The methods are the gamma test, pattern reconstruction, the torus‐translation test and the randomized‐habitats procedure. We simulated neutral landscapes representing habitat patches and point patterns representing fine‐scale plant distributions. We built into our simulations known positive and negative species–habitat associations. Results: All four methods were equally good at detecting species–habitat associations. Detected positive associations better than negative ones. Furthermore, correct detections were mostly influenced by the initial spatial distribution of the point patterns, landscape fragmentation and the number of simulated null model randomizations. Conclusions: The four methods have advantages and disadvantages, and which is the most suitable method largely depends on the characteristics of the available data. However, our simulation study shows that the results are consistent between methods. [ABSTRACT FROM AUTHOR]

To determine whether intravenous indigo carmine provides a visualization advantage compared to saline in the evaluation of ureteral patency in a randomized, controlled clinical trial. Patients undergoing urological or gynecological surgical procedures in which the patency of the ureter was to be assessed received a saline injection and were randomized to receive 2.5 mL or 5.0 mL of indigo carmine. Blinded video assessments were conducted by independent reviewers using a conspicuity scale ranked 1 (poorest) to 5 (best), and subjects with scores ≥3 and at least a + 1-point difference from saline were considered responders. Time to visualization was recorded for indigo carmine. A responder analysis evaluated whether indigo carmine showed improved visualization. There were 96 ureters evaluated with the 5.0 mL dose of indigo carmine, 92 with the 2.5 mL dose, and 180 with saline. Most ureters were scored a 4 or higher on the conspicuity scale following indigo carmine; both doses were significantly better than saline (P <.0001). Overall, 92.3% of patients were rated as a responder for either ureter. The median time to visualization of blue color was not significantly different (6.0 minutes in the 5.0 mL group and 5.9 minutes in the 2.5 mL group). There were no adverse events related to indigo carmine use. Both dose levels of indigo carmine were significantly better than saline as a visualization aid for ureter patency. [ABSTRACT FROM AUTHOR]

Background: Light therapy is widely used in medicine. Specifically, photobiomodulation has been shown to exert beneficial effects in wound healing disorders, which present a major challenge in health care. The study's aim was providing information on the effect of a novel, red‐laser‐based wound therapy device (WTD) on keratinocytes and fibroblasts during wound healing under optimal and non‐optimal conditions. Methods: The scratch wound assay was employed as a wound healing model for mechanical damage with readjustment of specific cell milieus, explicitly chronic TH1 inflammation and TH2‐dominant conditions. Furthermore, gene expression analysis of pro‐inflammatory cytokines (IL1A, IL6, CXCL8), growth factors (TGFB1, PDGFC), transcription factors (NFKB1, TP53) and heat shock proteins (HSP90AA1, HSPA1A, HSPD1) as well as desmogleins (DSG1, DSG3) in keratinocytes and collagen (COL1A1, COL3A1) in fibroblasts was performed after WTD treatment. Results: It was shown that WTD treatment is biocompatible and supports scratch wound closure under non‐optimal conditions. A distinct enhancement of desmoglein and collagen gene expression as well as induction of early growth factor gene expression was observed under chronic inflammatory conditions. Moreover, WTD increased HSPD1 transcript levels in keratinocytes and augmented collagen expression in fibroblasts during wound healing under TH2 conditions. WTD treatment also alleviated the inflammatory response in keratinocytes and induced early growth factor gene expression in fibroblasts under physiological conditions. Conclusion: Positive effects described for wound treatment with WTD could be replicated in vitro and seem to be to be conferred by a direct influence on cellular processes taking place in keratinocytes and fibroblasts during wound healing. [ABSTRACT FROM AUTHOR]

On December 23, 1969, the National Education Association and the Alabama State Teachers Association (a black organization) filed a class action suit in federal court against the Alabama Department of Education on behalf of Carrie Coleman Robinson, Negro School Library Supervisor in Alabama's Department of Education. The suit argued that Robinson had suffered racial discrimination in hiring and stated that her First, Fifth, Thirteenth, and Fourteenth Amendment rights had been violated. The American Association of School Librarians and its parent American Library Association (Robinson had been a member of both for decades) chose not to participate in the suit. The decision reflected the library profession's unwillingness to openly discuss public school segregation, one of the nation's major social issues in the last half of the twentieth century that was sparked by the Supreme Court's landmark decision Brown v. Board of Education (1954). This article recounts the heretofore untold story of Carrie Coleman Robinson's experiences with racial discrimination within the professions of education and librarianship. [ABSTRACT FROM AUTHOR]

Background: Patients with subarachnoid hemorrhage (SAH) often necessitate intra-hospital transport (IHT) during intensive care treatment. These transfers to facilities outside of the neurointensive care unit (NICU) pose challenges due to the inherent instability of the hemodynamic, respiratory, and neurological parameters that are typical in these patients. Methods: In this retrospective, single-center cohort study, a total of 108 IHTs were analyzed for demographics, transport rationale, clinical outcomes, and pre/post-IHT monitoring parameters. After establishing clinical thresholds, the frequency of complications was calculated, and predictors of thresholds violations were determined. Results: The mean age was 55.7 (+/−15.3) years, with 68.0% showing severe SAH (World Federation of Neurosurgical Societies Scale 5). IHTs with an emergency indication made up 30.8% of all transports. Direct therapeutic consequences from IHT were observed in 38.5%. On average, the first IHT occurred 1.5 (+/−2.0) days post-admission and patients were transported 4.3 (+/−1.8) times during their stay in the NICU. Significant parameter changes from pre- to post-IHT included mean arterial pressure, systolic blood pressure, oxygen saturation, blood glucose levels, temperature, dosages of propofol and ketamine, tidal volume, inspired oxygen concentration, Horovitz index, glucose, pH, intracranial pressure, and cerebral perfusion pressure. Relevant hemodynamic thresholds were violated in 31.5% of cases, while respiratory complications occurred in 63.9%, and neurological complications in 20.4%. For hemodynamic complications, a low heart rate with a threshold of 61/min (OR 0.96, 95% CI 0.93–0.99, p = 0.0165) and low doses of midazolam with a threshold of 17.5 mg/h (OR 0.97, 95% CI 0.95–1.00, p = 0.0232) significantly predicted adverse events. However, the model did not identify significant predictors for respiratory and neurological outcomes. Conclusions: Conclusively, IHTs in SAH patients are associated with relevant changes in hemodynamic, respiratory, and neurological monitoring parameters, with direct therapeutic consequences in 4/10 IHTs. These findings underscore the importance of further studies on the clinical impact of IHTs. [ABSTRACT FROM AUTHOR]

The present study investigated whether incidental learning of spatial and temporal associations in hybrid visual and memory search enable observers to predict targets in space and time. In three experiments, observers looked for four, previously memorized, target items across many trials. We examined effects of learning target item sequences (e.g., the butterfly always follows the paint-box), target item-location associations (the butterfly is always in the right corner), and target item-location sequences (the butterfly in the right corner always follows the paint-box in the lower middle-left). Learning effects for the sequences of target items alone were weak. By contrast, we found good learning of target item-location associations and a reliable effect of sequence learning for target item-location associations. These findings suggest that spatiotemporal learning in hybrid search is hierarchical: Only if spatial and non-spatial target features are bound, temporal associations bias attention dynamically to the target expected to occur next. [ABSTRACT FROM AUTHOR]

An early diagnosis of autism spectrum disorder (ASD) can improve outcomes for children and assist families in accessing services. Part C providers are often tasked with screening for ASD. The purpose of this study was to survey Part C providers nationwide to understand their ASD screening practices and training needs and extend a survey conducted by Tomlin and colleagues. A total of 327 providers participated. Results indicated a majority of respondents (75.8%) screen for ASD using a variety of different measures, while only 26.9% are required by their program to conduct universal screenings. Most participants reported feeling confident in screening for ASD, discussing a child's red flags with a family, referring a child for further evaluation, and discussing recent evidence surrounding ASD. An area where providers were less confident was working with interpreters to screen for ASD or discuss screening results and ASD with families with cultural or linguistic diversity. Despite high confidence levels in screening for ASD, a vast majority of participants reported they would be interested in attending a training on screening for ASD. Professional development surrounding screening for ASD and discussing ASD with families from diverse backgrounds may assist in improving Part C provider screening practices. [ABSTRACT FROM AUTHOR]

The article deals with antithrombotic therapy and the evaluation of bleeding diathesis in elective gastrointestinal endoscopies. It discusses whether discontinuation of antithrombotic medication before the procedure is necessary and whether coagulation testing can reduce the risk of post-interventional bleeding. It is recommended to assess bleeding diathesis using a questionnaire and to perform coagulation testing in case of increased bleeding risk. The use of antithrombotic drugs and the challenges in managing these medications before and after endoscopic procedures are also discussed. The recommendations for therapy during endoscopic procedures were published in 2016 by American and European/British authorities. It is stated that clopidogrel does not significantly increase the risk of bleeding after colon polypectomy compared to acetylsalicylic acid. The current international guidelines support the recommendation to no longer interrupt antithrombotic drugs before polypectomy, unless it is a procedure with a high bleeding risk. The recommendations were developed in collaboration with an experienced hematologist and are based on current guidelines and recommendations from America, Europe, and the United Kingdom. [Extracted from the article]

Although it is well recognized that the strength of plant–herbivore interactions can vary with the plant sex, the distance, and the density of conspecific neighbors, no study has yet assessed their combined influence. Here, we filled this knowledge gap by focusing on the dioecious palm Chamaeropshumilis L., and its two main herbivores, the invasive moth Paysandisiaarchon Burmeister and the feral goat Caprahircus L. We evaluated levels and spatial patterns of herbivory, as well as those of plant size and number of inflorescences in two palm populations in Mallorca (Balearic Islands, Spain). Our spatial point pattern analyses revealed that palms not affected by moth herbivory or goat florivory were spatially aggregated, goats fed more strongly upon inflorescences in palms with more neighbors, but they consumed more leaves in isolated palms. Interestingly, we could reveal for the first time that plant sex is a key plant trait modulating neighborhood effects. For instance, whereas aggregated female palms experienced lower intensity of goat florivory than isolated ones, male palms showed the opposite pattern. Palm size and number of inflorescences also showed sex-related differences, suggesting that sexual dimorphism is a key driver of the observed neighborhood effects on herbivory. Our study highlights the importance of considering relevant plant traits such as sex when investigating plant neighborhood effects, calling for further research to fully understand the dynamics governing plant–herbivore interactions in dioecious systems. [ABSTRACT FROM AUTHOR]

Interspecific ecological interactions are inherently context‐dependent. They may vary in both magnitude and sign depending on the biotic and abiotic conditions, depicting a mutualism–antagonism continuum. However, how population abundances and the activity of interacting species modulate these interactions remains underexplored. Here, we chose the interaction between the Mediterranean palm Chamaerops humilis and the feral goat Capra hircus in Mallorca (Balearic Islands, Spain). We selected three study plots with low, intermediate and high intensities of goat activity where we characterized palm distribution, seed rain, seed predation and early palm recruitment during two consecutive years. Since goats can cause both costs (e.g. florivory) and benefits (e.g. seed dispersal) to C. humilis performance, we investigated the following three questions: 1) does the spatial distribution of adult palms vary depending on the intensity of goat activity? 2) Does the intensity of goat activity influence seed rain and its potential spatial association with adult palms? 3) To what extent does the intensity of goat activity determine post‐dispersal events such as seed predation and seedling emergence? We found that adult palms showed a more clumped and complex distribution (double‐cluster process) in plots with low and intermediate goat activity compared to that with high goat activity (simple‐cluster process). In the low goat activity plot, dispersed seeds were spatially aggregated around adult palms, showing twice as much insect‐seed predation and nearly three times lower seed germination success than those in the intermediate goat activity plot. Palm seed dispersal and recruitment were almost nil in the high goat activity plot due to heavy consumption of palm inflorescences and developing fruits by goats. Our findings demonstrate how the net outcome of plant–animal interactions can change from mutualism to antagonism, from reproductive service to reproductive collapse, depending on the abundance and the activity of the interacting species. [ABSTRACT FROM AUTHOR]

A lack of comprehensive studies of the C–C bond cleavage in organic molecules hampers the rational design of catalysts for many applications, such as in fuel cells and steam reforming technologies. Employing ethanol on Ir(100) as an example, we studied 14 C–C bond cleavages of various species involved in the ethanol oxidation reaction using density functional theory calculations and used the degree of dehydrogenation (DoDH) of the reactant species as a variable to correlate the C–C bond cleavage barrier and reaction energy. This correlation method was also applied to the dehydrogenation reactions of ethanol on various catalysts, and great insight was obtained. The results show that the C–C cleavage barrier generally decreases with DoDH, with a local minimum around 33.3% DoDH. For reactants having more than 50% DoDH, the C–C cleavage is more ready to take place than the dehydrogenation and can occur at room temperature. Furthermore, the O atom in the reactive species plays a critical role in lowering the C–C bond cleavage barrier. The results provide necessary inputs for kinetic studies of ethanol reactions under operando conditions, where a reaction network beyond the minimum energy pathway is needed. The results will also serve as a benchmark for future studies of the ethanol C–C cleavage on other facets of Ir catalysts or on different catalysts. Furthermore, this work demonstrates that the proposed method opens up a new and effective way of correlating catalytic activities for the C–C bond cleavage involving long-chain alkanes and alcohols. [ABSTRACT FROM AUTHOR]

The article provides information on the project You Ask we explain, wherein monthly live podcasts were produced in public locations within the heart of communities, fostering citizen discussions on sensitive medical topics. For each podcast, an interprofessional discussion panel was invited which consisted of a medical student as moderator and three experts from different fields. The evaluation showed that the moderating students improved their skills for future presentations.

Librarianship has a propensity to sanitize its history. As evidence for this statement, this article uses the Library Bill of Rights that the American Library Association adopted in 1939 and the School Library Bill of Rights that the American Association of School Librarians adopted in 1955 as lenses through which to view the profession's response to selected events in American library history since 1939. By such means, the article attempts to show that librarianship has manifested a consistent desire to control the narrative surrounding libraries and their defense of intellectual freedom and opposition to censorship. [ABSTRACT FROM AUTHOR]

Background: Healthcare in the USA is increasingly delivered by large healthcare systems that include one or more hospitals and associated outpatient practices. It is unclear what role healthcare systems play in driving or preventing overutilization of healthcare services in the USA. Objective: To learn how high-value healthcare systems avoid overuse of services Design: We identified "positive deviant" health systems using a previously constructed Overuse Index. These systems have much lower-than-average overuse of healthcare services. We confirmed that these health systems also delivered high-quality care. We conducted semi-structured interviews with executive leaders of these systems to validate a published framework for understanding drivers of overuse. Participants: Leaders at select healthcare systems in the USA. Interventions: None Approach: We developed an interview guide and conducted semi-structured interviews. We iteratively developed a code book. Paired reviewers coded and reconciled each interview. We analyzed the interviews by applying constant comparative techniques. We mapped the emergent themes to provide the first empirical data to support a previously developed theoretical framework. Key Results: We interviewed 15 leaders from 10 diverse healthcare systems. Consistent with important domains from the overuse framework, themes from our study support the role of clinicians and patients in avoiding overuse. The leaders described how they create a culture of professional practice and how they modify clinicians' attitudes to facilitate high-value practices. They also described how their patients view healthcare consumption and the characteristics of their patient populations allowed them to practice high-value medicine. They described the role of quality metrics, insurance plan ownership, and alternative payment model participation as encouraging avoidance of overuse. Conclusions: Our qualitative analysis of positive deviant health systems supports the framework that is in the published literature, although health system leaders also described their financial structures as another important factor for reducing overuse and encouraging high-value care delivery. [ABSTRACT FROM AUTHOR]

Background: Severe mental illnesses are risk factors for SARS-CoV-2-related morbidity and mortality. Vaccination is an effective protection; therefore, high vaccination rates should be a major priority for people with mental illnesses. Objectives: (1) Identification of at-risk groups for non-vaccination and structures and interventions needed for widespread vaccination among people with mental illnesses from the perspective of outpatient psychiatrists and neurologists, (2) discussion of the results in the context of the international literature and (3) recommendations derived from them. Material and methods: Qualitative content analysis of COVID-19 vaccination-related questions from the COVID Ψ online survey of n = 85 psychiatrists and neurologists in Germany. Results: In the survey, people with schizophrenia, severe lack of drive, low socioeconomic status and homelessness were seen as risk groups for non-vaccination. Increased and targeted information, education, addressing and motivation and easily accessible vaccination offers by general practitioners, psychiatrists, and neurologists as well as complementary institutions were considered as important interventions. Discussion: COVID-19 vaccinations as well as information, motivation and access support should be systematically offered by as many institutions of the psychiatric, psychotherapeutic and complementary care systems in Germany as possible. [ABSTRACT FROM AUTHOR]

In this paper we evaluate the impact of road development on household welfare in rural Papua New Guinea (PNG) between 1996 and 2010, using two geocoded cross-sectional national household surveys and corresponding road maps. We make use of time-variation in road surface type and condition as recorded in PNG's National Road Asset Management System, focusing on routes that connect rural households to urban areas. To tackle endogenous placement of road infrastructure programs, we employ a correlated random effects model that controls for the location-specific average road quality over the period of analysis. We also use a newly developed generalised quantile regression method to investigate whether road works favour the poor. Our estimates show that better roads to nearest towns lead to higher consumption levels and housing quality, and to less reliance on subsistence farming. The effects are stronger among poor and remote households. [ABSTRACT FROM AUTHOR]

Background Small sample sizes have limited prior studies' ability to capture severe COVID-19 outcomes, especially among Ad26.COV2.S vaccine recipients. This study of 18.9 million adults aged ≥18 years assessed relative vaccine effectiveness (rVE) in three recipient cohorts: (1) primary Ad26.COV2.S vaccine and Ad26.COV2.S booster (2 Ad26.COV2.S), (2) primary Ad26.COV2.S vaccine and mRNA booster (Ad26.COV2.S+mRNA), (3) two doses of primary mRNA vaccine and mRNA booster (3 mRNA). Methods We analyzed two de-identified datasets linked using privacy-preserving record linkage (PPRL): insurance claims and retail pharmacy COVID-19 vaccination data. We assessed the presence of COVID-19 diagnosis during January 1-March 31, 2022 in: (1) any claim, (2) outpatient claim, (3) emergency department (ED) claim, (4) inpatient claim, and (5) inpatient claim with intensive care unit (ICU) admission. rVE for each outcome comparing three recipient cohorts (reference: two Ad26.COV2.S doses) was estimated from adjusted Cox proportional hazards models. Results Compared with two Ad26.COV2.S doses, Ad26.COV2.S+mRNA and three mRNA doses were more effective against all COVID-19 outcomes, including 57% (95% CI: 52–62) and 62% (95% CI: 58–65) rVE against an ED visit; 44% (95% CI: 34–52) and 54% (95% CI: 48–59) rVE against hospitalization; and 48% (95% CI: 22–66) and 66% (95% CI: 53–75) rVE against ICU admission, respectively. Conclusions This study demonstrated that Ad26.COV2.S + mRNA doses were as good as three doses of mRNA, and better than two doses of Ad26.COV2.S. Vaccination continues to be an important preventive measure for reducing the public health impact of COVID-19. [ABSTRACT FROM AUTHOR]

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) BA.2/BA.2.12.1 and BA.4/BA.5 subvariants have mutations associated with increased capacity to evade immunity when compared with prior variants. We evaluated mRNA monovalent booster dose effectiveness among persons ≥5 years old during BA.2/BA.2.12.1 and BA.4/BA.5 predominance. Methods A test-negative, case-control analysis included data from 12 148 pharmacy SARS-CoV-2 testing sites nationwide for persons aged ≥5 years with ≥1 coronavirus disease-2019 (COVID-19)-like symptoms and a SARS-CoV-2 nucleic acid amplification test from April 2 to August 31, 2022. Relative vaccine effectiveness (rVE) was estimated comparing 3 doses of COVID-19 mRNA monovalent vaccine to 2 doses; for tests among persons ≥50 years, rVE estimates also compared 4 doses to 3 doses (≥4 months since third dose). Results A total of 760 986 test-positive cases and 817 876 test-negative controls were included. Among individuals ≥12 years, rVE of 3 versus 2 doses ranged by age group from 45% to 74% at 1-month post vaccination and waned to 0% by 5–7 months post vaccination during the BA.4/BA.5 period. Adults aged ≥50 years (fourth dose eligible) who received 4 doses were less likely to have symptomatic SARS-CoV-2 infection compared with those with 3 doses; this rVE remained >0% through at least 3 months since last dose. For those aged ≥65 years, rVE of 4 versus 3 doses 1-month post vaccination was higher during BA.2/BA.2.12.1 (rVE = 49%; 95% confidence interval [CI], 43%–53%) than BA.4/BA.5 (rVE = 40%; 95% CI, 36%–44%). In 50- to 64-year-olds, rVE estimates were similar. Conclusions Monovalent mRNA booster doses provided additional protection against symptomatic SARS-CoV-2 infection during BA.2/BA.2.12.1 and BA.4/BA.5 subvariant circulation, but protection waned over time. [ABSTRACT FROM AUTHOR]

Purpose: Lymphatic malformations (LM) are congenital malformations of the lymphatic system, mainly located in the head and neck area. They can be staged based on location according to de Serres and based on different morbidity items using the Cologne Disease Score (CDS), a clinical staging system. In many cases, functional impairment greatly affects the life of patients suffering from lymphatic malformations. The present study aims to analyze a cohort of pediatric patients with LM. Methods: A retrospective analysis of 144 pediatric patients with head and neck LM was performed. Location, type of malformation (microcystic, macrocystic, mixed), scoring according to two different scoring systems and therapy were analyzed. Kruskal–Wallis test was used to analyze the difference in CDS between the patient groups and Dunn's test was used for post-hoc pairwise comparison. Results: The average age at presentation was 6.1 years. The most common sites were neck (47%), cheek/parotid gland (26%), tongue (17%) and orbit (8%). Macrocystic malformations dominated the lateral neck, while microcystic malformations were predominantly localized in the tongue and floor of mouth. Macrocystic malformations (mean CDS 9.44) were associated with significantly better CDS than microcystic (mean CDS 7.11) and mixed (mean CDS 5.71) malformations (p < 0.001). LM in stage V according to de Serres had the lowest values (mean CDS: 4.26). The most common therapeutic procedures were conventional surgical (partial) resection, laser therapy and sclerotherapy with OK-432. Conclusions: There is an association between malformation type, location according to de Serres and CDS in children with LM of the head and neck. Patients with microcystic and mixed malformations in stage V had lowest CDS levels. [ABSTRACT FROM AUTHOR]

• Patients with a present fall-related hip fracture have significantly worse visual functions as compared to age-matched controls. • Visual impairment poses a risk for falls in the elderly. • ET is suitable for bedside testing of postoperative patients in a hospital setting. • Visual acuity, static, and dynamic stereovision tests might serve as valuable tools in the prevention of re-fractures of the hip region. • Mobile device-based screening enables cost-effective visual risk assessment. Patients undergoing surgery due to hip fracture face an elevated risk of a subsequent fall during rehabilitation. An important contributing factor to this risk is deteriorated visual function, often responsive to intervention. This study aims to explore differences in visual acuity (VA) and stereovision (SV) between individuals with a history of fall-related hip injuries (study group) and age-matched controls, utilizing a mobile application (EuvisionTab, ET) to distinguish age-related visual decline from pathological vision. A total of 32 and 71 participants were enrolled in the study and control groups, respectively (mean age: 74.9 years, range: 60–96). Monocular logMAR VA was measured using a tablet by means of an adaptive threshold-search algorithm. SV was assessed using low-dot density static and dynamic random dot stereograms. An age-dependent reference limit for VA was established. For ET stereotests, the number of correctly identified optotypes out of 10 random presentations served as the measure for further comparisons. Visually impaired status in the study group was determined if patients failed either the VA threshold or the SV criteria. In the control group, an apparent but statistically nonsignificant decline in VA was observed, while stereovision remained stable and did not exhibit significant age-related variations based on ET stereotests. Conversely, the study group demonstrated significantly worse results in monocular VA (p = 0.0032) and for both stereotests (p = 0.018 for static, p = 0.036 for dynamic) according to paired samples t -test and chi-square test, respectively. Hip injuries were significantly associated with visual impairment (OR = 4.88, p = 0.0012). This study focuses on one possible risk factor of elderly falls, namely, vision impairment. Patients with visual decay present a higher incidence of hip injuries compared to age-matched controls. This data suggest that vision screening and, when feasible, restoration of visual function may contribute to the prevention of secondary falls, refractures, or contralateral fractures. A mobile-based screening protocol, executable as part of a postoperative bedside examination and independent of specialized eye care, can be proposed. [ABSTRACT FROM AUTHOR]

Gram-negative bacteria naturally secrete nano-sized outer membrane vesicles (OMVs), which are important mediators of communication and pathogenesis. OMV uptake by host cells activates TLR signalling via transported PAMPs. As important resident immune cells, alveolar macrophages are located at the air-tissue interface where they comprise the first line of defence against inhaled microorganisms and particles. To date, little is known about the interplay between alveolar macrophages and OMVs from pathogenic bacteria. The immune response to OMVs and underlying mechanisms are still elusive. Here, we investigated the response of primary human macrophages to bacterial vesicles (Legionella pneumophila, Klebsiella pneumoniae, Escherichia coli, Salmonella enterica, Streptococcus pneumoniae) and observed comparable NF-κB activation across all tested vesicles. In contrast, we describe differential type I IFN signalling with prolonged STAT1 phosphorylation and strong Mx1 induction, blocking influenza A virus replication only for Klebsiella, E.coli and Salmonella OMVs. OMV-induced antiviral effects were less pronounced for endotoxin-free Clear coli OMVs and Polymyxin-treated OMVs. LPS stimulation could not mimic this antiviral status, while TRIF knockout abrogated it. Importantly, supernatant from OMV-treated macrophages induced an antiviral response in alveolar epithelial cells (AEC), suggesting OMV-induced intercellular communication. Finally, results were validated in an ex vivo infection model with primary human lung tissue. In conclusion, Klebsiella, E.coli and Salmonella OMVs induce antiviral immunity in macrophages via TLR4-TRIF-signaling to reduce viral replication in macrophages, AECs and lung tissue. These gram-negative bacteria induce antiviral immunity in the lung through OMVs, with a potential decisive and tremendous impact on bacterial and viral coinfection outcome. 7FMb6rvPxRFWumGrBQKEMq Video Abstract [ABSTRACT FROM AUTHOR]

Background: Utilizing a 1-year chart review as the data, Furo et al. conducted a research study on an association between buprenorphine dose and the urine "norbuprenorphine" to "creatinine" ratio and found significant differences in the ratio among 8-, 12-, and 16-mg/day groups with an analysis of variance (ANOVA) test. This study expands the data for a 2-year chart review and is intended to delineate an association between buprenorphine dose and the urine "norbuprenorphine" to "creatinine" ratio with a higher statistical power. Methods: This study performed a 2-year chart review of data for the patients living in a halfway house setting, where their drug administration was closely monitored. The patients were on buprenorphine prescribed at an outpatient clinic for opioid use disorder (OUD), and their buprenorphine prescription and dispensing information were confirmed by the New York Prescription Drug Monitoring Program (PDMP). Urine test results in the electronic health record (EHR) were reviewed, focusing on the "buprenorphine," "norbuprenorphine," and "creatinine" levels. The Kruskal–Wallis H and Mann–Whitney U tests were performed to examine an association between buprenorphine dose and the "norbuprenorphine" to "creatinine" ratio. Results: This study included 371 urine samples from 61 consecutive patients and analyzed the data in a manner similar to that described in the study by Furo et al. This study had similar findings with the following exceptions: (1) a mean buprenorphine dose of 11.0 ± 3.8 mg/day with a range of 2 to 20 mg/day; (2) exclusion of 6 urine samples with "creatinine" level <20 mg/dL; (3) minimum "norbuprenorphine" to "creatinine" ratios in the 8-, 12-, and 16-mg/day groups of 0.44 × 10−4 (n = 68), 0.1 × 10−4 (n = 133), and 1.37 × 10−4 (n = 82), respectively; however, after removing the 2 lowest outliers, the minimum "norbuprenorphine" to "creatinine" ratio in the 12-mg/day group was 1.6 × 10−4, similar to the findings in the previous study; and (4) a significant association between buprenorphine dose and the urine "norbuprenorphine" to "creatinine" ratios from the Kruskal-Wallis test (P <.01). In addition, the median "norbuprenorphine" to "creatinine" ratio had a strong association with buprenorphine dose, and this association could be formulated as: [y = 2.266 ln(x) + 0.8211]. In other words, the median ratios in 8-, 12-, and 16-mg/day groups were 5.53 × 10−4, 6.45 × 10−4, and 7.10 × 10−4, respectively. Therefore, any of the following features should alert providers to further investigate patient treatment compliance: (1) inappropriate substance(s) in urine sample; (2) "creatinine" level <20 mg/dL; (3) "buprenorphine" to "norbuprenorphine" ratio >50:1; (4) buprenorphine dose >24 mg/day; or (5) "norbuprenorphine" to "creatinine" ratios <0.5 × 10−4 in patients who are on 8 mg/day or <1.5 × 10−4 in patients who are on 12 mg/day or more. Conclusion: The results of the present study confirmed those of the previous study regarding an association between buprenorphine dose and the "norbuprenorphine" to "creatinine" ratio, using an expanded data set. Additionally, this study delineated a clearer relationship, focusing on the median "norbuprenorphine" to "creatinine" ratios in different buprenorphine dose groups. These results could help providers interpret urine test results more accurately and apply them to outpatient opioid treatment programs for optimal treatment outcomes. [ABSTRACT FROM AUTHOR]

Summary: Objectives: Associations between body mass index (BMI)‐ standard deviation score (SDS)/waist‐to‐height ratio (WHtR) were studied with (i) serum uric acid (sUA)/gamma‐glutamyl‐transferase (GGT) and (ii) cardiometabolic risk markers in children with obesity, considering sex, pubertal development, and degree of weight loss/type of patient care. Methods: 102 936 children from the Adiposity‐Follow‐up registry (APV; 47% boys) were included. Associations were analysed between sUA/GGT and anthropometrics, transaminases, lipids, fasting insulin (FI), homeostasis model assessment of insulin resistance (HOMA‐IR), triglycerides to HDL‐cholesterol (TG/HDL)‐ratio. Follow‐up analyses (3–24 months after baseline) considered a BMI‐SDS reduction ≥0.2 (n = 11 096) or ≥0.5 (n = 3728). Partialized correlation analyses for sex and BMI‐SDS were performed, taking pubertal development into consideration. Results: At baseline, BMI‐SDS showed the strongest correlations to sUA (r = 0.35; n = 26 529), HOMA‐IR/FI (r = 0.30; n = 5513 /n = 5880), TG/HDL‐ratio (r = 0.23; n = 24 501), and WHtR to sUA (r = 0.32; n = 10 805), GGT (r = 0.34; n = 11 862) and Alanine‐aminotransferase (ALAT) (r = 0.33; n = 11 821), with stronger correlations in boys (WHtR and GGT: r = 0.36, n = 5793) and prepubertal children (r = 0.36; n = 2216). GGT and sUA (after partializing effects of age, sex, BMI‐SDS) showed a correlation to TG/HDL‐ratio (r = 0.27; n = 24 501). Following a BMI‐SDS reduction ≥0.2 or ≥0.5, GGT was most strongly related to Aspartate‐aminotransferase (ASAT)/ ALAT, most evident in prepuberty and with increasing weight loss, and also to TG/HDL‐ratio (r = 0.22; n = 1528). Prepubertal children showed strongest correlations between BMI‐SDS/WHtR and GGT. ΔBMI‐SDS was strongly correlated to ΔsUA (r = 0.30; n = 4160) and ΔGGT (r = 0.28; n = 3562), and ΔWHtR to ΔGGT (r = 0.28; n = 3562) (all p < 0.0001). Conclusion: Abdominal obesity may trigger hyperuricemia and hepatic involvement already in prepuberty. This may be stronger in infancy than anticipated to date. Even moderate weight loss has favourable effects on cardiometabolic risk profile and glucose homeostasis. [ABSTRACT FROM AUTHOR]

Repetitive head impacts (RHI) are commonly observed in athletes participating in contact sports such as American football, ice hockey, and soccer. RHI usually do not result in acute symptoms and are therefore often referred to as subclinical or "subconcussive" head impacts. Epidemiological studies report an association between exposure to RHI and an increased risk for the development of neurodegenerative diseases. Diffusion magnetic resonance imaging (dMRI) has emerged as particularly promising for the detection of subtle alterations in brain microstructure following exposure to sport-related RHI. The purpose of this study was to perform a systematic review of studies investigating the effects of exposure to RHI on brain microstructure using dMRI. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to determine studies that met inclusion and exclusion criteria across three databases. Seventeen studies were identified and critically evaluated. Results from these studies suggest an association between white matter alterations and RHI exposure in youth and young adult athletes. The most consistent finding across studies was lower or decreased fractional anisotropy (FA), a measure of the directionality of the diffusion of water molecules, associated with greater exposure to sport-related RHI. Whether decreased FA is associated with functional outcome (e.g., cognition) in those exposed to RHI is yet to be determined. This review further identified areas of importance for future research to increase the diagnostic and prognostic value of dMRI in RHI and to improve our understanding of the effects of RHI on brain physiology and microstructure. [ABSTRACT FROM AUTHOR]

Research into bio-based epoxy resins has intensified in recent decades. Here, it is of great importance to use raw materials whose use does not compete with food production. In addition, the performance of the newly developed materials should be comparable to that of conventional products. Possible starting materials are lignin degradation products, such as vanillin and syringaldehyde, for which new synthesis routes to the desired products must be found and their properties determined. In this article, the first synthesis of two amine hardeners, starting with vanillin and syringaldehyde, using the Smiles rearrangement reaction is reported. The amine hardeners were mixed with bisphenol A diglycidyl ether, and the curing was compared to isophorone diamine, 4-4′-diaminodiphenyl sulfone, and 4-Aminonbenzylamine by means of differential scanning calorimetry. It was found that the two amines prepared are cold-curing. As TG-MS studies showed, the thermal stability of at least one of the polymers prepared with the potentially bio-based amines is comparable to that of the polymer prepared with isophorone diamine, and similar degradation products are formed during pyrolysis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Utilizing a 1-year chart review as the data, Furo et al. conducted a research study on an association between buprenorphine dose and the urine "norbuprenorphine" to "creatinine" ratio and found significant differences in the ratio among 8-, 12-, and 16-mg/ day groups with an analysis of variance (ANOVA) test. This study expands the data for a 2-year chart review and is intended to delineate an association between buprenorphine dose and the urine "norbuprenorphine" to "creatinine" ratio with a higher statistical power. METHODS: This study performed a 2-year chart review of data for the patients living in a halfway house setting, where their drug administration was closely monitored. The patients were on buprenorphine prescribed at an outpatient clinic for opioid use disorder (OUD), and their buprenorphine prescription and dispensing information were confirmed by the New York Prescription Drug Monitoring Program (PDMP). Urine test results in the electronic health record (EHR) were reviewed, focusing on the "buprenorphine," "norbuprenorphine," and "creatinine" levels. The Kruskal-Wallis H and Mann-Whitney U tests were performed to examine an association between buprenorphine dose and the "norbuprenorphine" to "creatinine" ratio. RESULTS: This study included 371 urine samples from 61 consecutive patients and analyzed the data in a manner similar to that described in the study by Furo et al. This study had similar findings with the following exceptions: (1) a mean buprenorphine dose of 11.0 ± 3.8 mg/day with a range of 2 to 20 mg/day; (2) exclusion of 6 urine samples with "creatinine" level <20 mg/dL; (3) minimum "norbuprenorphine" to "creatinine" ratios in the 8-, 12-, and 16-mg/day groups of 0.44 x 10-4 (n = 68), 0.1 x 10-4 (n = 133), and 1.37 x 10-4 (n = 82), respectively; however, after removing the 2 lowest outliers, the minimum "norbuprenorphine" to "creatinine" ratio in the 12-mg/day group was 1.6 x 10-4, similar to the findings in the previous study; and (4) a significant association between buprenorphine dose and the urine "norbuprenorphine" to "creatinine" ratios from the Kruskal-Wallis test (P< . 01). In addition, the median "norbuprenorphine" to "creatinine" ratio had a strong association with buprenorphine dose, and this association could be formulated as: [y = 2.266 ln(x) + 0.8211]. In other words, the median ratios in 8-, 12-, and 16-mg/day groups were 5.53 x 10-4, 6.45 x 10-4, and 7.10 x 10-4, respectively. Therefore, any of the following features should alert providers to further investigate patient treatment compliance: (1) inappropriate substance(s) in urine sample; (2) "creatinine" level <20 mg/dL; (3) "buprenorphine" to "norbuprenorphine" ratio >50:1; (4) buprenorphine dose >24 mg/day; or (5) "norbuprenorphine" to "creatinine" ratios <0.5 x 10-4 in patients who are on 8 mg/day or <1.5 x 10-4 in patients who are on 12 mg/day or more. CONCLUSION: The results of the present study confirmed those of the previous study regarding an association between buprenorphine dose and the "norbuprenorphine" to "creatinine" ratio, using an expanded data set. Additionally, this study delineated a clearer relationship, focusing on the median "norbuprenorphine" to "creatinine" ratios in different buprenorphine dose groups. These results could help providers interpret urine test results more accurately and apply them to outpatient opioid treatment programs for optimal treatment outcomes. [ABSTRACT FROM AUTHOR]

• Aryl phosphate esters (APEs) induce pericardial edema in zebrafish embryos. • APE-induced pericardial edema was mitigated in the presence of D -mannitol. • APE-induced pericardial edema was decreased when exposed in ion-deficient media. • Pericardial edema may be influenced by the ionic composition of exposure media. Pericardial edema – fluid accumulation within the pericardium – is a frequently observed malformation in zebrafish embryo-based chemical toxicity screens. We recently discovered that the severity of triphenyl phosphate (TPHP)-induced pericardial edema was dependent on the ionic strength of exposure media. TPHP is an aryl phosphate ester (APE) widely used as a plasticizer and flame retardant. APEs are characterized by having one or more aryl groups bound to a phosphate center, with TPHP containing only unsubstituted aryl groups. Therefore, the objective of this study was to begin investigating whether, similar to TPHP, pericardial edema induced by other structurally related APEs is dependent on the ionic composition of exposure media. We first mined the peer-reviewed literature to identify other APEs that 1) induced pericardial edema in zebrafish embryos within a minimum of three peer-reviewed publications, and 2) demonstrated a statistically significant induction of pericardial edema in at least 70 % of the studies evaluated. Based on this meta-analysis, we identified four other APEs that caused pericardial edema in zebrafish embryos: isopropylated triphenyl phosphate (IPTPP), cresyl diphenyl phosphate (CDP), tricresyl phosphate (TMPP), and 2-ethylhexyl diphenyl phosphate (EDHPHP). Using TPHP as a positive control and pericardial edema as a readout, we developed concentration-response curves for all four APEs based on static exposure from 24 to 72 h post-fertilization (hpf). We then conducted co-exposures with D -Mannitol (an osmotic diuretic) and exposures within reverse osmosis (RO) water determine whether the ionic composition of exposure media mitigated APE-induced pericardial edema at 72 hpf. Using pericardial edema as an endpoint, the approximate EC 50 s for TPHP (positive control), IPTPP, CDP, TMPP, and EDHPHP were 6.25, 3.125, 3.125, 25, and 100 µM, respectively, based on exposure from 24 to 72 hpf. Interestingly, similar to our findings with TPHP, co-exposure with D -Mannitol and exposure within ion-deficient water significantly mitigated IPTPP- CDP-, TMPP-, and EDHPHP-induced pericardial edema in zebrafish embryos, suggesting that chemically-induced pericardial edema may be 1) dependent on the ionic composition of exposure media and 2) driven by a disruption in osmoregulation across the embryonic epidermis. Therefore, similar to other assay parameters, our findings underscore the need to standardize the osmolarity of exposure media in order to minimize the potential for false positive/negative hits in zebrafish embryo-based chemical toxicity screens conducted around the world. [ABSTRACT FROM AUTHOR]

Residents of nursing homes remain an epidemiologically important population for COVID-19 prevention efforts, including vaccination. We aim to understand effectiveness of bivalent vaccination for preventing SARS-CoV-2 infections in this population. We used a retrospective cohort of nursing home residents from November 1, 2022, through March 31, 2023, to identify new SARS-CoV-2 infections. A Cox proportional hazards model was used to estimate hazard ratios comparing residents with a bivalent vaccination compared with residents not up to date with vaccination recommendations. Vaccine effectiveness was estimated as (1 – Hazard Ratio) * 100. Among 6,916 residents residing in 76 nursing homes included in our cohort, 3,211 (46%) received a bivalent vaccine 7 or more days prior to censoring. Adjusted vaccine effectiveness against laboratory confirmed SARS-CoV-2 infection comparing receipt of a bivalent vaccine versus not up to date vaccine status was 29% (95% Confidence interval 18% to 39%). Vaccine effectiveness for receipt of a bivalent vaccine against residents who were unvaccinated or vaccinated more than a year prior was 32% (95% CI: 20% to 42%,) and was 25% compared with residents who were vaccinated with a monovalent vaccine in the past 61–365 days (95% CI:10% to 37%). Bivalent COVID-19 vaccines provided additional protection against SARS-CoV-2 infections in nursing home residents during our study time-period, compared to both no vaccination or vaccination more than a year ago and monovalent vaccination 60 – 365 days prior. Ensuring nursing home residents stay up to date with vaccine recommendations remains a critical tool for COVID-19 prevention efforts. [ABSTRACT FROM AUTHOR]

Thermophoresis describes mass transport in a non-isothermal temperature field and thus provides a fundamental understanding of the behavior of colloidal particles. Various methods have been proposed for measuring the Soret coefficient, a representative value of thermophoresis. In particular, microscopic channels are an emerging method as they shorten the equilibrium time and allow direct observation of the particles. However, little emphasis has been placed on the simultaneous consideration of fluid dynamics, heat transfer, and mass transfer characteristics within the microfluidic channel, despite the simultaneous presence of natural convection and thermodiffusion phenomena. In this study, we present a novel approach to address this gap by introducing a figure of merit , which incorporates essential parameters to accurately characterize a specific cell configuration. This figure of merit allows for the identification of a reliable measurement range in a microfluidic channel with a temperature gradient, while accounting for fluid dynamics, heat transfer, and mass transfer characteristics. The proposed approach is validated through rigorous simulations and experiments, enabling an evaluation of the impact of figure of merit -derived parameters on the measurement channel. The findings from our study demonstrate that the figure of merit serves as a representative measure for stable thermophoretic measurements in a microfluidic channel. Moreover, we propose a threshold value that signifies the transition from a diffusion-dominant to a convection-dominant field. [Display omitted] • Thermal design of non-isothermal microfluidic channel analyzed for fluid, heat, and mass transfer. • Figure of merit proposed for the channel employing convection and thermophoresis. • Unity of figure of merit differentiates diffusion- and convection-dominant fields in channel. • Figure of merit provides criterion for reliable Soret coefficient measurement in channel. [ABSTRACT FROM AUTHOR]

The analysis of the spatial phylogenetic and phenotypic structure of plant communities can provide insight into the underlying processes and interactions governing their assembly, and how these may change during plant ontogeny. We used point pattern analysis to find out if saplings and adult plants are surrounded by phylogenetically and phenotypically more similar or more dissimilar neighbours than expected by chance, and whether these associations change from the sapling to the adult stage. To this end, we combined information on the phylogenetic structure and eight phenotypic traits of 15 woody plant species in two Mediterranean mixed forests of southeastern Spain. At the community level, we found that the sapling bank at both sites did not show phylogenetic or phenotypic spatial patterns, but adults showed phylogenetic clustering (i.e. heterospecific neighbours were more similar than expected). At the species level, we found frequently repulsive patterns in the sapling bank of less abundant species (i.e. heterospecific sapling or adult neighbours were more dissimilar than expected) in both, phylogenetic and phenotypic analyses. For the adult stage, we found phylogenetic attraction (i.e. more similar neighbours) in just one species and phenotypic clustering in four species. The processes driving the assembly of the communities of saplings and adults leave detectable signals in the spatial phylogenetic and phenotypic structure of our two forest communities. Our findings reinforce the existence of ontogenetic shifts in the mechanisms involved in plant community assembly. Facilitation between phylogenetically distant and phenotypically divergent species favours the recruitment of less abundant species. However, processes acting later in the ontogeny ameliorate the competition between close relatives and determine the spatial structure of adult plants. Nevertheless, the role of phenotype in shaping the interactions between adult plants was context‐ and trait‐dependent. The use of spatial point pattern analysis allowed a nuanced interpretation of the phylogenetic and phenotypic structures of plant communities. [ABSTRACT FROM AUTHOR]

Diagnostic errors – inaccurate or untimely diagnoses or failures to communicate diagnoses – are harmful and costly for patients and health systems. Diagnostic disparities occur when diagnostic errors are experienced at disproportionate rates by certain patient subgroups based, for example, on patients' age, sex/gender, or race/ethnicity. We aimed to develop and test the feasibility of a human centered design workshop series that engages diverse stakeholders to develop solutions for mitigating diagnostic disparities. We employed a series of human centered design workshops supplemented by semi-structured interviews and literature evidence scans. Co-creation sessions and rapid prototyping by patient, clinician, and researcher stakeholders were used to generate design challenges, solution concepts, and prototypes. A series of four workshops attended by 25 unique participants was convened in 2019–2021. Workshops generated eight design challenges, envisioned 29 solutions, and formulated principles for developing solutions in an equitable, patient-centered manner. Workshops further resulted in the conceptualization of 37 solutions for addressing diagnostic disparities and prototypes for two of the solutions. Participants agreed that the workshop processes were replicable and could be implemented in other settings to allow stakeholders to generate context-specific solutions. The incorporation of human centered design through a series of workshops promises to be a productive way of engaging patient-researcher stakeholders to mitigate and prevent further exacerbation of diagnostic disparities. Healthcare stakeholders can apply human centered design principles to guide thinking about improving diagnostic performance and to center diverse patients' needs and experiences when implementing quality and safety improvements. [ABSTRACT FROM AUTHOR]

In late December of 2019, high-throughput sequencing technologies enabled rapid identification of SARS-CoV-2 as the etiological agent of COVID-19, and global sequencing efforts are now a critical tool for monitoring the ongoing spread and evolution of this virus. Here, we provide a short retrospective analysis of SARS-CoV-2 variants by analyzing a subset (n = 97,437) of all publicly available SARS-CoV-2 genomes (n = ~11.9 million) that were randomly selected but equally distributed over the course of the pandemic. We plot the appearance of new variants of concern (VOCs) over time and show that the mutation rates in Omicron (BA.1) and Omicron sub-lineages (BA.2–BA.5) are significantly elevated compared to previously identified SARS-CoV-2 variants. Mutations in Omicron are primarily restricted to the spike and nucleocapsid proteins, while 24 other viral proteins—including those involved in SARS-CoV-2 replication—are generally conserved. Collectively, this suggests that the genetic distinction of Omicron primarily arose from selective pressures on the spike, and that the fidelity of replication of this variant has not been altered. [ABSTRACT FROM AUTHOR]

Looking at the German production and reception context, this article argues for increased attention to part-talkies as a transitional phenomenon and hybrid medium in film history. Part-talkies are films that alternate between silent and sound film sequences, creating 'changes in register', ruptures and ambiguities, which point to the unevenness and duration of cinema's conversion to sound. The article presents several types of part-talkies and other hybrid films from around 1930, giving reasons for their marginalization in film historiography and the need for a critical and non-judgmental examination of their cultural, economic, and aesthetic implications. As a look at contemporary reviews in German trade papers reveals, part-talkies were the subject of heterogeneous debates on film aesthetics, in which differing views on their artistic value clashed. Furthermore, an exemplary historical analysis of the German part-talkie Cyankali (Cyanide) (dir. Hans Tintner, 1930) shows how the film's hybridity resulted from its production history and became the focus of contemporary censorship debates. A close reading of some of the film's sound sequences brings to the fore the complex audiovisual methods operating in the film, especially at moments of transition. [ABSTRACT FROM AUTHOR]

Purpose: Children with extensive lymphatic malformations of the head and neck often suffer from functional impairment and aesthetic deformity which significantly affect the quality of life and may be life-threatening. Treatment with sirolimus has the potential to improve symptoms and downsize lymphatic malformations. This systematic review summarizes the current information about sirolimus treatment of lymphatic malformations of the head and neck in children, its efficacy and side effects. Methods: A systematic search of the literature regarding studies on sirolimus treatment of children with lymphatic malformations of the head and neck was performed in PubMed, Embase, and Google Scholar up to July 2021 with the search terms "lymphatic malformation", "lymphangioma", "cystic hygroma", "low-flow malformation", "sirolimus", "rapamycin", "mTOR inhibitor" and "children". Results: In all, 28 studies including 105 children from newborn to 17 years treated with sirolimus for lymphatic malformations of the head and neck were analyzed. The most frequent initial dose was 0.8 mg/m2 per dose, twice daily at 12-h interval. The target blood level differed between studies, 10–15 ng/mL and 5–15 ng/mL were most often used. More than 91% of the children responded to sirolimus treatment which lasts from 6 months to 4 years. Typical side effects were hyperlipidemia, neutropenia and infections. Methods: Sirolimus could be an effective treatment for children with large complicated lymphatic malformations of the head and neck. As not all patients will benefit from treatment, the decision to treat sirolimus should be made by a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Background: Plantar fasciitis (PF) is a common overuse injury experienced by runners. PF may decrease the ability of the plantar fascia to create tension and reduce stability of the foot. Stability of the foot is necessary for whole-body dynamic stability during running which consists of cyclical periods of single leg stance. Given that a major risk factor for running-related injury is previous injury, evaluating dynamic stability in runners with PF, runners with resolved PF, and healthy runners may elucidate differences between these individuals and clarify risk for secondary injury in these groups.Research Question: Is dynamic stability reduced in runners with PF and runners with resolved PF compared to healthy runners?Methods: Thirty runners were recruited for this retrospective comparative study based on mileage and injury status: current PF (PF), resolved PF (RPF), or healthy (CON). Kinematic and kinetic data were collected during running and dynamic stability was determined by time-to-contact (TtC) analysis for early, mid, and late stance to the anterior, posterior, medial, and lateral boundary of the foot. Dynamic stability was compared between groups one-way ANOVAs (α = 0.05) and Tukey post-hoc tests conducted when appropriate. Cohen's d effect sizes (d) were reported for all TtC comparisons (small = 0.20, medium = 0.50, large = 0.80).Results: TtC values were shorter in PF compared to the other groups to all boundaries during mid-stance. TtC was significantly greater in PF compared to RPF to the anterior boundary during late stance.Significance: Shorter TtC observed in PF compared to the other groups during midstance may indicate reduced dynamic stability during the most stable portion of running which may lead to increased injury risk. [ABSTRACT FROM AUTHOR]