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Honey bees (Apis mellifera L.) are the premier agricultural pollinators with direct ecological value and are key to some agro-economies. Major factors have negatively impacted honey bee health in the past 2 decades with Varroa (Varroa destructor Anderson and Trueman) infestation rising as a principal predictor of colony mortality. A key strategy deployed in Varroa management is breeding for resistant honey bee populations that can maintain comparable levels of productivity as nonresistant populations. In this study, we examine one such population, Hilo honey bees, within the context of a common garden contrast with a commercial population in a stationary honey production operation. We compare colony survival, health, yield, and profit outcomes to show how this specific breeding population retains a profit value in honey production operations while maintaining higher survival and lower Varroa infestation levels than the commercial population. This information can be used by commercial beekeepers to make best management practice decisions and inspire further work examining what trade-offs, if any, are present in this Varroa- resistant population. [ABSTRACT FROM AUTHOR]

We review currently available Canadian and international lithostratigraphic and lithodemic schemes and find most of them inadequate for classifying intrusive and strongly metamorphosed rocks of Canada and beyond. A new system is proposed, one that unifies, complements, and extends components of the revised North American Stratigraphic Code, the British Geological Survey Rock Unit Classification System of 2021, and the International Stratigraphic Guide of 1999. This new Cooperative Lithodemic and Stratigraphic System (CLASS) is intended to serve as a practical guide to geoscientists who need to classify and report on lithodemic units in North America and has broad applicability to other jurisdictions. It is built with database management practices in mind and employs the concept of inheritance of root characteristics between seven formal rock unit ranks, which will allow incorporation of the scheme into compact object-oriented and relational databases designed for purpose. Broad application of CLASS, especially to historically problematic lithodemic units, should help to foster jurisdictional interoperability, data sharing, global compilations, and thematic studies. At the heart of this proposed system is a subdivision and accompanying nomenclature that allows classification of rocks into seven formal ranks. Following the well-established lithostratigraphic supergroup, group, subgroup, formation, member, submember, and bed approach, CLASS proposes three classes of lithodemic subdivisions for formally naming lithodemic rock units. [ABSTRACT FROM AUTHOR]

Introduction: Anemia is a common comorbidity of chronic kidney disease (CKD) that has been associated with increased risk of complications, healthcare expenditure, and reduced quality of life. In China, the treatment of anemia of CKD has been reported to be suboptimal in part because of a lack of awareness of the condition and its management. It is therefore important to raise awareness of the condition by estimating the future health and economic burden of anemia of CKD and also to understand how it may be addressed through proactive policies. This study aims to project the health and economic burden of anemia of CKD, in China, from 2023 to 2027 and to estimate the impact of a hypothetical intervention on related clinical and cost outcomes. Methods: A virtual Chinese population was simulated using demographic, clinical, and economic statistics within a validated CKD microsimulation model. Each individual was assigned a CKD stage, anemia stage, comorbidity status (type 2 diabetes, hypertension), complication status (stroke, heart failure, and/or myocardial infarction), and a probability of receiving treatments and therapies. Annual direct healthcare costs were assigned and based on these factors. The hypothetical intervention reduced the prevalence of moderate and severe anemia by 5% annually. This hypothetical scenario was chosen to highlight the impact of implementing policies that could reduce anemia of CKD, and is aligned with the Healthy China 2030 policy, which aims to reduce mortality from noncommunicable diseases by 30%. Interventions could consist of early screening and intervention to reduce the escalation of anemia from mild to moderate or severe. Results were compared with a baseline "no change" scenario which reflects current trends. Results: The number of patients with moderate/severe anemia of CKD was projected to increase from 3.0 to 3.2 million patients, with associated costs increasing from ¥22.0 billion (B) to ¥24.4B between 2023 and 2027, respectively. Compared with the no change scenario, the hypothetical intervention reduced the prevalence of moderate and severe anemia of CKD, saving ¥3.9B in healthcare costs in 2027 (¥24.4B vs ¥20.6B, respectively). Conclusions: Consistent with trends in CKD burden in China, the prevalence of anemia of CKD is projected to increase, leading to greater related healthcare costs. The introduction of healthcare interventions designed to screen for and treat anemia more effectively could therefore reduce its future burden and related costs. Plain Language Summary: Anemia, a common issue in chronic kidney disease, can lead to complications and increased healthcare costs. In China, anemia treatment for chronic kidney disease is often suboptimal because of a lack of awareness. This study aimed to estimate the future health and economic impact of anemia in chronic kidney disease in China from 2023 to 2027 and assess the effects of a hypothetical intervention. The research used a computer model to simulate a virtual Chinese population based on demographics, clinical data, and economic statistics. In the "no change" scenario, the prevalence of moderate/severe anemia in chronic kidney disease was projected to increase, with associated healthcare costs rising from ¥22.0B to ¥24.4B. A hypothetical intervention, reducing anemia prevalence by 5% annually, resulted in cost savings, lowering healthcare costs to ¥20.58B in 2027. In conclusion, anemia in chronic kidney disease is expected to increase in China, raising healthcare costs. Implementing interventions, such as early screening and treatment, could significantly reduce future burdens and related costs, emphasizing the need for proactive healthcare policies. [ABSTRACT FROM AUTHOR]

Effective treatment and immunoprophylaxis of viral respiratory infections with neutralizing monoclonal antibodies (mAbs) require maintaining inhibitory concentrations of mAbs at the airway surface. While engineered mAbs with increased affinity to the neonatal Fc receptor (FcRn) are increasingly employed, little is known how increased affinity of Fc to FcRn influences basal-to-apical transepithelial transport (transcytosis) of mAbs across the airway epithelium. To investigate this, we utilized a model of well-differentiated human airway epithelium (WD-HAE) that exhibited robust FcRn expression, and measured the transepithelial transport of a mAb against SARS-CoV-2 Spike protein (CR3022) with either wildtype IgG1-Fc or Fc modified with YTE or LS mutations known to increase affinity for FcRn. Despite the marked differences in the affinity of these CR3022 variants for FcRn, we did not find substantial differences in basal-toapical transport reflective of systemic dosing, or apical-to-basal transport reflective of inhaled dosing, compared to the transport of wildtype IgG1-Fc. These results suggest increasing FcRn affinity may only have limited influence over transcytosis rates of systemically dosed mAbs across the human airway epithelium over short time scales. Over longer time scales, the elevated circulating levels of mAbs with greater FcRn affinity, due to more effective FcRn-mediated recycling, may better resupply mAb into the respiratory tract, leading to more effective extended immunoprophylaxis. [ABSTRACT FROM AUTHOR]

Copyright of Promotion de la Santé et Prévention des Maladies Chroniques au Canada is the property of Public Health Agency of Canada and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Promotion de la Santé et Prévention des Maladies Chroniques au Canada is the property of Public Health Agency of Canada and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sexual minority men (SMM) living with HIV report significantly greater methamphetamine use compared with heterosexual and HIV-negative peers. Greater use may be related to stressors (e.g., HIV-related stigma) faced by SMM living with HIV and subsequent psychological and behavioral sequelae. We tested an integrated theoretical model comprised of pathways between stigma, discrimination, childhood sexual abuse, psychological distress, sexual compulsivity, and cognitive escape in predicting methamphetamine use among SMM living with HIV. Among 423 SMM living with HIV, we tested a structural equation model examining factors hypothesized to be directly and indirectly associated with methamphetamine use. Analyses were adjusted for demographic covariates and sampling bias. The model showed good fit (CFI = 0.96, RMSEA = 0.01). Heterosexist discrimination was associated with psychological distress (β = 0.39, p < 0.001) and psychological distress was associated with sexual compulsivity (β = 0.33, p < 0.001). Sexual compulsivity was associated with cognitive escape (β = 0.31, p < 0.001), which was associated with methamphetamine use (β = 0.51, p < 0.001). Psychological distress was associated with methamphetamine use via serial indirect effects of sexual compulsivity and cognitive escape (β = 0.05, p < 0.05). Heterosexist discrimination contributed to psychological distress among SMM living with HIV. Psychological distress is linked to methamphetamine use via sexual compulsivity and cognitive avoidance. Interventions seeking to reduce the likelihood that SMM living with HIV use methamphetamine should include coping strategies specific to heterosexism and related psychological distress. [ABSTRACT FROM AUTHOR]

Introduction: Social prescribing (SP) is a holistic and collaborative approach to help individuals access community-based supports and services for their nonmedical social needs. The aim of this study was to assess the needs and priorities of Canadian older adults (aged 55 years and older), with a focus on optimizing SP programs for those who are systemically disadvantaged and socially marginalized. Methods: Semistructured focus groups (N = 10 groups, 43 participants) were conducted online via Zoom with participants from across Canada. Data transcription and thematic analysis were completed in NVivo. Analyses were informed by self-determination theory. Results: Our results suggest that older adults desire SP programs that respect their ability to maintain their autonomy and independence, aid and facilitate the development of connectedness and belonging, are built on a foundation of trust and relationship-building in interactions with providers and link workers, and prioritize the person and thus personalize SP to the unique needs of each individual. Conclusion: SP programs should be informed by the values of older adults. As work is currently underway to formalize and scale SP in Canada, personalizing these programs to the unique circumstances, needs and priorities of participants should be a top priority. [ABSTRACT FROM AUTHOR]

Objective: SARS-CoV-2 remains the third most common cause of death in North America. We studied the effects of methotrexate and tumor necrosis factor inhibitor (TNFi) on neutralization responses after COVID-19 vaccination in immune-mediated inflammatory disease (IMID). Methods: Prospective data and sera of adults with inflammatory bowel disease (IBD), rheumatoid arthritis (RA), spondyloarthritis (SpA), psoriatic arthritis (PsA), and systemic lupus (SLE) were collected at six academic centers in Alberta, Manitoba, Ontario, and Quebec between 2022 and 2023. Sera from two time points were evaluated for each subject. Neutralization studies were divided between five laboratories, and each lab's results were analyzed separately using multivariate generalized logit models (ordinal outcomes: absent, low, medium, and high neutralization). Odds ratios (ORs) for the effects of methotrexate and TNFi were adjusted for demographics, IMID, other biologics and immunosuppressives, prednisone, COVID-19 vaccinations (number/type), and infections in the 6 months prior to sampling. The adjusted ORs for methotrexate and TNFi were then pooled in random-effects meta-analyses (separately for the ancestral strains and the Omicron BA1 and BA5 strains). Results: Of 479 individuals (958 samples), 292 (61%) were IBD, 141 (29.4%) were RA, and the remainder were PsA, SpA, and SLE. The mean age was 57 (62.2% female). For both the individual labs and the meta-analyses, the adjusted ORs suggested independent negative effects of TNFi and methotrexate on neutralization. The meta-analysis adjusted ORs for TNFi were 0.56 (95% confidence interval (CI) 0.39, 0.81) for the ancestral strain and 0.56 (95% CI 0.39, 0.81) for BA5. The meta-analysis adjusted OR for methotrexate was 0.39 (95% CI 0.19, 0.76) for BA1. Conclusions: SARS-CoV-2 neutralization in vaccinated IMID was diminished independently by TNFi and methotrexate. As SARS-CoV-2 circulation continues, ongoing vigilance regarding optimized vaccination is required. [ABSTRACT FROM AUTHOR]

There is scant information on Salmonella in indigenous poultry in Nigeria. We investigated the occurrence and characterized Salmonella serovars in indigenous poultry and their drinking water sources to enhance the monitoring of the infection in poultry and to promote public health. We collected 1208 samples, poultry droppings (n = 1108), and water (n = 100) across 15 markets in North Central Nigeria. Salmonella spp. were isolated following World Organisation for Animal Health guidelines. Salmonella spp., confirmed through invA gene detection by a polymerase chain reaction assay, were 6.8% (75/1108) droppings and 3% (3/100) water. Susceptibility testing against 13 antimicrobials showed 60.3% (47/78) susceptibility to all the antimicrobials tested while 14.1% (11/78) were multidrug resistant. Serotyping and whole-genome sequencing were carried out on 44 of the isolates, and 23 different serovars were identified. Genomes of serovars Luedinghausen, Laredo, Widemarsh, and Lansing are being documented in Africa for the first time. Twenty (20) antimicrobial resistance (AMR) gene markers encoding for resistance to aminoglycosides, tetracyclines, sulphonamides, quinolones, trimethoprim, penicillins and phenicols were found. Phylogenetic cluster analysis showed close relatedness among isolates from different sources. This study shows both low Salmonella prevalence and AMR, but since uncommon serovars are circulating, continuous monitoring is recommended so as to ensure food safety and poultry health. [ABSTRACT FROM AUTHOR]

Habitat fragmentation and host community composition are implicated as key drivers of changing tick populations and tick‐borne pathogen dynamics, altering infection risk through coupled socioecological pathways that mediate interactions between tick vectors, vertebrate hosts, and humans. Patterns of host diversity may be particularly idiosyncratic across urbanized landscapes, due to trade‐offs between extreme fragmentation that reduces habitat suitability and access, and human activities that artificially increase resource availability for wildlife. We used camera and hair trap surveys and tick sampling to identify links between landscape composition and configuration, the mammalian host community, and the presence of three tick vector species at a human–wildlife interface in New York City, an emerging area within an endemic region for several tick‐borne diseases. We found that human infrastructures, such as the presence of fences in yards, could affect mammal host community composition by changing the "hardness" of edges between urban greenspaces and residential areas. We identified yard‐ and broader landscape‐level features associated with the presence of urban mammal species, and identified cascading effects of host community composition on tick distribution in yards, suggesting management implications for the mitigation of human exposure to tick‐borne pathogens. In particular, we identified a possible role of ubiquitous mesomammals, such as raccoons (Procyon lotor), in transporting Amblyomma americanum ticks between parks and neighboring residential yards, and confirmed the key role of white‐tailed deer (Odocoileus virginianus) for introducing Ixodes scapularis ticks into yards. Our results challenge assumptions that biodiversity loss in human‐modified areas always increases the risk for tick‐borne diseases. Instead, we found many residential sites had higher mammal species richness and higher detection of low reservoir competent ("dilution") hosts for Borrelia burgdorferi, such as opossums (Didelphis virginiana), than paired forested greenspaces. Our study highlights the importance of disentangling the mechanisms mediating tick‐borne disease hazard as a critical first step toward reducing urban tick‐borne disease risk. [ABSTRACT FROM AUTHOR]

Introduction: Social prescribing offers a formal pathway of connecting patients in the health system with sources of support within the community to help improve their health and well‐being. Since its launch in March 2022, the Canadian Institute for Social Prescribing has acted as a collective impact network to identify, connect and build upon established social prescribing initiatives using a co‐design methodology. The institute received input from a participant advisory council, co‐design partners and several communities of interest groups. This study aimed to describe the perceptions of the Canadian Institute for Social Prescribing's role in advancing social prescribing using a co‐design approach and the barriers and facilitators to implementing social prescribing in Canada. Methods: We used a qualitative descriptive study design, document analysis, participant observation and semi‐structured individual interviews (n = 7) with members of the Canadian Institute for Social Prescribing co‐design group and the institute's leadership. We also analysed documents, field notes and transcripts using codebook thematic analysis. Results: Four themes were developed representing the facilitators of implementing the Canadian Institute for Social Prescribing to support social prescribing: Creating relational mechanisms (i.e., partnerships and connections), Bringing awareness to social prescribing and contributing to the evidence (i.e., values and beliefs), Addressing systemic conditions (i.e., having a common language for social prescribing and organizing the community health sector) and Enabling funding and policy to drive social prescribing initiatives (i.e., shifting evidence into policy and securing sustainable funding). Conclusion: Participants' reflections on the co‐design process demonstrated that the Canadian Institute for Social Prescribing development provided networking opportunities and shared resources relevant to social prescribing. Co‐design efforts also fostered relational and informational support, which laid the necessary groundwork in Canada to overcome the complex interplay between the macro‐ and micro‐level settings in which social prescribing is practiced. Patient or Public Contribution: The interviews and observations involved participants with lived experience of delivering, receiving or advocating for social prescribing. [ABSTRACT FROM AUTHOR]

A trade‐off between growth and defence against biotic stresses is common in plants. Fungal endophytes of the genus Epichloë may relieve this trade‐off in their host grasses since they can simultaneously induce plant growth and produce antiherbivore alkaloids that circumvent the need for host defence. The Epichloë ability to decouple the growth‐defence trade‐off was evaluated by subjecting ryegrass with and without Epichloë endophytes to an exogenous treatment with gibberellin (GA) followed by a challenge with Rhopalosiphum padi aphids. In agreement with the endophyte‐mediated trade‐off decoupling hypothesis, the GA‐derived promotion of plant growth increased the susceptibility to aphids in endophyte‐free plants but did not affect the insect resistance in endophyte‐symbiotic plants. In line with the unaltered insect resistance, the GA treatment did not reduce the concentration of Epichloë‐derived alkaloids. The Epichloë mycelial biomass was transiently increased by the GA treatment but at the expense of hyphal integrity. The response of the phyllosphere bacterial microbiota to both GA treatment and Epichloë was also evaluated. Only Epichloë, and not the GA treatment, altered the composition of the phyllosphere microbiota and the abundance of certain bacterial taxa. Our findings clearly demonstrate that Epichloë does indeed relieve the plant growth‐defence trade‐off. Summary statement: A debate has been raised if fungal endophytes can relieve the plant growth‐defence trade‐off. Epichloë endophytes decoupled the trade‐off: the growth‐mediated penalisation of plant defences was observed in E− but not in E+ plants. The Epichloë production of alkaloids was likely the decoupling mechanism. [ABSTRACT FROM AUTHOR]

Introduction: Gout, a common comorbidity of chronic kidney disease (CKD), is associated with high morbidity and healthcare utilization. However, a large proportion of gout remains undermanaged or untreated which may lead to worse patient outcomes and greater healthcare costs. This study estimates the present and future health and economic burden of controlled and uncontrolled gout in a virtual United States (US) CKD population. Methods: A validated microsimulation model was used to project the burden of gout in patients with CKD in the USA through 2035. Databases were utilized to build a virtual CKD population of "individuals" with controlled or uncontrolled gout. Modelling assumptions were made on the basis of the literature, which was sparse in some cases. Health and economic outcomes with the current care (baseline) scenario were evaluated, along with potential benefits of urate-lowering intervention scenarios. Results: The prevalence of comorbid gout and CKD in the USA was projected to increase by 29%, from 7.9 million in 2023 to 9.6 million in 2035 in the baseline scenario. Gout flares, tophi, and comorbidity development were also projected to increase markedly through 2035, with the economic burden of gout in the CKD population subsequently increasing from $38.9 billion in 2023 to $47.3 billion in 2035. An increased use of oral urate-lowering therapies in undermanaged patients, and pegloticase use in patients refractory to oral urate-lowering therapies were also project to result in 744,000 and 353,000 fewer uncontrolled gout cases, respectively, by 2035. Marked reductions in complications and costs ensued. Conclusions: This study projected a substantial increase in comorbid gout and CKD. However, improved use of urate-lowering interventions could mitigate this growth and reduce the health and economic burdens of gout. [ABSTRACT FROM AUTHOR]

Artificial intelligence tools are being increasingly used to do content analysis in technical and professional communication (TPC). The authors consider some of the affordances and constraints of these tools and suggest that construct validity is an underdiscussed form of validity within TPC research that will become more important as artificial intelligence research tools become increasingly prevalent. But construct validity is an important idea for graduate programming on research methods regardless of the type of method, technique, or tool used—whether qualitative or computational. Thus, training in construct validity is important for strengthening graduate research preparation in TPC. [ABSTRACT FROM AUTHOR]

The following investigation is a cognitive-historical analysis of the conceptual development of complex numbers. The history we explore spans nearly two millennia, from the earliest appearance of the square root of a negative quantity in the calculations of Heron of Alexandra (first century CE) to the full flowering of complex numbers in the first half of the 19th century. The approach we use is Nersessian's, including her formulations of model-based reasoning and mental models. Additional aspects feature the prominent roles played by process representations, including object-process complementarities, and by core numerical systems. Our analysis provides support for mental rotation as a fourth core system and for bootstrapping scenarios in both the senses of Nersessian and of Carey. We use the results of our analysis and discussion to update previous con- ceptual metaphor mapping approaches to complex numbers by Fauconnier and Turner and by Lakoff and Núñez. Finally, we review recent empirical studies of complex number learning and find them to be consistent with the present work. [ABSTRACT FROM AUTHOR]

Background: Consultation with primary healthcare professionals may provide an opportunity to identify patients at higher suicide risk. Aim: To explore primary care consultation patterns in the 5 years before suicide to identify suicide high-risk groups and common reasons for consulting. Design and setting: This was a case–control study using electronic health records from England, 2001 to 2019. Method: An analysis was undertaken of 14 515 patients aged ≥15 years who died by suicide and up to 40 matched live controls per person who died by suicide (n = 580 159), (N = 594 674). Results: Frequent consultations (>1 per month in the final year) were associated with increased suicide risk (age- and sex -adjusted odds ratio [OR] 5.88, 95% confidence interval [CI] = 5.47 to 6.32). The associated rise in suicide risk was seen across all sociodemographic groups as well as in those with and without psychiatric comorbidities. However, specific groups were more influenced by the effect of high-frequency consultation (>1 per month in the final year) demonstrating higher suicide risk compared with their counterparts who consulted once: females (adjusted OR 9.50, 95% CI = 7.82 to 11.54), patients aged 15–<45 years (adjusted OR 8.08, 95% CI = 7.29 to 8.96), patients experiencing less socioeconomic deprivation (adjusted OR 6.56, 95% CI = 5.77 to 7.46), and those with psychiatric conditions (adjusted OR 4.57, 95% CI = 4.12 to 5.06). Medication review, depression, and pain were the most common reasons for which patients who died by suicide consulted in the year before death. Conclusion: Escalating or more than monthly consultations are associated with increased suicide risk regardless of patients' sociodemographic characteristics and regardless of the presence (or absence) of known psychiatric illnesses. [ABSTRACT FROM AUTHOR]

In the natural world, animals make decisions on an ongoing basis, continuously selecting which action to undertake next. In the lab, however, the neural bases of decision processes have mostly been studied using artificial trial structures. New experimental tools based on the genetic toolkit of model organisms now make it experimentally feasible to monitor and manipulate neural activity in small subsets of neurons during naturalistic behaviors. We thus propose a new approach to investigating decision processes, termed reverse neuroethology. In this approach, experimenters select animal models based on experimental accessibility and then utilize cutting-edge tools such as connectomes and genetically encoded reagents to analyze the flow of information through an animal's nervous system during naturalistic choice behaviors. We describe how the reverse neuroethology strategy has been applied to understand the neural underpinnings of innate, rapid decision making, with a focus on defensive behavioral choices in the vinegar fly Drosophila melanogaster. [ABSTRACT FROM AUTHOR]

Summary: To address the lack of contemporary population‐based epidemiological studies of hepatosplenic T‐cell lymphoma (HSTCL), we undertook a population‐based study of ICD‐O‐3‐coded HSTCL in England. We used the National Cancer Registration Dataset and linked datasets on hospital admissions, Systemic Anti‐Cancer Therapy, socio‐demographics, comorbidities and death, identifying cases from 1 January 2013 to 31 December 2019 with survival data up to 5 January 2021. Crude and directly age‐standardised incidence rates per million persons per year were calculated. Crude and adjusted incidence rate ratios compared incidence between groups using Poisson regression. A Cox proportional hazards model estimated mortality risks adjusted for age, sex, ethnicity, deprivation and allogenic stem cell transplant (allo‐SCT; time varying). We identified 44 patients, mean age 42 years. Median survival was 11 months, and 1 and 5 year survivals were 48% (95% CI 29%–43%) and 22% (95% CI 12%–42%) respectively. The age‐standardised incidence was 0.1 per million/year. Incidence was higher in areas with greater deprivation (0.15 per million/year), and more cases than expected were in non‐White patients (39%). Non‐Whites had a twofold increased risk of death (adjusted hazard ratio 2.21 [95% CI 1.03–4.78]) even after adjusting for deprivation, younger age and allo‐SCT. In conclusion, ethnicity and socio‐economic status affect both the incidence and survival of HSTCL. [ABSTRACT FROM AUTHOR]

The surveillance of antimicrobial resistance (AMR) in commensal Escherichia coli from livestock at slaughter is widely employed to assess the potential for risk to humans. There is currently a limited understanding of AMR in Bangladesh poultry at retail in live bird markets, with studies focussing solely on phenotypic characterisation of resistance. To address this evidence gap we performed antimicrobial susceptibility testing and whole genome sequencing on E. coli obtained from chickens from live bird markets in Dhaka in 2018 (n = 38) and 2020 (n = 45). E. coli were isolated from caeca samples following ISO guidelines and sequenced using short and long read methods. Multidrug resistance was extremely common (n = 77) and there was excellent concordance between AMR phenotype and the presence of corresponding AMR genes or mutations. There was considerable genomic diversity, with 43 different sequence types detected. Public health considerations included the high occurrence of resistance to ciprofloxacin (n = 75) associated with plasmid-residing qnrS or mutations in the gyrA and parC chromosomal genes; and the detection of a tigecycline resistant isolate harbouring tet(X4) on an IncHI1A/B-IncFIA mosaic plasmid. Thirty-nine isolates were resistant to azithromycin and harboured mphA, with a significant increase in the incidence of resistance between 2018 and 2020. Although azithromycin is banned for veterinary use in Bangladesh it remains an important treatment option for humans. Interestingly, mphA confers highlevel resistance to azithromycin and erythromycin, and the latter is commonly used on poultry farms in Bangladesh. Seven isolates were colistin resistant and carried mcr1. For two isolates hybrid assemblies revealed that mcr1 resided on a highly conserved IncHI2 plasmid that had 93% nucleotide identity to a plasmid from the published genome of an E. coli isolate of Bangladeshi human origin. Six isolates had resistance to third generation cephalosporins, associated with plasmid-residing blaCTX-M-55, blaCTX-M-65, or blaDHA-1. By employing phenotypic and genomic approaches for AMR surveillance we have provided new insights into the potential for One Health AMR linkages in Bangladesh. Employing similar approaches in human and environmental sectors will help inform the One Health approach to addressing AMR, and generate evidence to support mitigation measures such as improved antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Objectives: This is the protocol for an evidence and gap map. The objectives are as follows: The aim of this evidence and gap map is to map the available evidence on the effectiveness of social prescribing interventions addressing a non‐medical, health‐related social need for older adults in any setting. Specific objectives are as follows: 1.To identify existing evidence from primary studies and systematic reviews on the effects of community‐based interventions that address non‐medical, health‐related social needs of older adults to improve their health and wellbeing.2.To identify research evidence gaps for new high‐quality primary studies and systematic reviews.3.To highlight evidence of health equity considerations from included primary studies and systematic reviews. [ABSTRACT FROM AUTHOR]

Epichloë is a genus of filamentous fungal endophytes that have co-evolved with cool-season grasses with which they form long-term, symbiotic associations. In natural ecosystems Epichloë have implications for species diversity, food web structures and fundamental ecological processes. Epichloë produce a range of secondary metabolites that can have negative effects on herbivores, be they invertebrates or vertebrates. In many managed pastoral systems, selected asexual Epichloë strains are purposefully associated with grass cultivars (termed novel endophyte-grass associations) as they confer beneficial traits that protect the host from abiotic stresses (e.g. drought) and biotic stresses (e.g. herbivory from invertebrates) while having minimal impact on the health and welfare of ruminant livestock. As well as conferring beneficial traits, agriculturally selected strains of Epichloë can also increase plant biomass and seed yield. Epichloë endophyte-technology has and continues to be a scientific, agricultural, and marketing success with selected asexual strains of Epichloë now essential components of many pasture ecosystems, within New Zealand and abroad. An estimated 90% of proprietary ryegrass now sold in New Zealand contains a selected endophyte strain while the economic impact in New Zealand of AR37 alone has been estimated at NZ$3.6 billion over 20 years. With a changing climate, agriculture will continue to experience increasing temperatures, elevated atmospheric CO2 levels and changing precipitation patterns that will likely increase the geographic range and overwintering survival rates of pests. Furthermore, plant disease outbreaks are expected to intensify due to increases in the severity of existing phytopathogens and/or invasions by new phytopathogens. Functional symbioses, such as those between temperate grasses and Epichloë, are among the most successful mechanisms by which plants can improve their ability to tolerate stress. Future research is likely to utilise targeted genetic manipulation techniques to broaden the biocontrol ability of Epichloë strains, particularly to mitigate climate related stresses. [ABSTRACT FROM AUTHOR]

Copyright of Promotion de la Santé et Prévention des Maladies Chroniques au Canada is the property of Public Health Agency of Canada and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

How can tenants affect housing policy? This paper compares rental housing politics in Los Angeles (USA) and Berlin (Germany) between 2008-2020 by examining how political processes influenced policy. It serves as a case of the emergence, escalation, and impact of tenant power. Tenant movement organizations employed five mechanisms to affect policymaking: (1) making demands, (2) forming coalitions, (3) promoting referendums, (4) engaging government officials in dialogue, and (5) transferring agents to government. The paper draws on multiple data sources, including interviews and participant observation over ten years. The cities witnessed policy episodes with four parallel characteristics: (1) locally progressive and regionally moderate, (2) shifting from defensive to offensive, (3) shifting from particular to universal, and (4) signs of a breakthrough beyond neoliberal housing policymaking. The findings suggest that the rise of tenant movements and their allies help drive policy change via multiple channels, exhibiting both similarities and differences across cities, especially in terms of money power and people power. [ABSTRACT FROM AUTHOR]

There is a pressing need for ecologically valid versions of traditional neuropsychological tests indexing executive function (EF), such as the Trail-Making Task (TMT), that incorporate movement and bodily awareness in healthy participants with varying abilities. We designed a proprioceptive version of the TMT (pTMT) that involved coordinated gross motor movement and proprioceptive awareness to investigate whether this measure of visual attention, task switching, and working memory positively correlated with a computerized version of the TMT (the dTMT). We aimed to establish the initial validity of our proprioceptive TMT (pTMT) by comparing performances on the dTMT and pTMT among a cohort of 36 healthy participants (18 dancers, 18 non-dancers; M age = 22, SD = 5.27; 64% female) anticipating that dancers would express higher intrinsic bodily awareness than non-dancers. Results revealed a mild to moderate but statistically significant positive correlation between dTMT and pTMT completion times [part A: r (36) =.33, p =.04; part B: r (36) =.37, p =.03] and numbers of errors [part B: r (36) =.41, p =.01] across both participant groups. These data suggest partial measurement convergence between these two TMT versions. Relative to non-dancers, dancers exhibited a higher level of performance (likely due to their better proprioceptive ability) through their faster completion times on dTMT-B [ t (34) = 3.81, p =.006, d = 1.27] and pTMT-B [ t (34) = 2.97, p =.005, d =.99], and their fewer errors on dTMT-B [ t (34) = 2.93, p =.006, d = 1.0]. By identifying cognitive differences between these different groups of healthy individuals, our data contribute to both a theoretical understanding and the initial development of gross motor movement-based cognitive assessments, providing a path toward the further refinement of an ecologically valid full-body TMT. [ABSTRACT FROM AUTHOR]

Care is a practice and form of labour making human survival and flourishing possible. This Symposium explores the place and work of care within housing movements, asking how care operates as a politics, an ethics, and a set of practices through which tenants survive-and ultimately seek to transform-the structural violence of capitalist housing systems. Situated in US cities with abiding associations with Blackness and indigeneity, papers in the Symposium examine housing movements that take care as the starting point. As we discuss in this introduction to the Symposium, in such movements, care operates as connective tissue across households and modes of difference; challenges relations of racial capitalism and settler colonialism that underlie dominant understandings of who deserves and can demand care; and drives calls for public care and experiments with non-propertised forms of ownership. Housing systems are care infrastructures, making housing movements a vital place for care work. [ABSTRACT FROM AUTHOR]

Social prescribing offers a practical mechanism by which public health and health care systems can work together toward a future in which well-being is prioritized, health equity is addressed and people and communities thrive. The articles in this second part of the Health Promotion and Chronic Disease Prevention in Canada special issue on social prescribing explore how social prescribing in Canada supports action on two frameworks important to public health and health care communities: the Ottawa Charter for Health Promotion, which emphasizes building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services, and the Quintuple Aim for health care improvement, which focusses on improved population health, health equity, patient experience, care team well-being and reduced costs. [ABSTRACT FROM AUTHOR]

Background: Familial hypercholesterolemia (FH) is a heritable disorder affecting 1.3 million individuals in the USA. Eighty percent of people with FH are undiagnosed, particularly minoritized populations including Black or African American people, Asian or Asian American people, and women across racial groups. Family cascade screening is an evidence-based practice that can increase diagnosis and improve health outcomes but is rarely implemented in routine practice, representing an important care gap. In pilot work, we leveraged best practices from behavioral economics and implementation science—including mixed-methods contextual inquiry with clinicians, patients, and health system constituents—to co-design two patient-facing implementation strategies to address this care gap: (a) an automated health system-mediated strategy and (b) a nonprofit foundation-mediated strategy with contact from a foundation-employed care navigator. This trial will test the comparative effectiveness of these strategies on completion of cascade screening for relatives of individuals with FH, centering equitable reach. Methods: We will conduct a hybrid effectiveness-implementation type III randomized controlled trial testing the comparative effectiveness of two strategies for implementing cascade screening with 220 individuals with FH (i.e., probands) per arm identified from a large northeastern health system. The primary implementation outcome is reach, or the proportion of probands with at least one first-degree biological relative (parent, sibling, child) in the USA who is screened for FH through the study. Our secondary implementation outcomes include the number of relatives screened and the number of relatives meeting the American Heart Association criteria for FH. Our secondary clinical effectiveness outcome is post-trial proband cholesterol level. We will also use mixed methods to identify implementation strategy mechanisms for implementation strategy effectiveness while centering equity. Discussion: We will test two patient-facing implementation strategies harnessing insights from behavioral economics that were developed collaboratively with constituents. This trial will improve our understanding of how to implement evidence-based cascade screening for FH, which implementation strategies work, for whom, and why. Learnings from this trial can be used to equitably scale cascade screening programs for FH nationally and inform cascade screening implementation efforts for other genetic disorders. Trial registration: ClinicalTrials.gov, NCT05750667. Registered 15 February 2023—retrospectively registered, https://clinicaltrials.gov/study/NCT05750667. [ABSTRACT FROM AUTHOR]

We revisit the estimation of industry wage differentials using linked employer-employee data. Cross-sectional industry differences overstate pay premiums due to unmeasured heterogeneity. Estimates based on models with person and industry effects understate true premiums: workers who switch to a higher-premium industry typically move from higher-paying firms in their origin industry to lower-paying firms in their destination (and vice versa). The corrected standard deviation of log wage effects is 0.122 across narrowly defined industries and is similar at higher levels of aggregation. Higher-skilled workers sort to higher-pay industries. Premiums and worker sorting are more variable in cities with higher-wage firms and higher-skilled workers. [ABSTRACT FROM AUTHOR]

Background: Rising housing prices are becoming a top public health priority and are an emerging concern for policy makers and community leaders. This report reviews and synthesizes evidence examining the association between changes in housing price and health outcomes. Methods: We conducted a systematic literature review by searching the SCOPUS and PubMed databases for keywords related to housing price and health. Articles were screened by two reviewers for eligibility, which restricted inclusion to original research articles measuring changes in housing prices and health outcomes, published prior to June 31st, 2022. Results: Among 23 eligible studies, we found that changes in housing prices were heterogeneously associated with physical and mental health outcomes, with multiple mechanisms contributing to both positive and negative health outcomes. Income-level and home-ownership status were identified as key moderators, with lower-income individuals and renters experience negative health consequences from rising housing prices. This may have resulted from increased stress and financial strain among these groups. Meanwhile, the economic benefits of rising housing prices were seen to support health for higher-income individuals and homeowners – potentially due to increased wealth or perception of wealth. Conclusions: Based on the associations identified in this review, it appears that potential gains to health associated with rising housing prices are inequitably distributed. Housing policies should consider the health inequities born by renters and low-income individuals. Further research should explore mechanisms and interventions to reduce uneven economic impacts on health. [ABSTRACT FROM AUTHOR]

Background There is no evidence base to support the use of 6-monthly monitoring blood tests for the early detection of liver, blood and renal toxicity during established anti-tumour necrosis factor alpha (TNFα) treatment. Objectives To evaluate the incidence and risk factors of anti-TNFα treatment cessation owing to liver, blood and renal side-effects, and to estimate the cost-effectiveness of alternate intervals between monitoring blood tests. Methods A secondary care-based retrospective cohort study was performed. Data from the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR) were used. Patients with at least moderate psoriasis prescribed their first anti-TNFα treatment were included. Treatment discontinuation due to a monitoring blood test abnormality was the primary outcome. Patients were followed-up from start of treatment to the outcome of interest, drug discontinuation, death, 31 July 2021 or up to 5 years, whichever came first. The incidence rate (IR) and 95% confidence intervals (CIs) of anti-TNFα discontinuation with monitoring blood test abnormality was calculated. Multivariate Cox regression was used to examine the association between risk factors and outcome. A mathematical model evaluated costs and quality-adjusted life years (QALYs) associated with increasing the length of time between monitoring blood tests during anti-TNFα treatment. Results The cohort included 8819 participants [3710 (42.1%) female, mean (SD) age 44.76 (13.20) years] that contributed 25 058 person-years (PY) of follow-up and experienced 125 treatment discontinuations owing to a monitoring blood test abnormality at an IR of 5.85 (95% CI 4.91–6.97)/1000 PY. Of these, 64 and 61 discontinuations occurred within the first year and after the first year of treatment start, at IRs of 8.62 (95% CI 6.74–11.01) and 3.44 (95% CI 2.67–4.42)/1000 PY, respectively. Increasing age (in years), diabetes and liver disease were associated with anti-TNFα discontinuation after a monitoring blood test abnormality [adjusted hazard ratios of 1.02 (95% CI 1.01–1.04), 1.68 (95% CI 1.00–2.81) and 2.27 (95% CI 1.26–4.07), respectively]. Assuming a threshold of £20 000 per QALY gained, no monitoring was most cost-effective, but all extended periods were cost-effective vs. 3- or 6-monthly monitoring. Conclusions Anti-TNFα drugs were uncommonly discontinued owing to abnormal monitoring blood tests after the first year of treatment. Extending the duration between monitoring blood tests was cost-effective. Our results produce evidence for specialist society guidance to reduce patient monitoring burden and healthcare costs. [ABSTRACT FROM AUTHOR]

Wet markets in low-and middle-income countries are often reported to have inadequate sanitation resulting in fecal contamination of sold produce. Consumption of contaminated wet market-sourced foods has been linked to individual illness and disease outbreaks. This pilot study, conducted in two major wet markets in Dhaka city, Bangladesh during a 4-month period in 2021 aimed to assess the occurrence and characteristics of Escherichia coli and nontyphoidal Salmonella spp. (NTS) from tilapia (Oreochromis niloticus) and shrimp (Penaeus monodon). Fifty-four individuals of each species were collected. The identity of the bacterial isolates was confirmed by PCR and their susceptibility toward 15 antimicrobials was tested by disk diffusion. The whole genome of 15 E. coli and nine Salmonella spp. were sequenced using Oxford Nanopore Technology. E. coli was present in 60–74% of tilapia muscle tissue and 41– 44% of shrimp muscle tissue. Salmonella spp. was found in skin (29%) and gills (26%) of tilapia, and occasionally in muscle and intestinal samples of shrimp. The E. coli had several Multilocus sequence typing and serotypes and limited antimicrobial resistance (AMR) determinants, such as point mutations on glpT and pmrB. One E. coli (BD17) from tilapia carried resistance genes for betalactams, quinolones, and tetracycline. All the E. coli belonged to commensal phylogroups B1 and A and showed no Shiga-toxin and other virulence genes, confirming their commensal non-pathogenic status. Among the Salmonella isolates, five belonged to Kentucky serovar and had similar AMR genes and phenotypic resistance patterns. Three strains of this serovar were ST198, often associated with human disease, carried the same resistance genes, and were genetically related to strains from the region. The two undetermined sequence types of S. Kentucky were distantly related and positioned in a separate phylogenetic clade. Two Brunei serovar isolates, one Augustenborg isolate, and one Hartford isolate showed different resistance profiles. This study revealed high fecal contamination levels in tilapia and shrimp sold at two main wet markets in Dhaka. Together with the occurrence of Salmonella spp., including S. Kentucky ST198, a well-known human pathogen, these results stress the need to improve hygienic practices and sanitation standards at markets to improve food safety and protect consumer health. [ABSTRACT FROM AUTHOR]

'Type V' natural deep eutectic solvents (TV NADES) are a novel class of solvent media with many potential 'green chemistry' applications. Here, we assess the potential of two TV NADES: menthol:carvacrol (M:C) and menthol:thymol (M:T), and a single terpenoid extraction media carvacrol (C), as media from total lipid extraction of three compositionally diverse, freeze‐dried marine tissues: hoki (Macruronus novaezelandaiae), jack mackerel (Trachurus declivis) and green‐lipped mussel (kuku, Perna canaliculus). Room temperature extraction yields into these media were benchmarked relative to lipid yields from chloroform‐methanol‐water extractions. Relative extraction yields using the M:C and M:T media were (both) 87% for jack mackerel, 85%–87% for hoki, and 43%–47% for green‐lipped mussels. Comprehensive chemical analyses of TV NADES lipid extracts suggested that neutral lipids were extracted in greater yield than phospholipids, and that phosphatidylinositol, lysophospholipids and (in the case of mussels) ceramideaminoethylphosphonates were particularly resistant to extraction into C, M:C and M:T. C—a thymol isomer that, unlike menthol and thymol is a liquid at room temperature—appeared to perform (marginally) better than M:C and M:T systems, implying there may be no advantage to using the TV NADES over a single terpenoid with similar chemistry for total lipid extraction. [ABSTRACT FROM AUTHOR]

We explored attitudes of gay, bisexual, and other men who have sex with men (GBM) toward their amphetamine-use and associations with reduced use over time. We recruited sexually-active GBM aged 16+ years in Montreal, Toronto, and Vancouver, Canada, from 02-2017 to 08-2019, with follow-up visits every 6–12 months until November 2020. Among participants who reported past-six-month (P6M) amphetamine-use at enrollment, we used logistic regression to identify demographic, psychological, social, mental health, other substance-use, and behavioral factors associated with reporting needing help reducing their substance-use. We used mixed-effects logistic regression to model reduced P6M amphetamine-use with perceived problematic-use as our primary explanatory variable. We enrolled 2,449 GBM across sites. 15.5-24.7% reported P6M amphetamine-use at enrollment and 82.6 − 85.7% reported needing no help or only a little help in reducing their substance use. Reporting needing a lot/of help or completely needing help in reducing substance-use was associated with group sex participation (AOR = 2.35, 95%CI:1.25–4.44), greater anxiety symptomatology (AOR = 2.11, 95%CI:1.16–3.83), greater financial strain (AOR = 1.35, 95%CI:1.21–1.50), and greater Escape Motive scores (AOR = 1.07, 95%CI:1.03–1.10). Reductions in P6M amphetamine-use were less likely among GBM who perceived their amphetamine-use as problematic (AOR = 0.17 95% CI 0.10 − 0.29). Most amphetamine-using GBM did not feel they needed help reducing their substance use, and many reported reduced amphetamine-use at subsequent visits. Those who perceived their use as problematic were less likely to reduce their use. Further interventions to assist GBM in reducing their use are needed to assist those who perceive their use as problematic. [ABSTRACT FROM AUTHOR]

PURPOSE This study investigated the effectiveness of algorithmic testing in hematopathology at the Brigham and Women's Hospital and Dana-Farber Cancer Institute (DFCI). The algorithm was predicated on test selection after an initial pathologic evaluation tomaximize cost-effective testing, especially for expensive molecular and cytogenetic assays. MATERIALS AND METHODS Standard ordering protocols (SOPs) for 17 disease categories were developed and encoded in a decision support application. Six months of retrospective data from application beta testing was obtained and compared with actual testing practices during that timeframe. In addition, 2 years of prospective data were also obtained from patients at one community satellite site. RESULTS A total of 460 retrospective cases (before introduction of algorithmic testing) and 109 prospective cases (following introduction)were analyzed. In the retrospective data, 61.7% of tests (509 of 825) were concordant with the SOPs while 38.3% (316 of 825) were overordered and 30.8%(227 of 736) of SOP-recommended tests were omitted. In the prospective data, 98.8% of testing was concordant (244 of 247 total tests) with only 1.2%overordered tests (3 of 247) and 7.6%omitted tests (20 of 264 SOP-recommended tests; overall P < .001). The cost of overordered tests before implementing SOP indicates a potential annualized saving of $1,347,520 in US dollars (USD) in overordered testing at Brigham and Women's Hospital/DFCI. Only two of 316 overordered tests (0.6%) returned any additional information, both for extremely rare clinical circumstances. CONCLUSION Implementation of SOPs dramatically improved test ordering practices, with a just right number of ancillary tests that minimizes cost and has no significant impact on acquiring key informative test results. [ABSTRACT FROM AUTHOR]

Anterior cruciate ligament (ACL) injuries are devastating injuries for athletes. Prior studies have shown increased ACL injury rates on non-natural surfaces versus natural grass in several sports. The purpose of this study is to calculate the prevalence of ACL injuries in the NFL on natural versus non-natural surfaces to determine if there is a significant increase on non-natural surfaces. Accessing publicly available data for NFL seasons beginning with the 2017–2018 season through 2021–2022 seasons, all ACL injuries with publicly available data concerning timing and playing surface were recorded and categorized according to playing surface. Practice injuries or those without an identifiable playing surface were excluded. Incidence rates, defined as ACL ruptures per game, were calculated. ACL injuries were recorded for each playing surface, as well as the combined category of non-natural grass surface. Odds ratio was calculated to compare the risk of ACL rupture on non-natural surfaces vs natural grass. During the 2017–2021 NFL seasons, 173 ACL ruptures were identified with known surfaces. Injury rate for non-natural surfaces was 0.134 compared to 0.097 for grass. Injury rate ratio for non-natural vs natural grass surfaces was 1.211, a 21.1% increased risk of ACL injury in the NFL on non-natural surfaces vs natural grass. OR for non-natural surfaces 1.239 (95% CI 0.900–1.704). Based on these findings there is a trend toward increased risk of ACL injury on non natural grass surfaces, however this did not reach statistical significance. Numerous published studies show trends toward increasing rates of ACL injuries on non-natural playing surfaces vs natural grass. Based on our findings the difference is not statistically significant, however it does trend toward increased risk of ACL injury with non-natural surfaces. Further studies should be performed with larger sample sizes in order to further determine the risk of non-natural surfaces. [ABSTRACT FROM AUTHOR]

The Lalonde report, published in 1974 by the Canadian Minister of National Health and Welfare, broke ground for public health in Canada by acknowledging that the determinants of health are much broader than health care services. Fifty years later, this special issue of Health Promotion and Chronic Disease Prevention in Canada charts a clear path towards addressing upstream determinants of health through an emerging intervention called "social prescribing." Social prescribing connects patients with community resources tailored to their individual priorities, fostering a paradigm shift from a deficitbased to a strengths-based approach in health promotion. Part 1 of this issue covers the rapid growth and diverse applications of social prescribing across Canada, with targeted initiatives for various populations and interventions ranging from nature and arts to physical activity and social connectivity. Contributions from a wide range of partners, including researchers, health professionals and community members, explore the adaptability of social prescribing for different groups, underscore the role of community and lived experiences in research, and call for more studies on social prescribing's effectiveness and outcomes. Highlighted case studies demonstrate tangible benefits in health equity and access to social services. This issue not only reflects the current scope and impact of social prescribing in Canada but also sets the stage for its future development and integration into broader health practices. [ABSTRACT FROM AUTHOR]

This article discusses the case of a 25-year-old Caucasian male with tuberous sclerosis complex (TSC) who was referred for evaluation of multifocal retinal tumors in both eyes. The patient had a history of cardiac rhabdomyoma and subependymal giant cell astrocytoma. The examination revealed nodular, cream-colored tumors in both eyes, as well as congenital hypertrophy of the retinal pigmented epithelium and a punched-out retinal pigmented epithelium lesion. The diagnosis of retinal astrocytic hamartoma (RAH) was made, and observation was advised. The article also provides information on the classification of RAH and the differentiation between RAH and retinoblastoma using optical coherence tomography (OCT). [Extracted from the article]

Purpose: In response to a demonstrable need for 24/7, specialist oncology advice for patients undergoing systemic anti-cancer therapy, many healthcare institutions have adopted a telephone triage (TT) service. This is true of the Clatterbridge Cancer Centre which uses the UKONS framework to guide its decisions. This study aims to investigate the utilisation and outcomes of this TT service, with a focus on the most unwell call outcomes and factors leading to referrals to accident and emergency departments that could be mitigated with service development and modifications. Methods: A retrospective evaluation study was conducted of calls occurring between 1st September 2021 and 31st August 2022. A descriptive analysis of call UKONS grading, triage outcome and primary complaint was performed. Results: The TT hotline received 23,766 calls of which only 9066 were for clinical advice. Of the clinical calls, 45.2% were UKONS red. The majority of red calls 53.3% were directed to AED. The proportion of red calls going to AED changed drastically depending on the timing of call and the corresponding services available at those times, with 38.3% of reds being sent to AED in hours but 72.3% out of hours. The profile of complaints also showed significant differences in hours versus out of hours. Conclusion: Significant use of the hotline supports a genuine demand for oncology TT services. In order to reduce referrals to AED, this study supports the creation of alternative destinations of emergency care, especially out of hours. [ABSTRACT FROM AUTHOR]

Purpose: Smoking is a risk factor for some autoimmune diseases, but its association with autoimmune hepatitis remains unknown. We conducted a population-based matched case–control study to examine the association between tobacco smoking and the risk of autoimmune hepatitis in England. Patients and Methods: From the Clinical Practice Research Datalink and linked Hospital Episode Statistics, 2005– 2017, we included 987 cases diagnosed with autoimmune hepatitis after age 18 years and up to 10 frequency-matched population controls per case. We used multiple logistic regression to estimate the odds ratio of autoimmune hepatitis in ever-smokers vs never-smokers, adjusting for sex, age, general practice, calendar time of registration with the general practice, and socioeconomic status. Results: The autoimmune hepatitis cases were more likely to be ever-smokers than the controls (44% vs 37%). The ever-smokers had an increased risk of autoimmune hepatitis compared with the never-smokers (adjusted odds ratio = 1.20, 95% confidence interval 1.03– 1.39). Conclusion: Smoking was associated with an increased risk of autoimmune hepatitis. Plain Language Summary: Autoimmune hepatitis is a chronic liver disease associated with genetic variants and environmental exposures, but the causes of autoimmune hepatitis remain unknown. Using registry data, we evaluated the association between tobacco smoking and the risk for autoimmune hepatitis. We found that tobacco smoking was associated with an increased risk of autoimmune hepatitis. [ABSTRACT FROM AUTHOR]

Objective: Racial and ethnic disparities in arthroplasty utilization are evident, but the reasons are not known. We aimed to identify concerns that may contribute to barriers to arthroplasty from the patient's perspective. Methods: We identified patients' concerns about arthroplasty by performing a mixed methods study. Themes identified during semi-structured interviews with Black and Hispanic patients with advanced symptomatic hip or knee arthritis were used to develop a questionnaire to quantify and prioritize their concerns. Multiple linear and logistic regression analyses were conducted to determine the association between race/ethnicity and the importance of each theme. Models were adjusted for sex, insurance, education, HOOS, JR/KOOS, JR, and discussion of joint replacement with a doctor. Results: Interviews with eight participants reached saturation and provided five themes used to develop a survey answered by 738 (24%) participants; 75.5% White, 10.3% Black, 8.7% Hispanic, 3.9% Asian/Other. Responses were significantly different between groups (p < 0.05). Themes identified were "Trust in the surgeon" "Recovery", "Cost/Insurance", "Surgical outcome", and "Personal suitability/timing". Compared to Whites, Blacks were two-fold, Hispanics four-fold more likely to rate "Trust in the surgeon" as very/extremely important. Blacks were almost three times and Hispanics over six times more likely to rate "Recovery" as very/extremely important. Conclusion: We identified factors of importance to patients that may contribute to barriers to arthroplasty, with marked differences between Blacks, Hispanics, and Whites. [ABSTRACT FROM AUTHOR]