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We investigate strategies to suppress phase separation and reduce threading dislocation density (TDD) in AlGaInAs compositionally graded buffers (CGBs) that span the lattice constant range from GaAs to InP. Combining the results from high resolution x-ray diffraction, cathodoluminescence, transmission electron microscopy, and photovoltaic device measurements, we correlate the choices of epitaxial growth conditions with the defect structure of the CGBs and subsequent device performance. Both the use of substrates with high misorientation off (100) toward the (111)A plane and Zn doping instead of Si doping are shown to suppress phase separation and reduce TDD. We demonstrate a 0.74 eV GaInAs device grown on a GaAs substrate offcut 19.5° toward (111)A using a Zn-doped AlGaInAs CGB with TDD = 3.5 ± 0.2 × 106 cm−2 that has a bandgap-open circuit voltage offset of only 0.434 V measured under the AM1.5G solar spectrum. We characterized this device under high-intensity irradiance from a 1570 nm laser and measured a 31.9% peak laser power conversion efficiency at 3.6 W/cm2 irradiance. These results provide a roadmap to the manufacture of laser- and thermal-power conversion devices with the performance and cost-effectiveness needed to drive adoption of these technologies at scale. [ABSTRACT FROM AUTHOR]

Organizations must excel at what they do well while also learning new ways of operating to achieve long‐term success. Work teams may thus find themselves pursuing contradictory objectives to support the organization's strategy. We investigated teams' goal orientation (in)congruence and its impact on task meaningfulness and, ultimately, performance, hypothesizing the potential pitfalls of teams simultaneously pursuing both learning‐ and performance‐goal orientations. Three‐wave, multisource data were collected from 109 teams at a large North American mortgage company. In a polynomial regression and response surface analytical framework, team task meaningfulness—and subsequent team performance—was enhanced when teams had greater divergence between their learning‐ and performance‐goal orientations but suffered when both goal orientations were more aligned. Our investigation thus revealed the potential pitfalls of teams simultaneously pursuing both learning‐ and performance‐goal orientations. We discuss the theoretical contributions of the team goal orientation incongruence effect substantiated in this study, as well as implications for practice and future research. [ABSTRACT FROM AUTHOR]

We develop a surface for the electric dipole moment of three interacting helium atoms and use it with state-of-the-art potential and polarizability surfaces to compute the third dielectric virial coefficient, Cɛ, for both 4He and 3He isotopes. Our results agree with previously published data computed using an approximated form for the three-body polarizability and are extended to the low-temperature regime by including exchange effects. In addition, the uncertainty of Cɛ is rigorously determined for the first time by propagating the uncertainties of the potential and polarizability surfaces; this uncertainty is much larger than the contribution from the dipole-moment surface to Cɛ. Our results compare reasonably well with the limited experimental data. The first-principles values of Cϵ computed in this work will enhance the accuracy of primary temperature and pressure metrology based on measurements of the dielectric constant of helium. [ABSTRACT FROM AUTHOR]

Background/Purpose: The purpose of this study was to investigate physical educators' self-reported use, understanding, and confidence with game-based approaches (GBAs) in their K–12 physical education programs. Method: A survey of New York State physical education professionals was conducted that yielded quantitative data on how they used game-based approaches. Data were analyzed using Observation Oriented Modeling (version 5.4.2022), a tool well suited for survey data, especially teachers' reports of game-based lesson sequences. Results: Physical educators reported both awareness and confidence with various GBAs spending most physical education game-based lessons teaching invasion games with emphasis on the psychomotor domain. Respondents' typical game lesson sequences did not match model GBA lesson sequences. Conclusions: Findings from this study indicate respondents do not use GBAs for their game-based lessons. Beyond teacher preparation, intentional professional development should address conceptual, pedagogical, cultural, and political obstacles, and may help practitioners become more pedagogically fluent with GBAs. [ABSTRACT FROM AUTHOR]

Improved two-body and three-body potentials for helium have been used to calculate from first principles the third density and acoustic virial coefficients for both 4He and 3He. For the third density virial coefficient C(T), uncertainties have been reduced by a factor of 4–5 compared to the previous state of the art; the accuracy of first-principles C(T) now exceeds that of the best experiments by more than two orders of magnitude. The range of calculations has been extended to temperatures as low as 0.5 K. For the third acoustic virial coefficient γa(T), we applied the Schlessinger point method, which can calculate γa and its uncertainty based on the C(T) data, overcoming some limitations of direct path-integral calculation. The resulting γa are calculated at temperatures down to 0.5 K; they are consistent with available experimental data but have much smaller uncertainties. The first-principles data presented here will enable improvement of primary temperature and pressure metrology based on gas properties. [ABSTRACT FROM AUTHOR]

Here, we report the frequency-dependent spectrum of ice Ih in the range of 0.2–2 THz. We confirm the presence of a feature that blue-shifts from around 1.55–1.65 THz with a decreasing temperature from 260 to 160 K. There is also a change in the trend of the refractive index of ice corresponding to a dispersion, which is also around 1.6 THz. The features are reproduced in data acquired with three commercial terahertz time-domain spectrometers. Computer-simulated spectra assign the feature to lattice translations perpendicular to the 110 and 1 ̄ 10 planes of the ice Ih crystal. The feature's existence should be recognized in the terahertz measurements of frozen aqueous solution samples to avoid false interpretations. [ABSTRACT FROM AUTHOR]

We present a complete calculation, fully accounting for quantum effects and for molecular flexibility, of the first dielectric virial coefficient of water and its isotopologues. The contribution of the electronic polarizability is computed from a state-of-the-art intramolecular potential and polarizability surface from the literature, and its small temperature dependence is quantified. The dipolar polarizability is calculated in a similar manner with an accurate literature dipole-moment surface; it differs from the classical result both due to the different molecular geometries sampled at different temperatures and due to the quantization of rotation. We calculate the dipolar contribution independently from spectroscopic information in the HITRAN2020 database and find that the two methods yield consistent results. The resulting first dielectric virial coefficient provides a complete description of the dielectric constant at low density that can be used in humidity metrology and as a boundary condition for new formulations for the static dielectric constant of water and heavy water. [ABSTRACT FROM AUTHOR]

Purpose: Chronic pain assessment tools exist for children, but may not be valid, reliable, and feasible for populations with functional, cognitive or communication limitations, for example, cerebral palsy (CP). This study aimed to (i) identify chronic pain assessment tools used with children and young people and rate their measurement properties; (ii) develop a CP specific feasibility rating tool to assess the feasibility of tools in CP; and (iii) categorise tools according to reporting method. Materials and methods: Assessment tools were identified by literature review. Their measurement properties were rated using the COnsensus based standards for the Selection of health Measurement INstruments. The CP specific Feasibility Rating Tool was developed and used to rate the tools. Results: Fifty-seven chronic pain assessment tools were identified. Six have content validity for CP, four of these use proxy-report. Forty-two tools were considered feasible for people with CP; 24 self report and 18 observational/proxy-report. Only the Paediatric Pain Profile has content validity and feasibility for people with CP unable to self-report. Conclusions: There are few valid, reliable and feasible tools to assess chronic pain in CP. Further research is required to modify tools to enable people with cognitive limitations and/or complex communication to self-report pain. IMPLICATIONS FOR REHABILITATION: Few of the existing chronic pain assessment tools are feasible or valid to use with all young people with cerebral palsy (CP). Modifications to self-report tools are needed to improve access for young people who have cognitive impairment or use alternative and augmentative communication. The pain assessment tool with the strongest feasibility and measurement properties for young people who cannot self-report is the Paediatric Pain Profile. Clinicians will need to consider a range of chronic pain assessment tools to assess the biopsychosocial domains important to young people with cerebral palsy. [ABSTRACT FROM AUTHOR]

Importance: Many social need screening to advance population health and reduce health disparities, but barriers to screening remain. Improved knowledge of patient populations at risk for social needs based on administrative data could facilitate more targeted practices, and by extension, feasible social need screening and referral efforts. Objective: To illustrate the use of cluster analysis to identify patient population segments at risk for social needs. Design: We used clustering analysis to identify population segments among Veterans (N=2010) who participated in a survey assessing nine social needs (food, housing, utility, financial, employment, social disconnection, legal, transportation, and neighborhood safety). Clusters were based on eight variables (age, race, gender, comorbidity, region, no-show rate, rurality, and VA priority group). We used weighted logistic regression to assess association of clusters with the risk of experiencing social needs. Participants: National random sample of Veterans with and at risk for cardiovascular disease who responded to a mail survey (N=2010). Main Outcomes and Measures: Self-reported social needs defined as the risk of endorsing (1) each individual social need, (2) one or more needs, and (3) a higher total count of needs. Key Results: From the clustering analysis process with sensitivity analysis, we identified a consistent population segment of Veterans. From regression modeling, we found that this cluster, with lower average age and higher proportions of women and racial minorities, was at higher risk of experiencing ≥ 1 unmet need (OR 1.74, CI 1.17–2.56). This cluster was also at a higher risk for several individual needs, especially utility needs (OR 3.78, CI 2.11–6.78). Conclusions: The identification of characteristics associated with increased unmet social needs may provide opportunities for targeted screenings. As this cluster was also younger and had fewer comorbidities, they may be less likely to be identified as experiencing need through interactions with healthcare providers. [ABSTRACT FROM AUTHOR]

Background: Migrants face barriers accessing healthcare, risking delays in cancer diagnosis. Diagnostic delays result in later stage diagnosis which is associated with poorer cancer survival. This review aims to compare the differences in cancer stage at diagnosis between migrants and non-migrants. Methods: We conducted a systematic review and meta-analysis of three databases from 2000 to 2023 for studies conducted in OECD countries that compared stage at diagnosis between migrants and non-migrants. Meta-analysis compared odds ratios (OR) for early (stage I and II) stage at diagnosis. The Risk of Bias in Non-randomised Studies of Exposure tool was used to assess study quality. Results: 41 of the 11,549 studies identified were included; 34 studies had suitable data for meta-analysis. Overall, migrants were significantly less likely to be diagnosed with early stage cancer compared with non-migrants (OR 0.84; 95% CI 0.78–0.91). This difference was maintained across cancer types, although only statistically significant for breast (OR 0.78; 95% CI 0.70–0.87) and prostate cancer (OR 0.92; 95% CI 0.85–0.99). Discussion: Published studies indicate that migrants are less likely to be diagnosed with early stage cancer. Variation by cancer type, study location and region of origin highlights the need for further research to understand these differences. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relative strengths of 3 frailty assessment instruments for predicting mortality and prolonged hospitalization in acute coronary syndrome patients. Design: Prospective cohort study. Setting: Acute cardiac care units in New Zealand. Participants: 1174 patients >70 years of age hospitalized with an acute coronary syndrome. Interventions: The Clinical Frailty Scale (CFS), Edmonton Frail Scale (EFS) and Fried Criteria (Fried), were completed during hospital admission following an acute coronary syndrome when the patient was clinically stable. Primary and secondary outcome measures: All-cause mortality over the next ~5 years and hospitalization for >10 days in the next year determined from national administrative data. Results: During median follow-up of 5.1 years there were 353 deaths. Harrell's C-statistic for mortality for EFS was 0.663, Fried 0.648 and CFS 0.640 (p<0.001 for all). C-statistics for hospitalization >10 days (n = 267, 22%) were EFS 0.649, Fried 0.628, and CFS 0.584 (p<0.001 for all). Associations between increase in frailty scores and mortality were graded including in patients not classified as frail. The hazard ratio (HR) for mortality, adjusted for age and sex, for patients with an EFS score ≥9 (n = 197) compared to ≤2 (n = 331) was 5.0 (95% CI: 3.4–7.4). In models which included the Euroscore II or GRACE risk scores the EFS improved risk discrimination for both mortality and prolonged hospitalization more than the CFS and Fried. Conclusion: In older patients assessed following an acute coronary syndrome the EFS discriminated the risk of all cause mortality and prolonged hospitalization better than the CFS and Fried tests, and improved risk discrimination when added to clinical risk scores. [ABSTRACT FROM AUTHOR]

The skin, the body's largest organ, has a heterogeneous structure with various cell types and tissue layers. In vivo noninvasive 3D volumetric imaging with multi-contrast, high resolution, a large field-of-view (FOV), and no-motion artifacts is crucial for studying skin biology and diagnosing/evaluating diseases. Traditionally high-resolution in vivo skin microscopy methods capture images in the en-face (xy) plane parallel to the skin surface but are affected by involuntary motion, particularly during large-area volumetric data acquisition using xy-z mosaicking. In this work, we developed an xz-y imaging method that acquires images in the vertical (xz) plane and extends the FOV by moving the skin laterally along the y-direction. This approach is conceived based on our observation that involuntary skin movements are mostly along the vertical direction. Combined with a unique motion correction method, it enables 3D image reconstruction with subcellular resolution and an extended FOV close to a centimeter (8 mm). A multimodality microscopy system using this method provides simultaneous reflectance confocal, two-photon excited fluorescence, and second harmonic generation imaging, enabling multi-contrast capabilities. Using this system, we captured histology-like features of normal skin, vitiligo, and melanoma, demonstrating its potential for in vivo skin biology studies, clinical diagnosis, treatment planning and monitoring. A microscopy imaging method was developed for in vivo skin imaging by stacking vertical sectioning images to reconstruct 3D volume. It achieves multi-contrast, subcellular resolution, a near centimeter field of view, and is motion tolerant. [ABSTRACT FROM AUTHOR]

Introduction: In an aging population, white matter hyperintensities (WMHs), observed on FLAIR MRI sequences, are indicators of cognitive decline, motor impairment, and increased vascular risk. However, the pathophysiological mechanisms underlying WMHs, including dynamic changes in cerebral blood flow (CBF) within and adjacent to lesions, remain poorly understood. Methods: Our study examined a diverse cohort of 300 elderly participants through arterial spin labeling (ASL) on 3 Tesla MRI, analyzing both cross-sectional and longitudinal data. We characterized the relationship between CBF and WMH development in different lesion locations (based on distance from ventricles) and brain tissue types (WMH lesion, penumbra, and normal white matter). Results: Our findings reveal that WMHs exhibit significantly lower relative CBF (rCBF) compared to penumbra, normal-appearing white matter, and gray matter, with juxtaventricular WMHs (JVWMH) displaying the most substantial reductions. Longitudinally, WMHs that increased in size over a two-year period had lower baseline rCBF than those that remained stagnant, particularly in juxtaventricular and periventricular regions. Discussion: This study not only highlights the predictive value of rCBF in WMH progression but also provides location-specific hemodynamic information about WMHs that can guide clinical management of WMH-related brain changes and their clinical manifestations. [ABSTRACT FROM AUTHOR]

We modelled patterns of collaboration, team gender composition, and funding amounts across awarded Australian government-funded competitive team research grants from 2000 to 2020. The percentage of grants awarded to women at mid- and senior-career levels was higher for team grants than sole investigator grants compared to men at those levels. Teams led by women tended to have a greater percentage of women coinvestigators than teams led by men, but this was below gender parity regardless of team leader gender. Funding amounts per grant did not differ by the principal investigator's gender and reached parity in 2020 across teams with both high and low representation of women. Since teams tend to be more gender-balanced when led by women, women's grant leadership may be an important mechanism for shifting overall representation of women in research. We offer public policy measures to address gender inequities in the research sector. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic required mental health clinicians globally to transition to the delivery of care via telehealth. This study aimed to gain an understanding of clients' satisfaction with and attitudes towards telehealth mental health services. Method: Seventy adults who had attended a clinic for mood and anxiety disorders, and participated in at least one telehealth consultation with a psychologist or psychiatrist, completed an anonymous online survey. Results: The majority of participants (81.5%) reported satisfaction with telehealth mental health care provided during the COVID-19 pandemic. However, satisfaction overall was significantly higher amongst participants who had received both telehealth and face-to-face mental health care, compared to participants who received care via telehealth only. Advantages of telehealth care reported included convenience and increased access to mental health clinicians. However, disadvantages of telehealth care included greater difficulty developing a rapport with a clinician and expressing oneself via telehealth. Conclusions: Whilst client satisfaction with telehealth mental health care for mood and anxiety disorders is generally high, clinicians should consider the limitations of telehealth from clients' perspectives. In particular, strategies to enhance therapeutic connection during telehealth sessions may be needed, and client preferences for mode of delivery should be taken into consideration when possible. [ABSTRACT FROM AUTHOR]

Liver hepatocellular carcinoma is a common cancer type with an increasing mortality rate. Identifying the potential biomarker will increase the accuracy of the diagnosis and prognosis. The aim of the study is to comprehend the DDx49 association with the liver tumorusing various bioinformatic tools. STRING and ShinyGO web-based tools were utilized to study the interacting partners and their associated pathways. The UALCAN database was used to study the expression of different demographic variables. GEPIA was performed to analyze the expression, correlation and survival of the patients. The results show that DDx49 is up-regulated in liver cancers (P< 0.0001). DDx49 is a DEAD-box helicase that is involved in RNA metabolism and the ribosomal biogenesis pathway. The alteration in the DDx49 expression may be associated with dysfunction of the pathway and promote proliferation. Additionally, the Spearman correlation revealed that DDx49 is significantly correlated with the cell cycle and apoptotic genes. In TCGA datasets, DDx49 is mostly altered by amplification in liver cancer patients. Survival analysis showed that overexpression of DDx49 leads to a poor prognosis (P = 0.0038) in hepatocellular carcinoma patients. In conclusion, this study suggests DDx49 may act as a prognostic or/and diagnostic biomarker in a patient with liver cancer. [ABSTRACT FROM AUTHOR]

Significant changes have occurred during the last few decades across the North Atlantic climate system, including in the atmosphere, ocean, and cryosphere. These large-scale changes play a vital role in shaping regional climate and extreme weather events across the UK and Western Europe. This review synthesizes the characteristics of observed large-scale changes in North Atlantic atmospheric and oceanic circulations during past decades, identifies the drivers and physical processes responsible for these changes, outlines projected changes due to anthropogenic warming, and discusses the predictability of these circulations. On multi-decadal time scales, internal variability, anthropogenic forcings (especially greenhouse gases), and natural forcings (such as solar variability and volcanic eruptions) are identified as key contributors to large-scale variability in North Atlantic atmospheric and oceanic circulations. However, there remain many uncertainties regarding the detailed characteristics of these various influences, and in some cases their relative importance. We therefore conclude that a better understanding of these drivers, and more accurate quantification of their relative roles, are crucial for more reliable decadal predictions and projections of regional climate for the North Atlantic and Europe. [ABSTRACT FROM AUTHOR]

This article explores the role of history in management learning. Our starting point is the notion of historical reflexivity, which promotes a non-linear analysis of what becomes taken-for-granted, acknowledging that past, present and future are bound up with the historical development of management and organization. Our analysis recalibrates historical reflexivity to emphasize its multi-temporal character, examining how multi-temporal reflexivity impacts on the practice, performance and future-directed vision of individual managers. We approach this from the perspective of three practising managers: entrepreneurs based in Northeast England, who built up a business which they later sold, before turning to philanthropy. All three had experienced in their personal history lingering painful episodes that exerted ongoing influence in the present and future. We show that multi-temporal reflexivity is intrinsically multi-level, as reflexive learning gleaned from formative personal experience is redirected towards the organization, community and society, harnessed to build positive social futures for others. [ABSTRACT FROM AUTHOR]

Metaphors to describe and understand dementia have been used in Western culture for many years. However, the ways in which people living with dementia and care partners use metaphors and symbols to illustrate and give meaning to their own experiences has been less understood. In this paper we explore the use of metaphor as methodology-- a way to support people living with dementia and their care partners in reflecting on and sharing their experiences of dementia. More specifically, drawing on our experiences using metaphor and symbols to map out the dementia journey from the perspectives of people living with dementia, care partners, and health and social care providers in Ontario, Canada, we describe our process of employing metaphor as methodology. We reflect on the use of metaphor as methodology through framing the dementia experience, exploring complexity, and representing multidimensionality. The use of metaphors has the potential to open space for new understandings of dementia. [ABSTRACT FROM AUTHOR]

The goal of this study was to identify which anatomical and dosimetric changes correlated with late patient-reported dysphagia throughout the course of head and neck chemo-radiotherapy treatment. The patient cohort (n = 64) considered oropharyngeal and nasopharyngeal patients treated with curative intent, exhibiting no baseline dysphagia with a follow-up time greater than one year. Patients completed the MD Anderson Dysphagia Inventory during a follow-up visit. A composite score was measured ranging from 20 to 100, with a low score indicating a high symptom burden; a score ≤60 indicated patient-reported dysphagia. The pharyngeal (PCM) and cricopharyngeal constrictor muscles (CPM) were contoured on a planning CT image and adapted to weekly cone-beam CT anatomy using deformable image registration and dose was accumulated using weighted dose-volume histogram curves. The PCM and CPM were examined for volume, thickness, and dosimetric changes across treatment with the results correlated to symptom group. Anatomical evaluation indicated the PCM thickness increased more during treatment for patients with dysphagia, with base of C2 vertebrae (p = 0.04) and superior-inferior middle PCM (p = 0.01) thicknesses indicating a 1.0–1.5 mm increase. The planned and delivered mean dose and DVH metrics to PCM and CPM were found to be within random error measured for the dose accumulation, indicating delivered and planned dose are equivalent. The PCM and CPM organs were found to lie approximately 5 mm closer to high dose gradients in patients exhibiting dysphagia. The volume, thickness, and high dose gradient metrics may be useful metrics to identify patients at risk of late patient-reported dysphagia. [ABSTRACT FROM AUTHOR]

Background: Despite the association between depression symptoms and cannabis use, it is unknown how military affiliation may modify this relationship. Methods: Patients reported frequency of cannabis use (past 30 days) and answered the Patient Health Questionnaire-2 (PHQ-2), as well as offered sociodemographic information (n = 484). Data were retrieved from a medical records database linked to a screening, brief intervention, and referral to treatment (SBIRT) program from three clinics in Alabama. With incomplete data for 89% of the sample for education, employment status, and income, we used multiple imputation with chained equations (MICE) to estimate a linear regression model where frequency of cannabis use was regressed on the previously described variables, plus an interaction term for military family status and depression. Results: Frequency of cannabis use was greater among civilians with depression symptoms (M = 7.66 days, SE = 0.60) than individuals from military families with depression symptoms (M = 1.44 days, SE = 1.75). Cannabis use was similar among civilians and military-connected individuals without depression symptoms, respectively (M = 4.01, SE = 0.18 vs. M = 3.85, SE = 0.48). The interaction between term for military family status and depression was statistically significant (b = −5.99, SE = 2.74, p =.03). Conclusion: A personal military connection may be a protective factor against cannabis use for those with depression symptoms. Future research should investigate other substances used for coping with depression symptoms among those military affiliated. [ABSTRACT FROM AUTHOR]

Background: Modern contraceptives have been widely promoted as an effective tool for birth control. They are highly effective for preventing unintended pregnancies thereby reducing the risk of abortions, maternal morbidities, and mortalities. Abortion or planned abstinence from sexual intercourse may be perceived as alternatives to the use of modern contraceptives. The aim of this study was to assess whether knowledge of the legal status of abortion, and knowledge of the monthly fertile period, were associated with the use of modern contraceptives among women of reproductive age in Ghana. Methods: We used nationally representative secondary data from the 2017 Ghana Maternal Health Survey. A weighted sample of 23,466 non-pregnant women aged 15–49 years were included in the study. Pearson chi-square and multivariable logistic regression analysis were conducted to assess the association between the independent and the outcomes variables. Sampling weight, cluster, and strata were applied at all levels of the analysis. Results: More than half (55.4%) lived in urban area, 80.1% were 20 years or older, 52.2% were multiparous women, 61.9% had secondary or higher education, and 34.5% were in the lower two wealth quintiles. We found no statistically significant association between knowledge of the legal status of abortion and use of modern contraceptives, or between knowledge of the monthly fertile period and use of modern contraceptives. Women with history of an induced abortion were 1.57 times as likely to use modern contraceptives compared to those with no history [adjusted odds ratio (aOR) 1.57, 95% CI 1.41–1.75]. Each additional increase in knowledge of a different modern contraceptive method was associated with 1.25 times increase in modern contraceptive use (aOR 1.25, 95% CI 1.22–1.29). Conclusions: Intensifying education on modern contraceptive methods and use, especially at abortion facilities, may help improve the uptake of modern contraceptives among women in Ghana. Plain Language Summary: Modern contraceptive use is known to have positive health benefits for women, their children and the entire family. When used correctly and consistently, it is effective in preventing unplanned pregnancies and abortion related complications among women. However, the prevalence of modern contraceptive use has been consistently low in Ghana. Previous studies have identified socio-demographic and health services related factors as affecting the use of modern contraceptives among women in Ghana. Our study used a nationally representative survey data to assess how knowledge of the abortion law in Ghana and knowledge of monthly menstrual period might affect the use of modern contraceptives among women in Ghana. We found that women's knowledge of the abortion law in Ghana and knowledge of their monthly menstrual period were not associated with the use of modern contraceptives. However, knowledge of more than one different modern contraceptive methods and history of an induced abortion were associated with higher utilization of modern contraceptives among women in Ghana. Intensifying education on modern contraceptive methods and use, especially at abortion clinics, may help improve the of modern contraceptives among women in Ghana. [ABSTRACT FROM AUTHOR]

I offer a response to Professor Joseph Stieb's article entitled 'Rethinking Gore-War: Counterfactuals and the 2003 Iraq War'. In his critique of my book, Explaining the Iraq War: Counterfactual Theory, Logic and Evidence, Stieb claims that neoconservatives and right-wing hawks in the Bush administration were singularly responsible for mobilizing domestic and international support for the US–UK invasion based on fabricated threats about Iraq's WMD and links to 9/11, Al-Qaeda and globalized terrorism. The central objective of my book (and this reply) is to refute and repudiate Stieb's fundamentally flawed and simplistic 'neoconist' account of the 2003 invasion. [ABSTRACT FROM AUTHOR]

Background: Eczema Care Online () is an online self-management toolkit which includes tailored content for young people (13–25 years) and for parents of children that have eczema (0–12 years). Testing in two randomised controlled trials has shown that it is easy to use, cost effective and offers a sustained improvement in eczema symptoms. Implementing Eczema Care Online outside of a funded research study and ensuring that it reaches those that will most benefit from is now a key challenge. This paper describes the lessons learnt from developing and delivering an implementation strategy. Methods: Data from systematic reviews, stakeholder consultation meetings, interviews with trial participants, intervention usage data during the trial, and existing eczema information websites informed our implementation plan. Using Normalisation Process Theory, an implementation plan combined these findings with practical, context-specific actions to encourage wider adoption of the intervention. Results: Data was successfully mapped to the four constructs of Normalisation Process Theory, and factors and processes that encourage implementation identified. These include: promoting how Eczema Care Online is different to other sources of information; aligning to and embedding in existing eczema resources (from charities and healthcare providers); simplifying aspects to aid ease of use; and, highlighting evidence that shows that Eczema Care Online works. Key lessons in developing an implementation strategy include 1) start implementation work early 2) maintain flexibility to explore multiple routes to implementation 3) use secondary data sources 4) balance theory with practicalities 5) consider longer-term maintenance beyond the life of the research project. Conclusion: Implementation planning is a key stage of the research process that is often not adequately resourced. Implementation planning ensures effective interventions developed and evaluated in research studies are utilised in everyday practice. [ABSTRACT FROM AUTHOR]

The basal forebrain (BF), in particular its cholinergic projections to cortex, has been implicated in regulation of attention in sensory systems. Here, we examine the role of GABAergic projections of the posterior nucleus basalis (pNB) and globus pallidus (GP) in attentional regulation in the auditory system. We employed a detection task where rats detected a narrow band target embedded in broad band noise, while optogenetically modulating GABAergic BF activity. We found that GABAergic BF modulation impacted target detection specifically close to perceptual threshold, consistent with a role in attentional modulation. We also present evidence for target frequency specificity of this modulation, including frequency selectivity and tonotopic organization of pNB/GP, as well as frequency band specific effects of optogenetics on behavioural target detection and on neural activity in auditory cortex and thalamus. Our findings highlight an important role of BF GABAergic neurons in modulating attention in the auditory pathway. We provide evidence for tonotopy in auditory basal forebrain and document that optogenetic modulation of efferent projections impact neural activity in thalamic and cortical auditory pathway structures, as well as influencing performance in an auditory detection task. [ABSTRACT FROM AUTHOR]

Introduction: In high-altitude cities located above 2,500 m, hospitals face a concerning mortality rate of over 50% among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS). This elevated mortality rate is largely due to the absence of altitude-specific medical protocols that consider the unique physiological adaptations of high-altitude residents to hypoxic conditions. This study addresses this critical gap by analyzing demographic, clinical, sex-specific, and preclinical data from ICUs in Bogotá, Colombia (2,650 m) and El Alto, Bolivia (4,150 m). Methods: A cohort of seventy ARDS patients, aged 18 and older, was evaluated within 24 h of ICU admission. Data collected included demographic information (age, sex), clinical characteristics (primary pathology, weight, height), vital signs, respiratory variables, cardiorespiratory parameters, blood count results, inflammatory markers, severity assessment scores, and comorbidities. Advanced statistical analyses, such as multivariate logistic regression and principal component analysis, were utilized to identify key clinical predictors of ARDS-related mortality. Results: Our findings indicate that in high-altitude ICUs, monitoring inflammatory markers may be more beneficial for improving ARDS survival rates than emphasizing respiratory failure markers. Unexpectedly, we found no significant differences in clinical outcomes between altitudes of 2,650 and 4,150 m or between male and female patients. Conclusion: The study concludes that, in high-altitude settings, ARDS patient survival in ICUs is more closely associated with managing inflammatory responses than with focusing solely on respiratory parameters. Further large-scale studies are recommended to validate the impact of inflammatory marker monitoring on survival outcomes in high-altitude ICUs. [ABSTRACT FROM AUTHOR]

Background: Internationally, COVID-19 restrictions impacted negatively on participation in sport and physical activity. Participation in community club sport was particularly disrupted with cancelled training and competitions, and this has been shown to impact the health of individuals. We now need to investigate the effects of the lifting of COVID-19 restrictions. Aim: The aim of this study was to longitudinally investigate the health of Australian adult sports club participants, during and post-COVID-19 restrictions. Methods: Two waves of an online survey were conducted in mid-2020 and mid-2021. The first wave also captured retrospective pre-COVID19 (2019) data. For each year 2019–2021 each survey respondent was categorized as participating (Yes/No) in club sport. Respondents also assessed their current health (overall, physical and mental) in both 2020 and 2021. The six health assessments were cross-tabulated against three patterns of participation (dropout, dropout and return, continuation), for the survey sample overall and for six demographic subsamples: 42 crosstabulations in all. Results: A total of 1,037 Australians aged 18 years and above completed both survey waves. Those who continued playing club sport throughout, and to a lesser degree those who returned to club sport in 2021, reported better physical and general health than those who dropped out. This pattern was consistent, for the overall survey sample and for the sub-samples based on gender, age and region of residence, with statistically significantly associations (p < 0.05) in 24 of 28 analyses. The pattern of club sport participation was only weakly associated with reported mental health, with only one of 14 associations being statistically significant. Conclusion: Changes in club sport participation impact general and physical health of adults; continuation or return were associated with better physical and general health than drop-out. There was little evidence of an association between participation in sport and mental health, which is inconsistent with previously reported cross-sectional results; this may be due to a combination of factors, including confounding with the broader effects of the pandemic. In conclusion, it is clear that retention in participation in sport is not just important for sports management policy and strategies; it is also important for the health of individuals. [ABSTRACT FROM AUTHOR]

Layer 4 (L4) of rabbit V1 contains fast-spike GABAergic interneurons (suspected inhibitory interneurons, SINs) that receive potent synaptic input from the LGN and generate fast, local feedforward inhibition. These cells display receptive fields with overlapping ON/OFF subregions, nonlinear spatial summation, very broad orientation/directional tuning, and high spontaneous and visually driven firing rates. Fast-spike interneurons are also found in Layer 5 (L5), which receives a much sparser input from the LGN, but the response properties and thalamocortical connectivity of L5 SINs are relatively unstudied. Here, we study L5 SINs in awake rabbits (both sexes) and compare their response properties with previously studied SINs of L4. We also assess thalamocortical connectivity of L5 SINs, examining cross-correlation of retinotopically aligned LGN-SIN spike trains and L5 SIN responses to electrical stimulation of the LGN. These analyses confirmed that many L5 SINs, like L4 SINs, receive a strong, fast monosynaptic drive from the LGN. Moreover, these LGN-connected L5 SINs had response properties similar to those of L4 SINs and were predominantly found in the upper half of L5. In contrast, L5 SINs with longer synaptic latencies to LGN stimulation displayed (1) sharper orientation tuning, (2) longer visual response latencies, (3) lower spontaneous and (4) visually driven firing rates, and (5) were found in the deeper half of L5. We suggest that the long-latency synaptic responses in such L5 SINs reflect a multisynaptic intracortical pathway that generates a different constellation of response properties than seen in L5 SINs that are driven directly by LGN input. [ABSTRACT FROM AUTHOR]

Coronaviruses express their structural and accessory genes via a set of subgenomic RNAs, whose synthesis is directed by transcription regulatory sequences (TRSs) in the 5′ genomic leader and upstream of each body open reading frame. In SARS-CoV-2, the TRS has the consensus AAACGAAC; upon searching for emergence of this motif in the global SARS-CoV-2 sequences, we find that it evolves frequently, especially in the 3′ end of the genome. We show well-supported examples upstream of the Spike gene—within the nsp16 coding region of ORF1b—which is expressed during human infection, and upstream of the canonical Envelope gene TRS, both of which have evolved convergently in multiple lineages. The most frequent neo-TRS is within the coding region of the Nucleocapsid gene, and is present in virtually all viruses from the B.1.1 lineage, including the variants of concern Alpha, Gamma, Omicron and descendants thereof. Here, we demonstrate that this TRS leads to the expression of a novel subgenomic mRNA encoding a truncated C-terminal portion of Nucleocapsid, which is an antagonist of type I interferon production and contributes to viral fitness during infection. We observe distinct phenotypes when the Nucleocapsid coding sequence is mutated compared to when the TRS alone is ablated. Our findings demonstrate that SARS-CoV-2 is undergoing evolutionary changes at the functional RNA level in addition to the amino acid level. Coronaviruses can evolve novel transcription regulatory sequences, generating new RNA transcripts during human infection. This study identifies a prevalent subgenomic RNA in SARS-CoV-2, which produces a C-terminal nucleocapsid fragment that suppresses interferon signaling and enhances viral fitness. [ABSTRACT FROM AUTHOR]

Determining COVID-19 vaccination strategies presents many challenges in light of limited vaccination capacity and the heterogeneity of affected communities. Who should be prioritized for early vaccination when different groups manifest different levels of risks and contact rates? Answering such questions often becomes computationally intractable given that network size can exceed millions. We obtain a framework to compute the optimal vaccination strategy within seconds to minutes from among all strategies, including highly dynamic ones that adjust vaccine allocation as often as required, and even with modest computation resources. We then determine the optimal strategy for a large range of parameter values representative of various US states, countries, and case studies including retirement homes and prisons. The optimal is almost always one of a few candidate strategies, and, even when not, the suboptimality of the best among these candidates is minimal. Further, we find that many commonly deployed vaccination strategies, such as vaccinating the high risk group first, or administering second doses without delay, can often incur higher death rates, hospitalizations, and symptomatic infection counts. Our framework can be easily adapted to future variants or pandemics through appropriate choice of the compartments of the disease and parameters. [ABSTRACT FROM AUTHOR]

This systematic map explores the role of sustainability certification schemes and labels in reducing greenhouse gas emissions across biobased value chains. With increasing global and EU interest in transitioning to a sustainable bioeconomy, these certification mechanisms are seen as critical tools for promoting low-emission practices. This review maps the available evidence regarding the effectiveness of certification schemes, examining sector-specific variations and identifying knowledge gaps. A comprehensive search strategy was employed across three major databases and grey literature sources, yielding 41 relevant articles. There are significant disparities in the evidence on the impact of sustainability certification schemes and labels on greenhouse gas (GHG) emissions across biobased sectors. Agriculture has the most data, but studies are heavily focused on organic systems, limiting broader conclusions. Most research is concentrated in Southeast Asia and Europe, reducing generalizability to other regions. Additionally, most studies focus on the production stage, leaving value chain phases like processing and disposal under-represented. Knowledge gaps exist across sectors, certification schemes, and life cycle stages, highlighting the need for further research. While some schemes incorporate GHG management tools, evidence on their effectiveness remains insufficient and context-dependent, warranting more robust, targeted research. Though this research looked at all biobased feedstocks, it did not review schemes and labels specifically targeting biofuels, which presents an avenue for future research. [ABSTRACT FROM AUTHOR]

An example of chemotherapy‐induced cardiotoxicity in cancer survivors is acquired long QT syndrome (aLQTS), which may cause serious yet preventable life‐threatening consequences. Our objective was to identify and characterize childhood acute lymphoblastic leukemia (ALL) survivors with possible aLQTS using maximal exercise testing. In this cross‐sectional study with exploratory analysis, a total of 250 childhood ALL survivors were evaluated for abnormal QT interval prolongation using the McMaster cycle exercise test. A total of 198 survivors (102 males; 96 females), having reached their V̇O2 peak (mean 32.1 ± 8.4 mL/kg/min; range 15.5–57.8 mL/kg/min), were included in our analyses. Two survivors were excluded for possible congenital LQTS. QT intervals were corrected for heart rate using the Bazett, Fridericia, and Rautaharju formulas at rest (supine, sitting, and standing positions), at the end of each stage of the CPET, and at 1, 3, and 5 minutes into the recovery period. The corrected QT (QTc) of borderline (n = 37) and long QT survivors (n = 20) was significantly longer than normal survivors (n = 141) at rest, exercise, and recovery. Out of 57 survivors presenting an abnormal QTc prolongation, 40 survivors (70%) showed no QT interval anomalies at rest but developed various anomalies during exercise. No significant differences were found between the groups for any of the measured clinical characteristics or cardiac parameters. The standardization of exercise testing in the regular follow‐up of oncology patients is necessary for appropriate cardiac prevention and surveillance to enhance the health and quality of life of the ever‐increasing number of cancer survivors. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS) lacks a specific biomarker, but is defined by relatively selective toxicity to motor neurons (MN). As others have highlighted, this offers an opportunity to develop a sensitive and specific biomarker based on detection of DNA released from dying MN within accessible biofluids. Here we have performed whole genome bisulfite sequencing (WGBS) of iPSC-derived MN from neurologically normal individuals. By comparing MN methylation with an atlas of tissue methylation we have derived a MN-specific signature of hypomethylated genomic regions, which accords with genes important for MN function. Through simulation we have optimised the selection of regions for biomarker detection in plasma and CSF cell-free DNA (cfDNA). However, we show that MN-derived DNA is not detectable via WGBS in plasma cfDNA. In support of our experimental finding, we show theoretically that the relative sparsity of lower MN sets a limit on the proportion of plasma cfDNA derived from MN which is below the threshold for detection via WGBS. Our findings are important for the ongoing development of ALS biomarkers. The MN-specific hypomethylated genomic regions we have derived could be usefully combined with more sensitive detection methods and perhaps with study of CSF instead of plasma. Indeed we demonstrate that neuronal-derived DNA is detectable in CSF. Our work is relevant for all diseases featuring death of rare cell-types. [ABSTRACT FROM AUTHOR]

The health disparities between rural and urban populations in Australia, driven by socioeconomic, environmental, and healthcare access factors, highlight the urgent need for rural-focused medical education. The Melbourne Medical School's Rural Health Discovery program addresses this need by integrating adult learning principles within a redesigned curriculum that includes the Rural Health Foundations and Integrating Rural Health topics. These Discovery topics engage medical students from diverse backgrounds through a blend of self-directed learning, problem-solving, and immersive clinical placements in rural settings. By aligning with andragogical principles—such as fostering autonomy, practical relevance, and experiential learning—the program prepares students for the unique demands of rural healthcare practice. Students are introduced to the complexities of rural health, including the social determinants affecting rural communities, through asynchronous modules, case studies, and team-based learning. This innovative curriculum, which is flexible and inclusive of rural and metropolitan students, represents a strategic model for promoting rural healthcare careers, addressing workforce shortages, and ensuring equitable health outcomes for underserved communities. [ABSTRACT FROM AUTHOR]

Piezoelectric materials directly convert between electrical and mechanical energies. They are used as transducers in applications such as nano-positioning and ultrasound imaging. Improving the properties of these devices requires piezoelectric materials capable of delivering a large longitudinal strain on the application of an electric field. A large longitudinal strain of more than 1% is generally anticipated in suitably oriented single crystals of specific compositions of ferroelectric materials1. Polycrystalline piezoceramics typically show a longitudinal strain of approximately 0.2–0.4%. We demonstrate that when the thickness of a polycrystalline piezoceramic is reduced to such an extent that a large fraction of the grains are in the triaxial–biaxal crossover regime, the domain-switching fraction increases considerably. If the positive and the negative surfaces of the piezoceramic respond to electric fields symmetrically, as in the classical PbZrxTixO3, a longitudinal strain of approximately 1% can be achieved in a 0.2 mm disc of the morphotropic phase boundary composition (a 300% increase from a thickness of 0.7 mm). We show that oxygen vacancies in piezoceramics cause asymmetrical switching at the positive and negative surfaces, which causes thin piezoceramics to bend. We expect these findings will encourage further engineering of these mechanisms across different piezoelectric material systems, opening new applications for electromechanical actuation.We find that if the thickness of a polycrystalline piezoceramic is reduced such that a large fraction of the grains are in the triaxial–biaxal crossover regime, the longitudinal strain is enhanced and the piezoceramic bends. [ABSTRACT FROM AUTHOR]

While PTSD continues to be researched in great depth, less attention has been given to the continuum of traumatic responses that resides outside this diagnosis. This investigation begins with a literature review examining the spectrum of responses through the lens of the default mode network (DMN). To build upon this literature, a systematic exploratory study was incorporated, examining DMN-related neuropsychological functioning of 27 participants (16 trauma-exposed, and 11 non-trauma-exposed), with a subset (15 participants) completing neuroimaging. This study revealed that in comparison to the control group, the trauma-exposed group had reductions in their capacity for self-referential processing, social cognition, autobiographical recall, prospection, and increased mind-wandering. While correlations were encountered between cognitive findings and brain volume, comparative volumetric findings between trauma-exposed and non-t rauma exposed were insignificant. This suggests that the conservation of DMN structural integrity may play a role in resilience, supporting the existing theory that reduced hippocampal volume may be a pre-existing vulnerability to PTSD rather than a consequence and that reductions in DMN related cognition are functionally mediated. [ABSTRACT FROM AUTHOR]

Cell size is a critical regulator of many metabolic processes in protists. We explored whether body size and abundances vary consistently in phytoplankton capable of both autotrophy and heterotrophy (mixoplankton) by manipulating environmental stoichiometric conditions in a mesocosm experiment. We applied two allochthonous subsidy treatments: high C: nutrient ratios (leaves) should favour bacterivory through phagotrophy, while low ratios (insects) should favour autotrophy. We identified three focal mixoplankton taxa, common in our study system and that represented facultative (Cryptomonas sp. and Plagioselmis sp) and more obligate phagotrophs (Ochromonas sp.). Ochromonas was largest in the leaf treatment, which were also associated with larger sizes in Cryptomonas (but not the other cryptophyte). The obligately mixotrophic Ochromonas responded more significantly to conditions favouring phagotrophy than did the facultative phagotrophic cryptophytes. All mixoplankton taxa densities declined with insect subsidies that favour autotrophy. Future research should examine a wider range of mixoplankton under varying ecological conditions. [ABSTRACT FROM AUTHOR]

Objective Low inpatient mobility is associated with poor hospital outcomes. Poor communication between clinicians has been identified as a barrier to improving mobility. Understanding how mobility is communicated within the multidisciplinary team may help inform strategies to improve inpatient mobility. The aim of this study was to describe written mobility communication by physical therapists and nurses in acute care medical wards. Methods This cross-sectional observational study was conducted across 4 hospitals in an Australian health service. A survey of physical therapists and nurses identified preferred sources and content of written mobility communication. An audit described and compared written mobility communication in the most strongly preferred documentation sources. Findings were described and compared graphically between discipline and site. Results Questionnaires were completed by 85 physical therapists and 150 nurses. Twenty-two sources of documentation about mobility were identified. Preferences for sources and content varied between disciplines. Physical therapists nominated several preferred information sources and sought and documented broader mobility content. Nurses often sought nursing documents that focused on current mobility assistance and aids, with limited communication of mobility level or mobility goals. Audits of 104 patient records found that content varied between sources and sites, and content was variably missing or inconsistent between sources. Conclusion Written mobility communication focused on mobility assistance and aids, rather than mobility levels or mobility goals, with poor completion and inconsistency within documentation. More complete and consistent documentation might improve progressive mobilization of hospital inpatients. Impact Physical therapists and nurses seek and document different content in a wide range of locations, leading to incomplete and inconsistent written documentation. Understanding and resolving these practice differences offers potential to improve mobility communication and practice. [ABSTRACT FROM AUTHOR]

This study introduces a new approach to multi-hazard risk assessment, leveraging hypergraph theory to model the interconnected risks posed by cascading natural hazards. Traditional single-hazard risk models fail to account for the complex interrelationships and compounding effects of multiple simultaneous or sequential hazards. By conceptualising risks within a hypergraph framework, our model overcomes these limitations, enabling efficient simulation of multi-hazard interactions and their impacts on infrastructure. We apply this model to the 2015 Mw 7.8 Gorkha earthquake in Nepal as a case study, demonstrating its ability to simulate the primary and secondary effects of the earthquake on buildings and roads across the whole earthquake-affected area. The model predicts the overall pattern of earthquake-induced building damage and landslide impacts, albeit with a tendency towards over-prediction. Our findings underscore the potential of the hypergraph approach for multi-hazard risk assessment, offering advances in rapid computation and scenario exploration for cascading geo-hazards. This approach could provide valuable insights for disaster risk reduction and humanitarian contingency planning, where the anticipation of large-scale trends is often more important than the prediction of detailed impacts. [ABSTRACT FROM AUTHOR]

Objectives: To (1) determine associations between maternal risk conditions and severe adverse outcomes that may benefit from risk-appropriate care and (2) assess whether associations between risk conditions and outcomes vary by level of maternal care (LoMC). Methods: We used the 2017–2019 National Inpatient Sample (NIS) to calculate associations between maternal risk conditions and severe adverse outcomes. Risk conditions included severe preeclampsia, placenta accreta spectrum (PAS) conditions, and cardiac conditions. Outcomes included disseminated intravascular coagulation (DIC) with blood products transfusion or shock, pulmonary edema or acute respiratory distress syndrome (ARDS), stroke, acute renal failure, and a composite cardiac outcome. Then we used 2019 delivery hospitalization data from five states linked to hospital LoMC. We calculated associations between risk conditions and outcomes overall and stratified by LoMC and assessed for effect modification by LoMC. Results: We found positive measures of association between risk conditions and outcomes. Among patients with severe preeclampsia or PAS, the magnitudes of the associations with DIC with blood products transfusion or shock, pulmonary edema or ARDS, and acute renal failure were lower in Level III/IV compared with