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β-Ga2O3 is of great interest for power electronic devices with efficiency beyond current generation Si, 4H-SiC, and GaN devices due to its large breakdown electric field of ∼8 MV/cm. However, taking advantage of this large field strength in power diodes requires device engineering to reduce leakage current that arises at high electric fields. In this work, we elucidate the current transport mechanisms of metal/TiO2/β-Ga2O3 diodes, showing that thermionic emission is an excellent descriptor of current in forward and reverse bias. It is shown that tunneling current is greatly suppressed, and consequently, that the diodes with the TiO2 interlayer can block orders of magnitude more current than Schottky barrier diodes with the same barrier heights. Finally, a 1200 V diode structure is designed based on the derived transport models, and calculated on- and off-state current characteristics closely align with those of state-of-the-art 4H-SiC commercial devices, indicating that this diode structure is ready to enable the realization of β-Ga2O3 power diodes. [ABSTRACT FROM AUTHOR]

Workplace and non‐workplace homicides in the United States (U.S.) have declined for over 30 years until recently. This study was conducted to address the change in trends for both workplace and non‐workplace homicides and to evaluate the homogeneity of the change in workplace homicides by specified categories. Joinpoint and autoregressive models were used to assess trends of U.S. workplace and non‐workplace homicides utilizing surveillance data collected by the Bureau of Labor Statistics and the Federal Bureau of Investigation from 1994 through 2021. Both workplace and non‐workplace homicides decreased significantly from 1994 through 2014. Workplace homicides showed no significant trend from 2014 through 2021 (p = 0.79), while non‐workplace homicides showed a significant average annual increase of 4.1% from 2014 through 2020 (p = 0.0013). The large decreases in the trend of workplace homicides occurring during a criminal act, such as robbery, leveled off and started to increase by the end of the study period (p < 0.0001). Declines in workplace homicides due to shootings also leveled off and started to increase by the end of the study period (p < 0.0001). U.S. workplace and non‐workplace homicide rates declined from the 1990s until around 2014. Trends in workplace homicides varied by the types of the homicide committed and by the type of employee that was the victim. Criminal‐intent‐related events, such as robbery, appear to be the largest contributor to changes in workplace homicides. Researchers and industry leaders could develop and evaluate interventions that further address criminal‐intent‐related workplace homicides. [ABSTRACT FROM AUTHOR]

The aims of this study were 3-fold: (1) to compare technical proficiency scores between training and matches for tackling, ball-carrying, and rucking outcomes; (2) to determine the relationship between technique in training and technique in matches for tackling, ball carrying, and rucking; and (3) to determine how contact technique (in training and matches) relates to match performance and injury outcomes. Twenty-four male players from an amateur rugby union club participated in the study. At the beginning of the season, players' contact technique proficiency was assessed in a training drill. Contact technique in matches was assessed during 14 competitive matches. The technique proficiency was assessed using standardized criteria, and the outcomes of each tackle, ball carry, and ruck were recorded. In training and matches, positive performance outcomes were associated with higher contact technique proficiency scores. For instance, in both settings, tackle technique was significantly lower in missed tackles when compared to effective and ineffective tackles. Players' contact technique scores in matches also had a positive effect on their tackle performance in matches. Ball-carry technique was associated with tackle breaks in matches (P <.05, r2 =.31). In training and match environments, tackler, ball-carrier, and ruck technique scores were significantly associated with effective tackles, ball carries, and rucks. Despite the relationship between technical proficiency scores and performance, there were small to moderately higher scores in training compared with matches. The current study highlights the importance of contact skill training, in different environments and conditions, to ensure that skills developed in training are transferred to match performance. [ABSTRACT FROM AUTHOR]

Purpose: To test the effects of mental fatigue (MF) on tackling technique on the dominant and nondominant shoulders in rugby union. Methods: Twenty male amateur rugby union players and a total of 953 tackles were analyzed. A randomized crossover counterbalanced design was used across a non-MF (control) and an MF condition. During each condition, each player performed 24 tackles, divided into 4 sets of 6 tackles (3 tackles on each shoulder). In the MF condition, players performed the Stroop Task between each set of tackles. A video recording of each tackle was used to evaluate each player's technical proficiency. A score of 1 point was awarded if a specific technique was performed correctly, and 0 point was given if not. The total score, measured in arbitrary units (AU) out of 11, represents the player's overall tackling proficiency. Results: Overall, players displayed a significantly lower technical proficiency score in the MF condition compared to control (set 2: control 7.30 [7.04–7.57] AU vs MF 6.91 [6.70–7.12] AU, P =.009, effect size (ES) = 0.30 small and set 3: control 7.34 [7.11–7.57] AU vs MF 6.88 [6.66–7.11] AU, P =.002, ES = 0.37 small). For the nondominant shoulder, players had a significantly lower technical proficiency score during the MF condition at set 2 (control 7.05 [6.68–7.41] AU vs MF 6.69 [6.42–6.96] AU, P =.047, ES = 0.29 small) and set 3 (control 7.14 [6.83–7.45] AU vs MF 6.61 [6.35–6.87] AU, P =.007, ES = 0.49 small). Conclusions: MF can diminish a player's overall tackling proficiency, especially when tackling on the nondominant shoulder. The physiological mechanism for this finding may be impaired executive function and suboptimal functioning of neural signals and pathways, which result in less skillful coordination of movement. To further understand and explain MF-induced physiological changes in tackling, the feasibility of monitoring brain activity (such as electroencephalogram) and neuromuscular function (such as electromyogram) needs to be investigated. The findings from this study may also contribute to the development of more effective tackle training programs for injury prevention and performance. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorders (AUD) are prevalent and responsible for substantial morbidity and mortality; yet efficacious treatments are underused. Previous studies have identified demographic and clinical predictors of medication fills, yet these studies typically do not include patients who were prescribed a medication but did not fill it. Objectives: To examine rates of and factors associated with prescription order and prescription fill for medications for AUD (MAUD) among individuals diagnosed with AUD in outpatient settings. Design: In a cross-sectional analysis, we used multivariate logistic regression to identify factors associated with prescription order and fill. Patients: We used data from the Optum Labs Data Warehouse that linked 2016–2021 de-identified claims and electronic health record (EHR) data, allowing us to observe prescription orders and whether they were filled. We identified 14,674 patients aged ≥ 18 who had an index outpatient encounter with an AUD diagnosis in the EHR. Key Measures: We computed the proportion for whom a MAUD prescription was ordered within 1 year of index visit, and for whom one was filled within 30 days of the order. Key Results: 5.8% of the sample had a MAUD prescription order within 1 year of their index visit. Among those with an order, 87% filled their MAUD prescription within 30 days of receipt (i.e., 5.1% of full sample). After multivariable adjustment, receipt of a MAUD prescription order was more likely for patients who were female (adjusted odds ratio (aOR) [95%CI] = 1.44 [1.24–1.67]), or had moderate or severe AUD (1.74 [1.50–2.01]). Patients receiving an order were more likely to fill it if they had a comorbid mental disorder (1.64 [1.09–2.49]). Conclusions: The low rate of prescription orders was notable. Low use of MAUD appears to result chiefly from prescription order decisions, rather than from prescription fill decisions made by patients. [ABSTRACT FROM AUTHOR]

PTEN hamartoma tumor syndrome (PHTS) has a broad clinical spectrum including various benign and malignant tumors at varying age of diagnosis. Many patients remain unrecognized, unaware of their increased cancer risk. We aimed to describe the cancer spectrum, age of onset and histopathological cancer characteristics to assess whether specific cancer characteristics could improve PHTS recognition. Genetic testing results and pathology reports were collected for patients tested for germline PTEN variants between 1997 and 2020 from the diagnostic laboratory and the Dutch nationwide pathology databank (Palga). The cancer spectrum and age of onset were assessed in patients with (PTENpos) and without (PTENneg) a germline PTEN variant. Histopathological cancer characteristics were assessed in a nested cohort. 341 PTENpos patients (56% females) and 2882 PTENneg patients (66% females) were included. PTENpos patients presented mostly with female breast (BC, 30%), endometrial (EC, 6%), thyroid (TC, 4%) or colorectal cancer (4%). PTENpos were significantly younger at cancer onset (43 vs. 47 years) and had more often (46% vs. 18%) a second BC than PTENneg. PTEN detection rates were highest for BC <40 years (9%), TC <20 years (15%) and EC <50 years (28%), and dropped to 6%, 4%, and 15% by age 60. Histopathological characteristics were similar between groups. No histopathological cancer characteristics were distinctive for PHTS. However, PTENpos were significantly younger at cancer onset. Therefore early‐onset BC, EC, or TC warrants consideration of PHTS diagnostics either through a pre‐screen for other PHTS features or direct germline testing. [ABSTRACT FROM AUTHOR]

Introduction: Long-acting injectable (LAI) antipsychotic medications and clozapine are effective yet underutilized medical therapies in early intervention services. The purpose of this study was to conduct a pre-implementation evaluation of contextual determinants of early intervention programs to implement innovations optimizing LAI antipsychotic and clozapine use within a shared decision-making model. Methods: Semi-structured interviews explored barriers and facilitators to implementing LAI antipsychotics and clozapine in early intervention services. Participants were: prescribers (n = 2), non-prescribing clinicians (n = 5), administrators (n = 3), clients (n = 3), and caregivers (n = 3). Interviews were structured and analyzed using the Consolidated Framework for Implementation Research (CFIR 2.0). Results: Participants were supportive of using LAI antipsychotics, despite barriers (e.g., transportation, insurance coverage), while most were unfamiliar with clozapine (Innovation). Critical incidents (e.g., COVID-19) did not interfere with implementation, while barriers included lack of performance measures; stigma affecting willingness to take medication; and clozapine considered to be a "last resort" (Outer Setting). Treatment culture was described as clientcentered and collaborative, and most participants indicated LAI antipsychotic use was compatible with clinic workflows, but some were in need of resources (e.g., individuals trained to administer LAI antipsychotics; Inner Setting). Participants on the healthcare team expressed confidence in their roles. Family education and collaborative decision-making were recommended to improve client/family engagement (Individuals). Participants related the importance of tracking medication compliance, addressing client concerns, and providing prescribers with updated guidelines on evidence-based treatment (Implementation Process). Discussion: Results may guide implementation strategy selection for future programs seeking to optimize the use of LAI antipsychotics and clozapine for early-phase schizophrenia, when appropriate. [ABSTRACT FROM AUTHOR]

Sea ice altimetry currently remains the primary method for estimating sea ice thickness from space, however time-series of sea ice thickness estimates are of limited use without having been quality-controlled against reference measurements. Such reference observations for sea ice thickness validation in the polar regions are sparse and rarely presented in a format matching the satellite-derived products. Here, the first published comprehensive collection of sea ice reference observations including freeboard, thickness, draft and snow depth from sea ice-covered regions in the Northern Hemisphere (NH) and the Southern Hemisphere (SH) is presented. The observations have been collected using airborne sensors, autonomous drifting buoys, moored and submarine-mounted upward-looking sonars, and visual observations. The data package has been prepared to match the spatial (25 km for NH and 50 km for SH) and temporal (monthly) resolutions of conventional satellite altimetry-derived sea ice thickness data products for a direct evaluation of these. This data package, also known as the Climate Change Initiative (CCI) sea ice thickness (SIT) Round Robin Data Package (RRDP) was produced within the ESA CCI sea ice project. The current version of the CCI SIT RRDP covers the polar satellite altimetry era (1993–2021) and is part of ongoing efforts to keep the dataset updated. The CCI SIT RRDP has been collocated to satellite-derived sea ice thickness products from CryoSat-2, Envisat and ERS-1/2 produced within ESA CCI and the Fundamental Data Records for Altimetry (FDR4ALT) project to demonstrate the overlap and inter-comparison between the reference observations and satellite-derived products. Here, the CCI SIT RRDP is introduced along with examples of its use as a validation source for satellite altimetry products, where the averaging, collocation and uncertainty methodology is presented and their advantages and limitations are discussed. [ABSTRACT FROM AUTHOR]

Reliable and highly resolved information about onshore wind energy potential (WEP) is essential for expanding renewable energy to eventually achieve carbon neutrality. In this pilot study, simulated 60 m wind speeds (ws60m) from a km‐scale, convection‐permitting 3.3 km‐resolution ICON‐LAM simulation and often‐used 31 km‐resolution ERA5 reanalysis are evaluated at 18 weather masts. The estimated ICON‐LAM and ERA5 WEPs are then compared using an innovative approach with 1.8 million eligible wind turbine placements over southern Africa. Results show ERA5 underestimates ws60m with a Mean Error (ME) of −1.8 m s−1 (−27%). In contrast, ICON‐LAM shows a ME of −0.1 m s−1 (−1.8%), resulting in a much higher average WEP by 48% compared to ERA5. A combined Global Wind Atlas‐ERA5 product reduces the ws60m underestimation of ERA5 to −0.3 m s−1 (−4.7%), but shows a similar average WEP compared to ERA5 resulting from the WEP spatial heterogeneity. Plain Language Summary: Onshore wind energy is expected to play a major role in the global energy transition. However, reliable and highly resolved information on the onshore wind energy potential (WEP) crucial for expansion planning is missing over southern Africa. This study evaluated high resolution 3.3 km ICON‐LAM atmospheric simulations and 31 km ERA5 reanalysis against 60 m wind speed (ws60m) observations and compared the corresponding derived WEPs. The results show that ERA5 underestimates ws60m by 27%, resulting in a 48% lower WEP assessment than ICON‐LAM, whose ws60m simulation results show a very small bias. Underestimation of wind energy yields may hinder further expansion of wind energy, as less economic performance is expected, which underlines the importance of highly resolved weather data. Key Points: Simulated ERA5 and km‐scale ICON‐LAM wind speeds are evaluated and corresponding southern Africa wind energy potentials are calculatedERA5 underestimates 60 m wind speed, whereas ICON‐LAM produces lower biases in the wind speed simulationsHigher wind energy potentials are revealed from wind speeds simulated by ICON‐LAM compared to ERA5, which is often used for such assessments [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the difference in head acceleration event (HAE) incidence between training and match‐play in women's and men's players competing at the highest level of domestic rugby union globally. Players from Women's (Premiership Women's Rugby, Farah Palmer Cup) and Men's (Premiership Rugby, Currie Cup) rugby union competitions wore instrumented mouthguards during matches and training sessions during the 2022/2023 seasons. Peak linear (PLA) and angular (PAA) acceleration were calculated from each HAE and included within generalized linear mixed‐effects models. The incidence of HAEs was significantly greater in match‐play compared to training for all magnitude thresholds in both forwards and backs, despite players spending approximately 1.75–2.5 times more time in training. For all HAEs (PLA > 5 g and PAA > 400 rad/s2), incidence rate ratios (IRRs) for match versus training ranged from 2.80 (95% CI: 2.38–3.30; men's forwards) to 4.00 (3.31–4.84; women's forwards). At higher magnitude thresholds (PLA > 25 g; PAA > 2000 rad/s2), IRRs ranged from 3.64 (2.02–6.55; PAA > 2000 rad/s2 in men's backs) to 11.70 (6.50–21.08; PAA > 2000 rad/s2 in women's forwards). Similar trends were observed in each competition. Players experienced significantly more HAEs during match‐play than training, particularly at higher magnitude thresholds. Where feasible, HAE mitigation strategies may have more scope for HAE reduction if targeted at match‐play, particularly where higher magnitude HAEs are the primary concern. However, the number of HAEs associated with different training drills requires exploration to understand if HAEs can be reduced in training, alongside optimizing match performance (e.g., enhancing contact technique). [ABSTRACT FROM AUTHOR]

Objective: Although olfactory dysfunction is one of the most common presenting signs of COVID‐19 infection, little is known about which populations are most susceptible. The aim of this study is to evaluate the risk of COVID‐19‐induced chemosensory dysfunction in malnourished individuals. Methods: The N3C database was queried for adults having positive COVID‐19 test result, diagnosis of chemosensory dysfunction within 2 weeks of positive test date, and overnutrition or undernutrition (i.e., deficiency or excess of micro‐ and macronutrients) related diagnoses prior to COVID‐19 infection. Individuals previously diagnosed with chemosensory dysfunction were excluded. COVID‐19‐positive adults without olfactory dysfunction were similarly analyzed. Statistical analysis was performed using odds ratio calculations (95% confidence interval [CI]). Results: Of 3,971,536 patients with COVID‐19, 73,211 adults were identified with a diagnosis of undernutrition and 428,747 adults were identified with a diagnosis of overnutrition prior to infection. Of those with undernutrition, 264 (0.36%) individuals were identified with a diagnosis of olfactory dysfunction within 2 weeks of infection. Of those with overnutrition, 2851 (0.66%) individuals were identified with a diagnosis of olfactory dysfunction within 2 weeks of infection. The calculated odds ratio for undernutrition and olfactory dysfunction was 0.731 (p < 0.0001, 95% CI [0.0647, 0.0825]). The calculated odds ratio for overnutrition and olfactory dysfunction was 1.419 (p < 0.0001, 95% CI [1.3359, 1.5081]). Conclusion: Overnutrition may increase the risk of COVID‐19‐related olfactory dysfunction, while undernutrition may slightly protect. While reasons are unclear, baseline differences in metabolic, inflammatory, and structural biochemistry deserve closer inspection. Level of Evidence: 3 Laryngoscope, 134:4338–4343, 2024 [ABSTRACT FROM AUTHOR]

Background: Catheter Ablation (CA) is an effective treatment for atrial fibrillation (AF). However, frail elderly patients have been understudied due to their exclusion from landmark trials. Objectives: Our study aims to evaluate outcomes in this population. Methods: The national readmission database (2016–2020) was queried, and frailty categories were defined based on hospital risk frailty scores ≦5 as low while >5 as intermediate/high frailty (IHF). We used multivariate regression and propensity‐matched analysis to compare outcomes in patients undergoing CA for atrial fibrillation based on frailty index. Results: Among 55 936 CAs for AF, 33,248 patients had low frailty, while 22 688 had intermediate/high frailty (IHF). After propensity matching (N 12 448), IHF patients were found to have higher adverse events, including mortality (3% vs. 0.3%, p <.001), stroke (1.9% vs. 0.2%, p <.001), acute heart failure (53.8% vs. 42.2%, p <.001), AKI (42.5% vs. 6.8%, p <.001), pericardial complications (2.8 vs. 1.6%, p <.001), respiratory complications (27.8 vs. 7.2%, p <.001), major adverse cardiovascular events (21.2 vs. 9.4%, p <.001) and net adverse events (76.7 vs. 55%, p <.001). IHF patients had higher readmissions at 30 (15.5 vs. 12.6%, p <.001), 90 (31.9 vs. 25.1%, p <.001), and 180‐day (41 vs. 34.7%, p <.001) intervals. A higher median length of stay (LOS) (7 vs. 3 days, p <.001) and cost ($44 287 vs. $27 517, p <.001) at index admission and subsequent readmissions were also observed (p <.001). Conclusion: Intermediate/high frailty patients undergoing catheter ablation had worse clinical outcomes, higher healthcare burden, and readmission rates. LOS has decreased in both groups from 2016 to 2020; however, total cost has increased. [ABSTRACT FROM AUTHOR]

Purpose: To identify clinician-perceived barriers and facilitators to the delivery of outcome measurement and evidence-based treatment practices and integration of these practices in aphasia rehabilitation. Materials and methods: Using a convergent mixed methods design, aphasia clinicians (n = 87) across care settings in the United States completed an online survey designed within the Theoretical Domains Framework (TDF). Participants responded to open-ended questions and rated Likert scale statements. Qualitative data were analyzed using content analysis and quantitative data were summarized using descriptive statistics. Results: Factors related to the TDF domain of "environmental context and resources" (priority and productivity demands; characteristics of resources) were cited as primary barriers in 70% of qualitative responses for both outcome and treatment practices and were consistent with Likert rating statements. Facilitators were associated with TDF domains of "memory, attention, decision-making" (decision-making processes), "knowledge" (awareness of evidence) and "social influences" (client and caregiver preferences). Conclusions: Organizational-level factors and the misalignment of the research evidence with clinical needs are barriers to delivering evidence-based care in aphasia rehabilitation. Theoretically informed strategies such as establishing organizational infrastructure for practice change, developing clinically relevant evidence through research-practice partnerships, and implementing algorithms to support clinical decision-making can address barriers and leverage facilitators. IMPLICATIONS FOR REHABILITATION: Rehabilitation research needs to engage clinical partners and consider the healthcare context to provide the field with evidence-based outcome measures and treatment recommendations that meet the needs of the clinical environment. Clinical decision-making tools and algorithms have potential to support systematic, evidence informed care. Future implementation efforts need to test strategies that go beyond knowledge and skills training. Clinicians are optimistic for change in clinical practice within themselves and the profession. [ABSTRACT FROM AUTHOR]

Background: Ex vivo haematopoietic stem/progenitor cell (HSPCs) expansion constitutes an important area of research, and has the potential to improve access to umbilical cord blood (UCB) as a source of stem cells for haematopoietic stem cell transplantation (HSCT). The ability to improve stem cell dose and thereby reduce delayed engraftment times, which has plagued the use of UCB as a stem cell source since inception, is a recognised advantage. The extent to which cluster of differentiation (CD)34 sub-populations are affected by expansion with StemRegenin1 (SR1), and whether a particular subtype may account for better engraftment than others, is currently unknown. The purpose of this study was to determine the impact of SR1-induced HSPC expansion on CD34+ immunophenotypic subsets and gene expression profiles. Methods: UCB-derived CD34+ HSPCs were characterised before (D0) and after expansion (D7) with SR1 using an extensive immunophenotypic panel. In addition, gene expression was assessed and differentially expressed genes were categorised into biological processes. Results: A dose-dependent increase in the number of CD34+ HSPCs was observed with SR1 treatment, and unbiased and extensive HSPC immunophenotyping proved to be a powerful tool in identifying unique sub-populations within the HSPC repertoire. In this regard, we found that SR1 promotes the emergence of HSPC subsets which may aid engraftment post expansion. In addition, we observed that SR1 has a minimal effect on the transcriptome of 7-day expanded CD34+ HSPCs when compared to cells expanded without SR1, with only two genes being downregulated in the former. Conclusion: This study revealed that SR1 selects for potentially novel immunophenotypic HSPC subsets post expansion and has a minimal effect on the transcriptome of 7-day expanded HSPCs when compared to vehicle controls. Whether these distinct immunophenotypic sub-populations possess greater engraftment capacity remains to be tested in animal models. [ABSTRACT FROM AUTHOR]

Background: South Asian Americans bear a high burden of atherosclerotic cardiovascular disease (ASCVD), but little is known about the sustainability of evidence-based interventions (EBI) to prevent ASCVD in this population. Using community-based participatory research, we previously developed and implemented the South Asian Healthy Lifestyle Intervention (SAHELI), a culturally-adapted EBI targeting diet, physical activity, and stress management. In this study, we use the Integrated Sustainability Framework to investigate multisectoral partners' perceptions of organizational factors influencing SAHELI sustainability and strategies for ensuring sustainability. Methods: From 2022 to 2023, we conducted a mixed-methods study (quant- > QUAL) with 17 SAHELI partners in the Chicago area. Partners' settings included: community organization, school district, public health department, and healthcare system. Descriptive statistics summarized quantitative results. Two coders used a hybrid thematic analysis approach to identify qualitative themes. Qualitative and quantitative data were integrated and analyzed using mixed methods. Results: Surveys (score range 1–5: higher scores indicate facilitators; lower scores indicate barriers) indicated SAHELI sustainability facilitators to be its "responsiveness to community values and needs" (mean = 4.9). Barriers were "financial support" (mean = 3.5), "infrastructure/capacity to support sustainment" (mean = 4.2), and "implementation leadership" (mean = 4.3). Qualitative findings confirmed quantitative findings that SAHELI provided culturally-tailored cardiovascular health education responsive to the needs of the South Asian American community, increased attention to health issues, and transformed perceptions of research among community members. Qualitative findings expanded upon quantitative findings, showing that the organizational fit of SAHELI was a facilitator to sustainability while competing priorities were barriers for partners from the public health department and health system. Partners from the public health department and health system discussed challenges in offering culturally-tailored programming exclusively for one targeted population. Sustainability strategies envisioned by partners included: transitioning SAHELI to a program delivered by community members; integrating components of SAHELI into other programs; and expanding SAHELI to other populations. Modifications made to SAHELI (i.e., virtual instead of in-person delivery) had both positive and negative implications for sustainability. Discussion: This study identifies common sustainability barriers and facilitators across different sectors, as well as those specific to certain settings. Aligning health equity interventions with community needs and values, organizational activities, and local context and resources is critical for sustainability. Challenges also arise from balancing the needs of specific populations against providing programming for broader audiences. [ABSTRACT FROM AUTHOR]

Improving the understanding of the complex relationship between genetic predispositions, environmental influences, and sociocultural factors in the development and progression of mental illness is crucial for optimizing treatment efficacy and addressing longstanding health disparities. This paper discusses the ethical, legal, and social implications (ELSI) of recent advancements in biomedical research, particularly in genome-wide association studies (GWAS), phenome-wide association studies (PheWAS), and genome-wide environment interaction studies (GWEIS). Despite recent scientific progresses, challenges such as inadequate study methodology (e.g., correlational studies) and lack of diversity within study samples persist. Recent discoveries of several genetic variants of diseases, could augment and improve, or even challenge, existing understanding of the onset and management of mental illness. Leveraging real-world data (RWD), including electronic health record data (EHRs) focused on social determinant of health alongside biobank data, offers further opportunities to enhance the understanding of gene-environment interactions and inform efforts for reducing disparities in mental healthcare. Increased knowledge can support timely, holistic, evidence-based, and personalized care. Addressing ELSI considerations and maximizing the use of RWD is essential for advancing ethical and inclusive psychiatric genetics research, ultimately improving patient outcomes and promoting equitable access to evidence-based treatments. [ABSTRACT FROM AUTHOR]

Anthropogenic climate change is increasing the frequency and severity of extreme heat events, leading to increased morbidity and mortality. Many of the populations at greatest risk from the health threats of extreme heat are also more likely to receive health insurance coverage from the Medicaid program. While Medicaid has not historically covered air conditioners, an increasing number of states are offering coverage. Of the Medicaid programs administered by the 50 states and Washington DC, 13 currently offer an air conditioner coverage benefit and 2 have applied to offer coverage to the federal government. Most of these states have obtained various types of waivers under the Social Security Act to cover air conditioners. Section 1115 waivers tend to offer more flexible and holistic coverage. The states offering coverage vary in the types of air conditioners covered, the approximate frequency with which air conditioners have been furnished, and the billing codes utilized. The lack of a specific billing code or procedure modifier code for air conditioners is a barrier to tracking the effectiveness, reach, and implementation of air conditioner coverage policies within and across states. [ABSTRACT FROM AUTHOR]

Zearalenone and radicicol are resorcylic acid lactones produced by numerous plant pathogenic fungi. Zearalenone is a non-steroidal estrogen mimic that can cause serious reproductive issues in livestock that consume contaminated feed. Radicicol is a potent inhibitor of the molecular chaperone Hsp90, which, in plants, has an important role in coordinating the host's immune response during infection. Here, we describe the identification and characterization of a soil-borne strain of the Gram-positive bacterium Aeromicrobium sp. capable of hydrolyzing the macrolide ring of resorcylic acid lactones, including zearalenone and radicicol. Proteomic analysis of biochemically enriched fractions from the isolated and cultured bacterium identified an α/β-hydrolase responsible for this activity. A recombinantly expressed and purified form of the hydrolase (termed RALH) was active against both zearalenone and radicicol. Interpretation of high-resolution mass spectrometry and NMR data confirmed the structures of the enzymatic products as the previously reported non-toxic metabolite hydrolyzed zearalenone and hydrolyzed radicicol. Hydrolyzed radicicol was demonstrated to no longer inhibit the ATPase activity of the Saccharomyces cerevisiae Hsp90 homolog in vitro. Enzymatic degradation of resorcylic acid lactones will enable insight into their biological functions. [ABSTRACT FROM AUTHOR]

To meet the Biden-Harris administration's goal of deploying 30 GW of offshore wind power by 2030 and 110 GW by 2050, expansion of wind energy into U.S. territorial waters prone to tropical cyclones (TCs) and extratropical cyclones (ETCs) is essential. This requires a deeper understanding of cyclone-related risks and the development of robust, resilient offshore wind energy systems. This paper provides a comprehensive review of state-of-the-science measurement and modeling capabilities for studying TCs and ETCs, and their impacts across various spatial and temporal scales. We explore measurement capabilities for environments influenced by TCs and ETCs, including near-surface and vertical profiles of critical variables that characterize these cyclones. The capabilities and limitations of Earth system and mesoscale models are assessed for their effectiveness in capturing atmosphere–ocean–wave interactions that influence TC/ETC-induced risks under a changing climate. Additionally, we discuss microscale modeling capabilities designed to bridge scale gaps from the weather scale (a few kilometers) to the turbine scale (dozens to a few meters). We also review machine learning (ML)-based, data-driven models for simulating TC/ETC events at both weather and wind turbine scales. Special attention is given to extreme metocean conditions like extreme wind gusts, rapid wind direction changes, and high waves, which pose threats to offshore wind energy infrastructure. Finally, the paper outlines the research challenges and future directions needed to enhance the resilience and design of next-generation offshore wind turbines against extreme weather conditions. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by clinical symptoms of memory and cognitive deficiencies. Postmortem evaluation of AD brain tissue shows proteinopathy that closely associate with the progression of this dementing disorder, including the accumulation of extracellular beta amyloid (Aβ) and intracellular hyperphosphorylated tau (pTau) with neurofibrillary tangles (NFTs). Current therapies targeting Aβ have limited clinical efficacy and life‐threatening side effects and highlight the need for alternative treatments targeting pTau and other pathophysiologic mechanisms driving AD pathogenesis. The brain's extracellular matrices (ECM), particularly perineuronal nets (PNNs), play a crucial role in brain functioning and neurocircuit stability, and reorganization of these unique PNN matrices has been associated with the progression of AD and accumulation of pTau in humans. We hypothesize that AD‐associated changes in PNNs may in part be driven by the accumulation of pTau within the brain. In this work, we investigated whether the presence of pTau influenced PNN structural integrity and PNN chondroitin sulfate‐glycosaminoglycan (CS‐GAG) compositional changes in two transgenic mouse models expressing tauopathy‐related AD pathology, PS19 (P301S) and Tau4RTg2652 mice. We show that PS19 mice exhibit an age‐dependent loss of hippocampal PNN CS‐GAGs, but not the underlying aggrecan core protein structures, in association with pTau accumulation, gliosis, and neurodegeneration. The loss of PNN CS‐GAGs were linked to shifts in CS‐GAG sulfation patterns to favor the neuroregenerative isomer, 2S6S‐CS. Conversely, Tau4RTg2652 mice exhibit stable PNN structures and normal CS‐GAG isomer composition despite robust pTau accumulation, suggesting a critical interaction between neuronal PNN glycan integrity and neighboring glial cell activation. Overall, our findings provide insights into the complex relationship between PNN CS‐GAGs, pTau pathology, gliosis, and neurodegeneration in mouse models of tauopathy, and offer new therapeutic insights and targets for AD treatment. [ABSTRACT FROM AUTHOR]

This review and meta‐analysis aimed to describe the current rugby‐7s injury epidemiological literature by examining injury data from both sexes, all levels of play, and their associated risk factors. Studies published up until March 2024 were included. These studies were retrieved from six databases using search terms related to rugby‐7s or sevens, tackle, collision, collision sport, injury, athlete, incidence rate, mechanism, and risk factor. Only peer‐reviewed original studies using prospective or retrospective cohort designs with a clearly defined rugby‐7s sample were considered. Included studies needed to report one injury outcome variable. Non‐English and qualitative studies; reviews, conference papers, and abstracts were excluded. Twenty studies were included. The meta‐analysis used the DerSimonian–Laird continuous random‐effects method to calculate the pooled estimated means and 95% confidence interval. The estimated mean injury incidence rate for men was 108.5/1000 player‐hours (95% CI: 85.9–131.0) and 76.1/1000 player‐hours (95% CI: 48.7–103.5) for women. The estimated mean severity for men was 33.9 days (95% CI: 20.7–47.0) and 44.2 days (95% CI: 32.1–56.3) for women. Significantly more match injuries occurred in the second half of matches, were acute, located at the lower limb, diagnosed as joint/ligament, and resulted from being tackled. Fatigue, player fitness, and previous injuries were associated with an increased risk of injury. There were no statistically significant differences between women's and men's injury profiles. However, the inherent cultural and gendered factors which divide the two sports should not be ignored. The findings from this review will help pave the way forward beyond the foundational stages of injury prevention research in rugby‐7s. Highlights: Rugby‐7s injury prevention research has not moved past the early stages of injury prevention research frameworks, such as the TRIPP model, because the injury epidemiological profile has not been comprehensively summarised.Significantly, more match injuries occurred in the second half, were acute, located at the lower limb, diagnosed as joint/ligament and resulted from being tackled. Fatigue, player fitness, and previous injuries were associated with an increased risk of injury. However, there were no differences across sex.These findings will help pave the way forward beyond the foundational stages of injury prevention research in rugby‐7s and will form the basis from which future injury prevention strategies can be developed. [ABSTRACT FROM AUTHOR]

Bluetongue (BT) is a Culicoides midge-borne hemorrhagic disease affecting cervids and ruminant livestock species, resulting in significant economic losses from animal production and trade restrictions. Experimental animal infections using the α/β interferon receptor knockout IFNAR mouse model and susceptible target species are critical for understanding viral pathogenesis, virulence, and evaluating vaccines. However, conducting experimental vector-borne transmission studies with the vector itself are logistically difficult and experimentally problematic. Therefore, experimental infections are induced by hypodermic injection with virus typically derived from baby hamster kidney (BHK) cells. Unfortunately, for many U.S. BTV serotypes, it is difficult to replicate the severity of the disease seen in natural, midge-transmitted infections by injecting BHK-derived virus into target host animals. Using the IFNAR BTV murine model, we compared the virulence of traditional BHK cell-derived BTV-17 with C. sonorensis midge (W8) cell-derived BTV-17 to determine whether using cells of the transmission vector would provide an in vitro virulence aspect of vector-transmitted virus. At both low and high doses, mice inoculated with W8-BTV-17 had an earlier onset of viremia, earlier onset and peak of clinical signs, and significantly higher mortality compared to mice inoculated with BHK-BTV-17. Our results suggest using a Culicoides W8 cell-derived inoculum may provide an in vitro vector-enhanced infection to more closely represent disease levels seen in natural midge-transmitted infections while avoiding the logistical and experimental complexity of working with live midges. [ABSTRACT FROM AUTHOR]

Vesicular stomatitis (VS) is a viral disease that affects horses, cattle, and swine that is transmitted by direct contact and hematophagous insects. In 2023, a multi-state outbreak of vesicular stomatitis New Jersey virus (VSNJV) occurred in California, Nevada, and Texas, infecting horses, cattle, and rhinoceros. To identify possible insect vectors, we conducted insect surveillance at various locations in San Diego County, CA, including at a wildlife park. CO2 baited traps set from mid-May to mid-August 2023 collected 2357 Culicoides biting midges and 1215 Simulium black flies, which are insect genera implicated in VSNJV transmission. Insects were pooled by species, location, and date, then tested for viral RNA. Nine RNA-positive pools of Culicoides spp. and sixteen RNA-positive pools of Simulium spp were detected. Infectious virus was detected by cytopathic effect in 96% of the RNA-positive pools. This is the first report of VSNJV in wild-caught C. bergi, C. freeborni, C. occidentalis, S. argus, S. hippovorum, and S. tescorum. The vector competency of these species for VSNJV has yet to be determined but warrants examination. Active vector surveillance and testing during disease outbreaks increases our understanding of the ecology and epidemiology of VS and informs vector control efforts. [ABSTRACT FROM AUTHOR]

While the impacts of climate change on global food security have been studied extensively, the capability of emerging tools that couple land surface processes and crop growth in reproducing inter‐annual yield variability at regional scale remains to be tested rigorously. In this study, we analyzed the effects of weather variations between years (1999–2019) on regional crop productivity for two agriculturally managed regions with contrasting climate and cropping conditions: the German state of North Rhine‐Westphalia (DE‐NRW) and the Australian state of Victoria (AUS‐VIC), using the latest version of the Community Land Model (CLM5) and the WFDE5 (WATCH Forcing Data methodology applied to ECMWF reanalysis version 5) reanalysis. Overall, the simulation results were able to reproduce the total annual crop yields of certain crops, while also capturing the differences in total yield magnitudes between the domains. However, the simulations showed limitations in correctly capturing inter‐annual differences of crop yield compared to official yield records, which resulted in relatively low correlation coefficients between 0.07 and 0.39 in AUS‐VIC and between 0.11 and 0.42 in DE‐NRW. The mean absolute deviation of simulated winter wheat yields was up to 4.6 times lower compared to state‐wide records from 1999 to 2019. Our results suggest the following limitations of CLM5: (a) limitations in simulating yield responses from plant hydraulic stress; (b) errors in simulating soil moisture contents compared to satellite‐derived data; and (c) errors in the representation of cropland in general, for example, crop parameterizations and human influences. Plain Language Summary: This study evaluates how year‐to‐year weather variations impact crop yield predictions for two regions, North Rhine‐Westphalia in Germany and Victoria in Australia changes. We use the community land model (CLM5) land surface model in combination with reanalysis weather data to investigate the model performance with respect to the representation of crop phenology, plant water stress, and soil moisture. Our results showcase the model's ability to predict total annual crop yield magnitudes for both regions, while also capturing the differences between the respective simulation domains. However, year‐to‐year changes in crop yield were lower in simulation results compared to official records, which indicated a lack of model sensitivity toward drought stress and general limitations in the representation of agricultural land. This research systematically assesses CLM5 model performance over arable land and provides useful insights into limitations of CLM5 that can help guide future empirical and technical model improvements. Key Points: Land surface models (LSMs) with integrated crop models can be used to quantify the impact of climate change on agro‐ecosystemsThe potential value of LSMs for agricultural purposes depends on their ability to adequately simulate inter‐annual variability of yieldThe representation of plant hydraulics and the soil moisture regime play key role in accurately simulating agro‐ecosystems [ABSTRACT FROM AUTHOR]

(1) Background: Pulmonary hypertension (PH) increases pulmonary vascular resistance and right ventricular (RV) afterload. Assessment of RV systolic function in PH using RV fractional area change (RV FAC) as a marker directly correlates with mortality and the need for extracorporeal membrane oxygenation (ECMO). However, few studies have assessed neurodevelopmental outcomes. We hypothesize that cardiac RV systolic dysfunction with lower RV FAC is associated with worse neurodevelopmental impairment (NI). (2) Methods: Retrospective study of 42 subjects with PH to evaluate neurodevelopmental outcomes in the first two years of life based on (i) subjective assessment of RV systolic function and (ii) RV FAC, a specific echocardiographic marker for RV function. (3) Results: Subjects from the initial study cohort (n = 135) with PH who had long-term follow-up were divided into RV dysfunction (study, n = 20) and non-RV dysfunction (control, n = 22) groups. RV FAC in the study vs. control group (0.18 vs. 0.25) was lower (p = 0.00017). There was no statistically significant difference in NI either with RV dysfunction or lower RV FAC. Although not significant, RV dysfunction was associated with longer mean duration of mechanical ventilation, time on ECMO, and length of stay. In the initial cohort (135), mortality was 16.3% and the percentage of NI was 62%. (4) Conclusions: Neonatal pulmonary hypertension is associated with a high degree of neurodevelopment impairment. Early RV systolic dysfunction, as identified by RV FAC, was not an optimal predictive biomarker for infants with PH and neurodevelopmental impairment. [ABSTRACT FROM AUTHOR]

Background: The rise in prevalence of high deductible health plans (HDHPs) in the United States may raise concerns for high-need, high-utilization populations such as those with comorbid chronic conditions. In this study, we examine changes in total and out-of-pocket (OOP) spending attributable to HDHPs for enrollees with comorbid substance use disorder (SUD) and cardiovascular disease (CVD). Methods: We used de-identified administrative claims data from 2007 to 2017. SUD and CVD were defined using algorithms of ICD 9 and 10 codes and HEDIS guidelines. The main outcome measures of interest were spending measure for all non-SUD/CVD-related services, SUD-specific services, and CVD-specific services, for all services and medications specifically. We assessed both total and OOP spending. We used an intent-to-treat two-part model approach to model spending and computed the marginal effect of HDHP offer as both the dollar change and percent change in spending attributable to HDHP offer. Results: Our sample included 33,684 enrollee-years and was predominantly white and male with a mean age of 53 years. The sample had high demonstrated substantial healthcare utilization with 94% using any non-SUD/CVD services, and 84% and 78% using SUD and CVD services, respectively. HDHP offer was associated with a 17.0% (95% CI = [0.07, 0.27] increase in OOP spending for all non-SUD/CVD services, a 21.1% (95% CI = [0.11, 0.31]) increase in OOP spending for all SUD-specific services, and a 13.1% (95% CI = [0.04, 0.23]) increase in OOP spending for all CVD-specific services. HDHP offer was also associated with a significant increase in OOP spending on non-SUD/CVD-specific medications and SUD-specific medications, but not CVD-specific medications. Conclusions: This study suggests that while HDHPs do not change overall levels of annual spending among enrollees with comorbid CVD and SUD, they may increase the financial burden of healthcare services by raising OOP costs, which could negatively impact this high-need and high-utilization population. [ABSTRACT FROM AUTHOR]

Fluorinated cyclopropanes are highly desired pharmacophores in drug discovery owing to the rigid nature of the cyclopropane ring and the beneficial effects of C−F bonds on the pharmacokinetic properties, cell permeability, and metabolic stability of drug molecules. Herein a biocatalytic strategy for the stereoselective synthesis of mono‐fluorinated and gem‐difluoro cyclopropanes is reported though the use of engineered myoglobin‐based catalysts. In particular, this system allows for a broad range of gem‐difluoro alkenes to be cyclopropanated in the presence of diazoacetonitrile with excellent diastereo and enantiocontrol (up to 99 : 1 d.r. and 99 % e.e.), thereby enabling a transformation not currently accessible with chemocatalytic methods. The synthetic utility of the present approach is further exemplified through the gram‐scale synthesis of a key gem‐difluorinated cyclopropane intermediate useful for the preparation of fluorinated bioactive molecules. [ABSTRACT FROM AUTHOR]

Fluorinated cyclopropanes are highly desired pharmacophores in drug discovery owing to the rigid nature of the cyclopropane ring and the beneficial effects of C−F bonds on the pharmacokinetic properties, cell permeability, and metabolic stability of drug molecules. Herein a biocatalytic strategy for the stereoselective synthesis of mono‐fluorinated and gem‐difluoro cyclopropanes is reported though the use of engineered myoglobin‐based catalysts. In particular, this system allows for a broad range of gem‐difluoro alkenes to be cyclopropanated in the presence of diazoacetonitrile with excellent diastereo and enantiocontrol (up to 99 : 1 d.r. and 99 % e.e.), thereby enabling a transformation not currently accessible with chemocatalytic methods. The synthetic utility of the present approach is further exemplified through the gram‐scale synthesis of a key gem‐difluorinated cyclopropane intermediate useful for the preparation of fluorinated bioactive molecules. [ABSTRACT FROM AUTHOR]

Appendicular osteosarcoma was diagnosed and treated in a pair of littermate Rottweiler dogs, resulting in distinctly different clinical outcomes despite similar therapy within the context of a prospective, randomized clinical trial (NCI-COTC021/022). Histopathology, immunohistochemistry, mRNA sequencing, and targeted DNA hotspot sequencing techniques were applied to both dogs' tumors to define factors that could underpin their differential response to treatment. We describe the comparison of their clinical, histologic and molecular characteristics, as well as those from a companion cohort of Rottweiler dogs. A pan-cancer genomic sequencing panel conducted in the sibling dogs demonstrated both shared and distinct alterations in several genes implicated in osteosarcoma, including CDKN2B, SETD2, MYC, and PDGFRA, while transcriptional profiling of primary tumor tissue indicated under-expression of key immunological response genes. This report provides new insight into molecular features and potential prognostic biomarkers for canine osteosarcoma. [ABSTRACT FROM AUTHOR]

The transmembrane protein β-amyloid precursor protein (APP) is central to the pathophysiology of Alzheimer's disease (AD). The β-amyloid hypothesis posits that aberrant processing of APP forms neurotoxic β-amyloid aggregates, which lead to the cognitive impairments observed in AD. Although numerous additional factors contribute to AD, there is a need to better understand the synaptic function of APP. We have found that Drosophila APP-like (APPL) has both shared and non-shared roles at the synapse with Kismet (Kis), a chromatin helicase binding domain (CHD) protein. Kis is the homolog of CHD7 and CHD8, both of which are implicated in neurodevelopmental disorders including CHARGE Syndrome and autism spectrum disorders, respectively. Loss of function mutations in kis and animals expressing human APP and BACE in their central nervous system show reductions in the glutamate receptor subunit, GluRIIC, the GTPase Rab11, and the bone morphogenetic protein (BMP), pMad, at the Drosophila larval neuromuscular junction (NMJ). Similarly, processes like endocytosis, larval locomotion, and neurotransmission are deficient in these animals. Our pharmacological and epistasis experiments indicate that there is a functional relationship between Kis and APPL, but Kis does not regulate appl expression at the larval NMJ. Instead, Kis likely influences the synaptic localization of APPL, possibly by promoting rab11 transcription. These data identify a potential mechanistic connection between chromatin remodeling proteins and aberrant synaptic function in AD. [ABSTRACT FROM AUTHOR]

Adverse effects of obesity on reproduction are believed in part due to diet related factors leading to hyperlipidemia and hyperinsulinemia. It is unknown whether administration of a low fat eating plan, regardless of weight loss, will improve reproductive axis function in women with obesity. To develop an acceptable and feasible low fat eating plan for a diverse group of reproductive aged women with obesity. Focus groups to determine preferences and barriers to a planned dietary intervention providing very low fat (22% daily calories from fat) eucaloric food to control fat exposure, but not cause weight loss. Logistics of the intervention and monitoring over three menstrual cycles were discussed. Eighteen women enrolled into 4 different focus groups both live and video, 2 at the University of Colorado and 2 at the Morehouse School of Medicine. All participants expressed interest in implementing a low fat dietary intervention and were further interested in instruction on how to maintain healthy eating habits for future fertility. Provision of ethnically appropriate foods, social support to avoid lapses, and tasty alternatives to high fat foods were considered ideal aspects of a feasible intervention. Incentives and graduated compensation for adherence were considered desirable features. Women with obesity are interested in implementing dietary interventions that may improve their health and fertility. Given the diversity of responses based upon the demographics of our sample, it is important to assess geographical and cultural preferences prior to implementing of a dietary strategy. [ABSTRACT FROM AUTHOR]

Objective: Using eye tracking technology, this study sought to determine if differences in hazard statement (HS) compliance based on design elements are attributable to attention maintenance (AM). Background: Recent empirical work has demonstrated counter-intuitive findings for HS designs embedded in procedures. Specifically, prevalent HS designs in procedures were associated with lower compliance. Method: The current study utilized eye tracking technology to determine whether participants are attending to HSs differently based on the inclusion or absence of visually distinct HS design elements typically used for consumer products. We used two different designs that previously yielded the largest gap in HS compliance. In a fully-crossed design, 33 participants completed four rounds of tasks using four procedures with embedded HSs. To assess AM, eye tracking was used to measure gaze and fixation duration. Results: The results indicated there are differences in AM between the two designs. The HSs that included elements traditionally considered effective in the consumer products literature elicited lower fixation duration times, and were associated with lower compliance. However, AM did not mediate the design effect on compliance. Conclusions: The study results suggest the design of HSs are impacting individuals as early as the AM stage of the C-HIP model. The absence of HS design-AM-compliance mediation suggests other C-HIP elements more directly explain the HS design-compliance effects. Application: These results provide more evidence that the communication of Health, Environment, and Safety information in procedures may need to be different from those on consumer products, suggesting design efficacy may be task dependent. [ABSTRACT FROM AUTHOR]

Background: Due to the progressive deterioration of motor, cognitive, and psychological function, individuals with Huntington's disease (HD) rely heavily on family caregivers, including children in the home. This "young carer" role can result in responsibilities that are inappropriate for the child's age and abilities. Also referred to as parentification, this experience can result in both positive and negative outcomes for the child, spanning multiple domains of health and well-being. Objective: To explore the manifestation of parentification among young carers of a parent with HD. Method: Directed content analysis, guided by a literature-derived framework of parentification, was utilized for this qualitative study. Participants included 28 young carers (mean age of 16.6 (± 2.6)) who self-identified as engaging in caregiving activities related to HD with the majority providing care for 1–3 years (53.6%)- averaging 25.4 h of care per week. Results: Three main themes with subthemes emerged: (1) being a young carer [perceptions of caregiving, learning to be a caregiver, caregiver burden, coping], (2) living with a new normal (school and friends, feeling unheard/alone, support system, personal growth), and (3) facing HD as a young carer (stigma and isolation, parent/child relationship, end of life, genetic risk). Conclusions: Young carers in the context of HD experience many attributes and consequences of parentification generally present among young carers of ill parents. However, HD specific findings emerged from this study that can be used to inform clinicians and direct future research aimed at guiding policy and developing tailored support services. [ABSTRACT FROM AUTHOR]

Community violence and crime are significant public health problems with serious and lasting effects on young people, families, and communities. This violence and crime have significant ripple effects, affecting not just those who are directly physically injured, but also those who witness violent episodes, those who have friends or loved ones killed or injured, and those who must everyday navigate streets that they know have been frequent sites of serious violence and crime. The current study presents evidence of the impact that a data-driven, collective impact approach — the Communities that Care prevention system — can have on violence and crime outcomes within a large urban, high-burden community. Established as one of the national Youth Violence Prevention Centers (YVPC) funded by the Centers for Disease Control and Prevention, the Chicago Center for Youth Violence Prevention is among the first to implement the CTC approach in a large, urban community. The current study's findings show reductions in violence (i.e., aggravated assaults and robberies) in the Bronzeville community, compared to similar communities in Chicago. [ABSTRACT FROM AUTHOR]

Prevention science has increasingly turned to integrative data analysis (IDA) to combine individual participant-level data from multiple studies of the same topic, allowing us to evaluate overall effect size, test and model heterogeneity, and examine mediation. Studies included in IDA often use different measures for the same construct, leading to sparse datasets. We introduce a graph theory method for summarizing patterns of sparseness and use simulations to explore the impact of different patterns on measurement bias within three different measurement models: a single common factor, a hierarchical model, and a bifactor model. We simulated 1000 datasets with varying levels of sparseness and used Bayesian methods to estimate model parameters and evaluate bias. Results clarified that bias due to sparseness will depend on the strength of the general factor, the measurement model employed, and the level of indirect linkage among measures. We provide an example using a synthesis dataset that combined data on youth depression from 4146 youth who participated in 16 randomized field trials of prevention programs. Given that different synthesis datasets will embody different patterns of sparseness, we conclude by recommending that investigators use simulation methods to explore the potential for bias given the sparseness patterns they encounter. [ABSTRACT FROM AUTHOR]

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As a proposed mediator between stigma-related stressors and negative mental health outcomes, HIV-related shame has been predictive of increased rates of substance use and difficulties adhering to antiretroviral treatment among people with HIV. These downstream manifestations have ultimately impeded progress toward national goals to End the HIV Epidemic, in part due to limited success of conventional psychotherapies in addressing HIV-related shame. In a pilot clinical trial (N = 12), receipt of psilocybin-assisted group therapy was associated with a large pre-post decrease in HIV-related shame as measured by the HIV and Abuse Related Shame Inventory, with a median (IQR) change of − 5.5 (− 6.5, − 3.5) points from baseline to 3-months follow-up (Z = − 2.6, p = 0.009, r = − 0.75). A paradoxical exacerbation of sexual abuse-related shame experienced by two participants following receipt of psilocybin raises critical questions regarding the use of psilocybin therapy among patients with trauma. These preliminary findings carry potential significance for the future of HIV care. [ABSTRACT FROM AUTHOR]

The coaching and performance context in women's rugby is not well understood, despite growing popularity worldwide. The aim of this study was to describe the knowledge, attitudes and tackle training practices of women's rugby coaches in relation to tackle safety and performance. A globally distributed online survey exploring coaches' knowledge, attitudes and practices towards tackling women's rugby was completed by 357 coaches (mean age 41 ± 0.6 years) from 58 countries. The cross-sectional survey was distributed from March 2023 to June 2023. Survey development was guided by the Health Action Process Approach and informed by coaching experts, research evidence synthesis, and guidelines for international tackle safety programmes. Coaches believed that the risk of tackle injury in women's rugby is high and that proper tackle technique for safety is very important. More than 75% of coaches had never completed a tackle-specific training course, with only 39% aware of the availability of such courses. Time spent on controlled-contact and full-contact activities varied from 0 to 40+ min per week, averaging 10–20 min for both types of training. Barriers to the effectiveness of tackle training related to sociocultural factors, coach knowledge gaps, training environments, and player training considerations. Coach education, improved infrastructures, and physical development were ranked the highest priorities for improving tackle safety and performance. These findings inform future implementation strategies for tackle safety and performance in the context of women's rugby, highlighting the need to involve coaches in providing practical solutions, and the role of education and institutional/organisational support in facilitating such improvements. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the perceptions of key stakeholder groups, i.e. coaches, players, and referees, of a reduced maximum legal tackle height law variation trial in a collegiate amateur rugby competition. A pragmatic qualitative approach was used. Eighteen semi-structured interviews were performed. Thematic analysis was used to analyse the data. Three main law trial-related themes and four additional contextual themes were identified. The most important contextual factors include perceptions of resource scarcity of the implementation context, deficient concussion knowledge and lack of education among all stakeholder groups, tackle technique deficiencies, and an entrenched culture of a dismissive attitude towards serious injuries and non-disclosure of concussion by players. Real-world challenges such as inconsistent sanctioning during gameplay, multi-tackler tackles, and player fatigue underscore the gap between the theoretical knowledge of the law and the complex, dynamic nature of its execution. Furthermore, deeply ingrained issues like entrenched tackle techniques, the quality of coaching, and prevailing attitudes towards concussion compounded these challenges, indicating a need for a more comprehensive approach to bridge the divide between understanding and implementation. Despite these challenges, several participants felt the law variation was still more effective than the existing law; and that it created more awareness around concussion, while sending a clear message that player welfare is being taken seriously. Collectively these factors indicate the difficulty of addressing a complex problem such as concussion, with a law variation intervention in a challenging (resource-constrained) setting. [ABSTRACT FROM AUTHOR]

Background: The Collaborative Care Model (CoCM) is an evidence-based mental health treatment in primary care. A greater understanding of the determinants of successful CoCM implementation, particularly the characteristics of multi-level implementers, is needed. Methods: This study was a process evaluation of the Collaborative Behavioral Health Program (CBHP) study (NCT04321876) in which CoCM was implemented in 11 primary care practices. CBHP implementation included screening for depression and anxiety, referral to CBHP, and treatment with behavioral care managers (BCMs). Interviews were conducted 4- and 15-months post-implementation with BCMs, practice managers, and practice champions (primary care clinicians). We used framework-guided rapid qualitative analysis with the Consolidated Framework for Implementation Research, Version 2.0, focused on the Individuals domain, to analyze response data. These data represented the roles of Mid-Level Leaders (practice managers), Implementation Team Members (clinicians, support staff), Innovation Deliverers (BCMs), and Innovation Recipients (primary care/CBHP patients) and their characteristics (i.e., Need, Capability, Opportunity, Motivation). Results: Mid-level leaders (practice managers) were enthusiastic about CBHP (Motivation), appreciated integrating mental health services into primary care (Need), and had time to assist clinicians (Opportunity). Although CBHP lessened the burden for implementation team members (clinicians, staff; Need), some were hesitant to reallocate patient care (Motivation). Innovation deliverers (BCMs) were eager to deliver CBHP (Motivation) and confident in assisting patients (Capability); their opportunity to deliver CBHP could be limited by clinician referrals (Opportunity). Although CBHP alleviated barriers for innovation recipients (patients; Need), it was difficult to secure services for those with severe conditions (Capability) and certain insurance types (Opportunity). Conclusions: Overall, respondents favored sustaining CoCM and highlighted the positive impacts on the practice, health care team, and patients. Participants emphasized the benefits of integrating mental health services into primary care and how CBHP lessened the burden on clinicians while providing patients with comprehensive care. Barriers to CBHP implementation included ensuring appropriate patient referrals, providing treatment for patients with higher-level needs, and incentivizing clinician engagement. Future CoCM implementation should include strategies focused on education and training, encouraging clinician buy-in, and preparing referral paths for patients with more severe conditions or diverse needs. Trial registration: ClinicalTrials.gov(NCT04321876). Registered: March 25,2020. Retrospectively registered. [ABSTRACT FROM AUTHOR]