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Regional institutions may lack diversity due to a largely local enrollment base. Cross-university collaborations offer a unique way to introduce students in these isolated settings to peers from different regions and backgrounds. This study involved 72 students from three universities who were paired up to complete course assignments and reflections. After the conclusion of the semester, students' written reflections were downloaded and analyzed to identify common themes. Simultaneously, the three professors involved formally debriefed and recorded their reflections. Five student themes were identified, including: (a) challenges, (b) recognizing diversity, (c) acknowledging assumptions, (d) noticing connections and (e) positives. The findings of the present study suggest cross-university collaborations can be an effective way to introduce students enrolled at regionally isolated institutions to some sense of diversity. [ABSTRACT FROM AUTHOR]

We recorded and analyzed the microwave spectra of 2,5-dimethylanisole using a pulsed molecular jet Fourier transform microwave spectrometer and the newly developed Passage And Resonant-Impulse Synergy spectrometer across a frequency range of 2–26.5 GHz with support from quantum chemical calculations. Only one conformer was predicted and observed, where the methoxy group and its adjacent methyl group adopt anti-positions. The two methyl groups, located at the ortho- and meta-positions of the anisole ring, exhibit internal rotation, resulting in quintet splitting of all rotational transitions. The low torsional barrier of the m-methyl group, amounting to 65.723 611(84) cm−1, combined with the intermediate barrier of 451.664(19) cm−1 for the o-methyl group, presented challenges in the spectral analysis. Using the XIAM and BELGI-Cs-2Tops programs, we successfully fitted 460 torsional intrastate rotational transitions, allowing for precise determination of molecular parameters and internal rotation characteristics. The torsional barriers are compared to those in the related isomers 2,3-, 2,4-, and 3,4-dimethylanisole as well as other o- and m-substituted toluene derivatives. [ABSTRACT FROM AUTHOR]

This study investigated the effect of oral and topical sodium bicarbonate (SB) on soccer-specific performance during simulated soccer exercise. In a block randomized, double-blind, crossover design, 10 collegiate male soccer players (stature: 181.7 ± 3.2 cm, body mass: 81.7 ± 10.5 kg) performed soccer-specific performance tests (countermovement jumps, Illinois agility, 8 × 25 m repeated sprints) throughout a 90-min soccer-specific aerobic field test (SAFT90) following 0.3 g/kg body mass SB in capsules (SB-ORAL), 0.9036 g/kg body mass PR Lotion (SB-LOTION), or placebo capsules and lotion (PLA). Soccer-specific performance tests were conducted pre-SAFT90, during half-time and post-SAFT90. Blood samples were analyzed for acid–base balance (pH; bicarbonate, HCO 3 − ) and strong ions (sodium, Na+; potassium, K+). Average sprint times were quicker for SB-ORAL than PLA during half-time (3.7%; p =.049; g =.57) and post-SAFT90 (4.9%; p =.041; g =.66). SB-ORAL increased pH and HCO 3 − prewarm-up and during half-time (p <.05), and lowered K+ during half-time (p =.035) compared with PLA. SB-LOTION increased pH (p =.019) and lowered K+ (p =.012) during half-time compared with PLA. SB-LOTION increased Na+ postexercise compared with PLA (p =.008). Repeated sprint times during simulated soccer exercise improved for SB-ORAL, which might have been mechanistically underpinned by elevated blood buffering capacity and greater regulation of strong ion concentration. Consuming SB in capsules is a more effective strategy than topical SB application for improving blood buffering capacity and repeated sprint performance throughout competitive soccer matches. [ABSTRACT FROM AUTHOR]

Sex trafficking is a prominent human rights issue that has been increasingly associated with the hosting of large-scale sport events. Despite insufficient evidence demonstrating a causal or correlative link, event stakeholders have implemented antitrafficking efforts in attempts to prevent and promote awareness of sex trafficking. Using Google Trends data to measure audiences' information-seeking behavior online and Twitter data as a proxy for antitrafficking efforts on social media, we employed a difference-in-differences approach to estimate the change in online demand for sex-trafficking information among the residents of Miami-Dade, the host city of Super Bowl LIV (54). Findings highlight an increase in the online demand for sex-trafficking information in the host city during and after the event. This increased demand attributed to the Super Bowl may offer support for host communities utilizing sport events to promote awareness of pressing social issues. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the relationship between items of the Short Recovery and Stress Scale (SRSS) related to physical stress and recovery and the biomarker creatine kinase (CK) in professional handball. Methods: CK and SRSS items (physical performance capability, overall recovery, muscular stress, and overall stress) were assessed in an observational study of 16 adult male professional handball players from a team in the highest German league during the 2019–20 preseason. Their preseason training schedule included several microcycles, each consisting of 3 consecutive days of intense training followed by a rest day. On 5 of these rest days, when players were classified as nonrested, and the 5 immediately following days, when players were classified as rested, players completed the SRSS between 8:00 and 9:00 AM, followed by blood sampling. Correlations between SRSS items were performed using Kendall τ. The relationship between each SRSS item and CK levels over time was examined using a mixed-effects model with a random intercept. Results: CK levels and SRSS stress items were significantly higher and SRSS recovery items were significantly lower in nonrested players. SRSS items were significantly positively or negatively correlated (all items: P <.001) and showed a significant effect indicating lower CK levels in rested players (all items: P ≤.001; η p 2 =.1 −.32). Conclusions: The investigated SRSS items may be a viable option for assessing muscle recovery in adult male professional handball players in a cost-effective and noninvasive manner. They can be used as a single monitoring tool or as part of a multimodal approach. [ABSTRACT FROM AUTHOR]

Purpose: The Rehabilitation Interventions for Individuals with a Spinal Cord Injury in the Community (RIISC) team aimed to develop and evaluate innovative rehabilitation interventions to identify endocrine metabolic disease (EMD) risk, intending to reduce the frequency and severity of EMD related morbidity and mortality among adults living with chronic spinal cord injury or disease (SCI/D). Materials and Methods: An interprovincial team from Ontario and Quebec reviewed available EMD literature and evidence syntheses and completed an inventory of health services, policies and practices in SCI/D care. The review outcomes were combined with expert opinion to create an EMD risk model to inform health service transformation. Results: EMD risk and mortality are highly prevalent among adults with chronic SCI/D. In stark contrast, few rehabilitation interventions target EMD outcomes. The modelled solution proposes: 1) abandoning single-disease paradigms and examining a holistic perspective of the individual's EMD risk, and 2) developing and disseminating practice-based research approaches in outpatient community settings. Conclusions: RIISC model adoption could accelerate EMD care optimization, and ultimately inform the design of large-scale longitudinal pragmatic trials likely to improve health outcomes. Linking the RIISC team activities to economic evaluations and policy deliverables will strengthen the relevance and impact among policymakers, health care providers and patients. IMPLICATIONS FOR REHABILITATION: Living with a spinal cord injury or disease (SCI/D) increases endocrine metabolic disease (EMD) risk. EMD-related outcomes include fracture; type II diabetes; and cardiovascular disease (myocardial infarction, sudden cardiac death and stroke), directly contributing to higher morbidity and mortality. Single-disease paradigms are not the ideal strategy to address multimorbidity contexts experienced in SCI/D. Practice-based research could be an alternative/adjunct to randomized control trials at generating evidence on current and emerging rehabilitation approaches. [ABSTRACT FROM AUTHOR]

Organizations that perform Health Policy and Systems Research (HPSR) need robust capacities, but it remains unclear what these organizations should look like in practice. We sought to define 'HPSRIs' (pronounced as 'hip-srees', i.e. 'Health Policy and Systems Research Institutions') as organizational models and developed a conceptual framework for assessing their capacities based on a set of attributes. We implemented a multi-method study in the Philippines that comprised: a qualitative analysis of perspectives from 33 stakeholders in the HPSR ecosystem on the functions, strengths and challenges of HPSRIs; a workshop with 17 multi-sectoral representatives who collectively developed a conceptual framework for assessing organizational capacities for HPSRIs based on organizational attributes; and a survey instrument development process that determined indicators for assessing these attributes. We defined HPSRIs to be formally constituted organizations (or institutions) with the minimum essential function of research. Beyond the research function, our framework outlined eight organizational attributes of well-performing HPSRIs that were grouped into four domains, namely: 'research expertise' (1) excellent research, (2) capacity-building driven; 'leadership and management' (3) efficient administration, (4) financially sustainable; 'policy translation' (5) policy orientation, (6) effective communication; and 'networking' (7) participatory approach, (8) convening influence. We developed a self-assessment instrument around these attributes that HPSRIs could use to inform their respective organizational development and collectively discuss their shared challenges. In addition to developing the framework, the workshop also analysed the positionality of HPSRIs and their interactions with other institutional actors in the HPSR ecosystem, and recommends the importance of enhancing these interactions and assigning responsibility to a national/regional authority that will foster the community of HPSRIs. When tailored to their context, HPSRIs that function at the nexus of research, management, policy and networks help achieve the main purpose of HPSR, which is to 'achieve collective health goals and contribute to policy outcomes'. [ABSTRACT FROM AUTHOR]

Building from recent criticisms that mainstream political corporate social responsibility has failed to effectively address the potential expansion of corporate influence in society, we advance a new conceptualization of corporate social responsibility inspired by U.S. federalist political theory. As federalism has served as a prevailing U.S. theory for arranging governmental political power for the advancement of the public interest, we derive from federalist principles descriptive, normative, and instrumental theoretical foundations for arranging corporate power and directing corporate social action in the pursuit of similar goals. What we call "federated corporate social responsibility" (FCSR) revives an older institutional approach to corporate responsibility, paying particular attention to the division of moral labor in society and how different corporate responsibility prescriptions stand to affect the social ecosystem of power. Federalist institutional strategies deploying separations of power and constitutions are used to develop a concept of corporate "constitutional devices," which have promise to constrain the corporation as it fulfills its social responsibilities, even outside the ambit of a strong state and in light of barriers to constant, effective stakeholder accountability. We conclude by outlining FCSR managerial strategies, which sometimes endorse corporate social inaction in the interest of a desirable distribution of authority across society. [ABSTRACT FROM AUTHOR]

SnO2 is a prototypical transparent conducting oxide that finds widespread applications as transparent electrodes, gas sensors, and transparent thin-film devices. Hydrogen impurities in SnO2 give rise to unintentional n-type behavior and unexpected changes to conductivity. Interstitial H (Hi) and H at an oxygen vacancy (HO) are both shallow donors in SnO2. An O–H vibrational line at 3155 cm−1, that can be produced by a thermal anneal at 500 °C followed by a rapid quench, has been assigned to the Hi center and is unstable at room temperature on a timescale of weeks. An IR absorption study of the decay kinetics of the 3155 cm−1 O–H line has been performed. The disappearance of Hi upon annealing has been found to follow second-order kinetics. Measurements of the decay rate for a range of temperatures have determined an activation energy for the diffusion of interstitial H in SnO2. These results provide fundamental information about how unintentional hydrogen impurities and their reactions can change the conductivity of SnO2 device materials in processes as simple as thermal annealing in an inert ambient. [ABSTRACT FROM AUTHOR]

Purpose: Neighborhood socioeconomic deprivation (NSD) is associated with worse outcomes among patients with cancer, but little is known about NSD-related disparities in patient-reported outcomes (PRO) in clinical trials. We examined the relationship between PROs and NSD in symptom management trials among women with breast cancer. Methods: We pooled data from three SWOG randomized trials to examine four outcomes: physical and functional wellbeing (PWB, FWB), average pain, and pain interference. NSD was measured using participants' zip code linked to the area deprivation index (ADI) score, categorized into tertiles. Multivariable linear regression adjusted for sociodemographic and clinical characteristics was used to analyze baseline PROs. Linear mixed models were used to examine if trajectory of PROs from baseline through 24 weeks varied by ADI. Results: We examined 761 participants, of whom 51% were from least deprived neighborhoods. Participants in the most deprived neighborhoods had worse average pain at baseline (β =.38, 95% CI =.03 to.72, p =.03) while participants in somewhat deprived areas also had worse FWB (β = −1.07, 95% CI = −1.95 to −.20, p =.02) and pain interference (β = 0.42, 95% CI =.09 to.75, p =.01) compared to those from least deprived areas. Hispanic ethnicity and having Medicaid/no insurance were associated with worse outcomes. After adjusting for baseline score, ADI was not associated with any outcome over time. Conclusions: Breast cancer patients living in areas with NSD had worse FWB, joint pain, and pain interference at baseline. Clinical trial participants should be screened for community-level needs. Implementing interventions to address those needs could help mitigate disparities. [ABSTRACT FROM AUTHOR]

Introduction: Patient and Public Involvement and Engagement (PPIE) involves working 'with' or 'by' patients and the public, rather than 'to,' 'about,' or 'for' them, and is integral to neurological and digital health research. This rapid review examined PPIE integration in the development and implementation of digital health technologies for neurological conditions. Methods: Key terms were input into six databases. Included articles were qualitative studies or PPIE activities involving patient perspectives in shaping digital health technologies for neurological conditions. Bias was evaluated using the NICE qualitative checklist, with reporting following PRISMA guidelines. Results: 2,140 articles were identified, with 28 included. Of these, 25 were qualitative studies, and only three were focused PPIE activities. Patient involvement was mostly limited to one-off consultations during development.There was little evidence of PPIE during implementation, and minimal reporting on its impact. Conclusions: PPIE has been inconsistently reported in this research area, highlighting the need for more guidance and best-practice examples This review used a UK-based definition of PPIE, which may have excluded relevant activities from other countries. Future reviews should broaden terminology to capture PPIE integration globally. [ABSTRACT FROM AUTHOR]

New global multi-directional migration flows are decentering extant analyses of White expatriate migration. As migration becomes more diversified, new lines of intellectual inquiry are surfacing about the experiences of middle-class non-white expatriates. This paper uses the case study of China, which with the rise in immigration, has an increasingly diverse 'expatriate' population. While the visibility of White expatriates in non-white-majority host countries may compel them to adopt lifestyles segregated from the local population, expatriates of Chinese heritage in China have the (dis)advantage of blending in with the local population. This paper examines the experiences of Singaporean-Chinese migrants in China where their ethnic proximity to the Chinese can be both a boon and a bane. We present our findings in three sections addressing: first, how ethnic proximity can enable mobilities including motility and a mobile sense of belonging; second, how mobilities can condition ethnic proximity as experiences of privilege but also reminders of non-belonging; and third, how participants' change in life phases i.e. temporalities shift meanings of proximity, mobility and mobile belonging. Through highlighting the multidimensional nature of mobilities – proximity, motility, temporalities – this paper contributes to studies of middling migration, (ethnic) proximity and mobilities. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of high-efficacy disease-modifying therapies (HE DMT) for multiple sclerosis (MS) may pose challenges to the administration and monitoring burden of the therapies. This article presents the results of the Delphi consensus method to generate insights from experts on the administration and monitoring burden of HE DMT in Saudi Arabia with a special focus on cladribine. Methods: Between January and March 2023, a two-round modified Delphi method was used to establish consensus regarding the administration and monitoring burden of HE DMTs used for MS. Through a questionnaire, the advisors evaluated 17 properties of six individual HE DMTs on the basis of their clinical experience. Advisors were required to rank each property on a scale of 1–5, with 1 being the lowest burden and 5 being the highest burden. Results: Experts ranked cladribine as having the lowest monitoring burden, followed by ofatumumab and ocrelizumab. Natalizumab and fingolimod were ranked fourth, and alemtuzumab had the highest burden. During the first round, experts agreed on the scores of the administration burden properties, except for hospital visit time and facility use during administration for ofatumumab, route of administration for fingolimod, monitoring of specific side effects and frequency of lab tests at follow-up, and the washout period for natalizumab. During the second round, there was agreement on all properties. Conclusion: In the absence of alternative scientific data, recommendations from experts and their consensus provide useful insights into the administration and monitoring burden of HE DMTs used for MS in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Macroautophagy/autophagy-lysosome function promotes growth and survival of cancer cells, making them attractive targets for cancer therapy. One intriguing lysosomal target is PPT1 (palmitoyl-protein thioesterase 1). PPT1 inhibitors derived from chloroquine block autophagy, have significant antitumor activity in preclinical models and are being developed for clinical trials. However, the role of PPT1 in tumorigenesis remains poorly understood. Here we report that in melanoma cells, acute siRNA or pharmacological PPT1 inhibition led to increased ferroptosis sensitivity and significant loss of viability, whereas chronic PPT1 knockout using CRISPR-Cas9 produced blunted ferroptosis that led to sustained viability and growth. Each mode of PPT1 inhibition produced lysosome-autophagy inhibition but distinct proteomic changes, demonstrating the complexity of cellular adaptation mechanisms. To determine whether total genetic loss of Ppt1 would affect tumorigenesis in vivo, we developed a Ppt1 conditional knockout mouse model. We then crossed it into the BrafCA, PtenloxP, Tyr:CreERT2 melanoma mouse model to investigate the impact of Ppt1 loss on tumorigenesis. Loss of Ppt1 had no impact on melanoma histology, time to tumor initiation, or survival of tumor-bearing mice. These results suggest that chemical PPT1 inhibitors produce different adaptations than genetic PPT1 inhibition, and additional studies are warranted to fully understand the mechanism of chloroquine derivatives that target PPT1 in cancer.Abbreviations: 4-HT: 4-hydroxytamoxifen; BRAF: B-Raf proto-oncogene, serine/threonine kinase; cKO: conditional knockout; CRISPR-Cas9: clustered regularly interspaced short palindromic repeats-CRISPR-associated protein 9; DC661: A specific PPT1 inhibitor; DMSO: dimethyl sulfoxide; Dox; doxycycline hyclate; Easi-CRISPR: efficient additions with ssDNA inserts-CRISPR; GNS561/ezurpimtrostat: A PPT1 inhibitor; Hug: human guide; iCas: inducible CRISPR-Cas9; KO: knockout; LC-MS/MS: Liquid chromatography-tandem mass spectrometry; LDLR: low density lipoprotein receptor; NFE2L2/NRF2: NFE2 like bZIP transcription factor 2; NT: non-target; PTEN: phosphatase and tensin homolog; PPT1: palmitoyl-protein thioesterase 1; RSL3: RAS-selective lethal small molecule 3; SCRIB/SCRB1: scribble planar cell polarity protein; Tyr:CreERT2: tyrosinase-driven Cre recombinase fused with the tamoxifen-inducible mutant ligand binding domain of the human estrogen receptor; UGCG: UDP-glucose ceramide glucosyltransferase; WT: wild-type. [ABSTRACT FROM AUTHOR]

Youth between ages 13 and 25 who experience homelessness face numerous barriers to excellent health, including social stigma and discrimination. Applying socio-ecological model and intersectionality theory, an integrative literature review was conducted. Peer-reviewed studies (N = 29) representing 808,296 participants extracted from four databases (CINAHL, MEDLINE, PsychINFO, SocINDEX) were analyzed. The studies included sources of discrimination and stigma from interpersonal interactions with support services staff upwards to policy and systemic levels with housing and justice systems. Health outcomes include poorer physical and behavioral health status from increased likeliness of denied access to support services, prolonged time spent being homeless, and higher incidences of experiencing violence. School nursing has power to push for recommended changes and support unhoused youth towards excellent health. Proposed changes include adapting Housing First framework, engaging with unhoused youth in program planning, policy writing, and public education that address the causes of poverty. [ABSTRACT FROM AUTHOR]

Human embryonic stem cell (hESC)-derived pancreatic α- and β-cells can be used to develop cell replacement therapies to treat diabetes. However, recent published differentiation protocols yield varying amounts of α- and β-cells amid heterogeneous cell populations. To visualize and isolate hESC-derived α- and β-cells, we generated a GLUCAGON-2A-mScarlet and INSULIN-2A-EGFP dual fluorescent reporter (INSEGFPGCGmScarlet) hESC line using CRISPR/Cas9. We established robust expression of EGFP and mScarlet fluorescent proteins in insulin- and glucagon-expressing cells, respectively, without compromising the differentiation or function of these cells. We also showed that the insulin- and glucagon-expressing bihormonal population at the maturing endocrine cell stage (stage 6) of our pancreatic islet differentiation lose insulin expression over time, while maintaining an α-like expression profile, suggesting these bihormonal cells are cell-autonomously fated to become α-like cells. We also demonstrated this cell line can be used to monitor hESC-derived insulin- and glucagon-expressing cells, and hESC-derived islet morphology in vivo, by transplanting them into the anterior chamber of the eye in mice. Together, the INSEGFPGCGmScarlet hESC line provides an efficient strategy for tracking populations of hESC-derived β- and α-like cells. Article Highlights: Differentiation protocols used to generate stem cell–derived islet cells yield heterogenous cell populations. We generated a human embryonic stem cell line that reports insulin- and glucagon-expressing cells in vitro and in vivo without altering their differentiation or function. We showed some insulin- and glucagon-expressing bihormonal cells are cell-autonomously fated to become α-like cells. This reporter cell line can be used to further study and improve stem cell–derived islet differentiation and transplantation. [ABSTRACT FROM AUTHOR]

The challenges facing non-native English-speaking students (NNESSs) in adapting to the conventions of academic writing at the tertiary level in English-medium institutions have been widely canvassed in scholarly research. Nonetheless, there does not appear to be a great deal of research that investigates the experiences of Arabic-speaking students with English academic writing across the disciplines at undergraduate level. This mixed-method study aimed to fill in this gap by utilizing three data collection methods: focus groups, an online questionnaire, and semi-structured interviews. The findings suggest that Arabic-speaking students' experiences with English writing are shaped by several factors. Such factors include past language learning experiences, the lack of clarity around discipline lecturers' academic writing expectations, linguistic differences between Arabic and English, and the impact of IELTS. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to investigate the association between parental unemployment and grade point average and school completion in adolescence, and the importance of family cohesion, parental education, and family income in explaining these associations. Methods: Data stem from the Norwegian cross-sectional 2012 youth@hordaland-survey including 8437 adolescents (53.4% girls). Information on grade point average, school completion, parental education, and family income were retrieved from the National Education Database. Parental work status and family cohesion were assessed by adolescent self-report. Results: Adolescents with at least one unemployed parent had lower grade point averages (3.49 compared with 3.92, P <0.001) and rates of school completion (71.9% compared with 86.6%, P <0.001) compared with adolescents with two working parents. The associations between parental unemployment and both grade point average (b = −0.22, 95% confidence interval −0.32, –0.12) and school completion (odds ratio 0.59, 95% confidence interval 0.46, 0.76) partly attenuated but remained significant when taking family cohesion, parental education, and family income into account. There was a significant interaction between parental unemployment and family cohesion on grade point average, in which the positive association between family cohesion and grade point average was weaker for adolescents with unemployed parents. Conclusions: Adolescents with parents outside of the workforce are at higher risk of poorer educational outcomes than peers with working parents. Combined with the positive associations between parental education, family cohesion, family income, and educational outcomes, this underscores the importance of parents for adolescent educational outcomes, and suggests that parents and the family situation should be considered when providing academic support for adolescents who struggle in upper secondary school. [ABSTRACT FROM AUTHOR]

Background: Research indicates a high prevalence of depressive disorders in individuals with autism spectrums disorders (ASD), highlighting a need for depression screening in this population. Both depression screening tools used in the general population and tools developed specifically for individuals with ASD are used in the ASD population. Because depressive symptoms may manifest differently in individuals with ASD, it is important to establish the psychometric properties of depression instruments in individuals with ASD to determine whether and how these instruments can be applied in assessing these individuals. Objective: Our objective was to synthesize knowledge regarding the psychometric properties of (a) depression instruments developed for the general populations and (b) depression instruments developed specifically for individuals with ASD. Methods: A scoping review was conducted using Covidence to identify, screen, and review available literature on the use and psychometric properties of generalized and ASD-specific depression instruments in individuals with ASD. Results: Results for both generalized and ASD-specific instruments indicated moderate psychometric strength, enough for these instruments to be potentially helpful in psychiatric assessments but not enough to be conclusive on their own. The data are limited by the small number of studies examining this population, that is, only 1 to 3 articles for each instrument, and the often-limited number of psychometric measurements taken in each study. Conclusions: As the prevalence of depression in individuals with ASD is high, reliable and valid measures are needed. Current research shows some support for existing instruments, although additional, more robust research is needed. [ABSTRACT FROM AUTHOR]

This study examined the impacts of different LED spectra on the growth of in vitro cultures of Musa acuminata cv. red banana and their biochemical profile, including the antioxidant enzymes catalase and ascorbate peroxidase, photosynthetic pigment and accumulation of total carbohydrate content. The far-red LEDs significantly increase shoot elongation (10.04 cm). The greatest number of shoots (2.97) and the greatest multiplication rate (80%) were obtained under the treatment with blue + red LEDs. The formation of microshoots were also enhanced by blue and white LED exposure in a range of 2–2.57 shoots per explant. Root formation was also stimulated by dichromatic blue + red (6.00) LED using MS medium with 2 µM indole-3-butyric acid (IBA). The enzymes catalase and ascorbate peroxidase were significantly up-regulated by irradiation with far-red (0.11 ± 0.02 CAT, 0.18 ± 0.04 APX U/mg) and blue (0.08 ± 0.01CAT, 0.10 ± 0.01APX U/mg) LED light. Total chlorophyll (0.45 to 0.80 mg/g) was elevated significantly by blue, blue + red and mint-white LED. On the other hand, carotenoids (12.08–14.61 mg/g) were significantly boosted by blue + red, red and mint-white LED light. Meanwhile, porphyrin (294.10–350.57 mg/g) was highly synthesised after irradiation with mint-white light. Irradiation with LED light significantly increased the accumulation of carbohydrates with the highest carbohydrate content under blue + red LED light (102.22 ± 2.46 mg/g) and blue light (91.69 ± 2.10 mg/g). In conclusion, these results confirm that the vegetative properties and biochemical profile of red banana in vitro are eustress response to LED spectra. [ABSTRACT FROM AUTHOR]

To meaningfully measure crime and track increases and decreases in public safety, some criminologists have argued for the need to focus on the harms associated with crime rather than counts of the number of crimes. Although numerous other countries have established crime harm indexes, the United States continues to rely heavily on traditional approaches to enumerating crime and to focus primarily on crimes reported to police. This article sets out to examine the harms and consequences of violence as assessed by the National Crime Victimization Survey (NCVS). We provide a descriptive assessment of the physical and social-emotional harms associated with experiencing a violent victimization and use this incident-level information to create an index that moves from simple enumeration to a fuller accounting of harm. We compare harm levels and trends over time to crime counts and by various crime and victim types. We examine how these harms are associated with help-seeking behavior, including reporting to the police and victim assistance. Our aim is to demonstrate how incident-based information about harms can provide additional information about the magnitude of crime and victim help-seeking behavior. [ABSTRACT FROM AUTHOR]

Little attention is given to the history of the data that underlie research on crime trends and patterns. This article considers the evolution of the National Crime Victimization Survey's (NCVS) police reporting and response questions. These questions are particularly important as the NCVS is the only nationally representative source of information on whether crime is reported to the police and citizen views of police actions. In addition, the current NCVS redesign is set to substantially add to these items. To provide a context for this discussion, this article applies the police reporting and response questions to an understudied victim group, specifically older women who experience violent victimization. This application illustrates the research opportunities and challenges for working with these data. [ABSTRACT FROM AUTHOR]

Background: Surgical site infections (SSIs) are a major driver of morbidity after combined liver and colorectal surgery for metastatic colorectal cancer. Available literature is inadequate to characterize risk factors and benchmarks for quality improvement. Methods: Consecutive cases of simultaneous liver and colorectal surgery for colorectal adenocarcinoma from November 2013 through September 2022 were reviewed for SSIs per National Surgical Quality Improvement Program (NSQIP) and National Healthcare Safety Network (NHSN) criteria. Univariable and multivariable logistic regression evaluated associations with NSQIP 30-day organ-space SSIs. Results: In 580 procedures, the rate of 30-day organ-space SSIs was 16% (n = 94) using NSQIP criteria and 11% (n = 64) using NHSN criteria; 4% (n = 24) had incisional SSIs by both criteria. Most organ-space SSIs were perihepatic, and a minority were associated with bile (26%) or anastomotic (15%) leak. Independent risk factors for organ-space SSIs included major liver resection, upper abdominal (compared with lower abdominal/pelvic) colorectal procedure, and ostomy reversal. Organ-space SSI rates increased over time by approximately 16% per calendar year (p = 0.02) despite a declining rate of major liver resection; incisional SSI rates remained low. Overall, major morbidity was 22%, with 7-day median length of stay (interquartile range 6–9) and 0.3% 90-day mortality. Conclusion: Organ-space SSIs are a significant driver of postoperative morbidity in simultaneous liver and colorectal resections for metastatic colorectal adenocarcinoma. Our findings confirm simultaneous resection remains safe and interventions to mitigate the risk of perihepatic organ-space SSIs in high-risk patients are warranted. [ABSTRACT FROM AUTHOR]

Background: Checkpoint inhibitor pneumonitis (CIP) that develops following immune checkpoint inhibitor (ICI) treatment can be difficult to distinguish from other common etiologies of lung inflammation in cancer patients. Here, we evaluate the bronchoalveolar lavage fluid (BAL) for potential biomarkers specific to CIP. Methods: We conducted a retrospective study of patients who underwent standard of care bronchoscopy to compare the cytokines of interest between patients with and without CIP and with and without immune-mediated pulmonary diseases. Pulmonary diagnoses were determined by the treating clinician at the time of bronchoscopy and retroactively reviewed for agreement by the study team. Results: Thirty-seven patients were included, and 24 (64.9%) had pulmonary infection, 2 (5.4%) had pulmonary edema, 6 (16.2%) had non-CIP drug-induced pneumonitis, 3 (8.1%) had CIP, 5 (13.5%) had immune-mediated ILD or autoimmune vasculitis, 4 (10.8%) had cancer progression, and 4 (10.8%) had nonimmune-mediated interstitial lung disease (ILD). IL-6 from the BAL was significantly higher in patients with CIP compared to those with cancer progression and nonimmune-mediated ILD, and IL-6 was significantly higher in patients with immune-mediated pulmonary diseases compared to cancer progression, nonimmune-mediated ILD, and infection. Conclusions: BAL IL-6 distinguished CIP from other common, important causes of pulmonary infiltrates in patients with cancer, suggesting it may give insight into the pathophysiology of CIP and has potential as a biomarker. [ABSTRACT FROM AUTHOR]

Aim: To systematically review the psychometric properties of the Alberta Infant Motor Scale (AIMS) when used for infant populations internationally, defined as infants not living in Canada, where the normative sample was established. Method: Seven databases were searched for studies that informed the psychometric properties of the AIMS and culturally adapted or translated versions in non‐Canadian infant cohorts. Results: Forty‐nine studies reported results from 11 663 infants representing 22 countries. Country‐specific versions of the AIMS are available for Brazilian, Polish, Serbian, Spanish, and Thai infant cohorts. Country‐specific norms were introduced for Brazilian, Dutch, Polish, and Thai cohorts. The original Canadian norms were appropriate for Brazilian, Greek, and Turkish cohorts. Across countries, the validity, reliability, and responsiveness of the AIMS was generally sufficient, except for predictive validity. Sufficient structural validity was found in one study, responsiveness in one study, discriminant validity in four of four studies, concurrent validity in 14 of 16 studies, reliability in 26 of 26 studies, and predictive validity in only eight of 13 studies. Interpretation: The use of the AIMS with validated versions and norms is recommended. The AIMS or country‐specific versions should be used with caution if norms have not been validated within the specific cultural context. [ABSTRACT FROM AUTHOR]

This study describes trends in the number of administrators in Pennsylvania hospitals from 1991 to 2020, and in the proportion of administrators to other hospital staff. Data are from the Pennsylvania Department of Health and the American Hospital Association. We find that between 1991 and 2020, the average number of administrators increased by 102% (60% when adjusted for patient volume). RNs, all nurses, and total hospital staff did not increase to the same extent, so the proportion of administrators to these staff increased by 24%, 33%, and 70% respectively. Common policies for reducing administrative costs may or may not apply to reducing administrator growth. Other policies should be explored as we discover specifics about this growth. Future studies should include data from other states and lower-level administrative staff. Studies should also examine the relationship between the number and proportion of administrators and nurse staffing, costs and quality of care. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review evaluates recent literature to understand the ways in which war disrupts HIV prevention and creates conditions for HIV outbreaks, with a focus on Ukraine. We also examine potential responses that can be deployed to sustain HIV prevention services amid ongoing conflict. Recent Findings: Recent studies and frameworks suggest that disruptions caused during war are comparable to other emergencies, like natural disasters. The most important disruptions included health system/infrastructure destabilization, displacement, and psychological and financial challenges for individuals in key populations. Wars in most settings, as exemplified by the recent war in Ukraine, demonstrate that these disruptions can be tempered through a coordinated, rapid response. Summary: Lesson learned from Ukraine show that adequate preparation and a rapid, collaborative response by providers is needed to ensure HIV prevention during war. Future research should develop comprehensive frameworks outlining how to facilitate this response. [ABSTRACT FROM AUTHOR]

The heavy chain of an antibody is crucial for mediating antigen binding. IGHV genes, which partially encode the heavy chain of antibodies, exhibit vast genetic diversity largely through polymorphism and copy number variation (CNV). These genetic variations impact population-level expression levels. In this study, we analyzed expressed antibody transcriptomes and matched germline IGHV genes from donors from KwaZulu-Natal, South Africa. Amplicon NGS targeting germline IGHV sequences was performed on genomic DNA from 70 participants, eight of whom had matched datasets of expressed antibody transcriptomes. Germline IGHV sequencing identified 161 unique IGHV alleles, of which 32 were novel. A further 21 novel IGHV alleles were detected in the expressed transcriptomes of these donors. We also examined the datasets for CNV, uncovering gene duplications of 10 IGHV genes from germline sequencing and 33 genes in the expressed transcriptomes. Many of the IGHV gene duplications have not been described in other populations. This study expands our understanding of genetic differences in distinct populations and suggests the potential impact of genetic diversity on immune responses. [ABSTRACT FROM AUTHOR]

Background: Therapeutic antibodies for the treatment of neurological disease show great potential, but their applications are rather limited due to limited brain exposure. The most well-studied approach to enhance brain influx of protein therapeutics, is receptor-mediated transcytosis (RMT) by targeting nutrient receptors to shuttle protein therapeutics over the blood–brain barrier (BBB) along with their endogenous cargos. While higher brain exposure is achieved with RMT, the timeframe is short due to rather fast brain clearance. Therefore, we aim to increase the brain half-life of antibodies by binding to myelin oligodendrocyte glycoprotein (MOG), a CNS specific protein. Methods: Alpaca immunization with mouse/human MOG, and subsequent phage selections and screenings for MOG binding single variable domain antibodies (VHHs) were performed to find mouse/human cross-reactive VHHs. Their ability to increase the brain half-life of antibodies was evaluated in healthy wild-type mice by coupling two different MOG VHHs (low/high affinity) in a mono- and bivalent format to a β-secretase 1 (BACE1) inhibiting antibody or a control (anti-SARS-CoV-2) antibody, fused to an anti-transferrin receptor (TfR) VHH for active transport over the BBB. Brain pharmacokinetics and pharmacodynamics, CNS and peripheral biodistribution, and brain toxicity were evaluated after intravenous administration to balb/c mice. Results: Additional binding to MOG increases the Cmax and brain half-life of antibodies that are actively shuttled over the BBB. Anti-SARS-CoV-2 antibodies coupled with an anti-TfR VHH and two low affinity anti-MOG VHHs could be detected in brain 49 days after a single intravenous injection, which is a major improvement compared to an anti-SARS-CoV-2 antibody fused to an anti-TfR VHH which cannot be detected in brain anymore one week post treatment. Additional MOG binding of antibodies does not affect peripheral biodistribution but alters brain distribution to white matter localization and less neuronal internalization. Conclusions: We have discovered mouse/human/cynomolgus cross-reactive anti-MOG VHHs which have the ability to drastically increase brain exposure of antibodies. Combining MOG and TfR binding leads to distinct PK, biodistribution, and brain exposure, differentiating it from the highly investigated TfR-shuttling. It is the first time such long brain antibody exposure has been demonstrated after one single dose. This new approach of adding a binding moiety for brain specific targets to RMT shuttling antibodies is a huge advancement for the field and paves the way for further research into brain half-life extension. [ABSTRACT FROM AUTHOR]

DOPA Decarboxylase (DDC) has been proposed as a cerebrospinal fluid (CSF) biomarker with increased concentrations in Lewy body disorders (LBDs) and highest levels in patients receiving dopaminergic treatment. Here we evaluate plasma DDC, measured by proximity extension assay, and the effect of dopaminergic treatment in three independent LBD (with a focus on dementia with Lewy bodies (DLB) and Parkinson's disease (PD)) cohorts: an autopsy-confirmed cohort (n = 71), a large multicenter, cross-dementia cohort (n = 1498) and a longitudinal cohort with detailed treatment information (n = 66, median follow-up time[IQR] = 4[4, 4] years). Plasma DDC was not altered between different LBDs and other disease groups or controls in absence of treatment. DDC levels increased over time in PD, being significantly associated to higher dosages of dopaminergic treatment. This emphasizes the need to consider treatment effect when analyzing plasma DDC, and suggests that plasma DDC, in contrast to CSF DDC, is of limited use as a diagnostic biomarker for LBD, but could be valuable for treatment monitoring. DOPA decarboxylase (DDC) in cerebrospinal fluid has great diagnostic potential for Lewy body disorders. Here, the authors report limited diagnostic potential of plasma DDC and a strong association with dopaminergic treatment. [ABSTRACT FROM AUTHOR]

Cell therapies, including tumor antigen-loaded dendritic cells used as therapeutic cancer vaccines, offer treatment options for patients with malignancies. We evaluated the feasibility, safety, immunogenicity, and clinical activity of adjuvant vaccination with Wilms' tumor protein (WT1) mRNA-electroporated autologous dendritic cells (WT1-mRNA/DC) in a single-arm phase I/II clinical study of patients with advanced solid tumors receiving standard therapy. Disease status and immune reactivity were evaluated after 8 weeks and 6 months. WT1-mRNA/DC vaccination was feasible in all patients, except one. Vaccination was well tolerated without evidence of systemic toxicity. The disease control rate and overall response rate among a total of 39 evaluable patients were 74.4% and 12.8%, respectively. Median overall survival (OS) was 43.7 months among 13 patients with glioblastoma multiforme, 41.9 months among 12 patients with metastatic breast cancer, and 48.8 months among 10 patients with malignant pleural mesothelioma, comparing favourably with historical controls reported in the literature. OS was longer in patients with stable disease at 8 weeks and disease control at 6 months versus patients without disease control at either time point. Disease control and higher OS were associated with antigen-specific type 1 CD4+ and/or CD8+ T-lymphocyte responses, mainly induced by WT1-mRNA/DC vaccination. Antigen-nonspecific type 2 CD8+ T-cell responses were common before WT1-mRNA/DC vaccination but did not show any association with clinical outcome. Collectively, these data indicate that WT1-mRNA/DC vaccination is feasible, safe, and immunogenic and shows clinical activity in patients with advanced solid tumors, suggesting that it has the potential to help improve their survival. [ABSTRACT FROM AUTHOR]

Pacific fin whales (Balaenoptera physalus velifera), once the most abundant cetacean species in British Columbia (BC), were also one of the most heavily targeted by commercial whaling. Much of what we know about their phenology and ecology is from catch records, but their current status has not yet been summarized in Canadian waters. Here, we collated evidence from dedicated surveys, opportunistic sightings, and passive acoustic records that had not been reported before and reviewed them in the context of past data. This was to add new findings to what is known, and to establish if the population was showing signs of recovery. This is particularly relevant considering discussions of downlisting their population status in Canada from endangered to threatened. We then asked if this rebounding was consistent with what is known about pre-whaling presence and movement patterns, or if changes in whale distribution reflected altered oceanic regimes, prey availability, or increased anthropogenic pressures. The evidence suggested that fin whale populations in the northeast Pacific Ocean are repopulating areas along the BC coast recognized as part of their historic range. However, they are recovering in a different ocean than they were removed from, which makes them increasingly vulnerable to new anthropogenic threats. The sightings data suggested that, at least for the west coast of Vancouver Island, this repopulation has occurred over a relatively short period, with fin whales still absent from regular surveys as recent as the early 2000's. The recent acoustic recordings suggested their presence is not transitory, but that fin whales may be using locales along the BC coast for feeding and breeding activities. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) recommended cryptococcal antigen (CrAg) screening for people presenting with advanced HIV disease (AHD) and for those with positive CrAg without evidence of meningitis to initiate preemptive antifungal medication. Data on the implementation of WHO recommendations regarding CrAg screening is limited. We estimated pooled prevalence of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis and initiation of preemptive antifungal medication from available eligible published studies conducted in Africa. Methods: PubMed, Cochrane Library and Embase were searched for articles published between January 2011 and December 2023. CrAg uptake was defined as percentage of eligible people (CD4 ≤ 200 cells/mm3 or WHO stage III/IV) who received cryptococcal antigen testing. Stratified analysis to compare uptake and cryptococcal antigenemia between studies that involved multiple vs single sites was performed. Using random effects models, we computed the pooled estimate of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis, preemptive antifungals treatment and 95% confidence intervals (CIs). Results: Ten studies with 18,820 individuals with AHD were analyzed. Overall, the pooled estimate of CrAg screening uptake was 57.1% (95% CI: 41.4–72.7). CrAg screening uptake was significantly lower among studies that involved multiple sites compared to those that involved single site, (47.3% vs 73.3%; p<0.001). Overall, the pooled prevalence of cryptococcal antigenemia was 9.6% (95% CI:6.4–12.9). Cryptococcal antigenemia was significantly lower among studies that involved multiple sites compared to those that involved single site, (9.1% vs 10.4%; p<0.001). Among those who tested positive for CrAg, 84.6% (95% CI: 54.1–99.0) received preemptive antifungal treatment, though nearly 25% did not undergo lumbar puncture, highlighting gaps in diagnostic follow-up. Six studies evaluated CrAg positive patients with lumbar puncture and the overall prevalence of lumbar puncture was 74.9% (48.0–94.8). The overall prevalence of cryptococcal meningitis was 58.1% (46.6–69.6). Conclusions: Not screening for CrAg among people with AHD and failure to initiate antifungal medications among eligible patients with cryptococcal antigenemia presents a significant missed opportunity. Emphasis on improving CrAg screening is critical given its proven cost-effective benefits. [ABSTRACT FROM AUTHOR]

Background: Self-reported health problems following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are common and often include relatively non-specific complaints such as fatigue, exertional dyspnoea, concentration or memory disturbance and sleep problems. The long-term prognosis of such post-acute sequelae of COVID-19/post-COVID-19 syndrome (PCS) is unknown, and data finding and correlating organ dysfunction and pathology with self-reported symptoms in patients with non-recovery from PCS is scarce. We wanted to describe clinical characteristics and diagnostic findings among patients with PCS persisting for >1 year and assessed risk factors for PCS persistence versus improvement. Methods and findings: This nested population-based case-control study included subjects with PCS aged 18–65 years with (n = 982) and age- and sex-matched control subjects without PCS (n = 576) according to an earlier population-based questionnaire study (6–12 months after acute infection, phase 1) consenting to provide follow-up information and to undergo comprehensive outpatient assessment, including neurocognitive, cardiopulmonary exercise, and laboratory testing in four university health centres in southwestern Germany (phase 2, another 8.5 months [median, range 3–14 months] after phase 1). The mean age of the participants was 48 years, and 65% were female. At phase 2, 67.6% of the patients with PCS at phase 1 developed persistent PCS, whereas 78.5% of the recovered participants remained free of health problems related to PCS. Improvement among patients with earlier PCS was associated with mild acute index infection, previous full-time employment, educational status, and no specialist consultation and not attending a rehabilitation programme. The development of new symptoms related to PCS among participants initially recovered was associated with an intercurrent secondary SARS-CoV-2 infection and educational status. Patients with persistent PCS were less frequently never smokers (61.2% versus 75.7%), more often obese (30.2% versus 12.4%) with higher mean values for body mass index (BMI) and body fat, and had lower educational status (university entrance qualification 38.7% versus 61.5%) than participants with continued recovery. Fatigue/exhaustion, neurocognitive disturbance, chest symptoms/breathlessness and anxiety/depression/sleep problems remained the predominant symptom clusters. Exercise intolerance with post-exertional malaise (PEM) for >14 h and symptoms compatible with myalgic encephalomyelitis/chronic fatigue syndrome were reported by 35.6% and 11.6% of participants with persistent PCS patients, respectively. In analyses adjusted for sex-age class combinations, study centre and university entrance qualification, significant differences between participants with persistent PCS versus those with continued recovery were observed for performance in three different neurocognitive tests, scores for perceived stress, subjective cognitive disturbances, dysautonomia, depression and anxiety, sleep quality, fatigue and quality of life. In persistent PCS, handgrip strength (40.2 [95% confidence interval (CI) [39.4, 41.1]] versus 42.5 [95% CI [41.5, 43.6]] kg), maximal oxygen consumption (27.9 [95% CI [27.3, 28.4]] versus 31.0 [95% CI [30.3, 31.6]] ml/min/kg body weight) and ventilatory efficiency (minute ventilation/carbon dioxide production slope, 28.8 [95% CI [28.3, 29.2]] versus 27.1 [95% CI [26.6, 27.7]]) were significantly reduced relative to the control group of participants with continued recovery after adjustment for sex-age class combinations, study centre, education, BMI, smoking status and use of beta blocking agents. There were no differences in measures of systolic and diastolic cardiac function at rest, in the level of N-terminal brain natriuretic peptide blood levels or other laboratory measurements (including complement activity, markers of Epstein–Barr virus [EBV] reactivation, inflammatory and coagulation markers, serum levels of cortisol, adrenocorticotropic hormone and dehydroepiandrosterone sulfate). Screening for viral persistence (PCR in stool samples and SARS-CoV-2 spike antigen levels in plasma) in a subgroup of the patients with persistent PCS was negative. Sensitivity analyses (pre-existing illness/comorbidity, obesity, medical care of the index acute infection) revealed similar findings. Patients with persistent PCS and PEM reported more pain symptoms and had worse results in almost all tests. A limitation was that we had no objective information on exercise capacity and cognition before acute infection. In addition, we did not include patients unable to attend the outpatient clinic for whatever reason including severe illness, immobility or social deprivation or exclusion. Conclusions: In this study, we observed that the majority of working age patients with PCS did not recover in the second year of their illness. Patterns of reported symptoms remained essentially similar, non-specific and dominated by fatigue, exercise intolerance and cognitive complaints. Despite objective signs of cognitive deficits and reduced exercise capacity, there was no major pathology in laboratory investigations, and our findings do not support viral persistence, EBV reactivation, adrenal insufficiency or increased complement turnover as pathophysiologically relevant for persistent PCS. A history of PEM was associated with more severe symptoms and more objective signs of disease and might help stratify cases for disease severity. Author summary: Why was this study done?: Self-reported health problems following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have commonly been described and may persist for months. They typically include relatively non-specific complaints such as fatigue, exertional dyspnoea, concentration or memory disturbance and sleep problems. The long-term prognosis of this post-COVID-19 syndrome (PCS) is unknown. To the best of our knowledge, measurable single or multiple organ dysfunction and pathology and their correlation with self-reported symptoms in patients with non-recovery from PCS for more than a year have not been well described. What did the researchers do and find?: We invited individuals who had participated in a previous population-based survey of post-acute complaints and symptoms after acute SARS-CoV-2 infection to undergo a follow-up investigation that included a comprehensive medical evaluation. Results were compared between patients with persistent PCS (cases) and those study participants who had not developed PCS (controls). We found that two-thirds of the individuals with PCS had persisting disease for more than a year with no major changes in symptom clusters. Objective signs of organ dysfunction and pathology among individuals with persistent PCS correlated with self-reported symptoms, were detected more often among PCS patients with longer lasting post-exertional malaise, and included both reduced physical exercise capacity and reduced cognitive test performances while we did not find differences in the results of multiple laboratory investigations after adjustment for possible confounders such as body mass index and educational status. The severity of the index infection, lower educational status, no previous full-time employment and (need for) specialist consultation or a rehabilitation programme (the latter probably due to reverse causation) were factors for non-recovery from PCS. What do these findings mean?: In the majority of patients, PCS symptoms did not improve in the second year of their illness and typically continued to include fatigue and measurable exercise intolerance and cognition deficits, but there seems to be no major pathology in laboratory investigations. Sociodemographic variables appear to play a role not only for the development, but also for the non-recovery from PCS. Limitations include the missing information on pathology before acute infection, response and recall biases. In a population-based case-control study, Raphael Peter and colleagues investigate the clinical characteristics and diagnostic findings in patients with post-COVID-19 syndrome. [ABSTRACT FROM AUTHOR]

Background: The approach to induction of labour differs internationally, with timing of amniotomy being controversial. Some institutions favour performing artificial rupture of membranes prior to commencement of oxytocin infusion, with the belief that the labour will progress more efficiently. In other institutions, the approach recommended is for oxytocin infusion with intact amniotic membranes until the person has reached the active phase of labour, citing risk of infection with early amniotomy. Current evidence is inconclusive. We are performing a randomised controlled trial assessing whether delaying amniotomy until the active phase of labour can decrease the rate of chorioamnionitis. Methods: This is a randomised controlled trial at a single centre in New Zealand. Pregnant people undergoing induction of labour at ≥ 37 weeks gestational age with intact membranes and a singleton gestation are eligible for the trial. Participants are randomised to 'Early' amniotomy, at the commencement of oxytocin infusion, or to 'Late' amniotomy, when they have reached a cervical dilation of 6 or more centimetres or when they have been receiving oxytocin infusion for 12 h. The primary outcome of the trial is chorioamnionitis. To detect a decrease in chorioamnionitis from 9 to 3% with a power of 80% and a 95% CI, we will require 488 participants in total, randomised in a 1:1 ratio. Discussion: If delaying amniotomy reduces the rate of chorioamnionitis, this is important to inform future practice. Chorioamnionitis entails risk to both the pregnant person and the fetus and is an important contributor to neonatal sepsis, neonatal intensive care unit admission, maternal sepsis, caesarean, wound infection and postoperative infective complications. Conversely, if the rate of chorioamnionitis is not affected by timing of amniotomy, this will allow for safe individualization of care. Trial registration: The trial is registered on the Australian and New Zealand Clinical Trials Registry, anzctr.org.au. Full registry title is 'Impact of early versus late artificial rupture of membranes during oxytocin induction of labour on the incidence of chorioamnionitis: A randomised controlled trial'. Trial ID: ACTRN12621000405819. Date registered 14 April 2021. [ABSTRACT FROM AUTHOR]

Background: Aromatase inhibitors (AI) reduce hormone receptor-positive breast cancer recurrence risk by about 50%. However, half of AI-treated postmenopausal women report new or worsened musculoskeletal symptoms (AIMSS), and 20% discontinue therapy prematurely. Acupuncture is effective for reducing symptoms, but many women are not able to access acupuncture therapy. We hypothesize that self-administered acupressure will reduce AIMSS. Materials and methods: Postmenopausal women who have been receiving treatment with an AI for more than 3 weeks but less than 2 years, and who report new or worsened joint pain or myalgias since starting AI therapy with worst pain of at least 4 out of 10 on a numerical rating scale, are eligible. Fifty participants will be enrolled and randomized 1:1 to treatment with true or sham acupressure for 12 weeks. Participants will self-apply pressure for 3 minutes to each of the 9 acupoints daily. All participants will complete a pain assessment weekly, and a battery of symptom questionnaires every 6 weeks. Optional stool samples will be collected after 0 and 12 weeks of acupressure to examine changes in the gut microbiome. The primary endpoint is change in worst pain on the Brief Pain Inventory-Short Form with 12 weeks of the acupressure intervention, evaluated with generalized estimating equations. Conclusion: Determination that self-administered acupressure reduces AIMSS in this randomized phase 2 pilot trial will lead to a larger randomized phase 3 clinical trial to confirm the efficacy of self-acupressure. Reduction of AI-related arthralgias may improve persistence with breast cancer therapy, breast cancer outcomes, and quality of life for AI-treated patients. Trial registration: Clinicaltrials.gov NCT06228768. [ABSTRACT FROM AUTHOR]

Background: Ancillary tests are often used in the determination of death by neurologic criteria (DNC), especially when the clinical examination is inconclusive. DNC is widely accepted, as defined by the comprehensive report of the World Brain Death Project. However, there are several medical, legal, religious, ethical, and social controversies. Accordingly, "premature" and "delayed" diagnoses of brain death attract these issues. Methods: Depending upon the availability and experience of the managing medical teams, various ancillary tests are employed for an early and supplementary diagnosis of brain death. Results: We describe the practicality, test performance, and utility of some of the commonly employed ancillary tests for the diagnosis of brain death in clinical practice, along with their case examples. Conclusion: Brain death is a clinical diagnosis determined by history, physical examination, and adherence to recommended criteria. All ancillary investigations are used as supplementary tests with variable accuracy parameters. These ancillary tests often facilitate an early and "timely" diagnosis of brain death. [ABSTRACT FROM AUTHOR]

Background: A novel and rapid cell-based bioassay, Turbo TSI, for measurement of thyroid-stimulating immunoglobulins (TSI) was recently reported. An assessment of the analytical performance of this TSI bioassay is described herein. Methods: Thawed cells from Turbo TSI kits were treated with different concentrations of a World Health Organization (WHO) international standard (IS) TSI-positive serum. TSI was measured as a function of luciferase activity measured as relative light units (RLU) and converted into international units per liter (IU/L). Analytical performance studies were performed on numerous samples, over multiple days, by two users at two sites. Results: The limit of blank, limit of detection and limit of quantitation were determined to be 0.007 IU/L, 0.014 IU/L, and 0.021 IU/L, respectively. Receiver operator characteristics (ROC) analysis determined the cut-off to be 0.0241 IU/L with an area under the curve of 0.984. The linear range was shown to be from 0.015 to 11.958 IU/L. The intra-laboratory precision was ≤15%CV. The overall reproducibility of the assay was ≤20%CV for five concentrations (0.06 to 5.16 IU/L). Interference and cross reactivity studies with a variety of substances showed that the assay was robust. The Turbo TSI bioassay demonstrated 95.2% (95% CI 83.3-98.1) positive percent agreement and 94.8% (95% CI 90.9-97.1) negative percent agreement with an FDA-cleared bioassay (Thyretain ® TSI) using serum from 295 patients with autoimmune thyroid disease. Conclusions: The Turbo TSI bioassay exhibits excellent analytical performance and a high level of reproducibility. The performance compared well with Thyretain ® TSI, an FDA-cleared TSI bioassay. [ABSTRACT FROM AUTHOR]

Background: The aging of the world's population and the increase in sedentary lifestyles are leading to an increase in walking impairments at older ages. Here, we aimed to comprehensively discuss walking in the context of an aging population; and identify and agree on a list of future research priorities and policy actions. Methods: We followed a participatory approach and held a multidisciplinary two-day workshop on October, 2023 in Barcelona, Spain, with experts in the fields of aging and walking, and participants from the general public. Results: A total of 56 national and international participants, from a multidisciplinary background, joined the workshop. They had a median age of 40 years (range 24–83), and 62% were female. Participants discussed the meaning of walking from different perspectives and its change with age and in the presence of diverse mobility-impairing conditions; the emotional and social components of walking; and the role of the environment in walking. Participants identified unmet needs, research priorities and policy actions related to walking in older ages. Conclusions: This two-day workshop provided a space for professionals and public to comprehensively discuss walking at older ages. Participants highlighted the relevance of a better and more comprehensive assessment of walking; the need to shift focus towards comprehensive health that considers physical, emotional and social aspects as well as individuals' preferences and expectations; and the importance of translating research into action. Future work can draw on the discussions held during this event in a thought-provoking and hypothesis-generating way. [ABSTRACT FROM AUTHOR]

Background: Joubert syndrome (JS) is an autosomal recessive disorder with a distinctive mid-hindbrain malformation known as the "molar tooth sign" which involves the breathing control center and its connections with other structures. Literature has reported significant respiratory abnormalities which included hyperpnea interspersed with apneic episodes during wakefulness. Larger-scale studies looking at polysomnographic findings or subjective reports of sleep problems in this population have not yet been published. Objectives: The primary objectives were (1) compare a large group of children with JS and their unaffected siblings for caregiver-reported sleep difficulties. Secondary objectives were (1) present new polysomnography (PSG) data on our JS cohort; (2) review sleep disordered breathing (SDB) in other rare congenital hindbrain anatomic abnormalities. Design: We conducted a cross-sectional study on a cohort of 109 families affected by JS. Methods: Pediatric Sleep Questionnaire (PSQ) and the Children's Sleep Habits Questionnaire (CSHQ) along with general medical health information focused on respiratory and sleep problems were mailed to all patients and families. Caregivers were asked to complete the survey for both children with JS and unaffected siblings, if any. Baseline diagnostic PSG was retrospectively reviewed for those with available studies, and the sleep parameters were compared to a referent cohort. Results: Study participants with JS were older than their unaffected siblings (p = 0.02). Genetic mutations were available for 41 out of 118 individuals, with the most common mutation being MKS3 (31.4%). Patients with JS had higher scores in the PSQ compared to their unaffected siblings (p < 0.001). PSG data showed severe SDB with apnea-hypopnea index (AHI) of 23 ± 15 events/h in patients with JS. Events were primarily obstructive (obstructive AHI 18 ± 15 events/h vs central AHI 4 ± 4 events/h). Abnormal sleep architecture with increased arousal indices, decreased efficiency, and more time awake and in light sleep or wakefulness when compared to the referent data. Conclusion: SDB is common and severe in patients with JS, and the significantly greater obstructive component reported in this cohort makes it necessary to perform complete PSG studies to address or prevent clinical manifestations in this at-risk population. PSQ could represent a viable method to screen for SDB in JS. [ABSTRACT FROM AUTHOR]

Summary: Grasses (Poaceae) comprise c. 11 800 species and are central to human livelihoods and terrestrial ecosystems. Knowing their relationships and evolutionary history is key to comparative research and crop breeding. Advances in genome‐scale sequencing allow for increased breadth and depth of phylogenomic analyses, making it possible to infer a new reference species tree of the family.We inferred a comprehensive species tree of grasses by combining new and published sequences for 331 nuclear genes from genome, transcriptome, target enrichment and shotgun data. Our 1153‐tip tree covers 79% of grass genera (including 21 genera sequenced for the first time) and all but two small tribes. We compared it to a newly inferred 910‐tip plastome tree.We recovered most of the tribes and subfamilies previously established, despite pervasive incongruence among nuclear gene trees. The early diversification of the PACMAD clade could represent a hard polytomy. Gene tree–species tree reconciliation suggests that reticulation events occurred repeatedly. Nuclear–plastome incongruence is rare, with very few cases of supported conflict.We provide a robust framework for the grass tree of life to support research on grass evolution, including modes of reticulation, and genetic diversity for sustainable agriculture. [ABSTRACT FROM AUTHOR]