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Black huckleberry (Vaccinium membranaceum)—an economically, ecologically, and culturally important shrub across the Pacific and Inland Northwest—is experiencing widespread declines in suitable habitat because of fire suppression and climate change. We tested the role of experimentally placed downed woody debris (DWD) in mitigating unsuitable habitat conditions through creating favorable abiotic microsites and promoting black huckleberry seedling survival. We planted 1‐year‐old black huckleberry seedlings at four distances (0, 0.25, 0.5, and 1.5 m) from DWD, on the north and south aspects of east‐to‐west‐oriented DWD, at three study sites in Northern Idaho, United States. Over one growing season (May to September), we measured seedling survival, chlorophyll fluorescence (Fv/fm), soil surface temperature (SST), and soil volumetric water content (VWC) monthly. Only 21% of seedlings survived the entire season, but survival on the north DWD aspect (28.3%) was twice that of the south (14.2%). Additionally, survival at the nearest distances (0 and 0.25 m; 29%) was double that of farther distances (0.5 and 1.5 m; 13.6%) for both DWD aspects. The north aspect and nearest distances were also associated with the highest Fv/fm, lowest SST, and highest VWC, confirming expected abiotic characteristics of the DWD‐associated microsite. The distinct spatial and directional effects highlight a facet of DWD microsites, which can improve best practices for microsites during restoration. We demonstrate that DWD‐facilitated microsites can be a pivotal restoration tool to ameliorate climate extremes and enhance shrub recruitment into more durable life stages. [ABSTRACT FROM AUTHOR]

The two-week Home Base Intensive Clinical Program (ICP) provides treatment to veterans and active duty service members suffering from primary diagnoses of posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), anxiety, or depression. First launched in 2015, this paper provides a programmatic update, including new treatment components implemented since inception, and examines outcomes for all participants who entered the program from September 2015 to July 2024 (n = 2561). The Home Base ICP provides a massed care approach through daily individual Prolonged Exposure, Cognitive Processing Therapy, Unified Protocol, or cognitive rehabilitation, along with groups targeting coping skills. Participants entering the program are provided with core group programming, as well as individualized therapy sessions tailored to their unique needs and symptom presentation. Supplemental dual recovery support is also available for all participants with co-occurring substance use or behavioral addiction concerns. Participants' support people receive education, support, and case management services. Participants have a multidisciplinary team comprising therapists, psychopharmacology providers, case managers, nurses, and wellness providers. Results demonstrate that program participants exhibited statistically significant reductions in PTSD symptoms (Cohen's d = 0.80), depression (d = 0.68), post-concussion symptoms (d = 0.71), and increased satisfaction in social roles (d = -0.65). Completion rate was 94.60% (n = 2422), suggesting that the Home Base ICP is a well-received and effective model of care for veterans and service members. [ABSTRACT FROM AUTHOR]

Objective: We examined how attributions of broad ambiguous desire symptoms (eg, irritability) and elaborations on specific substances (ie, caffeine/food) influence subsequent self-reported cravings for these substances. Participants: 346 undergraduates were randomized to attribute their ambiguous desire symptoms to a lack of caffeine, food, or a vacation (active control), and then elaborate on the assigned stimulus. There was also a no-elaboration control group. Methods: Generalized Linear Models were used to test whether elaborating on one substance would increase cravings for that substance and decrease craving for the unelaborated substance relative to controls. Results: Participants who elaborated in terms of food reported increased food cravings, whereas participants who elaborated in terms of caffeine reported increased caffeine cravings. Conclusions: Findings suggest that food and caffeine cravings are malleable, and point to the importance of elaboration in polysubstance contexts. Food and caffeine elaborations may matter for heightening craving and determining the targets of craving. [ABSTRACT FROM AUTHOR]

Utilizing a randomized control design, this mixed method study aimed to assess the impact of a personalized music intervention on mood, agitation level, and psychotropic drug use in individuals with moderate to advanced dementia residing in long-term care facilities. The sample comprised of 261 participants, with 148 in the intervention group and 113 in the control group. Data were collected from three sources: quantitative data from the Minimum Data Set and the Cohen-Mansfield Agitation Inventory, observational data of music-listening sessions, and an administrator survey regarding the lead staff person's perceptions of the intervention. Findings, based on Mixed Effect Models and content analyses, revealed positive impacts of the personalized music intervention on residents living with dementia. This low-cost, easily implementable intervention, requiring no special licensure for administration, can significantly enhance the quality of life for nursing facility residents. [ABSTRACT FROM AUTHOR]

Little is known regarding the relationship between common comorbidities in persons with tuberculosis (TB) (including human immunodeficiency virus [HIV], diabetes, and hepatitis C virus [HCV]) and post-TB mortality. We conducted a retrospective cohort study among persons who initiated treatment for rifampicin-resistant or multi/extensively drug-resistant (RR or M/XDR) TB reported to the country of Georgia's TB surveillance during 2009–2017. Exposures included HIV serologic status, diabetes, and HCV status. Our outcome was all-cause post-TB mortality determined by cross-validating vital status with Georgia's death registry through November 2019. We estimated adjusted hazard rate ratios (aHR) and 95% confidence intervals (CI) of post-TB mortality among participants with and without comorbidities using cause-specific hazard regressions. Among 1032 eligible participants, 34 (3.3%) died during treatment and 87 (8.7%) died post-TB treatment. The median time to post-TB death was 21 months (interquartile range 7–39) after TB treatment. After adjusting for confounders, the hazard rates of post-TB mortality were higher among participants with HIV co-infection (aHR = 3.74, 95%CI 1.77–7.91) compared to those without HIV co-infection. In our cohort, post-TB mortality occurred most commonly in the first 3 years post-TB treatment. Linkage to care for common TB comorbidities post-treatment may reduce post-TB mortality rates. [ABSTRACT FROM AUTHOR]

Andrea Beaty's and David Roberts's The Questioneers series—including Iggy Peck Architect (2007); Rosie Revere Engineer (2013); Ada Twist Scientist (2016); Sofia Valdez Future Prez (2019); and Aaron Slater Illustrator (2021)—features imaginative children navigating challenges in pursuit of their goals. This article explores how the series interrogates age-based power dynamics through the interactions between its young protagonists and authoritative adults. Drawing on Maria Nikolajeva's concept of aetonormativity and Clementine Beauvais's formulations of children's might adults' authority and the transformation from one to another this article explores the books' foregrounding of dialogic encounters that transform both children and adults in a renegotiation of age-based power. These encounters occur through Max Weber's three types of legitimate authority: legal traditional and charismatic. Through close reading of the five picturebooks in the series alongside theoretical engagements with age power and Freirean learning communities the article considers the arguably irresolvable tension between literature for children that represents those renegotiations of power and its context in the inherently aetonormative structure of children's book publishing. [ABSTRACT FROM AUTHOR]

Lasiosiphon Fresen. (Thymelaeaceae: Thymelaeoideae) is now understood to be a morphologically diverse genus distributed across southern and tropical Africa, Madagascar, and India. It is diagnosed morphologically by ± involucrate, mostly pedunculate heads of pentamerous or tetramerous flowers, with or without petaloid scales, and a bright yellow, orange, or red corolla. The taxonomic history of Lasiosiphon has been marked by several revisions in its circumscription and status, particularly regarding its relationship with Gnidia L. Our phylogenetic analysis of nuclear (ITS) and plastid (matK, rbcL, rps16 and trnL-F) regions of an expanded sampling of the tropical African species of Gnidia provides compelling supporting evidence for existing morphological evidence to include all the tropical African species of Gnidia in Lasiosiphon. We accordingly provide 31 new combinations in Lasiosiphon for species of Gnidia that currently lack combinations in that genus. We also provide a comprehensive nomenclator of all currently recognized Lasiosiphon species at the regional level encompassing their distribution across different geographic regions globally. This will serve as the framework for future taxonomic revisions in the genus. [ABSTRACT FROM AUTHOR]

Stoma surgery can be critical in helping to restore the well-being of patients suffering from gastrointestinal disease or injury but it inevitably comes with numerous psychological and physiological complications. Disposable pouch systems which enable the collection of bowel waste have revolutionized stoma care but providing robust, discreet devices that can efficiently meet the requirements of the patient can be challenging. Pouches must securely store a microbially active waste whilst preventing leakage, protecting the underlying skin from inflammation and minimizing odor. All of this needs to be achieved within the design constraints of a pouch that is easy to manage and yet still maintains a discreet body contour. Stoma collection has moved from the waste being collected in butyl rubber pouches to much more elaborate systems incorporating assemblies of polyvinylidene chloride, ethylene vinyl acetate, ethyl vinyl alcohol and polyvinyl alcohol with new, skin-friendly adhesive such as hydrocolloid and silicones impregnated with ceramides and aloe. Moreover, 3D printing has emerged as a means of providing personalized stoma pouches that can potentially address the age-old issue of leakage. Despite such advances, stoma pouches have evolved slowly over the past 70 or so years. A survey of the literature reveals an abundance of quality-of-life studies but a dearth of reports addressing the key technological challenges. Consequently, this narrative review considers current stoma pouch technology and highlights the issues that continue to afflict stoma patients. Research and patent literature is critically appraised in terms of current pouch technology and the potential opportunities for new composite materials are identified. [ABSTRACT FROM AUTHOR]

Bepirovirsen is a developmental antisense oligonucleotide (ASO) for treatment of chronic hepatitis B virus infection. No pharmacokinetic (PK) studies comparing participants with hepatic impairment (HI) and healthy participants (HPs) have been conducted with ASOs. Given the target patient population, characterization of bepirovirsen PK in HI was imperative. This phase 1, nonrandomized, open‐label study (NCT04971928) evaluated the PKs of a single 300‐mg dose of bepirovirsen in participants with HI and matched HPs, enrolled in 2 parts (Part 1: moderate HI; Part 2: mild HI). If no predefined difference in the area under the concentration‐time curve from time 0 (predose) to infinite time (AUC0‐∞) and maximum observed concentration (Cmax; geometric mean ratio [GMR] 0.5‐1.5) was identified in Part 1, findings were applied to mild HI, eliminating Part 2. Participants were monitored for 50 days post‐treatment and noncompartmental analysis estimated PK parameters. Twenty‐four participants (moderate HI, n = 12; HP, n = 12) received bepirovirsen and completed Part 1. AUC0‐∞ and Cmax were lower in participants with moderate HI (GMR 0.69 and 0.67, respectively) than in HPs, while apparent clearance (CL/F) and apparent terminal phase volume of distribution (Vz/F) were higher (GMR 1.44 and 1.64, respectively), but fell within the predefined thresholds of difference for this study. Part 2 was omitted. Adverse events were mild. Moderate HI did not have a clinically relevant impact on bepirovirsen PK or safety. [ABSTRACT FROM AUTHOR]

Introduction: The purpose was to examine the prevalence of low energy availability (LEA), explore dietary behaviors in men collegiate gymnasts (n = 14), and investigate the relationships between energy availability (EA), body composition, and plyometric performance. Methods: Body composition was measured using air displacement plethysmography. Lower- and upper-body peak power (PWRpeak) and modified reactive strength index (RSImod) were calculated from countermovement jump (CMJ) and plyometric push-up (PP) assessments. Energy expenditure was tracked over 3 days, while daily energy and macronutrient intake were recorded. EA was calculated and used to categorize athletes into LEA and non-LEA groups. Pearson correlation coefficients were used to examine relationships between EA, body composition, and performance metrics. Results: 85.7% of athletes (n = 12) exhibited LEA (20.98 ± 5.2 kcals/kg FFM), with non-LEA athletes (n = 2) marginally surpassing the <30 kcal/kg of fat-free mass (FFM) threshold (30.58 ± 0.2 kcals/kg FFM). The cohort (n = 14) consumed insufficient energy (30.5 ± 4.5 kcal/kg/day) and carbohydrates (3.7 ± 1.1 g/kg/day), resulting in LEA (22.36 ± 5.9 kcal/kg/FFM). EA was not correlated with body composition or performance metrics. Discussion: A high prevalence of LEA may exist in men gymnasts, largely due to a low relative energy and carbohydrate intake. [ABSTRACT FROM AUTHOR]

Purpose: Incisional hernia (IH) is a common complication following abdominal surgery. Surgical repair of IH is associated with the alleviation of symptoms and improvement of quality of life. Operative intervention can pose a significant burden to the patient and healthcare facilities. This study aims to describe and compare outcomes of elective and emergency surgical repair of IH. Methods: This study is a single-centre comparative retrospective study including patients who had repair of IH. Patients were divided into Group I (Emergency) and Group II (Elective), and a comparison was conducted between them. Results: Two hundred sixty-two patients were identified with a mean age of 61.8 ± 14.2 years, of which 152 (58%) were females. The mean BMI was 31.6 ± 7.2 kg/m2. More than 58% had at least one comorbidity. 169 (64.5%) patients had an elective repair, and 93 (35.5%) had an emergency repair. Patients undergoing emergency repair were significantly older and had higher BMI, p = 0.031 and p = 0.002, respectively. The significant complication rate (Clavien–Dindo III and IV) was 9.54%. 30 and 90-day mortality rates were 2.3% (n = 6) and 2.68% (n = 7), respectively. In the emergency group, the overall complications, 30-day and 90-day mortality rates were significantly higher than in the elective group, p ≤ 0.001, 0.002 and 0.001, respectively. Overall, 42 (16.1%) developed wound complications, 25 (9.6%) experienced a recurrence, and 41 (15.71%) were readmitted within 90 days, without significant differences between the two groups. Conclusion: Patients who underwent emergency repair were significantly older and had a higher BMI than the elective cases. Emergency IH repair is associated with higher complication rates and mortality than elective repair. [ABSTRACT FROM AUTHOR]

Speaking is a highly conventional enterprise. But unusual usages are, nonetheless, frequently encountered. Some of these novelties fall flat, while others find favour, to the extent of entering common usage. He considered to say something will sound wrong to most native speakers, while The military disappeared her husband, which was more or less unsayable prior to the 1960s, has come to seem fine. Linguist Adelle E. Goldberg has recently argued that speakers display a remarkable openness to new words, phrases and even grammatical forms, when there is no current way of communicating whatever it is those novel strings serve to express. My paper exegetes Goldberg's findings to illuminate the question of poetic judgement. It proposes that there is a strong parallel between how people judge linguistic innovation in everyday speaking, and the way poets and critics judge innovative poetic diction: in both cases there is a premium on what cannot otherwise be said. The paper proceeds to deepen the analogies between these two modes of judgement. It starts by linking the lack of rules for determining the acceptability of new words and phrases in everyday speaking with the indifference to prior rules associated with aesthetic judgement in Kant's third critique, and apparent in the appraisals of many a contemporary poetry critic. It turns to consider the claim that what motivates the judgements under consideration is a preference in the human conceptual system for distinct symbols to have mutually exclusive meanings. A fourth section concerns what Construction Grammar, the broad field of Goldberg's intervention, has to reveal about the conditions under which new words and phrases can take on meaning in the first place. This too has something to suggest about why we judge certain poetic efforts poor, others landed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the validity of the conclusion from Cochrane reviews and meta‐analyses that treatment with calcium supplementation during pregnancy reduces the risk for pre‐eclampsia by 55%, which has been influential in international guidelines and future research. Design: Sensitivity analysis of data from Cochrane reviews of trials evaluating high‐dose calcium supplementation (of at least 1 g/day) for reduction of pre‐eclampsia risk. Setting: Systematic review and meta‐analysis. Population: The Cochrane reviews and meta‐analyses included 13 trials enrolling a total of 15 730 women. Random‐effects meta‐analysis of these studies resulted in a mean risk ratio (RR, calcium/placebo) of 0.45 (95% confidence interval [CI] 0.31–0.65; p < 0.0001). Methods: We carried out a sensitivity analysis of evidence from the relevant Cochrane review, to examine the impact of study size. Main outcome measures: pre‐eclampsia. Results: In the three largest studies, accounting for 13 815 (88%) of total recruitment, mean RR was 0.92 (95% CI 0.80–1.06) and there was no evidence of heterogeneity between studies (I2 = 0). With inclusion of the smaller studies, mean RR decreased to 0.45 and I2 increased to 70%. Conclusions: In assessment of the effect of calcium supplementation on pre‐eclampsia risk, the naive focus on the mean of the random‐effects meta‐analysis in the presence of substantial heterogeneity is highly misleading. Linked article: This article is commented on by Thornton pp. 1530–1531 in this issue. To view this article visit https://doi.org/10.1111/1471‐0528.17805. [ABSTRACT FROM AUTHOR]

Objective: To prospectively determine the nature of adnexal masses diagnosed during pregnancy and investigate whether ultrasound was a reliable means of assessing these. Methods: A single-centre prospective observational cohort study was conducted in a large tertiary referral hospital in London. Pregnant women with an adnexal mass detected at or prior to the 12-week routine ultrasound received a detailed ultrasound by a level II ultrasound practitioner at the time of detection; at 12 weeks; 20 weeks; and 6 weeks postpartum. The following outcomes were recorded: subjective impression of the mass; International Ovarian Tumor Analysis simple rules classification; resolution and intervention rate; and the incidence of complications related to the mass. Results: A total of 28,683 pregnant patients were scanned and an adnexal masses was detected in 277 patients, yielding an incidence of 1%. 274 participants were included in the analysis. Subjective impression was as follows: simple 75.9%; dermoid 29.1%; endometrioma 6.6%; haemorrhagic 3.3%; para-ovarian 2.6%; torted simple 0.7%; decidualized endometrioma 0.4%; fibroma 0.4%; theca luteal 0.4%; and borderline ovarian tumour: 0.7%. There was a significant reduction in the volume at each scan (p < 0.0001). Approximately 74.2% of the masses resolved spontaneously. Surgery was performed in 14/274: 2 antenatally, 6 at caesarean section, and 6 postpartum. In 5/247 (2%), there were complications due to the mass. Using IOTA simple rules, 272/274 (99.3%) (p < 0.0001) were classifiable. Only 1/274 (0.4%) had malignant features as per IOTA (p = 0.05). As there were no confirmed malignancies, the accuracy of IOTA simple rules could not be calculated. Conclusions: Adnexal masses in pregnancy are uncommon and the majority spontaneously resolve. Malignancy is rare, as are complications. In the absence of concerns regarding malignancy or cyst accident, there is no need for additional monitoring of these masses during pregnancy. [ABSTRACT FROM AUTHOR]

We present a new determination of the evolving galaxy ultraviolet (UV) luminosity function (LF) over the redshift range |$8.5< z< 15.5$| using a combination of several major Cycle-1 JWST imaging programmes – Public Release IMaging for Extragalactic Research, JWST Advanced Deep Extragalactic Survey, and Next Generation Deep Extragalactic Exploratory Public Survey. This multifield approach yields a total of |$\simeq 370$| arcmin2 of JWST /NIRCam imaging, reaching (5- |$\sigma$|⁠) depths of |$\simeq 30$| AB mag in the deepest regions. We select a sample of 2548 galaxies with a significant probability of lying at high redshift (⁠|$p(z> 8.5)> 0.05$|⁠) to undertake a statistical calculation of the UV LF. Our new measurements span |$\simeq 4$|  mag in UV luminosity at |$z=9-12.5$|⁠ , placing new constraints on both the shape and evolution of the LF at early times. Our measurements yield a new estimate of the early evolution of cosmic star-formation rate density (⁠|$\rho _{\rm {SFR}}$|⁠) confirming the gradual decline deduced from early JWST studies, at least out to |$z \simeq 12$|⁠. Finally we show that the observed early evolution of the galaxy UV LF (and |$\rho _{\rm {SFR}}$|⁠) can be reproduced in a |${\rm \Lambda }$| cold dark matter Universe, with no change in dust properties or star-formation efficiency required out to |$z \simeq 12$|⁠. Instead, a progressive trend towards younger stellar population ages can reproduce the observations, and the typical ages required at |$z \simeq$| 8, 9, 10, and 11 all converge on |$\simeq 380-330$|  Myr after the big bang, indicative of a rapid emergence of early galaxies at |$z \simeq 12 - 13$|⁠. This is consistent with the first indications of a steeper drop-off in |$\rho _{\rm {SFR}}$| we find beyond |$z \simeq 13$|⁠ , possibly reflecting the rapid evolution of the halo mass function at earlier times. [ABSTRACT FROM AUTHOR]

Anxiety is a psychiatric non-motor symptom of Parkinson's that can appear in the prodromal period, prior to significant loss of midbrain dopamine neurons and motor symptoms. Parkinson's-related anxiety affects females more than males, despite the greater prevalence of Parkinson's in males. How stress, anxiety and Parkinson's are related and the basis for a sex-specific impact of stress in Parkinson's are not clear. We addressed this using young adult male and female mice carrying a G2019S knockin mutation of leucine-rich repeat kinase 2 (Lrrk2G2019S) and Lrrk2WT control mice. In humans, LRRK2G2019S significantly elevates the risk of late-onset Parkinson's. To assess within-sex differences between Lrrk2G2019S and control mice in stress-induced anxiety-like behaviors in young adulthood, we used a within-subject design whereby Lrrk2G2019S and Lrrk2WT control mice underwent tests of anxiety-like behaviors before (baseline) and following a 28 day (d) variable stress paradigm. There were no differences in behavioral measures between genotypes in males or females at baseline, indicating that the mutation alone does not produce anxiety-like responses. Following chronic stress, male Lrrk2G2019S mice were affected similarly to male wildtypes except for novelty-suppressed feeding, where stress had no impact on Lrrk2G2019S mice while significantly increasing latency to feed in Lrrk2WT control mice. Female Lrrk2G2019S mice were impacted by chronic stress similarly to wildtype females across all behavioral measures. Subsequent post-stress analyses compared cFos immunolabeling-based cellular activity patterns across several stress-relevant brain regions. The density of cFos-activated neurons across brain regions in both male and female Lrrk2G2019S mice was generally lower compared to stressed Lrrk2WT mice, except for the nucleus accumbens of male Lrrk2G2019S mice, where cFos-labeled cell density was significantly higher than all other groups. Together, these data suggest that the Lrrk2G2019S mutation differentially impacts anxiety-like behavioral responses to chronic stress in males and females that may reflect sex-specific adaptations observed in circuit activation patterns in some, but not all stress-related brain regions. [ABSTRACT FROM AUTHOR]

We investigated the ability of a panel of immune-related cytokines and chemokines to predict the disease activity state in localized scleroderma (LS) subjects followed longitudinally. A total of 194 sera samples were obtained from 45 LS subjects with diverse types of LS (40% linear, 20% mixed, 16% craniofacial, 13% generalized, and 11% circumscribed) in our cohort. Cytokines/chemokines that were significantly elevated at the baseline active disease visit compared to the inactive disease state at follow-up were Interferon-Gamma-Inducible Protein (IP)-10 (p < 0.021) and Tumor Necrosis Factor (TNF)-α (p < 0.033). Mixed effect logit modeling identified IP-10 (Odds Ratio (OR) [95% confidence interval] = 2.1 [1.4, 3.2], p < 0.001), TNF-α (OR = 1.8 [1.1, 3.0], p = 0.016), and Monocyte Chemoattractant Protein (MCP)-1 (OR = 2.0 [1.1, 3.9], p = 0.034) as significant predictors of active disease status. These findings support earlier correlations between IP-10 and TNF-α with disease activity parameters in a cross-sectional Luminex™ serological study and may enhance clinical decision-making when disease activity is challenging to assess by clinical examination alone. [ABSTRACT FROM AUTHOR]

The Breast Cancer UK—Breast Cancer Prevention Conference addressed risk from environmental pollutants and health behaviour‐related breast‐cancer risk. Epidemiological studies examining individual chemicals and breast cancer risk have produced inconclusive results including endocrine disrupting chemicals (EDCs) Bisphenol A, per‐ and polyfluorinated alkyl substances as well as aluminium. However, laboratory studies have shown that multiple EDCs, can work together to exhibit effects, even when combined at levels that alone are ineffective. The TEXB‐α/β assay measures total estrogenic load, and studies have provided evidence of a link between multiple‐chemical exposures and breast cancer. However, prospective studies using TEXB‐α/β are needed to establish a causative link. There is also a need to assess real‐life exposure to environmental‐chemical mixtures during pregnancy, and their potential involvement in programming adverse foetal health outcomes in later life. Higher rates of breast cancer have occurred alongside increases in potentially‐modifiable risk factors such as obesity. Increasing body‐mass index is associated with increased risk of developing postmenopausal breast cancer, but with decreased risk of premenopausal breast cancer. In contrast, lower rates of breast cancer in Asian compared to Western populations have been linked to soya/isoflavone consumption. Risk is decreased by breastfeeding, which is in addition to the decrease in risk observed for each birth and a young first‐birth. Risk is lower in those with higher levels of self‐reported physical activity. Current evidence suggests breast‐cancer survivors should also avoid weight gain, be physically active, and eat a healthy diet for overall health. A broad scientific perspective on breast cancer risk requires focus on both environmental exposure to chemicals and health behaviour‐related risk. Research into chemical exposure needs to focus on chemical mixtures and prospective epidemiological studies in order to test the effects on breast cancer risk. Behaviour‐related research needs to focus on implementation as well as deeper understanding of the mechanisms of cancer prevention. [ABSTRACT FROM AUTHOR]

This study assesses the effect of chemical abrasion on in situ mass spectrometric isotopic and elemental analyses in zircon. Chemical abrasion improves the U–Pb systematics of SIMS (secondary ion mass spectrometry) analyses of reference zircons, while leaving other isotopic systems largely unchanged. SIMS 206Pb/238U ages of chemically abraded reference materials TEMORA-2, 91500, QGNG, and OG1 are precise to within 0.25 % to 0.4 % and are within uncertainty of chemically abraded TIMS (thermal ionization mass spectrometry) reference ages, while SIMS 206Pb/238U ages of untreated zircons are within uncertainty of TIMS reference ages where chemical abrasion was not used. Chemically abraded and untreated zircons appear to cross-calibrate within uncertainty using all but one possible permutation of reference materials, provided that the corresponding chemically abraded or untreated reference age is used for the appropriate material. In the case of reference zircons QGNG and OG1, which are slightly discordant, the SIMS U–Pb ages of chemically abraded and untreated material differ beyond their respective 95 % confidence intervals. SIMS U–Pb analysis of chemically abraded zircon with multiple growth stages is more difficult to interpret. Treated igneous rims on zircon crystals from the S-type Mount Painter Volcanics are much lower in common Pb than the rims on untreated zircon grains. However, the analyses of chemically abraded material show excess scatter. Chemical abrasion also changes the relative abundance of the ages of zircon cores inherited from the sedimentary protolith, presumably due to some populations being more likely to survive the chemical abrasion process than others. We consider these results from inherited S-type zircon cores to be indicative of results for detrital zircon grains from unmelted sediments. Trace element, δ18 O, and ε Hf analyses were also performed on these zircons. None of these systems showed substantial changes as a result of chemical abrasion. The most discordant reference material, OG1, showed a loss of OH as a result of chemical abrasion, presumably due to dissolution of hydrous metamict domains or thermal dehydration during the annealing step of chemical abrasion. In no case did zircon gain fluorine due to exchange of lattice-bound substituted OH or other anions with fluorine during the HF partial dissolution phase of the chemical abrasion process. As the OG1, QGNG, and TEMORA-2 zircon samples are known to be compositionally inhomogeneous in trace element composition, spot-to-spot differences dominated the trace element results. Even the 91500 megacrystic zircon pieces exhibited substantial chip-to-chip variation. The light rare earth elements (LREEs) in chemically abraded OG1 and TEMORA-2 were lower than in the untreated samples. Ti concentration and phosphorus saturation ((Y + REE) / P) were generally unchanged in all samples. [ABSTRACT FROM AUTHOR]

The world is experiencing an accelerating digital transformation. One aspect of this is the implementation of algorithmic decision-making, often supported by Artificial Intelligence. Algorithmic systems have the potential to change the meaning of critical elements of the engagement between social workers and people who need support. At the same time, social workers are increasingly being required by their agencies to integrate such abstracting technologies and techniques evermore comprehensively into their professional practice. This integration also creates tensions for training future social workers. It requires on the one hand directly responding to an old but intensifying tension between training students technically, and, on the other, providing the pedagogical tools for finding some critical distance from those same technologies and techniques. The article works through this tension of technique/critique, and a second associated tension between deploying technologies of mediated engagement and being present 'in the room' (presence/mediation). The consequences of how both tensions are handled, we suggest, are being intensified through the technologization of service-delivery. The article suggests ways of approaching a technical-critical pedagogy that responds to this complexity by being practice-embedded and theoretically engaged. [ABSTRACT FROM AUTHOR]

Recent concerns have been raised regarding the ethical considerations of conducting body composition assessments in sports. Specific apprehensions pertain to the inappropriate use of percent body fat and the limited application of the results to performance and recovery. Fat-free mass index (FFMI), a height-adjusted assessment of FFM, can serve as an alternative body composition metric to focus on in sports. Fat-free mass index provides valuable context regarding an optimal amount of FFM, accounting for skeletal frame and height while helping to qualify an athlete's FFM as low, moderate, or high. This review posits that shifting the focus of body composition measures to FFM can support more ideal targets across athletic seasons, careers, and the return to play after injury. In addition, a FFM focus may help change the perception of body composition assessment and how athletes perceive their current body because of the increased focus on the FFM compartment and the goal of maximizing tissue accrual, rather than focusing on fat loss. Fat-free mass index is calculated by dividing FFM (kg) by height (m²) and can serve to normalize FFM, relative to height, and enable comparisons across athletes, sport types, and sex. Previous research has identified differences in FFMI across sex and among sport categories. Still, there is a need for more published data to develop optimal ranges for FFMI across sex, sports, and positions. As more data become available, FFMI has the potential to provide normative guidelines for optimal FFM development, performance, and injury risk reduction. The purpose of the current review was to summarize FFMI values across collegiate sport categories and competitive status to provide normative profiles, according to sex and sport type. [ABSTRACT FROM AUTHOR]

Conspecific density dependence (CDD) in plant populations is widespread, most likely caused by local‐scale biotic interactions, and has potentially important implications for biodiversity, community composition, and ecosystem processes. However, progress in this important area of ecology has been hindered by differing viewpoints on CDD across subfields in ecology, lack of synthesis across CDD‐related frameworks, and misunderstandings about how empirical measurements of local CDD fit within the context of broader ecological theories on community assembly and diversity maintenance. Here, we propose a conceptual synthesis of local‐scale CDD and its causes, including species‐specific antagonistic and mutualistic interactions. First, we compare and clarify different uses of CDD and related concepts across subfields within ecology. We suggest the use of local stabilizing/destabilizing CDD to refer to the scenario where local conspecific density effects are more negative/positive than heterospecific effects. Second, we discuss different mechanisms for local stabilizing and destabilizing CDD, how those mechanisms are interrelated, and how they cut across several fields of study within ecology. Third, we place local stabilizing/destabilizing CDD within the context of broader ecological theories and discuss implications and challenges related to scaling up the effects of local CDD on populations, communities, and metacommunities. The ultimate goal of this synthesis is to provide a conceptual roadmap for researchers studying local CDD and its implications for population and community dynamics. [ABSTRACT FROM AUTHOR]

Reduced hours of instruction are reported within the gross anatomy education literature. Anatomy instruction continues to be challenged with motivating and inspiring learners to value the contribution of gross anatomy knowledge to their career development alongside increased organizational demands for efficiency and effectiveness. To address these demands, this retrospective study sought to understand how the relative timing and amount of gross anatomy instruction were related to examination performance. Undergraduate and graduate students between 2018 and 2022 were assigned to three cohorts determined by enrollment in prosection‐based anatomy only (n = 334), concurrent enrollment in prosection‐ and dissection‐based anatomy in the same semester (n = 67), or consecutive enrollment in the courses one year apart (n = 43). Concurrent students had higher prosection‐based anatomy examination scores than prosection‐only and consecutive students. Consecutively, enrolled students outperformed concurrently enrolled students on the first two dissection examinations but showed no performance differences on the third and fourth dissection examinations. While the results on the timing and presentation of anatomical instruction were inconclusive, the results do support increased instructional time using both prosection and dissection modalities concurrently to improve performance on identification‐based gross anatomy examinations. [ABSTRACT FROM AUTHOR]

Maternal vaccination during pregnancy, in general and against COVID-19 infection, offers protection to both mother and baby, but uptake remains suboptimal. This study aimed to explore the perceptions regarding COVID-19 vaccination in pregnancy, particularly for marginalised populations and those living with social or medical complexity. A total of 96 semi-structured in-depth interviews were conducted with 40 women, 15 partners, 21 HCPs, and 20 policy makers, across all four nations of the United Kingdom (UK), discussing their lived experience of utilising, delivering, or developing policy for COVID-19 vaccination in pregnancy during the pandemic. Three themes were derived: (1) historical and social context, (2) communication of information and guidance, and (3) appraisal and action. Together these captured the participants' legacy of mistrust in drugs during pregnancy; prior positive experiences; concerns about missing information, conflicting information, or false information about COVID-19 vaccines; and confusing guidance for pregnant women. The final theme describes the participants' behaviour and actions undertaken consequent to their experiences and the available information. The findings suggest efforts to improve COVID-19 vaccination in pregnancy may be best focused on personalised communication of information. A trusting relationship and prior positive experiences with other vaccines, both in and outside of pregnancy, positively influenced perceptions of COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Objective: examine the prevalence of driver distraction in naturalistic driving when implementing European New Car Assessment Program (Euro NCAP)-defined distraction behaviours. Background: The 2023 introduction of Occupant Status monitoring (OSM) into Euro NCAP will accelerate uptake of Driver State Monitoring (DSM). Euro NCAP outlines distraction behaviours that DSM must detect to earn maximum safety points. Distraction behaviour prevalence and driver alerting and intervention frequency have yet to be examined in naturalistic driving. Method: Twenty healthcare workers were provided with an instrumented vehicle for approximately two weeks. Data were continuously monitored with automotive grade DSM during daily work commutes, resulting in 168.8 hours of driver head, eye and gaze tracking. Results: Single long distraction events were the most prevalent, with.89 events/hour. Implementing different thresholds for driving-related and driving-unrelated glance regions impacts alerting rates. Lizard glances (primarily gaze movement) occurred more frequently than owl glances (primarily head movement). Visual time-sharing events occurred at a rate of.21 events/hour. Conclusion: Euro NCAP-described driver distraction occurs naturalistically. Lizard glances, requiring gaze tracking, occurred in high frequency relative to owl glances, which only require head tracking, indicating that less sophisticated DSM will miss a substantial amount of distraction events. Application: This work informs OEMs, DSM manufacturers and regulators of the expected alerting rate of Euro NCAP defined distraction behaviours. Alerting rates will vary with protocol implementation, technology capability, and HMI strategies adopted by the OEMs, in turn impacting safety outcomes, user experience and acceptance of DSM technology. [ABSTRACT FROM AUTHOR]

To assess the capability of determining the mixed chemical composition of urinary stones using spectral imaging properties of Dual Energy Computed Tomography (DECT) Gemstone Spectral Imaging (GSI) software. Material and Methods: Twenty-six single and 24 mixed composition ex vivo urinary stones with known chemical composition determined by Fourier-transform infrared spectroscopy (FTIR) prior to this project were scanned with DECT imaging and GSI in vitro. The major components of the stones included Uric Acid (UA), Calcium Oxalate (CaOx), Calcium Phosphate (CaP), Magnesium Ammonium Phosphate (MAP), and Cystine (Cys). A histogram to display the distribution of the effective atomic number (Z-eff) of each pixel of the tested area, spectral curve (40– 140 keV, with 10 keV interval) and Hounsfield Units (HU) of each stone scanned was provided with analysis of monochromatic images at 140 keV in the axial plane. Results: The overall pooled sensitivity, specificity, and accuracy of DECT for identifying major stone composition were 0.802, 0.831, and 0.807, respectively, with a 95% confidence interval. Accuracy was 100% for identifying UA and Cys stones. Conclusion: DECT is a superior imaging modality when compared to low dose computed tomography kidney ureter bladder scans. It allows for improved characterization of major components of urinary stones, in an accurate, non-invasive approach to pre-treatment. This can translate to urologists having greater confidence in determining patient suitability for medical or surgical management of their renal stones, in clinical practice. [ABSTRACT FROM AUTHOR]

Background: There is an emerging need to systematically investigate the causes for the increased cesarean section rates in Greece and undertake interventions so as to substantially reduce its rates. To this end, the ability of the participating Greek obstetricians to follow evidence-based guidelines and respond to other educational and behavioral interventions while managing labor will be explored, along with barriers and enablers. Herein discussed is the protocol of a stepped-wedge designed intervention trial in Greek maternity units with the aforementioned goals in mind, named ENGAGE (ENhancinG vAGinal dElivery in Greece). Methods: Twenty-two selected maternity units in Greece will participate in a multicenter stepped-wedge randomized prospective trial involving 20,000 to 25,000 births, with two of them entering the intervention period of the study each month (stepped randomization). The maternity care units entering the study will apply the suggested interventions for a period of 8–18 months depending on the time they enter the intervention stage of the study. There will also be an initial phase of the study lasting from 8 to 18 months including observation and recording of the routine practice (cesarean section, vaginal birth, and maternal and perinatal morbidity and mortality) in the participating units. The second phase, the intervention period, will include such interventions as the application of the HSOG (the Hellenic Society of Obstetrics and Gynecology) Guidelines on labor management, training on the correct interpretation of cardiotocography, and dealing with emergencies in vaginal deliveries, while the steering committee members will be available to discuss and implement organizational and behavioral changes, answer questions, clarify relevant issues, and provide practical instructions to the participating healthcare professionals during regular visits or video conferences. Furthermore, during the study, the results will be available for the participating units in order for them to monitor their own performance while also receiving feedback regarding their rates. Τhe final 2-month phase of the study will be devoted to completing follow-up questionnaires with data concerning maternal and neonatal morbidities that occurred after the completion of the intervention period. The total duration of the study is estimated at 28 months. The primary outcome assessed will be the cesarean section rate change and the secondary outcomes will be maternal and neonatal morbidity and mortality. Discussion: The study is expected to yield new information on the effects, advantages, possibilities, and challenges of consistent clinical engagement and implementation of behavioral, educational, and organizational interventions described in detail in the protocol on cesarean section practice in Greece. The results may lead to new insights into means of improving the quality of maternal and neonatal care, particularly since this represents a shared effort to reduce the high cesarean section rates in Greece and, moreover, points the way to their reduction in other countries. Trial registration: NCT 04504500 (ClinicalTrials.gov). The trial was prospectively registered. Ethics Reference No: 320/23.6.2020, Bioethics and Conduct Committee, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece [ABSTRACT FROM AUTHOR]

Background: Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection. PUDDLES is an international collaboration investigating the pandemic's impact on care for people who suffered a perinatal bereavement. Presented here are initial qualitative findings undertaken with UK-based women who suffered early pregnancy losses during the pandemic, about how they navigated the healthcare system and its restrictions, and how they were supported. Methods: In-keeping with a qualitative research design, in-depth semi-structured interviews were undertaken with an opportunity sample of women (N = 32) who suffered any early pregnancy loss during the COVID-19 pandemic. Data were analysed using a template analysis to understand women's access to services, care, and networks of support, during the pandemic following their pregnancy loss. The thematic template was based on findings from parents who had suffered a late-miscarriage, stillbirth, or neonatal death in the UK, during the pandemic. Results: All women had experienced reconfigured maternity and early pregnancy services. Data supported themes of: 1) COVID-19 Restrictions as Impractical & Impersonal; 2) Alone, with Only Staff to Support Them; 3) Reduction in Service Provision Leading to Perceived Devaluation in Care; and 4) Seeking Their Own Support. Results suggest access to early pregnancy loss services was reduced and pandemic-related restrictions were often impractical (i.e., restrictions added to burden of accessing or receiving care). Women often reported being isolated and, concerningly, aspects of early pregnancy loss services were reported as sub-optimal. Conclusions: These findings provide important insight for the recovery and rebuilding of health services in the post-pandemic period and help us prepare for providing a higher standard of care in the future and through any other health system shocks. Conclusions made can inform future policy and planning to ensure best possible support for women who experience early pregnancy loss. [ABSTRACT FROM AUTHOR]

Fostemsavir is an approved gp120‐directed attachment inhibitor and prodrug for the treatment of human immunodeficiency virus type 1 infection in combination with other antiretrovirals (ARVs) in heavily treatment‐experienced adults with multi‐drug resistance, intolerance, or safety concerns with their current ARV regimen. Initial in vitro studies indicated that temsavir, the active moiety of fostemsavir, and its metabolites, inhibited organic cation transporter (OCT)1, OCT2, and multidrug and toxin extrusion transporters (MATEs) at tested concentration of 100 uM, although risk assessment based on the current Food and Drug Administration in vitro drug–drug interaction (DDI) guidance using the mechanistic static model did not reveal any clinically relevant inhibition on OCTs and MATEs. However, a DDI risk was flagged with EMA static model predictions. Hence, a physiologically based pharmacokinetic (PBPK) model of fostemsavir/temsavir was developed to further assess the DDI risk potential of OCT and MATEs inhibition by temsavir and predict changes in metformin (a sensitive OCT and MATEs substrate) exposure. No clinically relevant impact on metformin concentrations across a wide range of temsavir concentrations was predicted; therefore, no dose adjustment is recommended for metformin when co‐administered with fostemsavir. [ABSTRACT FROM AUTHOR]

Rehabilitation from musculoskeletal injuries focuses on reestablishing and monitoring muscle activation patterns to accurately produce force. The aim of this study is to explore the use of a novel low-powered wearable distributed Simultaneous Musculoskeletal Assessment with Real-Time Ultrasound (SMART-US) device to predict force during an isometric squat task. Participants (N = 5) performed maximum isometric squats under two medical imaging techniques; clinical musculoskeletal motion mode (m-mode) ultrasound on the dominant vastus lateralis and SMART-US sensors placed on the rectus femoris, vastus lateralis, medial hamstring, and vastus medialis. Ultrasound features were extracted, and a linear ridge regression model was used to predict ground reaction force. The performance of ultrasound features to predict measured force was tested using either the Clinical M-mode, SMART-US sensors on the vastus lateralis (SMART-US: VL), rectus femoris (SMART-US: RF), medial hamstring (SMART-US: MH), and vastus medialis (SMART-US: VMO) or utilized all four SMART-US sensors (Distributed SMART-US). Model training showed that the Clinical M-mode and the Distributed SMART-US model were both significantly different from the SMART-US: VL, SMART-US: MH, SMART-US: RF, and SMART-US: VMO models (p < 0.05). Model validation showed that the Distributed SMART-US model had an R2 of 0.80 ± 0.04 and was significantly different from SMART-US: VL but not from the Clinical M-mode model. In conclusion, a novel wearable distributed SMART-US system can predict ground reaction force using machine learning, demonstrating the feasibility of wearable ultrasound imaging for ground reaction force estimation. [ABSTRACT FROM AUTHOR]

Background: Multi-disciplinary Meetings (MDM) play a crucial role in complex patient care, involving input from various specialties to formulate evidence-based management plans. However, traditional unidirectional approaches and reliance on manual processes have led to inefficiencies in the MDM pathway. Aims: This study identified and aimed to improve four critical moments where Information Communication Technologies (ICTs) could enhance the MDM process. Initial referral, information synthesis, meeting presentation and the creation of actionable/auditable items. Methods: Microsoft Office Forms, a customisable survey platform, was implemented to streamline MDM processes. Forms were created to gather patient information, develop agendas, and track outcomes. Automation through Excel scripting further optimised data organisation and agenda creation. Results: Referrals using Forms takes an average of 7 min and 21 s. Over 15 months the submission time has reduced and is trending towards under 5 min for each referral. The system's scalability has allowed 1744 cases to be discussed over a 15-month period. Active departments using Forms is expanding to seven from two prior to the pilot. Conclusion(s): Microsoft Office Forms proved to be a valuable and adaptable tool for MDMs, offering benefits such as streamlined information gathering, real-time collaboration, and scalability. The study highlights the potential of existing tools within Microsoft licenses for healthcare process optimisation, providing a cost-effective and customisable solution for MDM agendas. While recognising some limitations, the study concludes that leveraging Microsoft Office Forms can significantly improve system efficiency in a multi-disciplinary setting. [ABSTRACT FROM AUTHOR]

To assess the utility of targeted surveillance for the identification of moderate to profound PCHI in babies who pass newborn hearing screening in England and have risk factors. Retrospective analysis. A total of 3,957,891 children born 01/04/2012–31/03/2018 in England. A total of 7148 PCHI cases were identified (1.81 per 1,000 babies). 6,707 followed an immediate referral from the screen (1 per 16 referrals), 51 followed targeted surveillance referral (1 per 540 referrals) and 390 without a referral. Audiology uptake was higher following an immediate referral (96.7% overall, 77.2% within NHSP-defined timescales) than following targeted surveillance (63.8% overall, 51.1% within 52 weeks of birth). The screening was 94.5% sensitive overall, with similar sensitivities for each of the risk factors. General linearised logistic regression models identified syndrome as the risk factor with the highest odds ratio (14.08 for all babies, 22.19 for babies without immediate referral). Close family history of hearing loss was the next highest (10.93 for all babies, 12.29 for babies without immediate referral). The evidence for a targeted surveillance programme, based on risk factors, for babies in England who pass the newborn screen is not strong. [ABSTRACT FROM AUTHOR]

Objective: During public health emergencies such as the ongoing COVID-19 illness pandemic, it is essential to rapidly disseminate crisis messages which often contain embedded health directives. This study investigated which of three variants of the same messages (neutral tone, positive/compassionate tone, negative/fear-inducing tone) were most likely to motivate readers to engage in the health behavior proscribed in the message. Participants: Participants were 87 female and 41 male undergraduates at an urban university in the northeast U.S. Methods: A survey with three versions of eight different COVID messages containing health directives was administered. Results: Those who indicated stronger influence of positive/compassionate crisis messages (i.e., had higher Crisis Messages Survey scores) had higher adaptive health engagement scores, lower worry scores, and were likely to have had a past diagnosis of COVID-19. Moreover, a regression model including COVID-19 status and worry scores accounted for a significant proportion of variance in Crisis Messages Survey scores. Conclusions: Findings indicate that the use of neutral and compassionate language is optimal in motivating health behaviors embedded in university crisis messages. [ABSTRACT FROM AUTHOR]

This article examines the use of a standardized set of outcomes, known as a Core Outcome Set (COS), in clinical trials for anxiety disorders. The study found that there was a decrease in reporting of outcome measures before the publication of the COS, but no significant change after. The most commonly measured outcomes were 'symptom burden' and 'functioning', while 'medication side effects' and 'absenteeism' were less frequently measured. The study also found that the continent and funding type of the trials had an impact on outcome measurement, with trials from Australia and those funded by industry reporting the highest percentage of COS outcomes. The lack of adherence to the COS leads to inconsistent outcomes across trials, making it difficult to compare treatments and make clinical decisions. Further research is needed to identify barriers to adherence and increase awareness of the importance of the COS. [Extracted from the article]

A recent industry perspective published in this journal describes the benefits received by drug companies from participation in the MIDD Pilot Program. Along with the primary objectives of supporting good decision‐making in drug development, there were substantial savings in time and development costs. Furthermore, many sponsors reported qualitative benefits such as new learnings and clarity on MIDD strategies and methodology that could be applied to other development programs. Based on the success of the Pilot Program, the FDA recently announced the continuation of the MIDD Paired Meeting Program as part of the Prescription Drug User Fee Act (PDUFA VII). In this report, we describe the collective experiences of industry participants in the MIDD Program to date, including all aspects of the process from meeting request submission to follow‐up actions. The purpose is to provide future participants with information to optimize the value of the MIDD Program. [ABSTRACT FROM AUTHOR]

Objective: Measuring disability as a concept of impaired global function enables beneficiaries of treatment, the impact of treatment, and targets of health system investment to be rigorously assessed. Measures of disability are not well established for cleft lip and palate. This study aims to systematically review disability weight (DW) studies pertaining to orofacial clefts (OFCs) and identify methodological strengths and shortcomings of each approach. Design: Systematic literature review of studies that met the following criteria: (1) peer-reviewed publication, (2) focus on disability valuation, (3) mention orofacial clefts, and (4) publication January 2001-December 2021. Setting: None. Patients/Participants: None. Interventions: None. Main Outcome Measure(s): Disability weight method of valuation and the value itself. Results: The final search strategy yielded 1,067 studies. Seven manuscripts were ultimately included for data extraction. The disability weights used in our studies, including those newly generated or taken from the Global Burden of Disease Studies (GBD), ranged widely for isolated cleft lip (0.0–0.100) and cleft palate with or without cleft lip (0.0−0.269). The GBD studies limited their consideration of cleft sequelae informing disability weights to impact on appearance and speech-related concerns, while other studies accounted for comorbidities such as pain and social stigma. Conclusions: Current measures of cleft disability are sparse, inadequately reflect the comprehensive impact of an OFC on function and socialization, and are limited in detail or supporting evidence. Use of a comprehensive health state description in evaluating disability weights offers a realistic means of accurately representing the diverse sequelae of an OFC. [ABSTRACT FROM AUTHOR]

Background: Testing positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The COVID-19 pandemic caused unprecedented disruption to everyday life. This included major reconfiguration of maternal, child, and perinatal mental health and care services and provision. This study aimed to investigate the experiences of those who tested positive for COVID-19 during pregnancy, labour and birth, or the early postnatal period. Methods: National on-line recruitment from across the United Kingdom resulted in sixteen mothers being invited to qualitative semi-structured interviews to understand the experiences of mothers who had been infected by COVID-19 during pregnancy, labour and birth, or the early postnatal period. Interviews were conducted, recorded, and transcribed using video-conferencing software. A Grounded Theory approach was used to analyse the data gathered pertaining to women's experiences of their positive COVID-19 diagnosis during pregnancy, labour and birth, or the early postnatal period. Results: The theory of 'Oscillating Autonomy – Losing and Seeking to Regain Control by Striving for Agency' was developed, comprising three main themes: 'Anxious Anticipation: The fear of infection was worse than COVID-19 itself'; 'Fluctuating Agency: What changed when COVID-19 took control'; and 'Reclaiming Control: Seeking reassurance during COVID-19 positivity'. Testing positive for COVID-19 whilst pregnant, during labour or birth, or in the early postnatal period was associated with a perceived loss of control. Those who were able to regain that control felt more secure in their situation. Conclusions: Support was paramount to manage increased vulnerability, as was reassurance achieved by information seeking and positive action including increased health monitoring and COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

The ecology of forest ecosystems depends on the composition of trees. Capturing fine-grained information on individual trees at broad scales provides a unique perspective on forest ecosystems, forest restoration, and responses to disturbance. Individual tree data at wide extents promises to increase the scale of forest analysis, biogeographic research, and ecosystem monitoring without losing details on individual species composition and abundance. Computer vision using deep neural networks can convert raw sensor data into predictions of individual canopy tree species through labeled data collected by field researchers. Using over 40,000 individual tree stems as training data, we create landscape-level species predictions for over 100 million individual trees across 24 sites in the National Ecological Observatory Network (NEON). Using hierarchical multi-temporal models fine-tuned for each geographic area, we produce open-source data available as 1 km2 shapefiles with individual tree species prediction, as well as crown location, crown area, and height of 81 canopy tree species. Site-specific models had an average performance of 79% accuracy covering an average of 6 species per site, ranging from 3 to 15 species per site. All predictions are openly archived and have been uploaded to Google Earth Engine to benefit the ecology community and overlay with other remote sensing assets. We outline the potential utility and limitations of these data in ecology and computer vision research, as well as strategies for improving predictions using targeted data sampling. Detailed maps of tree species can be used for forest analysis, biogeographic research and ecosystem monitoring. This study provides individual tree species maps for 24 sites in the United States National Ecological Observatory Network (NEON), covering 80 tree species and 100 million individuals. [ABSTRACT FROM AUTHOR]

Background: Lipodystrophy syndromes are a heterogeneous group of rare, life-limiting diseases characterized by a selective loss of adipose tissue and severe metabolic complications. There is a paucity of information describing the experiences and challenges faced by physicians who have seen and treated patients with lipodystrophy. This study aimed to provide a better understanding of the physician's perspective regarding the patient journey in lipodystrophy, including diagnosis, the burden of disease, and treatment approaches. Methods: Thirty-three physicians from six countries who had seen or treated patients with lipodystrophy were interviewed using a semi-structured questionnaire. Interviews were transcribed, anonymized, and analyzed for themes and trends. Four main themes were developed: (1) the diagnostic journey in lipodystrophy including the disease features or 'triggers' that result in the onward referral of patients to specialist medical centers with experience in managing lipodystrophy; (2) the impact of lipodystrophy on patient quality of life (QoL); (3) the use of standard therapies and leptin replacement therapy (metreleptin) in lipodystrophy, and (4) barriers to metreleptin use. Results: Participants reported that, due to their rarity and phenotypic heterogeneity, lipodystrophy cases are frequently unrecognized, leading to delays in diagnosis and medical intervention. Early consultation with multidisciplinary specialist medical teams was recommended for suspected lipodystrophy cases. The development and progression of metabolic complications were identified as key triggers for the referral of patients to specialist centers for follow-up care. Participants emphasized the impact of lipodystrophy on patient QoL, including effects on mental health and self-image. Although participants routinely used standard medical therapies to treat specific metabolic complications associated with lipodystrophy, it was acknowledged that metreleptin was typically required in patients with congenital generalized lipodystrophy and in some acquired generalized and partial lipodystrophy cases. A lack of experience among some participants and restrictions to access remained as barriers to metreleptin use. Conclusions: To our knowledge, this is one of the first studies describing the qualitative experiences of physicians regarding the diagnosis and management of lipodystrophy. Other physician-centered studies may help increase the awareness of lipodystrophy among the wider medical community and support clinical approaches to this rare disease. [ABSTRACT FROM AUTHOR]

This study evaluates the efficacy of bias-correction (BC) and data assimilation (DA) techniques in refining hydrological model predictions. Both approaches are routinely used to enhance hydrological forecasts, yet there have been no studies that have systematically compared their utility. We focus on the application of these techniques to improve operational river flow forecasts in a diverse dataset of 316 catchments in the UK, using the Ensemble Streamflow Prediction (ESP) method applied to the GR4J hydrological model. This framework is used in operational seasonal forecasting, providing a suitable testbed for method application. Assessing the impacts of these two approaches on model performance and forecast skill, we find that BC yields substantial and generalised improvements by rectifying errors post-simulation. Conversely, DA, adjusting model states at the start of the forecast period, provides more subtle enhancements, with the biggest effects seen at short lead times in catchments impacted by snow accumulation/melting processes in winter and spring, and catchments with high Base Flow Index (BFI) during summer months. The choice between BC and DA involves trade-offs, considering conceptual differences, computational demands, and uncertainty handling. Our findings emphasise the need for selective application based on specific scenarios and user requirements. This underscores the potential for developing a selective system (e.g., decision-tree) to refine forecasts effectively and deliver user-friendly hydrological predictions. While further work is required to enable implementation, this research contributes insights into the relative strengths and weaknesses of these forecast enhancement methods. These could find application in other forecasting systems, aiding the refinement of hydrological forecasts and meeting the demand for reliable information by end-users. [ABSTRACT FROM AUTHOR]