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Background: The ActiPASS software was developed from the open-source Acti4 activity classification algorithm for thigh-worn accelerometry. However, the original algorithm has not been validated in children or compared with a child-specific set of algorithm thresholds. This study aims to evaluate the accuracy of ActiPASS in classifying activity types in children using 2 published sets of Acti4 thresholds. Methods: Laboratory and free-living data from 2 previous studies were used. The laboratory condition included 41 school-aged children (11.0 [4.8] y; 46.5% male), and the free-living condition included 15 children (10.0 [2.6] y; 66.6% male). Participants wore a single accelerometer on the dominant thigh, and annotated video recordings were used as a reference. Postures and activity types were classified with ActiPASS using the original adult thresholds and a child-specific set of thresholds. Results: Using the original adult thresholds, the mean balanced accuracy (95% CI) for the laboratory condition ranged from 0.62 (0.56–0.67) for lying to 0.97 (0.94–0.99) for running. For the free-living condition, accuracy ranged from 0.61 (0.48–0.75) for lying to 0.96 (0.92–0.99) for cycling. Mean balanced accuracy for overall sedentary behavior (sitting and lying) was ≥0.97 (0.95–0.99) across all thresholds and conditions. No meaningful differences were found between the 2 sets of thresholds, except for superior balanced accuracy of the adult thresholds for walking under laboratory conditions. Conclusions: The results indicate that ActiPASS can accurately classify different basic types of physical activity and sedentary behavior in children using thigh-worn accelerometer data. [ABSTRACT FROM AUTHOR]

Volunteer leaders and staff in NIRSA: Leaders in Collegiate Recreation (NIRSA) aimed to establish shared norms for belonging, guided by recommendations from the Association's climate study conducted by 122 Consulting Group. The climate study precipitated the formation of an implementation team for justice, diversity, equity, and inclusion (JDEI). This case study explored stakeholders' perspectives about shared norms (diversity, equity, inclusion, justice, and respect) for belonging, using multiple data points (historical context, JDEI trends, association reports, and focus groups) to ignite action. Analysis of these perspectives at in-person and virtual NIRSA educational sessions identified three themes: positive reception, action/accountability, and integration/ongoing engagement. The study provides valuable insights for association leaders to shape belonging initiatives by using shared expectations, thus effectively guiding actions based on the findings of a climate study. This study is essential for associations, and its findings can also empower members to drive similar initiatives on their respective campuses. [ABSTRACT FROM AUTHOR]

To understand the environmental determinants of physical activity (PA), precise spatial localization is crucial. This cross-sectional study focuses on the spatiotemporal distribution of PA among Czech adolescents (n = 171) using Global Positioning System loggers and accelerometers. The results showed that adolescents spent most of their time in sedentary behavior, with 57.2% and 58.5% of monitored time at home and school, respectively. The park and playground had the lowest proportion of sedentary behavior but also the lowest amount of moderate to vigorous PA (MVPA). However, when considering the time spent in each domain, the highest proportion of MVPA was seen in publicly accessible playgrounds (13.3% of the time). Chi-square analysis showed that the relative distribution of different PA intensities did not differ across spatial domains. Based on these results, the authors propose 2 key strategies for increasing MVPA in adolescents: Increase the time spent in activity-supportive environments, such as parks and playgrounds, and design techniques to increase MVPA at home and school settings. [ABSTRACT FROM AUTHOR]

One of the most reactive intermediates for oxidative reactions is the oxyl radical, an electron-deficient oxygen atom. The discovery of a new vibration upon photoexcitation of the oxygen evolution catalysis detected the oxyl radical at the SrTiO3 surface. The vibration was assigned to a motion of the sub-surface oxygen underneath the titanium oxyl (Ti–O●−) created upon hole transfer to (or electron extraction from) a hydroxylated surface site. Evidence for such an interfacial mode is derived from its spectral shape, which exhibited a Fano resonance—a coupling of a sharp normal mode to continuum excitations. Here, this Fano resonance is utilized to derive precise formation kinetics of the oxyl radical and its associated potential energy surface (PES). From the Fano lineshape, the formation kinetics are obtained from the anti-resonance (the kinetics of the coupling factor), the resonance (the kinetics of the coupled continuum excitations), and the frequency integrated spectrum (the kinetics of the normal mode's cross-section). All three perspectives yield logistic function growth with a half-rise of 2.3 ± 0.3 ps and a time constant of 0.48 ± 0.09 ps. A non-equilibrium transient associated with photoexcitation is separated from the rise of the equilibrated PES. The logistic function characterizes the oxyl coverage at the very initial stages (t ∼ 0) to have an exponential growth rate that quickly decreases toward zero as a limiting coverage is reached. Such time-dependent reaction kinetics identify a dynamic activation barrier associated with the formation of a PES and quantify it for oxyl radical coverage. [ABSTRACT FROM AUTHOR]

Non-accidental violence in women's gymnastics has gained significant attention, and is a sport where gender is clearly differentiated. Despite the volume of gymnastics research on these themes it seemingly had little impact in preventing harm. We conducted a critical interpretative synthesis of 45 articles to reexamine the literature for understanding of, and connections between, gender and violence. We found that where gender viewed as a structure was explicit, violence was not. Conversely where violence was explicit, gender was implicit and viewed in individualist terms. Only one article explicitly connected gender and violence recognizing violence as a gendered outcome. We encourage researchers to incorporate gender as a structure in analytical inquiries and identify the wider contexts and associated mechanisms through which gender intersects with violence. Doing so can help to develop prevention measures that align with international definitions of gender-based violence. [ABSTRACT FROM AUTHOR]

Polaritonic states, which are formed by resonances between a molecular excitation and the photonic mode of a cavity, have a number of useful properties that offer new routes to control molecular photochemistry using electric fields. To provide a theoretical description of how polaritonic states affect the real-time electron dynamics in molecules, a new method is described where the effects of strong light–molecule coupling are implemented using real-time electronic structure theory. The coupling between the molecular electronic states and the cavity is described by the Pauli–Fierz Hamiltonian, and transitions between polaritonic states are induced via an external time-dependent electric field using time-dependent configuration interaction (TDCI) theory, producing quantum electrodynamics TDCI (QED-TDCI). This method is used to study laser-induced ultrafast charge transfer and dipole-switching dynamics of the LiCN molecule inside a cavity. The increase in cavity coupling strength is found to have a significant impact on the energies and transition dipole moments of the molecule–cavity system. The convergence of the polaritonic state energies as a function of the number of included electronic and photonic basis states is discussed. [ABSTRACT FROM AUTHOR]

The letter to the editor discusses the importance of long-term follow-up of autologous stem cell transplantation (ASCT) for mantle cell lymphoma (MCL). A retrospective study in Alberta, Canada, involving 141 patients who underwent ASCT as part of first-line therapy for MCL between 2000 and 2022, revealed a median progression-free survival (PFS) of 11.3 years and an overall survival (OS) of 14.0 years. The study suggests that ASCT achieves durable remissions in MCL, with a subset of patients experiencing remissions lasting 10-20 years, indicating potential functional cure. The findings highlight the need for further research and longer-term follow-up data to determine the efficacy of ASCT in MCL treatment. [Extracted from the article]

Objective: To assess the association between provider type (primary care provider [PCP] or perioperative provider) and excessive preoperative testing. Study Design: Cross‐sectional study. Setting: Academic medical center. Methods: Electronic medical records of adult patients who obtained an outpatient preoperative assessment and underwent surgery in the Department of Otolaryngology–Head and Neck Surgery during the first 2 weeks of January 2019 (n = 94) were reviewed. Patients receiving preoperative tests beyond those recommended by the guidelines were deemed to have had excessive testing. Descriptive statistics were used to characterize the study population. Simple and multivariate logistic regression were used to analyze the association between the outcome and the predictor variables. Results: Overall, 44.7% of preoperative evaluations had excessive testing. Patients who had their preoperative evaluation performed by a perioperative provider had 89% lower odds of having excessive preoperative testing compared to those evaluated by a PCP (odds ratio = 0.11, 95% confidence interval: [0.03, 0.37], P <.001). Female sex, younger age, and higher risk of major adverse cardiac events were associated with greater odds of excessive testing. Conclusion: Excessive preoperative testing is more commonly performed by PCPs compared to perioperative providers. These results give preliminary evidence in support of a potential shift in the clinical responsibility of preoperative evaluation from PCPs to perioperative providers in order to reduce excessive testing and promote high‐value health care. The next steps include validating these findings, identifying reasons for differential guideline concordance, and intervening accordingly. [ABSTRACT FROM AUTHOR]

Openness and transparency in the research process are a prerequisite to the production of high quality research outputs. Efforts to maximise these features have substantially accelerated in recent years, placing open and transparent research practices at the forefront of funding and related priorities, and encouraging investment in resources and infrastructure to enable such practices. Despite these efforts, there has been no systematic documentation of current practices, infrastructure, or training and resources that support open and transparent research in the UK. To address this gap, we developed and conducted the Open and Transparent Research Practices survey, a large-scale audit study completed by research-active staff in UK research institutions to better understand existing practices, needs, support, and barriers faced when implementing open and transparent research. The data presented here capture responses from over 2,500 research-active staff based at 15 institutions affiliated with the UK Reproducibility Network. The data provide a snapshot of open research practices that can be used to identify barriers, training needs, and areas that require greater investments. [ABSTRACT FROM AUTHOR]

Openness and transparency in the research process are a prerequisite to the production of high quality research outputs. Efforts to maximise these features have substantially accelerated in recent years, placing open and transparent research practices at the forefront of funding and related priorities, and encouraging investment in resources and infrastructure to enable such practices. Despite these efforts, there has been no systematic documentation of current practices, infrastructure, or training and resources that support open and transparent research in the UK. To address this gap, we developed and conducted the Open and Transparent Research Practices survey, a large-scale audit study completed by research-active staff in UK research institutions to better understand existing practices, needs, support, and barriers faced when implementing open and transparent research. The data presented here capture responses from over 2,500 research-active staff based at 15 institutions affiliated with the UK Reproducibility Network. The data provide a snapshot of open research practices that can be used to identify barriers, training needs, and areas that require greater investments. [ABSTRACT FROM AUTHOR]

Copyright of Contemporary Accounting Research is the property of Canadian Academic Accounting Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Real-time (RT) electronic structure methods provide a natural framework for describing light–matter interactions in arbitrary time-dependent electromagnetic fields (EMF). Optically induced excited state transitions are of particular interest, which require tuned EMF to drive population transfer to and from the specific state(s) of interest. Intersystem crossing, or spin-flip, may be driven through shaped EMF or laser pulses. These transitions can result in long-lived "spin-trapped" excited states, which are especially useful for materials requiring charge separation or protracted excited state lifetimes. Time-dependent configuration interaction (TDCI) is unique among RT methods in that it may be implemented in a basis of eigenstates, allowing for rapid propagation of the time-dependent Schrödinger equation. The recent spin–orbit TDCI (TD-SOCI) enables a real-time description of spin-flip dynamics in an arbitrary EMF and, therefore, provides an ideal framework for rational pulse design. The present study explores the mechanism of multiple spin-flip pathways for a model transition metal complex, FeCO, using shaped pulses designed to drive controlled intersystem crossing and charge transfer. These results show that extremely tunable excited state dynamics can be achieved by considering the dipole transition matrix elements between the states of interest. [ABSTRACT FROM AUTHOR]

The aim of this investigation was to quantify professional rugby union player activity profiles after the most intense (peak) passages of matches. Movement data were collected from 30 elite and 30 subelite professional rugby union athletes across respective competitive seasons. Accelerometer-derived PlayerLoad and global navigation satellite system–derived measures of mean speed and metabolic power were analyzed using a rolling-average method to identify the most intense 5- to 600-second passages (ie, worst-case scenarios) within matches. Player activity profiles immediately post their peak 5- to 600-second match intensity were identified using 5 epoch duration-matched intervals. Mean speed, metabolic power, and PlayerLoad declined sharply (∼29%–86%) after the most intense 5 to 600 seconds of matches. Following the most intense periods of rugby matches, exercise intensity declined below the average match-half intensity 81% of the time and seldom returned to or exceeded it, likely due to a host of individual physical and physiological characteristics, transient and/or accumulative fatigue, contextual factors, and pacing strategies. Typically, player exercise intensities after the most intense passages of matches were similar between match halves, positional groups, and levels of rugby competition. Accurate identification of the peak exercise intensities of matches and movement thereafter using novel methodologies has improved the limited understanding of professional rugby union player activity profiles following the worst-case scenarios of matches. Findings of the present study may inform match-representative training prescription, monitoring, and tactical match decisions (eg, substitutions and positional changes). [ABSTRACT FROM AUTHOR]

Openness and transparency in the research process are a prerequisite to the production of high quality research outputs. Efforts to maximise these features have substantially accelerated in recent years, placing open and transparent research practices at the forefront of funding and related priorities, and encouraging investment in resources and infrastructure to enable such practices. Despite these efforts, there has been no systematic documentation of current practices, infrastructure, or training and resources that support open and transparent research in the UK. To address this gap, we developed and conducted the Open and Transparent Research Practices survey, a large-scale audit study completed by research-active staff in UK research institutions to better understand existing practices, needs, support, and barriers faced when implementing open and transparent research. The data presented here capture responses from over 2,500 research-active staff based at 15 institutions affiliated with the UK Reproducibility Network. The data provide a snapshot of open research practices that can be used to identify barriers, training needs, and areas that require greater investments. [ABSTRACT FROM AUTHOR]

Objective: COVID-19 increased moral distress (MD) and moral injury (MI) among healthcare professionals (HCPs). The purpose of this study was to examine MD and MI among inpatient and outpatient HCPs during March of 2022. The study sought to examine (1) the relationship between MD and MI; (2) the relationship between MD/MI and pandemic-related burnout and resilience; and (3) the degree to which HCPs experienced pandemic-related MD and MI based on background characteristics. Methods: A survey was conducted to measure MD, MI, burnout, resilience, and intent to leave healthcare at two academic medical centers during a 4-week period. A convenience sample of 184 participants (physicians, nurses, residents, respiratory therapists, advanced practice providers) completed the survey. In this mixed-methods approach, researchers analyzed both quantitative and qualitative survey data and triangulated the findings. Results: A moderate association was found between MD and MI (r =.47, P <.001). Regression results indicated that burnout was significantly associated with both MD and MI (P =.02 and P <.001, respectively), while intent to leave was associated only with MD (P <.001). Qualitative results yielded eight sources of MD and MI: workload, distrust, lack of teamwork/collaboration, loss of connection, lack of leadership, futile care, outside stressors, and vulnerability. Conclusions: While interrelated conceptually, MD and MI should be viewed as distinct constructs. Many HCPs were significantly impacted by the COVID-19 pandemic, with MD and MI being experienced by those in all HCP categories. Understanding the sources of MD and MI among HCPs could help to improve well-being, work satisfaction, and the quality of patient care. [ABSTRACT FROM AUTHOR]

Introduction: To promote optimal healthcare delivery, safeguarding older adults from the risks associated with inappropriate medication use is paramount. Objective: This study aims to evaluate the effectiveness of implementing the Qatar Tool for Reducing Inappropriate Medication (QTRIM) in ambulatory older adults to enhance medication safety. Method: The QTRIM was developed by an expert consensus panel using the Beers Criteria and contained a list of potentially inappropriate medications (PIMs) based on the local formulary. Using quality improvement methodology, it was piloted and implemented in two outpatient pharmacy settings serving geriatric medicine and dermatology clinics at Rumailah Hospital, Qatar. Key performance indicators (KPIs) using implementation documentation as a process measure and the percentage reduction in PIM prescriptions as an outcome measure were assessed before and after QTRIM implementation. This study was conducted between July 2022 and September 2023. Results: In the outpatient department (OPD) geriatric pharmacy, the prescription rate of PIMs was reduced from an average of 1.2 ± 0.7 PIMs per 1000 orders in 2022 to an average of 0.8 ± 0.2 PIMs per 1000 orders in 2023. In the OPD geriatric pharmacy, the results showed a 66.6% reduction in tricyclic antidepressants (TCAs) (from 30 to 10), a reduction in first-generation antihistamines by 51.7% (29 to 14), and muscle relaxants by 33.3% (36 to 24). While in dermatology, the older adult prescription rate of PIMs was reduced from an average of 8 ± 3 PIMs per 1000 orders in 2022 to a rate of 5 ± 3 PIMs per 1000 orders in 2023; the most PIM reductions were (49.4%) in antihistamines (from 89 to 45), while muscle relaxants and TCAs showed a minimal reduction. Conclusions: Implementing QTRIM with pharmacy documentation monitoring markedly reduced the PIMs dispensed from two specialized outpatient pharmacies serving older adults. It may be a promising effective strategy to enhance medication safety in outpatient pharmacy settings. [ABSTRACT FROM AUTHOR]

Northwest Atlantic leatherback (Dermochelys coriacea) sea turtle populations are endangered and have low hatching success compared to other sea turtles. Hatchling survival is an important element of their conservation. This longitudinal study assessed developmental phase and pathology of leatherback embryos and hatchlings at Sandy Point National Wildlife Refuge (SPNWR) on St. Croix, US Virgin Islands, in 2019 to identify patterns in mortality and lesions across a nesting season, and to make regional comparisons. Hatching and emergence success averaged 63.6% and 56.6%, respectively, and both differed significantly by month. 'Breakout' analysis was conducted on 41 nests and showed a preponderance of unhatched eggs lacking grossly evident embryological development (52%). Necropsies were performed on 79 unhatched and dead in nest individuals from 34 nests, and most (58%) had lesions including inflammation associated with microorganisms (34%), renal mineralization (15%), mild multifocal skeletal muscle degeneration and necrosis (5%), and anatomic malformations (4%). Inflammatory lesions included chorioallantoitis, esophagitis, stomatitis, dermatitis, gastritis, and yolk sacculitis. These were associated with bacteria (n = 13), fungi (n = 4), or both (n = 7). Sex was determined histologically and was predominantly female (90%) with no males identified in nests laid after 3 April 2019. Although hatching success was higher in in situ relative to relocated nests, embryological development and lesion patterns were similar in both groups. Patterns of lesions observed in leatherback embryos and hatchlings did not differ across the season and are comparable to other Caribbean nesting sites. Future studies pairing 'breakout' and pathological analyses with assessments of potentially influential environmental and/or maternal factors could help develop targeted strategies for improving hatchling production. [ABSTRACT FROM AUTHOR]

The brain must guide immediate responses to beneficial and harmful stimuli while simultaneously writing memories for future reference. While both immediate actions and reinforcement learning are instructed by dopamine, how dopaminergic systems maintain coherence between these 2 reward functions is unknown. Through optogenetic activation experiments, we showed that the dopamine neurons that inform olfactory memory in Drosophila have a distinct, parallel function driving attraction and aversion (valence). Sensory neurons required for olfactory memory were dispensable to dopaminergic valence. A broadly projecting set of dopaminergic cells had valence that was dependent on dopamine, glutamate, and octopamine. Similarly, a more restricted dopaminergic cluster with attractive valence was reliant on dopamine and glutamate; flies avoided opto-inhibition of this narrow subset, indicating the role of this cluster in controlling ongoing behavior. Dopamine valence was distinct from output-neuron opto-valence in locomotor pattern, strength, and polarity. Overall, our data suggest that dopamine's acute effect on valence provides a mechanism by which a dopaminergic system can coherently write memories to influence future responses while guiding immediate attraction and aversion. Dopamine is important for guiding immediate responses to beneficial and harmful stimuli and simultaneously writing memories for future reference. This study shows how dopaminergic systems mediate both functions in Drosophila. [ABSTRACT FROM AUTHOR]

The complexities encountered in microbial metabolic engineering continue to elude prediction and design. Unravelling these complexities requires strategies that go beyond conventional genetics. Using multiplex mutagenesis with double stranded (ds) DNA, we extend the multiplex repertoire previously pioneered using single strand (ss) oligonucleotides. We present ReaL-MGE (Recombineering and Linear CRISPR/Cas9 assisted Multiplex Genome Engineering). ReaL-MGE enables precise manipulation of numerous large DNA sequences as demonstrated by the simultaneous insertion of multiple kilobase-scale sequences into E. coli, Schlegelella brevitalea and Pseudomonas putida genomes without any off-target errors. ReaL-MGE applications to enhance intracellular malonyl-CoA levels in these three genomes achieved 26-, 20-, and 13.5-fold elevations respectively, thereby promoting target polyketide yields by more than an order of magnitude. In a further round of ReaL-MGE, we adapt S. brevitalea to malonyl-CoA elevation utilizing a restricted carbon source (lignocellulose from straw) to realize production of the anti-cancer secondary metabolite, epothilone from lignocellulose. Multiplex mutagenesis with dsDNA enables the incorporation of lengthy segments that can fully encode additional functions. Additionally, the utilization of PCR to generate the dsDNAs brings flexible design advantages. ReaL-MGE presents strategic options in microbial metabolic engineering. ReaL-MGE (Recombineering and Linear CRISPR/Cas9 assisted Multiplex Genome Engineering) enables precise insertion of large DNA sequences in multiple species. Here, authors demonstrate its utility in enhancing malonyl-CoA levels and producing valuable compounds like epothilone from lignocellulose. [ABSTRACT FROM AUTHOR]

Background: The unprecedented increase in the older population and ever-increasing incidence of dementia are leading to a "silver tsunami" in upcoming decades. To combat multimorbidity and maintain daily activities, elderly people face a high prevalence of polypharmacy. However, how these medications affect dementia-related pathology, such as Alzheimer's β-amyloid (Aβ) fibrils formation, remains unknown. In the present study, we aimed to analyze the medication profiles of Alzheimer's disease (AD; n = 124), mild cognitive impairment (MCI; n = 114), and non-demented (ND; n = 228) patients to identify highly prevalent drugs and to determine the effects of those drugs on Aβ fibrils formation. Methods: Study subjects (≥ 65 years) were recruited from an academic geriatric practice that heavily focuses on memory disorders. The disease state was defined based on the score of multiple cognitive assessments. Individual medications for each subject were listed and categorized into 10 major drug classes. Statistical analysis was performed to determine the frequency of individual and collective drug classes, which are expressed as percentages of the respective cohorts. 10 µM monomeric β-amyloid (Aβ) 42 and fibrillar Aβ (fAβ) were incubated for 6–48 h in the presence of 25 µM drugs. fAβ was prepared with a 1:10 ratio of Aβ42 to Aβ40. The amount of Aβ fibrils was monitored using a thioflavin T (Th-T) assay. Neuronal cells (N2A and SHSY-5Y) were treated with 25 µM drugs, and cell death was measured using a lactose dehydrogenase (LDH) assay. Results: We noticed a high prevalence (82–90%) of polypharmacy and diverse medication profiles including anti-inflammatory (65–77%), vitamin and mineral (64–72%), anti-cholesterol (33–41%), anti-hypersensitive (35–39%), proton pump inhibitor (23–34%), anti-thyroid (9–21%), anti-diabetic (5–13%), anti-constipation (9–11%), anti-coagulant (10–13%), and anti-insomnia (9–20%) drugs in the three cohorts. Our LDH assay with 18 highly prevalent drug components showed toxic effects of Norvasc, Tylenol, Colace, and Plavix on N2A cells, and of vitamin D and Novasc on SH-SY5Y cells. All these drugs except Colace significantly reduced the amount of Aβ fibril when incubated with Aβ42 for a short period (6 h). However, Lipitor, vitamin D, Levothyroxine, Prilosec, Flomax, and Norvasc prominently reduce the amount of fibrils when incubated with monomeric Aβ42 for a longer period (48 h). Furthermore, our disaggregation study with fAβ showed consistent results for cholecalciferol (vitamin D), omeprazole (Prilosec), clopidogrel hydrogensulfate (Flomax), levothyroxine, and amlodipine (Norvasc). The chemical structures of these four efficient molecules contain polyphenol components, a characteristic feature of the structures of polyphenolic inhibitors of Aβ fibrillation. Conclusion: A higher polypharmacy incidence was observed in an elderly population of 228 ND, 114 MCI, and 124 AD patients. We found that several highly recommended drug components, including vitamin D3, Levothyroxine, Prilosec, Flomax, and Norvasc, efficiently reduce the amount of fibrils formed by monomeric Aβ42 and existing preformed Aβ fibrils in vitro. However, only Levothyroxine was able to prevent Aβ-mediated toxicity to SH-SY5Y cells. Our study suggested that these drugs likely function as polyphenolic inhibitors of Aβ. [ABSTRACT FROM AUTHOR]

We explore the optical properties of La3Ni2O7 bilayer nickelates by using density functional theory including a Coulomb repulsion term. Convincing agreement with recent experimental ambient-pressure spectra is achieved for U ~ 3 eV, which permits tracing the microscopic origin of the characteristic features. Simultaneous consistency with angle-resolved photoemission spectroscopy and x-ray diffraction suggests the notion of rather moderate electronic correlations in this novel high-Tc superconductor. Oxygen vacancies form predominantly at the inner apical sites and renormalize the optical spectrum quantitatively, while the released electrons are largely accommodated by a defect state. We show that the structural transition occurring under high pressure coincides with a significant enhancement of the Drude weight and a reduction of the out-of-plane interband contribution that acts as a fingerprint of the emerging hole pocket. We further calculate the optical spectra for various possible magnetic phases including spin-density waves and discuss the results in the context of experiment. Finally, we investigate the role of the 2–2 versus 1–3 layer stacking and compare the bilayer nickelate to La4Ni3O10, La3Ni2O6, and NdNiO2, unveiling general trends in the optical spectrum as a function of the formal Ni valence in Ruddlesden–Popper versus reduced Ruddlesden–Popper nickelates. [ABSTRACT FROM AUTHOR]

Over the past three decades, global aquaculture production has significantly increased, emphasizing the need for sustainable and cost‐effective alternatives to traditional fish meal in aquafeed. This study's objective was to elucidate the impact of utilizing a combination of fish and crustacean byproducts—namely, smoked salmon (Salmo salar) skins (SSs), smoked salmon trimmings (STs), and shrimp (Litopenaeus setiferus) heads (SHs)—as primary ingredients in pelleted aquafeed. Importantly, this work focuses on nonextruded pellets, where the physical properties are more influenced by ingredient composition compared to extruded pellets. The tested formulations were not nutritionally comprehensive for any specific commercial aquaculture species, as the goal of this study was to highlight the effect of the byproducts on pellet physical integrity. SH and de‐oiled solid fractions of SS and ST were dehydrated for 24 h at 60°C, ground into dried powders, and formulated into six samples at a 1:1 (w/w) ratio and one sample at a 1:1:1 ratio. Potato starch (80 g/kg) was added to each sample, along with varying deionized (DI) water amounts before steam conditioning, pelletizing, and drying. Analyses included pellet nutrient composition, floatability, durability, water stability, bulk density, water absorption index (WAI), and water solubility index (WSI). Results revealed that SS pellets exhibited 97% floatability at 1 min, decreasing to 70% at 60 min. SS and ST combinations showed slow sinking behavior, while all other formulations sank quickly. Pellets containing SH had lower water stability (65.65% ± 4.44% to 0.05% ± 0.07%), in contrast to over 92% for SS and ST pellets. Durability ranged from 98.48% ± 0.37% for SS to 75.29% ± 5.82% for SH and ST combinations, further underlining the significant impact of byproduct choice on pellet performance. Overall, the inclusion of SS or ST and their combination as primary ingredients for pelleted aquafeed produced pellets that scored well on important quality parameters, while pellets containing SH performed poorly. This information may be used in the development of nutritionally comprehensive nonextruded aquafeeds containing SS and/or ST to conduct feeding trials with commercially relevant species. [ABSTRACT FROM AUTHOR]

Annually, tens of thousands of U.S. children and adolescents are hospitalized with seasonal influenza virus infection. Both influenza vaccination and early initiation of antiviral treatment can reduce complications of influenza. Using data from two U.S. influenza surveillance networks for children and adolescents aged <18 years with medically attended, laboratory-confirmed influenza for whom antiviral treatment is recommended, the percentage who received treatment was calculated. Trends in antiviral treatment of children and adolescents hospitalized with influenza from the 2017-18 to the 2023-2024 influenza seasons were also examined. Since 2017-18, when 70%-86% of hospitalized children and adolescents with influenza received antiviral treatment, the proportion receiving treatment notably declined. Among children and adolescents with influenza during the 2023-24 season, 52%-59% of those hospitalized received antiviral treatment. During the 2023-24 season, 31% of those at higher risk for influenza complications seen in the outpatient setting in one network were prescribed antiviral treatment. These findings demonstrate that influenza antiviral treatment is underutilized among children and adolescents who could benefit from treatment. All hospitalized children and adolescents, and those at higher risk for influenza complications in the outpatient setting, should receive antiviral treatment as soon as possible for suspected or confirmed influenza. [ABSTRACT FROM AUTHOR]

Clinical trials conducted by the Intergroup Rhabdomyosarcoma (RMS) Study Group and the Children's Oncology Group have been pivotal to establishing current standards for diagnosis and therapy for RMS. Recent advancements in understanding the biology and clinical behavior of RMS have led to more nuanced approaches to diagnosis, risk stratification, and treatment. The complexities introduced by these advancements, coupled with the rarity of RMS, pose challenges to conducting large‐scale phase 3 clinical trials to evaluate new treatment strategies for RMS. Given these challenges, systematic planning of future clinical trials in RMS is paramount to address pertinent questions regarding the therapeutic efficacy of drugs, biomarkers of response, treatment‐related toxicity, and patient quality of life. Herein, the authors outline the proposed strategic approach of the Children's Oncology Group Soft Tissue Sarcoma Committee to the next generation of RMS clinical trials, focusing on five themes: improved novel agent identification and preclinical to clinical translation, more efficient trial development and implementation, expanded opportunities for knowledge generation during trials, therapeutic toxicity reduction and quality of life, and patient engagement. The rarity and complexity of rhabdomyosarcoma makes early and systematic planning for the next generation of phase 3 trials essential. This commentary reviews the Children's Oncology Group Soft Tissue Sarcoma Committee's strategy for the design and conduct of their next generation of rhabdomyosarcoma trials. [ABSTRACT FROM AUTHOR]

Substance use disorder (SUD) is a chronic condition, with maintained abuse of a substance leading to physiological and psychological alterations and often changes in cognitive and social behaviours. Current therapies include psychotherapy coupled with medication; however, high relapse rates reveal the shortcomings of these therapies. The signalling, expression profile, and neurological function of the serotonin 2C receptor (5‐HT2C receptor) make it a candidate of interest for the treatment of SUD. Recently, psychedelics, which broadly act at 5‐HT2 receptors, have indicated potential for the treatment of SUD, implicating the 5‐HT2C receptor. The modern psychedelic movement has rekindled interest in the 5‐HT2C receptor, resulting in many new studies, especially structural analyses. This review explores the structural, molecular and cellular mechanisms governing 5‐HT2C receptor function in the context of SUD. This provides the basis of the preclinical and clinical evidence for their role in SUD and highlights the potential for future exploration. [ABSTRACT FROM AUTHOR]

Background: In an evolving landscape of practices and policies, reviewing and incorporating the latest scientific evidence is necessary to ensure optimal clinical management for people with opioid use disorder. We provide a synopsis of the 2024 update of the 2018 National Guideline for the Clinical Management of Opioid Use Disorder, from the Canadian Research Initiative in Substance Matters. Methods: For this update, we followed the United States Institute of Medicine's Standards for Developing Trustworthy Clinical Practice Guidelines and used the Appraisal of Guidelines Research and Evaluation—Recommendation Excellence tool to ensure guideline quality. We carried out a comprehensive systematic literature review, capturing the relevant literature from Jan. 1, 2017, to Sept. 14, 2023. We drafted and graded recommendations according to the Grading of Recommendations, Assessments, Development and Evaluation approach. A multidisciplinary external national committee, which included people with living or lived experience of opioid use disorder, provided input that was incorporated into the guideline. Recommendations: From the initial 11 recommendations in the 2018 guideline, 3 remained unchanged, and 8 were updated. Specifically, 4 recommendations were consolidated into a single revised recommendation; 1 recommendation was split into 2; another recommendation was moved to become a special consideration; and 2 recommendations were revised. Key changes have arisen from substantial evidence supporting that methadone and buprenorphine are similarly effective, particularly in reducing opioid use and adverse events, and both are now considered preferred first-line treatment options. Slow-release oral morphine is recommended as a second-line option. Psychosocial interventions can be offered as adjunctive treatment but should not be mandatory. The guideline reaffirms the importance of avoiding withdrawal management as a standalone intervention and of incorporating evidence-based harm reduction services along the continuum of care. Interpretation: This guideline update presents new recommendations based on the latest literature for standardized management of opioid use disorder. The aim is to establish a robust foundation upon which provincial and territorial bodies can develop guidance for optimal care. [ABSTRACT FROM AUTHOR]

The complexities encountered in microbial metabolic engineering continue to elude prediction and design. Unravelling these complexities requires strategies that go beyond conventional genetics. Using multiplex mutagenesis with double stranded (ds) DNA, we extend the multiplex repertoire previously pioneered using single strand (ss) oligonucleotides. We present ReaL-MGE (Recombineering and Linear CRISPR/Cas9 assisted Multiplex Genome Engineering). ReaL-MGE enables precise manipulation of numerous large DNA sequences as demonstrated by the simultaneous insertion of multiple kilobase-scale sequences into E. coli, Schlegelella brevitalea and Pseudomonas putida genomes without any off-target errors. ReaL-MGE applications to enhance intracellular malonyl-CoA levels in these three genomes achieved 26-, 20-, and 13.5-fold elevations respectively, thereby promoting target polyketide yields by more than an order of magnitude. In a further round of ReaL-MGE, we adapt S. brevitalea to malonyl-CoA elevation utilizing a restricted carbon source (lignocellulose from straw) to realize production of the anti-cancer secondary metabolite, epothilone from lignocellulose. Multiplex mutagenesis with dsDNA enables the incorporation of lengthy segments that can fully encode additional functions. Additionally, the utilization of PCR to generate the dsDNAs brings flexible design advantages. ReaL-MGE presents strategic options in microbial metabolic engineering. ReaL-MGE (Recombineering and Linear CRISPR/Cas9 assisted Multiplex Genome Engineering) enables precise insertion of large DNA sequences in multiple species. Here, authors demonstrate its utility in enhancing malonyl-CoA levels and producing valuable compounds like epothilone from lignocellulose. [ABSTRACT FROM AUTHOR]

Background: The recurrence of cancer will significantly impact an individual's quality of life (QoL) as they adjust to living with a condition that is often incurable. Patients remain at risk of further progression following recurrence, but fear of cancer progression (FOP) at this time is not commonly examined. Importantly, these fears are known to reach levels in which there are consequences for QoL. Methods: This study sought to explore levels of FOP, health-related QoL, anxiety, and depression in patients after a recurrence of their cancer in a longitudinal manner. With the study taking place throughout the COVID-19 pandemic, an assessment of fears related to cancer and the pandemic was included. A sequential mixed method approach was employed for complementarity and expansion purposes. A questionnaire was administered to 44 participants on three different occasions one month apart. A sub-sample of 10 participants then took part in semi-structured interviews. Findings: FOP was present at moderate levels in patients with a cancer recurrence, with over a third of the sample reaching levels considered dysfunctional. Levels of fear were stable over three months and were not predicted by select demographic or clinical factors. On average, depression was low, but anxiety reached mild levels. Challenges to health-related QoL were evident. Low levels of concern about COVID-19 in relation to cancer were reported. Integrated findings provided more nuanced answers to the research questions, including more specific worries about cancer progression. Implications: Findings support the development of psychosocial interventions to manage FOP, and future recommendations are provided. Identifying the presence of fears not commonly screened for after cancer recurrence adds to the existing knowledge in this area. Through acknowledging and attending to the psychosocial impact of FOP, healthcare professionals can provide tailored support to enhance the well-being of those with a recurrence of their cancer. [ABSTRACT FROM AUTHOR]

Assisted coral recovery (ACR) initiatives are establishing rapidly in coral reefs worldwide, using a variety of devices and techniques. In the Great Barrier Reef (GBR, the Reef), site-scale ACR field trials are occurring at multiple sites in the Cairns-Port Douglas region through Reef stewardship activities involving GBR tourism operators, Traditional Owners, and not-for-profit organisations. It is hypothesised that these field trials and the presence of ACR devices at reef tourism sites do not negatively affect visitor experiences, and when accompanied by appropriate educational information, can potentially help to raise awareness of Reef stewardship and conservation efforts. We tested these hypotheses using a survey of 708 Reef visitors on five tourism vessels, 346 of whom reported observing ACR devices in situ during their coral reef experience. Ordinal regression tests of survey responses found no statistical relationship between respondents' observation of ACR devices and (i) their overall Reef trip satisfaction, (ii) the perceived aesthetic beauty of the site(s) they visited, and (iii) their concern about the future health of the GBR. However, Reef visitors who observed ACR devices showed significantly lower levels of concern about the use of these devices on the Reef. The perceived quality of educational information presented to respondents was among the significant factors associated with their reef trip satisfaction and perceived beauty of reef sites. Our findings have implications for ACR practitioners and proponents who are concerned about public visibility, perceptions, and support for ACR initiatives, as the scale of such initiatives is expected to increase. [ABSTRACT FROM AUTHOR]

Background: Salmon aquaculture involves freshwater and seawater phases. Recently there has been an increase in multifactorial gill health challenges during the seawater phase which has led to an urgent need to understand the gill microbiome. There is a lack of understanding on what drives the composition of the gill microbiome, and the influence the freshwater stage has on its long-term composition. We characterise the gill microbiome from seven cohorts of Atlantic salmon raised in six different freshwater operational systems—recirculating aquaculture system (RAS), flowthrough (FT) and loch-based system, prior to and after transfer to seven seawater farms, over two different input seasons, S0 (2018) and S1 (2019). Results: Using the V1-V2 region of the 16S rRNA gene, we produced amplicon libraries absent of host contamination. We showed that hatchery system influenced the gill microbiome (PERMAOVA R2 = 0.226, p < 0.001). Loch and FT systems were more similar to each other than the three RAS systems, which clustered together. On transfer to sea, the gill microbiomes of all fish changed and became more similar irrespective of the initial hatchery system, seawater farm location or season of input. Even though the gill microbiome among seawater farm locations were different between locations (PERMAOVA R2 = 0.528, p < 0.001), a clustering of the gill microbiomes by hatchery system of origin was still observed 7–25 days after transfer (PERMAOVA R = 0.164, p < 0.001). Core microbiomes at genera level were observed among all fish in addition to freshwater only, and seawater only. At ASV level core microbiomes were observed among FT and loch freshwater systems only and among all seawater salmon. The gill microbiome and surrounding water at each hatchery had more shared ASVs than seawater farms. Conclusion: We showed hatchery system, loch, FT or RAS, significantly impacted the gill microbiome. On transfer to sea, the microbiomes changed and became more similar. After transfer, the individual sites to which the fish were transferred has a significant influence on microbiome composition, but interesting some clustering by hatchery system remained. Future gill disease mitigation methods that target enhancing the gill microbiome may be most effective in the freshwater stage, as there were more shared ASVs between water and gill at hatchery, compared to at sea. [ABSTRACT FROM AUTHOR]

Background: Addiction medicine providers have a key role in HIV prevention amidst rising HIV incidence in persons who inject drugs (PWID). Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are vastly underutilized in this population. Inpatient hospitalization represents a potential touchpoint for initiation of HIV prophylaxis, though little research explores the role of addiction providers. Here we describe rates of PrEP/PEP delivery to hospitalized PWID seen by an Addiction Consult Service (ACS) at an urban, essential hospital. Methods: We performed a cross-sectional study of hospitalized patients who were seen by the ACS from January 1, 2020 to December 31, 2022 and had plausible injection drug use. We calculated the proportion of patients who received a new prescription for PrEP/PEP at discharge. We used descriptive statistics to characterize demographics, substance use, reason for admission, and indications for PrEP/PEP. Secondarily, we calculated the monthly proportion of all patients discharged from the hospital with PrEP/PEP who were seen by the ACS compared to those not seen by the ACS. Results: The average monthly proportion of ACS consults with plausible injection drug use who received PrEP/PEP was 6.4%. This increased from 4.2% in 2020 to 7.5% in 2022. Those seen by the ACS who received PrEP/PEP had high rates of opioid use disorder (97.5%), stimulant use disorder (77.8%), and homelessness (58.1%); over half were admitted for an injection-related infection. The indications for PrEP/PEP were injection drug use only (70.6%), followed by combined injection and sexual risk (20.2%); 71.9% of prescriptions were for PrEP and 28.1% for PEP. Overall, the ACS was involved in 83.9% of hospital-wide discharges with PrEP/PEP prescriptions (n = 242). Conclusions: PWID who were seen by the ACS received PrEP/PEP prescriptions at rates exceeding national averages. The ACS was also involved with the care of the majority of admitted patients who received PrEP/PEP at discharge. While PrEP/PEP use for PWID remains low, the inpatient ACS represents a key resource to improve uptake by leveraging the reachable moment of an inpatient hospitalization. [ABSTRACT FROM AUTHOR]

Gastrointestinal disease is a leading cause of death in mature horses. A lack of in vitro modeling has impeded the development of novel therapeutics. The objectives of this study were to develop and further characterize a small intestinal monolayer cell culture derived from equine jejunum including establishing normal measurements of intestinal permeability and restitution. Three-dimensional enteroids, derived from postmortem sampling of equine jejunum, were utilized to develop confluent epithelial monolayers. The presence of differentiated intestinal epithelial cell types and tight junctions were confirmed using histology, reverse transcription PCR (RT-PCR), RNAscope, protein immunofluorescence and transmission electron microscopy. Transepithelial resistance (TER) and macromolecule flux were assessed as measurements of paracellular and transcellular permeability. Scratch assays were utilized to model and assess intestinal restitution. Monolayer cell cultures reached 100% confluency by ~5–7 days. Equine jejunum monolayers were confirmed as epithelial in origin, with identification of differentiated intestinal epithelial cell types and evidence of tight junction proteins. Function of the intestinal barrier was supported by acquisition of physiologically normal TER values (179.9 ± 33.7 ohms*cm2) and limited macromolecule flux (22 ± 8.8% at 60 min). Additionally, following a scratch wound, epithelial cell monolayers migrated to close gap defects within 24 h. In conclusion, this study describes the development of a novel intestinal epithelial monolayer cell culture for equine jejunum, and provides evidence of intestinal epithelial cell differentiation, formation of physiologically relevant barrier function and use as a model of intestinal restitution to test potential therapeutics for equine colic. [ABSTRACT FROM AUTHOR]

Metabolic diseases are caused by a complex interplay between genetics and the environment, yet many basic studies guiding our understanding of metabolism are confined to single genetic backgrounds, like the C57BL/6 J mouse. Recent studies across different genetic backgrounds have revealed profound phenotypic diversity, questioning the robustness and utility of observations derived from isolated strains. Those embracing genetic diversity will likely discover novel and penetrant mechanisms underlying metabolic dysregulation and disease, and findings may even benefit from increased translatability to humans. The purpose of this commentary is to equip researchers with a practical guide to performing studies across genetically diverse mice, and to highlight some of the important challenges such studies present. As part of EMBO Journal's 2024 metabolism methods series, this commentary revisits the impact of genetics on metabolic studies, enabling dissection of novel mechanisms and phenotypes. [ABSTRACT FROM AUTHOR]

Introduction: Children and adolescents treated in specialty mental health services are more likely to have sleep disturbances than those without mental health problems. Few studies have investigated the relationship between sleep and psychopathology in broad clinical samples of children. We examined the relationship between sleep disturbance and age on internalizing and externalizing psychopathology in a sample who sought treatment at children's mental health centers. Methods: Secondary data analyses were completed on a sample of children (N = 13,472; aged 4 to 18; 55% male) from 39 children's mental health agencies in Ontario, Canada, who completed a semi-structured assessment, the interRAI Children and Youth Mental Health (ChYMH). A split-half sample approach was utilized (S1 n = 6,773, S2 n = 6,699). Hierarchical regressions examined the effects of sleep disturbances (i.e., difficulty falling asleep, staying asleep, night waking, bedtime resistance, falling asleep during the day) on internalizing and externalizing symptoms, above and beyond established child- (i.e., age, sex, sensory sensitivity, pain) and family-level variables (family functioning, caregiver distress, parenting strengths). Age was tested as a moderator for sleep disturbances on both outcome variables. Results: Overall, 6.7% of children had clinically significant sleep disturbance scores (≥10 out of 16) on the interRAI ChYMH. In both samples, sleep disturbances predicted internalizing (S1 ΔR2 = 10%, S2 ΔR2 = 10%) and externalizing symptoms (S1 ΔR2 = 2%, S2 ΔR2 = 1%), above and beyond child and family variables. Age moderated the relationship between sleep disturbances and internalizing symptoms (S1 ß = 0.07; S2 ß = 0.07; ΔR2 = 0.004 in both samples), but not externalizing symptoms; sleep disturbance was more strongly related to internalizing symptoms amongst adolescents (ß = 0.98) than children (ß = 0.62). Discussion: The relationship between sleep and internalizing symptoms appears to change as children move through development. Further, sleep was a stronger predictor of internalizing problems in adolescents than children, suggesting an additional focus of clinician efforts in this age group. These findings strengthen the importance of routine assessment of sleep, as is done with the interRAI ChYMH. [ABSTRACT FROM AUTHOR]

Objective: POLR3B encodes the second largest subunit of RNA polymerase III, which is essential for transcription of small non‐coding RNAs. Biallelic pathogenic variants in POLR3B are associated with an inherited hypomyelinating leukodystrophy. Recently, de novo heterozygous variants in POLR3B were reported in six individuals with ataxia, spasticity, and demyelinating peripheral neuropathy. Three of these individuals had epileptic seizures. The aim of this article is to precisely define the epilepsy phenotype associated with de novo heterozygous POLR3B variants. Methods: We used online gene‐matching tools to identify 13 patients with de novoPOLR3B variants. We systematically collected genotype and phenotype data from clinicians using two standardized proformas. Results: All 13 patients had novel POLR3B variants. Twelve of 13 variants were classified as pathogenic or likely pathogenic as per American College of Medical Genetics (ACMG) criteria. Patients presented with generalized myoclonic, myoclonic‐atonic, atypical absence, or tonic‐clonic seizures between the ages of six months and 4 years. Epilepsy was classified as epilepsy with myoclonic‐atonic seizures (EMAtS) in seven patients and "probable EMAtS" in two more. Seizures were treatment resistant in all cases. Three patients became seizure‐free. All patients had some degree of developmental delay or intellectual disability. In most cases developmental delay was apparent before the onset of seizures. Three of 13 cases were reported to have developmental stagnation or regression in association with seizure onset. Treatments for epilepsy that were reported by clinicians to be effective were: sodium valproate, which was effective in five of nine patients (5/9) who tried it; rufinamide (2/3); and ketogenic diet (2/3). Additional features were ataxia/incoordination (8/13); microcephaly (7/13); peripheral neuropathy (4/13), and spasticity/hypertonia (6/13). Significance: POLR3B is a novel genetic developmental and epileptic encephalopathy (DEE) in which EMAtS is the predominant epilepsy phenotype. Ataxia, neuropathy, and hypertonia may be variously observed in these patients. [ABSTRACT FROM AUTHOR]

Primary care encounters are common among patients at risk for suicide. Prior suicide care programs that incorporate depression screening, suicide risk assessment, and collaborative safety planning show promise in nonprimary care settings. This secondary analysis of a stepped-wedge, cluster randomized implementation trial examines the effectiveness of a primary care–based suicide care program embedded alongside a substance use care program in reducing suicide attempts within 90 days of the primary care visit. Visual Abstract. Effectiveness of Integrating Suicide Care in Primary Care: Primary care encounters are common among patients at risk for suicide. Prior suicide care programs that incorporate depression screening, suicide risk assessment, and collaborative safety planning show promise in nonprimary care settings. This secondary analysis of a stepped-wedge, cluster randomized implementation trial examines the effectiveness of a primary care–based suicide care program embedded alongside a substance use care program in reducing suicide attempts within 90 days of the primary care visit. Background: Primary care encounters are common among patients at risk for suicide. Objective: To evaluate the effectiveness of implementing population-based suicide care (SC) in primary care for suicide attempt prevention. Design: Secondary analysis of a stepped-wedge, cluster randomized implementation trial. (ClinicalTrials.gov: NCT02675777) Setting: 19 primary care practices within a large health care system in Washington State, randomly assigned launch dates. Patients: Adult patients (aged ≥18 years) with primary care visits from January 2015 to July 2018. Intervention: Practice facilitators, electronic medical record (EMR) clinical decision support, and performance monitoring supported implementation of depression screening, suicide risk assessment, and safety planning. Measurements: Clinical practice and patient measures relied on EMR and insurance claims data to compare usual care (UC) and SC periods. Primary outcomes included documented safety planning after population-based screening and suicide risk assessment and suicide attempts or deaths (with self-harm intent) within 90 days of a visit. Mixed-effects logistic models regressed binary outcome indicators on UC versus SC, adjusted for randomization stratification and calendar time, accounting for repeated outcomes from the same site. Monthly outcome rates (percentage per 10 000 patients) were estimated by applying marginal standardization. Results: During UC, 255 789 patients made 953 402 primary care visits and 228 255 patients made 615 511 visits during the SC period. The rate of safety planning was higher in the SC group than in the UC group (38.3 vs. 32.8 per 10 000 patients; rate difference, 5.5 [95% CI, 2.3 to 8.7]). Suicide attempts within 90 days were lower in the SC group than in the UC group (4.5 vs. 6.0 per 10 000 patients; rate difference, −1.5 [CI, −2.6 to −0.4]). Limitation: Suicide care was implemented in combination with care for depression and substance use. Conclusion: Implementation of population-based SC concurrent with a substance use program resulted in a 25% reduction in the suicide attempt rate in the 90 days after primary care visits. Primary Funding Source: National Institute of Mental Health. [ABSTRACT FROM AUTHOR]

Artificially intelligent physical activity digital assistants that use the full spectrum of machine learning capabilities have not yet been developed and examined. This study aimed to explore potential users' perceptions and expectations of using such a digital assistant. Six 90‐min online focus group meetings (n = 45 adults) were conducted. Meetings were recorded, transcribed and thematically analysed. Participants embraced the idea of a 'digital assistant' providing physical activity support. Participants indicated they would like to receive notifications from the digital assistant, but did not agree on the number, timing, tone and content of notifications. Likewise, they indicated that the digital assistant's personality and appearance should be customisable. Participants understood the need to provide information to the digital assistant to allow for personalisation, but varied greatly in the extent of information that they were willing to provide. Privacy issues aside, participants embraced the idea of using artificial intelligence or machine learning in return for a more functional and personal digital assistant. In sum, participants were ready for an artificially intelligent physical activity digital assistant but emphasised a need to personalise or customise nearly every feature of the application. This poses challenges in terms of cost and complexity of developing the application. [ABSTRACT FROM AUTHOR]

Objectives: Drowsiness has been shown to impair reaction times, decision-making abilities, and awareness of hazards critical to driving in a manner similar to the effects of driving under the influence of alcohol.1 Drowsy driving has been estimated to cause thousands of fatal crashes per year and has resulted in billions of dollars in lost revenue.2 However, while breathalyzers and ignition interlock devices can be used to mitigate the risk of drunk driving, no such devices are commercially available for roadside or behind-the-wheel diagnostics for drowsiness. To address this gap, the objective of this study was to demonstrate the efficacy and feasibility of a breath sensor to detect fatigue and drowsiness in a simulated driving environment. Data and methods: Solid state breath sensors calibrated to previously identified breath biomarkers of fatigue and drowsiness were arrayed to determine changes in the breath profiles of subjects undergoing a full-motion driving simulation designed to elicit driver fatigue. A multi-sensor approach was used rather than relying on a single biomarker. The biomarker profile targeted compounds such as benzene derivatives (e.g., benzene, benzaldehyde, toluene, phenol), 2-butanone, and 2-ethyl-1-hexanol, among others. To address potential confounders such as eating/drinking, cigarette smoke, alcohol, and medical conditions like COPD or diabetes, the study was conducted under controlled conditions: participants refrained from eating for a couple of hours before the experiment, were nonsmokers, had not consumed alcohol for the past day, and had no known medical conditions. The breath biomarker profiles were then correlated with established drowsiness metrics, specifically the PERCLOS (Percentage of Eye Closure) and the Karolinska Sleepiness Scale (KSS). Results: The breath sensor array collected breath biomarker profiles for 61 subjects. The biomarker profiles demonstrated a trend consistent with increasing PERCLOS and KSS responses (see Figure). During the 60-minute driving simulation designed to elicit driver fatigue, the PERCLOS showed a steady increase in response over time, while the KSS did not show an increase in perceived sleepiness until the 60 min mark. Similarly, the breath biomarker sensor response showed a significant increase at the 60-minute timepoint, consistent with increases in both the PERCLOS and the KSS, demonstrating evidence of increased driver fatigue and drowsiness. Conclusions: These findings suggest that integrating drowsiness breath sensor arrays into vehicle systems could significantly enhance drowsiness detection, thereby reducing crashes, injuries, and fatalities. Moreover, the scalability and non-invasiveness of the proposed system lays the groundwork for broader applications, extending beyond vehicles to fields such as aviation and healthcare. [ABSTRACT FROM AUTHOR]