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Context: There is a well-established increased risk of lower-extremity (LE) musculoskeletal (MSK) injury following a sport-related concussion (SRC). Neuromuscular training programs improve biomechanics associated with LE MSK injury and reduce LE MSK injury incidence, but their relative effectiveness in athletes with history of SRC is unknown. The purpose of this study was to evaluate LE MSK injury incidence in female adolescent athletes with history of SRC following a neuromuscular training intervention. Design: Prospective case-control. Methods: Seventy-seven adolescent female athletes aged 12–18 years who participated in soccer, volleyball, or basketball were recruited from a single institutional sports medicine research and performance center to complete a 6-week neuromuscular training program prior to competitive athletic season. Group (Control, History of SRC) comparisons of athlete exposure and relative LE MSK injury risk and rates during the competitive athletic season were assessed. Results: Ten injuries were recorded by 9 athletes. Female athletes who reported history of SRC had increased injury risk (Risk Ratio 3.9, 95% CI, 1.1–13.8, P =.01) and increased injury rate (rate ratio 4.1, 95% CI, 1.1–15.8, P =.03) compared with female athletes without history of SRC. Conclusions: Female adolescent athletes with history of SRC showed a greater risk of LE MSK injury compared with athletes with no history of SRC. Future work is still needed to understand the underlying mechanisms associated with future LE MSK injury following SRC and interventions that ameliorate elevated injury risk. [ABSTRACT FROM AUTHOR]

To evaluate bifunctional ligand reactivity involving NH acidic sites in the secondary coordination sphere, complexes where the proton has been substituted with a methyl group (NMe) are often investigated. An alternative strategy involves substitution of the NH group for an O. This contribution considers and compares the merits of these approaches; the synthesis and characterization of cationic square‐planar Rh carbonyl complexes bearing diprotic bispyrazole pyridine ligand L1, and the bis‐methylated pyrazole pyridine ligand L1Me are described. The syntheses and characterization of the novel monoprotic pyrazole isoxazole pyridine ligand L2 and aprotic bisisoxazole pyridine ligand L3, and their corresponding Rh carbonyl complexes are also described. Comparison of the CO stretching frequencies of the four Rh complexes suggest that substitutions of NH with NMe, as well as with O, lead to significant electronic differences. These electronic differences result in different reactivities with respect to ligand addition/substitution of the Rh carbonyl complexes. Overall, the data suggest that electronic differences arising due to the NH substitutions can be significant and should be considered when the NH group is substituted in investigations of the participation of the NH proton in a reaction. [ABSTRACT FROM AUTHOR]

Background: The TrialNet Oral Insulin (OI) prevention trial showed no overall treatment effect, using the diagnosis of type 1 diabetes as an endpoint. A significant delay in onset was only found in a high‐risk stratum (termed secondary stratum 1) of participants with low first‐phase insulin release (FPIR). Methods: Since trials with an endpoint of type 1 diabetes take years to complete, in this post hoc analysis, we assessed whether a novel combination of glucose and C‐peptide markers could identify a therapeutic benefit after 1 year of follow‐up (trial participants followed for a median 2.7 years). Results: Participants were relatives with multiple islet autoantibodies and low FPIR (n = 40). Glucose rose, and C‐peptide declined in the placebo group, whereas glucose rose minimally, and C‐peptide increased in the OI group. When glucose and C‐peptide were plotted on two‐dimensional grids using 30–120‐min oral glucose tolerance test (OGTT) time points, changes in ratios of their central points (centroid ratio) differed between groups (p = 0.037 adjusted for age, BMI, and baseline C‐peptide and glucose). Conclusions: These findings support a favorable early effect of OI on combined glucose and C‐peptide endpoints in high‐risk individuals, indicating metabolic benefit. With further study, these measures may allow for shorter trials compared to the standard endpoint of type 1 diabetes diagnosis. [ABSTRACT FROM AUTHOR]

Climate changes in temperate regions are expected to result in warmer, shorter winters in temperate latitudes. These changes may have consequences for germination of plant species that require a period of physiological dormancy. The effect of cold duration on seed germination has been investigated in a number of plant taxa, but has not been well studied in wetland and bottomland forest tree species, an ecosystem that is threatened by habitat homogenization. Our work sought to test the role of changing winter temperatures on seed germination in specialist (Nyssa aquatica and Taxodium distichum) and generalist (Acer rubrum and Liquidambar styraciflua) tree species within forested wetlands throughout the eastern U.S. The experiment was conducted in an environmental chamber in Norfolk, VA, USA. Seeds of T. distichum, N. aquatica, A. rubrum, and L. styraciflua were exposed to each of seven pre-germination cold exposure durations (0, 15, 30, 45, 60, 75, and 90 days) and observed for germination for 30 days. Cold stratification duration positively impacted total percent germination in N. aquatica (p < 0.0001) as well as A. rubrum (p = 0.0008) and T. distichum (p = 0.05). Liquidambar styraciflua seeds exhibited more rapid rates of germination with increasing cold exposure duration and greater percent germination compared to the others regardless of cold stratification duration. Our results provide insight into how community dynamics and biodiversity of wetland and bottomland trees may shift with a changing climate. Further, this work emphasizes the importance of understanding the role of plant functional traits in early life stages in community dynamics and has implications for management practices. [ABSTRACT FROM AUTHOR]

Objectives. To determine whether geographic prioritization of limited COVID-19 vaccine supply was effective for reducing geographic disparities in case rates. Methods. Rhode Island allocated a portion of the initial COVID-19 vaccine supply to residents of Central Falls, a community already affected by structural policies and inadequate systems that perpetuate health inequities and experiencing disproportionately high COVID-19 morbidity and mortality. The policy was implemented with a culturally and linguistically appropriate community engagement plan and was intended to reduce observed disparities. Using a Bayesian causal analysis with population surveillance data, we evaluated the impact of this prioritization policy on recorded cases over the subsequent 16 weeks. Results. Early geographic prioritization of Central Falls accelerated vaccine uptake, averting an estimated 520 cases (95% confidence interval = 22, 1418) over 16 weeks and reducing cases by approximately 34% during this period (520 averted vs 1519 expected without early prioritization). Conclusions. Early geographic prioritization increased vaccine uptake and reduced cases in Central Falls, thereby reducing geographic disparities. Public Health Implications. Public health institutions should consider geographic prioritization of limited vaccine supply to reduce geographic disparities in case rates. (Am J Public Health. 2024;114(S7):S580–S589. https://doi.org/10.2105/AJPH.2024.307741) [ABSTRACT FROM AUTHOR]

'Design thinking' necessitates that we challenge our core beliefs to reframe our understanding and generate innovative solutions. The noun 'design' may also connote cunning. Mêtis (mῆτις) is such a form of thought and knowledge. Through wise application of prudence, vigilance and opportunism, it operates in unstable and uncertain environments. While the nature of crime is enduring, its character is transitory. If forensic science is to remain a valuable force-multiplier, it must co-adapt with a policing model that is orienting towards proactivity and disruption. 'Forensic intelligence (FORINT) is intelligence derived from technical and forensic information and expertise', and is the epitome of forensic science agility and a manifestation of mêtis in design. It is transdisciplinary, operating in different phases of the (pre-)investigative workflow, across the tactical-operational-strategic continuum. FORINT may emerge readily from a consultative/integrative forensic organization. Alternatively, its establishment may be a 'Trojan Horse' (consider Odysseus, master of mêtis): in design parlance this refers to an artefact that also is a vehicle for strategic change. Countering polymorphic transnational serious and organized crime requires us to be more multiple, more polyvalent, without compromise of ethics or integrity – leveraging mêtis in designing the future of forensic science through FORINT. [ABSTRACT FROM AUTHOR]

Industrial hemp (Cannabis sativa) production is complex, with strict regulatory constraints and challenges associated with a lack of labeled pesticides due to its status as a novel crop in the US. Four experiments were conducted in 2020 and 2021 to establish herbicide tolerances for hemp production in the coastal plain of Georgia, USA. Objectives included evaluating hemp response to pretransplant or posttransplant herbicides, determining if planting method influenced herbicide injury from residual preplant applied herbicides, and understanding how plastic mulch may influence hemp flower yields. When applied one day prior to transplanting, maximum hemp crop visual injury was less than 12% compared to the untreated control, with acetochlor, flumioxazin, fomesafen, pendimethalin, and norflurazon while dithiopyr, halosulfuron, isoxaben, and isoxaflutole resulted in greater than 50% injury. Posttransplant applications of S-metolachlor, acetochlor, pendimethalin, and clethodim resulted in less than 15% injury while halosulfuron, metribuzin, trifloxysulfuron, imazethapyr, and prometryn applications resulted in greater than 50% injury to plants. Preplant and posttransplant applied herbicides were found to have little effect on total tetrahydrocannabinol (THC), cannabidiol (CBD), or total cannabinoids in the dry flower after harvest. In a separate experiment, injury from halosulfuron and metribuzin was 52% to 56% less when planted with a mechanical transplanter as compared to the practice of using a transplant wheel to depress a hole in the soil followed by hand transplanting. In the final experiment, hemp dry flower yield in a non-plastic mulched (bareground) system was similar to that in a plastic mulched system. However, early season plant above-ground biomass was less in the plastic mulched system, which may have been due to elevated soil temperatures inhibiting early season growth. [ABSTRACT FROM AUTHOR]

This article presents the first study of the interaction between the Jupiter Icy Moons Explorer (JUICE) spacecraft and the solar wind environment at 1 AU. The state‐of‐the‐art software Spacecraft Plasma Interaction Software was used to simulate the surface charging of the spacecraft and the altered particle environment around the spacecraft. The simulations show that for a typical solar wind environment the spacecraft will charge to around 6 V, with the different dielectric parts of the spacecraft charging to potentials from around −36 to 8 V. For the studied extreme solar wind environment, similar to the environment found in the sheath region inside the shock front of an Interplanetary Coronal Mass Ejection, the surface potential of the spacecraft is lower due to the increased accumulation of electrons. The spacecraft will charge to around 3 V, with the different dielectric surfaces charging from around −45 to 9 V. We also show how the interaction between the spacecraft and its environment alters the ion and electron particle environment around the spacecraft. This study is the first step toward developing correction techniques for the impact that the interaction between the JUICE spacecraft and its environment has on the JUICE charged particle and field measurements. Plain Language Summary: All spacecraft interact with their space environment. This interaction can create a variety of different problems, with a severity that depends on the environment and the design of the spacecraft. Here, we present a study of the interaction between the Jupiter Icy Moons Explorer (JUICE) spacecraft and the solar wind environment at 1 AU. We study both a typical solar wind environment and an extreme environment, for example, the environment encountered during an Interplanetary Coronal Mass Ejection. Our simulations show that we can expect the different parts of the spacecraft to charge from around −45 to 9 V. The interaction between JUICE and the solar wind will also alter the particle environment around the spacecraft. We present the altered charged particle environment around the spacecraft, both for the ion and the various electron populations. This study is the first step toward developing correction techniques for the impact that the interaction between the JUICE spacecraft and its environment has on the JUICE measurements. Key Points: The interaction between the Jupiter Icy Moons Explorer spacecraft and the solar wind environment at 1 AU, is simulatedWe present the spacecraft surface potentials, typically ranging from −45 to 9 V, for different solar wind conditionsWe also present the near spacecraft particle environment, which is altered due to the interaction between the spacecraft and its environment [ABSTRACT FROM AUTHOR]

Dementia incidence is lower among Asian Americans than among Whites, despite higher prevalence of type 2 diabetes, a well-known dementia risk factor. Determinants of dementia, including type 2 diabetes, have rarely been studied in Asian Americans. We followed 4846 Chinese, 4129 Filipino, 2784 Japanese, 820 South Asian, and 123 360 non-Latino White members of a California-based integrated health-care delivery system from 2002 to 2020. We estimated dementia incidence rates by race/ethnicity and type 2 diabetes status, and we fitted Cox proportional hazards and Aalen additive hazards models for the effect of type 2 diabetes (assessed 5 years before baseline) on age of dementia diagnosis, controlling for sex/gender, educational attainment, nativity, height, race/ethnicity, and a race/ethnicity × diabetes interaction. Type 2 diabetes was associated with higher dementia incidence in Whites (hazard ratio [HR] = 1.46; 95% CI, 1.40-1.52). Compared with Whites, the estimated effect of diabetes was larger in South Asians (HR = 2.26; 95% CI, 1.48-3.44), slightly smaller in Chinese (HR = 1.32; 95% CI, 1.08-1.62) and Filipino (HR = 1.31; 95% CI, 1.08-1.60) individuals, and similar in Japanese individuals (HR = 1.44; 95% CI, 1.15-1.81). Heterogeneity in this association across Asian subgroups may be related to type 2 diabetes severity. Understanding this heterogeneity may inform prevention strategies to prevent dementia for all racial and ethnic groups. [ABSTRACT FROM AUTHOR]

For Black students in the United States, attending schools with a higher proportion of White students is associated with worse mental and physical health outcomes in adolescence/early adulthood. To our knowledge, no prior studies have evaluated the association between school racial/ethnic composition from kindergarten through grade 12 and later-life mental health. In a cohort of Black adults aged ≥50 years in Northern California who retrospectively reported (2017-2020) school racial/ethnic composition for grades 1, 6, 9, and 12, we assessed the association between attending a school with mostly Black students versus not and mid-/late-life depressive symptoms (8-item Patient-Reported Outcomes Measurement Information System (PROMIS) depression score, standardized to the 2000 US adult population) using age-, sex/gender-, southern US birth–, and parental education–adjusted generalized estimating equations, and assessed effect modification by the presence of a caring teacher/staff member. Levels of later-life depressive symptoms were lower among those who attended schools with mostly Black students in grades 1 and 6 (β = −0.12 [95% CI, −0.23 to 0.00] and β = −0.11 [95% CI, −0.22 to 0.00], respectively). In grade 6, this difference was larger for students without an adult at school who cared about them (β = −0.29 [95% CI, −0.51 to −0.07] vs β = −0.04 [95% CI, −0.17 to 0.09]). Among Black Americans, experiencing early schooling with mostly Black students may have later-life mental health benefits; this protective association appears more important for students without the presence of caring teachers/staff. This article is part of a Special Collection on Mental Health. [ABSTRACT FROM AUTHOR]

Restoration researchers and practitioners alike advocate for novel restoration approaches, informed by ecological theories and principles, to enhance the likelihood of meeting restoration goals. Forested wetland restoration has historically focused on creating abiotic conditions that support the tolerance thresholds of desired species, but the stress gradient hypothesis provides guidance for potential new strategies that use biotic interactions to ameliorate stressful abiotic conditions. In this study, we tested whether multi‐species planting approaches can be used to enhance the survival and growth of a target restoration tree species, Bald cypress, along multiple abiotic gradients. We conducted a fully factorial controlled greenhouse experiment which manipulated above‐ and belowground interactions between two species (Bald cypress and Soft rush), as well as light availability and depth of inundation. Our findings showed that co‐planting Bald cypress seedlings with Soft rush did not increase tree biomass production or growth metrics (e.g. stem height and leaf area) under any exposed stress combination. Importantly, we found that full‐sun irradiance negatively impacted functional traits associated with the tree seedlings' health and ability to photosynthesize. Our findings are important for consideration by practitioners as light is rarely the focus of wetland ecosystem restoration and degraded forested wetlands or restoration sites often have open canopies. [ABSTRACT FROM AUTHOR]

Let (Ω , Σ , μ) be a measure space, and 1 ≤ p ≤ ∞ . A subspace E ⊆ L p (μ) is said to do stable phase retrieval (SPR) if there exists a constant C ≥ 1 such that for any f , g ∈ E we have 0.1 inf | λ | = 1 ‖ f - λ g ‖ ≤ C ‖ | f | - | g | ‖. In this case, if |f| is known, then f is uniquely determined up to an unavoidable global phase factor λ ; moreover, the phase recovery map is C-Lipschitz. Phase retrieval appears in several applied circumstances, ranging from crystallography to quantum mechanics. In this article, we construct various subspaces doing stable phase retrieval, and make connections with Λ (p) -set theory. Moreover, we set the foundations for an analysis of stable phase retrieval in general function spaces. This, in particular, allows us to show that Hölder stable phase retrieval implies stable phase retrieval, improving the stability bounds in a recent article of M. Christ and the third and fourth authors. We also characterize those compact Hausdorff spaces K such that C(K) contains an infinite dimensional SPR subspace. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the performance of international and domestic counselors-in-training attending a CACREP-accredited counseling program in the northwest region of the U.S. The effectiveness and efficiency of reducing distress levels were compared between these two groups of students. We examined the outcome of 286 clients seen by 57 counselors-in-training over 1-year period in a University Training Counseling Center. Data were analyzed using mixed ANOVA to determine and to evaluate clients' treatment outcomes per group of counselors. Results indicated a significant decrease in the clients' distress scores, and there were no significant differences in effectiveness and efficiency between international and domestic counselors-in-training. Implications are made for counselor educators and researchers. [ABSTRACT FROM AUTHOR]

Background Histologic and serologic studies suggest the induction of local and systemic Treponema pallidum -specific CD4+ T-cell responses to T. pallidum infection. We hypothesized that T. pallidum -specific CD4+ T cells are detectable in blood and in the skin rash of secondary syphilis and persist in both compartments after treatment. Methods Peripheral blood mononuclear cells collected from 67 participants were screened by interferon-γ (IFN-γ) ELISPOT response to T. pallidum sonicate. T. pallidum -reactive T-cell lines from blood and skin were probed for responses to 89 recombinant T. pallidum antigens. Peptide epitopes and HLA class II restriction were defined for selected antigens. Results We detected CD4+ T-cell responses to T. pallidum sonicate ex vivo. Using T. pallidum -reactive T-cell lines we observed recognition of 14 discrete proteins, 13 of which localize to bacterial membranes or the periplasmic space. After therapy, T. pallidum -specific T cells persisted for at least 6 months in skin and 10 years in blood. Conclusions T. pallidum infection elicits an antigen-specific CD4+ T-cell response in blood and skin. T. pallidum -specific CD4+ T cells persist as memory in both compartments long after curative therapy. The T. pallidum antigenic targets we identified may be high-priority vaccine candidates. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study utilized structural equation modeling to examine effects of COVID-19 stress on food insecurity and fruit and vegetable consumption mediated through personal agency and behavioral intention. Participants: Students (n = 749) enrolled at one federally designated Hispanic-serving public university during the fall 2020 semester. Methods: A 34-item survey was developed and administered. Results: COVID-19 stress had a statistically significant impact on food insecurity (B =.341; p <.001) and an inverse impact on personal agency to consume fruit and vegetables (B = −.283; p <.001). Personal agency (B =.389; p <.001) and behavioral intention to consume fruit and vegetables were directly associated while food insecurity inversely impacted behavioral intention (B = −.076; p =.034). Conclusions: Pandemic-related stress impacts nutrition behaviors among the student population already at risk of poor fruit and vegetable intake. During periods of high pandemic-related stress, college students need adequate access to fruits and vegetables and health promotion programs emphasizing stress management and healthy dietary behaviors. [ABSTRACT FROM AUTHOR]

Since the establishment of 4 molecular subgroups of endometrial carcinoma (EC), there has been significant interest in understanding molecular classification in the context of histologic features and diagnoses. ECs with undifferentiated, spindle, and/or sarcomatous components represent a diagnostically challenging subset of tumors with overlapping clinical and histologic features. We examined the clinicopathologic, morphologic, immunohistochemical, and molecular features of these tumors identified in our institutions' pathology databases using immunohistochemistry and targeted sequencing. Disease-specific survival (DSS) and progression-free survival (PFS) were analyzed using Kaplan-Meier curves and log-rank tests. One hundred sixty-two ECs were included: carcinosarcomas (UCS; n=96), dedifferentiated/undifferentiated EC (DDEC/UDEC; n=49), and grade 3 endometrioid EC with spindled growth (GR3spEEC) (n= 17). All molecular subgroups were represented in all histologic subtypes and included 12 (7%) POLE-mutated (POLEmut), 43 (27%) mismatch repair-deficient (MMRd), 77 (48%) p53-abnormal (p53abn), and 30 (19%) no specific molecular profile (NSMP) tumors. However, the molecular classification (irrespective of histologic diagnosis) was a significant predictor for both DSS (P= 0.008) and P=0.0001). POLEmut EC showed an excellent prognosis with no recurrences or deaths from the disease. MMRd tumors also showed better outcomes relative to NSMP and p53abn tumors. In conclusion, molecular classification provides better prognostic information than histologic diagnosis for high-grade EC with undifferentiated and sarcomatous components. Our study strongly supports routine molecular classification of these tumors, with emphasis on molecular group, rather than histologic subtyping, in providing prognostication. [ABSTRACT FROM AUTHOR]

Background: Total pancreatectomy with islet autotransplantation (TPIAT) is a potentially curative treatment for patients with chronic pancreatitis (CP) refractory to medical and endoscopic therapies. Patients often receive the initial follow‐up medical care at the surgery‐performing center, but then may follow up closer to where they live. We sought to describe the characteristics and outcomes of pediatric patients who underwent TPIAT at a national surgical referral center and were subsequently followed at our regional subspecialty center, the Children's Hospital Colorado. Methods: We performed a retrospective analysis of baseline and outcomes data for the 10 pediatric patients who underwent TPIAT from 2007 to 2020 and received follow‐up care at our institution. Results: All patients had a diagnosis of CP, and nine of 10 patients had an identified underlying genetic risk factor. Insulin usage was common immediately following TPIAT, but at 1 year of follow‐up, five of nine patients (55.6%) were insulin‐independent and nine of nine had an HbA1c below 6.5%. For the four patients on insulin 1 year after TPIAT, total daily insulin dose ranged from 0.06 to 0.71 units/kg/day. All patients who underwent mixed meal tolerance testing had a robust peak C‐peptide response at 1 year. There were significant improvements in nausea, school/work absences, narcotic dependence, and pancreas‐related hospital admissions 1 year after TPIAT. Conclusions: Patients followed at our center had long‐term improvements with low‐insulin usage, detectable C‐peptide, and improved pancreatitis‐related outcomes after TPIAT. Pediatric patients who undergo TPIAT can be successfully co‐managed in conjunction with the original surgery‐performing center. [ABSTRACT FROM AUTHOR]

Summary: Differences in demographic and environmental niches facilitate plant species coexistence in tropical forests. However, the adaptations that enable species to achieve higher demographic rates (e.g. growth or survival) or occupy unique environmental niches (e.g. waterlogged conditions) remain poorly understood. Anatomical traits may better predict plant environmental and demographic strategies because they are direct measurements of structures involved in these adaptations.We collected 18 leaf and twig traits from 29 tree species in a tropical freshwater swamp forest in Singapore. We estimated demographic parameters of the 29 species from growth and survival models, and degree of association toward swamp habitats. We examined pairwise trait–trait, trait–demography and trait–environment links while controlling for phylogeny.Leaf and twig anatomical traits were better predictors of all demographic parameters than other commonly measured leaf and wood traits. Plants with wider vessels had faster growth rates but lower survival rates. Leaf and spongy mesophyll thickness predicted swamp association.These findings demonstrate the utility of anatomical traits as indicators of plant hydraulic strategies and their links to growth–mortality trade‐offs and waterlogging stress tolerance that underlie species coexistence mechanisms in tropical forest trees. [ABSTRACT FROM AUTHOR]

Quantitative methods to characterize bone contusions and associated cartilage injury remain limited. We combined standardized voxelwise normalization and 3D mapping to automate bone contusion segmentation post‐anterior cruciate ligament (ACL) injury and evaluate anomalies in articular cartilage overlying bone contusions. Forty‐five patients (54% female, 26.4 ± 11.8 days post‐injury) with an ACL tear underwent 3T magnetic resonance imaging of their involved and uninvolved knees. A novel method for voxelwise normalization and 3D anatomical mapping was used to automate segmentation, labeling, and localization of bone contusions in the involved knee. The same mapping system was used to identify the associated articular cartilage overlying bone lesions. Mean regional T1ρ was extracted from articular cartilage regions in both the involved and uninvolved knees for quantitative paired analysis against ipsilateral cartilage within the same compartment outside of the localized bone contusion. At least one bone contusion lesion was detected in the involved knee within the femur and/or tibia following ACL injury in 42 participants. Elevated T1ρ (p = 0.033) signal were documented within the articular cartilage overlying the bone contusions resulting from ACL injury. In contrast, the same cartilaginous regions deprojected onto the uninvolved knees showed no ipsilateral differences (p = 0.795). Automated bone contusion segmentation using standardized voxelwise normalization and 3D mapping deprojection identified altered cartilage overlying bone contusions in the setting of knee ACL injury. [ABSTRACT FROM AUTHOR]

In this article, we examine a chaos theory view of accidental dwelling fire injuries using data from a UK fire and rescue service over a 10‐year period. Although chaos theory could not predict if or when a fire injury will occur for a given individual, chaos theory provided further information above and beyond the typical statistical analyses undertaken by fire and rescue services in terms of identifying pattern repetitions, interconnectedness of circumstances and sensitivity to initial conditions relating to the circumstances of accidental dwelling fire injuries. Householder behaviours such as attempting to tackle the fire or being under the influence of alcohol or drugs were the most prevalent circumstances relating to fire injury over the period studied. Proportions of smoke/toxic fumes inhalation injuries and injuries sustained attempting to fight the fire compared to the overall numbers of fire injuries per year showed pattern repetition over the period studied. In terms of interconnectedness, although there were roughly equal numbers of male and female fire injuries overall, the likelihood of an alcohol‐/drug‐related fire injury or a fire injury resulting from attempting to put out a fire was strongly connected with the gender of the householder involved. [ABSTRACT FROM AUTHOR]

Individuals with neuromuscular disorders display a combination of motor control deficits and lower limb weakness contributing to knee extension deficiency characterized by exaggerated stance phase knee flexion. There is a lack of evidence for long-term improvement of knee extension deficiency with currently available clinical treatment programs. Our previous work testing a wearable robotic exoskeleton with precisely timed assistive torque applied at the knee showed immediate increases in knee extension during walking for children with cerebral palsy, which continued to improve over an acute practice period. When we applied interleaved assistance and resistance to knee extension, we observed improvements in knee extension and increased muscle activation indicating the potential for muscle strengthening when used over time. There is a need for additional, high-quality trials to assess the impact of dosage, intensity and volume of training necessary to see persistent improvement in lower limb function for these patient populations. This randomized crossover study (ClinicalTrials.gov: NCT05726591) was designed to determine whether 12 weeks of overground gait training with a robotic exoskeleton outside of the clinical setting, following an initial in clinic accommodation period, has a beneficial effect on walking ability, muscle activity and overall motor function. Participants will be randomized to either complete the exoskeleton intervention or continue their standard therapy for 12 weeks first, followed by a crossover to the other study component. The primary outcome measure is change in peak knee extension angle during walking; secondary outcome measures include gait speed, strength, and validated clinical scales of motor function and mobility. Assessments will be completed before and after the intervention and at 6 weeks post-intervention, and safety and compliance will be monitored throughout. We hypothesize that the 12-week exoskeleton intervention outside the clinical setting will show greater improvements in study outcome measures than the standard therapy. [ABSTRACT FROM AUTHOR]

Stigmatization is a significant healthcare barrier among individuals who utilize substances during pregnancy. Of the 3.6 million U.S. births each year, approximately 10% are affected by perinatal substance use, an estimate which is likely underestimated due to fear of stigma and prosecution. Of those experiencing perinatal substance use, less than 11% receive treatment, while maternal deaths due to overdose during the postpartum period have increased by 81% from 2017 to 2020. Societal perception of non-pregnant individuals experiencing substance use disorders recognizes the biological basis of addiction, whereas for pregnant individuals, societal perception slides into moral failing as the basis of addiction. Many recommendations and guidelines for decreasing substance use stigmatization among non-pregnant and pregnant individuals exist. We focus on the use of mindfulness in recognizing and addressing structural and social stigma within healthcare systems. Mindfulness has been extracted from its roots as an essential element of the Eightfold Path in Buddhism, which largely centers on living ethically to reduce suffering of self and others. By acknowledging the roots of mindfulness, providers can engage mindfully in practices that help identify one's overarching personal values and encourage one to lead healthcare encounters compassion and willingness to support help-seeking community members who are experiencing suffering. A deeper awareness of mindfulness practices within the context of ethical conduct can support healthcare shifts away from criminalization toward more patient- and family-centered approaches. [ABSTRACT FROM AUTHOR]

The new generation of heterogeneous CPU/GPU computer systems offer much greater computational performance but are not yet widely used for climate modeling. One reason for this is that traditional climate models were written before GPUs were available and would require an extensive overhaul to run on these new machines. In addition, even conventional "high–resolution" simulations don't currently provide enough parallel work to keep GPUs busy, so the benefits of such overhaul would be limited for the types of simulations climate scientists are accustomed to. The vision of the Simple Cloud‐Resolving Energy Exascale Earth System (E3SM) Atmosphere Model (SCREAM) project is to create a global atmospheric model with the architecture to efficiently use GPUs and horizontal resolution sufficient to fully take advantage of GPU parallelism. After 5 years of model development, SCREAM is finally ready for use. In this paper, we describe the design of this new code, its performance on both CPU and heterogeneous machines, and its ability to simulate real‐world climate via a set of four 40 day simulations covering all 4 seasons of the year. Plain Language Summary: This paper describes the design and development of a 3 km version of the Energy Exascale Earth System Model (E3SM) atmosphere model, which has been fully rewritten in C++ using the Kokkos library for performance portability. This newly rewritten model is able to take advantage of the state–of–the–science high performance computing systems which use graphical processor units (GPUs) to mitigate much of the computational expense which typically plagues high–resolution global modeling. Taking advantage of this high–performance we are able to run four seasons of simulations at 3 km global resolution. We discuss the biases, including the diurnal cycle, by comparing model results with satellite and Atmospheric Radiation Measurement ground‐based site data. Key Points: Describes the C++/Kokkos implementation of the Simple Cloud–Resolving E3SM Atmosphere Model (SCREAMv1)SCREAMv1 leverages GPUs to surpass one simulated year per compute day at global 3 km resolutionHigh resolution improves some meso‐scale features and the diurnal cycle but large‐scale biases require improvement across all four seasons [ABSTRACT FROM AUTHOR]

Predation is an important species interaction to monitor when assessing an invasive species' impact on a particular ecosystem, but it can be difficult to observe and thus, fully understand. On Kaua'i island, invasive Barn Owls (Tyto alba) predate native seabirds, but difficult terrain in this region and the cryptic nature of owl predation make traditional monitoring of predation quite challenging. Using Barn Owls collected as part of removal efforts on Kaua'i and Lehua islands, we conducted DNA metabarcoding of owl digestive tracts to detect and determine seabird species they predate. We used a seabird-targeted 12s marker to sequence 112 swabs from 55 owls and detected 6 seabird taxa, including 2 ESA-listed seabirds—Hawaiian Petrel (Pterodroma sandwichensis) and Newell's Shearwater (Puffinus newelli), in 12 swabs from 11 owls (20% of sampled owls). Corresponding morphological assessment of owl stomach contents detected seabird species as prey items in only 2% (1/55) of sampled owls, highlighting the utility of molecular approaches for detecting diet items, especially degraded or visually absent items. Additionally, this approach has proven very useful in revealing cryptic trophic interactions in inaccessible seabird populations. For the most comprehensive analysis of diet, the use of both esophageal and cloacal swabs for metabarcoding is recommended. Supplementing metabarcoding with other methods that can provide complementary prey information, such as stable isotope analysis, would help to characterize trophic interactions more fully. The method described here has proven to be a reliable tool for investigating diet in invasive owls and may be used to investigate cryptic predation in living birds as a minimally invasive technique, as well. [ABSTRACT FROM AUTHOR]

Autistic students are a growing subgroup within post-secondary schooling; however, little is known about barriers to their success in that context. Research suggests autistic students face more challenges to completing post-secondary education than neurotypical students, but findings often rely on expert opinion and fail to incorporate first-hand perspectives. To address this gap, a qualitative inquiry into barriers to success for autistic post-secondary students was conducted. Thematic Analysis yielded 10 themes in three categories, while two separate cross-cutting themes emerged; themes interact with one another, intensifying concerns of autistic students. Findings can support post-secondary institutions to reflect on the extent to which these barriers are present for their autistic students and modify support services accordingly. [ABSTRACT FROM AUTHOR]

Human beings' domination of the planet has not been kind to many species. This is to be expected. Humans have radically altered natural landscapes, harvested heavily from the ocean, and altered the climate in an unprecedented way. Recent concerns over the extent and rate of biodiversity loss have led to renewed interest in extinction outcomes and speculation concerning humans' potential role in any future mass extinction. In this paper, we discuss the economic causes of extinction in two high-profile cases—Sharks and the North American Buffalo—and then extend our analysis to multiple species and discuss the possibility of mass extinction. Throughout, we present evidence drawn from authoritative data sources with a focus on shark populations to ground our analysis. Despite large gaps in our data, the available evidence reveals a worrisome trend: extinction risks are rising for many species and policymakers have been very slow to react. [ABSTRACT FROM AUTHOR]

Reduction of the previously reported Iron (III) complex PhCC4MeFeCl with sodium naphthalide forms the square pyramidal complex PhCC4MeFe (1), cleanly in moderate yield with short reaction times. The related diamagnetic complex PhCC4MeFe(CNtBu) (2) was prepared by addition of an equivalent of tert‐butylisocyanide to a solution of 1. XRD of 2 reveals a rare bent form of the isocyanide moiety with a C−N−C bond angle of 142.67(18)° consistent with sp2 hybridization at the N‐atom while IR spectroscopy reveals an atypically broadened isocyanide stretch at νCNR=1981 cm−1; taken together these metrics are demonstrative of the excellent donor ability of the dianionic penta‐carbene framework and point to a degree of metal‐to‐ligand π‐backbonding rarely seen at isocyanide complexes of iron. [ABSTRACT FROM AUTHOR]

Many faculty perform work as public intellectuals, producing essays, op-eds, interviews, and other forms of media to amplify their academic work. However, educational research has not examined how faculty conceptualize non-academic audiences, influencing who faculty address in their public scholarship and what they work on as public intellectuals. This study engaged with 14 education faculty members to explore how these individuals conceptualized the audiences for their public scholarship. Findings suggest faculty often conceptualize audiences of public scholarship as larger, non-academic audiences, speaking to the constraints of academic audiences. However, faculty often described their audiences as being educated, being educators, and being passionate about education—identities that they held—possibly perpetuating a public echo chamber between education faculty and educators in the public sphere. Implications for faculty development and public scholarship are addressed. [ABSTRACT FROM AUTHOR]

Growing global concerns over water scarcity, worsened by climate change, drive wastewater reclamation efforts. Inadequately treated wastewater presents significant public health risks. Previous studies in South Africa (SA) have reported high norovirus levels in final effluent and sewage-polluted surface water, indicating pathogen removal inefficiency. However, the viability of these virions was not explored. This study assessed human norovirus viability in final effluent from wastewater treatment works (WWTWs) in Pretoria, SA. Between June 2018 and August 2020, 200 samples were collected from two WWTWs, including raw sewage and final effluent. Norovirus concentrations were determined using in-house RNA standards. Viability of noroviruses in final effluent was assessed using viability RT-qPCR (vPCR) with PMAxx™-Triton X-100. There was no significant difference in GI concentrations between raw sewage (p = 0.5663) and final effluent (p = 0.4035) samples at WWTW1 and WWTW2. WWTW1 had significantly higher GII concentrations in raw sewage (p < 0.001) compared to WWTW2. No clear seasonal pattern was observed in norovirus concentrations. At WWTW1, 50% (7/14) of GI- and 64.9% (24/37) of GII-positive final effluent samples had no quantifiable RNA after vPCR. At WWTW2, the majority (92.6%, 25/27) of GII-positive final effluent samples showed a 100% RNA reduction post vPCR. PMAxx™-Triton X-100 vPCR provides a more accurate reflection of discharge of potentially viable noroviruses in the environment than standard RT-qPCR. Despite significant reductions in potentially viable noroviruses after wastewater treatment, the levels of potentially viable viruses in final effluent are still of concern due to the high initial load and low infectious dose of noroviruses. [ABSTRACT FROM AUTHOR]

Chronic migraines result in debilitating pain requiring complex and multifaceted daily management, including acting purposefully to attenuate symptoms and decrease impairment. Experiencing migraines may be more psychologically challenging for adolescent and young adult (AYA) women due to complex and recurrent stressors. This study examined the relationships between illness specific cognitive appraisal mechanisms (i.e., illness uncertainty and illness intrusiveness) and psychological adjustment (i.e., anxious and depressive symptoms) in AYA women with self-reported chronic migraines. AYA women (N = 74, Mage = 20.19, SD = 3.41) with chronic migraines completed measures of illness uncertainty, illness intrusiveness, anxious, and depressive symptoms. Two hierarchical regression analyses indicated that illness uncertainty (B =.44, p <.001) and intrusiveness (B =.27, p =.026) significantly predicted anxious, F(4, 68) = 12.83, p <.001, and depressive symptoms, F(4, 68) = 8.48, p <.001, B =.31, p =.021 and B =.27, p =.037. Greater illness uncertainty and illness intrusiveness were associated with greater anxious and depressive symptoms. Thus, it may be that AYA women who experience chronic migraines have increased perceptions of ambiguity, unpredictability, and disruption to their life that significantly contribute to their psychological adjustment outcomes. This study demonstrates a need for health education on the role of illness related cognitive appraisal mechanisms for AYA women with chronic migraines. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) [ABSTRACT FROM AUTHOR]

Taxon‐specific quantitative PCR (qPCR) assays are commonly used for environmental DNA sampling‐based inference of animal presence. These assays require thorough validation to ensure that amplification truly indicates detection of the target taxon, but a thorough validation is difficult when there are potentially many non‐target taxa, some of which may have incomplete taxonomies. Here, we use a previously published, quantitative model of cross‐amplification risk to describe a framework for assessing qPCR assay specificity when there is missing information and it is not possible to assess assay specificity for each individual non‐target confamilial. In this framework, we predict assay specificity against unsampled taxa (non‐target taxa without sequence data available) using the sequence information that is available for other confamilials. We demonstrate this framework using four case study assays for: (1) An endemic, freshwater arthropod (meltwater stonefly; Lednia tumana), (2) a globally distributed, marine ascidian (Didemnum perlucidum), (3) a continentally distributed freshwater crustacean (virile crayfish; Faxonius virilis, deanae and nais species complex) and (4) a globally distributed freshwater teleost (common carp; Cyprinus carpio and its close relative C. rubrofuscus). We tested the robustness of our approach to missing information by simulating application of our framework for all possible subsamples of 20—all non‐target taxa. Our results suggest that the modelling framework results in estimates which are largely concordant with observed levels of cross‐amplification risk using all available sequence data, even when there are high levels of data missingness. We explore potential limitations and extensions of this approach for assessing assay specificity and provide users with an R Markdown template for generating reproducible reports to support their own assay validation efforts. [ABSTRACT FROM AUTHOR]

Summary: Mornings are salient times for disrupted affect that may be impacted by prior sleep. The current study extends work linking sleep disruptions with negative affect by examining how nightly changes in sleep duration, timing, and quality relative to a person's average impact morning affect. We further tested whether depression severity moderated the relationship between nightly variations in sleep and morning affect. This is a secondary analysis of participants ages 18–65 years with varying levels of depression (N = 91) who wore an Actiwatch for 3–17 days (n = 73) while reporting morning affect using a visual analogue scale. Multilevel models tested the previous night's sleep duration, timing, or quality as a predictor of morning affect. Sleep measures were group‐mean centred to account for nightly variation in participants' sleep. A cross‐level interaction between depression severity and nightly sleep was entered. Sleeping longer (b = 0.1; p < 0.001) and later (b = 1.8; p = 0.01) than usual were both associated with better morning mood. There was a significant interaction between nightly actigraphic sleep duration and depression severity on morning affect (b = 0.003; p = 0.003). Participants with higher depression severity reported worse affect upon waking after sleeping less than their usual. In comparison, sleeping less than usual did not affect morning affect ratings for participants with lower depression. A similar interaction was found for sleep quality (b = 0.02; p < 0.001). There was no interaction for midsleep timing. Sleeping less than usual impacted morning affect in individuals with greater depression, potentially suggesting a pathway by which sleep disturbances perpetuate depression. [ABSTRACT FROM AUTHOR]

Background: Although firefighters have increased risk for colon and prostate cancer, limited information exists on screening practices for these cancers in volunteer firefighters who compose two‐thirds of the US fire service. We estimated the prevalence of colon and prostate cancer screening among volunteer firefighters using eligibility criteria from 4 evidence‐based screening recommendations and evaluated factors influencing screening. Methods: We evaluated colon (n = 569) and prostate (n = 498) cancer screening prevalence in a sample of US volunteer firefighters using eligibility criteria from the US Preventive Services Taskforce (USPSTF), National Fire Protection Association, American Cancer Society, and National Comprehensive Cancer Network. We assessed associations with fire service experience, demographics, and cancer risk perception based on USPSTF guidelines. Results: For those eligible based on USPSTF guidelines, colon and prostate cancer screening prevalence was 51.7% (95% CI: 45.7, 57.8) and 48.8% (95% CI: 40.0, 57.6), respectively. Higher odds of colon and prostate cancer screening were observed with older age and with some college education compared to those with less education. Fire service experience and cancer risk perception were not associated with screening practices. Conclusion: This is the first large study to assess colon and prostate cancer screening among US volunteer firefighters based on different screening guidelines. Our findings suggest gaps in cancer prevention efforts in the US volunteer fire service. Promoting cancer screening education and opportunities for volunteer firefighters by their fire departments, healthcare professionals, and public health practitioners, may help to address the gaps. [ABSTRACT FROM AUTHOR]

Background: Induced pluripotent stem cell-derived microglia (iMGL) represent an excellent tool in studying microglial function in health and disease. Yet, since differentiation and survival of iMGL are highly reliant on colony-stimulating factor 1 receptor (CSF1R) signaling, it is difficult to use iMGL to study microglial dysfunction associated with pathogenic defects in CSF1R. Methods: Serial modifications to an existing iMGL protocol were made, including but not limited to changes in growth factor combination to drive microglial differentiation, until successful derivation of microglia-like cells from an adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) patient carrying a c.2350G > A (p.V784M) CSF1R variant. Using healthy control lines, the quality of the new iMGL protocol was validated through cell yield assessment, measurement of microglia marker expression, transcriptomic comparison to primary microglia, and evaluation of inflammatory and phagocytic activities. Similarly, molecular and functional characterization of the ALSP patient-derived iMGL was carried out in comparison to healthy control iMGL. Results: The newly devised protocol allowed the generation of iMGL with enhanced transcriptomic similarity to cultured primary human microglia and with higher scavenging and inflammatory competence at ~ threefold greater yield compared to the original protocol. Using this protocol, decreased CSF1R autophosphorylation and cell surface expression was observed in iMGL derived from the ALSP patient compared to those derived from healthy controls. Additionally, ALSP patient-derived iMGL presented a migratory defect accompanying a temporal reduction in purinergic receptor P2Y12 (P2RY12) expression, a heightened capacity to internalize myelin, as well as heightened inflammatory response to Pam3CSK4. Poor P2RY12 expression was confirmed to be a consequence of CSF1R haploinsufficiency, as this feature was also observed following CSF1R knockdown or inhibition in mature control iMGL, and in CSF1RWT/KO and CSF1RWT/E633K iMGL compared to their respective isogenic controls. Conclusions: We optimized a pre-existing iMGL protocol, generating a powerful tool to study microglial involvement in human neurological diseases. Using the optimized protocol, we have generated for the first time iMGL from an ALSP patient carrying a pathogenic CSF1R variant, with preliminary characterization pointing toward functional alterations in migratory, phagocytic and inflammatory activities. [ABSTRACT FROM AUTHOR]

Background The National Institutes of Health (NIH) mobilized more than $4 billion in extramural funding for the COVID-19 pandemic. Assessing the research output from this effort is crucial to understanding how the scientific community leveraged federal funding and responded to this public health crisis. Methods NIH-funded COVID-19 grants awarded between January 2020 and December 2021 were identified from NIH Research Portfolio Online Reporting Tools Expenditures and Results using the "COVID-19 Response" filter. PubMed identifications of publications under these grants were collected and the NIH iCite tool was used to determine citation counts and focus (eg, clinical, animal). iCite and the NIH's LitCOVID database were used to identify publications directly related to COVID-19. Publication titles and Medical Subject Heading terms were used as inputs to a machine learning–based model built to identify common topics/themes within the publications. Results and Conclusions We evaluated 2401 grants that resulted in 14 654 publications. The majority of these papers were published in peer-reviewed journals, though 483 were published to preprint servers. In total, 2764 (19%) papers were directly related to COVID-19 and generated 252 029 citations. These papers were mostly clinically focused (62%), followed by cell/molecular (32%), and animal focused (6%). Roughly 60% of preprint publications were cell/molecular-focused, compared with 26% of nonpreprint publications. The machine learning–based model identified the top 3 research topics to be clinical trials and outcomes research (8.5% of papers), coronavirus-related heart and lung damage (7.3%), and COVID-19 transmission/epidemiology (7.2%). This study provides key insights regarding how researchers leveraged federal funding to study the COVID-19 pandemic during its initial phase. [ABSTRACT FROM AUTHOR]

Large horizontal winds and shears across the mesopause region have been observed by sounding rockets and satellites but with limited simultaneous temperature profiles to date. This feature is critical to the diagnosis of the insitu dynamic conditions. Theories suggest this feature may be related to variations of the atmosphere static stability, Brunt‐Väisälä frequency square (N2), and the wave activity in the mesosphere and lower thermosphere (MLT) that cannot be resolved by the models. Since 2020, the Na Doppler lidar at Utah State University has attained several hundred hours of wind and temperature profiles in the MLT up to ∼110 km altitude. This paper focuses on the variations of these large winds and shears (>40 m/s/km), along with their potential relation to the activities of the various scales of gravity waves in the static state upper mesosphere, measured coordinately by the Advanced Mesospheric Temperature Mapper operating alongside the lidar. The investigation reveals that larger shears tend to occur in the meridional direction than the zonal direction and are observed more frequently in winter. The shears are comparable in both directions in summer and more large shears were observed in zonal direction. In addition, small shears occur when the medium‐scale waves are completely or partially blocked by the mean wind, though no convincing evidence relates small‐scale wave activities with these large winds and shears. Furthermore, small and decreasing N2 in the upper mesopause region are associated with insignificant magnitude of the shears. Plain Language Summary: Throughout the year, extremely large horizontal wind shears in the atmosphere occur in the mesopause region near or above 105 km altitude around the globe. Theoretical and numerical simulations suggest their formation is closely related to the atmospheric gravity waves generated in the troposphere, but experimental observations at these altitudes are difficult to obtain. In this paper, an advanced wind and temperature lidar and a temperature mapper are utilized at Utah State University to investigate this topic comprehensively. The coordinated campaigns by the two instruments are capable of observing these large shears and the gravity wave behaviors in the mesopause region simultaneously, providing critical information to understand this dramatic atmospheric feature. Key Points: The large horizontal winds and the associated shears occur more frequently in the meridional wind than the zonal windThe very large shears occur more in the winter than summerThe large shears are highly correlated with medium scale gravity waves with large horizontal phase speed and long horizontal wavelength [ABSTRACT FROM AUTHOR]

This study examines changes in college students' relationships with their grandparents during the COVID-19 pandemic and lockdown, and whether these relationship changes were associated with college students' coping with the pandemic and mental health. 441 college students (76% female) completed an online survey. The majority of participants reported changes to the grandparent-grandchild relationship. Reduced contact and closeness was the most commonly reported change and was related to greater participant COVID-19 concerns and anticipatory grief for grandparents. A small number of participants reported increased closeness, which was related to their lower anxiety and depression. For younger students, grandparent contracting COVID-19 was associated with lower COVID-19 concerns and greater negative reactions to lockdown restrictions. [ABSTRACT FROM AUTHOR]

Pulmonary balloon valvuloplasty (PBV) is the treatment of choice for subjects with isolated pulmonary valve stenosis (IPS). The purpose of this study was to define fetal echocardiographic features associated with an inpatient PBV prior to newborn hospital discharge and characterize resource utilization of IPS fetuses among participating centers. Six center, retrospective case series of singleton fetuses identified between 2010 and 2020 with IPS. Third-trimester echocardiogram data was compared with postnatal data, included pulmonary valve Doppler velocities, pulmonary valve insufficiency and ductus arteriosus flow direction. Comparison between subjects who underwent inpatient PBV during their newborn hospital admission versus those infants referred for outpatient PBV after initial hospital discharge. We analyzed data by logistic regression, student t test and Chi-Square testing with a p value of ≤ 0.05 considered statistically significant. Forty-nine IPS fetuses were identified. Thirty-eight (78%) underwent inpatient PBV at 5 (range 1–58) days and 11 (22%) underwent outpatient PBV at 51.8 (11–174) days. Newborns requiring an inpatient PBV were more likely to have one or more characteristics on 3rd-trimester fetal echocardiogram: left to right or bidirectional ductus arteriosus flow (61% vs 0%), and/or a peak pulmonary valve velocity > 3.0 m/s (odds ratio 16.9, 95% confidence interval 3.02–94.17) with a sensitivity of 90.4% and specificity of 97.7%. Ductus arteriosus flow direction and pulmonary valve peak velocity in the 3rd trimester can successfully predict the need for newborn inpatient PBV. We speculate these findings may be useful in choosing delivery site for the pregnancy complicated by fetal IPS. [ABSTRACT FROM AUTHOR]