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Sustainable crop production systems should promote large and diverse soil microbial communities to enhance biological soil processes rather than depend solely on chemical interventions that include pesticide applications. Crop rotation increases above-ground temporal diversity which, relative to monoculture, usually increases soil microbial diversity. But comparisons between short and long crop rotations that also include pesticide effects are rare. A 5-yr (2013-2017) field study was conducted to investigate crop rotation and fungicide effects on the soil microbiome and activity. There were nine rotations, with or without fungicide applications, that included four 2-yr rotations (wheat preceded by canola, barley, pea, or flax), four 3-yr rotations where barley or canola were added to the 2-yr rotations, and one rotation where canola and wheat were stacked (canola-canola-wheat-wheat). In 2017, soil microbial biomass, composition, diversity and enzyme activities were measured in the rhizosphere of the final wheat crop in each rotation. Fungicides reduced fungal richness (the number of different fungal taxa) in the wheat rhizosphere (e.g., Chao1 indices of 64.0 vs. 79.9) especially in 2-yr rotations, but rotation length/type and the crops that preceded wheat had different effects on different taxa. Two of the three most predominant prokaryotic phyla, Proteobacteriota and Actinobacteriota, responded differently to rotation length: 3-yr rotations enriched the former (27.4% vs. 20.1% relative abundances), but 2-yr rotations enriched the latter (19.9% vs. 28.3% relative abundances). Relative to oilseed crops preceding the sampled wheat, a field pea preceding crop enriched Actinobacteriota (31.7% vs. 24.8% relative abundances) and the most abundant fungal class, Sordariomycetes (39.1% vs. 22.1% relative abundances), in addition to increasing microbial biomass carbon (MBC) and arylsulphatase activity by 33% and 57%, respectively. Correlations of the relative abundances of fungal or prokaryotic genera with β-glucosidase and arylsulphatase activities were similar (both positive or negative), but they were the opposite of correlations with acid phosphomonoesterase, suggesting a close link between C and S cycling. Besides the nutrient cycling implications of these soil microbial characteristics, there is need to study their biological disease control significance.

Although herbicides have been a dominant and effective weed control strategy for decades in Western Canada, herbicide resistance and the lack of new modes of action have resulted in weed management challenges. Integrated weed management strategies have been shown to be successful in controlling certain weed species that are problematic in cropping systems. The objective of this study was to investigate integrated weed management strategies that have been successful on individual species to determine their applicability to a multiple weed species that may coexist in a field. In addition, harvest weed seed control was incorporated into these integrated weed management strategies to determine its impact in western Canadian cropping systems. A 5-year rotational study was conducted from 2016 to 2020 at Beaverlodge, Lacombe, and Lethbridge, AB; Scott and Saskatoon, SK; and Carman, MB, that incorporated integrated weed management strategies such as rotational crop diversity (including winter annuals and perennials), increased seeding rates, crop silaging, chaff collection, and with or without in-crop herbicides. This research confirmed success in managing some species of weeds such as wild oat when increased seeding rates, 2 years of early cut silage barley, and competitive winter cereals were incorporated into a cropping system, even when no in-crop herbicides were applied. However, some weed growth morphologies (e.g., twining weeds) or life cycles (e.g., facultative winter annuals) were not managed successfully with this combination of strategies. Chaff collection provided incremental weed control benefits but did not serve as a replacement for herbicidal weed control. Weed densities had an apparent impact on the success of these integrated weed management strategies, suggesting that the sooner they are adopted, the more likely they are to be successful at maintaining or reducing weed densities. This study not only showed the ability to reduce reliance on herbicides with strategies that can be effective in Western Canada but also highlighted the need for further understanding of different weed species and their responses to integrated weed management strategies, as well as the complexity of managing a weed community with integrated weed management.

Potential host range and spillover risk for novel viruses can be predicted using a network informed by known virus-host associations.

Peatlands have been widely studied in terms of their ecohydrology, carbon dynamics, ecosystem services and palaeoenvironmental archives. However, several assumptions are frequently made about peatlands in the academic literature, practitioner reports and the popular media which are either ambiguous or in some cases incorrect. Here we discuss the following ten common assumptions about peatlands: 1. the northern peatland carbon store will shrink under a warming climate; 2. peatlands are fragile ecosystems; 3. wet peatlands have greater rates of net carbon accumulation; 4. different rules apply to tropical peatlands; 5. peat is a single soil type; 6. peatlands behave like sponges; 7. Sphagnum is the main ‘ecosystem engineer’ in peatlands; 8. a single core provides a representative palaeo-archive from a peatland; 9. water-table reconstructions from peatlands provide direct records of past climate change; and 10. restoration of peatlands results in the re-establishment of their carbon sink function. In each case we consider the evidence supporting the assumption and, where appropriate, identify its shortcomings or ways in which it may be misleading.

Stretchable batteries are needed to accommodate deformable geometries in tantalizing applications such as smart textiles, biomedical implants, and stretchable electronics. An increasing number of studies have focused on flexible and bendable batteries, but very few have investigated a stretchable lithium ion battery in which some or all components, including the electrodes, electrolyte, and encapsulation may be stretched. Here, we report the design, fabrication and characterization of a stretchable-sliding battery where the electrodes can slide, and the solid polymer electrolyte is stretched. The battery consists of a single solid polymer electrolyte film sandwiched between two sliding layered electrodes on each side. The two cathode layers are based on LiFePO4 active material, and the two anode layers are graphite based. The stretchable polymer electrolyte is composed of a specific blend of polyethylene oxide (PEO) of 100k and 600k molecular weights to enhance both the ionic conductivity and mechanical properties. Results show that the capacity of the stretchable-sliding battery increases at small tensile strains, but can degrade at larger strains. Tensile stress-strain curves of the stretchable battery and its components until failure are also presented. In situ strain-dependent electrochemical measurements provide critical insights on the stretching and sliding mechanisms in the battery. This study further validates the dual-functionality of the PEO solid electrolyte as both a stretchable film and a lithium ion conductor in a charged/discharged battery. This stretchable-sliding battery configuration can offer an experimental platform for in situ characterizations of solid polymer electrolyte films subjected to stretching inside an active electrochemical cell.

The mitochondrial inner membrane proteases YME1L and OMA1 are critical regulators of essential mitochondrial functions, including inner membrane proteostasis maintenance and mitochondrial dynamics. Here, we show that YME1L and OMA1 are reciprocally degraded in response to distinct types of cellular stress. OMA1 is degraded through a YME1L-dependent mechanism in response to toxic insults that depolarize the mitochondrial membrane. Alternatively, insults that depolarize mitochondria and deplete cellular ATP stabilize active OMA1 and promote YME1L degradation. We show that the differential degradation of YME1L and OMA1 alters their proteolytic processing of the dynamin-like GTPase OPA1, a critical regulator of mitochondrial inner membrane morphology, which influences the recovery of tubular mitochondria following membrane-depolarization-induced fragmentation. Our results reveal the differential stress-induced degradation of YME1L and OMA1 as a mechanism for sensitively adapting mitochondrial inner membrane protease activity and function in response to distinct types of cellular insults.

Abstract Young children exposed to trauma are vulnerable to developing posttraumatic stress disorder (PTSD). Although experts agree on the importance of tailoring PTSD assessments to be developmentally-appropriate for young children, there is little research on which assessment methods best identify clinically significant symptomatology in this difficult-to-assess population. Two competing models for assessing PTSD have been proposed by the DSM-5 and ICD-11. This study compared a DSM-5 measure to an ICD-11 measure in young children (ages 1–6) exposed to a natural disaster. The measures identified similar rates of PTSD in children; however, diagnostic agreement between the measures was low (31–36%). Both PTSD measures were associated with actual and perceived life threat, functional impairment, and comorbid psychopathology. PTSD symptom and cluster endorsement rates were also binned by age and compared to functional impairment to identify commonly-reported and highly impairing symptoms in trauma-exposed young children, as potential candidates for inclusion in future revisions of diagnostic criteria. Across age ranges, increased clinginess post-trauma was the most commonly reported symptom and was associated with functional impairment. Arousal symptoms (startle, hypervigilance) and Re-experiencing symptoms (nightmares) also emerged as relevant for young children. Findings may contribute to efforts to improve assessment for PTSD in young children.

Abstract Background Diet and exercise are important components of treatment for complex chronic conditions, however access to allied health support is limited. When available, support is often siloed and fragmented. Digital health incorporating patient choice may help to align health care services with preferences and goals. This study evaluated the implementation of a ubiquitously accessible patient-centred digital health diet and exercise service. Methods U-DECIDE was a single-centre, 26-week randomised controlled trial set in kidney and liver disease clinics in a tertiary hospital in Brisbane, Australia. Participants were adults with a complex chronic condition referred for dietetic consultation with at least one feature of the metabolic syndrome. All participants received a dietary consultation, an activity monitor and usual care. Intervention participants were offered one text message per week and access to additional digital health options (increased text message frequency, nutrition app, exercise app, group-based diet and/or exercise video consultations). The primary outcome of feasibility was determined by safety (study-related serious adverse events: SRSAEs), recruitment (≥ 50% eligible patients), retention (≥ 70%), exposure uptake (≥ 75% of intervention group had greater access to health professional contact than comparator) and video consultation adherence (≥ 80% attendance). Secondary outcomes included process evaluation metrics and clinical outcomes. Results Of 67 participants (intervention n = 33, comparator n = 34), 37 (55%) were men, median (IQR) age was 51 (41–58) years. The most chosen digital health options were the nutrition app (n = 29, 88%) and exercise video consultations (n = 26, 79%). Only one participant chose no additional digital health options. The intervention group had no SRSAEs. The study exceeded targets for recruitment (52%), retention (81%) and exposure uptake (94%). Video consultation adherence was 42%. Engagement across digital health options was inconsistent. Conclusions Digital health options incorporating patient choice were feasible and can be offered to people with complex chronic disease as a service model option. Trial registration Australia and New Zealand Trials Register: Trial Registration Number: ACTRN12620001282976. Registered 27th November 2020.

Background As an emerging approach, arts-based research holds potential to advance understanding of the complex and multidimensional experiences of chronic pain and means of communicating this experiential evidence. This scoping review aimed to map and explore the extent of arts-based research in chronic non-cancer pain, understand the rationale behind using arts-based research methods, and identify directions for future research.Methods Databases PsycINFO, MEDLINE, EMBASE, and CINAHL were searched for eligible English-language articles from inception to November 2022. Out of 1321 article titles and abstracts screened for eligibility, 18 articles underwent full-text screening, with 14 ultimately meeting all inclusion criteria. We conducted a narrative synthesis of data extracted from the 14 reviewed articles.Results The review articles focused on a wide range of chronic non-cancer pain conditions, with 12/14 employing qualitative methods (86%), one repeated measures experimental design, and another a multiphase, multimethod design. Seven articles described the use of drawing, painting, or mixed-media artwork; four used photography; two used body mapping; and one used e-book creation. The rationale for arts-based research included exploring and better understanding patients’ experiences with chronic non-cancer pain, constructing an intervention, and investigating or validating a clinical tool. Nine articles reported that their arts-based research methods produced unintended therapeutic benefits for participants. Recommendations for future research included using arts-based research to better understand and communicate with patients and providers, exploring convergence with art therapy, and designing creative and flexible multiphased studies involving collaboration across disciplines.Conclusions Despite the wide variation in sample and art modalities across reviewed articles, arts-based methods were considered suitable and highly effective for investigating chronic non-cancer pain.

ABSTRACT The objective of the study was to ascertain an optimal Helicobacter pylori diagnostic strategy using population-level laboratory data comparing the performance of serology against urea breath test (UBT). H. pylori diagnostic test results for serology and UBT from two laboratories over a 12-year period (2006–20017) were extracted, linked, and analyzed. A subset of this population underwent both methods of testing within days of each other, enabling a direct comparison of the two methods. The average prevalence of H. pylori positivity was 21.3% by serology and 17.5% by UBT. There were 2,612 individuals who had serology performed first, followed by UBT within 14 days. For this subset, the sensitivity of serology compared with UBT was 96.5% with a specificity of 79.2%. The negative predictive value for serology was 98.4%. Contrary to various recent clinical guidelines, the data show that serology still has utility as a sensitive enough test to be used as an initial H. pylori screening test in a lower prevalence population. Negative serology can be used with confidence to rule out active infection, whereas a positive serology could be followed up with a UBT or a similar performing test such as stool antigen to differentiate active from past infection. For population-based diagnostic recommendations, such a strategy may be ideal since serology generally costs less than UBT and may be combined with a blood draw being done for other diagnostic tests. Continuing to offer serology increases options for patients and may provide economic benefits for single-payer health care systems or health maintenance organizations.IMPORTANCEThis study compares the performance of serology with urea breath test in the diagnosis of Helicobacter pylori in a population-level data set and mimics a head-to-head direct comparison as the study population had both tests performed within 2 weeks of each other. This provides new information supporting the use of serology in a diagnostic algorithm. There are several instances where serology could be preferable to patients to rule out disease, despite some guidelines suggesting serology should not be used.

Although the social determinants of health have guided equity work with the tailoring of men’s health promotion programs, the role of, and potential for, the commercial determinants of health in those interventions is rarely addressed and poorly understood. While four commercial products, tobacco, alcohol, ultra-processed food, and fossil fuels, account for more than a third of global deaths, there is a need to recognize that consumer goods industries can make both positive and negative contributions to health. This article begins much-needed discussions about what we might learn from, and strategically tap in the commercial sector to seed, scale, and sustain men’s health promotion programs. Three case studies, online sports betting, beer and the rise of the nonny, and athleisurewear, are discussed. Connections between online sports betting and masculinities explain young men’s disproportionate involvement and gambling addictions with recommendations to legislate an end to gambling advertisements and de-incentivize industry profiteering through penalties and higher taxes. Regarding beer and the rise of the nonny, brewers have innovated with non-alcoholic beer based on shifting consumption patterns and masculinities in their core market—men. The nonny reminds health promoters to know their end-user’s values and behaviors to bolster program acceptability. Detailing Under Armour and Lululemon, two highly gendered but diversifying athleisurewear brands, the complexities of, and potential for, leveraging public health and industry collaborations are underscored. Taken together, the article findings suggest men’s health promoters should rigorously explore tapping key commercial entities and tax revenues to advance the health of men and their communities.

Abstract Defining children’s “trauma exposure” in the context of the COVID-19 pandemic has been a source of debate. Children were exposed to threatening messaging about COVID-19 but might interpret this information differently than adults. Perceived life threat (PLT), the belief that one’s life is in danger, has been identified as a robust predictor of posttraumatic stress symptoms (PTSS), and may be a better predictor of PTSS than actual life threat (ALT). This study investigated parent reports of children’s self-PLT (belief that they might die from COVID-19) and family-PLT (belief that a family member might die from COVID-19). The aims were to compare PLT to ALT, evaluate their associations with children’s psychological functioning, and identify risk factors associated with PLT. We hypothesized an association between PLT and children’s psychological functioning in the context of the COVID-19 pandemic. Parents (N = 140) reported on their child’s (M age = 9.81 years, 47% female) pandemic experiences, psychological functioning, and both self-PLT and family-PLT. Results revealed self-PLT for 10% of the children and family-PLT for 43% of the children, yet only 6% experienced ALT (i.e., they or their parent tested positive for COVID-19). Children with reported self- or family-PLT had higher PTSS, depressive symptoms, anxiety symptoms, and functional impairment compared to children without these reported beliefs. PLT, but not ALT, was associated with psychological outcomes. Children with only PLT had greater PTSS and impairment than children with ALT. There were differences in parental functioning and pandemic-related information/media exposure between children with and without PLT. Children’s perceptions, rather than objective experiences, may be more central to their psychological functioning. This has implications for screening for pandemic-related symptomatology in children as traditional trauma exposure measures may not adequately identify distressed children.

Purpose: To develop a deep learning model for the detection of Segond fractures on anteroposterior (AP) knee radiographs and to compare model performance to that of trained human experts. Methods: AP knee radiographs were retrieved from the Hospital for Special Surgery ACL Registry, which enrolled patients between 2009 and 2013. All images corresponded to patients who underwent anterior cruciate ligament reconstruction by 1 of 23 surgeons included in the registry data. Images were categorized into 1 of 2 classes based on radiographic evidence of a Segond fracture and manually annotated. Seventy percent of the images were used to populate the training set, while 20% and 10% were reserved for the validation and test sets, respectively. Images from the test set were used to compare model performance to that of expert human observers, including an orthopaedic surgery sports medicine fellow and a fellowship-trained orthopaedic sports medicine surgeon with over 10 years of experience. Results: A total of 324 AP knee radiographs were retrieved, of which 34 (10.4%) images demonstrated evidence of a Segond fracture. The overall mean average precision (mAP) was 0.985, and this was maintained on the Segond fracture class (mAP = 0.978, precision = 0.844, recall = 1). The model demonstrated 100% accuracy with perfect sensitivity and specificity when applied to the independent testing set and the ability to meet or exceed human sensitivity and specificity in all cases. Compared to an orthopaedic surgery sports medicine fellow, the model required 0.3% of the total time needed to evaluate and classify images in the independent test set. Conclusions: A deep learning model was developed and internally validated for Segond fracture detection on AP radiographs and demonstrated perfect accuracy, sensitivity, and specificity on a small test set of radiographs with and without Segond fractures. The model demonstrated superior performance compared with expert human observers. Clinical Relevance: Deep learning can be used for automated Segond fracture identification on radiographs, leading to improved diagnosis of easily missed concomitant injuries, including lateral meniscus tears. Automated identification of Segond fractures can also enable large-scale studies on the incidence and clinical significance of these fractures, which may lead to improved management and outcomes for patients with knee injuries.

Objective The acceptability of being offered a choice from a suite of digital health service options to support optimal diet and exercise behaviors in adults with complex chronic conditions was evaluated. This study sought to understand many areas of acceptability including satisfaction, ease of use, usefulness and user appropriateness and perceived effectiveness. Methods This mixed-methods study was embedded within a randomized-controlled feasibility trial providing digital health services managing diet and exercise for adults from specialist kidney and liver disease clinics. Post study surveys and semistructured interviews were used to determine patients’ acceptability of the trial interventions. Quantitative (surveys) and qualitative (surveys and interviews) results were merged using integrative analysis and mapped to each construct of the modified version of the Theoretical Framework of Acceptability. Results Seventeen interviews (intervention group) and 50 surveys ( n = 24 intervention, n = 26 comparator) completed from a possible 67 participants were analyzed. In the intervention group, the survey results revealed high areas of acceptability for the digital health services including overall support received, ease of use, timely advice and feeling safe. The interviews also revealed high areas of acceptability including convenience, ability to adopt healthier behaviors and having regular interactions with health professionals. However, the interviews also revealed lower areas of acceptability as a result of absence of individualization, low digital literacy, and limitations from life circumstances. Conclusions Recipients of digital health services that supported diet and exercise interventions found these useful, effective, and safe. Individualized care, technical support and patient confidence remain important to improve the acceptability of digital health service interventions.

Abstract Problem Disordered eating, such as binge, graze, and emotional eating, has been strongly linked to weight gain. Improved understanding of disordered eating by adults who elect bariatric weight loss procedures in a real‐world setting is required. Purpose To determine the association between the number and type of disordered eating patterns (DEPs), as described by healthcare professionals during routine care without standardized assessment, with clinical outcomes in adults who elected a bariatric weight loss procedure. Method An observational cohort study recruited laparoscopic sleeve gastrectomy (LSG) and endoscopic sleeve gastroplasty (ESG) patients. DEPs documented in the medical record during routine care were observed and tested for association with events (symptoms, side‐effects, or adverse events), micronutrient deficiencies, weight loss, and attrition. Data were observed up to 12‐month post‐procedure. Results 215 LSG and 32 ESG patients were recruited. The mean number of DEPs was 6.4 (SD: 2.1) and 6.4 (SD: 2.1) in the LSG and ESG cohorts, respectively. Night eating was associated with a higher number of events (p

Abstract Background Behavioural support via mobile health (mHealth) is emerging. This study aimed to assess the feasibility, acceptability, cost, and potential effect on weight of a mHealth follow-up program in bariatric surgery. Methods This was a non-randomised feasibility study describing intervention development and proof in the concept of a mHealth follow-up program in bariatric surgery. The study compares a prospective cohort with a historical control group and was conducted in a tertiary bariatric surgery service in Australia. The intervention group included individuals who had bariatric surgery (2019–2021) and owned a smart device, and the historical control group received usual postoperative care (2018). The intervention involved usual care plus codesigned biweekly text messages, monthly email newsletters, and online resources/videos over a 6-month period. The primary outcome measures included feasibility (via recruitment and retention rate), acceptability (via mixed methods), marginal costs, and weight 12 months postoperatively. Quantitative analysis was performed, including descriptive statistics and inferential and regression analysis. Multivariate linear regression and mixed-effects models were undertaken to test the potential intervention effect. Qualitative analysis was performed using inductive content analysis. Results The study included 176 participants (n = 129 historical control, n = 47 intervention group; mean age 56 years). Of the 50 eligible patients, 48 consented to participate (96% recruitment rate). One participant opted out of the mHealth program entirely without disclosing their reason (98% retention rate). The survey response rate was low (n = 16/47, 34%). Participants agreed/strongly agreed that text messages supported new behaviours (n = 13/15, 87%); however, few agreed/strongly agreed that the messages motivated goal setting and self-monitoring (n = 8/15, 53%), dietary change (n = 6/15, 40%), or physical activity (n = 5/15, 33%). Interviews generated four main themes (n = 12): ‘motivators and expectations’, ‘preferences and relevance’, ‘reinforced information”, and ‘wanting social support’. The intervention reinforced information, email newsletters were lengthy/challenging to read, and text messages were favoured, yet tailoring was recommended. The intervention cost AUD 11.04 per person. The mean 12-month weight was 86 ± 16 kg and 90 ± 16 kg (intervention and historical control) with no statistically significant difference. Intervention recipients enrolled at 3 months postoperatively demonstrated a statistically significant difference in 12-month weight (p = 0.014). Conclusion Although this study observed high rates of recruitment and retention, findings should be considered with caution as mHealth may have been embraced more by the intervention cohort as a result of the 2019 coronavirus pandemic. Of the various digital strategies developed and tested, the text message approach was the most acceptable; however, future intervention iterations could be strengthened through tailoring information when possible. The use of email newsletters and online resources/videos requires further testing of effectiveness to determine their value for continued use in bariatric surgery services.

After primary infection, human cytomegalovirus (HCMV) establishes lifelong persistence, underpinned by latent carriage of the virus with spontaneous reactivation events. In the immune-competent, primary infection or reactivation from latency rarely causes disease. However, HCMV can cause significant disease in immune-compromised individuals such as immune-suppressed transplant patients. Latency, where the viral genome is carried in the absence of the production of infectious virions, can be established in undifferentiated cells of the myeloid lineage. A number of stimuli can cause virus reactivation from latency to occur, beginning with the induction of viral immediate-early (IE) lytic gene expression. The suppression of viral IE gene expression to establish and maintain latent infection is known to result from a balance of viral and cellular factors. One key viral factor involved in this is the G protein-coupled receptor US28. Recently, we have shown that US28 is targeted for degradation by a modified nanobody (PCTD-Vun100bv) based on the novel PACTAC (PCSK9-antibody clearance-targeting chimeras) approach for targeted protein degradation. Furthermore, we have shown that this PCTD-Vun100bv-induced degradation of US28 results in IE gene expression in experimentally latently infected CD14+ monocytes. However, HCMV also establishes latency in CD34+ bone marrow cells, the progenitors of CD14+ cells. Here, we show that PCTD-Vun100bv also causes US28 degradation in these CD34+ primary cells, again resulting in the induction of viral IE gene expression. Additionally, we show that PCTD-Vun100bv can target US28 in naturally latently infected CD14+ monocytes from an HCMV-seropositive donor, allowing these latently infected cells to be killed by HCMV-specific cytotoxic T cells from that same donor. These observations support the view that targeting US28 for degradation during natural latency could be a tractable ‘shock-and-kill’ strategy to target the latent HCMV reservoir in myeloid cells.

This study investigated the association of physiological attributes with in-game workload measures during competitive Gaelic football match-play. Fifty-two male developmental level Gaelic football players (mean ± SD; age: 22.9 ± 3.8 years) underwent measurements of anthropometric characteristics, running speed, muscular strength and power, blood lactate (BLa), running economy and aerobic capacity during two separate testing visits. Global Positioning System units (18-Hz) were used to record players in-game workloads during a competitive match 1-week following the baseline physiological assessments. Results indicated that players body fat percentage, drop jump height (DJ) and running velocity at 4 mmol · L −1 BLa were significantly associated with the number of high-speed runs completed (Adjusted R 2 26.8% to 39.5%; p < 0.05) while 20 m running speed, running velocity at 2 mmol · L −1 BLa and DJ were significantly associated with the number of accelerations completed (Adjusted R 2 17.2% to 22.0%; p < 0.05) during match-play. Additionally, aerobic capacity and body fat percentage were significantly associated with total distance (Adjusted R 2 14.4% to 22.4%; p < 0.05) while body fat percentage, DJ and 20 m running speed were significantly associated with high speed distance (Adjusted R 2 17.8% to 22.0%; p < 0.05). Players were also divided into higher-standard and lower standard groups using a median split of these physiological attributes. Players in the higher-standard groups completed significantly more high-speed runs and accelerations and covered significantly larger total and high-speed distances (+10.4% to +36.8%; ES = 0.67 to 0.88; p < 0.05) when compared to the lower-standard groups. Thisstudy demonstrates that superior levels of physical conditioning are associated with larger in-game workloads during Gaelic football match-play.

Summary: A limitation of conventional bulk-tissue proteome studies in amyotrophic lateral sclerosis (ALS) is the confounding of motor neuron (MN) signals by admixed non-MN proteins. Here, we leverage laser capture microdissection and nanoPOTS single-cell mass spectrometry-based proteomics to query changes in protein expression in single MNs from postmortem ALS and control tissues. In a follow-up analysis, we examine the impact of stratification of MNs based on cytoplasmic transactive response DNA-binding protein 43 (TDP-43)+ inclusion pathology on the profiles of 2,238 proteins. We report extensive overlap in differentially abundant proteins identified in ALS MNs with or without overt TDP-43 pathology, suggesting early and sustained dysregulation of cellular respiration, mRNA splicing, translation, and vesicular transport in ALS. Together, these data provide insights into proteome-level changes associated with TDP-43 proteinopathy and begin to demonstrate the utility of pathology-stratified trace sample proteomics for understanding single-cell protein dynamics in human neurologic diseases.

Uranium hexafluoride (UF6) is a commonly utilized material feedstock in uranium enrichment processes due to its high vapor pressure and ease of sublimation. When exposed to air, UF6 undergoes spontaneous hydrolysis to form uranyl fluoride (UO2F2) particulates which are utilized for the detection of undeclared nuclear activities by nuclear safeguards organizations. The kinetics of the hydrolysis reaction and how they relate to particle morphology of the product are still debated in the literature. Here, we report the direct, in situ observation of UF6 reaction intermediates by cooling the reaction to cryogenic temperatures to significantly reduce the rate of hydrolysis. The reaction is then observable by Fourier transform infrared (FTIR) spectroscopy. The conversion of UF6 to UOF4 is observed as well as several other bands associated with possible long lived intermediate complexes. Chemometrics are used to further elucidate the reaction pathway from UF6 to UO2F2.

Anxiety disorders are one of the most commonly diagnosed mental illnesses amongst men. Despite this, research exploring men's lived experiences of anxiety is sparse. The current photovoice study offers key insights to the understandings of nineteen New Zealand based men aged 24-62 who live with anxiety disorders. Using reflexive thematic analysis to analyse individual in-depth photo-elicitation interviews, two overarching themes were inductively derived: 1) Experiencing and embodying anxiety wherein men's internalized anxiety was characterised as an amorphous and unpredictable entity which could render them powerless, isolated and trapped; 2) Managing uncertainties in which men employed several strategies to control their anxiety amid an array of challenging circumstances. Discussed within a masculinities framework, the findings reveal complex lived experiences embedded in men's social worlds and gendered practices. Findings indicate the need to develop targeted interventions for men experiencing anxiety.

Accurate liquid water modelling is challenging. Here the authors use X-ray micro-computed tomography, deep learned super-resolution, multi-label segmentation, and direct multiphase simulation to simulate fuel cell and guide fuel cell design.

Family caregivers of patients with cancer provide substantial physical, emotional, and functional care throughout the cancer trajectory. While caregiving can create employment and financial challenges, there is insufficient evidence to inform the development of caregiver-reported outcomes (CROs) that assess these experiences. The study purpose was to describe the occupational and financial consequences that were important to family caregivers of a patient with colorectal cancer (CRC) in the context of public health care, which represent potential considerations for CROs. In this qualitative Interpretive Description study, we analyzed interview data from 78 participants (25 caregivers, 37 patients, and 16 healthcare providers). Our findings point to temporary and long-term occupational and financial setbacks in the context of CRC. Caregiving for a person with CRC involved managing occupational implications, including (1) revamping employment arrangements, and (2) juggling work, family, and household demands. Caregiver financial struggles included (1) responding to financial demands at various stages of life, and (2) facing the spectre of lifelong expenses. Study findings offer novel insight into the cancer-related occupational and financial challenges facing caregivers, despite government-funded universal health care. Further research is warranted to develop CRO measures that assess the multifaceted nature of these challenges.

Photovoice offers creative participatory action methods for conveying community strengths and challenges with the goal of addressing health inequities. Accelerated by COVID-19 restrictions, photovoice has increasingly become virtual, and this shift has given rise to new considerations including navigating online recruitment and data collection, e-participatory action trends and working with multi-site large qualitative data sets. Within these contexts, the current article discusses the case for and against virtual photovoice, drawing from a large study comprising 110 men’s experiences of, and perspectives about, equitable and sustainable intimate partner relationships. The findings are shared across three themes. The first theme, e-Efficiencies and concessions contrasts increased recruitment reach and data collection cost-savings with vulnerabilities to phishing and challenges for working with participants’ wide-ranging internet literacies and practices. Theme two, Participatory action changed , chronicles the participants’ varied relationships to photography including sourcing third-party and archived photographs. Revealed also were privacy concerns whereby some participants opted for audio only interviews and/or restricted the use of their photographs. The third theme, Reckoning breadth and depth in a large dataset , discusses emergent study design considerations including analytics for interpreting and contextually representing large multi-site projects that are made possible through virtual photovoice. While technological advances and COVID-19 have forged photovoice virtually, the case for and against this trend reveals complex considerations that will likely manifest a continuum of approaches ranging virtual, hybrid and in-person models. In summary, we suggest that integral to weighing the case for and against virtual photovoice researchers will need to thoughtfully adapt to changing technologies, as well as potential post COVID-19 tilts for returning to in-person.

Abstract Background Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease with high morbidity and limited treatment options. Type 2 diabetes mellitus (T2DM) is a common comorbid illness among patients with IPF and is often treated with metformin, the first-line agent in the management of T2DM. There is growing evidence demonstrating metformin’s anti-fibrotic properties; however, there is little real-world clinical data regarding its potential effectiveness in IPF. This study aims to evaluate the clinical benefit of metformin in patients with IPF and T2DM. Methods This nationwide cohort study used de-identified administrative claims data from OptumLabs® Data Warehouse to identify 3599 adults with IPF and concomitant T2DM between January 1, 2014 and June 30, 2019. Two cohorts were created: a cohort treated with metformin (n = 1377) and a cohort not treated with metformin (n = 2222). A final 1:1 propensity score-matched cohort compared 1100 patients with IPF and T2DM receiving metformin to those with both diagnoses but not receiving metformin; matching accounted for age, sex, race/ethnicity, residence region, year, medications, oxygen use, smoking status, healthcare use, and comorbidities. Outcomes were all-cause mortality (primary) and hospitalizations (secondary). Results Among 2200 patients with IPF and T2DM included in this matched analysis, metformin therapy was associated with a reduction in all-cause mortality (hazard ratio [HR], 0.46; 95% confidence interval [CI], 0.36–0.58; p

Abstract Background The importance of patient-centered measurement in cancer care has led to recognition of the potential for caregiver-reported outcomes to improve caregiver, patient and healthcare system outcomes. Yet, there is limited evidence to inform caregiver-reported outcome implementation. Our purpose was to generate evidence to inform the meaningful and constructive integration of caregiver-reported outcomes into cancer care to benefit caregivers, including exploration of the question of the extent to which these assessments should be shared with patients. We focused on caregivers of patients with colorectal cancer (CRC) because CRC is common, and associated caregiving can be complex. Results From our Interpretive Description analysis of qualitative interview data from 78 participants (25 caregivers, 37 patients, and 16 healthcare providers [HCPs]), we identified contrasting perspectives about the sharing of caregiver-reported outcome assessments with patients with CRC. Those who preferred open communication with both the patient and caregiver present considered this essential for supporting the caregiver. The participants who preferred private communication without the patient, cited concern about caregiver- and patient-burden and guilt. Recognizing these perspectives, HCPs described strategies used to navigate sensitivities inherent in preferences for open versus private communication. Conclusions The integration of caregiver-reported outcomes into cancer care will require careful consideration of caregiver and patient preferences regarding the communication of caregiver assessments to prevent additional burden.

Abstract Freshwater phytoplankton blooms are increasing in prevalence and there are conflicting views on whether trace metals limit growth of key species and thus bloom formation. The Taupō Volcanic Zone (TVZ), New Zealand, was formed by multiple eruptions of a super-volcano which emitted rhyolitic tephra leaving lakes depleted in trace metals. This provides an opportunity to test the potential of trace metal limitation on freshwater phytoplankton growth under nanomolar concentrations. Growth responses of two algal species isolated from Lake Taupō, Dolichospermum lemmermannii (cyanobacteria) and Fragilaria crotonensis (diatom), to six biologically important trace metals (manganese, iron, zinc, cobalt, copper and molybdenum) were examined in culture experiments. These were conducted at three trace metal concentrations: (1) ambient, (2) two-times ambient, and (3) ten-times ambient concentrations in Lake Taupō. Elevated concentrations of iron significantly increased growth rates and maximum cell densities in D. lemmermannii, whereas no significant concentration dependence was observed for other trace metals. Fragilaria crotonensis showed no significant growth response to elevated concentrations of trace metals. These results highlight the importance of iron as a growth limiting nutrient for cyanobacteria and indicate that even small (twofold) increases in Fe concentrations could enhance cyanobacteria growth rates in Lake Taupō, potentially causing cyanobacterial blooms.

Abstract To assess the effects of a multidisciplinary care protocol on cost, length of hospital stay (LOS), and mortality in hip-fracture-operated patients over 65 years. Prospective cohort study between 2011 and 2017. The unexposed group comprised patients who did not receive care according to the multidisciplinary protocol, while the exposed group did. Variables analyzed were demographics, medical comorbidities, treatment, blood parameters, surgical delay, LOS, re-admissions, mortality, and a composite outcome considering in-hospital mortality and/or LOS > 10 days. We performed a Poisson regression and cost analysis. The cohort included 681 patients: 310 unexposed and 371, exposed. The exposed group showed a shorter surgical delay (3.0 vs. 3.6 days; p

The two-way coupled Weather Research and Forecasting and Community Multiscale Air Quality (WRF-CMAQ) model has been developed to more realistically represent the atmosphere by accounting for complex chemistry–meteorology feedbacks. In this study, we present a comparative analysis of two-way (with consideration of both aerosol direct and indirect effects) and offline coupled WRF v3.4 and CMAQ v5.0.2 over the contiguous US. Long-term (5 years from 2008 to 2012) simulations using WRF-CMAQ with both offline and two-way coupling modes are carried out with anthropogenic emissions based on multiple years of the U.S. National Emission Inventory and chemical initial and boundary conditions derived from an advanced Earth system model (i.e., a modified version of the Community Earth System Model/Community Atmospheric Model). The comprehensive model evaluations show that both two-way WRF-CMAQ and WRF-only simulations perform well for major meteorological variables such as temperature at 2 m, relative humidity at 2 m, wind speed at 10 m, precipitation (except for against the National Climatic Data Center data), and shortwave and longwave radiation. Both two-way and offline CMAQ also show good performance for ozone (O3) and fine particulate matter (PM2.5). Due to the consideration of aerosol direct and indirect effects, two-way WRF-CMAQ shows improved performance over offline coupled WRF and CMAQ in terms of spatiotemporal distributions and statistics, especially for radiation, cloud forcing, O3, sulfate, nitrate, ammonium, elemental carbon, tropospheric O3 residual, and column nitrogen dioxide (NO2). For example, the mean biases have been reduced by more than 10 W m−2 for shortwave radiation and cloud radiative forcing and by more than 2 ppb for max 8 h O3. However, relatively large biases still exist for cloud predictions, some PM2.5 species, and PM10 that warrant follow-up studies to better understand those issues. The impacts of chemistry–meteorological feedbacks are found to play important roles in affecting regional air quality in the US by reducing domain-average concentrations of carbon monoxide (CO), O3, nitrogen oxide (NOx), volatile organic compounds (VOCs), and PM2.5 by 3.1 % (up to 27.8 %), 4.2 % (up to 16.2 %), 6.6 % (up to 50.9 %), 5.8 % (up to 46.6 %), and 8.6 % (up to 49.1 %), respectively, mainly due to reduced radiation, temperature, and wind speed. The overall performance of the two-way coupled WRF-CMAQ model achieved in this work is generally good or satisfactory and the improved performance for two-way coupled WRF-CMAQ should be considered along with other factors in developing future model applications to inform policy making.

Objective Gain an understanding of the lived experiences and unique psychosocial impacts following bariatric surgery. Methods Qualitative study design, consisting of semi-structured interviews. Based on thematic analysis principles, transcripts were inductively coded. Results Fifteen participants were included; predominantly female (n = 9, 60%) and underwent Roux-en-Y gastric bypass (n =12, 80%), with a mean age of 57 years. Five themes were generated including ‘Key Motivators to Undergo Bariatric Surgery’, “Positive Changes”, “Facing the Challenges”, “Tackling Social Relationships”, and “Skills to Move Forward”. There were common health-related motivators to undergo surgery, yet psychosocial motivators were not reported. Patients reported positive changes post-operatively; though not exclusively. Challenges included being surprised by the rapid weight loss, a delayed identification of their new body, and new body image concerns. Participants reported using different sources of support for the different types of support needs and were required to navigate negative confrontations and perceived stigma. Skills to move forward included implementing strategies and behaviour change techniques along with adjusting their lifestyle, routine, and mindset. Conclusion Experiences and psychosocial challenges post-operatively are multifaceted. Tailoring services to address these challenges in both pre- and post-operative healthcare settings is recommended. KEY POINTS What is already known about this topic: Long-term psychological and dietary support is important to help individuals navigate the challenges and maintain positive changes achieved after bariatric surgery. Lived experiences of bariatric surgery are characterised by normality, control, and ambivalence. To date, no qualitative study has been conducted in Australia to report the lived experience and unique psychosocial impacts following bariatric surgery. What this topic adds: Health-related motivators to undergo bariatric surgery were common; however, there were no reports of psychosocial motivators to undergo surgery (i.e., improved body image). Patients electing bariatric surgery may not be fully prepared for the psychosocial challenges rapid weight loss presents. Different sources of support were utilized by patients for different types of social support, with the prominent use of Online Health Communities.

Male suicide continues to be a significant issue worldwide for which there are a myriad of social risk factors. Amongst these, distressed and/or disrupted (i.e., separation, divorce) intimate partner relationships are known to heighten men's mental illness and suicide risk. The current qualitative study offers novel insights to the connections between masculinity and mental illness in and after men's intimate partner relationships. Drawing from in-depth interviews with 47 Canadian and Australian men, three themes were inductively derived: 1) The trouble inside, 2) Breaking up and breaking down, and 3) Finding help. The ‘trouble inside’ results revealed relationship transitions wherein challenges to couple dynamics flowed from diverse life course events (conflict, illness, bereavement, co-parenting). Partnership transgressions (most often infidelity) also featured to heighten men's mental illness vulnerabilities and threaten the feasibility of the relationship. ‘Breaking up and breaking down’ chronicled participants' anxiety, depression and suicidality in the aftermath of their relationship ending. Herein, substance use and other maladaptive behaviours were used by men to blunt feelings and/or self-medicate mental illness. These strategies were ineffectual for moving on from blaming partners or grieving the loss of support and social connectedness provided by ex-partners. ‘Finding help’ included men's eventual self-help, uptake of informal assistance from friends and family, formal professional care services, and the use of facilitated male peer group resources. Norming the use of these diverse help resources were men's alignments to strength-based asset-building masculine ideals, wherein their help-seeking was bridged to, and reflective of their (albeit latent) commitment to better managing their mental health and future relationships. Highlighting the gendered dimensions of mental illness in men's intimate partner relationships, the current study also thoughtfully considers content and contexts for the delivery of tailored upstream suicide prevention programs focussed on men building better relationships.

For men, significant risks associated with partner-initiated break-ups include domestic violence, mental health challenges and difficultly with life transition. This narrative analysis study shares three storylines drawn from interviews with 25 men who experienced a partner-initiated break-up. Ill equipped to stay or to initiate leaving narratives positioned participants as conflict averse, lacking agency and withdrawing emotionally from the partnership and its demise. Victims of circumstance narratives included men who engaged in cyclic arguments and ongoing power struggles with partners, a pattern that often amplified conflict after the break-up. Transitioning these two impasse narratives were some participants whose Accountability and growth storylines highlighted their introspective self-work, aided by resources including professional help to deconstruct, understand, and adjust their behaviours. Making connections to masculinities theory, these findings suggest that tailored interventions, including narrative therapy, might usefully interrupt impasse narratives to aid men’s development and healthful transitions through partner-initiated break-ups.

In spite of overall improvements in air and water quality, biological stress from low pH and high concentrations of inorganic aluminum continue to impact fish and fish habitat in northeastern North America, with independent and interactive effects on individuals, populations and communities. Integrative indicators can therefore be useful in monitoring both impact and recovery across multiple scales. Using coupled water chemistry (pH, conductivity, and base cation and inorganic aluminum concentration), geographic (site elevation and watershed area) and biological (fish diversity, fish abundance, gill aluminum concentration and gill physiology) data, we developed an integrated indicator of acid-aluminum stress across the White and Green mountains in central New England, USA. As has been established in a number of previous studies, preliminary analysis clearly indicated that across all sites, inorganic aluminum concentration was consistently greatest during the spring season. Structural Equation modeling (SEM) revealed that toxic conditions (concurrent low pH and high concentrations of inorganic aluminum) were well summarized with an integrated toxicity score, related to both base cation concentrations and elevation, with sites at higher elevations more likely to experience toxic conditions as well as low base cation concentrations. Fish diversity and abundance generally trended negatively with toxicity score, with fewer cyprinids and sculpins at high toxicity score sites. In spite of considerable variation among individuals, gill aluminum was positively related to toxicity score for both Atlantic salmon and brook trout. Observed elevated gill aluminum levels associated with reduced gill metabolic activity in Atlantic salmon smolts from impacted systems likely result in impaired osmoregulatory function and seawater tolerance. Overall, our results suggest that the integrated toxicity score metric is associated with a syndrome of acute physiological stress, reduced abundance, and low species diversity for sensitive stream fishes in New England, and can likely serve as a reliable indicator of continued impairment or recovery of acid-aluminum vulnerable systems in this ecoregion.

Cross-correlation of image-pairs derived from both optical and synthetic aperture radar satellite imagery is the most common technique for measuring glacier flow velocity and quantifying the dynamics and discharge of glaciers. While the technique has been shown to be effective on polar ice sheets, the accuracy of satellite-derived velocities in temperate alpine regions is poorly constrained. Flow velocities were measured in situ using an RTK-GPS along four profiles on Taku, Matthes, Vaughan-Lewis, and Llewellyn Glaciers in southeast Alaska from 2016 through 2018. These GNSS-measured velocities were correlated against spatially coincident and contemporaneous satellite-derived velocity datasets, including both versions 1 and 2 of ITS_LIVE and velocities determined by offset tracking of SAR data in the Sentinel Application Platform (SNAP) and GAMMA (RETREAT dataset). Significant gaps in velocity maps derived from optical imagery (Landsat/Sentinel-2) were observed and determined to be due to low coherence rather than cloud contamination. Cross-correlation of SAR data (Sentinel-1) in SNAP and RETREAT achieved better accuracy compared to optical, although a strong dichotomy in performance was observed. SAR-derived velocities in the accumulation zone and transient snowline area showed overall poor correlation to GNSS-measured velocities that were likely due to significant shifts in the backscatter amplitude of the homogenous, snow-covered surface, although both SAR-derived SNAP and RETREAT velocities were anomalously accurate where GNSS velocities were below 0.10 m/day along the glacier margins. SNAP and RETREAT achieved the most accurate results in the study in the ablation zone of the Llewellyn Glacier where stable backscatter targets on the glacier surface (crevasses, supraglacial debris) facilitated high coherence in the cross-correlation procedure. SAR data are likely the most suitable for the derivation of satellite-derived velocities on temperate alpine glaciers, particularly in slow-moving and ablation zones, but should be subject to scrutiny for fast-flowing glaciers and those with an active hydrologic surface system.

Abstract Background Idiopathic Pulmonary Fibrosis is a chronic, progressive interstitial lung disease for which there is no cure. However, lung function decline, hospitalizations, and mortality may be reduced with the use of the antifibrotic medications, nintedanib and pirfenidone. Historical outcomes for hospitalized patients with Idiopathic Pulmonary Fibrosis are grim; however there is a paucity of data since the approval of nintedanib and pirfenidone for treatment. In this study, we aimed to determine the effect of nintedanib and pirfenidone on mortality following respiratory-related hospitalizations, intensive care unit (ICU) admission, and mechanical ventilation. Methods Using a large U.S. insurance database, we created a one-to-one propensity score matched cohort of patients with idiopathic pulmonary fibrosis treated and untreated with an antifibrotic who underwent respiratory-related hospitalization between January 1, 2015 and December 31, 2018. Mortality was evaluated at 30 days and end of follow-up (up to 2 years). Subgroup analyses were performed for all patients receiving treatment in an ICU and those receiving invasive and non-invasive mechanical ventilation during the index hospitalization. Results Antifibrotics were not observed to effect utilization of mechanical ventilation or ICU treatment during the index admission or effect mortality at 30-days. If patients survived hospitalization, mortality was reduced in the treated cohort compared to the untreated cohort when followed up to two years (20.1% vs 47.8%). Conclusions Treatment with antifibrotic medications does not appear to directly improve 30-day mortality during or after respiratory-related hospitalizations. Post-hospital discharge, however, ongoing antifibrotic treatment was associated with improved long-term survival.

Abstract Fire can promote biodiversity, but changing patterns of fire threaten species worldwide. While scientific literature often describes ‘‘inappropriate fire regimes’’ as a significant threat to biodiversity, less attention has been paid to the characteristics that make a fire regime inappropriate. We go beyond this generic description and synthesize how inappropriate fire regimes contribute to declines of animal populations using threatened mammals as a case study. We developed a demographic framework for classifying mechanisms by which fire regimes cause population decline and applied the framework in a systematic review to identify fire characteristics and interacting threats associated with population declines in Australian threatened land mammals (n = 99). Inappropriate fire regimes threaten 88% of Australian threatened land mammals. Our review indicates that intense, large, and frequent fires are the primary cause of fire‐related population declines, particularly through their influence on survival rates. However, several species are threatened by a lack of fire, and there is considerable uncertainty in the evidence base for fire‐related declines. Climate change and predation are documented or predicted to interact with fire to exacerbate mammalian declines. This demographic framework will help target conservation actions globally and will be enhanced by empirical studies of animal survival, movement, and reproduction.

BackgroundThe metabolic syndrome is common across many complex chronic disease groups. Advances in health technology have provided opportunities to support lifestyle interventions. ObjectiveThe purpose of this study is to test the feasibility of a health technology-assisted lifestyle intervention in a patient-led model of care. MethodsThe study is a single-center, 26-week, randomized controlled trial. The setting is specialist kidney and liver disease clinics at a large Australian tertiary hospital. The participants will be adults with a complex chronic condition who are referred for dietetic assessment and display at least one feature of the metabolic syndrome. All participants will receive an individualized assessment and advice on diet quality from a dietitian, a wearable activity monitor, and standard care. Participants randomized to the intervention group will receive access to a suite of health technologies from which to choose, including common base components (text messages) and optional components (online and mobile app–based nutrition information, an online home exercise program, and group-based videoconferencing). Exposure to the optional aspects of the intervention will be patient-led, with participants choosing their preferred level of engagement. The primary outcome will be the feasibility of delivering the program, determined by safety, recruitment rate, retention, exposure uptake, and telehealth adherence. Secondary outcomes will be clinical effectiveness, patient-led goal attainment, treatment fidelity, exposure demand, and participant perceptions. Primary outcome data will be assessed descriptively and secondary outcomes will be assessed using an analysis of covariance. This study will provide evidence on the feasibility of the intervention in a tertiary setting for patients with complex chronic disease exhibiting features of the metabolic syndrome. ResultsThe study was funded in 2019. Enrollment has commenced and is expected to be completed by June 2022. Data collection and follow up are expected to be completed by December 2022. Results from the analyses based on primary outcomes are expected to be submitted for publication by June 2023. ConclusionsThe study will test the implementation of a health technology–assisted lifestyle intervention in a tertiary outpatient setting for a diverse group of patients with complex chronic conditions. It is novel in that it embeds patient choice into intervention exposure and will inform health service decision-makers in regards to the feasibility of scale and spread of technology-assisted access to care for a broader reach of specialist services. Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12620001282976; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378337 International Registered Report Identifier (IRRID)DERR1-10.2196/37556

Abstract Background Sepsis is a life-threatening complication of infection that rapidly triggers tissue damage in multiple organ systems and leads to multi-organ deterioration. Up to date, prognostic biomarkers still have limitations in predicting the survival of patients with sepsis. We need to discover more prognostic biomarkers to improve the sensitivity and specificity of the prognosis of sepsis patients. Sphingosine-1-phosphate (S1P) receptor 3 (S1PR3), as one of the S1P receptors, is a prospective prognostic biomarker regulating sepsis-relevant events, including compromised vascular integrity, antigen presentation, and cytokine secretion. Until now, no S1PR3-related prognostic gene signatures for sepsis patients have been found. Methods This study intends to obtain an S1PR3-associated gene signature from whole blood samples to be utilized as a probable prognostic tool for patients with sepsis. Results We obtained an 18-gene S1PR3-related molecular signature (S3MS) from the intersection of S1PR3-associated genes and survival-associated genes. Numerous important immunity pathways that regulate the progression of sepsis are enriched among our 18 genes. Significantly, S3MS functions greatly in both the discovery and validation cohort. Furthermore, we demonstrated that S3MS obtains significantly better classification performance than random 18-gene signatures. Conclusions Our results confirm the key role of S1PR3-associated genes in the development of sepsis, which will be a potential prognostic biomarker for patients with sepsis. Our results also focus on the classification performance of our S3MS as biomarkers for sepsis, which could also provide an early warning system for patients with sepsis.

Objective To determine the perspectives to the adoption, scale-up, sustainability, and spread of technology-supported models of nutrition care, in hospital and ambulatory care settings. Methods Thirty-one health service providers participated in individual semi-structured interviews from a tertiary health service in Queensland, Australia. The Non-adoption, Abandonment, and challenges to the Scale up, Spread and Sustainability (NASSS) framework, designed to evaluate technology-supported models’ success, informed the qualitative design. Results Key findings were that technology-supported models of care could benefit many chronic condition patient groups; dietitians are well suited to adopting this technology: and the value proposition in creating efficiency gains in the health service. However, challenges of transitioning and sustainability were identified. Perceived enablers for technology supported models of care included: previous intentions for technology supported models of care prior to the 2019 novel coronavirus pandemic; opportunity for clinicians to complete higher valued tasks; and integration of technology systems and assisted staff roles. Perceived barriers included: suitability for patients is dependent on experience and ability to use technology, varied confidence by clinicians when conducting clinical assessments; high investment required for set up and ongoing maintenance; and patients desire for adopting face-to-face care over technology. Health service providers perceived that embedding and adapting such models requires maintenance of high-quality service and continued research. Conclusions Health service providers recognize adopting, scaling, and sustaining technology-supported models of nutrition care benefits patients, clinicians, and health services in general. Robust clinical trials and health service evaluations of technology-supported models of care, across practice settings are now needed.

Abstract Understanding movement patterns of anadromous fishes is critical to conservation and management of declining wild populations and preservation of habitats. Yet, the duration of observations for individual animals can constrain accurate descriptions of movements. In this study, we synthesized over a decade (2006–2018) of acoustic telemetry tracking observations of green sturgeon (Acipenser medirostris) in the Sacramento River system to describe major anadromous movement patterns. We observed that green sturgeon exhibited a unimodal in‐migration during the spring months but had a bimodal distribution of out‐migration timing, split between an “early” out‐migration (32%) group during May–June, or, alternatively, holding in the river until a “late” out‐migration (68%), November–January. Focusing on these out‐migration groups, we found that river discharge, but not water temperature, may cue the timing of migration and that fish showed a tendency to maintain out‐migration timing between subsequent spawning migration events. We recommend that life history descriptions of green sturgeon in this region reflect the distinct out‐migration periods described here. Furthermore, we encourage the continued use of biotelemetry to describe migration timing and life history variation, in not only this population but also other green sturgeon populations and other species.

Abstract Background Perspectives of clinical trial (CT) personnel on accrual to oncology CTs are relatively absent from the literature. This study explores CT personnel's experience recruiting patients to oncology CTs. Methods A qualitative study design was utilized. In‐depth, individual interviews with 12 oncology CT personnel were conducted, including six CT nurses and six physician‐investigators. Interviews were digitally recorded and transcribed verbatim. Data were subjected to thematic and ethical analysis to identify key concepts and themes. Results CT personnel reported considering two ethical commitments in CT recruitment: maintaining trial integrity and ensuring patient autonomy through obtaining informed consent. The process of gatekeeping emerged as a way to navigate these ethical commitments during CT accrual. Gatekeeping was influenced by: (a) perceptions of patients’ personal suitability for a trial, and (b) healthcare resources and infrastructure. CT personnel's discernment of personal suitability was influenced by patients’ cognitive and mental health status, language and cultural background, geographic location, family support, and disease status. Three structural factors impacted gatekeeping: complexity of CTs, consent process, and time limitations in the healthcare system. CT personnel experienced most factors as constraints to accrual and gaining patients’ informed consent. Conclusion CT personnel discussed navigating ethical challenges in CT recruitment by offering enrollment to specific patient populations, exacerbating other ethical tensions. Systems‐level strategies are needed to address barriers to ethical CT recruitment. Future research should investigate the role of policies and/or tools (eg, decision aids) to support patients and CT personnel's discussions about CT participation, promote more ethical recruitment, and potentially increase accrual.

Acidity, defined as pH, is a central component of aqueous chemistry. In the atmosphere, the acidity of condensed phases (aerosol particles, cloud water, and fog droplets) governs the phase partitioning of semivolatile gases such as HNO3, NH3, HCl, and organic acids and bases as well as chemical reaction rates. It has implications for the atmospheric lifetime of pollutants, deposition, and human health. Despite its fundamental role in atmospheric processes, only recently has this field seen a growth in the number of studies on particle acidity. Even with this growth, many fine-particle pH estimates must be based on thermodynamic model calculations since no operational techniques exist for direct measurements. Current information indicates acidic fine particles are ubiquitous, but observationally constrained pH estimates are limited in spatial and temporal coverage. Clouds and fogs are also generally acidic, but to a lesser degree than particles, and have a range of pH that is quite sensitive to anthropogenic emissions of sulfur and nitrogen oxides, as well as ambient ammonia. Historical measurements indicate that cloud and fog droplet pH has changed in recent decades in response to controls on anthropogenic emissions, while the limited trend data for aerosol particles indicate acidity may be relatively constant due to the semivolatile nature of the key acids and bases and buffering in particles. This paper reviews and synthesizes the current state of knowledge on the acidity of atmospheric condensed phases, specifically particles and cloud droplets. It includes recommendations for estimating acidity and pH, standard nomenclature, a synthesis of current pH estimates based on observations, and new model calculations on the local and global scale.

Imaging mass spectrometry is a powerful emerging tool for mapping the spatial distribution of biomolecules across tissue surfaces. Here the authors showcase an automated technology for deep proteome imaging that utilizes ultrasensitive microfluidics and a mass spectrometry workflow to analyze tissue voxels, generating quantitative cell-type-specific images.

COVID-19 restrictions have transitioned in-person qualitative research interviews to virtual platforms. The purpose of the current article is to detail some benefits and concessions derived from our experiences of using Zoom to interview men about their intimate partner relationship breakdowns and service providers who work with men to build better relationships. Three benefits; 1) Rich therapeutic value, 2) There’s no place like home, and 3) Reduced costs to extend recruitment reach and inclusivity, highlighted Zoom’s salutary value, the data richness afforded by being interviewed from home, and the potential for cost-effectively progressing qualitative study designs. In particular, reduced labour and travel costs made viable wider reaching participant recruitment and multi-site data collection. The concessions; 1) Being there differently, 2) Choppy purviews and 3) Preparing and pacing, and adjusting to the self-stream revealed the need for interviewers to nimbly adjust to circumstances outside their direct control. Included were inherent challenges for adapting to diverse interviewee locations, technology limits and discordant audio-visual feeds. Amongst these concessions there was resignation that many in-person interview nuances were lost amid the virtual platform demanding unique interviewer skills to compensate some of those changes. Zoom interviews will undoubtedly continue post COVID-19 and attention should be paid to emergent ethical and operational issues.

Freshwater eels are ecologically, and culturally important worldwide. The New Zealand long-finned eel (Anguilla dieffenbachii) and short-finned eel (Anguilla australis) are apex predators, playing an important role in ecosystem functioning of rivers and lakes. Recently, there has been a national decline in their populations due to habitat destruction and commercial harvest. The emergence of targeted environmental DNA detection methodologies provides an opportunity to enhance information about their past and present distributions. In this study we successfully developed species-specific droplet digital Polymerase Chain Reaction (ddPCR) assays to detect A. dieffenbachii and A. australis DNA in water and sediment samples. Assays utilized primers and probes designed for regions of the mitochondrial cytochrome b and 16S ribosomal RNA genes in A. dieffenbachii and A. australis, respectively. River water samples (n = 27) were analyzed using metabarcoding of fish taxa and were compared with the ddPCR assays. The presence of A. dieffenbachii and A. australis DNA was detected in a greater number of water samples using ddPCR in comparison to metabarcoding. There was a strong and positive correlation between gene copies (ddPCR analyses) and relative eel sequence reads (metabarcoding analyses) when compared to eel biomass. These ddPCR assays provide a new method for assessing spatial distributions of A. dieffenbachii and A. australis in a range of environments and sample types.

Designing effective control policies requires efficient quantification of the nonlinear response of air pollution to emissions. However, neither the current observable indicators nor the current indicators based on response surface modeling (RSM) can fulfill this requirement. Therefore, this study developed new observable RSM-based indicators and applied them to ambient fine-particle (PM2.5) and ozone (O3) pollution control in China. The performance of these observable indicators in predicting O3 and PM2.5 chemistry was compared with that of the current RSM-based indicators. H2O2 × HCHO∕NO2 and total ammonia ratio, which exhibited the best performance among indicators, were proposed as new observable O3 and PM2.5 chemistry indicators, respectively. Strong correlations between RSM-based and traditional observable indicators suggested that a combination of ambient concentrations of certain chemical species can serve as an indicator to approximately quantify the response of O3 and PM2.5 to changes in precursor emissions. The observable RSM-based indicator for O3 (observable peak ratio) effectively captured the strong NOx-saturated regime in January and the NOx-limited regime in July, as well as the strong NOx-saturated regime in northern and eastern China and their key regions, including the Yangtze River Delta and Pearl River Delta. The observable RSM-based indicator for PM2.5 (observable flex ratio) also captured strong NH3-poor conditions in January and NH3-rich conditions in April and July, as well as NH3-rich conditions in northern and eastern China and the Sichuan Basin. Moreover, analysis of these newly developed observable response indicators suggested that the simultaneous control of NH3 and NOx emissions produces greater benefits in provinces with higher PM2.5 exposure by up to 1.2 µg m−3 PM2.5 per 10 % NH3 reduction compared with NOx control only. Control of volatile organic compound (VOC) emissions by as much as 40 % of NOx controls is necessary to obtain the co-benefits of reducing both O3 and PM2.5 exposure at the national level when controlling NOx emissions. However, the VOC-to-NOx ratio required to maintain benefits varies significantly from 0 to 1.2 in different provinces, suggesting that a more localized control strategy should be designed for each province.

Abstract Background Homelessness is increasing globally. It results in poorer physical and mental health than age matched people living in permanent housing. Better information on the health needs of people experiencing homelessness is needed to inform effective resourcing, planning and service delivery by government and care organisations. The aim of this review was to identify assessment tools that are valid, reliable and appropriate to measure the health status of people who are homeless. Methods Data sources: A systematic literature search was conducted in PubMed (and Medline), PsychInfo, Scopus, CINAHL and ERIC from database inception until September 2018. Key words used were homeless, homelessness, homeless persons, vagrancy, health status, health, health issues, health assessment and health screening. The protocol was registered with PROSPERO. The National Health and Medical Research Council of Australia (NHMRC) hierarchy of evidence was applied; methodological quality of included articles was assessed using the McMaster critical appraisal tools and psychometric properties of the tools were appraised using the International Centre for Allied Health Evidence Ready Reckoner. Results Diverse tools and measures (N = 71) were administered within, and across the reviewed studies (N = 37), with the main focus being on general health, oral health and nutrition. Eleven assessment tools in 13 studies had evidence of appropriate psychometric testing for the target population in domains of quality of life and health status, injury, substance use, mental health, psychological and cognitive function. Methodological quality of articles and tools were assessed as moderate to good. No validated tools were identified to assess oral health, chronic conditions, anthropometry, demography, nutrition, continence, functional decline and frailty, or vision and hearing. However, assessments of physical constructs (such as oral health, anthropometry, vision and hearing) could be applied to homeless people on a presumption of validity, because the constructs would be measured with clinical indicators in the same manner as people living in permanent dwellings. Conclusions This review highlighted the need to develop consistent and comprehensive health assessment tools validated with, and tailored for, adults experiencing homelessness.