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Microbes able to convert gaseous one-carbon (C1) waste feedstocks are increasingly important to transition to the sustainable production of renewable chemicals and fuels. Acetogens are interesting biocatalysts since gas fermentation using Clostridium autoethanogenum has been commercialised. However, most acetogen strains need complex nutrients, display slow growth, and are not robust for bioreactor fermentations. In this work, we used three different and independent adaptive laboratory evolution (ALE) strategies to evolve the wild-type C. autoethanogenum to grow faster, without yeast extract and to be robust in operating continuous bioreactor cultures. Multiple evolved strains with improved phenotypes were isolated on minimal media with one strain, named "LAbrini", exhibiting superior performance regarding the maximum specific growth rate, product profile, and robustness in continuous cultures. Whole-genome sequencing of the evolved strains identified 25 mutations. Of particular interest are two genes that acquired seven different mutations across the three ALE strategies, potentially as a result of convergent evolution. Reverse genetic engineering of mutations in potentially sporulation-related genes CLAU_3129 (spo0A) and CLAU_1957 recovered all three superior features of our ALE strains through triggering significant proteomic rearrangements. This work provides a robust C. autoethanogenum strain "LAbrini" to accelerate phenotyping and genetic engineering and to better understand acetogen metabolism., Competing Interests: Declaration of Competing Interest We declare that LanzaTech has interest in commercial gas fermentation with C. autoethanogenum and Audrey Harris, Steven D. Brown, Grant Hawkins, Jim Daleiden, Loan Tran, Hunter Zeleznik, Rasmus O. Jensen, Vinicio Reynoso, Heidi Schindel, and Michael Köpke are employees of LanzaTech., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

A recently reported behavioral screen in larval zebrafish for phenocopiers of known anesthetics and associated drugs yielded an isoflavone. Related isoflavones have also been reported as GABA A potentiators. From this, we synthesized a small library of isoflavones and incorporated an in vivo phenotypic approach to perform structure-behavior relationship studies of the screening hit and related analogs via behavioral profiling, patch-clamp experiments, and whole brain imaging. This revealed that analogs effect a range of behavioral responses, including sedation with and without enhancing the acoustic startle response. Interestingly, a subset of compounds effect sedation and enhancement of motor responses to both acoustic and light stimuli. Patch clamp recordings of cells with a human GABA A receptor confirmed that behavior-modulating isoflavones modify the GABA signaling. To better understand these molecules' nuanced effects on behavior, we performed whole brain imaging to reveal that analogs differentially effect neuronal activity. These studies demonstrate a multimodal approach to assessing activities of neuroactives.

Background: The incidence of postoperative complications among patients with coronavirus disease 2019 (COVID-19) positivity undergoing elective surgical operations is poorly understood. This study aimed to identify differences in postoperative complications after elective abdominal wall reconstruction (AWR) in patients diagnosed with COVID-19 compared with patients presenting prepandemic., Methods: A single-institution, retrospective chart review was performed of patients undergoing AWR between January 2017 and September 2022. Patients were stratified by date: pre-COVID-19 (January 2017 to December 2019) and post-COVID-19 (January 2020 to September 2022). Patients confirmed as COVID-19-positive were also identified. Data collected included demographics, clinical characteristics, and complications. Univariate and multivariate analyses were performed., Results: We included 168 patients. The mean age was 54 years, and the mean body mass index was 33 kg/m2. Seventy-five patients underwent surgery pre-COVID-19 and 93 patients after. Of 93 patients, 16 (17%) had a positive COVID-19 test before surgery or during the perioperative period. These 2 groups were risk-matched. Patients with COVID-19 had no significant increase in postoperative complications. Major complications occurred at 13.3% in the pre-COVID-19 group and 7.5% in the post-COVID-19 group. Patients with COVID-19 were more likely to be younger (48 versus 57; P = 0.049) and more likely to have a shorter length of stay in the hospital (3 versus 5.8; P = 0.038)., Conclusions: In our case series, there was an associated increase in the incidence of overall pulmonary-related complications in the postpandemic group. This study is limited by its small sample size. Further investigation should be carried out on this topic., Competing Interests: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Objective: Intensive care unit length of stay (ICU LOS) accounts for a large percent of inpatient cost following cardiac surgery. The Society of Thoracic Surgeons (STS) risk calculator predicts total LOS but does not discriminate between ICU and non-ICU time. We sought to develop a predictive model of prolonged ICU LOS., Methods: Adult patients undergoing STS index operations within a regional collaborative (2014-2021) were included. Prolonged ICU LOS was defined as ICU care for ≥72 hours postoperatively. A logistic regression model was utilized to develop a prediction model for the prolonged ICU LOS with pre-specified risk factors identified from our previous single center study. Internal prediction model validation was determined by bootstrapping resampling method. The prediction model performance was assessed by measures of discrimination and calibration., Results: We identified 37,519 patients that met inclusion criteria with 11,801 (31.5%) patients experiencing prolonged ICU stay. From the logistic regression model, there were significant associations between prolonged ICU LOS and all pre-specified factors except sleep apnea (all p<0.05). MELD, preoperative intra-aortic balloon pump use, and procedure types were the most significant predictors of prolonged ICU LOS (all p<0.0001). Our prediction model had not only a good discrimination power (bootstrapped-corrected C-index=0.71) but also excellent calibration (bootstrapped-corrected mean absolute error=0.005)., Conclusions: Prolonged ICU stay following cardiac surgery can be predicted with good predictive accuracy utilizing preoperative data and may aid in patient counseling and resource allocation. Through use of a state-wide database, the application of this model may extend to other practices., (Copyright © 2024. Published by Elsevier Inc.)

Background: The COVID-19 pandemic and recovery period have exacerbated workforce challenges for nurses and midwives. The increasingly complex nature of healthcare, combined with rising workloads and staff attrition highlights the need for initiatives that improve workplace satisfaction and retention. In response, mentoring programs aimed at enhancing job satisfaction and retention are being increasingly implemented., Aims: This study sought to measure the workplace satisfaction of nurses and midwives across five New South Wales local health districts, utilising data captured from a wider study investigating the implementation of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring program., Design: An exploratory, mixed methods study using purposive sampling was employed., Methods: A secondary analysis of a modified version of the Nursing Workplace Satisfaction Questionnaire, was used to quantify intrinsic, extrinsic, and relational workplace satisfaction constructs among nursing and midwifery staff. Open ended questions included in the survey were thematically analysed using methods developed by Braun and Clarke (2022)., Results: Between June-October 2023, n =  106 participants returned the survey. Differences between intrinsic (items 2 & 5), extrinsic (item 9) relational (items 13-15) constructs were observed for health districts, Aboriginality, age, and professional role characteristics ( P  < 0.05). Five qualitative themes emerged from the data: Helping people is the priority; Teams make a difference to my workplace satisfaction; Managers impact my satisfaction; Scope and recognition; and Organisational factors., Conclusions: Overall, our findings indicate noticeable differences in workforce satisfaction and retention across various factors, including workforce areas, Aboriginality, age, and professional roles. For these groups, initiatives aimed at improving satisfaction and retention should prioritise fostering teamwork and a sense of belonging, as these elements have significant impact on job satisfaction for nurses and midwives and provide valuable guidance for nursing leaders., Impact Statement: This study identifies that teamwork and belongingness impact workplace satisfaction for nurses and midwives.

While microRNAs (miRs) like miR-9 are crucial for neurogenesis and neuronal differentiation, their regulatory mechanisms are not well understood. miR-9 is highly expressed in the brain and plays a significant role in neurogenesis. Using the Collaborative Cross resource, we identified significant quantitative trait loci (QTL) through genetic analyses. We then characterized over 130 candidate genes within these QTL regions using RNA interference, qPCR, and neuronal differentiation assays, narrowing them down to 13 promising candidates. Among these, Panx2, Polr1c, and Mgea5 were found to colocalize in the neurogenic niches of the SVZ and DG regions, as shown by immunofluorescence. Further ChIP-seq and Co-IP analyses revealed their interaction and binding to the miR-9 locus, forming a DNA-protein regulatory complex we termed 'miRSome-9.' A 3C/ChIP-loop assay confirmed the chromatin organization of miRSome-9 at the miR-9 locus, shedding light on the upstream mechanisms regulating miR-9 expression during neurogenesis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Groundwater transport of chloride (Cl) containing road salt deicers is an important contributor to salinization of fresh surface waters in temperate climates. While mass loading of salt to streams via groundwater has received greater recognition lately, only a few studies have demonstrated the unique risk posed by the direct discharge of salt-laden groundwater to aquatic life residing in the benthic zone (e.g., macroinvertebrates, mussels, plant roots, fish eggs). These studies revealed high Cl concentrations in stream porewater but provided limited information on its spatio-temporal variability and factors influencing it. To address this gap, this study conducted a detailed 2-year field investigation on 100-m scale reaches of two streams adjacent to salt-receiving roads in London, Ontario, applying year-round streambed porewater sampling, streambed surface electrical conductivity mapping, and electrical imaging (geophysics) techniques. Areas of probable groundwater upwelling and surface water downwelling were identified using streambed temperature mapping and hydraulic head gradients. Benthic porewater Cl concentrations were commonly above water quality guidelines, but also varied substantially over small spatial scales, ranging from <100 to >5000 mg/L over ≤10 m distances. Generally, porewater Cl concentrations were relatively stable seasonally compared to the stream water, leading to benthic areas with year-round exposure to elevated Cl and limiting prospects for benthic zone refugia. Key factors affecting this spatial and temporal variability included proximity to roads, impacts from point sources (snow storage locations), and surface water downwelling (hyporheic flows). These observations have direct implications for the health of urban stream benthic communities and for designing management and remediation strategies., Competing Interests: Declaration of competing interest Clare E. Robinson reports financial support was provided by the Natural Sciences and Engineering Research Council of Canada. Grant Hodgins reports financial support was provided by the Natural Sciences and Engineering Research Council of Canada., (Copyright © 2024. Published by Elsevier B.V.)

Hydrocarbon-determined shake-flask measurements have demonstrated great utility for optimizing lipophilicity during early drug discovery. Alternatively, chromatographic methods confer reduced experimental error and improved handling of complex mixtures. In this study, we developed a chromatographic approach for estimating hydrocarbon-water shake-flask partition coefficients for a variety of macrocyclic peptides and other bRo5 molecules including PROTACs. The model accurately predicts experimental shake-flask measurements with high reproducibility across a wide range of lipophilicities. The chromatographic retention times revealed subtle conformational effects and correlated with the ability to sequester hydrogen bond donors in low dielectric media. Estimations of shake-flask lipophilicity from our model also accurately predicted trends in MDCK passive cell permeability for a variety of thioether-cyclized decapeptides. This method provides a convenient, high-throughput approach for measuring lipophilic permeability efficiency and predicting passive cell permeability in bRo5 compounds that is suitable for multiplexing pure compounds or investigating the properties of complex library mixtures.

H3K27M-mutant diffuse midline gliomas (DMGs) express high levels of the disialoganglioside GD2 (ref. 1 ). Chimeric antigen receptor-modified T cells targeting GD2 (GD2-CART) eradicated DMGs in preclinical models 2 . Arm A of Phase I trial no. NCT04196413 (ref.  3 ) administered one intravenous (IV) dose of autologous GD2-CART to patients with H3K27M-mutant pontine (DIPG) or spinal DMG (sDMG) at two dose levels (DL1, 1 × 10 6  kg - 1 ; DL2, 3 × 10 6  kg -1 ) following lymphodepleting chemotherapy. Patients with clinical or imaging benefit were eligible for subsequent intracerebroventricular (ICV) intracranial infusions (10-30 × 10 6 GD2-CART). Primary objectives were manufacturing feasibility, tolerability and the identification of maximally tolerated IV dose. Secondary objectives included preliminary assessments of benefit. Thirteen patients enroled, with 11 receiving IV GD2-CART on study (n = 3 DL1 (3 DIPG); n = 8 DL2 (6 DIPG, 2 sDMG)). GD2-CART manufacture was successful for all patients. No dose-limiting toxicities occurred on DL1, but three patients experienced dose-limiting cytokine release syndrome on DL2, establishing DL1 as the maximally tolerated IV dose. Nine patients received ICV infusions, with no dose-limiting toxicities. All patients exhibited tumour inflammation-associated neurotoxicity, safely managed with intensive monitoring and care. Four patients demonstrated major volumetric tumour reductions (52, 54, 91 and 100%), with a further three patients exhibiting smaller reductions. One patient exhibited a complete response ongoing for over 30 months since enrolment. Nine patients demonstrated neurological benefit, as measured by a protocol-directed clinical improvement score. Sequential IV, followed by ICV GD2-CART, induced tumour regressions and neurological improvements in patients with DIPG and those with sDMG., Competing Interests: Competing interests M.M., R.M. and C. Mackall are coinventors on a patent for the use of GD2-CAR T cells in regard to H2K27M gliomas, coordinated through Stanford University. C. Mackall is a coinventor on patents for the use of dasatinib and other small molecules to modulate CAR function and control CAR-associated toxicity, and on several patents related to CAR T cell therapies. C. Mackall holds equity in CARGO Therapeutics, Link Cell Therapies and GBM Newco, which are developing CAR-based therapies, and consults for CARGO, Link, Immatics, Ensoma, GBM NewCo and Red Tree Capital. She receives research funding from Lyell and Tune Therapeutics. R.M. is a cofounder of, and holds equity in, Link Cell Therapies and CARGO Therapeutics, and is a consultant for Lyell Immunopharma, NKarta, Arovella Pharmaceuticals, Innervate Radiopharmaceuticals, Aptorum Group, Gadeta, FATE Therapeutics (Data and Safety Monitoring Board) and Waypoint Bio. S.A.F. holds several patents in the field of cellular immunotherapy. V.B. is an investor and Director at Umoja Biopharma and Arsenal Bio. S.P.R. holds equity in Lyell Immunopharma. M.M. holds equity in MapLight Therapeutics and CARGO Therapeutics. The other authors declare no competing interests., (© 2024. The Author(s).)

Objective: To compare rates of participation in the National Bowel Cancer Screening Program (NBCSP) and follow-up for people with severe mental illness with those for people without severe mental illness or not prescribed antidepressants., Study Design: Retrospective cohort study; analysis of de-identified linked NBCSP, Pharmaceutical Benefits Scheme (PBS), and Medicare Benefits Schedule (MBS) data., Setting: Australia, 2006-2019., Participants: People aged 50-74 years (NBCSP-eligible) with severe mental illness, defined as those dispensed two or more prescriptions for second generation antipsychotics or for lithium (PBS data), and a random sample of people aged 50-74 years eligible for Medicare-subsidised services but never prescribed psychotropic medications (antipsychotics, lithium, antidepressants)., Main Outcome Measures: NBCSP participation (returned faecal occult blood test sample), valid test result, positive test result, and follow-up colonoscopy rates., Results: A total of 119 475 people with severe mental illness and 1 090 574 control group people were included in our analyses. The proportion of women was larger in the severe mental illness group (51.3%) than the control group (48.7%), as were the proportions who lived in inner regional areas (23.5% v 19.1%) or in areas in the lowest socio-economic quintile (21.8% v 14.7%). The NBCSP participation rate was lower among people with severe mental illness (adjusted incidence rate ratio [IRR], 0.70; 95% confidence interval [CI], 0.69-0.84). The proportion of valid test results was smaller for people with severe mental illness (95.9% v 98.7%; adjusted IRR, 0.97; 95% CI, 0.96-0.99), and the positive test result proportion larger (12.3% v 6.6%; adjusted IRR, 2.01; 95% CI, 1.94-2.09). The proportion of positive test results followed by colonoscopy was smaller for people with severe mental illness (71.7% v 82.6%; adjusted IRR, 0.88; 95% CI, 0.85-0.92)., Conclusions: People with severe mental illness were less likely to participate in the NBCSP or to undergo colonoscopy after a positive test result than other Australians. These differences may contribute to higher colorectal cancer mortality among people with severe mental illness. The contributions of differences in cancer stage at diagnosis and subsequent treatment to higher colorectal cancer mortality require further study., (© 2024 The Author(s). Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.)

Barth syndrome (BTHS) is a rare mitochondrial disease caused by pathogenic variants in the gene TAFAZZIN, which leads to abnormal cardiolipin (CL) metabolism on the inner mitochondrial membrane. Although TAFAZZIN is ubiquitously expressed, BTHS involves a complex combination of tissue specific phenotypes including cardiomyopathy, neutropenia, skeletal myopathy, and growth delays, with a relatively minimal neurological burden. To understand both the developmental and functional effects of TAZ-deficiency in different tissues, we generated isogenic TAZ knockout (TAZ-KO) and WT cardiomyocytes (CMs) and neural progenitor cells (NPCs) from CRISPR-edited induced pluripotent stem cells (iPSCs). In TAZ-KO CMs we discovered evidence of dysregulated mitophagy including dysmorphic mitochondria and mitochondrial cristae, differential expression of key autophagy-associated genes, and an inability of TAZ-deficient CMs to properly initiate stress-induced mitophagy. In TAZ-deficient NPCs we identified novel phenotypes including a reduction in CIV abundance and CIV activity in the CIII2&CIV2 intermediate complex. Interestingly, while CL acyl chain manipulation was unable to alter mitophagy defects in TAZ-KO CMs, we found that linoleic acid or oleic acid supplementation was able to partially restore CIV abundance in TAZ-deficient NPCs. Taken together, our results have implications for understanding the tissue-specific pathology of BTHS and potential for tissue-specific therapeutic targeting. Moreover, our results highlight an emerging role for mitophagy in the cardiac pathophysiology of BTHS and reveal a potential neuron-specific bioenergetic phenotype., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

DNA metabarcoding is a contemporary technique in diet composition studies and stands to fill key knowledge gaps left by traditional diet analysis methods. For endangered species such as the African wild dog ( Lycaon pictus ), the fulfilment of these knowledge gaps presents an opportunity for improved management practices and vulnerability assessments. There are an estimated ~600 African wild dogs remaining in South Africa. These dogs are generally understood to prey upon impala ( Aepyceros melampus ) and other medium-sized ungulates. Here, we present the first assessment of DNA metabarcoding as a valuable method for diet composition analysis of this highly social carnivore. DNA from faecal samples collected across seven landscape types in the Kruger National Park (KNP) was extracted and used to determine the presence of seven unique prey taxa, including novel species such as the Cape hare ( Lepus capensis ). Impala was identified as a prey item in all landscape types, complementing the diet preference prediction made with stable isotope analysis using the same samples and existing understanding of wild dog diet. Given recommended improvements, the application of DNA metabarcoding in wild dog diet analysis shows promising prospects for identifying novel prey species and validating previous records of this endangered canids diet., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Author(s). Ecology and Evolution published by John Wiley & Sons Ltd.)

Introduction: We implemented two cross-sectional reproductive age mortality surveys in 2007-2008 and 2018-2019 to assess changes in the MMR and causes of death in Zimbabwe. We collected data from health institutions, civil registration and vital statistics, the community, and surveillance. This paper analyses missingness and misclassification of deaths in the two surveys., Methods: We compared proportions of missed and misclassified deaths in the surveys using Chi-square or Fisher's exact tests. Using log-linear regression models, we calculated and compared risk ratios of missed deaths in the data sources. We assessed the effect on MMRs of misclassifying deaths and analysed the sensitivity and specificity of identifying deaths in the surveys using the six-box method and risk ratios calculated through Binomial exact tests., Results: All data sources missed and misclassified the deaths. The community survey was seven times [RR 7.1 (5.1-9.7)] and CRVS three times [RR 3.4 (2.4-4.7)] more likely to identify maternal deaths than health records in 2007-08. In 2018-19, CRVS [RR 0.8 (0.7-0.9)] and surveillance [RR 0.7 (0.6-0.9)] were less likely to identify maternal deaths than health records. Misclassification of causes of death significantly reduced MMRs in health records [RR 1.4 (1.2-1.5)]; CRVS [RR 1.3 (1.1-1.5)] and the community survey/surveillance [RR 1.4 (1.2-1.6)]., Conclusion: Incompleteness and misclassification of maternal deaths are still high in Zimbabwe. Maternal mortality studies must triangulate data sources to improve the completeness of data while efforts to reduce misclassification of deaths continue., Competing Interests: Declarations Conflict of Interest The authors declare no competing interests. Ethics Approval and Consent to Participate The University of Pretoria and the Medical Research Council of Zimbabwe institutional review boards (IRBs) approved the study including collection of clinical notes for obstetricians to use to recode the causes of death. The MoHCC and RG’s office approved the study including collecting person identifying data used to link and de-duplicate data across sources. Verbal autopsy informants gave written informed consent to be interviewed in the 2007–08 survey. Informed consent was waived in the 2018–19 survey when all data were collected from existing records. Consent for Publication Not applicable., (© 2024. The Author(s).)

Shortly after the first case of SARS-CoV-2 was diagnosed a public health emergency (PHE) was declared and a multi-agency response was initiated within the US federal government to create and propagate testing capacity. As part of this response, an unprecedented program designated Rapid Acceleration of Diagnostics (RADx) Tech was established by the National Institutes of Health (NIH) to facilitate the development of point-of-care tests for the COVID-19. The RADx Tech Clinical Studies Core (CSC), located at the University of Massachusetts Chan Medical School (UMass Chan), with partnering academic, private, and non-governmental organizations around the country, was tasked with developing clinical studies to support this work. This manuscript details development of a biorepository specifically focused on the collection and storage of samples designed for diagnostic platform development. It highlights the unified collection and annotation process that enabled gathering a diverse set of samples. This diversity encompasses the geography and backgrounds of the participants as well as sample characteristics such as variant type and RT-PCR cycle threshold (CT) value of the corresponding reference sample on a uniform clinical reference platform., Competing Interests: Declarations Ethics approval and consent to participate This study was approved by the UMass Chan Institutional Review Board reference number [H00022475]. Informed consent for participation was obtained from all participants. In the case of pediatric participants, informed consent was obtained from the parent or legal guardian as well as assent from the child. Clinical trial number: not applicable. Consent for publication Not applicable. Competing interests The views expressed in this article are those of the authors and do not necessarily represent the views of the National Institute of Biomedical Imaging and Bioengineering; the National Heart, Lung, and Blood Institute; the National Institutes of Health (NIH); or the U.S. Department of Health and Human Services., (© 2024. The Author(s).)

The CRISPR (clustered regularly interspaced short palindromic repeats)/Cas (CRISPR-associated protein) programmable nuclease system continues to evolve, with in vivo therapeutic gene editing increasingly applied in clinical settings. However, off-target effects remain a significant challenge, hindering its broader clinical application. To enhance the development of gene-editing therapies and the accuracy of prediction algorithms, we developed CRISPRoffT (https://ccsm.uth.edu/CRISPRoffT/). Users can access a comprehensive repository of off-target regions predicted and validated by a diverse range of technologies across various cell lines, Cas enzyme variants, engineered sgRNAs (single guide RNAs) and CRISPR editing systems. CRISPRoffT integrates results of off-target analysis from 74 studies, encompassing 29 experimental prediction techniques, 368 guide sequences, 226 164 potential guide and off-target pairs and 8840 validated off-targets. CRISPRoffT features off-target data from different CRISPR approaches (knockout, base editing and prime editing) applied under diverse experimental conditions, including 85 different Cas/guide RNA (gRNA) combinations used across 34 different human and mouse cell lines. CRISPRoffT provides results of comparative analyses for individual guide sequences, genes, cell types, techniques and Cas/gRNA combinations under different conditions. CRISPRoffT is a unique resource providing valuable insights that facilitate the safety-driven design of CRISPR-based therapeutics, inform experimental design, advance the development of computational off-target prediction algorithms and guide RNA design algorithms., (© The Author(s) 2024. Published by Oxford University Press on behalf of Nucleic Acids Research.)

Most high grade serous ovarian cancers (HGSOC) originate in the fallopian tube but spread to the ovary and peritoneal cavity, highlighting the need to understand antitumor immunity across HGSOC sites. Using spatial analyses, we discover that tertiary lymphoid structures (TLSs) within ovarian tumors are less developed compared with TLSs in fallopian tube or omental tumors. We reveal transcriptional differences across a spectrum of lymphoid structures, demonstrating that immune cell activity increases when residing in more developed TLSs and produce a prognostic, spatially derived TLS signature from HGSOC tumors. We interrogate TLS-adjacent stroma and assess how normal mesenchymal stem cells MSCs (nMSCs) may support B cell function and TLS, contrary to cancer-educated MSCs (CA-MSCs) which negate the prognostic benefit of our TLS signature, suggesting that pro-tumorigenic stroma could limit TLS formation., Competing Interests: Declaration of interests I.P.M. is a consultant for Galvanize Therapeutics and founder of Llusern Spatial Solutions LLC. T.C.B. is a consultant for Galvanize Therapeutics, Mestag Therapeutics, Tallac Therapeutics, Attivare Therapeutics, and Kalivir Therapeutics. T.C.B. serves on the Scientific Advisory Board of Tabby Therapeutics. R.B. declares PCT/US15/612657 (Cancer Immunotherapy), PCT/US18/36052 (Microbiome Biomarkers for Anti-PD-1/PD-L1 Responsiveness: Diagnostic, Prognostic and Therapeutic Uses Thereof), PCT/US63/055227 (Methods and Compositions for Treating Autoimmune and Allergic Disorders)., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The site-of-disease microbiome and predicted metagenome were evaluated in a cross-sectional study involving people with presumptive tuberculous pericarditis. We also explored the interaction between C-reactive protein (CRP) and the microbiome., Methods: People with effusions requiring diagnostic pericardiocentesis (n=139) provided pericardial fluid for sequencing and blood for CRP measurement., Results: Pericardial fluid microbiota differed in β-diversity among people with definite (dTB, n=91), probable (pTB, n=25), and non- (nTB, n=23) tuberculous pericarditis. dTBs were Mycobacterium-, Lacticigenium-, and Kocuria-enriched vs. nTBs. HIV-positive dTBs were Mycobacterium-, Bifidobacterium-, Methylobacterium-, and Leptothrix-enriched vs. HIV-negative dTBs. HIV-positive dTBs on ART were Mycobacterium- and Bifidobacterium-depleted vs. those not on ART. dTBs exhibited enrichment in short-chain fatty acid (SCFA) and mycobacterial metabolism pathways vs. nTBs. Additional non-pericardial involvement (pulmonary infiltrates) was associated with Mycobacterium-enrichment and Streptococcus-depletion. Mycobacterium reads were in 34 % (31/91) of dTBs, 8 % (2/25) of pTBs and 17 % (4/23) nTBs. People with CRP above (vs. below) the median value had different β-diversity (Pseudomonas-depleted). No correlation was found between enriched taxa in dTBs and CRP., Conclusions: Pericardial fluid microbial composition varies by tuberculosis status, HIV (and ART) status and dTBs are enriched in SCFA-associated taxa. The clinical significance, including mycobacterial reads in nTBs and pTBs, requires evaluation., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Background: Concussions are common, particularly among young adults, and often are associated with persistent, debilitating, and hard-to-treat symptoms. Anxiety and concussion symptoms often amplify each other, and growing evidence indicates that anxiety plays a key role in symptoms persistence after concussion. Targeting anxiety early after concussion may be a promising means of helping prevent persistent concussion symptoms in this population. We developed the Toolkit for Optimal Recovery after Concussion (TOR-C), the first mind-body program tailored for young adults with a recent concussion and anxiety, aiming to prevent persistent concussion symptoms., Objective: This study aims to conduct an open pilot of TOR-C to test preliminary feasibility, signal of change in measures, and treatment perceptions., Methods: Five young adults (aged 18-24 years) attended 4 weekly one-on-one live video sessions with a clinician. Participants completed questionnaires measuring treatment targets (ie, pain catastrophizing, mindfulness, fear avoidance, limiting behaviors, and all-or-nothing behaviors) and outcomes (ie, postconcussive symptoms, physical function, anxiety, depression, and pain) at baseline, immediately following the intervention, and 3 months after intervention completion. At the conclusion of the program, participants attended a qualitative interview and provided feedback about the program to help optimize study content and procedures., Results: Feasibility markers were excellent for credibility and expectancy (5/5, 100% of participants scored above the credibility and expectancy scale midpoint), client satisfaction (4/5, 80% of participants scored above the Client Satisfaction Questionnaire midpoint), therapist adherence (97% adherence), acceptability of treatment (5/5, 100% of participants attended 3 or more sessions), adherence to homework (87% home practice completion), and feasibility of assessments (no measures fully missing). The feasibility of recruitment was good (5/7, 71% of eligible participants agreed to participate). There were preliminary signals of improvements from pre-post comparisons in treatment targets (d=0.72-2.20) and outcomes (d=0.41-1.38), which were sustained after 3 months (d=0.38-2.74 and d=0.71-1.63 respectively). Exit interviews indicated overall positive perceptions of skills and highlighted barriers (eg, busyness) and facilitators (eg, accountability) to engagement., Conclusions: TOR-C shows preliminary feasibility, is associated with a signal of improvement in treatment targets and outcomes, and has the potential to support recovery from concussion. The quantitative findings along with the qualitative feedback obtained from the exit interviews will help optimize TOR-C in preparation for an upcoming randomized controlled trial of TOR-C versus an active control condition of health education for concussion recovery., International Registered Report Identifier (irrid): RR2-10.2196/25746., (©Molly Elizabeth Becker, Nadine Stratton Levey, Gloria Y Yeh, Joseph Giacino, Grant Iverson, Noah Silverberg, Robert A Parker, Ellen McKinnon, Caitlin Siravo, Priyanca Shah, Ana-Maria Vranceanu, Jonathan Greenberg. Originally published in JMIR Formative Research (https://formative.jmir.org), 08.11.2024.)

Background: Accessible, accurate screening tests are necessary to advance tuberculosis (TB) case finding and early detection in high-burden countries., Methods: We prospectively screened adults with ≥2 weeks of cough at primary health centers in the Philippines, Vietnam, South Africa, Uganda, and India. Participants received chest-X-ray, Cepheid Xpert TB Host Response (Xpert HR) testing, and point-of-care C-reactive protein (CRP) testing (Boditech). Chest-X-ray images were processed using CAD4TB v7, a computer-aided detection algorithm. We assessed diagnostic accuracy against a microbiologic reference standard (sputum Xpert Ultra, culture). Optimal cut-points were chosen to maximize specificity at 90% sensitivity. Two-test screening algorithms were considered, using 1) sequential negative serial screening (positive defined as positive on either test) and 2) sequential positive serial screening (positive defined as positive on both tests)., Results: Between July 2021 and August 2022, 1,392 participants with presumptive TB had valid index tests and reference standard results, and 303 (22%) had confirmed TB. In head-to-head comparisons, CAD4TB v7 showed the highest specificity at 90% sensitivity (70.3% vs. 65.1% for Xpert HR, difference 95% CI 1.6 to 8.9; 49.7% for CRP, difference 95% CI 17.0 to 24.3). Three two-test screening algorithms met WHO target product profile (TPP) minimum accuracy thresholds and had higher accuracy than any test alone. At 90% sensitivity, the specificity was 79.6% for Xpert HR-CAD4TB [sequential negative], 75.9% for CRP-CAD4TB [sequential negative], and 73.7% for Xpert HR-CAD4TB [sequential positive]., Conclusions: CAD4TB achieves TPP targets and outperforms Xpert HR and CRP. Combining screening tests further increased accuracy., Registration: NCT04923958., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Nano-picoplankton are the dominant primary producers during the post-upwelling period in St Helena Bay, South Africa. Their dynamics on short time scales are not well understood and neither are the community composition, structure, and potential functionality of the surrounding microbiome. Samples were collected over five consecutive days in March 2018 from three depths (1 m, 25 m, 50 m) at a single sampling station in St Helena Bay. There was clear depth-differentiation between the surface and depth in both diversity and function throughout the sampling period for the archaea, bacteria and eukaryotes. Daily difference in eukaryote diversity, was more pronounced at 1 m and 25 m with increased abundances of Syndiniales and Bacillariophyta. Surface waters were dominated by photosynthetic and photoheterotrophic microorganisms, while samples at depth were linked to nitrogen cycling processes, with high abundances of nitrifiers and denitrifiers. Strong depth gradients found in the nutrient transporters for ammonia were good indicators of measured uptake rates. This study showed that nano-picoplankton dynamics were driven by light availability, nutrient concentrations, carbon biomass and oxygenation. The nano-picoplankton help sustain ecosystem functioning in St Helena Bay through their ecological roles, which emphasizes the need to monitor this size fraction of the plankton., (© The Author(s) 2024. Published by Oxford University Press on behalf of FEMS.)

The historical use and storage of aqueous film-forming foams (AFFF) containing per- and poly-fluoroalkyl substances (PFAS) at a range of sites including airports, defence, and port facilities have resulted in a legacy of contaminated infrastructure such as concrete. Contaminated concrete constitutes an ongoing source of PFAS contamination requiring management to ensure the protection of human health and the environment. In this study, modified Leaching Environmental Assessment Framework (LEAF) and Australian Standard Leaching Procedure (ASLP) were used to examine the leachability of PFAS, specifically, perfluorooctanesulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonate (PFHxS) and perfluorohexanoic acid (PFHxA) from AFFF-contaminated concrete collected from an Australian Defence Fire Training Area (FTA). In general, PFAS readily leached from intact contaminated concrete monoliths with the cumulative proportion (%) decreasing in the order: PFHxA (>95%) > PFOS (26-84%) ≈ PFHxS (14-78%) > PFOA (<1-54%). Higher leachability for PFHxA from concrete is consistent with previous findings for solids, however, inconsistent for PFOA with higher retention (lower leachability) in concrete as compared to PFOS. Duration of exposure to water (0.5-48 h) and temperature (25 °C and 50 °C) had little influence on the proportion of PFAS leachability from powdered concrete. A higher proportion of PFAS leached from a <2 mm concrete powder size fraction as compared to 2-20 mm and 20 mm size fractions. This behavior reflects an increase in surface area with decreasing concrete particle size. Reducing the particle size could enhance PFAS removal from waste concrete.

Importance: Respiratory syncytial virus (RSV) infection can cause severe illness in adults. However, there is considerable uncertainty in the burden of RSV-associated hospitalizations among adults prior to RSV vaccine introduction., Objective: To describe the demographic characteristics of adults hospitalized with laboratory-confirmed RSV and to estimate annual rates and numbers of RSV-associated hospitalizations, intensive care unit (ICU) admissions, and in-hospital deaths., Design, Setting, and Participants: This cross-sectional study used data from the RSV Hospitalization Surveillance Network (RSV-NET), a population-based surveillance platform that captures RSV-associated hospitalizations in 58 counties in 12 states, covering approximately 8% of the US population. The study period spanned 7 surveillance seasons from 2016-2017 through 2022-2023. Included cases from RSV-NET were nonpregnant hospitalized adults aged 18 years or older residing in the surveillance catchment area and with a positive RSV test result., Exposure: Laboratory-confirmed RSV-associated hospitalization, defined as a positive RSV test result within 14 days before or during hospitalization., Main Outcomes and Measures: Hospitalization rates per 100 000 adult population, stratified by age group. After adjusting for test sensitivity and undertesting for RSV in adults hospitalized with acute respiratory illnesses, rates were extrapolated to the US population to estimate annual numbers of RSV-associated hospitalizations. Clinical outcome data were used to estimate RSV-associated ICU admissions and in-hospital deaths., Results: From the 2016 to 2017 through the 2022 to 2023 RSV seasons, there were 16 575 RSV-associated hospitalizations in adults (median [IQR] age, 70 [58-81] years; 9641 females [58.2%]). Excluding the 2020 to 2021 and the 2021 to 2022 seasons, when the COVID-19 pandemic affected RSV circulation, hospitalization rates ranged from 48.9 (95% CI, 33.4-91.5) per 100 000 adults in 2016 to 2017 to 76.2 (95% CI, 55.2-122.7) per 100 000 adults in 2017 to 2018. Rates were lowest among adults aged 18 to 49 years (8.6 [95% CI, 5.7-16.8] per 100 000 adults in 2016-2017 to 13.1 [95% CI, 11.0-16.1] per 100 000 adults in 2022-2023) and highest among adults 75 years or older (244.7 [95% CI, 207.9-297.3] per 100 000 adults in 2022-2023 to 411.4 [95% CI, 292.1-695.4] per 100 000 adults in 2017-2018). Annual hospitalization estimates ranged from 123 000 (95% CI, 84 000-230 000) in 2016 to 2017 to 193 000 (95% CI, 140 000-311 000) in 2017 to 2018. Annual ICU admission estimates ranged from 24 400 (95% CI, 16 700-44 800) to 34 900 (95% CI, 25 500-55 600) for the same seasons. Estimated annual in-hospital deaths ranged from 4680 (95% CI, 3570-6820) in 2018 to 2019 to 8620 (95% CI, 6220-14 090) in 2017 to 2018. Adults 75 years or older accounted for 45.6% (range, 43.1%-48.8%) of all RSV-associated hospitalizations, 38.6% (range, 36.7%-41.0%) of all ICU admissions, and 58.7% (range, 51.9%-67.1%) of all in-hospital deaths., Conclusions and Relevance: In this cross-sectional study of adults hospitalized with RSV before the 2023 introduction of RSV vaccines, RSV was associated with substantial burden of hospitalizations, ICU admissions, and in-hospital deaths in adults, with the highest rates occurring in adults 75 years or older. Increasing RSV vaccination of older adults has the potential to reduce associated hospitalizations and severe clinical outcomes.

Mice lacking monoacylglycerol acyltransferase 2 (mMGAT2 1 ) are resistant to diet-induced fatty liver, suggesting hMOGAT2 inhibition is a viable option for treating metabolic dysfunction-associated steatotic liver disease (MASLD)/metabolic dysfunction-associated steatohepatitis (MASH). We generated humanized hMOGAT2 mice (HuMgat2) for use in pre-clinical studies testing the efficacy of hMOGAT2 inhibitors for treating MASLD/MASH. HuMgat2 mice developed MASH when fed a steatotic diet. Computer-aided histology revealed the presence of hepatocyte cell ballooning, immune cell infiltration, and fibrosis. Hepatocytes accumulated Mallory-Denk bodies containing phosphorylated p62/sequestosome-1-ubiquintinated protein aggregates likely caused by defects in autophagy. Metainflammation and apoptotic cell death were seen in the livers of HuMgat2 mice. Treating HuMgat2 mice with elafibranor reduced several MASH phenotypes. RNASeq analysis predicted changes in bile acid transporter expression that correlated with altered bile acid metabolism indicative of cholestasis. Our results suggest that HuMgat2 mice will serve as a pre-clinical model for testing hMOGAT2 inhibitor efficacy and toxicity and allow for the study of hMOGAT2 in the context of MASH., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: To assess the feasibility of the Toolkit for Optimal Recovery after Concussion (TOR-C), the first mind-body program aiming to prevent persistent concussion symptoms among young adults with anxiety, and an active control (Health Enhancement after Concussion; HE-C). We also tested preliminary improvements in outcome measures and putative mechanistic targets., Design: Single-blind, 2-arm, randomized controlled trial., Setting: Academic medical center in the US Northeast., Participants: Fifty young adults (ages 18-35) with a recent concussion (3-10 weeks prior) and anxiety (≥5 on the GAD7 questionnaire)., Interventions: Both interventions consisted of four 45-minute 1:1 sessions with a clinician over Zoom. TOR-C (n=25) taught mind-body, cognitive-behavioral, and return-to-activity skills. HE-C (n=25) taught health education (e.g., sleep, nutrition) without skills., Main Outcome Measures: Primary: feasibility outcomes (e.g., recruitment, credibility, expectancy, acceptability, safety, feasibility of assessments, fidelity, satisfaction, TOR-C homework adherence) with a-priori-set benchmarks. Secondary: intervention outcomes were concussion symptoms (PCSS), physical function (WHODAS), anxiety (GAD7/HAD-A), depression (HADS-D) and pain (NRS). TOR-C mechanistic targets were pain catastrophizing (PCS), mindfulness (CAMS-R), fear avoidance (FAB-TBI), limiting behavior and all-or-nothing behavior (BRIQ)., Results: Both interventions met all feasibility benchmarks and were associated with significant improvements in outcomes (concussion symptoms, physical function, anxiety, depression and pain; d=0.44-1.21) and TOR-C mechanistic targets (pain catastrophizing, mindfulness, fear-avoidance, and limiting behavior; Cohen's d=0.41-1.24). Improvements in all-or-nothing behavior were only significant in TOR-C (d=0.52). Improvements in all mechanistic targets except all-or-nothing behavior following TOR-C were significantly associated with improvements in at least one outcome., Conclusion: Findings provide strong support for the feasibility of TOR-C and HE-C, and preliminary evidence for improvements in mechanistic targets and outcomes. Findings inform a future fully-powered RCT testing efficacy of TOR-C vs. HE-C., Competing Interests: Declaration of competing interest GI received royalties from PAR, Inc. WCST-64, an honorarium from the Major Soccer League, and served as a consultant for NanoDx and Sway Medical System. JTG was funded in part by the Department of Defense and Abbott Point Care, Inc. (payments to institution). The above entities affiliated with GI and JTG were not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication. The other authors have nothing to disclose., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: To determine whether γδ T cells regulate natural killer (NK) cells in the herpes simplex virus 1 (HSV-1)-infected cornea., Methods: CD57Bl/6 (wild-type [WT]), TCRδ-/-, and IFN-γ-/- mice were infected intracorneally with HSV-1. TCR-/- mice were treated with IL-17A at 24 hours post-infection (PI), and the WT mice received treatments of fingolimod (FTY720) and anti-IL-17A. At 48 hours PI, corneas were excised, and intracellular staining flow cytometry was performed, as well as multiplex analysis. Additionally, single-cell RNA sequencing (scRNAseq) was done to analyze the transcriptome of NK cells from WT and TCRδ-/- mice., Results: In mice lacking γδ T cells, there were significantly fewer NK cells following ocular HSV-1 infection. This reduction of NK cells corresponded with lower levels of cytokines and chemokines associated with the antiviral response. Furthermore, NK cells from WT mice had enriched IL-17A signaling compared to those from TCRδ-/- mice. The NK cell response was partially rescued in TCRδ-/- mice by administration of IL-17A. Correspondingly, the NK cell response could be blunted in WT mice by administration of anti-IL-17A. Finally, IFN-γ-/- mice had significantly less IL-17A production compared to WT mice., Conclusions: γδ T17 cells promote NK cell accumulation in HSV-1-infected corneas. In turn, NK cells secrete IFN-γ, which negatively regulates further IL-17A production by γδ T cells.

Introduction: Adolescent idiopathic scoliosis (AIS) is a common diagnosis managed by pediatric orthopedic surgeons with nonoperative radiographic monitoring representing a cornerstone of treatment. Differences in practices and techniques for obtaining radiographic studies contribute to variation, cost of care, and hamper data aggregation. We surveyed several large organizations dedicated to children's orthopedics or scoliosis care to obtain a consensus for radiographic evaluation of AIS., Methods: A REDCap-based survey was developed across four institutions and beta-tested by staff and fellows from a single institution. The finalized survey was distributed to members of POSNA, PSSG, and SOSORT, and shared on social media. Participants were asked to rank the importance of various datapoints in radiographic assessment of the spinal deformity, skeletal maturity, and study indications during initial, subsequent, preoperative, and final office visits for AIS. Response rate for the overall group was 26%., Results: Cobb angle was considered the most important (> 94%) radiographic index across all time points. For positioning, 46% of respondents favored arms bent touching clavicles as the ideal positioning for X-rays, and another 24% favored arms down with palms forward (Table 2). The majority of respondents obtain lateral X-rays at the first visit (99%) and at the preoperative visit (70%). At the preoperative visit, sagittal contour (86%), apex location (85%), and Lenke classification (73%) were considered important factors to record. Flexibility studies are primarily obtained at the preoperative visit (89%) and 81% of respondents prefer bending films as the flexibility technique of choice. Regarding measures of skeletal maturity, Sanders bone age was considered to be the most important by over 70% of respondents across initial, subsequent, preoperative and brace wean visits (Fig. 2). MRIs were obtained routinely by 34% of respondents and only when the patient had a concerning symptom or finding for 67% of respondents., Conclusions: Despite large variations in radiographic examination of AIS, large areas of agreement were found. It is important to establish standards for positioning patients, evaluating skeletal maturity, and obtaining assessments including lateral views, flexibility studies, and advanced imaging. Establishing common practices for radiographic evaluation of AIS will allow for less variation in care and for critical questions to be answered through registry formation and large multicenter data collection., Significance: This study establishes current practitioner opinion on the radiographic evaluation of the AIS patient. Minimum data sets are useful for data aggregation and answering research questions in the face of data variability., Level of Evidence: Level V., (© 2024. The Author(s).)

Background: Efforts in browlifting longevity, desire for minimally invasive procedures, patient individualization, and minimization of complications led to the development of the gliding brow lift (GBL). The GBL has proven to be a successful, minimally invasive technique targeting brow elevation in combination with the hemostatic net., Objectives: To evaluate maintenance of cutaneous brow elevation with the GBL technique at specific post-operative time points., Methods: A retrospective review was conducted of 63 patients (59 females; 4 males) who underwent a GBL by the senior author (JCG) between 2019 and 2022 for co-morbidities, maintenance of brow lift, and incidence of complications at four post-operative time points: 3, 6, 9, and 12 months. Pre- and postoperative photographs were analyzed at four anatomic locations: supraorbital rim, lateral canthus, mid pupil, and medial canthus., Results: The cohort consisted of 59 female-only patients; male patients were excluded due to small sample size. The average age of 62.8 years old (SD ±7.01) and a mean BMI of 24. Only one patient required return to the operating room for hematoma evacuation; this was a result of a concomitant rhytidectomy and not involving the brow. All locations maintained a statistically significant lift (p<0.01). The most significant lift was at the lateral canthus (3.09 mm) and tail of the brow (2.74 mm) at 1 year post-operatively., Conclusions: The GBL is a successful innovation in aesthetic brow surgery. Depending on patient needs, it is an excellent choice for selective and long-term elevation of the lateral brow., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Colibacillosis caused by avian pathogenic Escherichia coli (APEC) is causing economic losses to the global poultry industry. Increased prevalence of antibiotic resistance in APEC is the leading cause for increased indiscriminate use of various antimicrobial compounds in farms. The study aimed to investigate the presence of phenotypic and genotypic markers for antibiotic resistance, metals, and biocides in APEC from Bangladeshi poultry and details about the antimicrobials used in poultry farms. In total, 55 APEC were isolated from hearts or liver samples of 86 sick or dead chickens using culture on agar plate and biochemical testing. APEC isolates were tested for antibiotic susceptibility to 14 antimicrobial agents according to the European Committee on Antimicrobial Susceptibility Testing. A series of PCRs was performed to screen the presence of genes for quinolones, colistin, aminoglycosides, ESBL, metals, and biocides. Detailed information regarding antibiotic use was collected from farmers during clinical investigations. Resistance was found to 10 antibiotics and prevalence was as follows: ampicillin (86%), ciprofloxacin (86%), trimethoprim-sulphamethoxazole (73%), chloramphenicol (33%), mecillinam (13%), gentamicin (11%), cefoxitin (11%), cefotaxime (9%), tigecycline (2%), and nitrofurantoin (2%). The most common multiresistance phenotype was CIP-AMP-SXT, and 35% of isolates were multidrug resistant. Genotypic analysis confirmed the presence of quinolone resistance genes [ qnrS1 and aac-(6')-lb-cr ], silver-resistant genes ( silE ), and mercury-resistant genes ( merA ) but not others. In total, 88% farmers were using different antimicrobial compounds, and, of them, 56% were using antimicrobials without prescriptions from veterinarians. Ciprofloxacin was most extensively used followed by oxytetracycline. Critically important antibiotics like ciprofloxacin, colistin, and gentamicin are extensively used in the farms. This study confirmed the presence of antibiotics, metals, and biocide-resistant APEC in poultry farms in Bangladesh. Increased resistance to quinolones is a serious ongoing problem. The indiscriminate use of antibiotics in poultry farms is alarming and should be stopped.

Background: Screening for SARS-CoV-2 infection among hospital admissions made interpretation of COVID-19 hospitalization data challenging as SARS-CoV-2-positive persons with mild or asymptomatic infection may be incorrectly identified as COVID-19-associated hospitalizations. The study objective is to estimate the proportion of hospitalizations likely attributable to COVID-19 among SARS-CoV-2-positive hospitalized patients., Methods: A sample of laboratory-confirmed SARS-CoV-2-positive hospitalizations from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) from June 2020 to September 2023 was analyzed, with a focus on July 2022 to September 2023. Likely COVID-19-attributable hospitalizations were defined as hospitalizations among SARS-CoV-2-positive non-pregnant adults ages ≥ 18 years with COVID-19-related presenting complaint, treatment, or discharge diagnosis., Results: Among 44,816 sampled hospitalizations, 90% met the definition of likely COVID-19-attributable. Among the 9866 admissions occurring during July 2022 to September 2023, 86% were likely COVID-19-attributable; 87% had a COVID-19-related presenting complaint, 64% received steroids or COVID-19-related treatment, 47% had respiratory- and 10% had coagulopathy-related discharge diagnoses, and 39% had COVID-19 as the principal discharge diagnosis code. More than 70% met ≥ 2 criteria. Compared with likely COVID-19-attributable hospitalizations, SARS-CoV-2-positive patients who did not meet the case definition were more likely to be ages 18-49 years (27% vs. 13%), have no underlying medical conditions (14% vs. 4%), or be asymptomatic for COVID-19 upon admission (46% vs. 10%) (all p < 0.05)., Conclusions: Most hospitalizations among SARS-CoV-2-positive adults in a recent period were likely attributable to COVID-19. COVID-19-attributable hospitalizations are less common among younger SARS-CoV-2-positive hospitalized adults but still account for nearly three quarters of all admissions among SARS-CoV-2-positive adults in this age group., (Published 2024. This article is a U.S. Government work and is in the public domain in the USA. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Objectives: Natural killer (NK) cells make important contributions to anti-malarial immunity through antibody-dependent cellular cytotoxicity (ADCC), but the role of different components of this pathway in promoting NK cell activation remains unclear., Methods: We compared the functions and phenotypes of NK cells from malaria-exposed and malaria-naive donors, and then varied the erythrocyte genetic background, Plasmodium falciparum strain and opsonising plasma used in ADCC to observe their impacts on NK cell degranulation as measured by CD107a mobilisation., Results: Natural killer cells from malaria-exposed adult Ugandan donors had enhanced ADCC, but an impaired pro-inflammatory response to cytokine stimulation, compared to NK cells obtained from malaria-naive adult North American donors. Cellular phenotypes from malaria-exposed donors reflected this specialisation for ADCC, with a compartment-wide downregulation of the Fc receptor γ-chain and enrichment of highly differentiated CD56 dim and CD56 neg populations. NK cell degranulation was enhanced in response to opsonised P. falciparum schizonts cultured in sickle cell heterozygous erythrocytes relative to wild-type erythrocytes, and when using opsonising plasma collected from donors living in a high transmission area compared to a lower transmission area despite similar levels of 3D7 schizont-specific IgG levels. However, degranulation was lowered in response to opsonised field isolate P. falciparum schizonts isolated from clinical malaria infections, compared to the 3D7 laboratory strain typically used in these assays., Conclusion: This work highlights important host and parasite factors that contribute to ADCC efficacy that should be considered in the design of ADCC assays., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Clinical & Translational Immunology published by John Wiley & Sons Australia, Ltd on behalf of Australian and New Zealand Society for Immunology, Inc.)

Introgressive hybridization may lead to contrasting evolutionary outcomes that are difficult to predict, since they depend on the fitness effects of endogenous genomic interactions and environmental factors. Conservation of endemic biodiversity may be more effective with require direct measurement of introgressed ancestry and fitness in wild populations, especially for keystone taxa at risk of hybridization following species introductions. We assessed the relationship of non-native ancestry with growth and body condition in the basin-restricted Neosho Bass (Micropterus velox; NB), focusing on two streams in the NB native range that are admixed extensively with non-native Smallmouth Bass (M. dolomieu; SMB). We quantified genetic composition of 116 fish from Big Sugar Creek (N=46) and Elk River (N=70) at 14 microsatellite loci. Using back-calculated total length-at-age estimated from sagittal otoliths, we assessed whether genetic ancestry explained variation in von Bertalanffy growth model parameters, accounting for sex and stream effects. We then assessed the relationship of ancestry and body condition. We found no differences in growth parameters by sex, stream, or ancestry, suggesting phenotypic homogenization which could be mediated by selection on body size. We found a negative correlation between SMB ancestry and condition, including lower condition in Big Sugar Creek, possibly reflecting a trade-off between maximum length and condition with respect to overall fitness. We show that ongoing non-native introgression, which may be augmented by anthropogenic SMB introductions, may attenuate evolutionary differentiation between species and directly influence fitness, possibly having critical implications for long-term persistence and management of adaptive potential in a popular and ecologically important endemic sportfish., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Evolutionary Biology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

OBJECTIVES: To (1) investigate whether different labels for neck pain after a motor vehicle crash (MVC) influenced recovery expectations and management beliefs, (2) explore reasons for low recovery expectations and greater likelihood for lodging a claim, and (3) explore the moderating effect of neck pain history and sociodemographic characteristics. DESIGN: Online randomized experiment with nested qualitative content analysis. METHODS: We randomized 2229 participants from the general population (mean age: 46.7 ± 17.5 years; 72.4% females; 66% with previous or current neck pain; 10% with an MVC experience) to read 1 of 5 scenarios describing a patient with neck pain after an MVC, each was labeled as whiplash injury , whiplash-associated disorder , posttraumatic neck pain , neck pain , or neck strain. The primary outcome was recovery expectations, rated on a 0- to 10-point scale. RESULTS: Participants allocated to whiplash-associated disorder or neck pain had lower recovery expectations than those allocated to neck strain (adjusted mean difference [95% confidence interval]: -0.5 [-0.9 to -0.1] for both comparisons). Whiplash-associated disorder led to more recovery uncertainty, while neck pain led to greater doubt about the health care provider. Most secondary outcomes showed significant but small differences. Participants allocated to neck strain were less inclined to claim than those allocated to whiplash-associated disorder or whiplash injury due to less perceived need for financial support. Neck pain history moderated labeling effects on recovery expectations; household income moderated the claim intention. CONCLUSIONS: Labels for neck pain after an MVC influenced recovery expectations and management preferences. The clinical relevance of the small effects was unclear. J Orthop Sports Phys Ther 2024;54(11):1-10. Epub 5 September 2024. doi:10.2519/jospt.2024.12590 .

Background: For emergency department (ED) patients with cardiac chest pain, introduction of high-sensitivity troponin (hsTnT) pathways has been associated with reductions in length of stay of less than 1 h., Methods: At two urban Canadian sites, we introduced hsTnT on January 26, 2016. While the prior diagnostic algorithm required troponin testing at 0 and 6 h, serial hsTnT serial testing was conducted at 0 and 3 h. We identified consecutive patients who presented with cardiac chest pain from January 1, 2015, to March 31, 2017, along with 30-day outcomes. The primary outcome was a missed 30-day major adverse cardiac event, (MACE) defined as death, revascularization, or readmission for myocardial infarction occurring in a patient-discharged home with a minimizing diagnosis and without cardiac-specific follow-up. Secondary outcomes included admission rate, ED length of stay, and MACE. We compared pre- and post- implementation periods using descriptive methods and repeated this analysis in patients with noncardiac chest pain., Results: We collected 5585 patients with cardiac chest pain, (2678 pre- and 2907 post-introduction) and 434 had (7.8%, 95% CI 7.1 to 8.5%) MACE, with 1 missed MACE. (0.2%, 95% CI 0.04 to 1.3%). Admission rate was stable at 24.1% pre- and 23.7% while median length of stay decreased from 464 to 285 min, a difference of 179 min. (95% CI 61 to 228 min). For 11,611 patients with noncardiac chest pain, admission rate (9%) and length of stay (191 versus 193 min) remained constant., Conclusions: Implementation of hsTnT for evaluation of ED chest pain patients was safe and associated with a 3-h decrease in length of stay., Competing Interests: Declarations Conflict of interest On behalf of all authors, the corresponding author states there is no conflict of interest., (© 2024. The Author(s), under exclusive licence to the Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).)

Despite the global nature of psychological issues, an overwhelming majority of research originates from a small segment of the world's population living in high-income countries (HICs). This disparity risks distorting our understanding of psychological phenomena by underrepresenting the cultural and contextual diversity of human experience. Research from lower- and middle-income countries (LMIC) is also less frequently cited, both because it is seemingly viewed as a "special case" and because it is less well known due to language differences and biases in indexing algorithms. Acknowledging and actively addressing this imbalance is crucial for a more inclusive, diverse, and effective science of evidence-based intervention. In this state-of-the-science review, we used a machine learning method to identify key topics in LMIC research on Acceptance and Commitment Therapy (ACT), choosing ACT due to the significant body of work from LMICs. We also examined one indication of study quality (study size), and overall citations. Research in LMICs was often nonindexed, leading to lower citations, but study size could not explain a lack of indexing. Many objectively identified topics in ACT research became invisible when LMIC research was ignored. Specific countries exhibited potentially important differences in the topics. We conclude that strong and affirmative actions are needed by scientific associations and others to ensure that research from LMICs is conducted, known, indexed, and used by CBT researchers and others interested in evidence-based intervention science., (Copyright © 2024 Association for Behavioral and Cognitive Therapies. Published by Elsevier Ltd. All rights reserved.)

Background: Tenecteplase has potential benefits over alteplase, the standard agent for intravenous thrombolysis in acute ischaemic stroke, because it is administered as a single bolus and might have superior efficacy. The ATTEST-2 trial investigated whether tenecteplase was non-inferior or superior to alteplase within 4·5 h of onset., Methods: We undertook a prospective, randomised, parallel-group, open-label trial with masked endpoint evaluation in 39 UK stroke centres. Previously independent adults with acute ischaemic stroke, eligible for intravenous thrombolysis less than 4·5 h from last known well, were randomly assigned 1:1 to receive intravenous alteplase 0·9 mg/kg or tenecteplase 0·25 mg/kg, by use of a telephone-based interactive voice response system. The primary endpoint was the distribution of the day 90 modified Rankin Scale (mRS) score and was analysed using ordinal logistic regression in the modified intention-to-treat population. We tested the primary outcome for non-inferiority (odds ratio for tenecteplase vs alteplase non-inferiority limit of 0·75), and for superiority if non-inferiority was confirmed. Safety outcomes were mortality, symptomatic intracranial haemorrhage, radiological intracranial haemorrhage, and major extracranial bleeding. The trial was prospectively registered on ClinicalTrials.gov (NCT02814409)., Findings: Between Jan 25, 2017, and May 30, 2023, 1858 patients were randomly assigned to a treatment group, of whom 1777 received thrombolytic treatment and were included in the modified intention-to-treat population (n=885 allocated tenecteplase and n=892 allocated alteplase). The mean age of participants was 70·4 (SD 12·9) years and median National Institutes of Health Stroke Scale was 7 (IQR 5-13) at baseline. Tenecteplase was non-inferior to alteplase for mRS score distribution at 90 days, but was not superior (odds ratio 1·07; 95% CI 0·90-1·27; p value for non-inferiority<0·0001; p=0·43 for superiority). 68 (8%) patients in the tenecteplase group compared with 75 (8%) patients in the alteplase group died, symptomatic intracerebral haemorrhage (defined by SITS-MOST criteria) occurred in 20 (2%) versus 15 (2%) patients, parenchymal haematoma type 2 occurred in 37 (4%) versus 26 (3%) patients, post-treatment intracranial bleed occurred in 94 (11%) versus 78 (9%) patients, significant extracranial haemorrhage occurred in 13 (1%) versus six (1%) patients, respectively, and angioedema occurred in six (1%) participants in both groups., Interpretation: Tenecteplase 0·25 mg/kg was non-inferior to 0·9 mg/kg alteplase within 4·5 h of symptom onset in acute ischaemic stroke. Easier administration of tenecteplase, especially in the context of interhospital transfers, indicates that tenecteplase should be preferred to alteplase for thrombolysis in acute ischaemic stroke. The ATTEST-2 population was large and representative of thrombolysis-eligible patients in the UK and, together with findings from other trials, provides robust evidence supporting the introduction of tenecteplase in preference to alteplase., Funding: The Stroke Association and British Heart Foundation., Competing Interests: Declaration of interests KWM reports lecture and advisory board fees from Boehringer Ingelheim; lecture fees from Brainomix and IschemaView; and consultancy fees from Abbvie, Biogen, Hyperfine, Lumosa, and Woolsey. GAF reports personal remuneration for advisory board or steering committee activity from CSL Behring; educational activities from Bayer; and his employer (University of Oxford and Oxford University Hospitals NHS Foundation Trust) has received remuneration for consultancy with AstraZeneca. IF reports research grants to the University of Glasgow from The Stroke Association and the British Heart Foundation. JMW reports academic research grants but no industry, advisory or speaker fees or stock interests. AM reports research grants to the University of Glasgow from The Stroke Association and the British Heart Foundation. NG reports research grants to the University of Glasgow from The Stroke Association and the British Heart Foundation. GM reports personal remuneration for consultancy with Canon Medical Research Europe. MJM reports advisory board and educational meeting remuneration from Astra Zeneca. WNW reports drafting the European Stroke Organisation guideline for thrombolysis; and Data Monitoring Committee for TEMPO-2. AH reports being a clinical advisor to the Peninsula Technology Assessment Group, University of Exeter Medical School (External Advisory Group National Institute for Health & Care Excellence Technology Appraisal of Tenecteplase for treating acute ischaemic stroke, NICE reference number ID6306), all unpaid. MB reports research meeting remuneration for the LIBREXIA trial from Janssen and Bristol Myers Squibb. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Intermittent preventive treatment for malaria in pregnancy (IPTp) can improve birth outcomes, but whether it confers benefits to postnatal growth is unclear. We investigated the effect of IPTp on infant growth in Uganda and its pathways of effects using causal mediation analyses., Methods: We analysed data from 633 infants born to mothers enrolled in a randomised trial of monthly IPTp with dihydroartemisinin-piperaquine (DP) vs. sulfadoxine-pyrimethamine (SP) (NCT02793622). Weight and length were measured from 0 to 12 months of age. Using generalised linear models, we estimated effects of DP vs. SP on gravidity-stratified mean length-for-age (LAZ) and weight-for-length Z-scores (WLZ). We investigated mediation by placental malaria, gestational weight change, maternal anaemia, maternal inflammation-related proteins, preterm birth, birth length, and birth weight. Mediation models adjusted for infant sex, gravidity, gestational age at enrolment, maternal age, maternal parasitaemia at enrolment, education, and wealth., Findings: SP increased mean LAZ by 0.18-0.28 Z from birth through age 4 months compared to DP, while DP increased mean WLZ by 0.11-0.28 Z from 2 to 8 months compared to SP among infants of multigravidae; at these ages, confidence intervals for mean differences excluded 0. We did not observe differences among primigravida. Mediators of SP included birth weight, birth length, maternal stem cell factor, and DNER. Mediators of DP included placental malaria and birth length, maternal IL-18, CDCP1, and CD6 at delivery., Interpretation: In high malaria transmission settings, this exploratory study suggests different IPTp regimens may influence infant growth among multigravidae, potentially through distinct pathways, in the exclusive breastfeeding period, when few other interventions are available., Funding: Stanford Center for Innovation in Global Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bill & Melinda Gates Foundation., Competing Interests: Declaration of interests Anna Nguyen is the recipient of a grant from them National Institute of Allergy and Infectious Diseases (F31AI179107) focused on evaluating the causal effects of anti-malarial chemoprevention in pregnancy and childhood on growth outcomes using a different dataset. The other authors declare no further potential conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: The COVID-19 pandemic highlighted the negative impact of moral injury on nurses' well-being. However, there is a lack of research about generational differences among nurses, particularly on newer nurses who have been identified as having a higher rate of intention to leave., Objective: This study examines generational differences among nurses on moral injury, well-being, resilience, and intention to leave their nursing position and profession., Methods: This is a secondary analysis of cross-sectional data from registered nurses in clinical practice in Ohio between July and August 2021. Data on demographics, moral injury, resilience, and well-being were collected using an online survey. Participants were categorized into 4 generational groups based on their age in 2021: Baby Boomers (57-75 years old), Generation X (42-56 years old), Generation Y (27-41 years old), and Generation Z (12-26 years old). Descriptive and inferential statistics, including logistic regression and analysis of variance, were employed for analysis., Results: Significant generational differences were found in years of clinical experience, moral injury, resilience, and well-being. Baby Boomers reported higher well-being and resilience and lower moral injury. Notably, the intention to leave the profession was more strongly associated with well-being and moral injury levels than with the years of experience or generational group., Conclusions: The findings suggest that interventions to improve nurse retention should prioritize enhancing well-being and addressing the root causes of moral injury. Tailored strategies addressing the needs of different generations are necessary for mitigating the adverse effects of current healthcare challenges on nurse attrition., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Description: In March 2020, the White House Coronavirus Task Force determined that clinicians in the United States needed expert treatment guidelines to optimally manage patients with COVID-19, a potentially life-threatening disease caused by a new pathogen for which no specific treatments were known to be effective., Methods: The U.S. Department of Health and Human Services requested that the National Institutes of Health (NIH) take the lead in expeditiously convening a panel of experts to create "living" guidelines that would be widely accessible and capable of frequent updating as important new information became available., Recommendations: The purpose of this article is to expand on the experiences of the NIH COVID-19 Treatment Guidelines Panel (the Panel) over the past 4 years, summarize the Panel's final recommendations for COVID-19, highlight some challenges and unanswered questions about COVID-19 management, and inform future responses to public health emergencies. The Panel was formed in March 2020, and the first iteration of the guidelines was released in April 2020. Now that the public health emergency has ended, the NIH COVID-19 Treatment Guidelines have sunsetted. This role will now fall to professional societies and organizations, such as the American College of Physicians, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the World Health Organization, all of which have been active in this area., Competing Interests: Disclosures: Disclosure forms are available with the article online.

The humoral response is complex and involves multiple cellular populations and signaling pathways. Bacterial and viral infections, as well as immunization regimens, can trigger this type of response, promoting the formation of microanatomical cellular structures called germinal centers (GCs). GCs formed in secondary lymphoid organs support the differentiation of high-affinity plasma cells and memory B cells. There is growing evidence that the quality of the humoral response is influenced by genetic variants. Using 12 genetically divergent mouse strains, we assessed the impact of genetics on GC cellular traits. At steady state, in the spleen, lymph nodes and Peyer's patches, we quantified GC B cells, plasma cells and follicular helper T cells. These traits were also quantified in the spleen of mice following immunization with a foreign antigen, namely, sheep red blood cells, in addition to the number and size of GCs. We observed both strain- and organ-specific variations in cell type abundance, as well as for GC number and size. Moreover, we find that some of these traits are highly heritable. Importantly, the results of this study inform on the impact of genetic diversity in shaping the GC response and identify the traits that are the most impacted by genetic background., (© 2024 The Author(s). Immunology & Cell Biology published by John Wiley & Sons Australia, Ltd on behalf of the Australian and New Zealand Society for Immunology, Inc.)

Temporomandibular joint disorders are common, with alloplastic temporomandibular joint replacement (TMJR) being one method of addressing chronic pain and movement limitations that cannot otherwise be managed. Despite this, TMJR has known complications that can lead to failure. We present our experience of managing these cases and review the current evidence on the management and outcomes of alloplastic TMJR failures. Until 2015 our unit regularly used Dundee full metal prostheses, and encountered multiple issues such as infection, heterotopic bone formation, and progression of osteoarthritis beneath the condylar element. We also present our experience with other standard TMJR implants. One common cause of failure we observed is improper placement of a prosthesis due to poor technique, for instance, placement of the fossa implant too close to the ear canal can cause unresolved postoperative pain. There is no consensus on the management of TMJR, but non-surgical measures are preferred initially and surgical intervention is reserved for later stages. Recently our unit has managed numerous failure cases, employing a multidisciplinary approach combined with thorough preoperative planning and postoperative care, which has proven effective in reducing complications and improving outcomes. Based on our experience, we do not recommend the use of Dundee full metal prostheses for TMJR. Appropriate training in the placement of contemporary implants remains crucial. Suboptimal alignment of the implant in some cases does not need surgical intervention, but surgical management is justifiable in cases of persistent symptoms and functional limitations. When placing stock implants or designing a custom-made implant for an adult, we recommend that the posterior edge of the fossa component is at least 3 mm away from the bone of the ear canal., (Copyright © 2024 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Retinal vascular resistance is of interest in glaucoma research, as a potential link between retinal ganglion cell loss and observed phenomena including disrupted vascular autoregulation, altered biomechanical stiffness, and impaired neurovascular coupling. It can now be assessed in vivo, using laser speckle flowgraphy. However, continued progress in the field requires better understanding of its physiology. In this study, we test the hypothesis of homogeneity of vascular resistance indices between regions of the retina: specifically, between superior and inferior hemifields. The resistivity index (maximum flow minus minimum flow, as a proportion of the maximum) and pulsatility index (maximum minus minimum, as a proportion of the mean) were measured in major vessels within the optic nerve head, in the remaining tissue within the optic nerve head, and in peripapillary branch retinal arteries, separated in each case into superior and inferior quadrants. This was performed in 378 eyes of 189 participants with suspected, early or moderate glaucoma; and in 99 eyes of 50 participants without any ocular pathology. In the glaucoma cohort, the resistivity index was on average 9% higher superiorly than inferiorly in vessels within the optic nerve head; 8% higher superiorly in remaining tissue; and 8% higher superiorly in peripapillary vessels (all p < 0.001). The pulsatility index was on average 11% higher superiorly in all three locations (all p < 0.001). Average flow was slightly higher superiorly in major vessels in the nerve head, but higher inferiorly elsewhere. In the healthy control cohort, resistivity index was higher superiorly by 10% in vessels and 8% in tissue within the optic nerve head; pulsatility index was 12% and 10% higher superiorly respectively (all p < 0.001). The fact that these differences were similar between the two cohorts suggests that they are not caused by the disease process. However, it is notable that glaucomatous loss most frequently occurs first in the superior visual field, corresponding with the inferior retina. The finding that vascular resistance indices are consistently higher in the superior retina warrants further investigation, both for its causes and consequences., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

We explored whether ankle torque variability or plantar perceptual threshold explains human balance control more effectively. We hypothesized that ankle torque variance is a better indicator of center of pressure (COP) velocity variance than plantar perceptual sensitivity. Two conditions were tested: loaded (23-kg vest added) and unloaded, as loading should diminish plantar sensitivity and increase COP velocity variability. We created a linear feedback model to assess the noise change in the sensorimotor loop induced by loading. Plantar sensitivity was quantified using a psychophysical approach while participants stood barefoot. A linear motor applied a force impulse on the participant's heel. A "yes-no" method of limits was selected to identify plantar sole sensory thresholds in both conditions. We observed reduced plantar sensitivity in loaded compared with unloaded conditions. In the loaded condition, participants exhibited greater COP velocity variance, with significant positive Pearson's correlations confirming a substantial association between ankle torque and COP velocity variances for both loaded [variance accounted for (VAF): r 2 = 44.56%, P = 0.018] and unloaded conditions (VAF: r 2 = 58.83%, P = 0.004). No significant correlation existed between COP velocity variance and plantar sensitivity threshold for both loaded (VAF: r 2 = 0.002%, P = 0.99) and unloaded conditions (VAF: r 2 = 21.81%, P = 0.35). The model confirmed an ∼88% rise in sensorimotor loop noise in the loaded condition. Ankle torque variance assesses the precision of nonperceptual and perceptual detection mechanisms in evaluating whole body motions and the accuracy in converting sensory cues into ankle torque. NEW & NOTEWORTHY Plantar cutaneous information contributes to balance control by modulating motor commands, but plantar perceptual sensitivity is a suboptimal indicator of balance performance. Multiple sensory cues encode whole body dynamics, guiding sensorimotor mechanisms to minimize body sway variability. Ankle torque variance is proposed as a superior measure for explaining balance control performance and evaluating the sensorimotor loop's functioning in balance control.

Background: Numerous feeding strategies have been used to mitigate the catabolism of major burn injury. Whether higher energy and/or protein delivery results in better long-term outcomes is unknown., Methods: We performed a secondary analysis of data from adults with major burn injuries enrolled in the Randomized Trial of Enteral Glutamine to Minimize the Effects of Burn Injury at 54 burn centers in 18 countries. The sample was restricted to those who were mechanically ventilated within 72 hours of injury and for ≥7 days. Our key exposure was adequacy of energy, and protein ([Delivered i /Prescribed i ] × 100) was categorized into three groups each: low, 0% to 50%; moderate, ≥50% to 79%; and high, ≥80%. We also analyzed adequacy using restricted cubic splines. Primary and secondary outcomes included 6-month mortality and functional outcomes (i.e., 36-Item Short-Form Health Survey, Katz Index of Independence in Activities of Daily Living, Lawton Activities of Daily Living scores), respectively. Regression models were adjusted for age, body mass index, Charlson Comorbidity Index, baseline Acute Physiology and Chronic Health Evaluation II and modified Sequential Organ Failure Assessment scores, burn size, energy/protein adequacy, and study site., Results: A total of 493 participants met the cohort restriction criteria; 336 participants were alive at 6 months. 36-Item Short-Form Health Survey, Katz Index of Independence in Activities of Daily Living, and Lawton Instrumental Activities of Daily Living Scale were completed by 218, 216, and 215 participants, respectively. The mean ± SD age was 48 ± 17 years, and 74% were male. The mean ± SD burn size was 41% ± 18% total body surface area. Participants who received 25% of recommended calories had nearly four times the hazard of death during the 6-month follow-up period than participants who received 100% of prescribed calories (adjusted hazard ratio, 3.89; 95% confidence interval, 1.35-11.20) ( p = 0.02). There was no significant association between protein and 6-month mortality or energy/protein delivery and 6-month functional outcomes., Conclusion: There was a positive association between higher doses of energy and 6-month survival. This relationship conflicts somewhat with several energy studies among critically ill and non-burn-injured patients. The lack of consistent evidence on optimal nutrition for critically injured patients, a fundamental component of burn care, suggests potential for a randomized trial of lower versus higher energy to improve long-term outcomes after burn injury., Level of Evidence: Therapeutic/Care Management; Level III., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Lifestyle (diet and exercise) interventions across the cancer care continuum among younger cancer survivors (<60 years of age) demonstrate utility in improving physical function, and other cancer relevant health outcomes. However, the impact of lifestyle interventions on physical function in older (≥60 years) cancer survivors is not entirely clear. This scoping review aims to map and characterize the existing literature on the effect of diet and exercise interventions on physical function in older cancer survivors. Conducted to the JBI Manual for Evidence Synthesis and reported to the PRISMA guidelines, the literature search was performed on multiple databases through March 2024. A total of 19,901 articles were identified for screening with 49 articles published between 2006 and 2024 selected for full-text review. Of these, 36 studies included an exercise intervention, two focused on diet intervention, while 11 studies included both diet and exercise intervention. These 49 studies included various cancer types, cancer stages, and timepoints across the cancer care continuum. Most studies described physical function as their primary outcome and demonstrated maintenance or improvement in physical function. We identified several gaps in the current evidence including lack of (adequately powered) trials focused only on older cancer survivors, and trials focused on dietary interventions alone or dietary interventions combined with exercise interventions within this population vulnerable for nutritional inadequacies and declining physical function. Considering the growing population of older cancer survivors, this represents an important area for further research., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose., (Copyright © 2024. Published by Elsevier Ltd.)

A key challenge in the development of organic mixed ionic-electronic conducting materials (OMIEC) for high performance electrochemical transistors is their stable performance in ambient. When operating in aqueous electrolyte, potential reactions of the electrochemically injected electrons with air and water could hinder their persistence, leading to a reduction in charge transport. Here, the impact of deepening the LUMO energy level of a series of electron-transporting semiconducting polymers is evaluated, and subsequently rendering the most common oxidation processes of electron polarons thermodynamically unfavorable, on organic electrochemical transistors (OECTs) performance. Employing time resolved spectroelectrochemistry with three analogous polymers having varying electron affinities (EA), it is found that an EA below the thermodynamic threshold for oxidation of its electron polarons by oxygen significantly improves electron transport and lifetime in air. A polymer with a sufficiently large EA and subsequent thermodynamically unfavorable oxidation of electron polarons is reported, which is used as the semiconducting layer in an OECT, in its neutral and N-DMBI doped form, resulting in an excellent and air-stable OECT performance. These results show a general design methodology to avoid detrimental parasitic reactions under ambient conditions, and the benefits that arise in electrical performance., (© 2024 The Author(s). Advanced Materials published by Wiley‐VCH GmbH.)