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The Association of Reproductive and Clinical Scientists (ARCS) has long promoted the importance of externally accredited training and assessment of scientific staff within assisted conception centres to ensure professional registration and relevant training at all levels. This not only gives scientific staff the opportunity to empower themselves but also acts to ensure assisted conception centres maintain the highest standards of care and quality for patients whilst meeting HFEA requirements for staffing and training. It also provides assurance to patients that treatment is being delivered by highly trained and competent staff. Clinical embryology practice requires intense concentration, with increasingly complex treatment plans and options coupled with the ever-present consequences of clinical error at the forefront of practitioners' minds, exhaustion and burn out are very real risks. Overloading embryology teams is likely to lead to increased error rates and serious incidents. This guideline aims to bring the sector in line with other Clinical Science specialities to optimise patient care, increase safety, reduce risk (including the risk of legal action against centres and individuals), ensure the use of recognised job titles with appropriate levels of remuneration, and provide centres with a template to work towards for appropriate levels of scientific staffing.

Mangrove productivity is crucial for the global carbon cycle, yet previous research has mostly focused on small-scale temporal changes or static global patterns, with limited investigation into global or regional temporal trends. This study used existing data on mangrove leaf litter to model mangrove Net Primary Productivity (NPP) on a monthly timescale from 1980 to 2094 across global regions defined by the Marine Ecoregions of the World framework. The models showed a slight global decrease in NPP of approximately 1.4 %, from 239.2 ± 87.6 Tg yr -1 (1980-1990) to 235.9 ± 81.9 Tg yr -1 (2085-2094). However, significant regional changes were identified, including substantial increases in NPP in the Southwest Australian Shelf (60.58 ± 97.9 %), the Warm Temperate Northeast Pacific (43.75 ± 65.7 %), and the Warm Temperate Northwest Pacific (31.55 ± 55.7 %), as well as decreases in Southeast Asian provinces like the Java Transitional (11.45 ± 6.2 %) and Western Coral Triangle (7.61 ± 9.6 %). These findings highlight previously unreported regional shifts in mangrove productivity, which could significantly impact carbon sequestration and the transfer of organic matter to adjacent ecosystems., 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. Published by Elsevier B.V.)

Cortical areas have traditionally been defined by their distinctive layer cyto- and/or myelo- architecture using postmortem histology. Recent studies have delineated many areas by measuring overall cortical myelin content and its spatial gradients using the T1w/T2w ratio MRI in living primates, including humans. While T1w/T2w studies of areal transitions might benefit from using the layer profile of this myelin-related contrast, a significant confound is Gibbs' ringing artefact, which produces signal fluctuations resembling cortical layers. Here, we address these issues with a novel approach using cortical layer thickness-adjusted T1w/T2w-FLAIR imaging, which effectively cancels out Gibbs' ringing artefacts while enhancing intra-cortical myelin contrast. Whole-brain MRI measures were mapped onto twelve equivolumetric layers, and layer-specific sharp myeloarchitectonic transitions were identified using spatial gradients resulting in a putative 182 area/subarea partition of the macaque cerebral cortex. The myelin maps exhibit notably high homology with those in humans, suggesting cortical myelin shares a similar developmental program across species. Comparison with histological Gallyas myelin stains explains over 80% of the variance in the laminar T1w/T2w-FLAIR profiles, substantiating the validity of the method. Altogether, our approach provides a novel, noninvasive means for precision mapping layer myeloarchitecture in the primate cerebral cortex, advancing the pioneering work of classical neuroanatomists.

Blue carbon ecosystems (BCEs) remove carbon dioxide from the atmosphere and store significant amounts of organic carbon (OC) in their soils. Consequently, the protection and restoration of BCEs may contribute to net greenhouse gas emissions abatement and help address the global challenges of both mitigating and adapting to climate change. An ongoing debate is whether OC sequestered out with the blue carbon (BC) project and transported to its present location (allochthonous) should be counted as 'additional'. There are inconsistencies in the treatment of allochthonous carbon between BCE methodologies, potentially undermining the credibility of global BC accounting initiatives. To explore these inconsistences, we compare the methodologies which we were able to find online, with particular focus on the VERRA, IPCC and BlueCAM methodologies, and review the science underlying any approach to account for allochthonous OC. Our findings indicate that there are currently no robust scientific approaches to define an appropriate apportioning of allochthonous OC for discounting in the calculation of additionality. We therefore advocate for the inclusion of allochthonous OC in BC crediting projects when an observational and experimental approach does not support the calculation (and discounting) of the refractory allochthonous carbon contribution., (© 2024 The Author(s). Global Change Biology published by John Wiley & Sons Ltd.)

Objectives: To determine the prevalence of eczema among children in New Zealand., Methods: Population-based retrospective observational study utilising national pharmaceutical dispensing records for topical corticosteroids and emollients for all New Zealand children aged 0-14 years from 1st January 2006 to 31st December 2019. Data are reported using descriptive statistics, with comparisons between ethnicities and socioeconomic quintiles undertaken with rate ratios., Results: Based on dispensing data, the prevalence of eczema for New Zealand children aged 0-14 years in 2018 was 14.0% (95% CI 14.0%-14.1%), with prevalence decreasing in older age groups (children aged <1 year 26.0% (25.6%-26.4%); children aged 10-14 years 8.8% (8.7%-8.9%)). Prevalence was higher in Pacific children (23.6% (23.3%-24.0%)), but slightly lower in Māori children (13.2% (13.0%-13.3%))., Conclusion: Eczema is a common condition affecting a considerable proportion of children in New Zealand. This study provides nationwide paediatric prevalence data for New Zealand, and highlights the increased burden of eczema in Pacific children. Inequity in dispensing of topical corticosteroids is postulated to explain the reduced rates found for Māori children compared to previous studies. These results support the need for further research to determine factors contributing to differing eczema prevalence rates in New Zealand., (© 2024 Australasian College of Dermatologists.)

Background: A potential link between isotretinoin and sexual dysfunction has been reported in various studies. However, such an association has not been explored within the context of a literature review until now., Objectives: To evaluate the methodology and quality of studies investigating this association, and to examine the definitions of sexual dysfunction used., Methods: A scoping review approach was used to identify peer-reviewed research articles. The search terms used were 'isotretinoin', 'sexual dysfunction', 'erectile dysfunction', 'ejaculatory disorders', 'decreased libido', 'female sexual interest', 'female arousal disorder', 'libido', 'pelvic pain', 'dyspareunia', 'orgasmic disorder', 'impotence', 'ovaries', 'fertility' and 'menstrual irregularity'., Results: In total, 55 peer-reviewed manuscripts were included, consisting of 8 animal studies and 46 human studies with 2420 patients. Of the studies in humans, there were 18 case reports or case series, 2 case-control studies, 4 cross-sectional studies, 6 longitudinal studies, 3 pharmacovigilance reports and 13 cohort studies. The most frequently observed dose range of isotretinoin was 0.5-1.0 mg kg-1 per day, usually for a duration of 1-6 months. More than half of the studies (54%, n = 25) reported a beneficial or neutral effect of isotretinoin on sexual function. The majority of studies (89%, n = 41) were categorized as Oxford Evidenced-Based Medicine level 4., Conclusions: This scoping review revealed very weak evidence supporting a link between isotretinoin and sexual dysfunction. Notably, the diverse definitions of sexual dysfunction pose a significant challenge for comparative analysis. The authors advocate for a standardized definition of sexual dysfunction and a framework for determining causality in order to contribute to a more comprehensive understanding of the relationship between isotretinoin and sexual dysfunction., Competing Interests: Conflicts of interest MR has been an investigator for Douglas Pharmaceuticals, NZ and has published a number of articles on low-dose isotretinoin., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. 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.)

Cutaneous reactions to povidone (PVP)-iodine are widely reported; however, distinction between allergic and irritant reactions can be challenging. Free iodine is responsible for irritant reactions and is released when PVP-iodine is in a liquid state. The aim of this study was to review the clinical presentation and results of patch testing in patients with PVP-iodine contact dermatitis. A systematic review was conducted by searching Pubmed, MEDLINE, and Google Scholar databases for reports of contact dermatitis secondary to PVP-iodine. Data were collated including study design, patient age and gender identity, iodine exposure, skin biopsy findings, and patch test methodology and results. The search revealed 187 reports with 38 eligible studies; 30 case reports/case series and 8 retrospective cohort studies. Overall, there were 223 patients with PVP-iodine contact dermatitis. The commonest reaction was irritant contact dermatitis (51%), followed by allergic contact dermatitis (40%) and contact dermatitis not further specified (9%). Irritant reactions were characterised by burn-like morphology and, when due to surgical skin disinfectant, were often distant from the surgical incision site. Patch testing was most often performed with a 10% PVP-iodine aqueous solution; however, irritant reactions in controls occur. Various testing methods including iodine in petrolatum, ethanol, dried powder, and open application testing were described. Most reactions to PVP-iodine are irritant and patch testing using a closed-chamber method yields inconsistent results due to risk of irritation from free iodine release over the 2-day occlusion time. Surgeons should be aware of the risk of prolonged skin contact with wet iodine solution., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Paget's Disease of the Vulva is a relatively rare condition with a high rate of recurrence. Extensive work-up and treatment is warranted as lesions have the capacity to become invasive and can be associated with underlying malignancy. First line therapy includes surgical resection. For those that are not surgical candidates or who do not desire surgical intervention, non-surgical management options include topical therapy with imiquimod. Unfortunately, irritating side effects often results in poor treatment compliance and premature discontinuation limiting efficacy. Here we present a unique case of extensive, recurrent vulvar Paget's disease with excellent response to a combination therapy of imiquimod and Silver Sulfadiazine. To the best of our knowledge, this is the first documented case illustrating the utility of non-surgical management with combination therapy with topical imiquimod and Silver Sulfadiazine for treatment in patients who do not desire surgical intervention., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Floor Backes: Advisory boards/consulting: Merck, Eisai, ImmunoGen, AstraZeneca, EMD Serono, BioNTech, Daiichi Sankyo. Research funding: Merck, Eisai, ImmunoGen, AstraZeneca, Tempus, Natera., (© 2024 Published by Elsevier Inc.)

Background/objectives: In the last 10 years methylisothiazolinone (MI) emerged as a global cause of preservative-related ACD. New Zealand has liberal regulations for the MI concentration limit in cosmetic products compared to Europe and Australia. The aim of this study was to evaluate the prevalence of MI sensitisation in New Zealand, explore sources of MI exposure and make recommendations on New Zealand regulations for MI use., Methods: This retrospective study included data from patients who underwent patch testing with MI from 2008 to 2021 in a tertiary hospital dermatology clinic and a private dermatology clinic in Auckland, New Zealand. Patient baseline characteristics were recorded along with results of patch testing. Sources of MI exposure were identified from medical records., Results: Over the study period, 1049 patch tests were performed in 1044 patients. MI was only tested as a stand-alone allergen from 2015; positive reactions to MI increased from 5.3% in 2015 to a peak of 11.9% in 2017 and then decreased to 6.4% in 2021. The most common source of MI exposure was shampoo or conditioner (27.7% of all relevant reactions) followed by occupational exposures to paints, biocides or glue (19.1%)., Conclusion: Both sensitisation and ACD to MI appear to be decreasing, likely secondary to changes in product compounding due to stricter concentration limits internationally. We recommend New Zealand adopt lower MI concentration limits for cosmetics to match the limits of Australia and Europe., (© 2024 Australasian College of Dermatologists.)

The term 'hyperkeratotic flexural erythema' (HFE) has been used synonymously with granular parakeratosis (GP), to describe a scaly, typically intertriginous rash associated with contact factors such as benzalkonium chloride. However, clinical HFE can occur without the classical GP histological pattern. We reviewed skin biopsies from 10 patients with clinically diagnosed HFE. A progression of histopathological features is suggested. The absence of histological GP should not exclude the clinical diagnosis of HFE when there is a high index of suspicion., (© 2024 Australasian College of Dermatologists.)

Objective: Understanding biopsychosocial contributions to a sensitised pain system is a key target of many pain management programs. The 'Protectometer' is a freely available educational tool that guides people with chronic pain to explore their personal threats and reassurances, identifying them as 'DIMs' (danger in me) or 'SIMs' (safety in me), to guide personalised pain management. This study aimed to explore common types of DIMs and SIMs, and examine differences between adults and young people., Materials and Methods: A retrospective qualitative study was conducted. Written DIMs ( n = 504) and SIMs ( n = 711) were collected from 96 participants with chronic pain (77 adults aged 18-85 years; 19 young people aged 9-17 years) across 15 multidisciplinary pain management groups. DIMs and SIMs were transcribed and analysed using deductive content analysis., Results: Four overarching themes were identified: 'Engaging with the environment', 'In my body', 'My emotional health', and 'Activities and behaviours'. Similarities in SIMs were found, with the greatest proportion of SIMs in the social domain (49% adults; 47% young people). While adult DIMs were fairly evenly spread across the biological (37%), psychological (27%) and social domains (36%), young people's DIMs were predominantly in the psychological (44%) and social (43%) domains., Discussion: These findings provide insights into common threats and reassurances people in pain perceive, and revealed age-related differences in biopsychosocial contributions to pain and pain relief. Findings also highlight the importance of social-based interventions as part of pain management therapies for both adults and young people., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Despite a five order of magnitude range in size, the brains of mammals share many anatomical and functional characteristics that translate into cortical network commonalities. Here we develop a machine learning framework to quantify the degree of predictability of the weighted interareal cortical matrix. Partial network connectivity data were obtained with retrograde tract-tracing experiments generated with a consistent methodology, supplemented by projection length measurements in a nonhuman primate (macaque) and a rodent (mouse). We show that there is a significant level of predictability embedded in the interareal cortical networks of both species. At the binary level, links are predictable with an area under the ROC curve of at least 0.8 for the macaque. Weighted medium and strong links are predictable with an 85%-90% accuracy (mouse) and 70%-80% (macaque), whereas weak links are not predictable in either species. These observations reinforce earlier observations that the formation and evolution of the cortical network at the mesoscale is, to a large extent, rule based. Using the methodology presented here, we performed imputations on all area pairs, generating samples for the complete interareal network in both species. These are necessary for comparative studies of the connectome with minimal bias, both within and across species., Competing Interests: Competing Interests: The authors have declared that no competing interests exist., (© 2023 Massachusetts Institute of Technology.)

During 2021 and 2022, eight field-collected and five laboratory Helicoverpa zea strains with varying susceptibility to different Bt proteins were evaluated for their responses against HearNPV using diet-overlay bioassays. The five laboratory strains included SS (susceptible to all Bt proteins), CRY-RR (resistant to Cry1 and Cry2), VIP-RR-70 (resistant to Vip3Aa), VIP-RR-15 (resistant to Vip3Aa), and TRE-RR (resistant to Cry1, Cry2, and Vip3Aa). Our findings showed that the susceptibility of TRE-RR, VIP-RR-70, and VIP-RR-15 strains to HearNPV was similar to that of the SS strain. However, the field and Cry-RR strains were more resistant to HearNPV compared to the SS strain. Because most feral H. zea strains in the southern U.S. have developed practical resistance to Cry Bt proteins but remain susceptible to Vip3Aa, the results suggest that the reduced susceptibility to HearNPV in H. zea may be associated with the resistance to Cry Bt proteins but not with the resistance to Vip3Aa. Correlation analysis confirmed that there was a significant positive relationship between Cry resistance and HearNPV resistance, but not between the Vip3Aa resistance and HearNPV resistance in H. zea. Our findings provide valuable insights into the relationship between susceptibility to HearNPV and resistance to Bt proteins in H. zea .

Background: Post-Transplant Diabetes Mellitus (PTDM) affects 20%-40% of lung transplant recipients within five years, impacting rejection, infection, cardiovascular events, and mortality. Continuous glucose monitoring (CGM) is used in diabetes but not well-studied in PTDM., Objective: This study assessed CGM performance in detecting hypoglycemia and hyperglycemia post-lung transplantation, compared to self-monitoring blood glucose., Methods: A prospective pilot study included 15 lung transplant patients (mean age 58.6 years; 53.3% men; 73.3% with pre-transplantation diabetes) managing hyperglycemia with insulin. Patients used a blinded CGM and self-monitored glucose for ten days. Data were categorized (% time in range, % high, % very high, % low, % very low) and compared using paired t-tests., Results: CGM showed superior hyperglycemia detection. Mean differences for "% very high", "% high", and "% high and % very high" were 7.12 (95% CI, 1.8-12.4), 11.1 (95% CI, 3.5-18.8), and 18.3 (95% CI: 7.37-29.24), respectively. No significant difference was found for "% low and % very low". All patients reported a positive CGM experience., Conclusion: CGM use post-lung transplantation seems feasible and offers advantages in detecting hyperglycemia and in optimizing glucose management. Study limitations include a small sample size, requiring larger studies to assess glycemic control, hypoglycemia detection, and transplant outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Munoz Pena, Algarra, Kennedy, Leong and Salloum.)

Competing Interests: Conflicts of interest M.R. has been an investigator for Douglas Pharmaceuticals, NZ and has published a number of articles on low-dose isotretinoin.

Background: Indigenous experiences and perspectives of resilience, healing and recovery from trauma is gaining increasing attention, with a growing qualitative literature that spans multiple indigenous cultural groups. However, few quantitative measures are available. In this article, development of a preliminary version of the Aboriginal Resilience and Recovery Questionnaire is described., Aim: The first aim of this study was to describe findings from two focus groups that provided theoretical knowledge and development of items for a draft version of an Aboriginal Resilience Recovery Questionnaire. The second aim of the study was to conduct a preliminary psychometric analysis of the properties of the measure., Design: Multi-method research design grounded in indigenous research methodologies., Measures: Aboriginal Resilience and Recovery Questionnaire, Australian Aboriginal Version of the Harvard Trauma Questionnaire Trauma symptom subscale, Growth and Empowerment Measure., Results: (1) Two focus groups with six counselling staff from an Aboriginal health service were run that explored Victorian Aboriginal understandings of resilience, healing, and recovery from trauma. Sixty different protective factors viewed as potentially important to resilience, healing and recovery from trauma were identified by participants. (2) Following a review of the resilience literature, 75 items were reviewed and revised, with additional items developed by the focus group. (3) The final outcome was 60 items selected for a preliminary version of the Aboriginal Resilience Recovery Questionnaire, 50 of which made up 19 different subscales in addition to 10 single items. (4) Structured interviews were conducted with 81 help seeking Aboriginal clients recruited from the same health service. Preliminary psychometric assessment of the Aboriginal Resilience Recovery Questionnaire was undertaken using Principal Components Analysis. Two component subscales were extracted with adequate internal consistency and good convergent and discriminant validity. For both subscales there were moderate to strong positive associations with empowerment, and moderate to strong negative associations with trauma symptom severity., Conclusion: The preliminary results are promising for a strength-based resilience measure developed from the knowledge of Aboriginal practitioners and staff of a counselling service. Further research to address some psychometric limitations in the measure is required. A larger sample size will allow for a common factor analysis to be conducted. The Aboriginal Resilience Recovery Questionnaire has potential to assist Aboriginal Community Controlled Health Organisations and other organisations to evaluate whether services and programs can effectively support community members to strengthen individual, relational, community and cultural resilience resources., (© 2023. Crown.)

Background: Pyramiding Bt proteins is a key strategy to delay insect resistance development. However, the durability of pyramided Bt crops for controlling insect pests is threatened by cross-resistance among Bt proteins, which can ultimately contribute to resistance development. The corn earworm, Helicoverpa zea, is a major agricultural pest of pyramided Bt crops. Previous studies have examined cross-resistance and redundant killing of Cry resistance in H. zea, but such information is lacking for Vip3Aa resistance in this pest. Here, we evaluated cross-resistance and redundant killing of Vip3Aa-resistant H. zea to purified Bt proteins, as well as Bt corn and Bt cotton., Results: Diet bioassays demonstrated high susceptibility of Vip3Aa-resistant H. zea to Cry1Ac, Cry1A.105, and Cry2Ab2 purified proteins. No Vip3Aa-susceptible, -heterozygous, or -resistant H. zea could survive on pyramided Bt corn containing Cry1 and/or Cry2 proteins. Complete redundant killing was observed in pyramided Bt corn containing Cry1 and/or Cry2 proteins against Vip3Aa resistance in H. zea. Vip3Aa-susceptible, -heterozygous, and -resistant H. zea exhibited survival rates ranging from 0.0% to 22.5% on pyramided Bt cotton with Cry1 and/or Cry2 proteins. Incomplete to complete redundant killing was observed for Vip3Aa-resistant H. zea on pyramided Bt cotton containing Cry1 and/or Cry2 proteins., Conclusion: Our findings indicate that Vip3Aa-resistant H. zea does not exhibit positive cross-resistance to Cry1 or Cry2 proteins. In addition, most pyramided Bt crops showed complete or nearly complete redundant killing of Vip3Aa-resistant H. zea. These results indicate that a pyramiding strategy would often be effective for managing Vip3Aa resistance in regions of the United States where H. zea has not evolved resistance to Cry1 and Cry2 toxins. © 2023 Society of Chemical Industry., (© 2023 Society of Chemical Industry.)

Movements designed to engage youth in tobacco control have been an important part of tobacco prevention for decades. Today, young people are increasingly diverse, and their primary issues of concern are gun control, racism, mental health, and climate change. To engage today's young people, tobacco control programs need to draw connections between youth's identities, top issues, and tobacco. UpRISE is a social justice youth tobacco control movement that engages diverse youth in identifying the root causes of youth nicotine use. In 2018-2019, 21 youth-serving organizations and schools hosted youth coalitions. Coalitions engaged in a six-session workbook called "Getting to the root cause," and adults were provided training and reflective supervision. Pre/post surveys with youth participants (n = 180) and end-of-year interviews with adult facilitators (n = 22) were used to assess outcomes. The primary outcomes were supportive adult relationships, youth voice in decision-making, anti-tobacco industry attitudes and beliefs, psychological empowerment, critical consciousness, and global belief in a just world. Quantitative measures of supportive adult relationships, youth voice in decision-making, psychological empowerment, and anti-tobacco industry attitudes and beliefs all increased significantly over time (p < .0001, p < .0001, p < .0001, p = .0034, respectively). Critical consciousness and global belief in a just world did not change significantly. During interviews, adults reported learning how: to engage in youth-adult partnerships, the tobacco industry abused its power, to engage in critical reflection about power. Adults also felt empowered. UpRISE may be a promising approach to increase racially diverse youth's engagement in social justice-oriented tobacco control efforts that advance equity.

NF1 is a key tumor suppressor that represses both RAS and estrogen receptor-α (ER) signaling in breast cancer. Blocking both pathways by fulvestrant (F), a selective ER degrader, together with binimetinib (B), a MEK inhibitor, promotes tumor regression in NF1-depleted ER + models. We aimed to establish approaches to determine how NF1 protein levels impact B+F treatment response to improve our ability to identify B+F sensitive tumors. We examined a panel of ER + patient-derived xenograft (PDX) models by DNA and mRNA sequencing and found that more than half of these models carried an NF1 shallow deletion and generally have low mRNA levels. Consistent with RAS and ER activation, RET and MEK levels in NF1-depleted tumors were elevated when profiled by mass spectrometry (MS) after kinase inhibitor bead pulldown. MS showed that NF1 can also directly and selectively bind to palbociclib-conjugated beads, aiding quantification. An IHC assay was also established to measure NF1, but the MS-based approach was more quantitative. Combined IHC and MS analysis defined a threshold of NF1 protein loss in ER + breast PDX, below which tumors regressed upon treatment with B+F. These results suggest that we now have a MS-verified NF1 IHC assay that can be used for patient selection as a complement to somatic genomic analysis., Significance: A major challenge for targeting the consequence of tumor suppressor disruption is the accurate assessment of protein functional inactivation. NF1 can repress both RAS and ER signaling, and a ComboMATCH trial is underway to treat the patients with binimetinib and fulvestrant. Herein we report a MS-verified NF1 IHC assay that can determine a threshold for NF1 loss to predict treatment response. These approaches may be used to identify and expand the eligible patient population., (© 2023 The Authors; Published by the American Association for Cancer Research.)

LGBTQIA+ (lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and more) youth in rural communities have little to no access to gender or sexuality-affirming support, compared with their peers in the metro areas of Colorado. Without access to support and exposure to bullying or discrimination, many rural LGBTQIA+ youth struggle to find belonging. Staff from One Colorado and the Hub for Justice-centered Youth Engagement partnered to develop Colorado's Queer Youth Network (CQYN) to foster a virtual community to support rural LGBTQIA+ youth, enhance belonging and acceptance, and feel empowered to make a change in their community. CQYN is offered virtually, every other week during the academic year, to create a consistent safe space for rural LGBTQIA+ youth and to offer opportunities to grow their unique leadership skills and connect with affirming LGBTQIA+ adults. This article highlights the development of the partnership, design of the virtual network, and challenges in recruiting youth who have been pushed to the margins.

In addition to resilience and resistance, collective and personal experiences of trauma are commonly cited within the context of Aboriginal and Torres Strait Islander and other Indigenous First People's experiences of colonisation. This study investigated whether a range of risk and protective factors, including cultural determinants of social and emotional wellbeing, were associated with posttraumatic stress outcomes among 81 Aboriginal help-seeking clients from an Aboriginal community-controlled counselling service in Melbourne, Australia. The study explored potential relationships between trauma exposure, child removal from natural family, experiences of racism, gender, and trauma symptom severity. The study also investigated whether personal, relationship, community and cultural strengths and determinants of wellbeing, as detailed in the Aboriginal Resilience and Recovery Questionnaire, moderated the relationship between trauma exposure and posttraumatic stress symptom severity. Participants commonly endorsed symptoms of distress consistent with Posttraumatic Stress Disorder and cultural idioms of distress as documented in the Aboriginal Australian Version of the Harvard Trauma Questionnaire. Two generations of child removal from one's natural family, experiences of racism, stressful life events experienced during the past 12 months, being male, and not having access to funds for basic living expenses were all associated with greater trauma symptom severity. Conversely, participants self-reported access to personal, relationship, community and cultural strengths was associated with lower trauma symptom severity. Regression analysis revealed that trauma exposure, stressful life events, access to basic living expenses, and personal, relationship, community, and cultural strengths were all important predictors of posttraumatic stress symptom severity. Participant access to strength and resources that included connections to community and culture, moderated the relationship between trauma exposure and trauma symptom severity., (© 2023. The Author(s).)

Mental health nursing requires a specialist range of capabilities and values. In Australian contexts, the preparation of nurses to work in mental health settings has attracted criticism from government reviews, academics, and graduate nurses. Insufficient mental health content and clinical placement experience in undergraduate nursing courses have been central to this criticism. The study aim was to identify the areas and modalities of capability development of graduate mental health nurses, from the perspectives of end point users. In order to meet the aim, a four-item cross-sectional online survey with three additional and open-ended questions was developed. The questions were co-designed with consumer academics and reviewed by consumer and carer organizations. The survey was widely distributed across Australian consumer and carer organizations, with 95 useable responses. Findings indicated strong support for lived experience being integrated into teaching teams for nurses, as well as support for undergraduate direct entry for mental health nursing. Themed content from open-ended responses reflected the survey outcomes as well as prioritizing skill development to support better therapeutic relating and nurse self-care. Key findings included strong support for greater lived experience input into mental health nurse education, specialist undergraduate preparation and a focus on developing relational capabilities in the mental health nurse workforce., (© 2022 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

Background: Math anxiety is a common experience that interferes with learning and achievement in mathematics. Considering that mathematics learning mostly takes place within the classroom, it is critical to examine how math anxiety develops in this context., Aims: The purpose of the current scoping review was to identify classroom-learning environment factors associated with math anxiety in elementary and high school students., Sample(s): Out of an initial sample of 3011 studies, 28 were eligible for inclusion., Methods: Data on author(s), publication year, and study location; sample demographics; classroom variables; intervention details (if applicable); measures; and key results were extracted from articles., Results: Numerous protective and vulnerability factors were identified., Conclusions: Directions for future research and methodological implications were explored., (© 2022 The British Psychological Society.)

Background and Objectives: There is sparse evidence that modern hospital architecture designed to prevent violence and self-harm can prevent restrictive practices (RP). We examine if the use of RPs was reduced by the structural change of relocating a 170-year-old psychiatric university hospital (UH) in Central Denmark Region (CDR) to a new modern purpose-built university hospital., Methods: The dataset includes all admissions (N = 19.567) and RPs (N = 13.965) in the self-contained CDR one year before and after the relocation of the UH. We compare RPs at the UH a year prior to and after relocation on November 16th (November 2017, November 2019) with RPs at the other psychiatric hospitals (RH) in CDR. We applied linear regression analysis to assess the development in the monthly frequency of RPs pre- and post-relocation and examine underlying trends., Results: At UH, RPs performed decreased from 4073 to 2585 after relocation, whereas they remained stable (from 3676 to 3631) at RH. Mechanical restraint and involuntary acute medication were aligned at both UH and RH. Using linear regression analysis, we found an overall significant decrease in the use of all restrictive practices at UH with an inclination of -9.1 observations (95% CI - 12.0; - 6.3 p < 0.0001) per month throughout the two-year follow-up. However, the decrease did not deviate significantly from the already downward trend observed one year before relocation. Similar analyses performed for RH showed a stable use of coercion., Conclusion: The naturalistic features of the design preclude any definitive conclusion whether relocation to a new purpose-built psychiatric hospital decreased the RPs. However, we argue that improving the structural environment at the UH had a sustained effect on the already declining use of RPs, particularly mechanical restraint and involuntary acute medication., (© 2022. The Author(s).)

Postpartum haemorrhage continues to be a leading cause of morbidity and mortality in the obstetric population worldwide, especially in patients at extremes of body weight. Quantification of blood loss has been considered extensively in the literature. However, these volumes must be contextualised to appreciate the consequences of blood loss for individual parturients. Knowledge of a patient's peripartum circulating blood volume is essential to allow accurate interpretation of the significance of haemorrhage and appropriate resuscitation. Greater body weight in obesity can lead to overestimation of blood volume, resulting in inappropriately high thresholds for blood product transfusion and delays in treatment. The most recent Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) surveillance report demonstrated the risk to this population, with more than half of all maternal mortality recorded in parturients who were either overweight or obese. Current linear calculations used to estimate circulating blood volumes based on patients' weights could be contributing to this phenomenon, as blood volume increases at a disproportional rate to body composition. In this review, we summarise the relevant physiology and explore the existing literature on the estimation of circulating blood volume, both during pregnancy and in obesity. Building on key works and principal findings, we present a practical, nonlinear approach to the adjustment of estimated blood volume with increasing body mass. This clinical tool aims to reduce the clinical bias influencing the management of obstetric haemorrhage in a population already at increased risk of morbidity and mortality. Discussion of the limitations of this approach and the call for further research within this field completes this review., (Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

Background: Ductal carcinoma in situ (DCIS) is the most common type of in situ premalignant breast cancers. What drives DCIS to invasive breast cancer is unclear. Basal-like invasive breast cancers are aggressive. We have previously shown that NRAS is highly expressed selectively in basal-like subtypes of invasive breast cancers and can promote their growth and progression. In this study, we investigated whether NRAS expression at the DCIS stage can control transition from luminal DCIS to basal-like invasive breast cancers., Methods: Wilcoxon rank-sum test was performed to assess expression of NRAS in DCIS compared to invasive breast tumors in patients. NRAS mRNA levels were also determined by fluorescence in situ hybridization in patient tumor microarrays (TMAs) with concurrent normal, DCIS, and invasive breast cancer, and association of NRAS mRNA levels with DCIS and invasive breast cancer was assessed by paired Wilcoxon signed-rank test. Pearson's correlation was calculated between NRAS mRNA levels and basal biomarkers in the TMAs, as well as in patient datasets. RNA-seq data were generated in cell lines, and unsupervised hierarchical clustering was performed after combining with RNA-seq data from a previously published patient cohort., Results: Invasive breast cancers showed higher NRAS mRNA levels compared to DCIS samples. These NRAS high lesions were also enriched with basal-like features, such as basal gene expression signatures, lower ER, and higher p53 protein and Ki67 levels. We have shown previously that NRAS drives aggressive features in DCIS-like and basal-like SUM102PT cells. Here, we found that NRAS-silencing induced a shift to a luminal gene expression pattern. Conversely, NRAS overexpression in the luminal DCIS SUM225 cells induced a basal-like gene expression pattern, as well as an epithelial-to-mesenchymal transition signature. Furthermore, these cells formed disorganized mammospheres containing cell masses with an apparent reduction in adhesion., Conclusions: These data suggest that elevated NRAS levels in DCIS are not only a marker but can also control the emergence of basal-like features leading to more aggressive tumor activity, thus supporting the therapeutic hypothesis that targeting NRAS and/or downstream pathways may block disease progression for a subset of DCIS patients with high NRAS., (© 2022. The Author(s).)

Issue: Prior to the COVID-19 pandemic, there was evidence of challenges surrounding the psychological well-being of health care professionals (HCPs). HCPs already frayed psychological ability to cope risks being further compromised by COVID-19-related stresses., Critical Theoretical Analysis: Most research on stress, psychological distress, and coping among HCPs is done in a piecemeal manner without a theoretical model connecting these different but related phenomena. This critical advancement article aims to apply and extend Wheaton and Montazer's model of stressors, stress, and distress to the literature on HCPs, generally, and COVID-19, specifically, to summarize past and guide future research on HCPs' mental health, resilience, and coping. Our model describes how different sources of support buffer the effect of stressors on stress and how coping strategies moderate the effect of stress on psychological distress., Advance: We extended the model by (a) distinguishing context from the support in HCPs' environment; (b) distinguishing adaptive from maladaptive coping strategies and their relationships with antecedents and outcomes; (c) describing the adverse impacts that psychological distress has on patients, HCPs, and health services; and (d) describing how such outcomes can become stressors, in turn, further contributing to HCPs' stress in a vicious cycle., Practice Implications: Our model provides a broader perspective of HCPs' work-related mental health and helps guide the creation, implementation, and evaluation of different sources of support and promote adaptive coping strategies. This model helps HCPs, researchers, and health services managers better understand and respond to the well-being crisis HCPs are facing, especially during the pandemic., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Blue Carbon Ecosystems (BCEs) help mitigate and adapt to climate change but their integration into policy, such as Nationally Determined Contributions (NDCs), remains underdeveloped. Most BCE conservation requires community engagement, hence community-scale projects must be nested within the implementation of NDCs without compromising livelihoods or social justice. Thirty-three experts, drawn from academia, project development and policy, each developed ten key questions for consideration on how to achieve this. These questions were distilled into ten themes, ranked in order of importance, giving three broad categories of people, policy & finance, and science & technology. Critical considerations for success include the need for genuine participation by communities, inclusive project governance, integration of local work into national policies and practices, sustaining livelihoods and income (for example through the voluntary carbon market and/or national Payment for Ecosystem Services and other types of financial compensation schemes) and simplification of carbon accounting and verification methodologies to lower barriers to entry., (© 2022. The Author(s).)

Background: Seed mixture strategy can guarantee the compliance of planting non-Bt crops to host the susceptible insects for resistance management. However, pollen movement between Bt and non-Bt corn in the mixed plantings could reduce the efficacy of this strategy for ear-feeding insects. Few studies have evaluated the effects of cross-pollination among non-Bt and pyramided Bt corn in seed mixtures on the resistance development of insects possessing multiple resistances. Here, we provided the first study to investigate whether cross-pollination in mixed plantings of pyramided Bt corn producing Cry1A.105 and Cry2Ab2 would increase the dominance of resistance of dual-gene resistant populations of Helicoverpa zea, a target of pyramided Bt corn and cotton in the USA., Results: We compared the survival and development of susceptible, dual-gene resistant (resistance to both Cry1 and Cry2 proteins) and heterozygous genotypes of H. zea in the laboratory on non-Bt and pyramided Bt corn ears collected from mixed plantings and structured plantings in the field. We found higher fitness for F 1 heterozygous insects than for the susceptible insects of H. zea on both pyramided Bt corn and non-Bt corn in the mixed plantings., Conclusion: These results suggest that cross-pollination in mixed plantings will significantly increase the dominance of resistance by supporting survival of heterozygous insects for dual-gene resistant populations of H. zea, and therefore accelerate evolution of resistance to pyramided Bt crops. © 2022 Society of Chemical Industry., (© 2022 Society of Chemical Industry.)

CD19 CAR-T have emerged as a new standard treatment for relapsed/refractory (r/r) large B-cell lymphoma (LBCL). CAR-T real-world (RW) outcomes published to date suggest significant variability across countries. We provide results of a large national cohort of patients intended to be treated with CAR-T in the UK. Consecutive patients with r/r LBCL approved for CAR-T by the National CAR-T Clinical Panel between December 2018 and November 2020 across all UK CAR-T centres were included. 404/432 patients were approved [292 axicabtagene ciloleucel (axi-cel), 112 tisagenlecleucel (tisa-cel)], 300 (74%) received the cells. 110/300 (38.3%) patients achieved complete remission (CR) at 6 months (m). The overall response rate was 77% (52% CR) for axi-cel, 57% (44% CR) for tisa-cel. The 12-month progression-free survival was 41.8% (axi-cel) and 27.4% (tisa-cel). Median overall survival for the intention-to-treat population was 10.5 m, 16.2 m for infused patients. The incidence of grade ≥3 cytokine release syndrome and neurotoxicity were 7.6%/19.6% for axi-cel and 7.9%/3.9% for tisa-cel. This prospective RW population of CAR-T eligible patients offers important insights into the clinical benefit of CD19 CAR-T in LBCL in daily practice. Our results confirm long-term efficacy in patients receiving treatment similar to the pivotal trials, but highlight the significance of early CAR-T failure., (© 2022 British Society for Haematology and John Wiley & Sons Ltd.)

Background and Objectives: Activation of ghrelin receptor growth hormone secretagogue receptor (GHS-R) by endogenous or synthetic ligands amplifies pulsatile release of growth hormone (GH) and enhances food intake, very relevant to development and growth. GHS-R is a G-protein coupled receptor that has great druggable potential. Understanding the precise ligand and receptor interactions is crucial to advance the application of GHS-R., Materials and Methods: We used radiolabeled ligand-binding assay and growth hormone release assay to assess the binding and functional characteristics of GHS-R to synthetic agonists MK-0677 and GHS-25, as well as to endogenous peptide ligand ghrelin. We analyzed the ligand-dependent activity of GHS-R by measuring aequorin-based [Ca ++ ] i responses. To define a ligand-binding pocket of GHS-R, we generated a series of human/puffer fish GHS-R chimeras by domain swapping, as well as a series of mutants by site-directed mutagenesis., Results: We found that the synthetic ligands have high binding affinity to GHS-R in the in vitro competitive binding assay. Remarkably, the in vivo GH secretagogue activity is higher with the synthetic agonists MK-0677 and GHS-25 than that of ghrelin. Importantly, the activity was completely abolished in GHS-R knockout mice. In GHS-R chimera analysis, we identified the C-terminal region, particularly the transmembrane domain 6 (TM6), to be critical for the ligand-dependent activity. Our site-directed mutagenesis study further revealed that amino acid residues D99 and W276 in GHS-R are essential for ligand binding. Interestingly, critical residues distinctively interact with different ligands, MK-0677 activation depends on E124, while ghrelin and GHS-25 preferentially interact with F279., Conclusion: The ligand-binding pocket of human GHS-R is mainly defined by interactive residues in TM6 and the adjacent region of the receptor. This novel finding in GHS-R binding domains advances the structural/ functional understanding of GHS-R, which will help to select/design better GHS-R agonists/ antagonists for future therapeutic applications., Competing Interests: Conflict of Interest The authors declare no conflict of interest., (© 2022 Yuxiang Sun, Xiangcang Ye, Hilda Kennedy, Alexander G. A. Smith, Roy G. Smith, published by Sciendo.)

In the early days of the Covid-19 pandemic, images of the virus molecule and 'flatten-the-curve' line charts were inescapable. There is now a vast visual repertoire of vaccines, people wearing face masks in everyday settings, choropleth maps and both bar and line charts. These 'generic visuals' circulate widely in the news media and, however unremarkable, play an important role in representing the crisis in particular ways. We argue that these generic visuals promote banal nationalism, localism and cosmopolitanism in the face of the crisis, and that they do so through the symbolic reiteration of a range of visual resources across news stories. Through an analysis of three major news outlets in the UK, we examine how generic visuals of Covid-19 contribute to these banal visions and versions of belonging and, in doing so, also to foregrounding the role of the state in responding to the crisis., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

The social work profession has made tremendous contributions to youth well-being, laying the foundation for social welfare systems and child protection laws. However, deficit-based constructions of youth are deeply engrained in the profession. Social work researchers have called for attention to critical approaches like youth participatory action research (YPAR). YPAR has an action-oriented epistemology and engages youth as coresearchers, providing an opportunity to shift social work research and practice paradigms. Yet, social work scholars lag behind cognate disciplines in adopting YPAR. This article examines challenges that have stymied YPAR in social work. The authors review the historical roots of the profession and its relationship to youth; examine present challenges, including social work's training and career progression; and make suggestions for the future, calling social work to affirm our values by reevaluating the way we do research on youth, the way we train future social workers, and the paradigms driving our practice., (© 2022 National Association of Social Workers.)

Objectives: Cisplatin is commonly used during intraperitoneal chemotherapy however has well-established nephrotoxic side-effects. Sodium thiosulfate is often added to cisplatin-based hyperthermic intraperitoneal chemotherapy (HIPEC) protocols to mitigate this, however evidence regarding risk of hypernatraemia is scarce as of yet., Methods: We retrospectively identified patients undergoing cytoreductive surgery (CRS) for peritoneal surface malignancies of any origin at a single high-volume unit between April 2018 and December 2020. Patients were included if they received cisplatin-based HIPEC with intravenous sodium thiosulfate. Blood tests were collected pre-surgery and then daily during admission. Hypernatraemia was defined as serum sodium >145 mmol/L. Renal impairment was defined using the RIFLE criteria., Results: Eleven CRSs met inclusion criteria, the majority of which were indicated for ovarian cancer (72.7%). One (9.1%) patient with mesothelioma received mitomycin C as an additional chemotherapy agent. The incidence of hypernatraemia was 100% but all cases were transient, with no clinical sequelae observed. The rate of AKI was 36.4%, with three (27.3%) patients classified as risk and one (9.1%) instance of failure. No long-term renal impairment was observed., Conclusions: Despite biochemical evidence of mild hypernatraemia but with the absence of clinical sequelae, sodium thiosulfate appears to be safe when used in adjunct to cisplatin-based HIPEC during CRS. These findings should be evaluated with further comparative studies. When describing renal impairment, it is important that standardisation in reporting occurs, with the RIFLE and Acute Kidney Injury Network criteria now the preferred consensus definitions., Competing Interests: Competing interests: Authors state no conflict of interest., (© 2022 Anais Alonso et al., published by De Gruyter, Berlin/Boston.)

Parkinson's disease (PD) evolves over an extended and variable period in humans; years prior to the onset of classical motor symptoms, sleep and biological rhythm disorders develop, significantly impacting the quality-of-life of patients. Circadian-rhythm disorders are accompanied by mild cognitive deficits that progressively worsen with disease progression and can constitute a severe burden for patients at later stages. The gold-standard 6-methyl-1-methyl-4-phenyl-1,2,3,6-tetrahydropyridin (MPTP) macaque model of PD recapitulates the progression of motor and nonmotor symptoms over contracted periods of time. Here, this multidisciplinary/multiparametric study follows, in five animals, the steady progression of motor and nonmotor symptoms and describes their reversal following grafts of neural precursors in diverse functional domains of the basal ganglia. Results show unprecedented recovery from cognitive symptoms in addition to a strong clinical motor recuperation. Both motor and cognitive recovery and partial circadian rhythm recovery correlate with the degree of graft integration, and in a subset of animals, with in vivo levels of striatal dopaminergic innervation and function. The present study provides empirical evidence that integration of neural precursors following transplantation efficiently restores function at multiple levels in parkinsonian nonhuman primates and, given interindividuality of disease progression and recovery, underlines the importance of longitudinal multidisciplinary assessments in view of clinical translation., (© 2022 The Authors. Advanced Science published by Wiley-VCH GmbH.)

Neocortical computations underlying vision are performed by a distributed network of functionally specialized areas. Mouse visual cortex, a dense interareal network that exhibits hierarchical properties, comprises subnetworks interconnecting distinct processing streams. To determine the layout of the mouse visual hierarchy, we have evaluated the laminar patterns formed by interareal axonal projections originating in each of ten areas. Reciprocally connected pairs of areas exhibit feedforward/feedback relationships consistent with a hierarchical organization. Beta regression analyses, which estimate a continuous hierarchical distance measure, indicate that the network comprises multiple nonhierarchical circuits embedded in a hierarchical organization of overlapping levels. Single-unit recordings in anaesthetized mice show that receptive field sizes are generally consistent with the hierarchy, with the ventral stream exhibiting a stricter hierarchy than the dorsal stream. Together, the results provide an anatomical metric for hierarchical distance, and reveal both hierarchical and nonhierarchical motifs in mouse visual cortex., (© 2022. The Author(s).)

In this issue of Neuron, Xu et al. (2022) use electrical microstimulation of macaque prefrontal cortex combined with functional MRI to map weighted orderly topographic relationships with other association cortex domains, revealing a spatially embedded large-scale organization likely to be functionally important., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Introduction: Health care providers (HCPs) have experienced more stress and burnout during COVID-19 than before. We compared sources and levels of stress, distress, and approaches to coping between nurses and physicians, and examined whether coping strategies helped mitigate the negative impact of stress and intentions to quit., Methods: Using a cross-sectional study design, burnout was measured with the Maslach Burnout Inventory. Psychological distress was measured using the Depression, Anxiety, and Stress Scale. A self-reported survey was used to evaluate stressors, impact on perceived performance, and intentions to quit. The data were analyzed using t-tests and linear regression models., Results: Responses of 119 HCPs were analyzed. Findings suggest that (1) compared to physicians, nurses experienced a higher level of distress and burnout, and used more maladaptive coping strategies. (2) Both nurses and physicians experienced more distress and burnout during COVID-19 than before. (3) Adaptive coping strategies moderated the negative impact of stress on work performance (4) Adaptive coping strategies moderated the negative effect of stress on burnout, which in turn reduced intentions to quit. Stress negatively impacted work performance and burnout only for those with low, but not high, levels of adaptive coping strategies., Discussion: The current findings of HCPs' challenges, risks, and protective factors provide valuable information (1) on COVID-19's impact on HCPs, (2) to guide the distribution of institutional supportive efforts and recommend adaptive coping strategies, and (3) to inform medical education, such as resilience training, focusing on adaptive coping approaches., Competing Interests: Disclosures: This research was funded by The McGill Interdisciplinary Initiative in Infection and Immunity (MI4). MI4 adjudicates funds from the McGill University Health Centre (MUHC) Foundation. This study surveyed MUHC healthcare workers. N.M. Lou reports payment from MI4. T.M. Montreuil reports grant from MI4 (PA). L.F. Feldman reports grant from MI4 and TheatOR, and is on the advisory board for Abbott and Merck. G.M. Fried reports grant from MI4 and Theator, Inc. Dr. Lavoie-Tremblay reports grant from MI4. M.L.-T. Bhanji reports grant from MI4. H. Kennedy reports payment from MI4. J.M. Harley reports grant from MI4 (NPA) and having received a speaking honorarium from Bayer Canada outside the submitted work. P. Kaneva declare no conflict of interest., (Copyright © 2021 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education.)

Cognitive functions are subserved by rhythmic neuronal synchronization across widely distributed brain areas. In 105 area pairs, we investigated functional connectivity (FC) through coherence, power correlation, and Granger causality (GC) in the theta, beta, high-beta, and gamma rhythms. Between rhythms, spatial FC patterns were largely independent. Thus, the rhythms defined distinct interaction networks. Importantly, networks of coherence and GC were not explained by the spatial distributions of the strengths of the rhythms. Those networks, particularly the GC networks, contained clear modules, with typically one dominant rhythm per module. To understand how this distinctiveness and modularity arises on a common anatomical backbone, we correlated, across 91 area pairs, the metrics of functional interaction with those of anatomical projection strength. Anatomy was primarily related to coherence and GC, with the largest effect sizes for GC. The correlation differed markedly between rhythms, being less pronounced for the beta and strongest for the gamma rhythm., Competing Interests: Declaration of interests P.F. and C.M.L. have a patent on thin-film electrodes and are beneficiaries of a respective license contract with Blackrock Microsystems LLC (Salt Lake City, UT, USA). P.F. is a member of the Scientific Technical Advisory Board of CorTec GmbH (Freiburg, Germany) and is managing director of Brain Science GmbH (Frankfurt am Main, Germany)., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: There are currently scarce data exploring ureteric reimplantation (UR) during cytoreductive surgery (CRS)., Methods: We identified patients undergoing CRS for peritoneal surface malignancies (PSM) of any origin at a single high-volume unit. UR was defined as ureteroureterostomy, transureterouretostomy, ureteroneocystostomy, ureterosigmoidostomy or ileal conduit performed during CRS. Peri-operative outcomes, long-term survival and risk factors for requiring UR were analysed., Results: Seven hundred and sixty-seven CRSs were identified. Twenty-three (3.0%) procedures involved UR. Bladder resection and colorectal cancer (CRC) were associated with increased risk of UR (bladder resection: OR 12.90, 95% CI 4.91-33.90, p<0.001; CRC: OR 2.51, 95% CI 1.05-6.01, p=0.038). UR did not increase the risk of Grade III-IV morbidity or mortality. The rate of ureteric leak was 3/23 (13.0%) in the UR group. Mean survival was equivocal in patients with CRC (58.14 vs. 34.25 months, p=0.441) but significantly lower in those with high-grade appendiceal mucinous neoplasm (HAMN) undergoing UR (73.98 vs. 30.90 months, p=0.029)., Conclusions: UR during CRS does not increase major morbidity or mortality for carefully selected patients, and is associated with low rates of urologic complications. Whilst decreased survival was apparent in patients with HAMN undergoing UR, it is unclear whether this relationship is causal., Competing Interests: Competing interests: Authors state no conflict of interest., (© 2021 Anais Alonso et al., published by De Gruyter, Berlin/Boston.)

Dopamine is required for working memory, but how it modulates the large-scale cortex is unknown. Here, we report that dopamine receptor density per neuron, measured by autoradiography, displays a macroscopic gradient along the macaque cortical hierarchy. This gradient is incorporated in a connectome-based large-scale cortex model endowed with multiple neuron types. The model captures an inverted U-shaped dependence of working memory on dopamine and spatial patterns of persistent activity observed in over 90 experimental studies. Moreover, we show that dopamine is crucial for filtering out irrelevant stimuli by enhancing inhibition from dendrite-targeting interneurons. Our model revealed that an activity-silent memory trace can be realized by facilitation of inter-areal connections and that adjusting cortical dopamine induces a switch from this internal memory state to distributed persistent activity. Our work represents a cross-level understanding from molecules and cell types to recurrent circuit dynamics underlying a core cognitive function distributed across the primate cortex., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Chronic pain is a significant health problem worldwide and requires a biopsychosocial treatment approach. Access to traditional pain medicine specialist services is limited and innovative treatment models are required to support patients in tertiary care. The study evaluated the clinical effectiveness and safety of the Treatment Access Pathway (TAP), an allied health expanded scope model of care which included innovative group assessment and collaboration with patients to create individualized treatment plans., Methods: One hundred and eighty-one patients referred to a tertiary level chronic pain service were randomly allocated to either the TAP or the waitlist study groups. Primary (pain interference) and secondary outcome measures were collected at recruitment and again at 6 months. Per-protocol analyses were utilized due to high participant attrition (46% across groups)., Results: The TAP group reported greater reductions in pain interference at 6 months than waitlist group (0.9, 95% CI: 0.2-1.6), with more than half of the TAP group (52%) reporting clinically significant improvement. In addition, statistically significant differences between the TAP and waitlist groups were observed for objective measurements of walking endurance (5.4 m, 95% CI: 1.7-9.1); and global impressions of change (1.4 unit decrease, 95% CI: 1-1.9). Nil adverse events were recorded., Conclusions: The study suggests that an expanded scope allied health model of care prioritizing patient choice and group-based interventions provides modest benefits for tertiary-referral chronic pain patients. TAP warrants further investigation as a potentially viable alternative for tertiary healthcare where traditional pain services are unavailable or have long waiting lists., Significance: The study tests effectiveness and safety of an expanded scope allied health-led chronic pain program. Despite a high attrition rate, the study showed reduced pain interference and increased physical function in those who completed the protocol. The results are promising and support introduction of this model as an adjunct to existing traditional chronic pain models of care, with a particular focus on improving participant retention in the program. Additionally, the model of care can be used as a standalone chronic pain model of care where no other pain management resources are available. The study was registered on ANZCTR (Trial ID: ACTRN12617001284358)., (© 2021 European Pain Federation - EFIC®.)

What are the key topological features of connectivity critically relevant for generating the dynamics underlying efficient cortical function? A candidate feature that has recently emerged is that the connectivity of the mammalian cortex follows an exponential distance rule, which includes a small proportion of long-range high-weight anatomical exceptions to this rule. Whole-brain modeling of large-scale human neuroimaging data in 1,003 participants offers the unique opportunity to create two models, with and without long-range exceptions, and explicitly study their functional consequences. We found that rare long-range exceptions are crucial for significantly improving information processing. Furthermore, modeling in a simplified ring architecture shows that this improvement is greatly enhanced by the turbulent regime found in empirical neuroimaging data. Overall, the results provide strong empirical evidence for the immense functional benefits of long-range exceptions combined with turbulence for information processing., Competing Interests: Declaration of interests The authors declare no competing interests. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript., (Copyright © 2021 Elsevier Inc. All rights reserved.)