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Laren D Tan,1 Anthony A Hilliard,2 Ricardo L Peverini,3 Robert D Martin,4 Tamara L Thomas,5 Trevor G Wright,6 Lyndon C Edwards,6 Angela M Lalas,6 Helen M Staples-Evans,6 Barbara J Sharp,7 Stella L Ahn-Kim,7 Kent A Hansen,6 Richard H Hart8 1Department of Medicine, Pulmonary, Critical Care, Hyperbaric and Sleep Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA; 2Department of Medicine, Cardiology, Loma Linda University School of Medicine, Loma Linda, CA, USA; 3Department of Pediatrics, Neonatology, Loma Linda University School of Medicine, Loma Linda, CA, USA; 4Department of Anesthesia, Loma Linda University School of Medicine, Loma Linda, CA, USA; 5Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA; 6Loma Linda University Health, Loma Linda, CA, USA; 7Loma Linda University School of Medicine, Loma Linda, CA, USA; 8Department of Preventive Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USACorrespondence: Laren D Tan, Email Latan@llu.eduAbstract: Navigating the healthcare conundrum in the Blue Zone of Loma Linda, California, requires understanding the unique factors that make this region stand out in terms of health and longevity. But more important is understanding the healthcare system sustaining the Blue Zone in Loma Linda, California. In an era marked by soaring healthcare costs and diminishing reimbursement rates, hospitals and physicians face an unprecedented challenge: providing excellent patient care while maintaining financial sustainability. This leadership perspective publication paper delves into the multifaceted struggles encountered by healthcare and hospital leaders, exploring the root causes, implications, and potential solutions for this complex issue. As we examine the evolving healthcare landscape, we aim to shed light on the critical need for innovative approaches to sustain the future of healthcare excellence in one of the five original Blue Zones.Keywords: blue

This study investigates the qualitative experiences of Jewish Canadians who were bereaved during the COVID-19 pandemic. Using ethnodrama as the methodology, nine participants were interviewed, and their words were transcribed. The transcripts were thematically analyzed through hermeneutic phenomenology as a point of departure, and organized into the form of a theatrical script to make the results more accessible to an audience, but also to prioritize and stay true to participants’ interpretations. While generalizations cannot be made from such a small sample, this study demonstrates the possibility of presenting research in an artistic format, and offers a snapshot in time of the unique experience of mourning during extraordinary circumstances., 2024-05, 2024-01-03T17:32:16Z

Violence in healthcare is a global concern for all health care professionals with nurses being recognized as most likely to be a target. Much of the research conducted on the experience of violence in nursing pertains to nurses working in emergency or psychiatric departments and long-term care. There is a paucity of research exploring the experience of violence among nurses in other care areas. This study intended to explore the experience of violence amongst neonatal nurses. A qualitative description methodology was used to begin to understand the complexities of violence toward neonatal nurses. Participants articulated experiencing both HV and VV and provided valuable insight into the personal impacts of such violence. Findings from this study provide important qualitative information that could be used to understand, mitigate, and address violence in the NICU. Further studies exploring the experiences of neonatal nurses would be beneficial to gain further understanding of the prevalence of violence, the influence of unit design, and the role of managers and healthcare leaders in violence prevention and response., 2024-06, 2024-02-01T18:30:01Z

A novel Flux Limited Splitting (FLS) non-linear Finite Volume (FV) method for families of linear Control Volume Distributed Multi Point Flux Approximation (CVD-MPFA) schemes is presented. The new formulation imposes a local discrete maximum principal (LDMP) which ensures that the discrete solution is free of spurious oscillations. The FLS scheme can be seen as a natural extension of the M-Matrix Flux Splitting method that splits the MPFA flux components in terms of the Two-Point Flux Approximation (TPFA) flux and Cross Diffusion Terms (CDT), with the addition of a dynamically computed relaxation parameter to the CDT that identifies and locally corrects the regions where the LDMP is violated. Moreover, the whole non-linear procedure was devised as a series of simple straightforward matrix operations. The methodology is presented considering the Multi-Point Flux Approximation with a Diamond (MPFA-D) in what we call the FLS + MPFA-D formulation which is tested using a series of challenging benchmark problems. For all test cases, the FLS repair technique imposes the LDMP and eliminates the spurious oscillations induced by the original MPFA-D method., Numerical Analysis

Invasive species offer insights into rapid adaptation to novel environments. The iconic cane toad (Rhinella marina) is an excellent model for studying rapid adaptation during invasion. Previous research using the mitochondrial NADH dehydrogenase 3 (ND3) gene in Hawai'ian and Australian invasive populations found a single haplotype, indicating an extreme genetic bottleneck following introduction. Nuclear genetic diversity also exhibited reductions across the genome in these two populations. Here, we investigated the mitochondrial genomics of cane toads across this invasion trajectory. We created the first reference mitochondrial genome for this species using long‐read sequence data. We combined whole‐genome resequencing data of 15 toads with published transcriptomic data of 125 individuals to construct nearly complete mitochondrial genomes from the native (French Guiana) and introduced (Hawai'i and Australia) ranges for population genomic analyses. In agreement with previous investigations of these populations, we identified genetic bottlenecks in both Hawai'ian and Australian introduced populations, alongside evidence of population expansion in the invasive ranges. Although mitochondrial genetic diversity in introduced populations was reduced, our results revealed that it had been underestimated: we identified 45 mitochondrial haplotypes in Hawai'ian and Australian samples, none of which were found in the native range. Additionally, we identified two distinct groups of haplotypes from the native range, separated by a minimum of 110 base pairs (0.6%). These findings enhance our understanding of how invasion has shaped the genetic landscape of this species.

Many organisms can adjust their development according to environmental conditions, including the presence of conspecifics. Although this developmental plasticity is common in amphibians, its underlying molecular mechanisms remain largely unknown. Exposure during development to either ‘cannibal cues’ from older conspecifics, or ‘alarm cues’ from injured conspecifics, causes reduced growth and survival in cane toad (Rhinella marina) tadpoles. Epigenetic modifications, such as changes in DNA methylation patterns, are a plausible mechanism underlying these developmental plastic responses. Here we tested this hypothesis, and asked whether cannibal cues and alarm cues trigger the same DNA methylation changes in developing cane toads. We found that exposure to both cannibal cues and alarm cues was associated with local changes in DNA methylation patterns. These DNA methylation changes affected genes putatively involved in developmental processes, but in different genomic regions for different conspecific‐derived cues. Genetic background explains most of the epigenetic variation among individuals. Overall, the molecular mechanisms triggered by exposure to cannibal cues seem to differ from those triggered by alarm cues. Studies linking epigenetic modifications to transcriptional activity are needed to clarify the proximate mechanisms that regulate developmental plasticity in cane toads.

Purpose The aim of this review was to assess current evidence regarding changes in cognitive function according to time-of-day (TOD) and assess the key components of research design related to manuscripts of chronobiological nature. Methods An English-language literature search revealed 523 articles through primary database searches, and 1868 via organization searches/citation searching. The inclusion criteria were met by eleven articles which were included in the review. The inclusion criteria set were healthy adult males, a minimum of two timepoints including morning and evening, cognitive measures of performance, and peer-reviewed academic paper. Results It was established that cognitive performance varies with TOD and the degree of difference is highly dependent on the type of cognitive task with differences ranging from 9.0 to 34.2% for reaction time, 7.3% for alertness, and 7.8 to 40.3% for attention. The type of cognitive function was a determining factor as to whether the performance was better in the morning, evening, or afternoon. Conclusion Although some studies did not establish TOD differences, reaction time and levels of accuracy were highest in the evening. This implies that cognitive processes are complex, and existing research is contradictory. Some studies or cognitive variables did not show any measurable TOD effects, which may be due to differences in methodology, subjects involved, testing protocols, and confounding factors. No studies met all requirements related to chronobiological research, highlighting the issues around methodology. Therefore, future research must use a rigorous, approach, minimizing confounding factors that are specific to examinations of TOD.

We use an observationally calibrated ice-sheet model to investigate the future trajectory of the Antarctic ice sheet related to uncertainties in the future balance between sub-shelf melting and ice discharge, on the one hand, and the surface mass balance, on the other. Our ensemble of simulations, forced by a panel of climate models from the sixth phase of the Coupled Model Intercomparison Project (CMIP6), suggests that the ocean will be the primary driver of short-term Antarctic mass loss, initiating ice loss in West Antarctica already during this century. The atmosphere initially plays a mitigating role through increased snowfall, leading to an Antarctic contribution to global mean sea-level rise by 2100 of 6 (−8 to 15) cm under a low-emission scenario and 5.5 (−10 to 16) cm under a very high-emission scenario. However, under the very high-emission pathway, the influence of the atmosphere shifts beyond the end of the century, becoming an amplifying driver of mass loss as the ice sheet's surface mass balance decreases. We show that this transition occurs when Antarctic near-surface warming exceeds a critical threshold of +7.5 ∘C, at which the increase in surface runoff outweighs the increase in snow accumulation, a signal that is amplified by the melt–elevation feedback. Therefore, under the very high-emission scenario, oceanic and atmospheric drivers are projected to result in a complete collapse of the West Antarctic ice sheet along with significant grounding-line retreat in the marine basins of the East Antarctic ice sheet, leading to a median global mean sea-level rise of 2.75 (6.95) m by 2300 (3000). Under a more sustainable socio-economic pathway, we find that the Antarctic ice sheet may still contribute to a median global mean sea-level rise of 0.62 (1.85) m by 2300 (3000). However, the rate of sea-level rise is significantly reduced as mass loss is likely to remain confined to the Amundsen Sea Embayment, where present-day climate conditions seem sufficient, info:eu-repo/semantics/published

Objective Family food purchasing decisions have a direct influence on children's food environments and are powerful predictors of obesity and dietary quality. This study explored parents' capability, opportunities, and motivations regarding food purchasing for their families, as well as barriers and facilitators of healthy food purchasing behaviour, in an ethnically diverse, low-income area. Design Semi-structured interviews with parents of under-11-year-old children were conducted to investigate family food purchases, both when eating inside and outside the home. Interviews were analysed using framework analysis mapped against the COM-B model (Michie et al., 2011). Setting An ethnically diverse, low-income area in Birmingham, UK. Participants Sixteen parents (13F, 3M) of under-11-year-old children. 75% Pakistani, 12.5% White British, 6.3% White and Black Caribbean, and 6.3% “Other”. Results Four themes were identified: i) I know how to provide healthy meals for my family, ii) Family food purchase decisions are complex, iii) I want what they are eating and iv) Healthy eating is important but eating outside of the home is a treat. The barriers of healthy family food purchasing were predominantly at family and community levels, including time, cost, and both parents' and children's food enjoyment and preferences. Facilitators of healthy family food purchasing were primarily identified at an individual level, with high levels of capability and motivation for healthy food provision. Conclusions Attempts to enhance parental capability to improve healthy food purchasing through nutrition education is not likely to be a useful intervention target in this group. Emphasis on enjoyment, palatability and value for money could be key to increasing parental motivation to purchase healthy family foods.

IntroductionFood enjoyment can be conveyed through facial expressions. Observing others’ enjoyment of food has been found to influence adults’ desirability of liked and disliked food. Exposing adults to other eaters enjoying nutritious foods that are typically disliked (e.g., vegetables) could enhance the consumption of vegetables by young adults. However, this remains to be examined in young adult populations. This study examined the effect of models’ facial expressions towards raw broccoli on young adult women’s change in liking and change in desire to eat a modelled vegetable (raw broccoli) and a non-modelled vegetable (cucumber).MethodsYoung adult women (N = 205) were randomised to watch a video of unfamiliar adult models eating raw broccoli with a positive, negative, or neutral facial expression. Participants’ change in liking and change in desire to eat the modelled and non-modelled vegetable was examined.ResultsObserving models conveying negative facial expressions whilst eating raw broccoli resulted in a statistically significant reduction in liking ratings of broccoli, but not cucumber. There was no effect of models’ facial expressions on the change in desire to eat foods.DiscussionThese findings suggest that watching others express a negative facial expression whilst eating a raw vegetable reduces women’s liking of the modelled vegetable, in the absence of a significant change to their desire to consume these foods. This highlights the power of others’ negative facial expressions on food liking. Further work is needed to establish the effect of others’ facial expressions on vegetable intake.

Objective Family food purchasing decisions have a direct influence on children's food environments and are powerful predictors of obesity and dietary quality. This study explored parents' capability, opportunities, and motivations regarding food purchasing for their families, as well as barriers and facilitators of healthy food purchasing behaviour, in an ethnically diverse, low-income area. Design Semi-structured interviews with parents of under-11-year-old children were conducted to investigate family food purchases, both when eating inside and outside the home. Interviews were analysed using framework analysis mapped against the COM-B model (Michie et al., 2011). Setting An ethnically diverse, low-income area in Birmingham, UK. Participants Sixteen parents (13F, 3M) of under-11-year-old children. 75% Pakistani, 12.5% White British, 6.3% White and Black Caribbean, and 6.3% “Other”. Results Four themes were identified: i) I know how to provide healthy meals for my family, ii) Family food purchase decisions are complex, iii) I want what they are eating and iv) Healthy eating is important but eating outside of the home is a treat. The barriers of healthy family food purchasing were predominantly at family and community levels, including time, cost, and both parents' and children's food enjoyment and preferences. Facilitators of healthy family food purchasing were primarily identified at an individual level, with high levels of capability and motivation for healthy food provision. Conclusions Attempts to enhance parental capability to improve healthy food purchasing through nutrition education is not likely to be a useful intervention target in this group. Emphasis on enjoyment, palatability and value for money could be key to increasing parental motivation to purchase healthy family foods.

IntroductionFood enjoyment can be conveyed through facial expressions. Observing others’ enjoyment of food has been found to influence adults’ desirability of liked and disliked food. Exposing adults to other eaters enjoying nutritious foods that are typically disliked (e.g., vegetables) could enhance the consumption of vegetables by young adults. However, this remains to be examined in young adult populations. This study examined the effect of models’ facial expressions towards raw broccoli on young adult women’s change in liking and change in desire to eat a modelled vegetable (raw broccoli) and a non-modelled vegetable (cucumber).MethodsYoung adult women (N = 205) were randomised to watch a video of unfamiliar adult models eating raw broccoli with a positive, negative, or neutral facial expression. Participants’ change in liking and change in desire to eat the modelled and non-modelled vegetable was examined.ResultsObserving models conveying negative facial expressions whilst eating raw broccoli resulted in a statistically significant reduction in liking ratings of broccoli, but not cucumber. There was no effect of models’ facial expressions on the change in desire to eat foods.DiscussionThese findings suggest that watching others express a negative facial expression whilst eating a raw vegetable reduces women’s liking of the modelled vegetable, in the absence of a significant change to their desire to consume these foods. This highlights the power of others’ negative facial expressions on food liking. Further work is needed to establish the effect of others’ facial expressions on vegetable intake.

Introduction: Adequate (predeployment) training of the nowadays highly specialized Western military surgical teams is vital to ensure a broad range of surgical skills to treat combat casualties. This survey study aimed to assess the self-perceived preparedness, training needs, deployment experience, and post-deployment impact of surgical teams deployed with the Danish, Dutch, or Finnish Armed Forces. Study findings may facilitate a customized predeployment training. Methods: A questionnaire was distributed among Danish, Dutch, and Finnish military surgical teams deployed between January 2013 and December 2020 (N = 142). The primary endpoint of self-perceived preparedness ratings, and data on the training needs, deployment experiences, and post-deployment impacts were compared between professions and nations. Results: The respondents comprised 35 surgeons, 25 anesthesiologists, and 39 supporting staff members, with a response rate of 69.7 % (99/142). Self-perceived deployment preparedness was rated with a median of 4.0 (IQR 4.0–4.0; scale: 1 [very unprepared]–5 [more than sufficient]). No differences were found among professions and nations. Skills that surgeons rated below average (median <6.0; scale: 1 [low]–10 [high]) included tropical disease management and maxillofacial, neurological, gynecological, ophthalmic, and nerve repair surgery. The deployment caseload was most often reported as <1 case per week (41/99, 41.4 %). The need for professional psychological help was rated at a median of 1.0 (IQR 1.0–1.0; scale: 1 [not at all]–5 [very much]). Conclusions: Military surgical teams report overall adequate preparedness for deployment. Challenges remain for establishing broadly skilled teams because of a low deployment caseload and ongoing primary specializations. Additional training and exposure were indicated for several specialism-specific skill areas. The need for specific training should be addressed through customized predeployment programs.

The effects of polyethylene glycol- (PEG) modified lipids and gangliosides on the Ca2+ induced interaction between liposomes composed of palmitoyl-oleoyl phosphatidylethanolamine (POPE) and palmitoyl-oleoyl phosphatidylserine (POPS) was investigated at physiological ionic strength. Förster resonance energy transfer (FRET) studies complemented with dynamic light scattering (DLS) and cryo-transmission electron microscopy (Cryo-EM) show that naked liposomes tend to adhere, rupture, and collapse on each other's surfaces upon addition of Ca2+, eventually resulting in the formation of large multilamellar aggregates and bilayer sheets. Noteworthy, the presence of gangliosides or PEGylated lipids does not prevent the adhesion-rupture process, but leads to the formation of small, long-lived bilayer fragments/disks. PEGylated lipids seem to be more effective than gangliosides at stabilizing these structures. Attractive interactions arising from ion correlation are proposed to be a driving force for the liposome-liposome adhesion and rupture processes. The results suggest that, in contrast with the conclusions drawn from previous solely FRET-based studies, direct liposome-liposome fusion is not the dominating process triggered by Ca2+ in the systems studied.

Objective: To perform a cost-effectiveness analysis of high-intensity interval training (HIIT) compared with moderate intensity steady-state (MISS) training in people with coronary artery disease (CAD) attending cardiac rehabilitation (CR). Design: Secondary cost-effectiveness analysis of a prospective, assessor-blind, parallel group, multi-center RCT. Setting: Six outpatient National Health Service cardiac rehabilitation centers in England and Wales, UK. Participants: 382 participants with CAD (N=382). Interventions: Participants were randomized to twice-weekly usual care (n=195) or HIIT (n=187) for 8 weeks. Usual care was moderate intensity continuous exercise (60%-80% maximum capacity, MISS), while HIIT consisted of 10 × 1-minute intervals of vigorous exercise (>85% maximum capacity) interspersed with 1-minute periods of recovery. Main Outcome Measures: We conducted a cost-effectiveness analysis of the HIIT or MISS UK trial. Health related quality of life was measured with the EQ-5D-5L to estimate quality-adjusted life years (QALYs). Costs were estimated with health service resource use and intervention delivery costs. Cost-utility analysis measured the incremental cost-effectiveness ratio (ICER). Bootstrapping assessed the probability of HIIT being cost-effective according to the UK National Institute for Health and Care Excellence (NICE) threshold value (£20,000 per QALY). Missing data were imputed. Uncertainty was estimated using probabilistic sensitivity analysis. Assumptions were tested using univariate/1-way sensitivity analysis. Results: 124 (HIIT, n=59; MISS, n=65) participants completed questionnaires at baseline, 8 weeks, and 12 months. Mean combined health care use and delivery cost was £676 per participant for HIIT, and £653 for MISS. QALY changes were 0.003 and -0.013, respectively. For complete cases, the ICER was £1448 per QALY for HIIT compared with MISS. At a willingness-to-pay threshold of £20,000 per QALY, the probability of HIIT being cost-eff

This study investigates the qualitative experiences of Jewish Canadians who were bereaved during the COVID-19 pandemic. Using ethnodrama as the methodology, nine participants were interviewed, and their words were transcribed. The transcripts were thematically analyzed through hermeneutic phenomenology as a point of departure, and organized into the form of a theatrical script to make the results more accessible to an audience, but also to prioritize and stay true to participants’ interpretations. While generalizations cannot be made from such a small sample, this study demonstrates the possibility of presenting research in an artistic format, and offers a snapshot in time of the unique experience of mourning during extraordinary circumstances., 2024-05

Anthropogenically forced changes in global freshwater biodiversity demand more efficient monitoring approaches. Consequently, environmental DNA (eDNA) analysis is enabling ecosystem-scale biodiversity assessment, yet the appropriate spatio-temporal resolution of robust biodiversity assessment remains ambiguous. Here, using intensive, spatio-temporal eDNA sampling across space (five rivers in Europe and North America, with an upper range of 20–35 km between samples), time (19 timepoints between 2017 and 2018) and environmental conditions (river flow, pH, conductivity, temperature and rainfall), we characterise the resolution at which information on diversity across the animal kingdom can be gathered from rivers using eDNA. In space, beta diversity was mainly dictated by turnover, on a scale of tens of kilometres, highlighting that diversity measures are not confounded by eDNA from upstream. Fish communities showed nested assemblages along some rivers, coinciding with habitat use. Across time, seasonal life history events, including salmon and eel migration, were detected. Finally, effects of environmental conditions were taxon-specific, reflecting habitat filtering of communities rather than effects on DNA molecules. We conclude that riverine eDNA metabarcoding can measure biodiversity at spatio-temporal scales relevant to species and community ecology, demonstrating its utility in delivering insights into river community ecology during a time of environmental change.

In this paper, we advance the question: What are the semiotic (meaning-making) and learning opportunities offered by student-produced films? Our point of departure is a pedagogical project in which we invited management students to produce films on scalar issues related to global environmental change. Our analytical lens and our empirical findings (examined through a template analysis and a multimodal video transcription) help us make three contributions. First, we synthesize a new ontological and epistemological foundational "positioning" that portrays the nature of learning processes as revolving on meaning-making activities (a positioning that we have termed a performative, design-oriented multimodality). Second, we provide a framework that advances understanding of the "inner workings" of student film-making as resting on a triple engagement (cognitive-affective, behavioral, and relational), anchored on underpinning multimodal composing activities. These conceptual moves and empirical work allow us to distill several implications, or "provocations": film-making fosters radical openness in management learning curricula, gives new momentum to the instructor's role change ("from sage on the stage to guide on the side") and expands existing cultures of recognition around what gets valued and can be assessed as (signs of) learning. Third, we offer a pedagogical prototype containing practical teaching guidelines.

The indoor air quality of a residential home during winter in Fairbanks, Alaska, was investigated and contrasted with outdoor levels. Twenty-four-hour average indoor and outdoor filter samples were collected from January 17 to February 25, 2022, in a residential area with high outdoor PM2.5 concentrations. The oxidative potential of PM2.5 was determined using the dithiothreitol-depletion assay (OPDTT). For the unoccupied house, the background indoor-to-outdoor (I/O) ratio of mass-normalized OP (OPmDTT), a measure of the intrinsic health-relevant properties of the aerosol, was less than 1 (0.53 ± 0.37), implying a loss of aerosol toxicity as air was transported indoors. This may result from transport and volatility losses driven by the large gradients in temperature (average outdoor temperature of -19°C/average indoor temperature of 21 °C) or relative humidity (average outdoor RH of 78%/average indoor RH of 11%), or both. Various indoor activities, including pellet stove use, simple cooking experiments, incense burning, and mixtures of these activities, were conducted. The experiments produced PM2.5 with a highly variable OPmDTT. PM2.5 from cooking emissions had the lowest OP values, while pellet stove PM2.5 had the highest. Correlations between volume-normalized OPDTT (OPvDTT), relevant to exposure, and indoor PM2.5 mass concentration during experiments were much lower compared to those in outdoor environments. This suggests that mass concentration alone can be a poor indicator of possible adverse effects of various indoor emissions. These findings highlight the importance of considering both the quantity of particles and sources (chemical composition), as health metrics for indoor air quality.

Choroideremia (CHM) is a rare X-linked chorioretinal dystrophy affecting the photoreceptors, retinal pigment epithelium (RPE) and choroid, however, the involvement of the choroid in disease progression is not fully understood. CHM is caused by mutations in the CHM gene, encoding the ubiquitously expressed Rab escort protein 1 (REP1). REP1 plays an important role in intracellular trafficking of vesicles, including melanosomes. In this study, we examined the ultrastructure of the choroid in chm(ru848) fish and Chm(null/WT) mouse models using transmission electron and confocal microscopy. Significant pigmentary disruptions were observed, with lack of melanosomes in the choroid of chm(ru848) fish from 4 days post fertilisation (4dpf), and a reduction in choroidal blood vessel diameter and interstitial pillars suggesting a defect in vasculogenesis. Total melanin and expression of melanogenesis genes tyr, tryp1a, mitf, dct and pmel were also reduced from 4dpf. In Chm(null/WT) mice, choroidal melanosomes were significantly smaller at 1 month, with reduced eumelanin at 1 year. The choroid in CHM patients were also examined using spectral domain optical coherence tomography (SD-OCT) and OCTangiography (OCT-A) and the area of preserved choriocapillaris (CC) was found to be smaller than that of overlying photoreceptors, suggesting that the choroid is degenerating at a faster rate. Histopathology of an enucleated eye from a 74-year-old CHM male patient revealed isolated areas of RPE but no associated underlying CC. Pigmentary disruptions in CHM animal models reveal an important role for REP1 in melanogenesis, and drugs that improve melanin production represent a potential novel therapeutic avenue., Funding Agencies|Wellcome Trust [205174/ Z/16/Z]; Choroideremia Research Foundation, USA; Moorfields Eye Charity; National Institute for Health and Care Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust; UCL Institute of Ophthalmology

Mercury (Hg) is a naturally occurring metalloid element and an environmental contaminant of global concern. It can be emitted to the environment from anthropogenic activities, such as fossil fuel combustion, as well as through natural emissions, such as volcanic activity. While anthropogenic Hg emissions have been fairly well constrained and are projected to decline with recent emission reduction efforts, there remain major uncertainties in the amount of Hg emitted from volcanoes due to a scarcity of field measurements, methodological uncertainties, and the diversity of Earth’s volcanism over space and time. This is an important knowledge gap because evaluating the effectiveness of Hg emission regulations such as the Minamata Convention on Mercury requires sufficient knowledge of both anthropogenic and natural inputs to the global Hg cycle. This thesis reports the results of four field campaigns from 2019 to 2022 on the highly active volcanic island country of Iceland. During the 2021 and 2022 effusive eruptions of the Fagradalsfjall volcanic system, Hg was measured in the volcanic plume by drone directly above the active vent (a first for volcanic Hg research) as well as at more distant downwind locations, with a relatively low time-averaged Hg flux of 84 ± 62 kg a–1 for these eruptions. To assess the role of geothermal degassing in Iceland’s natural Hg emissions, we measured soil gaseous elemental mercury (GEM) concentrations at six geothermal fields and used an adapted gradient method to estimate soil–air fluxes. These yielded similarly low GEM emission figures: an estimated Icelandic geothermal flux of 1.8 kg a–1 and a total Icelandic flux (including non-geothermal areas) of ~18 kg a–1. Despite the minor geothermal flux, soil gas GEM concentrations at 10 cm depth were often hundreds and in some cases thousands of times higher than surface air concentrations, and geothermal soils showed major enrichments in total Hg (THg). This thesis shows that Icelandic geother

Text-to-image artificial intelligence (AI) programs are popular public-facing tools that generate novel images based on user prompts. Given that they are trained from Internet data, they may reflect societal biases, as has been shown for text-to-text large language model programs. We sought to investigate whether 3 common text-to-image AI systems recapitulated stereotypes held about surgeons and other health care professionals. All platforms queried were able to reproduce common aspects of the profession including attire, equipment, and background settings, but there were differences between programs most notably regarding visible race and gender diversity. Thus, historical stereotypes of surgeons may be reinforced by the publics use of text-to-image AI systems, particularly those without procedures to regulate generated output. As AI systems become more ubiquitous, understanding the implications of their use in health care and for health care-adjacent purposes is critical to advocate for and preserve the core values and goals of our profession.

Daylight is essential for ecosystems and for the physical and mental well-being of people. In densely populated cities, only a small proportion of total daylight is available to support urban greenery and most people have little daily exposure to natural daylight. Despite this, many cities have followed a strategy of densification as a way of preventing urban sprawl and reducing energy consumption. In this article, we review the biological importance of daylight and show that urban densification leads to a reduction in the daylight available for both people and nature. We conclude that daylight in cities should be treated as a limiting resource that needs to be planned and managed carefully, much like water or energy. We suggest elements for a policy framework aimed at optimizing urban daylight, including how to determine daylight needs, how to determine the maximum viable urban density, and policy options for built and unbuilt areas.

Background Change of direction (COD) movements are associated with non-contact anterior cruciate ligament (ACL) injuries in multidirectional sports. Females appear at increased risk compared to males, which could be attributable to whole body kinematic strategies and greater multiplanar knee joint loads (KJLs) during COD which can increase ACL loading. Objective The aim of this systematic review and meta-analysis was to examine and quantitatively synthesise the evidence for differences between males and females regarding KJLs and their biomechanical determinants (whole body kinematic strategies determining KJLs) during COD tasks. Methods Databases including SPORTDiscus, Web of Science, and PubMed were systematically searched (July 2021–June 2023) for studies that compared differences in knee joint loads and biomechanical determinants of KJLs during COD between males and females. Inclusion criteria were: (1) females and males with no prior history of ACL injury (18–40 years); (2) examined biomechanical determinants of KJLs and/ or KJLs during COD tasks > 20°; (3) compared ≥ 1 outcome measure between males and females. Studies published between 2000 and 2023 examining a cutting task > 20° with a preceding approach run that compared KJLs or the whole body multiplanar kinematics associated with them, between sexes, using three-dimensional motion analysis. Results This meta-analysis included 17 studies with a pooled sample size of 451 participants (227 males, 224 females). Meta-analysis revealed females displayed significantly less peak knee flexion during stance (SMD: 0.374, 95% CI 0.098–0.649, p = 0.008, I2: 0%); greater knee abduction at initial contact (IC) (SMD: 0.687, 95% CI 0.299–1.076, p = 0.001, I2: 55%); less hip internal rotation (SMD: 0.437, 95% CI 0.134–0.741, p = 0.005, I2: 34%) and hip abduction at IC (SMD: −0.454, 95% CI 0.151–0.758, p = 0.003, I2: 33%). No significant differences were observed between males and females for any internal or externally appl

Promoting international student mobility is a key consideration in the internationalisation of higher education. Due to this attention, it has become increasingly important to understand international students’ experiences. Previous research on international students’ adjustment experiences has reported various issues and unique aspects depending on the context of their adjustment. However, there is a need for research on Omani international students in New Zealand to provide insight into what might affect students’ academic, social, and cultural adjustment. This study explored how Omani students described their sociocultural and academic adjustment experiences and how they gave meaning to these from their viewpoints. A qualitative phenomenological approach underpinned by an interpretive research paradigm was used to investigate the adjustment experiences of 12 Omani student participants. Data were gathered through semi-structured interviews from January to September 2020 at one New Zealand university. Two rounds of interviews were held for each participant. During data collection, Omani participants were enrolled in bachelor degree programmes in Engineering, Education, Earth Science, and Management. NVivo 11 was used to assist in organising and analysing data from the interviews using a thematic approach. Findings suggest that Omani students experienced adjustment as an interactive social, cultural, and academic experience. For most of them, their initial experience was facilitated by their homestay, attendance at language school, and participation in the Omani Students’ Association. This triad of interactions and support meant Omani students felt happy and included in the local community. However, after this initial stage of comfort, many experienced negative emotions, such as homesickness, especially during Islamic holidays. Omani students’ sociocultural adjustment was made easier by them engaging in social interaction and seeking out friendships. However, they r

Behaviour that occurs online is an important component of many people’s social interactions. It is, therefore, crucial that the detrimental impacts of cyberbullying and similar behaviour (i.e., online aversive behaviour) are addressed. To this end, I present research that progresses from an exploration of online social behaviour in general (Chapter 2) through to quantitative discounting studies that examine an avenue for behaviour change initiatives that improve the online social environment. In the exploratory phase (Chapter 2), I conducted a series of focus groups with young people between 12- and 21-years old on the broad topic of Social Networking Site use (SNS). Participants spoke about how they manage their use of SNS, which coalesced around several key themes. One of these ideas was the importance of showing and receiving support from their online social communities, especially in instances of adversity. An effective way to show support for another person online is to actively intervene when witnessing adverse (or aversive) behaviour directed toward that person. In Chapter 3, I explored a novel application of discounting methods to assess whether social outcomes related to online bystander (i.e., cyberbystander) intervention are discounted similarly to outcomes more common within the discounting literature. I used discounting methods in conjunction with the framework of the Bystander Intervention Model (BIM; Latané & Darley, 1970), reframing the latter to be congruent with the concepts of behaviour analysis. In Chapter 4, I tested the applicability of discounting methods to the decision-making of young adult cyberbystanders. As discounting studies using monetary outcomes have been well-established, I compared the probabilistic discounting of money to that of social outcomes related to cyberbystander behaviour. Having established that probability discounting can be applied to cyberbystander’s decision-making, in Chapter 5, I examined whether scenario severity

Missoula, MT

The ability to accurately estimate the age at time-of-death of an individual is crucial in numerous fields, particularly in a biological or forensic context. There are various methods, features, and bones that are utilized for determining the estimated age of an individual. This study dives into the Lovejoy et al. (1985) age estimation method of the auricular surface of the ilium by using the current age phase descriptions against different reference photos. The study tests whether updated color photos, when working collaboratively with the current age phase descriptions, increases the age estimation accuracy when estimating age based on the auricular surface of the ilium. The study is completed by conducting an affordable and non-destructive analysis utilizing photography and blind test groups. The results of this study should yield useful information in forensic contexts by presenting whether the Lovejoy et al. age estimation method using the auricular surface would benefit from updated photography.

From the second half of the eighteenth century onwards, song collections gave dramatic presence to the distinctive landscapes, histories and traditions of the nations and regions of Britain and Ireland. This essay analyses some of the musical, linguistic and cultural features of ‘national airs’ through case studies from Scotland and Wales. Focussing on editors John Parry, George Thomson and Alexander Campbell, we trace crosscurrents of travel, language and translation revealing how Romantic songs move unpredictably between manuscript and print, beyond national borders and across lines of class – powerfully shaping the cultural and political imagination of the Celtic-speaking countries in the process.

From the second half of the eighteenth century onwards, song collections gave dramatic presence to the distinctive landscapes, histories and traditions of the nations and regions of Britain and Ireland. This essay analyses some of the musical, linguistic and cultural features of ‘national airs’ through case studies from Scotland and Wales. Focussing on editors John Parry, George Thomson and Alexander Campbell, we trace crosscurrents of travel, language and translation revealing how Romantic songs move unpredictably between manuscript and print, beyond national borders and across lines of class – powerfully shaping the cultural and political imagination of the Celtic-speaking countries in the process.

From the second half of the eighteenth century onwards, song collections gave dramatic presence to the distinctive landscapes, histories and traditions of the nations and regions of Britain and Ireland. This essay analyses some of the musical, linguistic and cultural features of ‘national airs’ through case studies from Scotland and Wales. Focussing on editors John Parry, George Thomson and Alexander Campbell, we trace crosscurrents of travel, language and translation revealing how Romantic songs move unpredictably between manuscript and print, beyond national borders and across lines of class – powerfully shaping the cultural and political imagination of the Celtic-speaking countries in the process.

From the second half of the eighteenth century onwards, song collections gave dramatic presence to the distinctive landscapes, histories and traditions of the nations and regions of Britain and Ireland. This essay analyses some of the musical, linguistic and cultural features of ‘national airs’ through case studies from Scotland and Wales. Focussing on editors John Parry, George Thomson and Alexander Campbell, we trace crosscurrents of travel, language and translation revealing how Romantic songs move unpredictably between manuscript and print, beyond national borders and across lines of class – powerfully shaping the cultural and political imagination of the Celtic-speaking countries in the process.

From the second half of the eighteenth century onwards, song collections gave dramatic presence to the distinctive landscapes, histories and traditions of the nations and regions of Britain and Ireland. This essay analyses some of the musical, linguistic and cultural features of ‘national airs’ through case studies from Scotland and Wales. Focussing on editors John Parry, George Thomson and Alexander Campbell, we trace crosscurrents of travel, language and translation revealing how Romantic songs move unpredictably between manuscript and print, beyond national borders and across lines of class – powerfully shaping the cultural and political imagination of the Celtic-speaking countries in the process.

From the second half of the eighteenth century onwards, song collections gave dramatic presence to the distinctive landscapes, histories and traditions of the nations and regions of Britain and Ireland. This essay analyses some of the musical, linguistic and cultural features of ‘national airs’ through case studies from Scotland and Wales. Focussing on editors John Parry, George Thomson and Alexander Campbell, we trace crosscurrents of travel, language and translation revealing how Romantic songs move unpredictably between manuscript and print, beyond national borders and across lines of class – powerfully shaping the cultural and political imagination of the Celtic-speaking countries in the process.

Avid eating behaviours, including greater responsiveness to food cues and emotional over-eating, have been linked to child overweight and obesity. Parental feeding practices are modifiable components of a child’s food environment and may be key levers for behaviour change in tailored interventions to support parents of children with avid eating behaviour. However, there is a lack of research examining parents’ experiences in this context. This study aimed to explore parents’ experiences of feeding children with avid eating behaviour and to understand any challenges experienced in this context. Semi-structured interviews with parents (N=15) of a preschool child (3-5 years) identified as having an avid eating behaviour profile explored how children’s avid eating manifests, the parental feeding practices used to manage avid eating, and the perceived effectiveness of these strategies. Data were analysed using reflexive thematic analysis. Four core themes were generated. Theme one, ‘Have they got worms? Children’s insatiable hunger’, captures parents’ interpretation of the complex ways in which avid eating behaviour manifests. Theme two, ‘Parenthood as a duty’, illustrates how parents’ perceived responsibilities shape their feeding practices. Theme three, ‘Lifelong habits’, captures parents’ use of responsive feeding practices to support children’s healthy relationship with food. Theme four, ‘Picking battles’, captures the structure- and coercive-based feeding strategies commonly used to manage children’s avid eating. This novel study provides an in-depth understanding of the complex ways that children’s avid eating behaviour manifests, and the strategic and creative parental feeding practices used to manage these behaviours. Such findings are valuable for informing the development of future support resources for parents/caregivers to help their children with avid eating behaviours to develop a healthy relationship with food.

Background: An avid eating behavior profile is characterized by a greater interest in food and a tendency to overeat in response to negative emotions. Parents use specific strategies to manage feeding interactions with children with avid eating behavior. While momentary and contextual factors, such as parental mood, have been found to influence parental feeding practices, there is a lack of research examining parents’ daily experiences of feeding children with avid eating behavior. Examining this is important because parental feeding practices are key levers in tailored interventions to support children’s healthy eating behavior. Objective: We aim to describe the ecological momentary assessment methods and procedures used in the APPETItE (Appetite in Preschoolers: Producing Evidence for Tailoring Interventions Effectively) project, which aims to examine how variation in parental mood, feeding goals, and the context of eating occasions affect the parental feeding practices used to manage feeding interactions with children with an avid eating behavior profile. Methods: Participants are primary caregivers from the APPETItE cohort who have a preschool-age child (aged 3-5 years) with an avid eating behavior profile. Caregivers complete a 10-day ecological momentary assessment period using signal- and event-contingent surveys to examine (1) mood and stress, (2) parental feeding goals, and (3) contextual factors as predictors of parental feeding practices. Results: Recruitment and data collection began in October 2023 and is expected to be completed by spring 2024. The data have a 3-level structure: repeated measurements (level 1) nested within days (level 2) nested within an individual (level 3). Thus, lag-dependent models will be conducted to test the main hypotheses. Conclusions: The findings from this study will provide an understanding of caregivers’ daily experiences of feeding preschool children with avid eating behavior, who are at greater risk for the development

Exposing children to adults eating a raw vegetable with positive facial expressions (‘positive modelling’) increases children's consumption of the modelled vegetable. However, whether repeated versus a single exposure to positive modelling enhances this effect, and whether it generalises to a non-modelled vegetable, remains to be examined. Hence, this study examined the effect of a single exposure, versus repeated, exposure to positive modelling on children's acceptance and intake of a modelled and non-modelled vegetable. Children aged 5–6 years (N = 153; 81 males, 72 females) were randomised to one of three conditions in which they had i) a single or ii) repeated exposure to a video of adults eating raw broccoli with positive facial expressions or iii) were exposed to a no-food control video. Children's acceptance (measured as willingness to try and number of tastes), intake and liking of a modelled (raw broccoli) and non-modelled vegetable (raw mangetout) were measured. Children had greater raw broccoli consumption and liking if they had received repeated exposure to positive modelling, compared to children who had received a single exposure, but not compared to children in the control condition. Children's mangetout intake was greater in the single (versus repeated) positive condition, but this effect was not dependent on time. There was no effect on children's vegetable acceptance. Repeatedly exposing children to adults enjoying a vegetable encourages children's intake of the modelled vegetable in comparison to a single exposure. Thus, repeated exposure to others' food enjoyment may be a practical and useful strategy to encourage children's vegetable consumption.

Exposing children to adults eating a raw vegetable with positive facial expressions (‘positive modelling’) increases children's consumption of the modelled vegetable. However, whether repeated versus a single exposure to positive modelling enhances this effect, and whether it generalises to a non-modelled vegetable, remains to be examined. Hence, this study examined the effect of a single exposure, versus repeated, exposure to positive modelling on children's acceptance and intake of a modelled and non-modelled vegetable. Children aged 5–6 years (N = 153; 81 males, 72 females) were randomised to one of three conditions in which they had i) a single or ii) repeated exposure to a video of adults eating raw broccoli with positive facial expressions or iii) were exposed to a no-food control video. Children's acceptance (measured as willingness to try and number of tastes), intake and liking of a modelled (raw broccoli) and non-modelled vegetable (raw mangetout) were measured. Children had greater raw broccoli consumption and liking if they had received repeated exposure to positive modelling, compared to children who had received a single exposure, but not compared to children in the control condition. Children's mangetout intake was greater in the single (versus repeated) positive condition, but this effect was not dependent on time. There was no effect on children's vegetable acceptance. Repeatedly exposing children to adults enjoying a vegetable encourages children's intake of the modelled vegetable in comparison to a single exposure. Thus, repeated exposure to others' food enjoyment may be a practical and useful strategy to encourage children's vegetable consumption.

Avid eating behaviours, including greater responsiveness to food cues and emotional over-eating, have been linked to child overweight and obesity. Parental feeding practices are modifiable components of a child’s food environment and may be key levers for behaviour change in tailored interventions to support parents of children with avid eating behaviour. However, there is a lack of research examining parents’ experiences in this context. This study aimed to explore parents’ experiences of feeding children with avid eating behaviour and to understand any challenges experienced in this context. Semi-structured interviews with parents (N=15) of a preschool child (3-5 years) identified as having an avid eating behaviour profile explored how children’s avid eating manifests, the parental feeding practices used to manage avid eating, and the perceived effectiveness of these strategies. Data were analysed using reflexive thematic analysis. Four core themes were generated. Theme one, ‘Have they got worms? Children’s insatiable hunger’, captures parents’ interpretation of the complex ways in which avid eating behaviour manifests. Theme two, ‘Parenthood as a duty’, illustrates how parents’ perceived responsibilities shape their feeding practices. Theme three, ‘Lifelong habits’, captures parents’ use of responsive feeding practices to support children’s healthy relationship with food. Theme four, ‘Picking battles’, captures the structure- and coercive-based feeding strategies commonly used to manage children’s avid eating. This novel study provides an in-depth understanding of the complex ways that children’s avid eating behaviour manifests, and the strategic and creative parental feeding practices used to manage these behaviours. Such findings are valuable for informing the development of future support resources for parents/caregivers to help their children with avid eating behaviours to develop a healthy relationship with food.

Background: An avid eating behavior profile is characterized by a greater interest in food and a tendency to overeat in response to negative emotions. Parents use specific strategies to manage feeding interactions with children with avid eating behavior. While momentary and contextual factors, such as parental mood, have been found to influence parental feeding practices, there is a lack of research examining parents’ daily experiences of feeding children with avid eating behavior. Examining this is important because parental feeding practices are key levers in tailored interventions to support children’s healthy eating behavior. Objective: We aim to describe the ecological momentary assessment methods and procedures used in the APPETItE (Appetite in Preschoolers: Producing Evidence for Tailoring Interventions Effectively) project, which aims to examine how variation in parental mood, feeding goals, and the context of eating occasions affect the parental feeding practices used to manage feeding interactions with children with an avid eating behavior profile. Methods: Participants are primary caregivers from the APPETItE cohort who have a preschool-age child (aged 3-5 years) with an avid eating behavior profile. Caregivers complete a 10-day ecological momentary assessment period using signal- and event-contingent surveys to examine (1) mood and stress, (2) parental feeding goals, and (3) contextual factors as predictors of parental feeding practices. Results: Recruitment and data collection began in October 2023 and is expected to be completed by spring 2024. The data have a 3-level structure: repeated measurements (level 1) nested within days (level 2) nested within an individual (level 3). Thus, lag-dependent models will be conducted to test the main hypotheses. Conclusions: The findings from this study will provide an understanding of caregivers’ daily experiences of feeding preschool children with avid eating behavior, who are at greater risk for the development

This report highlights the urgent need for equitable opportunities for girls in football. The report endorsed by leading figures in the football community and backed by the UK Government, underscores the importance of addressing gender disparities in sports provision and support.