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Aim: LifeLab is co-designed by and for Junior Cycle students from social disadvantage in Ireland, with the hope to improve health literacy and subsequent health outcomes in this cohort. The aim of this study was to evaluate the enjoyment levels of students participating in the pilot of LifeLab, with a view to informing future development of the intervention. Method: As part of the process evaluation of the pilot of LifeLab, a series of focus groups and purposively designed enjoyment scales were completed by 80 adolescents, from one disadvantaged school in Dublin, Ireland. Inductive thematic analysis was carried out to analyse focus group data, and descriptive analysis of the enjoyment scales was conducted. Findings of the focus groups and enjoyment scales were synthesised and integrated resulting in the generation of a series of higher order and lower order themes of enjoyment. Results: Results of the inductive thematic analysis identified barriers, facilitators and suggestions for increasing enjoyment. Adolescents' enjoyment of the LifeLab intervention can be improved through the integration of fun activity-based learning, competition, variety, and challenge. Conclusions: Findings suggested specific areas of improvement within the intervention, and by using the participant voice, these factors can be incorporated within the LifeLab intervention. It is hoped these refinements, as part of ongoing intervention development, may increase levels of enjoyment, which will therefore enhance the usability and success of LifeLab.

When pelagic organisms die and fall onto the deep-sea floor they create food falls, i.e., parcels of organic enrichment that subsidize deep benthic scavenging communities. The diversity and quantities of food falls remain unstudied for many ocean regions since they are stochastically deposited and rapidly scavenged. The Southern Ocean habitat supports large populations of megafauna but few food falls have been documented. To investigate the diversity and quantity of food falls in the northwestern Weddell Sea, we analyzed 8476 images from the deep seafloor that were captured during the expedition PS118 on RV Polarstern in 2019 by the camera system OFOBS (Ocean Floor Observation and Bathymetry System). OFOBS was towed 1.5 m above the seafloor along five transects (400 to 2200 m seafloor depth) east of the Antarctic Peninsula. We observed the carcasses of one baleen whale, one penguin, and four fish at depths of 647 m, 613 m, 647 m, 2136 m, 2165 m, and 2112 m, respectively, as well as associated scavenging fauna. To the best of our knowledge, we describe here the first in situ observations of deep-sea food falls for penguins and fish in the Southern Ocean. While the whale carcass seemed in an intermediate successional stage, both the penguin and the fish were likely recently deposited and three of the fish potentially resulted from fishery discards. Our relatively small data set suggests that a diverse array of food falls provide nutrients to the slopes of the Powell Basin.

BACKGROUND: Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces a prothrombotic state, but long-term effects of COVID-19 on incidence of vascular diseases are unclear. METHODS: We studied vascular diseases after COVID-19 diagnosis in population-wide anonymized linked English and Welsh electronic health records from January 1 to December 7, 2020. We estimated adjusted hazard ratios comparing the incidence of arterial thromboses and venous thromboembolic events (VTEs) after diagnosis of COVID-19 with the incidence in people without a COVID-19 diagnosis. We conducted subgroup analyses by COVID-19 severity, demographic characteristics, and previous history. RESULTS: Among 48 million adults, 125 985 were hospitalized and 1 319 789 were not hospitalized within 28 days of COVID-19 diagnosis. In England, there were 260 279 first arterial thromboses and 59 421 first VTEs during 41.6 million person-years of follow-up. Adjusted hazard ratios for first arterial thrombosis after COVID-19 diagnosis compared with no COVID-19 diagnosis declined from 21.7 (95% CI, 21.0-22.4) in week 1 after COVID-19 diagnosis to 1.34 (95% CI, 1.21-1.48) during weeks 27 to 49. Adjusted hazard ratios for first VTE after COVID-19 diagnosis declined from 33.2 (95% CI, 31.3-35.2) in week 1 to 1.80 (95% CI, 1.50-2.17) during weeks 27 to 49. Adjusted hazard ratios were higher, for longer after diagnosis, after hospitalized versus nonhospitalized COVID-19, among Black or Asian versus White people, and among people without versus with a previous event. The estimated whole-population increases in risk of arterial thromboses and VTEs 49 weeks after COVID-19 diagnosis were 0.5% and 0.25%, respectively, corresponding to 7200 and 3500 additional events, respectively, after 1.4 million COVID-19 diagnoses. CONCLUSIONS: High relative incidence of vascular events soon after COVID-19 diagnosis declines more rapidly for arterial thromboses than VTEs. However, incidence remains elevated up to 49 weeks after COVID-19 diagnosis. These results support policies to prevent severe COVID-19 by means of COVID-19 vaccines, early review after discharge, risk factor control, and use of secondary preventive agents in high-risk patients., This work was funded by the Longitudinal Health and Wellbeing COVID-19 National Core Study, which was established by the UK Chief Scientific Officer in October 2020 and funded by UK Research and Innovation (grant references MC_PC_20030 and MC_PC_20059), by the British Heart Foundation as part of the BHF Data Science Centre led by HDR UK (BHF grant number SP/19/3/34678), and by the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation(grant reference MC_PC_20058). This work uses data provided by patients and collected by the NHS as part of their care and support. We would also like to acknowledge all data providers who make anonymised data available for research. This work was supported by the Con-COV team funded by the Medical Research Council (grant number: MR/V028367/1). This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust. This work was supported by core funding from the: British Heart Foundation (BHF; RG/13/13/30194; RG/18/13/33946), BHF Cambridge CRE (RE/13/6/30180) and NIHR Cambridge Biomedical Research Centre (BRC-1215-20014) [*]. This work was supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyse anonymised data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales. SI was funded by a BHF-Turing Cardiovascular Data Science Award (BCDSA\100005) and is funded by a University College London FB Cancer Research UK Award (C18081/A31373). RK, JAC and JACS were supported by the NIHR Bristol Biomedical Research Centre. RK, VW GDS were supported by the MRC Integrative Epidemiology Unit at the University of Bristol. RK was supported by NIHR ARC West. RD and JACS were supported by Health Data Research UK. SK is funded by the NIHR Blood and Transplant Research Unit in Donor Health and Genomics (NIHR BTRU-2014-10024). TM was funded by the NIHR Blood and Transplant Research Unit in Donor Health and Genomics (NIHR BTRU-2014-10024). AMW is part of the BigData@Heart Consortium, funded by the Innovative Medicines Initiative-2 Joint Undertaking under grant agreement No 116074 and was supported by the BHF-Turing Cardiovascular Data Science Award (BCDSA\100005). WW is supported by the Chief Scientist’s Office (CAF/01/17). CS, CS, MB AW and WW are supported by Stroke Association (SA CV 20\100018).

Introduction: Clopidogrel is an antiplatelet agent recommended for secondary prevention of ischemic stroke (IS) and transient ischemic attack (TIA). Conversion of clopidogrel to its active metabolite by hepatic cytochrome P450-2C19 (CYP2C19) is essential for the inhibition of the P2Y12 receptor and subsequent platelet aggregation to prevent thrombotic events. CYP2C19 is highly polymorphic, with over 30 loss of function (LoF) alleles. This review considers whether there is sufficient data to support genotype guided antiplatelet therapy after stroke. Areas covered: A systematic literature review retrieved articles, which describe the interaction between CYP2C19 genotype and clinical outcomes following IS or TIA when treated with clopidogrel. The review documents efforts to identify optimal antiplatelet regimens and explores the value genotype guided antiplatelet therapy. The work outlines the contemporary understanding of clopidogrel metabolism and appraises evidence linking CYP2C19 LoF variants with attenuated platelet inhibition and poorer outcomes. Expert opinion: There is good evidence that CYP2C19 LoF allele carriers of Han-Chinese ancestry have increased risk for further vascular events following TIA or IS when treated with clopidogrel. The evidence base is less certain in other populations. The expansion of pharmacogenetics into routine clinical practice will facilitate further research and help tailor other aspects of secondary prevention.

Recently, the Hydrogen Epoch of Reionization Array (HERA) collaboration has produced the experiment's first upper limits on the power spectrum of 21-cm fluctuations at z~8 and 10. Here, we use several independent theoretical models to infer constraints on the intergalactic medium (IGM) and galaxies during the epoch of reionization (EoR) from these limits. We find that the IGM must have been heated above the adiabatic cooling threshold by z~8, independent of uncertainties about the IGM ionization state and the nature of the radio background. Combining HERA limits with galaxy and EoR observations constrains the spin temperature of the z~8 neutral IGM to 27 K < T_S < 630 K (2.3 K < T_S < 640 K) at 68% (95%) confidence. They therefore also place a lower bound on X-ray heating, a previously unconstrained aspects of early galaxies. For example, if the CMB dominates the z~8 radio background, the new HERA limits imply that the first galaxies produced X-rays more efficiently than local ones (with soft band X-ray luminosities per star formation rate constrained to L_X/SFR = { 10^40.2, 10^41.9 } erg/s/(M_sun/yr) at 68% confidence), consistent with expectations of X-ray binaries in low-metallicity environments. The z~10 limits require even earlier heating if dark-matter interactions (e.g., through millicharges) cool down the hydrogen gas. Using a model in which an extra radio background is produced by galaxies, we rule out (at 95% confidence) the combination of high radio and low X-ray luminosities of L_{r,ν}/SFR > 3.9 x 10^24 W/Hz/(M_sun/yr) and L_X/SFR, 40 pages, 19 figures, accepted to ApJ

Additional file 1.

We report the most sensitive upper limits to date on the 21 cm epoch of reionization power spectrum using 94 nights of observing with Phase I of the Hydrogen Epoch of Reionization Array (HERA). Using similar analysis techniques as in previously reported limits (HERA Collaboration 2022a), we find at 95% confidence that $\Delta^2(k = 0.34$ $h$ Mpc$^{-1}$) $\leq 457$ mK$^2$ at $z = 7.9$ and that $\Delta^2 (k = 0.36$ $h$ Mpc$^{-1}) \leq 3,496$ mK$^2$ at $z = 10.4$, an improvement by a factor of 2.1 and 2.6 respectively. These limits are mostly consistent with thermal noise over a wide range of $k$ after our data quality cuts, despite performing a relatively conservative analysis designed to minimize signal loss. Our results are validated with both statistical tests on the data and end-to-end pipeline simulations. We also report updated constraints on the astrophysics of reionization and the cosmic dawn. Using multiple independent modeling and inference techniques previously employed by HERA Collaboration (2022b), we find that the intergalactic medium must have been heated above the adiabatic cooling limit at least as early as $z = 10.4$, ruling out a broad set of so-called "cold reionization" scenarios. If this heating is due to high-mass X-ray binaries during the cosmic dawn, as is generally believed, our result's 99% credible interval excludes the local relationship between soft X-ray luminosity and star formation and thus requires heating driven by evolved low-metallicity stars., Comment: 57 pages, 37 figures. Updated to match the accepted ApJ version. Corresponding author: Joshua S. Dillon

Combining the visibilities measured by an interferometer to form a cosmological power spectrum is a complicated process. In a delay-based analysis, the mapping between instrumental and cosmological space is not a one-to-one relation. Instead, neighbouring modes contribute to the power measured at one point, with their respective contributions encoded in the window functions. To better understand the power measured by an interferometer, we assess the impact of instrument characteristics and analysis choices on these window functions. Focusing on the Hydrogen Epoch of Reionization Array (HERA) as a case study, we find that long-baseline observations correspond to enhanced low-k tails of the window functions, which facilitate foreground leakage, whilst an informed choice of bandwidth and frequency taper can reduce said tails. With simple test cases and realistic simulations, we show that, apart from tracing mode mixing, the window functions help accurately reconstruct the power spectrum estimator of simulated visibilities. The window functions depend strongly on the beam chromaticity, and less on its spatial structure - a Gaussian approximation, ignoring side lobes, is sufficient. Finally, we investigate the potential of asymmetric window functions, down-weighting the contribution of low-k power to avoid foreground leakage. The window functions presented here correspond to the latest HERA upper limits for the full Phase I data. They allow an accurate reconstruction of the power spectrum measured by the instrument and will be used in future analyses to confront theoretical models and data directly in cylindrical space., Comment: 18 pages, 19 figures, accepted for publication in MNRAS

Supplemental material, sj-docx-1-eso-10.1177_23969873221136927 for Molecular biomarkers predicting newly detected atrial fibrillation after ischaemic stroke or TIA: A systematic review by Kirsty Ward, Andy Vail, Alan Cameron, Mira Katan, Gregory YH Lip, Jesse Dawson, Craig J Smith and Amit K Kishore in European Stroke Journal

Supplemental material, sj-docx-1-eso-10.1177_23969873221136927 for Molecular biomarkers predicting newly detected atrial fibrillation after ischaemic stroke or TIA: A systematic review by Kirsty Ward, Andy Vail, Alan Cameron, Mira Katan, Gregory YH Lip, Jesse Dawson, Craig J Smith and Amit K Kishore in European Stroke Journal

Introduction Stroke-associated pneumonia (SAP) is a common complication associated with poor outcomes. Early dysphagia screening and specialist assessment is associated with reduced risk of SAP. Evidence about oral care and nasogastric tube (NGT) placement is equivocal. This study aimed to expose variations in dysphagia management practices and explore their associations with SAP. Participants and methods Speech Pathologists from 166 stroke units in England and Wales were surveyed about dysphagia assessment and management, oral care and NGT placement. Survey data were then linked to the Sentinel Stroke National Audit Programme (SSNAP), the national register of stroke. Univariable and multivariable linear regression models were fitted to estimate the association between dysphagia management practices and SAP incidence. Results 113 hospitals completed the survey (68%). Variation was evident in dysphagia screening protocols (DSPs), oral care and NGT practice while specialist swallow assessment data patterns were more consistent. Multivariable analysis showed no evidence of an association in incidence of SAP when using a water-only hospital DSP compared to a multi-consistency DSP (B -.688, 95% CI –2.912-1.536), when using written swallow assessment guidelines compared to not using written guidelines (B .671, 95% CI –1.567-2.908), when teams inserted NGTs overnight compared to teams which did not (B –.505, 95% CI –2.759-1.749) and when teams had a written oral care protocol compared to those which did not (B –1.339, 95% CI –3.551 - .873). Discussion and Conclusion Variation exists in dysphagia screening and management but there was no evidence of an association between clinical practice patterns and incidence of SAP. Further research with larger sample sizes is needed to examine association with SAP.

We report upper-limits on the Epoch of Reionization (EoR) 21 cm power spectrum at redshifts 7.9 and 10.4 with 18 nights of data ($\sim36$ hours of integration) from Phase I of the Hydrogen Epoch of Reionization Array (HERA). The Phase I data show evidence for systematics that can be largely suppressed with systematic models down to a dynamic range of $\sim10^9$ with respect to the peak foreground power. This yields a 95% confidence upper limit on the 21 cm power spectrum of $\Delta^2_{21} \le (30.76)^2\ {\rm mK}^2$ at $k=0.192\ h\ {\rm Mpc}^{-1}$ at $z=7.9$, and also $\Delta^2_{21} \le (95.74)^2\ {\rm mK}^2$ at $k=0.256\ h\ {\rm Mpc}^{-1}$ at $z=10.4$. At $z=7.9$, these limits are the most sensitive to-date by over an order of magnitude. While we find evidence for residual systematics at low line-of-sight Fourier $k_\parallel$ modes, at high $k_\parallel$ modes we find our data to be largely consistent with thermal noise, an indicator that the system could benefit from deeper integrations. The observed systematics could be due to radio frequency interference, cable sub-reflections, or residual instrumental cross-coupling, and warrant further study. This analysis emphasizes algorithms that have minimal inherent signal loss, although we do perform a careful accounting in a companion paper of the small forms of loss or bias associated with the pipeline. Overall, these results are a promising first step in the development of a tuned, instrument-specific analysis pipeline for HERA, particularly as Phase II construction is completed en route to reaching the full sensitivity of the experiment., Comment: Accepted to ApJ. https://reionization.org/science/public-data-release-1/

Project sustainability in the construction sector has its own unique challenges that come from the very nature of this industry. This relates to the difficulty in collecting data and effectively analysing them to generate valuable insight. To assist with project management, decision support systems (DSSs) have become a useful tool to help manage and improve sustainability. The aim of this paper is to present the current state of research into DSSs in the construction sector and to define potential avenues for future research in the field. This paper examines the application of artificial intelligence (AI) and data analytics (DA) in developing DSSs with a focus on project sustainability. While most studies emphasise the two dimensions, economic and environmental, future opportunities on the social sustainability are highlighted. These include research about the use of AI for improving workplace safety and personnel management.

The abyssal seafloor, that is, ocean depths of ∼3,000 to 6,000 m, is widely considered simply to be vast, featureless plains of sediment. For example, Wikipedia asserts that “abyssal plains cover more than 50% of the Earth’s surface” and “are among the flattest, smoothest, and least explored regions on Earth” (1). Featureless tracts of mud make intuitive sense since abyssal plains are formed by the deposition of thick blankets of fine-grained sediments sinking from the surface ocean or transported as turbidity currents down continental margins. In most of the abyss, especially on seafloors >10 My old, this sediment blanket is tens to thousands of meters thick (2) and seems likely to bury or smoothen most of the irregularities in seafloor crust (e.g., basalt pillows) formed at midocean spreading centers. Riehl et al. in PNAS (3) help to dispel this notion that the abyssal seafloor is featureless, providing evidence of extensive rocky habitats along transform faults in the abyss. Scientists studying the deep sea have long known that rocky or hard substrates do occur on abyssal plains. Perhaps the best known are polymetallic (“manganese”) nodules that were discovered during the Challenger expedition (1872 to 1876) (4); nodules are widespread in the Pacific abyss and, to a much lesser extent, the Indian and the Atlantic Oceans (5). In some Pacific regions, nodules may cover 10 to >50% of the seafloor area, providing abundant rocky habitat (6, 7). Seamounts also provide rocky substrates at abyssal depths where their slopes and outcrops are too steep to hold sediments (8). With as many as 200,000 seamounts in the world ocean, seamounts too provide significant habitat area for hard-bottom faunas, but once again, seamounts are concentrated in the Pacific Ocean (8). Surveys with lowered cameras, human-occupied vehicles, remotely operated vehicles, and autonomous underwater vehicles … [↵][1]1Email: craigsmi{at}hawaii.edu. [1]: #xref-corresp-1-1

This paper aims at evaluating the current state of research into artificial intelligence (AI)-based decision support systems (DSS) for improving construction project sustainability. The literature was systematically reviewed to explore the use of AI in the construction project lifecycle together with the consideration of the economic, environmental, and social goals of sustainability. A total of 2688 research papers were reviewed, and 77 papers were further analyzed, and the major tasks of the DSSs were categorized. Our review results suggest that the main research stream is dedicated to early-stage project prediction (50% of all papers), with artificial neural networks (ANNs) and fuzzy logic (FL) being the most popular AI algorithms in use. Hybrid AI models were used in 46% of all studies. The goal for economic sustainability is the most considered in research, with 87% of all papers considering this goal, and there is evidence given of a trend towards the environmental and social goals of sustainability receiving increasing attention throughout the latter half of the decade.

Objective To describe a novel England-wide electronic health record (EHR) resource enabling whole population research on covid-19 and cardiovascular disease while ensuring data security and privacy and maintaining public trust. Design Data resource comprising linked person level records from national healthcare settings for the English population, accessible within NHS Digital’s new trusted research environment. Setting EHRs from primary care, hospital episodes, death registry, covid-19 laboratory test results, and community dispensing data, with further enrichment planned from specialist intensive care, cardiovascular, and covid-19 vaccination data. Participants 54.4 million people alive on 1 January 2020 and registered with an NHS general practitioner in England. Main outcome measures Confirmed and suspected covid-19 diagnoses, exemplar cardiovascular conditions (incident stroke or transient ischaemic attack and incident myocardial infarction) and all cause mortality between 1 January and 31 October 2020. Results The linked cohort includes more than 96% of the English population. By combining person level data across national healthcare settings, data on age, sex, and ethnicity are complete for around 95% of the population. Among 53.3 million people with no previous diagnosis of stroke or transient ischaemic attack, 98 721 had a first ever incident stroke or transient ischaemic attack between 1 January and 31 October 2020, of which 30% were recorded only in primary care and 4% only in death registry records. Among 53.2 million people with no previous diagnosis of myocardial infarction, 62 966 had an incident myocardial infarction during follow-up, of which 8% were recorded only in primary care and 12% only in death registry records. A total of 959 470 people had a confirmed or suspected covid-19 diagnosis (714 162 in primary care data, 126 349 in hospital admission records, 776 503 in covid-19 laboratory test data, and 50 504 in death registry records). Although 58% of these were recorded in both primary care and covid-19 laboratory test data, 15% and 18%, respectively, were recorded in only one. Conclusions This population-wide resource shows the importance of linking person level data across health settings to maximise completeness of key characteristics and to ascertain cardiovascular events and covid-19 diagnoses. Although this resource was initially established to support research on covid-19 and cardiovascular disease to benefit clinical care and public health and to inform healthcare policy, it can broaden further to enable a wide range of research.

Background: There is little information regarding the safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke and COVID-19. Methods: This multicenter study included consecutive stroke patients with and without COVID-19 treated with IV-tPA between February 18, 2019, to December 31, 2020, at 9 centers participating in the CASCADE initiative. Clinical outcomes included modified Rankin Scale (mRS) at hospital discharge, in-hospital mortality, the rate of hemorrhagic transformation. Using Bayesian multiple regression and after adjusting for variables with significant value in univariable analysis, we reported the posterior adjusted odds ratio (OR, with 95% Credible Intervals [CrI]) of the main outcomes. Results: A total of 545 stroke patients, including 101 patients with COVID-19 were evaluated. Patients with COVID-19 had a more severe stroke at admission. In the study cohort, 85 (15.9%) patients had a hemorrhagic transformation, and 72 (13.1%) died in the hospital. After adjustment for confounding variables, discharge mRS score >2 (OR: 0.73, 95% CrI: 0.16, 3.05), in-hospital mortality (OR: 2.06, 95% CrI: 0.76, 5.53), and hemorrhagic transformation (OR: 1.514, 95% CrI: 0.66, 3.31) were similar in COVID-19 and non COVID-19 patients. High -sensitivity C reactive protein level was a predictor of hemorrhagic transformation in all cases (OR:1.01, 95%CI: 1.0026, 1.018), including those with COVID-19 (OR:1.024, 95%CI:1.002, 1.054). Conclusion: IV-tPA treatment in patients with acute ischemic stroke and COVID-19 was not associated with an increased risk of disability, mortality, and hemorrhagic transformation compared to those without COVID-19. IVtPA should continue to be considered as the standard of care in patients with hyper acute stroke and COVID-19.

Additional file 1: Supplementary File 1 Adapted Questionnaire.

Additional file 3: Supplementary File 3 Vignette examples.

Supplemental material, sj-pdf-1-wso-10.1177_17474930211045880 for Use of risk scores for predicting new atrial fibrillation after ischemic stroke or transient ischemic attack—A systematic review by Amit K Kishore, Mohammad J Hossain, Alan Cameron, Jesse Dawson, Andy Vail and Craig J Smith in International Journal of Stroke

Bacteria and archaea are key contributors to deep-sea biogeochemical cycles and food webs. The disruptions these microbial communities may experience during and following polymetallic nodule mining in the Clarion-Clipperton Zone (CCZ) of the North Pacific Ocean could therefore have broad ecological effects. Our goals in this synthesis are to characterize the current understanding of biodiversity and biogeography of bacteria and archaea in the CCZ and to identify gaps in the baseline data and sampling approaches, prior to the onset of mining in the region. This is part of a large effort to compile biogeographic patterns in the CCZ, and to assess the representivity of no-mining Areas of Particular Environmental Interest, across a range of taxa. Here, we review published studies and an additional new dataset focused on 16S ribosomal RNA (rRNA) gene amplicon characterization of abyssal bacterial and archaeal communities, particularly focused on spatial patterns. Deep-sea habitats (nodules, sediments, and bottom seawater) each hosted significantly different microbial communities. An east-vs.-west CCZ regional distinction was present in nodule communities, although the magnitude was small and likely not detectable without a high-resolution analysis. Within habitats, spatial variability was driven by differences in relative abundances of taxa, rather than by abundant taxon turnover. Our results further support observations that nodules in the CCZ have distinct archaeal communities from those in more productive surrounding regions, with higher relative abundances of presumed chemolithoautotrophic Nitrosopumilaceae suggesting possible trophic effects of nodule removal. Collectively, these results indicate that bacteria and archaea in the CCZ display previously undetected, subtle, regional-scale biogeography. However, the currently available microbial community surveys are spatially limited and suffer from sampling and analytical differences that frequently confound inter-comparison; making definitive management decisions from such a limited dataset could be problematic. We suggest a number of future research priorities and sampling recommendations that may help to alleviate dataset incompatibilities and to address challenges posed by rapidly advancing DNA sequencing technology for monitoring bacterial and archaeal biodiversity in the CCZ. Most critically, we advocate for selection of a standardized 16S rRNA gene amplification approach for use in the anticipated large-scale, contractor driven biodiversity monitoring in the region.

Additional file 2: Supplementary File 2 Focus Group Guide.

Supplemental material, sj-pdf-1-wso-10.1177_17474930211045880 for Use of risk scores for predicting new atrial fibrillation after ischemic stroke or transient ischemic attack—A systematic review by Amit K Kishore, Mohammad J Hossain, Alan Cameron, Jesse Dawson, Andy Vail and Craig J Smith in International Journal of Stroke

The Generation IV International Forum (GIF) Experts Group tasked the Risk and Safety Working Group (RSWG) with assessing the high-level safety design characteristics of all six GIF systems. The objective is to review and identify the main safety advantages and possible challenges of the individual technologies, with a view to assess the current status of safety- related research & development (R&D) activities and identify future R&D needs for each system. In this context, the RSWG requested that the GIF Lead-cooled Fast Reactor (LFR) provisional System Steering Committee (pSSC) prepare a system safety assessment (SSA) document summarizing the safety advantages and challenges of LFR concepts under consideration. The present report is structured according to the “table of contents” below as proposed by the RSWG. In preparing this assessment, the LFR pSSC has placed emphasis on the outcomes of safety- related R&D for the GIF LFR Reference Systems and the review of LFR safety aspects by the French “Institut de Radioprotection et de Sûreté Nucléaire” (IRSN)

ObjectiveWe set out to determine which characteristics and outcomes of stroke are associated with COVID-19.MethodsThis case-control study included patients admitted with stroke to 13 hospitals in England and Scotland between 9 March and 5 July 2020. We collected data on 86 strokes (81 ischaemic strokes and 5 intracerebral haemorrhages) in patients with evidence of COVID-19 at the time of stroke onset (cases). They were compared with 1384 strokes (1193 ischaemic strokes and 191 intracerebral haemorrhages) in patients admitted during the same time period who never had evidence of COVID-19 (controls). In addition, the whole group of stroke admissions, including another 37 patients who appeared to have developed COVID-19 after their stroke, were included in two logistic regression analyses examining which features were independently associated with COVID-19 status and with inpatient mortality.ResultsCases with ischaemic stroke were more likely than ischaemic controls to occur in Asians (18.8% vs 6.7%, pConclusionsOur data suggest that COVID-19 may be an important modifier of the onset, characteristics and outcome of acute ischaemic stroke.

Recent extreme fire seasons in California have prompted utilities such as Pacific Gas and Electric to pre-emptively de-energize portions of the electrical grid during periods of extreme fire weather to reduce the risk of powerline-related fire ignitions. The policy was deployed in 2019, resulting in 12 million person-days of power outages and widespread societal disruption. Retrospective weather and vegetation moisture data highlight hotspots of historical risk across northern California. We estimate an average of 1.6 million person-days of de-energization per year, based on recent historical climate conditions and assuming publicly stated utility de-energization thresholds. We further estimate an additional 70% increase in the population affected by de-energization when vegetation remains abnormally dry later into autumn - suggesting that climate change will likely increase population vulnerable to de-energization. Adaptation efforts to curtail fire risk can be beneficial, but efforts to prepare affected populations, modernize the grid, and refine decision-making surrounding such policies have high potential to reduce the magnitude of negative externalities experienced during the 2019 de-energization events.

Free Neuropathology, Bd. 1 (2020)

La afirmación de que existe una relación causal entre la trata y la financiación del terrorismo se pone en duda por las escasas pruebas y datos de que disponemos, así como por sus problemáticas implicaciones políticas.

The lack of effective treatments for mitochondrial disease has seen the development of new approaches, including those that aim to stimulate mitochondrial biogenesis to boost ATP generation above a critical disease threshold. Here, we examine the effects of the peroxisome proliferator-activated receptor &gamma, (PPAR&gamma, ) activator pioglitazone (PioG), in combination with deoxyribonucleosides (dNs), on mitochondrial biogenesis in cybrid cells containing &gt, 90% of the m.3243A&gt, G mutation associated with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). PioG + dNs combination treatment increased mtDNA copy number and mitochondrial mass in both control (CON) and m.3243A&gt, G (MUT) cybrids, with no adverse effects on cell proliferation. PioG + dNs also increased mtDNA-encoded transcripts in CON cybrids, but had the opposite effect in MUT cybrids, reducing the already elevated transcript levels. Steady-state levels of mature oxidative phosphorylation (OXPHOS) protein complexes were increased by PioG + dNs treatment in CON cybrids, but were unchanged in MUT cybrids. However, treatment was able to significantly increase maximal mitochondrial oxygen consumption rates and cell respiratory control ratios in both CON and MUT cybrids. Overall, these findings highlight the ability of PioG + dNs to improve mitochondrial respiratory function in cybrid cells containing the m.3243A&gt, G MELAS mutation, as well as their potential for development into novel therapies to treat mitochondrial disease.

Precipitation forecasts made by Numerical Weather Prediction (NWP) models are typically verified using precipitation gauge observations that are often prone to the wind‐induced undercatch of solid precipitation. Therefore, apparent model biases in solid precipitation forecasts may be due in part to the measurements and not the model. To reduce solid precipitation measurement biases, adjustments in the form of transfer functions were derived within the framework of the World Meteorological Organization Solid Precipitation Inter‐Comparison Experiment (WMO‐SPICE). These transfer functions were applied to single‐Alter shielded gauge measurements at selected SPICE sites during two winter seasons (2015–2016 and 2016–2017). Along with measurements from the WMO automated field reference configuration at each of these SPICE sites, the adjusted and unadjusted gauge observations were used to analyze the bias in a Global NWP model precipitation forecast. The verification of NWP winter precipitation using operational gauges may be subject to verification uncertainty, the magnitude and sign of which varies with the gauge‐shield configuration and the relation between model and site‐specific local climatologies. The application of a transfer function to alter‐shielded gauge measurements increases the amount of solid precipitation reported by the gauge and therefore reduces the NWP precipitation bias at sites where the model tends to overestimate precipitation, and increases the bias at sites where the model underestimates the precipitation. This complicates model verification when only operational (non‐reference) gauge observations are available. Modelers, forecasters, and climatologists must consider this when comparing modeled and observed precipitation.

The Lunar Rover Convertible Mobility System (LRCMS) is a convertible chassis designed to be used for lunar missions into permanently shadowed regions (PSRs) of the moon, primarily consisting of steep lunar craters. This design utilizes flexible members called compliant mechanisms that replace typical joints and reduce abrasive dust build-up in the chassis. The compliant mechanisms allow the chassis to bend into different positions for both explicit point steering and Ackerman style steering. Inside the chassis, linear actuators are used to push/pull the chassis into the different steering configurations. Using SolidWorks simulations, the resilience of the chassis was tested under static forces, cyclic forces, and extreme thermal conditions. The results showed that the chassis will perform as desired. In addition to the simulations, physical testing plans have been designed to gauge the system’s endurance and capabilities.

Additional file 1: Supplementary Figure 1. Heatmap plot, showing expression of known genes implicated in the stages of Müllerian duct development (specification, invagination, elongation and differentiation) (Log2 cpm). Transcripts of known genes such as PAX2, LIM1 (LHX1), WNT4, DMRT1 were all present and enriched in the datasets.

Additional file 8.

Heart disease affects many and accounts for a large portion of deaths in the United States. Research into CFD modeling of the left ventricle (LV) can help gain an understanding in this dilemma. The purpose of this study was to examine two different heart models and compare the fluid dynamic alterations between the two. A two-dimensional model of a healthy mouse LV was simulated and processed to visualize the streamlines and vortices for comparison to a previous study performed by Dr. Maysam Mousaviraad on a healthy mouse LV with only one valve at the aorta for both inflow and outflow. The results show that the fluid flow was similar between the two cases for systole, yet the flow evolved differently during diastole. Afterwards, directions for future work in the field of fluid flow in mice hearts is briefly discussed.

Additional file 6: Supplementary Figure 6. RT-PCR analysis. Un-cropped gel images of RT-PCR analysis shown in Fig. 5b.

Additional file 7.

Supplemental material, sj-pdf-1-eso-10.1177_2396987316651759 for Clinical risk scores for predicting stroke-associated pneumonia: A systematic review by Amit K Kishore, Andy Vail, Benjamin D Bray, Angel Chamorro, Mario Di Napoli, Lalit Kalra, Peter Langhorne, Joan Montaner, Christine Roffe, Anthony G Rudd, Pippa J Tyrrell, Diederik van de Beek, Mark Woodhead, Andreas Meisel and Craig J Smith in European Stroke Journal

Supplemental material, sj-pdf-1-eso-10.1177_2396987316651759 for Clinical risk scores for predicting stroke-associated pneumonia: A systematic review by Amit K Kishore, Andy Vail, Benjamin D Bray, Angel Chamorro, Mario Di Napoli, Lalit Kalra, Peter Langhorne, Joan Montaner, Christine Roffe, Anthony G Rudd, Pippa J Tyrrell, Diederik van de Beek, Mark Woodhead, Andreas Meisel and Craig J Smith in European Stroke Journal

We describe the validation of the HERA Phase I software pipeline by a series of modular tests, building up to an end-to-end simulation. The philosophy of this approach is to validate the software and algorithms used in the Phase I upper limit analysis on wholly synthetic data satisfying the assumptions of that analysis, not addressing whether the actual data meet these assumptions. We discuss the organization of this validation approach, the specific modular tests performed, and the construction of the end-to-end simulations. We explicitly discuss the limitations in scope of the current simulation effort. With mock visibility data generated from a known analytic power spectrum and a wide range of realistic instrumental effects and foregrounds, we demonstrate that the current pipeline produces power spectrum estimates that are consistent with known analytic inputs to within thermal noise levels (at the 2 sigma level) for k > 0.2 h/Mpc for both bands and fields considered. Our input spectrum is intentionally amplified to enable a strong `detection' at k ~0.2 h/Mpc -- at the level of ~25 sigma -- with foregrounds dominating on larger scales, and thermal noise dominating at smaller scales. Our pipeline is able to detect this amplified input signal after suppressing foregrounds with a dynamic range (foreground to noise ratio) of > 10^7. Our validation test suite uncovered several sources of scale-independent signal loss throughout the pipeline, whose amplitude is well-characterized and accounted for in the final estimates. We conclude with a discussion of the steps required for the next round of data analysis., 32 pages, 20 figures. Submitted to the Astrophysical Journal

Among younger men who have sex with men (MSM), the incidence of HIV is rising nationally. Of the 281 persons who entered into care at a large HIV clinic in the southeastern United States in 2010 to 2012, 78 (27.8%) were

(1) Background: Patients with dysphagia are at increased risk of stroke-associated pneumonia. There is wide variation in the way patients are screened and assessed. The aim of this study is to explore staff opinions about current practice of dysphagia screening, assessment and clinical management in acute phase stroke. (2) Methods: Fifteen interviews were conducted in five English National Health Service hospitals. Hospitals were selected based on size and performance against national targets for dysphagia screening and assessment, and prevalence of stroke-associated pneumonia. Participants were purposefully recruited to reflect a range of healthcare professions. Data were analysed using a six-stage thematic process. (3) Results: Three meta themes were identified: delays in care, lack of standardisation and variability in resources. Patient, staff, and service factors that contribute to delays in dysphagia screening, assessment by a speech and language therapist, and delays in nasogastric tube feeding were identified. These included admission route, perceived lack of ownership for screening patients, prioritisation of assessments and staff resources. There was a lack of standardisation of dysphagia screening protocols and oral care. There was variability in staff competences and resources to assess patients, types of medical interventions, and care processes. (4) Conclusion: There is a lack of standardisation in the way patients are assessed for dysphagia and variation in practice relating to staff competences, resources and care processes between hospitals. A range of patient, staff and service factors have the potential to impact on stroke patients being assessed within the recommended national guidelines.

Special care dentistry (SCD) provides holistic oral service provision for people with complex health and care needs. These can include physical, sensory, intellectual, mental, medical, emotional or social impairment or disability or, more often, a combination of these factors. The level of disability within these population groups can vary, and a proportion of people will have multiple and overlapping impairments and/or medical conditions. This paper explores a number of possible research methods that may better reflect the diversity and challenges of this population group, where the emphasis is placed on co-production and co-design.

VISTA Collaboration and PISCES Group., [Introduction] Antibiotics used to treat post-stroke infections have differing antimicrobial and anti-inflammatory effects. Our aim was to investigate whether antibiotic class was associated with outcome after post-stroke infection., [Methods] We analyzed pooled individual participant data from the Virtual International Stroke Trials Archive (VISTA)-Acute. Patients with ischemic stroke and with an infection treated with systemic antibiotic therapy during the first 2 weeks after stroke onset were eligible. Antibiotics were grouped into eight classes, according to antimicrobial mechanism and prevalence. The primary analysis investigated whether antibiotic class for any infection, or for pneumonia, was independently associated with a shift in 90 day modified Rankin Scale (mRS) using ordinal logistic regression., [Results] 2,708 patients were eligible (median age [IQR] = 74 [65 to 80] y; 51% female; median [IQR] NIHSS score = 15 [11 to 19]). Pneumonia occurred in 35%. Treatment with macrolides (5% of any infections; 9% of pneumonias) was independently associated with more favorable mRS distribution for any infection [OR (95% CI) = 0.59 (0.42 to 0.83), p = 0.004] and for pneumonia [OR (95% CI) = 0.46 (0.29 to 0.73), p = 0.001]. Unfavorable mRS distribution was independently associated with treatment of any infection either with carbapenems, cephalosporins or monobactams [OR (95% CI) = 1.62 (1.33 to 1.97), p < 0.001], penicillin plus β-lactamase inhibitors [OR (95% CI) = 1.26 (1.03 to 1.54), p = 0.025] or with aminoglycosides [OR (95% CI) = 1.73 (1.22 to 2.46), p = 0.002]., [Conclusion] This retrospective study has several limitations including effect modification and confounding by indication. Macrolides may have favorable immune-modulatory effects in stroke-associated infections. Prospective evaluation of the impact of antibiotic class on treatment of post-stroke infections is warranted., The Open Access Publication Fund of Charité—Universitätsmedizin Berlin and Professor Meisel as corresponding author will provide funding to cover the open access publication/article processing fee.

BACKGROUND: Among patients with aortic stenosis who are at intermediate or high risk for death with surgery, major outcomes are similar with transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve replacement. There is insufficient evidence regarding the comparison of the two procedures in patients who are at low risk. METHODS: We randomly assigned patients with severe aortic stenosis and low surgical risk to undergo either TAVR with transfemoral placement of a balloon-expandable valve or surgery. The primary end point was a composite of death, stroke, or rehospitalization at 1 year. Both noninferiority testing (with a prespecified margin of 6 percentage points) and superiority testing were performed in the as-treated population. RESULTS: At 71 centers, 1000 patients underwent randomization. The mean age of the patients was 73 years, and the mean Society of Thoracic Surgeons risk score was 1.9% (with scores ranging from 0 to 100% and higher scores indicating a greater risk of death within 30 days after the procedure). The Kaplan-Meier estimate of the rate of the primary composite end point at 1 year was significantly lower in the TAVR group than in the surgery group (8.5% vs. 15.1%; absolute difference, -6.6 percentage points; 95% confidence interval [CI], -10.8 to -2.5; P

LLNL-CONF-771059 Hardened Electronics and Radiation Technology San Diego, CA, United States April 8, 2019 through April 12, 2019 We have developed a GEANT4 model of neutron detectors based on Bismuth Germanate (BGO) to improve understanding of their performance especially in their potential application to the detection of special nuclear materials. DTRA-NSERC U.S. Department of Energy, National Nuclear Security Administration DE-AC52-07NA27344

AimBlockade of the cytokine interleukin-1 (IL-1) with IL-1 receptor antagonist (IL-1Ra) is a candidate treatment for stroke entering phase II/III trials, which acts by inhibiting harmful inflammatory responses. Infection is a common complication after stroke that significantly worsens outcome and is related to stroke-induced deficits in systemic immune function thought to be mediated by the sympathetic nervous system. Therefore, immunomodulatory treatments for stroke, such as IL-1Ra, carry a risk of aggravating stroke-associated infection. Our primary objective was to determine if factors associated with antibody-mediated antibacterial defences were further compromised in patients treated with IL-1Ra after stroke.MethodsWe assessed plasma concentrations of immunoglobulin isotypes and complement components in stroke patients treated with IL-1Ra or placebo and untreated non-stroke controls using multiplex protein assays. Activation of the SNS was determined by measuring noradrenaline, a major SNS mediator.ResultsThere were significantly lower plasma concentrations of IgM, IgA, IgG1 and IgG4 in stroke-patients compared to non-stroke controls, however there were no differences between stroke patients treated with placebo or IL-1Ra. Concentrations of complement components associated with the classical pathway were increased and those associated with the alternative pathways decreased in stroke patients, neither being affected by treatment with IL-1Ra. Noradrenaline concentrations were increased after stroke in both placebo and IL-1Ra-treated stroke patients compared to non-stroke controls.ConclusionThese data show treatment with IL-1Ra after stroke does not alter circulating immunoglobulin and complement concentrations, and is therefore unlikely to further aggravate stroke-associated infection susceptibility through reduced availability of these key anti-microbial mediators.