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This study took a family systems perspective and tested spillover theory to examine the transmission of stress from parents to children during COVID-19. Using a longitudinal design with a 1-year interval, we tested the association between parent perceived stress and perceived child stress, and the sequential mediating effects of poor family functioning and parent–child closeness. The data comprised 134 parents residing in the US who were assessed from the initial first peak of COVID-19 infections in 2020 to 2021, 1 year later. Results indicated that when controlling for covariates, there was a significant association between parent perceived stress and perceived child stress. What is more, poor family functioning and parent–child closeness fully mediated the former link in sequence. These findings highlighted the need for improving family relationship quality when providing interventions that target families suffering in stressful contexts.

Patients with cancer are at high risk of malnutrition, yet relevant ICD-10 codes for malnutrition are underutilized in cancer clinics. Understanding oncologists' perspectives is crucial for optimizing malnutrition diagnosis codes and enhancing nutritional practices to improve patient care. This study aims to explore oncologists' perspectives on the use and feasibility of the ICD-10 codes for malnutrition.

Adolescent anxiety, depressive, and eating disorders are a worsening population health issue that primary care clinicians play a critical role in addressing. Implementing universal screening into clinical practices for depression at age 12 years and anxiety at age 8 years is the first step to diagnosis. Referencing 5th edition of the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria is essential to making the correct diagnosis after ruling out underlying medical conditions. The evidence-based mainstays of treatment are unique to each specific disorder.

Background Collection of high-quality videorecorded speech samples is essential for speech outcomes research.Solution Cleft palate team SLPs were trained to collect standard videorecorded speech samples in the clinic setting across 20 sites in North America. Standard training and equipment was provided.What We Did That is New Quality management procedures were developed and utilized to verify video quality and protocol adherence. Over 97% of speech samples collected by trained SLPs met defined quality standards.

Ni-Mn-Ga-based magnetic shape memory alloys can exhibit large magnetic field induced strains (MFIS). Recently, additive manufacturing techniques, especially laser powder bed fusion (L-PBF), have been successfully used to manufacture functional polycrystalline Ni-Mn-Ga with complex geometries, such as ‘bamboo-grained’ lattice structures. However, previous approaches of L-PBF of Ni-Mn-Ga have used pre-alloyed powders, which can limit the compositional freedom of the manufactured devices. This study explores, for the first time, the feasibility of an in-situ L-PBF alloying approach using a powder blend of elemental Ni, Mn, and Ga. Promising results were obtained despite the significant differences between the elemental Ni and Mn powders and the liquid Ga. The microstructure of the as-built sample showed distinct stripe patterns from the 14 M structure confirmed by XRD analysis. Heat-treatment significantly improved chemical homogeneity, dissolved the Ni-rich phase but couldn’t dissolve MnO hindering the shape memory effect.

Timely detection of endometrial carcinoma in Lynch syndrome patients ensures prompt treatment and appropriate cancer screening for the patient and impacted family members. While cervical cytology is utilized primarily in cervical cancer screening, endometrial glandular abnormalities can be identified as part of routine cervical cancer screening or during work-up for abnormal uterine bleeding.

IMPORTANCE: Understanding of the genetics of accessory atrioventricular pathways (APs) and affiliated arrhythmias is limited. OBJECTIVE: To investigate the genetics of APs and affiliated arrhythmias. DESIGN, SETTING, AND PARTICIPANTS: This was a genome-wide association study (GWAS) of APs, defined by International Classification of Diseases (ICD) codes and/or confirmed by electrophysiology (EP) study. Genome-wide significant AP variants were tested for association with AP-affiliated arrhythmias: paroxysmal supraventricular tachycardia (PSVT), atrial fibrillation (AF), ventricular tachycardia, and cardiac arrest. AP variants were also tested in data on other heart diseases and measures of cardiac physiology. Individuals with APs and control individuals from Iceland (deCODE Genetics), Denmark (Copenhagen Hospital Biobank, Danish Blood Donor Study, and SupraGen/the Danish General Suburban Population Study [GESUS]), the US (Intermountain Healthcare), and the United Kingdom (UK Biobank) were included. Time of phenotype data collection ranged from January 1983 to December 2022. Data were analyzed from August 2022 to January 2024. EXPOSURES: Sequence variants. MAIN OUTCOMES AND MEASURES: Genome-wide significant association of sequence variants with APs. RESULTS: The GWAS included 2310 individuals with APs (median [IQR] age, 43 [28-57] years; 1252 [54.2%] male and 1058 [45.8%] female) and 1 206 977 control individuals (median [IQR] year of birth, 1955 [1945-1970]; 632 888 [52.4%] female and 574 089 [47.6%] male). Of the individuals with APs, 909 had been confirmed in EP study. Three common missense variants were associated with APs, in the genes CCDC141 (p.Arg935Trp: adjusted odds ratio [aOR], 1.37; 95% CI, 1.24-1.52, and p.Ala141Val: aOR, 1.55; 95% CI 1.34-1.80) and SCN10A (p.Ala1073Val: OR, 1.22; 95% CI, 1.15-1.30). The 3 variants associated with PSVT and the SCN10A variant associated with AF, supporting an effect on AP-affiliated arrhythmias. All 3 AP risk alleles were associated with higher heart rate and shorter PR interval, and have reported associations with chronotropic response. CONCLUSIONS AND RELEVANCE: Associations were found between sequence variants and APs that were also associated with risk of PSVT, and thus likely atrioventricular reentrant tachycardia, but had allele-specific associations with AF and conduction disorders. Genetic variation in the modulation of heart rate, chronotropic response, and atrial or atrioventricular node conduction velocity may play a role in the risk of AP-affiliated arrhythmias. Further research into CCDC141 could provide insights for antiarrhythmic therapeutic targeting in the presence of an AP.

Limited reporting of Indigenous-led planetary health education programmes has constrained efforts to expand planetary health education, in Indigenous communities and beyond, despite urgent need. Although incorporation of Indigenous knowledge and cultures cannot be standardised, showcasing successful programmes could reveal good practices and aid replicability. In this Personal View, we highlight how shellfish toxin education programmes, designed and organised by the Sitka Tribe of Alaska, reduce local environmental health risks and support youth in pathways towards careers in planetary health. We describe how programmes build awareness and understanding of the local environment, environmental and health risks, and context-appropriate adaptation strategies by centring Tlingit culture and using hands-on activities that integrate Tlingit culture with western science. Lesson plans and resources created by Sitka Tribe of Alaska staff for these programmes are available in the US National Institute for Environmental Health Sciences Partnerships for Environmental Public Health resources web database.

Discovery of cancer risk variants in the sequence of the germline genome can shed light on carcinogenesis. Here we describe gene burden association analyses, aggregating rare missense and loss of function variants, at 22 cancer sites, including 130,991 cancer cases and 733,486 controls from Iceland, Norway and the United Kingdom. We identified four genes associated with increased cancer risk; the pro-apoptotic BIKfor prostate cancer, the autophagy involved ATG12for colorectal cancer, TGfor thyroid cancer and CMTR2for both lung cancer and cutaneous melanoma. Further, we found genes with rare variants that associate with decreased risk of cancer; AURKBfor any cancer, irrespective of site, and PPP1R15Afor breast cancer, suggesting that inhibition of PPP1R15A may be a preventive strategy for breast cancer. Our findings pinpoint several new cancer risk genes and emphasize autophagy, apoptosis and cell stress response as a focus point for developing new therapeutics.

The consumption of artificially sweetened beverages is on the rise. Use of artificial sweeteners has been associated with adverse health outcomes. There is a need to identify novel objective biomarkers of artificially sweetened beverages in order to improve dietary assessment and to provide insight into their metabolic impact.

AbstractNuclear forensics relies on different signatures to identify the source of nuclear material. Such signatures include crystalline structure, chemical composition, and particle morphology. One way to quantify morphology in electron microscope imagery is through image segmentation, where pixels are assigned to several partitions (or groups) that correspond to particles, grains, and other objects of interest within the image. Once pixels are assigned to segments, it is relatively straightforward to quantify other quantities of interest, such as grain size, circularity, etc. However, the range and diversity of microscope images make it difficult to obtain an accurate segmentation automatically. The accuracy of segmentation can be improved through supervised learning, but this requires many images to be manually segmented. Another way to improve the accuracy is to use interactive segmentation. Interactive segmentation requires a human to provide image-specific user input to improve performance. However, the amount of user input (effort) is generally far less than is required for supervised learning. In this paper, we investigate several parallelization strategies to automatically explore the user input parameter space of interactive segmentation algorithms across a large number of images. Specifically, we investigate four different parallelization mechanisms in a high-performance computing (HPC) environment and use the Amdahl fraction to evaluate efficiency on multiple processor cores across multiple nodes. Ultimately, the parallelization strategy that was most efficient utilized the message passing interface integrated with the segmentation and quantification code. This strategy had an Amdahl fraction of 0.985 and a performance of about 0.251 s/image. These results indicate that the parameter space of interactive segmentation algorithms can be efficiently explored using HPC. This opens the door to future work where user input is reduced and where interactive image segmentation algorithms are automatically applied to large image sets.

According to the most recent pulmonary hypertension (PH) guidelines, a main pulmonary artery (MPA) diameter > 25 mm on transthoracic echocardiography supports the diagnosis of PH. However, the size of the pulmonary artery (PA) may vary according to body size, age, and cardiac phases.

Integrative structural biology synergizes experimental data with computational methods to elucidate the structures and interactions within biomolecules, a task that becomes critical in the absence of high-resolution structural data. A challenging step for integrating the data is knowing the expected accuracy or belief in the dataset. We previously showed that the Modeling Employing Limited Data (MELD) approach succeeds at predicting structures and finding the best interpretation of the data when the initial belief is equal to or slightly lower than the real value. However, the initial belief might be unknown to the user, as it depends on both the technique and the system of study. Here we introduce MELD-Adapt, designed to dynamically evaluate and infer the reliability of input data while at the same time finding the best interpretation of the data and the structures compatible with it. We demonstrate the utility of this method across different systems, particularly emphasizing its capability to correct initial assumptions and identify the correct fraction of data to produce reliable structural models. The approach is tested with two benchmark sets: the folding of 12 proteins with coarse physical insights and the binding of peptides with varying affinities to the extraterminal domain using chemical shift perturbation data. We find that subtle differences in data structure (e.g., locally clustered or globally distributed), starting belief, and force field preferences can have an impact on the predictions, limiting the possibility of a transferable protocol across all systems and data types. Nonetheless, we find a wide range of initial setup conditions that will lead to successful sampling and identification of native states, leading to a robust pipeline. Furthermore, disagreements about how much data is enforced and satisfied rapidly serve to identify incorrect setup conditions.

Engineering educators prepare students for responsible, ethical, and socially aware engineering practice by contextualizingengineering in a variety of ways. Recently, ABET and the NAE have prioritized engineers' ability to make judgments considering a variety of contexts and specifically advocated for building engineers' contextual competencies. Educators can often agree that contextualizing engineering work and problems is beneficial, while taking different approaches to that contextualization. It is important for engineering educators to know how their modes of contextualization compare with others, as well as how they define and achieve success. This scoping literature review answers two research questions: How are engineering educators contextualizing engineering through their programs, courses, and pedagogies? And what are the justifications, motivations, or desired ends of engineering educators' contextualization? The original search yielded 500 articles from pertinent engineering education venues. After detailed exclusion and inclusion criteria were applied, 104 relevant articles were analyzed. These remaining articles were sorted into six modes of contextualization: context tools, professional skills, real‐world problems, design, sociotechnical thinking, and social impact. The categorization and analysis led to a complex understanding of the multiplicity of contextualization in engineering education. The wide variety of modes of contextualization results in a variety of bettering strategies, or ways that these forms of pedagogy can improve engineering education, and, in turn, larger engineering contexts. We conclude that engineering content and context are “interactional” and co‐constructed, showing how different modes of contextualization demarcate different images of what engineering content and contexts are and ought to be.

ABSTRACTThis study used responses from 17,354 student veterans on the Community College Survey of Student Engagement (CCSSE) to investigate the relationship between student engagement and likelihood of withdrawal. Student veterans who utilized campus services more often, and those who perceived campus services as important, reported a higher likelihood of withdrawing from classes. We also examined differences between non-veterans and student veterans in utilization of essential campus services. The two groups differed across campus service utilization, with the use of library services (lower for student veterans) and computer labs (lower for student veterans) representing the largest differences (d = .14, and .13 respectively). Along with findings, we present recommendations for future examination, policy, and campus practices.

This article contributes to the state of the art by gathering practitioners’ perspectives in terms of the challenges they face while aligning security and usability in the development of systems and services and prospects for future consideration and improvement in the state of the art.

Background: The treatment of failed ankle replacements is debated, and little is published about the medium- and long-term results of revision implants. We wanted to examine prosthesis survival and physical function at least 5 years after insertion of the Salto XT revision prosthesis.Methods: All consecutive patients operated with a Salto XT revision prosthesis underwent clinical and radiologic examinations preoperatively and after 3, 12, 24, and 60 months. Complications and reoperations are described, and changes in patient-reported outcome measures and clinical scores are reported.Results: Thirty patients were operated with a Salto XT revision prosthesis between March 2014 and March 2017. Three of these were revised (1 to a fusion and 2 to a new prosthesis), and 3 patients were reoperated with screw removal. A concurrent subtalar fusion was performed on 13 patients, and there was 1 case of likely nonunion after these procedures, but no reoperations. The mean AOFAS score increased from 39.2 (95% CI 30.8-47.5) preoperatively to 75.1 (95% CI 67.3-82.9) after 5 years, and the mean improvement was 34.2 points (95% CI 23.8-44.6). Mean EQ-5D increased from 0.36 (95% CI 0.30-0.42) preoperatively to 0.74 (95% CI 0.64-0.85) after 5 years, an improvement of 0.34 (95% CI 0.19-0.49). Radiolucent lines were present in all but 3 patients. Five-year prosthesis survival was 93% (83.6-100).Conclusion: This is the first study to present medium-term results of this implant. We found good improvement in outcome scores and good implant survival, but also a high prevalence of radiolucent lines.

Bicycles are a potential first-last mile mode that can augment the service area of public transit, yet it is difficult to fully account for bike-to-transit trips in planning and travel demand modeling processes. This paper presents a methodology for assessing bicycle first-last mile trips from one area to many possible areas using three visualizations on accessibility, travel times, and transit mode(s) utilized. Two configurations of bicycle first-last mile travel are considered: bringing the bicycle aboard transit to have the bicycle for biking at both ends of the trip (bike-transit-bike) and leaving the bike at the first stop (bike-transit-walk). Three locations in and near Atlanta, GA, U.S., are selected for analysis, and the optimal routes to all possible destinations in the transit service area are calculated for walk-transit-walk, bike-transit-walk, and bike-transit-bike. The walking and biking portions of trips are modeled using Dijkstra’s algorithm, and the transit portion is modeled using the round-based public transit optimized routing (RAPTOR) algorithm. Results indicate that bike-transit-bike and bike-transit-walk decrease travel and wait times for transit, and in many cases reduce the number of transfers required compared with walk-transit-walk. Transit services with higher travel speeds or frequencies, such as heavy rail, greatly increased the number of accessible destinations and reduced travel times. Thus, an origin’s distance to rail service had a major impact on the number of accessible TAZs. Planners and engineers can use this research to examine how public transit service changes and new cycling infrastructure can affect the accessibility of bike-transit trips.

Low knowledge sharing across disciplines studying geo-evolutionary processes determining species adaptations hinders the mitigation of biodiversity loss driven by human-induced climate warming. Further, the impacts of microbes and light regimes on species adaptations to accelerated climate warming are largely ignored. On a geologic timescale, range shifts to higher latitudes necessitate adaptation to new light environments, including extreme polar seasons, i.e., "polar night." Chemical crosstalk among coevolving microbes and plants modulates ecologically relevant traits, and photosensitive and other microbes may aid plant adaptation. We hypothesize that hybridization in new "circumpolar hybrid zones” and plant-microbial cooperation in those zones and elsewhere will be significant in maintaining genetic admixture and species diversity on a geological timescale. We propose the concept of circumpolar hybrid zones and an integrated framework, inclusive of microbes, to unite disparate research disciplines, advance understanding of evolution, and improve strategies for climate adaptation and mitigation.

Human genetic studies of common variants have provided substantial insight into the biological mechanisms that govern ovarian ageing1. Here we report analyses of rare protein-coding variants in 106,973 women from the UK Biobank study, implicating genes with effects around five times larger than previously found for common variants (ETAA1, ZNF518A, PNPLA8, PALB2and SAMHD1). The SAMHD1association reinforces the link between ovarian ageing and cancer susceptibility1, with damaging germline variants being associated with extended reproductive lifespan and increased all-cause cancer risk in both men and women. Protein-truncating variants in ZNF518Aare associated with shorter reproductive lifespan—that is, earlier age at menopause (by 5.61 years) and later age at menarche (by 0.56 years). Finally, using 8,089 sequenced trios from the 100,000 Genomes Project (100kGP), we observe that common genetic variants associated with earlier ovarian ageing associate with an increased rate of maternally derived de novo mutations. Although we were unable to replicate the finding in independent samples from the deCODE study, it is consistent with the expected role of DNA damage response genes in maintaining the genetic integrity of germ cells. This study provides evidence of genetic links between age of menopause and cancer risk.