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Purpose: Self-stigma occurs when a person internalizes and applies stereotypes, prejudice, and discrimination to themselves. For adults who stutter, selfstigma is linked to negative outcomes and reduced quality of life. The development of self-stigma in people who stutter is not well understood. The aim of this study is to evaluate stuttering self-stigma in school-age children and adolescents and explore potential relationships to stuttering's overall adverse impact. Method: One hundred one children and adolescents who stutter, aged 10-18 years, completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), a measure of adverse impact related to stuttering, and the Childhood Self-Stigma of Stuttering Scale (Child 4S), our novel adapted version of the Self-Stigma of Stuttering Scale (4S) created for this study. The Child 4S comprises three subscales measuring three stages of self-stigma: Awareness, Agreement, and Application. Each stage was evaluated for relationships with child age and the adverse impact of stuttering. Results: We found a range of self-stigma scores among children and adolescents who stutter. Child age did not correlate with Awareness and Agreement; however, older children and adolescents reported greater Application. All stages of self-stigma strongly predicted adverse impact as measured by the OASES, and latter stages of the model were stronger predictors than earlier stages. Conclusions: Children as young as 10 years old may experience stuttering selfstigma, and the application of self-stigma increases in adolescence, a critical period in the development of personal identity. Importantly, all stages of selfstigma predicted adverse impact related to stuttering, with latter stages being stronger predictors than earlier ones consistent with the progressive model of self-stigma being tested. The findings highlight the need for targeted, early intervention to mitigate downstream effects of stuttering self-stigma. [ABSTRACT FROM AUTHOR]

Social media play an important role in political communication, leading to growing concerns about the credibility of shared information. Attempts to slow the spread of misinformation by platforms such as Facebook and Twitter include adding fact-checking labels to social media posts, the effectiveness of which remains unclear. Using two experiments, we tested the credibility effects of fact-checking labels (confirmed vs. disputed) on graphical presentations of political (Democrat vs. Republican) quotes and social media news posts. Study 1 (N = 312) tested the effects of these labels on political social media posts with political quotes, and Study 2 (N = 356) replicated and extended this research to a news story post about a politician. Results indicate that the valence of verification labels on their own do not affect perceptions of the content. Instead, users find corrections of opposite-party political figures more credible and are more willing to share content when it negatively portrays opposite-party political figures. These results demonstrate potential limitations of fact-checking labels and highlight the importance of considering political ideology in correcting misinformation on social media sites. [ABSTRACT FROM AUTHOR]

Only 20% of the estimated 5 million species of insects on Earth are named and yet insects are poorly represented in protected area assessments, and insect declines are of concern globally. Here, we explore how to increase the discovery of new species and understanding of this group through analysis of 10,097 tropical rainforest bark beetles (Scolytinae) from eight different ecological studies between 2000 and 2018 in the Australian Wet Tropics. Of the 107 species identified, 58 are undescribed: an increase of 37% on the 156 species known from Australia. Rarefaction indicates doubling sampling would increase the number of species by 17. As hypothesised, new species are significantly smaller, less abundant and less widespread than described species making them more extinction‐prone than named species. Flight interception traps collected 84% of individuals and 98% of species confirming the effectiveness of a single sampling method for some beetles. Increased locations and collection from the canopy may sample further species rather than additional collecting methods. Scolytines are relatively well studied with taxonomists at the forefront of using modern methods to resolve formerly intractable groups. Hence, these new species are more likely to be named than others in many other beetle groups where taxonomy has largely stalled. To increase species description rates and to avoid most species becoming extinct before being named, we call on taxonomists to use new character systems provided by DNA methods and advances in the rapidly developing field of artificial intelligence. [ABSTRACT FROM AUTHOR]

Background: We investigated the effectiveness of Nurse‐Family Partnership (NFP), a prenatal‐to‐age‐two‐years home‐visiting programme, in British Columbia (BC), Canada. Methods: For this randomised controlled trial, we recruited participants from 26 public health settings who were: <25 years, nulliparous, <28 weeks gestation and experiencing socioeconomic disadvantage. We randomly allocated participants (one‐to‐one; computer‐generated) to intervention (NFP plus existing services) or comparison (existing services) groups. Prespecified outcomes were prenatal substance exposure (reported previously); child injuries (primary), language, cognition and mental health (problem behaviour) by age two years; and subsequent pregnancies by 24 months postpartum. Research interviewers were masked. We used intention‐to‐treat analyses. (ClinicalTrials.gov, NCT01672060.) Results: From 2013 to 2016 we enrolled 739 participants (368 NFP, 371 comparison) who had 737 children. Counts for child injury healthcare encounters [rate per 1,000 person‐years or RPY] were similar for NFP (223 [RPY 316.17]) and comparison (223 [RPY 305.43]; rate difference 10.74, 95% CI ‐46.96, 68.44; rate ratio 1.03, 95% CI 0.78, 1.38). Maternal‐reported language scores (mean, M [SD]) were statistically significantly higher for NFP (313.46 [195.96]) than comparison (282.77 [188.15]; mean difference [MD] 31.33, 95% CI 0.96, 61.71). Maternal‐reported problem‐behaviour scores (M [SD]) were statistically significantly lower for NFP (52.18 [9.19]) than comparison (54.42 [9.02]; MD ‐2.19, 95% CI −3.62, −0.75). Subsequent pregnancy counts were similar (NFP 115 [RPY 230.69] and comparison 117 [RPY 227.29]; rate difference 3.40, 95% CI ‐55.54, 62.34; hazard ratio 1.01, 95% CI 0.79, 1.29). We observed no unanticipated adverse events. Conclusions: NFP did not reduce child injuries or subsequent maternal pregnancies but did improve maternal‐reported child language and mental health (problem behaviour) at age two years. Follow‐up of long‐term outcomes is warranted given that further benefits may emerge across childhood and adolescence. [ABSTRACT FROM AUTHOR]

Understanding how community assembly processes drive biodiversity patterns is a central goal of community ecology. While it is generally accepted that ecological communities are assembled by both stochastic and deterministic processes, quantifying their relative importance remains challenging. Few studies have investigated how the relative importance of stochastic and deterministic community assembly processes vary among taxa and along gradients of habitat degradation. Using data on 1645 arthropod species across seven taxonomic groups in Malaysian Borneo, we quantified the importance of ecological stochasticity and of a suite of community assembly processes across a gradient of logging intensity. The relationship between logging and community assembly varied depending on the specific combination of taxa and stochasticity metric used, but, in general, the processes that govern invertebrate community assembly were remarkably robust to changes in land use intensity. [ABSTRACT FROM AUTHOR]

A male infant born in a tertiary maternity facility was noted to have microretrognathia, a small mouth and macroglossia at delivery. He was born limp and apnoeic and required multiple attempts at intubation before a definitive airway was eventually sited. Chest X-rays, while in the paediatric intensive care unit, demonstrated dysplastic ribs with associated ’high-riding’ clavicles. A later X-ray was reported as showing interrupted posterior ribs. A tracheostomy was formed on day of life 9 given the immediate risk to the baby’s airway. Further imaging of the facial bones, skull and brain showed generous CSF spaces over the cerebral convexities and also marked hypoplasia of the mandible and mid-face. The baby’s middle ear cavities were shown to be completely opacified. Genetic testing eventually went on to confirm a diagnosis of cerebrocostomandibular syndrome, with the detection of a pathogenic variant of the small nuclear ribonucleoprotein polypeptide B gene. [ABSTRACT FROM AUTHOR]

Insects are posited to be declining globally. This is particularly pertinent in tropical forests, which exhibit both the highest levels of biodiversity and the highest rates of biodiversity loss. However, for the hyper-diverse tropical insects there are scant data available to evidence declines. Understanding tropical insect diversity and its response to environmental change has therefore become a challenge, but it is estimated that 80% of tropical insect species remain undescribed 1. Insect biodiversity predictions are based mostly on well-studied taxa and extrapolated to other groups, but no one knows whether resilience to environmental change varies between undescribed and described species. Here, we collected staphylinid beetles from unlogged and logged tropical forests in Borneo and investigated their responses to environmental change. Out of 252 morphospecies collected, 76% were undescribed. Undescribed species showed higher community turnover, reduced abundance and decreased probability of occurrence in logged forests. Thus the unknown components of tropical insect biodiversity are likely more impacted by human-induced environmental change. If these patterns are widespread, how accurate will assessments of insect declines in the tropics be? Boyle et al. present a case study to demonstrate that the unknown components of tropical insect biodiversity are likely those that are more greatly impacted by environmental change. The authors ask the question: given that an expected 80% of tropical insects remain undescribed, how accurate will assessments of insect declines in the tropics be? [ABSTRACT FROM AUTHOR]

INTRODUCTION: The advent of non-governmental crewed commercial spaceflight and efforts to send astronauts beyond low earth orbit introduce new medical risks that must be considered in the design of future vehicles. Shock is a significant risk which is more likely to develop in commercial crew with more comorbidities, and in any astronaut on a longer-duration mission further from definitive care. Atmospheric reentry is a particularly hazardous phase of flight for a patient in shock due to the deleterious effects of reentry acceleration on cerebral perfusion. G-induced loss of consciousness (GLOC) occurs when arterial pressure at the brain becomes so low that cerebral perfusion ceases, which, when prolonged, could cause permanent neurologic injury. For this reason it is important to understand the implications of crew positioning during high-G maneuvers. This work establishes limitations on G tolerance and seatback angles for crew members in shock. METHODS: Using validated models, max G tolerances were determined for hypotensive patients with varying heart-level mean arterial pressures (MAPs) and seatback angles. Seatback angles from 0 to 75 degrees from vertical were assessed for the 1st percentile to 99th percentile of the US male and female population. RESULTS: For patients with a MAP of 65 at the heart, maximum tolerable Gz at 75 degrees seatback angle was 10.6 and 7.8 for the 1st percentile female and the 99th percentile male respectively, which decreased to 2.8 and 2.0 at 0 degrees (vertical). For a MAP of 50, maximum tolerable Gz at 75 degrees seatback angle was 8.2 and 6 for the 1st percentile female and the 99th percentile male, which decreased to 2.1 and 1.6 at 0 degrees. DISCUSSION: These results demonstrate that hypotensive patients are particularly vulnerable to neurological injury during reentry. The degree of mitigation depends both on the acceleration vector relative to the vehicle, as well as crew member orientation within the vehicle. This has significant implications for future vehicle design, as return trajectories from the Moon and Mars will experience significant acceleration forces on reentry. For SpaceX's Starship design, reentry accelerations are near-perpendicular to launch accelerations, potentially precluding a single optimized seat orientation. As commercial and exploration-class spaceflight expands, the increased probability of adverse medical events means that engineers must consider these limitations in vehicle design. Learning Objectives 1. The audience will learn about the physiology of G-LOC and the influence of spaceflight on crew susceptibility to GLOC. 2. The audience will learn about the physical modeling methods used to determine G-LOC. 3. The audience will learn about the implications of hypotension and reentry G-forces for commercial spaceflight. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Imaging is central to modern diagnostics, yet to date only ultrasound has been utilized in spaceflight. Advancing the level of care on exploration-class missions and permanent off-world habitats will likely require advanced imaging capabilities to reduce medical risk. The NASA IMPACT tool suite was designed for exploration-class mission probabilistic risk assessment and trade space analysis. Its associated IMPACT Condition List (ICL) includes 120 inflight medical conditions of high concern as established by flight and terrestrial data as well as expert opinion. This study evaluated the clinical utility of ultrasound (US) and radiography (XR) for the diagnosis and management of each of the ICL conditions to identify the conditions for which XR would add value. METHODS: For each condition, two reviewers performed a rapid systematic literature review of professional society guidelines and applied subject matter expertise and clinical experience to semi-quantitatively score the utility of US and XR for both diagnosis and management. Diagnostic utility of a modality for a condition was evaluated for the most common clinical presentation(s) of said condition as well as the worst-case scenario and its sequelae as defined by the ICL. Evidence tracing and quality of evidence scores were also recorded. RESULTS: Of the 120 ICL conditions, XR diagnostic utility surpasses that of US for 14 (12%) and provides complementary capabilities for an additional 29 conditions (24%). For condition management, XR utility surpasses US for 13 conditions (13%) and provides complementary capabilities for an additional 16 conditions (13%). DISCUSSION: Radiography provides diagnostic and management capabilities that surpass or complement ultrasound for over one third of medical conditions of greatest concern on exploration class missions. Specifically, XR provides superior diagnostic ability for conditions involving bony injuries, particularly to the axial skeleton, dental conditions, and certain diseases of the lung parenchyma, among others. It provides superior capability for management of conditions requiring orthopedic reductions, endotracheal tube placement, and drain placement confirmation. This analysis suggests future exploration class missions may consider augmenting the medical system with portable radiography if resource constraints allow, and future work should attempt to quantify the risk reduction provided by this capability. Learning Objectives 1. Understand the overall degree of utility of imaging in diagnosis and management of the conditions on the IMPACT conditions list. 2. Understand the medical conditions of highest concern on exploration class missions for which radiography provides complementary or superior capabilities compared to ultrasound. [ABSTRACT FROM AUTHOR]