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Still rebounding from the impact of the global pandemic, the higher education sector is being challenged even further by the next wave of Artificial Intelligence (AI) technologies. These technologies have the power to generate in a matter of seconds, quality text, images, music and coding responses to questions or prompts entered into an online chat box. Currently, one of the most accessible and popular text generators is OpenAI's ChatGPT which was released in November 2022. Early evaluation indicates that the quality of the responses exceed standard pass rates for comparable university assessments. Even if academic protocols mandate that text cited from AI sources should be acknowledged and referenced as any other source material, the speed, accessibility and high quality of the AI material justifies a rethink of the purpose of higher education and a redesign of curriculum, pedagogy and assessment. An initial suggestion being promoted in the sector is that learning outcomes and assessments should move away from a focus on content memorisation and recall, to development of higher order thinking skills such as critical analysis, evaluation, resilience, creativity, problem solving, appraising and mastery of verbal communication and computer literacy. This preliminary paper examines some of the literature to date, which discusses potential risks and threats, as well as the opportunities to enhance learning, embedded in this new wave of emerging AI technologies in higher education.

Although the ideals of higher education promote learning and personal growth irrespective of an individual's social identity including their perceived or declared race, systemic racism continues to subject Indigenous, Black, and otherwise racialized students, staff, and faculty to unwelcoming academic cultures and, at times, hostilities. The aim of this rapid scoping review was to identify and analyze some of the available peer-reviewed, published research literature between 2000 and 2022 focused on systemic racism in the Canadian higher education context. The authors analyzed 32 articles included in the scoping review to identify the theoretical frameworks used to situate each study. In addition, the analysis surfaced concepts related to how systemic racism is structured and enacted. Using a thematic analysis, a narrative summary is also presented to describe the experiences of Indigenous and racialized staff, students, and faculty. This study offers insight to those committed to building healthier academic communities through understandings of systemic racism as it is theoretically framed, conceptualized, and experienced.

As an epistemological, axiological, and methodological paradigm, Critical Race Theory (CRT; Crenshaw et al., 2000; Harris, 1993) is a scholarly tool to identify and disrupt inequities, possible via CRT's core tenets towards troubling systemic racism. We argue that political movements in North Carolina (NC) exhibit attempts to delegitimize critical race scholarship and curricula that accurately portray history and contemporary student populations' racialized experiences, a manifestation of the conservative agenda to whitewash the state's history that is predicated on racism and white supremacy. In alignment with radical theorizations and research that examine ideologies at the root of ill-informed hysteria, we present a Critical Discourse Analysis (CDA) of the effects of political power in foreclosing educational possibilities toward building equitable societies through our analysis of data from NC's Fairness and Accountability in the Classroom for Teachers and Students for North Carolinian "FACTS" submissions (Robinson, 2021). FACTS is a reporting tool targeting NC educators who employ critical lenses in their instruction that promotes unfounded antagonism toward CRT. The significance of this research is a localized example of CRT being targeted by conservative politicians toward the intent of delegitimizing critical scholarship and education and thus perpetuating ahistorical ideals rooted in racism and white supremacy.

Before the COVID-19 outbreak, universities were already exploring the potential of online education. Colleges and universities throughout the world became more reliant on online learning management systems (LMSs) and videoconferencing tools like "Zoom" and "Microsoft Teams" during the 2020-2021 campus' lockdowns. The transition from traditional face-to-face teaching to online learning presented significant difficulties for universities, particularly those that depended heavily on international students. The project reported in this paper was undertaken in Australia in 2021 at the request of a private higher education institution. A new student-centric version of the Moodle learning management system (LMS) was created to maximise the platform's pedagogical, communicative, and informational capabilities. The purpose of this article is to demonstrate how online learning platforms that are flexible, utilise embedded interactive features and resources, and are freely available can enhance and support the delivery of quality online education. The paper discusses how well-designed learning management systems have the capacity to motivate, engage and retain students in online learning. Academics, at both the undergraduate and graduate levels, as well as those working in curriculum development and information technology at institutions of higher learning, may find this article to be of interest and value.

The rapid spread of the COVID-19 pandemic in the first half of 2020 disrupted and changed higher education across the world, and into the future. Campuses were shut down, almost overnight. International and State borders were closed and business models that relied heavily on high-paying international students collapsed. University leaders and academics were forced to find new ways of attracting, engaging with, and retaining students. This paper describes a project that was undertaken in Australia in 2021 which investigated the implications of, and scope for online assessment in this "new virtual world" of learning and teaching in higher education. After extensive research and consultation, the project developed a Digital Assessment Framework dubbed DASH C21, which stands for Digital Assessment Stretching Horizons for the 21st Century. The Framework is based on a set of underpinning principles and values; the Inputs. The Inputs feed into four Dimensions. These Dimensions are Practices and Pedagogies, Strategies, Emerging Technologies and Stretching Horizons. The Outputs are a series of authentic, innovative, experiential and forward looking, digital assessments, reinforced by academic integrity values. This paper will be of particular interest to higher education senior managers, academics, learning and teaching specialists, staff professional developers and curriculum designers.

This article explores the interplay between perceived employability (PE), mental health, and equity group membership amongst students at a large public urban university in Australia. The article reports from a study conducted between 2017 and 2022, during which students self-assessed their PE. Differences in PE by equity group membership were assessed using responses to structured fields in the questionnaire (n = 24,329). Custom measures were constructed using student responses to open-ended fields to proxy student wellbeing based on sentiment analysis and mention of mental health or synonymous terms (n = 12,819). Analyses included two-way tests of differences between groups and multivariate analyses considering the effect of equity group membership and mental health concerns on employability beliefs. Results indicate that students with a disability, with English as a second language, or with wellbeing concerns report lower perceived employability. Of all the PE dimensions, academic self-efficacy is most consistently affected by equity group membership and wellbeing concerns. Further, wellbeing concerns are more prevalent for students with disabilities. The findings strengthen support for policy and institutional initiatives focusing on student wellbeing in general but also specifically for equity groups that are already associated with poorer employability beliefs. In particular, students with disabilities appear to have poorer self-esteem and academic self-efficacy and are more likely to have mental health concerns.

Objective: Growing evidence suggests digital interventions may provide neurocognitive benefits for children with ADHD. This study aimed to investigate the efficacy of a digital attention intervention in children with ADHD. Method: In this double-blind randomized controlled trial 55 children with ADHD (5-9 years) were allocated to the intervention (N=28) or control program (N=27). Both programs were delivered via touchscreen tablets at home 5 days a week for 5 weeks. The primary outcome was change in the Test of Variables of Attention (TOVA) Attention Comparison Score (ACS) from pre- to post-intervention. Results: Participants who received the intervention had significantly greater improvements in the TOVA ACS from pre- to post-intervention than those in the control (p<0.044). No intervention effects were observed on secondary outcomes assessing executive functioning, ADHD symptoms, or functional impairment. Conclusion: Collectively these findings provide insufficient evidence for the implementation of digital attention interventions for children with ADHD.

Teachers' expectations of student capabilities can meaningfully affect future achievement. However, the consistency of teachers' expectations over time and their differential impact by student gender and ethnicity have not been thoroughly investigated in the context of students' reading achievement. The current study investigates the longitudinal influence of teacher expectancy effects on student achievement through a novel measurement approach that considers classroom context while drawing on cognitive assessments and teacher ratings collected through the large, nationally representative Early Childhood Longitudinal Study-Kindergarten data set (N = 8,503 students). Results of the autoregressive cross-lagged models with five time points between kindergarten and eighth grade indicate teachers' expectations of students' reading achievement are not significantly associated from one time point to the next, though their effects increase over time. Significant differences in longitudinal expectancy effects based on student gender and ethnicity were not found. Implications for teaching practice based on these results are discussed.

BackgroundGestational nutrition can protect against adverse neurodevelopmental outcomes.ObjectivesWe developed a short tool for collecting maternal nutritional intake during pregnancy to facilitate research in this area and compared its retrospective use to prospectively-collected food frequency questionnaires (FFQ).MethodsMaternal nutritional intake was retrospectively assessed using three versions (full interview, full self-administered online, and shortened interview) of the Early Life Exposure Assessment Tool (ELEAT) among participants of the MARBLES pregnancy cohort study of younger siblings of autistic children. Retrospective responses were compared with responses to supplement questions and the validated 2005 Block FFQ prospectively collected in MARBLES during pregnancies 2-7 years prior. ELEAT nutrient values were calculated using reported food intake frequencies and nutrient values from the USDA nutrient database. Correlations between retrospectively- and prospectively-reported intake were evaluated using Kappa coefficients, Youden's J, and Spearman Rank Correlation Coefficients (rs).ResultsMARBLES FFQ dietary intakes were compared among 54 women who completed the ELEAT full form including 12 online, and among 23 who completed the ELEAT short form. Correlations across most foods were fair to moderate. Most ELEAT quantified nutrient values were moderately correlated (rs = 0.3-0.6) with those on the Block FFQ. Supplement questions in both MARBLES and the ELEAT were completed by 114 women. Kappas were moderate for whether or not supplements were taken, but modest for timing. Correlations varied by version and child diagnosis or concerns, and were higher when mothers completed the ELEAT when their child was 4 years old or younger.ConclusionsWith recall up to several years, ELEAT dietary and supplement module responses were modestly to moderately reliable and produced nutrient values moderately correlated with prospectively-collected measures. The ELEAT dietary and vitamin supplements modules can be used to rank participants in terms of intake of several nutrients relevant for neurodevelopment.

The number of school-aged students with diverse linguistic and cultural backgrounds is increasing across the United States. This survey identifies strategies school nurses use for communicating to families with limited English proficiency and describes recommendations to improve language needs. The online survey was completed by K-12 school nurses and data were analyzed using descriptive statistics. Among the 52 participants, only 23% (n = 12) indicated that resources they were currently using to interpret health information always met their language needs, with the most common resource described as school personnel who can speak the language needed for interpretation. To improve communication, most (73%; n = 38) participants described preferences for in-person resources and estimated that if on-demand interpreter resources were readily available, they would use on-demand resources for approximately 3.6 hours per week. By improving linguistic and cultural competencies among students and families with limited English proficiency, school nurses can improve student health outcomes.

Children with autism spectrum disorder (ASD) report high rates of sleep problems. In 2012, the Autism Treatment Network/Autism Intervention Research Network on Physical Health (ATN/AIR-P) Sleep Committee developed a pathway to address these concerns. Since its publication, ATN/AIR-P clinicians and parents have identified night wakings as a refractory problem unaddressed by the pathway. We reviewed the existing literature and identified 76 scholarly articles that provided data on night waking in children with ASD. Based on the available literature, we propose an updated practice pathway to identify and treat night wakings in children with ASD.

BACKGROUND: The US Department of Agriculture's (USDA) summer meal programs are designed to provide meals at no cost while school is out of session. In response to the COVID-19 pandemic, several regulatory waivers were enacted to facilitate meal distribution. The aim of this study was to assess the rates of meal distribution before and after these waivers were in effect. METHODS: Meal distribution patterns for 2019, 2020, and 2021 were examined through (1) a descriptive comparison of the number of participating districts, sponsors, meal sites, and meals distributed statewide; and (2) repeated measures ANOVAs to examine changes among districts in operation all years. RESULTS: The waivers were associated with an increase in the total number of participating districts, sponsors, and meal sites; an increase in the total number of meals distributed to children during the summer months; and an increase in meal distribution among sponsors that had been in place since 2019. Conclusion: Expanding the area eligibility criteria and enabling flexibility in meal distribution methods increased the number of meals provided. This study provides important preliminary evidence to suggest that the USDA should consider permanent regulatory changes to this program to maximize its reach.

Moderating the intensity and expression of our emotions is necessary for successful engagement in learning. This systematic review explored, "what are schools doing to support autistic children and young people to develop their emotion regulation skills?" Critical analyses considered the inclusiveness of interventions and whether/how autistic pupils were asked about their participation. PsycINFO, Web of Science (Core Collection) and ERIC were searched on 18 July 2022. Eight studies were included, incorporating 419 autistic pupils, aged three to 17, from at least 955 schools in the USA, Australia and France. A narrative synthesis was used to provide an overview of the literature. Seven different approaches to emotion regulation were utilised, and only one was used in the school prior to the research. Forty out of 419 autistic pupils were asked for their views of the intervention they received. There is a lack of research considering school-led approaches to embedding emotion regulation skill development in everyday school practices and a lack of involvement of autistic pupil's views about emotion-regulation interventions. More research is needed to enable educational professionals to provide evidence-informed support for autistic pupils to develop their emotion regulation skills.

The dearth of historically underrepresented minorities (URMs) in science, technology, engineering, and mathematics (STEM) faculty positions is one of the most significant challenges in higher education in the U.S. Increasing underrepresented groups' success in academia through achieving and retention in tenure-track faculty roles has been the central goal of the National Science Foundation's (NSF) Alliances for Graduate Education and the Professoriate (AGEP) program. In the present study, we draw on organizational change theories in higher education reform and interpret the landscape of AGEP project alliances through mapping their theories of change, barriers to success, levels of change, and foci of change, based on semistructured interviews with 17 AGEP alliances' core teams. Our mapping reveals local structures as well as interesting patterns across AGEP alliances that inform national trends. We identify alignment and misalignment between our analysis frameworks and AGEP projects which amplifies contemporary questions of providing direct student support within a deficit mindset context as well as sustainability and scalability for both the AGEP community and the broader community of diversifying STEM.

The COVID-19 pandemic drastically affected higher education and higher education students around the world, but few studies of college students' experiences during the COVID-19 pandemic have been conducted in Latin America. This study describes the COVID-19-related experiences and perspectives of Peruvian college students. We surveyed 3,427 full-time college students (average age: 23 years) attending a multi-campus Peruvian university in fall 2020. Participants were recruited through the digital platform of the learning management system at their university, email, and social media. We asked participants how they were managing risks related to COVID-19; the continuity of social, educational, and work activities; and the psychological and economic impacts of the pandemic on their lives. Since March 2020, 73.0% of participants reported COVID-19-related symptoms, but only 33.9% were tested for COVID-19. During the national quarantine imposed by the Peruvian government (March 15-June 30, 2020), 64.3% of participants remained in their house. Furthermore, while 44.0% of participants were working in February 2020 (95% CI: [41.7%, 46.4%]), only 23.6% (95% CI: [21.7%, 25.7%]) were working immediately after the pandemic began (i.e., at the end of April 2020). Participants were more stressed about the health and educational implications of COVID-19 for Peruvian society and their families than about themselves. The public health, economic, and educational implications of COVID-19 on college students are continuing to unfold. This study informed Peruvian higher education institutions' continued response to the COVID-19 pandemic, the progressive return to postpandemic activities, as well as other future pandemics and other crises.

Diamond-like Carbon (DLC) has been used as a coating material of choice for a variety of technological applications owing to its favorable bio-tribo-thermo-mechanical characteristics. Here, the possibility of bringing DLC into orthopedic joint implants is examined. With ever increasing number of patients suffering from osteoarthritis as well as with the ingress of the osteoarthritic joints malaise into younger and more active demographics, there is a pressing need to augment the performance and integrity of conventional total joint replacements (TJRs). Contemporary joint replacement devices use metal-on-polymer articulations to restore function to worn, damaged or diseased cartilage. The wear of polymeric components has been addressed using crosslinking and antioxidants; however, in the context of the metallic components, complications pertaining to corrosion and metal ion release inside the body still persist. Through this review article, we explore the use of DLC coatings on metallic bearing surfaces and elucidate why this technology might be a viable solution for ongoing electrochemical challenges in orthopedics. The different characteristics of DLC coatings and their feasibility in TJRs are examined through assessment of tribo-material characterization methods. A holistic characterization of the coating-substrate interface and the wear performance of such systems are discussed. As with all biomaterials used in TJRs, we need mindful consideration of potential in-vivo challenges. We present a few caveats for DLC coatings including delamination, hydrophobicity, and other conflicting as well as outdating findings in the literature. We recommend prudently exploring DLC films as potential coatings on metallic TJR components to solve the problems pertaining to wear, metal ion release, and corrosion. Ultimately, we advise bringing DLC into clinical use only after addressing all challenges and concerns outlined in this article.

Estimates of the spectrum and frequency of pathogenic variants in Parkinsons disease (PD) in different populations are currently limited and biased. Furthermore, although therapeutic modification of several genetic targets has reached the clinical trial stage, a major obstacle in conducting these trials is that PD patients are largely unaware of their genetic status and, therefore, cannot be recruited. Expanding the number of investigated PD-related genes and including genes related to disorders with overlapping clinical features in large, well-phenotyped PD patient groups is a prerequisite for capturing the full variant spectrum underlying PD and for stratifying and prioritizing patients for gene-targeted clinical trials. The Rostock Parkinsons disease (ROPAD) study is an observational clinical study aiming to determine the frequency and spectrum of genetic variants contributing to PD in a large international cohort. We investigated variants in 50 genes with either an established relevance for PD or possible phenotypic overlap in a group of 12 580 PD patients from 16 countries [62.3% male; 92.0% White; 27.0% positive family history (FH+), median age at onset (AAO) 59 years] using a next-generation sequencing panel. Altogether, in 1864 (14.8%) ROPAD participants (58.1% male; 91.0% White, 35.5% FH+, median AAO 55 years), a PD-relevant genetic test (PDGT) was positive based on GBA1 risk variants (10.4%) or pathogenic/likely pathogenic variants in LRRK2 (2.9%), PRKN (0.9%), SNCA (0.2%) or PINK1 (0.1%) or a combination of two genetic findings in two genes (∼0.2%). Of note, the adjusted positive PDGT fraction, i.e. the fraction of positive PDGTs per country weighted by the fraction of the population of the world that they represent, was 14.5%. Positive PDGTs were identified in 19.9% of patients with an AAO ≤ 50 years, in 19.5% of patients with FH+ and in 26.9% with an AAO ≤ 50 years and FH+. In comparison to the idiopathic PD group (6846 patients with benign variants), the positive PDGT group had a significantly lower AAO (4 years, P = 9 × 10-34). The probability of a positive PDGT decreased by 3% with every additional AAO year (P = 1 × 10-35). Female patients were 22% more likely to have a positive PDGT (P = 3 × 10-4), and for individuals with FH+ this likelihood was 55% higher (P = 1 × 10-14). About 0.8% of the ROPAD participants had positive genetic testing findings in parkinsonism-, dystonia/dyskinesia- or dementia-related genes. In the emerging era of gene-targeted PD clinical trials, our finding that ∼15% of patients harbour potentially actionable genetic variants offers an important prospect to affected individuals and their families and underlines the need for genetic testing in PD patients. Thus, the insights from the ROPAD study allow for data-driven, differential genetic counselling across the spectrum of different AAOs and family histories and promote a possible policy change in the application of genetic testing as a routine part of patient evaluation and care in PD.

Glucagon plays a central role in amino acid (AA) homeostasis. The dog is an established model of glucagon biology, and recently, metabolomic changes in people associated with glucagon infusions have been reported. Glucagon also has effects on the kidney; however, changes in urinary AA concentrations associated with glucagon remain under investigation. Therefore, we aimed to fill these gaps in the canine model by determining the effects of glucagon on the canine plasma metabolome and measuring urine AA concentrations. Employing two constant rate glucagon infusions (CRI) - low-dose (CRI-LO: 3 ng/kg/min) and high-dose (CRI-HI: 50 ng/kg/min) on five research beagles, we monitored interstitial glucose and conducted untargeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) on plasma samples and urine AA concentrations collected pre- and post-infusion. The CRI-HI induced a transient glucose peak (90-120 min), returning near baseline by infusion end, while only the CRI-LO resulted in 372 significantly altered plasma metabolites, primarily reductions (333). Similarly, CRI-HI affected 414 metabolites, with 369 reductions, evidenced by distinct clustering post-infusion via data reduction (PCA and sPLS-DA). CRI-HI notably decreased circulating AA levels, impacting various AA-related and energy-generating metabolic pathways. Urine analysis revealed increased 3-methyl-l-histidine and glutamine, and decreased alanine concentrations post-infusion. These findings demonstrate glucagons glucose-independent modulation of the canine plasma metabolome and highlight the dogs relevance as a translational model for glucagon biology. Understanding these effects contributes to managing dysregulated glucagon conditions and informs treatments impacting glucagon homeostasis.

Introduction: In the United States, more chronic and preventive healthcare is being delivered in the emergency department (ED) setting. Understanding the availability of preventive health services in the ED setting is crucial. Our goal was to understand the availability of a subset of preventive health services in US EDs and explore how that has changed over time.Methods: In 2022–2023, using the National Emergency Department Inventory (NEDI)-USA, we surveyed a random 20% (1,064) sampling of all 5,613 US EDs. We asked directors of these EDs about the availability of and preference for 12 preventive health services, social worker availability, self-reported percentage of uninsured ED patients, and measures of ED crowding. We also asked about perceptions of barriers to implementing preventive health services in the ED. We used unadjusted and multivariable logistic regression models to compare service frequency in 2022–2023 to prior findings from 2008–2009 that represented a 5.7% random sampling of all EDs.Results: Among 302 responders to the 2022–2023 survey (5.4% random sampling, 28.4% response rate), 94% reported offering at least one preventive health service, with a median of five services. The most common service offered was intimate partner violence screening (83%), while the least common was routine HIV screening (19%). Seven services (eg, intimate partner violence, alcohol risk, and smoking cessation screening) had a higher odds of being offered in 2022–2023 than in 2008–2009; findings were unchanged in sensitivity analyses. A small proportion of directors opposed offering preventive health services. However, many expressed concerns that preventive health services in the ED would lead to longer lengths of stay (56%), increased costs to their ED (58%), a diversion of staff time from providing acute care (50%), or that their patients would not have access to adequate follow-up (49%).Conclusion: Nearly all EDs offer at least one preventive health service. Many offer multiple services; rates were higher than those identified in 2008–2009, in both unadjusted and multivariable models. Although limited by the response rate, this work provides the most recent and comprehensive snapshot of the type and frequency of a subset of preventive health services currently offered in US EDs.

Neurocognitive aging researchers are increasingly focused on the locus coeruleus, a neuromodulatory brainstem structure that degrades with age. With this rapid growth, the field will benefit from consensus regarding which magnetic resonance imaging (MRI) metrics of locus coeruleus structure are most sensitive to age and cognition. To address this need, the current study acquired magnetization transfer- and diffusion-weighted MRI images in younger and older adults who also completed a free recall memory task. Results revealed significantly larger differences between younger and older adults for maximum than average magnetization transfer-weighted contrast (MTC), axial than mean or radial single-tensor diffusivity (DTI), and free than restricted multi-compartment diffusion (NODDI) metrics in the locus coeruleus; with maximum MTC being the best predictor of age group. Age effects for all imaging modalities interacted with sex, with larger age group differences in males than females for MTC and NODDI metrics. Age group differences also varied across locus coeruleus subdivision for DTI and NODDI metrics, and across locus coeruleus hemispheres for MTC. Within older adults, however, there were no significant effects of age on MTC or DTI metrics, only an interaction between age and sex for free diffusion. Finally, independent of age and sex, higher restricted diffusion in the locus coeruleus was significantly related to better (lower) recall variability, but not mean recall. Whereas MTC has been widely used in the literature, our comparison between the average and maximum MTC metrics, inclusion of DTI and NODDI metrics, and breakdowns by locus coeruleus subdivision and hemisphere make important and novel contributions to our understanding of the aging of locus coeruleus structure.

Up to 80% of Parkinson's disease patients develop dementia, but time to dementia varies widely from motor symptom onset. Dementia with Lewy bodies presents with clinical features similar to Parkinson's disease dementia, but cognitive impairment precedes or coincides with motor onset. It remains controversial whether dementia with Lewy bodies and Parkinson's disease dementia are distinct conditions or represent part of a disease spectrum. The biological mechanisms underlying disease heterogeneity, in particular the development of dementia, remain poorly understood, but will likely be the key to understanding disease pathways and, ultimately, therapy development. Previous genome-wide association studies in Parkinson's disease and dementia with Lewy bodies/Parkinson's disease dementia have identified risk loci differentiating patients from controls. We collated data for 7804 patients of European ancestry from Tracking Parkinson's, The Oxford Discovery Cohort, and Accelerating Medicine Partnership-Parkinson's Disease Initiative. We conducted a discrete phenotype genome-wide association study comparing Lewy body diseases with and without dementia to decode disease heterogeneity by investigating the genetic drivers of dementia in Lewy body diseases. We found that risk allele rs429358 tagging APOEe4 increases the odds of developing dementia, and that rs7668531 near the MMRN1 and SNCA-AS1 genes and an intronic variant rs17442721 tagging LRRK2 G2019S on chromosome 12 are protective against dementia. These results should be validated in autopsy-confirmed cases in future studies.

OBJECTIVE: There is widespread overuse of antibiotics in neonatal intensive care units (NICUs). The objective of this study was to safely reduce antibiotic use in participating NICUs by targeting early-onset sepsis (EOS) management. STUDY DESIGN: Twenty-eight NICUs participated in this statewide multicenter antibiotic stewardship quality improvement collaborative. The primary aim was to reduce the total monthly mean antibiotic utilization rate (AUR) by 25% in participant NICUs. RESULT: Aggregate AUR was reduced by 15.3% (p

Life on Earth comprises prokaryotes and a broad assemblage of endosymbioses. The pages of Molecular Biology and Evolution and Genome Biology and Evolution have provided an essential window into how these endosymbiotic interactions have evolved and shaped biological diversity. Here, we provide a current perspective on this knowledge by drawing on decades of revelatory research published in Molecular Biology and Evolution and Genome Biology and Evolution, and insights from the field at large. The accumulated work illustrates how endosymbioses provide hosts with novel phenotypes that allow them to transition between adaptive landscapes to access environmental resources. Such endosymbiotic relationships have shaped and reshaped life on Earth. The early serial establishment of mitochondria and chloroplasts through endosymbioses permitted massive upscaling of cellular energetics, multicellularity, and terrestrial planetary greening. These endosymbioses are also the foundation upon which all later ones are built, including everything from land-plant endosymbioses with fungi and bacteria to nutritional endosymbioses found in invertebrate animals. Common evolutionary mechanisms have shaped this broad range of interactions. Endosymbionts generally experience adaptive and stochastic genome streamlining, the extent of which depends on several key factors (e.g. mode of transmission). Hosts, in contrast, adapt complex mechanisms of resource exchange, cellular integration and regulation, and genetic support mechanisms to prop up degraded symbionts. However, there are significant differences between endosymbiotic interactions not only in how partners have evolved with each other but also in the scope of their influence on biological diversity. These differences are important considerations for predicting how endosymbioses will persist and adapt to a changing planet.

Major dengue epidemics throughout Nicaraguas history have been dominated by 1 of 4 dengue virus serotypes (DENV-1-4). To examine serotypes during the dengue epidemic in Nicaragua in 2022, we performed real-time genomic surveillance in-country and documented cocirculation of all 4 serotypes. We observed a shift toward co-dominance of DENV-1 and DENV-4 over previously dominant DENV-2. By analyzing 135 new full-length DENV sequences, we found that introductions underlay the resurgence: DENV-1 clustered with viruses from Ecuador in 2014 rather than those previously seen in Nicaragua; DENV-3, which last circulated locally in 2014, grouped instead with Southeast Asia strains expanding into Florida and Cuba in 2022; and new DENV-4 strains clustered within a South America lineage spreading to Florida in 2022. In contrast, DENV-2 persisted from the formerly dominant Nicaragua clade. We posit that the resurgence emerged from travel after the COVID-19 pandemic and that the resultant intensifying hyperendemicity could affect future dengue immunity and severity.

Inherited peripheral neuropathies (IPNs) are a group of diseases associated with mutations in various genes with fundamental roles in the development and function of peripheral nerves. Over the past 10 years, significant advances in identifying molecular disease mechanisms underlying axonal and myelin degeneration, acquired from cellular biology studies and transgenic fly and rodent models, have facilitated the development of promising treatment strategies. However, no clinical treatment has emerged to date. This lack of treatment highlights the urgent need for more biologically and clinically relevant models recapitulating IPNs. For both neurodevelopmental and neurodegenerative diseases, patient-specific induced pluripotent stem cells (iPSCs) are a particularly powerful platform for disease modeling and preclinical studies. In this review, we provide an update on different in vitro human cellular IPN models, including traditional two-dimensional monoculture iPSC derivatives, and recent advances in more complex human iPSC-based systems using microfluidic chips, organoids, and assembloids.

It has been hypothesized that air pollution can increase an individual&apos;s susceptibility to COVID-19. Our study sought to investigate if short-term exposure to a high average level of Air Quality Index (AQI), ozone ([O.sub.3]), particulate matter (P[M.sub.2.5], P[M.sub.10]), sulfur dioxide (S[O.sub.2]), carbon monoxide (CO), and nitrogen dioxide (N[O.sub.2]) are risk factors for death from COVID-19. We conducted an unmatched case-control study to compare the risk of mortality among reported COVID-19 cases within metropolitan statistical areas in Indiana from March 31, 2020, to December 31, 2020 (N = 53,459). Air pollution concentration data at the county level were retrieved from the U.S. Environmental Protection Agency. Pollutant concentrations for the 90 days before disease development were averaged. Data were analyzed using stepwise logistic regression accounting for median air temperature, race, ethnicity, and preexisting conditions as confounders. At the population level, individuals who were exposed to a greater average of P[M.sub.2.5] in the 90 days before the development of COVID-19 had an increased risk of death: OR = 2.16, 95% confidence interval (CI) [1.12, 18.57]. Individuals with chronic lung disease had an increased risk of death in relation to P[M.sub.10]: OR = 2.72, 95% CI [1.15, 6.43]. Short-term exposure to particulate matter may serve as a risk factor for COVID-19 mortality. Keywords: COVID-19, air pollution, Indiana, particulate matter, Introduction In 2020, the third leading cause of death in Indiana was COVID-19 (Centers for Disease Control and Prevention, 2024). Since 2020, preliminary studies have demonstrated a relationship between COVID-19 [...]