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Although teacher recruitment and retention are widespread challenges in education, rural and urban counties in Nevada often feel particularly challenged. Within the research conducted, a common theme was uncovered as to why this challenge may be the case. Consistently and unprompted, inservice and preservice teachers mention their perceptions of the violence that occurs in rural and urban schools and communities.

This quantitative-correlational study aimed to examine the relationship between online game addiction and mental well-being of high school students from Angeles City, in the Philippines, during the COVID-19 pandemic. To obtain data from the respondents, the Internet Gaming Disorder Scale--Short-Form and Depression, Anxiety, and Stress Scale (DASS-21) were utilised. After obtaining data from purposively selected 162 high-school students, it was observed that there was a positive and significant relationship between online game addiction and mental well-being. The study highlighted that individuals who are highly dependent on online games are more likely to experience higher levels of depression, anxiety and stress. Based on the findings, implications for theory and practice, particularly in learning and development, are presented, along with recommendations for schools, teachers, students, and future research directions.

The research evaluates the impact of face-to-face and online flipped learning (OFL) on the academic performance in students of single-degree (SD) and double-degree (DD), compared to that achieved in the traditional methodology. A descriptive, quasi-experimental, cross-sectional, quantitative study was carried out with a sample of 223 university marketing and communication students. The study was conducted in three phases: before, during, and after the COVID-19 pandemic. Results align with previous studies, which find that flipped learning (FL) face-to-face yields higher performance than traditional methodology. Like other studies, the highest scores in asynchronous activities were found for DD students. However, this study reveals that those adopting FL, both online and face-to-face, demonstrated superior academic performance compared to SD students using the traditional method in practical assessments. Notably, DD students who used OFL methodology outperformed their SD peers who used the traditional method in the overall subject score and in the synchronous and asynchronous activities. Furthermore, although modality did not influence the ratings of FL methodology; DD students who experienced this methodology online or face-to-face reported more positively on their attitudes, perceptions, interactions, academic results, and perceived satisfaction than SD students. These findings contribute to understanding of how the adoption of diverse learning methods and modalities influence the performance, attitudes, perceptions, interactions, results, and satisfaction of SD and DD students in the fields of marketing and communication. In conclusion, university business education institutions can enhance student performance and satisfaction by expanding DDs offerings and integrating active learning methods.

In the field of complexity, new methodologies emerge, such as horizon architecture, which help to focus solutions that can be integrated to foster innovation in university education. Technologies are also opening up opportunities for training, such as virtual and augmented reality. This article aims to answer the question: What innovations do postgraduate students perceive in environments using horizons architecture to integrate virtual reality? In this project's training experience for students, the horizons architecture strategy was implemented with virtual reality resources and emerging technologies. The present research was conducted with a mixed methodology, using a concurrent triangulation design. The participants were chosen from a sample for non-probability convenience. Three instruments were administered to 99 graduate students in Humanities and Education: i) a semi-structured questionnaire with demographic data and interests in contributing to the Sustainable Development Goals (SDGs), ii) a semi-structured questionnaire on students' perceptions of learning and innovative projects, and iii) a validated Likert-scale questionnaire on elements and types of educational innovation. Virtual and augmented reality supported the distance education modalities and project presentations. The results show that: (a) open and systemic innovation, (b) creation of new products and services, (c) the potential of horizons architecture strategy, (d) motivation boosted by virtual and augmented reality, and (e) critical aspects of integrating virtual and augmented reality (technical and academic). It is concluded that horizons architecture with virtual reality in university education encourages complex reasoning and invites the search for new solutions. The challenge is to train citizens with critical, scientific, systemic, innovative and entrepreneurial thinking, who are also empathetic, cooperative and committed to sustainable development. This study may be valuable to teachers, entrepreneurs, and decision-makers interested in innovative educational environments and technologies, especially those in graduate education.

Background: Latinos/as/xs continue to face many barriers as they pursue engineering degrees, including remedial placement, lack of access to well-funded schools, and high poverty rates. We use the concept of "arrebatos" to describe the internal reckoning that Latino/a/x engineering students experience through their journeys, particularly focusing on the impact of socioeconomic inequalities. Purpose: To bring counternarratives in engineering education research focusing on the experiences and lived realities of low-income Latino/a/x engineering students. These counternarratives are an important step in interrogating systemic biases and exclusionary cultures, practices, and policies at HSIs and emerging HSIs and within engineering programs. Methods: "Pláticas" were conducted with 22 Latino/a/x engineering undergraduates from four different universities in the US Southwest. These "pláticas" were coded and analyzed drawing from Anzaldúa's theoretical concept of "el arrebato." Special attention was given to participants' "arrebatos" triggered by their college experiences as low-income individuals. Results: Analysis indicates that Latino/a/x engineering students' "arrebatos" arise from events that shake up the foundation of their own identity, including an institutional lack of sociopolitical consciousness. This lack of consciousness becomes evident not only in individuals' attitudes toward these students but also in institutional policies that put them at a further disadvantage. Conclusions: Findings have implications for engineering programs, particularly at HSIs and emerging HSIs regarding the creation of policies and practices that aim to secure the retention of low-income Latino/a/x engineering students and alleviate the systemic barrier they face by affirming the practice of servingness.

Background: The gender gap in engineering presents a critical barrier to achieving a diverse and innovative engineering workforce. This gap is influenced by gender stereotypes, socialization processes, masculine culture, and insufficient early experiences with engineering. These contribute to diminished STEM self-concept, interest, and participation among women. Purpose/Hypothesis: This study assessed an engineering outreach program's impact on children's understanding of and interest in engineering and beliefs about who can be an engineer. It compared whether discussions of gender bias differentially influenced these outcomes for girls and boys. Design/Method: The study was a short-term sequential quasi-experimental design with boys and girls in grades 4-5. Six classroom groups attended a half-day engineering field trip and were randomly assigned to two conditions: Gender Presentation or No Gender Presentation. Pre- and post-program surveys measured changes in understanding of and interest in engineering and beliefs about who can be an engineer. Results: All children, regardless of gender or condition, had higher understanding of and interest in engineering after the program, but also demonstrated a bias in selecting men over women as engineers. Participants reported that both girls and boys like and are good at engineering and these ratings increased from the pre-program to the post-program survey. Conclusion: This research affirms the effectiveness of immersive and inclusive programming in enhancing children's understanding of and interest in engineering. No substantial gender-specific differences emerged regarding the impact of discussions on gender biases. The program underscores the value of early inclusive educational interventions in fostering equitable interest in engineering among young students.

Internationalization in higher education is essential, and although active learning methodologies are increasing and allow students to develop transversal skills, most still have a very local scope. In this context, the Collaborative Online International Learning (COIL) methodology is an interesting approach to benefit the students' development. It consists of an online program that involves creating multicultural teams to develop a specific learning project. Although this methodology is expanding, its use in physiology is still scarce. This paper aims to show an example of applying COIL methodology in physiology topics to enhance higher-education students' innovation and business skills. Our example project developed a sports-assessment service concept focused on physiology and biomechanics assessments. The program involved teams from Brazil, Germany, and Spain, comprising undergraduate and master students. Over 7 weeks, these teams, mentored by professors and researchers, engaged in workshops covering COIL methodology, business model design, executive summary planning, economic analyses, and communication techniques. Key outcomes included learning new concepts, developing soft skills, building confidence in innovative solution proposals, and experiencing diverse cultures. Challenges faced were language barriers, scheduling, task complexity, and logistical issues. This experience confirms the effectiveness of incorporating programs using COIL methodology into educational curriculums. Doing so exposes physiology students to innovation, entrepreneurship, and business creation while strengthening their professional connections and opening up postgraduation opportunities.

Particle tracking (PT) is a popular technique in microscopy, microfluidics and colloidal transport studies, where image analysis is used to reconstruct trajectories from bright spots in a video. The performance of many PT algorithms has been rigorously tested for directed and Brownian motion in open media. However, PT is frequently used to track particles in porous media where complex geometries and viscous flows generate particles with high velocity variability over time. Here, we present an evaluation of four PT algorithms for a simulated dispersion of particles in porous media across a range of particle speeds and densities. Of special note, we introduce a new velocity-based PT linking algorithm (V-TrackMat) that achieves high accuracy relative to the other PT algorithms. Our findings underscore that traditional statistics, which revolve around detection and linking proficiency, fall short in providing a holistic comparison of PT codes because they tend to underpenalize aggressive linking techniques. We further elucidate that all codes analyzed show a decrease in performance due to high speeds, particle densities, and trajectory noise. However, linking algorithms designed to harness velocity data show superior performance, especially in the case of high-speed advective motion. Lastly, we emphasize how PT error can influence transport analysis.

Multicomponent catalysts can be designed to synergistically combine reaction intermediates at interfacial active sites, but restructuring makes systematic control and understanding of such dynamics challenging. We here unveil how reducibility and mobility of indium oxide species in Ru-based catalysts crucially control the direct, selective conversion of CO2 to ethanol. When uncontrolled, reduced indium oxide species occupy the Ru surface, leading to deactivation. With the addition of steam as a mild oxidant and using porous polymer layers to control In mobility, Ru-In2O3 interface sites are stabilized, and ethanol can be produced with superior overall selectivity (70 %, rest CO). Our work highlights how engineering of bifunctional active ensembles enables cooperativity and synergy at tailored interfaces, which unlocks unprecedented performance in heterogeneous catalysts.

Most studies about the menstrual cycle are laboratory-based, in small samples, with infrequent sampling, and limited to young individuals. Here, we use wearable and diary-based data to investigate menstrual phase and age effects on finger temperature, sleep, heart rate (HR), physical activity, physical symptoms, and mood. A total of 116 healthy females, without menstrual disorders, were enrolled: 67 young (18-35 years, reproductive stage) and 53 midlife (42-55 years, late reproductive to menopause transition). Over one menstrual cycle, participants wore Oura ring Gen2 to detect finger temperature, HR, heart rate variability (root mean square of successive differences between normal heartbeats [RMSSD]), steps, and sleep. They used luteinizing hormone (LH) kits and daily rated sleep, mood, and physical symptoms. A cosinor rhythm analysis was applied to detect menstrual oscillations in temperature. The effect of menstrual cycle phase and group on all other variables was assessed using hierarchical linear models. Finger temperature followed an oscillatory trend indicative of ovulatory cycles in 96 participants. In the midlife group, the temperature rhythms mesor was higher, but period, amplitude, and number of days between menses and acrophase were similar in both groups. In those with oscillatory temperatures, HR was lowest during menses in both groups. In the young group only, RMSSD was lower in the late-luteal phase than during menses. Overall, RMSSD was lower, and number of daily steps was higher, in the midlife group. No significant menstrual cycle changes were detected in wearable-derived or self-reported measures of sleep efficiency, duration, wake-after-sleep onset, sleep onset latency, or sleep quality. Mood positivity was higher around ovulation, and physical symptoms manifested during menses. Temperature and HR changed across the menstrual cycle; however, sleep measures remained stable in these healthy young and midlife individuals. Further work should investigate over longer periods whether individual- or cluster-specific sleep changes exist, and if a buffering mechanism protects sleep from physiological changes across the menstrual cycle.

OBJECTIVES: Cancer is a leading cause of death in unhoused adults. We sought to examine the association between housing status, stage at diagnosis and all-cause survival following cancer diagnosis at a public hospital. DESIGN: Retrospective cohort study examining new cancer diagnoses between 1 July 2011 and 30 June 2021. SETTING: A public hospital in San Francisco. EXPOSURE: Housing status (housed, formerly unhoused, unhoused) was ascertained via a county-wide integrated dataset that tracks both observed and reported homelessness. METHODS: We reported univariate analyses to investigate differences in demographic and clinical characteristics by housing group. We then constructed Kaplan-Meier curves stratified by housing group to examine unadjusted all-cause mortality. Finally, we used multivariable Cox proportional hazards models to compare the hazard rate of mortality for each housing status group, adjusting for demographic and clinical factors. RESULTS: Our cohort included 5123 patients with new cancer diagnoses, with 4062 (79%) in housed patients, 623 (12%) in formerly unhoused patients and 438 (9%) in unhoused patients. Unhoused and formerly unhoused patients were more commonly diagnosed with stage 4 disease (28% and 27% of the time, respectively, vs 22% of housed patients). After adjusting for demographic and clinical characteristics, unhoused patients with stage 0-3 disease had a 50% increased hazard of death (adjusted HR (aHR) 1.5, 95% CI 1.1 to 1.9; p

This music score was submitted for Resonate 2024: An Open Access Call for Scores by the UCLA Music Library with Bent Frequency and Jan Berry Baker.

BACKGROUND: The global cancer burden is rising, particularly in low- and middle-income countries (LMIC), highlighting a critical research gap in understanding disparities in supportive care access. To address this, the Multinational Association of Supportive Care in Cancer (MASCC) Health Disparities Committee initiated a global survey to investigate and delineate these disparities. This study aims to explore and compare supportive care access disparities between LMIC and High-Income Countries (HIC). METHODS: An online cross-sectional survey was conducted among active members of MASCC. Members, representing diverse healthcare professions received email invitations. The survey, available for 3 weeks, comprised sections covering (1) sociodemographic information; (2) clinical service/practice-related disparities in their region/nation; (3) population groups facing disparities within their region or country. Chi-squared or Fishers exact test for cross-sectional analyses, and a multivariable logistic regression model was employed for statistical analysis. RESULTS: A total of 218 active members participated, with one-quarter (26.6%) from LMIC and 18.4% ethnic minorities, timely cancer care (43.7%) and timely supportive care (45.0%) emerged as the most pressing disparities globally. Notably, participants from LMIC underscored cancer drug affordability (56.4%) and supportive care guideline implementation (56.4%) as critical issues. Economically disadvantaged populations were noted as more likely to face disparities by both LMIC and HIC (non-US-based) respondents, while US-based respondents identified racial/ethnic minorities as facing more disparities. CONCLUSION: This global survey reveals significant disparities in cancer supportive care between LMIC and HIC, with a particular emphasis on medication affordability and guideline implementation in LMIC. Addressing these disparities requires targeted intervention, considering specific regional priorities.

The hypocretin (Hcrt) system modulates arousal and anxiety-related behaviors and has been considered as a novel treatment target for stress-related affective disorders. We examined the effects of Hcrt acting in the nucleus accumbens shell (NAcSh) and anterodorsal bed nucleus of the stria terminalis (adBNST) on social behavior in male and female California mice (Peromyscus californicus). In female but not male California mice, infusion of Hcrt1 into NAcSh decreased social approach. Weak effects of Hcrt1 on social vigilance were observed in both females and males. No behavioral effects of Hcrt1 infused into the adBNST were observed. Analyses of sequencing data from California mice and Mus musculus NAc showed that Hcrtr2 was more abundant than Hcrtr1, so we infused the selective Hcrt receptor 2 antagonist into the NAcSh, which increased social approach in females previously exposed to social defeat. A calcium imaging study in the NAcSh of females before and after stress exposure showed that neural activity increased immediately following the expression of social avoidance but not during freezing behavior. This observation is consistent with previous studies that identified populations of neurons in the NAc that drive avoidance. Intriguingly, calcium transients were not affected by stress. These data suggest that hypocretin acting in the NAcSh plays a key role in modulating stress-induced social avoidance.

We present a new software module, QRCODE (Quantum Research for Calculating Optically Driven Excitations), for massively parallelized real-time time-dependent density functional theory (RT-TDDFT) calculations of periodic systems in the open-source Qbox software package. Our approach utilizes a custom implementation of a fast Fourier transformation scheme that significantly reduces inter-node message passing interface (MPI) communication of the major computational kernel and shows impressive scaling up to 16,344 CPU cores. In addition to improving computational performance, QRCODE contains a suite of various time propagators for accurate RT-TDDFT calculations. As benchmark applications of QRCODE, we calculate the current density and optical absorption spectra of hexagonal boron nitride (h-BN) and photo-driven reaction dynamics of the ozone-oxygen reaction. We also calculate the second and higher harmonic generation of monolayer and multi-layer boron nitride structures as examples of large material systems. Our optimized implementation of RT-TDDFT in QRCODE enables large-scale calculations of real-time electron dynamics of chemical and material systems with enhanced computational performance and impressive scaling across several thousand CPU cores.

OBJECTIVES: Implicit bias perpetuates health care inequities and manifests in patient-provider interactions, particularly nonverbal social cues like dominance. We investigated the use of artificial intelligence (AI) for automated communication assessment and feedback during primary care visits to raise clinician awareness of bias in patient interactions. MATERIALS AND METHODS: (1) Assessed the technical performance of our AI models by building a machine-learning pipeline that automatically detects social signals in patient-provider interactions from 145 primary care visits. (2) Engaged 24 clinicians to design usable AI-generated communication feedback for their workflow. (3) Evaluated the impact of our AI-based approach in a prospective cohort of 108 primary care visits. RESULTS: Findings demonstrate the feasibility of AI models to identify social signals, such as dominance, warmth, engagement, and interactivity, in nonverbal patient-provider communication. Although engaged clinicians preferred feedback delivered in personalized dashboards, they found nonverbal cues difficult to interpret, motivating social signals as an alternative feedback mechanism. Impact evaluation demonstrated fairness in all AI models with better generalizability of provider dominance, provider engagement, and patient warmth. Stronger clinician implicit race bias was associated with less provider dominance and warmth. Although clinicians expressed overall interest in our AI approach, they recommended improvements to enhance acceptability, feasibility, and implementation in telehealth and medical education contexts. DISCUSSION AND CONCLUSION: Findings demonstrate promise for AI-driven communication assessment and feedback systems focused on social signals. Future work should improve the performance of this approach, personalize models, and contextualize feedback, and investigate system implementation in educational workflows. This work exemplifies a systematic, multistage approach for evaluating AI tools designed to raise clinician awareness of implicit bias and promote patient-centered, equitable health care interactions.

OBJECTIVE: To pilot test and assess the feasibility and acceptability of chaplain-led decision coaching alongside the GOALS (Getting Optimal Alignment around Life Support) decision support tool to enhance decision-making in threatened periviable delivery. METHODS: Pregnant people admitted for threatened periviable delivery and their important other (IO) were enrolled. Decisional conflict, acceptability, and knowledge were measured before and after the intervention. Chaplains journaled their impressions of training and coaching encounters. Descriptive analysis and conventional content analysis were completed. RESULTS: Eight pregnant people and two IOs participated. Decisional conflict decreased by a mean of 6.7 (SD = 9.4) and knowledge increased by a mean of 1.4 (SD = 1.8). All rated their experience as good or excellent, and the amount of information was just right. Participants found it helpful to have someone to talk to and noted chaplains helped them reach a decision. Chaplains found the intervention a valuable use of their time and skillset. CONCLUSION: This is the first small-scale pilot study to utilize chaplains as decision coaches. Our results suggest that chaplain coaching with a decision support tool is feasible and well-accepted by parents and chaplains. INNOVATIONS: Our findings recognize chaplains as an underutilized, yet practical resource in value-laden clinical decision-making.

Contribution: A methodology based on the learning by teaching approach facilitated by a mobile learning tool for creating tutorials. A study of the impact this methodology has had on the emotional well-being of students and its correlation with academic performance has also been carried out. Background: Insufficient resources and the absence of targeted teaching methods for technical content in vocational training may impact academic outcomes and lead to student demotivation. Previous studies indicate that employing active group methodologies contributes to the improvement of educational quality and positively influences the emotional well-being of students. Intended Outcomes: Improved academic performance, motivation levels, and collaborative work among peers, particularly within vocational training cycles. Application Design: A quasi-experimental design with a pre-post assessment of knowledge and emotional states. The study was carried out with 131 vocational training students, with one group following a conventional master class methodology that used practical activities, and another group following the learning by teaching methodology, where students created explanatory tutorials for their peers using a mobile application. Findings: Students who followed the proposed methodology significantly improved learning results compared to those who followed the traditional methodology. This improvement was evident both at the end of the experience and in the final evaluation of the course. Moreover, results revealed that the emotions of enjoyment and pride at the end of the learning process positively correlated with the acquisition of knowledge and that this correlation was more pronounced within the cohort that followed the learning by teaching methodology.

A substantial body of research shows that various types of audiovisual (AV) input such as videos and videos with second language (L2) subtitles can facilitate language learning. However, language teachers' day-to-day practices with regard to multimodal input is less understood. To bridge the gap in language education, this study investigates teachers' perceived use of four types of AV input (video only, video with subtitles, video with captions and video with enhanced captions) and factors influencing teachers' perspectives on these types of input for in-class and out-of-class learning. Questionnaire data were collected from 193 L2 teachers across the globe about their perceived use of AV input. Teachers reported that they use video and captioned video most frequently in both classroom and out-of-class contexts. Logistic regression analyses revealed that teachers' perceived importance and comfort using specific AV input types were the two most important factors explaining teachers' reported use. Complementarily, open-ended responses were analyzed qualitatively to identify teachers' additional reasons for (non)use of such input.

Autistic people often experience difficulties navigating face-to-face social interactions. Historically, the empirical literature has characterised these difficulties as cognitive 'deficits' in social information processing. However, the empirical basis for such claims is lacking, with most studies failing to capture the complexity of social interactions, often distilling them into singular communicative modalities (e.g. gaze-based communication) that are rarely used in isolation in daily interactions. The current study examined how gaze was used in concert with communicative hand gestures during joint attention interactions. We employed an immersive virtual reality paradigm, where autistic (n = 22) and non-autistic (n = 22) young people completed a collaborative task with a non-autistic confederate. Integrated eye-, head- and hand-motion-tracking enabled dyads to communicate naturally with each other while offering objective measures of attention and behaviour. Autistic people in our sample were similarly, if not more, effective in responding to hand-cued joint attention bids compared with non-autistic people. Moreover, both autistic and non-autistic people demonstrated an ability to adaptively use gaze information to aid coordination. Our findings suggest that the intersecting fields of autism and social neuroscience research may have overstated the role of eye gaze during coordinated social interactions.

Computational Thinking (CT) is crucial for the advancement of the STEM field, where there continues to be a lack of female representation. Teaching and learning (T/L) of CT should incorporate didactic strategies that aim to eliminate gender biases and integrate girls/women into this context. In response to the question, "What didactic strategies have been implemented in the T/L of CT in primary and secondary education?". A systematic review was conducted following a PRISMA protocol specifically designed for this review. The study analysed Didactic Strategies (DS) and examined whether they incorporated the so-called "minimum actions" (MA) proposed in this article as a strategy to integrate females into CT. The findings revealed a limited number of studies that implemented these actions. In conclusion, there is an urgent need to continue developing DS that incorporate these MA to effectively integrate girls and women into CT, allowing them to play a central role in its advancement and development.

Familial racial-ethnic socialization (RES) helps youth build tools of cultural resilience by providing messages regarding race and ethnicity that enable them to negotiate and survive the demands of a racialized society. Thus, RES is an important caregiving task for historically minoritized families, including Latine families in the United States. In this article, we review research on RES in Latine families, which has focused primarily on RES processes in middle childhood to adolescence, to provide an evidence-informed conceptual model delineating the youth, parental, dyadic/familial, and sociohistorical factors that shape how Latine families engage in RES. We argue that it is important to focus on which RES messages are provided, how families provide these messages, and the concomitant family processes that support RES efforts that result in culturally adaptive outcomes. We also review research on this topic to identify where evidence supports the role of these factors in the delivery of RES and to identify new directions for research and intervention.

In the United States, in 2013, 610,042 people were estimated homeless in one night. Improving the effectiveness of homeless assistance programs, particularly aligning programs' practices with their goals, is critical to serving this population. Using a theory that predicts homeless exits, this study presents an innovative, low-cost evaluation tool that can be used by a wide range of human service providers to conduct more frequent "in-house" process evaluations. The Gap Assessment of Policy and Practice (GAPP) tool streamlines process evaluations thus improving social programs. To test this tool's effectiveness, we compared the results of a traditional process evaluation and a GAPP tool evaluation of a homeless assistance program. Both evaluations revealed a consistent disparity between program activities and expressed goals. The GAPP tool is less time intensive and provides a useful road map for structuring a process evaluation for program providers, thus increasing program impact by encouraging more frequent and efficient self-assessments.

The efficiency of light-harvesting and energy transfer in multi-chromophore ensembles underpins natural photosynthesis. Dendrimers are highly branched synthetic multi-chromophoric conjugated supra-molecules that mimic these natural processes. After photoexcitation, their repeated units participate in a number of intramolecular electronic energy relaxation and redistribution pathways that ultimately funnel to a sink. Here, a model four-branched dendrimer with a pyrene core is theoretically studied using nonadiabatic molecular dynamics simulations. We evaluate excited-state photoinduced dynamics of the dendrimer, and demonstrate on-the-fly simulations of its transient absorption pump-probe (TA-PP) spectra. We show how the evolutions of the simulated TA-PP spectra monitor in real time photoinduced energy relaxation and redistribution, and provide a detailed microscopic picture of the relevant energy-transfer pathways. To the best of our knowledge, this is the first of this kind of on-the-fly atomistic simulation of TA-PP signals reported for a large molecular system.

Meningiomas are tumors originating from arachnoid meningothelial cells. Occasionally, meningiomas are identified outside the central nervous system, and are referred to as extracranial meningiomas (EMs). The vast majority of EMs are an extension from an intracranial or intraspinal tumor. However, primary EMs may arise from extracranial sites with the most common sites being the skin and scalp subcutis, which are further categorized as cutaneous meningiomas (CMs). CMs are rare cutaneous tumors with similar ultrastructural and cytologic findings compared to those of intracranial meningiomas, but with a wide range of histologic differences. Therefore, an assessment using a panel of investigative tools, including imaging, histopathology, and immunohistochemistry, is required to determine the diagnosis of CMs. Here, we report the case of a 64-year-old gentleman presenting with a posttraumatic well-circumscribed superficial mass overlying the right nasal bridge. We are unable to identify other cases arising in the nasal bridge.

Coastal habitat restoration, especially of coral reef ecosystems, can significantly reduce the exposure of coastal communities to natural hazards and, consequently, the risk of wave-driven flooding. Likewise, reef degradation can increase coastal flood risks to people and property. In this study, the valuation of coral reefs in the United States Virgin Islands (USVI), along the coasts of St. Croix, St. John, and St. Thomas, demonstrated the social and economic benefits provided by these natural defenses. Across the territory, more than 481 people and $31.2 million of infrastructure were estimated to receive protection from coral reefs per year (2010 U.S. dollars). In 2017, Hurricanes Irma and Maria significantly damaged coral reefs throughout the archipelago. By combining engineering, ecological, geospatial, social, and economic data and tools, this study provided a rigorous valuation of where potential coral reef restoration projects could help rebuild these damaged habitats and decrease the risks from coastal hazards faced by USVI’s reef-fronted communities. Multiple restoration scenarios were considered in the analysis, two of which are detailed in this report. These include (1) ‘Ecological’ restoration, where restoration creates a structure that is 0.25 m high and 25-m-wide reef, and (2) ‘Hybrid’ restoration, where restoration creates a structure that is 1.25 m high and 5 m wide. There are many ways that such structures could be developed. In the hydrodynamic analyses, there are no assumptions about how the restoration is developed. Many practitioners of both coral (and oyster reef) restoration consider that a reef height of 0.25 m might be delivered from planting corals alone and that 1.25 m might require a combination of artificial structures and coral planting. In a third scenario, the analysis investigated the reduction of protection benefits that would occur through the reduction of 1 meter of naturally occurring reef height due to reef degradation. The reduction of protection due to the loss of reefs can also be interpreted as the protection value of the existing reefs. In all studied restoration scenarios, it was assumed that the planting of corals would enhance hydrodynamic roughness, effectively dissipating incident wave energy and reducing the potential for coastal flooding. A standardized approach was employed to strategically locate potential restoration projects along the entire linear extent of existing reefs bordering the USVI, and to identify where coral reef restoration could offer valuable benefits in flood reduction. Potential restoration projects were only located within the existing distribution of reefs across the region, even though numerous sites were positioned far offshore (2-3 km), and some were at relatively deep depths (up to 7 m). Risk-based valuation approaches were followed to delineate flood zones at a 10 m2 resolution along the entire region's reef-lined shorelines for all the potential coral reef restoration scenarios. These were subsequently compared to flood zones without coral reef restoration. The potential reduction in coastal flood risk provided by coral reef restoration, and the protection value of existing reefs, were quantified utilizing the latest information available at the time of analysis from the U.S. Census Bureau, Federal Emergency Management Agency (FEMA), and Bureau of Economic Analysis for return-interval storm events. The change in Expected Annual Damages (EAD), a metric indicating the annual protection gained due to coral reef restoration, was calculated based on the damages associated with each storm probability. The findings suggest that the benefits of reef restoration are spatially variable within the USVI. In some areas, the analysis showed limited benefits from reef restoration, which may be attributed to the depth or offshore distances of proposed restoration sites. However, there were a number of key areas where reef restoration could have substantial benefits for flood risk reduction. The annual flood risk reduction attributed to potential ‘ecological’ coral reef restoration in the USVI was 99 people and $6.1 million (2010 U.S. dollars). The Benefit-to-Cost Ratio (BCR) for this restoration approach was found to be larger than 1 (i.e., cost-effective) along 11% of the St. Croix coastline, 4.9% of the St. John coastline, and 8.7% of the St. Thomas coastline. This analysis offers stakeholders and decision-makers a spatially explicit and rigorous evaluation that illustrates how, where, and when potential coral reef restoration efforts in St. Croix, St. John, and St. Thomas could be instrumental to reducing coastal storm-induced flooding. Understanding areas where reef management, recovery, and restoration could effectively reduce climate hazard-related risks is crucial to protect and enhance the resilience of coastal communities in USVI.

BACKGROUND: Deeper insights into ERBB2-driven cancers are essential to develop new treatment approaches for ERBB2+ breast cancers (BCs). We employed the Collaborative Cross (CC) mouse model to unearth genetic factors underpinning Erbb2-driven mammary tumour development and metastasis. METHODS: 732 F1 hybrid female mice between FVB/N MMTV-Erbb2 and 30 CC strains were monitored for mammary tumour phenotypes. GWAS pinpointed SNPs that influence various tumour phenotypes. Multivariate analyses and models were used to construct the polygenic score and to develop a mouse tumour susceptibility gene signature (mTSGS), where the corresponding human ortholog was identified and designated as hTSGS. The importance and clinical value of hTSGS in human BC was evaluated using public datasets, encompassing TCGA, METABRIC, GSE96058, and I-SPY2 cohorts. The predictive power of mTSGS for response to chemotherapy was validated in vivo using genetically diverse MMTV-Erbb2 mice. FINDINGS: Distinct variances in tumour onset, multiplicity, and metastatic patterns were observed in F1-hybrid female mice between FVB/N MMTV-Erbb2 and 30 CC strains. Besides lung metastasis, liver and kidney metastases emerged in specific CC strains. GWAS identified specific SNPs significantly associated with tumour onset, multiplicity, lung metastasis, and liver metastasis. Multivariate analyses flagged SNPs in 20 genes (Stx6, Ramp1, Traf3ip1, Nckap5, Pfkfb2, Trmt1l, Rprd1b, Rer1, Sepsecs, Rhobtb1, Tsen15, Abcc3, Arid5b, Tnr, Dock2, Tti1, Fam81a, Oxr1, Plxna2, and Tbc1d31) independently tied to various tumour characteristics, designated as a mTSGS. hTSGS scores (hTSGSS) based on their transcriptional level showed prognostic values, superseding clinical factors and PAM50 subtype across multiple human BC cohorts, and predicted pathological complete response independent of and superior to MammaPrint score in I-SPY2 study. The power of mTSGS score for predicting chemotherapy response was further validated in an in vivo mouse MMTV-Erbb2 model, showing that, like findings in human patients, mouse tumours with low mTSGS scores were most likely to respond to treatment. INTERPRETATION: Our investigation has unveiled many new genes predisposing individuals to ERBB2-driven cancer. Translational findings indicate that hTSGS holds promise as a biomarker for refining treatment strategies for patients with BC. FUNDING: The U.S. Department of Defense (DoD) Breast Cancer Research Program (BCRP) (BC190820), United States; MCIN/AEI/10.13039/501100011039 (PID2020-118527RB-I00, PDC2021-121735-I00), the European Union Next Generation EU/PRTR, the Regional Government of Castile and León (CSI144P20), European Union.

The menstrual cycle is a loop involving the interplay of different organs and hormones, with the capacity to impact numerous physiological processes, including body temperature and heart rate, which in turn display menstrual rhythms. The advent of wearable devices that can continuously track physiological data opens the possibility of using these prolonged time series of skin temperature data to noninvasively detect the temperature variations that occur in ovulatory menstrual cycles. Here, we show that the menstrual skin temperature variation is better represented by a model of oscillation, the cosinor, than by a biphasic square wave model. We describe how applying a cosinor model to a menstrual cycle of distal skin temperature data can be used to assess whether the data oscillate or not, and in cases of oscillation, rhythm metrics for the cycle, including mesor, amplitude, and acrophase, can be obtained. We apply the method to wearable temperature data collected at a minute resolution each day from 120 female individuals over a menstrual cycle to illustrate how the method can be used to derive and present menstrual cycle characteristics, which can be used in other analyses examining indicators of female health. The cosinor method, frequently used in circadian rhythms studies, can be employed in research to facilitate the assessment of menstrual cycle effects on physiological parameters, and in clinical settings to use the characteristics of the menstrual cycles as health markers or to facilitate menstrual chronotherapy.

BackgroundSocial care integration refers to the incorporation of activities into health systems that assist patients with health-related social needs (HRSNs) that negatively impact the health outcomes of their patients, such as food insecurity or homelessness. Social care integration initiatives are becoming more common. The COVID-19 pandemic strained health systems while simultaneously increasing levels of unmet social needs.ObjectiveTo describe the effects of the COVID-19 pandemic on established social care delivery in a primary care setting.DesignWe used qualitative semi-structured interviews of stakeholders to assess barriers and facilitators to social care delivery in the primary care setting during the COVID-19 health emergency. Data was analyzed using a hybrid inductive/deductive thematic analysis approach with both the Consolidated Framework for Implementation Research (CFIR) and the Screen-Navigate-Connect-Address-Evaluate model of social care integration.SettingTwo safety-net, hospital-based primary care clinics with established screening for food insecurity, homelessness, and legal needs.ParticipantsSix physicians, six nurses, six members of the social work team (clinical social workers and medical case workers), six community health workers, and six patients (total N = 30) completed interviews.ResultsFour major themes were identified. (1) A strained workforce experienced challenges confronting increased levels of HRSNs. (2) Vulnerable populations experienced a disproportionate negative impact in coping with effects of the COVID-19 pandemic on HRSNs. (3) COVID-19 protections compounded social isolation but did not extinguish the sense of community. (4) Fluctuations in the social service landscape led to variable experiences.ConclusionsThe COVID-19 pandemic disrupted established social care delivery in a primary care setting. Many of the lessons learned about challenges to social care delivery when health systems are strained are important considerations that can inform efforts to expand social care delivery.

INTRODUCTION: Oral pre-exposure prophylaxis (PrEP) for HIV-1 infection is over 99% effective in protecting against HIV acquisition when used consistently and appropriately. However, PrEP uptake and persistent use remains suboptimal, with a substantial gap in utilization among key populations who could most benefit from PrEP. In Latin America specifically, there is poor understanding of barriers to PrEP uptake and persistence among transgender (trans) women. METHODS: In April-May 2018, we conducted qualitative interviews lasting 25-45 min as part of an end-of-project evaluation of TransPrEP, a pilot RCT that examined the impact of a social network-based peer support intervention on PrEP adherence among trans women in Lima, Peru. Participants in the qualitative evaluation, all adult trans women, included individuals who either (1) screened eligible to participate in the TransPrEP pilot, but opted not to enroll (n = 8), (2) enrolled, but later withdrew (n = 6), (3) were still actively enrolled at the time of interview and/or successfully completed the study (n = 16), or (4) were study staff (n = 4). Interviews were audio recorded and transcribed verbatim. Codebook development followed an immersion/crystallization approach, and coding was completed using Dedoose. RESULTS: Evaluation participants had a mean age of 28.2 years (range 19-47). When describing experiences taking PrEP, participant narratives highlighted side effects that spanned three domains: physical side effects, such as prolonged symptoms of gastrointestinal distress or somnolence; economic challenges, including lost income due to inability to work; and social concerns, including interpersonal conflicts due to HIV-related stigma. Participants described PrEP use within a broader context of social and economic marginalization, with a focus on daily survival, and how PrEP side effects negatively contributed to these stressors. Persistence was, in some cases, supported through the interventions educational workshops. CONCLUSION: This research highlights the ways that physical, economic, and social side effects of PrEP can impact acceptability and persistence among trans women in Peru, amplifying and layering onto existing stressors including economic precarity. Understanding the unique experiences of trans women taking PrEP is crucial to informing tailored interventions to improve uptake and persistence.

The current study examined associations between risk contexts (i.e., immigration discrimination,classism, colorism), acculturation (i.e., assimilation, separation, integration, marginalization),and adjustment (i.e., school belonging, substance use, GPA) among U.S. Latinx adolescents.Additionally, we considered how gender may moderate study associations. Participants for thisstudy include a subsample of Latinx adolescents from a larger study with two public highschools in the western United States (N=703, Mage=15.93 (SD =1.22); 51.3% male). Preliminaryresults revealed that experiencing more colorism, classism, and immigrant discrimination wasassociated with a higher inclination for separation and substance use (e.g., tobacco, cannabis,alcohol). Specifically, Latinx adolescents were more likely to reject U.S. culture and formstronger ties with the culture and values of their country of origin, as well as engage in substanceuse, when they experienced higher levels of risk contexts. Regarding differences by gender,bi-variate associations revealed that higher levels of separation were linked with higher GPA forLatinx female adolescents only. Male adolescents, on the other hand, were more likely to reporthigher levels of assimilation to U.S. culture, in conjunction with higher levels of colorism,classism, and immigration discrimination. Follow-up analyses will include testing howcomponents of the acculturation process mediate associations between each risk context andadjustment, as well as differences by gender. Findings have implications for how Latinxadolescents navigate risky contexts and the critical role of acculturation processes in relation tohealthy adjustment.

BACKGROUND: Cardiac arrest is a common and devastating emergency of both the heart and brain. More than 380,000 patients suffer out-of-hospital cardiac arrest annually in the USA. Induced cooling of comatose patients markedly improved neurological and functional outcomes in pivotal randomized clinical trials, but the optimal duration of therapeutic hypothermia has not yet been established. METHODS: This study is a multi-center randomized, response-adaptive, duration (dose) finding, comparative effectiveness clinical trial with blinded outcome assessment. We investigate two populations of adult comatose survivors of cardiac arrest to ascertain the shortest duration of cooling that provides the maximum treatment effect. The design is based on a statistical model of response as defined by the primary endpoint, a weighted 90-day mRS (modified Rankin Scale, a measure of neurologic disability), across the treatment arms. Subjects will initially be equally randomized between 12, 24, and 48 h of therapeutic cooling. After the first 200 subjects have been randomized, additional treatment arms between 12 and 48 h will be opened and patients will be allocated, within each initial cardiac rhythm type (shockable or non-shockable), by response adaptive randomization. As the trial continues, shorter and longer duration arms may be opened. A maximum sample size of 1800 subjects is proposed. Secondary objectives are to characterize: the overall safety and adverse events associated with duration of cooling, the effect on neuropsychological outcomes, and the effect on patient-reported quality of life measures. DISCUSSION: In vitro and in vivo studies have shown the neuroprotective effects of therapeutic hypothermia for cardiac arrest. We hypothesize that longer durations of cooling may improve either the proportion of patients that attain a good neurological recovery or may result in better recovery among the proportion already categorized as having a good outcome. If the treatment effect of cooling is increasing across duration, for at least some set of durations, then this provides evidence of the efficacy of cooling itself versus normothermia, even in the absence of a normothermia control arm, confirming previous RCTs for OHCA survivors of shockable rhythms and provides the first prospective controlled evidence of efficacy in those without initial shockable rhythms. TRIAL REGISTRATION: ClinicalTrials.gov NCT04217551. Registered on 30 December 2019.

The incidence of inflammatory bowel disease (IBD) is increasing annually. Children with IBD often suffer significant morbidity due to physical and emotional effects of the disease and treatment. Corticosteroids, often a component of therapy, carry undesirable side effects with long term use. Steroid-free remission has become a standard for care-quality improvement. Anticipating therapeutic outcomes is difficult, with treatments often leveraged in a trial-and-error fashion. Artificial intelligence (AI) has demonstrated success in medical imaging classification tasks. Predicting patients who will attain remission will help inform treatment decisions. The provided dataset comprises 951 tissue section scans (167 whole-slides) obtained from 18 pediatric IBD patients. Patient level structured data include IBD diagnosis, 12- and 52-week steroid use and name, and remission status. Each slide is labelled with biopsy site and normal or abnormal classification per the surgical pathology report. Each tissue section scan from an abnormal slide is further classified by an experienced pathologist. Researchers utilizing this dataset may select from the provided outcomes or add labels and annotations from their own institutions.

There has been an increase in volume as well as an improvement in overall survival (OS) after hematopoietic cell transplantation (HCT) for hematologic disorders. It is unknown if these changes have affected racial/ethnic minorities equally. In this observational study from the Center for International Blood and Marrow Transplant Research of 79 904 autologous (auto) and 65 662 allogeneic (allo) HCTs, we examined the volume and rates of change of autoHCT and alloHCT over time and trends in OS in 4 racial/ethnic groups: non-Hispanic Whites (NHWs), non-Hispanic African Americans (NHAAs), and Hispanics across 5 2-year cohorts from 2009 to 2018. Rates of change were compared using Poisson model. Adjusted and unadjusted Cox proportional hazards models examined trends in mortality in the 4 racial/ethnic groups over 5 study time periods. The rates of increase in volume were significantly higher for Hispanics and NHAAs vs NHW for both autoHCT and alloHCT. Adjusted overall mortality after autoHCT was comparable across all racial/ethnic groups. NHAA adults (hazard ratio [HR] 1.13; 95% confidence interval [CI] 1.04-1.22; P = .004) and pediatric patients (HR 1.62; 95% CI 1.3-2.03; P < .001) had a higher risk of mortality after alloHCT than NHWs. Improvement in OS over time was seen in all 4 groups after both autoHCT and alloHCT. Our study shows the rate of change for the use of autoHCT and alloHCT is higher in NHAAs and Hispanics than in NHWs. Survival after autoHCT and alloHCT improved over time; however, NHAAs have worse OS after alloHCT, which has persisted. Continued efforts are needed to mitigate disparities for patients requiring alloHCT.

The dry mass and the orientation of biomolecules can be imaged without a label by measuring their permittivity tensor (PT), which describes how biomolecules affect the phase and polarization of light. Three-dimensional (3D) imaging of PT has been challenging. We present a label-free computational microscopy technique, PT imaging (PTI), for the 3D measurement of PT. PTI encodes the invisible PT into images using oblique illumination, polarization-sensitive detection and volumetric sampling. PT is decoded from the data with a vectorial imaging model and a multi-channel inverse algorithm, assuming uniaxial symmetry in each voxel. We demonstrate high-resolution imaging of PT of isotropic beads, anisotropic glass targets, mouse brain tissue, infected cells and histology slides. PTI outperforms previous label-free imaging techniques such as vector tomography, ptychography and light-field imaging in resolving the 3D orientation and symmetry of organelles, cells and tissue. We provide open-source software and modular hardware to enable the adoption of the method.

BACKGROUND: Acute lung allograft dysfunction (ALAD) is an imprecise syndrome denoting concern for the onset of chronic lung allograft dysfunction (CLAD). Mechanistic biomarkers are needed that stratify risk of ALAD progression to CLAD. We hypothesized that single cell investigation of bronchoalveolar lavage (BAL) cells at the time of ALAD would identify immune cells linked to progressive graft dysfunction. METHODS: We prospectively collected BAL from consenting lung transplant recipients for single cell RNA sequencing. ALAD was defined by a ≥10% decrease in FEV1 not caused by infection or acute rejection and samples were matched to BAL from recipients with stable lung function. We examined cell compositional and transcriptional differences across control, ALAD with decline, and ALAD with recovery groups. We also assessed cell-cell communication. RESULTS: BAL was assessed for 17 ALAD cases with subsequent decline (ALAD declined), 13 ALAD cases that resolved (ALAD recovered), and 15 cases with stable lung function. We observed broad differences in frequencies of the 26 unique cell populations across groups (p = 0.02). A CD8 T cell (p = 0.04) and a macrophage cluster (p = 0.01) best identified ALAD declined from the ALAD recovered and stable groups. This macrophage cluster was distinguished by an anti-inflammatory signature and the CD8 T cell cluster resembled a Tissue Resident Memory subset. Anti-inflammatory macrophages signaled to activated CD8 T cells via class I HLA, fibronectin, and galectin pathways (p

The SARS-CoV-2 virus that led to COVID-19 is associated with significant and long-lasting neurologic symptoms in many patients, with an increased mortality risk for people with Alzheimer's disease (AD) and/or Down syndrome (DS). However, few studies have evaluated the neuropathological and inflammatory sequelae in postmortem brain tissue obtained from AD and people with DS with severe SARS-CoV-2 infections. We examined tau, beta-amyloid (Aβ), inflammatory markers and SARS-CoV-2 nucleoprotein in DS, AD, and healthy non-demented controls with COVID-19 and compared with non-infected brain tissue from each disease group (total n = 24). A nested ANOVA was used to determine regional effects of the COVID-19 infection on arborization of astrocytes (Sholl analysis) and percent-stained area of Iba-1 and TMEM 119. SARS-CoV-2 antibodies labeled neurons and glial cells in the frontal cortex of all subjects with COVID-19, and in the hippocampus of two of the three DS COVID-19 cases. SARS-CoV-2-related alterations were observed in peri-vascular astrocytes and microglial cells in the gray matter of the frontal cortex, hippocampus, and para-hippocampal gyrus. Bright field microscopy revealed scattered intracellular and diffuse extracellular Aβ deposits in the hippocampus of controls with confirmed SARS-CoV-2 infections. Overall, the present preliminary findings suggest that SARS-CoV-2 infections induce abnormal inflammatory responses in Down syndrome.

We present results from a 3.25 kg-day target exposure of two silicon charge-coupled devices (CCDs), each with 24 megapixels and skipper readout, deployed in the DAMIC setup at SNOLAB. With a reduction in pixel readout noise of a factor of 10 relative to the previous detector, we investigate the excess population of low-energy events in the CCD bulk previously observed above expected backgrounds. We address the dominant systematic uncertainty of the previous analysis through a depth fiducialization designed to reject surface backgrounds on the CCDs. The measured bulk ionization spectrum confirms the presence of an excess population of low-energy events in the CCD target with characteristic rate of ∼7 events per kg-day and electron-equivalent energies of ∼80 eV, whose origin remains unknown.