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The naked mole-rat (Heterocephalus glaber) is a mouse-sized rodent species, notable for its eusociality and long lifespan. Previously, we reported that demographic aging, i.e., the exponential increase of mortality hazard that accompanies advancing age in mammals and other organisms, does not occur in naked mole-rats (Ruby et al., 2018), a finding that has potential implications for human healthy aging. The demographic data supporting that conclusion had taken over three decades to accumulate, starting with the original rearing of H. glaberin captivity. This finding was controversial since many of the animals in that study were relatively young. In the 5 years following that study, we have doubled our quantity of demographic data. Here, we re-evaluated our prior conclusions in light of these new data and found them to be not only supported but indeed strengthened. We additionally provided insight into the social dynamics of captive H. glaberwith data and analyses of body weight and colony size versus mortality. Finally, we provide a phylogenetically proximal comparator in the form of lifespan data from our Damaraland mole-rat (Fukomys damarensis) colony and demographic meta-analysis of those data along with published data from Ansell’s mole-rat (Fukomys anselli). We found Fukomysmortality hazard to increase gradually with age, an observation with inferences on the evolution of exceptional lifespan among mole-rats and the ecological factors that may have accompanied that evolution.

At Cleveland clinic, an incorrect surgical count triggers Code Rust; a protocol that mandates an intraoperative patient X-ray, staff radiology read, and discussion with the surgeon before the incision is closed. Code Rust calls from November 2014 to December 2022 were retrospectively reviewed. Realtime workflow and operative details of Code Rust cases were analyzed.1277 Code Rusts were identified. Average time from ordering the X-ray to final radiology report was 50 minutes, totalling $2,362,450.00 spent on operating room time. Code Rust was called twice as frequently during urgent or emergent cases, compared to elective. There were more staff in Code Rust rooms compared to non-Code Rust rooms. A foreign body on X-ray was identified in 42/1277 (3.3%) cases. Code Rust is a resource intensive process that is more common in emergent cases that involve multiple staff. While retained foreign bodies are identified in a small percentage of cases, the current system should be revisited to reduce operating time and expense.

This review examined the therapeutic support literature for children with autism and/or an intellectual disability who have experienced interpersonal trauma. We captured studies that implemented a therapeutic support with this population and synthesised articles that made clinical practice recommendations. Fifty-two relevant articles were identified, and four patterns were uncovered. First, primary studies in this research domain are scant, diffuse, and largely lacking in methodological consistency. Second, the literature favoured therapeutic supports that relied less on verbal skills and/or demanded a high cognitive load. Further, parent/caregiver involvement was repeatedly emphasised. Finally, methods of therapeutic support delivery appeared consistent with the broader neurodevelopmental literature. Overall, these results provide an important first step toward establishing best practice for supporting these vulnerable children.

Imraand Mahomed, partner Hogan Lovells South Africa, and Megan Smith, trainee solicitor, look at the opportunities and challenges created by new technologies and examine some of the legal implications for [...]

Introduction: The most appropriate method of reconstructing the abdominal wall at the site of a simultaneous stoma takedown is controversial. The contaminated field, concomitant GI procedure being performed and presence of a hernia all complicate decision-making. We sought to describe the surgical approaches, mesh type and outcomes of concomitant abdominal wall reconstruction during stoma takedown in a large hernia registry. Methods and procedures: All patients who underwent stoma takedown with simultaneous hernia repair with retromuscular mesh placement from January 2014 to May 2022 were identified within the Abdominal Core Health Quality Collaborative (ACHQC). Patients were stratified by mesh type including permanent synthetic (PS), resorbable synthetic (RS) and biologic mesh. Association of mesh type with 30-day wound events and other complications and 1-year outcomes were evaluated. Results: There were 368 patients who met inclusion criteria. Eighty-nine patients had ileostomies, 276 colostomies and 3 had both. Two hundred and seventy-nine (75.8%) patients received PS mesh, 46 (12.5%) biologic, and 43 (11.7%) RS. Seventy percent (259/368) had a parastomal hernia, 75% (285/368) had a midline incisional hernia, and 48% (178/368) had both. All groups had similar preoperative comorbidities and the majority had a transversus abdominus release. All mesh groups had similar thirty-day SSI (13.2–14.3%), SSO (10.5–17.8%) and SSOPI (7.9–14.1%), p= 0.6. Three patients with PS mesh developed infected synthetic mesh and one PS mesh required excision. Four patients with PS developed an enterocutaneous fistula. Of these, only one patient was recorded as having both an enterocutaneous fistula and mesh infection. Thirty-day reoperation and readmission were similar across all mesh groups. Recurrence at 1-year was similar between mesh groups. Quality of life measured using HerQLes scores were higher at one year compared to baseline in all groups indicating improvement in hernia-specific quality of life. Conclusion: Early complication rates associated with simultaneous stoma takedown and abdominal wall reconstruction are significant, regardless of mesh type utilized. Concomitant surgery should be weighed heavily and tailored to individual patients.

ABSTRACTAffordable housing is a critical resource with serious ramifications for a range of outcomes for low-income households. However, low-income prospective tenants are often denied subsidized housing through the U.S. Department of Housing and Urban Development (HUD) on the basis of factors directly or indirectly related to their poverty and racialized identities. This study assesses how the admissions policies of public housing authorities and Section 8 Project-Based Rental Assistance developments in Rhode Island define criteria for denial on the basis of applicants’ criminal legal history, alcohol use, landlord history, and credit history. Three key findings emerge from this study that highlight the endemic nature of housing exclusion and elucidate how it is enacted. First, the plans include grounds for denial that far exceed the HUD-mandated criteria and utilize long lookback periods. Second, plans lack clarity and transparency. Third, admissions criteria vary significantly by development characteristics. Policy interventions include increased oversight and transparency and advocacy for inclusionary language.

Although participation rates vary by field, Latiné and women engineers continue to be underrepresented across most segments of the engineering workforce. Research has examined engagement and persistence of Latiné and White women in engineering; however, few studies have investigated how race, ethnicity, gender, and institutional setting interact to produce inequities in the field. To address these limitations, we examined how Latina, Latino, and White women and men students' engagement in engineering was informed by their intersecting identities and within their institutional setting over the course of a year. We interviewed 32 Latina, Latino, and White women and men undergraduate engineering students attending 11 different predominantly White and Hispanic Serving Institutions. Thematic analysis was used to interpret themes from the data. Our findings illustrate how Latinas, Latinos, and White women developed a strong engineering identity, which was critical to their engagement in engineering. Students' engineering identity was grounded in their perceived fit within engineering culture, sense of purpose for pursuing their degree, and resistance to the dominance of White male culture in engineering. Latinas described unique forms of gendered, racialized marginalization in engineering, whereas Latinas and Latinos highlighted prosocial motivations for completing their degree. Findings suggest that institutional cultures, norms, and missions are critical to broadening participation of Latinas, Latinos, and White women in engineering. Disrupting White male culture, leveraging Latiné students' cultural wealth, and counter‐framing traditional recruitment pitches for engineering appear to be key in these efforts.

Background Adults aging with long-term physical disabilities (AAwPD) face personal and environmental barriers to living independently, but little is known about their perspectives on and experiences with physical activity (PA).Purpose The purpose of this study was to explore the perspectives of AAwPD on PA.Research Design Qualitative semi-structured interviews with AAwPD were conducted virtually via phone or videoconference.Study Sample A convenience sample of AAwPD aged 45-65 and living with a physical disability for at least 5 years was recruited through aging organizations, disability organizations, and social media in St. Louis, Missouri until thematic saturation was reached (n = 20).Data Collection and Analysis Participants were asked semi-structured interview questions about their perspectives and experiences with PA following an interview guide developed by disability, aging, and qualitative research experts. Data were analyzed using text analysis in NVivo 12. Codes were developed into themes by the research team and validated using member checking methods.Results Four themes emerged from the data: barriers and facilitators to engaging in PA, motivations and beliefs regarding PA, benefits of PA, and PA routines and habits. Participants reported a desire to engage in more PA but described barriers such as pain and fatigue symptoms, secondary health conditions, lack of social support, and fear of falling. Accessibility of facilities and equipment (eg, lack of ramps or equipment not at wheelchair height) and transportation barriers (eg, inconvenient schedules or excessive wait times) were specifically described as major environmental barriers.Conclusion Most participants’ reported PA routines did not meet the quantity or intensity levels recommended by current guidelines. These results may help inform healthcare providers, community programs, and future interventions to improve PA levels for AAwPD, an underserved but growing demographic.

Background. Health human resources continue to emerge as a critical health policy issue across the United States. Objective. The purpose of this study was to develop a strategy for modeling future workforce projections to serve as a basis for analyzing annual supply of and demand for physical therapists across the United States into 2020. Design. A traditional stock-and-flow methodology or model was developed and populated with publicly available data to produce estimates of supply and demand for physical therapists by 2020. Methods. Supply was determined by adding the estimated number of physical therapists and the approximation of new graduates to the number of physical therapists who immigrated, minus US graduates who never passed the licensure examination, and an estimated attrition rate in any given year. Demand was determined by using projected US population with health care insurance multiplied by a demand ratio in any given year. The difference between projected supply and demand represented a shortage or surplus of physical therapists. Results. Three separate projection models were developed based on best available data in the years 2011, 2012, and 2013, respectively. Based on these projections, demand for physical therapists in the United States outstrips supply under most assumptions. Limitations. Workforce projection methodology research is based on assumptions using imperfect data; therefore, the results must be interpreted in terms of overall trends rather than as precise actuarial data-generated absolute numbers from specified forecasting. Conclusions. Outcomes of this projection study provide a foundation for discussion and debate regarding the most effective and efficient ways to influence supply-side variables so as to position physical therapists to meet current and future population demand. Attrition rates or permanent exits out of the profession can have important supply-side effects and appear to have an effect on predicting future shortage or surplus of physical therapists., Health human resource (HHR) policy and planning continues to emerge as a critical element of health system reform in the United States and elsewhere. (1-8) An effective and efficient health [...]

Attention training programs have demonstrated potential for improving select cognitive skills and behaviors in children, but reported benefits are inconsistent. It is unclear whether variability in training benefits can be attributed to differences in children’s learning trajectories on training tasks over the intervention period. This study examined the functional form of learning trajectories on adaptive attention training tasks in primary school children, and potential associations between these learning trajectories and (a) pre-training child characteristics (general cognitive ability, hyperactivity, inattention, age) and (b) outcomes on untrained tasks from pre- to post-training (attention, hyperactivity, inattention). A total of 38 children (5–9 years) completed a 5-week attention training program in class. The training sessions involved four tasks targeting selective attention, sustained attention, inhibition, or interference control. Assessments were conducted pre- and immediately post-training. Based on non-linear mixed-effects models, the learning trajectories were best described by asymptotic regression, where the largest rate of improvement occurred initially, followed by gradual flattening out as task difficulty approached the asymptote. For the sustained attention training task, lower asymptotes predicted larger reductions in hyperactive behaviour from pre- to post-training. For the sustained and selective attention training tasks, age was associated with the asymptotes of the learning trajectories. Collectively, these findings suggest that learning trajectories on certain attention training tasks are associated with select child characteristics and training outcomes. It is of interest for future cognitive training studies to examine the learning trajectories of tasks targeting different skills to contribute understanding of the processes associated with cognitive training outcomes.

Pharmacies belonging to the Community Pharmacy Enhanced Service Networks (CPESN) are transforming their practices with support of the Flip the Pharmacy initiative. These pharmacies are submitting eCare plans that describe care that they have provided to patients.

To describe the operational model, epidemiology and outcomes of COVID-19 cases managed by the first decentralised Victorian Public Health Unit (PHU) in the Barwon South-West (BSW) region in 2020.

ABSTRACT: Over the past 2 decades wildlife managers in Wyoming have documented that moose (Alces alces shirasi) populations within the 8 herd units in western Wyoming are declining; habitat condition [...]

On October 25, 2018, we visited the offices of Alaska Business. We were curious about how a magazine operates and what we would need to do to prepare ourselves for [...]

Community pharmacists are often the most accessible health professional in rural areas, which makes them well positioned to increase vaccine access in their communities. This study sought to document rural pharmacists’ ability to and interest in administering coronavirus disease 2019 (COVID-19) vaccinations.

Parental engagement is a common theme of education policy in most countries. In Aotearoa New Zealand, policies frame parental engagement in broad terms giving schools flexibility in enacting them. However, the generality assumes the complex and differentiated activities associated with parental engagement are well understood, leaving schools with little guidance for this work. This article examines the enactment of parental engagement in one New Zealand primary school to understand these activities better and provide a basis for improved policy. It partly draws on Ball et al. (Routledge https://doi.org/10.4324/9780203153185, 2012) policy enactment framework identifying several enactment roles associated with parental engagement, particularly in-school ‘narrators’ who are pivotal actors in articulating a rationale for engagement. Key findings were that teachers interpreted parental engagement differently, leading to differentiated practice, and parents are identified as important policy actors. The article concludes that there is a strong case for greater clarity in policy on parental engagement.

Objective: The purpose of this study was to examine symptoms of posttraumatic stress disorder (PTSD) in a community sample of low-income pregnant women who met the DSM-IV diagnostic criteria for the disorder. Method: Pregnant women (N=948) were screened for trauma, PTSD, depression, and co-occurring illicit substance use. PTSD symptoms were compared in traumatized pregnant women and a sample of nonpregnant traumatized women from the National Comorbidity Survey. Results: Suicidal thoughts and a high degree of psychiatric comorbidity were common in pregnant women with PTSD. Pregnant women were selectively and significantly less likely to endorse reexperiencing symptoms of PTSD (29.5%, N= 82), compared to nonpregnant women (79.4%, N=464). Conclusions: PTSD in pregnancy was associated with comorbidity, poor health behaviors, and lower recall of memory-related PTSD symptoms. Further prospective study is needed.

Nearly twice as many women as men suffer from clinical depression, and up to 50% of ob/gyn patients have the disorder or its symptoms. Since you may be the only [...]

Unfortunately there are still some clinicians and patients who believe that pregnant women don't suffer from severe depression. But roughly one in four women will have depressive symptoms during pregnancy--and [...]

The article offers information on the recent changes in cervical cancer screening in Australia, emphasizing the shift from Pap smears to human papillomavirus (HPV) testing. Topics discussed include the benefits of HPV testing over Pap smears; the option for self-collection of samples; and the impact of these changes on cervical cancer rates and prevention strategies.

Detecting introgression between closely related populations or species is a fundamental objective in evolutionary biology. Existing methods for detecting migration and inferring migration rates from population genetic data often assume a neutral model of evolution. Growing evidence of the pervasive impact of selection on large portions of the genome across diverse taxa suggests that this assumption is unrealistic in most empirical systems. Further, ignoring selection has previously been shown to negatively impact demographic inferences (e.g. of population size histories). However, the impacts of biologically realistic selection on inferences of migration remain poorly explored. Here, we simulate data under models of background selection, selective sweeps, balancing selection, and adaptive introgression. We show that ignoring selection sometimes leads to false inferences of migration in popularly used methods that rely on the site frequency spectrum. Specifically, balancing selection and some models of background selection result in the rejection of isolation-only models in favor of isolation-with-migration models and lead to elevated estimates of migration rates. BPP, a method that analyzes sequence data directly, showed false positives for all conditions at recent divergence times, but balancing selection also led to false positives at medium-divergence times. Our results suggest that such methods may be unreliable in some empirical systems, such that new methods that are robust to selection need to be developed.

Objective: The authors investigated the impact of medical comorbidity on the acute phase of antidepressant treatment in subjects with major depressive disorder. Method: A total of 384 outpatients meeting DSM-III-R criteria for major depressive disorder enrolled in 8-week open treatment with fluoxetine, 20 mg/day. The authors used the Cumulative Illness Rating Scale to measure the burden of medical comorbidity and the 17-item Hamilton Rating Scale for Depression to assess changes in depressive symptoms. The outcome measures were response to treatment ([greater than or eqaul to]50% reduction in score) and clinical remission (score [less than or equal to]7 at the end of the trial). Results: Compared to responders to fluoxetine, nonresponders had significantly higher Cumulative Illness Rating Scale scores and a greater number of Cumulative Illness Rating Scale categories were endorsed. Compared to subjects who achieved remission with antidepressant treatment, those who did not achieve remission had significantly higher Cumulative Illness Rating Scale scores and a greater number of Cumulative Illness Rating Scale categories were endorsed (i.e., more organs were affected by medical illness). The final Hamilton depression scale score was directly correlated with the total Cumulative Illness Rating Scale score and the number of Cumulative Illness Rating Scale categories endorsed. Conclusions: The total burden of medical illness and the number of organ systems affected by medical illness had a significantly negative predictive value for clinical outcome in the acute phase of treatment in major depressive disorder. (Am J Psychiatry 2003; 160:2122-2127

A furcate cord insertion is a rare finding, which increases the risk of adverse fetal outcomes. There are few reports of prenatal detection in the literature. We present a case of prenatally detected furcate cord insertion, diagnosed at 39 weeks’ gestation and delivered by elective caesarean section. The neonate was small for dates, but this finding was non‐specific due to smoking during pregnancy. No other adverse effects to the fetus were found. The placenta required manual removal after attempted cord traction resulted in vessel avulsion at the furcate cord insertion site. Further research is required to develop recommendations for the safe management of this condition.

The prevalence of cardiovascular disease increases exponentially with age, highlighting the contribution of aging mechanisms to cardiac diseases. Although model organisms which share human disease pathologies can elucidate mechanisms driving disease, they do not provide us with innate examples how cardiac aging might be slowed or attenuated. The identification of animal models that preserve cardiac function throughout most of life offers an alternative approach to study mechanisms which might slow cardiac aging. One such species may be the naked mole-rat (NMR), a mouse-sized (40 g) rodent with extraordinary longevity (> 37 years), and constant mortality hazard over its four decades of life. We used a cross-sectional study design to measure a range of physiological parameters in NMRs between 2 and 34 years of age and compared these findings with those of mice aged between 3 months and 2.5 years. We observed a rapid decline in body fat content and bone mineral density in old mice, but no changes in NMRs. Similarly, rhythm disorders (premature atrial and ventricular complexes) occurred in aged mice but not in NMRs. Magnetic resonance and ultrasound imaging showed age-dependent increases in cardiac hypertrophy and diastolic dysfunction in mice which were absent in NMRs. Finally, cardiac stress tests showed an age-dependent decline in normalized cardiac output in mice, which was absent in NMRs. Unlike mice, that manifest several aspects of human cardiac aging, NMRs maintain cardiac function and reserve capacity throughout their long lives and may offer insights on how to delay or prevent cardiac aging.

The Rhesus D antigen (RhD) has been associated with susceptibility to several viral infections. Reports suggest that RhD-negative individuals are better protected against infectious diseases and have overall better health. However, potential mechanisms contributing to these associations have not yet been defined. Here, we used transcriptomic and genomic data from the Milieu Interieurcohort of 1000 healthy individuals to explore the effect of Rhesus status on the immune response. We used the rs590787 SNP in the RHD gene to classify the 1000 donors as either RhD-positive or -negative. Whole blood was stimulated with LPS, polyIC, and the live influenza A virus and the NanoString human immunology panel of 560 genes used to assess donor immune response and to investigate sex-specific effects. Using regression analysis, we observed no significant differences in responses to polyIC or LPS between RhD-positive and -negative individuals. However, upon sex-specific analysis, we observed over 40 differentially expressed genes (DEGs) between RhD-positive (n= 384) and RhD-negative males (n= 75) after influenza virus stimulation. Interestingly these Rhesus-associated differences were not seen in females. Further investigation, using gene set enrichment analysis, revealed enhanced IFNγ signalling in RhD-negative males. This amplified IFNγ signalling axis may explain the increased viral resistance previously described in RhD-negative individuals.

The Australian High Court's decision of Kable v Director of Public Prosecutions for New South Wales is an important constitutional interpretation of separation of powers. The Court majority held that the New South Wales Parliament could not assign a non-judicial duty to New South Wales's Supreme Court. New South Wales's 1994 Community Protection Act was found unconstitutional for violating the Commonwealth Constitution's Chapter III on a unified Judicature. The decision came on a case involving the release of a convicted murderer who had plea bargained diminished responsibilty.

A malicious prosecution case was decided by Western Australia's Supreme Court, Mullaby v. CBFC Leasing Pty Ltd. The Court rejected charges of malicious prosecution for two convictions which were reversed on appeal, noting that a third conviction of false pretenses remained. This reasoning fits the Australian High Court's ruling in Commonwealth Life Assurance Society Ltd v. Smith.

The Australian High Court's decision of Wilson v Minister for Aboriginal and Torres Strait Islander Affairs is an important constitutional interpretation of separation of powers. The Court majority held that a Federal Court judge could not assume a non-judicial duty of reporting to a Minister. Issues of compatibility and dissenting opinions are also discussed.

ABSTRACTWhile the benefits of human papillomavirus (HPV) vaccination relating to cervical cancer prevention have been widely documented, recent published evidence is suggestive of an impact on adverse pregnancy outcomes (APOs) in vaccinated mothers and their infants, including a reduction in rates of preterm births and small for gestational age infants. In this review, we examine this evidence and the possible mechanisms by which HPV vaccination may prevent these APOs. Large-scale studies linking HPV vaccination status with birth registries are needed to confirm these results. Potential confounding factors to consider in future analyses include other risk factors for APOs, and historical changes in both the management of cervical precancerous lesions and prevention of APOs. If confirmed, these additional benefits of HPV vaccination in reducing APO rates will be of global significance, due to the substantial health, social and economic costs associated with APOs, strengthening the case for worldwide HPV immunization.

Visual processing deficits have been widely reported in developmental dyslexia however the locus of cognitive dysfunction remains unclear. Here, we examined the neural correlates of perceptual decision-making using a dot-motion task and electroencephalography (EEG) and investigated whether presenting deficits were unique to children with dyslexia or if they were also evident in other, typically developing children with equally immature reading systems. Sixty-eight children participated: 32 with dyslexia (DD; 16 females); 21 age-matched controls (AM; 11 females) and 15 reading-matched controls (RM; 9 females). All participants completed a bilaterally presented random-dot-motion task while EEG was recorded. Neural signatures of low level sensory processing (steady state visual evoked potentials; SSVEPs), pre-target attentional bias (posterior α power), attentional orienting (N2), evidence accumulation (centro-parietal positive decision signal; CPP) and execution of a motor response (β) were obtained to dissect the temporal sequence of perceptual decision-making. Reading profile provided a score of relative lexical and sublexical skills for each participant. Although all groups performed comparably in terms of task accuracy and false alarm rate, the DD group were slower and demonstrated an earlier peak latency, reduced slope and lower amplitude of the CPP compared with both AM and RM controls. Reading profile was found to moderate the relationship between word reading ability, reaction time as well as CPP indices showing that lexical dyslexics responded more slowly and had a shallower slope, reduced amplitude and earlier latency of CPP waveforms than sublexical dyslexics. These findings suggest that children with dyslexia, particularly those with relatively poorer lexical abilities, have a reduced rate and peak of evidence accumulation as denoted by CPP markers yet remain slow in their overt response. This is in keeping with hypotheses that children with dyslexia have impairment in effectively sampling and processing evidence about visual motion stimuli.

Background: Female representation in surgery and surgical subspecialties has increased over the last decade. Studies have shown a discrepancy in compensation in the field of surgery, and several groups have advocated for increasing transparency as a primary solution to decrease this gender salary gap in surgery. The aim of this study was to evaluate differences in compensation between genders in surgical specialties within a large academic healthcare system. Methods: Using a public compensation database from January 1, 2016 through December 31, 2016, this retrospective observational study analyzed salaries of full-time faculty surgeons within a large multi-institutional academic healthcare system. Surgeons included those who were employed for the entirety of 2016 and were full-time faculty who were then stratified according to surgical specialty and rank. The median base and median total salaries were compared between male and female surgeons with adjustment for rank and surgical specialty. Results: There were 170 surgeons from eight surgical subspecialties included in the study with 29% being female (n= 50). Overall, unadjusted and adjusted median total salaries were significantly lower for female compared to male surgeons by $121,578 and $45,904, respectively. The three subspecialties with the highest compensation had a median total salary of $558,998 and had a high male to female ratio (3.7 male to 1 female), whereas the three subspecialties with the lowest compensation had a median total salary of $376,174 and had a male to female ratio of 1.5 male to 1 female. Conclusions: In a large academic healthcare system with transparent and publicly accessible salaries, the gender compensation gap in surgery persists. In conjunction with transparency, future academic institutions should consider a value-based, objective compensation plan with personal and systemic introspection of traditional gender biases, in efforts to circumvent the impact of gender on salary.

Infections in adult patients with hematological malignancies (HM) and stem cell transplant (SCT) recipients are a significant cause of morbidity and mortality. A timely diagnosis of infections can have a major impact on outcomes. Tools that help rule out infectious causes of fever can decrease antibiotic use, toxicities, hospitalization costs, and potentially decrease antibiotic resistance in the long term. We retrospectively evaluated the ability of cell-free DNA next-generation sequencing (NGS) testing in the timely identification of pathogenic microorganisms and its impact on the antimicrobial management of immunocompromised patients with hematologic malignancies. In the period between 2018 to 2020, 95 samples were reviewed, of which 31 adult patients (32 tests) had hematologic malignancies or were recipients of SCT. The NGS tests were performed in the following patients: (a) patients with prolonged fever and negative conventional tests, (b) persistent fever despite positive conventional test and appropriate antimicrobials, and (c) fever-free patients with imaging suspicious for infection. The median time from fever to NGS sampling was 5 days (range, 1-28). The median time to NGS results was 2 days (range, 1-6). The NGS resulted in an escalation of antibiotics in 28% of cases (9/32) and de-escalation of antibiotics in 31% of cases (10/32). Overall, NGS testing changed management in nearly 59% (19/32) of patients. The sensitivity and specificity of NGS to detect clinically significant infection was 80% and 58%, respectively. The test identified uncommon and difficult to diagnose organisms such as Nocardia, Legionella, Toxoplasmaand Pneumocystis jiroveciiresulting in rapid antimicrobial interventions. In conclusion, in patients with HM or SCT recipients, microbial cell-free DNA sequencing allowed rapid and actionable treatment. This strategy can target appropriate antibiotic use, avoid overtreatment, and potentially decrease the hospital length-of-stay.

James Barker Jr. Roswell, GA PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) PHOTO (COLOR) Zakkary Snedeker Clifford, PA Dear Dirt Wheels, Nothing quite like the tree-shots and hill-climbs above the spent riding lakes in the Spinreel Dunes in Oregon. Dear Dirt Wheels, When I was little, my dad and I would go to the store. [Extracted from the article]

Performing large-scale plasma proteome profiling is challenging due to limitations imposed by lengthy preparation and instrument time. We present a fully automated multiplexed proteome profiling platform (AutoMP3) using the Hamilton Vantage liquid handling robot capable of preparing hundreds to thousands of samples. To maximize protein depth in single-shot runs, we combined 16-plex Tandem Mass Tags (TMTpro) with high-field asymmetric waveform ion mobility spectrometry (FAIMS Pro) and real-time search (RTS). We quantified over 40 proteins/min/sample, doubling the previously published rates. We applied AutoMP3 to investigate the naked mole-rat plasma proteome both as a function of the circadian cycle and in response to ultraviolet (UV) treatment. In keeping with the lack of synchronized circadian rhythms in naked mole-rats, we find few circadian patterns in plasma proteins over the course of 48 h. Furthermore, we quantify many disparate changes between mice and naked mole-rats at both 48 h and one week after UV exposure. These species differences in plasma protein temporal responses could contribute to the pronounced cancer resistance observed in naked mole-rats. The mass spectrometry proteomics data have been deposited to the ProteomeXchange Consortium via the PRIDE [1] partner repository with the dataset identifier PXD022891.

Before William F. 'Buffalo Bill' Cody started his world-renowned Wild West shows, he became famous as a character in dime novels. The first dime novels were introduced in the mid-1800s, [...]

In September 2014, the American Physical Therapy Association published the Choosing Wisely list of 'Five Things Physical Therapists and Patients Should Question,'1-2 in a partnership with the American Board of [...]

The primary objective of this study was to evaluate the National Association of Chain Drugstores’ point-of-care testing (POCT) training program’s effect on the implementation of pharmacy POCT services in Arkansas and barriers that may have prevented or slowed implementation. The secondary objective was to evaluate the quality of the training program by asking participants to report their feelings of preparedness at the conclusion of the training and once they began implementing POCT services independently.

Diabetes mellitus (DM) and hypertension (HTN) are increasing in prevalence in the population. Level 1 trauma facilities are often faced with managing these chronic conditions. Recent studies indicated that 12-44% of patients presenting traumas are found to have incidental findings by imaging representing undiagnosed medical conditions, with 10% reported requiring further management [Surendran A, Mori A, Varma DK, Gruen RL. Systematic review of the benefits and harms of whole-body computed tomography in the early management of multitrauma patients: Are we getting the whole picture? J Trauma and Acute Care Surg. 2014;76(4):1122-1130]. Between 2015 and 2016, 852 patients seen at a level 1 trauma center were analyzed. Patients were evaluated who received a new diagnosis of HTN or DM, or had preexisting diagnosis of HTN or DM whose management was changed. Uncontrolled HTN or DM was defined as a need for either a change in medication or primary care optimization prior to discharge. Among the patients evaluated, 6.3% and 3.0% received new diagnoses of HTN and DM, respectively. Additionally, 34.4% and 35.3% of patients were found to have uncontrolled HTN and DM and required medical optimization, respectively. The high prevalence of undiagnosed or suboptimal management for chronic conditions indicates that more research is warranted for defining, screening for, and treating surgical patients with poorly controlled medical conditions with these comorbidities.

ABSTRACTThis article presents the conceptual underpinnings of a homelessness intervention program, accompanied by a social work course, that provide direct services and cause advocacy with and on behalf of people experiencing homelessness. A program goal is to educate students in social work, medicine, law, pharmacy, public health, and nursing about systemic causes and human consequences of homelessness, while teaching students skills for providing trauma informed care while simultaneously pursuing mezzo and macro-level systems change. The program’s and course’s evolution and efforts to collect evaluation data are described. In detailing the iterative process that spawned the still evolving program and course, the article illuminates person-centered ways to teach about homelessness, social work practice, interprofessional teamwork, humility, flexibility, and persistence.

We have developed a new class of sodium carbonate/silicone composite sorbents that selectively capture carbon dioxide (CO2) and can purify biogas to natural gas pipeline-quality biomethane. These nontoxic composites can be three-dimensionally printed or extruded at low costs, can have high specific CO2sorption rates (in excess of 5 μmol s–1g–1bar–1) and high selectivity due to their chemical mechanism, and can be regenerated with low-energy air stripping. Therefore, these composite sorbents combine the high selectivity of liquid sorbents with the high specific sorption rates and low regeneration energies found in many solid sorbents. We characterized these composite sorbents with X-ray computed tomography, scanning electron microscopy (SEM), and X-ray diffraction (XRD). Furthermore, we measured composite sorption capacities of up to 0.62 mol CO2kg–1and recorded breakthrough curves in a flow-through, fixed-bed reactor using both simulated biogas and locally sourced industrial biogas. Additional tests of the composite sorbent were carried out with pure CO2in a sealed pressure drop apparatus. This experimental data was used to validate a numerical model of the setup and to simulate an industrial-scale biogas upgrading process. Finally, we performed a preliminary technoeconomic analysis for this upgrading process and found that this composite sorbent can upgrade biogas at a lower cost (∼$0.97 per GJ) than other currently implemented techniques.

ABSTRACTResearch on policy and programmatic responses to homelessness has focused largely on urban areas, with comparatively little attention paid to the rural context. We conducted qualitative interviews with a nationwide sample of rural-serving agencies receiving grants through the U.S. Department of Veterans Affairs’ Supportive Services for Veteran Families program to better understand the housing needs, available services, needed resources, and challenges in serving homeless and unstably housed veterans in rural areas. Respondents discussed key challenges—identifying unstably housed veterans, providing services within the rural resource context, and leveraging effective collaboration—and strategies to address these challenges. Unmet needs identified included emergency and subsidized long-term housing options, transportation resources, flexible financial resources, and additional funding to support the intensive work required in rural areas. Our findings identify promising programmatic innovations and highlight the need for policy remedies that are responsive to the unique challenges of addressing homelessness and housing instability in rural areas.

Positron emission tomography (PET) imaging using 68Ga-labeled bisphosphonates to target bone metastasis could be a valuable tool in cancer diagnosis and monitoring therapeutic treatment. A 68Ga labeled ligand, N,N′-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-N,N′-diacetic acid (HBED-CC) containing one bisphosphonate group (HBED-CC-BP, 1) was prepared and evaluated. The new ligand, 1, reacted rapidly to form [68Ga]Ga-1, via complexing with [68Ga]GaCl3eluted from a commercially available 68Ge/68Ga generator (in a sodium acetate buffer at pH 4, reaching >95% labeling yield at room temperature in 5 min). The resulting [68Ga]Ga-1showed excellent stability in vitroand in vivo. [68Ga]Ga-1displayed high binding affinity to hydroxyapatite and good uptake in the tibia and femur bone of normal mice. Biodistribution and MicroPET imaging studies of [68Ga]Ga-1in normal mice and rats showed excellent bone uptake and retention comparable to that of Na[18F]F. The results suggested that [68Ga]Ga-1might be suitable as a bone imaging agent in humans and it could be useful as a convenient alternative to the current bone imaging PET agent, Na[18F]F, without the need of a near-by cyclotron. Also, an automated synthesis module was developed to produce clinical doses of [68Ga]Ga-1in a consistent and reproducible manner. Currently, the investigation new drug application (IND) for [68Ga]Ga-HBED-CC-BP, [68Ga]Ga-1, has received FDA approval, and it is currently under clinical trial (IND #129870).