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Introduction The health care of marginalized communities has been at the forefront of diversity, equity, and inclusion initiatives across the USA. Among the marginalized is the health and health care [...], Objective. The purpose of this study was to understand the lesbian, gay, bisexual, transgender, queer, intersex, agender, and other gender and sexually diverse identities (LGBTQIA+) health care experience and associated cultural competence from the physical therapist perspective (physical therapist and physical therapist assistant). Methods.An exploratory qualitative approach implementing semi-structured focus groups and private interviews was utilized. To further anonymity, researchers allowed subjects to keep their camera off on Zoom. An interview protocol included questions guided by Campinha-Bacote domains of cultural competence (cultural awareness, skill, knowledge, encounter, and desire) to collect individual experiences, stories, discussions, thoughts, and opinions. Physical therapist clinicians were recruited from the clinical education affiliation lists of Regis University and Thomas Jefferson University. Seventy-one practicing physical therapists from the USA agreed to be part of the study. Results. Themes were organized using the Social Ecological Model Framework. Themes are in parentheses following each level of the Social Ecological Model and include intrapersonal level (psychological stress and implicit and explicit biases), interpersonal (acceptance and competency), organizational (experience), community (advocacy), and society and policy (explicit biases and policy). Conclusion. Cultural competence in physical therapy is influenced by intrapersonal, interpersonal, organizational, community, and social and policy factors. Themes of psychological stress, limited awareness, decreased acceptance, and competency as well as limited exposure and experience, and a lack of advocacy and broader societal and policy issues prevent adequate LGBTQIA+ cultural competency of physical therapist providers. Further research in the physical therapist profession is needed to elaborate on the student, educator, and patient perspectives and how this information informs the LGBTQIA+ cultural competence of clinicians. Impact. This project may have a significant impact on suggestions for the delivery of content for health profession education to best impact health equity goals and save lives. Implementation of this content may have a direct impact on health disparities in LGBTQIA+ populations by reducing stigma and discrimination from health care providers, thus improving quality of health care and decreasing rates of patient mortality for LGBTQIA+ individuals. Keywords: Cultural Competence, Diversity, LGBTQ, Physical Therapy, Policy

The former CNN and NBC boss wants a new media empire. Is that even possible in 2024? A CLASSIC 20TH-CENTURY WAY for an outsider to achieve Establishment status has been [...]

The Student Academy Awards are changing things up in more ways than one this year. The 2024 ceremony was held in London, far across the pond from the academy's traditional […]

Rupert Murdoch didn't want to DUMP HIS RATINGS LEADER and favorite Fox host. But was Tucker Carlson giving him a choice? After Donald Trump was elected president in 2016, Fox [...]

TABLE OF CONTENTS I. INTRODUCTION 424 II. UNCERTAIN DOCTRINE: THE LAW GOVERNING THE CONFIDENTIALITY OF FIRMS' CYBERSECURITY EFFORTS 431 A. Attorney-Client Privilege and Work-Product Immunity for Incident Response 433 1. [...], In recent years, cyberattacks have cost firms countless billions of dollars, undermined consumer privacy, distorted world geopolitics, and even resulted in death and bodily harm. Rapidly accelerating cyberat-tacks have not, however, been bad news for many lawyers. On the contrary, lawyers that specialize in coordinating all elements of victims' incident-response efforts are increasingly in demand. Lawyers' dominant role in cyber-incident response is driven in part by their purported capacity to ensure that information produced during the breach response process remains confidential, particularly in any subsequent lawsuit. By interposing themselves between their clients and any third-party consultants involved in incident response, lawyers can often shield any materials produced after a breach from discovery under either attorney-client privilege or work-product immunity. Moreover, by limiting and shaping the documentation produced by breached firms' personnel and third-party consultants in the wake of a cyberattack, attorneys can limit the availability of potentially damaging information to plaintiffs' attorneys, regulators, or media, even if their attorney-client privilege and work-product immunity arguments falter. Relying on over sixty interviews with a broad range of actors in the cybersecurity landscape--including lawyers, forensic investigators, insurers, and regulators--this Article shows how, in their efforts to preserve the confidentiality of incident-response efforts, lawyers may undermine the long-term cybersecurity of both their clients and society more broadly. We find that lawyers often direct forensic providers to refrain from making recommendations to clients about how to enhance their cyber defenses, restrict direct communications between cybersecurity firms and clients, insist upon hiring cybersecurity firms with limited familiarity with the client's networks or internal processes, and strictly limit dissemination of the cybersecurity firm's conclusions to the client's internal personnel. To ensure their clients do not inadvertently waive any legal confidentiality protections, lawyers also frequently refuse to share any written documentation regarding a breach with third parties like insurers, regulators, and law enforcement. Even worse, we find that law firms overseeing breach investigations increasingly instruct cybersecurity firms not to craft any final report regarding a breach whatsoever. These practices, we find, may impair the ability of breached firms to learn from cybersecurity incidents and implement long-term remediation measures. Furthermore, such efforts to protect confidentiality inhibit insurers' capacity to understand the efficacy of different security countermeasures and regulators' power to investigate cybersecurity incidents. To reverse these trends, the Article suggests that materials produced during incident response should be entitled to confidentiality protections that are untethered from the provision of legal services. But such protections should be coupled with new requirements that firms impacted by a cyberattack disclose specific forensic evidence and analysis. By disentangling the incident-response process from the production of information that can hold firms accountable for failing to take appropriate and required precautions, the Article aims to remove barriers to effective incident response while preserving incentives for firms to take cybersecurity seriously.

I. Introduction Arguably, the development of China's investment law system since the beginning of the reform process in late 1978 (1) mirrors the development of China's economy, if not the [...]

Tamsen Fadal was 47 when her job--reporting the news from the anchor chair at WPIX-NY--suddenly became difficult. 'I couldn't read the teleprompter,' says Tamsen, now 52. It wasn't that her [...]

•Successful pregnancies are possible among female alloHCT recipients, although birth rate is >6 times lower than in the general population.•Key factors increasing the chance of pregnancy were younger age at HCT, nonmalignant disease, no TBI or dose <8 Gy and RIC/NMA conditioning

1 | INTRODUCTION Older adults with cognitive impairment represent a growing population with unique and significant care needs requiring a costly mix of social and medical services. (1-6) There is [...], Objective: To assess whether home health agencies incur significantly higher care delivery costs for patients with cognitive impairment across three timeframes relevant to home health payment policy. Data Sources: Linked Medicare home health claims and patient assessments, National Health and Aging Trends Study (NHATS), and home health agency cost reports for a nationally representative sample of Medicare beneficiaries receiving home health between 2011 and 2016. Study Design: We modeled care delivery costs incurred by the home health agency as a function of patient cognitive impairment using multivariable, propensity score-adjusted, generalized linear models. Data Collection/Extraction Methods: We identified NHATS participants who experienced an index home health episode between 2011 and 2016 (n = 1214; weighted n = 5,856,333) and linked their NHATS survey data to standardized patient assessment and claims data for the episode, as well as cost report data for the home health agency that provided care. Principal Findings: Across the first 30, 60, and 120 days of caring for a patient with cognitive impairment, we estimate additional costs of care to the home health agency of $186.19 (p = 0.02), $282.46 (p = 0.01), and $740.91 (p = 0.04), respectively. Conclusions: Home health agencies incur significantly higher costs when caring for a patient with cognitive impairment. As patient cognitive function is not considered in the most recent Medicare home health reimbursement model, agencies may be disincentivized from providing care to those with cognitive impairment. Policy makers and researchers should carefully monitor home health access among Medicare beneficiaries with cognitive impairment and further investigate the inclusion of patient cognitive function in future risk adjustment models. KEYWORDS cognitive function, dementia, home care services, home health, Medicare What is known on this topic * An estimated one-third of home health patients have cognitive impairment. * Patients with cognitive impairment receive more intensive care during Medicare-funded home health (including receiving a greater number of visits and longer duration of home health care). * Centers for Medicare and Medicaid Services revised the Medicare home health reimbursement model in 2020; the new model adjusts for patient health status/characteristics but excludes cognitive function. What this study adds * Nationally representative estimates of variation in home health care delivery costs by patient cognitive function. * Home health agencies incurred higher costs when caring for patients with cognitive impairment across all timeframes considered (first 30, 60, or 120 days of care). * Failure to adjust for patient cognitive function in risk adjustment models may financially penalize home health agencies caring for a greater proportion of older adults with cognitive impairment, potentially threatening access and/or care quality.

Belumosudil is a first in class ROCK2-inhibitor approved by the FDA for the 3rd line treatment of chronic graft-versus-host disease (cGvHD). In this retrospective real-world analysis, we report safety and efficacy data of belumosudil treatment from 5 German/Swiss transplant centers. A total of 33 adult patients (median age 59 years) with moderate (n= 2) or severe (n= 31) cGvHD were treated on individual request due to lack of EMA approval. The patient cohort had a long history of cGvHD (median 44 months) and was heavily pretreated (median 4 prior lines). The overall response rate was 42% (95%CI, 25–60%) including organ responses in all organs except the liver (n= 2). The median time to response was 3 months (range, 1–9 months) and 8 of 14 patients (57%) had a durable response at last follow-up. One-third of patients had at least a 50% reduction in concomitant corticosteroid dosage. Median failure-free survival and median overall survival were 16.5 and 23.1 months, respectively. Adverse events ≥CTCAE grade 3 were reported in 27% of patients, with a predominance of infectious events, including one fatal course. The results are consistent with previous prospective trials including a favorable safety profile, while acknowledging the challenges of a heavily pretreated patient cohort.

Aufgrund multimodaler therapeutischer Konzepte für Brustkrebspatientinnen mit Brustkrebs im Frühstadium führen Behandlungen bei mehr als 70–80 % der Fälle zu vollständiger Heilung. Die Belastungen können enorm sein. Brustkrebsüberlebende, aber auch Patientinnen mit metastasierender Erkrankung stehen vor einer Vielzahl physiologischer und psychosozialer Herausforderungen, oft im Umgang mit späten und langfristigen Folgen intensiver Therapien. Trotz dieser Schwierigkeiten vertreten Brustkrebspatient:innen einen starken Wunsch, die Gesundheit aktiv zu managen. Um dies zu ermöglichen, steht die Edukation und ein anschließendes Coaching für einen nachhaltigen Effekt an erster Stelle. Es gibt zahlreiche digitale Unterstützungsangebote für Patientinnen mit Brustkrebs, die jedoch große Unterschiede in Bezug auf die Qualität der Inhalte, der Nutzerfreundlichkeit und der Evidenz zur Wirksamkeit aufweisen. Neben Patient-Reported Outcomes, die mittlerweile international in zahlreichen Studien therapiebegleitend und auch während der Nachsorge genutzt wurden, um Nebenwirkungen frühzeitig zu erkennen und die Symptomkontrolle zu verbessern, spielt auch digitales und analoges Coaching eine immer wichtigere Rolle. Alle diese Möglichkeiten konnte bereits in randomisiert-kontrollierten Studien signifikante und klinisch relevante Ergebnisse zeigen. Das Potenzial digitaler Begleitungen und Coachings von Patientinnen mit Mammakarzinom können nicht nur die gesundheitsbezogene Lebensqualität, sondern auch die Adhärenz zur Therapie, das progressionsfreie Überleben und das Gesamtüberleben positiv beeinflussen.

Major curricular reforms have appeared via the revised Icelandic National Curriculum for Secondary Education released in 2015. Few studies in Iceland have explored teachers’ views and beliefs of motivational strategies for English teaching or considered the impact of the national curriculum on the learning experience in Iceland (Ingvarsdóttir, 2018, Sigurgeirsson et al., 2018). Consequently, the primary goal of this study is to capture English teachers’ views at the secondary level regarding (a) the role of motivational strategies in their own classroom practice and (b) its influence on the language learning experience of their students. Focus group interviews with beginning and experienced teachers, i.e., teachers in their first 3 years of teaching and those with 10 or more years of teaching experience, comprise the primary data. Interviews were transcribed and analyzed for significant themes in relation to the research focus (Braun & Clarke, 2021). Results are explored in relation to Dörnyei’s L2 Experiencedimension, particularly regarding teacher practices (Dörnyei, 2009) relating to how English teachers in Iceland understand their role in learners’ L2 experience, how they think about their students’ motivation, how they develop their own motivational practices, and the interplay between these aspects.

Productivity in the Pleistocene glacial Southern Ocean was probably enhanced owing to iron fertilization by aeolian dust. Marine sediments indicate such an increase north of the modern Antarctic Polar Front but reduced biogenic activity south of it. However, quantitative estimates for the integrated net effect are difficult to obtain. Here we use the SO42−isotopic composition and other geochemical ice core records from the Atlantic sector of the Southern Ocean to reconstruct net changes in integrated biogenic sulfur productivity in the surface ocean over the penultimate glacial termination. We show that biogenic SO42−aerosol contributes 58% and 85% to the sulfate budget in Dronning Maud Land during glacial and interglacial times, respectively, and that biogenic sulfate is derived predominately from the seasonal sea ice zone. Using our quantitative reconstruction of biogenic aerosol production in the Southern Ocean source region, we show that the average biogenic sulfate production integrated over the Atlantic sector was 16% higher in the penultimate glacial 137,000–153,000 years ago compared with the later Last Interglacial 120,000–125,000 years ago. An intermittent decrease in productivity observed during early peak interglacial warming suggests that a reduction in the seasonal sea ice zone may disrupt Southern Ocean ecosystems.

Background: Despite the relatively low infection rate following transperineal prostate biopsy (TPB), it remains unresolved whether periprocedural antibiotic prophylaxis (PAP) can be omitted. Our aim was to compare infectious complications (genitourinary infections/GUI, fever, sepsis, readmission rate, 30-day-mortality) following TPB, considering all studies of varying levels of evidence that enable a direct comparison between patients with and without PAP. Methods: We performed a comprehensive search in PubMed/Medline, Embase, Web of Science, and Cochrane databases, as well as grey literature sources, to identify reports published until January 2024. All studies comparing the incidence of infectious endpoints following TPB with vs. without PAP were included in the analyses. The GRADE approach was employed to assess the certainty of evidence for each comparison. Results: Twenty-three studies met the inclusion criteria involving 6520 and 5804 patients who underwent TPB with vs. without PAP, respectively. Two of the 23 studies were randomized-controlled trials, not all studies investigated all endpoints. Pooled incidences between patients with vs. without PAP for the endpoints GUI (0.50% vs. 0.37%), fever (0.44% vs. 0.26%), sepsis (0.16% vs. 0.13%), and readmission rate (0.35% vs. 0.29%) showed no significant differences (all p> 0.250). The corresponding odds ratios (including 95% confidence interval) also revealed no statistically significant differences: 1.37 (0.74–2.54) [GUI], 0.87 (0.28–2.66) [fever], 1.30 (0.46–3.67) [sepsis], and 1.45 (0.70–3.03) [readmission rate]. No study reported events regarding 30-day-mortality. In subgroup analyses and sensitivity analyses, TPB without PAP showed no significantly higher complication rates regarding all analyzed endpoints. Conclusions: Infectious complications after TPB occur very rarely and cannot be further reduced by PAP. Considering the results of this systematic review and adhering to the principles of effective antibiotic stewardship, omitting PAP in the context of TPB is advisable.

Aminoglycosides are concentration-dependent antibiotics exerting a bactericidal effect when concentrations at the site of infection are equal to or greater than 5 times the minimum inhibitory concentrations (MIC). When administered intravenously, they exhibit poor lung penetration and high systemic renal and ototoxicity, imposing to restrict their administration to 5 days. Experimental studies conducted in anesthetized and mechanically ventilated sheep and pigs provide evidence that high doses of nebulized aminoglycosides induce a rapid and potent bacterial killing in the infected lung parenchyma. They also confirm that the alveolar-capillary membrane, either normal or injured by the infectious process, restricts the penetration of intravenous aminoglycosides in the infected lung parenchyma, precluding a bactericidal effect at the site of infection. However, injury of the alveolar-capillary membrane promotes the systemic diffusion of nebulized aminoglycosides. Based on experimental data obtained in animals with inoculation pneumonia, it challenges the classical belief that nebulization protects against systemic toxicity. Loss of lung aeration decreases the lung penetration of nebulized aminoglycosides. Nevertheless, lung tissue concentrations measured in non-aerated lung regions with severe and extended pneumonia are most often greater than 5 times the MICs, resulting in a bactericidal effect followed by a progressive pulmonary reaeration. It is likely that the penetration into the consolidated lung, results from the bronchial diffusion of nebulized aminoglycosides toward adjacent non-aerated infected alveolar spaces and their penetration into mechanical ventilation-induced intraparenchymal pseudocysts and distended bronchioles. In animals receiving nebulized aminoglycosides, epithelial lining fluid concentrations grossly overestimate lung interstitial fluid concentrations because of the bronchial contamination of the distal tip of the bronchoscope during the bronchoalveolar procedures. Lung microdialysis is the only technique able to accurately assess lung pharmacokinetics in animals with inoculation pneumonia treated by nebulized aminoglycosides. In 2024, the European Investigators Network for Nebulized Antibiotics in Ventilator-associated Pneumonia (ENAVAP) called for the creation of an international research network for Lung Microdialysis applied to Nebulized Antibiotics (LUMINA) to promote multicentered, experimental, randomized, and controlled studies addressing lung pharmacokinetics of intravenous vs. nebulized antibiotics, using different dosing and ventilator settings.

This study investigates how the Psychological Capital (PsyCap) of small and medium enterprises (SME) leaders has influenced their strategic responses, ultimately impacting the performance of their companies, during the COVID-19 pandemic. Embedded within research on behavioral micro-foundations in strategy, and based on the resource-based theory (RBT) of the individual entrepreneur as well as positive organizational behavior literature, we hypothesize that SME leaders’ psychological resources can act as a strategic advantage during crises by making them adopt cost-cutting and investment measures for their companies performance. By using a sample of 372 SMEs, we find that while leaders mostly use both measures, leaders with a high PsyCap prefer adopting investment measures, which positively influences the performance of their companies during a crisis. However, adopting cost-cutting measures lowers performance. We contribute to the entrepreneurship literature by using PsyCap in the context of the RBT of the individual entrepreneur and shedding light on which measures sustain or increase SMEs’ performance during a crisis.JEL CLASSIFICATION:D91; L25; L26; M10

Epilepsy is a common neurological disorder characterized by abnormal activity of neuronal networks, leading to seizures. The racetam class of anti-seizure medications bind specifically to a membrane protein found in the synaptic vesicles of neurons called synaptic vesicle protein 2 (SV2) A (SV2A). SV2A belongs to an orphan subfamily of the solute carrier 22 organic ion transporter family that also includes SV2B and SV2C. The molecular basis for how anti-seizure medications act on SV2s remains unknown. Here we report cryo-electron microscopy structures of SV2A and SV2B captured in a luminal-occluded conformation complexed with anticonvulsant ligands. The conformation bound by anticonvulsants resembles an inhibited transporter with closed luminal and intracellular gates. Anticonvulsants bind to a highly conserved central site in SV2s. These structures provide blueprints for future drug design and will facilitate future investigations into the biological function of SV2s.

In his upcoming book about Fox News, Michael Wolff writes that Rupert Murdoch hates Donald Trump and wishes he were dead, the Guardian reports. Wolff makes the claim in The [...]

While everybody at the Republican National Convention in Milwaukee was preoccupied with Donald Trump's triumphal story after the assassination attempt and the prospect of near-certain victory in November, I dwelled [...]

Critical public infrastructure systems that rely on GNSS for reception of positioning, navigation and timing (PNT) data have been identified by national security agencies across the globe as potential cybersecurity [...]

1 | INTRODUCTION The shift from a hierarchical model of 'doctor knows best' toward individuals playing a 'starring role in their care' (1) has led to wide ranging efforts to [...], Objective: To review definitions, concepts, and evidence regarding person and family engagement for persons with multiple chronic conditions (MCCs) in order to identify opportunities to advance the field. Data Source: Ovid MEDLINE. Study Design: We performed a two-step process as follows: (1) a critical review of conceptual models of engagement to identify key concepts most pertinent to engagement among persons with MCC as a "launch pad" to our scoping review and (2) a scoping review of reviews of engagement for persons living with MCC. Data Collection/Extraction Methods: First, we critically reviewed six models of engagement. Second, our scoping review identified 1297 citations, with 67 articles meeting criteria for inclusion. Of these, we focused on reviews, of which there were nine titles/abstracts retained for full-text consideration. Six full-text reviews were included in the final analysis. The purpose, review type, population, number/type of included studies, theoretical framework, and findings of each study were extracted and analyzed thematically. Principal Findings: Conceptual models of engagement differ with respect to areas of emphasis (e.g., systems or clinical encounters) as well as attention to vulnerable populations, involvement of family, consideration of cost-benefit trade-offs, and attention to outcomes that matter most. Our scoping review of reviews identified just one article explicitly focused on engagement interventions for those with MCC. Other reviews examined elements of self-management and involvement in decision making, conceptually related to engagement without explicit use of the word. We find that existing evidence has predominantly described individual-level strategies rather than targeting organizations, systems, or policies. Barriers to engagement are not well described nor are potential downsides to engagement. Family engagement is rarely considered. Conclusions: Promising areas of future work include attention to barriers to engagement including trust, goal-based care, the design of structural changes to care delivery, trade-offs between benefits and costs, and family engagement. KEYWORDS caregivers, choice behavior, delivery of health care, multiple chronic conditions, patient participation, review, self-management What is known on this topic * Policy makers, scholars, patients, and advocates consider person and family engagement strategies to have a great potential for improving the quality and outcomes of care delivery. * Despite the fact that nearly half of US adults live with multiple chronic conditions (MCCs), little is known about engagement in the context of MCC. * Overall, there is limited and inconclusive evidence regarding community- and primary care-based interventions that improve outcomes for persons with MCC. What this study adds * Most evidence regarding the effects of engagement in the context of MCC focuses on the point-of-care rather than at organizational or systems levels. * There is a lack of consistent evidence regarding the effects of engagement in the context of MCC, and heterogeneity in definitions, terms, populations, and reporting has limited the development of a comprehensive evidence base. * Promising areas of future research and policy work in the field of engagement in MCC include addressing barriers of engagement among those with MCC including trust, advancing goal-based care, design of structural changes to care delivery, trade-offs between benefits and unintentional costs, and family engagement.

Introduction Older adults demonstrate great heterogeneity in functional recovery following hip fracture. (1) Physical therapist interventions associated with hip fracture rehabilitation are complex behaviors that take time, physical effort, and [...], Objectives. Physical therapist intervention studies can be deemed ineffective when, in fact, they may not have been delivered as intended. Measurement of treatment fidelity (TF) can address this issue. The purpose of this study was to describe TF of a home-based intervention, identify factors associated with TF, and examine whether components of TF were associated with the outcome of change in 6-minute walk distance (A6MWD). Methods. This is a secondary analysis of community-dwelling hip fracture participants who completed standard therapy and were randomly assigned to the active intervention (Push). Push was 16 weeks of lower extremity strengthening, function, and endurance training. TF was defined as delivery (attendance rate, exercise duration) and receipt (progression in training load, heart rate reserve [HRR] during endurance training, and exercise position [exercise on floor]). The outcome was A6MWD. Independent variables included baseline (demographic and clinical) measures. Descriptive statistics were calculated; linear and logistic regressions were performed. Results. Eighty-nine participants were included in this analysis; 59 (66%) had attendance of 75% or greater. Participants walked for 20 minutes or more for 78% of sessions. The average training load increased by 22%; the mean HRR was 35%; and 61 (69%) participants exercised on the floor for at least 75% of sessions. Regression analyses showed that a higher body mass index and greater baseline 6MWD were related to components of TF; 4 out of 5 components of TF were significantly related to A6MWD. The strongest TF relationship showed that those who exercised on the floor improved by 62 m (95% CI = 31-93 m) more than those who did not get on the floor. Conclusions. Measures of TF should extend beyond attendance rate. This analysis demonstrates how measures of TF, including program attendance, progression in training load, endurance duration, and exercising on the floor were significantly related to improvement in 6MWD in participants post hip fracture. Impact. This careful analysis of treatment fidelity assured that the intervention was delivered and received as intended. Analysis of data from a large trial with participants after hip fracture showed that regular attendance, frequent endurance training for 20 minutes, increases in lower extremity training loads, and exercising on the floor were associated with improvements in the outcome of 6-minute-walk distance. The strongest association with improvement was exercising on the floor. Keywords: Exercise, Hip Fractures, Physical Therapists, Treatment Fidelity

Jokes, including the Jewish variety, are a staple of Western civilization. Some Jewish jokes have been around for centuries and are passed from generation to generation; others might have made [...]

We investigate the effective oxidation state and local environment of yttrium in photochromic YHO thin film structures produced by e-beam evaporation, along with their chemical structure and optical properties. Transmission electron microscopy images reveal the oxidized yttrium hydride thin film sample exhibiting a three-layered structure. X-ray photoelectron spectroscopy (XPS) measurements manifest that the oxidation state of yttrium is modified, dependent on the film’s composition/depth. Furthermore, Ion beam analysis confirms that this variability is associated with a composition gradient within the film. X-ray absorption spectroscopy at the Y K-edge reveals that the effective oxidation state of yttrium is approximately +2.5 in the transparent/bleached state of YHO. Spectroscopic ellipsometry investigations showed a complex non-linear optical depth profile of the related sample confirming the dominant phase of YHO and the presence of Y2O3and Y towards the middle of the film. The first evidence of (n; k) dispersion curves for e-beam sputtered photochromic YHO thin films are reported for transparent and dark states.

In perovskite/silicon tandem solar cells, the utilization of silicon heterojunction (SHJ) solar cells as bottom cells is one of the most promising concepts. Here, we present optimization strategies for the top cell processing and their integration into SHJ bottom cells based on industrial Czochralski (Cz)-Si wafers of 140 μm thickness. We show that combining the self-assembled monolayer [4-(3,6-dimethyl-9H-carbazol-9-yl)butyl]phosphonic acid (Me-4PACz) with an additional phosphonic acid (PA) with different functional groups, can improve film formation when used as a hole transport layer improving wettability, minimizing shunt fraction and reducing nonradiative losses at the buried interface. Transient surface photovoltage and transient photoluminescence measurements confirm that the combined Me-4PACz/PA layer has similar charge transport properties to Me-4PACz alone. Moreover, this work demonstrates the potential for thin, double-side submicron-sized textured industry-relevant silicon bottom cells yielding a high accumulated short-circuit current density of 40.2 mA/cm2and reaching a stabilized power conversion efficiency of >30%. This work paves the way toward industry-compatible, highly efficient tandem cells based on a production-compatible SHJ bottom cell.

Purpose: To assess the prognostic value of subretinal (SRF) and intraretinal fluid (IRF) localizations in type 1 macular neovascularization (MNV) due to age-related macular degeneration (AMD). Subjects: Eyes were prospectively treated with anti-vascular epithelial growth factor (anti-VEGF) intravitreal injections (IVT) according to a Pro-Re-Nata (PRN) or Treat and Extend (TAE) regimen during 24 months. A total of 211 eyes with treatment-naïve type 1 MNV secondary to AMD were consecutively included. Eyes were divided between 2 groups according to the fluid localization: presence of SRF alone (SRF group), or presence of IRF associated or not with SRF (IRF ± SRF group). Results: At baseline the mean BCVA was 66.2 letters. SRF was present in 94.8% of eyes, IRF in 30.8%, and both in 25.6%. Data were available for 201 eyes at 12 months, and 157 eyes at 24 months. The presence of IRF at baseline was associated with lower baseline BCVA and significantly lower BCVA at 12 months (p &lt; 0.001) and 24 months (p &lt; 0.001). Eyes with SRF alone displayed better visual outcomes (BCVA at month 12, SRF = 74.3 letters, IRF ± SRF = 56.9 letters). In the presence of baseline IRF, fibrosis (p = 0.03) and atrophy (p &lt; 0.001) were more frequently found at 24 months. In a multivariate model, the presence of baseline IRF was significantly associated with lower BCVA at month 12 but not at month 24. Conclusion: In type 1 MNV, the presence of baseline IRF was associated with worse visual outcomes compared to SRF alone, and more frequent atrophy and fibrosis.

Nuclear magnetic resonance (NMR) spectroscopy is a valuable and complementary tool in environmental research, but it is underutilized due to the cost, size, and maintenance requirements of standard “high-field” NMR spectrometers. “Low-field” NMR spectrometers are a financially and physically accessible alternative, but their lower sensitivity and increased spectral overlap limit the analysis of heterogeneous environmental/biological media, especially with fast-relaxing samples that produce broad, low-intensity spectra. This study therefore investigates the potential of the steady-state free precession (SSFP) experiment to enhance signal-to-noise ratios (SNRs) of fast-relaxing, complex samples at both high- and low-field. SSFP works by obtaining steady-state transverse signal using a train of equally spaced radiofrequency pulses with the same flip angle and a time between pulses less than the transverse relaxation time, allowing for thousands of scans to be summed in a short time period. Here, 13C-SSFP is applied to samples of varying complexity (egg white, dissolved organic matter, and crude oil) at low-field and at high-field for testing and comparison. The potential of in vivoSSFP NMR is additionally investigated by applying 31P-SSFP to live Eisenia fetidaat high-field. In some samples, SSFP increased 13C SNR by over 2000% at both high-field and low-field compared to standard 13C NMR and enabled detection of peaks that were not observable by standard 13C NMR. Ultimately, SSFP holds great potential for improving analysis of fast-relaxing, complex samples, which could in turn make low-field NMR spectroscopy a more effective tool not only in environmental/biological research but also in numerous other disciplines.

Many animals use visual information to navigate1–4, but how such information is encoded and integrated by the navigation system remains incompletely understood. In Drosophila melanogaster, EPG neurons in the central complex compute the heading direction5by integrating visual input from ER neurons6–12, which are part of the anterior visual pathway (AVP)10,13–16. Here we densely reconstruct all neurons in the AVP using electron-microscopy data17. The AVP comprises four neuropils, sequentially linked by three major classes of neurons: MeTu neurons10,14,15, which connect the medulla in the optic lobe to the small unit of the anterior optic tubercle (AOTUsu) in the central brain; TuBu neurons9,16, which connect the AOTUsu to the bulb neuropil; and ER neurons6–12, which connect the bulb to the EPG neurons. On the basis of morphologies, connectivity between neural classes and the locations of synapses, we identify distinct information channels that originate from four types of MeTu neurons, and we further divide these into ten subtypes according to the presynaptic connections in the medulla and the postsynaptic connections in the AOTUsu. Using the connectivity of the entire AVP and the dendritic fields of the MeTu neurons in the optic lobes, we infer potential visual features and the visual area from which any ER neuron receives input. We confirm some of these predictions physiologically. These results provide a strong foundation for understanding how distinct sensory features can be extracted and transformed across multiple processing stages to construct higher-order cognitive representations.

ABSTRACTMediatised standards of beauty in contemporary western societies contribute to stigma and discrimination of individuals labelled ‘obese’ by medical professionals. Most people who undergo weight-reduction treatments, including bariatric surgery, choose it due to serious health conditions, often unable to lose weight in any other way. However, they are commonly constructed as ‘cheaters’ and blamed for lacking will and self-control. Cultural beliefs demonising fat and fat people produce the perceptions of an inferior identity, often leading to internalised fatphobia among such individuals. This study investigates the lived experiences of 11 individuals after bariatric surgery using semi-structured interviews analysed via narrative framework. The findings demonstrate paradoxical effects bariatric surgery can have on identity, through a persistent ‘obese’ view of self and body perception challenges, indicating long-lasting harmful effects of symbolic violence these individuals experience due to stigmatisation and medicalisation of fat and highlighting hegemonic discourses inscribing normative views on human bodies.

The article discusses the historical context of wealth distribution in the United States and China, highlighting the impact of economic growth on social cohesion. It examines the shift in wealth distribution in the U.S. from 1820 to 2020, attributing it to factors such as globalization and the rise of China as a major economic power. The text suggests the possibility of a negotiated settlement between the U.S. and China, involving other global powers, to prevent potential conflicts and promote a multipolar world. [Extracted from the article]

ABSTRACTDisruptive behaviors are the most common clinical presentation in children and adolescents, particularly among disadvantaged youth referred to community mental health clinics (CMHCs). When left unaddressed, disruptive behaviors can increase the risk of adverse mental health outcomes. While parenting interventions are known to be efficacious and efficient treatment approaches, there are many barriers to involvement in such programs, particularly for disadvantaged populations. This pilot randomized controlled trial evaluated a technology-assisted parenting intervention (Parenting Wisely, PW) with therapist coaching compared to treatment as usual (TAU) at a CMHC. Participants included 53 caregiver-adolescent dyads and 13 clinicians recruited from a CMHC. Dyads randomized to PW + therapist coaching received a multi-component intervention that utilized a technology-assisted parenting program alongside therapist coaching sessions. Feasibility/acceptability assessments were conducted and preliminary findings on parenting outcomes and adolescent behavior outcomes were collected at 3- and 6-months post-baseline. Qualitative and quantitative results supported the feasibility and acceptability of the parenting PW + therapist coaching intervention as evidenced by caregiver engagement, therapist adherence, lack of treatment withdrawals, and satisfaction ratings. Exploratory analyses did not show differences between treatment conditions for parenting and adolescent behavioral outcomes. PW + therapist coaching may be better suited for early adolescents, who are at a critical period when disruptive behavior patterns are not yet ingrained, and parents have more authority and opportunity to address family interactions. Next steps for further evaluation include testing the effectiveness, predictors, moderators, and mechanisms of treatment outcomes of PW + therapist coaching as an adjunct to usual care.

The molecular activation mechanism of the nuclear retinoid X receptors (RXRs) crucially involves ligand-induced corepressor release and coactivator recruitment which mediate transcriptional repression or activation. The ability of RXR to bind diverse coactivators suggests that a coregulator-selective modulation by ligands may open an avenue to tissue- or gene-selective RXR activation. Here, we identified strong induction of peroxisome proliferator-activated receptor γ coactivator 1α (PGC1α) binding to RXR by a synthetic agonist but not by the endogenous ligand 9-cis retinoic acid. Structure-guided diversification of this lead resulted in a set of three structurally related RXR agonists with different ability to promote PGC1α recruitment in cell-free and cellular context. These results demonstrate that selective modulation of coregulator recruitment to RXR can be achieved with molecular glues and potentially open new therapeutic opportunities by targeting the ligand-induced RXR-PGC1α interaction.

Drawing from theoretical and practical notions of negativity, the concept of a "work of the negative" bridges between various approaches to the "negative" within philosophy and theology—from apophatic theology to queer studies. This article analyzes how the concept of negative work, i.e., continued wrestling with the limits of language and understanding, builds a fruitful lens for studying liturgical texts. It presents the concept of "work of the negative," its origins and connections to adjacent fields; applies insights and questions raised by this dynamic to liturgical examples from the recently published community-centered liturgical resource "A Liturgy for All Bodies"; and finally explores the potential of such an approach for the ecclesiological implications of liturgy (lex orandi, lex credendi). [ABSTRACT FROM AUTHOR]

ABSTRACTBackgroundSiblings of individuals with neurodevelopmental conditions (NDCs) are a minority population at higher genetic and environmental risk of poorer neurocognitive and psychosocial outcomes compared to siblings of individuals without NDCs.MethodMeasured over a 15-month interval between 2021 and 2022, the present prospective follow-up study is the first Bayesian examination of the unique relationships between self-reported modifiable individual-level risk, resilience, and neuropsychiatric variables amongst siblings of persons with (n = 134) and without (n = 143) NDCs (mean age 22.42, range 9–38 years, 75.81% female, 79.78% White Caucasian).ResultsThe NDC group maintained elevated rates of self-reported mental health diagnoses at follow-up (effect size δ −0.57), with greater risk and fewer resilience variables than controls (δ ranging 0.50–1.07). The NDC group demonstrated group-level worsening of depression (δ −0.32). At the participant level, NDC siblings had statistically reliable declines in executive functioning and self-regulation (anxiety, empathy, attention, cognitive reappraisal) compared to the controls. Baseline self-reported sleep difficulties strongly predicted both depression and anxiety at follow-up for NDC siblings. Life events had minimal impact on mental health outcomes.ImplicationsFindings suggest the clinical utility of interventions for NDC siblings could be improved with a multi-modal approach, and monitoring and targeting changes in transdiagnostic risk factors contributing to poorer mental health.

For mega-projects like fusion power plants, modularity is a key enabler to cost and schedule efficiency. One way of achieving more modularity is aiming for higher numbers of smaller fusion reactors. Previous work has demonstrated that the levelized cost of electricity (LCOE) of commercial magnetic confinement fusion power plants falls at a decreasing rate with increasing net electric power. Furthermore, net electric power increases more rapidly than size/cost. This is because as fusion power increases the proportion of energy being exported as net electric power plateaus but the size of the plant required increases linearly. Increases in plant size increase upfront capital costs and project complexity. Therefore, there is an optimal design point beyond which any increases in net electric power continue to increase the project cost and complexity but deliver only marginal gains in LCOE. This helps identify a sweet spot between anticipated, better economy of size (cost per unit being smaller at larger unit sizes), and economy of scale (cost per unit being smaller at a higher scale of production).