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Objective: We evaluated the safety of maximal cardiopulmonary exercise testing (CPET) in individuals with sickle cell disease (SCD). Maximal CPET using gas exchange analysis is the gold standard for measuring cardiopulmonary fitness in the laboratory, yet its safety in the SCD population is unclear.Design: Systematic review.Data Sources: Systematic search of Medline (PubMed), EMBASE, Cochrane, ClinicalTrials.gov and professional society websites for all published studies and abstracts through December 2020.Eligibility Criteria For Selecting Studies: Two reviewers independently extracted data of interest from studies that assessed safety outcomes of maximal CPET in children and adults with SCD. A modified version of the Newcastle-Ottawa Scale was used to assess for risk of bias in studies included.Results: In total, 24 studies met inclusion/exclusion criteria. Adverse events were reported separately or as part of study results in 36 (3.8%) of 939 participants with SCD undergoing maximal CPET in studies included. Most adverse events were related to transient ischaemic changes on ECG monitoring or oxygen desaturation during testing, which did not result in arrhythmias or other complications. Only 4 (0.43%) of 939 participants experienced pain events due to maximal CPET.Conclusion: Maximal CPET appears to be a safe testing modality in children and adults with SCD and can be used to better understand the physiological basis of reduced exercise capacity and guide exercise prescription in this population. Some studies did not focus on reporting adverse events related to exercise testing or failed to mention safety monitoring, which contributed to risk of bias. [ABSTRACT FROM AUTHOR]

Abstract When sharing a common goal, confident and competent members are often motivated to contribute to the group, boosting its decision performance. However, it is unclear whether this process remains effective when members can opt in or out of group decisions and prioritize individual interests. Our laboratory experiment (n = 63) and cognitive modeling showed that at the individual level, confidence, competence, and a preference for risk motivated participants’ opt-out decisions. We then analyzed the group-level accuracy of majority decisions by creating many virtual groups of 25 members resampled from the 63 participants in the experiment. Whereas the majority decisions by voters who preferred to participate in group decision making were inferior to individual decisions by loners who opted out in an easy task, this was reversed in a difficult task. Bootstrap-simulation analyses decomposed these outcomes into the effects of a decrease in group size and a decrease in voters’ accuracy accruing from the opt-in/out mechanism, demonstrating how these effects interacted with task difficulty. Our results suggest that the majority rule still works to tackle challenging problems even when individual interests are emphasized over collective performance, playing a functional as well as a democratic role in consensus decision making under uncertainty.

Behavioral and fMRI experiments using a dot estimation task provide insight into how social interactions create and stabilize perceptual norms as socially shared realities within groups.

Aggregation of α-synuclein (α-syn) is associated with the development of a number of neurodegenerative diseases, including Parkinson's disease (PD). The formation of α-syn aggregates results from aberrant accumulation of misfolded α-syn and insufficient or impaired activity of the two main intracellular protein degradation systems, namely the ubiquitin-proteasome system and the autophagy-lysosomal pathway. In this study, we investigated the role of transcription factor EB (TFEB), a master regulator of the autophagy-lysosomal pathway, in preventing the accumulation of α-syn aggregates in human neuroglioma cells. We found that TFEB overexpression reduces the accumulation of aggregated α-syn by inducing autophagic clearance of α-syn. Furthermore, we showed that pharmacological activation of TFEB using 2-hydroxypropyl-β-cyclodextrin promotes autophagic clearance of aggregated α-syn. In summary, our findings demonstrate that TFEB modulates autophagic clearance of α-syn and suggest that pharmacological activation of TFEB is a promising strategy to enhance the degradation of α-syn aggregates.

Purpose: Listening is the gateway to learning in the mainstream classroom; however, classrooms are noisy environments, making listening challenging. Therefore, speech-in-noise tests that realistically incorporate the complexity of the classroom listening environment are needed. The aim of this article was to review the speech stimuli, noise stimuli, presentation mode, and presentation levels of current classroom speech-in-noise tests to determine how representative they are of real-world classroom listening., Method: A comprehensive search of Scopus database following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines was conducted to identify classroom speech-in-noise tests used in the research literature. The search term was classroom AND (listening OR (speech AND (perception OR intelligibility OR recognition OR discrimination) AND noise) OR speech-in-noise) AND (test OR task OR measure OR assessment) AND children in the article title, abstract, and key word fields ., Results: A total of 97 papers met the criteria to be included in the review. While the speech and noise stimuli were generally presented at realistic speech and noise levels, the speech materials were not representative of real-world classroom listening. Additionally, unrealistic noise and presentation modes were used in several studies., Conclusion: This review will help researchers choose appropriate speech-in-noise test stimuli in future research and also help researchers understand what to consider when creating new speech-in-noise tests for classroom listening., Supplemental Material: https://doi.org/10.23641/asha.27659619.

Background: The EQ-5D-Y-3L is widely used for measuring and valuing HRQoL in paediatric populations. This mixed methods study used the EQ-5D-Y-3L measure and applied a retrospective think-aloud approach to examine the self-report validity in children of varying chronological age., Methods: A mixed methods study was conducted in a community-based sample of 39 children aged 6-12 years. In a semi-structured interview, children self-completed the EQ-5D-Y-3L and then engaged in retrospective think-aloud. Conversations were audio-recorded and transcribed for analysis in NVivo using the Tourangeau four-stage response model framework to assess comprehension, judgment, recall, and response mapping issues. Fisher's exact test was used to assess the differences between child-self reported HRQoL across subgroups. The inter-rater agreement between child-parent dyads was assessed with CCC for overall HRQoL and Gwet's AC 1 for dimension level HRQoL., Results: Overall, response issues were detected in n = 18 (46%) children. Comprehension issues were apparent in the "having pain or discomfort" dimension where children found it challenging to understand 'discomfort'. Recall-related issues were observed where children's responses were influenced by their typical tendencies (e.g., being usually worried) or past incidences (e.g., feeling pain sometimes). Judgement-related issues were the most common, particularly in the "doing usual activities" dimension, where children tended to respond based on their self-perceived ability to engage in activities rather than health-related limitations. None of the participants were found to have problems with response mapping. A healthy lifestyle that included diet and exercise was a notable consideration in EQ VAS ratings. The younger age groups had a higher proportion of response issues (6-7 years: 64%, 8-10 years: 62%), compared to older children (11-12 years: 20%). Moreover, children with response issues demonstrated significantly lower EQ-5D-Y-3L scores (mean = 0.78, se = 0.04) as compared to those without (mean = 0.95, se = 0.02) (p-value < 0.001). The overall inter-rater agreement was higher for those without any response issues (CCC = 0.33) than those with (CCC = 0.14). Additionally, higher agreement was noted across all the five dimensions in the subgroup with no response issues relative to those with., Conclusions: Children in the general community may have different perceptions of HRQoL when responding to the EQ-5D-Y-3L possibly due to their limited experience with health-related challenges. The retrospective think-aloud approach adopted highlighted the relatively higher prevalence of response issues in the younger children (ages < 11 years), indicating the need for careful interpretation of self-reported HRQoL using the current version of the EQ-5D-Y-3L in this population., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the Flinders University’s Human Research Ethics Committee (Project ID 4178). Consent for publication: Written informed consent was obtained from the parents on behalf of each child-parent dyad included in the study. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Purpose: Older people (aged ≥ 65 years) are significant users of health and social care systems. However, many outcome measures for quality assessment and economic evaluation lack content validation for this population. Cognitive interviews are a key approach for generating content validity evidence. This systematic scoping review aimed to synthesise evidence on cognitive interviewing practices with older adults, including those with cognitive impairment and dementia, to determine the content validity of outcome measures used with these populations in health and social care settings., Methods: A search was conducted across five databases, and results were uploaded to Covidence review management software. Two researchers performed screening and data extraction using a custom template. The initial search identified 8814 articles. After removing duplicates and conducting title and abstract screening, 105 articles remained. Full-text screening excluded 86 references, resulting in 19 included articles., Results: Studies utilised various cognitive interviewing approaches, predominantly concurrent think-aloud combined with verbal probing. Inductive analysis based on Tourangeau's four-stage response model was commonly used for analysing verbal protocol data. Only one in four included studies indicated any allowances to alleviate cognitive burden for older participants. There was limited involvement of older people with cognitive impairment and dementia, but studies including these populations reported several modifications enhancing meaningful inclusion., Competing Interests: Declarations. Competing interests: The authors have not disclosed any competing interests., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Recent years have seen an explosion of interest in naturalistic behaviour and in machine learning tools for automatically tracking it. However, questions about what to measure, how to measure it, and how to relate naturalistic behaviour to neural activity and cognitive processes remain unresolved. In this Perspective, we propose a general experimental and computational framework - kinematic coding - for measuring how information about cognitive states is encoded in structured patterns of behaviour and how this information is read out by others during social interactions. This framework enables the design of new experiments and the generation of testable hypotheses that link behaviour, cognition, and neural activity at the single-trial level. Researchers can employ this framework to identify single-subject, single-trial encoding and readout computations and address meaningful questions about how information encoded in bodily motion is transmitted and communicated., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Becchio Cristina reports financial support was provided by European Commission. I, the corresponding authors, serve in an editorial capacity for the journal to which I am submitting. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Lanthanide nitride ( Ln N) materials have garnered significant interest in recent years due to their promising potential as heterogeneous catalysts for green ammonia synthesis under low temperature and pressure reaction conditions. Here, we report on the synthesis of an extended series of lanthanide ( Ln ) nitride powders ( Ln = lanthanum, cerium, neodymium, samarium, gadolinium, terbium, dysprosium, erbium, lutetium) and their structural and vibrational properties. Polycrystalline powders were fabricated using a ball milling mechanochemical process, and their structural properties were assessed by X-ray diffraction (XRD) and transmission electron microscopy (TEM). The experimental lattice constants deduced from XRD and TEM were compared with density functional theory-based calculated lattice constants using the Perdew-Burke-Ernzerhof exchange-correlation functional. We show that the calculated lattice constants are within 1-1.5% of the experimental values for the majority of the Ln N species-a notable increase in accuracy over prior computational approaches. The frequencies of Raman scattering from the LO(Γ) phonon are reported across the series and compare well with published thin-film data on a smaller selection of the series. As expected, there is a linear relationship between the LO(Γ) phonon frequency and atomic number. Finally, we demonstrate that Raman spectroscopy can be used to detect the presence of a nanoscale oxide layer on the surface of ErN powders., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Background: Although regular physical activity (PA) mitigates the risk for cardiovascular disease (CVD) during midlife, existing PA interventions are minimally effective. Harnessing social influences in daily life shows promise: digital micro-interventions could effectively engage these influences on PA and require testing., Purpose: This feasibility study employed ecological momentary assessment with embedded micro-randomization to activate two types of social influences (i.e., comparison, support; NCT04711512)., Methods: Midlife adults (N = 30, MAge = 51, MBMI = 31.5 kg/m2, 43% racial/ethnic minority) with ≥1 CVD risk conditions completed four mobile surveys per day for 7 days while wearing PA monitors. After 3 days of observation, participants were randomized at each survey to receive 1 of 3 comparison micro-interventions (days 4-5) or 1 of 3 support micro-interventions (days 6-7). Outcomes were indicators of feasibility (e.g., completion rate), acceptability (e.g., narrative feedback), and potential micro-intervention effects (on motivation and steps within-person)., Results: Feasibility and acceptability targets were met (e.g., 93% completion); ratings of micro-intervention helpfulness varied by intervention type and predicted PA motivation and behavior within-person (srs=0.16, 0.27). Participants liked the approach and were open to ongoing micro-intervention exposure. Within-person, PA motivation and behavior increased from baseline in response to specific micro-interventions (srs=0.23, 0.13), though responses were variable., Conclusions: Experimental manipulation of social influences in daily life is feasible and acceptable to midlife adults and shows potential effects on PA motivation and behavior. Findings support larger-scale testing of this approach to inform a digital, socially focused PA intervention for midlife adults., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

Women age 40-60 are disproportionately affected by health problems that increase their risk for cardiovascular disease (CVD; e.g. hypertension). Social comparisons (i.e. self-evaluations relative to others) are known to influence health in this and other groups, but their nature and consequences in daily life are poorly understood. We conducted an ecological momentary assessment study over 10 days (5x/day) with 75 women ages 40-60 who had ≥1 CVD risk conditions (M Age  = 51.6 years, M BMI  = 34.0 kg/m 2 ). Using a mix of frequentist and Bayesian analytic approaches, we examined characteristics of women's naturally occurring comparisons and tested predictions from the Identification/Contrast Model within-person (e.g. identifying with an upward target results in positive affect, whereas contrasting results in negative affect). Comparisons occurred at 21% of moments, with considerable within-person variability in response. In line with predictions from the Identification/Contrast Model, women were more likely to experience positive affect after upward identification or downward contrast and more likely to experience negative affect after upward contrast or downward identification, though observed nuances warrant additional consideration. Overall, findings support the Identification/Contrast Model to describe women's comparison experiences as they occur in daily life. Future work should determine pathways between the immediate consequences of comparisons and longer-term health outcomes., (© 2024 The Authors. Applied Psychology: Health and Well‐Being published by John Wiley & Sons Ltd on behalf of International Association of Applied Psychology.)

Living systems continually respond to signals from the surrounding environment. Survival requires that their responses adapt quickly and robustly to the changes in the environment. One particularly challenging example is olfactory navigation in turbulent plumes, where animals experience highly intermittent odor signals while odor concentration varies over many length- and timescales. Here, we show theoretically that Drosophila olfactory receptor neurons (ORNs) can exploit proximity to a bifurcation point of their firing dynamics to reliably extract information about the timing and intensity of fluctuations in the odor signal, which have been shown to be critical for odor-guided navigation. Close to the bifurcation, the system is intrinsically invariant to signal variance, and information about the timing, duration, and intensity of odor fluctuations is transferred efficiently. Importantly, we find that proximity to the bifurcation is maintained by mean adaptation alone and therefore does not require any additional feedback mechanism or fine-tuning. Using a biophysical model with calcium-based feedback, we demonstrate that this mechanism can explain the measured adaptation characteristics of Drosophila ORNs.

More than half of older people in long-term care facilities have dementia. Little is currently known about the methods and instruments which can be used to capture the perspectives of older people, including those with dementia, regarding the quality of care provided in such facilities. The main aims of this scoping review were two-fold. Firstly, to identify quality of care instruments that have been applied in long-term care settings. Secondly, to evaluate how these instruments have been developed and validated, particularly in terms of their applicability among older people with dementia. Seven databases (Medline, Web of Science, Scopus, ProQuest, Ageline, CINHAL and google scholar) were searched for relevant literature without any date limit. We used quality criteria adapted from COSMIN (Consensus-based Standards for the selection of health status Measurement Instruments) guidelines to assess the psychometric properties of the instruments. The search identified 16 quality of care instruments which had been used in long-term care settings. Of which, two (12.5%) were specifically designed for older people with dementia, and three instruments (18.7%) were modified for use with older people with mild to moderate dementia. A variety of methods were used to develop the identified instruments including literature reviews, qualitative interviews, expert panel reviews, pre-testing and piloting with older people. None of the identified instruments had been subjected to comprehensive psychometric assessment. Most instruments for assessing quality of care in long term care settings lack alternative communication techniques tailored to people with dementia. This review highlights the need for more rigorous psychometric testing of existing instruments for assessing quality of care in long-term care settings. Several existing measures show promise and may be taken forward for further testing and development for widespread application with older people, including those living with dementia, in long term care settings., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: The paediatric intensive care unit changed heparin infusion dosing from a variable weight-based concentration to a fixed concentration strategy, when smart pump-based drug library was introduced. This change meant significantly lower rates of infusion were needed for the same dose of heparin in the neonatal population. We performed a safety and efficacy assessment of this change., Methods: We performed a retrospective single-centre evaluation based on data from respiratory VA-extracorporeal membrane oxygenation (ECMO) patients weighing ≤5 kg, pre and post the change to fixed strength heparin infusion. Efficacy was analysed by distribution of activated clotting times (ACT) and heparin dose requirements between the groups. Safety was analysed using thrombotic and haemorrhagic event rates. Continuous variables were reported as median, interquartile ranges, and non-parametric tests were used. Generalised estimating equations (GEE) were used to analyse associations of heparin dosing strategy with ACT and heparin dose requirements in the first 24 h of ECMO. Incidence rate ratios of circuit related thrombotic and haemorrhagic events between groups were analysed using Poisson regression with offset for run hours., Results: 33 infants (20 variable weight-based, 13 fixed concentration) were analysed. Distribution of ACT ranges and heparin dose requirements were similar between the two groups during the ECMO run and this was confirmed by GEE. Incidence rate ratios of thrombotic (fixed v weight-based) (1.9 [0.5-8], p = .37), and haemorrhagic events (0.9 [0.1-4.9], p = .95) did not show statistically significant differences., Conclusions: Fixed concentration dosing of heparin was at least equally effective and safe compared to a weight-based dosing., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: The aim of this research note is to introduce a new appraisal form, the Classroom Communication and Collaboration (C3) Appraisal, designed to evaluate communication and collaboration within classroom settings., Method: A comprehensive synthesis of the key skills from a broad range of publications on successful communication and collaboration in the classroom was conducted. The resulting appraisal comprises 39 items across six scales: crafting clear messages, appropriateness of communication exchange, active listening, pragmatics and discourse, communication breakdown, and collaboration. To demonstrate its application, an exemplar usage of the C3 Appraisal involving a hearing child and a child with hearing loss engaged in a collaborative learning task is presented., Results: The C3 Appraisal allowed for the quality and successfulness of the collaborative learning task between the two children to be assessed and quantified across the six scales., Conclusions: These findings highlight the utility of the C3 Appraisal as a valuable tool for evaluating communication and collaboration in classroom environments. Next steps are to test the reliability and validity of the C3 Appraisal on a large data set.

Background/aim: There have been advances in the development of immune checkpoint inhibitors for monotherapy and combination therapy with other anticancer agents in recent years. The combination of bevacizumab, carboplatin, and paclitaxel with atezolizumab, an anti-programmed death ligand 1 antibody (ABCP therapy), has been reported to be effective for treating non-small cell lung cancer. However, reports on its adverse events are limited. In this study, a survey and disproportionality analysis based on the Japanese Adverse Drug Event Report (JADER) database was conducted to elucidate the adverse event profile of ABCP therapy., Materials and Methods: The reporting odds ratio (ROR) and information component were used as indicators for the disproportionality analysis. The ROR was also used to assess the changes in the reporting intensity with combination therapy, and the mutual exclusivity of the 95% confidence interval between the compared groups was considered., Results: The reported adverse events of ABCP therapy mirrored those of the individual drugs that constituted it. ABCP therapy enhanced the reporting intensity of adverse events related to leukocytes and the skin, while decreased those related to interstitial lung disease and hepatic function abnormality as immune-related adverse events caused by atezolizumab, and gastrointestinal perforation caused by bevacizumab., Conclusion: Our analysis of data from the JADER database has revealed the adverse event profile of ABCP therapy. Our findings emphasize the importance of effectively managing febrile neutropenia and skin-related adverse events in ABCP therapy., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Introduction From a coronavirus disease (COVID-19) pandemic perspective, Aotearoa New Zealand (NZ) rural residents formed an at-risk population, and disparities between rural and urban COVID-19 vaccination coverage have been found. Aim To gain insight into factors contributing to the urban-rural COVID-19 vaccination disparity by exploring NZ rural health providers' experiences of the vaccine rollout and pandemic response in rural Māori and Pasifika communities. Methods Rural health providers at four sites participated in individual or focus group semi-structured interviews exploring their views of the COVID-19 vaccine rollout. Thematic analysis was undertaken using a framework-guided rapid analysis method. Results Twenty interviews with 42 participants were conducted. Five themes were identified: Pre COVID-19 rural situation, fragile yet resilient; Centrally imposed structures, policies and solutions - urban-centric and Pakehā focused; Multiple logistical challenges - poor/no consideration of rural context in planning stages resulting in wasted resource and time; Taking ownership - rural providers found geographically tailored, culturally anchored and locally driven solutions; Future directions - sustained investment in rural health services, including funding long-term integrated (rather than 'by activity') health services, would ensure success in future vaccine rollouts and other health initiatives for rural communities. Discussion In providing rural health provider perspectives from rural areas serving Māori and Pasifika communities during the NZ COVID-19 vaccine rollout, the importance of the rural context is highlighted. Findings provide a platform on which to build further research regarding models of rural health care to ensure services are designed for rural NZ contexts and capable of meeting the needs of diverse rural communities.

Acanthamoeba keratitis (AK) is a severe infection of the cornea. Prevention and treatment are difficult due to the inefficacy of currently available compounds. The impact of many commonly used compounds for routine examinations of Acanthamoeba is unexplored but might offer insight useful in combatting AK. In this study, we demonstrate that sodium metabisulfite, a common preservation constituent of eye care solutions, was found to be active against Acanthamoeba trophozoites at concentrations lower than that commonly found in eye drops (IC 50 0.03 mg/mL). We demonstrate that sodium metabisulfite depletes thiamine from growth medium and that Acanthamoeba is a thiamine auxotroph, requiring thiamine salvage for growth. The inhibitory effects of sodium metabisulfite can be overcome by thiamine supplementation. These results are consistent with the lack of key enzymes for thiamine biosynthesis in the genome of Acanthamoeba , an area which might prove exploitable using new or existing compounds. Indeed, this study highlights sodium metabisulfite as a useful inhibitor of Acanthamoeba castellanii trophozoites in vitro and that it acts, at least in part, by limiting available thiamine.

Objective: Use of 52-mg levonorgestrel intrauterine system (LNG-IUS) in adolescents for heavy menstrual bleeding (HMB), dysmenorrhea, and contraception has increased, yet little is known about the factors predicting removal and dissatisfaction in adolescents. The aim of this study was to identify factors predicting LNG-IUS removal in adolescents., Methods: This was a retrospective cohort study including all adolescents (9-19 years) who underwent LNG-IUS insertion between 2012 and 2021 (n = 536). A medical record review was conducted and data were collated on medical and gynecological history, age, indications for insertion, complications, expulsions, and removals. The data were analyzed using χ 2 tests., Results: Indications for LNG-IUS insertions (n = 536) among 517 individual patients (n = 517) included menstrual management (n = 142), HMB alone (n = 118), HMB and pelvic pain/dysmenorrhea (n = 105), dysmenorrhea/pelvic pain alone (n = 47), and contraception (n = 16). Associated diagnoses included intellectual disability (44.29%, 229/517), chronic pain conditions (12.77%, 66/517), and additional mental health concerns (24.37%, 126/517). Patient dissatisfaction with LNG-IUS led to removal in 61 (11.38%), mostly for pain or persistent bleeding. Higher removal rates occurred in those with associated chronic pain conditions (46.97%, χ 2 = 55.9, P < .05), mental health concerns (16.67%, χ 2 = 5.06, P < .05), and bleeding disorders (26.32%, χ 2 = 5.09, P < .05). Among the cohort with an intellectual disability, lower rates of removal occurred (5.7%, χ 2 = 11.2, P < .05). Whereas the LNG-IUS removal rate among gender-diverse youth was 23.07%, this was not statistically significant. Younger age was also not associated with a statistically significant increase in removals (13.72%, χ 2 = 0.73, P > .05)., Discussion: Adolescents have a low dissatisfaction and removal rate (11.38%) of LNG-IUS. Chronic pain, bleeding tendency, and mental health concerns are associated with higher removal rates and intellectual disability with lower rates. These findings are useful in counselling patients and families about LNG-IUS., Competing Interests: Conflicts of Interest There are no potential conflicts of interests, real or perceived, relating to this submission. This study did not receive funding and is not sponsored, and we do not have any further disclosures. The corresponding author (Alexandra Baum) has written the first draft of the manuscript with input from other listed authors. No honorarium, grant, or other form of payment was given to anyone to produce this manuscript., (Copyright © 2023. Published by Elsevier Inc.)

Background: Quality of life is an important quality indicator for health and aged care sectors. However, self-reporting of quality of life is not always possible given the relatively high prevalence of cognitive impairment amongst older people, hence proxy reporting is often utilised as the default option. Internationally, there is little evidence on the impact of proxy perspective on interrater agreement between self and proxy report., Objectives: To assess the impacts of (i) cognition level and (ii) proxy perspective on interrater agreement using a utility instrument, the Quality of Life-Aged Care Consumers (QOL-ACC)., Methods: A cross-sectional study was undertaken with aged care residents and family member proxies. Residents completed the self-report QOL-ACC, while proxies completed two proxy versions: proxy-proxy perspective (their own opinion), and proxy-person perspective (how they believe the resident would respond). Interrater agreement was assessed using quadratic weighted kappas for dimension-level data and concordance correlation coefficients and Bland-Altman plots for utility scores., Results: Sixty-three residents (22, no cognitive impairment; 41, mild-to-moderate cognitive impairment) and proxies participated. In the full sample and in the mild-to-moderate impairment group, the mean self-reported QOL-ACC utility score was significantly higher than the means reported by proxies, regardless of perspective (p < 0.01). Agreement with self-reported QOL-ACC utility scores was higher when proxies adopted a proxy-person perspective., Conclusion: Regardless of cognition level and proxy perspective, proxies tend to rate quality of life lower than residents. Further research is needed to explore the impact of such divergences for quality assessment and economic evaluation in aged care., (© 2024. The Author(s).)

The internet is the primary source of infertility-related information for most people who are experiencing fertility issues. Although no longer shrouded in stigma, the privacy of interacting only with a computer provides a sense of safety when engaging with sensitive content and allows for diverse and geographically dispersed communities to connect and share their experiences. It also provides businesses with a virtual marketplace for their products. The introduction of ChatGPT, a conversational language model developed by OpenAI to understand and generate human-like text in response to user input, in November 2022, and other emerging generative artificial intelligence (AI) language models, has changed and will continue to change the way we interact with large volumes of digital information. When it comes to its application in health information seeking, specifically in relation to fertility in this case, is ChatGPT a friend or foe in helping people make well-informed decisions? Furthermore, if deemed useful, how can we ensure this technology supports fertility-related decision-making? After conducting a study into the quality of the information provided by ChatGPT to people seeking information on fertility, we explore the potential benefits and pitfalls of using generative AI as a tool to support decision-making., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

Purpose: Teachers spend a significant amount of time in classrooms, which can be noisy environments. The aim of this scoping review was to determine what is known from the literature about the effect of classroom acoustic conditions on teachers' health and well-being., Method: This scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) protocol. Four bibliographic databases were searched: ERIC, PubMed, Scopus, and Web of Science., Results: Thirty-three articles were deemed relevant for the review. The most studied health aspect was teachers' vocal health. The majority of results showed higher noise levels or a higher number of students have a negative effect on teachers' health and well-being (61% and 60%, respectively), while 39% showed a negative effect of longer reverberation times. Most other results showed no effect., Conclusions: These results show that poor classroom acoustic conditions can have a negative effect on teachers' health and well-being. Therefore, creating classrooms with good acoustic conditions and controlling noise is vital. Limitations are discussed, and future research to better understand the relationship between classroom acoustic conditions and teachers' health and well-being is proposed. This future research will help in understanding the acoustic conditions that are needed to optimize teachers' health and well-being in the classroom.

Background: Quality-of-life is an essential outcome for quality assessment and economic evaluation in health and social care. The-Quality-of-Life - Aged Care Consumers (QOL-ACC) is a new preference-based quality-of-life measure, psychometrically validated with older people in aged care. More evidence is needed to inform the self-report reliability of the QOL-ACC in older people with varying levels of cognitive impairment and dementia., Methods: A think-aloud protocol was developed and applied with older residents. The Mini Mental State Examination (MMSE) was applied to assign participants to no cognitive impairment (NCI - MMSE score ≥ 27) and cognitive impairment (MMCI - MMSE score < 27) subgroups. Three independent raters utilised a Tourangeau survey response model-based framework to identify response issues. Data were compared across cognition subgroups and synthesized using a 'traffic light' grading to classify frequency and type of response issues. Gradings were utilised to assess self-report reliability according to different levels of cognitive impairment., Results: Qualitative data from 44 participants (NCI = 20, MMCI = 24) were included for analysis. Response issues were more evident in the cognitive impairment subgroup than the no cognitive impairment subgroup. All participants who received a 'red' grade had an MMSE score of < 20 and 66% of 'amber' grades occurred in the cognitive impairment subgroup., Conclusions: The QOL-ACC is able to be completed reliably by older residents with an MMSE score > 17. Future research is needed to assess the generalisability of these findings to other preference-based quality of life instruments and for older people in other care settings including health systems., (© 2023. The Author(s).)

Mammalian type 2 carnitine parmitoyltransferase (EC 2.3.1.21), abbreviated as CPT2, is an enzyme involved in the translocation of fatty acid into the mitochondrial matrix space, and catalyzes the reaction acylcarnitine + CoA = acyl-CoA + carnitine. When rat CPT2 was expressed in Escherichia coli, its behavior was dependent on the presence or absence of i) its mitochondrial localization sequence and ii) a short amino acid sequence thought to anchor it to the mitochondrial inner membrane: CPT2 containing both sequences behaved as a hydrophobic protein, while recombinant CPT2 lacking both regions behaved as a water soluble protein; if only one region was present, the resultant proteins were observed in both fractions. Because relatively few protein species could be obtained from bacterial lysates as insoluble pellets under the experimental conditions used, selective enrichment of recombinant CPT2 protein containing both hydrophobic sequences was easily achieved. Furthermore, when CPT2 enriched in insoluble fraction was resuspended in an appropriate medium, it showed catalytic activity typical of CPT2: it was completely suppressed by the CPT2 inhibitor, ST1326, but not by the CPT1 inhibitor, malonyl-CoA. Therefore, we conclude that the bacterial expression system is an effective tool for characterization studies of mammalian CPT2.

Objectives: No guidance currently exists as to the cognition threshold beyond which self-reported quality of life for older people with cognitive impairment and dementia is unreliable., Methods: Older aged care residents (≥ 65 years) were randomly assigned to complete the EQ-5D-5L in computer-based (eye movements were tracked) or hard copy (participants were encouraged to 'think aloud') format. Cognition was assessed using the Mini-Mental State Examination (MMSE). Think aloud and eye tracking data were analysed by two raters, blinded to MMSE scores. At the participant level, predefined criteria were used to assign traffic light grades (green, amber, red). These grades indicate the extent to which extracted data elements provided evidence of self-report reliability. The MMSE-defined cognition threshold was determined following review of the distributions of assigned traffic light grades., Results: Eighty-one residents participated and provided complete data (38 eye tracking, 43 think aloud). In the think aloud cohort, all participants with an MMSE score ≤ 23 (n = 10) received an amber or red grade, while 64% of participants with an MMSE score ≥ 24 (21 of 33) received green grades. In the eye tracking cohort, 68% of participants with an MMSE score ≥ 24 (15 of 22) received green grades. Of the 16 eye tracking participants with an MMSE score ≤ 23, 14 (88%) received an amber or red grade., Conclusions: Most older residents with an MMSE score ≥ 24 have sufficient cognitive capacity to self-complete the EQ-5D-5L. More research is needed to better understand self-completion reliability for other quality-of-life instruments in cognitively impaired populations., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objectives: This study assessed hearing aid benefits for people with a normal audiogram but hearing-in-noise problems in everyday listening situations., Design: Exploratory double-blinded case-control study whereby participants completed retrospective questionnaires, ecological momentary assessments, speech-in-noise testing, and mental effort testing with and without hearing aids. Twenty-seven adults reporting speech-in-noise problems but normal air conduction pure-tone audiometry took part in the study. They were randomly separated into an experimental group that trialed mild-gain hearing aids with advanced directional processing and a control group fitted with hearing aids with no gain or directionality., Results: Self-reports showed mild-gain hearing aids reduce hearing-in-noise difficulties and provide a better hearing experience (i.e., improved understanding, participation, and mood). Despite the self-reported benefits, the laboratory tests did not reveal a benefit from the mild-gain hearing aids, with no group differences on speech-in-noise tests or mental effort measures. Further, participants found the elevated cost of hearing aids to be a barrier for their adoption., Conclusions: Hearing aids benefit the listening experience in some listening situations for people with normal audiogram who report hearing difficulties in noise. Decreasing the price of hearing aids may lead to greater accessibility to those seeking remediation for their communication needs., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Markets for international surrogacy often arise in jurisdictions with limited regulations regarding assisted reproductive technologies. In some countries, like Australia, regulated domestic surrogacy services are often sidestepped for international providers. This study describes how Australian intended parents decide where to pursue surrogacy and compares the characteristics and outcomes of arrangements completed within and outside of Australia. The findings show that, although intended parents preferred undergoing surrogacy in Australia, perceiving the process as too long and complicated was a common reason to pursue an international arrangement. Multiple embryo transfer, anonymous gamete donation, and a lack of counselling were common in international surrogacy arrangements. When compared to surrogacy arrangements completed in Australia, where single embryo transfer is mandatory for surrogacy cycles, the rates of multiple birth, preterm birth and neonatal intensive care in international surrogacy were higher. These findings raise concerns about the health and welfare of international surrogacy participants, particularly the surrogates and children. In lieu of any international instrument regulating surrogacy, improving access to surrogacy at a domestic level would reduce the number of people engaging with international arrangements and in turn, reduce the potential for harm.

Purpose: Self-Reporting using traditional text-based Quality-of-Life (QoL) instruments can be difficult for people living with sensory impairments, communication challenges or changes to their cognitive capacity. Adapted communication techniques, such as Easy-Read techniques, or use of pictures could remove barriers to participation for a wide range of people. This review aimed to identify published studies reporting adapted communication approaches for measuring QoL, the methodology used in their development and validation among adult populations., Methods: A scoping review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews checklist was undertaken., Results: The initial search strategy identified 13,275 articles for screening, with 264 articles identified for full text review. Of these 243 articles were excluded resulting in 21 studies for inclusion. The majority focused on the development of an instrument (12 studies) or a combination of development with some aspect of validation or psychometric testing (7 studies). Nineteen different instruments were identified by the review, thirteen were developed from previously developed generic or condition-specific quality of life instruments, predominantly aphasia (7 studies) and disability (4 studies). Most modified instruments included adaptations to both the original questions, as well as the response categories., Conclusions: Studies identified in this scoping review demonstrate that several methods have been successfully applied e.g. with people living with aphasia post-stroke and people living with a disability, which potentially could be adapted for application with more diverse populations. A cohesive and interdisciplinary approach to the development and validation of communication accessible versions of QOL instruments, is needed to support widespread application, thereby reducing reliance on proxy assessors and promoting self-assessment of QOL across multiple consumer groups and sectors., (© 2023. The Author(s).)

Purpose: Increasingly there are calls to routinely assess the health-related quality of life (HRQoL) of older people receiving aged care services, however the high prevalence of dementia and cognitive impairment remains a challenge to implementation. Eye-tracking technology facilitates detailed assessment of engagement and comprehension of visual stimuli, and may be useful in flagging individuals and populations who cannot reliably self-complete HRQoL instruments. The aim of this study was to apply eye-tracking technology to provide insights into self-reporting of HRQoL among older people in residential care with and without cognitive impairment., Methods: Residents (n = 41), recruited based on one of three cognition subgroups (no, mild, or moderate cognitive impairment), completed the EQ-5D-5L on a computer with eye tracking technology embedded. Number and length of fixations (i.e., eye gaze in seconds) for key components of the EQ-5D-5L descriptive system were calculated., Results: For all dimensions, participants with no cognitive impairment fixated for longer on the Area of Interest (AOI) for the response option they finally chose, relative to those with mild or moderate cognitive impairment. Participants with cognitive impairment followed similar fixation patterns to those without. There was some evidence that participants with cognitive impairment took longer to complete and spent relatively less time attending to the relevant AOIs, but these differences did not reach statistical significance generally., Conclusions: This exploratory study applying eye tracking technology provides novel insights and evidence of the feasibility of self-reported HRQoL assessments in older people in aged care settings where cognitive impairment and dementia are highly prevalent., (© 2023. The Author(s).)

Acanthamoeba is an opportunistic free-living heterotrophic protist that is the most predominant amoeba in diverse ecological habitats. Acanthamoeba causes amoebic keratitis (AK), a painful and potentially blinding corneal infection. Major risk factors for AK have been linked to non-optimal contact lens hygiene practices and Acanthamoeba contamination of domestic and recreational water. This study investigated the incidence and seasonal variation of Acanthamoeba spp. within coastal lagoons located on the eastern coast of Australia and then examined the association between Acanthamoeba and water abiotic factors and bacterial species within the water. Water samples were collected from four intermittently closed and open lagoons (ICOLLs) (Wamberal, Terrigal, Avoca and Cockrone) every month between August 2019 to July 2020 except March and April. qPCR was used to target the Acanthamoeba 18S rRNA gene, validated by Sanger sequencing. Water abiotic factors were measured in situ using a multiprobe metre and 16S rRNA sequencing (V3-V4) was performed to characterise bacterial community composition. Network analysis was used to gauge putative associations between Acanthamoeba incidence and bacterial amplicon sequence variants (ASVs). Among 206 water samples analysed, 79 (38.3%) were Acanthamoeba positive and Acanthamoeba level was significantly higher in summer compared with winter, spring, or autumn (p = 0.008). More than 50% (23/45) water samples of Terrigal were positive for Acanthamoeba which is a highly urbanised area with extensive recreational activities while about 32% (16/49) samples were positive from Cockrone that is the least impacted lagoon by urban development. All sequenced strains belonged to the pathogenic genotype T4 clade except two which were of genotype clades T2 and T5. Water turbidity, temperature, intl1 gene concentration, and dissolved O 2 were significantly associated with Acanthamoeba incidence (p < 0.05). The ASVs level of cyanobacteria, Pseudomonas spp., Candidatus spp., and marine bacteria of the Actinobacteria phylum and Acanthamoeba 18S rRNA genes were positively correlated (Pearson's r ≥ 0.14). The presence of Acanthamoeba spp. in all lagoons, except Wamberal, was associated with significant differences in the composition of bacterial communities (beta diversity). The results of this study suggest that coastal lagoons, particularly those in urbanised regions with extensive water recreational activities, may pose an elevated risk to human health due to the relatively high incidence of pathogenic Acanthamoeba in the summer. These findings underscore the importance of educating the public about the rare yet devastating impact of AK on vision and quality of life, highlighting the need for collaborative efforts between public health officials and educators to promote awareness and preventive measures, especially focusing lagoons residents and travellers., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

During midlife (ages 40-60), women experience myriad changes that elevate their risk for cardiovascular disease (CVD), including decreased physical activity (PA). Women cite lack of social support for PA and lack of active peers who can serve as role models as key barriers. Digital tools such as web applications can provide exposure to these social inputs; they are also accessible in daily life and require modest time investment. However, as few tools have been designed to meet the unique needs of women in midlife with CVD risk, our research team previously built a web application that is tailored for this population. In the present study, we used a convergent mixed methods design to develop a deep understanding of the feasibility, usability, and acceptability of this web application in a sample of identified end users. Participants ( N  = 27, M Age  = 53 years, M BMI  = 32.6 kg/m 2 ) used the web application at the start of each day for 7 days and completed a 1-hour qualitative interview at the end of this test period. Integration of findings from two-level multilevel models (quantitative) and thematic analysis (qualitative) indicated support for the feasibility, usability, and acceptability of the new web application among women in midlife with CVD risk conditions and identified critical opportunities for improving the user experience. Findings also speak to the utility of options for content selection that can meet women's needs in daily life and highlight women's desire for PA resources that prioritize their perspectives., Competing Interests: The authors declare that there is no conflict of interest. The Institutional Review Board at Rowan University approved this study (PRO-2021-422)., (© The Author(s) 2023.)

Purpose: University is an important time for learning; therefore, it is vital that the classroom acoustic environment is conducive for all students. The aim of this scoping review was to determine what is known from the literature about the effect of classroom acoustic conditions on university students' listening, learning, and well-being and identify future research needs., Method: This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol. After a search of four online databases, a total of 29 articles met the criteria to be included in the review., Results: The scoping review revealed that poor classroom acoustic conditions such as increased noise, decreased signal-to-noise ratio, increased reverberation time, decreased clarity, or decreased speech transmission index largely have a negative effect on university students' listening, learning, and well-being. Nonnative speakers were more adversely affected than native speakers. Students with hearing loss were also more adversely affected, though these students were only included in two studies., Conclusions: It would be beneficial for acoustic modifications to be made in classrooms to enhance students' listening, learning, and well-being. Limitations of the reviewed studies and future research needs are discussed.

The aim of this article is to demonstrate "mentoring through service-learning" models can be powerful avenues to support the development of emerging adult practitioners, and are scalable to new global contexts when careful attention is paid to the local culture and evidence-based principles for mentoring and service-learning. The study presents outcome findings for mentors who participated in Campus Connections Aotearoa, a culturally translated version of a US-based service-learning experience and therapeutic youth mentoring program implemented in New Zealand, based on a mixed-method, pre-post evaluation survey involving 62 ethnically diverse mentors (81% female). A large, significant increase in mentoring self-efficacy and small to moderate significant increases for attunement to others, sociability and leadership, and problem-solving and perspective-taking were found. Open-ended survey responses revealed self-reported changes in both personal and professional growth. The discussion highlights the importance of theory and evidence-driven design decisions and an intensive evidence-informed training curriculum for mentoring-based service-learning programs., (© 2023 The Authors. Journal of Community Psychology published by Wiley Periodicals LLC.)

Purpose: The EQ-5D-5L is a preference-based instrument for measuring and valuing health-related quality of life (HRQoL). The EQ-5D-5L has been used extensively in economic evaluation, including in aged care. However, older adults' understanding of the EQ-5D-5L has not been comprehensively investigated to date. This research aimed to assess older adults' understanding of the EQ-5D-5L using a think-aloud protocol with two cognition groups: no cognitive impairment and mild/moderate cognitive impairment., Methods: Participants' cognition was assessed using the Standardised Mini-Mental State Examination (SMMSE). Face-to face interviews were conducted with concurrent and retrospective think-aloud encouraged through verbal probing. Audio recordings were transcribed, and qualitative analysis, informed by the Tourangeau four-stage Response Model (comprehension, retrieval, decision process, response process) was conducted in NVivo., Results: In total, 46 older adults (age 65 +) were recruited from 10 residential care facilities across South Australia (n = 25 no cognitive impairment, n = 21 mild/moderate cognitive impairment). Comprehension, retrieval, judgement and response mapping issues were common across all cognition levels and EQ-5D-5L dimensions. The two dimensions resulting in the most response issues were usual activities and personal care., Conclusion: Older adults may bring a different understanding to the EQ-5D-5L descriptive system than that expected given testing with general population samples. Dimension descriptors that are more relevant to this population may facilitate responses that better align with the underlying EQ-5D-5L concept model., (© 2023. The Author(s).)

This work presents a general chemical reaction network theory for olfactory sensing processes that employ G-protein-coupled receptors as olfactory receptors (ORs). The theory can be applied to general mixtures of odorants and an arbitrary number of ORs. Reactions of ORs with G-proteins, in both the presence and absence of odorants, are explicitly considered. A unique feature of the theory is the definition of an odor activity vector consisting of strengths of odorant-induced signals from ORs relative to those due to background G-protein activity in the absence of odorants. It is demonstrated that each component of the odor activity defined this way reduces to a Michaelis-Menten form capable of accounting for cooperation or competition effects between different odorants. The main features of the theory are illustrated for a two-odorant mixture. Known and potential mixture effects, such as suppression, shadowing, inhibition, and synergy, are quantitatively described. Effects of relative values of rate constants, basal activity, and G-protein concentration are also demonstrated.

The Two Weeks in the World research project has resulted in a dataset of 3087 clinically relevant bacterial genomes with pertaining metadata, collected from 59 diagnostic units in 35 countries around the world during 2020. A relational database is available with metadata and summary data from selected bioinformatic analysis, such as species prediction and identification of acquired resistance genes., (© 2023. Springer Nature Limited.)

When sharing a common goal, confident and competent members are often motivated to contribute to the group, boosting its decision performance. However, it is unclear whether this process remains effective when members can opt in or out of group decisions and prioritize individual interests. Our laboratory experiment (n = 63) and cognitive modeling showed that at the individual level, confidence, competence, and a preference for risk motivated participants' opt-out decisions. We then analyzed the group-level accuracy of majority decisions by creating many virtual groups of 25 members resampled from the 63 participants in the experiment. Whereas the majority decisions by voters who preferred to participate in group decision making were inferior to individual decisions by loners who opted out in an easy task, this was reversed in a difficult task. Bootstrap-simulation analyses decomposed these outcomes into the effects of a decrease in group size and a decrease in voters' accuracy accruing from the opt-in/out mechanism, demonstrating how these effects interacted with task difficulty. Our results suggest that the majority rule still works to tackle challenging problems even when individual interests are emphasized over collective performance, playing a functional as well as a democratic role in consensus decision making under uncertainty., (© 2023. Springer Nature Limited.)

Objectives: Cognitive analytic therapy (CAT) is used within UK mental health settings as a treatment for transdiagnostic complex psychological presentations. However, it is not routinely offered by the NHS Talking Therapies, for anxiety and depression (NHS Talking Therapies) programme which provides psychological treatments for common mental health difficulties. We aimed to evaluate the outcomes of providing CAT treatment to patients presenting with depression and/or anxiety, within the context of relational difficulties, adverse childhood experience or difficulty managing emotions, returning for further psychological treatment within NHS Talking Therapies., Methods: This was a pragmatic, real-world evaluation, involving routinely collected self-report measures of depression and anxiety, to examine the treatment outcomes of NHS Talking Therapies patients offered CAT over an 18-month period. Quantitative validated measures of depression and anxiety were administered at the beginning and end of CAT treatment, and at follow up. Within-group change in depression and anxiety scores were examined statistically, and rates of reliable improvement and recovery calculated., Results: Statistically significant decreases in depression and anxiety scores were observed during the CAT active treatment phase. The recovery rate was 46.4%, and 71.4% of patients showed a reliable improvement post-treatment. Positive outcomes continued to be observed at follow-up, with a recovery rate of 50% and a reliable improvement rate of 79.4%., Conclusions: CAT shows promise as a treatment option for NHS Talking Therapies patients re-presenting with depression and/or anxiety. More research is required to determine if CAT should be offered more widely within NHS Talking Therapies services., (© 2023 British Psychological Society.)

Observing and voluntarily imitating the biological kinematics displayed by a model underpins the acquisition of new motor skills via sensorimotor processes linking perception with action. Differences in voluntary imitation in autism could be related to sensorimotor processing activity during action-observation of biological motion, as well as how sensorimotor integration processing occurs across imitation attempts. Using an observational practice protocol, which minimized the active contribution of the peripheral sensorimotor system, we examined the contribution of sensorimotor processing during action-observation. The data showed that autistic participants imitated both the temporal duration and atypical kinematic profile of the observed movement with a similar level of accuracy as neurotypical participants. These findings suggest the lower-level perception-action processes responsible for encoding biological kinematics during the action-observation phase of imitation are operational in autism. As there was no task-specific engagement of the peripheral sensorimotor system during observational practice, imitation difficulties in autism are most likely underpinned by sensorimotor integration issues related to the processing of efferent and (re)afferent sensorimotor information during trial-to-trial motor execution., (© 2023 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.)

Objective: Treatments for cystic fibrosis (CF) are complex, labour-intensive, and perceived as highly burdensome by caregivers of children with CF. An instrument assessing burden of care is needed., Design: A stepwise, qualitative design was used to create the CLCF with caregiver focus groups, participant researchers, a multidisciplinary professional panel, and cognitive interviews., Main Outcome Measures: Preliminary psychometric analyses evaluated the reliability and convergent validity of the CLCF scores. Cronbach's alpha assessed internal consistency and t-tests examined test-retest reliability. Correlations measured convergence between the Treatment Burden scale of the Cystic Fibrosis Questionnaire-Revised (CFQ-R) and the CLCF. Discriminant validity was assessed by comparing CLCF scores in one vs two-parent families, across ages, and in children with vs without Pseudomonas aeruginosa ( PA )., Results: Six Challenge subscales emerged from the qualitative data and the professional panel constructed a scoresheet estimating the Time and Effort required for treatments. Internal consistency and test-retest reliability were adequate. Good convergence was found between the Total Challenge score and Treatment Burden on the CFQ-R ( r =-0.49, p  = 0.02, n  = 31). A recent PA infection signalled higher Total Challenge for caregivers ( F (23)11.72, p  = 0.002)., Conclusions: The CLCF, developed in partnership with parents/caregivers and CF professionals, is a timely, disease-specific burden measure for clinical research.

Asphyxiation and strangulation are predominant murder methods, with ligature and hands being common weapons in such attacks. This study examines a broad sample with the goal of establishing statistical significance between manual and instrument asphyxiation/strangulation and both victim and offender characteristics. Two hundred cases of perpetrators who strangled or asphyxiated at least one victim on or after 1970 were randomly selected from the Radford-FGCU Serial Killer Database. Descriptive analysis and association tests were performed for characteristics of the perpetrators, victims and crimes. In 68% of the cases, perpetrators only targeted women. The primary murder motives were sadism (36%) and intense emotions (22%), which were statistically associated with the perpetrators' relationship with their victims, serial killing and motive of asphyxiation. There was a relationship between the perpetrators' favoring the use of manual or ligature strangulation/asphyxiation and their ethnicity, prior history of abuse and the victims' racial/ethnic group. Findings highlight the variety of contexts in which strangulation takes place, ranging from sexually or sadism motivated homicide and intimate partner violence. Moreover, the predominance of manual or ligature asphyxiation/strangulation among different racial/ethnic groups may have implications in legal processes, as well as in risk and threat assessments., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

The ability to anticipate what others will do next is crucial for navigating social, interactive environments. Here, we develop an experimental and analytical framework to measure the implicit readout of prospective intention information from movement kinematics. Using a primed action categorization task, we first demonstrate implicit access to intention information by establishing a novel form of priming, which we term kinematic priming: subtle differences in movement kinematics prime action prediction. Next, using data collected from the same participants in a forced-choice intention discrimination task 1 h later, we quantify single-trial intention readout-the amount of intention information read by individual perceivers in individual kinematic primes-and assess whether it can be used to predict the amount of kinematic priming. We demonstrate that the amount of kinematic priming, as indexed by both response times (RTs) and initial fixations to a given probe, is directly proportional to the amount of intention information read by the individual perceiver at the single-trial level. These results demonstrate that human perceivers have rapid, implicit access to intention information encoded in movement kinematics and highlight the potential of our approach to reveal the computations that permit the readout of this information with single-subject, single-trial resolution., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Endometrial scratching is a common IVF add-on. In 2015, a survey in Australia, New Zealand and the United Kingdom (UK) reported that 83% of fertility specialists recommended endometrial scratching for IVF. Several large trials have since been published reporting no clear evidence for improved live birth rates following endometrial scratching before IVF. An online survey was undertaken to ascertain the current practices and views across Australia, New Zealand, and the UK. A total of 121 eligible responses were received between October and December 2020 (fertility specialists ( n  = 61), embryologists ( n  = 26) and fertility nurses ( n  = 24)). Among fertility specialists, 34% currently offer endometrial scratching, mostly in the case of recurrent implantation failure. Most respondents were neutral or did not believe endometrial scratching improved pregnancy and live birth rates (>90%), except for in women with recurrent implantation failure (29% believed it can increase pregnancy and live birth rates in this group). More than half of respondents viewed reducing psychological distress as a benefit of endometrial scratching (55%). Among fertility specialists not offering endometrial scratching, 51% previously offered it but no longer do. The decline in use over the last five years likely reflects a response to recent evidence reporting no benefit from the procedure.

Precision medicine programs aim to utilize novel technologies to identify personalized treatments for children with cancer. Delivering these programs requires interdisciplinary efforts, yet the many groups involved are understudied. This study explored the experiences of a broad range of professionals delivering Australia's first precision medicine trial for children with poor-prognosis cancer: the PRecISion Medicine for Children with Cancer (PRISM) national clinical trial of the Zero Childhood Cancer Program. We conducted semi-structured interviews with 85 PRISM professionals from eight professional groups, including oncologists, surgeons, clinical research associates, scientists, genetic professionals, pathologists, animal care technicians, and nurses. We analyzed interviews thematically. Professionals shared that precision medicine can add complexity to their role and result in less certain outcomes for families. Although many participants described experiencing a greater emotional impact from their work, most expressed very positive views about the impact of precision medicine on their profession and its future potential. Most reported navigating precision medicine without formal training. Each group described unique challenges involved in adapting to precision medicine in their profession. Addressing training gaps and meeting the specific needs of many professional groups involved in precision medicine will be essential to ensure the successful implementation of standard care.

The green fluorescent protein (GFP) drove revolutionary progress in bioimaging. Photoconvertible fluorescent proteins (PCFPs) are an important branch of the FP family, of which Kaede is the prototype. Uniquely, PCFPs can be permanently switched from green to red emitting forms on UV irradiation, facilitating applications in site-specific photolabelling and protein tracking. Optimisation and exploitation of FPs requires understanding of the photophysical and photochemical behaviour of the chromophore. Accordingly, the principal GFP chromophore has been the subject of intense experimental and theoretical investigation. In contrast, the photophysics of the red emitting PCFP chromophore are largely unstudied. Here we present a detailed investigation of the excited-state properties of the Kaede chromophore in solution, utilising steady state measurements, ultrafast time-resolved electronic and vibrational spectroscopies, and electronic structure theory. Its excited state dynamics are very different to those of the parent GFP. Most remarkably, the PCFP chromophore has highly complex wavelength-dependent fluorescence decays and a mean lifetime an order of magnitude longer than the GFP chromophore. Transient electronic and vibrational spectroscopies suggest that these dynamics arise from a range of excited-state conformers that are spectrally and kinetically distinct but chemically similar. These conformers are populated directly by excitation of a broad thermal distribution of ground state structures about a single conformer, suggesting an excited-state potential surface with several minima. Temperature-dependence confirms the existence of barriers on the excited-state surface and reveals the radiationless decay mechanism to be internal conversion. These experimental observations are consistent with a model assuming a simple ground state potential energy surface accessing a complex excited state possessing multiple minima., Competing Interests: There are no conflicts of interest to declare., (This journal is © The Royal Society of Chemistry.)