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The magnetic fields, activity and dynamos of young solar-type stars can be empirically studied using time series of spectropolarimetric observations and tomographic imaging techniques such as Doppler imaging and Zeeman-Doppler imaging. In this paper, we use these techniques to study the young Sun-like star EK Draconis (SpType: G1.5V, HD 129333) using ESPaDOnS at the Canada-France-Hawaii Telescope and NARVAL at the Télescope Bernard Lyot. This multi-epoch study runs from late 2006 until early 2012. We measure high levels of chromospheric activity indicating an active, and varying, chromosphere. Surface brightness features were constructed for all available epochs. The 2006/2007 and 2008 data show large spot features appearing at intermediate latitudes. However, the 2012 data indicate a distinctive polar spot. We observe a strong, almost unipolar, azimuthal field during all epochs, which is similar to that observed on other Sun-like stars. Using magnetic features, we determined an average equatorial rotational velocity, Ωeq, of ~2.50±0.08 rad d-1. High levels of surface differential rotation were measured with an average rotational shear, ΔΩ, of ~0.27-0.26+0.24 rad d-1. During an intensively observed 3-month period, from 2006 December until 2007 February, the magnetic field went from predominantly toroidal (~80 per cent) to a more balanced poloidal-toroidal (~40-60 per cent) field. Although the large-scale magnetic field evolved over the epochs of our observations, no polarity reversals were found in our data. [ABSTRACT FROM AUTHOR]

A major source of toxic per- and polyfluoroalkyl substances (PFAS) is aqueous film-forming foams (AFFF) used in firefighting and training at airports and military installations, however, PFAS have many additional sources in consumer products and industrial processes. A field study was conducted on fish tissues from three reaches of the Columbia Slough, located near Portland International Airport, OR, that are affected by AFFF and other PFAS sources. Fishes including largescale sucker (Catostomus macrocheilus), goldfish (Carassius auratus), and largemouth bass (Micropterus salmoides) were collected in 2019 and 2020. Fish blood, liver, and fillet (muscle) were analyzed for target and suspect PFAS by liquid chromatography high resolution mass spectrometry (LC-HRMS). Data were analyzed for patterns by fish species, tissue type, and river reach. Thirty-three out of 50 target PFAS and additional suspect compounds were detected at least once during the study, at concentrations up to 856 ng/g. Seven carboxylic acids (PFOA, PFNA, PFDA, PFUdA, PFDoA, PFTrDA, PFTeDA), three sulfonates (PFHxS, PFOS, PFDS), three electrofluorination-based compounds (FBSA, FHxSA, FOSA), and two fluorotelomer-based compounds (8:2 FTS, 10:2 FTS) were the most frequently detected compounds in all tissue types. The C6 (PFHxS) to C10 (PFDS) homologs were detected with PFOS and FHxSA at concentrations 1-3 orders of magnitude greater than the other PFAS detected. This is the first report of Cl-PFOS, FPeSA, and FHpSA detected in fish tissue. In all fish samples, fillet concentrations of PFAS were the lowest, followed by liver, and blood concentrations of PFAS were the highest. Differences in PFAS concentrations were driven primarily by tissue types and to a lesser extent fish species, but weakly by river reach. The Oregon Health Authority modified an existing fish consumption advisory on the Columbia Slough to recommend no whole-body consumption of most fish to avoid elevated levels of PFOS in fish liver. Measured PFAS concentrations in fish tissues indicate the potential for adverse ecological effects., 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., (Published by Elsevier B.V.)

Objective: To compare real-world data from a single centre heart failure rehabilitation programme, evaluating the effect of programme completion and improved functional capacity on morbidity and mortality in patients with heart failure., Design: A retrospective longitudinal analysis of service outcomes., Setting: A single-centre London based NHS trust., Participants: Patients attending heart failure rehabilitation between 2016 and 2020., Intervention: Patients participated in a 12-week heart failure rehabilitation programme with those completing ≥6 rehabilitation sessions classified as 'completers'., Main Measures: Pre and post 6-min walk tests measured improvement in physical ability, depicted by a meaningful increase in distance (≥30 m). Kaplan-Meier survival analysis was used to predict risk of event (myocardial infarction, cerebrovascular accident, heart failure readmission and death) between 'completers' and 'non-completers'. Kaplan-Meier Log rank was employed for 'completers', examining time to event between 'improvers' (6-min walk test ≥30 m) and 'non-improvers' (6-min walk test <30 m)., Results: 137 patients (male 61%) attended heart failure rehabilitation over the 4-year period. 86% ( n = 117) of patients completed the programme. During the follow-up period, there were 25 events, including three deaths. There was no statistically significant difference in time to event between completers and non-completers, ( P = 0.563). Improvement in 6-min walk test results demonstrate some short-term benefit, however no long-term benefits in morbidity and mortality were seen ( P = 0.888)., Conclusions: Completion of heart failure rehabilitation is not associated with a lower risk of combined event in this study. Improved 6-min walk test appears to be associated with short-term advantage in event-free survival time.

Introduction: While many professional associations within clinical and counseling psychology have made an aspirational call for clinician awareness of social position, there is a lack of research into how socially-conferred privilege impacts psychotherapy. Specifically of interest is the differences in race and gender within the therapeutic dyad, in which there is a BIPOC (Black, Indigenous, and Persons of Color)/white or male/female-identified dynamic., Method: The authors utilized a Grounded Theory approach to analyze qualitative interviews with practicing psychologists to construct a process model regarding how socially-conferred privileged identity domains impact the therapeutic relationship and the participants' professionalization process., Results: The analysis identified the core conceptual theme of the Therapist Paragon, representing an idealized version of what a perfect therapist should be. This replicated the foundational figures of our field - primarily older, white men. The process model consisted of two distinct pathways toward the Therapist Paragon, one for BIPOC psychologists and one for white psychologists. The female BIPOC pathway consisted of imposter syndrome, persistent feelings of inadequacy, and tendencies to over-credential their professional identity to seek credibility in the eyes of clients and colleagues. The white pathway consisted of down-playing whiteness and attempting to initially modify behavior toward client cultural norms., Discussion: The results point to a distinct professionalization and practice process for BIPOC psychologists compared to white counterparts. This dynamic may have implications beyond increasing support for BIPOC clinicians specifically, but instead indicate a lack of acknowledgement of the psychological impact of socially-conferred privilege in the psychotherapy enterprise overall. Recommendations are offered for revisions to training models, continuing education, and supervision/consultation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bergkamp, O’Leary Sloan, Krizizke, Lash, Trantel, Vaught, Fulmer, Waite, Martin, Scheiderer and Olson.)

The SARS-CoV-2 (COVID-19) pandemic brought disruption to cardiac rehabilitation (CR) services in the UK, requiring innovation and use of remote interventions. This retrospective longitudinal study compares single-centre CR service data across three time periods: 'pre' (June 2019 to December 2019), 'during' (January 2020 to May 2020) and 'post' (June 2020 to December 2020), evaluating adaptations in programme delivery and subsequent effect on efficiency. There were 614 patients (72.7% male) identified between June 2019 and December 2020. Eligible CR referrals reduced 30.3% and encountered >50% decrease in engagement 'during' the pandemic, compared with 'pre' pandemic. The 'post' pandemic hybrid redesign led to a significant reduction in hospital discharge to CR contact (mean 5.39 days, p=0.001), and time spent in CR (41.33 days, p=0.001) when compared with 'pre' and 'during' figures. CR engagement significantly increased 'post' pandemic for ST-elevation myocardial infarction (STEMI)/non-STEMI (NSTEMI)/acute coronary syndrome (ACS) (56%, p=0.02) and 'post' cardiac surgery (76%, p=0.015). Referrals to cardiac psychology increased >50% 'post' pandemic (7.8%, p=0.038). A 'post' pandemic hybrid CR programme is effective at reducing wait times, increasing engagement and reducing time to completion of CR, compared with 'pre' and 'during' pandemic figures. A significant increase in cardiac psychology referrals 'post' pandemic highlights the importance of psychology support within CR., Competing Interests: Conflicts of interest None declared., (Copyright © 2023 Medinews (Cardiology) Limited.)

Background: Twelve weeks of renal rehabilitation (RR) have been shown to improve exercise capacity in patients with chronic kidney disease (CKD); however, survival following RR has not been examined., Methods: This study included a retrospective longitudinal analysis of clinical service outcomes. Programme completion and improvement in exercise capacity, characterised as change in incremental shuttle walk test (ISWT), were analysed with Kaplan-Meier survival analyses to predict risk of a combined event including death, cerebrovascular accident, myocardial infarction and hospitalisation for heart failure in a cohort of patients with CKD. Time to combined event was examined with Kaplan-Meier plots and log rank test between 'completers' (attended >50% planned sessions) and 'non-completers'. In completers, time to combined event was examined between 'improvers' (≥50 m increase ISWT) and 'non-improvers' (<50 m increase). Differences in time to combined event were investigated with Cox proportional hazards models (adjusted for baseline kidney function, body mass index, diabetes, age, gender, ethnicity, baseline ISWT and smoking status)., Results: In all, 757 patients (male 54%) (242 haemodialysis patients, 221 kidney transplant recipients, 43 peritoneal dialysis patients, 251 non-dialysis CKD patients) were referred for RR between 2005 and 2017. There were 193 events (136 deaths) during the follow-up period (median 34 months). A total of 43% of referrals were classified as 'completers', and time to event was significantly greater when compared with 'non-completers' (P = 0.009). Responding to RR was associated with improved event-free survival time (P = 0.02) with Kaplan-Meier analyses and log rank test. On multivariate analysis, completing RR contributed significantly to the minimal explanatory model relating clinical variables to the combined event (overall χ2 = 38.0, P < 0.001). 'Non-completers' of RR had a 1.6-fold [hazard ratio = 1.6; 95% confidence interval (CI) 1.00-2.58] greater risk of a combined event (P = 0.048). Change in ISWT of >50 m contributed significantly to the minimal explanatory model relating clinical variables to mortality and morbidity (overall χ2 = 54.0, P < 0.001). 'Improvers' had a 40% (hazard ratio = 0.6; 95% CI 0.36-0.98) independent lower risk of a combined event (P = 0.041)., Conclusions: There is an association between completion of an RR programme, and also RR success, and a lower risk of a combined event in this observational study. RR interventions to improve exercise capacity in patients with CKD may reduce risk of morbidity and mortality, and a pragmatic randomised controlled intervention trial is warranted., (© The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA.)

We assessed how diatom metrics were related to different ranges of agricultural land use. Diatom assemblage composition, nutrients, and landscape characteristics were determined at 232 sites in eight agriculturally dominated study areas of the continental United States. Two regional groups based on differences in diatom relations to human disturbance were determined. Changes in diatom species composition were related to nutrients, pH, and conductivity in the eastern study areas (due to more wetlands) and more exclusively to nutrients in the west-central study areas. Homogenization of diatom flora among streams was related to high agricultural disturbance at this transcontinental scale. Species traits were developed separately for the east and west-central study groups and calculated two ways: indicator species analysis for taxa in low and high TN or TP conditions and weighted average partial least squares models of TN and TP concentration. These diatom metrics were significantly related to many indicators of agricultural land use in watersheds, especially percent row crops. Further analysis was conducted on only the west-central region due to its larger sample size. Overall, diatom metrics using species responses to N gradients were better related to agricultural land use than were species responses to P gradients. Most nutrient-based diatom metrics changed greatly in response to low ranges of percent row crops, but only a few high N diatom metrics responded to high row crop conditions. The greater response of diatoms to changes in low agriculture conditions may be due to past diatom evolution occurring when most waters had low nutrient conditions.

Stable isotope probing is a combined molecular and isotopic technique used to probe the identity and function of uncultivated microorganisms within environmental samples. Employing stable isotopes of common elements such as carbon and nitrogen, RNA-SIP exploits an increase in the buoyant density of RNA caused by the active metabolism and incorporation of heavier mass isotopes into the RNA after cellular utilization of labeled substrates pulsed into the community. Labeled RNAs are subsequently separated from unlabeled RNAs by density gradient centrifugation followed by identification of the RNAs by sequencing. Therefore, RNA stable isotope probing is a culture-independent technique that provides simultaneous information about microbiome community, composition and function. This chapter presents the detailed protocol for performing an RNA-SIP experiment, including the formation, ultracentrifugation, and fractional analyses of stable isotope-labeled RNAs extracted from environmental samples.

Background: Evidence suggests that elective cardiac patients are at risk of functional and psychological deterioration in the time preceding surgery. This poses a risk to successful post-operative rehabilitation. This prospective one-group pre-test, post-test evaluation was designed to assess a clinical Pre-operative Rehabilitation (PREHAB) home-based exercise programme, to optimise pre-operative physical function and frailty in patients awaiting elective Coronary Artery By-Pass Graft (CABG) or Valve Surgery., Method: Consenting patients awaiting cardiac surgery, with wait time ≥ 6 weeks were referred to a Senior Physiotherapist for baseline assessment. Patients were offered PREHAB in the form of functional home-based exercise that was prescribed from baseline physical outcomes. All patients were followed up via telephone to ensure progression of exercise and any problems associated with it. This continued weekly until the patient attended Surgical Pre-assessment clinic, where all outcome measures were re-assessed., Results: Twenty two patients, out of a total number of 36 patients seen in the surgical clinic between March 2016 and August 2016, participated in the prehab clinical evaluation. Twenty patients completed their prescribed exercises on a weekly basis prior to surgery. No adverse events or cardiac symptoms were reported as a result of the home exercise intervention. Paired t-Test analyses revealed a significant mean difference in clinical frailty score (CFS) of -0.53 ± 0.51 (95% CI [-0.774, -0.279], P = 0.0003). Significant mean difference in six-minute walk test (6MWT) distance of 42.5 ± 27.8 m (95% CI [23.840, 61.251], P = 0.0005), 6MWT walking speed of 0.5 ± 0.4kmh (95% CI, [0.2433, 0.7567], P = 0.001), and short physical performance battery (SPPB) total score of 2.2 ± 1.7, (95% CI [3.066, 1.200], P = 0.0002) were also observed. The change in 6MWT distance was shown to be significantly associated with hospital length of stay (LOS) (r = 0.7; P = 0.03)., Conclusion: This small exploratory evaluation suggests that providing a home-based PREHAB programme for frail patients undergoing CABG or Valve surgery may be able to improve functional ability and reduce hospital length of stay for those patients undergoing cardiac surgery. A frailty score with greater sensitivity may be required to elucidate the influence frailty could have in reducing length of stay. A large randomised controlled study is required to reveal the potential beneficial effects of PREHAB in this patient population.

Acid stimulated accumulation of insoluble phosphorus within microbial cells is highly beneficial to wastewater treatment but remains largely unexplored. Using single cell analyses and next generation sequencing, the response of active polyphosphate accumulating microbial communities under conditions of enhanced phosphorus uptake under both acidic and aerobic conditions was characterised. Phosphorus accumulation activities were highest under acidic conditions (pH 5.5>8.5), where a significant positive effect on bioaccumulation was observed at pH 5.5 when compared to pH 8.5. In contrast to the Betaproteobacteria and Actinobacteria dominated enhanced biological phosphorus removal process, the functionally active polyP accumulators at pH 5.5 belonged to the Gammaproteobacteria, with key accumulators identified as members of the families Aeromonadaceae and Enterobacteriaceae. This study demonstrated a significant enrichment of key polyphosphate kinase and exopolyphosphatase genes within the community metagenome after acidification, concomitant with an increase in P accumulation kinetics., (Copyright © 2016 Elsevier Ltd. All rights reserved.)