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We develop the methods used by Rudnev and Wheeler (2022) to prove an incidence theorem between arbitrary sets of Möbius transformations and point sets in F p 2 . We also note some asymmetric incidence results, and give applications of these results to various problems in additive combinatorics and discrete geometry. For instance, we give an improvement to a result of Shkredov concerning the number of representations of a non-zero product defined by a set with small sum-set, and a version of Beck's theorem for Möbius transformations. [ABSTRACT FROM AUTHOR]

We study sources for torsion in Poincarè gauge theory in any dimension, signature, and spin. We find that symmetric kinetic terms for non-Yang–Mills bosonic fields of arbitrary rank drive torsion. Our detailed discussion of spin-3/2 Rarita–Schwinger fields shows that they source all independent parts of the torsion. We develop systematic notation for spin-(2k+1)/2 fields and find the spin tensor for arbitrary k in n ≥ 2k+1 dimensions. For k > 0 there is a novel direct coupling between torsion and spinor fields. We also cast the well-known gauge relation between the canonical and Belinfante–Rosenfield energy tensors in terms of different choices of independent variables. [ABSTRACT FROM AUTHOR]

We investigate the occurrence of naked singularities, local and global, in the incoming Vaidya spacetimes with zero initial mass. While it is well-known that these spacetimes admit locally and globally naked singularities, we demonstrate that globally naked singularities are significantly more common than is stressed in the literature, being generic in a natural topology on this collection of spacetimes. A heuristic consequence of the results is that the slow accumulation of mass is both necessary and sufficient for both types of naked singularity in these spacetimes. We demonstrate that the naked singularity, as long as it exists, always has divergent curvature (Kretschmann scalar) associated to it along emerging null curves, regardless of the form of the mass function. In particular, a consequence is that the curvature strength of the singularity cannot be smoothed away. [ABSTRACT FROM AUTHOR]

Predictive toxicity models, including interspecies correlation estimation (ICE) models, are reliable alternatives to animal toxicity testing. The ICE models describe mathematical relationships facilitating toxicity prediction from one surrogate test species to a species of unknown sensitivity. The ICE models were developed from curated aquatic toxicity data for 19 nonionic alcohol ethoxylate (AE) surfactants manufactured through the same process. Comparison of AE–ICE predictions with observed values from external validation datasets indicates a reasonable predictive accuracy. Model predictions were also closer to observed values than predictions from previously published ICE models for other substance groups. Comparison of acute fifth percentile hazard concentrations (HC5s) from species sensitivity distributions enhanced with AE–ICE predictions with chronic HC5s published elsewhere produced an acute‐to‐chronic ratio of 5, which was used to estimate chronic HC5s. With both acute and chronic HC5s for 14 AE substances, regressions were made relative to their respective liposome–water partitioning coefficients (log Klipw), resulting in HC5–log Klipw relationships useful in estimating HC5s for AE substances with known composition but with limited or unavailable toxicity data. The findings from this case study further demonstrate that ICE models are viable alternatives to toxicity testing and could be used as weight of evidence in hazard assessment evaluations. Environ Toxicol Chem 2021;40:2073–2082. © 2021 SETAC [ABSTRACT FROM AUTHOR]

We find a large internal symmetry within 4-dimensional Poincarè gauge theory. In the Riemann-Cartan geometry of Poincaré gauge theory the field equation and geodesics are invariant under projective transformation, just as in affine geometry. However, in the Riemann-Cartan case the torsion and nonmetricity tensors change. By generalizing the Riemann-Cartan geometry to allow both torsion and nonmetricity while maintaining local Lorentz symmetry the difference of the antisymmetric part of the nonmetricity Q and the torsion T is a projectively invariant linear combination S = T - Q with the same symmetry as torsion. The structure equations may be written entirely in terms of S and the corresponding Riemann-Cartan curvature. The new description of the geometry has manifest projective and Lorentz symmetries, and vanishing nonmetricity. Torsion, S and Q lie in the vector space of vector-valued 2-forms. Within the extended geometry we define rotations with axis in the direction of S. These rotate both torsion and nonmetricity while leaving S invariant. In n dimensions and (p, q) signature this gives a large internal symmetry. The four dimensional case acquires SO(11,9) or Spin(11,9) internal symmetry, sufficient for the Standard Model. The most general action up to linearity in second derivatives of the solder form includes combinations quadratic in torsion and nonmetricity, torsion-nonmetricity couplings, and the Einstein-Hilbert action. Imposing projective invariance reduces this to dependence on S and curvature alone. The new internal symmetry decouples from gravity in agreement with the Coleman-Mandula theorem. [ABSTRACT FROM AUTHOR]

We study the growth of product sets in some finite three-dimensional matrix groups. In particular, we prove two results about the group of 2 × 2 upper triangular matrices over arbitrary finite fields: a product set estimate using techniques from multiplicative combinatorics and an energy estimate using incidence geometry. The energy method gives better quantitative results but only applies to small sets. We also prove an energy result for the Heisenberg group. [ABSTRACT FROM AUTHOR]

Background and Aims The success of invasive plants can be attributed to many traits including the ability to adapt to variable environmental conditions. Whether by adaptation, acclimation or phenotypic plasticity, these plants often increase their resource-use efficiency and, consequently, their fitness. The goal of this study was to examine the hydraulic and eco-physiological attributes of sun and shade populations of Pteridium aquilinum , a weedy fern, to determine whether the presence of vessels and other hydraulic attributes affects its success under a variety of light conditions. Methods Hydraulic traits such as cavitation resistance, hydraulic conductivity, photosynthesis and water potential at turgor loss point were measured on fronds from sun and shade populations. Anatomical and structural traits such as conduit diameter and length, stomatal density and vein density were also recorded. Diurnal measures of leaf water potential and stomatal conductance complement these data. Key Results Gas exchange was nearly double in the sun plants, as was water-use efficiency, leaf-specific conductivity, and stomatal and vein density. This was largely achieved by a decrease in leaf area, coupled with higher xylem content. There was no significant difference in petiole cavitation resistance between the sun and shade leaves, nor in xylem-specific conductivity. Hydraulic conduit diameters were nearly equivalent in the two leaf types. Conclusions Shifts in leaf area and xylem content allow P. aquilinum to occupy habitats with full sun, and to adjust its physiology accordingly. High rates of photosynthesis explain in part the success of this fern in disturbed habitats, although no change was observed in intrinsic xylem qualities such as cavitation resistance or conduit length. This suggests that P. aquilinum is constrained by its fundamental body plan, in contrast to seed plants, which show greater capacity for hydraulic adjustment. [ABSTRACT FROM AUTHOR]

Objectives: (1) To develop an adaptation framework for MTM delivery for pharmacists (the MTM Adaptability Framework), (2) to examine the impact of an educational intervention informed by the MTM Adaptability Framework on MTM completion rates over a 2-year period, and (3) to explore pharmacists' perceptions regarding knowledge and beliefs about MTM and MTM implementation self-efficacy pre- and post-intervention.Methods: This study is a prospective, mixed-methods research study including a quasi-experimental, one-group pretest-posttest quantitative study with a sequential explanatory qualitative study arm featuring semi-structured key informant interviews. US supermarket pharmacy chain setting included 93 community pharmacy sites located in Tennessee, Kentucky, and Alabama. MTM completion rates are reported as percentage of completed comprehensive medication reviews (CMRs) and targeted medication reviews (TMRs) and pharmacist perceptions.Results: An 11.4% absolute increase in MTM completion rates was seen after the educational intervention targeting adaptation of MTM in the community pharmacy setting. This was found to be significant (46.92% vs. 58.3%; p < 0.001). Responses to the semi-structured interviews were mapped against CFIR and included themes: "knowledge and beliefs about MTM (pre-intervention)," "self-efficacy for MTM implementation (pre-intervention)," "knowledge and beliefs about MTM (post-intervention)," and "self-efficacy for MTM implementation (post-intervention)." Data convergence was found across these methodologies and suggested that targeting adaptability of MTM delivery increases MTM completion rates (quantitative data) and positively changes perceptions of MTM feasibility and self-efficacy (interviews).Conclusion: The use of an educational intervention about adaptation of MTM to influence adaptation of MTM to a chain community pharmacy setting part of an implementation strategy improved MTM completion rates significantly. Future research should investigate combined implementation strategies and their impact on MTM implementation success. [ABSTRACT FROM AUTHOR]

A novel perspective on defining black holes designed to be more broadly applicable outside of asymptotically flat spacetimes, in the context of classical general relativity, is presented, discussed, and characterized. The construction formalizes the heuristic idea that black holes are the "past Cauchy development of the set of singularities". As such, the formulation depends in a critical way on the identification of singularities, which has been treated in the literature through various boundary constructions. While many of the known boundary constructions (e.g.Schmidt's b-boundary or Geroch's g-boundary) could in principal be cited as underlying one's notion of a black hole, well-known topological concerns leads us to take the perspective that Scott and Szekeres' abstract boundary provides the most natural choice. The framework is utilized to put forward a general, non-IVP formulation of the Weak Cosmic Censorship Conjecture. • Intuitively developed a novel, general, and global definition of classical black holes. • Captures global nature of a black hole without any asymptotic requirement. • Demonstrated definitions in several classic black hole spacetimes. • Rigorously affirmed several key intuitive features of the definitions. • Used this to pose a general non-IVP formulation of weak cosmic censorship. [ABSTRACT FROM AUTHOR]

Although frequently examined as a target organ for non-endocrine toxicity, histopathological evaluation of the liver is becoming a routine component of endocrine disruption studies that utilize various fish species as test subjects. However, the interpretation of microscopic liver findings can be challenging, especially when attempting to distinguish adverse changes associated with endocrine disrupting substances from those caused by systemic or direct hepatic toxicity. The purpose of this project was to conduct a critical assessment of the available peer-reviewed and grey literature concerning the histopathologic effects of reproductive endocrine active substances (EAS) and non-endocrine acting substances in the livers of fish models, and to determine if liver histopathology can be used to reliably distinguish endocrine from non-endocrine etiologies. The results of this review suggest that few compound-specific histopathologic liver effects have been identified, among which are estrogen agonist-induced increases in hepatocyte basophilia and proteinaceous intravascular fluid in adult male teleosts, and potentially, decreased hepatocyte basophilia in female fish exposed to substances that possess androgenic, anti-estrogenic, or aromatase inhibitory activity. This review also used published standardized methodology to assess the credibility of the histopathology data in each of the 117 articles that reported liver effects of treatment, and consequently it was determined that in only 37% of those papers were the data considered either highly credible or credible. The outcome of this work highlights the value of histopathologic liver evaluation as an investigative tool for EAS studies, and provides information that may have implications for EAS hazard assessment. [ABSTRACT FROM AUTHOR]

This review critically examines the data on claimed endocrine-mediated adverse effects of chemicals on wildlife populations. It focuses on the effects of current-use chemicals, and compares their apparent scale and severity with those of legacy chemicals which have been withdrawn from sale or use, although they may still be present in the environment. The review concludes that the effects on wildlife of many legacy chemicals with endocrine activity are generally greater than those caused by current-use chemicals, with the exception of ethinylestradiol and other estrogens found in sewage effluents, which are causing widespread effects on fish populations. It is considered that current chemical testing regimes and risk assessment procedures, at least those to which pesticides and biocides are subjected, are in part responsible for this improvement. This is noteworthy as most ecotoxicological testing for regulatory purposes is currently focused on characterizing apical adverse effect endpoints rather than identifying the mechanism(s) responsible for any observed effects. Furthermore, a suite of internationally standardized ecotoxicity tests sensitive for potential endocrine-mediated effects is now in place, or under development, which should ensure further characterization of substances with these properties so that they can be adequately regulated. [ABSTRACT FROM AUTHOR]

Considerable uncertainty surrounds the impacts of anthropogenic climate change on the composition and structure of Amazon forests. Building upon results from two large-scale ecosystem drought experiments in the eastern Brazilian Amazon that observed increases in mortality rates among some tree species but not others, in this study we investigate the physiological traits underpinning these differential demographic responses. Xylem pressure at 50% conductivity (xylem-P50), leaf turgor loss point ( TLP), cellular osmotic potential (π o), and cellular bulk modulus of elasticity (ε), all traits mechanistically linked to drought tolerance, were measured on upper canopy branches and leaves of mature trees from selected species growing at the two drought experiment sites. Each species was placed a priori into one of four plant functional type ( PFT) categories: drought-tolerant versus drought-intolerant based on observed mortality rates, and subdivided into early- versus late-successional based on wood density. We tested the hypotheses that the measured traits would be significantly different between the four PFTs and that they would be spatially conserved across the two experimental sites. Xylem-P50, TLP, and π o, but not ε, occurred at significantly higher water potentials for the drought-intolerant PFT compared to the drought-tolerant PFT; however, there were no significant differences between the early- and late-successional PFTs. These results suggest that these three traits are important for determining drought tolerance, and are largely independent of wood density-a trait commonly associated with successional status. Differences in these physiological traits that occurred between the drought-tolerant and drought-intolerant PFTs were conserved between the two research sites, even though they had different soil types and dry-season lengths. This more detailed understanding of how xylem and leaf hydraulic traits vary between co-occuring drought-tolerant and drought-intolerant tropical tree species promises to facilitate a much-needed improvement in the representation of plant hydraulics within terrestrial ecosystem and biosphere models, which will enhance our ability to make robust predictions of how future changes in climate will affect tropical forests. [ABSTRACT FROM AUTHOR]

The authors reflect on the significant considerations in the establishment of a successful clinical practice. Topics discussed include the search for the unmet needs in clinical facilities, the establishment of the clinical practice, pitching of clinical practice ideas, the communication between parties in faculty positions, and the promotion of these practices.

The understory of the redwood forests of California's coast harbors perennial ferns, including Polystichum munitum and Dryopteris arguta. Unusual for ferns, these species are adapted to the characteristic Mediterranean-type dry season, but the mechanisms of tolerance have not been studied., The water relations of P. munitum and D. arguta were surveyed for over a year, including measures of water potential (Ψ), stomatal conductance ( gs) and frond stipe hydraulic conductivity ( K). A dehydration and re-watering experiment on potted P. munitum plants corroborated the field data., The seasonal Ψ varied from 0 to below −3 MPa in both species, with gs and K generally tracking Ψ; the loss of K rarely exceeded 80%. Quantile regression analysis showed that, at the 0.1 quantile, 50% of K was lost at −2.58 and −3.84 MPa in P. munitum and D. arguta, respectively. The hydraulic recovery of re-watered plants was attributed to capillarity., The seasonal water relations of P. munitum and D. arguta are variable, but consistent with laboratory-based estimates of drought tolerance. Hydraulic and Ψ recovery following rain allows perennial ferns to survive severe drought, but prolonged water deficit, coupled with insect damage, may hamper frond survival. The legacy effects of drought on reproductive capacity and community dynamics are unknown. [ABSTRACT FROM AUTHOR]

The article focuses on the development and implementation of an interdisciplinary pulmonary care clinic at the University of Tennessee (UT) family medicine residency clinic in response to the prevalence of asthma and chronic obstructive pulmonary disorder (COPD) in the U.S. It mentions a brief background on the family medicine residency clinic, the processes for patient referrals and types of return visits to the clinic ranging from asthma care to smoking cessation visits.

In this article the author discusses role of adverse outcome pathway (AOP) framework in chemical safety assessment. Topics discussed include use of biomarkers in environmental monitoring, toxicity testing guidelines proposed by the Organization for Economic Co-operation and Development (OECD) and, need to understand internal dose for molecular initiating events.

The chronic toxicity of chemicals to fish is routinely assessed by using fish early life stage (ELS) test results. Fish full life cycle (FLC) tests are generally required only when toxicity, bioaccumulation, and persistence triggers are met or when there is a suspicion of potential endocrine-disrupting properties. This regulatory approach is based on a relationship between the results of fish ELS and FLC studies first established more than 35 yrs ago. Recently, this relationship has been challenged by some regulatory authorities, and it has been recommended that more substances should undergo FLC testing. In addition, a project proposal has been submitted to the Organisation for Economic Cooperation and Development (OECD) to develop a fish partial life cycle (PLC) test including a reproductive assessment. Both FLC and PLC tests are animal- and resource-intensive and technically challenging and should therefore be undertaken only if there is clear evidence that they are necessary for coming to a regulatory decision. The present study reports on an analysis of a database of paired fish ELS and FLC endpoints for plant protection product active substances from European Union draft assessment reports and the US Environmental Protection Agency Office of Pesticide Programs Pesticide Ecotoxicity Database. Analysis of this database shows a clear relationship between ELS and FLC responses, with similar median sensitivity across substances when no-observed-effect concentrations (NOECs) are compared. There was also no indication that classification of a substance as a mammalian reproductive toxicant leads to more sensitive effects in fish FLC tests than in ELS tests. Indeed, the response of the ELS tests was generally more sensitive than the most sensitive reproduction NOEC from a FLC test. This analysis indicates that current testing strategies and guidelines are fit for purpose and that there is no need for fish full or partial life cycle tests for most plant protection product active substances. Environ Toxicol Chem 2014;33:1874-1878. © 2014 SETAC [ABSTRACT FROM AUTHOR]

Endocrine screening assays not only provide mechanistic information on the potential of a substance to interact with the endocrine system, but also data potentially relevant for risk assessment. However, these screening assays have a number of limitations that should be considered before the direct use of such data for risk assessment purposes. This paper discusses the limitations that should be considered for both human and environmental risk assessment. A proposal is made to provide an objective and transparent process in order to consider which endpoint(s) might be incorporated into a risk assessment, and when more definitive studies may be of value. The proposal is complemented with an easy-to-follow flowchart to aid industry scientists and regulators when evaluating the relevance of these data. Such an approach is necessary to ensure the appropriate use of screening data to further our understanding of the eco/toxicological profile of substances undergoing screening. [ABSTRACT FROM AUTHOR]

We prove new incidence bounds between a plane point set, which is a Cartesian product, and a set of translates H of the hyperbola x y = λ ≠ 0 , over a field of asymptotically large positive characteristic p. They improve recent bounds by Shkredov, which are based on using explicit incidence estimates in the early terminated procedure of repeated applications of the Cauchy-Schwarz inequality, underlying many qualitative results related to growth and expansion in groups. The improvement – both quantitative, plus we are able to deal with a general H , rather than a Cartesian product – is mostly due to a non-trivial "intermediate" bound on the number of k -rich Möbius hyperbolae in positive characteristic. In addition, we make an observation that a certain energy-type quantity in the context of H can be bounded via the L 2 -moment of the Minkowski distance in H and can therefore fetch the corresponding estimates apropos of the Erdős distinct distance problem. [ABSTRACT FROM AUTHOR]

Fish toxicity testing has been conducted since the 1860's in order to help define safe levels of chemical contaminants in lakes, rivers and coastal waters. The historical emphasis on acute lethality testing of chemicals has more recently focussed on long term sublethal effects of chemicals on fish and their prey species. Fish toxicity testing is now embedded in much environment legislation on chemical safety while it is recognized that animal use should be Replaced, Reduced and Refined (the 3Rs) where possible. The OECD Fish Toxicity Testing Framework provides a useful structure with which to address the needs of environmental safety assessment whilst implementing the 3Rs. This commentary aims to promote the implementation of the recommendations of the OECD Fish Toxicity Testing Framework. [ABSTRACT FROM AUTHOR]

Biconformal gravity, based on gauging of the conformal group to 2 n dimensions, reproduces n -dim scale-covariant general relativity on the co-tangent bundle in any dimension. We generalize this result to include Yang-Mills matter sources formulated as S U (N) gauge theories with a twisted action on the full 2 n -dimensional biconformal space. We show that the coupling of the sources to gravity does not stop the reduction of effective dimension 2 n → n of the gravity theory, and instead forces the Yang-Mills source to reduce to ordinary n -dimensional Yang-Mills theory on the gravitating cotangent bundle, with the usual Yang-Mills energy tensor as gravitational source. The results apply as well to gravity with sources on Kähler manifolds and in double field theories. [ABSTRACT FROM AUTHOR]

While many tools exist to study immune‐cell chemotaxis in vitro, current methods often lack desirable features. Using fluid‐walled microfluidics, circuits are built around primary murine macrophages deposited in pre‐defined patterns on Petri dishes or microplates. Concentration gradients of complement component 5a (C5a) are established in flow‐free or flowing environments, cell migration imaged, and cell directionality and velocity correlated to calculated local C5a concentrations. In flow‐free circuits built around patterned macrophages, only cells nearest the C5a source migrate regardless of local attractant concentration. Conversely, in flowing circuits free from intercellular signaling and attractant degradation, only cells distant from the source migrate. In both systems, cells respond to lower C5a concentrations than previously reported (≈0.1 pM). Finally, macrophages follow instantly‐shifted gradients better than slowly‐shifting ones, suggesting that migration depends on both spatial and temporal responses to concentration. [ABSTRACT FROM AUTHOR]

The article discusses whether the new standards for pharmacy technician education as of July 2019 are effective in reforming pharmacy practice. Other topics include the partnership between the American Society of Health-System Pharmacists (ASHP) and the Accreditation Council for Pharmacy Education (ACPE) to issue accreditation standards for pharmacy technician education and training programs, as well as the potential benefits like improved patient safety.

The aim of our study was to investigate the cumulative effective dose of radiation resulting from medical imaging in orthopaedic patients with isolated extremity trauma. Deidentified radiology records of consecutive patients without age restriction with isolated extremity trauma requiring operative treatment at a regional hospital were reviewed retrospectively over a 1-year period, and the effective dose per patient for each study type of plain film X-ray, computed tomography, and operative fluoroscopy was used to calculate cumulative effective dose. Values were summarised as mean, ± standard deviation, maximum, and proportion with overdose (>20 mSv). The study cohort included 428 patients (193 male and 235 female) with an average age of 44 years (±28). There were 447 procedures performed, i.e., all involved operative fluoroscopy, 116 involved computed tomography, and 397 involved X-ray. The mean cumulative effective dose per patient was 1.96 mSv (±4.98, 45.12). The mean cumulative effective dose for operative fluoroscopy was 0.32 mSv (±0.73, 5.91), for X-ray was 1.12 mSv (±3.6, 39.23) and for computed tomography was 2.22 mSv (±4.13, 20.14). The mean cumulative effective dose of 1.96 mSv falls below the recommended maximum annual exposure of 20 mSv. This study can serve as a guide for informing clinicians and patients of the acceptable radiation risk in the context of isolated extremity trauma. [ABSTRACT FROM AUTHOR]

Secondary sexual characteristics (SSCs) are important features that have evolved in many fish species because of inter-individual competition for mates. SSCs are crucial not only for sexual selection, but also for other components of the reproductive process and parental care. Externally, they are especially clear in males (for instance, tubercles, fatpad, anal finnage, colouration) but are also externally present in the females (for instance, ovipositor). These characters are under hormonal control and as such there has been much interest in incorporating them as measures in fish test methods to assess the potential endocrine activity of chemicals. Here we describe the external SSCs in typical laboratory test species for endocrine testing - fathead minnow (Pimephales promelas), Japanese medaka (Oryzias latipes), zebrafish (Danio rerio) and the three-spined stickleback (Gasterosteus aculeatus L.). We also provide some examples and discuss the utility of SSC responses to the endocrine activity of chemicals in the field and the laboratory. This paper is not aimed to provide a comprehensive review of SSCs in fish but presents a view on the assessment of SSCs in regulatory testing. Due to the current regulatory importance of establishing an endocrine mode-of-action for chemicals, we also consider other, non-endocrine factors that may lead to SSC responses in fish. We conclude with recommendations for how the assessment of SSCs in fish could be usefully incorporated into the endocrine hazard and risk assessment of chemicals. [ABSTRACT FROM AUTHOR]

The fish short-term reproduction assay (FSTRA) is an in vivo screen to assess potential interactions with the fish endocrine system. After a 21-day exposure period vitellogenin (VTG) and secondary sexual characteristics are measured in males and females. Egg production and fertility are also monitored daily throughout the test. This paper presents data from 49 studies performed to satisfy test orders from the United States Environmental Protection Agency's Endocrine Disruptor Screening Program. Data Evaluation Records were used to collate the typical control variability and performance of test parameters in FSTRAs conducted in different laboratories with fathead minnow (Pimephales promelas). We also examine the statistical power of FSTRA endpoints and assess whether available historical control data (HCD) assist evidence-based interpretation of the endpoints. Statistically significant inter-laboratory differences were found for all endpoints except survival. HCD could therefore be usefully developed on a laboratory-by-laboratory basis to aid interpretation of new study data. Reliable HCD ranges could be developed for survival, body weight/length, gonadal somatic index, fertilisation success, and male tubercle score, and used in association with stated test acceptability criteria to interpret FSTRA data. In contrast, high intra- and inter-laboratory control variability for VTG and fecundity means that HCD for these endpoints are of limited use during study interpretation. • Most fish short-term reproduction endpoints differ significantly between laboratories. • Useful Historical Control Data (HCD) ranges are calculable for most endpoints. • High variability precludes HCD calculation for vitellogenin and fecundity. [ABSTRACT FROM AUTHOR]

The article discusses the role of videoconferencing in the implementation of the Phase II Match in the National Resident Matching Program in the U.S. It identifies the responsibilities of residency program directors (RPDs) and preceptors in the program. Some of the benefits of videoconferencing to the program are identified, including reduced costs and the streamlined interview process.

Dengue fever, a prevalent and rapidly spreading arboviral disease, poses substantial public health and economic challenges in tropical and sub-tropical regions worldwide. Predicting infectious disease outbreaks on a countrywide scale is complex due to spatiotemporal variations in dengue incidence across administrative areas. To address this, we propose a machine learning ensemble model for forecasting the dengue incidence rate (DIR) in Brazil, with a focus on the population under 19 years old. The model integrates spatial and temporal information, providing one-month-ahead DIR estimates at the state level. Comparative analyses with a dummy model and ablation studies demonstrate the ensemble model's qualitative and quantitative efficacy across the 27 Brazilian Federal Units. Furthermore, we showcase the transferability of this approach to Peru, another Latin American country with differing epidemiological characteristics. This timely forecast system can aid local governments in implementing targeted control measures. The study advances climate services for health by identifying factors triggering dengue outbreaks in Brazil and Peru, emphasizing collaborative efforts with intergovernmental organizations and public health institutions. The innovation lies not only in the algorithms themselves but in their application to a domain marked by data scarcity and operational scalability challenges. We bridge the gap by integrating well-curated ground data with advanced analytical methods, addressing a significant deficiency in current practices. The successful transfer of the model to Peru and its consistent performance during the 2019 outbreak in Brazil showcase its scalability and practical application. While acknowledging limitations in handling extreme values, especially in regions with low DIR, our approach excels where accurate predictions are critical. The study not only contributes to advancing DIR forecasting but also represents a paradigm shift in integrating advanced analytics into public health operational frameworks. This work, driven by a collaborative spirit involving intergovernmental organizations and public health institutions, sets a precedent for interdisciplinary collaboration in addressing global health challenges. It not only enhances our understanding of factors triggering dengue outbreaks but also serves as a template for the effective implementation of advanced analytical methods in public health. [ABSTRACT FROM AUTHOR]

We consider the conformal group of a space of dim n = p + q , with S O (p , q) metric. The quotient of this group by its homogeneous Weyl subgroup gives a principal fiber bundle with 2 n -dim base manifold and Weyl fibers. The Cartan generalization to a curved 2 n -dim geometry admits an action functional linear in the curvatures. Because symmetry is maintained between the translations and the special conformal transformations in the construction, these spaces are called biconformal; this same symmetry gives biconformal spaces overlapping structures with double field theories, including manifest T-duality. We establish that biconformal geometry is a form of double field theory, showing how general relativity with integrable local scale invariance arises from its field equations. While we discuss the relationship between biconformal geometries and the double field theories of T-dual string theories, our principal interest is the study of the gravity theory. We show that vanishing torsion and vanishing co-torsion solutions to the field equations overconstrain the system, implying a trivial biconformal space. With co-torsion unconstrained, we show that (1) the torsion-free solutions are foliated by copies of an n -dim Lie group, (2) torsion-free solutions generically describe locally scale-covariant general relativity with symmetric, divergence-free sources on either the co-tangent bundle of n -dim (p , q) -spacetime or the torus of double field theory, and (3) torsion-free solutions admit a subclass of spacetimes with n -dim non-abelian Lie symmetry. These latter cases include the possibility of a gravity-electroweak unification. It is notable that the field equations reduce all curvature components to dependence only on the solder form of an n -dim Lagrangian submanifold, despite the increased number of curvature components and doubled number of initial independent variables. [ABSTRACT FROM AUTHOR]

Adaptive Mentalization Based Integrative Therapy (AMBIT) is a systemic, mentalization based intervention designed for young people with multiple problems including mental health problems. The purpose of this paper is to examine the impact of this approach both on clinical and functional outcomes for young people seen by a specialist young people's substance use service between 2015 and 2018. About 499 cases were seen by the service during this period. Substance use outcomes were obtained for 383 cases using the Treatment Outcome Profile (TOP). Cannabis and alcohol use were the key substance use problems for 81% and 63% respectively. Functional outcomes using the AMBIT Integrative Measure (AIM) were obtained for 100 cases covering domains of daily living, socio-economic context, peer relationships and mental health. At treatment end, cannabis use reduced significantly (t = 10.78; df = 311; p =.00; Cohen's d ES.61 as did alcohol use (t = 6.938; df = 242; p =.000; ES 0.44). Functional improvements were shown in five out of seven domains with highly significant total functional improvements on key problems selected by the client (t = 14.01; df = 99; p =.000; ES1.34). Measuring functional as well as clinical outcomes appears to reflect more accurately the overall benefit of the service to clients. [ABSTRACT FROM AUTHOR]

We develop the properties of Weyl geometry, beginning with a review of the conformal properties of Riemannian spacetimes. Decomposition of the Riemann curvature into trace and traceless parts allows an easy proof that the Weyl curvature tensor is the conformally invariant part of the Riemann curvature, and shows the explicit change in the Ricci and Schouten tensors required to insure conformal invariance. We include a proof of the well-known condition for the existence of a conformal transformation to a Ricci-flat spacetime. We generalize this to a derivation of the condition for the existence of a conformal transformation to a spacetime satisfying the Einstein equation with matter sources. Then, enlarging the symmetry from Poincaré to Weyl, we develop the Cartan structure equations of Weyl geometry, the form of the curvature tensor and its relationship to the Riemann curvature of the corresponding Riemannian geometry. We present a simple theory of Weyl-covariant gravity based on a curvature-linear action, and show that it is conformally equivalent to general relativity. This theory is invariant under local dilatations, but not the full conformal group. [ABSTRACT FROM AUTHOR]

California's coastal climate is characterized by rainy winters followed by a dry summer season that is supplemented by frequent fog. While rising temperatures and drought caused massive tree mortality in central California during the 2011–2015 extreme drought, dying trees were less common in the central coast region. We hypothesized that cooler, maritime-ameliorated temperatures reduced the effects of drought stress on coastal vegetation. To test this, weekly measurements of water potential and stomatal conductance were made on two coast evergreen tree species, Arbutus menziesii and Quercus agrifolia, throughout the summer 2014 dry season. Water potential remained generally constant during this period but stomatal conductance declined in both species as the dry season progressed. Species' resistance to embolism was determined using the centrifuge method, and showed Q. agrifolia to be more vulnerable to embolism than A. menziesii. The stem vulnerability curves were consistent with species' seasonal water relations as well as their anatomy; the ring-porous Q. agrifolia had substantially larger conduits than the diffuse-porous A. menziesii. Leaf turgor loss points differed significantly as did other pressure-volume parameters but these data were consistent with the trees' seasonal water relations. Overall, the two species appear to employ differing water use strategies; A. menziesii is more profligate in its water use, while Q. agrifolia is more conservative, with a narrower safety margin against drought-induced loss of xylem transport capacity. Despite the extended drought, these species exhibited neither branch die-back nor any obvious symptoms of pronounced water-stress during the study period, implying that the maritime climate of California's central coast may buffer the local vegetation against the severe effects of prolonged drought. [ABSTRACT FROM AUTHOR]

Background: Reconstruction techniques after subtotal colectomy (STC) and end ileostomy for ulcerative colitis (UC), include ileal pouch-anal anastomosis (IPAA), ileorectal anastomosis (IRA) and continent ileostomy. Aim: To assess surgical strategies and outcomes after subtotal colectomy for UC by calculating the proportions of patients who had further surgery 10 years post-STC and those who did not undergo surgery but who were under surveillance, and histological analysis of pathology specimens from STC and proctectomy. Methods: Patients who had STC for UC from 2002 to 2018 were identified. Variables of interest were extracted from electronic records. Survival analysis on reconstruction surgery was performed using Kaplan–Meier curves. Curves were censored for loss from follow-up and death. Subtotal colectomy and proctectomy specimens were assessed by a pathologist for acute inflammation at the distal resection margin and within the resected bowel, and for dysplasia or cancer. Results: One hundred and ninety-two patients were included. Eighty-nine (46.3%) underwent proctectomy: eight had panproctocolectomy; thirty had completion proctectomy and the remaining fifty-one of the eighty-nine patients (27%) had IPAA. One patient who did not undergo a proctectomy had an ileorectal anastomosis. Sixty-one (69%) proctectomy specimens had active inflammation, with 29 (48%) including the resection margins. Of the 103 patients who did not have completion surgery, 72 (69%) were under surveillance as of August 2021. No patients in this non-operative group had developed cancer of the residual rectum at follow up. Conclusions: At 10 years after STC for UC, eighty-nine (46.4%) patients had proctectomy, of which fifty-two had IPAA (27%). However, no inflammation was found in the proctectomy specimen in one third of these patients. Therefore, it is possible that IRA may still have a role in the occasional patient with UC. [ABSTRACT FROM AUTHOR]

Aim: The incidence of benign colonic anastomotic stricture is approximately 2% in patients undergoing left hemicolectomy or anterior resection and as high as 16% in patients undergoing low anterior or intersphincteric resection. In the majority, rather than complete occlusion, a stenosis forms, which can be managed with endoscopic balloon dilatation, a self‐expanding metallic stent or endoscopic electroincision. In the less common scenario of a completely occluded colonic anastomosis, surgery is often required. In this study, we aim to describe the technique we used to treat this condition non‐operatively Method: We describe a case series of three patients with benign complete occlusion of their colorectal anastomosis and how we managed them nonoperatively with a colonic/rectal endoscopic ultrasound (EUS) anastomosis technique and a Hot lumen‐apposing metallic stent. Results: We demonstrate that the technical and clinical success for this technique is 100%. Conclusions: We believe that the technique we describe is effective and safe. It should be widely reproducible in centres with expertise in interventional EUS, given the similarity to well‐established procedures such as EUS‐guided gastroenterostomy. Patient selection and timing of reversal of ileostomy need careful consideration, especially in patients with a history of keloid formation. Given the shorter hospital stay and reduced invasiveness of this technique, we believe it should be considered for all patients who have complete benign occlusion of a colonic anastomosis. However, given the small number of cases and short period of follow‐up, the long‐term outcome of this technique is not known. More studies with higher power and a longer period of follow‐up should be conducted to further ascertain the effectiveness of this technique. [ABSTRACT FROM AUTHOR]

The authors discuss the use of mesenchymal stem cells (MSCs) in treatment of knee osteoarthritis (OA). Topics discussed include MSCs found in bone marrow and adipose tissue, use of tissue-engineered scaffolds to improve osteochondral regeneration, and higher dose of MSCs showing improvement in osteochondral regeneration.

The amphibian metamorphosis assay (AMA) is a key in vivo endocrine screen to investigate chemicals with potential thyroid activity. The test guidelines and associated guidance consider that treatment‐related effects on thyroid gland histomorphology automatically result in the assay being considered positive for thyroid activity, independent of the direction of change or conflicting results in the other biological endpoints. An AMA study was conducted with five different feeding rations equivalent to 50%, 30%, 20%, 10%, and 5% of the recommended feeding rate. Biological endpoints relating to growth and development, including thyroid gland histopathology, were evaluated, and the specificity of these endpoints for the determination of thyroid activity was assessed. There was no effect on survival or clinical signs of toxicity. Effects related to feed reduction generally occurred in a feeding ration–response manner and included reduced development stage; reduced body weight and body length metrics; decreased prevalence of thyroid follicular cell hyperplasia and hypertrophy, and the occurrence of thyroid atrophy; reduced liver vacuolation; and the occurrence of liver atrophy. The results indicate that treatment‐related histopathological changes in the AMA can be induced by Non‐chemical factors; therefore histopathological results are not necessarily diagnostically specific for chemically induced thyroid endocrine activity. Consequently, the interpretation of data from AMA studies should be adjusted accordingly. We recommend that the decision logic presented in the test guidelines and associated guidance be changed to reflect a requirement for directional agreement between the thyroid histopathology findings and the growth and developmental endpoints before it is concluded that a test substance has thyroid endocrine activity. Environ Toxicol Chem 2023;42:1061–1074. © 2023 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. [ABSTRACT FROM AUTHOR]

Multiple in vivo test guidelines focusing on the estrogen, androgen, thyroid, and steroidogenesis pathways have been developed and validated for mammals, amphibians, or fish. However, these tests are resource‐intensive and often use a large number of laboratory animals. Developing alternatives for in vivo tests is consistent with the replacement, reduction, and refinement principles for animal welfare considerations, which are supported by increasing mandates to move toward an "animal‐free" testing paradigm worldwide. New approach methodologies (NAMs) hold great promise to identify molecular, cellular, and tissue changes that can be used to predict effects reliably and more efficiently at the individual level (and potentially on populations) while reducing the number of animals used in (eco)toxicological testing for endocrine disruption. In a collaborative effort, experts from government, academia, and industry met in 2020 to discuss the current challenges of testing for endocrine activity assessment for fish and amphibians. Continuing this cross‐sector initiative, our review focuses on the current state of the science regarding the use of NAMs to identify chemical‐induced endocrine effects. The present study highlights the challenges of using NAMs for safety assessment and what work is needed to reduce their uncertainties and increase their acceptance in regulatory processes. We have reviewed the current NAMs available for endocrine activity assessment including in silico, in vitro, and eleutheroembryo models. New approach methodologies can be integrated as part of a weight‐of‐evidence approach for hazard or risk assessment using the adverse outcome pathway framework. The development and utilization of NAMs not only allows for replacement, reduction, and refinement of animal testing but can also provide robust and fit‐for‐purpose methods to identify chemicals acting via endocrine mechanisms. Environ Toxicol Chem 2023;42:757–777. © 2023 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. [ABSTRACT FROM AUTHOR]

Children and young people in contact with forensic child and adolescent mental health services present with more complex needs than young people in the general population. Recent policy in child and adolescent mental health has led to the implementation of new workstreams and programmes to improve service provision. This research examines the characteristics of children and young people referred to recently commissioned Community Forensic Child and Adolescent Services (F:CAMHS) and service activity during the first 24 months of service. The study is a national cohort study to describe the population and investigate service provision and access across England. Secondary data on 1311 advice cases and 1406 referrals are included in analysis. Findings show that 71.9% of the sample had accessed mainstream CAMHS before their referral, 50.9% had experienced/witnessed multiple traumatic events and 58.4% of young people presented with multiple difficulties. The results of the study highlight the complexity of the cohort and a need for interagency trauma-informed working. This is the first study to describe the characteristics of children and young people referred to Community F:CAMHS and provides valuable information on pathways and needs to inform service policy and provision. [ABSTRACT FROM AUTHOR]

This document is a response to a previous paper on the impact of hospital and surgeon volumes on outcomes in rectal cancer surgery. The authors agree that quality improvement measures are important in the treatment of rectal cancer, but express concern about the message offered by the previous paper regarding case volumes. They argue that specialization, rather than centralization, is crucial in the treatment of rectal cancer and support the minimum surgical volume caseload outlined by the National Institute of Health and Care Excellence (NICE) guidance. The authors also emphasize the complexity and diversity of surgical options for rectal cancer and the need for a significant skill set to achieve optimal outcomes. They cite evidence that higher-volume surgeons have improved mortality rates and advocate for higher individual surgeon case volumes to encourage specialization. The authors suggest that patient and trainee perspectives should be considered when determining appropriate strategies for the treatment of rectal cancer. They acknowledge the limitations of the data presented in the previous paper and emphasize the importance of interpreting the data in the context of patient care. No funding or conflicts of interest are reported. Ethical approval was not required for this response. [Extracted from the article]

Background: The present case-series describes the first full-robotic colorectal resections performed with the new CMR Versius platform (Cambridge Medical Robotics Surgical, 1 Evolution Business Park, Cambridge, United Kingdom) by an experienced robotic surgeon. Methods: In a period between July 2020 and December 2020, patients aged 18 years or older, who were diagnosed with colorectal cancer and were fit for minimally invasive surgery, underwent robotic colorectal resection with CMR Versius robotic platform at "Casa di Cura Cobellis" in Vallo della Lucania,Salerno, Italy. Three right colectomies, 2 sigmoid colectomies and 1 anterior rectal resection were performed. All the procedures were planned as fully robotic. Surgical data were retrospectively reviewed from a prospectively collected database. Results: Four patients were male and 2 patients were female with a median (range) age of 66 (47–72) years. One covering ileostomy was created. Full robotic splenic flexure mobilization was performed. No additional laparoscopic gestures or procedures were performed in this series except for clipping and stapling which were performed by the assistant surgeon due to the absence of robotic dedicated instruments. Two ileocolic anastomoses, planned as robotic-sewn, were performed extracorporeally. One Clavien–Dindo II complication occurred due to a postoperative blood transfusion. Median total operative time was 160 (145–294) min for right colectomies, 246 (191–300) min for sigmoid colectomies and 250 min for the anterior rectal resection. Conclusions: The present series confirms the feasibility of full-robotic colorectal resections while highlighting the strengths and the limitations of the CMR Versius platform in colorectal surgery. New devices will need more clinical development to be comparable to the current standard. [ABSTRACT FROM AUTHOR]

The impact of body mass index (BMI) on long-term survival outcomes after colorectal cancer surgery is debated. A systematic literature review and meta-analysis was performed to compare long-term survival outcomes of patients of different BMI categories after colorectal cancer surgery. Of the 2588 articles screened, 56 articles met the inclusion criteria, reporting on 72,582 participants. Patients with BMI <18.5 had significantly worse overall survival [hazard ratio (HR) 1.91; P < 0.0001], cancer-specific survival (HR = 1.91; P < 0.0001), disease-free survival (HR = 1.50; P < 0.0001) and recurrence-free survival (HR = 1.13; P = 0.007) compared to patients with a BMI of 18.5–25. There was no significant difference between those with BMI 25–30 and 18.5–25 in overall survival, cancer-specific survival, disease-free survival and recurrence-free survival, except for the subgroup of patients with colon cancer where patients with BMI 25–30 had significantly improved overall survival (HR = 0.90; P = 0.05) and disease-free survival (HR = 0.90; P = 0.04). Patients with BMI >30 had significantly worse disease-free survival (HR = 1.05; P = 0.03) compared to patients with a BMI of 18.5–25, but no significant difference in overall survival, cancer-specific survival and recurrence-free survival. Patients with BMI >35 compared to 18.5–25 had significantly worse overall survival (HR = 1.24; P = 0.02), cancer-specific survival (HR = 1.36; P = 0.01), disease-free survival (HR = 1.15; P = 0.03) and recurrence-free survival for colon (HR = 1.11; P = 0.04) and rectal (HR = 4.10; P = 0.04) cancer. Being underweight (BMI < 18.5) or class II/III obese (BMI > 35) at the time of colorectal cancer surgery may result in worse long-term survival outcomes, whereas being overweight (BMI 25–30) may improve survival in a subgroup of patients with colon cancer. Optimising BMI may preoperatively improve long-term survival after surgery for colorectal cancer. • Assess the impact of body mass index (BMI) on survival after colorectal cancer surgery. • Systematic review and meta-analysis performed based on 56 studies (72,582 patients). • Underweight (BMI < 18.5) or class II/III obese (BMI > 35) have worse long-term survival. • Overweight (BMI 25–30) patients have improved survival after colon cancer surgery. • Optimising BMI preoperatively may improve long-term survival outcomes. [ABSTRACT FROM AUTHOR]

The Xenopus Eleutheroembryonic Thyroid Assay (XETA) was recently published as an OECD Test Guideline for detecting chemicals acting on the thyroid axis. However, the OECD validation did not cover all mechanisms that can potentially be detected by the XETA. This study was therefore initiated to investigate and consolidate the applicability domain of the XETA regarding the following mechanisms: thyroid hormone receptor (THR) agonism, sodium-iodide symporter (NIS) inhibition, thyroperoxidase (TPO) inhibition, deiodinase (DIO) inhibition, glucocorticoid receptor (GR) agonism, and uridine 5′-diphospho-glucuronosyltransferase (UDPGT) induction. In total, 22 chemicals identified as thyroid-active or -inactive in Amphibian Metamorphosis Assays (AMAs) were tested using the XETA OECD Test Guideline. The comparison showed that both assays are highly concordant in identifying chemicals with mechanisms of action related to THR agonism, DIO inhibition, and GR agonism. They also consistently identified the UDPGT inducers as thyroid inactive. NIS inhibition, investigated using sodium perchlorate, was not detected in the XETA. TPO inhibition requires further mechanistic investigations as the reference chemicals tested resulted in opposing response directions in the XETA and AMA. This study contributes refining the applicability domain of the XETA, thereby helping to clarify the conditions where it can be used as an ethical alternative to the AMA. • The Xenopus Eleutheroembryonic Thyroid Assay (XETA) was recently developed to screen for thyroid activity of chemicals. • XETA results were compared to Amphibian Metamorphosis Assay (AMA) outcomes for the detection of thyroid-active chemicals. • Results were concordant for all selected mechanisms, but the XETA did not detect inhibition of the sodium-iodide symporter. • Thyroperoxidase inhibition requires further mechanistic investigations due to equivocal responses in the XETA. • The XETA and the AMA consistently identified uridine 5′-diphospho-glucuronosyltransferase inducers as thyroid-inactive. [ABSTRACT FROM AUTHOR]