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Children's sense of place is important for wellbeing, development and belonging in a community or place. The VIP-CLEAR (Voices in a Pandemic – Children's Lockdown Experiences Applied to Recovery) project used creative methods and repeat engagement to capture children's experiences of the COVID-19 pandemic in socially disadvantaged, urban settings, in Bristol, UK. This paper focuses on findings from the two-phased 'deep mapping' activity conducted in schools with 6–11-year-olds to consider children's sense of place at this time. Children's maps showed how their mobility was restricted to the home and/or adult-controlled, looped routes for functional tasks rather than child-directed exploration. Key locations - including school, family houses, and parks - were disconnected and highlighted as sites of 'absence', where children were excluded. These places were given meaning due to pre-COVID practice, sensory experience, and/or their relationship with valued people. As pandemic mitigation relaxed, children's maps showed increasing connections and greater visibility of the community and non-essential activities. As places changed, the amplification of existing social inequalities became apparent. In both phases, sense of place evolved and digital and natural spaces (through animals) showed potential for children to increase practice and connections with place. A strong sense of place may support adaptation to change, and this paper contributes to limited research on how children's sense of place is dynamic, altering with fluctuating social and environmental conditions, e.g. mitigation of a global pandemic. The implications of findings on future recovery planning involving children are also considered. [ABSTRACT FROM AUTHOR]

The purpose of this article is to review the place of Humanism in religious education in England and Wales and to initiate a debate on the importance currently accorded to it. Our discussion begins with a short account of historical efforts to include the study of Humanism in religious education, followed by an equally short account of more recent educational policy documents and reports supporting the inclusion of Humanism. Our enquiry considers the issue of how many (self-identifying) humanists there are, for it is in terms of adherents and supporters that humanists often frame their case for inclusion. The relationship between those who identify as humanist and those who identify as non-religious is then considered. This is followed by a review of the place of Humanism in a small sample of agreed syllabuses. The conclusion is reached that there is a case for a reassessment of the degree of focus on Humanism in religious education. This conclusion raises challenges for religious educators going forward, two of which are considered and positive policies are proposed. [ABSTRACT FROM AUTHOR]

Cellular and Gene Therapy product (CGT product) manufacturers are required by regulations to qualify sites performing cell collection and processing as part of their manufacturing processes. The use of audits to qualify a site is part of the traditional supplier quality models for drug products. Due to the rapid growth of the CGT industry in recent years, healthcare institutions and manufacturers are finding it difficult to manage the increasing workload and resources needed to support audits when they are applied to the provision of Cellular Starting Material (CSM) collection from patients/subjects for the purpose of manufacturing. To alleviate this audit burden, several manufacturers have applied risk-based approaches to determine the needs and scope of audits. The authors of this commentary recommend that all manufacturers utilize a risk-based assessment program when appropriate and explain the use of tools created to facilitate a risk-based approach to streamline and reduce duplicative audits. This approach and tools, created by The NextGen Industry Working Group (IWG) site certification workstream with representation from pharmaceutical and biotech companies, health care institutions, accrediting organizations, and other stakeholders, is aligned with proposals from other multistakeholder groups, including the ASTCT 80/20 Task Force. The tools aim to streamline the site qualification processes performed by each manufacturer, offering a standardized approach to audits or gap analysis assessments. Offering an abbreviated audit model for sites that have already attained accreditation through agencies such as the AABB (Association for the Advancement of Blood & Biotherapies) and FACT (Foundation for the Accreditation of Cellular Therapy), helping the manufacturer to focus on product-specific requirements rather than re-evaluating systems that have already been audited in great detail by other parties., (Copyright © 2024. Published by Elsevier Inc.)

While nitrous oxide (N 2 O) has demonstrated antidepressant properties in treatment-resistant major depression (TRD), little is known about neural mechanisms mediating these effects. Employing serial resting-state functional magnetic resonance imaging (rs-fMRI), we compared spatiotemporal effects of inhaled N 2 O on brain functional connectivity in TRD patients (n=14) and non-depressed healthy controls (n=16, CNTL). Participants received sequential, one-hour inhalations of either 50% N 2 O/oxygen or air/oxygen (placebo), with sessions separated by at least one month in random cross-over order. BOLD-contrast rs-fMRI scans were acquired at three time points: pre-inhalation, 2 hours post-inhalation, and 24 hours post-inhalation. For the rs-fMRI functional connectivity analyses, five a priori seeds in medial limbic structures targeted cortical networks implicated in major depression - the salience, anterior and posterior default mode, reward, and cingulo-opercular networks - and a nexus in the dorsal paracingulate region previously identified in MDD ("dorsal nexus"). Depression, dissociation, and psychosis assessments were made before and after inhalations. In TRD patients, functional connectivity was reduced in all seeded networks and the voxel-wise global analysis after N 2 O exposure. N 2 O progressively decreased connectivity in patients with TRD but increased connectivity in healthy controls. In TRD patients, each seeded network demonstrated post-inhalation functional connectivity reductions in the dorsal paracingulate gyrus ("dorsal nexus"). This study further elucidates neural mechanisms underlying the antidepressant properties of N 2 O, supporting the notion that N 2 O specifically alters mood-associated brain regions in the depressed brain state by reducing functional connectivity within these brain networks. The trial was registered at ClinicalTrials.gov (NCT02994433)., Competing Interests: CRC has received research support from the National Institute of Mental Health, Taylor Family Institute for Innovative Psychiatric Research, Brain & Behavior Research Foundation, The American Foundation for Suicide Prevention, Assurex Health Inc., August Busch IV Foundation, and Barnes-Jewish Hospital Foundation; and he is currently serving as a research consultant to LivaNova PLC and has previously served on the Sage Therapeutics Advisory Board. CFZ serves on the Scientific Advisory Board of Sage Therapeutics. PN is currently receiving or has received funding from NIMH, American Foundation for Prevention of Suicide, Brain & Behavior Research Foundation, and has received reimbursement as advisory board member for Becton-Dickinson unrelated to this work and has previously filed for intellectual property protection related to the use of nitrous oxide in major depression (“Compositions and methods for treating depressive disorders”, US20170071975A1). All other authors declare that they have no competing interests. All other authors declare that they have no competing interests.

Every day we make thousands of saccades and take thousands of steps as we explore our environment. Despite their common co-occurrence in a typical active state, we know little about the coordination between eye movements, walking behaviour and related changes in cortical activity. Technical limitations have been a major impediment, which we overcome here by leveraging the advantages of an immersive wireless virtual reality (VR) environment with three-dimensional (3D) position tracking, together with simultaneous recording of eye movements and mobile electroencephalography (EEG). Using this approach with participants engaged in unencumbered walking along a clear, level path, we find that the likelihood of eye movements at both slow and natural walking speeds entrains to the rhythm of footfall, peaking after the heel-strike of each step. Compared to previous research, this entrainment was captured in a task that did not require visually guided stepping - suggesting a persistent interaction between locomotor and visuomotor functions. Simultaneous EEG recordings reveal a concomitant modulation entrained to heel-strike, with increases and decreases in oscillatory power for a broad range of frequencies. The peak of these effects occurred in the theta and alpha range for slow and natural walking speeds, respectively. Together, our data show that the phase of the step-cycle influences other behaviours such as eye movements, and produces related modulations of simultaneous EEG following the same rhythmic pattern. These results reveal gait as an important factor to be considered when interpreting saccadic and time-frequency EEG data in active observers, and demonstrate that saccadic entrainment to gait may persist throughout everyday activities., (© 2024. The Author(s).)

Acute kidney injury and respiratory failure that requires mechanical ventilation are both common complications of critical illnesses. Failure of either of these organ systems also increases the risk of failure to the other. As a result, there is a high incidence of patients with concomitant acute kidney injury and the need for mechanical ventilation, which has a devasting impact on intensive care unit outcomes, including mortality. Despite decades of research into the mechanisms of ventilator-lung-kidney interactions, several gaps in knowledge remain and current treatment strategies are primarily supportive. In this review, we outline our current understanding of the mechanisms of acute kidney injury due to mechanical ventilation including a discussion of; 1) The impact of mechanical ventilation on renal perfusion, 2) activation of neurohormonal pathways by positive pressure ventilation, and 3) the role of inflammatory mediators released during ventilator induced lung injury. We also provide a review of the mechanisms by which acute kidney injury increases the risk of respiratory failure. Next, we outline a summary of the current therapeutic approach to preventing lung and kidney injury in the critically ill, including fluid and vasopressor management, ventilator strategies, and treatment of acute kidney injury. Finally, we conclude with a discussion outlining opportunities for novel investigations that may provide a rationale for new treatment approaches., 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 © 2024 Kumar, Epler, DeWolf, Barnes and Hepokoski.)

Background: The expected increase of dementia prevalence in the coming decades will mainly be in low-income and middle-income countries and in people with low socioeconomic status in high-income countries. This study aims to reduce dementia risk factors in underserved populations at high-risk using a coach-supported mobile health (mHealth) intervention., Methods: This open-label, blinded endpoint, hybrid effectiveness-implementation randomised controlled trial (RCT) investigated whether a coach-supported mHealth intervention can reduce dementia risk in people aged 55-75 years of low socioeconomic status in the UK or from the general population in China with at least two dementia risk factors. The primary effectiveness outcome was change in cardiovascular risk factors, ageing, and incidence of dementia (CAIDE) risk score from baseline to after 12-18 months of intervention. Implementation outcomes were coverage, adoption, sustainability, appropriateness, acceptability, fidelity, feasibility, and costs assessed using a mixed-methods approach. All participants with complete data on the primary outcome, without imputation of missing outcomes were included in the analysis (intention-to-treat principle). This trial is registered with ISRCTN, ISRCTN15986016, and is completed., Findings: Between Jan 15, 2021, and April 18, 2023, 1488 people (601 male and 887 female) were randomly assigned (734 to intervention and 754 to control), with 1229 (83%) of 1488 available for analysis of the primary effectiveness outcome. After a mean follow-up of 16 months (SD 2·5), the mean CAIDE score improved 0·16 points in the intervention group versus 0·01 in the control group (mean difference -0·16, 95% CI -0·29 to -0·03). 1533 (10%) invited individuals responded; of the intervention participants, 593 (81%) of 734 adopted the intervention and 367 (50%) of 734 continued active participation throughout the study. Perceived appropriateness (85%), acceptability (81%), and fidelity (79%) were good, with fair overall feasibility (53% of intervention participants and 58% of coaches), at low cost. No differences in adverse events between study arms were found., Interpretation: A coach-supported mHealth intervention is modestly effective in reducing dementia risk factors in those with low socioeconomic status in the UK and any socioeconomic status in China. Implementation is challenging in these populations, but those reached actively participated. Whether this intervention will result in less cognitive decline and dementia requires a larger RCT with long follow-up., Funding: EU Horizon 2020 Research and Innovation Programme and the National Key R&D Programmes of China., Translation: For the Mandarin translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests AW received research grants from EU IMI2 (MOPEAD), JPND (ADDITION, EURO-FINGER, PMI-AD), IHI (PROMINENT), and the Swedish VINNOVA program (PREDEM)(all paid to institution) and is licence holder of RUD-instrument (in part); outside the submitted work. RH received research grants from JPND, ZonMW, IMI, H2020 (paid to institution); received consulting fees from Lilly Nederland, iMTA, Biogen Nederlands, Biogen MA, Eisai (paid to institution); is a member of ISPOR special interest group open-source models, IPECAD modelling group and Alzheimer Europe Expert Advisory Panel (unpaid); outside the submitted work. SA received grants from EU (Institutional grant [Horizon 2020 Research and Innovation Programme agreement 779238]); Region Occitanie/Pyrénées-Méditerranée (1901175); the European Regional Development Fund (MP0022856); MSD Avenir Inspire Chairs of Excellence (Alzheimer Prevention in Occitania and Catalonia, EDENIS, KORIAN, Pfizer, and Pierre-Fabre); AXA Personal (current); Biogen Personal (2022); Roche Personal (2021); Leventis foundation (2022); ADI (2022); and has a leadership role in the French Alzheimer association (Scientific Committee); outside the submitted work. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Objective: This study investigated the feasibility of in-store signage promoting sparkling water and the impact of this signage on sparkling water sales in convenience stores., Design: We conducted a randomized control trial., Setting: Convenience stores in North Carolina., Participants: Twenty-four convenience stores in neighborhoods with a higher proportion of Supplemental Nutrition Assistance Program-eligible households., Intervention(s): The 24 eligible stores were randomized to receive the in-store signage promoting sparkling water or to the control condition of no change. One poster was hung on the beverage cooler doors in front of the sparkling water selections at each of the 12 participating stores. Weekly sales data and fidelity checks were collected., Main Outcome Measure(s): The primary outcome measure was sales of total water, and the subanalysis was sales of sparkling water., Analysis: T tests were conducted to assess changes in total water and sparkling water sales between intervention and control stores., Results: In-store signage did not significantly increase sales of sparkling water, or all water, during the intervention., Conclusions and Implications: Signage alone may not be enough to impact healthy beverage purchasing, and signage should be paired with other promotional components to increase healthy beverage purchases in convenience stores., (Copyright © 2024 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

There is a critical need for fall-prevention interventions to reach medically underserved, hard-to-reach, rural older adults. The evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program reduces falls in older adults. This pre-COVID-19 pandemic study assessed the feasibility and impact of a 16-week tele-TJQMBB intervention in older adults. Instructors led six tele-TJQMBB classes via Zoom for 52 older adults (mean age ± SD 68.5 ± 7.7 years) at one academic and four community sites. Nearly all (97%) planned sessions were delivered. Average attendance was 61%. There were no adverse events. Fidelity was fair to good (mean 67%). Forty-one percent of sessions experienced technical disruptions. Participants improved their gait speed, balance, lower-extremity strength, and body mass index. Tele-TJQMBB was feasible with a positive impact on outcomes. This study was the first step toward establishing an additional delivery mode that could potentially expand TJQMBB's reach and maintenance.

Although a significant amount of biomedical research has been conducted to study HIV-associated neurocognitive disorder (HAND), there has been scant research done to assess the awareness and knowledge of this public health concern among middle-aged and older people living with HIV/AIDS (PLWH). Our qualitative community-based participatory research study sought to address this research gap by examining the awareness and knowledge of HAND among relevant stakeholders in southern Nevada, USA. We conducted 15 semistructured interviews with middle-aged and older PLWH to examine their awareness and knowledge of HAND and access to pertinent resources. After our thematic analysis of our interviews, we identified two overarching themes: (1) limited awareness and knowledge of HAND among PLWH, and (2) southern Nevada social determinants of health. Our findings underscore the importance of raising awareness and knowledge of HAND among PLWH through community-based education programs, and improving access to resources related to social determinants of health.

Dementia research lacks appropriate representation of diverse groups who often face substantial adversity and greater risk of dementia. Current research participants are primarily well-resourced, non-Hispanic White, cisgender adults who live close to academic medical centers where much of the research is based. Consequently, the field faces a knowledge gap about Alzheimer's-related risk factors in those other groups. The Alzheimer's Association hosted a virtual conference on June 14-16, 2021, supported in part by the National Institute on Aging (R13 AG072859-01), focused on health disparities. The conference was held entirely online and consisted of 2 days of core programming and a day of focused meetings centered on American Indian and Alaska Natives and on LGBTQIA+ populations. Over 1300 registrants attended discussions focused on the structural and systemic inequities experienced across diverse groups, as well as ways to investigate and address these inequities., (© 2024 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

A method of providing localised haptic feedback at precise locations on the body, utilising a lightweight textile garment is presented in this short paper. The textile comprises of subtly integrated actuator yarns (HaptiYarns) which are controlled by electropneumatic circuitry. Each yarn has two functional layers, an inner porous textile layer with limited extensibility and a second, durable outer layer made from an extensible elastomer. The HaptiYarns can provide radial forces and a maximum radial displacement of 28.09 ± 0.14 mm. It was found that the intrinsic addition of graphite powder (5% by weight), during elastomer preparation, offered better resistance to layer delamination and increased the ability of the yarn to withstand higher internal air pressures by 48%. Both the graphite-filled composite and the graphite free yarns demonstrated high durability, withstanding cyclic testing of >7500 cycles while having no significant impact on the force feedback. Finally, a wearable prototype knitted textile garment is presented with eight HaptiYarns subtly integrated within it and connected to a virtual reality (VR) program providing an immersive haptic experience. These yarns offer the potential to transform everyday clothing into wearable haptic devices with potential to revolutionise healthcare, VR-based training, gaming, and entertainment sectors.

Purpose: To understand health care students' perception of implicit bias and examine their insights to create a bias-free training environment., Methods: Clinical phase students from one university's 4 health care programs participated in this study. Students were surveyed regarding their knowledge of implicit bias and perception of their experiences in the clinical learning environment., Results: The response rate was 50.9%, N = 161. In total, 52.6% reported having prior training on implicit bias, and 55% self-reported that they had personally observed preceptors who exhibited an implicit bias toward patients based on race, ethnicity, or other qualities. There was no statistically significant relationship between those with prior training on implicit bias and being able to identify implicit bias exhibited by preceptors. Participants also expressed their unwillingness to report an incident unless it is confidential due to fear of retribution., Conclusion: This study found that health care students from one university's 4 health care programs perceived implicit bias in their clinical learning environment, which they believe could be improved by taking intentional steps. Some suggestions provided were "Safe space to report and openly discuss bias," "Education/training on implicit bias," "Time for self-reflection," and "Hiring process that evaluates/trains against implicit bias." The implication of our study is to create a bias-free training environment that will help interrupt the propagation of biases contributing to health disparity. Further research should examine a national population and identify interventional methods and outcomes in multiple health care disciplines., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 PA Education Association.)

Functionalised tetrahydropyran and spirooxepane scaffolds were prepared utilising an iodoetherification strategy and elaborated to demonstrate their potential use in library synthesis. The iodoetherification products could be readily transformed to the corresponding azides that could be further functionalised via copper-catalysed azide-alkyne cycloaddition or reduction to the amine. The lead-likeness and three-dimensionality of the scaffolds were examined and compared to commercial libraries., 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 © 2024 Elsevier Ltd. All rights reserved.)

Background: The optimal timing of post-mastectomy radiation therapy (PMRT) in autologous breast reconstruction is controversial. Our study compares overall reconstructive outcomes in patients who received post-mastectomy radiation therapy either before or after the autologous flap., Methods: A single-center retrospective review was performed for patients who underwent free flap breast reconstruction and post-mastectomy radiation from January 2004 through January 2021. Demographic, intraoperative, and post-operative variables were recorded., Results: A total of 452 free flaps were identified, and 82 underwent PMRT. 59.8% were radiated with an expander prior to free flap surgery (PreFlap), and 40.2% flaps underwent PMRT (PostFlap). PostFlap patients were significantly younger (43.0 vs. 47.9 years, p = .016). There were no significant differences in free flap outcomes between the two cohorts including thrombosis, venous congestion, flap loss, takebacks, fat necrosis, seroma, or infection. Mastectomy skin flap necrosis was significantly higher in the PostFlap cohort (9.1% vs. 0%, p = .032), but nipple necrosis rates did not differ. There were no significant differences in number or need for revision surgeries, fat necrosis, or fat grafting between groups. However, there were significantly more total reconstructive complications, including infection and wound breakdown, experienced by the PreFlap cohort (46.9% vs. 24.2%, p = .038)., Conclusions: Timing of PMRT did not impact free flap outcomes, but those who had the expander radiated experienced significantly more complications overall. For the 34.7% of patients in the preFlap group who planned for autologous reconstruction form initial consultation, radiation after the flap may have improved their overall outcomes. As added complications cause delays in cancer therapy and final reconstruction, our results suggest that PMRT of the flap when possible may improve the overall experience for breast cancer patients., (© 2023 Wiley Periodicals LLC.)