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The cause of death in people affected by sickle cell disease (SCD) is often challenging to define as prior studies have used retrospective or administrative data for analysis. We used a prospective longitudinal registry to assess mortality and clinical co-morbidities among subjects enrolled in the Sickle Cell Disease Implementation Consortium (SCDIC) registry. At enrollment, we collected the following data: patient-reported demographics, SCD phenotype, baseline laboratory values, comorbidities, and current medications. Subjects were followed for a median of 4.7 years before the present analysis. The relationship of clinical co-morbidities (at time of enrollment) to mortality was determined using survival analysis, adjusting for SCD phenotype and gender. There was a total of 2439 people with SCD enrolled in the SCDIC registry. One hundred and twenty-eight participants (5%) died during the observation period (2017-2022). Six people died from trauma and were excluded from further analysis. Proximate cause of death was unwitnessed in 17% of the deaths, but commonest causes of death include cardiac (18%), acute chest or respiratory failure (11%), sudden unexplained death (8%). Enrollment characteristics of the individuals who died (n = 122) were compared to those of survivors (n = 2317). Several co-morbidities at enrollment increased the odds of death on univariate analysis. All co-morbidities were included in a multivariable model. After backward elimination, iron overload, pulmonary hypertension, and depression, remained statistically significant predictors of the risk of death. SCD reduces life expectancy. Improved comprehensive and supportive care to prevent end-organ damage and address comorbidities is needed for this population.

AbstractSickle cell disease (SCD) is a genetic disorder affecting 100 000 people with an estimated annual medical cost of $3 billion in the United States; however, the economic impact on patients is not well described. We aimed to examine the indirect economic burden and test the hypothesis that socioeconomic status and greater social vulnerability risks are associated with increased absenteeism and employment loss. We surveyed adults and caregivers of children with SCD at 5 US centers from 2014 to 2021. Logistic regression models were used to examine the associations of employment loss and missed days of work with demographics and social determinants. Indirect costs were estimated by multiplying the self-reported missed days of work and job loss by 2022 average wages by the state of the participating institution. Of the 244 participants, 10.3% reported employment loss in the last 5 years, and 17.5% reported missing 10 or more days of work. Adults had 3 times more employment loss compared with caregivers of children with SCD (OR, 3.18; 95% CI, 1.12-9.01) but fewer missed days of work (OR, 0.24; 95% CI, 0.11-0.0.51). Participants who did not live with a partner reported increased employment loss (OR, 4.70; 95% CI, 1.04-21.17) and more missed days of work (OR, 4.58; 95% CI, 1.04-20.15). The estimated annual indirect economic burden was $2 266 873 ($9290 per participant). Adults with SCD and caregivers of children with SCD commonly report employment loss and missed days of work as important risk factors. The high indirect economic burden suggests that future economic evaluations of SCD should include SCD-related indirect economic burden.

SARS-CoV-2 often causes viral pneumonitis, hyperferritinemia, elevations in D-dimer, lactate dehydrogenase (LDH), transaminases, troponin, CRP, and other inflammatory markers. Lung ultrasound is increasingly used to diagnose and stratify viral pneumonitis severity. We retrospectively reviewed 427 visits in patients aged 14 days to 21 years who had had a point-of-care lung ultrasound in our pediatric emergency department from 30/November/2019 to 14/August/2021. Lung ultrasounds were categorized using a 6-point ordinal scale. Lung ultrasound abnormalities predicted increased hospitalization with a threshold effect. Increasingly abnormal laboratory values were associated with decreased discharge from the ED and increased admission to the ward and ICU. Among patients SARS-CoV-2 positive patients ferritin, LDH, and transaminases, but not CRP or troponin were significantly associated with abnormalities on lung ultrasound and also with threshold effects. This effect was not demonstrated in SARS-CoV-2 negative patients. D-Dimer, CRP, and troponin were sometimes elevated even when the lung ultrasound was normal.

Abstract Voxelotor is a small molecule that reduces the polymerization of sickle hemoglobin by increasing its affinity for oxygen. In patients with sickle cell anemia, it has been postulated that increasing hemoglobin‐oxygen affinity could limit oxygen offloading from hemoglobin, causing an increase in cerebral metabolic stress. To investigate this hypothetical concern, we used multimodal brain imaging to define the effects of voxelotor on cerebral blood flow and oxygen extraction. We followed four patients for 2–5 months during and/or after voxelotor therapy. This study showed no observable increase in cerebral blood flow or oxygen extraction fraction during treatment.

Objetivo: Avaliação de dados de encaminhamento de adolescentes portadores de doença falciforme (DF) para o ambulatório de adultos em um serviço único da cidade de São Paulo. Métodos: Foi realizada avaliação do prontuário eletrônico para coleta de dados de pacientes que completaram 18 anos entre os anos de 2021 a 2024. Em 2023, foi implementado o grupo de WhatsApp para informações sobre encaminhamentos de pacientes entre as equipes da Hematologia Pediátrica e de Adulto. Os dados agrupados em 2 grupos: Grupo 1 (G1): anos de 2021 e 2022 e Grupo 2 (G2): anos de 2023 e 2024. Dados coletados: ano de nascimento, genótipos, data da última consulta na pediatria e data da consulta no ambulatório de adultos. Resultados: Foram avaliados prontuários de 97 pacientes, 56 (58%) do G1 e 41 (42%) do G2, correspondendo a 2,3 pacientes/mês para ambos os grupos; destes 62 (64%) tinham anemia falciforme, 26 (27%) doença SC e 9 (9%) S-beta talassemia. No grupo total foram incluídos pacientes de outros serviços pediátricos (PCTE) (encaminhados via CROSS-Central de Regulação de Ofertas de Serviços de Saúde). No G1, observou-se 10 PCTE, com relação PCTE /internos (PCTI) de 1:5 e no G2 foram 4 PCTE com relação de 1:9. O tempo médio entre encaminhamento e consulta no ambulatório de adultos foi de 3 meses no G1 e no G2. Para PCTE, a mediana de tempo foi de 18 meses (IQ: 6;24) no G1 e 9 meses (IQ: 5;9,5) no G2. Houve diferença significante no tempo de encaminhamento (PCTI x PCTE) apenas no G1 (p < 0,0001). Sete pacientes do G1 abandonaram o tratamento (5 PCTI e 2 PCTE) e um do G2 (PCTI). Discussão: Segundo o Ministério da Saúde, o maior número óbitos em doentes com DF ocorreu na faixa etária de 20-29 anos. Estudos demonstram que o ambulatório de transição previne o abandono de tratamento desses adolescentes. A implementação do grupo de WhatsApp visou uma melhor comunicação entre hematologistas pediátricos e de adultos, mas não houve diferença no tempo de encaminhamento quando comparados G1 e G2, embora no G1 só tenham sido contabilizados pacientes que efetivamente chegaram ao ambulatório de adultos. Por isso, o abandono de tratamento observado no G1 pode ser ainda maior. No G2, devido à implantação do WhatsApp, foi possível busca ativa dos pacientes, diminuindo o abandono. Nos PCTE observou-se maior intervalo entre encaminhamento e consulta, e a pandemia de COVID pode ter contribuído nos achados do G1. Ressalta-se a diferença no número de PCTI e de PCTE: G1: 46 e 10; G2: 37 e 4, respectivamente. Na cidade de São Paulo existem 3 serviços pediátricos que não têm retaguarda para encaminhamento de seus pacientes e é sabido que a oferta de vagas pelos serviços que atendem adultos é restrita, o que nos leva a supor que muitos pacientes se encontram desassistidos. Conclusão: A implantação de um serviço de transição adequado para cada instituição é imprescindível para a diminuição do abandono do tratamento dos adolescentes com DF e, consequentemente, para maior sobrevida. No entanto, são necessárias políticas públicas que garantam que todos os adolescentes terão seu tratamento em serviços especializados em DF.

Abstract SARS-CoV-2 often causes viral pneumonitis, hyperferritinemia, elevations in D-dimer, lactate dehydrogenase (LDH), transaminases, troponin, CRP, and other inflammatory markers. Lung ultrasound is increasingly used to diagnose and stratify viral pneumonitis severity. We retrospectively reviewed 427 visits in patients aged 14 days to 21 years who had had a point-of-care lung ultrasound in our pediatric emergency department from 30/November/2019 to 14/August/2021. Lung ultrasounds were categorized using a 6-point ordinal scale. Lung ultrasound abnormalities predicted increased hospitalization with a threshold effect. Increasingly abnormal laboratory values were associated with decreased discharge from the ED and increased admission to the ward and ICU. Among patients SARS-CoV-2 positive patients ferritin, LDH, and transaminases, but not CRP or troponin were significantly associated with abnormalities on lung ultrasound and also with threshold effects. This effect was not demonstrated in SARS-CoV-2 negative patients. D-Dimer, CRP, and troponin were sometimes elevated even when the lung ultrasound was normal.

ABSTRACT Human intestinal enteroids (HIEs) are gaining recognition as physiologically relevant models of the intestinal epithelium. While HIEs from adults are used extensively in biomedical research, few studies have used HIEs from infants. Considering the dramatic developmental changes that occur during infancy, it is important to establish models that represent infant intestinal characteristics and physiological responses. We established jejunal HIEs from infant surgical samples and performed comparisons to jejunal HIEs from adults using RNA sequencing (RNA-Seq) and morphologic analyses. We then validated differences in key pathways through functional studies and determined whether these cultures recapitulate known features of the infant intestinal epithelium. RNA-Seq analysis showed significant differences in the transcriptome of infant and adult HIEs, including differences in genes and pathways associated with cell differentiation and proliferation, tissue development, lipid metabolism, innate immunity, and biological adhesion. Validating these results, we observed a higher abundance of cells expressing specific enterocyte, goblet cell, and enteroendocrine cell markers in differentiated infant HIE monolayers, and greater numbers of proliferative cells in undifferentiated 3D cultures. Compared to adult HIEs, infant HIEs portray characteristics of an immature gastrointestinal epithelium including significantly shorter cell height, lower epithelial barrier integrity, and lower innate immune responses to infection with an oral poliovirus vaccine. HIEs established from infant intestinal tissues reflect characteristics of the infant gut and are distinct from adult cultures. Our data support the use of infant HIEs as an ex vivo model to advance studies of infant-specific diseases and drug discovery for this population.IMPORTANCETissue or biopsy stem cell-derived human intestinal enteroids are increasingly recognized as physiologically relevant models of the human gastrointestinal epithelium. While enteroids from adults and fetal tissues have been extensively used for studying many infectious and non-infectious diseases, there are few reports on enteroids from infants. We show that infant enteroids exhibit both transcriptomic and morphological differences compared to adult cultures. They also differ in functional responses to barrier disruption and innate immune responses to infection, suggesting that infant and adult enteroids are distinct model systems. Considering the dramatic changes in body composition and physiology that begin during infancy, tools that appropriately reflect intestinal development and diseases are critical. Infant enteroids exhibit key features of the infant gastrointestinal epithelium. This study is significant in establishing infant enteroids as age-appropriate models for infant intestinal physiology, infant-specific diseases, and responses to pathogens.

Abstract Climate impacts increasingly unfold in interlinked systems of people, nature, and infrastructure. The cascading consequences are revealing sometimes surprising connections across sectors and regions, and prospects for climate responses also depend on complex, difficult‐to‐understand interactions. In this commentary, we build on the innovations of the United States Fifth National Climate Assessment to suggest a framework for understanding and responding to complex climate challenges. This approach involves: (a) integration of disciplines and expertise to understand how intersectionality shapes complex climate impacts and the wide‐ranging effects of climate responses, (b) collaborations among diverse knowledge holders to improve responses and better encompass intersectionality, and (c) sustained experimentation with and learning about governance approaches capable of handling the complexity of climate change. Together, these three pillars underscore that usability of climate‐relevant knowledge requires transdisciplinary coordination of research and practice. We outline actionable steps for climate research to incorporate intersectionality, integration, and innovative governance, as is increasingly necessary for confronting climate complexity and sustaining equitable, ideally vibrant climate futures.

This article describes the development of a theatre- and design-based Performance Lecture whose goal is to develop reflexivity around the theme of longevity and innovation in secondary and university level students. Theatre is an art form that aims at developing self-reflection and reflexivity in both audiences and participants, opening the door to reflective learning which, if combined with critical design and design fiction, offers an effective medium for addressing many dimensions of Responsible Innovation (RI). The workshop involves the presentation of a fictional “near-future” product, a drink called "Longevity". The drink contains nanobots that once ingested can be directed (with an app) to stimulate the body to produce certain compounds, allowing the user to control different properties in their blood “in flow”. This innovative use of technology offers more bodily efficiency, leading to a longer life. This methodology was primarily developed during the A Society for All Ages. Longevity-driven design Masters course at Milan Polytechnic (2022-23) and the Interaction Design and Service Design Masters courses at Milan Domus Academy (2023), and is grounded in grassroots approaches to Responsible Innovation.

To date, hydroxyurea is the only effective and safe drug that significantly reduces morbidity and mortality of individuals with Sickle cell disease. Twenty years of real-life experience has demonstrated that hydroxyurea reduces pain attacks, vaso-occlusive events, including acute chest syndrome, the number and duration of hospitalizations and the need for transfusion. The therapeutic success of hydroxyurea is directly linked to access to the drug, the dose used and adherence to treatment which, in part, is correlated to the availability of hydroxyurea. This consensus aims to reduce the number of mandatory exams needed to access the drug, prioritizing the requesting physician's report, without affecting patient safety.

Cancer is a global health challenge with rising incidence and mortality rates, posing significant concerns. The World Health Organization reports cancer as a leading cause of death worldwide, contributing to nearly one in six deaths. Cancer pathogenesis involves disruptions in cellular signaling pathways, resulting in uncontrolled cell growth and metastasis. Among emerging players in cancer biology, Transient Receptor Potential (TRP) channels, notably TRPV1, have garnered attention due to their altered expression in cancer cells and roles in tumorigenesis and progression. TRPV1, also known as the capsaicin receptor, is pivotal in cancer cell death and pain mediation, offering promise as a therapeutic target. Activation of TRPV1 triggers calcium influx and affects cell signaling linked to growth and death. Additionally, TRPV1 is implicated in cancer-induced pain and chemo-sensitivity, with upregulation observed in sensory neurons innervating oral cancers. Also, when capsaicin, a compound from chili peppers, interacts with TRPV1, it elicits a “hot” sensation and influences cancer processes through calcium influx. Understanding TRPV1’s multifaceted roles in cancer may lead to novel therapeutic strategies for managing cancer-related symptoms and improving patient outcomes. The current review elucidates the comprehensive role of capsaicin in cancer therapy, particularly through the TRPV1 channel, highlighting its effects in various cells via different signaling pathways and discussing its limitations.

Abstract The acute water and electricity shortages in Gaza necessitate comprehensive solutions that recognize the interconnected nature of these vital resources. This article presents pragmatic solutions to align supply with fundamental needs in both domains, offering viable pathways for achieving strategic water‐energy security in Gaza. Baseline data reveals a deficit in the current water supply, falling below the international minimum of 100 L per capita per day, while the reported 137–189 MW per day electricity supply significantly lags behind the estimated 390 MW per day peak demand. To meet projected 2024 residential, commercial, and industrial demands, this study proposes actionable measures including expanding wastewater treatment to enable over 150 MCM per year tertiary effluents for agricultural reuse and adopting energy‐efficient forward osmosis‐reverse osmosis and osmotically assisted reverse osmosis desalination methods to increase potable water supply to 150 MCM per year. Electricity supply strategies include scaling renewable capacity towards 110 MW per day, exploring regional cooperation to unlock over 360 MW of power per day, and potentially recovering up to 60 MW per day through system efficiencies. These recommendations aim to prevent exacerbated scarcity and alleviate hardships in Gaza.

BackgroundHydroxyurea is an evidence-based disease-modifying therapy for sickle cell disease (SCD) but is underutilized. The Integration of Mobile Health into Sickle Cell Disease Care to Increase Hydroxyurea Utilization (meSH) multicenter study leveraged mHealth to deliver targeted interventions to patients and providers. SCD studies often underenroll; and recruitment strategies in the SCD population are not widely studied. Unanticipated events can negatively impact enrollment, making it important to study strategies that ensure adequate study accrual. ObjectiveThe goal of this study was to evaluate enrollment barriers and the impact of modified recruitment strategies among patients and providers in the meSH study in response to a global emergency. MethodsRecruitment was anticipated to last 2 months for providers and 6 months for patients. The recruitment strategies used with patients and providers, new recruitment strategies, and recruitment rates were captured and compared. To document recruitment adaptations and their reasons, study staff responsible for recruitment completed an open-ended 9-item questionnaire eliciting challenges to recruitment and strategies used. Themes were extrapolated using thematic content analysis. ResultsTotal enrollment across the 7 sites included 89 providers and 293 patients. The study acceptance rate was 85.5% (382/447) for both patients and providers. The reasons patients declined participation were most frequently a lack of time and interest in research, while providers mostly declined because of self-perceived high levels of SCD expertise, believing they did not need the intervention. Initially, recruitment involved an in-person invitation to participate during clinic visits (patients), staff meetings (providers), or within the office (providers). We identified several important recruitment challenges, including (1) lack of interest in research, (2) lack of human resources, (3) unavailable physical space for recruitment activities, and (4) lack of documentation to verify eligibility. Adaptive strategies were crucial to alleviate enrollment disruptions due to the COVID-19 pandemic. These included remote approaching and consenting (eg, telehealth, email, and telephone) for patients and providers. Additionally, for patients, recruitment was enriched by simplification of enrollment procedures (eg, directly approaching patients without a referral from the provider) and a multitouch method (ie, warm introductions with flyers, texts, and patient portal messages). We found that patient recruitment rates were similar between in-person and adapted (virtual with multitouch) approaches (167/200, 83.5% and 126/143, 88.1%, respectively; P=.23). However, for providers, recruitment was significantly higher for in-person vs remote recruitment (48/50, 96% and 41/54, 76%, respectively, P

PurposeThis study aimed to identify determinants influencing the utilization of early intervention services among young children with sickle cell disease (SCD) based on perspectives from medical and early intervention providers.Design and methodsEarly intervention and medical providers from the catchment area surrounding St. Jude Children's Research Hospital and Washington University were recruited (20 total providers). Interviews were completed over the phone and audio recorded. All interviews were transcribed verbatim, coded, and analyzed using inductive thematic analysis.ResultsThree overarching themes were identified from both groups: Awareness (e.g., lack of awareness about the EI system and SCD), Access (e.g., difficulties accessing services), and Communication (e.g., limited communication between medical and early intervention providers, and between providers and families). Although these three themes were shared by medical and early intervention providers, the differing perspectives of each produced subthemes unique to the two professional fields.ConclusionsEarly intervention services can limit the neurodevelopmental deficits experienced by young children with SCD; however, most children with SCD do not receive these services. The perspectives of early intervention and medical providers highlight several potential solutions to increase early intervention utilization among young children with SCD.

Introduction/backgroundPhosphatase and tensin homolog (PTEN) genomic deletions and transmembrane protease, serine 2/v-ets avian erthyroblastosis virus E26 oncogene homolog (ERG) rearrangements are two of the most common genetic abnormalities associated with prostate cancer. Prior studies have demonstrated these alterations portend worse clinical outcomes. Our objective is to evaluate the impact of biopsy-determined PTEN losses and TMPRSS2-ERG fusion on biochemical progression-free survival (bPFS) and overall survival (OS) in patients who receive SBRT for localized prostate cancer.Methods/materialsPatients received SBRT for localized prostate cancer on a prospective quality-of-life (QoL) and cancer outcomes study. For each patient, the single biopsy core with the highest grade/volume of cancer was evaluated for PTEN and ERG abnormalities. Differences in baseline patient and disease characteristics between groups were analyzed using ANOVA for age and χ2 for categorical groupings. bPFS and OS were calculated using the Kaplan Meier (KM) method with Log-Rank test comparison between groups. Predictors of bPFS and OS were identified using the Cox proportional hazards method. For all analyses, p

Parvovirus B19 frequently infects children and targets cells of the erythroid lineage. Although healthy children rarely suffer severe disease, children with sickle cell disease (SCD) can experience transient red cell aplasia (TRCA), hospitalization, and life-threatening anemia upon first virus exposure. Given that children with SCD can also suffer chronic inflammation and that parvovirus B19 has been associated with autoimmune disease in other patient populations, we asked if parvovirus B19 infections contributed to acute and chronic immune abnormalities in children with SCD. Nineteen hospitalized patients with SCD and parvovirus B19–induced TRCA were evaluated. Blood tests included CBC, flow cytometry, and total antibody isotype analyses. Cytokine/chemokine analyses were performed on nasal wash (NW) samples, representing a common site of viral entry. Unusually high white blood cell count (WBC) and absolute neutrophil count (ANC) values were observed in some patients. A correlation matrix with Day 0 values from the 19 patients then identified two mutually exclusive phenotype clusters. Cluster 1 included WBC, ANC, absolute reticulocyte count (ARC), absolute lymphocyte count (ALC), lactate dehydrogenase (LDH), NW cytokines/chemokines, % naïve cells among B cell and T cell populations, and parvovirus-specific IgG. This cluster was negatively associated with virus load, suggesting a signature of successful adaptive immunity and virus control. Cluster 2 included virus load, % CD38+CD24− cells among CD19+ B cells (termed ‘plasmablasts’ for simplicity), % HLA-DRlow cells among CD19+ B cells, IgG4, and % memory phenotypes among B cell and T cell populations. Plasmablast percentages correlated negatively with parvovirus-specific IgG, possibly reflecting a non-specific trigger of cell activation. All patients were released from the hospital within 1 week after admission, and the highest WBC and ANC values were eventually reduced. Nonetheless, a concern remained that the acutely abnormal immune profiles caused by parvovirus B19 infections could exacerbate chronic inflammation in some patients. To avoid the numerous sequelae known to affect patients with SCD following hospitalizations with parvovirus B19, rapid development of a parvovirus B19 vaccine is warranted.

Hydrogen selenide (H2Se) is an emerging biomolecule of interest with similar properties to that of other gaseous signaling molecules (i.e., gasotransmitters that include nitric oxide, carbon monoxide, and hydrogen sulfide). H2Se is enzymatically generated in humans where it serves as a key metabolic intermediate in the production of selenoproteins and other selenium-containing biomolecules. However, beyond its participation in biosynthetic pathways, its involvement in cellular signaling or other biological mechanisms remains unclear. To uncover its true biological significance, H2Se-specific chemical tools capable of functioning under physiological conditions are required but lacking in comparison to those that exist for other gasotransmitters. Recently, researchers have begun to fill this unmet need by developing new H2Se-releasing compounds, along with pioneering methods for selenide detection and quantification. In combination, the chemical tools highlighted in this review have the potential to spark groundbreaking explorations into the chemical biology of H2Se, which may lead to its branding as the fourth official gasotransmitter.

Ground state nuclei usually have compact geometries. However, there have been theoretical predictions that excited nuclei can take on more extended shapes such as toroids or bubbles. There have been many attempts to identify signatures of such shapes in experimental data. One signature, both predicted by theory and reported in experimental data, is narrow resonances at high excitation energy in peripheral intermediate-energy heavy-ion collisions. This potential evidence for toroidal states was reported in the alpha particle disassembly of 28Si after collision with a 12C target at 35 MeV/nucleon. The prior work was limited by angular resolution and statistical uncertainties. The present work aims to measure the excitation energy distribution for these disassembly events with improved angular resolution and reduced statistical uncertainty using the Forward Array Using Silicon Technology (FAUST). FAUST is equipped with resistive dual-axis duo-lateral (DADL) position-sensitive silicon detectors capable of sub-millimeter position resolution. The measured excitation energy distributions of 7-α disassembly events showed no strong evidence for highly excited states at the cross section and widths suggested by previous experiment.

The central regions of the Milky Way constitute a unique laboratory for a wide swath of astrophysical studies; consequently, the inner ∼400 pc have been the target of numerous large surveys at all accessible wavelengths. In this paper, we present a catalog of sources at 25 and 37 μ m located within all of the regions observed with the SOFIA/FORCAST instrument in the inner ∼200 pc of the Galaxy. The majority of the observations were obtained as part of the SOFIA Cycle 7 Galactic Center Legacy program survey, which was designed to complement the Spitzer/MIPS 24 μ m catalog in regions saturated in the MIPS observations. Due to the wide variety of source types captured by our observations at 25 and 37 μ m, we do not limit the FORCAST source catalog to unresolved point sources, or treat all sources as if they are pointlike sources. The catalog includes all detectable sources in the regions, resulting in a catalog of 950 sources, including point sources, compact sources, and extended sources. We also provide the user with metrics to discriminate between the source types.

We present the detection of a magnetized dust ring (M0.8–0.2) in the central molecular zone (CMZ) of the Galactic center. The results presented in this paper utilize the first data release of the Far-Infrared Polarimetric Large Area CMZ Emission (FIREPLACE) survey (i.e., Paper I of this series). The FIREPLACE survey is a 214 μ m polarimetric survey of the Galactic center using the SOFIA/HAWC+ telescope. The M0.8–0.2 ring is a region of gas and dust that has a circular morphology with a central depression. The dust polarization in the M0.8–0.2 ring implies a curved magnetic field that traces the ring-like structure of the cloud. We posit an interpretation in which an expanding shell compresses and concentrates the ambient gas and magnetic field. We argue that this compression results in strengthening of the magnetic field, as we infer from the observations toward the interior of the ring.

We present the first data release of the Far-Infrared Polarimetric Large Area CMZ Exploration (FIREPLACE) survey. The survey was taken using the 214 μ m band of the HAWC+ instrument with the SOFIA telescope (19.″6 resolution; 0.7 pc). In this first data release we present dust polarization observations covering a ∼0.°5 region of the Galactic center’s central molecular zone (CMZ), approximately centered on the Sgr B2 complex. We detect ∼25,000 Nyquist-sampled polarization pseudovectors, after applying the standard SOFIA cuts for minimum signal-to-noise ratios in fractional polarization and total intensity of three and 200, respectively. Analysis of the magnetic field orientation suggests a bimodal distribution in the field direction. This bimodal distribution shows enhancements in the distribution of field directions for orientations parallel and perpendicular to the Galactic plane, which are suggestive of a CMZ magnetic field configuration with polodial and torodial components. Furthermore, a detailed analysis of individual clouds included in our survey (i.e., Sgr B2, Sgr B2-NW, Sgr B2-Halo, Sgr B1, and Cloud E/F) shows they have fractional polarization values of 1%–10% at 214 μ m, with most of the emission having values

We present infrared aperture-masking interferometry (AMI) observations of newly formed dust from the colliding winds of the massive binary Wolf–Rayet system WR 137 with JWST using the Near Infrared Imager and Slitless Spectrograph (NIRISS). NIRISS AMI observations of WR 137 and a point-spread function calibrator star, HD 228337, were taken using the F380M and F480M filters in 2022 July and August as part of the Director’s Discretionary Early Release Science program #1349. Interferometric observables (squared visibilities and closure phases) from the WR 137 “interferogram” were extracted and calibrated using three independent software tools: ImPlaneIA, AMICAL, and SAMpip. The analysis of the calibrated observables yielded consistent values except for slightly discrepant closure phases measured by ImPlaneIA. Based on all three sets of calibrated observables, images were reconstructed using three independent software tools: BSMEM, IRBis, and SQUEEZE. All reconstructed image combinations generated consistent images in both F380M and F480M filters. The reconstructed images of WR 137 reveal a bright central core with a ∼300 mas linear filament extending to the northwest. A geometric colliding-wind model with dust production constrained to the orbital plane of the binary system and enhanced as the system approaches periapsis provided a general agreement with the interferometric observables and reconstructed images. Based on a colliding-wind dust condensation analysis, we suggest that dust formation within the orbital plane of WR 137 is induced by enhanced equatorial mass loss from the rapidly rotating O9 companion star, whose axis of rotation is aligned with that of the orbit.

Importance: Individuals with sickle cell disease (SCD) are at heightened risk of poor neurocognitive and academic outcomes. The relationship between fine motor skills and academic outcomes is not well understood. Objective: To compare the fine motor skills of individuals with SCD with normative expectations, test whether demographic and medical factors are associated with fine motor performance, and determine the impact of fine motor performance on academic performance. Design: Cross-sectional. Setting: St. Jude Children's Research Hospital. Participants: Individuals with SCD (N = 376; ages 8–24 yr). Outcomes and Measures: Fine motor outcomes included visual–motor integration, manual dexterity, and graphomotor speed. Academic outcomes included math fluency and word reading. Demographic and medical variables were obtained via medical records and interviews. Results: Compared with normative expectations, the performance of individuals with SCD on all fine motor measures was lower than expected. Male sex, lower socioeconomic status, and lower oxygen saturation was associated with slower graphomotor speed. Lower socioeconomic status and older age were associated with lower visual–motor integration scores. Performance on all fine motor measures was positively associated with math fluency and word reading. Conclusions and Relevance: Individuals with SCD exhibited poorer than expected fine motor skills across multiple motor domains, and these deficits were associated with poorer academic outcomes. Early referral to intervention services for fine motor skills may facilitate improved academic outcomes for individuals with SCD. Plain-Language Summary: This study had three objectives: (1) Compare the fine motor skills of people with sickle cell disease (SCD) with normative expectations, (2) test whether demographic and medical factors are associated with fine motor performance, and (3) determine the impact of fine motor performance on academic performance. We found that SCD is a risk factor for lower than expected fine motor performance across multiple fine motor domains and that these deficits also affect functional academic skills. The study found that sickle cell disease is a risk factor for lower than expected fine motor performance across multiple domains and that these deficits also affect functional academic skills. [ABSTRACT FROM AUTHOR]

Background: Ethnically and racially diverse (ERD) nursing students experience unique challenges in the educational environment. Existing research on perspectives of ERD nurse faculty, with emphasis on their perceptions of the factors that support the academic success of ERD nursing students is limited. Purpose: The purpose of this study was to explore factors that contribute to the success of ERD nursing students as perceived by ERD nurse faculty. Methods: This qualitative study was conducted utilizing a focused ethnography design and methodology, with the theoretical underpinning of Critical Race Theory. Results: Twelve themes emerged relating to support, resources, relationships, faculty hiring practices, program structure, instructional content, flexibility, and culture of the educational environment. Conclusions: The perspectives of ERD nurse faculty provide an essential body of information that program administrators, faculty, and staff can utilize to positively impact the academic success of ERD nursing students. [ABSTRACT FROM AUTHOR]

The variability of cyber threats along with multiple cyber testing practices distracts teams from applying classical statistical measurements of test power and coverage to describe test effectiveness. In most cases, cyber test teams continue to test until reaching funding or schedule limits. This article explores the traditional measurements of test coverage and test power to propose multiple metrics for cyber test efficiency. The metrics are then applied to data collected on recent Defense Department programs. Original findings include feedback on cyber table top efforts, the use of linear approximation in predicting an optimum duration for penetration testing, predicting the length of time at the range by the number of machines in test, and the optimization of test teams between 9 and 14 testers. These findings greatly assist in what Scientific Test and Analysis Techniques (STAT) were designed to do: help anyone involved (customers, management, and the test team) understand, and agree upon, test risk, coverage, and decisions. [ABSTRACT FROM AUTHOR]