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Sacubitril/valsartan (SV) is currently recommended as a first-line therapy in patients with heart failure and reduced ejection fraction (HFrEF) due to its significant clinical and prognostic benefit; however, not all patients respond to therapy and predictors of clinical response to SV remain under-studied. To identify electrocardiographic (ECG) predictors of response to SV therapy in HFrEF patients. A retrospective analysis of a hospital heart failure registry was undertaken. Consecutive HFrEF patients (New York Heart Association class II–III) on maximal-dose SV were studied. Response to SV was defined as ≥10% relative improvement in left ventricular ejection fraction (LVEF) at 3-months post-maximal-dose therapy. Pre-therapy ECGs were retrospectively analyzed for axes and standard wave and interval durations. Logistic regression was used to estimate odds ratios and 95% confidence intervals for associations between predictors and therapeutic response. Backward stepwise regression was employed to develop a parsimonious model. P-wave duration (PWD) 100–120 ms, PWD >120 ms, and QTc >460 ms were associated with response to SV on univariate analysis: OR 18.00 (4.45–122.90), 5.00 (1.47–20.42), and 3.10 (1.18–9.22), respectively. The preferred model that included the former two predictors in combination with pre-therapy creatinine, mineralocorticoid receptor antagonist use, and LVEF was highly selective (area under the ROC curve = 0.868). Prolongation of both PWD and QTc interval on baseline ECG in HFrEF patients is predictive of therapeutic response to maximal-dose SV therapy and may indicate early cardiac remodeling that is highly amenable to reversal. SV can reverse cardiac remodeling in HFrEF patients; however, not all patients respond to therapy. In our retrospective study of 102 consecutive HFrEF patients, response to SV, i.e., 10% relative improvement in LVEF at 3-months post-maximal-dose therapy, was predicted by indicators of early atrial and ventricular remodeling (prolonged PWD and QTc interval) on the baseline ECG and not by indicators of terminal remodeling (PAF, LBBB, and RBBB). AUROC = area under the receiver operating characteristic curve; BBB = bundle branch block; HFrEF = heart failure with reduced ejection fraction; LAS = left atrial size; LBBB = left bundle branch block; LVEF = left ventricular ejection fraction; LVS = left ventricular size; PAF = permanent atrial fibrillation; PWD = P-wave duration; RBBB = right bundle branch block; SV = sacubitril/valsartan. Created with BioRender.com. [Display omitted] [ABSTRACT FROM AUTHOR]

The adequacy of the surgical resection is the main controllable variable that is in the hands of the surgical team. There exists an unmet need to increase the rate of negative margins, particularly in cancers invading the craniofacial area. The study aimed 1) at developing a gross tumor model to be utilized for research, educational, and training purposes and 2) establishing the 3-dimensional relationship between the outer surface of the surgical specimen and tumor surface and test the effect of guiding ablations on cadavers with surgical navigation (SN). Seven cadaver heads were employed to create 24 craniofacial tumor models. Simulation of tumor resections was performed by 8 surgeons. Fourteen and 10 resections were performed with and without SN-guidance, respectively. Gross specimens underwent computed tomography and 3-dimensional analysis through dedicated software. Task load was assessed through a validated questionnaire. Tumor model reliability was studied based on visual analogue scale rate by surgeons and radiologists. SN reduced the rate of margin involvement, particularly by decreasing the percentage of the gross specimen outer surface involvement in areas uncovered by normal bony structures. The workload of SN-aided ablations was found to be medium-to-somewhat-high. Tumor model reliability was deemed satisfactory except for the extension to bony structures. A gross tumor model for head and neck cancers involving the craniofacial area was developed and resulted satisfactorily reliable from both a surgical and radiologic standpoint. SN reduced the rate of margin involvement, particularly by improving delineation of bone-uncovered areas. [ABSTRACT FROM AUTHOR]

Major depression is a leading cause of disability and represents a significant health concern for adolescents. Evidence of temporal trends in adolescent depression stratified by sociodemographic characteristics is needed. This study drew on 11 years of the National Survey on Drug Use and Health (N = 167,783), a nationally representative survey of adolescents aged 12–17 years conducted between 2009 and 2019. The prevalence of past-year major depressive episode (MDE) increased by 7.7 percentage points from 8.1% to 15.8% between 2009 and 2019. MDE increased by 12 percentage points from 11.4% to 23.4% among girls. The gender difference in the prevalence of MDE increased from 6.4% to 14.8% between 2009 and 2019. Black participants experienced a comparatively small increase in depression (4.1%). Since 2009 there has been a sharp and sustained increase in depression among adolescent girls in the U.S. This concerning trend highlights the critical importance of directing prevention and intervention efforts toward this group. [ABSTRACT FROM AUTHOR]

The effect of the Cape Breton Investment Tax Credit (CBITC) on manufacturing employment and productivity in Cape Breton show that although CBITC increased productivity of labor due to capital infusion, the efficiency of the total factors of productivity remains unaffected. It is concluded that the CBITC does not lead to improved efficiency in Cape Breton manufacturing.

Introduction: Vaccines against COVID-19 have been developed in unprecedented time. However, the effectiveness of any vaccine is dictated by the proportion of the population willing to be vaccinated. This observational population-based study examines intentions to be vaccinated against COVID-19 throughout the pandemic.Methods: In November 2020, longitudinal data from a nationally representative sample of 7,547 U.S. adults enrolled in the Understanding America Study were analyzed using multinomial logistic regression. Participants reported being willing, undecided, and unwilling to get vaccinated against COVID-19 across 13 assessments conducted from April to October 2020. Public attitudes to vaccination against COVID-19 were also assessed on a 4-point Likert-type scale.Results: Willingness to vaccinate declined from 71% in April to 53.6% in October. This was explained by an increase in the percentage of participants undecided about vaccinating (from 10.5% to 14.4%) and the proportion of the sample unwilling to vaccinate (from 18.5% to 32%). The population subgroups most likely to be undecided/unwilling to vaccinate were those without a degree (undecided: RR=2.47, 95% CI=2.04, 3.00; unwilling: RR=1.92, 95% CI=1.67, 2.20), Black participants (undecided: RR=2.18, 95% CI=1.73, 2.74; unwilling: RR=1.98, 95% CI=1.63, 2.42), and female participants (undecided: RR=1.41, 95% CI=1.20, 1.65; unwilling: RR=1.29, 95% CI=1.14, 1.46). Participants who were older or were on higher incomes were least likely to be undecided or unwilling to vaccinate. Concerns about potential side effects of a vaccine were common.Conclusions: Intentions to be vaccinated against COVID-19 have declined rapidly during the pandemic, and close to half of Americans are undecided or unwilling to be vaccinated. [ABSTRACT FROM AUTHOR]

There is growing concern that the COVID-19 crisis may have long-standing mental health effects across society particularly amongst those with pre-existing mental health conditions. In this observational population-based study, we examined how psychological distress changed following the emergence of the COVID-19 crisis in the United States and tested whether certain population subgroups were vulnerable to persistent distress during the crisis. We analyzed longitudinal nationally representative data from eight waves of the Understanding America Study (UAS) collected between March 10th and July 20th, 2020 (N = 7319 Observations = 46,145). Differences in distress trends were examined by age, sex, race/ethnicity, and household income and by the presence of a pre-existing mental health diagnosis. Psychological distress was assessed using the standardized total score on the Patient Health Questionnaire-4 (PHQ-4). On average psychological distress increased significantly by 0.27 standard deviations (95% CI [0.23,0.31], p <.001) from March 10–18 to April 1–14, 2020 as the COVID-19 crisis emerged and lockdown restrictions began in the US. Distress levels subsequently declined to mid-March levels by June 2020 (d = –0.31, 95% CI [–0.34, –0.27], p <.001). Across the sociodemographic groups examined and those with pre-existing mental health conditions we observed a sharp rise in distress followed by a recovery to baseline distress levels. This study identified substantial increases in distress in the US during the emergence of the COVID-19 crisis that largely diminished in the weeks that followed and suggests that population level resilience in mental health may be occurring in response to the pandemic. • The global spread of COVID-19 may have had an enduring impact on mental health. • Longitudinal nationally representative studies addressing this topic are scarce. • This study examines mental health beyond the initial stage of the COVID-19 crisis. • Identifies a substantial rise in distress in the U.S. from March to April 2020. • Psychological distress levels returned to baseline by June 2020. [ABSTRACT FROM AUTHOR]

Introduction: Emerging evidence suggests that the COVID-19 pandemic and associated lockdown restrictions may have influenced alcohol consumption. This study examines changes in high-risk alcohol consumption from before to during the COVID-19 crisis in an established cohort of middle-aged British adults.Methods: Participants consisted of 3,358 middle-aged adults from the 1970 British Cohort Study who completed the Alcohol Use Disorders Identification Test for detecting hazardous drinkers in primary care settings in 2016-2018 (when aged 46-48 years) and May 2020 (aged 50 years). Multivariable logistic regression analysis was used to examine changes in high-risk drinking (scores of ≥5), and multinomial regression was used to compare responses with individual test items in 2016-2018 and May 2020.Results: Among middle-aged British adults, high-risk drinking increased by 5.2 percentage points from 19.4% to 24.6% (p<0.001) between 2016-2018 and May 2020. The increase in high-risk drinking was not moderated by sex, marital status, educational attainment, the presence of a chronic illness, or the year the baseline survey was completed. The prevalence of drinking ≥4 times a week doubled from 12.5% to 26% from before to during the pandemic (p<0.001), and there was also evidence of an increase in the frequency of being unable to stop drinking.Conclusions: This study provides evidence linking the COVID-19 crisis and associated lockdown restrictions to an increase in high-risk drinking patterns and particularly frequent drinking in British adults. Potential long-term changes in drinking habits should be monitored following the emergence of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Venous congestion after digital replantation or revascularization threatens digit survival in the immediate postoperative period. External bloodletting, including leech therapy, provides a central role in salvage of the congested finger. Although there have been previous studies describing the initiation of leech therapy for digits experiencing venous insufficiency, few published articles and no consensus guidelines have discussed the weaning of leeches in the postoperative period. We review the current evidence behind leech therapy and offer a treatment algorithm based on available data and existing leech weaning protocols. [ABSTRACT FROM AUTHOR]

Abstract Rationale Symptoms of mental health problems have been shown to predict adverse labour market outcomes including unemployment, but no studies have used sibling models to examine the relationship between clinically diagnosed psychiatric conditions in adolescence and subsequent unemployment. Objective This study used extensive Swedish registry data to investigate the link between psychiatric conditions diagnosed during military conscription and unemployment over two decades. Further, we identified whether this relation was amplified during an economic downturn and tested whether it was affected by adjustment for unobserved family characteristics using sibling fixed-effects models. Method Psychiatric conditions were diagnosed by psychologists and psychiatrists at military conscription in sample of 929,191 Swedish men (mean age = 18.4 years) between 1969 and 1989. The average number of days unemployed per year was observed from 1992 to 2012, using the records of the Swedish Public Employment Services. Results After adjustment for physical health and childhood socioeconomic status those diagnosed with any psychiatric condition experienced approximately an additional 10 days per year unemployment compared to others. Alcohol (16 days unemployment) and other substance use disorders (17 days) were the strongest predictors of exposure to future unemployment, followed by personality disorders (10 days), neurotic and adjustment conditions (nine days), and depressive disorders (six days). Family background factors accounted for approximately half of the observed relationship between mental health conditions and unemployment. Psychiatric conditions interacted with macroeconomic conditions such that those with pre-existing alcohol-related, and neurotic and adjustment disorders were disproportionately more likely to become unemployed following the 1990s crisis in Sweden. Conclusions Adolescent mental health conditions forecast an elevated risk of unemployment, which endures over the life course and is amplified in times of economic uncertainty. Investment in youth mental health services and alcohol and substance use prevention programs may yield economic benefits by reducing unemployment. Highlights • Large sample observed over two decades with adjustment for sibling fixed-effects. • Diagnosed adolescent psychiatric disorders predicted high risk of adult unemployment. • Alcohol and substance use disorders were most closely linked to adult unemployment. • Link between psychiatric disorders and unemployment was amplified during a crisis. • Investment in adolescent mental health services may yield long-run economic benefits. [ABSTRACT FROM AUTHOR]

• Drivers on slip roads want vehicles on the target lane to decelerate. • Drivers in target lanes rate the behaviour of vehicles on slip roads ambiguously. • AVs are rated identically or even more positively than MVs with identical behaviour. • No different safety distance is kept from automated vehicles. • Results show that cross-border traffic between Germany and UK with AVs is feasible. • Intercultural aspects must still be considered in the development of AVs. To ensure safe and uninterrupted traffic flow, (semi-)automated vehicles must be capable of providing comprehensible and agreeable implicit communication cues to human drivers. This driving simulator study investigated the assessment of implicit communication at a motorway slip road through longitudinal driving dynamics (acceleration, deceleration, and maintaining speed). The second aim of the study was to determine whether expectations of automated vehicles are different from those of human drivers. And thirdly, we investigated whether these findings are country-specific or can be (partially) generalised to other countries. The perception of three means of communication in connection with the presence of a labelling as an automated vehicle (eHMI) was examined in two samples in Germany and England. 27 participants drove from a slip road onto the motorway and interacted with another vehicle. After a stretch on the motorway, they passed a second slip road on which there was a vehicle merging onto the participants lane. This was repeated six times to test all variables. After each situation, the perceived cooperativity and criticality was recorded, as well as the time headway (THW) to the other vehicle. This paper presents the findings from the UK sample and compares them with the German results, which were previously published. Results show, that when the cooperating vehicles are on the slip road, participants from both countries prefer this vehicle to decelerate. However, when participants themselves are on the slip road, expectations for vehicles on the target lane are ambiguous in the UK sample. Except for one aspect (perceived cooperativity of decelerating vehicles on the slip road), the perception of automated vehicles is similar to those of manual drivers. Also, UK participants do not maintain a different safety distance from these vehicles, while this is the case in the German sample. This paper contributes valuable insights into the cross-cultural evaluation of driving dynamics, shedding light on implications for the development and acceptance of automated vehicles. [ABSTRACT FROM AUTHOR]

Treatment planning based on explicit dosimetry has the potential to improve a patient's therapeutic outcome. PDT treatment planning for solid tumors needs to result in the lowest number of diffusers required, their positions and assigned optical powers to restrict the clinical effective light power density to the target volume considering the spatial and temporal co-localization of the photons, photosensitizers, and oxygen concentration. The current treatment planning tools utilize only the population's average photosensitizer concentrations in the target and surrounding tissues. However, the photosensitizer and oxygen concentrations (pO 2) show variability within and between subjects. The objective of this study is to develop innovative methods for predicting spatially-resolved photosensitizer distribution and integrating this information into clinical personalized iPDT treatment planning Using intravital microscopy in combination with the dorsal skinfold and cranial window chamber models, the blood flow (BF), blood volume (BF), and mean transit time (MTT) is correlated with the temporal resolved spatial PS distribution to derive the extravasation diffusion constant k of two PSs for two oncological indications. Breast(EMT6), colon(CT26), and glioma (RG2) tumor models are utilized and combined with at least two different PSs (Fotolon and porphyrin lipid nanoparticles, ePS) to demonstrate that this technique has a high potential for general applicability. Once a PS's extravasation diffusion constants k for the host tissue and tumor compromised vasculature have been determined, clinical translatability is based on MRI established blood volume and flow quantification to predict the spatial distribution of PS. 3D photosensitizer distribution is quantified by spatial frequency domain imaging (SFDI) and compared to predict the spatial distribution of PS upon co-registration of the fluorescence microscopy and MRI datasets. [ABSTRACT FROM AUTHOR]

A new type of polymer composite was synthesized from peat ash which was obtained as industrial waste. This was added to high density polyethylene (HDPE) at varying mixing ratios and the resulting products were characterized using different experiments which included Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), melt flow index (MFI), density, wettability, tensile test, flexural test and cost analysis. The effects of various ash loadings and the use of the maleic anhydride grafted high density polyethylene (HDPE-g-MA) compatibilizer on the physical and mechanical properties of composites were investigated. It was observed that the utilization of peat ash significantly increased the tensile strength and the flexural modulus, where also reducing raw material cost. Incorporating (HDPE-g-MA) in the composites formulation led to further increases in tensile and flexural properties. Conversely, there was a significant decrease of impact strength found for all composites in comparison to the virgin HDPE. And the impact strengths generally decreased as peat ash content increases. Microstructural analyses showed that surface treated peat ash particles appeared to be well-incorporated into the HDPE matrix, as intimated polymer/peat ash contact was observed. In addition, the melt flow index of the composites decreased remarkably with an increase in peat ash content. No significant water uptake effect was detected on peat ash composites indicating that these materials could be used as a direct replacement for HDPE in applications where impact strength is not a critical factor. Furthermore, the use of peat ash increased the composite density in comparison to virgin HDPE. Nevertheless, as peat ash reinforcement does offer increased tensile and flexural properties, this may make the end product lighter as lower wall thickness parts can be used to fulfil the same function. From this study, it was concluded that the utilization of the peat ash from peat fired power stations has proved to have significant value-added potential as a filler material in polymer composites. [ABSTRACT FROM AUTHOR]

Rationale Several studies have shown a link between psychological distress in early life and subsequent higher unemployment, but none have used sibling models to account for the unobserved family background characteristics which may explain the relationship. Objective This paper uses the National Longitudinal Study of Youth 1997 data to examine whether adolescent psychological distress in 2000 predicts higher unemployment over 2000–11, whether this relationship changed in the period following the Great Recession, and whether it is robust to adjustment for family effects. Methods 7125 cohort members (2986 siblings) self-reported their mental health in 2000 and employment activities over 2000–11. This association was examined using Probit and ordinary least squares regressions controlling for intelligence, physical health, other sociodemographic characteristics and family background. Results After adjustment for covariates and compared to those with low distress, highly distressed adolescents were 2.7 percentage points (32%) more likely to be unemployed, 5.1 points (26%) more likely to be unemployed or out of the labor force and experienced 11 weeks (28%) more unemployment. The impact of high distress was similar to a one standard deviation decrease in intelligence, and double the magnitude of having a serious physical health problem, and these estimates were robust to adjustment for family fixed-effects. The highly distressed were also disproportionately more likely to become unemployed or exit the labor force in the years following the Great Recession. Conclusion These findings provide strong evidence of the unemployment penalty of early-life psychological distress and suggest that this relationship may be intensified during economic recessions. Investing in mental health in early life may be an effective way to reduce unemployment. [ABSTRACT FROM AUTHOR]

The effect of childhood mental health on later unemployment has not yet been established. In this article we assess whether childhood psychological distress places young people at high risk of subsequent unemployment and whether the presence of economic recession strengthens this relationship. This study was based on 19,217 individuals drawn from two nationally-representative British prospective cohort studies; the Longitudinal Study of Young People in England (LSYPE) and the National Child Development Study (NCDS). Both cohorts contain rich contemporaneous information detailing the participants' early life socioeconomic background, household characteristics, and physical health. In adjusted analyses in the LSYPE sample ( N = 10,232) those who reported high levels of distress at age 14 were 2 percentage points more likely than those with low distress to be unemployed between ages 16 and 21. In adjusted analyses of the NCDS sample ( N = 8985) children rated as having high distress levels by their teachers at age 7 and 11 were 3 percentage points more likely than those with low distress to be unemployed between ages 16 and 23. Our examination of the 1980 UK recession in the NCDS cohort found the difference in average unemployment level between those with high versus low distress rose from 2.6 pct points in the pre-recession period to 3.9 points in the post-recession period. These findings point to a previously neglected contribution of childhood mental health to youth unemployment, which may be particularly pronounced during times of economic recession. Our findings also suggest a further economic benefit to enhancing the provision of mental health services early in life. [ABSTRACT FROM AUTHOR]

Background Video-assisted thoracoscopic wedge resection of multiple small, non-visible, and nonpalpable pulmonary nodules is a clinical challenge. We propose an ultra-minimally invasive technique for localization of pulmonary nodules using the electromagnetic navigation bronchoscope (ENB)-guided transbronchial indocyanine green (ICG) injection and intraoperative fluorescence detection with a near-infrared (NIR) fluorescence thoracoscope. Methods Fluorescence properties of ICG topically injected into the lung parenchyma were determined using a resected porcine lung. The combination of ENB-guided ICG injection and NIR fluorescence detection was tested using a live porcine model. An electromagnetic sensor integrated flexible bronchoscope was geometrically registered to the three-dimensional chest computed tomographic image data by way of a real-time electromagnetic tracking system. The ICG mixed with iopamidol was injected into the pulmonary nodules by ENB guidance; ICG fluorescence was visualized by a near-infrared (NIR) thoracoscope. Results The ICG existing under 24-mm depth of inflated lung was detectable by the NIR fluorescence thoracoscope. The size of the fluorescence spot made by 0.1 mL of ICG was 10.4 ± 2.2 mm. An ICG or iopamidol spot remained at the injected point of the lung for more than 6 hours in vivo. The ICG fluorescence spot injected into the pulmonary nodule with ENB guidance was identified at the pulmonary nodule with the NIR thoracoscope. Conclusions The ENB-guided transbronchial ICG injection and intraoperative NIR thoracoscopic detection is a feasible method to localize multiple pulmonary nodules. [ABSTRACT FROM AUTHOR]

Abstract: Direct observation of halogenated natural products produced by different strains of marine cyanobacteria was accomplished by electrospray ionization and matrix assisted laser desorption ionization and gas phase separation via ion mobility mass spectrometry of extracts as well as intact organisms. [Copyright &y& Elsevier]

The aging-related decline in cardiac function is an important public health problem. The molecular basis of age-dependent loss of cardiac function is largely unknown and there are no effective therapies addressing this important form of heart disease. This study evaluates the role of the cytoskeletal protein dystrophin in the process of normal cardiac aging. Here, we show that the cytoskeletal protein dystrophin in the hearts of old mice is significantly decreased to a level of 36% that of young mice, whereas other key members of the dystrophin complex are unchanged. Age-dependent decreased ejection fraction was rescued by systemic delivery of an adeno-associated viral vector harboring a functional micro-dystrophin cassette (48.9 ± 2.5% in untreated aged vs. 61.6 ± 7.4% in treated aged mice, compared to 67.1 ± 2.6% in young mice). These data provide the first direct evidence that decreased dystrophin levels are an important modulator of cardiac function in the aged heart. [ABSTRACT FROM AUTHOR]

Abstract: Of patients who present with ischemic-type chest pain and a negative cardiac troponin T (cTnT) at first medical contact, there are patients at a very early stage of infarction. The aim of this research was to assess heart fatty acid–binding protein (H-FABP), a novel marker of myocyte necrosis, in combination with the 80-lead body surface potential map (BSPM) in the early diagnosis of acute myocardial infarction (AMI). Methods: In this prospective study, consecutive patients presenting with acute ischemic-type chest pain between 2003 and 2006 were enrolled. At first medical contact, blood was sampled for cTnT and H-FABP; in addition, a 12-lead electrocardiogram (ECG) and BSPM were recorded. A second cTnT was sampled 12 hours or more after presentation. Peak cTnT 0.03 μg/L or higher diagnosed AMI. Elevated H-FABP was 5 ng/mL or higher. A cardiologist blinded to both the clinical details and 12-lead ECG interpreted the BSPM. Results: Enrolled were 407 patients (age 62 ± 13 years; 70% men). Of these 407, 180 had cTnT less than 0.03 μg/L at presentation. Acute myocardial infarction occurred in 52 (29%) of 180 patients. Of these 180 patients, 27 had ST-segment elevation (STE) on ECG, 104 had STE on BSPM (sensitivity, 88%; specificity, 55%), and 95 (53%) had H-FABP elevation. The proportion with elevated H-FABP was higher in the AMI group compared with non-AMI group (P < .001). Body surface potential map STE was significantly associated with H-FABP elevation (P < .001). Of those with initial cTnT less than 0.03 μg/L, the c-statistic for the receiver operating characteristic curve distinguishing AMI from non-AMI using H-FABP alone was 0.644 (95% confidence interval [CI], 0.521-0.771), using BSPM alone was 0.716 (95% CI, 0.638-0.793), and using the combination of BSPM and H-FABP was 0.812 (95% CI, 0.747-0.876; P < .001). Conclusion: In patients with acute ischemic-type chest pain who have a normal cTnT at presentation, the combination of H-FABP and BSPM at first assessment identifies those with early AMI (c-statistic, 0.812; P < .001), thus allowing earlier triage to reperfusion therapy and secondary prevention. [Copyright &y& Elsevier]

• Link drivers and pedestrians in real-time distributed simulation. • Present driver's bimodal braking strategies. • Identify lateral movements as implicit cues in road user interactions. • Showcase pedestrians' behavioural adaptations to kinematic cues. • Highlight decisions of both actors shaped by time gaps and road infrastructure. As we move towards a future with Automated Vehicles (AVs) incorporated in the current traffic system, it is crucial to understand driver-pedestrian interaction, in order to enhance AV design and optimization. Previous research in this area, which has primarily used naturalistic observations or single-actor virtual reality simulations, has been limited by its inability to draw causal conclusions, also due to a lack of real human–human interactions. Our study addresses these limitations by employing a high-fidelity distributed simulation setup that links drivers in a motion-based simulator with pedestrians in a CAVE-based environment. This method allows for the examination of real-time and reciprocal interactions across a range of road-crossing scenarios. Using thirty-two pairs of drivers and pedestrians, we investigated how different factors, such as the presence of zebra crossings and varying time gaps of the approaching vehicle, influence driver behaviour and pedestrian crossing decisions. The effect of drivers' control of the vehicle during such crossings (e.g., braking behaviour and lateral deviation) on pedestrians' crossing decisions were also analysed. We found that the distribution of drivers' average deceleration values were bimodal, where drivers either markedly yielded to pedestrians, or continued in their path, with very few instances of intermediate behaviour. We also found that pedestrian decisions were seemingly influenced by the different braking strategies adopted by the driver, with pedestrians crossing before the vehicles in response to soft and early, or late and hard braking, while late and soft braking often resulted in the vehicle passing first. We also observed a slight lateral movement of the vehicle away from pedestrians when drivers were not yielding, but more of a lateral deviation towards them when yielding. This may be because drivers subconsciously transfer their walking interaction habits to their driving behaviour, to avoid a collision with pedestrians. Finally, our results showed a stronger influence of these kinematic cues on pedestrian crossing decisions, when compared to zebra crossings. As well as highlighting the value of a novel approach for investigating vehicle–pedestrian interactions, this study illustrates how vehicle cues can assist pedestrian decisions, adding new knowledge in the development of human-like behaviour for future AVs. [ABSTRACT FROM AUTHOR]

This study evaluates a long-acting liposomal fluorescence / CT dual-modality contrast agent (CF800) in head and neck cancer to enhance intraoperative tumor demarcation with fluorescence imaging and cone-beam computed tomography (CBCT). CF800 was administered to 12 buccal cancer-bearing rabbits. Imaging was acquired at regular time points to quantify time-dependent contrast enhancement. Surgery was performed 5–7 days after, with intraoperative near-infrared fluorescence endoscopy and CBCT, followed by histological and ex-vivo fluorescence assessment. Tumor enhancement on CT was significant at 24, 96 and 120 hours. Volumetric analysis of tumor segmentation showed high correlation between CBCT and micro-CT. Fluorescence signal was apparent in both ex-vivo and in-vivo imaging. Histological correlation showed [100%] specificity for primary tumor. Sensitivity and specificity of CF800 in detecting nodal involvement require further investigation.CF800 is long acting and has dual function for CT and fluorescence contrast, making it an excellent candidate for image-guided surgery. Long acting dual modality fluorescent / CT contrast liposomal agent for surgical navigation of head and neck cancers. [Display omitted] • CF800 allows for tumor enhancement on CT imaging for up to 5 days. • Volumetric assessment of tumor with CBCT and micro-CT was comparable. • Fluorescent guided surgery was effective at days 5–7 after CF800 administration. • Ex-vivo imaging with CF800 demonstrated clear demarcation of tumor. [ABSTRACT FROM AUTHOR]

Rationale. It is often assumed that experiencing an upward shift in social position from one generation to the next will provide happiness, yet empirical evidence demonstrating such a connection is limited. Objective. We provide a large-scale test of the relationship between intergenerational mobility and midlife life satisfaction using data from two prospective UK studies (N = 20,948). Method. Intergenerational mobility was modelled as a formative construct gauging the extent to which individuals moved up or down the social hierarchy compared to their parents, on a continuum ranging from high levels of downward mobility to high levels of upward mobility. Results. An intergenerational increase in social mobility, captured by greater educational attainment, social status, and home size than one's parents was positively associated with life satisfaction at age 42 in both cohorts. Mediation analyses revealed that almost half of this relationship was explained by better self-reported health and fewer perceived financial difficulties amongst the upwardly mobile. Conclusion. This study provides evidence that enhanced satisfaction with life may be a key outcome of intergenerational increases in social status. • Limited evidence that intergenerational mobility is related to well-being. • Large-scale test using two UK prospective Birth Cohorts (N = 20,948). • Mobility modelled as a continuum from high downward to high upward mobility. • Intergenerational mobility positively associated with life satisfaction at age 42. • Half of link was mediated by self-rated health and perceived financial difficulties. [ABSTRACT FROM AUTHOR]

Microsurgical nerve reconstruction has been advocated between 3 and 9 months of life in select patients with brachial plexus birth injury (BPBI), yet some patients undergo indicated surgery after this time frame. Outcomes in these older patients remain poorly characterized. We analyzed outcomes of nerve reconstruction performed after 9 months of age and hypothesized that (1) Active Movement Scale (AMS) scores improve after surgery, and (2) there are no differences in AMS scores between patients undergoing nerve transfers versus those undergoing nerve grafting. From 2000 to 2014, 750 patients at 6 U.S. centers were prospectively enrolled in a multicenter database. We included patients treated with nerve reconstruction after 9 months of age with minimum 12 months' follow-up. Patients were evaluated using AMS scores. To focus on the results of microsurgery, only outcomes prior to secondary surgery were analyzed. We analyzed baseline variables using bivariate statistics and change in AMS scores over time and across treatment groups using linear mixed models. We identified 32 patients (63% female) with median follow-up of 29.8 months. Median age at microsurgery was 11.2 months. Twenty-five (78%) had an upper trunk injury. Compared with before surgery, total AMS scores improved modestly at 1 year and 2 or more years follow-up. At 1 year follow-up, AMS scores improved for shoulder function (abduction, external rotation) and elbow flexion. Between-group comparisons found no differences in total AMS scores or AMS subscales between graft and transfer groups at 1 year or 2 or more years after surgery, so we cannot recommend one strategy over the other based on our findings. Overall, nerve reconstruction in patients with BPBI after 9 months of age resulted in improved function over time. There was no difference in outcomes between nerve transfer and nerve graft groups and 1 or 2 or more years follow-up. Therapeutic IV. [ABSTRACT FROM AUTHOR]

• Shared book reading between parents and 9-month-old children predicts 36-month vocabulary ability in an Irish cohort. • Four in 5 infants in Ireland are read to by at least 1 parent. • Irish children are most likely to be read to if their parents are educated, non-depressed, and report a rich communicative home environment. • Implications for the small yet significant effect of early shared reading are discussed. It is well-established that participation in shared book reading interactions with caregivers supports children's early language and literacy development. Most of this literature focuses on reading experiences during the preschool period. Less is known about the nature and importance of such practices during infancy. Therefore, the goal of this study was to examine literacy practices between parents and infants in a large cohort study, Growing Up in Ireland. Interview, survey, and direct measurements of children's language skills were used to examine whether parent-report of book reading practices when children were 9-months predicted child expressive vocabulary at 36-months (N = 9171). Regression analysis indicated that approximately 80% of 9-month-old Irish children are read to by parents. Characteristics of families who were more likely to report reading with children emerged: those with higher educational attainment, fewer depressive symptoms, and those who report a high-quality home language environment (e.g., reported talking more to children during everyday activities). Furthermore, children who were read to at 9-months had stronger expressive vocabulary skills at 36-months, even after accounting for socio-demographic and home literacy environment covariates measured at both 9- and 36-months. Results are discussed using a bioecological framework to describe how proximal and distal factors in the child's environment converge to impact early childhood literacy development. [ABSTRACT FROM AUTHOR]

The share of workers who work part-time because full-time jobs are not available remains larger compared to the period prior to the 2008 crisis. For part-time workers, being available to work more hours than offered may have negative mental health implications. Drawing on two nationally representative British surveys, we tested whether working less than 30 hours per week while preferring to work longer hours (underemployment) is associated with increased psychological distress. Distress was assessed using responses to the 12-item General Health Questionnaire in both samples. In the National Child Development Study (N = 6,295), propensity score estimates indicated that the hours-underemployed workers experienced higher levels of psychological distress (β = 0.25, p <0.001) than full-time workers matched on observable characteristics, including prior distress levels. Fixed effects estimates using 18 years of the British Household Panel Survey (N = 8,665) showed that transitioning from full-time employment to underemployment predicted an increase in distress levels (β = 0.19, p <0.01). Conversely, transitioning from underemployment to full-time employment forecasted a reduction in distress (β = -0.18, p <0.001). On average, job earnings and perceptions of job security explained a small (≈ 10%) portion of the potential psychological impact of hours-underemployment. These findings highlight the possibility that underemployment among part-time workers may have detrimental psychological consequences. Policy interventions geared towards improving career opportunities for part-time workers would potentially ameliorate losses in psychological well-being experienced by this group. • Examined underemployment defined as part-time workers preferring to work more hours. • Underemployment predicts increases in distress in matched sample of workers. • Moving to underemployment predicts elevated distress in fixed-effect models. • Underemployment effect is comparable to distress increases after job loss. • Returning to full-time work may reverse the effect of underemployment. [ABSTRACT FROM AUTHOR]

• Intratumoral cuts were avoided in all the simulations guided by navigation. • Navigation provided a 20% gain in terms of adequacy of margin delineation. • Experience, location, and tumor geometry didn't affect the benefit from navigation. To demonstrate and quantify, in a preclinical setting, the benefit of three-dimensional (3D) navigation guidance for margin delineation during ablative open surgery for advanced sinonasal cancer. Seven tumor models were created. 3D images were acquired with cone beam computed tomography, and 3D tumor segmentations were contoured. Eight surgeons with variable experience were recruited for the simulation of osteotomies. Three simulations were performed: 1) Unguided, 2) Guided using real-time tool tracking with 3D tumor segmentation (tumor-guided), and 3) Guided by 3D visualization of both the tumor and 1-cm margin segmentations (margin-guided). Analysis of cutting planes was performed and distance from the tumor surface was classified as follows: "intratumoral" when 0 mm or negative, "close" when greater than 0 mm and less than or equal to 5 mm, "adequate" when greater than 5 mm and less than or equal to 15 mm, and "excessive" over 15 mm. The three techniques (unguided, tumor-guided, margin-guided) were statistically compared. The use of 3D navigation for margin delineation significantly improved control of margins: unguided cuts had 18.1% intratumoral cuts compared to 0% intratumoral cuts with 3D navigation (p < 0.0001). This preclinical study has demonstrated the significant benefit of navigation-guided osteotomies for sinonasal tumors. Translation into the clinical setting – with rigorous assessment of oncological outcomes – would be the proposed next step. [ABSTRACT FROM AUTHOR]

Background: Increases in mental health problems have been observed during the COVID-19 pandemic. The objectives were to examine the extent to which mental health symptoms changed during the pandemic in 2020, whether changes were persistent or short lived, and if changes were symptom specific.Methods: Systematic review and meta-analysis of longitudinal cohort studies examining changes in mental health among the same group of participants before vs. during the pandemic in 2020.Results: Sixty-five studies were included. Compared to pre-pandemic outbreak, there was an overall increase in mental health symptoms observed during March-April 2020 (SMC = .102 [95% CI: .026 to .192]) that significantly declined over time and became non-significant (May-July SMC = .067 [95% CI: -.022 to .157]. Compared to measures of anxiety (SMC = 0.13, p = 0.02) and general mental health (SMC = -.03, p = 0.65), increases in depression and mood disorder symptoms tended to be larger and remained significantly elevated in May-July [0.20, 95% CI: .099 to .302]. In primary analyses increases were most pronounced among samples with physical health conditions and there was no evidence of any change in symptoms among samples with a pre-existing mental health condition.Limitations: There was a high degree of unexplained heterogeneity observed (I2s > 90%), indicating that change in mental health was highly variable across samples.Conclusions: There was a small increase in mental health symptoms soon after the outbreak of the COVID-19 pandemic that decreased and was comparable to pre-pandemic levels by mid-2020 among most population sub-groups and symptom types. [ABSTRACT FROM AUTHOR]