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Purpose: Previous research indicates that social support is protective for the mental health outcomes of exposure to childhood adversity. However, the impact of social support as a protective factor following exposure to cumulative childhood adversity is understudied with prospective longitudinal data. The aim of this present study was to examine how social support mediates the impact of cumulative exposure to childhood adversity on internalising disorder in adulthood. Methods: The Christchurch Health and Development Study (CHDS) is a general population birth cohort, born in 1977 and representative of Christchurch, New Zealand at the time of the cohort members' birth. The present study used a generalised estimating equations (GEE) framework to analyse direct associations between a cumulative measure of childhood adversity (CA) and internalising disorders (major depression, and any anxiety disorder), and indirect associations through social support. Results: Results indicated a dose-dependent relationship between increased exposure to CA and worsened odds of a diagnosis for major depression and any anxiety disorder, respectively. There was also a significant mediating effect of social support on the direct associations between CA and both major depression (OR (95%CI) =0.98 (0.97, 0.99), p < 001) and any anxiety disorder (OR (95%CI) =.98 (0.97, 0.99), p < 001). Conclusion: The findings indicate that social support reduces the impact of childhood adversity on adult mental health, and is therefore a target for future work examining potential interventions following CA. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta-analysis compared clinical outcome measures in patients undergoing reverse shoulder arthroplasty (RSA) for proximal humerus fracture (PHF) with healed versus non-healed greater tuberosity (GT). Methods: We performed a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines querying PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane for studies that stratified results by the GT healing status. Studies that did not attempt to repair the GT were excluded. We extracted and compared clinical outcomes including postoperative forward flexion (FF), external rotation (ER), internal rotation (IR), Constant score, and complications and revision rates. Results: Of the included patients, 295 (78.5%) demonstrated GT healing while 81 did not (21.5%). The healed GT cohort exhibited increased postoperative FF (P <.001), ER (P <.001), IR (P =.006), and Constant score (P =.006) compared to the non-healed GT cohort. The overall dislocation rate was 0.8% with no study differentiating GT status of dislocation cases. Conclusion: Healing of the GT after RSA for PHF yields improved postoperative range of motion and strength, whereas patient-reported pain and function were largely not affected by GT healing indicating merit to RSA for PHF regardless of the likelihood of the GT healing. [ABSTRACT FROM AUTHOR]

Purpose: To establish the prevalence and agreement between reported and observed leg weakness in people with sciatica. To establish which factors mediate any identified difference between reported and observed leg weakness in people with sciatica. Methods: 68 people with a clinical diagnosis of sciatica, records from spinal service, secondary care NHS Hospital, England, UK reviewed. Primary outcome measures were the sciatica bothersome index for reported leg weakness and the Medical Research Council scale for observed weakness. Agreement was established with Cohen's Kappa and intraclass correlation coefficient. Potential factors that may mediate a difference between reported and observed weakness included leg pain, sciatica bothersome index sensory subscale, age, hospital anxiety and depression subscale for anxiety. Results: 85% of patients reported weakness but only 34% had observed weakness. Cohen's Kappa (0.066, 95% CI − 0.53, 0.186; p = 0.317)] and ICC 0.213 (95% CI − 0.26, 0.428, p = 0.040) both showed poor agreement between reported and observed weakness. The difference between reported and observed measures of weakness was mediated by the severity of leg pain (b = 0.281, p = 0.024) and age (b = 0.253, p = 0.042). Conclusion: There is a high prevalence of reported leg weakness in people with sciatica, which is not reflected in observed clinical measures of weakness. Differences between reported and observed weakness may be driven by the severity of leg pain and age. Further work needs to establish whether other objective measures can detect patient reported weakness. [ABSTRACT FROM AUTHOR]

Parents of racialized children and children with disabilities experience a unique set of challenges and stressors in their parenting role. Many studies now exist focusing on parenting during the pandemic. Yet, there is a need for more research examining how parenting during COVID is complicated for minority parents who have a child with a disability. For this project, we used the Crowdsourcing: Impacts of COVID-19 on Canadians-Parenting During the Pandemic, 2020 dataset. Data in this national survey was collected from June 9 to June 22, 2020 (Statistics Canada, 2020a). We specifically examined how parenting at least one child with a disability intersected with being a racialized mother. After applying benchmarking and restrictions, the sample of 12,624 analyzed in this study consists non-Indigenous mothers with children either preschool age (0–5) or school age (6–14). The highest rates, across a broad range of concerns for children and family were reported by racialized mothers who also reported having child(ren) with a disability. Parents with only preschool children were less concerned for children but reported slightly higher levels of family concerns. A series of interactional analyses further revealed intersectional impacts on concerns between racialized mothers, parenting a child with a disability, and the age of the child. This study emphasizes the importance of intersectional considerations during the early pandemic relating to parenting for racialized mothers of children with disabilities. Societal implications, measurement/sample/analysis limitations, and policy implications are considered. Highlights: Racialized mothers (visible minorities) with at least one child with a disability experienced significantly higher parenting concerns for children and family during the COVID-19 pandemic than other groups. Parents of preschool-age children had lower parenting concerns than parents of school-age children during the COVID-19 pandemic. Understanding unique stressors experienced by racialized mothers with children with disabilities may provide opportunities for better community and service supports. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the microbial yield and factors predicting culture positivity for image-guided arthrocentesis of suspected septic sternoclavicular (SC) arthritis. Materials and methods: An electronic health record search identified image-guided SC joint aspirations for suspected septic arthritis. Data was extracted by retrospective chart review including patient demographics, procedure characteristics, pre-procedure lab testing, joint culture results, final SC joint diagnoses and any effect of positive synovial cultures on subsequent antibiotic therapy. Factors associated with positive joint fluid cultures were assessed using a Chi-squared test for categorical predictors and logistic regression for continuous predictors. Results: A total of 31 SC arthrocenteses met inclusion criteria with most (81%) performed using ultrasound guidance. Synovial fluid was successfully aspirated in 19/31 (61%) of cases, and in all other cases lavage fluid was successfully obtained. Synovial cultures were positive in 9/31 (29%) of cases. A final diagnosis of septic arthritis was assigned to 20/31 cases (65%) in which 9/20 (45%) had positive synovial cultures. There was no statistically significant association between synovial culture positivity and risk factors for septic arthritis, positive blood cultures, pre-aspiration antibiotics and whether synovial fluid or lavage fluid was cultured. Serum white blood cell count (WBC) and erythrocyte sedimentation rate (ESR) demonstrated statistically significant positive correlation with positive synovial cultures. Conclusion: Arthrocentesis is effective for microbial speciation in SC septic arthritis, and diagnostic yield may be increased with lavage when encountering a dry tap. Normal serum WBC and ESR values indicate an extremely low likelihood of positive synovial cultures. [ABSTRACT FROM AUTHOR]

Purpose: Lumbar discectomy is among the most common spine procedures in the US, with 300,000 procedures performed each year. Like other surgical procedures, this procedure is not excluded from potential complications. This paper presents a video annotation methodology for microdiscectomy including the development of a surgical workflow. In future work, this methodology could be combined with computer vision and machine learning models to predict potential adverse events. These systems would monitor the intraoperative activities and possibly anticipate the outcomes. Methods: A necessary step in supervised machine learning methods is video annotation, which involves labeling objects frame-by-frame to make them recognizable for machine learning applications. Microdiscectomy video recordings of spine surgeries were collected from a multi-center research collaborative. These videos were anonymized and stored in a cloud-based platform. Videos were uploaded to an online annotation platform. An annotation framework was developed based on literature review and surgical observations to ensure proper understanding of the instruments, anatomy, and steps. Results: An annotated video of microdiscectomy was produced by a single surgeon. Multiple iterations allowed for the creation of an annotated video complete with labeled surgical tools, anatomy, and phases. In addition, a workflow was developed for the training of novice annotators, which provides information about the annotation software to assist in the production of standardized annotations. Conclusions: A standardized workflow for managing surgical video data is essential for surgical video annotation and machine learning applications. We developed a standard workflow for annotating surgical videos for microdiscectomy that may facilitate the quantitative analysis of videos using supervised machine learning applications. Future work will demonstrate the clinical relevance and impact of this workflow by developing process modeling and outcome predictors. [ABSTRACT FROM AUTHOR]

Citizen science is increasingly credited for promoting scientific literacy and having the potential to empower and engage local people in conservation. However, rigorous evaluation of citizen science outcomes is limited, particularly those related to social capital and environmental stewardship. Social science can help to address this gap as it can identify barriers that hinder the success of citizen science programs and drivers that promote positive outcomes, such as social norms, community engagement, and effective communication strategies. However, little has been written about how academic partners in social science fields can engage with citizen science practitioners. In this paper we describe seven design components essential to the success of a long-term research collaboration between academic social scientists and staff of Billion Oyster Project (BOP), a nonprofit environmental organization whose mission is to restore oyster reefs to New York Harbor through citizen science, restoration, and public education initiatives. We describe how over an eight-year period, social science methodologies and findings were used to inform BOP’s environmental citizen science and volunteer programing and management. We argue that collaborative research is essential for the advancement of our field, and that action-driven research partnerships should become a key component of effective citizen science programs. [ABSTRACT FROM AUTHOR]

Decades of neuroimaging studies have shown modest differences in brain structure and connectivity in depression, hindering mechanistic insights or the identification of risk factors for disease onset1. Furthermore, whereas depression is episodic, few longitudinal neuroimaging studies exist, limiting understanding of mechanisms that drive mood-state transitions. The emerging field of precision functional mapping has used densely sampled longitudinal neuroimaging data to show behaviourally meaningful differences in brain network topography and connectivity between and in healthy individuals2–4, but this approach has not been applied in depression. Here, using precision functional mapping and several samples of deeply sampled individuals, we found that the frontostriatal salience network is expanded nearly twofold in the cortex of most individuals with depression. This effect was replicable in several samples and caused primarily by network border shifts, with three distinct modes of encroachment occurring in different individuals. Salience network expansion was stable over time, unaffected by mood state and detectable in children before the onset of depression later in adolescence. Longitudinal analyses of individuals scanned up to 62 times over 1.5 years identified connectivity changes in frontostriatal circuits that tracked fluctuations in specific symptoms and predicted future anhedonia symptoms. Together, these findings identify a trait-like brain network topology that may confer risk for depression and mood-state-dependent connectivity changes in frontostriatal circuits that predict the emergence and remission of depressive symptoms over time.Precision functional mapping shows that the frontostriatal salience network occupies nearly twice as much of the cortex in people with depression, and this was unaffected by mood changes and detected in children before onset of symptoms. [ABSTRACT FROM AUTHOR]

It is possible that the reproductive strategy of the short-beaked echidna is related to seasonal changes in fat deposition and energy availability, regulated by seasonal changes in endocrine function. We predicted that circulating leptin levels would be directly proportional to adiposity during most of the year, but that a change in this relationship would occur during the pre-breeding season to allow increased fat deposition. To test this hypothesis, we made use of a captive colony of echidnas to describe and quantify changes in fat distribution and the adipostatic hormone leptin. First we assessed seasonal changes in circulating leptin levels, body mass and adiposity for three male and three female adult echidnas maintained on a standard diet. Second, we explored the relationship between circulating leptin levels and increased caloric intake for an additional five adult female echidnas that were provided with supplemented nutrition. Third we visualised fat distribution in male and female adult echidnas using magnetic resonance imaging (MRI) before and after the breeding season, to determine where fat is deposited in this species. For echidnas maintained on the standard diet, there were no seasonal changes in body mass, body fat or plasma leptin levels. However, female echidnas provided with supplemented nutrition had significantly elevated plasma leptin levels during the breeding season, compared to the pre-and post- breeding periods. MRI showed substantial subcutaneous fat depots extending dorso-laterally from the base of the skull to the base of the tail, in both sexes. Pre-breeding season, both sexes had considerable fat deposition in the pelvic/rump region, whilst the female echidna accumulated most fat in the abdominal region. This study shows that male and female echidnas accumulate body fat in the pelvic/rump and the abdominal regions, respectively and that circulating leptin may promote fattening in female echidnas during the breeding season by means of leptin resistance. However, further research is required to evaluate the precise relationship between seasonal changes in leptin and adiposity. [ABSTRACT FROM AUTHOR]

Purpose: Radial tunnel syndrome (RTS) is a controversial diagnosis due to non-specific exam findings and frequent absence of positive electromyography (EMG) and nerve conduction study (NCS) findings. The purpose of this study was to identify the methods used to diagnose RTS in the literature. Methods: We queried PubMed, Embase, Web of Science, and Cochrane databases per PRISMA guidelines. Extracted data included article and patient characteristics, diagnostic assessments utilized and their respective findings, and treatments. Objective data were summarized descriptively. The relationship between reported diagnostic findings (i.e., physical exam and diagnostic tests) and treatments was assessed via a descriptive synthesis. Results: Our review included 13 studies and 391 upper extremities. All studies utilized physical exam in diagnosing RTS; most commonly, patients had tenderness over the radial tunnel (381/391, 97%). Preoperative EMG/NCS was reported by 11/13 studies, with abnormal findings in 8.9% (29/327) of upper extremities. Steroid and/or lidocaine injection for presumed lateral epicondylitis was reported by 9/13 studies (46/295 upper extremities, 16%), with RTS being diagnosed after patients received little to no relief. It was also common to inject the radial tunnel to make the diagnosis (218/295, 74%). The most common reported intraoperative finding was narrowing of the PIN (38/137, 28%). The intraoperative compressive site most commonly reported was the arcade of Frohse (142/306, 46%). Conclusions: There is substantial heterogeneity in modalities used to diagnose RTS and the reported definition of RTS. This, in conjunction with many patients having concomitant lateral epicondylitis, makes it difficult to compare treatment outcomes for RTS. Level of evidence: Level III. Systematic review of retrospective and prospective cohort studies [ABSTRACT FROM AUTHOR]

Objectives: Canalis sinuosus (CS) is a clinically relevant structure in the anterior maxilla. The present study aimed to determine the prevalence and distribution of CS and its accessory canals (ACs) in the South African population and describe its anatomical variations. Methods: In total, 500 cone-beam computed tomography (CBCT) scans of the anterior maxilla were assessed for prevalence, sidedness, diameter, and distribution of CS. The frequency, number, diameter, configuration, and point of termination of ACs were also recorded. Statistical analysis was performed using analysis of variance, Kruskal–Wallis, chi-squared, and Fisher Exact tests with P < 0.05. Results: CS was present in most cases (99.6%), and commonly occurred bilaterally (98.8%). The mean diameter of CS was 1.08 mm (range: 0.50 mm–2.39 mm). Sex, population group, and age had no significant effect on the prevalence or sidedness of CS. Additionally, 535 ACs were observed in 58.8% of the sample, with 42.9% of ACs found bilaterally and 57.1% unilaterally. The mean diameter of the ACs was 0.86 mm on the left and 0.87 mm on the right (range; 0.50 mm–1.52 mm). The majority of ACs maintained a straight vertical configuration (72.3%). ACs most commonly terminated in the anterior palatal region of the maxilla (57.2%). No significant differences were found in any groups mentioned (P > 0.05). Conclusions: A high prevalence of CS as well as ACs were observed in the sample population. Due to their clinical significance, surgical planning with the aid of high quality CBCT scans of the anterior maxilla is advisable. [ABSTRACT FROM AUTHOR]

Cultural and genetic inheritance combine to enable rapid changes in trait expression, but their relative importance in determining trait expression across generations is not clear. Birdsong is a socially learned cognitive trait that is subject to both cultural and genetic inheritance, as well as being affected by early developmental conditions. We sought to test whether early-life conditions in one generation can affect song acquisition in the next generation. We exposed one generation (F1) of nestlings to elevated corticosterone (CORT) levels, allowed them to breed freely as adults, and quantified their son's (F2) ability to copy the song of their social father. We also quantified the neurogenetic response to song playback through immediate early gene (IEG) expression in the auditory forebrain. F2 males with only one corticosterone-treated parent copied their social father's song less accurately than males with two control parents. Expression of ARC in caudomedial nidopallium (NCM) correlated with father-son song similarity, and patterns of expression levels of several IEGs in caudomedial mesopallium (CMM) in response to father song playback differed between control F2 sons and those with a CORT-treated father only. This is the first study to demonstrate that developmental conditions can affect social learning and neurogenetic responses in a subsequent generation. [ABSTRACT FROM AUTHOR]

Introduction: Interventional treatment options for the lumbar degenerative spine have undergone a significant amount of innovation over the last decade. As new technologies emerge, along with the surgical specialty expansion, there is no manuscript that utilizes a review of surgical treatments with evidence rankings from multiple specialties, namely, the interventional pain and spine communities. Through the Pacific Spine and Pain Society (PSPS), the purpose of this manuscript is to provide a balanced evidence review of available surgical treatments. Methods: The PSPS Research Committee created a working group that performed a comprehensive literature search on available surgical technologies for the treatment of the degenerative spine, utilizing the ranking assessment based on USPSTF (United States Preventative Services Taskforce) and NASS (North American Spine Society) criteria. Results: The surgical treatments were separated based on disease process, including treatments for degenerative disc disease, spondylolisthesis, and spinal stenosis. Conclusions: There is emerging and significant evidence to support multiple approaches to treat the symptomatic lumbar degenerative spine. As new technologies become available, training, education, credentialing, and peer review are essential for optimizing patient safety and successful outcomes. [ABSTRACT FROM AUTHOR]

Sushi rice is a ready-to-eat traditional Japanese dish seasoned with vinegar, sugar and salt that has gained popularity worldwide. There are many rice cultivars grown in the world which vary in their cooking, sensory, and processing quality. The aim of this study was to analyse chemical, physical, and functional properties of three rice varieties (Vietnamese, Italian, and Australian) to determine their suitability for sushi rice production. Rice was cooked using industry norms and vinegar was then added; samples with no vinegar were prepared for comparison. The rice was stored during 5 days at 4 °C after cooking for texture profile analysis and samples were taken on day 1 and day 5. Flour composition as well as amylose content, gelatinisation properties using differential scanning calorimeter, pasting properties using Rapid Visco Analyser, water absorption capacity (WAC), oil absorption capacity (OAC) and swelling power of extracted starch were determined. Results showed that the amylose content (16.51 to 21.37%) had a large impact on the functional and quality characteristics of the rice variants including texture, pasting, gelatinisation and WAC properties. Australian starch showed the highest amylose content, setback viscosity, final viscosity, pasting temperature and lowest gelatinisation temperature. The lower amylose content and gelatinisation temperature contributed to a softer texture in the Vietnamese rice samples over life. The added vinegar aided in keeping the texture soft during the shelf-life of the rice. Since sushi rice is usually prepared with vinegar, Italian and Vietnamese rice are better candidates for sushi rice based on their lower hardness after 5 days of storage when compared to the Australian variety. [ABSTRACT FROM AUTHOR]

Background: Menopausal hormone therapy (MHT), a common treatment to relieve symptoms of menopause, is associated with a lower risk of colorectal cancer (CRC). To inform CRC risk prediction and MHT risk-benefit assessment, we aimed to evaluate the joint association of a polygenic risk score (PRS) for CRC and MHT on CRC risk. Methods: We used data from 28,486 postmenopausal women (11,519 cases and 16,967 controls) of European descent. A PRS based on 141 CRC-associated genetic variants was modeled as a categorical variable in quartiles. Multiplicative interaction between PRS and MHT use was evaluated using logistic regression. Additive interaction was measured using the relative excess risk due to interaction (RERI). 30-year cumulative risks of CRC for 50-year-old women according to MHT use and PRS were calculated. Results: The reduction in odds ratios by MHT use was larger in women within the highest quartile of PRS compared to that in women within the lowest quartile of PRS (p-value = 2.7 × 10−8). At the highest quartile of PRS, the 30-year CRC risk was statistically significantly lower for women taking any MHT than for women not taking any MHT, 3.7% (3.3%–4.0%) vs 6.1% (5.7%–6.5%) (difference 2.4%, P-value = 1.83 × 10−14); these differences were also statistically significant but smaller in magnitude in the lowest PRS quartile, 1.6% (1.4%–1.8%) vs 2.2% (1.9%–2.4%) (difference 0.6%, P-value = 1.01 × 10−3), indicating 4 times greater reduction in absolute risk associated with any MHT use in the highest compared to the lowest quartile of genetic CRC risk. Conclusions: MHT use has a greater impact on the reduction of CRC risk for women at higher genetic risk. These findings have implications for the development of risk prediction models for CRC and potentially for the consideration of genetic information in the risk-benefit assessment of MHT use. [ABSTRACT FROM AUTHOR]

Long-duration spaceflight missions are on the rise. However, recent literature suggests that prolonged and deep-space exposure is likely to introduce increased risks for brain health and consequent detriments to performance and well-being. Given up-to-date evidence, we argue that transcranial magnetic stimulation (TMS) is a promising solution for mitigating behavioral and neurocognitive risks associated with long-duration and deep-space missions. We provide support from recent Earth-based applications of TMS and review several advantages it holds over current treatment approaches. Lastly, we highlight some of the needs in the process of applying such technology to the spaceflight environment. [ABSTRACT FROM AUTHOR]

Little is known about the developmental trajectories of parental self-efficacy as children transition into adolescence. This study examined parental self-efficacy among mothers and fathers over 3 1/2 years representing this transition, and whether the level and developmental trajectory of parental self-efficacy varied by cultural group. Data were drawn from three waves of the Parenting Across Cultures (PAC) project, a large-scale longitudinal, cross-cultural study, and included 1178 mothers and 1041 fathers of children who averaged 9.72 years of age at T1 (51.2% girls). Parents were from nine countries (12 ethnic/cultural groups), which were categorized into those with a predominant collectivistic (i.e., China, Kenya, Philippines, Thailand, Colombia, and Jordan) or individualistic (i.e., Italy, Sweden, and USA) cultural orientation based on Hofstede's Individualism Index (Hofstede Insights, 2021). Latent growth curve analyses supported the hypothesis that parental self-efficacy would decline as children transition into adolescence only for parents from more individualistic countries; parental self-efficacy increased over the same years among parents from more collectivistic countries. Secondary exploratory analyses showed that some demographic characteristics predicted the level and trajectory of parental self-efficacy differently for parents in more individualistic and more collectivistic countries. Results suggest that declines in parental self-efficacy documented in previous research are culturally influenced. [ABSTRACT FROM AUTHOR]

Drinking water quality sensor technology has rapidly advanced, facilitating the collection of rich datasets and real-time analytics. However, sensors have not yet been widely applied to monitor drinking water quality in premise plumbing. Richer quality of data in premise plumbing offers an improved understanding of the quality of drinking water present at the point-of-use. In this paper, online drinking water quality sensor nodes were temporarily installed in twenty-four homes in Detroit, Michigan. The water quality sensor nodes took measurements of five drinking water quality parameters every five minutes for four weeks. Additionally, free chlorine and lead were sampled periodically within each home. Together, these data make up a dataset that captures drinking water quality over time in a legacy city with an oversized drinking water system. This dataset offers more frequent measurements amongst more sample homes than are typically available in premise plumbing or at the tap. The data can be used to investigate temporal trends in drinking water quality, including diurnal patterns and anomaly detection. Additionally, this dataset could be utilized to evaluate water quality in comparison with other cities. [ABSTRACT FROM AUTHOR]

Empirical inquiry has demonstrated the benefits of autonomy-supportive parenting practices and harms of parental psychological control for youth development and wellbeing, though specific sources of variation in use of these practices remains unclear. Individual differences in parenting practices may be related to physiological stress reactivity; more importantly, the coordination of stress responses across multiple physiological systems within the autonomic nervous system (ANS) may account for differences in parenting practices. Guided by the autonomic space model of ANS functioning, this study investigates the role of mothers' physiological stress response in relation to autonomy-supportive and controlling parenting practices. Sixty-eight mothers (Mage = 40.88, SD = 6.97) of young adolescents watched their children participate in a stressful laboratory-based public speaking task. Changes from baseline in mothers' skin conductance level (SCL reactivity) and respiratory sinus arrhythmia (RSA reactivity) were calculated. Youth reported perceptions of mothers' promotion of volitional functioning, promotion of independence, and psychological control. Physiological measures interacted such that mothers who experienced higher SCL reactivity engaged in more youth-reported psychological control when RSA scores showed little to no change from baseline to stressful task, but less psychological control when RSA scores decreased from baseline to challenge. Thus, this asynchronous pattern of ANS activity was associated with a parenting practice that typically inhibits developmentally appropriate autonomy among young adolescents, suggesting that mothers' parenting behaviors are associated with the coordinated physiological stress response of the two ANS systems. Highlights: Mothers' parasympathetic and sympathetic nervous system activity assessed while children participated in a stressful task. Uncoordinated activity of two physiological branches was associated with controlling parenting practices. Reactivity amongst multiple physiological branches should be tested to understand variation in parenting practices. [ABSTRACT FROM AUTHOR]

Legacy phosphorus (P) is a reservoir of sparingly available P, and its recovery could enhance sustainable use of nonrenewable mineral fertilizers. Domestication has affected P acquisition, but it is unknown if subsequent breeding efforts, like the Green Revolution (GR), had a similar effect. We examined how domestication and breeding events altered P acquisition by growing wild, traditional (pre-GR), and modern (post-GR) tomato in soil with legacy P but low bioavailable P. Wild tomatoes, particularly accession LA0716 (Solanum pennellii), heavily cultured rhizosphere P solubilizers, suggesting reliance on microbial associations to acquire P. Wild tomato also had a greater abundance of other putatively beneficial bacteria, including those that produce chelating agents and antibiotic compounds. Although wild tomatoes had a high abundance of these P solubilizers, they had lower relative biomass and greater P stress factor than traditional or modern tomato. Compared to wild tomato, domesticated tomato was more tolerant to P deficiency, and both cultivated groups had a similar rhizosphere bacterial community composition. Ultimately, this study suggests that while domestication changed tomato P recovery by reducing microbial associations, subsequent breeding processes have not further impacted microbial P acquisition mechanisms. Selecting microbial P-related traits that diminished with domestication may therefore increase legacy P solubilization. [ABSTRACT FROM AUTHOR]

Post-acute sequelae of COVID-19 (PASC) or the continuation of COVID-19 (Coronavirus disease 2019) symptoms past 12 weeks may affect as many as 30% of people recovering from a SARS-CoV-2 (severe acute respiratory coronavirus 2) infection. The mechanisms regulating the development of PASC are currently not known; however, hypotheses include virus reservoirs, pre-existing conditions, microblood clots, immune dysregulation, as well as poor antibody responses. Importantly, virus neutralizing antibodies are essential for COVID-19 recovery and protection from reinfection but there is currently limited information on these immune regulators and associated cytokines in PASC patients. Understanding the key drivers of general and specific symptoms associated with Long COVID and the presence of virus neutralizing antibodies in PASC will aid in the development of therapeutics, diagnostics, and vaccines which currently do not exist. We designed a cross-sectional study to investigate systemic antibody and cytokine responses during COVID-19 recovery and PASC. In total, 195 participants were recruited in one of four groups: (1) Those who never had COVID-19 (No COVID); (2) Those in acute COVID-19 recovery (Acute Recovery) (4–12 weeks post infection); (3) Those who recovered from COVID-19 (Recovered) (+ 12 weeks from infection); and (4) those who had PASC (PASC) (+ 12 weeks from infection). Participants completed a questionnaire on health history, sex, gender, demographics, experiences with COVID-19 acute and COVID-19 recovery/continuing symptoms. Serum samples collected were evaluated for antibody binding to viral proteins, virus neutralizing antibody titers, and serum cytokine levels using Ella SimplePlex Immunoassay™ panels. We found participants with PASC reported more pre-existing conditions (e.g. such as hypertension, asthma, and obesity), and PASC symptoms (e.g. fatigue, brain fog, headaches, and shortness of breath) following COVID-19 than COVID-19 Recovered individuals. Importantly, we found PASC individuals to have significantly decreased levels of neutralizing antibodies toward both SARS-CoV-2 and the Omicron BA.1 variant. Sex analysis indicated that female PASC study participants had sustained antibody levels as well as levels of the inflammatory cytokines GM-CSF and ANG-2 over time following COVID-19. Our study reports people experiencing PASC had lower levels of virus neutralizing antibodies; however, the results are limited by the collection time post-COVID-19 and post-vaccination. Moreover, we found females experiencing PASC had sustained levels of GM-CSF and ANG-2. With lower levels of virus neutralizing antibodies, this data suggests that PASC individuals not only have had a suboptimal antibody response during acute SARS-CoV-2 infection but may also have increased susceptibility to subsequent infections which may exacerbate or prolong current PASC illnesses. We also provide evidence suggesting GM-CSF and ANG-2 to play a role in the sex-bias of PASC. Taken together, our findings maybe important for understanding immune molecular drivers of PASC and PASC subgroups. [ABSTRACT FROM AUTHOR]

Contemporary schools seek to employ teachers who are curious learners, who can employ practitioner inquiry skills to investigate, inform and grow their own classroom practice, responsive to their circumstances. As a profession, the question we must ask is how do we best prepare and continue to equip teachers with the necessary research skills to investigate and inform their own practice? In this study, we share our pedagogical stance and features of our approach in a new core undergraduate subject for pre-service teachers (PSTs). We discuss professional learning groups (PLGs) for initial teacher education students as the main intervention in the subject, and, more specifically, we elaborate how regular participation in PLGs formed in an on-campus subject can help PSTs to become researchers. We draw on 183 student exit tickets and student feedback surveys to consider broader implications for how to engage teachers in research. This study poses questions about the nature of practitioner research and investigates the role that PLGs play in disrupting the challenges universities face in preparing teachers to engage in and with research. [ABSTRACT FROM AUTHOR]

A new approach is presented to compute entropy for massless scalar quantum fields. By perturbing a skewed correlation matrix composed of field operator correlation functions, the mutual information is obtained for disjoint spherical regions of size r at separation R, including an expansion to all orders in r/R. This approach also permits a perturbative expansion for the thermal field entropy difference in the small temperature limit (T ≪ 1/r). [ABSTRACT FROM AUTHOR]

Housing insecurity is associated with co-occurring depression and pain interfering with daily activities. Network analysis of depressive symptoms along with associated risk or protective exposures may identify potential targets for intervention in patients with co-occurring bodily pain. In a community-based sample of adults (n = 408) living in precarious housing or homelessness in Vancouver, Canada, depressive symptoms were measured by the Beck Depression Inventory; bodily pain and impact were assessed with the 36-item Short Form Health Survey. Network and bootstrap permutation analyses were used to compare depressive symptoms endorsed by Low versus Moderate-to-Severe (Mod + Pain) groups. Multilayer networks estimated the effects of risk and protective factors. The overall sample was comprised of 78% men, mean age 40.7 years, with 53% opioid use disorder and 14% major depressive disorder. The Mod + Pain group was characterized by multiple types of pain, more persistent pain, more severe depressive symptoms and a higher rate of suicidal ideation. Global network connectivity did not differ between the two pain groups. Suicidal ideation was a network hub only in the Mod + Pain group, with high centrality and a direct association with exposure to lifetime trauma. Antidepressant medications had limited impact on suicidal ideation. Guilt and increased feelings of failure represented symptoms from two other communities of network nodes, and completed the shortest pathway from trauma exposure through suicidal ideation, to the non-prescribed opioid exposure node. Interventions targeting these risk factors and symptoms could affect the progression of depression among precariously housed patients. [ABSTRACT FROM AUTHOR]

The requirement for Australian initial teacher education (ITE) providers to administer a Teaching Performance Assessment (TPA) highlights a tension between policymaking directives and academic independence. It has raised fears of entrenching simplistic notions of measurement and evidence into a professional field distinguished by its complex relationship with intellectual and academic labour. Drawing on focus group data and reflections of academics co-designing an Australian TPA, this study considers how intellectual labour intertwines with its operational field, wherein co-construction of knowledge, critical thinking, and reflection define both academic and teachers' work. Our analysis explains how education academics, as principle-designers of an assessment instrument, might also negotiate the intellectual premise of a TPA within their own ITE programs. We find that Australia's initial TPA policy framework has been mediated with ITE academics. This offers opportunities for building knowledge to understand more precisely the TPA in its contexts, including admissible evidence to measure classroom-readiness. [ABSTRACT FROM AUTHOR]

In a changing publishing climate, with graphic novel adaptations of bestselling books becoming increasingly popular, we examined four Newbery Medal winning texts (Madeline L'Engle's A Wrinkle in Time, Lois Lowry's The Giver, Neil Gaiman's The Graveyard Book, and Kwame Alexander's The Crossover) and their graphic novel adaptations. Graphic novels, including graphic adaptations of award-winning texts, have long been viewed as second tier literature, both by educators and literature scholars alike. However, in this study, we attempt to elevate and make space for the unique affordances of both text types. Rather than comparing source texts and their adaptations in order to determine which exhibited higher literary quality (a highly subjective and contentious space that typically privileges the originals), we approach our analysis by asking how reading the paired texts could expand and enhance readers' transactions. The findings of our study suggest pairing award-winning texts and their graphic novel adaptations can allow readers' transactions to blossom, as the complementary experiences can deepen their understanding of and engagement with storytelling that unfolds in unique and important ways. [ABSTRACT FROM AUTHOR]

The United States (US) Food and Drug Administration (FDA) Investigational New Drug (IND) Final Rule (US FDA, Final rule: Investigational new drug safety reporting requirements for human drug and biological products and safety reporting requirements for bioavailability and bioequivalence studies in humans, 2010) applies to all human drugs and biological products being studied under an IND. The Final Rule specifies that a sponsor must file an IND safety report for any Suspected Unexpected Serious Adverse Reaction (SUSAR) of a medicinal product being investigated. To make a proper SUSAR classification, sponsors need to go beyond conventional Data Monitoring Committees (DMCs) with an interdisciplinary effort, using all relevant data (including data outside clinical trials), to make judgments on the possibility of serious adverse events being caused by the study drug—rather than the underlying condition of the patient or a concomitant therapy. Ball et al. (Ball et al. in Ther Innov Regul Sci 55:705–716, 2021) have reported on how the Final Rule has been implemented by large pharmaceutical companies. This paper explores the experiences of small sponsor companies regarding the Final Rule, to understand the current challenges that they have been facing to meet aggregate IND safety reporting requirements. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effects of load carriage in normoxia and normobaric hypoxia on ventilatory responses, hemodynamics, tissue oxygenation, and metabolism. Methods: Healthy males (n = 12) completed 3 randomly ordered baseline graded exercise tests in the following conditions: (1) unloaded normoxic (U: FIO2 = 20.93%), (2) loaded (~ 30 kg) normoxic (LN), and (3) loaded hypoxic simulating ~ 3650 m (LH: FIO2 = ~ 13%). Thereafter, experimental exercise trials were completed in quasi-randomized order (i.e., U completed first) consisting of 3 × 10 min of walking (separated by 5 min seated rest) with stages matched with the U condition (in ascending order) for relative intensity, absolute oxygen consumption ([VO2]; 1.7 L min−1), and walking speed (1.45 ± 0.15 m s−1). Results: Load carriage increased perceived exertion and reduced VO2max (LN: − 7%; LH: − 32%; p < 0.05). At matched VO2, stroke volume and tidal volume were reduced and maintained with LN and LH vs. U, respectively (p < 0.05). Increases in cardiac output and minute ventilation at matched VO2 (with LH) and speed (with LN and LH), were primarily accomplished via increases in heart rate and breathing frequency (p < 0.05). Cerebral oxygenated hemoglobin (O2HHb) was increased at all intensities with LN, but deoxygenated hemoglobin and total hemoglobin were increased with LH (p < 0.05). Muscle oxygen kinetics and substrate utilization were similar between LN and U, but LH increased CHO dependence and reduced muscle O2HHb at matched speed (p < 0.05). Conclusion: Load carriage reduces cardiorespiratory efficiency and increases physiological strain, particularly in hypoxic environments. Potential load carriage-induced alterations in cerebral blood flow may increase the risk for altitude illnesses and requires further study. [ABSTRACT FROM AUTHOR]

Genetic susceptibility to familial colorectal cancer (CRC), including for individuals classified as Familial Colorectal Cancer Type X (FCCTX), remains poorly understood. We describe a multi-generation CRC-affected family segregating pathogenic variants in both BRCA1, a gene associated with breast and ovarian cancer and RNF43, a gene associated with Serrated Polyposis Syndrome (SPS). A single family out of 105 families meeting the criteria for FCCTX (Amsterdam I family history criteria with mismatch repair (MMR)-proficient CRCs) recruited to the Australasian Colorectal Cancer Family Registry (ACCFR; 1998–2008) that underwent whole exome sequencing (WES), was selected for further testing. CRC and polyp tissue from four carriers were molecularly characterized including a single CRC that underwent WES to determine tumor mutational signatures and loss of heterozygosity (LOH) events. Ten carriers of a germline pathogenic variant BRCA1:c.2681_2682delAA p.Lys894ThrfsTer8 and eight carriers of a germline pathogenic variant RNF43:c.988 C > T p.Arg330Ter were identified in this family. Seven members carried both variants, four of which developed CRC. A single carrier of the RNF43 variant met the 2019 World Health Organization (WHO2019) criteria for SPS, developing a BRAF p.V600 wildtype CRC. Loss of the wildtype allele for both BRCA1 and RNF43 variants was observed in three CRC tumors while a LOH event across chromosome 17q encompassing both genes was observed in a CRC. Tumor mutational signature analysis identified the homologous recombination deficiency (HRD)-associated COSMIC signatures SBS3 and ID6 in a CRC for a carrier of both variants. Our findings show digenic inheritance of pathogenic variants in BRCA1 and RNF43 segregating with CRC in a FCCTX family. LOH and evidence of BRCA1-associated HRD supports the importance of both these tumor suppressor genes in CRC tumorigenesis. [ABSTRACT FROM AUTHOR]

Reactive arthritis, previously known as Reiter's Syndrome or Disease was a post-dysenteric, asymmetrical acute large joint polyarthritis, with fever, conjunctivitis, iritis, purulent urethral discharge, rash and penile soft tissue swelling. Although the eponym was given to Hans Reiter, various forms of the condition have been recorded in history a few hundred years before Reiter. Two French doctors, Noel Fiessinger (1881–1946) and Edgar Leroy (d. 1965), presented a paper at la Societe des Hopitaux-in Paris on the 8th December 1916 on dysentery in 80 soldiers on the Somme, and four of whom developed a "syndrome conjunctivo-uretro-synovial". Their paper was given 4 days before Reiter's presentation on 12th December 1916 at the Society of Medicine in Berlin, on a German army officer with an illness similar to those described by Fiessinger and Edgar Leroy. It is documented that Hans Reiter was one of a number of University professors who signed an oath of allegiance to Adolf Hitler in 1932. For socio-ethical reasons and for clinical utility, Reiter's syndrome is now known as reactive arthritis. [ABSTRACT FROM AUTHOR]

This review is based investigations on the Western Isles, Scotland, by Martin Martin, a notable Scottish Highlander, academic and medical doctor, of the 17th–18th century. His extensive observations of the geography and peoples of these Isles were recorded in his books, "On the Description of the Western Islands of Scotland Circa 1695" and "A Late Voyage to St Kilda". In these books and subsequent papers there were some noteworthy observations on the occurrence (and as he says non-occurrence) of "epidemical" diseases and conditions afflicting the peoples of The Isle of Skye and the Western Isles of Scotland in this period, and these are discussed in this review. Martin also gives details of a wide variety of remedies that were observed or reported by inhabitants around that time. Some of these remedies are interesting for their relevance to the period but others are of doubtful merit. These are reviewed here more for their significance in the understanding of the diseases and conditions of humans and even in some cases animals at that time. Introductions by Charles Withers and R.W. Munro, 11 and re-assessments of the contributions of Martin and colleagues of that time have given insight into the health and condition of peoples of the Western Isles of Scotland(the Occidental) (Martin 1695; Martin 1716). [ABSTRACT FROM AUTHOR]

The spondyloarthropathies are a group of conditions characterised by spinal joint pain and have related clinical, epidemiological and genetic-related features. Ankylosing spondylitis, reactive arthritis, the spinal form of psoriatic arthritis and Crohn's and colitis enteropathic arthritis are the major clinical entities of the spondyloarthropathies, and principally occur in HLA-B27 positive individuals. Ankylosing spondylitis is much more common in males than females. Patients are usually seronegative for rheumatoid factor, and extra-articular features including iridocyclitis, mucous membrane and skin lesions: aortitis, may occur in some patients. The reactive arthritis form classically occurs following an infection of the gastrointestinal or genitourinary tract. The Crohn's and colitis enteropathic arthritis forms often have an associated large joint asymmetrical arthritis. Also discussed are acute rheumatic fever and Lyme disease which are conditions where the individual develops arthritis after an infection. [ABSTRACT FROM AUTHOR]

Sir William Osler (1849–1919), who became Regius Professor of Medicine at Oxford in 1905, first drew attention in 1909 to the painful nodes in subacute bacterial endocarditis, which now carry his eponym, and he published an account in the Quarterly Journal of Medicine, which he helped establish. Attention is drawn to the often overlooked fact that it was a Dr John Alexander Mullin (1835–1899) of Hamilton, Ontario, Canada, who first drew the attention of Sir William Oster to their occurrence. Confusion arose over the relationship between Osler's nodes and the skin lesions described by Theodore Caldwell Janeway (1872–1917), which are generally non-tender and found in acute bacterial endocarditis. The evidence is that there is essentially no difference since their pathogenesis and histological findings are identical. [ABSTRACT FROM AUTHOR]

William Soutar (1898–1943) was a Scottish poet, but many are unaware of his scholarly work which includes his famous "brain-rhymes". He was born in Perth Scotland in 1898. He was educated at Perth Primary School and Perth Academy and proved to be adept at sport and academics. In 1916, he joined the Royal Navy. In 1918, he had "food poisoning" after which he was hospitalized and developed severe joint pain which became a chronic illness. He had a brief attempt at medical studies at Edinburgh University, but soon switched to the Arts Faculty to study English. Despite various treatments, the joint pain was chronic and disabling. He developed tuberculous lung disease in 1929, and again despite treatments, the problem persisted, and he died in 1943. [ABSTRACT FROM AUTHOR]

Non-medicinal therapies with water, salts, exercise, massage, supportive devices, and electricity have been used for centuries and continue to be of benefit for some people with musculoskeletal disorders. Historical texts refer to the two electuaries mithridatium and theriaca as early therapeutic attempts of man to provide relief of musculoskeletal symptoms and attempt disease cures. For over 200 years, morphine-derived products have been used for musculoskeletal pain. The development of acetyl salicylic acid was a major breakthrough in joint pain management. This was followed by the introduction of nonsteroidal anti-inflammatory agents, paracetamol, and the use of corticosteroids. The gold-based compounds were the initial disease-modifying drugs and have been followed by the highly successful biologics agents. The basic objectives of musculoskeletal pain management include: reduction or elimination of joint pain; improvement or restoration of joint function and mobility; improvement of muscle strength to protect cartilage, ligaments, and joint capsule; prevention and reduction of damage to joint cartilage and supporting structures. [ABSTRACT FROM AUTHOR]

The term clinical trial implies an investigation of a therapeutic intervention in the pursuit of evidence of benefit, short or sustained, and observations on the possibility of toxicity related to the therapeutic intervention. It is possible that the first clinical trial took place in the court of the Babylonian King Nebuchadnezzar circa 600 BC, as recorded in Chapter 1 of the Book of Daniel, verse 3-20. However, it is in the last 500 years that there has been good written documentation at attempts to interpret therapeutic benefit from the use of treatments. Lind's demonstration on the usefulness of oranges and lemons in the treatment of scurvy in 1747, and the unethical experiment by Edward Jenner (1749–1823) on the inoculation in 1796, of an 8-year-old boy, with cow pox obtained from a milk maid, followed by an attempt to give the young boy smallpox by direct inoculation 18 days later, are striking examples of clinical trials. Human ethics, strict clinical observations, statistics, the governed scientific purity of therapeutic agents, and safety testing of therapeutics, devices, and physical interventions, have created the basis for the modern clinical trial. [ABSTRACT FROM AUTHOR]

There is documentation of the use of opium derived products in the ancient history of the Assyrians: the Egyptians; in the sixth century AD by the Roman Dioscorides; and by Avicenna (980–1037). Reference to opium like products is made by Paracelsus and by Shakespeare. Charles Louis Derosne and Fredrich Wilhelm Adam Serturner isolated morphine from raw opium in 1802 and 1806 respectively, and it was Sertürner who named the substance morphine, after Morpheus, the Greek God of dreams. By the middle 1800s, Opium and related opioid derived products were the source of a major addiction in USA, and to some extent in the United Kingdom. Opioid products are of major therapeutic value in the treatment of pain from injury, post surgery, intractable pain conditions, and some forms of terminal cancer. [ABSTRACT FROM AUTHOR]

Crude forms of musculoskeletal surgery have been performed through history for the treatment of deformity, pain and the horrors of battle. In more modern times Muller is credited with the first synovectomy in rheumatoid arthritis in 1884, and a Synovectomy was first performed by Richard von Volkmann (1830–1889) for joint tuberculosis. Chemical synovectomy consisting of the intra-articular injection of various agents was popular for a while but is now largely discarded. Joint resection for sepsis and tuberculosis has been documented since the early 1800s, and also joint arthrodesis, and osteotomy. Modern arthroscopic techniques have added the utility of faster intra-joint inspection and treatment while reduced surgical time exposure and often applied with the use of limb regional anaesthetic nerve blocks, to avoid general anaesthetic. Joint arthroplasty has been developed since1800s, with the use of many artificial joint components. There have been many notable pioneers of this work who are documented in this text, among them Austin T. Moore (1899–1963), George McKee (1906–1991) and Sir John Charnley (1911–1982). The success of joint arthroplasty to the hip, knee, shoulder and other joints has resulted in life-changing benefit for hundreds of arthritis and injury sufferers. [ABSTRACT FROM AUTHOR]

Sjögren's syndrome (SS) is characterised as keratoconjunctivitis sicca (dry eyes), xerostomia (dry mouth) commonly associated with salivary gland enlargement, and is referred to as Primary Sjögren's syndrome. It is known as Secondary Sjögren's syndrome when it occurs in patients, with connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, polyarthritis nodosa, polymyositis, and systemic sclerosis. SS has also been associated with chronic graft-versus-host disease after allogeneic bone marrow transplantation, human immunodeficiency syndrome (AIDS), hepatitis C infection (HCV), chronic biliary cirrhosis, neoplastic and myeloplastic syndromes, fibromyalgia, and chronic fatigue syndrome. [ABSTRACT FROM AUTHOR]

The clinical appearance and radiological pattern of osteoarthritis have been identified in the skeletons of dinosaurs some 50–70 million years old, and in Egyptian mummies, and in ancient skeletons in England. Osteoarthritis patterns of joint involvement, often referred to as primary osteoarthritis, can be seen in the hands, spinal facet joints, hips, knees and feet, but can also be termed secondary osteoarthritis when seen in any joint that has had trauma, sepsis, surgery or metabolic insult. The prevalence of osteoarthritis increases with age. The histology and pathophysiology both demonstrate an inflammatory process. While there have been studies of genetic predisposition, the basic cause of primary osteoarthritis has not been determined. [ABSTRACT FROM AUTHOR]

It is difficult to determine from ancient writings, old human specimens, and from Art over the centuries, as to when Rheumatoid Arthritis first appeared. It may be a relatively modern condition, as it was reasonably well described in the seventeenth century. Augustin Jacob Landre-Beauvais (1772–1840), University of Paris is credited, with the first clear description of the disease in his thesis. In 1859 Sir Alfred Baring Garrod (1819–1907), the "father of rheumatology", gave the disease its current name which was finally adapted in Britain by the Ministry of Health in 1922. Some forms of Juvenile Arthritis are related to adult Rheumatoid Arthritis (aka Still's disease). If untreated Rheumatoid arthritis can result in severe destructive joint damage and often there are associated severe systemic complications. Disease modifying agents have benefited the disease management, but it was the discovery of the anti TNF-alpha agents in the 1990s, and subsequently many additional Biologic agents, which have greatly changed the clinical outcome in Rheumatoid Arthritis. [ABSTRACT FROM AUTHOR]

The challenge of securing IT environments has reached a new complexity level as a growing number of organisations adopt cloud solutions. This trend increases the possibility of overseen attack paths in an organisation's IT infrastructure. This paper proposes a methodology for assessing the security of a Microsoft cloud tenant based on the relationships between different cloud entities through the use of graphs. This paper argues for using graph theory as an effective method to understand and uncover complex entity attack paths. To achieve this, we implemented a graph analytics platform using data from a Microsoft cloud test tenant. Methods based on graph theory proved to measurably reduce possible attack paths. Our research can support defenders who want to better understand the interrelationships of Microsoft cloud entities as well as identify and remediate possible attack paths. [ABSTRACT FROM AUTHOR]

We use the 2015 Canadian time use survey to analyze gender differences in desired alone time and the gender gap in parenting time for Canadian parents with at least one child under five years of age (N = 1120). Over half of mothers with young children report desiring more alone time compared to about one-third of fathers. For mothers, household work, parenting time, and market work are predictive of self-reporting desired alone time. Surprisingly, for fathers and mothers, the desire to have more alone time is not predicted by actual alone time. Compared to fathers, mothers with young children spend more time in parenting and household work but less time in market work and alone time. We find that the gender gap in parenting remains persistent and predominantly unexplained by characteristic differences between mothers and fathers. After controlling for those differences and other demographic factors, results suggest that mothers desire more alone time than fathers as parenting and household labor time increases. We argue that the amount and higher level of responsibilities and stress faced by mothers parenting young children lead to personal isolation resulting in a desire to spend time alone. Fathers who play a less central role in domestic work have more time and energy to engage in their jobs and desire less alone time. We discuss the theoretical and policy implications of these findings. [ABSTRACT FROM AUTHOR]

Background: Remdesivir is an antiviral approved by the US Food and Drug Administration (FDA) for treatment of coronavirus disease 2019 (COVID-19), and aminotransferase elevation is commonly reported. Thresholds to be considered for discontinuation due to alanine aminotransferase (ALT) elevation differ between the FDA and European Medicines Agency (EMA). The primary objective was to describe aminotransferase thresholds being used in real-world practice for discontinuation of remdesivir in patients with COVID-19, and compare them with labeled recommendations. Methods: This study used a descriptive design based on an ongoing national registry of adverse events, the FDA ACMT COVID-19 ToxIC (FACT) pharmacovigilance project, with 17 participating health systems in the USA. Cases were identified retrospectively for an 18-month period (23 November 2020–18 May 2022). Classification of discontinuation as premature and due to aminotransferases was based on chart documentation by the treating team. Results: Of 1026 cases in the FACT registry, 116 cases were included with supplemental data forms completed for aminotransferase elevation with remdesivir, defined a priori for inclusion as ALT doubling or increasing by ≥ 50 U/L. ALT was elevated prior to remdesivir in 47% and increased above baseline during dosing by a median of 92 U/L [interquartile range (IQR) 51–164, max 8350]. Remdesivir was discontinued early in 37 (31.9%) patients due to elevated aminotransferases. The ALT threshold for premature discontinuation was median 200 U/L (IQR 145–396, range 92–5743). Among patients with premature discontinuation of remdesivir for aminotransferase elevation, only 21.6% met FDA criteria to consider discontinuation, and 40.5% met prior EMA criteria to consider discontinuation. Conclusion: In this descriptive study of real-world practice in the USA, clinicians are overall making more conservative treatment decisions than are recommended for consideration in approved drug labeling of discontinuation, with wide variation in the aminotransferase thresholds being used. [ABSTRACT FROM AUTHOR]