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Abstract Placebo effects are beneficial mind-body outcomes derived from beliefs or expectations, not explainable as the consequence of active medical treatments. These phenomena have long been considered a result of external manipulation, generally obtained with deceptive strategies (e.g., fake pills) or suggestions. Open-label placebos showed promising results, but even in that case, the individual has a passive role: they are not actively engaged in promoting the effect. We propose a framework to investigate the potential for individuals to self-induce placebo effects through conscious and deliberate psychological mechanisms, such as mental imagery, somatic focusing, and perceived control. These mechanisms may be tested in combination with open-label placebos and active treatments, as well as standalone strategies. The framework may push the boundaries of current mind-body research and have the potential to place these self-induced mechanisms alongside expectations and learning as key players in the placebo effect, ultimately elevating the individual’s active role in shaping their health.

Abstract Parasites, such as the malaria parasite P. falciparum, are critically dependent on host nutrients. Interference with nutrient uptake can lead to parasite death and, therefore, serve as a successful treatment strategy. P. falciparum parasites cannot synthesise cholesterol, and instead source this lipid from the host. Here, we tested whether cholesterol uptake pathways could be ‘hijacked’ for optimal drug delivery to the intracellular parasite. We found that fluorescent cholesterol analogues were delivered from the extracellular environment to the intracellular parasite. We investigated the uptake and inhibitory effects of conjugate compounds, where proven antimalarial drugs (primaquine and artesunate) were attached to steroids that mimic the structure of cholesterol. These conjugated antimalarial drugs improved the inhibitory effects against multiple parasite lifecycle stages, multiple parasite species, and drug-resistant parasites, whilst also lowering the toxicity to human host cells. Steroids with introduced peroxides also displayed antimalarial activity. These results provide a proof-of-concept that cholesterol mimics can be developed as a drug delivery system against apicomplexan parasites with the potential to improve drug efficacy, increase therapeutic index, and defeat drug resistance.

Abstract A prevailing question in contemporary transport research queries the contribution of transport infrastructure investment to regional and local economic growth. Notably, the benefits under consideration extend beyond travel-time savings to possible additional developmental benefits. Centering on the Chengdu-Chongqing twin-city economic circle, this study sheds light on this issue. It presents a comprehensive approach involving economic, investment, and political-institutional conditions, and underscores their synergistic operation in eliciting measurable economic benefits. We delve into the effects of road traffic accessibility on economic growth in 2019, using accessibility indicators integrated into a spatial econometric model. Our research relied on robust indicators of road traffic accessibility, transportation investments, and economic outputs from the Chengdu-Chongqing region. The study demonstrates that the road traffic network’s development level is higher in the central area compared to the peripheral regions. Further, it reveals an uneven economic development distribution within the circle. Moreover, the spatial effect of road traffic on economic growth surfaces as an error term spatial interaction effect, highlighting accessibility’s pivotal role. Factors like industrial infrastructure, labor force, and new economic geography also significantly affect growth. To wrap up, we discuss the broader implications of our findings. We suggest a stronger connection between road transportation and economic growth and stress the need to enhance the supporting economic environment. Our findings have broader implications, guiding policy and planning in other urban economic circles.

Purpose: Detection of molecular residual disease (MRD) allows for the identification of breast cancer patients at high-risk of recurrence, with the potential that early initiation of treatment at early stages of relapse could improve patient outcomes. The Invitae Personalized Cancer Monitoring™ assay (PCM) is a newly developed next-generation sequencing approach that utilizes up to 50 patient-specific, tumor-informed DNA variants, to detect circulating tumor DNA (ctDNA). The ability of the PCM assay to detect MRD before clinical relapse was evaluated. Methods: The cohort included 61 female patients with high-risk breast cancer who underwent neoadjuvant chemotherapy. Plasma samples were collected before and during neoadjuvant therapy, after surgery and during monitoring. PCM was used to detect ctDNA at each time point. Results: The sensitivity to detect ctDNA in plasma from patients who relapsed during the monitoring phase was 76.9% (10/13). Specificity and positive predictive values were both 100% with all (10/61, 16%) of the patients who had ctDNA detected during the monitoring phase subsequently relapsing. Detection of ctDNA during monitoring was associated with a high-risk of future relapse (HR 37.2, 95% CI 10.5–131.9, p < 0.0001), with a median lead-time from ctDNA detection to clinical relapse of 11.7 months. Conclusion: PCM detected ctDNA in patients who relapsed with a long lead-time over clinical relapse, shows strong association with relapse-free survival and may be used to identify patients at high-risk for relapse, allowing for earlier intervention. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: Gestational diabetes mellitus (GDM) affects 14% of all pregnancies worldwide and is associated with cardiometabolic risk. We aimed to exploit high-resolution wearable device time-series data to create a fine-grained physiological characterisation of the postpartum GDM state in free-living conditions, including clinical variables, daily glucose dynamics, food and drink consumption, physical activity, sleep patterns and heart rate. Methods: In a prospective observational study, we employed continuous glucose monitors (CGMs), a smartphone food diary, triaxial accelerometers and heart rate and heart rate variability monitors over a 2 week period to compare women who had GDM in the previous pregnancy (GDM group) and women who had a pregnancy with normal glucose metabolism (non-GDM group) at 1–2 months after delivery (baseline) and 6 months later (follow-up). We integrated CGM data with ingestion events recorded with the smartphone app MyFoodRepo to quantify the rapidity of returning to preprandial glucose levels after meal consumption. We inferred the properties of the underlying 24 h rhythm in the baseline glucose. Aggregating the baseline and follow-up data in a linear mixed model, we quantified the relationships between glycaemic variables and wearable device-derived markers of circadian timing. Results: Compared with the non-GDM group (n=15), the GDM group (n=22, including five with prediabetes defined based on fasting plasma glucose [5.6–6.9 mmol/l (100–125 mg/dl)] and/or HbA1c [39–47 mmol/mol (5.7–6.4%)]) had a higher BMI, HbA1c and mean amplitude of glycaemic excursion at baseline (all p≤0.05). Integrating CGM data and ingestion events showed that the GDM group had a slower postprandial glucose decrease (p=0.01) despite having a lower proportion of carbohydrate intake, similar mean glucose levels and a reduced amplitude of the underlying glucose 24 h rhythm (p=0.005). Differences in CGM-derived variables persisted when the five women with prediabetes were removed from the comparison. Longitudinal analysis from baseline to follow-up showed a significant increase in fasting plasma glucose across both groups. The CGM-derived metrics showed no differences from baseline to follow-up. Late circadian timing (i.e. sleep midpoint, eating midpoint and peak time of heart rate) was correlated with higher fasting plasma glucose and reduced amplitudes of the underlying glucose 24 h rhythm (all p≤0.05). Conclusions/interpretation: We reveal GDM-related postpartum differences in glucose variability and 24 h rhythms, even among women clinically considered to be normoglycaemic. Our results provide a rationale for future interventions aimed at improving glucose variability and encouraging earlier daily behavioural patterns to mitigate the long-term cardiometabolic risk of GDM. Trial registration: ClinicalTrials.gov no. NCT04642534 [ABSTRACT FROM AUTHOR]

Studies of the genetics of Alzheimer's disease (AD) have largely focused on single nucleotide variants and short insertions/deletions. However, most of the disease heritability has yet to be uncovered, suggesting that there is substantial genetic risk conferred by other forms of genetic variation. There are over one million short tandem repeats (STRs) in the genome, and their link to AD risk has not been assessed. As pathogenic expansions of STR cause over 30 neurologic diseases, it is important to ascertain whether STRs may also be implicated in AD risk. Here, we genotype 312,731 polymorphic STR tracts genome-wide using PCR-free whole genome sequencing data from 2981 individuals (1489 AD case and 1492 control individuals). We implement an approach to identify STR expansions as STRs with tract lengths that are outliers from the population. We then test for differences in aggregate burden of expansions in case versus control individuals. AD patients harbor a 1.19-fold increase of STR expansions compared to healthy elderly controls (p = 8.27×10-3, two-sided Mann-Whitney test). Individuals carrying >30 STR expansions have a 3.69-fold higher odds of having AD and have more severe AD neuropathology. AD STR expansions are highly enriched within active promoters in post-mortem hippocampal brain tissues and particularly within SINE-VNTR-Alu (SVA) retrotransposons. Together, these results demonstrate that expanded STRs within active promoter regions of the genome associate with risk of AD. The authors explore how short tandem repeats in DNA sequences affect risk of Alzheimer's disease. They find that individuals who carry a high burden of expanded repeats in their DNA have a more than three-fold increased risk for Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Recent genome-wide association studies (GWASs) of several individual sleep traits have identified hundreds of genetic loci, suggesting diverse mechanisms. Moreover, sleep traits are moderately correlated, so together may provide a more complete picture of sleep health, while illuminating distinct domains. Here we construct novel sleep health scores (SHSs) incorporating five core self-report measures: sleep duration, insomnia symptoms, chronotype, snoring, and daytime sleepiness, using additive (SHS-ADD) and five principal components-based (SHS-PCs) approaches. GWASs of these six SHSs identify 28 significant novel loci adjusting for multiple testing on six traits (p < 8.3e-9), along with 341 previously reported loci (p < 5e-08). The heritability of the first three SHS-PCs equals or exceeds that of SHS-ADD (SNP-h2 = 0.094), while revealing sleep-domain-specific genetic discoveries. Significant loci enrich in multiple brain tissues and in metabolic and neuronal pathways. Post-GWAS analyses uncover novel genetic mechanisms underlying sleep health and reveal connections (including potential causal links) to behavioral, psychological, and cardiometabolic traits. Data-driven composite sleep health scores, combining self-reported sleep duration, snoring, chronotype, insomnia, and sleepiness, provide heritable, interpretable phenotypes and novel GWAS discoveries elucidating regulatory pathways. [ABSTRACT FROM AUTHOR]

Background: Individuals with serious mental illness (SMI) have disproportionately high rates of criminal legal system involvement. For many, this becomes a repeated cycle of arrest and incarceration. Treatments that address symptoms of mental illness are a critical component of the continuum of services for people with SMI in the legal system; yet on their own, psychiatric treatments have not been successful at reducing criminal legal system involvement for this population. Research suggests that criminogenic risk factors, the major drivers of criminal legal system involvement, are disproportionately prevalent among individuals with SMI. However, promising criminogenic-focused interventions have only just begun to be adapted for individuals with SMI. The proposed study will examine the capacity of Forging New Paths (FNP), a novel criminogenic-focused group intervention developed for individuals with SMI, to engage its primary and secondary outcomes when delivered in community mental health settings. Methods: The proposed pilot study will engage a small-scale clinical trial comprising three cycles of FNP delivered in a community mental health center in a Southeastern state in the U.S. The anticipated total sample size is N = 72 and will consist of community-dwelling adults with SMI who have a moderate or higher criminogenic risk level and a history of criminal legal system contact. This study will examine the extent to which FNP is able to engage its primary (aggression and community tenure) and secondary (criminal attitudes and impulsivity) treatment outcomes. Discussion: FNP provides an important new service for community-based mental health settings to reduce criminal legal system involvement (and recidivism) among the individuals they serve with SMI. Clinical Trial Registration: NCT06290648. [ABSTRACT FROM AUTHOR]

Dairy farmers are grappling with serious business challenges, including rising operational costs, labour shortages, unstable milk prices, changing consumer preferences, long hours with minimal downtime and unstable weather patterns due to climate change impacts. Using a telephone-based representative survey and interviews with 147 Australian dairy farmers conducted in 2023, we employed a mixed-method approach combining quantitative and qualitative analysis to determine the challenges and primary concerns of the participants, as well as to explore potential solutions. Four key variables that contributed significantly to a binary logistic regression model of transition intentions were identified, namely: level of satisfaction with dairy farming, openness to exploring other agricultural alternatives to dairy farming, preference to receive financial and/or other support to remain in the industry and preference to receive financial and/or other support to transition into a different form of farming or business. This model accurately predicted the probability that farmers were considering transitioning away from dairy farming and the probability that they were considering staying in dairy farming. This deepens our understanding of the challenges faced by farmers in the Australian dairy industry, and provides policymakers, industry stakeholders and researchers with critical insights to facilitate transition pathways that will enhance farmers' future sustainability. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: Pudendal neuralgia is chronic pelvic pain associated with the pudendal nerve. Unfortunately, the best treatment approach is unknown. Our objective was to systematically assess interventions for pudendal neuralgia for improvement in pain. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we retrieved studies from MEDLINE, EMBASE, and clinicaltrials.gov through May 27, 2024. Our population included patients with pudendal neuralgia. Our interventions included surgery (decompression and nerve stimulation), injections and pulse radiofrequency treatments. Outcomes included improvement in pain (usually on a visual analog scale (VAS)) and adverse events. GRADE criteria were used to assess quality. Differences between pre- and post-intervention pain scores were compared with a random effects REML model and reported as mean difference and 95% confidence intervals. Results: Six hundred eighty-seven abstracts were screened yielding 37 studies that met eligibility criteria. Treatments included 16 surgeries with 12 nerve decompressions and 4 nerve stimulator placements, 14 injections, and 7 pulse radiofrequency treatments. The majority, 95%, were Grade C. All treatments appear to provide relief to a similar extent (mean difference in VAS of 2.73 cm (1.77, 3.69), p < 0.07, with high heterogeneity I2 = 98.18%), but no treatment was clearly superior for pain relief. Adverse events were inconsistently reported but more severe in the surgery group. Conclusions: There are many treatment approaches to pudendal neuralgia, but overall, the evidence includes heterogeneous patient populations, non-standardized treatments, poor-quality studies, variable pain measurement instruments, and short-term follow-up. All interventions improved pain with no statistically significant difference between groups. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that engaging in graphomotor activity for creating graphemes can enhance their subsequent visual discrimination. This suggests a positive influence of the motor system on visual learning. However, existing studies have emphasized the dominant hand, which is superiorly dexterous in fine-motor movements. This near-exclusive focus prompts the inquiry of whether the observed perceptual facilitation is a general characteristic of the motor system, or specific to pathways controlling the skilled over-trained dominant hand. Furthermore, the mechanistic underpinning of visual facilitation from graphomotor training (i.e., the individual contribution of motor activity, temporal evolution of the visual trace, variability of visual output) remain unclear. To address these questions, we assessed visual discrimination capabilities of healthy right-handed participants (N = 60) before and after graphomotor or visual training. Contrary to our initial expectation, graphomotor engagement with the non-dominant hand did not yield additional benefits to visual learning beyond those attainable through visual training alone. Moreover, graphomotor training with the non-dominant hand resulted in visual discrimination improvements comparable to those of dominant hand training, despite the inherent differences between hands in motor performance and in the amount of improvement in shape tracing throughout training. We conclude that the motor components of graphomotor activity may not be critical for visual learning of shapes through tracing activity. Instead, our results are in agreement with the symbolic theoretical account, suggesting that basic shape features required for discrimination can be acquired through visual inspection alone, providing a perspective on the improvements observed in prior studies. [ABSTRACT FROM AUTHOR]

Purpose: Digital health technologies (DHTs) have the potential to improve health outcomes and increase health system efficiency. However, to obtain these benefits, it is necessary to distinguish between high- and low-quality DHTs across domains such as effectiveness, clinical safety, data privacy, and usability. For this purpose, numerous DHT quality assessments have been developed. This review aimed to examine the background characteristics, domain coverage, and criteria overlap of such assessments. Methods: Assessment frameworks were identified through systematic searches of PubMed/MEDLINE, Embase and PsychINFO. Evaluation criteria of eligible assessments were extracted, and each criterion was assigned to one of twelve domains. The percentage of criteria included in each domain was compared across frameworks with different characteristics using Mann-Whitney U tests. Additionally, criteria overlap was examined among health system and government led third-party assessments. Results: The literature search identified 130 assessment frameworks that met eligibility criteria. Higher relative criteria coverage of the clinical safety and/or data privacy domains was observed for assessments that were published after rather than in or before 2016 (Pprivacy= 0.030), and that were developed with rather than without patient (Psafety= 0.006; Pprivacy= 0.034) or healthcare professional (Psafety= 0.005; Pprivacy= 0.015) input. Among health system and government led third-party assessments, the highest median criteria overlap was observed in the credibility domain at 78.2%, followed by the data privacy domain at 64.0%. The domains of security and technical robustness demonstrated the lowest criteria overlap at 42.1% and 30.7%, respectively. Conclusion: The observed differences in domain coverage based on stakeholder input and publication date highlight the importance of considering different perspectives and current best practices when developing and updating DHT quality assessments. Moreover, while the high criteria overlap found in some domains is encouraging, low overlap in other areas raises concerns regarding duplicated work and potential discrepancies in evaluation results, if a given DHT needs to meet varying standards across different assessments. To address these concerns, it would be beneficial for assessment owners to agree on a set of baseline criteria, which could be supplemented with separately-scored, context-specific criteria as needed. This would streamline evaluation processes and increase trust in assessment outcomes, thereby driving the adoption of high-quality DHTs and ultimately improving patient care quality and safety. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore associations between ABO blood type and postoperative adjacent segment degeneration/disease (ASD) following lumbar spine fusion, as well as evaluate differences in spinopelvic alignment, perioperative care, postoperative complications, and patient-reported outcome measures (PROMs). Methods: An ambispective study was performed. Patients who underwent posterolateral or posterior lumbar interbody fusion were included. Demographic, perioperative and postoperative, clinical, and blood type information was recorded. Pre- and post-operative radiographic imaging was analyzed for alignment parameters and development of ASD. Results: 445 patients were included, representing O+ (36.0%), O- (5.2%), A+ (36.2%), A- (6.3%), B+ (12.1%), B- (1.6%), and AB+ (2.7%) blood types. Most patients were female (59.1%), and had a mean age of 60.3 years and BMI of 31.1 kg/m2. Postoperatively, groups did not differ in duration of the hospital (p = 0.732) or intensive care unit (p = 0.830) stay, discharge disposition (p = 0.504), reoperation rate (p = 0.192), or in-hospital complication rate (p = 0.377). Postoperative epidural hematoma was most common amongst A + patients (p = 0.024). Over a mean of 11.0 months of follow-up, all patients exhibited similar improvement in PROMs, with 132 (29.7%) patients developing radiographic evidence of ASD. B + patients were significantly more likely than A + and O + patients to develop spondylolisthesis and ASD (p < 0.05). No significant differences in sagittal alignment parameters and number of levels of fusion were found (p > 0.05). Conclusions: This is the first large-scale study to address and demonstrate proof-of-principle that ABO blood type, a non-modifiable risk factor, is associated with ASD following lumbar spine fusion. [ABSTRACT FROM AUTHOR]

Acacia honey was infused with basil, oregano, marjoram, dill, garlic or cinnamon at infusion rates of 0–5% by mass for a 6 months period. After removal of the infusates, macro and micro element concentrations were measured by Inductively Coupled Plasma Optical Emission Spectrometry. Total phenolic and flavonoid contents were determined spectroscopically. The greatest release of elements, phenols and flavonoids, (% release/1% infusion rate) were for phenols (1.22–3.74, respectively), flavonoids (0.12–2.18), K (0.39–0.78), P (0.14–0.87), and S (0.07–0.85). The least release was for Ba (0.04–0.17), Fe (0.03–0.41) and B (− 0.006 to 2.33). Dill showed the most important effect on the Na concentration of honey enriched (at 5.00%) with > 90 times higher content (328 ± 4 mg/kg) compared to control honey (3.46 ± 0.07 mg/kg). Sr content was more than 50 times higher in honey enriched with marjoram (1383 ± 10 µg/kg), and honey enriched with dill showed more than 30 times higher Fe content (4112 ± 14 µg/kg). Enrichment with dill had the greatest effect on Ca, Cu, K, Mg, Na and Fe content of control honey, and garlic had the most important effect on the B, P, S, Zn, TP and TF content. Enrichment with these herbs and spices resulted in increases in element, total phenolic and flavonoid content of acacia honey. [ABSTRACT FROM AUTHOR]

The index of biotic integrity (IBI) is an effective multi-metric tool for assessing biological integrity of aquatic ecosystems and regulating water quality based on fish community surveys. Percentages of individuals with deformity, eroded fin, lesion, and tumor (DELT) anomalies are used in IBIs as a measure of fish health, while the percentage of hybrids reflects changes in reproductive isolation. When rare, these are combined into a joint '% DELT + hybrids' metric. We investigated the distribution and effects of this metric on overall fish IBI scores and biological condition ratings by analyzing data from 646 fish surveys from across Alabama. Following exploratory data analyses, we assessed the impacts of % DELT + hybrids by comparing IBI scores for sites before and after setting this metric to zero to simulate systematic error (no detection). While DELTs and other anomalies were infrequent (~ 11% of sites), the two most commonly diseased fish species were Campostoma oligolepis (Leuciscidae) and Lepomis cyanellus (Centrarchidae). Hybrids were less frequent (~ 7% of sites) than anomalies and were scored only for Lepomis sunfishes. Overall, we found no statistically significant differences in final IBI scores or biological condition ratings before and after anomaly and hybrid removal; however, removal led to increased IBI scores and biological condition ratings in 13.2% and ~ 6% of surveys, respectively. These findings demonstrate that, while IBI outcomes appear relatively robust to systematic error in % DELT + hybrids, anomaly and hybrid observations can alter IBI outcomes, with important implications for fish-based bioassessments and water quality management. [ABSTRACT FROM AUTHOR]

The availability of several HIV prevention options may allow women to choose a product that suits their lifestyle and preferences. Product attributes and contextual factors influence product acceptability, which affects uptake and effective use. We conducted a systematic review of acceptability and preference for biomedical HIV prevention products among women in sub-Saharan Africa (SSA) to inform the development of novel products. We used a comprehensive strategy to search three databases for peer-reviewed literature from SSA published between January 2015 and December 2023. A two-stage review process assessed references against eligibility criteria. Data were abstracted using a standardized spreadsheet, then organized by constructs from two theoretical frameworks of acceptability. Results were synthesized based on product classes defined by route of administration. We identified 408 unique references; 100 references met eligibility criteria. References assessed oral PrEP (n = 65), vaginal ring (n = 44), long-acting systemic products (injectable, implant, microarray patch) (n = 28), and other vaginal products (film, insert, gel) (n = 20). Over two-thirds reported qualitative or mixed-methods data, primarily from adolescent girls and young women. Frequent dosing, especially noted for daily oral PrEP, and perceived/experienced side effects were notably negative influences. Most end-users preferred long-acting products (systemically or vaginally delivered), though on-demand products offering user control were also valued. Influencing factors, especially partners, shaped end-user perceptions of product attributes and acceptability. All products were linked to at least some barriers to uptake and/or use, highlighting the need to provide end-users with a range of options and assist them in identifying one that best suits their circumstances and needs. Biomedical HIV prevention development should advance products that address gaps in available options while optimizing favorable product attributes to achieve high acceptability that ultimately supports adoption and use. [ABSTRACT FROM AUTHOR]

People with HIV (PWH) are at increased risk for metabolic disorders affecting body mass index (BMI), chronic symptoms, and impaired physical function and capacity. Although physical activity improves health and well-being, PWH often do not meet activity recommendations necessary to achieve these benefits. Despite the known impact of symptoms, physical activity, and physical function on health, little is known about the relationships and interactions between these variables and BMI and maximum oxygen consumption during exercise (VO2 max) in a multinational population of PWH. We examined the relationship of BMI with PROMIS-29 measures, physical activity, strength, flexibility, and VO2 max in a diverse sample of PWH. Additionally, we examined the relationship of VO2 max with PROMIS-29 measures. Data from 810 PWH who participated in a cross-sectional study conducted by the International Nursing Network for HIV Research (Study VII) were analyzed. Participants were recruited from 8 sites across the United States, Thailand, and South Africa. BMI was calculated from collected height and weight data. Physical function and symptoms were assessed using the PROMIS-29 measure. Physical activity was assessed using the 7-day Physical Activity Recall. VO2 max was calculated using sex at birth, age, BMI and the 6-minute Walk Test. Data were analyzed using descriptive, correlational, and regression statistical analyses. Participants had an average age of 49.1 (± 11.1) years, 44% were female, and the average BMI of the sample group was 27 kg/m2 (± 6.7). Increased BMI was associated with decreased 6-minute Walk Test (β=-2.18, p < 0.001), flexibility (β=-0.279, p < 0.001), and VO2 max (β=-0.598, p < 0.001), even after controlling for covariates (age, sex at birth, country, years living with HIV, and antiretroviral therapy status). BMI was not associated with self-reported physical activity. Increased VO2 max was associated with increased physical function (β = 0.069, p < 0.001), and decreased pain (β=-0.047, p < 0.006), even after controlling for covariates (country, years living with HIV, and antiretroviral therapy status). Future research should explore development of effective and sustainable symptom self-management interventions in PWH accounting for the potential impact of BMI and VO2 max. [ABSTRACT FROM AUTHOR]

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Measurement-based care (MBC) is an underutilized evidence-based practice, and current implementation efforts demonstrate limited success in increasing MBC use. A better understanding of MBC implementation determinants is needed to improve these efforts, particularly from studies examining the full range of MBC practices and that span multiple samples of diverse providers using different MBC systems. This study addressed these limitations by conducting a multi-site survey examining MBC predictors and use in youth treatment. Participants were 159 clinicians and care coordinators working in youth mental health care settings across the United States. Participants were drawn from three program evaluations of MBC implementation. Providers completed measures assessing use of five MBC practices (administering measures, viewing feedback, reviewing feedback in supervision, sharing feedback with clients in session, and using feedback to plan treatment), MBC self-efficacy, and MBC attitudes. Despite expectations that MBC should be standard care for all clients, providers reported only administering measures to 40–60% of clients on average, with practices related to the use of feedback falling in the 1–39% range. Higher MBC self-efficacy and more positive views of MBC practicality predicted higher MBC use, although other attitude measures were not significant predictors. Effects of predictors were not moderated by site, suggesting consistent predictors across implementation settings. Implications of study findings for future research and for the implementation of MBC are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Increasing physical activity (PA) is safe and associated with improved health outcomes in patients with metastatic breast cancer (MBC). Mobile health (mHealth) PA interventions that allow for remote monitoring and tailoring to abilities may be particularly useful for MBC patients. However, limited data exist on the acceptability of these interventions for MBC patients. This study examined the acceptability of Fit2ThriveMB, a highly tailored mHealth intervention targeting increased daily steps in MBC patients. Methods: Insufficiently active women with MBC ((N = 25) Mage = 57.2, SD = 11.9) received the Fit2ThriveMB intervention (Fit2ThrviveMB app, Fitbit, weekly coaching calls) for 12 weeks. Participants completed an online questionnaire (n = 22) and semi-structured interview (n = 23) at 12 weeks to assess intervention acceptability. Quantitative data were analyzed using descriptive statistics. Interviews were analyzed and coded using thematic content analysis and consensus review. Results: All (n = 23) participants indicated they were satisfied with the intervention, Fit2ThriveMB app design, and Fitbit usability via questionnaire. Four themes emerged from qualitative interview data: (1) Overall satisfaction with implementation, (2) Social interaction is important, but within-app social features need improvement, (3) Fit2ThriveMB was encouraging and enhanced accountability, (4) Fit2ThriveMB helped form sustainable habits. Participants were generally satisfied with the intervention. However, areas for improvement were identified for some study features. Conclusions: Findings indicate Fit2ThriveMB was acceptable among people with MBC. Further refinement of Fit2ThriveMB social feed features and step count goals is warranted for future testing in fully powered trials with a larger sample size. [ABSTRACT FROM AUTHOR]

Chromosome instability is a prevalent vulnerability of cancer cells that has yet to be fully exploited therapeutically. To identify genes uniquely essential to chromosomally unstable cells, we mined the Cancer Dependency Map for genes essential in tumor cells with high levels of copy number aberrations. We identify and validate KIF18A, a mitotic kinesin, as a vulnerability of chromosomally unstable cancer cells. Knockdown of KIF18A leads to mitotic defects and reduction of tumor growth. Screening of a chemical library for inhibitors of KIF18A enzymatic activity identified a hit that was optimized to yield VLS-1272, which is orally bioavailable, potent, ATP non-competitive, microtubule-dependent, and highly selective for KIF18A versus other kinesins. Inhibition of KIF18A's ATPase activity prevents KIF18A translocation across the mitotic spindle, resulting in chromosome congression defects, mitotic cell accumulation, and cell death. Profiling VLS-1272 across >100 cancer cell lines demonstrates that the specificity towards cancer cells with chromosome instability differentiates KIF18A inhibition from other clinically tested anti-mitotic drugs. Treatment of tumor xenografts with VLS-1272 results in mitotic defects leading to substantial, dose-dependent inhibition of tumor growth. The strong biological rationale, robust preclinical data, and optimized compound properties enable the clinical development of a KIF18A inhibitor in cancers with high chromosomal instability. Chromosomal instability occurs frequently in cancer, making it an attractive therapeutic target. Here, the authors identify KIF18A as a targetable vulnerability of cancer cells with chromosomal instability and target this using VLS-1272, a selective KIF18A inhibitor. [ABSTRACT FROM AUTHOR]

Propagule pressure is one of the key drivers of establishment success of non-native species, including insects. However, border interception data, which have the potential to act as a proxy for true arrival rates (i.e., propagule pressure) of insects into a country, are seldom used to predict invasions. This can be due to the limited amount of interception data in some countries, difficulties accessing such data, and when these data are available, difficulties in addressing biases caused by variation in interception probability for different taxa due to policy changes, and operational influences of import inspections. The type of interception data required to reliably estimate arrival rates is rarely available. To improve the use of interception data as a proxy for propagule pressure, we investigated the fraction of established species which had interceptions and vice versa by taxonomic group and by biological characteristics (development type and feeding group), using several national datasets from five continents. We identified higher fractions of established species that were intercepted for plant feeding insect groups compared to fractions of non-plant feeding groups, even in countries with more general import inspection strategies. This is likely to reflect greater search effort for and recording of plant-feeding insect groups during inspections. To address this variation in interception probability and improve establishment predictions based on interception frequency, we developed a methodology to account for such taxonomic variation. We apply this to three hazard lists of insects, containing potential pests for an industry or potential pests for a country, to assess its effectiveness. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore demographic disparities, regional and institutional variations, surgical timing, narcotic use, and management trends in neonatal brachial plexus palsy (NBPP) patients due to limited published literature. Methods: We conducted a retrospective cohort study using the Pediatric Health Information System (PHIS) database of NBPP patients who underwent surgery within the first 2 years of life. Patients were stratified into two groups based on age at surgery: ≤ 8 months and > 8 months. Results: A total of 788 patients were identified, with a mean surgical age of 8.1 months. Black patients were disproportionately affected (29%), over twice their national birth rate (14%). Narcotic use was more common in younger patients (63% vs. 53%, p = 0.003), as well as in those treated in the West (71%, p = 0.001) and Northeast (73%, p = 0.004), and by plastic (74%, p < 0.0001) or orthopedic surgeons (69%, p = 0.002). Patients prescribed narcotics had longer hospital stays (1.7 vs. 1.2 days, p < 0.0001) and higher complication rates (7.9% vs. 3.1%, p = 0.009). Narcotic use decreased significantly over the study period (p = 0.002). Short-term outcomes, including complication and readmission rates, were similar across the three primary surgical specialties (plastic, orthopedic, and neurosurgery). High-volume centers had lower complication rates (1.5% vs. 5.4%, p = 0.002) and ICU admissions (5.8% vs. 18%, p < 0.0001) compared to medium-volume centers. Conclusion: While narcotic use was associated with longer stays and complications, short-term outcomes were consistent across specialties. Standardized care protocols may help improve patient outcomes. [ABSTRACT FROM AUTHOR]

Medications for alcohol use disorder (MAUD) and opioid use disorder (MOUD) are underutilized evidence-based treatments. While patients often receive treatment in multiple medical treatment settings, it is unknown whether certain treatment settings or combinations of settings are associated with increased receipt of MAUD or MOUD. Data from the cross-sectional 2019 National Survey on Drug Use and Health were used to identify treatment settings where adult respondents received any past year alcohol treatment (n = 476, 33% female) or, separately, opioid treatment (n = 337, 38% female). Three-stage latent class analysis assessed the patterns of treatment settings utilization and their associations with receipt of MAUD or MOUD, adjusting for potential confounders. Only 10.9% of those in alcohol treatment received MAUD while 40.9% of those in opioid treatment received MOUD. Analyzing different treatment settings visited by respondents, a four-class model best fit the MAUD sample while a three-class model best fit the MOUD sample. There were significant differences in receipt of MAUD by treatment setting classes in unadjusted models (p < 0.05). There were no significant differences in receipt of MOUD across treatment utilization classes, but MOUD receipt was associated with severity of opioid use in all treatment setting classes. People in treatment for alcohol or opioid use were more likely to receive medication if their use was more severe, and were more likely to receive MAUD if they accessed care in many settings. As MOUD and especially MAUD are underutilized, these findings highlight opportunities to increase access to evidence-based care for alcohol and opioid use disorders. [ABSTRACT FROM AUTHOR]

This study examines criminogenic risk levels of individuals with serious mental illness (SMI) involved in the justice system compared to justice-involved individuals without mental illness. The sample (N = 436) consisted of ninety-three individuals with SMI incarcerated in a county jail in a mid-size Midwest city, 217 individuals with SMI incarcerated in a state prison in the US Northeast, and 126 individuals without mental illness incarcerated in a state prison in the US Southwest. Results indicated that people with SMI incarcerated in jail and prison had higher overall criminal risk levels than prison inmates without mental illness. Results further demonstrated that, on average, higher percentages of persons with SMI had high/very high criminogenic risk scores. Finally, we noted that persons with SMI scored higher on most of the eight criminogenic risk domains measured by the Level of Service Inventory. These findings are possibly the most compelling to date in the growing body of literature demonstrating that justice-involved people with SMI have elevated criminogenic risk comparable to or greater than their non-mentally ill peers involved in the justice system. Consequently, treatment programs and interventions for justice-involved individuals with SMI need to explicitly target criminogenic needs into treatment efforts. [ABSTRACT FROM AUTHOR]

This study investigated the impact of mild COVID-19 on HRV in groups stratified by time after infection and to compare to a healthy group of the same age without previous virus infection and without need of hospitalization. This is a cross-sectional study. We divided the sample into four groups: control group (CG) (n = 31), group 1 (G1): ≤6 weeks (n = 34), group 2 (G2): 2–6 months (n = 30), group 3 (G3): 7–12 months (n = 35) after infection. For HRV analysis, we used the indices of linear (time and frequency domain) and non-linear analysis. For comparisons between groups, ANOVA one way test or Kruskal–Wallis was used according to the data distribution. The effect size was calculated based on Cohen's d or η2. Simple and multiple linear regressions were performed to investigate the interaction between clinical outcomes and HRV parameters. A total of 130 individuals were included. Groups G1 and G2 showed less parasympathetic modulation when compared to CG (p < 0.05), while G3 showed an increase in parasympathetic modulation when compared to G1 (p < 0.05). Moderate to large effect sizes were found according to Cohen d or η2. The multiple linear regression models identified age and infection duration as significant predictors for RMSSD (adjusted R2 = 0.227) and SD1 (adjusted R2 = 0.242), while age was significant for SDNN (adjusted R2 = 0.213). BMI, hypertension, and dyslipidemia were non-significant in all models. For HF (n.u.), infection duration was consistently significant, with stress emerging as a predictor in Model 2 (adjusted R2 = 0.143). The recovery time since diagnosis and age influences recovery from HRV, suggesting a transient effect of the disease on the autonomic nervous system. [ABSTRACT FROM AUTHOR]

Purpose: To address the absence of medical education curriculum focused on LGBTQ+ inclusive healthcare, this performance improvement project evaluated a medical student-developed and -led workshop focused on inclusive healthcare, including aspects of sexual health and well-being care. Approach: The project utilized a peer-to-peer and community engaged approach to ensure inclusiveness and effectiveness in improving learner knowledge, confidence, and motivation to engage in evidence-based, patient-centered care. Over two years, the health professions student LGBTQIA+ interest group, Spectrum, hosted two voluntary workshops to support medical students' sexual health history-taking skills. The 2022 Spectrum leadership team wrote three LGBTQIA+ standardized patient scenarios set within the students' training hospitals focused on using the Centers for Disease Control and Prevention's 5Ps, using inclusive language, and recognizing institutional barriers to healthcare. Workshops included a 10-min discussion highlighting best practices, 45 min of small group practice with standardized patient-facilitator dyads, and a 10-min reflection. Project evaluation incorporated quantitative and qualitative feedback from participants and facilitators. Results: Quantitative feedback reflected consistently positive ratings, with learners reporting increased comfort, satisfaction, perceived applicability, and confidence. Qualitative feedback highlighted the benefits of including representative patients, practicing inclusive language, and receiving real-time feedback. Peer-led facilitation contributed to a supportive learning environment, emphasizing the importance of curricular co-production and experiential leadership development. Facilitators described feeling empowered to develop cases reflecting genuine lived experiences and not simplified scenarios. Conclusions: This study emphasizes the value of increased medical student engagement in sexual healthcare education and advocates for further integration of LGBTQ+ inclusive curriculum into the medical curriculum. [ABSTRACT FROM AUTHOR]

Research consistently demonstrates that differences between the policy preferences of high- and low-income individuals are surprisingly small, at least at the aggregate level. We depart from this work by considering the size of income-based differences in opinion within political parties. To do so, we use responses to 144 policy-specific questions in the 2010–2020 Cooperative Election Study (CES). Our effort demonstrates that differences in opinion among the rich and poor tend to be larger within the parties than in the overall population. Interestingly, these gaps are largest among Democrats. We find that these larger gaps persist even after accounting for the party's racial and ethnic diversity. Furthermore, among Democrats, class-based gaps in opinion are larger than the gaps we observe among other potential intraparty cleavages, such as age, gender, and religiosity. Our results suggest important implications for the growing literature on representational inequality. [ABSTRACT FROM AUTHOR]

The impact of the COVID pandemic on the 2020 election outcome is analyzed using Iowa Electronic Market data, measures of socially and economically driven market volatility, a measure of COVID severity, and selected election-related events. Building on research regarding two previous U.S. presidential elections, we find that the pandemic helped the incumbent in two ways. The largest impact supporting the incumbent came from the apparent medical severity. A secondary impact came from social and economic volatility with the surprising finding that both risks helped the incumbent relative to the challenger. However, these impacts were not adequate to overcome the relatively large advantage of the challenger. [ABSTRACT FROM AUTHOR]

Introduction: Epigenetics studies gene expression changes influenced by environmental and lifestyle factors, linked to health conditions like reproductive aging. Male reproductive aging causes sperm decline, conceiving difficulties, and increased genetic abnormalities. Recent research focuses on epigenetics' role in male reproductive aging. Objectives: This review explores epigenetics and male reproductive aging, focusing on sperm quality, environmental and lifestyle factors' impact, and potential health implications for offspring. Methods: An extensive search of the literature was performed applying multiple databases, such as PubMed and Google Scholar. The search phrases employed were: epigenetics, male reproductive ageing, sperm quality, sperm quantity, environmental influences, lifestyle factors, and offspring health. This review only included articles that were published in English and had undergone a peer-review process. The literature evaluation uncovered that epigenetic alterations have a substantial influence on the process of male reproductive ageing. Result: Research has demonstrated that variations in the quality and quantity of sperm that occur with ageing are linked to adjustments in DNA methylation and histone. Moreover, there is evidence linking epigenetic alterations in sperm to environmental and lifestyle factors, including smoking, alcohol intake, and exposure to contaminants. These alterations can have enduring impacts on the well-being of descendants, since they can shape the activation of genes and potentially elevate the likelihood of genetic disorders. In conclusion, epigenetics significantly influences male reproductive aging, with sperm quality and quantity influenced by environmental and lifestyle factors. Conclusion: This underscores the need for comprehensive approaches to managing male reproductive health, and underscores the importance of considering epigenetics in diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Rationale: Alcohol consumption despite negative consequences is a core symptom of Alcohol Use Disorder. In animal models, this is studied by pairing aversive stimuli with alcohol access, and continuation of drinking under these conditions is known as aversion resistance. Previously, we found that female mice are more aversion resistant than males. Corticotropin releasing hormone (Crh) and the Crh receptor 1 (Crhr1) regulate stress-induced reinstatement, alcohol dependence, and binge-like drinking. However, the role of the Crh system in aversion resistance has not been assessed. Objectives: We aimed to identify sex differences in the Crh system during quinine-adulterated alcohol intake. Methods: We used two-bottle choice and adulterated the alcohol solution with quinine. Next, we measured Crh and Crhr1 levels in brain tissue using real-time polymerase chain reaction (RT-qPCR) and RNAscope in situ hybridization. We then infused a Crhr1 antagonist into the medial prefrontal cortex (mPFC) prior to quinine-alcohol intake. Results: After quinine-alcohol consumption, females exhibited increased mPFC Crhr1 mRNA levels as measured by RT-qPCR. This was confirmed with greater anatomical specificity using RNAscope, with females exhibiting an increased number of Crhr1 + cells in the dorsomedial PFC and the ventromedial PFC. mPFC Crhr1 antagonist treatment reduced quinine-alcohol consumption in females but did not impact consumption in males. Quinine-free alcohol intake was unaffected by Crhr1 antagonist treatment. Conclusions: Our findings suggest that Crhr1 in mPFC plays a role in aversion resistant alcohol intake in females. Future experiments will examine the sources of Crh innervation to the mPFC and their distinct roles in alcohol seeking. [ABSTRACT FROM AUTHOR]

The goal of this qualitative study was to understand the perspectives of school community members (adolescents, parents, school administrators, teachers, mental health providers) regarding the adaptation of an evidence-based transdiagnostic mental health treatment, known as the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents, for delivery in racially/ethnically diverse schools. Thirty-three school community members (n = 9 adolescents, n = 4 parents, n = 5 school administrators, n = 10 teachers, n = 5 mental health providers) participated in a series of focus groups or individual interviews. We used a rapid qualitative analysis to summarize their recommendations for adapting our intervention across seven themes: (1) consider social determinants of health, (2) include content related to social media and digital literacy, (3) provide teachers and staff with training on identifying and referring to mental health services and basic psychoeducation, (4) build trust and reduce stigma, (5) use qualified mental health providers to conduct culturally relevant sessions in person during school hours, (6) consider flexible format offerings and extended intervention delivery window, and (7) anticipate low parental engagement. These data were critical for informing systematic content and procedural modifications to our adapted intervention, such as scheduling sessions for school lunch hours and identifying coaches (e.g., teachers, school administrators) to support students with check-ins regarding session attendance and skill practice. These adaptations may be applied more broadly to the implementation of evidence-based mental health interventions in diverse school settings. [ABSTRACT FROM AUTHOR]

Osteogenesis imperfecta (OI) is a rare heritable connective tissue disorder of skeletal fragility with an incidence of roughly 1:15,000. Approximately 85% of the pathogenic variants responsible for OI are in the type I collagen genes, COL1A1 and COL1A2, with the remaining pathogenic OI variants spanning at least 20 additional genetic loci that often involve type I collagen post-translational modification, folding, and intracellular transport as well as matrix incorporation and mineralization. In addition to being the most abundant collagen in the body, type I collagen is an important structural and extracellular matrix signaling molecule in multiple organ systems and tissues. Thus, OI disease-causing variants result not only in skeletal fragility, decreased bone mineral density (BMD), kyphoscoliosis, and short stature, but can also result in hearing loss, dentinogenesis imperfecta, blue gray sclera, cardiopulmonary abnormalities, and muscle weakness. The extensive genetic and clinical heterogeneity in OI has necessitated the generation of multiple mouse models, the growing awareness of non-skeletal organ and tissue involvement, and OI being more broadly recognized as a type I collagenopathy. This has driven the investigation of mutation-specific skeletal and extra-skeletal manifestations and broadened the search of potential mechanistic therapeutic strategies. The purpose of this review is to outline several of the extra-skeletal manifestations that have recently been characterized through the use of genetically and phenotypically heterogeneous mouse models of osteogenesis imperfecta, demonstrating the significant potential impact of OI disease-causing variants as a collagenopathy (affecting multiple organ systems and tissues), and its implications to overall health. [ABSTRACT FROM AUTHOR]

Self-care is a form of intentional focus on mental and physical wellness that is necessary for the optimal functioning of psychologists. The discussion of this topic has received an increased interest in the field of school psychology as self-care is one way to combat a well-documented concern in the field, burnout. While that is the case, there both is a lack of research and a lack of understanding regarding the effectiveness of self-care interventions. This study examined the characteristics of the literature surrounding self-care specific to the field of school psychology using the following peer-reviewed journals: Contemporary School Psychology, International Journal of School and Educational Psychology, Journal of Applied School Psychology, Journal of Educational and Psychological Consultation, Journal of School Psychology, Psychology in the Schools, School Mental Health, School Psychology International, School Psychology (Quarterly), and School Psychology Review. A bibliometric analysis was completed, and results indicated that 25 articles met inclusion criteria. Results demonstrated that the number of publications increased over the years (from 2005 on) with many of the articles being published in the last 4 years. Contemporary School Psychology and School Mental Health were the two most productive journals. Interestingly, most of the included articles did not discuss school psychologists and their self-care but instead addressed populations school psychologists serve. Included empirical articles primarily used mindfulness-based interventions and didactic methods as self-care interventions. Implications are discussed in terms of future research on the topic of self-care and combating burnout for practitioners. [ABSTRACT FROM AUTHOR]

Purpose: Numerous clinical practice guidelines and consensus statements have been published in hernia surgery, however, there is still a need for high-quality evidence to address remaining unanswered questions. The aim of this study was to conduct research priority setting through a modified Delphi process to identify a list of top research priorities in hernia surgery. Methods: A structured literature review of clinical practice guidelines was performed by the steering committee. Topics considered clinically significant, practical to study and lacking strong evidence were extracted and refined into a comprehensive list, then entered into a two-round Delphi survey for prioritization at the Abdominal Core Health Quality Collaborative (ACHQC) Quality Improvement Summit. In round 1, participants were instructed to select any topic that should be prioritized for future research. Topics were ranked according to the proportion of votes and the 25 highest-ranking topics were included in the second round. In round 2, participants were instructed to select only the top 10 topics for research prioritization. Results: Eleven clinical practice guidelines were reviewed. Eighty-seven topics were extracted by the steering committee and submitted for prioritization. After the first round, 25 of the highest-ranking topics were determined and included in the second round. A final list of 11 research questions was identified. The hernia types with the most research interest were inguinal and epigastric/umbilical hernias. Other topics of high interest were the management of diastasis recti, primary versus mesh repairs and expectant management versus surgical repair. Conclusion: Our study provides a research agenda generated through expert consensus that may be used in the prioritization of the design and funding of clinical trials in hernia surgery. [ABSTRACT FROM AUTHOR]

Introduction: Use of pre-exposure prophylaxis (PrEP) is an effective biomedical intervention contributing to Ending the HIV Epidemic (EHE) in the USA. However, PrEP effectiveness is hindered by inadequate uptake among populations vulnerable to HIV. This study examines the relationships between sexual behavior/identity and PrEP eligibility and uptake while controlling for race/ethnicity (given evidence of racial/ethnic disparities in PrEP eligibility and update). Methods: Data for this study were collected between 2012 and 2020 from the electronic medical record (EMR) from a Federally Qualified Health Center (FQHC) in Chicago. A series of bivariate and four parallel logistic regressions (one each for transgender women, cisgender women, transgender men, and cisgender men) were conducted to examine factors associated with PrEP eligibility, controlling for race/ethnicity. Two additional regressions examined PrEP uptake—measured by first and second prescription outcomes—among cisgender men. All models controlled for age, monthly income, year of initial appointment, and primary clinic location. Results: Gay/lesbian cisgender women who have sex with men only (WSMO) were less likely to be eligible for PrEP than their heterosexual WSMO counterparts. Bisexual and heterosexual cisgender women who have sex with men and women (WSMW) were more likely to be eligible for PrEP than heterosexual cisgender WSMO. Gay/lesbian cisgender WSMO were less likely to be eligible for PrEP than those cisgender WSMO who identified as heterosexual. Regardless of sexual identity, men who have sex with women only (MSWO) were less likely to be eligible for PrEP than men who have sex with men only (MSMO). Heterosexual cisgender MSMO and men who have sex with men and women (MSMW) were less likely to be eligible for PrEP compared to their gay cisgender MSMO peers. Compared to gay cisgender MSMO, gay and bisexual cisgender MSMW were more likely to be eligible for PrEP. Similarly, among cisgender men, those who did not identify as gay were significantly less likely to receive a first PrEP prescription compared to gay MSMO with odds of receiving a second PrEP prescription being lower for bisexual MSMW, and heterosexual MSMW and MSWO compared to gay MSMO. Moreover, among transgender women and transgender men, both Latinx and Black patients were more likely to be eligible for PrEP than their White counterparts. However, for cisgender men, both Latinx and Black patients were less likely than their White peers to be eligible for PrEP. Conclusions: Although assessment of PrEP eligibility relies on a number of criteria, the former CDC guidelines emphasized sexual behavior, particularly the gender(s) of sexual partners, as the most salient focus, our findings highlight the missed opportunities of not also including sexual identity in prior guidelines. While the new CDC guidelines use a more holistic approach to eligibility, assessment of sexual identity and behavior at intake are key to ensuring culturally appropriate and inclusive messaging. Policy Implications: PrEP eligibility criteria should be revisited and revised, particularly for cisgender and transgender women, who are frequently missed by current guidelines. Also, more attention is needed to ensure that advertisements and clinical encounters do not perpetuate monosexist viewpoints, including bisexual erasure. [ABSTRACT FROM AUTHOR]

Prior to its extirpation in the 1960s, Ovis canadensis texianus (a subspecies of desert bighorn sheep, DBS) occupied 16 mountain ranges in the Trans-Pecos Region of Texas. Restocking efforts relied on translocating individuals of DBS from Arizona, Nevada, Utah, and Mexico. One recipient site, Elephant Mountain Wildlife Management Area (WMA), now the primary source-stock for translocations in Texas, was examined to measure its genomic ancestry compared to other DBS from the Great Basin, Mojave, and Sonoran deserts. Genomic data (5,434–62,749 single nucleotide polymorphisms) were used to estimate kinship, inbreeding, and effective population size across three time periods (2000, 2017, and 2019). Individuals genetically were most similar to DBS from the Gabbs Valley Range and Muddy Mountains, Nevada (Mojave DBS lineage). Strong signatures of inbreeding were not detected among individuals. In addition, genetic pedigree reconstruction revealed familial relationships, including a four-generation pedigree, and indicated 39.51% and 41.89% of individuals translocated in 2017 and 2019, respectively, were parent–offspring or full-sibling pairs, suggesting capture methods tend to sample highly related individuals. In 2017, population estimates for Elephant Mountain WMA indicated 182 individuals with an effective population size (Ne) of 65, whereas in 2019, Ne was 92 with an estimated population size of 186. Although reintroduction efforts to Elephant Mountain WMA were successful, recurrent epizootic events since 2019 have reduced the population sizes of DBS across the Trans-Pecos Region. Our data illustrate how population genomics and overall assessments of genetic diversity can and should be used to guide management and conservation of DBS. [ABSTRACT FROM AUTHOR]

Rhombencephalosynapsis (RES) is a hindbrain malformation characterized by a missing cerebellar vermis with apposition or fusion of the cerebellar hemispheres. The present clinical case report provides a comprehensive, longitudinal overview of cognitive and affective manifestations in a 22-year-old patient with RES. The patient shows clinical signs of emotional reactivity and dysregulation, impulsivity, and impairments in executive functioning since early childhood. These features fit the constellation of neuropsychiatric symptoms observed in patients with congenital and acquired abnormalities of the posterior vermis. It is proposed that patients with RES may show affective and cognitive difficulties which increase their vulnerability to psychological stress and risk of developing mental health issues. [ABSTRACT FROM AUTHOR]

Long COVID, also known as PASC (post-acute sequelae of SARS-CoV-2), is a complex infection-associated chronic condition affecting tens of millions of people worldwide. Many aspects of this condition are incompletely understood. Among them is how this condition may manifest itself in older adults and how it might impact the older population. Here, we briefly review the current understanding of PASC in the adult population and examine what is known on its features with aging. Finally, we outline the major gaps and areas for research most germane to older adults. [ABSTRACT FROM AUTHOR]

People surviving cancer represent a particularly vulnerable population who are at a higher risk for food insecurity (FI) due to the adverse short- and long-term effects of cancer treatment. This analysis examines the influence of the COVID-19 pandemic on the prevalence of FI among cancer survivors across New York State (NYS). Data from the 2019 and 2021 NYS Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate the prevalence of FI. Multivariable logistic regression was used to explore socioeconomic determinants of FI. Among cancer survivors, FI varied geographically with a higher prevalence in New York City compared to the rest of the state (ROS) prior to (25.3% vs. 13.8%; p =.0025) and during the pandemic (27.35% vs. 18.52%; p = 0.0206). In the adjusted logistic regression model, pre-pandemic FI was associated with non-White race (OR 2.30 [CI 1.16–4.56]), household income <$15,000 (OR 22.67 [CI 6.39–80.43]) or $15,000 to less than <$25,000 (OR 22.99 [CI 6.85–77.12]), and more co-morbidities (OR 1.39 [CI 1.09–1.77]). During the pandemic, the association of FI with non-White race (OR 1.76 [CI 0.98–3.16]) was attenuated but remained significant for low household income and more co-morbidities. FI was newly associated with being out of work for less than one year (OR 6.36 [CI 1.80–22.54] and having one (OR 4.42 [CI 1.77–11.07]) or two or more children in the household (OR 4.54 [CI 1.78–11.63]). Our findings highlight geographic inequities and key determinants of FI among cancer survivors that are amendable to correction by public health and social policies, for which several were momentarily implemented during the pandemic. [ABSTRACT FROM AUTHOR]

This study investigated the influence of supplemental irrigation (SI) on yearly variation in potato yield and associated economics in a humid climate. On-farm trials were conducted in four to five fields annually in Prince Edward Island, Canada from 2019 to 2022. The research involved four different treatments: rainfed production as the control group, irrigation following conventional practices, irrigation guided by soil moisture monitoring, and irrigation guided by soil moisture monitoring coupled with a 20% reduction in fertilizer input. While six commonly-grown russet potato cultivars were used, local standard cultural practices were followed at all sites. In 2019 SI significantly increased marketable yields (MY), which was primarily attributed to a drought period that extended from July to early August. Similarly, in 2020 SI led to a substantial rise in MY due to growing season rainfall being significantly lower than the optimal water demand for the potato plant. Conversely, in 2021 and 2022, when rainfall was relatively sufficient and evenly distributed, farmers either refrained from irrigating or employed minimal irrigation rates, resulting in negligible MY responses. Tuber yield increase as a result of SI varied with rainfall and thus fluctuated yearly. Cross-year comparisons revealed that SI can effectively mitigate annual fluctuations in tuber yield. A cost–benefit analysis indicated that employing SI to minimize yearly variation in tuber yield can be either profitable or unprofitable in the long term, and is contingent on the costs linked to irrigation equipment, the water supply system, operational aspects, field scale, and rainfall distribution. These findings hold significance for guiding decisions in water management for potato production in humid environments. [ABSTRACT FROM AUTHOR]

Rationale and objectives: Interpreting CT studies of facial trauma is challenging, and there are often substantial differences in the characterization of complex facial trauma between radiologists and surgeons. We designed a collaborative multidisciplinary project to reconcile differences in facial fracture interpretation through an educational intervention. The effectiveness of this intervention was evaluated through surgeon feedback on radiology reports. Materials and methods: Radiology residents, neuroradiology fellows, and neuroradiology attendings were recruited as participants at a single tertiary care academic center. Otolaryngology residents were recruited as evaluators. Participants completed surveys and provided preliminary reports for example cases of facial trauma before and after attending an educational session. Evaluators performed a blinded review of these preliminary reports based on ideal reports developed by surgical and neuroradiology attendings. Results: 26 participants (20 residents, 1 neuroradiology fellow, 5 neuroradiology attendings) completed the study. Six otolaryngology residents participated as evaluators. To assess interrater reliability, three evaluators graded a shared set of 15 reports and demonstrated substantial agreement with a Kendall's W of 0.71. Participants demonstrated significant improvement in overall report accuracy, clarity, and organization. In subunit analysis, there were significant improvements in reporting Le Fort, nasoseptal, and nasoorbitoethmoid fractures. No significant improvements occurred in the reporting of upper face, zygomaticomaxillary complex, or mandibular fractures. In contrast, survey analysis demonstrated significantly improved confidence in interpreting trauma involving all facial subunits. Conclusion: Compared with survey results, surgeon assessment of radiology reports better demonstrated areas of improvement after an educational intervention. A multidisciplinary approach to assessing educational efforts may better evaluate the practical effectiveness of educational interventions. [ABSTRACT FROM AUTHOR]

Introduction: This study used network meta-analysis (NMA) to inform and compare the number needed to treat (NNT), number needed to harm (NNH), and cost per improved outcome (CPIO) associated with more recently approved treatments for anti-acetylcholine receptor antibody-positive (anti-AChR Ab+) generalized myasthenia gravis (gMG). Methods: Clinical trials of neonatal Fc receptor (FcRn) inhibitors, efgartigimod intravenous (IV) and rozanolixizumab, and complement inhibitors, ravulizumab and zilucoplan, versus placebo (with background conventional treatment) were included in the primary NMA to compare efficacy and safety outcomes. The outputs from the NMAs were used to estimate NNT and NNH of each treatment versus placebo. CPIO (2024 USD) was estimated for a ≥ 3- or ≥ 5-point reduction from baseline in Quantitative Myasthenia Gravis (QMG) and Myasthenia Gravis-Activities of Daily Living (MG-ADL) scores. Sensitivity analyses were performed adding efgartigimod PH20 subcutaneous (SC) and eculizumab to the NMA. Results: Efgartigimod IV had the lowest NNT versus placebo for achieving a ≥ 3- and ≥ 5-point reduction in QMG, as well as a ≥ 5-point reduction in MG-ADL, whereas rozanolixizumab had the lowest NNT for a ≥ 3-point reduction in MG-ADL. The NNH versus placebo was similar across comparator treatments. Efgartigimod IV had the lowest CPIO among all treatments for all assessed efficacy outcomes. Sensitivity analyses yielded results consistent with primary analysis and indicated that efgartigimod PH20 SC had comparable NNT and CPIO values to efgartigimod IV, whereas eculizumab had comparable NNT and higher CPIO values compared to other complement inhibitors. Conclusions: FcRn inhibitors and complement inhibitors assessed in this study all demonstrated clinical benefit in terms of NNT as well as an acceptable safety profile in terms of NNH. Within the limitations of this meta-analysis, efgartigimod was associated with a favorable benefit–risk profile as well as a better economic value compared to ravulizumab, rozanolixizumab, and zilucoplan as treatments for anti-AChR Ab+ gMG. [ABSTRACT FROM AUTHOR]

The inbred Babraham pig serves as a valuable biomedical model for research due to its high level of homozygosity, including in the major histocompatibility complex (MHC) loci and likely other important immune-related gene complexes, which are generally highly diverse in outbred populations. As the ability to control for this diversity using inbred organisms is of great utility, we sought to improve this resource by generating a long-read whole genome assembly and transcriptome atlas of a Babraham pig. The genome was de novo assembled using PacBio long reads and error-corrected using Illumina short reads. Assembled contigs were then mapped to the porcine reference assembly, Sscrofa11.1, to generate chromosome-level scaffolds. The resulting TPI_Babraham_pig_v1 assembly is nearly as contiguous as Sscrofa11.1 with a contig N50 of 34.95 Mb and contig L50 of 23. The remaining sequence gaps are generally the result of poor assembly across large and highly repetitive regions such as the centromeres and tandemly duplicated gene families, including immune-related gene complexes, that often vary in gene content between haplotypes. We also further confirm homozygosity across the Babraham MHC and characterize the allele content and tissue expression of several other immune-related gene complexes, including the antibody and T cell receptor loci, the natural killer complex, and the leukocyte receptor complex. The Babraham pig genome assembly provides an alternate highly contiguous porcine genome assembly as a resource for the livestock genomics community. The assembly will also aid biomedical and veterinary research that utilizes this animal model such as when controlling for genetic variation is critical. [ABSTRACT FROM AUTHOR]

In an era marked by the widespread use of digital technology, educators face the need to constantly learn and develop their own new literacies for the information era, as well as their competencies to teach and apply best practices using technologies. This paper underscores the vital role of ongoing teacher professional learning (OTPL) with a focus on reflective practices and pedagogical reasoning and action (PR&A) in shaping education quality and equity. Examining three key drivers of educational transformation—big data and learning analytics, Artificial Intelligence (AI), and shifting teacher identities—the paper explores their overall impact on teacher practices. This paper emphasizes technology as a crucial boundary object, a catalyst of educational transformation, when used to foster communication and professional growth. To this end, three boundary objects are identified, namely dashboards, AI-driven professional learning environments, and digital communities of practice. These tools illustrate technology's capacity to mediate relationships between transformative educational drivers and teacher practices, offering a pathway to navigate shifting perspectives on OTPL. With a theoretical foundation in equitable education, the paper provides insights into the intricate relationship between boundary objects and evolving educational dynamics. It highlights technology's pivotal role in achieving both quality and equitable education in the contemporary educational landscape. It presents a nuanced understanding of how specific tools may contribute to effective OTPL amid rapid educational transformations. [ABSTRACT FROM AUTHOR]