Search

Purpose: Robotic surgery has been incorporated in the treatment of endometrial cancer, with evidence suggesting that minimal access surgery offers advantages over laparotomy including less blood loss, lower rate of perioperative complications, and accelerated postoperative recovery. The laparoscopic approach to cervical cancer (LACC) study has recently demonstrated inferior survival outcomes in cervical cancer patients treated with minimal access surgery including robotic surgery. It is, therefore, imperative that further evaluation of the latter in endometrial cancer is performed. Methods: A retrospective analysis of clinical data was performed. We compared two different types of surgery performed for the treatment of FIGO stage 1 to 3 endometrial cancer; open surgery performed in the years 2013–2015 vs robotic surgery performed in 2017–2019, after the implementation of the robotic program in our institution. Main outcome measures were recurrence-free survival and overall survival, with secondary outcomes including surgical morbidity and postoperative recovery. Results: We compared 123 patients who had open surgery with 104 patients who underwent robotic surgery. One case from the second group was converted to open surgery due to the inability to complete it robotically. After a median follow-up of 68 months, there was no difference in recurrence-free survival or overall survival between the two groups. Length of stay after an operation was significantly different with mean hospital stay of 1.6 days after robotic surgery and 5 days after open surgery (p = 0.001). No significant difference was identified in the rate of complications (p = 0.304). Conclusion: Our analysis has demonstrated that robotic surgery offers better perioperative outcomes without compromising the oncological safety. [ABSTRACT FROM AUTHOR]

Purpose: 360° immersive videos may be useful in procedure-based healthcare settings. We hypothesized that extended reality (XR) neonatal intubation education is a feasible alternative to live demonstration in skill and knowledge transfer. Methods: This was a prospective single center evaluation of an educational XR intubation video using Premature Anne™ (Laerdal Medical, Stavanger, Norway) comparing to a live demonstration. Participants were randomly allocated to either live demonstration or XR group. Each group received 20 min of teaching from the pediatric respiratory care education specialist, either in person or in video format. Intubation success, knowledge and skill acquisition were measured using a questionnaire and checklist. Results: We had a total of 23 participants, XR (n = 11) and live demonstration (n = 12). The groups were heterogeneous in experience level.The XR group was successful at intubating 73% of the time (n = 8), which was not significantly different to the live demonstration group 58% (n = 7) (p = 0.667). For patients who achieved intubation, there was no difference between groups in the mean time to successful intubation; 98 s (SD 73) for the XR group and 65 s (SD 22) for the live demonstration group (p = 0.685).When comparing scores between groups there were no statistically significant differences regarding knowledge scores (p = 0.514), skill scores (p = 0.826) and total scores (p = 0.926). Conclusion: These preliminary findings indicated no significant differences between the XR and live demonstration groups in terms of intubation success, knowledge acquisition, skill performance, total scores or time to successful intubation. [ABSTRACT FROM AUTHOR]

Robotic bariatric surgery may overcome challenges associated with laparoscopy, potentially achieving technically superior results. This review aims to summarise current literature reporting on learning curves for surgeons newly adopting robotic bariatrics and implications for safety, efficiency and outcomes. A systematic review was performed in line with the PRISMA guidelines. Electronic databases PubMed and MEDLINE were searched and articles reporting on learning curves in robotic bariatric surgery were identified. Studies that reported changes in outcome over time, or learning curves for surgeons newly adopting robotic bariatric surgery were included in this review. Eleven studies reporting on 1237 patients were included in this review. Most surgeons reported prior bariatric surgical experience. Differences were noted regarding the approach and adoption of robotics. Ten studies found significant reduction in operative time, with the shortest learning curve of 11 cases. Reporting of clinical outcomes was limited. Three studies reported statistically significant improvement in outcomes after the learning curve. Long-term outcomes were in line with current literature, though none assessed differences between learning curve groups. Reported learning curves in robotic bariatric surgery is variable, with limited reporting of clinical outcomes. With appropriate mentorship, surgeons can improve efficiency, safety and clinical outcomes, maximising the benefits of minimally invasive surgery. [ABSTRACT FROM AUTHOR]

Background: Over half of veterans enrolled in the Veterans Health Administration (VA) are also enrolled in Medicare, potentially increasing their opportunity to receive low-value health services within and outside VA. Objectives: To characterize the use and cost of low-value services delivered to dually enrolled veterans from VA and Medicare. Design: Retrospective cross-sectional. Participants: Veterans enrolled in VA and fee-for-service Medicare (FY 2017–2018). Main Measures: We used VA and Medicare administrative data to identify 29 low-value services across 6 established domains: cancer screening, diagnostic/preventive testing, preoperative testing, imaging, cardiovascular testing, and surgery. We determined the count of low-value services per 100 veterans delivered in VA and Medicare in FY 2018 overall, by domain, and by individual service. We applied standardized estimates to determine each service's cost. Key Results: Among 1.6 million dually enrolled veterans, the mean age was 73, 97% were men, and 77% were non-Hispanic White. Overall, 63.2 low-value services per 100 veterans were delivered, affecting 32% of veterans; 22.9 services per 100 veterans were delivered in VA and 40.3 services per 100 veterans were delivered in Medicare. The total cost was $226.3 million (M), of which $62.6 M was spent in VA and $163.7 M in Medicare. The most common low-value service was prostate-specific antigen testing at 17.3 per 100 veterans (VA 55.9%, Medicare 44.1%). The costliest low-value service was percutaneous coronary intervention (VA $10.1 M, Medicare $32.8 M). Conclusions: Nearly 1 in 3 dually enrolled veterans received a low-value service in FY18, with twice as many low-value services delivered in Medicare vs VA. Interventions to reduce low-value services for veterans should consider their substantial use of such services in Medicare. [ABSTRACT FROM AUTHOR]

Background: The WASH benefits Bangladesh trial multi-component sanitation intervention reduced diarrheal disease among children < 5 years. Intervention components included latrine upgrades, child feces management tools, and behavioral promotion. It remains unclear which components most impacted diarrhea. Methods: We conducted mediation analysis within a subset of households (n = 720) from the sanitation and control arms. Potential mediators were categorized into indicators of latrine quality, latrine use practices, and feces management practices. We estimated average causal mediation effects (ACME) as prevalence differences (PD), defined as the intervention's effect on diarrhea through its effect on the mediator. Results: The intervention improved all indicators compared to controls. We found significant mediation through multiple latrine use and feces management practice indicators. The strongest mediators during monsoon seasons were reduced open defecation among children aged < 3 and 3–8 years, and increased disposal of child feces into latrines. The strongest mediators during dry seasons were access to a flush/pour-flush latrine, reduced open defecation among children aged 3–8 years, and increased disposal of child feces into latrines. Individual mediation effects were small (PD = 0.5–2 percentage points) compared to the overall intervention effect but collectively describe significant mediation pathways. Discussion: The effect of the WASH Benefits Bangladesh sanitation intervention on diarrheal disease was mediated through improved child feces management and reduced child open defecation. Although the intervention significantly improved latrine quality, relatively high latrine quality at baseline may have limited benefits from additional improvements. Targeting safe child feces management may increase the health benefits of rural sanitation interventions. [ABSTRACT FROM AUTHOR]

In this study, various 3D printed metamaterials are investigated for application in energy absorbing structures in motorsports. Impact attenuating structures are used to decelerate vehicles and protect drivers in the event of a crash. Additive manufacturing enables complex plastic structures which can facilitate improved angular resistance and reduced weight and cost compared with traditional approaches. Metamaterials were 3D printed from PLA using commercially available equipment and include gyroid structures, a novel reinforced gyroid design and a lattice designed using finite-element analysis-based topology optimization. Compression testing was used to measure stress–strain response, compressive modulus, and energy absorption. This demonstrated gyroids and reinforced gyroids have ideal compressive behavior for high energy absorption under impact. The topology optimized metamaterial was found unsuitable for this application due to its high stiffness, revealing a weakness in traditional topology optimization approaches which are not catered to maximize energy absorption. The reinforced gyroid demonstrated the highest specific energy absorption and was used to manufacture an impact attenuator which demonstrated the potential to safely stop a hypothetical 300 kg vehicle crash. This work supports that gyroid-based structures can reduce weight, volume and cost over current materials in all motorsport categories, with improved safety from oblique crashes. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitors have transformed the treatment landscape of many cancers, including melanoma and renal cell carcinoma (RCC). Randomised trials are evaluating outcomes from reduced ICI treatment schedules with the aim of improving quality of life, tolerability, and cost-effectiveness. This study aims to provide insight into patient and carer's perspectives of these trials. Methods: Seven focus groups were conducted with 31 people with stage IV melanoma, RCC, or caregivers for people receiving ICI. Transcripts were analysed using reflexive thematic analysis. Results: Three themes were generated: 1) "Treatment and clinic visits provide reassurance": reducing hospital visits may not improve quality of life. 2) "Assessment of personal risk versus benefit": the decision to participate in an ICI optimisation trial is influenced by treatment response, experience of toxicity and perceived logistical benefits based on the individual's circumstances. 3) "Pre-existing experience and beliefs about how treatment and trials work", including the belief that more treatment is better, influence views around ICI optimisation trials. Conclusion: This study provides insight into recruitment challenges and recommends strategies to enhance recruitment for ongoing ICI optimisation trials. These findings will influence the design of future ICI optimisation trials ensuring they are acceptable to patients. [ABSTRACT FROM AUTHOR]

Phenomenology, particularly as developed by Merleau-Ponty, primarily concerns how human beings perceive and act towards the world they encounter, their lifeworld. Umwelt theory, by contrast, primarily concerns the animal lifeworld, which is also the concern of Biosemiotics. Exploring the overlap between the two disciplines requires a fuller understanding of how human perception has evolved to become so very different from that of animals. This article will try to provide that and show how that may help to address the ecological crisis surrounding us. Human beings now develop and live in in a world where most of what they encounter are cultural artefacts. In fact, as Simondon suggests, human beings and technological objects are co-evolving. This has brought about radical changes in the way we relate to the natural world. But these are not necessarily changes for the better. Indeed, McGilchrist claims that the last thousand years or so of cultural evolution has profoundly impaired how human beings attend to the world. This paper will suggest that this impairment has contributed to the ecological crisis we now face, and that to help meet it both Biosemiotics and Umwelt theory should take more account of the revival of interest in panpsychism as seen in the work of Goff and others. [ABSTRACT FROM AUTHOR]

Research suggests that interlocutors manage the timing demands of conversation by preparing what they want to say early. In three experiments, we used a verbal question-answering task to investigate what aspects of their response speakers prepare early. In all three experiments, participants answered more quickly when the critical content (here, barks) necessary for answer preparation occurred early (e.g., Which animal barks and is also a common household pet?) rather than late (e.g., Which animal is a common household pet and also barks?). In the individual experiments, we found no convincing evidence that participants were slower to produce longer answers, consisting of multiple words, than shorter answers, consisting of a single word. There was also no interaction between these two factors. A combined analysis of the first two experiments confirmed this lack of interaction, and demonstrated that participants were faster to answer questions when the critical content was available early rather than late and when the answer was short rather than long. These findings provide tentative evidence for an account in which interlocutors prepare the content of their answer as soon as they can, but sometimes do not prepare its length (and thus form) until they are ready to speak. [ABSTRACT FROM AUTHOR]

The mechanical quality of trabecular bone is influenced by its mineral content and spatial distribution, which is controlled by bone remodelling and mineralisation. Mineralisation kinetics occur in two phases: a fast primary mineralisation and a secondary mineralisation that can last from several months to years. Variations in bone turnover and mineralisation kinetics can be observed in the bone mineral density distribution (BMDD). Here, we propose a statistical spatio-temporal bone remodelling model to study the effects of bone turnover (associated with the activation frequency Ac. f ) and mineralisation kinetics (associated with secondary mineralisation T sec ) on BMDD. In this model, individual basic multicellular units (BMUs) are activated discretely on trabecular surfaces that undergo typical bone remodelling periods. Our results highlight that trabecular BMDD is strongly regulated by Ac. f and T sec in a coupled way. Ca wt% increases with lower Ac. f and short T sec . For example, a Ac. f = 4 BMU/year/mm 3 and T sec = 8 years result in a mean Ca wt% of 25, which is in accordance with Ca wt% values reported in quantitative backscattered electron imaging (qBEI) experiments. However, for lower Ac. f and shorter T sec (from 0.5 to 4 years) one obtains a high Ca wt% and a very narrow skew BMDD to the right. This close link between Ac. f and T sec highlights the importance of considering both characteristics to draw meaningful conclusion about bone quality. Overall, this model represents a new approach to modelling healthy and diseased bone and can aid in developing deeper insights into disease states like osteoporosis. [ABSTRACT FROM AUTHOR]

Background: Energy system models based on linear programming have been growing in size with the increasing need to model renewables with high spatial and temporal detail. Larger models lead to high computational requirements. Furthermore, seemingly small changes in a model can lead to drastic differences in runtime. Here, we investigate measures to address this issue. Results: We review the mathematical structure of a typical energy system model, and discuss issues of sparsity, degeneracy and large numerical range. We introduce and test a method to automatically scale models to improve numerical range. We test this method as well as tweaks to model formulation and solver preferences, finding that adjustments can have a substantial impact on runtime. In particular, the barrier method without crossover can be very fast, but affects the structure of the resulting optimal solution. Conclusions: We conclude with a range of recommendations for energy system modellers: first, on large and difficult models, manually select the barrier method or barrier+crossover method. Second, use appropriate units that minimize the model's numerical range or apply an automatic scaling procedure like the one we introduce here to derive them automatically. Third, be wary of model formulations with cost-free technologies and dummy costs, as those can dramatically worsen the numerical properties of the model. Finally, as a last resort, know the basic solver tolerance settings for your chosen solver and adjust them if necessary. [ABSTRACT FROM AUTHOR]

Background: There is a need for diagnostic tests for screening, triaging and staging of epithelial ovarian cancer (EOC). Glycoproteomics of blood samples has shown promise for biomarker discovery. Methods: We applied glycoproteomics to serum of people with EOC or benign pelvic masses and healthy controls. A total of 653 analytes were quantified and assessed in multivariable models, which were tested in an independent cohort. Additionally, we analyzed glycosylation patterns in serum markers and in tissues. Results: We identified a biomarker panel that distinguished benign lesions from EOC with sensitivity and specificity of 83.5% and 90.1% in the training set, and of 86.7 and 86.7% in the test set, respectively. ROC analysis demonstrated strong performance across a range of cutoffs. Fucosylated multi-antennary glycopeptide markers were higher in late-stage than in early-stage EOC. A comparable pattern was found in late-stage EOC tissues. Conclusions: Blood glycopeptide biomarkers have the potential to distinguish benign from malignant pelvic masses, and early- from late-stage EOC. Glycosylation of circulating and tumor tissue proteins may be related. This study supports the hypothesis that blood glycoproteomic profiling can be used for EOC diagnosis and staging and it warrants further clinical evaluation. [ABSTRACT FROM AUTHOR]

Differentiation of adipose progenitor cells into mature adipocytes entails a dramatic reorganization of the cellular architecture to accommodate lipid storage into cytoplasmic lipid droplets. Lipid droplets occupy most of the adipocyte volume, compressing the nucleus beneath the plasma membrane. How this cellular remodeling affects sub-nuclear structure, including size and number of nucleoli, remains unclear. We describe the morphological remodeling of the nucleus and the nucleolus during in vitro adipogenic differentiation of primary human adipose stem cells. We find that cell cycle arrest elicits a remodeling of nucleolar structure which correlates with a decrease in protein synthesis. Strikingly, triggering cytoskeletal rearrangements mimics the nucleolar remodeling observed during adipogenesis. Our results point to nucleolar remodeling as an active, mechano-regulated mechanism during adipogenic differentiation and demonstrate a key role of the actin cytoskeleton in defining nuclear and nucleolar architecture in differentiating human adipose stem cells. Characterization of nuclear and nucleolar dynamics during adipogenic differentiation of human adipose stem cells points to nucleolar remodeling as an active, mechanoregulated mechanism triggered by cytoskeleton rearrangement. [ABSTRACT FROM AUTHOR]

To answer a question, speakers must determine their response and formulate it in words. But do they decide on a response before formulation, or do they formulate different potential answers before selecting one? We addressed this issue in a verbal question-answering experiment. Participants answered questions more quickly when they had one potential answer (e.g., Which tourist attraction in Paris is very tall?) than when they had multiple potential answers (e.g., What is the name of a Shakespeare play?). Participants also answered more quickly when the set of potential answers were on average short rather than long, regardless of whether there was only one or multiple potential answers. Thus, participants were not affected by the linguistic complexity of unselected but plausible answers. These findings suggest that participants select a single answer before formulation. [ABSTRACT FROM AUTHOR]

Protected areas are typically managed as a network of sites exposed to varying anthropogenic conditions. Managing these networks benefits from monitoring of conditions across sites to help prioritize coordinated efforts. Monitoring marine vessel activity and related underwater radiated noise impacts across a network of protected areas, like the U.S. National Marine Sanctuary system, helps managers ensure the quality of habitats used by a wide range of marine species. Here, we use underwater acoustic detections of vessels to quantify different characteristics of vessel noise at 25 locations within eight marine sanctuaries including the Hawaiian Archipelago and the U.S. east and west coasts. Vessel noise metrics, including temporal presence and sound levels, were paired with Automatic Identification System (AIS) vessel tracking data to derive a suite of robust vessel noise indicators for use across the network of marine protected areas. Network-wide comparisons revealed a spectrum of vessel noise conditions that closely matched AIS vessel traffic composition. Shifts in vessel noise were correlated with the decrease in vessel activity early in the COVID-19 pandemic, and vessel speed reduction management initiatives. Improving our understanding of vessel noise conditions in these protected areas can help direct opportunities for reducing vessel noise, such as establishing and maintaining noise-free periods, enhancing port efficiency, engaging with regional and international vessel quieting initiatives, and leveraging co-benefits of management actions for reducing ocean noise. [ABSTRACT FROM AUTHOR]

Traumatic brain injury is a leading cause of death and disability worldwide. Interventions that mitigate secondary brain injury have the potential to improve outcomes for patients and reduce the impact on communities and society. Increased circulating catecholamines are associated with worse outcomes and there are supportive animal data and indications in human studies of benefit from beta-blockade after severe traumatic brain injury. Here, we present the protocol for a dose-finding study using esmolol in adults commenced within 24 h of severe traumatic brain injury. Esmolol has practical advantages and theoretical benefits as a neuroprotective agent in this setting, but these must be balanced against the known risk of secondary injury from hypotension. The aim of this study is to determine a dose schedule for esmolol, using the continual reassessment method, that combines a clinically significant reduction in heart rate as a surrogate for catecholamine drive with maintenance of cerebral perfusion pressure. The maximum tolerated dosing schedule for esmolol can then be tested for patient benefit in subsequent randomized controlled trials. Trial registration ISRCTN, ISRCTN11038397, registered retrospectively 07/01/2021 https://www.isrctn.com/ISRCTN11038397 [ABSTRACT FROM AUTHOR]

The anterior cingulate cortex (ACC) responds to noxious and innocuous sensory inputs, and integrates them to coordinate appropriate behavioral reactions. However, the role of the projections of ACC neurons to subcortical areas and their influence on sensory processing are not fully investigated. Here, we identified that ACC neurons projecting to the contralateral claustrum (ACC→contraCLA) preferentially respond to contralateral mechanical sensory stimulation. These sensory responses were enhanced during attending behavior. Optogenetic activation of ACC→contraCLA neurons silenced pyramidal neurons in the contralateral ACC by recruiting local circuit fast-spiking interneuron activation via an excitatory relay in the CLA. This circuit activation suppressed withdrawal behavior to mechanical stimuli ipsilateral to the ACC→contraCLA neurons. Chemogenetic silencing showed that the cross-hemispheric circuit has an important role in the suppression of contralateral nociceptive behavior during sensory-driven attending behavior. Our findings identify a cross-hemispheric cortical-subcortical-cortical arc allowing the brain to give attentional priority to competing innocuous and noxious inputs. This study identified a cross-hemispheric anterior cingulate arc via the claustrum which allows the brain to allocate attentional priority to competing innocuous and noxious inputs by activating fast-spiking interneurons. [ABSTRACT FROM AUTHOR]

Mobile Health (mHealth) has the potential to be transformative in the management of chronic conditions. Machine learning can leverage self-reported data collected with apps to predict periods of increased health risk, alert users, and signpost interventions. Despite this, mHealth must balance the treatment burden of frequent self-reporting and predictive performance and safety. Here we report how user engagement with a widely used and clinically validated mHealth app, myCOPD (designed for the self-management of Chronic Obstructive Pulmonary Disease), directly impacts the performance of a machine learning model predicting an acute worsening of condition (i.e., exacerbations). We classify how users typically engage with myCOPD, finding that 60.3% of users engage frequently, however, less frequent users can show transitional engagement (18.4%), becoming more engaged immediately (< 21 days) before exacerbating. Machine learning performed better for users who engaged the most, however, this performance decrease can be mostly offset for less frequent users who engage more near exacerbation. We conduct interviews and focus groups with myCOPD users, highlighting digital diaries and disease acuity as key factors for engagement. Users of mHealth can feel overburdened when self-reporting data necessary for predictive modelling and confidence of recognising exacerbations is a significant barrier to accurate self-reported data. We demonstrate that users of mHealth should be encouraged to engage when they notice changes to their condition (rather than clinically defined symptoms) to achieve data that is still predictive for machine learning, while reducing the likelihood of disengagement through desensitisation. [ABSTRACT FROM AUTHOR]

Context: Quantifying spatial and temporal variations in landscape flammability is important for implementing ecologically desirable prescribed burns and gauging the level of fire risk across a landscape. Yet there is a paucity of models that provide adequate spatial detail about landscape flammability for these purposes. Objectives: Our aim was to quantify spatial and temporal variations in ignitability across a forested landscape. We asked: (1) How do fuel moisture and meteorological variables interact to affect ignitability? (2) Do fuel moisture thresholds for ignition vary across a gradient of forest types? (3) How does the spatial connectivity of ignitable fuel vary over time? (4) How could an ignitability model be used to inform fire management decision-making? Methods: We conducted field-based ignition tests with flaming firebrands over three fire seasons. Ignitions were attempted across a range of moisture and meteorological conditions at 15 sites in eucalypt forest in south-eastern Australia. Structural equation modelling and generalized linear models were used to quantify relationships between ignitability, aridity, fuel moisture and weather. Results: The strongest predictors of ignitability were the moisture content of dead near surface fine fuel and in-forest vapour pressure deficit. Ignition thresholds for both varied across an aridity gradient. Dense forests (i.e., wet and damp eucalypt forests) needed drier fuel and drier in-forest atmospheric conditions to ignite than sparser forests (i.e., shrubby foothill forest). Conclusion: Our modelling of ignitability could inform fire planning in south-eastern Australia and the methodology could be applied elsewhere to develop similar models for other regions. Days with consistently high ignitability across the landscape are more conducive to the development of large wildfires whereas days when ignitability is spatially variable are more suitable for prescribed burning. [ABSTRACT FROM AUTHOR]

The first part of this essay relates a minimal and primordial concept of agency to be found in science and technology studies to an overall ontology of liveliness. The second part explores the relation between minimal and higher-level conceptions of agency concerning goal-orientedness and adaptation, and moves towards specifically biological concerns via a discussion of cybernetic machines. [ABSTRACT FROM AUTHOR]

The two major aims of the present study were: (i) quantify localised cortical bone adaptation at the surface level using contralateral endpoint imaging data and image analysis techniques, and (ii) investigate whether cortical bone adaptation responses are universal or region specific and dependent on the respective peak load. For this purpose, we re-analyse previously published μ CT data of the mouse tibia loading model that investigated bone adaptation in response to sciatic neurectomy and various peak load magnitudes (F = 0, 2, 4, 6, 8, 10, 12 N). A beam theory-based approach was developed to simulate cortical bone adaptation in different sections of the tibia, using longitudinal strains as the adaptive stimuli. We developed four mechanostat models: universal, surface-based, strain directional-based, and combined surface and strain direction-based. Rates of bone adaptation in these mechanostat models were computed using an optimisation procedure (131,606 total simulations), performed on a single load case (F = 10 N). Subsequently, the models were validated against the remaining six peak loads. Our findings indicate that local bone adaptation responses are quasi-linear and bone region specific. The mechanostat model which accounted for differences in endosteal and periosteal regions and strain directions (i.e. tensile versus compressive) produced the lowest root mean squared error between simulated and experimental data for all loads, with a combined prediction accuracy of 76.6, 55.0 and 80.7% for periosteal, endosteal, and cortical thickness measurements (in the midshaft of the tibia). The largest root mean squared errors were observed in the transitional loads, i.e. F = 2 to 6 N, where inter-animal variability was highest. Finally, while endpoint imaging studies provide great insights into organ level bone adaptation responses, the between animal and loaded versus control limb variability make simulations of local surface-based adaptation responses challenging. [ABSTRACT FROM AUTHOR]

Purpose: We determined whether racial/ethnic differences in patient experiences with care influence timeliness and type of initial surgical breast cancer treatment for a sample of female Medicare cancer patients. Methods: We conducted a retrospective cohort study using the linked Epidemiology and End Results-Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) dataset. The outcomes were: (1) time-to-initial surgical treatment, and (2) type of treatment [breast conserving surgery (BCS) vs. mastectomy]. The indicators were reports of four types of patient experiences with care including doctor communication, getting care quickly, getting needed care, and getting needed Rx. Interaction terms in each multivariable logistic model examined if the associations varied by race/ethnicity. Results: Of the 2069 patients, 84.6% were White, 7.6% Black and 7.8% Hispanic. After adjusting for potential confounders, non-Hispanic Black patients who provided excellent reports of their ability to get needed prescriptions had lower odds of receiving surgery within 2-months of diagnosis, compared to NH-Whites who provided less than excellent reports (aOR: 0.29, 95% CI 0.09–0.98). There were no differences based on 1-month or 3-month thresholds. We found no other statistically significant effect of race/ethnicity. As to type of surgery, among NH Blacks, excellent reports of getting care quickly were associated with higher odds of receiving BCS versus mastectomy (aOR: 2.82, 95% CI 1.16–6.85) compared to NH Whites with less than excellent reports. We found no other statistically significant differences by race/ethnicity. Conclusion: Experiences with care are measurable and modifiable factors that can be used to assess and improve aspects of patient-centered care. Improvements in patient care experiences of older adults with cancer, particularly among minorities, may help to eliminate racial/ethnic disparities in timeliness and type of surgical treatment. [ABSTRACT FROM AUTHOR]

Trait social anxiety may predict differences in the cognitive control of emotional distraction when emotional face discrimination is required. This effect can be investigated using an emotional face flanker task. This study addresses an important research gap, as previous studies did not separate the effects of trait social interaction anxiety from the effects of trait social phobia upon emotional face flanker task performance. In this laboratory based behavioural experiment, the 87 participants (mean age 24.3) were university students or staff recruited via departmental adverts. We used an emotional (happy versus fearful) face flanker task, and assessed sub-clinical social anxiety with the SIAS/SPS. Elevated trait social phobia was related to an increased reaction time (RT) congruency effect, whereas trait social interaction anxiety was not. Elevated trait social interaction anxiety was related to a decreased happy face RT advantage for central target faces, but the effect of trait social phobia was very weak. Trait social interaction anxiety and trait social phobia may predict subtle differences when the cognitive control of reactions to emotional facial expressions is required. [ABSTRACT FROM AUTHOR]

Aspirin as a possible treatment of cancer has been of increasing interest for over 50 years, but the balance of the risks and benefits remains a point of contention. We summarise the valid published evidence 'for' and 'against' the use of aspirin as a cancer treatment and we present what we believe are relevant ethical implications. Reasons for aspirin include the benefits of aspirin taken by patients with cancer upon relevant biological cancer mechanisms. These explain the observed reductions in metastatic cancer and vascular complications in cancer patients. Meta-analyses of 118 observational studies of mortality in cancer patients give evidence consistent with reductions of about 20% in mortality associated with aspirin use. Reasons against aspirin use include increased risk of a gastrointestinal bleed though there appears to be no valid evidence that aspirin is responsible for fatal gastrointestinal bleeding. Few trials have been reported and there are inconsistencies in the results. In conclusion, given the relative safety and the favourable effects of aspirin, its use in cancer seems justified, and ethical implications of this imply that cancer patients should be informed of the present evidence and encouraged to raise the topic with their healthcare team. [ABSTRACT FROM AUTHOR]

Influenza virus infection alters the promoter DNA methylation of key immune response-related genes, including type-1 interferons and proinflammatory cytokines. However, less is known about the effect of the influenza vaccine on the epigenome. We utilized a targeted DNA methylation approach to study the longitudinal effects (day 0 pre-vaccination and day 28 post-vaccination) on influenza vaccination responses in peripheral blood mononuclear cells. We found that baseline, pre-vaccination methylation profiles are associated with pre-existing, protective serological immunity. Additionally, we identified 481 sites that were differentially methylated between baseline and day 28 post-vaccination. These were enriched for genes involved in the regulation of the RIG-I signaling pathway, an important regulator of viral responses. Our results suggest that DNA methylation changes to components of the RIG-I pathway are associated with vaccine effectiveness. Therefore, immunization strategies that target this pathway may improve serological responses to influenza vaccination. [ABSTRACT FROM AUTHOR]

Domestic pigs are a critical component of the food supply and one of the most commonly raised production animals. Pork consumption has driven the intensification of pig production expanding into environments conducive to increased emergence and spread of infectious diseases, including the spillover of pathogens into human populations. One of these emerging viruses, Reston virus (RESTV), is an enigma among the Orthoebolavirus genus in that its lack of human pathogenicity is in stark contrast to the high virulence associated with most other ebolaviruses. RESTV is, however, associated with outbreaks of highly lethal hemorrhagic disease in non-human primates (NHP), as well as poorly understood clinical manifestations of mixed virulence and lethality in naturally and experimentally infected domestic pigs. Our results show it is possible for RESTV derived from an NHP to infect domestic pigs resulting in a spectrum of disease, from asymptomatic to severe respiratory distress. Further, we report on the first experimental transmission of RESTV between infected pigs and a co-housed, naïve animal, as well as the first report of the successful use of group oral fluids for the detection of RESTV RNA and virus-specific IgA antibodies. [ABSTRACT FROM AUTHOR]

Although the recognition of Indigenous Peoples' contributions to climate governance by the international community has gradually increased, a rights-based approach in national climate action is still largely absent. This article analyses the recognition of Indigenous Peoples' rights in Nationally Determined Contributions (NDCs) under the Paris Agreement. We conducted a content analysis of all NDCs submitted between 2016 and May 2022. Through a five-pronged framework of sustainable self-determination, we assessed how the NDCs recognise: i. Indigenous Peoples as rights-holders; ii. Indigenous jurisdiction over land; iii. Indigenous knowledge systems; iv. Indigenous Peoples' right to full and effective participation in climate governance; and v. the legacy of colonialism. NDCs with references related to Indigenous Peoples are increasing. However, questions remain regarding their sincerity and commitment to implementation. States must therefore make more significant efforts to ensure that the NDCs take a rights-based approach and contribute to strengthening Indigenous Peoples' role and say in climate governance. [ABSTRACT FROM AUTHOR]

Recent advancements in tissue imaging techniques have facilitated the visualization and identification of various cell types within physiological and pathological contexts. Despite the emergence of cell-cell interaction studies, there is a lack of methods for evaluating individual spatial interactions. In this study, we introduce Ceograph, a cell spatial organization-based graph convolutional network designed to analyze cell spatial organization (for example,. the cell spatial distribution, morphology, proximity, and interactions) derived from pathology images. Ceograph identifies key cell spatial organization features by accurately predicting their influence on patient clinical outcomes. In patients with oral potentially malignant disorders, our model highlights reduced structural concordance and increased closeness in epithelial substrata as driving features for an elevated risk of malignant transformation. In lung cancer patients, Ceograph detects elongated tumor nuclei and diminished stroma-stroma closeness as biomarkers for insensitivity to EGFR tyrosine kinase inhibitors. With its potential to predict various clinical outcomes, Ceograph offers a deeper understanding of biological processes and supports the development of personalized therapeutic strategies. Cell spatial organization in tissue provides essential insights into diseases. Here, the authors show Ceograph, a graph convolutional network, for the analysis of pathology images to predict patient outcomes, highlighting cellular markers to guide personalized treatments and enhance biological understanding. [ABSTRACT FROM AUTHOR]

Although attention and early associative learning in preverbal children is predominantly driven by rapid eye-movements in response to moving visual stimuli and sounds/words (e.g., associating the word "bottle" with the object), the literature examining the role of visual attention and memory in ongoing vocabulary development across childhood is limited. Thus, this systematic review and meta-analysis examined the association between visual memory and vocabulary development, including moderators such as age and task selection, in neurotypical children aged 2-to-12 years, from the brain-based perspective of cognitive neuroscience. Visual memory tasks were classified according to the visual characteristics of the stimuli and the neural networks known to preferentially process such information, including consideration of the distinction between the ventral visual stream (processing more static visuo-perceptual details, such as form or colour) and the more dynamic dorsal visual stream (processing spatial temporal action-driven information). Final classifications included spatio-temporal span tasks, visuo-perceptual or spatial concurrent array tasks, and executive judgment tasks. Visuo-perceptual concurrent array tasks, reliant on ventral stream processing, were moderately associated with vocabulary, while tasks measuring spatio-temporal spans, associated with dorsal stream processing, and executive judgment tasks (central executive), showed only weak correlations with vocabulary. These findings have important implications for health professionals and researchers interested in language, as they advocate for the development of more targeted language learning interventions that include specific and relevant aspects of visual processing and memory, such as ventral stream visuo-perceptual details (i.e., shape or colour). [ABSTRACT FROM AUTHOR]

We investigated spaced retrieval and restudying in 3 preregistered, online experiments. In all experiments, participants studied 40 Swahili–English word pair translations during an initial study phase, restudied intact pairs or attempted to retrieve the English words to Swahili cues twice in three spaced practice sessions, and then completed a final cued-recall test. All 5 sessions were separated by 2 days. In Experiment 1, we manipulated the response format during retrieval (covert vs. overt) and the test list structure (blocked vs. intermixed covert/overt retrieval trials). A memory rating was required on all trials (retrieval: “Was your answer correct?”; restudy: “Would you have remembered the correct translation?”). Response format had no effect on recall, but surprisingly, final test performance for restudied items exceeded both the overt and covert retrieval conditions. In Experiment 2, we manipulated the requirement to make a memory rating. If a memory rating was required, final test restudy performance exceeded retrieval performance, replicating Experiment 1. However, the pattern was descriptively reversed if no rating was required. In Experiment 3, the memory rating was removed altogether, and we examined recall performance for items restudied versus retrieved once, twice, or thrice. Performance improved with practice, and retrieval performance exceeded restudy performance in all conditions. The reversal of the typical retrieval practice effect observed in Experiments 1 and 2 is discussed in terms of theories of reactivity of memory judgments. [ABSTRACT FROM AUTHOR]

Objectives: To test if the Community Complex Care Response Team (C3RT), a coordinated community response model, impacts the likelihood of abuse, neglect, and financial exploitation among at-risk community-dwelling older adults. Methods: One hundred forty-six participants were randomly assigned to receive either the C3RT intervention (n = 74) or the standard practice (n = 72). Cox regression analyses were used to test whether the intervention delayed incidents of EANF victimization measured by when adult protective services opened an investigation, when the police recorded a victimization, and when a hospital admission took place. Results: Assignment to the C3RT intervention program did not significantly delay incidents of EANF victimization indicator. Conclusions: This C3RT approach did not produce the desired outcomes, though the project demonstrates that it is ethical and feasible to implement an RCT to test an intervention with vulnerable populations. [ABSTRACT FROM AUTHOR]

300 M ultra-high-strength steel (UHSS) is widely used to produce landing gear components for aircraft. The conventional manufacturing route for these components involves extensive machining and significant material wastage. Here, the application of wire-based gas metal arc additive manufacturing to produce 300 M UHSS parts was investigated. In particular, the influence of torch shielding atmosphere on the process stability and material performance of 300 M UHSS was investigated. The shielding gases used for comparison are pure Ar, Ar with 2.5% CO2, Ar with 8% CO2, Ar with 20% CO2, and Ar with 2% CO2 and 38% He. It was found that the arc length decreased, the transfer mode changed from spray to droplet mode, and spattering became more severe as the CO2 proportion increased. Additionally, replacing Ar with He led to a broader arc core, and a slightly shorter arc length and maintained a spray transfer, which decreased spatter. The wall surface roughness followed the trend in spatter, becoming worse with the increasing CO2 proportion, and better with He addition. Adding CO2 and He in pure Ar significantly increased the bead and wall width. The microstructure and mechanical properties exhibited a strong location dependence in the as-built state, with fresh martensite and higher strength in the top region, and tempered martensite and better ductility in the reheated bulk. Generally, torch shielding gas composition appeared to have no significant effect on the microstructure evolution. This study provides a reference for the subsequent application of gas metal arc additive manufacturing to aircraft landing gear mass production to achieve a high deposition rate and process stability simultaneously. [ABSTRACT FROM AUTHOR]

Species occurrence data are foundational for research, conservation, and science communication, but the limited availability and accessibility of reliable data represents a major obstacle, particularly for insects, which face mounting pressures. We present BeeBDC, a new R package, and a global bee occurrence dataset to address this issue. We combined >18.3 million bee occurrence records from multiple public repositories (GBIF, SCAN, iDigBio, USGS, ALA) and smaller datasets, then standardised, flagged, deduplicated, and cleaned the data using the reproducible BeeBDC R-workflow. Specifically, we harmonised species names (following established global taxonomy), country names, and collection dates and, we added record-level flags for a series of potential quality issues. These data are provided in two formats, “cleaned” and “flagged-but-uncleaned”. The BeeBDC package with online documentation provides end users the ability to modify filtering parameters to address their research questions. By publishing reproducible R workflows and globally cleaned datasets, we can increase the accessibility and reliability of downstream analyses. This workflow can be implemented for other taxa to support research and conservation. [ABSTRACT FROM AUTHOR]

It is clear that there is an increased cardiovascular (CV) risk in rheumatoid arthritis (RA) as a result of systemic inflammation. Hand osteoarthritis (HOA) patients, also have an increased CV risk, but the causes are still debated. Our objective was to compare CV risk factors and risk scores between HOA and RA patients. Thirty-five HOA patients were matched by age (< 3 years) and sex to 35 RA patients in a case–control study. We compared their CV risk profiles and their risk of occurrence of CV events at 10 years using the risk equations SCORE1, SCORE2, and QRISK3. There was a significant increase in SCORE1, SCORE2, but not in QRISK3 in the RA group compared to the HOA group, provided that the multiplication coefficient for RA was applied. This increase was found to no longer be significant for SCORE1 when RA patients have low disease activity (DAS28 ≤ 3.2; n = 8). There was no difference between groups in the frequency of metabolic syndrome, blood pressure, abdominal circumference, body mass index, uricemia, triglyceridemia, HDL cholesterolemia, or pain intensity. Conversely, HOA patients had higher LDL cholesterol and fasting blood glucose levels, in the main analysis and in the subgroup of moderate/high RA activity patients (DAS28 > 3.2; n = 26). We found a higher CV risk in RA compared to HOA patients with moderate/high disease activity. The increased CV risk reported in OA remains to be confirmed in HOA, but these patients appear to have a pro-atherogenic lipid and glycemic profile. [ABSTRACT FROM AUTHOR]

Spatial variation in plant community composition is an important driver of variation in susceptibility to herbivores. In close proximity, certain neighbors can attract or repel herbivores to a focal plant ("associational effects"). Neighboring plants may also compete for resources, modifying their phenotype in ways that affect susceptibility to herbivores. To test whether and how competition contributes to associational effects, we manipulated the sharing of belowground resources among plant neighbors (spotted Joe Pye weed and common boneset) that serve as alternate hosts for an herbivorous beetle. In the field, the beetle Ophraella notata laid more eggs and inflicted more damage on plants of both species that were released from belowground competition with neighbors. Competition also weakened the effects of neighbor identity during field trials, reducing associational susceptibility. When beetles were forced to choose between the two host species in cage trials, competition again reduced beetle use of Joe Pye weed as a secondary host. To test the role of plant traits related to herbivore defense and nutrition, we quantified leaf protein, specific leaf area, and trichomes, and conducted behavioral assays on leaf disks. Beetles did not distinguish between Joe Pye weed treatments at the leaf disk level, and competition did not impact specific leaf area and protein. Trichome density was higher in both species in the preferred treatment. Overall, our results suggest that belowground interactions between plants may mediate the strength of associational effects, as secondary hosts become more attractive when released from competition with primary host plants. [ABSTRACT FROM AUTHOR]

Complex signalling between the apical ectodermal ridge (AER - a thickening of the distal epithelium) and the mesoderm controls limb patterning along the proximo-distal axis (humerus to digits). However, the essential in vivo requirement for AER-Fgf signalling makes it difficult to understand the exact roles that it fulfils. To overcome this barrier, we developed an amenable ex vivo chick wing tissue explant system that faithfully replicates in vivo parameters. Using inhibition experiments and RNA-sequencing, we identify a transient role for Fgfs in triggering the distal patterning phase. Fgfs are then dispensable for the maintenance of an intrinsic mesodermal transcriptome, which controls proliferation/differentiation timing and the duration of patterning. We also uncover additional roles for Fgf signalling in maintaining AER-related gene expression and in suppressing myogenesis. We describe a simple logic for limb patterning duration, which is potentially applicable to other systems, including the main body axis. The limb bud is patterned by crosstalk between the mesoderm and the overlying apical ectodermal ridge, but it has been difficult to determine the requirement for different ligands in this process. Here the authors use a chick wing explant system to show that fibroblast growth factors trigger a mesodermal programme that is key for timing limb bud patterning. [ABSTRACT FROM AUTHOR]

Protein translation (PT) declines with age in invertebrates, rodents, and humans. It has been assumed that elevated PT at young ages is beneficial to health and PT ends up dropping as a passive byproduct of aging. In Drosophila, we show that a transient elevation in PT during early-adulthood exerts long-lasting negative impacts on aging trajectories and proteostasis in later-life. Blocking the early-life PT elevation robustly improves life-/health-span and prevents age-related protein aggregation, whereas transiently inducing an early-life PT surge in long-lived fly strains abolishes their longevity/proteostasis benefits. The early-life PT elevation triggers proteostatic dysfunction, silences stress responses, and drives age-related functional decline via juvenile hormone-lipid transfer protein axis and germline signaling. Our findings suggest that PT is adaptively suppressed after early-adulthood, alleviating later-life proteostatic burden, slowing down age-related functional decline, and improving lifespan. Our work provides a theoretical framework for understanding how lifetime PT dynamics shape future aging trajectories. The transient elevation in protein translation during early-adulthood in Drosophila imposes long-lasting negative impacts on future aging trajectories by triggering proteostatic dysfunction at old ages. [ABSTRACT FROM AUTHOR]

Youth of immigrant origin vary across their families' migration history (e.g., country of heritage, reasons for migration, etc.) and in the communities in which they reside. As such, these youth are often faced with different cultural and immigrant stressors. Although prior research documented the detrimental impact of cultural and immigrant stressors, variable-centered approaches fail to account for the fact that these stressors often co-occur. Addressing this gap, the current study identified typologies of cultural stressors in Hispanic/Latino adolescents using latent profile analysis. Cultural stress profiles were derived using socio-political stress, language brokering, in-group identity threats, and within-group discrimination as indicators. The study was conducted in two sites (Los Angeles and Miami; total N = 306) during Spring and Summer 2020. A four-profile solution was identified: Low Cultural Stress (n = 94, 30.7%), Sociopolitical and Language Brokering Stress (n = 147, 48%), Sociopolitical and In-group Identity Threat Stress (n = 48, 15.7%), and Higher Stress (n = 17, 5.6%). Results indicate that profiles with stress were characterized by worse mental health symptoms, reporting higher means of depression, stress, and lower self-esteem, as well as by higher heritage cultural orientation compared to the low stress profile. Interventions designed to mitigate the deleterious effects of cultural stressors would benefit from adopting an individualized, tailored approach that addresses youth's stress profile membership. [ABSTRACT FROM AUTHOR]

Sepsis is a leading cause of mortality and early identification improves survival. With increasing digitalization of health care data automated sepsis prediction models hold promise to aid in prompt recognition. Most previous studies have focused on the intensive care unit (ICU) setting. Yet only a small proportion of sepsis develops in the ICU and there is an apparent clinical benefit to identify patients earlier in the disease trajectory. In this cohort of 82,852 hospital admissions and 8038 sepsis episodes classified according to the Sepsis-3 criteria, we demonstrate that a machine learned score can predict sepsis onset within 48 h using sparse routine electronic health record data outside the ICU. Our score was based on a causal probabilistic network model—SepsisFinder—which has similarities with clinical reasoning. A prediction was generated hourly on all admissions, providing a new variable was registered. Compared to the National Early Warning Score (NEWS2), which is an established method to identify sepsis, the SepsisFinder triggered earlier and had a higher area under receiver operating characteristic curve (AUROC) (0.950 vs. 0.872), as well as area under precision-recall curve (APR) (0.189 vs. 0.149). A machine learning comparator based on a gradient-boosting decision tree model had similar AUROC (0.949) and higher APR (0.239) than SepsisFinder but triggered later than both NEWS2 and SepsisFinder. The precision of SepsisFinder increased if screening was restricted to the earlier admission period and in episodes with bloodstream infection. Furthermore, the SepsisFinder signaled median 5.5 h prior to antibiotic administration. Identifying a high-risk population with this method could be used to tailor clinical interventions and improve patient care. [ABSTRACT FROM AUTHOR]

Purpose: Current decision-making in multilevel cervical fusion weighs the potential to protect adjacent levels and reduce reoperation risk by crossing the cervicothoracic junction (C7/T1) against increased operative time and risk of complication. Careful planning is required, and the planned distal and adjacent levels should be assessed for degenerative disc disease (DDD). This study assessed whether DDD at the cervicothoracic junction was associated with DDD, disc height, translational motion, or angular variation in the adjacent superior (C6/C7) or inferior (T1/T2) levels. Methods: This study retrospectively analyzed 93 cases with kinematic MRI. Cases were randomly selected from a database with inclusion criteria being no prior spine surgery and images having sufficient quality for analysis. DDD was assessed using Pfirrmann classification. Vertebral body bone marrow lesions were assessed using Modic changes. Disc height was measured at the mid-disc in neutral and extension. Translational motion and angular variation were calculated by assessing translational or angular motion segment integrity respectively in flexion and extension. Statistical associations were assessed with scatterplots and Kendall's tau. Results: DDD at C7/T1 was positively associated with DDD at C6/C7 (tau = 0.53, p < 0.01) and T1/T2 (tau = 0.58, p < 0.01), with greater disc height in neutral position at T1/T2 (tau = 0.22, p < 0.01), and with greater disc height in extended position at C7/T1 (tau = 0.17, p = 0.04) and at T1/T2 (tau = 0.21, p < 0.01). DDD at C7/T1 was negatively associated with angular variation at C6/C7 (tau = − 0.23, p < 0.01). No association was appreciated between DDD at C7/T1 and translational motion. Conclusion: The association of DDD at the cervicothoracic junction with DDD at the adjacent levels emphasizes the necessity for careful selection of the distal level in multilevel fusion in the distal cervical spine. [ABSTRACT FROM AUTHOR]

There is widespread concern that elder abuse and neglect (EAN) incidents increased during the onset of the COVID-19 pandemic due in part to increases in risk factors. Initial reports relying on administrative systems such as adult protective services records produced mixed results regarding whether or not there was a change in EAN incidents. Using data from an ongoing longitudinal study on EAN in dementia family caregiving that started before the pandemic, we assessed the hypothesis that the pandemic is related to a change in probability of EAN and EAN protective factors. Family caregivers to persons with dementia completed two waves of 21 daily diaries, 6-months apart, assessing their daily use of EAN behaviors. The first group (n = 32) completed their first wave before the pandemic and their second wave during the pandemic. The second group (n = 32) completed both waves during the pandemic. For this cohort, the generalized linear mixed logistic model results showed inconsistent associations between the onset of COVID-19 and the probability of a caregiver engaging in elder abuse or neglect behaviors. In terms of protective factors, the use of formal services was not significantly impacted by COVID-19; however, the likelihood of receiving informal support from family and friends increased significantly during the pandemic period. Dementia family caregivers were not likely impacted negatively by initial pandemic restrictions, such as shelter-in-place orders, as anticipated. These findings contribute to our understanding of how distal, disruptive processes may influence more proximal caregiver stresses and the likelihood of EAN. [ABSTRACT FROM AUTHOR]

This study investigates three westward propagating convective systems, associated with African easterly waves (AEW), which impacted Nigeria and subsequently migrated into the Atlantic Ocean. Convective variables and rainfall products were examined from National Oceanic and Atmospheric Administration National Center for Environmental Protection/Climate Prediction Center (NOAA NCEP/CPC) and ERA5 reanalysis. Two of the three storms were initiated during the early afternoon hours (between 12 and 13Z) and merged into a larger system during the late afternoon (around 15Z-19Z), consistent with previous studies that deep convective systems are most common in the late afternoon. It was observed that moderate–strong convective available potential energy (CAPE), between 1500 and 2000 J/kg, dominated the environment before and after initiation. One important finding is the presence of strong vertical wind shear northwest of the vicinity where all of the storms initiated. Strong moisture convergence was also observed before and during initiation of the three storms. During its widespread coverage over Nigeria, 3-h accumulated rainfall reached 60 mm for all the three storms, and the ice water content (IWC) of the storms was found to be significantly higher than the liquid water content for all of the three cases. The skew-T diagram indicated that the height of the three systems reached the tropopause and was consistent with the altitudes of the IWCs. Annually, during the Atlantic hurricane season, in July–September, westward propagating storms often resulted in heavy rainfall and associated floods, which frequently caused severe damages to properties and loss of lives in most West/Central African countries. [ABSTRACT FROM AUTHOR]

Advancements in ground- and space-based telescopes have resulted in an acute need for and improvement in the breadth and accuracy of the atomic data vital for the analysis of astronomical spectra. Many data, even for astrophysically important elements such as the iron group, have analyses dating back over 50 years, which are no longer suitable for the interpretation of modern, high-resolution astrophysical spectra. The Imperial College Spectroscopy group is addressing this need by measuring new atomic data and improving the accuracy of existing data using Fourier transform spectroscopy from the infrared to the vacuum ultraviolet. Analysis of these high-resolution spectra has led to new and improved atomic data for a wide range of astrophysically important elements. Reductions in uncertainties of transition wavelengths and energy levels are routinely over an order of magnitude and transition probabilities are measured to a few percent of uncertainty. Our work has increased both the quantity and quality of available atomic data. In this paper, we provide an update of our recent investigations and research plans. We also detail the improvements being made to our world-class laboratory to ensure we are able to meet the future data needs of the astrophysical community. [ABSTRACT FROM AUTHOR]

The 2030 Agenda envisages a world "in which democracy, good governance and the rule of law [...] are essential for sustainable development" (Transforming our world: The 2030 Agenda for sustainable development, 2015, paragraph 9). However, the extent to which democratic practices can help or hinder sustainable development remains contested. I show how the relationship between democracy and environmental sustainability can be illuminated by recent advances in research on policy coherence for sustainable development. I apply a framework developed by Shawoo et al., (2022), to illustrate how (in)coherence between these two objectives is driven by a mix of ideas, institutions and interests. This framework can, in turn, help to identify policy options for strengthening coherence between democratic and environmental aims, spanning pluralisation of integrative frames and discourses, inclusive institutional design and reforms that broaden the range of public interests included in decision-making while restraining undue influence of vested interests. [ABSTRACT FROM AUTHOR]

This article examines food security in the Sigatoka Valley, one of the most productive food regions in Fiji, in the context of recent socio-ecological challenges through a case study of Narewa village. Data were collected using semi-structured interviews (n = 25), a fixed question food insecurity experience survey (n = 25), and a free listing exercise about preferred and consumed foods (n = 24). Results revealed that while most households had access to sufficient food, the increased frequency and intensity of droughts, tropical cyclones, and flooding caused almost half to worry about meeting their future food needs. To date, a culture of sharing within the village has helped most households access food but this will likely be inadequate to meet future needs as climate change is projected to impact food production. Given that the foundation of food production in Narewa, like other villages in the valley, relies on the long-term viability of agricultural systems, better focus needs to be placed on the natural resources that form the backbone of these systems such as water availability, soil health, and slope stability and their resilience to anthropogenic and natural stressors. Efforts that focus on protecting and enhancing local ecosystems in light of expected future climate change, combined with greater attention on food storage and the use of resilient crops, and enhancing social cohesion and sharing networks are needed to avoid breaching tipping points in the food system. [ABSTRACT FROM AUTHOR]