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ABSTRACT Background This study aimed to determine the factors associated with feeling ashamed of disclosing HIV‐positive status among females who self‐reported to health facilities for HIV testing in Kenya. Method This study used the Kenya Demographic Health Survey data set for 2022. A total of 18,506 women aged 15–49 years were selected from the sample clusters; 13,815 had ever tested for HIV and 332 had positive results for HIV. The chi‐squared test was applied to determine the association between the selected variables of interest and the outcome variable. Furthermore, to identify the explanatory variables that were associated with the outcome variable of interest, logistic binary regression was performed. A p > 0.05 and all statistical analyses were conducted using Microsoft Excel (xlsx) and STATA15. Results The analysis included 332 women who had tested positive during the survey out of which 125(38%) women agreed to have felt ashamed to disclose their HIV+ status. Agreed to stigma (AOR = 1.92, 95% CI: 1.15, 3.22; p

Abstract Background and Aims Globally, millions of people suffer from road injuries, with Africa having the highest burden of road injury deaths. This public health problem has the potential to reduce labor productivity and hence hamper economic growth, especially on the African continent. This study, to the best of the authors' knowledge, therefore seeks to provide the first empirical evidence of the interaction or combined effect of road injuries and labor productivity on economic growth in African countries. Methods The study uses annual data on 45 African countries over the period, 2002 to 2019. The dynamic panel system generalized method of moments regression is used as the estimation technique. Results The findings show that the interaction of road injuries with labor productivity has a negative significant effect on economic growth in both the short‐run (coefficient: −1.96, p

Abstract Sodium–glucose cotransporter‐2 inhibitors (SGLT2is) reduce morbidity and mortality for heart failure (HF) patients and are recommended as cornerstones for their medical therapy. Utilization in clinical practice remains low for multiple reasons, one of which may be adverse events. We investigated the incidence of these events to see if they are associated with SGLT2i use. A systematic search was performed in databases, including PubMed, Embase, Cochrane Library, Clinicaltrials.gov, and WHO's International Clinical Trials Registry Platform. Relevant randomized controlled trial studies assessing the safety outcomes of SGLT2i in HF patients were included in this study. We conducted the common‐effect meta‐analysis to estimate the relative risk (RR) and 95% confidence interval (CI) of safety outcomes in SGLT2i compared with placebo. Eighteen studies were included in the meta‐analysis composed of 12 925 HF patients taking an SGLT2i and 12 747 taking a placebo. The meta‐analysis indicated that the all‐cause mortality and serious adverse events (SAEs) were lower in the SGLT2i group (RR, 0.91; 95% CI, 0.85–0.97; P = 0.005, I2 = 0%; and RR, 0.92; 95% CI, 0.90–0.95; P

Abstract Chronic thromboembolic pulmonary disease (CTEPD) is characterized by organized nonresolving thrombi in pulmonary arteries (PA). In CTEPD with pulmonary hypertension (PH), chronic thromboembolic PH (CTEPH), early wave reflection results in abnormalities of pulsatile afterload and augmented PA pressures. We hypothesized that exercise during right heart catheterization (RHC) would elicit more frequent elevations of pulsatile vascular afterload than resistive elevations in patients with CTEPD without PH. The interdependent physiology of pulmonary venous and PA hemodynamics was also evaluated. Consecutive patients with CTEPD without PH (resting mean PA pressure ≤20 mmHg) undergoing an exercise RHC were identified. Latent resistive and pulsatile abnormalities of pulmonary vascular afterload were defined as an exercise mean PA pressure/cardiac output >3 WU, and PA pulse pressure to PA wedge pressure (PA PP/PAWP) ratio >2.5, respectively. Forty‐five patients (29% female, 53 ± 14 years) with CTEPD without PH were analyzed. With exercise, 19 patients had no abnormalities (ExNOR), 26 patients had abnormalities (ExABN) of pulsatile (20), resistive (2), or both (4) elements of pulmonary vascular afterload. Exercise elicited elevations of pulsatile afterload (53%) more commonly than resistive afterload (13%) (p

Abstract Herbicide‐resistant waterhemp (Amaranthus tuberculatus [Moq.] J.D. Sauer) continues to threaten the productivity of many US crops. Thus, integrating non‐herbicidal tactics with herbicides to reduce weed seedbanks is gaining popularity. A field study was conducted near Logan, IA from fall 2021 to fall 2022 to evaluate the impacts of cereal rye (Secale cereale L.) cover crop, herbicides, and harvest weed seed destruction on the waterhemp seedbank inputs. The cereal rye cover crop reduced waterhemp seed production by 90% compared to treatments without the cereal rye cover crop, while herbicides did not significantly affect waterhemp seed production. Furthermore, 96% of waterhemp seeds that entered the combine at harvest were destroyed and seed destruction effectiveness was not affected by cereal rye cover crop, herbicide program, or combine speed. Thus, cover crops and weed seed destruction are effective tactics to minimize waterhemp seedbank inputs. Waterhemp seed retention and combine header losses of waterhemp seeds were evaluated at harvest. Waterhemp seed retention was not affected by the cereal rye cover crop or herbicide programs. Only 30% of waterhemp seeds remained on the plant at harvest; the likely causes of seed shattering were late harvest and windy conditions prior to harvest. Waterhemp seed shattering from the combine header averaged 2.6% and was not affected by cover crop, herbicide program, or combine speed. These results support the inclusion of non‐herbicidal control tactics to reduce herbicide‐resistant waterhemp seedbanks and suggest the need for future research to optimize weed seed destruction.

Abstract Storm disturbance and recovery of the peritidal benthic microbial ecosystem occurs as part of the natural climate regime in Shark Bay. However, tropical cyclone and winter storm frequency and intensity are known to be changing due to climate forcing. Presented here is an analysis of the biogeomorphic response of the benthic microbial ecosystem within the intertidal to upper subtidal zone and the beach face coquina deposits of Hamelin Pool, to the passage of Category 3 Severe Tropical Cyclone Olwyn (13 March 2015). Storm effects (initial response to 40 days post‐event) include: erosional sculpting of sediments, mats and structures; deposition and winnowing of sediments; accumulation of mucilaginous products into flocs, slurries and sludges; along with limited development of new coquina deposits in the beach face. Medium (15 months) term observations include: mat recovery and changes with transformation of mucilage deposits into new subtidal gelatinous mats, intertidal transitional mats and low‐elevation microbial structures. Observations suggest that this disturbance had both positive (the floc‐to‐mat biogeomorphic storm response) and negative feedbacks (enhanced bioturbation), which impact the development of stromatolite forming microbial mats and microbialite structures.

Abstract We present the outcomes of a program designed to engage primary school students with both Indigenous knowledge and biodiversity conservation, through the lens of “Totemic” species. The program provided resources for genuine engagement with Traditional Owners, and for the coordinating teachers to dedicate time to curriculum development and delivery. The material was embedded within a cross‐school core curriculum topic (biology), presenting both Indigenous and Western knowledge in parallel. Students' understanding of ecology and conservation increased significantly post‐program, as did their cultural awareness and appreciation of traditional knowledge. Care for the totemic species was also shown to increase and enthusiasm for this approach to teaching science was expressed by students. The co‐benefits of this program include creating habitat for threatened species, improvements in the health and wellbeing of students through engagement with biodiversity and the potential for ecosystem services such as cooling of the school grounds. Effective ways of embedding cultural awareness and Indigenous knowledge into the Australian curriculum are urgently needed and it is our hope that this program provides evidence of effective ways of embedding these knowledges moving forward.

Abstract Salinity regimes in coastal ecosystems are highly dynamic and driven by complex geomorphic and hydrological processes. Estuarine biota are generally adapted to salinity fluctuation, but are vulnerable to salinity extremes. Characterizing coastal salinity regime for ecological studies therefore requires representing extremes of salinity ranges at time scales relevant to ecology (e.g., daily, monthly, and seasonally). Here, we propose a framework for modeling coastal salinity with these overall goals: (1) quantify uncertainty in salinity associated with important terrestrial and oceanographic drivers, (2) examine time scales of salinity response to river streamflow events, and (3) predict salinity continuously over space at key time scales. Salinity is modeled as quantile surfaces related to river discharge, tidal dynamics, wind, and spatial location, applied to Suwannee Sound estuary, FL, USA, where salinity has been monitored spatially since 1981. Each quantile level is regressed independently, and together they comprise a distribution of salinity uncertainty across space, with upper and lower quantiles describing salinity extremes. Effects of physical drivers on salinity are compared through four base models with various combinations of tide and wind variables, each including spatial coordinates and a single streamflow metric (in cubic meters per second). Multiple time scales of streamflow are considered by taking means across various periods, from 1 to 12 days, and at various lagged intervals prior to salinity sample, totaling 144 streamflow metrics. We found that the Suwannee coastal salinity regime is dynamic at multiple time scales and varies nonlinearly across space from the river effluence outward. Salinity increases nonlinearly with decreasing river flow rates below 200 m3/s, most prominently in the lower quantiles of salinity (τ = 0.05–0.25). Wind appears to have a stronger influence on salinity than astronomic tides for this estuary. The regression approach developed here can be applied to any coastal system that has sufficient spatial and temporal monitoring coverage to capture multiple flood and drought events. It is implemented with a simple R routine, and is less computationally‐intensive than finite difference hydrodynamic modeling. The characterizations of salinity uncertainty developed in these analyses can be directly applied to future studies of fish and wildlife responses to changes in watershed management.

Abstract Objectives To describe the clinical presentation, investigations, management, and disease course in pediatric autoimmune limbic encephalitis (LE). Methods In this retrospective observational study, from the UK Childhood Neuroinflammatory Disease network, we identified children from six tertiary centers with LE

Abstract Introduction We report the case of a 65‐year‐old Coronavirus disease 2019 (COVID‐19) patient with pneumonia and subsequent end‐stage pulmonary failure who required 63 days of mechanical ventilation (MV) and 62 days of extracorporeal membrane oxygenation (ECMO). Methods On Day 45, a comprehensive interdisciplinary discussion on the best course of treatment resulted in the general consensus that his lungs would not recover. As such, he was evaluated and listed for a lung transplant. Results We performed a bilateral lung transplant, and the patient was weaned off ECMO and MV postoperatively. This is the first report of lung transplants in patients with COVID‐19 in Wuhan. Conclusions We suggest that a lung transplantation may be a viable treatment for patients with end‐stage pulmonary failure secondary to COVID‐19 in selected situations.

Abstract Peribronchiolar metaplasia (PBM) is a histological finding of uncertain significance commonly seen in interstitial lung disease (ILD). PBM is thought to be secondary to small airway injury from insults such as tobacco smoke and other environmental exposures. The term PBM‐ILD has been proposed for patients with ILD where PBM is the major histologic finding, however a lack of radiographic changes supportive of ILD in previously reported cases has limited recognition of the diagnosis. We present a rare case of welding‐associated ILD with clinical, radiographic, and histologic evidence consistent with the proposed definition of PBM‐ILD. We outline an approach to its consideration as a diagnosis based on our experience through multidisciplinary discussion.

Abstract The purpose of this study was to validate cardiac index (CI) measured noninvasively by four‐dimensional (4D) and two‐dimensional (2D) cardiovascular magnetic resonance (CMR) flows against the invasively measured CI by right heart catheterization (RHC) in patients with pulmonary hypertension (PH). Thirty patients with PH (mean age: 32 ± 10 years) were included. 4D and 2D flow measured CI within 24 h from RHC measured CI invasively. Qualitative analysis of 4D pulmonary flow (vortex presence and eccentricity of flow) was performed. All patients had helical right‐sided flow with vortex formation; the mean vortex diameter was 29 ± 7 mm, occupying 69% of the main pulmonary artery (MPA) lumen. MPA was dilated (42 ± 9 mm). Mean CI measured by 4D flow CMR was closer to mean CI measured invasively (indirect Fick method CI = 2.1 ± 0.8 L/min/m2 vs. PA 4D flow = 2.3 ± 0.7 L/min/m2 “bias 0.22 ± 0.25 L/min, p = 0.001,” and Ao 4D flow = 2.3 ± 0.7 L/min/m2 “bias 0.2 ± 0.28 L/min, p = 0.001”), while 2D flow had a higher mean CI (PA 2D flow = 2.5 ± 0.7 L/min/m2 “bias 0.45 ± 0.7 L/min, p = 0.001” and Ao 2D flow = 2.5 ± 0.8 L/min/m2 “bias 0.45 ± 0.67 L/min, p = 0.001”). The correlation coefficients among the different comparisons of CI showed: a low correlation between the 2D flow‐indirect Fick method (Ao r2 = 0.37, PA r2 = 0.32) and a high correlation between the 4D flow‐indirect Fick method (Ao r2 = 0.86, PA r2 = 0.89). There is an excellent agreement between CI measured by 4D flow and CI measured invasively. 4D flow, a noninvasive imaging technique, could accurately measure CI better than the conventional 2D flow in patients with PH.

Treatment options for chronic thromboembolic pulmonary hypertension (CTEPH) are rapidly expanding. The purpose of this study is to identify trends in CTEPH clinical trials and the publication of results. We performed a worldwide review of completed and ongoing clinical trials through searching the ClinicalTrials.gov database and the World Health Organization International Clinical Trials Registry Platform for “CTEPH” and related terms. Entries were classified as pharmaceutical/procedural interventions (Group 1), all other clinical trials (Group 2) and patient registries (Group 3). Trial characteristics and national affiliation were recorded. PubMed was searched for related publications. There were 117 clinical trials registry entries after removing duplicates and non‐target records. Group 1 comprised 29 pharmaceutical, 15 procedural, and four combined interventions starting in 2005, 2010, and 2016, respectively. Riociguat and balloon pulmonary angioplasty were the most frequent pharmaceutical and procedural interventions, respectively. The proportion of procedural trials increased over time from 0% of those in 2005–2009 to 29% in 2010–2014 and 54% in 2015–2020. There were 56 entries in Group 2 and 13 in Group 3. Japan was the most frequent national affiliation and the most frequent participating country, present in 28% of all trials. The proportion of entries with published results was highest with Group 3 (62%) and lowest with Group 1 (27%). Thirty percent of all publications occurred in 2020. In conclusion, CTEPH clinical trials are increasingly procedural based, with growth largely attributable to Japan and balloon pulmonary angioplasty. Most trials have not published, but results from balloon pulmonary angioplasty clinical trials are anticipated soon.

Abstract Manual wheelchair users place high stress on their shoulders. We describe a 69‐year‐old male who developed end‐stage shoulder osteoarthritis from chronic manual wheelchair (MW) use. Three prosthetic total shoulder replacements failed, reflecting his refusal to transition to an electric wheelchair. MW use must be avoided in some of these patients.

Abstract Background and Aim Open‐access (OA) colonoscopies are defined as those scheduled without a gastrointestinal (GI) office visit. Past research has not focused on split preparation use and patient perception within OA. We aim to identify differences in bowel preparation (BP) adequacy, adenoma detection rate (ADR), self‐reported compliance, and patient perception between OA and GI providers using split prep. Methods This was a cross‐sectional study using split BP for colonoscopies. Patients completed a survey, and demographics, BP adequacy, and ADR were recorded. BP compliance was self‐reported. Patients were asked three questions qualifying the BP instructions. Data were analyzed using chi square and Mann–Whitney tests by SPSS. Results BP adequacy was reported for 56 of 60 patients. Twenty‐one participants (38%) were scheduled on OA, and 35 participants (62%) were scheduled after a GI office visit. Adequate BP was more frequent in 86% (18/21) of OA patients compared to 60% (21/35) in the GI group (P = 0.043). OA patients reported better review and explanation of the BP instructions compared to GI patients. There was no statistical difference between the demographics of the OA and GI groups or self‐reported compliance and patient understanding of instructions. Conclusion OA scheduled colonoscopies were associated with more adequate BP. This could be explained by patients' self‐motivation or an explanation of the importance of completing BP. This study supports the use of OA procedures as a standard of care.

Abstract Background Congenital cataract is causing one‐third of blindness worldwide. Congenital cataract is heterogeneous in its inheritance patterns. The current study is aimed to explore the unknown genetic causes underlying congenital cataracts. Methods Blood samples from affected and normal individuals of n = 25 Pakistani families identified with congenital cataracts were collected. Genomic DNA was extracted and Sanger sequencing was performed to identify novel pathogenic variants in the FYCO1 (MIM#607182) gene. Later structural bioinformatics tools and molecular dynamics simulations were performed to analyze the impact of these variants on protein structure and function. Results Sanger sequencing resulted in the identification of a novel splice site mutation (NM_024513.3: c.3151‐29_3151‐7del) segregating in an autosomal recessive manner. This novel variant was confirmed to be absent in the n = 300 population controls. Further, bioinformatics tools revealed the formation of a mutant protein with a loss of the Znf domain. In addition, we also found a previously known (c.4127 T > C; p.Leu1376Pro) mutation in four families. We also report a novel heterozygous variant (c.3419G > A; p.Arg1140Gln) in another family. Conclusions In conclusion, we report a novel deletion (NM_024513.3: c.3151‐29_3151‐7del) in one family and a frequent homozygous missense mutation (c.4127 T > C; p.Leu1376Pro) in four Pakistani families. The current research highlights the importance of autophagy in lens development and maintaining its transparency.

Abstract Aims The aim of this study was to investigate the impact of digoxin use on the outcomes of patients with heart failure with reduced ejection fraction (HFrEF) and its possible interaction with atrial fibrillation or use of currently guideline‐recommended treatments in the real world in China. Methods and results Patients hospitalized with HFrEF from 45 hospitals participating in the China National Heart Failure Registration Study (CN‐HF) were enrolled to assess the all‐cause mortality, HF mortality, all‐cause re‐hospitalization, and HF re‐hospitalization associated with digoxin use. Eight hundred eighty‐two eligible HFrEF patients in the CN‐HF registry were included: 372 patients with digoxin and 510 patients without digoxin. Among them, 794 (90.0%) patients were followed up for the endpoint events, with a median follow‐up of 28.6 months. Kaplan–Meier survival analysis showed that the all‐cause mortality (P < 0.001) and all‐cause re‐hospitalization (P = 0.020) were significantly higher in digoxin group than non‐digoxin group, while HF mortality (P = 0.232) and HF re‐hospitalization (P = 0.098) were similar between the two groups. The adjusted Cox proportional‐hazards regression analysis demonstrated that digoxin use remained as an independent risk factor for increased all‐cause mortality [hazard ratio (HR) 1.76; 95% confidence interval (CI) 1.27–2.44; P = 0.001] and all‐cause re‐hospitalization (HR 1.27; 95% CI 1.03–1.57; P = 0.029) in HFrEF patients and the predictive value of digoxin for all‐cause mortality irrespective of rhythm or in combination with other guideline‐recommended therapies. Conclusions Digoxin use is independently associated with increased risk of all‐cause mortality and all‐cause re‐hospitalization in HFrEF patients.

Abstract Strong selection from herbicides has led to the rapid evolution of herbicide‐resistant weeds, greatly complicating weed management efforts worldwide. In particular, overreliance on glyphosate, the active ingredient in RoundUp®, has spurred the evolution of resistance to this herbicide in ≥40 species. Previously, we reported that Conyza canadensis (horseweed) has evolved extreme resistance to glyphosate, surviving at 40× the original 1× effective dosage. Here, we tested for underlying fitness effects of glyphosate resistance to better understand whether resistance could persist indefinitely in this self‐pollinating, annual weed. We sampled seeds from a single maternal plant (“biotype”) at each of 26 horseweed populations in Iowa, representing nine susceptible biotypes (S), eight with low‐level resistance (LR), and nine with extreme resistance (ER). In 2016 and 2017, we compared early growth rates and bolting dates of these biotypes in common garden experiments at two sites near Ames, Iowa. Nested ANOVAs showed that, as a group, ER biotypes attained similar or larger rosette size after 6 weeks compared to S or LR biotypes, which were similar to each other in size. Also, ER biotypes bolted 1–2 weeks earlier than S or LR biotypes. These fitness‐related traits also varied among biotypes within the same resistance category, and time to bolting was inversely correlated with rosette size across all biotypes. Disease symptoms affected 40% of all plants in 2016 and 78% in 2017, so we did not attempt to measure lifetime fecundity. In both years, the frequency of disease symptoms was greatest in S biotypes and similar in LR versus ER biotypes. Overall, our findings indicate there are no early growth penalty and possibly no lifetime fitness penalty associated with glyphosate resistance, including extremely strong resistance. We conclude that glyphosate resistance is likely to persist in horseweed populations, with or without continued selection pressure from exposure to glyphosate.

Endometrial cancer is the most commonly diagnosed gynaecological malignancy. Unfortunately, 15–20% of women demonstrate persistent or recurrent tumours that are refractory to current chemotherapies. We previously identified activating mutations in fibroblast growth factor receptor 2 (FGFR2) in 12% (stage I/II) to 17% (stage III/IV) endometrioid ECs and found that these mutations are associated with shorter progression‐free and cancer‐specific survival. Although FGFR inhibitors are undergoing clinical trials for treatment of several cancer types, little is known about the mechanism by which they induce cell death. We show that treatment with BGJ398, AZD4547 and PD173074 causes mitochondrial depolarization, cytochrome c release and impaired mitochondrial respiration in two FGFR2‐mutant EC cell lines (AN3CA and JHUEM2). Despite this mitochondrial dysfunction, we were unable to detect caspase activation following FGFR inhibition; in addition, the pan‐caspase inhibitor Z‐VAD‐FMK was unable to prevent cell death, suggesting that the cell death is caspase‐independent. Furthermore, while FGFR inhibition led to an increase in LC3 puncta, treatment with bafilomycin did not further increase lipidated LC3, suggesting that FGFR inhibition led to a block in autophagosome degradation. We confirmed that cell death is mitochondrial‐dependent as it can be blocked by overexpression of Bcl‐2 and/or Bcl‐XL. Importantly, we show that combining FGFR inhibitors with the BH3 mimetics ABT737/ABT263 markedly increased cell death in vitro and is more effective than BGJ398 alone in vivo, where it leads to marked tumour regression. This work may have implications for the design of clinical trials to treat a wide range of patients with FGFR‐dependent malignancies.

Abstract Purpose Axenfeld‐Rieger syndrome (ARS) is a rare autosomal dominant disorder that affects the anterior segment of the eye. The aim of this study was to examine the PITX2 gene to identify possible novel mutations in Pakistani and Mexican families affected by the ARS phenotype. Methods Three unrelated probands with a diagnosis of ARS were recruited for this study. Genomic DNA was isolated from the peripheral blood of the probands and their family members. Polymerase chain reaction and Sanger sequencing were used for the analysis of coding exons and the flanking intronic regions of the PITX2 gene. Bioinformatics tools and database (VarSome, Provean, and MutationTaster, SIFT, PolyPhen‐2, and HOPE) were evaluated to explore missense variants. Results We identified novel heterozygous variations in the PITX2 gene that segregated with the ARS phenotype within the families. The variant NM_153426.2(PITX2):c.226G > T or p.(Ala76Ser) and the mutation NM_153426.2(PITX2):c.455G > A or p.(Cys152Tyr) were identified in two Pakistani pedigrees, and the mutation NM_153426.2(PITX2):c.242_265del or p.(Lys81_Gln88del), segregated in a Mexican family. Conclusion Our study extends the spectrum of PITX2 mutations in individuals with ARS, enabling an improved diagnosis of this rare but serious syndrome.

Premise Pollen dispersal plays a critical role in gene flow of seed plants. Most often, pollen dispersal is measured using paternity assignment. However, this approach can be time‐consuming because it typically entails genotyping all pollen donors, receptors, and offspring at several molecular markers. Methods We developed a faster, simpler protocol to track paternity, using pollen receptors and grouped pollen donors that possess rare alleles. We tested this approach using wind‐pollinated Amaranthus tuberculatus and insect‐pollinated Solanum lycopersicum. After screening potential markers for rare alleles, we grew both species in experimental arrays under field conditions. Results All tested A. tuberculatus seeds and 97% of S. lycopersicum fruits could be assigned to the grouped pollen donors using each of two markers. From these results, we could infer paternity of untested offspring and assess pollen dispersal patterns in each array. Discussion By combining rare alleles and grouped pollen donors, we could assess pollen dispersal for both species and across all arrays after genotyping a small number of pollen donors and a representative subset of offspring. While directly applicable to A. tuberculatus and S. lycopersicum, this approach could be used in other species to assess pollen dispersal under field conditions.

Premise Environmentally controlled facilities, such as growth chambers, are essential tools for experimental research. Automated, low‐cost, remote‐monitoring hardware can greatly improve both reproducibility and maintenance. Methods and Results Using a Raspberry Pi computer, open‐source software, environmental sensors, and a camera, we developed Growth Monitor pi (GMpi), a cost‐effective system for monitoring growth chamber conditions. Coupled with our software, GMPi_Pack, our setup automates sensor readings, photography, and alerts when conditions fall out of range. Conclusions GMpi offers access to environmental data logging, improving reproducibility of experiments and reinforcing the stability of controlled environmental facilities. The device is also flexible and scalable, allowing researchers the ability to customize and expand GMpi for their own needs.

Background Clinical practice guideline (CPG) developers have yet to endorse a consistent and systematic approach for considering sex‐specific cardiovascular information in CPGs. This article describes an initiative led by the Canadian Cardiovascular Society to determine the feasibility and outcomes of a structured process for considering sex in a CPG for the management of ST‐segment–elevation myocardial infarction. Methods and Results A sex and gender champion was appointed to the guideline development committee. The feasibility of tailoring the CPG to sex was ascertained by recording (1) the male–female distribution of the study population, (2) the adequacy of sex‐specific representation in each study using the participation/prevalence ratio, and (3) whether data were disaggregated by sex. The outcome was to determine whether recommendations for CPGs based on an assessment of the evidence should differ by sex. In total, 175 studies were included. The mean percentage of female participants reported in the studies was 24.5% (SD: 6.6%; minimum: 0%; maximum: 51%). The mean participation/prevalence ratio was 0.62 (SD: 0.16; minimum: 0.00; maximum: 1.19). Eighteen (10.2%) studies disaggregated the data by sex. Based on the participation/prevalence ratio and the sex‐specific analyses presented, only 1 study provided adequate evidence to confidently inform the applicability of the CPG recommendations to male and female patients. Conclusions Implementing a systematic process for critically appraising sex‐specific evidence for CPGs was straightforward and feasible. Inadequate enrollment and reporting by sex hindered comprehensive sex‐specific assessment of the quality of evidence and strength of recommendations for a CPG on the management of ST‐segment–elevation myocardial infarction.