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Abstract Libraries of inherent optical properties (IOPs) of microplastics are sparse, yet they are essential for the development of optical techniques to detect and quantify microplastics in the ocean. In this study, we describe our results and technique for the measurement of the IOPs of microplastic suspensions generated from commonly utilized plastics. The measurements included angle‐resolved polarized light scattering, and spectral absorption and beam attenuation coefficients. We also performed ancillary characterization of particle properties, including size distribution, shape, and mass concentration of suspended matter. We observed several unique optical characteristics regarding absorption, scattering, and polarization properties compared with typical marine particle assemblages. We show that these results are useful for radiative transfer simulations as well as the potential development of novel plastic detection techniques from above‐ or in‐water optical measurements.

ABSTRACT Background and Aims An exploratory focus group study was conducted to better understand the needs of patients living with generalized myasthenia gravis (gMG). Methods US‐based adults with gMG and caregivers of patients with gMG participated in a Patient Engagement Research Council between August 2022 and January 2023. The study consisted of a 15‐min prework survey, followed by virtual focus groups facilitated using a semi‐structured interview guide. Data concepts were identified using conversational analysis and by direct observation. All transcripts were coded based on concepts using a qualitative research analysis program (MaxQDA). Results 16 participants (13 patients, three caregivers) were recruited. Participants reported impact on daily activities, fatigue, and psychosocial problems. Many participants experienced delayed diagnosis and difficulty accessing specialist care. Participants described multiple barriers related to their gMG, including barriers to treatment, access‐related issues, and communication disconnect between patients and healthcare professionals. Achieving stable disease was the most important goal. There was a preference for the autonomy of self‐administered medications at home versus infusions. Study insights led to recommendations to guide patient and healthcare professional education. Conclusion The study illustrates the need to improve access to specialist care, achieve earlier diagnosis, prioritize patients' preferences in disease management, and develop treatments that improve outcomes without additional burden. Patient or Public Contribution The data collected in this study was provided by the focus group participants, which included patients and caregivers of those with myasthenia gravis.

Background Diagnosis of hereditary amyloid transthyretin (hATTR) amyloidosis with cardiomyopathy is frequently delayed, in large part because of symptom overlap with other cardiovascular diseases and limited provider knowledge of this disease. The sponsored and provider referred hATTR Compass Genetic Testing Program (Ionis, Carlsbad, CA; Ambry Genetics, Aliso Viejo, CA) provided no‐cost genetic testing to adults with a family history or clinical suspicion of hATTR amyloidosis. This study aims to characterize patients with hATTR amyloidosis and increase awareness of genetic testing for hATTR. Methods and Results Patients were referred to the hATTR genetic testing program, and a cross‐sectional post hoc analysis was performed. A pathogenic TTR variant was identified in 1503 (6.6%) of 22 886 patients referred for genetic testing between June 2018 and March 2022. Patients were identified in all US states, 3 US territories, and Canada. Median age at testing was 63 years, and 44% were female. The p.V142I TTR variant was the most common (n=1263, 84.0%). Only 32% of patients with a pathogenic TTR variant reported a known family history; a lower percentage of Black individuals reported a known family history compared with other racial and ethnic groups. Black patients accounted for 23.7% of all patients referred and 81.9% of patients with the p.V142I variant. Conclusions This sponsored genetic testing program identified a large number of patients with a pathogenic TTR variant, notably, in geographic regions not previously reported, and demographic groups that are historically underrepresented in the literature.

ABSTRACT Comprehensive assessments of coastal biodiversity in complex coral communities are crucial but challenging, particularly under unfavorable conditions such as poor underwater visibility in urbanized and eutrophic environments. Here we aim to examine the scope of underwater diversity detection and community shifts across habitat transitions spanning different geographic regions in Hong Kong SAR, a highly urbanized coastal city with limited underwater visibility of 3.93 ± 1.25 m during the sampling period. We employ and compare two methods: 12S rRNA eDNA metabarcoding coupled with custom built reference database and simultaneous extensive underwater visual census (UVC) surveys. eDNA detected a higher species richness per site. Yet, each survey method featured a distinct species profile with associated trophic guilds, where 98 (32.3%) species found exclusively by UVC and 120 (39.6%) species detected only by eDNA. eDNA featured species from diverse habitats and evolutionary distances, including cryptic and large mobile fishes, offering enhanced prediction on local ecosystem functions. eDNA also recorded 90 putative species that had never been recorded in additional seven yearlong UVC dataset, with seven prospective new occurrence records to the territorial waters. UVC on the other hand was more efficient in documenting reef‐associated species. Both methods captured similar patterns of community spatial structure along the habitat transitions while only eDNA detected more large fish species in offshore compared to sheltered inshore environments, This may suggest inshore overfishing and incapability of UVC in surveying large mobile species in turbid environments. Considering the discrepancies between two methods, we highlight the importance of complementing both UVC and eDNA metabarcoding survey for a complete overview of local biodiversity under unfavored underwater conditions in an urbanized seascape.

Abstract Course‐based undergraduate research experiences (CUREs) can be a powerful tool in broadening participation in undergraduate research. In this paper, we review the benefits of and barriers to undergraduate research experiences and explore how CUREs can mitigate some of those issues. As a part of the NSF‐supported Biological Collections in Ecology and Evolution Network (BCEENET) activities, a series of network meetings produced a set of recommendations to increase the accessibility of CUREs for all students at all institution types. We use BCEENET CUREs that focus on digitized natural history collections data to illustrate how leveraging adaptable open educational resources that use freely available data and analysis tools can increase accessibility of undergraduate research. We also discuss how inclusive networks of educators and research collaborators can support broadening CURE implementation.

Abstract Objective The COVID‐19 pandemic required unprecedented changes to emergency medical services (EMS) educational frameworks in the United States. It is unclear if pandemic‐related changes impacted paramedic educational outcomes. We aimed to evaluate curricular and performance changes resulting from the initial COVID‐19 pandemic on paramedic educational programs. Methods We performed a retrospective cross‐sectional evaluation of paramedic educational programs in 2019 and 2020 using the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions annual reports. These reports contain detailed program components and measures of program success. We included programs reporting at least one graduate in the study period. Descriptive statistics (proportions [%], median [interquartile range, IQR]) were calculated for paramedic program characteristics in 2019 and 2020, as well as pandemic specific curriculum changes. Wilcoxon rank‐sum and Fisher's exact tests were used to evaluate differences in characteristics by year. Results The number of paramedic educational programs in our population decreased from 640 programs in 2019 to 612 in 2020, with a statistically significant decrease in clinical hours (2019: 219 [IQR 168‒272]; 2020: 200.5 [IQR 157‒261]). There was no difference in first or third‐attempt certification examination success between years. Temporary shutdown was experienced in 34% of programs (duration: 3 weeks [2‒7]) and 72% of required curricular changes. Curricular changes commonly included decreased in‐person education (86%), traditional classroom lectures (78%), number of clinical sites (78%), and increased online didactic education (92%). Only 20% of programs decreased laboratory simulation or total training hours. Conclusion During the pandemic, paramedic educational programs changed educational delivery with no observed differences on overall program performance. Identifying key curricular changes and best practices for implementation may be necessary to better optimize future educational delivery.

Abstract Background and Aims Due to the high symptom and treatment burden in myasthenia gravis (MG), understanding patient and care partner perspectives and preferences is crucial. Methods This study used voice analysis and virtual focus groups to understand patient and care partner experiences with MG‐related symptoms, treatments, and preferences. The voice analysis via social media listening used artificial intelligence‐powered tools to gather and structure public digital conversations on MG. Focus groups included people living with MG and care partners who completed a questionnaire and participated in a 1‐h virtual session facilitated using a semi‐structured interview guide. Qualitative data were aggregated, transcribed, and thematically analyzed. Results The voice analysis examined 11,554 posts from 8321 individuals, discussing MG symptoms, treatments, and burden. Of 7563 symptom‐related posts, 5902 (78%) conveyed negative, 1427 (19%) neutral, and 234 (3%) positive sentiment. The most frequently mentioned symptoms were categorized as dysarthria, muscle weakness, and dysphagia. MG treatment sentiment analysis identified 6667 posts (67%) as neutral, 2887 (29%) as negative, and 350 (4%) as positive. For the focus groups, 15 individuals (12 patients and 3 care partners) completed the questionnaire and 14 participated in the virtual focus group sessions. The 15 participants who completed the questionnaire prioritized treatment convenience, symptom control for improved quality of life, and preventing potential MG crises in their current treatment. New treatment expectations included increased effectiveness, less frequent dosing, faster onset, and fewer side effects. Participants were also receptive to wearable medication delivery systems placed on the body and valued direct involvement in treatment decisions. Conclusion Patients and care partners are often negatively impacted by MG symptoms and value convenient and fast‐acting treatments that control symptoms with minimal side effects. Considering patient preferences may help optimize treatment decisions and improve patients' overall well‐being and satisfaction in their care.

Background Sleep apnea (SA) has been linked to an increased risk of dementia in numerous observational studies; whether this is driven by neurodegenerative, vascular, or other mechanisms is not clear. We sought to examine the bidirectional causal relationships between SA, Alzheimer disease (AD), coronary artery disease (CAD), and ischemic stroke using Mendelian randomization. Methods and Results Using summary statistics from 4 recent, large genome‐wide association studies of SA (n=523 366), AD (n=94 437), CAD (n=1 165 690), and stroke (n=1 308 460), we conducted bidirectional 2‐sample Mendelian randomization analyses. Our primary analytic method was fixed‐effects inverse variance–weighted (IVW) Mendelian randomization; diagnostics tests and sensitivity analyses were conducted to verify the robustness of the results. We identified a significant causal effect of SA on the risk of CAD (odds ratio [ORIVW]=1.35 per log‐odds increase in SA liability [95% CI=1.25–1.47]) and stroke (ORIVW=1.13 [95% CI=1.01–1.25]). These associations were somewhat attenuated after excluding single‐nucleotide polymorphisms associated with body mass index (ORIVW=1.26 [95% CI=1.15–1.39] for CAD risk; ORIVW=1.08 [95% CI=0.96–1.22] for stroke risk). SA was not causally associated with a higher risk of AD (ORIVW=1.14 [95% CI=0.91–1.43]). We did not find causal effects of AD, CAD, or stroke on risk of SA. Conclusions These results suggest that SA increased the risk of CAD, and the identified causal association with stroke risk may be confounded by body mass index. Moreover, no causal effect of SA on AD risk was found. Future studies are warranted to investigate cardiovascular pathways between sleep disorders, including SA, and dementia.

Abstract Objectives The aim of this study is to evaluate the impact of radiologist and urologist variability on detection of prostate cancer (PCa) and clinically significant prostate cancer (csPCa) with magnetic resonance imaging (MRI)‐transrectal ultrasound (TRUS) fusion prostate biopsies. Patients and methods The Prospective Loyola University MRI (PLUM) Prostate Biopsy Cohort (January 2015 to December 2020) was used to identify men receiving their first MRI and MRI/TRUS fusion biopsy for suspected PCa. Clinical, MRI and biopsy data were stratified by radiologist and urologist to evaluate variation in Prostate Imaging‐Reporting and Data System (PI‐RADS) grading, lesion number and cancer detection. Multivariable logistic regression (MVR) models and area under the curve (AUC) comparisons assessed the relative impact of individual radiologists and urologists. Results A total of 865 patients (469 biopsy‐naïve) were included across 5 urologists and 10 radiologists. Radiologists varied with grading 15.4% to 44.8% of patients with MRI lesions as PI‐RADS 3. PCa detection varied significantly by radiologist, from 34.5% to 66.7% (p = 0.003) for PCa and 17.2% to 50% (p = 0.001) for csPCa. Urologists' PCa diagnosis rates varied between 29.2% and 55.8% (p = 0.013) and between 24.6% and 39.8% (p = 0.36) for csPCa. After adjustment for case‐mix on MVR, a fourfold to fivefold difference in PCa detection was observed between the highest‐performing and lowest‐performing radiologist (OR 0.22, 95%CI 0.10–0.47, p

Abstract Antibodies to programmed cell death protein 1 (anti‐PD‐1) have become a promising immunotherapy for triple negative breast cancer (TNBC), blocking PD‐L1 signaling from pro‐tumor cells through T cell PD‐1 receptor binding. Nevertheless, only 10%–20% of PD‐L1+ metastatic TNBC patients who meet criteria benefit from immune checkpoint blockade (ICB), and biomarkers to predict patient response have been elusive. We have previously developed an immunological niche, consisting of a microporous implant in the subcutaneous space, that supports tissue formation whose immune composition is consistent with that within vital organs. Herein, we investigated dynamic gene expression within this immunological niche to provide biomarkers of response to anti‐PD‐1. In a 4T1 model of metastatic TNBC, we observed sensitivity and resistance to anti‐PD‐1 based on primary tumor growth and survival. The niche was biopsied before, during, and after anti‐PD‐1 therapy, and analyzed for cell types and gene expression indicative of treatment refractivity. Myeloid cell‐to‐lymphocyte ratios were altered between ICB‐sensitivity and resistance. Longitudinal analysis of gene expression implicated dynamic myeloid cell function that stratified sensitivity from resistance. A niche‐derived gene signature predicted sensitivity or resistance prior to therapy. Analysis of the niche to monitor immunotherapy response presents a new opportunity to personalize care and investigate mechanisms underlying treatment resistance. Summary: A remote implant identified biomarkers that predict anti‐PD‐1 response before therapy, providing a unique tool to understand heterologous immunotherapy resistance in triple negative breast cancer.

Abstract Background High‐income countries offer social assistance (welfare) programs to help alleviate poverty for people with little or no income. These programs have become increasingly conditional and stringent in recent decades based on the premise that transitioning people from government support to paid work will improve their circumstances. However, many people end up with low‐paying and precarious jobs that may cause more poverty because they lose benefits such as housing subsidies and health and dental insurance, while incurring job‐related expenses. Conditional assistance programs are also expensive to administer and cause stigma. A guaranteed basic income (GBI) has been proposed as a more effective approach for alleviating poverty, and several experiments have been conducted in high‐income countries to investigate whether GBI leads to improved outcomes compared to existing social programs. Objectives The aim of this review was to conduct a synthesis of quantitative evidence on GBI interventions in high‐income countries, to compare the effectiveness of various types of GBI versus “usual care” (including existing social assistance programs) in improving poverty‐related outcomes. Search Methods Searches of 16 academic databases were conducted in May 2022, using both keywords and database‐specific controlled vocabulary, without limits or restrictions on language or date. Sources of gray literature (conference, governmental, and institutional websites) were searched in September 2022. We also searched reference lists of review articles, citations of included articles, and tables of contents of relevant journals in September 2022. Hand searching for recent publications was conducted until December 2022. Selection Criteria We included all quantitative study designs except cross‐sectional (at one timepoint), with or without control groups. We included studies in high income countries with any population and with interventions meeting our criteria for GBI: unconditional, with regular payments in cash (not in‐kind) that were fixed or predictable in amount. Although two primary outcomes of interest were selected a priori (food insecurity, and poverty level assessed using official, national, or international measures), we did not screen studies on the basis of reported outcomes because it was not possible to define all potentially relevant poverty‐related outcomes in advance. Data Collection and Analysis We followed the Campbell Collaboration conduct and reporting guidelines to ensure a rigorous methodology. The risk of bias was assessed across seven domains: confounding, selection, attrition, motivation, implementation, measurement, and analysis/reporting. We conducted meta‐analyses where results could be combined; otherwise, we presented the results in tables. We reported effect estimates as standard mean differences (SMDs) if the included studies reported them or provided sufficient data for us to calculate them. To compare the effects of different types of interventions, we developed a GBI typology based on the characteristics of experimental interventions as well as theoretical conceptualizations of GBI. Eligible poverty‐related outcomes were classified into categories and sub‐categories, to facilitate the synthesis of the individual findings. Because most of the included studies analyzed experiments conducted by other researchers, it was necessary to divide our analysis according to the “experiment” stage (i.e., design, recruitment, intervention, data collection) and the “study” stage (data analysis and reporting of results). Main Results Our searches yielded 24,476 records from databases and 80 from other sources. After screening by title and abstract, the full texts of 294 potentially eligible articles were retrieved and screened, resulting in 27 included studies on 10 experiments. Eight of the experiments were RCTs, one included both an RCT site and a “saturation” site, and one used a repeated cross‐sectional design. The duration ranged from one to 5 years. The control groups in all 10 experiments received “usual care” (i.e., no GBI intervention). The total number of participants was unknown because some of the studies did not report exact sample sizes. Of the studies that did, the smallest had 138 participants and the largest had 8019. The risk of bias assessments found “some concerns” for at least one domain in all 27 studies and “high risk” for at least one domain in 25 studies. The risk of bias was assessed as high in 21 studies due to attrition and in 22 studies due to analysis and reporting bias. To compare the interventions, we developed a classification framework of five GBI types, four of which were implemented in the experiments, and one that is used in new experiments now underway. The included studies reported 176 poverty‐related outcomes, including one pre‐defined primary outcome: food insecurity. The second primary outcome (poverty level assessed using official, national, or international measures) was not reported in any of the included studies. We classified the reported outcomes into seven categories: food insecurity (as a category), economic/material, physical health, psychological/mental health, social, educational, and individual choice/agency. Food insecurity was reported in two studies, both showing improvements (SMD = −0.57, 95% CI: −0.65 to −0.49, and SMD = −0.41, 95% CI: −0.57 to −0.26) which were not pooled because of different study designs. We conducted meta‐analyses on four secondary outcomes that were reported in more than one study: subjective financial well‐being, self‐rated overall physical health, self‐rated life satisfaction, and self‐rated mental distress. Improvements were reported, except for overall physical health or if the intervention was similar to existing social assistance. The results for the remaining 170 outcomes, each reported in only one study, were summarized in tables by category and subcategory. Adverse effects were reported in some studies, but only for specific subgroups of participants, and not consistently, so these results may have been due to chance. Authors' Conclusions The results of the included studies were difficult to synthesize because of the heterogeneity in the reported outcomes. This was due in part to poverty being multidimensional, so outcomes covered various aspects of life (economic, social, psychological, educational, agency, mental and physical health). Evidence from future studies would be easier to assess if outcomes were measured using more common, validated instruments. Based on our analysis of the included studies, a supplemental type of GBI (provided along with existing programs) may be effective in alleviating poverty‐related outcomes. This approach may also be safer than a wholesale reform of existing social assistance approaches, which could have unintended consequences.

Key Clinical Message Nuclear matrix protein (NXP‐2) positive amyopathic dermatomyositis (DM) may present without classic symptoms like muscle weakness, dysphagia, and edema, and mimic conditions like cutaneous lupus. Given DM's association with malignancy and interstitial lung disease, prompt and accurate diagnosis is important. Testing for myositis‐specific antibodies aids diagnosis in ambiguous cases.

Abstract The small subunit (SSU) ribosomal RNA (rRNA) is the most commonly used marker for the identification of microbial taxa, but its full‐length reconstruction from high‐throughput sequencing (HTS) data remains challenging. Metagenomics and total RNA sequencing (total RNA‐Seq) are target‐PCR‐free HTS methods that are used to characterize microbial communities and simultaneously reconstruct SSU rRNA sequences. However, more testing is required to determine and improve their effectiveness. We processed metagenomics and total RNA‐Seq data retrieved from a commercially available mock microbial community and an aquarium sample using 112 combinations of data processing tools. We determined the SSU rRNA reconstruction completeness of both sequencing methods for both samples and analysed the impact of data processing tools on SSU rRNA completeness. In contrast to metagenomics, total RNA‐Seq allowed for the complete or near‐complete reconstruction of all mock community SSU rRNA sequences and generated up to 438 SSU rRNA sequences with ≥80% completeness from the aquarium sample using only 1/5 of an Illumina MiSeq run. SSU rRNA completeness of metagenomics significantly correlated with the genome size of mock community species. Data processing tools impacted SSU rRNA completeness, in particular the utilized assemblers. These results are promising for the high‐throughput reconstruction of novel full‐length SSU rRNA sequences and could advance the simultaneous application of multiple ‐omics approaches in routine environmental assessments to allow for more holistic assessments of ecosystems.

Abstract Background COVID‐19 infection delays therapy and in‐person evaluation for oncology patients, but clinic clearance criteria are not clearly defined. Methods We conducted a retrospective review of oncology patients with COVID‐19 at a tertiary care center during the Delta and Omicron waves and compared clearance strategies. Results Median clearance by two consecutive negative tests was 32.0 days (Interquartile Range [IQR] 22.0–42.5, n = 153) and was prolonged in hematologic malignancy versus solid tumors (35.0 days for hematologic malignancy, 27.5 days for solid tumors, p = 0.01) and in patients receiving B‐cell depletion versus other therapies. Median clearance by single negative test was reduced to 23.0 days (IQR 16.0–33.0), with recurrent positive rate 25.4% in hematologic malignancy versus 10.6% in solid tumors (p = 0.02). Clearance by a predefined waiting period required 41 days until an 80% negative rate. Conclusions COVID‐19 clearance remains prolonged in oncology patients. Single‐negative test clearance can balance delays in care with risk of infection in patients with solid tumors.

Abstract Electrowetting on dielectric (EWOD) allows rapid movement of liquid droplets on a smooth surface, with applications ranging from lab‐on‐chip devices to micro‐actuators. The in‐plane force on a droplet is a key indicator of EWOD performance. This force has been extensively modeled but few direct experimental measurements are reported. We study the EWOD force on a droplet using two setups that allow, for the first time, the simultaneous measurement of force and contact angle, while imaging the droplet shape at 6000 frames/s. For several liquids and surfaces, we observe that the force saturates at a voltage of approximately 150 V. Application of voltages of up 2 kV, that is, 10 times higher than is typical, does not significantly increase forces beyond the saturation point. However, we observe that the transient dynamics, localized at the front contact line, do not show saturation with voltage. At the higher voltages, the initial front contact line speed continues to increase, the front contact angle temporarily becomes near zero, creating a thin liquid film, and capillary waves form at the liquid–air interface. When the localized EWOD forces at the contact line exceed the capillary forces, projectile droplets form. Increasing surface tension allows for higher droplet forces, which we demonstrate with mercury.

Abstract Nucleation of H2O vapor bubbles in magma requires surpassing a chemical supersaturation threshold via decompression. The threshold is minimized in the presence of a nucleation substrate (heterogeneous nucleation, 100 MPa). The existence of explosively erupted aphyric rhyolite magma staged from shallow (

Abstract We document the presence, composition, and number density (TND) of titanomagnetite nanolites and ultra‐nanolites in aphyric rhyolitic pumice, obsidian, and vesicular obsidian from the 1060 CE Glass Mountain volcanic eruption of Medicine Lake Volcano, California, using magnetic methods. Curie temperatures indicate compositions of Fe2.40Ti0.60O4 to Fe3O4. Rock‐magnetic parameters sensitive to domain state, which is dependent on grain volume, indicate a range of particle sizes spanning superparamagnetic (10 μm) particles. Cylindrical cores drilled from the centers of individual pumice clasts display anisotropy of magnetic susceptibility with prolate fabrics, with the highest degree of anisotropy coinciding with the highest vesicularity. Fabrics within a pumice clast require particle alignment within a fluid, and are interpreted to result from the upward transport of magma driven by vesiculation, ensuing bubble growth, and shearing in the conduit. Titanomagnetite number density (TND) is calculated from titanomagnetite volume fraction, which is determined from ferromagnetic susceptibility. TND estimates for monospecific assemblages of 1,000 nm–10 nm cubes predict 1012 to 1020 m−3 of solid material, respectively. TND estimates derived using a power law distribution of grain sizes predict 1018 to 1019 m−3. These ranges agree well with TND determinations of 1018 to 1020 m−3 made by McCartney et al. (2024), and are several orders of magnitude larger than the number density of bubbles in these materials. These observations are consistent with the hypothesis that titanomagnetite crystals already existed in extremely high number‐abundance at the time of magma ascent and bubble nucleation.

Abstract While the utility of environmental DNA (eDNA) metabarcoding surveys for biodiversity monitoring continues to be demonstrated, the spatial and temporal variability of eDNA, and thus the limits of the differentiability of an eDNA signal, remains under‐characterized. In this study, we collected eDNA samples from distinct micro‐habitats (~40 m apart) in a rocky intertidal ecosystem over their exposure period in a tidal cycle. During this period, the micro‐habitats transitioned from being interconnected, to physically isolated, to interconnected again. Using a well‐established eukaryotic (cytochrome oxidase subunit I) metabarcoding assay, we detected 415 species across 28 phyla. Across a variety of univariate and multivariate analyses, using exclusively taxonomically assigned data as well as all detected amplicon sequence variants (ASVs), we identified unique eDNA signals from the different micro‐habitats sampled. This differentiability paralleled expected ecological gradients and increased as the sites became more physically disconnected. Our results demonstrate that eDNA biomonitoring can differentiate micro‐habitats in the rocky intertidal only 40 m apart, that these differences reflect known ecology in the area, and that physical connectivity informs the degree of differentiation possible. These findings showcase the potential power of eDNA biomonitoring to increase the spatial and temporal resolution of marine biodiversity data, aiding research, conservation, and management efforts.

Abstract Numerous biological systems contain vesicle‐like biomolecular compartments without membranes, which contribute to diverse functions including gene regulation, stress response, signaling, and skin barrier formation. Coacervation, as a form of liquid–liquid phase separation (LLPS), is recognized as a representative precursor to the formation and assembly of membrane‐less vesicle‐like structures, although their formation mechanism remains unclear. In this study, a coacervation‐driven membrane‐less vesicle‐like structure is constructed using two proteins, GG1234 (an anionic intrinsically disordered protein) and bhBMP‐2 (a bioengineered human bone morphogenetic protein 2). GG1234 formed both simple coacervates by itself and complex coacervates with the relatively cationic bhBMP‐2 under acidic conditions. Upon addition of dissolved bhBMP‐2 to the simple coacervates of GG1234, a phase transition from spherical simple coacervates to vesicular condensates occurred via the interactions between GG1234 and bhBMP‐2 on the surface of the highly viscoelastic GG1234 simple coacervates. Furthermore, the shell structure in the outer region of the GG1234/bhBMP‐2 vesicular condensates exhibited gel‐like properties, leading to the formation of multiphasic vesicle‐like compartments. A potential mechanism is proposed for the formation of the membrane‐less GG1234/bhBMP‐2 vesicle‐like compartments. This study provides a dynamic process underlying the formation of biomolecular multiphasic condensates, thereby enhancing the understanding of these biomolecular structures.

Abstract Background People with Parkinson's disease (PD) do not always access specialist outpatient services in a timely manner in Ireland. The perspectives of people living with PD, relating to service access, are largely absent in the existing literature. Aim To explore experiences of PD service access for people living with PD, using a qualitative approach. Methods Purposive maximum variation sampling was used. Semi‐structured telephone interviews were conducted with 25 service users, including people with PD (n = 22) and supporting carers (n = 3). Informed consent was obtained from all participants. Interviews ranged in duration from 30 to 90 min. Data were managed in NVivo 12 and interpreted inductively using thematic analysis. The researchers were reflexive throughout the research process. The Consolidated Criteria for Reporting Qualitative Research checklist was employed to maximise transparency. Results The findings highlight several key barriers to and facilitators of equitable and timely service access. Three key themes were identified comprising experiences of PD service access including ‘geographical inequity’, ‘discriminatory practices’, and ‘public and private system deficits’. Together, these themes illustrate how a two‐tiered and under‐resourced health system lacks capacity, in terms of infrastructure and workforce, to meet PD needs for both public and private patients in Ireland. Conclusions These findings point to problems for PD care, relating to (i) how the health system is structured, (ii) the under‐provision and under‐resourcing of specialist outpatient PD services, including medical, nursing, and multidisciplinary posts, and (iii) insufficient PD awareness education and training across health settings. The findings also show that telemedicine can provide opportunities for making access to certain aspects of PD care more flexible and equitable, but the feasibility and acceptability of technology‐enabled care must be assessed on an individual basis. Implications for policy, practice and research are discussed. Patient or Public Contribution The design and conduct of this study were supported by an expert advisory group (EAG) of 10 co‐researchers living with PD. The EAG reviewed the interview schedule and the protocol for this study and provided detailed feedback from their perspective, to improve the methods, including the interview approach. The group also reviewed the findings of the study and contributed their insights on the meaning of the findings, which fed into this paper.

Abstract Metastatic breast cancer is often not diagnosed until secondary tumors have become macroscopically visible and millions of tumor cells have invaded distant tissues. Yet, metastasis is initiated by a cascade of events leading to formation of the pre‐metastatic niche, which can precede tumor formation by a matter of years. We aimed to distinguish the potential for metastatic disease from nonmetastatic disease at early times in triple‐negative breast cancer using sister cell lines 4T1 (metastatic), 4T07 (invasive, nonmetastatic), and 67NR (nonmetastatic). We used a porous, polycaprolactone scaffold, that serves as an engineered metastatic niche, to identify metastatic disease through the characteristics of the microenvironment. Analysis of the immune cell composition at the scaffold was able to distinguish noninvasive 67NR tumor‐bearing mice from 4T07 and 4T1 tumor‐bearing mice but could not delineate metastatic potential between the two invasive cell lines. Gene expression in the scaffolds correlated with the up‐regulation of cancer hallmarks (e.g., angiogenesis, hypoxia) in the 4T1 mice relative to 4T07 mice. We developed a 9‐gene signature (Dhx9, Dusp12, Fth1, Ifitm1, Ndufs1, Pja2, Slc1a3, Soga1, Spon2) that successfully distinguished 4T1 disease from 67NR or 4T07 disease throughout metastatic progression. Furthermore, this signature proved highly effective at distinguishing diseased lungs in publicly available datasets of mouse models of metastatic breast cancer and in human models of lung cancer. The early and accurate detection of metastatic disease that could lead to early treatment has the potential to improve patient outcomes and quality of life.

Background Despite reducing cardiovascular disease (CVD) events and death in SPRINT (Systolic Blood Pressure Intervention Trial), intensive systolic blood pressure goals have not been adopted in the United States. This study aimed to simulate the potential long‐term impact of 4 hypertension management strategies in SPRINT‐eligible US adults. Methods and Results The validated Blood Pressure Control–Cardiovascular Disease Policy Model, a discrete event simulation of hypertension care processes (ie, visit frequency, blood pressure [BP] measurement accuracy, medication intensification, and medication adherence) and CVD outcomes, was populated with 25 000 SPRINT‐eligible US adults. Four hypertension management strategies were simulated: (1) usual care targeting BP

Abstract Soybean [Glycine max (L.) Merr.] is a globally important crop due to its valuable seed composition, versatile feed, food, and industrial end‐uses, and consistent genetic gain. Successful genetic gain in soybean has led to widespread adaptation and increased value for producers, processors, and consumers. Specific focus on the nutritional quality of soybean seed composition for food and feed has further elucidated genetic knowledge and bolstered breeding progress. Seed components are historical and current targets for soybean breeders seeking to improve nutritional quality of soybean. This article reviews genetic and genomic foundations for improvement of nutritionally important traits, such as protein and amino acids, oil and fatty acids, carbohydrates, and specific food‐grade considerations; discusses the application of advanced breeding technology such as CRISPR/Cas9 in creating seed composition variations; and provides future directions and breeding recommendations regarding soybean seed composition traits.

Abstract High night air temperature (HNT) stress negatively impacts both rice (Oryza sativa L) yield and grain quality and has been extensively investigated because of the significant yield loss observed (10%) for every increase in air temperature (1°C). Most of the rice HNT studies have been conducted under greenhouse conditions, with limited information on field‐level responses for the major rice sub‐populations. This is due to a lack of a field‐based phenotyping infrastructure that can accommodate a diverse set of accessions representing the wider germplasm and impose growth stage‐specific stress. In this study, we built six high‐tunnel greenhouses and screened 310 rice accessions from the Rice Diversity Panel 1 (RDP1) and 10 commercial hybrid cultivars in a replicated design. Each greenhouse had heating and a cyber–physical system that sensed ambient air temperature and automatically increased night air temperature to about 4°C relative to ambient temperature in the field for two cropping seasons. The system successfully imposed HNT stress of 4.0 and 3.94°C as recorded by Raspberry Pi sensors for 2 weeks in 2019 and 2020, respectively. HOBO sensors (Onset Computer Corporation) recorded a 2.9 and 2.07°C temperature differential of ambient air between control and heated greenhouses in 2019 and 2020, respectively. These greenhouses were able to withstand constant flooding, heavy rains, strong winds (140 mph), and thunderstorms. Selected US rice cultivars showed an average of 24% and 15% yield reduction under HNT during the 2019 and 2020 cropping seasons, respectively. Our study highlights the potential of this computer‐based infrastructure for accurate implementation of HNT or other abiotic stresses under field‐growing conditions.

Abstract Managing social‐ecological systems (SES) requires balancing the need to tailor actions to local heterogeneity and the need to work over large areas to accommodate the extent of SES. This balance is particularly challenging for policy since the level of government where the policy is being developed determines the extent and resolution of action. We make the case for a new research agenda focused on ecological federalism that seeks to address this challenge by capitalizing on the flexibility afforded by a federalist system of governance. Ecological federalism synthesizes the environmental federalism literature from law and economics with relevant ecological and biological literature to address a fundamental question: What aspects of SES should be managed by federal governments and which should be allocated to decentralized state governments? This new research agenda considers the bio‐geo‐physical processes that characterize state‐federal management tradeoffs for biodiversity conservation, resource management, infectious disease prevention, and invasive species control. Read the free Plain Language Summary for this article on the Journal blog.

Abstract Aims Resistin is a circulating inflammatory biomarker that is associated with cardiovascular disease. We investigated the associations of resistin and incident heart failure (HF) and its subtypes, as well as specific measures of subclinical HF (myocardial fibrosis and relevant biomarkers). Methods We analysed data from 1968 participants in the Multi‐Ethnic Study of Atherosclerosis with measurements of plasma resistin levels at clinic visits from 2002 to 2005. Participants were subsequently followed for a median of 10.5 years for HF events. The associations between resistin levels and incident HF, HF with reduced ejection fraction (HFrEF), and HF with preserved ejection fraction (HFpEF) were examined using multivariable Cox proportional hazards models. Linear regression models assessed the associations between resistin levels and myocardial fibrosis from cardiac magnetic resonance imaging, as well as hs‐cTnT and NT‐proBNP. Results The mean age of the cohort was 64.7 years, and 50.0% were female. Seventy‐four participants (4%) developed incident HF during follow‐up. In a Cox proportional hazards model adjusted for age, gender, education level, race/ethnicity, and traditional risk factors, higher resistin levels were significantly associated with incident HF (HR 1.44, CI 1.18–1.75, P = 0.001) and HFrEF (HR 1.47, CI 1.07–2.02, P = 0.016), but not with HFpEF (HR 1.25, CI 0.89–1.75, P = 0.195). Resistin levels showed no significant associations with myocardial fibrosis, NT‐proBNP, or hs‐cTnT levels. Conclusions In a multi‐ethnic cohort free of cardiovascular disease at baseline, elevated resistin levels were associated with incident HF, more prominently with incident HFrEF than HFpEF, but not with subclinical myocardial fibrosis or biomarkers of HF.

Abstract Introduction The lack of racial/ethnic diversity in research potentially limits the generalizability of findings to a broader population, highlighting the need for greater diversity and inclusion in clinical research. Qualitative research (i.e., focus groups) was conducted to identify (i) the potential motivators and barriers to study participation across different races and ethnicities; (ii) preferred delivery of education and information to support healthcare decision‐making and the role of the community. Methods Patient focus groups were conducted with 26 participants from the sponsor's Patient Engagement Research Councils selected through subjective sampling. Recruitment prioritized adequate representation across different race/ethnic groups. Participation was voluntary and participants underwent a confidential interview process before selection. Narrative analysis was used to identify themes and draw insights from interactions. Experienced research specialists identified emerging concepts, and these were tested against new observations. The frequency of each concept was examined to understand its importance. Results Based on self‐selected race/ethnicity, participants were divided into five focus groups (Groups: African American/Black: 2; Hispanic/Latino, Asian American, and white: 1 each) and were asked to share their experiences/opinions regarding the stated objectives. Barriers to study participation included: limited awareness of opportunities to participate in research, fears about changes in standard therapy, breaking cultural norms/stigma, religion‐related concerns and mistrust of clinical research. Participants identified the importance of transparency by pharmaceutical companies and other entities to build trust and partnership and cited key roles that communities can play. The perceptions of the African American group regarding diversity/inclusion in research studies appeared to be different from other groups; a lack of trust in healthcare providers, concerns about historical instances of research abuse and the importance of prayer were cited. Conclusion This study provided insights into barriers to study participation, and also highlighted the need for pharmaceutical companies and other entities to authentically engage in strategies that build trust within communities to enhance recruitment among diverse populations. Patient or Public Contribution The data collected in the present study was provided by the participants in the focus groups.

Abstract Introduction The purpose of this descriptive study is to examine a learning health system (LHS) continuous improvement and learning approach as a case for increased quality, standardized processes, redesigned workflows, and better resource utilization. Hospital acquired pressure injuries (HAPI) commonly occur in the hospitalized patient and are costly and preventable. This study examines the effect of a LHS approach to reducing HAPI within a large academic medical center. Methods Our learning health center implemented a 6‐year series of iterative improvements that included both process and technology changes, with robust data and analytical reforms. In this descriptive, observational study, we retrospectively examined longitudinal data from April 1, 2018 to March 31, 2022, examining the variables of total number of all‐stage HAPI counts and average length of stay (ALOS). We also analyzed patient characteristics observed/expected mortality ratios, as well as total patient days, and the case‐mix index to determine whether these factors varied over the study period. We used the Agency for Healthcare Research and Quality cost estimates to identify the estimated financial benefit of HAPI reductions on an annualized basis. Results HAPI per 1000 patient days for FY 20 (October 1‐September 30) and FY 21, decreased from 2.30 to 1.30 and annualized event AHRQ cost estimates for HAPI decreased by $4 786 980 from FY 20 to FY 21. A strong, statistically significant, negative and seemingly counterintuitive correlation was found (r = −.524, P = .003) between HAPI and ALOS. Conclusions The LHS efforts directed toward HAPI reduction led to sustained improvements during the study period. These results demonstrate the benefits of a holistic approach to quality improvement offered by the LHS model. The LHS model goes beyond a problem‐based approach to process improvement. Rather than targeting a specific problem to solve, the LHS system creates structures that yield process improvement benefits over a continued time period.

Abstract Following a decision to require label warnings for concurrent use of opioids and benzodiazepines and increased risk of respiratory depression and death, the US Food and Drug Administratioin (FDA) recognized that other sedative psychotropic drugs may be substituted for benzodiazepines and be used concurrently with opioids. In some cases, data on the ability of these alternatives to depress respiration alone or in conjunction with an opioid are lacking. A nonclinical in vivo model was developed that could detect worsening respiratory depression when a benzodiazepine (diazepam) was used in combination with an opioid (oxycodone) compared to the opioid alone based on an increased arterial partial pressure of carbon dioxide (pCO2). The current study used that model to assess the impact on respiration of non‐benzodiazepine sedative psychotropic drugs representative of different drug classes (clozapine, quetiapine, risperidone, zolpidem, trazodone, carisoprodol, cyclobenzaprine, mirtazapine, topiramate, paroxetine, duloxetine, ramelteon, and suvorexant) administered alone and with oxycodone. At clinically relevant exposures, paroxetine, trazodone, and quetiapine given with oxycodone significantly increased pCO2 above the oxycodone effect. Analyses indicated that most pCO2 interaction effects were due to pharmacokinetic interactions resulting in increased oxycodone exposure. Increased pCO2 recorded with oxycodone‐paroxetine co‐administration exceeded expected effects from only drug exposure suggesting another mechanism for the increased pharmacodynamic response. This study identified drug‐drug interaction effects depressing respiration in an animal model when quetiapine or paroxetine were co‐administered with oxycodone. Clinical pharmacodynamic drug interaction studies are being conducted with these drugs to assess translatability of these findings.

Abstract The use of dynamic elastomeric fabric orthoses is examined in a young woman with hypermobile Ehlers‐Danlos syndrome (hEDS) referred for physiotherapy with hip dysplasia, prior to a right periacetabular osteotomy. Dynamic elastomeric fabric orthoses plus rigorous subjective examination, therapists' listening skills, and patient‐centered goals were useful for this hEDS patient.

Abstract Synthesis research in ecology and environmental science improves understanding, advances theory, identifies research priorities, and supports management strategies by linking data, ideas, and tools. Accelerating environmental challenges increases the need to focus synthesis science on the most pressing questions. To leverage input from the broader research community, we convened a virtual workshop with participants from many countries and disciplines to examine how and where synthesis can address key questions and themes in ecology and environmental science in the coming decade. Seven priority research topics emerged: (1) diversity, equity, inclusion, and justice (DEIJ), (2) human and natural systems, (3) actionable and use‐inspired science, (4) scale, (5) generality, (6) complexity and resilience, and (7) predictability. Additionally, two issues regarding the general practice of synthesis emerged: the need for increased participant diversity and inclusive research practices; and increased and improved data flow, access, and skill‐building. These topics and practices provide a strategic vision for future synthesis in ecology and environmental science.

Clothing with integrated high‐force actuators enables wearable haptics for immersive virtual reality (VR) and enables soft exoskeletons for rehabilitation or human augmentation. Electrostatic clutches (ESClutches) offer a very‐low‐energy solution to block motion and are mm thin. Challenges for ESClutches in wearables are 1) effective integration in clothing to accurately block body motion while ensuring comfort, 2) well‐controlled sliding for variable stiffness rendering, and 3) adaptation to shoulder or hip joints. Here, the control of sliding friction of soft ESClutches is demonstrated, using materials that enable both integration in textile and efficient force transfer to the user. We present a 1.3 mm‐thick soft glove with five ESClutches, providing up to 50 N of kinesthetic feedback per finger. A clutch in a thin haptic sleeve that controls elbow extension is reported. Eight cable‐format ESClutches on a shoulder are shown, selectively blocking multiple degrees of freedom. VR tests demonstrate that the glove and the sleeve give the user the ability to rank the softness and weight of virtual objects. In a teleoperation scenario, the glove enables the user to remotely feel an object's stiffness. The ESClutches and textile integration pave a path toward socially acceptable and comfortable kinesthetic haptics.

Abstract Background Daily rhythms are observed in humans and almost all other organisms. Most of these observed rhythms reflect both underlying endogenous circadian rhythms and evoked responses from behaviours such as sleep/wake, eating/fasting, rest/activity, posture changes and exercise. For many research and clinical purposes, it is important to understand the contribution of the endogenous circadian component to these observed rhythms. Content The goal of this manuscript is to provide guidance on best practices in measuring metrics of endogenous circadian rhythms in humans and promote the inclusion of circadian rhythms assessments in studies of health and disease. Circadian rhythms affect all aspects of physiology. By specifying minimal experimental conditions for studies, we aim to improve the quality, reliability and interpretability of research into circadian and daily (i.e., time‐of‐day) rhythms and facilitate the interpretation of clinical and translational findings within the context of human circadian rhythms. We describe protocols, variables and analyses commonly used for studying human daily rhythms, including how to assess the relative contributions of the endogenous circadian system and other daily patterns in behaviours or the environment. We conclude with recommendations for protocols, variables, analyses, definitions and examples of circadian terminology. Conclusion Although circadian rhythms and daily effects on health outcomes can be challenging to distinguish in practice, this distinction may be important in many clinical settings. Identifying and targeting the appropriate underlying (patho)physiology is a medical goal. This review provides methods for identifying circadian effects to aid in the interpretation of published work and the inclusion of circadian factors in clinical research and practice.

Background Although sufficient and healthy sleep is inversely associated with cardiovascular disease (CVD) and its risk factors, the American Heart Association's Life's Simple 7 (LS7), as a measure of cardiovascular health (CVH), did not include sleep. We evaluated an expanded measure of CVH that includes sleep as an eighth metric in relation to CVD risk. Methods and Results The analytic sample consisted of MESA (Multi‐Ethnic Study of Atherosclerosis) Sleep Study participants who had complete data on sleep characteristics from overnight polysomnography, 7‐day wrist actigraphy, validated questionnaires, and the outcome. We computed the LS7 score and 4 iterations of a new CVH score: score 1 included sleep duration, score 2 included sleep characteristics linked to CVD in the literature (sleep duration, insomnia, daytime sleepiness, and obstructive sleep apnea), scores 3 and 4 included sleep characteristics associated with CVD in MESA (score 3: sleep duration and efficiency, daytime sleepiness, and obstructive sleep apnea; score 4: score 3+sleep regularity). Multivariable‐adjusted logistic and Cox proportional hazards models evaluated associations of the LS7 and CVH scores 1 to 4 with CVD prevalence and incidence. Among 1920 participants (mean age: 69±9 years; 54% female), there were 95 prevalent CVD events and 93 incident cases (mean follow‐up, 4.4 years). Those in the highest versus lowest tertile of the LS7 score and CVH scores 1 to 4 had up to 80% lower odds of prevalent CVD. The LS7 score was not significantly associated with CVD incidence (hazard ratio, 0.62 [95% CI, 0.37–1.04]). Those in the highest versus lowest tertile of CVH score 1, which included sleep duration, and CVH score 4, which included multidimensional sleep health, had 43% and 47% lower incident CVD risk (hazard ratio, 0.57 [95% CI, 0.33–0.97]; and hazard ratio, 0.53 [95% CI, 0.32–0.89]), respectively. Conclusions CVH scores that include sleep health predicted CVD risk in older US adults. The incorporation of sleep as a CVH metric, akin to other health behaviors, may enhance CVD primordial and primary prevention efforts. Findings warrant confirmation in larger cohorts over longer follow‐up.

Abstract Abundance estimation is a critical component of conservation planning, particularly for exploited species where managers set regulations to restrict harvest based on current population size. An increasingly common approach for abundance estimation is through integrated population modeling (IPM), which uses multiple data sources in a joint likelihood to estimate abundance and additional demographic parameters. Lincoln estimators are one commonly used IPM component for harvested species, which combine information on the rate and total number of individuals harvested within an integrated band‐recovery framework to estimate abundance at large scales. A major assumption of the Lincoln estimator is that banding and recoveries are representative of the whole population, which may be violated if major sources of spatial heterogeneity in survival or harvest rates are not incorporated into the model. We developed an approach to account for spatial variation in harvest rates using a spatial predictive process, which we incorporated into a Lincoln estimator IPM. We simulated data under different configurations of sample sizes, harvest rates, and sources of spatial heterogeneity in harvest rate to assess potential model bias in parameter estimates. We then applied the model to data collected from a field study of wild turkeys (Meleagris gallapavo) to estimate local and statewide abundance in Maine, USA. We found that the band recovery model that incorporated a spatial predictive process consistently provided estimates of adult and juvenile abundance with low bias across a variety of spatial configurations of harvest rate and sampling intensities. When applied to data collected on wild turkeys, a model that did not incorporate spatial heterogeneity underestimated the harvest rate in some subregions. Consistent with simulation results, this led to overestimation of both local and statewide abundance. Our work demonstrates that a spatial predictive process is a viable mechanism to account for spatial variation in harvest rates and limit bias in abundance estimates. This approach could be extended to large‐scale band recovery data sets and has applicability for the estimation of population parameters in other ecological models as well.

Background Atrial fibrillation (AF) is associated with increased stroke risk and accelerated cognitive decline, but the association of early manifestations of left atrial (LA) impairment with subclinical changes in brain structure is unclear. We investigated whether abnormal LA structure and function, greater supraventricular ectopy, and intermittent AF are associated with small vessel disease on magnetic resonance imaging of the brain. Methods and Results In the Multi‐Ethnic Study of Atherosclerosis, 967 participants completed 14‐day ambulatory electrocardiographic monitoring, speckle tracking echocardiography and, a median 17 months later, magnetic resonance imaging of the brain. We assessed associations of LA volume index and reservoir strain, supraventricular ectopy, and prevalent AF with brain magnetic resonance imaging measures of small vessel disease and atrophy. The mean age of participants was 72 years; 53% were women. In multivariable models, LA enlargement was associated with lower white matter fractional anisotropy and greater prevalence of microbleeds; reduced LA strain, indicating worse LA function, was associated with more microbleeds. More premature atrial contractions were associated with lower total gray matter volume. Compared with no AF, intermittent AF (prevalent AF with

Abstract One third of chondrichthyan species (sharks, rays, and chimeras) are threatened with extinction, mainly due to unsustainable fishing. Large accessible international markets for meat and luxury products like dried fins can help drive overfishing by encouraging targeted capture or retention of high‐value export species. If this is common, then species in international trade could have heightened extinction risk. Here, we examined the species composition of the Hong Kong shark fin market from 2014 to 2018, finding that traded species disproportionately occur in threatened categories (70.9%) and all premium value species are threatened. A small number of cosmopolitan species dominate the trade, but noncosmopolitan coastal species are still traded at concerning levels given their limited distribution. These coastal species are not generally subject to retention prohibitions, fisheries management, or international trade regulations and without management many could become extinct. The conservation potential of international trade regulations alone for coastal chondrichthyans depends on the extent to which overfishing is driven by export markets; socioeconomic studies of coastal fishing communities are needed to make this determination. Nonetheless, adding international trade regulations for more coastal shark species that are in the fin trade could prompt broad engagement with overfishing in nations lacking effective management.

Abstract Background Interstitial glucose (IG) concentration measurement using a flash glucose monitoring system (FGMS) is a noninvasive, affordable, and informative method to regulate patients with diabetes mellitus (DM) but has not been fully validated in outpatient cats with DM. Objectives To further validate the FreeStyle Libre FGMS in outpatient diabetic cats. Animals Eight client‐owned cats with DM. Methods Prospective observational validation study. Tissue glue was used to attach the sensor to the cat. Lin's concordance correlation coefficient (ρc) was used to compare IG concentrations measured by the FGMS to blood glucose concentrations measured using an automated biochemistry analyzer (ABA) and point‐of‐care glucometer (POCG). Results Data from 15 sensor placements in 8 cats were analyzed. Paired IG and ABA glucose concentrations (139 samples) had excellent correlation (ρc = 0.96) as did IG and POCG glucose concentrations (142 samples, ρc = 0.92). Sensor failure or displacement were recorded for 12/15 (80%) sensor placements. Median time of sensor activity was 7 days (range, 2‐13 days). Conclusions and Clinical Importance In outpatient cats with DM, the FGMS‐measured IG concentration correlated well with ABA‐measured blood glucose concentration, but a high rate of sensor failures was observed.

Abstract Aim The aim was to critically analyse the body of evidence regarding the effectiveness of PFCC transition interventions on the quality of care and the experience of patients. Design We conducted a systematic review using the Cochrane Handbook's guidelines and adhered to a standardized reporting format: Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). Methods Four databases and grey literature were searched. Following a two‐step screening process, data from the eligible studies were extracted. Risk of bias and quality of the studies were also assessed. Narrative synthesis and vote counting were used for the data analysis. Results A total of 28 articles met our inclusion criteria. Interventions varied in regards to the extent of the PFCC focus and the comprehensiveness of the transition of care. Educating patients to promote self‐management was the most commonly included component and it was described in all 28 interventions.

Abstract Background Postprandial hyperglycemia (PPH) and circadian glucose concentration fluctuations recorded in the home environment of dogs with naturally occurring diabetes mellitus (DM) have not been reported. Objectives To determine if a flash glucose monitoring system (FGMS; FreeStyle Libre) can detect PPH and circadian fluctuations in glucose concentrations in dogs with variably controlled DM. Animals Fourteen client‐owned dogs with DM. Methods Prospective observational study. Interstitial glucose (IG) concentrations measured by the FGMS during a 13‐day study period were analyzed. Results A total of 17, 446 FGMS IG concentrations were analyzed. For all dogs analyzed together, median IG concentration measured within 30 (288 mg/dL), 60 (286 mg/dL), 90 (285 mg/dL), and 120 (285 mg/dL) minutes of meals was each significantly higher than the median IG concentration at all other times (260 mg/dL, 259 mg/dL, 258 mg/dL, and 257 mg/dL, respectively; range, 40‐500 mg/dL; P

Abstract Ecological communities are partly structured by indirect interactions, where one species can indirectly affect another by altering its interactions with a third species. In the absence of direct predation, nonconsumptive effects of predators on prey have important implications for subsequent community interactions. To better understand these interactions, we used a Daphnia‐parasite‐predator cue system to evaluate if predation risk affects Daphnia responses to a parasite. We investigated the effects of predator cues on two aspects of host–parasite interactions (susceptibility to infection and infection intensity), and whether or not these effects differed between sexes. Our results show that changes in response to predator cues caused an increase in the prevalence and intensity of parasite infections in female predator‐exposed Daphnia. Importantly, the magnitude of infection risk depended on how long Daphnia were exposed to the cues. Additionally, heavily infected Daphnia that were constantly exposed to cues produced relatively more offspring. While males were ~5× less likely to become infected compared to females, we were unable to detect effects of predator cues on male Daphnia–parasite interactions. In sum, predators, prey, and their parasites can form complex subnetworks in food webs, necessitating a nuanced understanding of how nonconsumptive effects may mediate these interactions.

Abstract Differential disturbance severity effects on forest vegetation structure, species diversity, and net primary production (NPP) have been long theorized and observed. Here, we examined these factors concurrently to explore the potential for a mechanistic pathway linking disturbance severity, changes in light environment, leaf functional response, and wood NPP in a temperate hardwood forest. Using a suite of measurements spanning an experimental gradient of tree mortality, we evaluated the direction and magnitude of change in vegetation structural and diversity indexes in relation to wood NPP. Informed by prior observations, we hypothesized that forest structural and species diversity changes and wood NPP would exhibit either a linear, unimodal, or threshold response in relation to disturbance severity. We expected increasing disturbance severity would progressively shift subcanopy light availability and leaf traits, thereby coupling structural and species diversity changes with primary production. Linear or unimodal changes in three of four vegetation structural indexes were observed across the gradient in disturbance severity. However, disturbance‐related changes in vegetation structure were not consistently correlated with shifts in light environment, leaf traits, and wood NPP. Species diversity indexes did not change in response to rising disturbance severity. We conclude that, in our study system, the sensitivity of wood NPP to rising disturbance severity is generally tied to changing vegetation structure but not species diversity. Changes in vegetation structure are inconsistently coupled with light environment and leaf traits, resulting in mixed support for our hypothesized cascade linking disturbance severity to wood NPP.