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Transmission of Hepatitis C (HCV) continues via sharing of injection equipment between people who inject drugs (PWID). Network‐based modelling studies have produced conflicting results about whether random treatment is preferable to targeting treatment at PWID with multiple partners. We hypothesise that differences in the modelled injecting network structure produce this heterogeneity. The study aimed to test how changing network structure affects HCV transmission and treatment effects. We created three dynamic injecting network structures connecting 689 PWID (UK‐net, AUS‐net and USA‐net) based on published empirical data. We modelled HCV in the networks and at 5 years compared prevalence of HCV 1) with no treatment, 2) with randomly targeted treatment and 3) with treatment targeted at PWID with the most injecting partnerships (degree‐based treatment). HCV prevalence at 5 years without treatment differed significantly between the three networks (UK‐net (42.8%) vs. AUS‐net (38.2%), p < 0.0001 and vs. USA‐net (54.0%), p < 0.0001). In the treatment scenarios UK‐net and AUS‐net showed a benefit of degree‐based treatment with a 5‐year prevalence of 1.0% vs. 9.6% p < 0.0001 and 0.15% vs. 0.44%, p < 0.0001. USA‐net showed no significant difference (29.3% vs. 29.2%, p = 0.0681). Degree‐based treatment was optimised with low prevalence, moderate treatment coverage conditions whereas random treatment was optimised in low treatment coverage, high prevalence conditions. In conclusion, injecting network structure determines the transmission rate of HCV and the most efficient treatment strategy. In real‐world injecting network structures, the benefit of targeting HCV treatment at individuals with multiple injecting partnerships may have been underestimated. [ABSTRACT FROM AUTHOR]

Post‐traumatic joint contracture (PTJC) in the elbow is a biological problem with functional consequences. Restoring elbow motion after injury is a complex challenge because contracture is a multi‐tissue pathology. We previously developed an animal model of elbow PTJC using Long‐Evans rats and showed that the capsule and ligaments/cartilage were the primary soft tissues that caused persistent joint motion loss. The objective of this study was to evaluate tissue‐specific changes within the anterior capsule and lateral collateral ligament (LCL) that led to their contribution to elbow contracture. In our rat model of elbow PTJC, a unilateral surgery replicated damage that commonly occurs due to elbow dislocation. Following surgery, the injured limb was immobilized for 42 days. The capsule and LCL were evaluated after 42 days of immobilization or 42 days of immobilization followed by 42 days of free mobilization. We evaluated extracellular matrix protein biochemistry, non‐enzymatic collagen crosslink content, tissue volume with contrast‐enhanced micro‐computed tomography, and tissue mechanical properties. Increased collagen content, but not collagen density, was observed in both injured limb capsules and LCLs, which was consistent with the increased tissue volume. Injured limb LCLs exhibited decreased normalized maximum force, and both tissues had increased immature collagen cross‐links compared to control. Overall, increased tissue volume and immature collagen crosslinks in the capsule and LCL drive their contribution to elbow contracture in our rat model. [ABSTRACT FROM AUTHOR]

Globally, one quarter of shark and ray species are threatened with extinction due to overfishing. Effective conservation and management can facilitate population recoveries. However, these efforts depend on robust data on movement patterns and stock structure, which are lacking for many threatened species, including the Critically Endangered soupfin shark Galeorhinus galeus, a circumglobal coastal‐pelagic species.Using passive acoustic telemetry, we continuously tracked 34 mature female soupfin sharks, surgically implanted with coded acoustic transmitters, for 7 years via 337 underwater acoustic receivers stationed along the west coast of North America. These sharks and an additional six were also externally fitted with spaghetti identification tags. Our tagging site was a shallow rocky reef off La Jolla (San Diego County), California, USA, where adult females were observed to aggregate every summer.Tagged soupfin sharks were highly migratory along the west coast of North America, between Washington, USA and Baja California Sur, Mexico. However, every 3 years, they returned to waters off La Jolla, California, where they underwent gestation. This is the first conclusive evidence of triennial migration and philopatry ('home‐loving') in any animal, which is apparently driven by this species' unusual triennial reproductive cycle. Females of other shark and ray species with triennial reproductive cycles are also likely to exhibit triennial cycles of migration and philopatry.At least six (15%) of our tagged soupfin sharks were killed in commercial gillnets in Mexico.Policy implications. Identifying multiennial migratory cycles in mature female sharks can reveal hidden stock structure in the form of discrete breeding cohorts, which are spatially and temporally segregated as they cycle through different reproductive phases. Accounting for this complexity may improve the performance of spatially structured stock assessment models, particularly when fishery removals are spatially heterogeneous, as well as inform the spatiotemporal design of fishery‐independent surveys. In the United States, the soupfin shark is neither actively managed nor recognized as a Highly Migratory Species; however, given the highly migratory behaviour we report, this designation should be revisited by the US Pacific Fishery Management Council. Finally, given the extensive fishery removals in Mexico, any future management must be internationally cooperative. [ABSTRACT FROM AUTHOR]

Objectives: Primary orbital melanoma (POM) is a rare disease with limited data on survival and best treatment practices. Here we utilize the National Cancer Database (NCDB) to determine the overall survival (OS) and covariates that influence mortality. Study Design: Retrospective cohort study. Methods: All patients diagnosed with POM from 2004 to 2016 were identified in the NCDB. Patient and oncologic data were analyzed using the Kaplan–Meier method and multivariate models for the primary outcome of OS. Results: A total of 129 patients were identified. Median OS was 36.9 months (95% confidence interval [CI] 24.1–78.7 months) with mean 5‐year survival of 42.0% (CI 33.2%–53.2%). Treatments received included surgery alone (43.4%), radiation alone (23.3%), and surgery followed by radiation (20.2%). The multivariate model demonstrated an increased risk of death associated with age over 80 years (hazard ratio [HR] 3.41, CI 1.31–8.86, P =.012), a Charlson‐Deyo comorbidity score of 2 or greater (HR 5.30, CI 1.87–15.03, P =.002), and no treatment (HR 2.28, CI 1.03–5.06, P =.042). For every 1 cm increase in tumor size, there was an increased risk of death (HR 1.06, CI 1.00–1.13, P =.039). When compared to surgery alone, no other treatment modality had an effect on OS. Conclusions: This study leveraged multiyear data from the NCDB to provide prognostic and demographic information on the largest known cohort of POM cases. Increased age, increased comorbidities, not receiving treatment, and larger tumor size were associated with increased mortality. There was no clear survival advantage for specific treatments. Level of Evidence: 4 Laryngoscope, 131:1790–1797, 2021 [ABSTRACT FROM AUTHOR]

Despite substantial efforts aimed at the detection and intervention for early symptoms of mental illness, there is relatively limited research on the clinical overlap between borderline personality disorder (BPD) and early psychosis, for example, clinical high risk (CHR) for psychosis, in young people. We present a narrative review of the clinical overlap between BPD and psychosis spectrum symptoms. Both conditions have unstable temporal course, and both are marked by functional impairment, increased suicide risk, and higher rates of psychiatric inpatient services. We then review evidence‐based treatments for psychosis and BPD, emphasizing treatments for early presentations of these symptoms and initial research considering treatments for the overlap. Psychotherapies with the strongest empirical support include cognitive behavioral models, with BPD showing limited response to adjunctive pharmacotherapy. We end by discussing specific recommendations for future research, including longitudinal studies to determine the predictors of the course of illness and the development of treatments to target comorbid BPD and CHR symptoms. [ABSTRACT FROM AUTHOR]

Organic‐based magnetic materials have been used for spintronic device applications as electrodes of spin aligned carriers and spin‐pumping substrates. Their advantages over more traditional inorganic magnets include reduced magnetic damping and lower fabrication costs. Vanadium tetracyanoethylene, V[TCNE]x (x ≈ 2), is an organic‐based ferrimagnet with an above room‐temperature magnetic order temperature (Tc ≈ 400 K). V[TCNE]x has deposition flexibility and can be grown on a variety of substrates via low‐temperature chemical vapor deposition (CVD). A systematic study of V[TCNE]x thin‐film CVD parameters to achieve optimal film quality, reproducibility, and excellent magnetic properties is reported. This is assessed by broadband ferromagnetic resonance (FMR) that shows most narrow linewidth of ≈1.5 Gauss and an extremely low Gilbert damping coefficient. The neat V[TCNE]x films are shown to be efficient spin injectors via spin pumping into an adjacent platinum layer. Also, under an optimized FMR linewidth, the V[TCNE]x films exhibit Fano‐type resonance with a continuum broadband absorption in the microwave range, which can be readily tuned by the microwave frequency. [ABSTRACT FROM AUTHOR]

Key points: We examined the influence of cutaneous feedback from the heel and metatarsal regions of the foot sole on the soleus stretch reflex pathway during standing.We found that heel electrical stimuli suppressed and metatarsal stimuli enhanced the soleus vibration response.Follow‐up experiments indicated that the interaction between foot sole cutaneous feedback and the soleus vibration response was likely not mediated by presynaptic inhibition and was contingent upon a modulation at the ⍺‐motoneuron pool level.The spatially organized interaction between cutaneous feedback from the foot sole and the soleus vibration response provides information about how somatosensory information is combined to appropriately respond to perturbations during standing. Cutaneous feedback from the foot sole provides balance‐relevant information and has the potential to interact with spinal reflex pathways. In this study, we examined how cutaneous feedback from the foot sole (heel and metatarsals) influenced the soleus response to proprioceptive stimuli during standing. We delivered noisy vibration (10–115 Hz) to the right Achilles tendon while we intermittently applied electrical pulse trains (five 1‐ms pulses at 200 Hz, every 0.8–1.0 s) to the skin under either the heel or the metatarsals of the ipsilateral foot sole. We analysed time‐dependent (referenced to cutaneous stimuli) coherence and cross‐correlations between the vibration acceleration and rectified soleus EMG. Vibration–EMG coherence was observed across a bandwidth of ∼10–80 Hz, and coherence was suppressed by heel but enhanced by metatarsal cutaneous stimuli. Cross‐correlations showed soleus EMG was correlated with the vibration (∼40 ms lag) and cross‐correlations were also suppressed by heel (from 104–155 ms) but enhanced by metatarsal (from 76–128 ms) stimuli. To examine the neural mechanisms mediating this reflex interaction, we conducted two further experiments to probe potential contributions from (1) presynaptic inhibition, and (2) modulations at the ⍺‐ and γ‐motoneuron pools. Results suggest the cutaneous interactions with the stretch reflex pathway required a modulation at the ⍺‐motoneuron pool and were likely not mediated by presynaptic inhibition. These findings demonstrate that foot sole cutaneous information functionally tunes the stretch reflex pathway during the control of upright posture and balance. Key points: We examined the influence of cutaneous feedback from the heel and metatarsal regions of the foot sole on the soleus stretch reflex pathway during standing.We found that heel electrical stimuli suppressed and metatarsal stimuli enhanced the soleus vibration response.Follow‐up experiments indicated that the interaction between foot sole cutaneous feedback and the soleus vibration response was likely not mediated by presynaptic inhibition and was contingent upon a modulation at the ⍺‐motoneuron pool level.The spatially organized interaction between cutaneous feedback from the foot sole and the soleus vibration response provides information about how somatosensory information is combined to appropriately respond to perturbations during standing. [ABSTRACT FROM AUTHOR]

A 51‐sample composition variation study was performed on glass‐ceramic waste forms for a raffinate waste stream from aqueous reprocessing of used nuclear fuel containing high fractions of Mo, alkalis, alkaline earths (AEs), and rare earths (REs). The study was designed with a single‐component‐at‐a‐time variation approach off a centroid composition. The components that were varied included Al, B, Ca, Li, Mo, Na, REs, Si, Zr, and Others (containing minor components). Data analysis included crystallization curves, microstructure, and phase compositions. A number of components (i.e., Li2O, B2O3, REOx, MoO3, Na2O, and ZrO2) significantly impacted the concentration and chemistry of phases, especially the primary phases of oxyapatite [i.e., Ca2RE8(SiO4)6O2] and powellite (i.e., AEMoO4), precipitated in the slow‐cool heat‐treated waste forms; minor phases included cerianite [i.e., CexZr(1‐x)O2], Ba‐molybdate [i.e., Ba(Gd0.67Mo0.33O3], noble metals, pollucite (i.e., CsAlSiO4), and RE‐borosilicate (i.e., RE3BSi2O10). [ABSTRACT FROM AUTHOR]

African American heterosexual and sexual minority (SM) adolescents report widespread bullying victimization (BV), which is associated with poorer psychosocial functioning. However, studies examining potential protective factors that moderate this association are limited. Using data from a cross‐sectional study conducted in Chicago, we examined the association between BV and psychosocial functioning among a sample of heterosexual (n = 475) and SM (n = 105) African American adolescents and examined whether four empirically‐supported protective factors moderated these associations. Among SM adolescents, having close parents was protective against psychosomatic symptoms for those who reported high BV and having caring teachers was protective against substance use for those who reported both high and low BV. Among heterosexual adolescents, having close parents was protective against substance use for those who reported high BV but having high neighborhood support exacerbated the risk of developing psychosomatic symptoms for those who reported high BV. Implications for school and parental‐based interventions are discussed. [ABSTRACT FROM AUTHOR]

For species reaching maturity at a range of ages or sizes, factors that influence juvenile growth and size at maturity may have lasting impacts on overall fitness. Assessing when animals reach maturity is especially challenging for species which are difficult to follow through time as a result of highly migratory behavior, long life spans, or both. We examined nesting female size in a reproductive assemblage of green turtles (Chelonia mydas) and loggerheads (Caretta caretta) on the east coast of Florida, USA. We used a long‐term dataset from 1982 to 2019 to estimate a minimum size at maturity interval on the basis of two standard deviations below mean female size for each species. The minimum size intervals for green turtles (81.4–89.3 cm) and loggerheads (68.1–79.1 cm) were lower than most previous estimates in the literature, many of which were simply the smallest individual ever observed. There was a significant decrease in the upper bound of the minimum size interval over the study period for both green turtles (1.6 cm) and loggerheads (4.1 cm). These shifts in size at maturity may be the result of changes in population demographics, habitat quality, and behavioral reactions to these changes. The development and periodic reassessment of robust estimators of maturity are an important part of programs centered around the monitoring and conservation of vulnerable wildlife populations. [ABSTRACT FROM AUTHOR]

Whereas the carbon footprint analysis for flights was derived from a flight emissions calculator to determine per passenger kilometre emissions factors, the rail footprint analysis for the TtV and MtH lines was derived from emissions factors provided to I VIA i clients and then used to calculate each route's average trip footprint. Keywords: passenger rail; aviation; climate change; carbon footprint; Canada; passagers qui voyage en train; changement climatique; empreinte carbone EN passenger rail aviation climate change carbon footprint Canada FR passagers qui voyage en train changement climatique empreinte carbone 141 151 11 06/23/21 20210601 NES 210601 Introduction Thanks to growing awareness about the high-carbon footprint of aviation, conscientious travellers around the world are opting to either fly less or travel by other more efficient transport modes instead. According to DEFRA, the average emissions factor for international rail is 0.012 kg CO SB 2 sb e/passenger km, meaning that Canadian long-haul rail emissions factors are orders of magnitude worse than the global average. Passenger A was told that their trip on a 1094-km segment of the Ocean route would generate 1053.71 kg CO SB 2 sb e, yielding a GHG emission factor of 0.96 kg CO SB 2 sb e per passenger km. [Extracted from the article]

Racial and ethnic differences across U.S. households in use of bank credit (e.g., credit cards) and nonbank credit (e.g., payday loans) are striking. We examine whether household characteristics and residential location can explain these differences. We use a novel dataset with information on previously unexplored factors, including income volatility, subjective attitudes about banks, geographic proximity to financial providers, and neighborhood population characteristics. We find that much of the raw disparities in credit use are attributable to observable household characteristics. Accounting for neighborhood population characteristics meaningfully reduces the disparities further. However, the residual racial and ethnic disparities remain large in magnitude. We show these disparities are not likely attributable to unobserved differences in households' family background, financial literacy, subjective attitudes, or credit scores. Instead, they are most likely attributable to unobserved supply‐side factors, such as racial and ethnic differences in households' exposure to marketing. We conclude with implications for policy. [ABSTRACT FROM AUTHOR]

Background: Skeletal muscle atrophy manifests across numerous diseases; however, the extent of similarities/differences in causal mechanisms between atrophying conditions in unclear. Ageing and disuse represent two of the most prevalent and costly atrophic conditions, with resistance exercise training (RET) being the most effective lifestyle countermeasure. We employed gene‐level and network‐level meta‐analyses to contrast transcriptomic signatures of disuse and RET, plus young and older RET to establish a consensus on the molecular features of, and therapeutic targets against, muscle atrophy in conditions of high socio‐economic relevance. Methods: Integrated gene‐level and network‐level meta‐analysis was performed on publicly available microarray data sets generated from young (18–35 years) m. vastus lateralis muscle subjected to disuse (unilateral limb immobilization or bed rest) lasting ≥7 days or RET lasting ≥3 weeks, and resistance‐trained older (≥60 years) muscle. Results: Disuse and RET displayed predominantly separate transcriptional responses, and transcripts altered across conditions were mostly unidirectional. However, disuse and RET induced directly inverted expression profiles for mitochondrial function and translation regulation genes, with COX4I1, ENDOG, GOT2, MRPL12, and NDUFV2, the central hub components of altered mitochondrial networks, and ZMYND11, a hub gene of altered translation regulation. A substantial number of genes (n = 140) up‐regulated post‐RET in younger muscle were not similarly up‐regulated in older muscle, with young muscle displaying a more pronounced extracellular matrix (ECM) and immune/inflammatory gene expression response. Both young and older muscle exhibited similar RET‐induced ubiquitination/RNA processing gene signatures with associated PWP1, PSMB1, and RAF1 hub genes. Conclusions: Despite limited opposing gene profiles, transcriptional signatures of disuse are not simply the converse of RET. Thus, the mechanisms of unloading cannot be derived from studying muscle loading alone and provides a molecular basis for understanding why RET fails to target all transcriptional features of disuse. Loss of RET‐induced ECM mechanotransduction and inflammatory profiles might also contribute to suboptimal ageing muscle adaptations to RET. Disuse and age‐dependent molecular candidates further establish a framework for understanding and treating disuse/ageing atrophy. [ABSTRACT FROM AUTHOR]

We advance the modeling capability of electron particle precipitation from the magnetosphere to the ionosphere through a new database and use of machine learning (ML) tools to gain utility from those data. We have compiled, curated, analyzed, and made available a new and more capable database of particle precipitation data that includes 51 satellite years of Defense Meteorological Satellite Program (DMSP) observations temporally aligned with solar wind and geomagnetic activity data. The new total electron energy flux particle precipitation nowcast model, a neural network called PrecipNet, takes advantage of increased expressive power afforded by ML approaches to appropriately utilize diverse information from the solar wind and geomagnetic activity and, importantly, their time histories. With a more capable representation of the organizing parameters and the target electron energy flux observations, PrecipNet achieves a >50% reduction in errors from a current state‐of‐the‐art model oval variation, assessment, tracking, intensity, and online nowcasting (OVATION Prime), better captures the dynamic changes of the auroral flux, and provides evidence that it can capably reconstruct mesoscale phenomena. We create and apply a new framework for space weather model evaluation that culminates previous guidance from across the solar‐terrestrial research community. The research approach and results are representative of the "new frontier" of space weather research at the intersection of traditional and data science‐driven discovery and provides a foundation for future efforts. Plain Language Summary: Space weather is the impact of solar energy on society and a key to understanding it is the way that regions of space between the Sun and the Earth's surface are connected. One of the most important and most challenging to model are the way that energy is carried into the upper atmosphere (100–1,000 km altitude). Particles moving along magnetic field lines "precipitate" into this region, carrying energy and momentum which drive space weather. We have produced a new model, using machine learning (ML), that better captures the dynamics of this precipitation from a large volume of data. Machine learning models, carefully evaluated, are capable of better representing nonlinear relationships than simpler approaches. We reveal our approach to using ML for space weather and provide a new framework to understand these models. Key Points: We utilize a data‐driven organization of input parameters to produce a new total electron energy flux nowcast model (see Figure 4)Extended input features and higher expressive power provided by machine learning (ML) approach yields more capable mesoscale and peak flux specification (see Figure 7) and an overall reduction in specification errors compared with the state‐of‐the‐art (see Table 1)A framework for evaluation of ML (and any model) in geospace is suggested, building on momentum in the community (see Section 6) [ABSTRACT FROM AUTHOR]

Nutrient pollution, defined as excess nitrogen and phosphorus related to human activities, is a widespread anthropogenic impact that decreases water quality and limits light penetration in estuarine habitats. These factors can lead to shifts in primary producer communities, but the association between these changes and marine consumer patterns of abundance and growth is relatively unknown. Understanding these relationships is necessary for herbivorous species of conservation concern like the green turtle (Chelonia mydas). We used generalized additive models to analyze concurrent 18‐yr data sets of seagrass cover, drift macroalgae cover, juvenile green turtle abundance, and growth to (1) evaluate long‐term trends in primary producer cover and green turtle demographics; and (2) gain insights into their interrelatedness at a study site known to be affected by nutrient pollution throughout the study period. We found that seagrass cover sharply declined during our study period while macroalgae cover was more resilient with trends varying over time. Juvenile green turtle abundance slowly declined throughout the study period with altered intra‐annual trends, while growth rates remained relatively stable. The incongruence of these trends suggests that relationships between marine consumers and nutrient pollution are more complex than effects on food availability alone. Our results focus on the green turtle but highlight the need for greater understanding of relationships between marine consumer species and nutrient pollution at both local and regional scales. [ABSTRACT FROM AUTHOR]

Management constraints in reduced tillage organic vegetable production may be alleviated by combining strip tillage (ST) with overwintering cereal–legume cover crop mixtures. Field studies in Michigan and New York over 6 site‐years evaluated the effects of preceding cover crops, including cereal rye (R; Secale cereale L.), hairy vetch (V; Vicia villosa Roth) and crimson clover (CC; Trifolium incarnatum), on N availability, weed management, and yields in ST organic cabbage (Brassica oleracea L. var. capitata). Cover crop treatments included R–legume mixtures (RV and RCC) planted under two spatial arrangements, standard full‐width mixed [‐M] vs. segregated strips [‐S] (legumes planted in‐row and R between‐row), and R and V monocultures. Cover crop aboveground biomass (5–10 Mg ha–1) and N content (>90 kg N ha–1) were not different among RV and RCC but the C/N of RCC was 58% greater than RV. Cabbage yields after RCC‐M were lower than RV‐M in five of six cases with yield reductions ranging from 22 to 41%. Spatial arrangement had no effect on cabbage yield after RV but improved yields after RCC from 23 to 39% in one, relatively dry, site‐year. Without N fertilizer, yields after RV and V were equivalent to or greater than R‐S with 134 kg N ha–1 in seven of nine and four of four cases, respectively. Legume species and spatial arrangement had little or no impact on the efficacy of in‐row mechanical cultivation, hand‐weeding time or weed biomass. Overall, N supplied from V and RV mixtures was an important driver of ST organic cabbage yields across different soil types and weather conditions. Core Ideas: Rye–crimson clover produced similar biomass to rye–vetch but supplied less N to cabbage.Nitrogen benefits of segregating cover crops were limited to rye–crimson clover in a dry year.Cover crop treatments had little to no effect on cultivation efficacy or hand‐weeding time.Cabbage yields were related to available N rather than weed competition in most site‐years.Vetch reduced fertilizer N required for ST cabbage across soil types and weather conditions. [ABSTRACT FROM AUTHOR]

Background/Aims: Glycogen synthesis and storage are normal hepatocyte functions. However, glycogenosis, defined as excess hepatocyte glycogen visible by routine H&E light microscopy, has not been well characterized in nonalcoholic fatty liver disease (NAFLD). Methods: Glycogenosis in NAFLD liver biopsies was graded as "none", "focal" (in <50% of hepatocytes), or "diffuse" (in ≥50% of hepatocytes). Clinical and pathological variables associated with glycogenosis were assessed. 2047 liver biopsies were prospectively analysed. Results: In adults and children, any glycogenosis was present in 54% of cases; diffuse glycogenosis was noted in approximately 1/3 of cases. On multiple logistic regression analysis, adults with glycogenosis tended to be older (P =.003), female (P =.04), have higher serum glucose (P =.01), and use insulin (P =.02). Adults tended to have lower steatosis scores (P =.006) and lower fibrosis stages (P =.005); however, unexpectedly, they also tended to have more hepatocyte injury including ballooning (P =.003). On multiple logistic regression analysis, paediatric patients with glycogenosis were more likely to be Hispanic (P =.03), have lower body weight (P =.002), elevated triglycerides (P =.001), and a higher fasting glucose (P =.007). Paediatric patients with glycogenosis also had less steatosis (P <.001) than those without. Conclusions: Glycogenosis is common in adult and paediatric NAFLD, and is associated with clinical features of insulin resistance. Glycogenosis is important to recognize histologically because it may be misinterpreted as ballooning, and when diffuse, confusion with glycogen storage disorders or glycogenic hepatopathy must be avoided. The newly observed dichotomous relationship between glycogenosis and increased liver cell injury but decreased steatosis and fibrosis requires further study. [ABSTRACT FROM AUTHOR]

Quantifying and understanding the processes driving turbulent mixing around Antarctica are key to closing the Southern Ocean's heat budget, an essential component of the global climate system. In 2016, a glider deployed in Ryder Bay, West Antarctic Peninsula, collected hydrographic and microstructure data, obtaining some of the first direct measurements of turbulent kinetic energy dissipation off West Antarctica. Elevated dissipation O(10−8) W kg−1 is found above a topographic ridge separating the 520‐m‐deep bay, where values are O(10−10) W kg−1, from a deep fjord of the continental shelf, suggesting the ridge is important in driving upward mixing of warm Circumpolar Deep Water. The 12 glider transects reveal significant temporal variability in hydrographic and dissipation conditions. Mooring‐based current and nearby meteorological data are used to attribute thermocline shoaling (deepening) to Ekman upwelling (downwelling) at Ryder Bay's southern boundary, driven by ∼3‐day‐long south‐westward (north‐westward) wind events. Anticyclonic winds generated near‐inertial shear in the bay's upper layers, causing elevated bay‐wide shear and dissipation ∼1.7 days later. High dissipation over the ridge appears to be controlled hydraulically, being co‐located (and moving) with steeply sloping isopycnals. These are observed in ∼60% of the transects, with a corresponding mean upward heat flux of ∼2.4 W m−2. The ridge, therefore, provides sustained heat to the base of the thermocline, which can be released into overlying waters during the bay‐wide, thermocline‐focused dissipation events (mean heat flux of ∼1.3 W m−2). This highlights the role of ridges, which are widespread across the West Antarctic Peninsula, in the regional heat budget. Plain Language Summary: Glacial ice flowing off the Antarctic continent either terminates directly into the ocean or forms floating tongues called ice shelves. Marine‐terminating glaciers and ice shelves in West Antarctica are melting rapidly, contributing significantly to global sea‐level rise. The melting has largely been attributed to the presence of warm deep waters, which travel at depth from the shelf break toward the coast, before mixing upwards and coming into contact with ice. However, we lack an understanding of the vertical mixing processes. In 2016, an autonomous underwater robot was used to measure the vertical mixing in Ryder Bay, off the West Antarctic Peninsula. Increased vertical mixing was consistently observed above a ridge on the seafloor at the bay's entrance, suggesting that the ridge is a hotspot for bringing sustained deep‐ocean heat to shallower depths. The heat rises until it reaches a strong temperature gradient in the ocean, with colder, less‐dense water above. This gradient typically prevents rapid mixing; however, strong winds are found to cause bay‐wide intense mixing events that release heat across the gradient into overlying waters. Similar ridges are widespread off the West Antarctic Peninsula, suggesting that they are important regionally for bringing heat toward glaciers and ice shelves. Key Points: Underwater glider time series reveals spatiotemporally varying turbulent dissipation and heat flux in Ryder BayBasin‐wide thermocline dissipation is associated with near‐inertial shear that occurs ∼1.7 days after strong wind eventsElevated dissipation at depth is generally confined to a topographic ridge and is likely controlled hydraulically [ABSTRACT FROM AUTHOR]

POSSIBLE ANSWERS TO MULTIPLE CHOICE QUESTION I Cryptococcus neoformans i Cerebrospinal nematodiasis Chronic wasting disease CORRECT ANSWER B) Cerebrospinal nematodiasis The section of elk brain contains I P. tenuis i eggs, some of which are mineralised. Clinically affected animals may exhibit ataxia, circling, head tilt, paresis and blindness prior to death.1 The susceptibility of elk to I P. tenuis i has been an important consideration for many of the elk restoration efforts that have taken place in the eastern United States.2 In these cases, cerebrospinal nematodiasis was grossly and microscopically evident. Brains from a yearling female and a 2-year-old bull wild elk ( I ervus elaphus i ) were submitted to the Wisconsin Veterinary Diagnostic Laboratory (WVDL) by the Wisconsin Department of Natural Resources (DNR) for postmortem evaluation. [Extracted from the article]

The ocean has absorbed approximately 90% of the accumulated heat in the climate system since 1970. As global warming accelerates, understanding ocean heat content changes and tracing these to surface heat input is increasingly important. We introduce a novel framework by organizing the ocean into temperature‐percentiles from warmest to coldest, allowing us to trace ocean temperature changes to changes in surface fluxes and mixing. Applying this framework to observations and historical CMIP6 simulations, we find that 50 ± 6% of surface heat uptake between 1970 and 2014 is confined to isotherms in the coldest 90% of the ocean volume. These isotherms outcrop over only 23% of the ocean's surface area in the sub‐polar regions, implying a disproportionately large heat input per unit area. Additionally, a cooling bias in the CMIP6 models is traced to inaccurate sea surface temperatures and surface heat fluxes into the warmest 5%–20% of the ocean volume. Plain Language Summary: The ocean has absorbed approximately 90% of the heat that has built up in the climate system since 1970. Understanding the processes which drive this uptake of heat by the ocean is critical to climate projections. Typically, this has required the use of climate and ocean models, which must be validated with ocean observations. To enable this, we introduce a new method, the tracer‐percentile framework, which allows us to directly use observations to understand the processes dictating heat uptake by the ocean. Using climate models (collectively called CMIP6) and ocean observations, we calculate the heat input into layers of water at the ocean surface, the total heat stored in these layers, and the mixing of heat between these layers. We find that the heat input at the surface and heat stored in the ocean has increased between 1970 and 2014, with 50 ± 6% of the increase in heat uptake at the surface happening over about a quarter of the ocean's surface, which connects to 90% of the world's ocean volume. We also identify inaccuracies in the CMIP6 models and trace these problems to the way the surface properties of the ocean (or surface heat input) are represented. Key Points: We introduce a novel tracer‐percentile framework which relates ocean heat content trends to surface flux and turbulent mixing changesHeat content changes in the coldest 90% of the ocean by volume are linked to surface heat fluxes which enter 23% of the ocean's surface areaUsing this framework, we identify a cooling bias in the 5%–20% warmest ocean volume in CMIP6 climate models traced to surface flux biases [ABSTRACT FROM AUTHOR]

Objective: As suicide risk screening becomes more common in healthcare settings, geospatial coding of behavioral health data may offer a means for identifying areas of elevated suicide risk for use in public health prevention efforts. The present study demonstrates an analytic approach for using universal suicide risk screening data to identify areas of elevated suicide risk.Method: Data were drawn from standard suicide risk screens recorded in electronic health records of a large pediatric emergency department. A total of 12,400 suicide risk screening responses were recorded, among youth aged 11-19 years (mean = 14.60, SD = 2.16; 57.2% girls, 47.8% Hispanic/Latinx, 72.1% White). A total of 86 unique ZIP codes had at least 50 completed screens, representing 9139 respondents.Results: Rates of positive screens ranged from 6.17% to 31.03% (mean = 18.33, SD = 5.14) for any suicide-related behavior and from 0.0% to 19.61% (mean = 9.14, SD = 3.43) for suicide attempt. Rates of positive screens approximated a normal distribution.Conclusions: Results demonstrated several areas with elevated rates of positive suicide risk screens, within the hospital catchment area. The proposed method capitalizes on large-scale screening data, provides an estimate of areas of relative increased risk, and may be used to inform public health responses to suicide prevention. [ABSTRACT FROM AUTHOR]

Anthropogenic increases in nitrogen (N) and phosphorus (P) concentrations can strongly influence the structure and function of ecosystems. Even though lotic ecosystems receive cumulative inputs of nutrients applied to and deposited on land, no comprehensive assessment has quantified nutrient‐enrichment effects within streams and rivers. We conducted a meta‐analysis of published studies that experimentally increased concentrations of N and/or P in streams and rivers to examine how enrichment alters ecosystem structure (state: primary producer and consumer biomass and abundance) and function (rate: primary production, leaf breakdown rates, metabolism) at multiple trophic levels (primary producer, microbial heterotroph, primary and secondary consumers, and integrated ecosystem). Our synthesis included 184 studies, 885 experiments, and 3497 biotic responses to nutrient enrichment. We documented widespread increases in organismal biomass and abundance (mean response = +48%) and rates of ecosystem processes (+54%) to enrichment across multiple trophic levels, with no large differences in responses among trophic levels or between autotrophic or heterotrophic food‐web pathways. Responses to nutrient enrichment varied with the nutrient added (N, P, or both) depending on rate versus state variable and experiment type, and were greater in flume and whole‐stream experiments than in experiments using nutrient‐diffusing substrata. Generally, nutrient‐enrichment effects also increased with water temperature and light, and decreased under elevated ambient concentrations of inorganic N and/or P. Overall, increased concentrations of N and/or P altered multiple food‐web pathways and trophic levels in lotic ecosystems. Our results indicate that preservation or restoration of biodiversity and ecosystem functions of streams and rivers requires management of nutrient inputs and consideration of multiple trophic pathways. [ABSTRACT FROM AUTHOR]

Background: Some patients with human papillomavirus (HPV)–associated oropharyngeal squamous cell carcinoma (OPSCC) do not receive guideline‐recommended postoperative radiation therapy (PORT) following primary transoral robotic surgery (TORS). Methods: Three‐hundred and sixty‐four patients with treatment‐naïve, HPV‐associated OPSCC were recommended to receive PORT based on clinicopathological features following TORS. Patients were stratified based on if they received PORT. Oncologic outcomes were compared. Results: The 3‐year locoregional failure (LRF) was 32% in patients who did not receive PORT and 4% in patients who received PORT (P <.001). Despite increased LRF, avoiding PORT was not associated with increased 3‐year distant metastasis rates (8% vs 4%, P =.56) or worse 3‐year survival (95% vs 98%, P =.34). Recurrences in the surgery alone cohort varied between local and regional sites and were often successfully salvaged. Conclusions: Patients with HPV‐associated OPSCC who do not receive indicated PORT have an increased risk of LRF but similar survival due to high salvage rates. [ABSTRACT FROM AUTHOR]

Tumor cell‐intrinsic programmed death‐ligand 1 (PD‐L1) signals mediate immunopathologic effects in breast, colon, and ovarian cancers and in melanomas, but bladder cancer (BC) effects are unreported. We show here that BC cell‐intrinsic PD‐L1 signals in mouse MB49 and human RT4, UM‐UC3, and UM‐UC‐14 BC cells regulate important pathologic pathways and processes, including effects not reported in other cancers. α‐PD‐L1 antibodies reduced BC cell proliferation in vitro, demonstrating direct signaling effects. BC cell‐intrinsic PD‐L1 promoted mammalian target of rapamycin complex 1 (mTORC1) signals in vitro and augmented in vivo immune‐independent cell growth and metastatic cancer spread, similar to effects we reported in melanoma and ovarian cancer. BC cell‐intrinsic PD‐L1 signals also promoted basal and stress‐induced autophagy, whereas these signals inhibited autophagy in melanoma and ovarian cancer cells. BC cell‐intrinsic PD‐L1 also mediated chemotherapy resistance to the commonly used BC chemotherapy agents cis‐platinum and gemcitabine and to the mTORC1 inhibitor, rapamycin. Thus, BC cell‐intrinsic PD‐L1 signals regulate important virulence and treatment resistance pathways that suggest novel, actionable treatment targets meriting additional studies. As a proof‐of‐concept, we showed that the autophagy inhibitor chloroquine improved cis‐platinum treatment efficacy in vivo, with greater efficacy in PD‐L1 null versus PD‐L1‐replete BC. [ABSTRACT FROM AUTHOR]

Volatile nitrogen oxides (N2O, NO, NO2, HONO, ...) can negatively impact climate, air quality, and human health. Using soils collected from temperate forests across the eastern United States, we show microbial communities involved in nitrogen (N) cycling are structured, in large part, by the composition of overstory trees, leading to predictable N‐cycling syndromes, with consequences for emissions of volatile nitrogen oxides to air. Trees associating with arbuscular mycorrhizal (AM) fungi promote soil microbial communities with higher N‐cycle potential and activity, relative to microbial communities in soils dominated by trees associating with ectomycorrhizal (ECM) fungi. Metagenomic analysis and gene expression studies reveal a 5 and 3.5 times greater estimated N‐cycle gene and transcript copy numbers, respectively, in AM relative to ECM soil. Furthermore, we observe a 60% linear decrease in volatile reactive nitrogen gas flux (NOy ≡ NO, NO2, HONO) as ECM tree abundance increases. Compared to oxic conditions, gas flux potential of N2O and NO increase significantly under anoxic conditions for AM soil (30‐ and 120‐fold increase), but not ECM soil—likely owing to small concentrations of available substrate (NO3‐) in ECM soil. Linear mixed effects modeling shows that ECM tree abundance, microbial process rates, and geographic location are primarily responsible for variation in peak potential NOy flux. Given that nearly all tree species associate with either AM or ECM fungi, our results indicate that the consequences of tree species shifts associated with global change may have predictable consequences for soil N cycling. [ABSTRACT FROM AUTHOR]

Dioxetane intermediates readily decompose to chemiluminescent triplet carbonyls, giving rise to what has been paradoxically called photochemistry in the dark. In this issue of Photochemistry and Photobiology, Bechara et al. report on mechanistic advances in such a reaction. With the use of horseradish peroxidase for isobutyraldehyde‐derived triplet acetone, light emission from acetone and singlet oxygen can be quenched. The experiments reveal that the reaction depends on oxygen and the amino acid. The analysis reveals that free tryptophan is a target of this form of "carbonyl stress," with the efficient formation of mono‐, bi‐ and tricyclic compounds (N‐formylkynurenine, indoline, 1λ2‐indole and 3H‐indoles). [ABSTRACT FROM AUTHOR]

We review the current state of knowledge of ozonesonde uncertainty and bias, with reference to recent developments in laboratory and field experiments. In the past 20 years ozonesonde precision has improved by a factor of 2, primarily through the adoption of strict standard operating procedures. The uncertainty budget for the ozone partial pressure reading has contributions from stoichiometry, cell background current, pump efficiency and temperature, sensing solution type, and volume. Corrections to historical data for known issues may reduce biases but simultaneously introduce additional uncertainties. This paper describes a systematic approach to quantifying these uncertainties by considering the physical and chemical processes involved and attempts to place our estimates on a firm theoretical or empirical footing. New equations or tables for ozone/iodine conversion efficiency, humidity and temperature corrections to pump flow rate, and altitude‐dependent pump flow corrections are presented, as well as detailed discussion of stoichiometry and conversion efficiencies. The nature of the so‐called "background current" is considered in detail. Two other factors particularly affecting past measurements, uncertainties and biases in the pressure measurement, and the comparison of sonde profiles to spectrophotometric measurements of total column ozone, are also discussed. Several quality assurance issues remain, but are tractable problems that can be addressed with further research. This will be required if the present goal of better than 5% overall uncertainty throughout the global ozonesonde network is to be achieved. Plain Language Summary: Ozonesondes are a stable reference for the global ozone observing network, making relatively inexpensive, accurate measurements of ozone from the ground to 30 km, with high vertical resolution, for more than 50 years. Ozonesonde data are used extensively for validation of satellite ozone measurements, models, and for trend analyses. The current state of knowledge of ozonesonde uncertainty and bias is reviewed, and a systematic approach to quantifying these uncertainties by considering the physical and chemical processes involved is presented. While ozonesonde precision has improved through the adoption of strict standard operating procedures, further improvement is possible with further research, toward a goal of less than 5% overall uncertainty throughout the global network. Key Points: Review of the current state of knowledge of ozonesonde uncertainty and biasA systematic approach to quantifying these uncertainties by considering the physical and chemical processes involvedUncertainties related to stoichiometry and sensor response may be reduced with further research, toward a goal of less than 5% uncertainty in the global network [ABSTRACT FROM AUTHOR]

Aim: Glycaemic control is known to be poor among emerging adults with type 1 diabetes, but the reasons for this are poorly understood. Examination of diabetes self‐management‐related habits, triggers and daily routines within the context of impulse control and perceived daily stress may provide increased understanding of glycaemic control during this transitional period. This study examined associations among checking blood glucose (CBG) habits, eating a meal (EAM) habits and glycaemic control within the context of CBG triggers, daily routines, impulse control and perceived daily stress, in emerging adults with type 1 diabetes. Methods: A cross‐sectional convenience sample of 100 emerging adults with type 1 diabetes was recruited from an outpatient diabetes care clinic for this age group. Participants self‐reported frequency of CBG and EAM habits, CBG triggers, daily routines, perceived daily stress and impulse control. Glycaemic control values were obtained from medical records. Path analysis was performed. Results: Better glycaemic control was positively and significantly associated with greater frequency of CBG and EAM habits. CBG habits were positively and significantly associated with CBG triggers and EAM habits. EAM habits were positively and significantly associated with daily routines. Conclusions: We suggest interventional research targeting CBG and EAM habits and daily routines to examine the impact on diabetes self‐management and glycaemic control. [ABSTRACT FROM AUTHOR]

Though endometriosis and infertility are clearly associated, the pathophysiological mechanism remains unclear. Previous work has linked endometrial ARID1A loss to endometriosis‐related endometrial non‐receptivity. Here, we show in mice that ARID1A binds and regulates transcription of the Foxa2 gene required for endometrial gland function. Uterine‐specific deletion of Arid1a compromises gland development and diminishes Foxa2 and Lif expression. Deletion of Arid1a with Ltf‐iCre in the adult mouse endometrial epithelium preserves the gland development while still compromising the gland function. Mice lacking endometrial epithelial Arid1a are severely sub‐fertile due to defects in implantation, decidualization, and endometrial receptivity from disruption of the LIF‐STAT3‐EGR1 pathway. FOXA2 is also reduced in the endometrium of women with endometriosis in correlation with diminished ARID1A, and both ARID1A and FOXA2 are reduced in nonhuman primates induced with endometriosis. Our findings describe a role for ARID1A in the endometrial epithelium supporting early pregnancy establishment through the maintenance of gland function. [ABSTRACT FROM AUTHOR]

Methane emission quantification from gas migration (GM) and surface casing vent flow (SCVF) is needed to support strategic methane reduction targets and mitigate explosion and groundwater quality risks. This paper assessed which of 451 990 Alberta oil and gas wells should have been (or will be) tested for SCVF and/or GM according to regulations, and compared the results with the provincial GM testing database. As of 2017, GM testing was required on 3.5%, and reported for 0.75%, of Alberta's energy wells. Similarly, SCVF testing was required on 58.2%, and reported for 6.2%, of all wells. An estimated 14.5% of all wells were legally abandoned before GM and SCVF testing regulations existed. All of the remaining wells will require SCVF testing prior to legal abandonment, and an estimated 32.9% to 75.5% of the total will not require GM testing before abandonment based on current regulations. The cumulative number of 'serious' GM reports that have remained open since submission has continuously been increasing each year, which contradicts the requirement for repair within 90 days, suggesting regulations are not enforced. The GM testing procedure is inadequate for quantitative testing. We conclude that fugitive methane emissions, and in particular gas migration, are not well constrained in Alberta. © 2020 Society of Chemical Industry and John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Over half of global rivers and streams lack perennial flow, and understanding the distribution and drivers of their flow regimes is critical for understanding their hydrologic, biogeochemical, and ecological functions. We analyzed nonperennial flow regimes using 540 U.S. Geological Survey watersheds across the contiguous United States from 1979 to 2018. Multivariate analyses revealed regional differences in no‐flow fraction, date of first no flow, and duration of the dry‐down period, with further divergence between natural and human‐altered watersheds. Aridity was a primary driver of no‐flow metrics at the continental scale, while unique combinations of climatic, physiographic and anthropogenic drivers emerged at regional scales. Dry‐down duration showed stronger associations with nonclimate drivers compared to no‐flow fraction and timing. Although the sparse distribution of nonperennial gages limits our understanding of such streams, the watersheds examined here suggest the important role of aridity and land cover change in modulating future stream drying. Plain Language Summary: A majority of global streams are nonperennial, flowing only part of the year, and are critical for sustaining flow downstream, providing habitat for many organisms, and regulating chemical and biological processes. Using long‐term U.S. Geological Survey measurements for 540 watersheds across the contiguous United States, we mapped patterns and examined the causes of no‐flow fraction, the fraction of each climate year with no flow, no‐flow timing, the date of the climate year on which the first recorded no flow takes place, and length of the dry‐down period, the average number of days from a local peak in daily flow to the first occurrence of no flow. We found differences in patterns of no‐flow characteristics between regions, with higher no‐flow fraction, earlier timing, and shorter dry‐down duration in the western United States. No‐flow fractions were greater and less variable in natural watersheds, while no‐flow timing was earlier and dry‐down duration was shorter in human‐modified watersheds. Aridity had the greatest effect on intermittence across the United States, but unique combinations of climate, biophysical, and human impacts were important in different regions. The number of gages measuring streamflow in nonperennial streams is small compared to perennial streams, and increased monitoring is needed to better understand drying behavior. Key Points: Three metrics reveal regional and human‐driven patterns of nonperennial flow: no‐flow fraction, day of first no flow, and dry‐down durationStreams with human modifications generally dry more quickly than unmodified streams, especially in California and the Southern Great PlainsClimate strongly influences no‐flow fraction and timing, but physiographic variables are more important for the duration of dry down [ABSTRACT FROM AUTHOR]

High‐efficiency solar cells are essential for high‐density terrestrial applications, as well as space and potentially vehicle applications. The optimum bandgap for the terrestrial spectrum lies beyond the absorption range of a traditional dual junction GaInP/GaAs cell, with the bottom GaAs cell having higher bandgap energy than necessary. Lower energy bandgaps can be achieved with multiple quantum wells (QWs), but such a pathway requires advanced management of the epitaxial growth conditions in order to be useful. Strain‐balanced GaAsP/GaInAs QWs are incorporated into a single junction GaAs solar cell and a dual junction GaInP/GaAs solar cell, leading to 27.2% efficiency in the single junction device and a one‐sun record 32.9% efficiency in the tandem device. Good carrier collection and low non‐radiative recombination are observed in the cells with up to 80 QWs. The GaAs cells employ a rear‐heterojunction architecture to boost the open‐circuit voltage to over 1.04 V in the quantum well device, despite the large number of QWs. [ABSTRACT FROM AUTHOR]

Background: When the transplant candidates are receiving oral anticoagulation therapy before transplantation, it is crucial to have an urgent reversal strategy to prevent hemorrhagic complications perioperatively. The aim of this study was to present the experience with idarucizumab to reverse the anticoagulant activity of dabigatran prior to lung transplantation. Methods: A single‐center retrospective study was performed to analyze the clinical outcomes of idarucizumab use before lung transplantation. Results: Between July 2016 and June 2019, six patients were on dabigatran at the time of transplantation. Out of the six patients, four patients received idarucizumab. These four recipients received a median of 3 units (range 0‐4 units) of packed red blood cells (pRBCs) and 450 ml (range 250‐1500 ml) of intraoperative salvage of shed blood (cell saver blood) during the lung transplant. The two patients who were not administered idarucizumab received 5 units and 13 units of pRBCs and 900 ml and 3600 ml of cell saver blood, respectively. There was no grade 3 primary graft dysfunction (PGD) at 72 hours after transplantation or in‐hospital mortality in idarucizumab group. In the group without idarucizumab, there was one case of grade 3 PGD without any in‐hospital mortality. Conclusion: Dabigatran reversal with idarucizumab provides reasonable hemostasis during lung transplantation. [ABSTRACT FROM AUTHOR]

This phenomenological study adds to current literature about clients' meaningful experiences in counseling by exploring the experiences of eight young clients (ages 8–18) in individual counseling with post‐master's counselors in an outpatient setting. Interviews with these clients revealed the following six themes: (a) the process of growth, (b) having a safe place to talk, (c) counselor accepts and meets the client where they are, (d) counseling is a team effort, (e) supportive accountability from the counselor, and (f) understanding self and others. The final theme includes two subthemes: learning coping and emotion management skills, and learning better ways to communicate and behave. Findings and implications for counselors are discussed. [ABSTRACT FROM AUTHOR]

Background: Subtyping chronic rhinosinusitis (CRS) by tissue eosinophilia has prognostic and therapeutic implications, and is difficult to predict using peripheral eosinophil counts or polyp status alone. The objective of this study was to test machine learning for prediction of eosinophilic CRS (eCRS). Methods: Input variables were defined as peripheral eosinophil count, urinary leukotriene E4 (uLTE4) level, and polyp status. The output was diagnosis of eCRS, defined as tissue eosinophil count >10 per high‐power field. Patients undergoing surgery for CRS were retrospectively reviewed for complete datasets. Univariate analysis was performed for each input as a predictor of eCRS. Logistic regression and artificial neural network (ANN) machine learning models were developed using random and surgeon‐specific training/test datasets. Results: A total of 80 patients met inclusion criteria. In univariate analysis, area under the receiver operator characteristic curve (AUC) for peripheral eosinophil count and uLTE4 were 0.738 (95% confidence interval [CI], 0.616 to 0.840) and 0.728 (95% CI, 0.605 to 0.822), respectively. Presence of polyps was 94.1% sensitive, but 51.7% specific. Logistic regression models using random and surgeon specific datasets resulted in AUC of 0.882 (95% CI, 0.665 to 0.970) and 0.945 (95% CI, 0.755 to 0.995), respectively. ANN models resulted in AUC of 0.918 (95% CI, 0.756 to 0.975) and 0.956 (95% CI, 0.828 to 0.999) using random and surgeon‐specific datasets, respectively. Model comparison of logistic regression and ANN was not statistically different. All machine learning models had AUC greater than univariate analyses (all p < 0.003). Conclusion: Machine learning of 3 clinical inputs has the potential to predict eCRS with high sensitivity and specificity in this patient population. Prospective investigation using larger and more diverse populations is warranted. [ABSTRACT FROM AUTHOR]

Understanding composition‐structure‐property relationships of high‐alumina nuclear waste glasses are important for vitrification of nuclear waste at the Hanford Site. Two series of glasses were designed, one with varying Al:Si ratios and the other with (Al + Na):Si ratios based on the international simple glass (ISG, a simplified nuclear waste model glass), with Al2O3 ranging from 0 to 23 mol% (0 to 32 wt%). The glasses were synthesized and characterized using electron probe microanalysis, X‐ray photoelectron spectroscopy, small angle X‐ray scattering, high‐temperature oxide melt solution calorimetry, and infrared spectroscopy. Glasses were crystal free, and the lowest Na2O and Al2O3 glass formed an immiscible glass phase. Evolution of various properties—glass‐transition temperature, percentage of 4‐coordinated B, enthalpy of glass formation—and infrared spectroscopy results indicate that structural effects differ based on the glass series. [ABSTRACT FROM AUTHOR]

Previous "fraction of young water" (Fyw) estimates based on relative annual isotopic amplitudes in precipitation (Ap) and streamflow (As) produced low Fyw values in mountain catchments, which is contrary to extensive research that reports rapid water transmission in mountains. This study investigated this discrepancy by testing the effect of snow accumulation on the model that underpins the Fyw method. A Monte‐Carlo analysis of simulations for 20,000 randomly‐generated catchment model configurations used 10 years of precipitation inputs for the Upper Elbow River catchment in the Rocky Mountains (Alberta, Canada) to model discharge with and without snowpack storage of winter precipitation. Neither direct nor modified precipitation input produced a 1:1 relationship between As/Ap and Fyw, undermining the applicability of the original Fyw method in mountain watersheds with large seasonal snow accumulation. With snowpack‐modified input a given As/Ap ratio corresponds to a range of Fyw values, which can still provide semi‐quantitative information. In the small (435 km2) Elbow River catchment a Fyw range of 7–23% supports previous findings of rapid transmission in mountain catchments. Further analysis showed that the improved discharge prediction (Nash–Sutcliffe efficiency > 0.9) correlates with higher Fyw values and demonstrated that the interannual shifts in δ18O can be used to estimate of new water (<1 year) fraction in winter streamflow, and the estimate of 20% for the Elbow River further supports rapid transmission in mountain catchments. [ABSTRACT FROM AUTHOR]

Background: Transcranial magnetic resonance–guided focused ultrasound (TcMRgFUS) systems currently employ computed tomography (CT)–based aberration corrections, which may provide suboptimal trans‐skull focusing. Objectives: The objective of this study was to evaluate a contrast agent microbubble imaging‐based transcranial focusing method, echo‐focusing (EF), during TcMRgFUS for essential tremor. Methods: A clinical trial of TcMRgFUS thalamotomy using EF for the treatment of essential tremor was conducted (NCT03935581; funded by InSightec [Tirat Carmel, Israel]). Patients (n = 12) were injected with Definity (Lantheus Medical Imaging, North Billerica, MA) microbubbles, and EF was performed using a research feature add‐on to a commercial TcMRgFUS system (ExAblate Neuro, InSightec). Subablative thermal sonications carried out using (1) EF and (2) CT‐based aberration corrections were compared via magnetic resonance thermometry, and the optimal focusing method for each patient was employed for TcMRgFUS thalamotomy. Results: EF aberration corrections provided increased sonication efficiency, decreased focal size, and equivalent targeting accuracy relative to CT‐based focusing. EF aberration corrections were employed successfully for lesion formation in all 12 patients, 3 of whom had previously undergone unsuccessful TcMRgFUS thalamotomy via CT‐based focusing. There were no adverse events related directly to the EF procedure. Conclusions: EF is feasible and appears safe during TcMRgFUS thalamotomy for essential tremor and improves on the trans‐skull focal quality provided by existing CT‐based focusing methods. © 2020 International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the factor structure, internal consistency reliability, construct and criterion validity, and measurement invariance of the Interpersonal Needs Questionnaire (INQ) among adolescents. Method: Participants (N = 539) included three distinct samples of youth drawn from two outpatient psychology clinics and an inpatient psychiatric unit. The combined sample was 63.3% female and had a mean age of 14.95 years (SD = 1.31 years). All participants completed the INQ as well as measures of depressive symptoms and suicide ideation. Results: Confirmatory factor analyses indicated that the removal of three items from the thwarted belongingness subscale of the INQ was needed to achieve acceptable model fit. The resulting combined 12‐item scale demonstrated good factor structure, internal consistency reliability, construct validity, and criterion validity. The modified 12‐item INQ also demonstrated scalar invariance across subgroups defined by sex, race, and age. Conclusions: Findings support the use of this reduced 12‐item version of the INQ among adolescents. Youth may have difficulty accurately responding to changes in item valence; thus, future research with youth should consider using a 12‐item version of the INQ that avoids valence changes within subscales. [ABSTRACT FROM AUTHOR]

Background: Cancer cachexia is a complex metabolic disease with unmet medical need. Although many rodent models are available, none are identical to the human disease. Therefore, the development of new preclinical models that simulate some of the physiological, biochemical, and clinical characteristics of the human disease is valuable. The HT‐1080 human fibrosarcoma tumour cell line was reported to induce cachexia in mice. Therefore, the purpose of this work was to determine how well the HT‐1080 tumour model could recapitulate human cachexia and to examine its technical performance. Furthermore, the efficacy of ghrelin receptor activation via anamorelin treatment was evaluated, because it is one of few clinically validated mechanisms. Methods: Female severe combined immunodeficient mice were implanted subcutaneously or heterotopically (renal capsule) with HT‐1080 tumour cells. The cachectic phenotype was evaluated during tumour development, including body weight, body composition, food intake, muscle function (force and fatigue), grip strength, and physical activity measurements. Heterotopic and subcutaneous tumour histology was also compared. Energy balance was evaluated at standard and thermoneutral housing temperatures in the subcutaneous model. The effect of anamorelin (ghrelin analogue) treatment was also examined. Results: The HT‐1080 tumour model had excellent technical performance and was reproducible across multiple experimental conditions. Heterotopic and subcutaneous tumour cell implantation resulted in similar cachexia phenotypes independent of housing temperature. Tumour weight and histology was comparable between both routes of administration with minimal inflammation. Subcutaneous HT‐1080 tumour‐bearing mice presented with weight loss (decreased fat mass and skeletal muscle mass/fibre cross‐sectional area), reduced food intake, impaired muscle function (reduced force and grip strength), and decreased spontaneous activity and voluntary wheel running. Key circulating inflammatory biomarkers were produced by the tumour, including growth differentiation factor 15, Activin A, interleukin 6, and TNF alpha. Anamorelin prevented but did not reverse anorexia and weight loss in the subcutaneous model. Conclusions: The subcutaneous HT‐1080 tumour model displays many of the perturbations of energy balance and physical performance described in human cachexia, consistent with the production of key inflammatory factors. Anamorelin was most effective when administered early in disease progression. The HT‐1080 tumour model is valuable for studying potential therapeutic targets for the treatment of cachexia. [ABSTRACT FROM AUTHOR]

Objective: Recognized as a premier approach for adverse event (AE) detection, trigger tools have been developed for multiple clinical settings outside the emergency department (ED). We recently derived and tested an ED trigger tool (EDTT) with enhanced features for high‐yield detection of harm, consisting of 30 triggers associated with AEs. In this study, we validate the EDTT in an independent sample and compare record selection approaches to optimize yield for quality improvement. Methods: This is a retrospective observational study using data from 13 months of visits to an urban, academic ED by patients aged ≥ 18 years (92,859 records). We conducted standard two‐tiered trigger tool reviews on an independent validation sample of 3,724 records with at least one of the 30 triggers found associated with AEs in our previous derivation sample (N = 1,786). We also tested three new candidate triggers and reviewed 72 records with no triggers for comparison purposes. We compare derivation and validation samples on: 1) triggers showing persistent associations with AEs, 2) AE yield (AEs detected/records reviewed), and 3) representativeness of AE types detected. We use bivariate associations of triggers with AEs as the basis for trigger selection. We then use multivariable modeling in the combined derivation and validation samples to determine AE risk scores using trigger weights. This allows us to predict occurrence of AEs and derive population prevalence estimates. Finally, we compare yield for detection of AEs under three record selection strategies (random selection, trigger counts, weighted trigger counts). Results: Twenty‐four of the 30 triggers were confirmed to be associated with AEs on bivariate testing. Three previously marginal triggers and two of three new candidate triggers were also found to be associated with AEs. The presence of any of these 29 triggers was associated with an AE rate of 10% in our selected sample (compared to 1.1% for none, p < 0.001). The risk of an AE increased with number of triggers. Combining data from both phases, we identified 461 AEs in 429 unique visits in 5,582 records reviewed. Our multivariable model (which emphasized parsimony) retained 12 triggers with a ROC AUC of 82% in both samples. Selecting records for review based on number of triggers improves yield to 14% for 4+ triggers (top 10% of visits) and to 28% for 8+ (top 1%). A weighted trigger count has corresponding yields of 18 and 38%. The method for selecting records for review did not appear to affect event‐type representativeness, with similar distributions of event types and severities detected. Conclusions: In this single‐site study of the EDTT we observed high levels of validity in trigger selection, yield, and representativeness of AEs, with yields that are superior to estimates for traditional approaches to AE detection. Record selection using weighted triggers outperforms a trigger count threshold approach and far outperforms random sampling from records with at least one trigger. The EDTT is a promising efficient and high‐yield approach for detecting all‐cause harm to guide quality improvement efforts in the ED. [ABSTRACT FROM AUTHOR]

Objective: The current study examines components of the Interpersonal Theory of Suicide as mediators of the association between attention‐deficit/hyperactivity disorder (ADHD) symptoms and suicide ideation in college students with elevated depressive symptoms. Specifically, indirect effects of perceived burdensomeness and thwarted belongingness were simultaneously evaluated on the association between self‐reported ADHD symptoms and suicide ideation, controlling for gender and levels of depression. Method: Participants were 217 college students with elevated depressive symptoms (Mage = 20.72 years old; SD = 3.74) who participated in a larger study on mood and well‐being. The sample was predominantly female (77.9% female) and Hispanic (72.7%). Results: In a multivariate mediation model controlling for gender and depressive symptoms, there were significant indirect effects of perceived burdensomeness and thwarted belongingness on the association between self‐reported ADHD symptoms and suicide ideation. Conclusion: Perceived burdensomeness and thwarted belongingness may represent promising targets for preventing suicide ideation in individuals with elevated ADHD symptoms. [ABSTRACT FROM AUTHOR]

Marrow adipocytes and osteoblasts differentiate from common mesenchymal progenitors in a mutually exclusive manner, and diversion of these progenitors toward adipocytes in old age has been proposed to account for the decline in osteoblasts and the development of involutional osteoporosis. This idea has been supported by evidence that thiazolidinedione (TZD)‐induced activation of PPARγ, the transcription factor required for adipocyte differentiation, increases marrow fat and causes bone loss. We functionally tested this hypothesis using C57BL/6J mice with conditional deletion of PPARγ from early mesenchymal progenitors targeted by the Prx1‐Cre transgene. Using a longitudinal littermate‐controlled study design, we observed that PPARγ is indispensable for TZD‐induced increase in marrow adipocytes in 6‐month‐old male mice, and age‐associated increase in marrow adipocytes in 22‐month‐old female mice. In contrast, PPARγ is dispensable for the loss of cortical and trabecular bone caused by TZD or old age. Instead, PPARγ restrains age‐dependent development of cortical porosity. These findings do not support the long‐standing hypothesis that increased marrow adipocyte differentiation contributes to bone loss in old age but reveal a novel role of mesenchymal cell PPARγ in the maintenance of cortical integrity. [ABSTRACT FROM AUTHOR]

The novel coronavirus SARS‐CoV‐2 has emerged as one of the most compelling and concerning public health challenges of our time. To address the myriad issues generated by this pandemic, an interdisciplinary breadth of research, clinical and public health communities has rapidly engaged to collectively find answers and solutions. One area of active inquiry is understanding the mode(s) of SARS‐CoV‐2 transmission. Although respiratory droplets are a known mechanism of transmission, other mechanisms are likely. Of particular importance to global health is the possibility of vertical transmission from infected mothers to infants through breastfeeding or consumption of human milk. However, there is limited published literature related to vertical transmission of any human coronaviruses (including SARS‐CoV‐2) via human milk and/or breastfeeding. Results of the literature search reported here (finalized on 17 April 2020) revealed a single study providing some evidence of vertical transmission of human coronavirus 229E; a single study evaluating presence of SARS‐CoV in human milk (it was negative); and no published data on MERS‐CoV and human milk. We identified 13 studies reporting human milk tested for SARS‐CoV‐2; one study (a non‐peer‐reviewed preprint) detected the virus in one milk sample, and another study detected SARS‐CoV‐2 specific IgG in milk. Importantly, none of the studies on coronaviruses and human milk report validation of their collection and analytical methods for use in human milk. These reports are evaluated here, and their implications related to the possibility of vertical transmission of coronaviruses (in particular, SARS‐CoV‐2) during breastfeeding are discussed. [ABSTRACT FROM AUTHOR]

The Persistent Complex Bereavement Disorder (PCBD) Checklist was constructed to facilitate the developmentally sensitive assessment of proposed PCBD criteria in bereaved children and adolescents 8-18 years of age. Initial analyses of the PCBD Checklist provided support for the hypothesized two-factor model. The purpose of the present study was to evaluate the measurement invariance of the PCBD Checklist with respect to gender (boys and girls), race/ethnicity (White, Black, and Hispanic youth), and age (school age, preadolescent, and adolescent youth). Participants were 594 youth (50.4% female) aged 7-18 years (M = 11.91, SD = 2.80) who were evaluated as part of standard care at a community-based grief support center. Youth self-identified as Hispanic (n = 184, 30.8%), non-Hispanic white (n = 179, 30.0%), and African American/Black (n = 136, 22.8%). A series of stepwise, multigroup confirmatory factor analyses provided evidence in support of the PCBD Checklist's measurement invariance for all three groups concerning configural invariance, metric invariance, and scalar invariance. These results suggest that PCBD Checklist Criterion B and C scores are measuring similar latent variables, to a similar degree, across gender, race/ethnicity, and age. Establishing the cross-group equivalence of the PCBD Checklist is an important endorsement of its generalizability and clinical utility in that it can be administered to diverse populations with confidence that it is measuring proposed PCBC diagnostic criteria similarly across subgroups. [ABSTRACT FROM AUTHOR]

The Active Inhibition Scale (AIS; Ayers, Sandler, & Twohey, 1998) is an 11-item, self-report measure of emotional suppression among children and adolescents. Previous research with the AIS has linked emotional suppression to several clinically significant outcomes, such as posttraumatic stress symptoms (PTSS) and suicide, among trauma-exposed and bereaved youth; however, there are no published evaluations of its psychometric properties. We examined the factor structure and criterion validity of the AIS in two samples. Sample 1 included youth (M = 12.22 years, SD = 2.96, range: 6-18 years; 55.4% female) referred to an outpatient psychology clinic specializing in childhood trauma and grief. Sample 2 included youth (M = 13.18 years, SD = 2.58, range: 8-18 years; 61.8% female) referred to a community grief counseling center. Confirmatory factor analytic results supported a one-factor solution, Cronbach's α = .94. Additionally, AIS scores correlated positively with PTSS, depression, and maladaptive grief, rs = .43-.64. Evidence of factorial invariance was found across gender, race/ethnicity, and age group. Emotional suppression scores were higher among girls compared to boys, Black and Hispanic youth compared to White youth, and older compared to younger age groups. The magnitude of correlations between AIS and symptom measure scores was comparable across groups. These results support the reliability and criterion validity of the AIS with diverse youth populations and underscore the role that emotional suppression may play in explaining group differences in mental health symptoms. [ABSTRACT FROM AUTHOR]