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With an evolving understanding and new discoveries in extracellular vesicle (EV) biology and their implications in health and disease, the significant diagnostic and therapeutic potential of EVs for vision research has gained recognition. In 2021, the National Eye Institute (NEI) unveiled its Strategic Plan titled 'Vision for the Future (2021–2025),' which listed EV research as a priority within the domain of Regenerative Medicine, a pivotal area outlined in the Plan. In alignment with this prioritization, NEI organized a workshop inviting twenty experts from within and beyond the visual system. The workshop aimed to review current knowledge in EV research and explore gaps, needs and opportunities for EV research in the eye, including EV biology and applications of EVs in diagnosis, therapy and prognosis within the visual system. This perspective encapsulates the workshop's deliberations, highlighting the current landscape and potential implications of EV research in advancing eye health and addressing visual diseases. [ABSTRACT FROM AUTHOR]

This article presents findings from a six‐month Language and Social Justice course collaboratively designed with multilingual educators in the Dominican Republic. Teaching and learning processes with Dominican and Haitian youth (ages 18–24) illustrate how opportunities to learn about English and Kreyòl from a transnational perspective can disrupt dominant discourses about youth's relationships with themselves and each other. By intentionally focusing on counternarratives to notions that Dominican youth reject their Blackness and that Dominican and Haitian youth interact in tension rather than solidarity, this study highlights how youth “translate blackness” (García Peña, 2022) through language learning. Drawing from transnational literacy frameworks that engage the cultural and linguistic repertoires of Black youth in relationship with one another (Skerrett & Omogun, 2020; Smith, 2023) and from Black‐centered language pedagogies (Anya, 2017; Clemons, 2021b), I describe how youth negotiate meanings and orientations to Blackness through language and literacy practices. [ABSTRACT FROM AUTHOR]

Background: Opioid pain management in cancer survivorship is a complex and understudied topic. Methods: The authors conducted in‐depth, qualitative interviews to understand clinician approaches to opioid pain management in chronic cancer pain and to generate ideas for improvement. They used a rigorous, inductive, qualitative, descriptive approach to examine clinician (n = 20) perspectives about opioid pain management in survivorship, including oncologists (n = 5), palliative care clinicians (n = 8), primary care clinicians (n = 5), and pain management specialists (n = 2). Results: The findings indicated that no consistent medical home exists for chronic pain management in cancer survivors and that there are fundamental differences in how each subspecialty approaches chronic pain management in survivorship (e.g., "Do we think of this as noncancer pain or cancer pain?... This is in this limbo zone—this gray zone—because it's cancer‐related pain, right?"). Simultaneously, clinicians are influenced by their peers' perceptions of their opioid prescribing decisions, sparking intraprofessional tension when disagreement occurs. In these instances, clinicians described overthinking and doubting their clinical decision‐making as well as a sense of judgment, pressure, and/or shame. Finally, clinicians acknowledged a fear of consequences for opioid prescribing decisions. Specifically, participants cited conflict with patients, sometimes escalating to aggression and threats of violence, as well as potential disciplinary actions and/or legal consequences. Conclusions: Participants suggested that opportunities to improve chronic cancer pain care include developing clear, systematic guidance for chronic cancer pain management, facilitating clinician communication and consultation, creating tailored survivorship care plans in partnership with patients, and developing accessible, evidence‐based, complementary pain treatments. Pain in cancer remission is common, yet there is no clear medical home or systematic treatment approach for people with chronic cancer pain. Thus, it is essential to develop clear, systematic guidance for chronic cancer pain management, facilitate clinician communication and consultation, create tailored survivorship care plans alongside patients, and improve access to evidence‐based nonpharmacologic pain treatments. [ABSTRACT FROM AUTHOR]

High‐impact practices (HIPs) are educational practices that foster student success. HIPs have not been widely used in cancer education and research despite the need for students to develop key transferable skills and cultivate social responsibility. Our study addresses this need by implementing four community‐based learning HIPs within the context of cancer education and research. Each HIP was classified as having low, moderate, or high alignment with the traits of effective HIPs. Undergraduate science students participated in one to four HIPs as a Feedback Participant, General Volunteer, Student Leader, or Cancer Undergraduate Research and Education (CURES) Class Student. We then studied the effect of these HIPs on students' development of knowledge and skills; career interest and preparedness; and social responsibility. Results from self‐reported questionnaires showed that HIPs increased students' cancer knowledge and developed their transferable and technical skills. Many students reported that these HIPs strongly impacted their career preparedness; positively influenced their interest in pursuing careers in health or biomedical sciences; and encouraged them to participate in community service activities. Thus, these findings provide new insights into the perceived benefits of HIPs in cancer education and research by undergraduate students. [ABSTRACT FROM AUTHOR]

The current work explores three potential facilitators of judicial performance. Participants in a state‐wide survey of judicial officers (response rate = 33.9 percent) completed self‐report measures of self‐efficacy, prosocial impact, and self‐legitimacy as well as subjectively perceived performance. Objective performance data collected by the state court administrative office were then merged with the survey data. Latent variable analysis confirmed the three predictor constructs' separability, and although all four concepts were correlated, self‐efficacy was the sole independent predictor of subjective performance. An unplanned mediation analysis suggested significant indirect effects of self‐legitimacy and prosocial impact on subjectively assessed performance through self‐efficacy. Regarding objective performance, self‐efficacy emerged as the only significant correlate or predictor. The research therefore empirically demonstrates the empirical distinctiveness of self‐efficacy, prosocial impact, and self‐legitimacy and provides some exploratory support for a causal model whereby self‐efficacy provides the proximal impact on performance but is itself facilitated by prosocial impact and self‐legitimacy. [ABSTRACT FROM AUTHOR]

Large mammals often impose significant costs such as livestock depredation or crop foraging on rural communities, and this can lead to the retaliatory killing of threatened wildlife populations. One conservation approach—payments to encourage coexistence (PEC)—aims to reduce these costs through financial mechanisms, such as compensation, insurance, revenue sharing, and conservation performance payments. Little is known about the equitability of PEC, however, despite its moral and instrumental importance, prevalence as a conservation approach, and the fact that other financial tools for conservation are often inequitable. We used examples from the literature to examine the capability of PEC—as currently perceived and implemented—to be inequitable. We recommend improving the equitability of current and future schemes through the cooperative design of schemes that promote compensatory equity and greater consideration of conservation performance payments and by changing the international model for funding PEC to reduce global coexistence inequalities. New and existing programs must address issues of equitability across scales to ensure that conservation efforts are not undermined by diminished social legitimacy. [ABSTRACT FROM AUTHOR]

Introduction: Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods: We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results: The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions: Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation. [ABSTRACT FROM AUTHOR]

This study investigated the efficacy of psychotherapy during hospitalization on an acute psychiatric ward. A controlled trial was conducted to assess the effects of Metacognitive Reflection and Insight Therapy (MERIT) upon metacognition and psychiatric symptoms. Data from 40 inpatient women were analysed. Findings included significant interaction effects between group (intervention or control group) and time (preintervention and postintervention) in regard to the metacognitive abilities and general psychiatric symptoms. Participating in MERIT seems to improve one's ability to use reflective knowledge to cope with psychological challenges and to improve symptomatology level. [ABSTRACT FROM AUTHOR]

Robotic arms are now commonplace in diverse settings and are poised to play a crucial role in automating laboratory tasks. However, biological experiments remain challenging for automation due to their dependence on human factors, such as researchers' skills and experience. This article introduces robotic automation and remote control for both general and biological research tasks through a modularized platform comprising a robotic arm, auxiliary tools, and software. This platform facilitates fully automated or remote execution of key experiments in chemistry and biology, including liquid handling, mixing, cell seeding, culturing, and genetic manipulation. The robot interfaces seamlessly with standard laboratory equipment and operates remotely in real time through an online program. Integration of a vision system via robotic arm webcams ensures precise positioning and object localization, enhancing accuracy. This modularized robotic platform signifies a substantial advancement in lab automation, promising enhanced efficiency, reproducibility, and scientific progress compared to human‐led experiments. [ABSTRACT FROM AUTHOR]

Summary: Depressive symptoms are prevalent in individuals living with sickle cell disease (SCD) and may exacerbate pain. This study examines whether higher depressive symptoms are associated with pain outcomes, pain catastrophizing, interference and potential opioid misuse in a large cohort of adults with SCD. The study utilized baseline data from the 'CaRISMA' trial, which involved 357 SCD adults with chronic pain. Baseline assessments included pain intensity, daily mood, the Patient Health Questionnaire (PHQ), the Generalized Anxiety Disorders scale, PROMIS Pain Interference, Pain Catastrophizing Scale, the Adult Sickle Cell Quality of Life Measurement Information System and the Current Opioid Misuse Measure. Participants were categorized into 'high' or 'low' depression groups based on PHQ scores. Higher depressive symptoms were significantly associated with increased daily pain intensity, negative daily mood, higher pain interference and catastrophizing, poorer quality of life and a higher likelihood of opioid misuse (all p < 0.01). SCD patients with more severe depressive symptoms experienced poorer pain outcomes, lower quality of life and increased risk of opioid misuse. Longitudinal data from this trial will determine whether addressing depressive symptoms may potentially reduce pain frequency and severity in SCD. [ABSTRACT FROM AUTHOR]

The startle response is a cross‐species defensive reflex that is considered a key tool for cross‐species translational emotion research. While the neural pathway mediating (affective) startle modulation has been extensively studied in rodents, human work on brain‐behavior interactions has lagged in the past due to technical challenges, which have only recently been overcome through non‐invasive simultaneous EMG‐fMRI assessments. We illustrate key paradigms and methodological tools for startle response assessment in rodents and humans and review evidence for primary and modulatory neural circuits underlying startle responses and their affective modulation in humans. Based on this, we suggest a refined and integrative model for primary and modulatory startle response pathways in humans concluding that there is strong evidence from human work on the neurobiological pathway underlying the primary startle response while evidence for the modulatory pathway is still sparse. In addition, we provide methodological considerations to guide future work and provide an outlook on new and exciting perspectives enabled through technical and theoretical advances outlined in this work. This comprehensive review addresses a critical gap in cross‐species translational emotion research by examining the current evidence for neural pathways of the startle response in humans. By highlighting key paradigms, methodological advancements, and the limited evidence for modulatory pathways in humans, this work provides an evidence‐based foundation for future investigations and details how non‐invasive simultaneous EMG‐fMRI assessments open new avenues for exploring (pathological) emotion processing in humans. [ABSTRACT FROM AUTHOR]

Objectives: Vertigo describes symptoms of abnormal movement of the environment or the patient's own body. As such, it affects patients' quality of life, prevents them from following their daily activities, and increases healthcare utilization. The Global Burden of Disease Project aims to quantify morbidity and mortality worldwide. In 2013, a separate disability weight for vertigo was introduced. The aim of this study is to estimate the symptom burden of disease caused by vertigo. Methods: This study analyzes data from the Gutenberg Health Study (GHS). The GHS is a population‐based cohort study representative of the city of Mainz and its district. Participants were asked whether they suffered from vertigo and, if so, how bothered they felt by it, rating their distress on a six‐level scale from 1 = little stressful to 6 = extremely stressful. Results: Eight thousand five hundred and nineteen participants could be included in the study. The overall prevalence of vertigo was 21.6% (95%‐confidence interval [CI] [20.7%; 22.5%]). Vertigo prevalence peaked in the age group of 55–64 years. Vertigo annoyance averaged 2.42 (±1.28). When an annoyance of 3–6 was considered bothersome, the prevalence of bothersome vertigo was 8.1 % (95%‐CI [7.5%; 8.7%]). Age‐standardized to the European Standard Population 2013, vertigo caused a burden of 2102 years lived with disability per 100,000 population. Conclusion: In this study, it was found that one in five people suffer at least occasionally from vertigo. This result suggests a significant burden of disease. This burden is reported at the symptom level. Future studies are needed to attribute the burden to specific causes. Level of Evidence: 2. [ABSTRACT FROM AUTHOR]

Middle infrared spectral results obtained in‐situ by the Hayabusa2 MARA instrument are generally in‐line with previous results and a new comparison with sample C0137 returned from asteroid (162173) Ryugu, being similar to an aqueously altered CI1 chondrite. The mid‐IR spectrum of the boulder on Ryugu measured by MARA is shallower around 9 μm compared to the laboratory spectrum of C0137. Here we show that discontinuous, fine dust deposits can partially explain the differences in the spectral data and remain in agreement with the temperature observations of the boulder by MARA if an opaque dust layer covers less than 3% of the field of view. Such a presence of dust covering a low porosity boulder was discounted by previous analysis of the mid‐infrared MARA data which did not consider a highly porous boulder as we do here. Plain Language Summary: The Japanese Hayabusa2 space mission returned samples from asteroid Ryugu. Here we compare the spectra of the sample observed in the middle infrared (5–25 μm) with in‐situ observations in the part of the electromagnetic spectrum. We find differences between the spectra that can be explained by the presence of fine particles on the surface of Ryugu. Earlier works found that little to no dust can be present on Ryugu and we revisit these studies an derive an upper limit on the amount of dust consistent with the infrared observations. We find that less than 3% of the observed surface can be covered in an opaque dust layer which is likely concentrated in cracks and pores. Our results are consistent with the results of other studies that the amount of dust that a surface of an asteroid can retain decreases with its size. Key Points: The Ryugu sample C0137's mid‐IR spectrum shows differences to in‐situ observations by MARAThe differences can be explained by the presence of dust on the boulders of RyuguThermal modeling reveals that dust covering less than 3% of the MARA field of view is consistent with the MARA data [ABSTRACT FROM AUTHOR]

Individual differences in sociodemographic characteristics and trait‐like perceptions of opportunities and constraints may shape how people respond to adversities such as the COVID‐19 pandemic. However, little is known about how these factors combine to form multifaceted profiles of developmental opportunity and constraint or the implications of such profiles for longitudinal well‐being following major life stressors. Using 1‐year data from a national sample of U.S. adults (n = 293), we identified profiles based on relevant sociodemographic characteristics (age, socioeconomic status, chronic conditions, functional status) and trait‐like perceptions of opportunity and constraints (perceived mastery, perceived constraints). Results of latent profile analyses showed that three common profiles emerged at pandemic onset (veridical opportunity, perceived constraints, perceived opportunity). Subsequent latent growth models showed that, despite reporting more sociodemographic constraints, the perceived opportunity profile exhibited better 1‐year emotional well‐being (positive and negative affect) during the pandemic than the perceived constraints profile. Findings advance the literature by identifying multifaceted individual differences in profiles of developmental opportunity and constraint and by showing these profiles have consequences for longitudinal well‐being following the pandemic onset. [ABSTRACT FROM AUTHOR]

The ability to reengage with new attainable goals after major setbacks is a core self‐regulatory trait linked to health and well‐being. Yet little is known about the extent to which such goal reengagement capacities may shift over time in response to changing contextual circumstances. Using a nationally‐representative sample of U.S. adults aged 18–80 (n = 293), the present 1‐year study examined whether changes in opportunity to influence life circumstances (perceived control) were coupled with dynamic shifts in goal reengagement capacity for individuals who differed in their levels of control at pandemic onset. Results from multilevel models showed that within‐person increases in perceived control during the pandemic predicted corresponding within‐person increases in goal reengagement capacity. Moderation models showed that the positive within‐person association between perceived control and goal reengagement was pronounced for individuals with lower levels of control at pandemic onset who may be particularly sensitive to periods of opportunity to pursue new attainable goals. Findings inform theories of personality and self‐regulation in pointing to contextual circumstances under which goal reengagement capacity exhibits dynamic shifts in populations who differ in their perceived opportunities for control. [ABSTRACT FROM AUTHOR]

Objectives: Initial responses to coronavirus disease 2019 vaccination are impaired in patients with hematological malignancies. We investigated immune responses after three or four doses of BNT162b2 in patients with myeloid and lymphoid malignancies compared to controls, and identified risk factors for humoral and cellular nonresponse 1 year after first vaccination. Methods: In 407 hematological patients (45 myeloid, 362 lymphoid) and 98 matched controls, we measured immunoglobulin G (IgG) and neutralizing antibodies specific for the receptor‐binding domain of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) at baseline, 3 weeks, 2, 6, and 12 months, and interferon‐γ release at 12 months. Results: In patients with lymphoid malignancies, SARS‐CoV‐2 receptor‐binding domain IgG concentration and mean neutralizing capacity was lower than in controls at all time points. A diagnosis of chronic lymphocytic B‐cell leukemia (CLL) or lymphoma was associated with humoral nonresponse at 12 months compared to having multiple myeloma/amyloidosis (p <.001 and p =.013). Compared to controls, patients with lymphoid malignancies had increased risk of cellular nonresponse. A lymphoma diagnosis was associated with lower risk of cellular nonresponse compared to patients with multiple myeloma/amyloidosis, while patients with CLL had comparable response rates to patients with multiple myeloma/amyloidosis (p =.037 and p =.280). Conclusions: In conclusion, long‐term humoral and cellular immune responses to BNT162b2 were impaired in patients with lymphoid malignancies. [ABSTRACT FROM AUTHOR]

Background: Narrative medicine is a powerful approach for strengthening clinicians' therapeutic alliances with patients and helping them understand others' perspectives by giving patients a voice. MyPaTH Story Booth is a cross‐sectional observational study that uses narrative medicine concepts to allow community participants to share their health and healthcare‐related experiences through relatively unstructured interviews (i.e., stories). The archive forms a qualitative research ʻcommonsʼ where researchers can learn about patient and caregiver perspectives and tailor research goals to better address community needs. Brief surveys allow storytellers to classify their stories so that the archive is searchable. Methods: This study assessed sensitivity, specificity, positive predictive and negative predictive values of self‐reported surveys for categorizing 83 stories, compared with a ʻgold standardʼ (most commonly accepted method for interpreting narratives) of qualitative coding. Stories were classified as either having or not having each of 38 different classifications based on US National Library of Medicine (NLM) Health Topics (Type of disorder or condition and Part of the body discussed) or developed with stakeholder input (Type of health/healthcare experience). Results: Survey data assessing ʻPart of the body discussedʼ and ʻType of disorder or conditionʼ typically was highly sensitive (64%–95%) and specific (73%–99%) suggesting high adequacy of surveys in identifying stories. Questions focused on ʻType of health/healthcare experienceʼ showed inconsistent and relatively lower sensitivities (48%–93%) and specificities (30%–79%) suggesting lower adequacy of surveys in identifying stories. Conclusion: Survey items based on NLM Health Topics allowed people to categorize their health narratives into relevant, searchable topics making the database more accessible. [ABSTRACT FROM AUTHOR]

Teachers are instrumental in antibullying efforts given their position of authority in the classroom context, yet teachers can only be effective at reducing victimization and bullying in their classrooms if they are aware of who is involved. Consequently, teachers' attunement to bullies and victims is a critical component of social dynamics management and antibullying practices. Given the importance of teacher attunement, there is a pressing need to identify relevant factors related to the degree to which teachers are attuned to bullies and victims. The major objective of the current investigation was to examine student‐ (gender, popularity status), classroom‐ (average bullying, norm salience of bullying, popularity hierarchy, class size), and teacher‐level (gender, teaching experience) factors associated with teachers' attunement to bullies and victims. Using a sample of students in 5th‐grade classrooms, we analyzed the likelihood of teachers being attuned to 267 bullies (76.8% boys) nested in 112 classrooms and 343 victims (55.1% boys) nested in 120 classrooms using multilevel mixed‐effects generalized linear models. Results indicated that teachers were more likely to be attuned to boy bullies and victims but less likely to be attuned to bullies and victims with higher popularity status. No classroom or teacher level factors related significantly to the likelihood of teachers' attunement. Implications for social dynamics management and bullying intervention efforts are discussed. [ABSTRACT FROM AUTHOR]

Caraway (Carum carvi L.) is a crop species that is gaining in importance in Europe, especially as a condiment and medicinal plant. Here, we present the plant–pollinator network of caraway in a central European agricultural landscape, focusing on two diverse potential pollinator taxa, Diptera: Brachycera (= true flies) and Hymenoptera (sawflies, bees, and wasps). We specifically studied qualitative differences in interactions between the two insect taxa as well as the intraday and intraseasonal variability of the network. Insect and pollen plant species determination was done via morphological identification and DNA (meta)barcoding. In total, 121 species representing 33 families of Hymenoptera and Brachycera were found to carry caraway pollen. These taxa included many nonhoneybee and nonhoverfly species, showing a wide taxonomic breadth of potential pollinators and a higher network complexity than previously anticipated. There are distinct qualitative differences between Brachycera and Hymenoptera networks, suggesting complementary roles of both taxa in the pollination of native and crop plants. Strong intraday differences in potential pollinator diversity make it necessary to collect insects and pollen at different times of the day to compile complete plant–pollinator networks. Intraseasonal analyses of the plant–pollinator network of caraway show the potential of caraway as an important food source for insect species with an activity peak in late summer. [ABSTRACT FROM AUTHOR]

Globally, the child health focus has been on reducing under‐5‐year mortality, with large populations in low‐resource regions prioritised. Children in older age groups, particularly in less populated regions such as the Pacific, have received limited attention. Child health research in the Pacific region has been lacking, and research approaches for the region have historically been from Western biomedical paradigms. We completed the study of primary school children's health over a period of 5 years. Firstly, we conducted a literature review, then we completed an audit of hospital admissions of primary school children, then we completed a two‐round Delphi process and finally, we piloted the survey in three primary schools. Our results found there were high levels of oral health problems, ear health, obesity and exposure to violence and poverty impacting on the quality of health of primary school‐age children. Identifying these indicators was made possible by the partnerships and trust established by the study team and provides specific and measurable targets for future work to improve the quality of child health outcomes. This paper describes key field work lessons learnt for research in the Pacific region. It must: (i) be on the platform of relationship, cultural safety and local ownership; (ii) include consideration of holistic Pacific paradigms of health; (iii) be adaptive to the context and environment; and (iv) be committed to long‐term partnership and work. [ABSTRACT FROM AUTHOR]

Copyright of Journal der Deutschen Dermatologischen Gesellschaft is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Onychomycosis is a fungal infection of the fingernails and toenails. In Europe, tinea unguium is mainly caused by dermatophytes. The diagnostic workup comprises microscopic examination, culture and/or molecular testing (nail scrapings). Local treatment with antifungal nail polish is recommended for mild or moderate nail infections. In case of moderate to severe onychomycosis, oral treatment is recommended (in the absence of contraindications). Treatment should consist of topical and systemic agents. The aim of this update of the German S1 guideline is to simplify the selection and implementation of appropriate diagnostics and treatment. The guideline was based on current international guidelines and the results of a literature review conducted by the experts of the guideline committee. This multidisciplinary committee consisted of representatives from the German Society of Dermatology (DDG), the German‐Speaking Mycological Society (DMykG), the Association of German Dermatologists (BVDD), the German Society for Hygiene and Microbiology (DGHM), the German Society of Pediatric and Adolescent Medicine (DGKJ), the Working Group for Pediatric Dermatology (APD) and the German Society for Pediatric Infectious Diseases (DGPI). The Division of Evidence‐based Medicine (dEBM) provided methodological assistance. The guideline was approved by the participating medical societies following a comprehensive internal and external review. [ABSTRACT FROM AUTHOR]

Background and purpose: The insula has important functions in monitoring and integrating physiological responses to a personal experience of multimodal input. The experience of chills in response to auditory stimuli is an important example for a relevant arousing experience coupled with bodily response. A group study about altered chill experiences in patients with insula lesions is lacking. Methods: Twenty‐eight stroke patients with predominantly insula lesions in the chronic stage and 14 age‐matched controls were investigated using chill stimuli of both valences (music, harsh sounds). Group differences were analyzed in subjective chill reports, associated bodily responses (skin conductance response), lesion mapping, diffusion‐weighted imaging and functional magnetic resonance imaging. Other neuropsychological deficits were excluded by comprehensive testing. Diffusion‐weighted imaging was quantified for four insula tracts using fractional anisotropy. Results: The frequency of chill experiences was comparable between participant groups. However, bodily responses were decreased for the stroke group. Whereas there was no association of lesion location, a positive association was found for the skin conductance response during aversive sounds and the tract connecting anterior inferior insula and left temporal pole in the stroke group. Similarly, functional magnetic resonance imaging activation in areas hypothesized to compensate for damage was increased with bodily response. Conclusions: A decoupling of felt arousal and bodily response after insula lesion was observed. Impaired bodily response was related to an impaired interaction of the left anterior insula and the temporal pole. [ABSTRACT FROM AUTHOR]

This article reports on findings from the first year of a professional learning partnership aimed at supporting elementary teachers in improving their writing instruction for emergent bilingual students. Specifically, we present a case study of one fourth grade teacher's writing instruction, exploring how an introduction to a functional approach to teaching argument writing contributed to shifts in practice and in her understanding of effective writing instruction for emergent bilingual students. The research team engaged in two cycles of data collection across 5 months, conducted before and after an introductory seven‐hour professional development workshop on systemic functional linguistics (SFL) genre pedagogy, in order to document changes in how the focal teacher was enacting and conceptualizing writing instruction for emergent bilinguals. Findings revealed three central shifts in the teacher's writing instruction: (1) from surface‐level genre engagement to exploring functional relationships between genre stages, (2) from assessment‐oriented writing instruction to learning activities grounded in authentic purpose and audience, and (3) from general language supports to targeted, contextualized writing scaffolds. This study builds upon existing scholarship by illustrating the potential of (even limited exposure to) SFL genre pedagogy to shift teachers' writing instruction toward social semiotic perspectives of language and literacy. We also extend existing research by interrogating the institutional and ideological challenges teachers encounter when taking up SFL genre pedagogy and by offering some initial insights into the potential for engaging in SFL genre pedagogy in bilingual learning spaces. [ABSTRACT FROM AUTHOR]

Aims: Intravenous iron therapy (IVIT) is known to improve functional status in chronic heart failure (CHF) patients. The exact mechanism is not completely understood. We correlated magnetic resonance imaging (MRI) patterns of T2* iron signal in various organs to systemic iron and exercise capacity (EC) in CHF before and after IVIT. Methods and results: We prospectively analysed 24 patients with systolic CHF for T2* MRI pattern of the left ventricle (LV), small and large intestines, spleen, liver, skeletal muscle, and brain for iron. In 12 patients with iron deficiency (ID), we restored iron deficit by IVIT using ferric carboxymaltose. The effects after 3 months were analysed by spiroergometry and MRI. Patients with vs. without ID showed lower blood ferritin, haemoglobin (76 ± 63 vs. 196 ± 82 μg/L and 12.3 ± 1.1 vs. 14.2 ± 1.1 g/dL, all P < 0.002), and in trend a lower transferrin saturation (TSAT) (19.1 [13.1; 28.2] vs. 25.1 [21.3; 29.1] %, P = 0.05). Spleen and liver iron was lower as expressed by higher T2* value (71.8 [66.4; 93.1] vs. 36.9 [32.9; 51.7] ms, P < 0.002 and 33.5 ± 5.9 vs. 28.8 ± 3.9 ms, and P < 0.03). There was a strong trend for a lower cardiac septal iron content in ID (40.6 [33.0; 57.3] vs. 33.7 [31.3; 40.2] ms, P = 0.07). After IVIT, ferritin, TSAT, and haemoglobin increased (54 [30; 104] vs. 235 [185; 339] μg/L, 19.1 [13.1; 28.2] vs. 25.0 [21.0; 33.7] %, 12.3 ± 1.1 vs. 13.3 ± 1.3 g/L, all P < 0.04). Peak VO2 improved (18.2 ± 4.2 vs. 20.9 ± 3.8 mL/min/kg−1, P = 0.05). Higher peak VO2 at anaerobic threshold was associated with higher blood ferritin, reflecting higher metabolic exercise capacity after therapy (r = 0.9, P = 0.0009). Increase in EC was associated with haemoglobin increase (r = 0.7, P = 0.034). LV iron increased by 25.4% (48.5 [36.2; 64.8] vs. 36.2 [32.9; 41.9] ms, P < 0.04). Spleen and liver iron increased by 46.4 and 18.2%, respectively (71.8 [66.4; 93.1] vs. 38.5 [22.4; 76.9] ms, P < 0.04 and 33.5 ± 5.9 vs. 27.4 ± 8.6 ms, P < 0.007). Iron in skeletal muscle, brain, intestine, and bone marrow remained unchanged (29.6 [28.6; 31.2] vs. 30.4 [29.7; 30.7] ms, P = 0.7, 81.0 ± 6.3 vs. 82.9 ± 9.9 ms, P = 0.6, 34.3 ± 21.4 vs. 25.3 ± 14.1 ms, P = 0.2, 9.4 [7.5; 21.8] vs. 10.3 [6.7; 15.7] ms, P = 0.5 and 9.8 ± 1.5 vs. 13.7 ± 8.9 ms, P = 0.1). Conclusions: CHF patients with ID showed lower spleen, liver, and in trend lower cardiac septal iron. After IVIT, iron signal of the left ventricle as well as spleen and liver increased. Improvement in EC was associated with increase in haemoglobin after IVIT. In ID, liver, spleen, and brain but not heart iron were associated with markers of systemic ID. [ABSTRACT FROM AUTHOR]

The article is a reply to a commentary on the ethical and legal framework for balanced opioid prescribing. The authors agree with the need for balanced opioid prescribing for patients with pain and emphasize the importance of personalized and compassionate care. They highlight the challenges in pain management, particularly for cancer survivors, due to conflicting guidelines, vague legal exemptions, and fragmented care models. The authors call for better guidance, education, consultation, and support for clinicians to make data-driven and patient-centered opioid recommendations. They also emphasize the need for further research to understand cancer pain in survivorship and improve care models for this population. [Extracted from the article]

When wildlife species exhibit unexpected associations with vegetation, replication of studies in different locales can illuminate whether patterns of use are consistent or divergent. Our objective was to describe fine‐scale forest conditions used by Pacific martens (Martes caurina) at 2 study sites in northern California that differed in forest composition and past timber harvest. We identified denning and resting locations of radio‐marked martens and sampled structure‐ and plot‐level vegetation using standardized forest inventory methods between 2009–2021. Woody structures used by martens were significantly larger than randomly available structures across types (e.g., live tree, snag, log) and at both study sites. Den and rest structures occurred in areas characterized by higher numbers of logs and snags, lower numbers of live trees and stumps, larger diameter live trees and logs, and greater variation in live tree and log diameter. Features of denning and resting locations were largely consistent across study sites and were generally representative of fine‐scale forest heterogeneity and increased structural complexity, conditions that martens have been widely associated with at broader spatial scales (i.e., home range or landscape). The spatial occurrence of denning and resting locations may indicate that fine‐scale structural complexity facilitates marten foraging while reducing predation risk. Our work offers timely and directed information that can guide forest management in the context of increased landscape change. [ABSTRACT FROM AUTHOR]

Aims: Cellular communication network factor 1 (CCN1) is an independent predictor of MACE after ACS and elevated levels correlated with infarct size after STEMI. We compared the prognostic accuracy of baseline levels of CCN1, NT‐proBNP, hsTnT, and ST2 and changes in levels over time to predict the development of structural and functional alterations typical of LV remodelling. Methods: Serial 3‐T cMRI scans were performed to determine LVEF, LVEDV, LVESV, infarct size, and relative infarct size, which were correlated with serial measurements of the four biomarkers. The prognostic significance of these biomarkers was assessed by multiple logistic regression analysis by examining their performance in predicting dichotomized cardiac MRI values 12 months after STEMI based on their median. For each biomarker three models were created using baseline (BL), the Δ value (BL to 6 months), and the two values together as predictors. All models were adjusted for age and renal function. Receiver operator curves were plotted with area under the curve (AUC) to discriminate the prognostic accuracy of individual biomarkers for MRI‐based structural or functional changes. Results: A total of 44 predominantly male patients (88.6%) from the ETiCS (Etiology, Titre‐Course, and Survival) study were identified at a mean age of 55.5 ± 11.5 (SD) years treated by successful percutaneous coronary intervention (97.7%) at a rate of 95.5% stent implantation within a median pain‐to‐balloon time of 260 min (IQR 124–591). Biomarkers hsTnT and ST2 were identified as strong predictors (AUC > 0.7) of LVEDV and LVEF. BL measurement to predict LVEF [hsTnT: AUC 0.870 (95% CI: 0.756–0.983), ST2: AUC 0.763 (95% CI: 0.615–0.911)] and the Δ value BL‐6M [hsTnT: AUC 0.870 (95% CI: 0.756–0.983), ST2: AUC 0.809 (95% CI: 0.679–0.939)] showed a high prognostic value without a significant difference for the comparison of the BL model vs. the Δ‐value model (BL‐6M) for hsTnT (P = 1) and ST2 (P = 0.304). The combined model that included baseline and Δ value as predictors was not able to improve the ability to predict LVEF [hsTnT: AUC 0.891 (0.791–0.992), P = 0.444; ST2: AUC 0.778 (0.638–0.918), P = 0.799]. Baseline levels of CCN1 were closely associated with LVEDV at 12 months [AUC 0.708 (95% CI: 0.551–0.865)] and infarct size [AUC 0.703 (95% CI: 0.534–0.872)]. Conclusions: Baseline biomarker levels of hsTnT and ST2 were the strongest predictors of LVEF and LVEDV at 12 months after STEMI. The association of CCN1 with LVEDV and infarct size warrants further study into the underlying pathophysiology of this novel biomarker. [ABSTRACT FROM AUTHOR]

BACKGROUND: Targeting programmed cell death protein 1 (PD‐1) and indoleamine 2,3‐dioxygenase (IDO1) pathways is an appealing option for cancer treatment. METHODS: The open‐label, phase 1/2 ECHO‐203 study evaluated the safety, tolerability, and efficacy of the IDO1 inhibitor epacadostat in combination with durvalumab, a human anti–PD‐L1 monoclonal antibody in adult patients with advanced solid tumors. RESULTS: The most common treatment‐related adverse events were fatigue (30.7%), nausea (21.0%), decreased appetite (13.1%), pruritus (12.5%), maculopapular rash (10.8%), and diarrhea (10.2%). Objective response rate (ORR) in the overall phase 2 population was 12.0%. Higher ORR was observed in immune checkpoint inhibitor (CPI)‐naïve patients (16.1%) compared with patients who had received previous CPI (4.1%). Epacadostat pharmacodynamics were evaluated by comparing baseline kynurenine levels with those on therapy at various time points. Only the 300‐mg epacadostat dose showed evidence of kynurenine modulation, albeit unsustained. CONCLUSIONS: Epacadostat plus durvalumab was generally well tolerated in patients with advanced solid tumors. ORR was low, and evaluation of kynurenine concentration from baseline to cycle 2, day 1, and cycle 5, day 1, suggested >300 mg epacadostat twice daily is needed to ensure sufficient drug effect. Clinical trial information: A study of epacadostat (INCB024360) in combination with durvalumab (MEDI4736) in subjects with selected advanced solid tumors (ECHO‐203) (NCT02318277). Epacadostat plus durvalumab was generally well tolerated in patients with advanced solid tumors. Objective response rate was low, and evaluation of kynurenine concentration from baseline to cycle 2, day 1, and cycle 5, day 1, suggested that >300 mg twice daily of epacadostat is needed to ensure sufficient drug effect. [ABSTRACT FROM AUTHOR]

Objective: Approximately 42% of American adults are living with obesity, increasing their risk of colorectal cancer (CRC). Efficacious approaches to prevent and treat obesity may reduce CRC incidence. Daily calorie restriction (Cal‐R) is the most common approach to treating obesity, yet clinically meaningful weight loss is elusive owing to waning adherence. Time‐restricted eating (TRE) consists of consuming foods within a specified time frame, creating a natural calorie deficit. TRE in animals shows cancer protective effects. In humans, TRE is safe and acceptable among adults with obesity, producing ~3% to 5% weight loss and reductions in oxidative stress and insulin resistance. However, TRE has not been tested rigorously for CRC preventive effects. Methods: The authors describe a 12‐month randomized controlled trial of 8‐hour TRE (ad libitum 12 PM‐8 PM), Cal‐R (25% restriction daily), or Control among 255 adults at increased risk for CRC and with obesity. Results: Effects on the following will be examined: 1) body weight, body composition, and adherence; 2) circulating metabolic, inflammation, and oxidative stress biomarkers; 3) colonic mucosal gene expression profiles and tissue microenvironment; and 4) maintenance of benefits on body weight/composition and CRC risk markers. Conclusions: This study will examine efficacious lifestyle strategies to treat obesity and reduce CRC risk among individuals with obesity. [ABSTRACT FROM AUTHOR]

Effective conservation of at‐risk species presents a conundrum, often requiring rapid status assessments and timely actions regardless of the adequacy of best available information. Here, we present a case study on Humboldt martens (Martes caurina humboldtensis), a rare and cryptic carnivore listed as threatened in 2020 under the United States Endangered Species Act. Given their rarity, many aspects of Humboldt marten population ecology remain understudied. To help inform marten conservation, we conducted exploratory analyses to estimate population growth by incorporating empirically derived data into two demographic modeling approaches. Population growth rates from each approach exhibited substantial variability and were uninformative to evaluating population status. Our results highlight the inherent difficulties of studying cryptic animals and exemplify the issues of using sparse or uncertain data in potentially consequential circumstances. Considering the shortcomings of our findings, we provide a framework of reliable actions to improve future conservation outcomes for poorly‐understood species. [ABSTRACT FROM AUTHOR]

In our target article (Hamm et al., Legal and Criminological Psychology, 2022), we propose a Concentric Diagram of Legitimacy as an organizing tool for legitimacy theory. In so doing, we hoped to stimulate a scholarly discussion about the state of the literature and the best avenues for pushing past the field's current intellectual plateau. Six experts took us up on this call and provided three commentaries that push our thinking but, more importantly, identify important opportunities for advancing legitimacy theory. In our response here, we distil their rich insights into key criticisms which then lead to opportunities for future research. [ABSTRACT FROM AUTHOR]

Purpose: Despite a common conceptual root, research applying legitimacy theory addresses any number of more or less distinct behaviours, attitudes, and processes. Although this variety in approaches has complicated theoretical development, we argue that it is critical to addressing the breadth of the construct. To address this state of affairs, we offer the Concentric Diagram of Legitimacy as an organizing tool for the literature. The diagram roots itself in the dialogue of legitimacy, and argues that legitimacy theory is fundamentally comprised of five key theoretical propositions. Proposition 1 addresses the link between authority and acquiescence directly while the remaining propositions link organizational support (Proposition 2) and public approval (Proposition 3) with authority, and interactions (Proposition 4) and the social context (Proposition 5) with acquiescence. [ABSTRACT FROM AUTHOR]

Geophysical techniques such as electrical resistivity, ground penetrating radar (GPR), gravity, magnetic, and seismic surveys are useful for prospecting archaeological remains. In this study, we delineated the domain and underground structure of the Bonghwang earth castle and the Royal Palace of the Geumgwan Gaya Kingdom, using multiple geophysical surveys (magnetic, electromagnetic, GPR, and electrical resistivity). Based on the results, the Bonghwang earth castle was extended from a small hill branching from the northern end of the Bonghwangdae hill with a width of 20 m to the hill on the southeast end with a width of slightly over 40 m. The Royal Palace inside the Bonghwang earth castle was further explored using magnetic and GPR surveys. As a result low magnetic values are surrounded radially by high magnetic values at multiple independent locations in an irregular shape in the centre of the Royal Palace. In contrast, the high anomaly zone near the centre of the Royal Palace had a rectangular or ellipsoidal shape, necessitating a clear need for archaeological investigation and excavation in the future. [ABSTRACT FROM AUTHOR]

Huriez syndrome (HRZ, OMIM181600) is a rare genodermatosis characterized by scleroatrophic hands and feet, hypoplastic nails, palmoplantar keratoderma, and predisposition to cutaneous squamous cell carcinoma (cSCC). We report herein three HRZ families from Croatia, the Netherlands, and Germany. Deep sequencing followed by Sanger validation, confirmed the presence of germline causative SMARCAD1 heterozygous pathogenic variants. All seven HRZ patients displayed hypohidrosis, adermatoglyphia, and one patient developed cSCC at 32 years of age. Two novel monoallelic germline mutations were identified which are predicted to disrupt the first exon‐intron boundary of the skin‐specific SMARCAD1 isoform. On the basis of phenotypic and genotypic convergence with Adermatoglyphia (OMIM136000) and Basan syndrome (OMIM129200), our results lend credence to the notion that these three Mendelian disorders are allelic. We propose adding Huriez syndrome to the previously suggested SMARCAD syndrome designation, which was originally invoked to describe the spectrum of monogenic disorders between Adermatoglyphia and Basan syndrome. [ABSTRACT FROM AUTHOR]

Background: The American Diabetes Association recommend glucagon‐like peptide‐1 (GLP‐1) agonists and sodium glucose co‐transporter 2 (SGLT‐2) inhibitors be considered as first‐line therapy for type 2 diabetes. A secondary analysis of the Look AHEAD study determined these agents are disproportionately prescribed at higher rates to White patients compared with Black patients. Objectives: The objective of this study is to evaluate if a disparity exists between the prescribing of SGLT‐2 inhibitors and GLP‐1 agonists between White patients and Black patients at an academic, safety‐net health system. Methods: A single‐center retrospective chart review was conducted on patients seen at a pharmacist‐managed or provider‐managed clinic. The primary outcome is the difference in prescribing of SGLT‐2 inhibitors and GLP‐1 agonists between Black and White patients in the pharmacist and provider‐managed group. Secondary outcomes include differences in prescribing in Hispanic patients and patients with a serious mental illness. Results: The primary outcome of prescribing rates for GLP‐1 agonists and SGLT‐2 inhibitors did not differ significantly in the pharmacist comanaged group. The primary outcome in the provider managed group did differ significantly. The largest prescribing rate was in the "other" race category. Only two variables were found in the combined datasets to play a role in the prescribing of a GLP‐1 agonist or SGLT‐2 inhibitor. Having only a provider and not a pharmacist involved in care was predictive of not being prescribed either agent (odds ratio = 0.096, P = <.001). Insurance status was the other statistically significant predictor of being prescribed a GLP‐1 agonist or SGLT‐2 inhibitor (odds ratio = 1.592, P =.006). Conclusion: A clinically significant difference in prescribing based on race did not exist in the pharmacist comanaged group or the provider only managed group. Pharmacist involvement and insurance status appear to have a positive impact on an SGLT‐2 inhibitor or GLP‐1 agonist being prescribed. [ABSTRACT FROM AUTHOR]

This article illustrates how two fourth‐grade bilingual teachers transformed their writing instruction for bi/multilingual learners by integrating a functional approach to language and literacy teaching and learning. The authors use a systemic functional linguistics genre pedagogy to explore and elucidate the teachers' innovative instructional practices, revealing how the teachers supported bi/multilingual students in (1) preparing to write about a topic, (2) engaging with texts to understand the purpose, organizational structure, and linguistic features of a genre, and (3) making language choices to develop a topic. Through clear and explicit instruction that centers language and meaning, these pedagogical innovations support bi/multilingual students' systematic engagement with and production of multiple text types for authentic and varied audiences across a range of communicative purposes and contexts. [ABSTRACT FROM AUTHOR]

Background: Treatment‐resistant depression in late‐life (TRLLD) is common. Perspectives of primary care providers (PCPs) and psychiatrists treating TRLLD could give insights into the challenges and potential solutions for managing this condition. Methods: To identify perspectives of providers who treat TRLLD, we conducted a qualitative descriptive study using semi‐structured interviews with providers treating older adults with TRLLD in five locations across North America (i.e., Los Angeles, New York City, Pittsburgh, St. Louis, and Toronto). We conducted semi‐structured interviews with 50 care providers (24 primary care providers [PCPs], 22 psychiatrists, and 4 depression care managers). Interviews elicited providers' perspectives on treatment options for TRLLD, including treatment within the primary care setting and referral to psychiatry, and sought suggestions for improvement. Results: We identified four themes. (1) Treating TRLLD takes an emotional toll on providers; (2) existing psychiatric services are inadequate to meet the needs of patients with TRLLD, mainly because of lack of access; (3) PCPs often attempt to treat TRLLD, even when they are not comfortable doing so; and (4) to better meet the needs of patients with TRLLD, providers recommend integrated care models involving PCPs, psychiatrists, and psychotherapists, potentially made more feasible by the growth of telehealth. Conclusions: Findings from these qualitative interviews show the challenges in providing care for TRLLD. These findings can guide knowledge dissemination to psychiatrists, PCPs, policy‐makers, and other stakeholders involved in the mental health system. They can also inform structural changes to clinical practice that may increase the implementation of the best treatment strategies across settings to improve long‐term outcomes for TRLLD. [ABSTRACT FROM AUTHOR]

Background: People with HIV (PWH) are at increased risk of severe COVID‐19. We aimed to determine humoral responses in PWH and controls who received two doses of BNT162b2. Methods: In 269 PWH and 538 age‐matched controls, we measured IgG and neutralizing antibodies specific for the receptor‐binding domain of SARS‐CoV‐2 at baseline, 3 weeks and 2 months after the first dose of BNT162b2. Results: IgG antibodies increased from baseline to 3 weeks and from 3 weeks to 2 months in both groups, but the concentrations of IgG antibodies were lower in PWH than that in controls at 3 weeks and 2 months (p = 0.025 and <0.001), respectively. The IgG titres in PWH with a humoral response at 2 months were 77.9% (95% confidence interval [62.5%–97.0%], age‐ and sex‐adjusted p = 0.027) of controls. Conclusions: Reduced IgG antibody response to vaccination with BNT162b2 was found in PWH, and thus increased awareness of breakthrough infections in PWH is needed. [ABSTRACT FROM AUTHOR]

Background: While MR enterography allows detection of inflammatory bowel disease (IBD), the findings continue to be of limited use in guiding treatment--medication vs. surgery. Purpose: To test the feasibility of MR elastography of the gut in healthy volunteers and IBD patients. Study Type: Prospective pilot. Population: Forty subjects (healthy volunteers: n = 20, 37 ± 14 years, 10 women; IBD patients: n = 20 (ulcerative colitis n = 9, Crohn's disease n = 11), 41 ± 15 years, 11 women). Field Strength/Sequence: Multifrequency MR elastography using a single-shot spin-echo echo planar imaging sequence at 1.5 T with drive frequencies of 40, 50, 60, and 70 Hz. Assessment: Maps of shear-wave speed (SWS, in m/s) and loss angle (f, in rad), representing stiffness and solid-fluid behavior, respectively, were generated using tomoelastography data processing. Histopathological analysis of surgical specimens was used as reference standard in patients. Statistical Tests: Unpaired t-test, one-way analysis of variance followed by Tukey post hoc analysis, Pearson's correlation coefficient and area under the receiver operating characteristic curve (AUC) with 95%-confidence interval (CI). Significance level of 5%. Results: MR elastography was feasible in all 40 subjects (100% technical success rate). SWS and f were significantly increased in IBD by 21% and 20% (IBD: 1.45 ± 0.14 m/s and 0.78 ± 0.12 rad; healthy volunteers: 1.20 ± 0.14 m/s and 0.65 ± 0.06 rad), whereas no significant differences were found between ulcerative colitis and Crohn's disease (P = 0.74 and 0.90, respectively). In a preliminary assessment, a high diagnostic accuracy in detecting IBD was suggested by an AUC of 0.90 (CI: 0.81-0.96) for SWS and 0.84 (CI: 0.71-0.95) for f. Data Conclusion: In this pilot study, our results demonstrated the feasibility of MR elastography of the gut and showed an excellent diagnostic performance in predicting IBD. [ABSTRACT FROM AUTHOR]

We investigated motivational regulation involving adjustment of recovery goals in post‐stroke rehabilitation via standard in‐clinic physiotherapy and in‐home telerehabilitation (TR). We used a secondary dataset collected at 11 US sites as part of a clinical trial using video games and game control pads designed to induce certain arm movements required for recovery (n = 124; Mage = 61.44, SD = 13.30). Participants were randomly assigned to either the TR or in‐clinic condition and underwent 36 therapy sessions, reporting on their activity‐inherent enjoyment for 6–8 weeks. Compared with the in‐clinic patients and TR patients with high game performance, TR patients with lower game performance reported lower activity‐inherent enjoyment, which is an important motivational resource for successful recovery. The results suggest that these differences occur because TR patients become discouraged by low game score feedback, which may have signaled a poor prospect for recovery. However, the results also suggest that low game performers who successfully adjusted their recovery goals were resilient to the impact of low game score feedback on their motivational resources and satisfaction with therapy. The findings suggest that goal adjustment may be particularly beneficial when patients are discouraged by feedback indicating suboptimal recovery prospects. [ABSTRACT FROM AUTHOR]

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The aim of this study was to evaluate the cartilage intermediate layer protein 1 (CILP1) as a biomarker of right ventricular dysfunction in patients with ischemic cardiomyopathy (ICM). CILP1 plasma concentrations were measured in 98 patients with ICM and 30 controls without any cardiac abnormalities. All participants underwent cardiac magnetic resonance imaging. Median CILP1 concentrations were higher in ICM than in controls. In the tertile analysis, low right ventricular ejection fraction (RVEF) and high right ventricular end‐systolic volume index and N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) were associated with higher CILP1 levels in ICM. However, there were no associations between CILP1 concentrations and left ventricular (LV) parameters in this group. In receiver‐operating characteristic (ROC) analysis CILP1 was a good predictor of RVEF < 40% with an optimal cut‐off value of 3545 pg/ml in ICM, whereas it was not predictive of LV ejection fraction (LVEF) < 40% (area under the curve [AUC] = 0.57) There was no significant difference between the ROC curves of CILP1 (AUC = 0.72) and NT‐proBNP (AUC = 0.77) for RVEF < 40% (p = 0.42). In multivariable regression analysis, RVEF was the only independent predictor of elevated CILP1. CILP1 and LVEF were the only independent predictors of RVEF < 40% in ICM. Our analysis demonstrates the potential role of CILP1 as a novel cardiac biomarker of prognostically relevant RV dysfunction in patients with ICM. [ABSTRACT FROM AUTHOR]

Genetic diversity becomes structured among populations over time due to genetic drift and divergent selection. Although population structure is often treated as a uniform underlying factor, recent resequencing studies of wild populations have demonstrated that diversity in many regions of the genome may be structured quite dissimilar to the genome‐wide pattern. Here, we explored the adaptive and nonadaptive causes of such genomic heterogeneity using population‐level, whole genome resequencing data obtained from annual Mimulus guttatus individuals collected across a rugged environment landscape. We found substantial variation in how genetic differentiation is structured both within and between chromosomes, although, in contrast to other studies, known inversion polymorphisms appear to serve only minor roles in this heterogeneity. In addition, much of the genome can be clustered into eight among‐population genetic differentiation patterns, but only two of these clusters are particularly consistent with patterns of isolation by distance. By performing genotype‐environment association analysis, we also identified genomic intervals where local adaptation to specific climate factors has accentuated genetic differentiation among populations, and candidate genes in these windows indicate climate adaptation may proceed through changes affecting specialized metabolism, drought resistance, and development. Finally, by integrating our findings with previous studies, we show that multiple aspects of plant reproductive biology may be common targets of balancing selection and that variants historically involved in climate adaptation among populations have probably also fuelled rapid adaptation to microgeographic environmental variation within sites. [ABSTRACT FROM AUTHOR]