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Background: Prostate cancer (PCa) is a highly heterogeneous disease, making tailored treatment approaches challenging. Magnetic resonance imaging (MRI), notably diffusion‐weighted imaging (DWI) and the derived Apparent Diffusion Coefficient (ADC) maps, plays a crucial role in PCa characterization. In this context, radiomics is a very promising approach able to disclose insights from MRI data. However, the sensitivity of radiomic features to MRI settings, encompassing DWI protocols and multicenter variations, requires the development of robust and generalizable models. Purpose: To develop a comprehensive radiomics framework for noninvasive PCa characterization using ADC maps, focusing on identifying reliable imaging biomarkers against intra‐ and inter‐institution variations. Materials and methods: Two patient cohorts, including an internal cohort (118 PCa patients) used for both training (75%) and hold‐out testing (25%), and an external cohort (50 PCa patients) for independent testing, were employed in the study. DWI images were acquired with three different DWI protocols on two different MRI scanners: two DWI protocols acquired on a 1.5‐T scanner for the internal cohort, and one DWI protocol acquired on a 3‐T scanner for the external cohort. One hundred and seven radiomics features (i.e., shape, first order, texture) were extracted from ADC maps of the whole prostate gland. To address variations in DWI protocols and multicenter variability, a dedicated pipeline, including two‐way ANOVA, sequential‐feature‐selection (SFS), and ComBat features harmonization was implemented. Mann–Whitney U‐tests (α = 0.05) were performed to find statistically significant features dividing patients with different tumor characteristics in terms of Gleason score (GS) and T‐stage. Support‐Vector‐Machine models were then developed to predict GS and T‐stage, and the performance was assessed through the area under the curve (AUC) of receiver‐operating‐characteristic curves. Results: Downstream of ANOVA, two subsets of 38 and 41 features stable against DWI protocol were identified for GS and T‐stage, respectively. Among these, SFS revealed the most predictive features, yielding an AUC of 0.75 (GS) and 0.70 (T‐stage) in the hold‐out test. Employing ComBat harmonization improved the external‐test performance of the GS model, raising AUC from 0.72 to 0.78. Conclusion: By incorporating stable features with a harmonization procedure and validating the model on an external dataset, model robustness, and generalizability were assessed, highlighting the potential of ADC and radiomics for PCa characterization. [ABSTRACT FROM AUTHOR]

Objectives: The overarching aim of this study is to explore, examine and identify the experience that young women with congenital heart disease face as they transition through adolescence into womanhood. Design: This is an empirical qualitative study conducted in the form of three focus groups. The study design and analysis adopted a feminist ontological positioning to elucidate the voice of women and offer an alternative perspective of cardiology health care. Data were analysed using the inductive thematic approach informed by the study aims. Participants: A group of seven female participants (mean age 26) based in the United Kingdom, each with varying degrees of congenital heart defects that required open heart surgery growing up, was included in the study. Results: Three key themes with antecedent concepts emerged: (a) the impact of womanhood and the potential influence of motherhood on the young women themselves transitioning through adolescence with CHD within medical and sociocultural contexts, (b) the challenges of being a woman and undergoing heart surgery during adolescence on the young women's health before, during and after surgery and (c) the effect of existing online/offline healthcare and social structures on women's health during transitioning through adolescence These themes were encompassed under an overarching theme of psychological complexities developed throughout the cardiac journey from diagnosis through to post‐surgery. Conclusion: This study built on the limited exploration of being a young woman and having CHD and confirmed that there are vulnerabilities and challenges in having CHD as a young woman transitioning through adolescence. This was a result of sex (biological characteristics) and gender factors (socially constructed roles). This leads to short‐ and long‐term implications on psychological well‐being. This research indicates that enhancements are needed in the provision of care and psychological support for young women with CHD. This will help to enable women to achieve a good quality of life in addition to increased life expectancy offered by medical advancements. Patient or Public Contribution: Active participant involvement was crucial to ensure the authentic female voice in the study. This study received support from young women with congenital heart disease. Young women contributed to the study design, recruitment of participants and analysis of results. Two of the women were also co‐authors of this paper. [ABSTRACT FROM AUTHOR]

Background: Oral intake in hospitalized patients is frequently below estimated targets. Multiple physiological symptoms are proposed to impact oral intake, yet many have not been quantified objectively. Aim: To describe the challenges of objectively measuring physiological nutrition‐impacting symptoms in hospitalized patients. Method: A secondary analysis of data from a single‐center, descriptive cohort study of physiological nutrition‐impacting symptoms in intensive care unit (ICU) survivors and general medical patients was conducted. Demographic and clinical characteristics were extracted for patients who completed the original study and collected retrospectively for those who were screened and recruited but did not complete the original study. Reasons for patient exclusion from the original study were quantified from the screening database. Descriptive data are reported as mean ± SD, median [interquartile range], or number (percentage). Results: ICU survivors and general medical patients were screened for inclusion in the original study between March 1 and December 23, 2021. Of the 644 patients screened, 97% did not complete the study, with 93% excluded at screening. Of the 266 ICU survivors and 398 general medical patients screened, 89% and 95% were excluded, respectively. Major exclusion criteria included the inability to follow commands or give informed consent (n = 155, 25%), the inability to consume the easy‐to‐chew and thin‐fluid buffet meal, and imminent discharge (both, n = 120, 19%). Conclusion: Understanding physiological factors that drive reduced oral intake in hospitalized patients is challenging. Exclusion criteria required to objectively quantify physiological nutrition‐impacting symptoms significantly preclude participation and likely act as independent barriers to oral intake. [ABSTRACT FROM AUTHOR]

Irruptions by boreal seed‐eating and frugivorous birds are assumed to be driven by the production of seeds and fruits, crops of which are highly variable between years. Using data from Sweden, we tested whether irruptions of Common Crossbills Loxia curvirostra were correlated with low Norway Spruce Picea abies seed production in the same year as the irruption and/or high seed production in the year prior to an irruption. Similar tests were made for Parrot Crossbill Loxia pytyopsittacus irruptions in relation to Scots Pine Pinus sylvestris seed production. In northern Europe, these conifers represent the key food species of the two crossbill species, respectively. Despite differing times that seeds take to mature and asynchronous seed production between the two conifer species, including a 3‐year cycle for Norway Spruce, the two crossbill species often irrupted in the same year as one another. Analyses showed that irruptions into Britain and other parts of western Europe by both crossbill species were correlated with low seed production by Norway Spruce in Sweden. Low seed production by Scots Pine had a marginally non‐significant additive effect on both crossbill species. In a second set of analyses, the best‐fitting model was one in which low seed production by both conifers in a given year and high seed production in the previous year were each correlated with large numbers of irrupting Common and Parrot Crossbills. The models indicate that the incidental co‐occurrence of low seed production of Norway Spruce and Scots Pine in a given year, after a year of high seed production, may result in an irruption. The seed production of Norway Spruce and Scots Pine in Sweden was correlated with production by the same species in Finland, indicating widespread synchrony of cropping across northern Europe. [ABSTRACT FROM AUTHOR]

Background: Current treatments for Tourette syndrome (TS) and persistent tic disorder (PTD) are often insufficiently effective, inaccessible, and frequently associated with adverse events. Thus, we must continue to develop and test effective, accessible, and safe treatment options. Objective: We aimed to conduct a pilot randomized controlled trial (RCT) comparing a novel, videoconference‐delivered group mindfulness‐based intervention for tics (MBIT) to videoconference‐delivered group psychoeducation, relaxation, and supportive therapy (PRST) for adults with TS or PTD. Methods: Thirty‐two adults with TS or PTD were randomly assigned to receive 8 weeks of either MBIT or PRST. Tic severity, tic‐related impairment, and global improvement were assessed by a trained, independent evaluator who was masked to treatment condition at baseline (week 0), posttreatment (week 9), 1‐month follow‐up, and 6‐month follow‐up. All study procedures were conducted online via secure videoconferencing. Results: Twenty‐eight participants began treatment and were included in analyses. MBIT, relative to PRST, was associated with a significantly greater decline in tic severity (d = 0.85) and tic‐related impairment (d = 0.99) from baseline to posttreatment. Treatment response was significantly higher in MBIT (69%) than in PRST (13%). Neither treatment resulted in serious adverse effects. The durability of treatment outcomes is also reported and discussed. Conclusions: The results from this pilot RCT suggest that videoconference‐delivered group MBIT may be an efficacious, accessible, and safe intervention for adults with tics. Future research is necessary to confirm these preliminary findings. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. [ABSTRACT FROM AUTHOR]

We report on the development of a rubric to reliably qualify and score responses to the Views of Nature of Science Questionnaire (VNOS): The VNOS Analysis and Scoring Rubric (VAScoR). The VAScoR is designed to (a) provide systematic guidance for the qualitative analysis, and score assignment to nuanced categories, of VNOS responses, (b) explicitly scaffold qualitative inferencing and standardize score assignment to substantially lessen the burden of, and variance in, analyzing and scoring the VNOS, and (c) improve the viability and meaningfulness of cross‐study comparisons drawing on VNOS data. The rubric adopted the VNOS's consensus NOS framework and further delineated core and related elements across 10 target NOS aspects. The VAScoR's reliability was examined in two studies that drew on VNOS questionnaires completed by 185 preservice secondary science teachers (58% female; 126 undergraduate and 59 graduate students) enrolled over several years in a combined undergraduate and graduate licensure program in a large U.S. Midwestern university. In Study I, VAScoR analyses of 86 VNOS questionnaires undertaken by a single author were used to examine the rubric's intra‐rater reliability, which resulted in a robust Cronbach's alpha value of 0.81. In Study II, analyses by four authors of a randomly generated, overlapping set of 18 questionnaires were used to examine inter‐rater reliability, which was supported with substantial consensus among raters as indicated by a Cohen's kappa of 0.71. Further evidence for the VAScoR's inter‐rater reliability was indicated by moderate to strong consistency among four raters with an overall Pearson's correlation coefficient of 0.82, and coefficient values ranging from 0.77 to 0.89 for six possible rater pairings. [ABSTRACT FROM AUTHOR]

This study pursued two major objectives. The first was to use bibliometric techniques to examine bidirectionality in the relationship between teachers and researchers, as indicated by collaborative authorship among these communities. The second was to explore more deeply knowledge mobilization to classrooms by documenting the extent to which research is cited in science education practitioner journals (SEPJ). Specifically, we examined: (a) the frequency of collaboration between researchers and practitioners in the writing of journal articles for both practitioner‐focused and academic journals in science education, and (b) the extent to which authors of articles in practitioner‐focused journals drew on academic research to support their advocacy for and/or description of science education programs, policies, or practices. Findings indicate that writing collaborations among academic researchers and practitioners are relatively infrequent, even on practitioner‐focused articles. Also, articles in SEPJs more often cite books and other resources over academic journals, even those academic journals focused on informing science education teaching and learning. Recommendations include providing open access to published research, development of research summaries for lay audiences, and incentivizing practitioners to engage in research and writing. This study explores only one mechanism by which knowledge can be mobilized to classrooms and only one type of dissemination product (i.e., journal articles) upon which researchers and practitioners can collaborate. Additional limitations are noted including the applicability of the findings only to the specific journals and timeframes analyzed. [ABSTRACT FROM AUTHOR]

Objective: To determine the effectiveness and adverse effects of urethrectomy alone or as part of multimodal therapy (MMT). Methods: A comprehensive search was conducted across MEDLINE (OVID), EMBASE, LILACS and the Cochrane Central Register of Controlled Trials (CENTRAL) databases, from their inception to the present date. The study cohort comprised individuals aged 16 years and older diagnosed with urethral tumours at any stage who underwent either isolated urethrectomy or urethrectomy as an integral component of MMT. Results: Ninety‐two studies comprising 25 480 patients met the inclusion criteria. Surgical outcomes for urethral cancer vary considerably, with 5‐year overall survival (OS) ranging from 10% to 68% based on disease extent, approach, and gender. Radiotherapy (RT) alone provides 5‐year OS of approximately 40%. Combined regimens provide better outcomes compared to single modalities, including reduced recurrence and enhanced survival. However, trimodal therapy showed survival benefits only for urothelial subtypes, indicating the need to tailor management according to cancer type. MMT with neoadjuvant chemotherapy prior to surgery demonstrated the most consistent survival gains. Conclusions: The management of urethral cancer demands a nuanced, personalised approach, accounting for factors such as tumour location, sex, and tumour stage. MMT combining surgery, chemotherapy and RT has shown the ability to enhance outcomes in advanced disease. More extensive collaborative studies through specialised centres are imperative to advance evidence‐based protocols and refine treatment in order to improve survival. [ABSTRACT FROM AUTHOR]

Dysregulation of growth hormone (GH) signaling consistently leads to increased lifespan in laboratory rodents, yet the precise mechanisms driving this extension remain unclear. Understanding the molecular underpinnings of the beneficial effects associated with GH deficiency could unveil novel therapeutic targets for promoting healthy aging and longevity. In our pursuit of identifying metabolites implicated in aging, we conducted an unbiased lipidomic analysis of serum samples from growth hormone‐releasing hormone knockout (GHRH‐KO) female mice and their littermate controls. Employing a targeted lipidomic approach, we specifically investigated ceramide levels in GHRH‐KO mice, a well‐established model of enhanced longevity. While younger GHRH‐KO mice did not exhibit notable differences in serum lipids, older counterparts demonstrated significant reductions in over one‐third of the evaluated lipids. In employing the same analysis in liver tissue, GHRH‐KO mice showed pronounced downregulation of numerous ceramides and hexosylceramides, which have been shown to elicit many of the tissue defects that accompany aging (e.g., insulin resistance, oxidative stress, and cell death). Additionally, gene expression analysis in the liver tissue of adult GHRH‐KO mice identified substantial decreases in several ceramide synthesis genes, indicating that these alterations are, at least in part, attributed to GHRH‐KO‐induced transcriptional changes. These findings provide the first evidence of disrupted ceramide metabolism in a long‐lived mammal. This study sheds light on the intricate connections between GH deficiency, ceramide levels, and the molecular mechanisms influencing lifespan extension. [ABSTRACT FROM AUTHOR]

A common goal in evolutionary biology is to discern the mechanisms that produce the astounding diversity of morphologies seen across the tree of life. Aposematic species, those with a conspicuous phenotype coupled with some form of defence, are excellent models to understand the link between vivid colour pattern variations, the natural selection shaping it, and the underlying genetic mechanisms underpinning this variation. Mimicry systems in which species share a conspicuous phenotype can provide an even better model for understanding the mechanisms of colour production in aposematic species, especially if comimics have divergent evolutionary histories. Here we investigate the genetic mechanisms by which mimicry is produced in poison frogs. We assembled a 6.02‐Gbp genome with a contig N50 of 310 Kbp, a scaffold N50 of 390 Kbp and 85% of expected tetrapod genes. We leveraged this genome to conduct gene expression analyses throughout development of four colour morphs of Ranitomeya imitator and two colour morphs from both R. fantastica and R. variabilis which R. imitator mimics. We identified a large number of pigmentation and patterning genes differentially expressed throughout development, many of them related to melanophores/melanin, iridophore development and guanine synthesis. We also identify the pteridine synthesis pathway (including genes such as qdpr and xdh) as a key driver of the variation in colour between morphs of these species, and identify several plausible candidates for colouration in vertebrates (e.g. cd36, ep‐cadherin and perlwapin). Finally, we hypothesise that keratin genes (e.g. krt8) are important for producing different structural colours within these frogs. [ABSTRACT FROM AUTHOR]

Hybrid zones occur in nature when populations with limited reproductive barriers overlap in space. Many hybrid zones persist over time, and different models have been proposed to explain how selection can maintain hybrid zone stability. More empirical studies are needed to elucidate the role of ecological adaptation in maintaining stable hybrid zones. Here, we investigated the role of exogenous factors in maintaining a hybrid zone between western gulls (Larus occidentalis) and glaucous‐winged gulls (L. glaucescens). We used ecological niche models (ENMs) and niche similarity tests to quantify and examine the ecological niches of western gulls, glaucous‐winged gulls, and their hybrids. We found evidence of niche divergence between all three groups. Our results support the bounded superiority model, providing further evidence that exogenous selection favoring hybrids may be an important factor in maintaining this stable hybrid zone. [ABSTRACT FROM AUTHOR]

We present a physical mechanism for generating ∼GeV ions in the Jovian radiation belts. The mechanism is called relativistic turning acceleration (RTA) and involves a special form of nonlinear wave trapping by electromagnetic ion cyclotron (EMIC) waves. Necessary conditions for RTA include a near‐equatorial source of EMIC waves, strong wave amplitudes (of the order of a few percent of the background magnetic field strength), and a source of ions of sufficiently high energy. RTA occurs when a fraction of equator‐ward moving ions encounters pole‐ward moving waves, and, in so doing, becomes entrapped and undergoes a turning motion. The trapped ions then move poleward in the same direction as the waves and eventually become detrapped, but during the turning motion the ions undergo significant acceleration. We rigorously verify this process by providing the theory of nonlinear interactions between relativistic protons and coherent EMIC waves. The RTA process has been previously established for the analogous whistler mode wave‐electron interaction. We carry out particle simulations for protons at R = 2RJ (where RJ = Jovian radius) interacting with EMIC waves of amplitude Bw = 0.02B0eq (where B0eq = background magnetic field strength at the equator). We confirm that a large portion of test protons experience RTA and that some protons of critical energy 240 MeV can be accelerated to 10 GeV in a period of 5 s. The nonlinear acceleration process is crucially controlled by the trapping condition 0 < S < 1 where S is the inhomogeneity factor. Plain Language Summary: We present a mechanism for energetic proton acceleration to relativistic energies with parameters representing the inner Jovian magnetosphere. We assume an electromagnetic ion cyclotron (EMIC) wave generated around the equator by anisotropic protons transported into the inner magnetosphere. After wave‐particle resonance occurs, energetic protons are trapped by the nonlinear potential of the wave. Energetic protons moving initially toward the equator change their direction of motion, and are accelerated by the wave electric field moving in the same direction of the wave propagating away from the equator. For an EMIC wave with amplitude 2% of the background magnetic field, protons ∼240 MeV are accelerated to 10 GeV in about 5 s through the relativistic turning motion near the equator. EMIC waves may contribute to the rapid formation of proton radiation belts in the inner Jovian magnetosphere. Key Points: We have conducted test particle simulations of relativistic proton acceleration by EMIC waves in the Jovian magnetosphereProtons with initial energy 240 MeV are accelerated to 10 GeV in 5 s through relativistic turning acceleration at R = 2RJEffective acceleration of protons is enhanced by anomalous trapping at low pitch angles, while it is limited in the parameter space [ABSTRACT FROM AUTHOR]

Ethylenediaminetetraacetic acid (EDTA), which has two amine and four carboxylate protonation sites, forms stable complexes with lanthanide ions. This work analyzes the coordination structure, in atomic resolution, of the Eu3+ ion complexed with EDTA in all its protonation states in aqueous solution. Eu‐EDTA complexes were modeled using classical molecular dynamics (MD) simulations using force field parameters optimized with ab initio molecular dynamics (AIMD) simulations. Structures from the MD simulations were used to predict extended X‐ray absorption fine structure (EXAFS) spectra and compared with EXAFS measurements of the Eu3+ aqua ion and Eu‐EDTA complexes at pH 3 and 11. This work details how Eu‐EDTA complex coordination structures change with increasing protonation of the EDTA ligand in the complex, from the tightly bound unprotonated complex to the unbinding of the fully protonated EDTA ligand from the Eu3+ ion as both become solvated by water. Agreement between predicted and measured EXAFS spectra supports the findings from simulation. [ABSTRACT FROM AUTHOR]

This mixed‐methods study examined characteristics and learning experiences of student veterans who transitioned from community college(s) into a 4‐year public university. The study descriptively compared veteran versus non‐veteran transfer students, using a survey and follow‐up interviews. Results illustrated that student veterans attended larger numbers of community colleges prior to their transfer compared with non‐veterans. They tended to be older, more ethnically diverse, and more likely to be men than non‐veterans. Transfer student veterans valued (a) differences among high school, military, community college, and 4‐year learning experiences; (b) connections between coursework and career work; (c) being informed about the cultural practices and norms of college, particularly for first‐generation student veterans; and (d) persistence in navigating multiple community colleges toward achieving successful 4‐year degree completion. For student veterans, the military became a way to enact and pay for their postsecondary aspirations. Interconnected community colleges meaningfully transported them to 4‐year postsecondary achievements. [ABSTRACT FROM AUTHOR]

Child safety is an ambiguous and transient construct within the child welfare court system. It being not statutorily defined yet is at the crux of the child welfare system. In this article, the measurement of child safety in the child welfare system is explored with a focus on how it has been measured within the context of the courts. Gaps in the current measurement structure are identified, focusing on how measurement might support a better understanding of a safety decision‐making framework and its application into practice. The article also introduces the Capacity Building Center for Courts' Judicial, Court, and Attorney Measures of Performance as a new approach to a standardized performance metric of safety practices within the child welfare court system. Limitation of these measures is discussed along with recommendations for moving the field forward toward measuring safety decision‐making. [ABSTRACT FROM AUTHOR]

Performance measurement is meant to help organizations to better understand current practices, processes, outputs, or outcomes. Yet, it is often limited in its use and usefulness, partly because it is not designed with the end user in mind. This article describes a process that integrates participatory design and design thinking methodologies to bring together a multidisciplinary group of systems professionals, researchers, and persons with lived experience to create meaningful child welfare court performance measures. The methods and process used to design the measures are described, including the resulting measures in one domain of measurement. Key lessons were learned throughout this process, including the value of lived experience in design and implementation. [ABSTRACT FROM AUTHOR]

The majority of ice mass loss from Antarctica flows through narrow, fast sliding regions of ice. The lateral boundaries of these regions, termed shear margins, are characterized by lateral shear strains in excess of ∼10−3 yr−1. Shear heating within these margins could warm ice significantly–even to the melting point–but other processes such as lateral advection of cold ice and fabric development compete with this effect. Radar observations can help constrain where temperate ice exists because englacial temperature increases electric conductivity which increases radar attenuation. We utilize the temperature‐dependent attenuation of ice to develop a novel method for constraining englacial temperature in shear margins by combining existing thermal models with very high frequency radar depth‐sounding data. We find evidence supporting temperate shear margins in 18 locations and find evidence for non‐temperate margins in 37 locations, notably in the Amundsen Sea Embayment. Plain Language Summary: Most of the ice lost from Antarctica to the ocean goes through narrow areas of fast sliding ice. At the sides of these fast sliding areas the fast ice abuts slow ice and heavily deforms. Deformation warms the ice–potentially to its melting temperature. This warming should be noticeable in radar data because ice at or near the melting point reduces the power of radar waves. We develop a method for using airborne radar measurements to look for the presence of this warm ice, and apply our method across the Antarctic continent. We find evidence supportive of warm ice in many locations, but we notably find little evidence of warm ice in the Amundsen Sea Embayment where the inflow of cold ice may offset warming. Key Points: We develop a novel method for identifying evidence for temperate ice in Antarctic shear margins using existing airborne radar data setsWe find evidence for temperate ice in 18, and evidence contrary in 37, of 106 radar lines over shear margins we consider across AntarcticaNeglecting heats sinks like advective cooling overpredicts the size of temperate zones, particularly in the Amundsen Sea Embayment [ABSTRACT FROM AUTHOR]

This article brings Black feminist thought to bear on the urban geography of racialised financial violence. Our analysis focuses on the Moms 4 Housing movement, which began when five Black mothers occupied a vacant, corporate investor-owned house in West Oakland to protest how real estate speculation is fuelling displacement and homelessness for Black Oakland residents, disrupting care at the scale of the home and community. In taking space through recuperating the house on Magnolia Street, the Moms insist on housing as a site of care central to the survival of Black families and reclaim Oakland as a Black geographic space. In claiming ownership based on relations of care while refusing the institution of private property, we argue the Moms engage in speculative urban worldmaking-a form of collective care and a praxis of providing an alternative present that imagines and advocates for urban futures beyond financialisation's abstract racial violence. [ABSTRACT FROM AUTHOR]

Despite strong support for integrating reading and writing instruction, writing practice is often crowded out of the schedule in elementary classrooms. To promote increased emphasis on writing, a working group of literacy researchers highlights three writing goals and six research‐based reading‐to‐writing practices to enliven instruction with more integrated opportunities. The three featured goals are maximize reading–writing connections, increase student collaborative writing, and promote a classroom writing community. To achieve these goals, the authors highlight flexible, evidenced‐based writing activities to encourage genre diversity, goal‐setting, peer feedback, and cross‐curricular reading tasks. The collection of recommended practices has the potential to engage students and improve both reading and writing achievement. [ABSTRACT FROM AUTHOR]

Background: Dogs with congenital intrahepatic portosystemic shunt (IHPSS) are predisposed to gastrointestinal inflammation, ulceration, and bleeding, unlike dogs with congenital extrahepatic portosystemic shunt (EHPSS). Limited information is available about hematologic differences between dogs with IHPSS and dogs with EHPSS. Objective: Compare hemogram variables between dogs with IHPSS and EHPSS. We hypothesized that hematologic variables would differ between the 2 populations, with a higher frequency and severity of anemia and microcytosis in dogs with IHPSS. Animals: Twenty‐six client‐owned dogs with IHPSS and 35 client‐owned dogs with EHPSS. Methods: Retrospective cross‐sectional study. Dogs were included if a CBC was performed before shunt attenuation. Contingency analysis was performed to determine if the frequency of clinical signs and of hematologic variables below the reference range differed between groups. Hematologic and selected biochemical variables were compared between groups using an analysis of covariance with age as a covariate. Results: Gastrointestinal clinical signs (IHPSS, 81% vs EHPSS, 34%; P =.01), anemia (31% vs 6%; P =.01), microcytosis (77% vs 29%; P =.002), and hypochromia (77% vs 49%; P =.03) were more common in dogs with IHPSS than in dogs with EHPSS. Dogs with IHPSS had lower packed cell volume (34% vs 41%, P =.04), hemoglobin concentration (11.5 g/dL vs 13.7 g/dL, P =.03), mean corpuscular volume (57 fL vs 65 fL; P =.001), and mean corpuscular hemoglobin concentration (32 g/dL vs 33 g/dL; P =.04) than dogs with EHPSS. Conclusions and Clinical Importance: Dogs with IHPSS had a higher frequency of anemia, microcytosis, and hypochromia and exhibited more gastrointestinal clinical signs. [ABSTRACT FROM AUTHOR]

Meteorological services are increasingly moving away from issuing weather warnings based on the exceedance of meteorological thresholds (e.g., windspeed), toward risk‐based (or "impact‐based") approaches. The UK Met Office's National Severe Weather Warning Service has been a pioneer of this approach, issuing yellow, amber, and red warnings based on an integrated evaluation of information about the likelihood of occurrence and potential impact severity. However, although this approach is inherently probabilistic, probabilistic information does not currently accompany public weather warning communications. In this study, we explored whether providing information about the likelihood and impact severity of forecast weather affected subjective judgments of likelihood, severity, concern, trust in forecast, and intention to take protective action. In a mixed‐factorial online experiment, 550 UK residents from 2 regions with different weather profiles were randomly assigned to 1 of 3 Warning Format conditions (Color‐only, Text, Risk Matrix) and presented with 3 warnings: high‐probability/moderate‐impact (amber HPMI); low‐probability/high‐impact (amber); high‐probability/high‐impact (red). Amongst those presented with information about probability and impact severity, red high‐likelihood/high‐impact warnings elicited the strongest ratings on all dependent variables, followed by amber HPMI warnings. Amber low‐likelihood/high‐impact warnings elicited the lowest perceived likelihood, severity, concern, trust, and intention to take protective responses. Taken together, this indicates that UK residents are sensitive to probabilistic information for amber warnings, and that communicating that severe events are unlikely to occur reduces perceived risk, trust in the warning, and behavioral intention, even though potential impacts could be severe. We discuss the practical implications of this for weather warning communication. [ABSTRACT FROM AUTHOR]

Black men regard their mothers as the source of primary support and may benefit from having counselors incorporate their mothers into the counseling process. In this study, the researchers attempted to understand Black men's lived experiences and the impact of their mother's influence upon their wellbeing. Drawing on interviews with 10 Black men, the researchers excavated 5 themes related to development and wellness of Black men as clients. The researchers discussed the results with implications for counselors, along with current study's limitations. [ABSTRACT FROM AUTHOR]

Many migratory bird species have undergone recent population declines, but there is considerable variation in trends between species and between populations employing different migratory routes. Understanding species‐specific migratory behaviours is therefore of critical importance for their conservation. The Common Sandpiper Actitis hypoleucos is an Afro‐Palaearctic migratory bird species whose European populations are in decline. We fitted geolocators to individuals breeding in England or wintering in Senegal to determine their migration routes and breeding or non‐breeding locations. We used these geolocator data in combination with previously published data from Scottish breeding birds to determine the distributions and migratory connectivity of breeding (English and Scottish) and wintering (Senegalese) populations of the Common Sandpiper, and used simulated random migrations to investigate wind assistance during autumn and spring migration. We revealed that the Common Sandpipers tagged in England spent the winter in West Africa, and that at least some birds wintering in Senegal bred in Scandinavia; this provides insights into the links between European breeding populations and their wintering grounds. Furthermore, birds tagged in England, Scotland and Senegal overlapped considerably in their migration routes and wintering locations, meaning that local breeding populations could be buffered against habitat change, but susceptible to large‐scale environmental changes. These findings also suggest that contrasting population trends in England and Scotland are unlikely to be the result of population‐specific migration routes and wintering regions. Finally, we found that birds used wind to facilitate their migration in autumn, but less so in spring, when the wind costs associated with their migrations were higher than expected at random. This was despite the wind costs of simulated migrations being significantly lower in spring than in autumn. Indeed, theory suggests that individuals are under greater time pressures in spring than in autumn because of the time constraints associated with reproduction. [ABSTRACT FROM AUTHOR]

Background: Resident‐focused concussion curricula that measure learner behaviours are currently unavailable. We sought to fill this gap by developing and iteratively implementing a Spiral Integrated Concussion Curriculum (SICC). Approach: Programme elements of the concussion curriculum include academic half‐days (AHDs) and three half‐day clinics for first‐ and second‐year family medicine residents. Our SICC utilises social cognitive learning principles, the constructivism paradigm and utilisation‐focused evaluation. Evaluation: A mixed‐method evaluation with a pre‐/post‐test design and interviews was utilised. Surveys and knowledge tests were used to measure knowledge and confidence pre‐AHD and 6 months post‐AHD. Interviews at 6 months explored programme perception and behaviour change. Of the 141 programme attendees, 114 (80%) participated in the pre‐intervention knowledge test and 33 completed the pre‐ and post‐AHD test. Immediate pre‐/post‐testing demonstrated statistically significant improvement in knowledge (p = 0.042). At 6 months post‐AHD, residents in Cycle 1 (n = 5) had a knowledge decrease of 3.33% (p > 0.05). Residents in Cycle 2 (n = 7) had a knowledge increase of 11.6% (p > 0.05). Both cycles of residents had an increase in confidence (Cycle 1: 65.0% [p = 0.025]; Cycle 2: 62.8% [p = 0.0014]). Residents (5 out of 6) reported positive behavioural changes at 6 months. Valued programme elements included concussion diagnosis and management, the self‐study guide resource and the organised structure. Implications: The SICC enriched these residents' learning and fostered sustained knowledge improvement and behavioural change at 6 months post‐intervention. This approach may provide a workable design for future competency‐based curriculum development. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to describe the natural history and predictors of all‐cause mortality and sudden cardiac death (SCD)/equivalent events in children with a RASopathy syndrome and hypertrophic cardiomyopathy (HCM). Methods and results: This is a retrospective cohort study from 14 paediatric cardiology centres in the United Kingdom and Ireland. We included children <18 years with HCM and a clinical and/or genetic diagnosis of a RASopathy syndrome [Noonan syndrome (NS), NS with multiple lentigines (NSML), Costello syndrome (CS), cardiofaciocutaneous syndrome (CFCS), and NS with loose anagen hair (NS‐LAH)]. One hundred forty‐nine patients were recruited [111 (74.5%) NS, 12 (8.05%) NSML, 6 (4.03%) CS, 6 (4.03%) CFCS, 11 (7.4%) Noonan‐like syndrome, and 3 (2%) NS‐LAH]. NSML patients had higher left ventricular outflow tract (LVOT) gradient values [60 (36–80) mmHg, P = 0.004]. Over a median follow‐up of 197.5 [inter‐quartile range (IQR) 93.58–370] months, 23 patients (15.43%) died at a median age of 24.1 (IQR 5.6–175.9) months. Survival was 96.45% [95% confidence interval (CI) 91.69–98.51], 90.42% (95% CI 84.04–94.33), and 84.12% (95% CI 75.42–89.94) at 1, 5, and 10 years, respectively, but this varied by RASopathy syndrome. RASopathy syndrome, symptoms at baseline, congestive cardiac failure (CCF), non‐sustained ventricular tachycardia (NSVT), and maximal left ventricular wall thickness were identified as predictors of all‐cause mortality on univariate analysis, and CCF, NSVT, and LVOT gradient were predictors for SCD or equivalent event. Conclusions: These findings highlight a distinct category of patients with Noonan‐like syndrome with a milder HCM phenotype but significantly worse survival and identify potential predictors of adverse outcome in patients with RASopathy‐related HCM. [ABSTRACT FROM AUTHOR]

Background: Intensive care unit (ICU) survivors have reduced oral intake; it is unknown whether intake and associated barriers are unique to this group. Objective: To quantify energy intake and potential barriers in ICU survivors compared with general medical (GM) patients and healthy volunteers. Design: A descriptive cohort study in ICU survivors, GM patients, and healthy volunteers. Following an overnight fast, participants consumed a 200 ml test‐meal (213 kcal) and 180 min later an ad libitum meal to measure energy intake (primary outcome). Secondary outcomes; taste recognition, nutrition‐impacting symptoms, malnutrition, and quality of life (QoL). Data are mean ± SD, median (interquartile range [IQR]) or number [percentage]). Results: Twelve ICU survivors (57 ± 17 years, BMI: 30 ± 6), eight GM patients (69 ± 19 years, BMI: 30 ± 6), and 25 healthy volunteers (58 ± 27 years, BMI: 25 ± 4) were included. Recruitment ceased early because of slow recruitment and SARS‐CoV‐2. Energy intake was lower in both patient groups than in health (ICU: 289 [288, 809], GM: 426 [336, 592], health: 815 [654, 1165] kcal). Loss of appetite was most common (ICU: 78%, GM: 67%). For ICU survivors, GM patients and healthy volunteers, respectively, severe malnutrition prevalence; 40%, 14%, and 0%; taste identification; 8.5 [7.0, 11.0], 8.5 [7.0, 9.5], and 8.0 [6.0, 11.0]; and QoL; 60 [40–65], 50 [31–55], and 90 [81–95] out of 100. Conclusions: Energy intake at a buffet meal is lower in hospital patients than in healthy volunteers but similar between ICU survivors and GM patients. Appetite loss potentially contributes to reduced energy intake. [ABSTRACT FROM AUTHOR]

Background: Endings in therapy are discussed widely in mainstream literature, however, there is only a small amount of research that considers endings in therapy for people with intellectual disabilities. Methods: Eight therapists were interviewed about their experience of ending therapy with people with intellectual disabilities. Interviews were analysed using Interpretative Phenomenological Analysis (IPA). Results: Four superordinate themes associated with endings that go well were identified: 'recognising', 'readying', 'reframing' and reflecting', with a fifth theme reflecting endings that were less successful. Participants worked hard to offer transformative experiences of endings and an overarching 'super‐superordinate' theme of 'facilitating transformative endings' encompassed the findings. Conclusions: Endings are a multi‐faceted component of psychological therapy with people with intellectual disabilities and are significant for both client and therapist. We discuss implications for therapy adaptations and future research. [ABSTRACT FROM AUTHOR]

Background: People with an acquired brain injury (ABI) find it challenging to use social media due to changes in their cognition and communication skills. Using social media can provide opportunities for positive connection, but there is a lack of interventions specifically designed to support safe and successful social media use after ABI. Aims: To investigate the outcomes of completing a social media skills intervention and identify barriers and facilitators for future implementation. Methods & Procedures: The study used a mixed‐methods, pre‐post‐intervention design. A total of 17 adults with an ABI were recruited. Participants completed an intervention that included a short self‐guided course about social media skills (social‐ABI‐lity course), and then participated in a private, moderated Facebook group over a 12‐week period (social‐ABI‐lity Facebook group). Data were collected over this period through observation of group activity and weekly surveys. They were also collected on social media use and quality of life at pre‐intervention, post‐intervention and after 3 months. Participants provided feedback on the experience of participating in the programme via a post‐intervention interview. Outcomes & Results: At post‐intervention, there were significant improvements in confidence in using Facebook (p = 0.002) and enjoyment of using Facebook to connect with others (p = 0.013). There was no significant change in reported quality of life, although participants described the multiple benefits of connection they perceived from involvement in the group. Observational data and feedback interviews were informative about the feasibility and acceptability of the intervention. Conclusions & Implications: This pilot study provided preliminary evidence that an intervention comprising a short, self‐guided training course and a private, moderated Facebook group improved outcomes for people with ABI. Key recommendations for future implementation include embedding active peer moderators within groups and taking an individualized approach to delivery of the intervention. WHAT THIS PAPER ADDS: What is already known on the subject: Research has documented the challenges that people with ABI experience in using social media, and the difficulty for rehabilitation clinicians in providing appropriate support in this field. What this paper adds to existing knowledge: This pilot study reports the outcomes of people with ABI completing a short, self‐guided social media skills course and participating in a private, moderated Facebook group. After the intervention, participants reported significantly increased confidence and enjoyment in using Facebook, described the benefits of connection found in the groups, and suggested potential improvements for future implementation. What are the potential or actual clinical implications of this work?: With the growing use of social media for connection and participation, there is a professional obligation to address social media communication skills in cognitive–communication rehabilitation for people with ABI. The findings of this study will inform interventions and future research to assist people with ABI to build their social media skills for communication, social support and a sense of connection. [ABSTRACT FROM AUTHOR]

Safety instrumented systems (SISs) are generally used against process safety hazards with the potential to severely injure, or even kill, personnel or members of the public. Reactive processes are a common application for SISs due to the potential for significant energy release during the reaction, which tends to cause catastrophic rupture of the vessel. While some applications can address the reactive hazard by closing emergency block valves, others may require blowdowns, kill agents, and other complex response actions. The more that needs to be done to address the reaction, the more complicated the SIS, resulting in the need for more experienced process engineering involvement to get the design right. The protection layers allocated to manage the risk of reactive applications typically focus on the prevention of runaway reactions by ensuring that the temperature or pressure never reach an unsafe state. This seems straightforward, but reactive processes can respond to loss of control in ways that are more difficult to predict, so the specification of trip point, response time, and sensor architecture requires more analysis than typical SIS. This paper discusses some of the unique challenges posed by reactive applications and provides examples to illustrate how to overcome these challenges. [ABSTRACT FROM AUTHOR]

Diethylenetriaminepentaacetic acid (DTPA) is a chelating agent whose complex with the Gd3+ ion is used in medical imaging. DTPA is also used in lanthanide‐actinide separation processes. As protonation of the DTPA ligand can facilitate dissociation of the Gd3+ ion from the Gd‐DTPA complex, this work investigates the coordination structures of the aqueous Gd3+ ion and its environment when chelated by DTPA in eight different DTPA protonation states. Both classical and ab initio molecular dynamics (MD) simulations are conducted to model the solvated complexes. Extended X‐ray absorption fine structure (EXAFS) measurements of the Gd3+aqua ion, and the Gd‐DTPA complex at pH 1 and 11, are compared to EXAFS spectra predicted from the MD simulations to verify the accuracy of the MD structures. The findings of this work provide atomic‐level details into the fluctuating Gd‐DTPA complex environment as the DTPA ligand gradually detaches from the Gd3+ ion with increased protonation. [ABSTRACT FROM AUTHOR]

Truncation of the C‐terminal tail of the β2‐AR, transfection of βARKct or over‐expression of a kinase‐dead GRK mutant reduces isoprenaline‐stimulated glucose uptake, indicating that GRK is important for this response. We explored whether phosphorylation of the β2‐AR by GRK2 has a role in glucose uptake or if this response is related to the role of GRK2 as a scaffolding protein. CHO‐GLUT4myc cells expressing wild‐type and mutant β2‐ARs were generated and receptor affinity for [3H]‐CGP12177A and density of binding sites determined together with the affinity of isoprenaline and BRL37344. Following receptor activation by β2‐AR agonists, cAMP accumulation, GLUT4 translocation, [3H]‐2‐deoxyglucose uptake, and β2‐AR internalization were measured. Bioluminescence resonance energy transfer was used to investigate interactions between β2‐AR and β‐arrestin2 or between β2‐AR and GRK2. Glucose uptake after siRNA knockdown or GRK inhibitors was measured in response to β2‐AR agonists. BRL37344 was a poor partial agonist for cAMP generation but displayed similar potency and efficacy to isoprenaline for glucose uptake and GLUT4 translocation. These responses to β2‐AR agonists occurred in CHO‐GLUT4myc cells expressing β2‐ARs lacking GRK or GRK/PKA phosphorylation sites as well as in cells expressing the wild‐type β2‐AR. However, β2‐ARs lacking phosphorylation sites failed to recruit β‐arrestin2 and did not internalize. GRK2 knock‐down or GRK2 inhibitors decreased isoprenaline‐stimulated glucose uptake in rat L6 skeletal muscle cells. Thus, GRK phosphorylation of the β2‐AR is not associated with isoprenaline‐ or BRL37344‐stimulated glucose uptake. However, GRKs acting as scaffold proteins are important for glucose uptake as GRK2 knock‐down or GRK2 inhibition reduces isoprenaline‐stimulated glucose uptake. [ABSTRACT FROM AUTHOR]

Background: Donor hyperglycaemia following brain death has been attributed to reversible insulin resistance. However, our islet and pancreas transplant data suggest that other mechanisms may be predominant. We aimed to determine the relationships between donor insulin use and markers of beta‐cell death and beta‐cell function in pancreas donors after brain death. Methods: In pancreas donors after brain death, we compared clinical and biochemical data in 'insulin‐treated' and 'not insulin‐treated donors' (IT vs. not‐IT). We measured plasma glucose, C‐peptide and levels of circulating unmethylated insulin gene promoter cell‐free DNA (INS‐cfDNA) and microRNA‐375 (miR‐375), as measures of beta‐cell death. Relationships between markers of beta‐cell death and islet isolation outcomes and post‐transplant function were also evaluated. Results: Of 92 pancreas donors, 40 (43%) required insulin. Glycaemic control and beta‐cell function were significantly poorer in IT donors versus not‐IT donors [median (IQR) peak glucose: 8 (7‐11) vs. 6 (6‐8) mmol/L, p =.016; C‐peptide: 3280 (3159‐3386) vs. 3195 (2868‐3386) pmol/L, p =.046]. IT donors had significantly higher levels of INS‐cfDNA [35 (18‐52) vs. 30 (8‐51) copies/ml, p =.035] and miR‐375 [1.050 (0.19‐1.95) vs. 0.73 (0.32‐1.10) copies/nl, p =.05]. Circulating donor miR‐375 was highly predictive of recipient islet graft failure at 3 months [adjusted receiver operator curve (SE) = 0.813 (0.149)]. Conclusions: In pancreas donors, hyperglycaemia requiring IT is strongly associated with beta‐cell death. This provides an explanation for the relationship of donor IT with post‐transplant beta‐cell dysfunction in transplant recipients. [ABSTRACT FROM AUTHOR]

Background: Small bowel carcinoid tumor is a rare neoplasm and increasing in incidence. Patients with small bowel carcinoid tumors often experience long delays in diagnosis due to the vague symptoms, slow growth of tumors, and lack of clinician awareness. Computed tomography (CT) is the most common imaging study for diagnosis of small bowel carcinoid tumor. It is often used with positron emission tomography (PET) to capture anatomical and functional aspects of carcinoid tumors and thus to increase the sensitivity. Purpose: We compared three different kinds of methods for the automatic detection of small bowel carcinoid tumors on CT scans, which is the first to the best of our knowledge. Methods: Thirty‐three preoperative CT scans of 33 unique patients with surgically‐proven carcinoid tumors within the small bowel were collected. Ground‐truth segmentation of tumors was drawn on CT scans by referring to available 18F‐DOPA PET scans and the corresponding radiology report. These scans were split into the trainval set (n = 24) and the test positive set (n= 9). Additionally, 22 CT scans of 22 unique patients who had no evidence of the tumor were collected to comprise the test negative set. We compared three different kinds of detection methods, which are detection network, patch‐based classification, and segmentation‐based methods. We also investigated the usefulness of small bowel segmentation for reduction of false positives (FPs) for each method. Free‐response receiver operating characteristic (FROC) curves and receiver operating characteristic (ROC) curves were used for lesion‐ and patient‐level evaluations, respectively. Statistical analyses comparing the FROC and ROC curves were also performed. Results: The detection network method performed the best among the compared methods. For lesion‐level detection, the detection network method, without the small bowel segmentation‐based filtering, achieved sensitivity values of (60.8%, 81.1%, 82.4%, 86.5%) at per‐scan FP rates of (1, 2, 4 ,8), respectively. The use of the small bowel segmentation did not improve the performance (p=0.742$p=0.742$). For patient‐level detection, again the detection network method, but with the small bowel segmentation‐based filtering, achieved the highest AUC of 0.86 with a sensitivity of 78% and specificity of 82% at the Youden point. Conclusions: The carcinoid tumors in this patient population were very small and potentially difficult to diagnose. The presented method showed reasonable sensitivity at small numbers of FPs for lesion‐level detection. It also achieved a promising AUC for patient‐level detection. The method may have clinical application in patients with this rare and difficult to detect disease. [ABSTRACT FROM AUTHOR]

Summary: Predicting the fate of coastal marshes requires understanding how plants respond to rapid environmental change. Environmental change can elicit shifts in trait variation attributable to phenotypic plasticity and act as selective agents to shift trait means, resulting in rapid evolution. Comparably, less is known about the potential for responses to reflect the evolution of trait plasticity.Here, we assessed the relative magnitude of eco‐evolutionary responses to interacting global change factors using a multifactorial experiment. We exposed replicates of 32 Schoenoplectus americanus genotypes 'resurrected' from century‐long, soil‐stored seed banks to ambient or elevated CO2, varying levels of inundation, and the presence of a competing marsh grass, across two sites with different salinities.Comparisons of responses to global change factors among age cohorts and across provenances indicated that plasticity has evolved in five of the seven traits measured. Accounting for evolutionary factors (i.e. evolution and sources of heritable variation) in statistical models explained an additional 9–31% of trait variation.Our findings indicate that evolutionary factors mediate ecological responses to environmental change. The magnitude of evolutionary change in plant traits over the last century suggests that evolution could play a role in pacing future ecosystem response to environmental change. See also the Commentary on this article by Kottler, 240: 1714–1716. [ABSTRACT FROM AUTHOR]

On March 13, 2023, in conjunction with the 19th Global Congress on Process Safety, four of the authors gathered to participate in a panel session. The discussion centered on the premise that many individual device failure rates published by some manufacturers and some certifying agencies are deemed—by members of the panel, many safety instrumented system (SIS) designers, and practicing engineers in the field—to be too low. This is especially true for mechanical final elements. A SIS designed using these unrealistic failure rates often results in estimated safety integrity levels (SILs) for the individual safety instrumented functions (SIFs) comprising the SIS, which would be achievable only under the most optimistic assumptions regarding installation, operation, and maintenance. These estimated SILs are unlikely to be achieved in the field. The panel discussed the underlying causes of this serious safety issue and proposed some possible solutions. This paper summarizes the panel discussion among four of the authors. Relevant graphics shown during the discussion and some panelists' quotations are included. [ABSTRACT FROM AUTHOR]

Background: Non‐standardized assessment tools are preferred when assessing communication of individuals with developmental disabilities. Currently, there are limited tools available for assessing this population. Informant report tools such as the Pragmatics Profile (PP) of Everyday Communication Skills are beneficial in gathering a representative view of an individual's communication. However, the PP is out of print and outdated, requiring revisions to meet contemporary assessment needs of speech–language therapists (SLTs). Aims: To seek consensus from an international panel regarding revising the Pragmatic Profile by (1) updating language and terminology, and (2) development of an online tool. Methods & Procedures: A total of 13 experienced SLTs and researchers in the disability field participated in a modified Delphi study including an initial online meeting followed by an anonymous four‐round survey. Participants reviewed the relevance and wording of questions in the original preschool, school‐age and adult versions to create a single combined version of the PP. In each Delphi round, the level of consensus was calculated and qualitative comments were analysed using thematic analysis. Outcomes & Results: A revised online version of the PP was created including 64 questions. Qualitative analysis illuminated key concepts in the creation of a revised form including the need for plain and age‐neutral language, which is inclusive of all communication modalities and physical impairments, and identifies behaviours that have the potential to be communicative acts. Using conditional logic, users are navigated to the appropriate questions based on the intentionality level of the individual rather than their age. Conclusions & Implications: This study resulted in the revision of a valued assessment tool appropriate for current disability service provision that identifies communication along the continuum of intentionality rather than age. WHAT THIS PAPER ADDS: What is already known on this subject: Non‐standardized tools are appropriate when assessing communication of individuals with developmental disabilities. However, there are limited published tools suitable for this population with several of them out of print, making it difficult to conduct a holistic assessment. What this study adds to the existing knowledge: This study resulted in the creation of an online PP based on experts' opinion. The revised PP modified the primary focus of the tool from age‐ to skill‐based whereby questions are targeted according to intentionality level. Revisions included plain language, and inclusion of all communication modalities and physical impairments via a series of prompts to ensure that the information provided by informants is accurate and relevant. What are the potential or actual clinical implications of this work?: The revised PP adds to the toolkit of an SLT working with individuals with a developmental disability and allows for accurate reporting of functional communication. Guided by experts' opinion, the revised PP is likely to be highly valued in the increasingly technological world in which we live. [ABSTRACT FROM AUTHOR]

Summary: Pollen and tracheophyte spores are ubiquitous environmental indicators at local and global scales. Palynology is typically performed manually by microscopic analysis; a specialised and time‐consuming task limited in taxonomical precision and sampling frequency, therefore restricting data quality used to inform climate change and pollen forecasting models. We build on the growing work using AI (artificial intelligence) for automated pollen classification to design a flexible network that can deal with the uncertainty of broad‐scale environmental applications.We combined imaging flow cytometry with Guided Deep Learning to identify and accurately categorise pollen in environmental samples; here, pollen grains captured within c. 5500 Cal yr BP old lake sediments.Our network discriminates not only pollen included in training libraries to the species level but, depending on the sample, can classify previously unseen pollen to the likely phylogenetic order, family and even genus.Our approach offers valuable insights into the development of a widely transferable, rapid and accurate exploratory tool for pollen classification in 'real‐world' environmental samples with improved accuracy over pure deep learning techniques. This work has the potential to revolutionise many aspects of palynology, allowing a more detailed spatial and temporal understanding of pollen in the environment with improved taxonomical resolution. [ABSTRACT FROM AUTHOR]

Background: Intensity is an important determinant of physiological adaptations and health benefits of exercise, but the role of exercise intensity on improving outcomes in people with chronic low back pain (CLBP) is unclear. This systematic review aimed to determine the effect of higher versus lower intensity exercise intensity on pain, disability, quality of life and adverse events in people with CLBP. Methods: Six databases and four clinical trial registries were searched from inception to 21 December 2022, for randomised controlled trials that compared two or more exercise intensities in adults with CLBP. Data were analysed using random‐effects meta‐analysis for disability and synthesised narratively for pain, quality of life and adverse events due to limited studies. Risk of bias was assessed using the Cochrane tool and certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluations framework. Results: Four trials (n = 214 participants, 84% male) reported across five studies were included. Higher intensity exercise reduced disability more than lower intensity exercise at end‐treatment (SMD [95% CI] = −0.39 [−0.56 to −0.22]; very low certainty) but not at 6‐month follow‐up (SMD [95% CI] = −0.20 [−0.53 to 0.13]; very low certainty). Higher intensity exercise did not reliably improve pain and quality of life more than lower intensity exercise. Adverse events did not differ between exercise intensities. All studies were at high risk of bias. Conclusion: Based on very low certainty evidence from a limited number of studies, exercise intensity does not appear to meaningfully influence clinical outcomes in people with CLBP. [ABSTRACT FROM AUTHOR]

High‐grade glioma is an aggressive cancer that occurs naturally in pet dogs. Canine high‐grade glioma (cHGG) is treated with radiation, chemotherapy or surgery, but has no curative treatment. Within the past eight years, there have been advances in our imaging and histopathology standards as well as genetic charactereization of cHGG. However, there are only three cHGG cell lines publicly available, all of which were derived from astrocytoma and established using methods involving expansion of tumour cells in vitro on plastic dishes. In order to provide more clinically relevant cell lines for studying cHGG in vitro, the goal of this study was to establish cHGG patient‐derived lines, whereby cancer cells are expanded in vivo by injecting cells into immunocompromized laboratory mice. The cells are then harvested from mice and used for in vitro studies. This method is the standard in the human field and has been shown to minimize the acquisition of genetic alterations and gene expression changes from the original tumour. Through a multi‐institutional collaboration, we describe our methods for establishing two novel cHGG patient‐derived lines, Boo‐HA and Mo‐HO, from a high‐grade astrocytoma and a high‐grade oligodendroglioma, respectively. We compare our novel lines to G06‐A, J3T‐Bg, and SDT‐3G (traditional cHGG cell lines) in terms of proliferation and sensitivity to radiation. We also perform whole genome sequencing and identify an NF1 truncating mutation in Mo‐HO. We report the characterization and availability of these novel patient‐derived lines for use by the veterinary community. [ABSTRACT FROM AUTHOR]

The distinction between point estimation and confidence interval estimation for failure rates is described. Why the upper bounds of failure rate confidence intervals are prescribed by safety standards for use in safety metric computations is explained. Statistical formulas for the failure rate upper bounds are provided. The requirements that the field failure data (FFD) must meet to ensure the validity of the failure rate estimations are discussed from both mathematical and engineering perspectives. The need to understand the underlying causes of failure in determining when FFD can be aggregated is explained. Examples illustrating the impacts on failure rate estimation when the data requirements are and are not met are presented. [ABSTRACT FROM AUTHOR]

Background: Relatively little is known about how distressing symptoms change among older persons in the setting of major surgery. Our objective was to evaluate changes in distressing symptoms after major surgery and determine whether these changes differ according to the timing of surgery (nonelective vs. elective), sex, multimorbidity, and socioeconomic disadvantage. Methods: From a prospective longitudinal study of 754 nondisabled community‐living persons, 70 years of age or older, 368 admissions for major surgery were identified from 274 participants who were discharged from the hospital from March 1998 to December 2017. The occurrence of 15 distressing symptoms was ascertained in the month before and 6 months after major surgery. Multimorbidity was defined as more than two chronic conditions. Socioeconomic disadvantage was assessed at the individual level, based on Medicaid eligibility, and neighborhood level, based on an area deprivation index (ADI) score above the 80th state percentile. Results: In the month before major surgery, the occurrence and mean number of distressing symptoms were 19.6% and 0.75, respectively. In multivariable analyses, the rate ratios, denoting proportional increases in the 6 months after major surgery relative to presurgery values, were 2.56 (95% confidence interval [CI], 1.91–3.44) and 2.90 (95% CI, 2.01–4.18) for the occurrence and number of distressing symptoms, respectively. The corresponding values were 3.54 (95% CI, 2.06–6.08) and 4.51 for nonelective surgery (95% CI, 2.32–8.76) and 2.12 (95% CI, 1.53–2.92) and 2.20 (95% CI, 1.48–3.29) for elective surgery; p‐values for interaction were 0.030 and 0.009. None of the other subgroup differences were statistically significant, although men had a greater proportional increase in the occurrence and number of distressing symptoms than women. Conclusions: Among community‐living older persons, the burden of distressing symptoms increases substantially after major surgery, especially in those having nonelective procedures. Reducing symptom burden has the potential to improve quality of life and enhance functional outcomes after major surgery. [ABSTRACT FROM AUTHOR]

Diagnosis of pathogenic genetic variants associated with neurodevelopmental and psychiatric disorders (NPDs) is increasingly made early in life. This narrative review focuses on the need for, and provision of, psychological supports following genetic diagnosis. We conducted a literature search of publications on how caregivers are informed about the NPD vulnerability associated with genetic variants, challenges and unmet needs when receiving this information, and whether psychological supports are provided. Given its early recognition, the 22q11.2 deletion has been studied thoroughly for two decades, providing generalizable insights. This literature indicates the complex caregivers' needs related to learning about potential NPD vulnerabilities associated with a genetic variant, include how to communicate the diagnosis, how to identify early signs of NPDs, how to deal with stigma and a lack of medical expertise outside of specialized genetics clinics. With one exception, no publications describe psychotherapeutic support provided to parents. In the absence of support, caregivers struggle with several unmet needs regarding potential longer‐term NPD implications of a genetic diagnosis. The field needs to go beyond explaining genetic diagnoses and associated vulnerabilities, and develop approaches to support caregivers with communicating and managing NPD implications across the child's lifespan. [ABSTRACT FROM AUTHOR]

Homozygous null mutation of the Csf1r gene (Csf1rko) in rats leads to the loss of most tissue macrophage populations and pleiotropic impacts on postnatal growth and organ maturation, leading to early mortality. The phenotype can be reversed by intraperitoneal transfer of WT BM cells (BMT) at weaning. Here, we used a Csf1r‐mApple transgenic reporter to track the fate of donor‐derived cells. Following BMT into Csf1rko recipients, mApple+ve cells restored IBA1+ tissue macrophage populations in every tissue. However, monocytes, neutrophils, and B cells in the BM, blood, and lymphoid tissues remained of recipient (mApple−ve) origin. An mApple+ve cell population expanded in the peritoneal cavity and invaded locally in the mesentery, fat pads, omentum, and diaphragm. One week after BMT, distal organs contained foci of mApple+ve, IBA1−ve immature progenitors that appeared to proliferate, migrate, and differentiate locally. We conclude that rat BM contains progenitor cells that are able to restore, replace, and maintain all tissue macrophage populations in a Csf1rko rat directly without contributing to the BM progenitor or blood monocyte populations. [ABSTRACT FROM AUTHOR]

A new high-pressure single-crystal diffraction setup has been designed and implemented at the Australian Synchrotron for collecting molecular and protein crystal structures. The setup incorporates a modified micro-Merrill-Bassett cell and holder designed specifically to fit onto the horizontal air-bearing goniometer, allowing high-pressure diffraction measurements to be collected with little to no modification of the beamline setup compared with ambient data collections. Compression data for the amino acid, l-threonine, and the protein, hen egg-white lysozyme, were collected, showcasing the capabilities of the setup. [ABSTRACT FROM AUTHOR]

Background: Although 50 years represents middle age among uninfected individuals, studies have shown that persons living with HIV (PWH) begin to demonstrate elevated risk for serious falls and fragility fractures in the sixth decade; the proportions of these outcomes attributable to modifiable factors are unknown. Methods: We analyzed 21,041 older PWH on antiretroviral therapy (ART) from the Veterans Aging Cohort Study from 01/01/2010 through 09/30/2015. Serious falls were identified by Ecodes and a machine‐learning algorithm applied to radiology reports. Fragility fractures (hip, vertebral, and upper arm) were identified using ICD9 codes. Predictors for both models included a serious fall within the past 12 months, body mass index, physiologic frailty (VACS Index 2.0), illicit substance and alcohol use disorders, and measures of multimorbidity and polypharmacy. We separately fit multivariable logistic models to each outcome using generalized estimating equations. From these models, the longitudinal extensions of average attributable fraction (LE‐AAF) for modifiable risk factors were estimated. Results: Key risk factors for both outcomes included physiologic frailty (VACS Index 2.0) (serious falls [15%; 95% CI 14%–15%]; fractures [13%; 95% CI 12%–14%]), a serious fall in the past year (serious falls [7%; 95% CI 7%–7%]; fractures [5%; 95% CI 4%–5%]), polypharmacy (serious falls [5%; 95% CI 4%–5%]; fractures [5%; 95% CI 4%–5%]), an opioid prescription in the past month (serious falls [7%; 95% CI 6%–7%]; fractures [9%; 95% CI 8%–9%]), and diagnosis of alcohol use disorder (serious falls [4%; 95% CI 4%–5%]; fractures [8%; 95% CI 7%–8%]). Conclusions: This study confirms the contributions of risk factors important in the general population to both serious falls and fragility fractures among older PWH. Successful prevention programs for these outcomes should build on existing prevention efforts while including risk factors specific to PWH. [ABSTRACT FROM AUTHOR]