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Background: Currently, there are no agreed quality standards for post‐stroke aphasia services. Therefore, it is unknown if care reflects best practices or meets the expectations of people living with aphasia. We aimed to (1) shortlist, (2) operationalise and (3) prioritise best practice recommendations for post‐stroke aphasia care. Methods: Three phases of research were conducted. In Phase 1, recommendations with strong evidence and/or known to be important to people with lived experience of aphasia were identified. People with lived experience and health professionals rated the importance of each recommendation through a two‐round e‐Delphi exercise. Recommendations were then ranked for importance and feasibility and analysed using a graph theory–based voting system. In Phase 2, shortlisted recommendations from Phase 1 were converted into quality indicators for appraisal and voting in consensus meetings. In Phase 3, priorities for implementation were established by people with lived experience and health professionals following discussion and anonymous voting. Findings: In Phase 1, 23 best practice recommendations were identified and rated by people with lived experience (n = 26) and health professionals (n = 81). Ten recommendations were shortlisted. In Phase 2, people with lived experience (n = 4) and health professionals (n = 17) reached a consensus on 11 quality indicators, relating to assessment (n = 2), information provision (n = 3), communication partner training (n = 3), goal setting (n = 1), person and family‐centred care (n = 1) and provision of treatment (n = 1). In Phase 3, people with lived experience (n = 5) and health professionals (n = 7) identified three implementation priorities: assessment of aphasia, provision of aphasia‐friendly information and provision of therapy. Interpretation: Our 11 quality indicators and 3 implementation priorities are the first step to enabling systematic, efficient and person‐centred measurement and quality improvement in post‐stroke aphasia services. Quality indicators will be embedded in routine data collection systems, and strategies will be developed to address implementation priorities. Patient and Public Contribution: Protocol development was informed by our previous research, which explored the perspectives of 23 people living with aphasia about best practice aphasia services. Individuals with lived experience of aphasia participated as expert panel members in our three consensus meetings. We received support from consumer advisory networks associated with the Centre for Research Excellence in Aphasia Rehabilitation and Recovery and the Queensland Aphasia Research Centre. [ABSTRACT FROM AUTHOR]

Concerns regarding man‐made organic chemicals pervading our ecosystem and having adverse and detrimental effects upon organisms, including man, have now been studied for several decades. Since the 1970s, some environmental pollutants were identified as having endocrine disrupting affects. These endocrine disrupting chemicals (EDC) were initially shown to have estrogenic or anti‐estrogenic properties and some were also shown to bind to a variety of hormone receptors. However, since the 1990s it has also been identified that many of these EDC additionally, have the ability of causing abnormal alterations in Ca2+ signalling pathways (also commonly involved in hormone signalling), leading to exaggerated elevations in cytosolic [Ca2+] levels, that is known to cause activation of a number of cell death pathways. The major emphasis of this review is to present a personal perspective of the evidence for some types of EDC, specifically alkylphenols and brominated flame retardants (BFRs), causing direct effects on Ca2+ transporters (mainly the SERCA Ca2+ ATPases), culminating in acute cytotoxicity and cell death. Evidence is also presented to indicate that this Ca2+ATPase inhibition, which leads to abnormally elevated cytosolic [Ca2+], as well as a decreased luminal ER [Ca2+], which triggers the ER stress response, are both involved in acute cytotoxicity. [ABSTRACT FROM AUTHOR]

Objective: Somatic variants in UBA1 cause VEXAS, a recently described, systemic autoinflammatory disease. Research on VEXAS has largely focused on highly symptomatic patients. We sought to determine the prevalence of canonical, VEXAS‐associated somatic variants and their disease penetrance in a diverse, unselected population. Methods: We analyzed clinical‐grade whole genome sequencing data from 245,368 participants in the All of Us Research Program. We compared persons carrying a canonical VEXAS‐associated somatic variant to age, sex, and ancestry matched controls across the domains of diagnoses, medications, and laboratory values. Results: 74 participants were identified who carry one VEXAS‐defining somatic variant, UBA1 c.121A>C, p.Met41Leu. The variant allele fraction ranged from 4.5% to 33%. No other canonical VEXAS‐associated variants were identified. Of the 74 carriers, 62 (84%) were women, 20 (27%) were African American, and 14 (19%) were American Admixed/Latino. There was no statistically significant association between case/control status and any VEXAS‐associated diagnosis code, medication prescription, or laboratory value. Conclusion: We report the largest cohort to date of persons with the VEXAS‐associated p.Met41Leu somatic variant. This cohort differed substantially from reported cohorts of patients with clinical VEXAS, having a higher proportion of persons who were young, female, and of diverse ancestry. Variant allele fractions were lower than reported in clinical VEXAS cohorts, and bioinformatic analysis detected no clinical manifestations of VEXAS. Thus, the UBA1 p.Met41Leu somatic variant displayed incomplete penetrance for VEXAS. Further study is needed to determine the natural history of VEXAS‐associated somatic variants in the predisease phase. [ABSTRACT FROM AUTHOR]

There is increasing concern into the decline of insect populations, with corresponding calls for conservation action aimed towards threatened species in particular. However, there is a distinct paucity of knowledge surrounding habitat requirements, microhabitat selection and conservation actions that may be undertaken for the vast majority of invertebrate species.Carabus intricatus (Coleoptera: Carabidae) Linnaeus, 1761 is a threatened ancient woodland specialist in the United Kingdom with a highly restricted distribution and is listed as a section 41 species of principal importance in England. Despite this, no empirical systematic evidence exists for even basic habitat requirements.Here, we used a patch‐occupancy modelling framework to determine occupancy and detection parameters for C. intricatus and a sympatric generalist species, C. problematicus, which is a potential competitor.Our models showed that decayed deadwood availability and leaf litter covering (an indicator of the availability of mature broadleaved trees) leads to higher occupancy of C. intricatus, whereas decayed dead wood availability and slug abundance are primary determinants of overall abundance. Additionally, detection models showed that higher humidity substantially increased activity of C. intricatus.For C. problematicus, ground moss coverage and overall deadwood volume most strongly influenced occupancy and abundance, whereas there were no humidity related influences on activity.The results support our general predictions about the specialist–generalist nature of the two species in the United Kingdom and indicate that key characteristics of old‐growth temperate rain forests, particularly the availability of deadwood and high humidity, are central to the conservation of these charismatic carabids. [ABSTRACT FROM AUTHOR]

This qualitative study describes the development and evaluation of a clinical pathway to facilitate the implementation of catch‐up vaccinations for children with significant needle fear, particularly in children with developmental disabilities. The Specialist Immunization Team, based at a tertiary level teaching children's hospital, participated in process mapping activities using Motivational Interviewing (MI) techniques and reflective discussions. Team members developed a clinical pathway by incorporating parental feedback from semistructured interviews and clinical expertise from within the team, facilitated by colleagues from the Child Development Unit. A process map was developed that included process strengths and touch points with an action plan that was discussed and agreed upon. A repeat process mapping activity was conducted 16 months later. Reports from parental feedback included: positive, efficient, and successful experiences of having their child undergo catch‐up vaccinations. The experience empowered families for further procedures. Team members reported improvements in triaging appropriate children for the pathway, and an increase in confidence to interact and manage behaviors of children with significant anxiety and challenging behaviors. They also reported an increase in successful vaccinations with improved clinical judgment of facilitating the sedation pathway. This study demonstrates that using group facilitation using motivational interviewing in reflective discussions and process mapping utilizing parent and staff feedback in service improvement activities results in efficient and successful service delivery with improved patient outcomes. [ABSTRACT FROM AUTHOR]

Ranging dynamics are physical and behavioral representations of how different socioecological factors affect an organism's spatial decisions and space use strategies. Western lowland gorillas (Gorilla gorilla gorilla) are a model species to investigate the drivers of spatial dynamics based on both the natural variation in socioecological factors within the species and compared with their mountain gorilla counterparts. In this study, we evaluate the influences of resource seasonality and social dynamics on variation in home range size, utilization, and intergroup overlap among multiple gorilla groups over an 8‐year study period in the northern Republic of Congo. This study shows that western lowland gorillas can have small home ranges comparable to mountain gorillas, rather than universally larger home ranges as previously supposed, and that home ranges are stable through time. The largest source of variation in space use was the degree of intergroup home range overlap. The study groups did not demonstrate intraspecific variation in range size nor changes in intergroup overlap with respect to seasonality of fruit resources, but all groups demonstrated expansion of monthly range and core area with group size, matching predictions of intragroup feeding competition. These findings highlight the potential impact of intergroup relationships on space use and prompt further research on the role of social dynamics in ranging strategies. In this study, we reveal a greater degree of variability and flexibility in gorilla ranging behavior than previously realized which is relevant to improving comparative studies and informing conservation strategies on behalf of these endangered primates. Research Highlights: Groups in this study had relatively smaller home range sizes than previous investigations on western lowland gorilla groups, with home range sizes more comparable to that of mountain gorilla groups.Western lowland gorilla home ranges were consistent with proposed foraging strategies but did not shift in size with the seasonality of fruit resources.Neighboring gorilla groups varied in degree of spatial overlap depending on the dyad of interest, with relationships in spatial overlap and utilization remaining consistent with the availability of fruit resources. [ABSTRACT FROM AUTHOR]

Congenital malformations, conditions, injuries, and illness can lead to long‐term physical impairment and disability in nonhuman primates. How individual primates change their behaviors flexibly to compensate for their disabilities can inform our understanding of their resilience and ability to adjust to environmental change. Here, we synthesize the literature on nonhuman primates and disability, addressing the questions: how does disability influence behavior in primates? What insights can we take from the literature to better understand and predict the capacity of primates to modify their behaviors in the face of human‐induced environmental change? We conducted a systematic review of the literature on spontaneous physical impairment and disability in captive, free‐ranging, and wild primates. We surveyed 2807 articles on Web of Science and Scopus and identified 114 studies that fit our predetermined inclusion criteria. Behavioral plasticity, maternal and conspecific care, and the potential for innovation of novel behaviors allow many primates with disabilities to compensate when faced with challenges that are outside the scope of usual circumstances. We also found that 60% of the publications connected primate physical impairment and disability to human activities, suggesting an entangled relationship among humans, the environment, and primate disability. Disability and physical impairments provide an opportunity to examine how primates modify their behavior when presented with challenging conditions, and their potential resilience to a changing environment. [ABSTRACT FROM AUTHOR]

Glucocorticoids (GCs) are hormones released in response to stressors and can provide insight into an organism's physiological well‐being. Experiencing chronic challenges to homeostasis is associated with significant deviations from baseline fecal GCs (fGCs) in many species, providing a noninvasive biomarker for assessing stress. In the group of free‐ranging Japanese macaques (Macaca fuscata) at the Awajishima Monkey Center in Japan, ~17% have congenital limb malformations. We collected 646 fecal samples from 27 females over three consecutive birth seasons (May–August) and analyzed them using enzyme immunoassay to extract fGCs. We explored the relationship between fGC levels and individual (physical impairment and reproductive status), social (dominance rank and availability of kin for social support), and ecological variables (exposure to potential predators, rainfall, and wild fruit availability). A disabled infant was associated significantly with higher fGC in the mother; however, physical impairment in adult females was not significantly related to fGC levels. Females with higher dominance rank had significantly lower fGC levels than lower ranking females. Other factors did not relate significantly to fGC. These results suggest that providing care that meets the support needs of disabled infants poses a physiological challenge for mothers and suggests that physically impaired adults are able to effectively compensate for their disabilities with behavioral plasticity. Once an individual with congenital limb malformations survives infancy through their mother's care, physical impairment does not appear to influence fGC values, while social variables like dominance rank significantly influenced cortisol values in free‐ranging female Japanese macaques. Highlights: Free‐ranging macaque mothers of disabled infants had higher fecal glucocorticoid (fGC) values than others. Physical impairments in adult females were not associated with differences in fGC values. Dominance rank related to fGCs: higher rank females had lower fCGs than lower rank. [ABSTRACT FROM AUTHOR]

Novel synthetic opioids contribute considerably to the opioid epidemic, especially with the frequent emergence of structurally similar compounds. This case report describes a fatal intoxication involving 2‐methyl AP‐237. A 54‐year‐old Caucasian male was found deceased from an apparent drug overdose. A plastic container labeled "2MAP" and a cut straw were found in the decedent's backpack at the scene. A white substance found in the container tested positive for fentanyl by field testing. According to his medical history, the decedent was treated for a drug overdose 3 years prior to his death. With no diagnostic findings at autopsy, the case was submitted for toxicological analysis. An unknown substance was detected in peripheral blood and urine using gas chromatography with nitrogen phosphorous detection (GC‐NPD). Further testing was conducted using gas chromatography–mass spectrometry (GC–MS) and liquid chromatography‐quadrupole‐time‐of‐flight mass spectrometry (LC‐QTOF‐MS) which confirmed the presence of 2‐methyl AP‐237 and potential metabolites in blood and urine. Quantitation by GC‐NPD revealed concentrations of 2‐methyl AP‐237 in blood and urine at 480 ng/mL and 4200 ng/mL, respectively. The toxicological analysis also identified and quantitated alprazolam in the blood at 55 ng/mL. Additionally, the metabolism of 2‐methyl AP‐237 was investigated and three hydroxylated metabolites were identified in peripheral blood and urine. Limited literature is available for the detection and quantitation of 2‐methyl AP‐237 in postmortem specimens. Given the toxicological findings with unremarkable autopsy findings, this case is an example of a fatal intoxication involving 2‐methyl AP‐237. [ABSTRACT FROM AUTHOR]

A 4‐year‐old, male Rothschild's giraffe presented with a rapidly growing, hemispherical, approximately 40 × 20 × 20 mm, raised, firm mass located on the mid‐region of the left lateral thigh. Complete surgical excision (minimal 20 mm margins in all orientations) was achieved under behavioural restraint and local anaesthesia. Cytology and histopathology diagnosed a poorly differentiated malignant mesenchymal neoplasm, with nuclear karyomegaly, multinucleation and atypical horseshoe‐like forms. The neoplastic cells exhibited diffuse strong cytoplasmic immunopositivity to vimentin, and were negative to smooth muscle actin, desmin, glial fibrillary acidic protein, and CD18 immunomarkers, giving a diagnosis of undifferentiated pleomorphic sarcoma. At 1 year follow‐up, the giraffe is clinically well with no health issues after complete excision, and no evidence of local recurrence or distant metastases, based on physical examination and routine haematology/biochemistry. To the authors' knowledge, this is the first report of an undifferentiated pleomorphic sarcoma (atypical fibroxanthoma‐subtype) in a giraffe. [ABSTRACT FROM AUTHOR]

Background: The focus of this paper is exemplary gerontological nursing interventions that effectively supported families and long‐term care residents in Canada during visiting restrictions resulting from COVID‐19. Objective: The aim was to describe exemplary gerontological nursing interventions that families and long‐term care residents in Canada found supportive during visiting restrictions resulting from COVID‐19. Methods: An analysis of data artefacts including news reports, blogs and social media postings was completed. Results: Thematic analysis resulted in four themes: dedication amidst challenge, innovation and continuous learning, living their nursing values and purposeful knowledge sharing. These themes are described using a framework that depicts four pillars of exemplary nursing practice: professionalism, scholarly practice, leadership and stewardship (Riley, Beal, & Ponte, 2021). Conclusions/Implications for Practice: A link is made between these pillars of exemplary practice and enactment of family‐focused care. Recommendations focused on gerontological nursing approaches that facilitate family‐focused care for older adults residing in long‐term care are included. [ABSTRACT FROM AUTHOR]

Understanding water consumption is an important component of water management. However, water consumption data are limited and consumption coefficients do not account for variability through time and across users. This study combines federally maintained discharge data with state‐maintained withdrawal data at monthly time steps to estimate facility‐level and spatially aggregated water consumption in Virginia between 2010 and 2016. We evaluate (1) the feasibility of using discharge and withdrawal datasets to estimate sub‐annual water consumption, (2) how these consumption estimates vary depending on the level of spatial aggregation, and (3) what patterns of seasonality exist in consumption estimates. We find that a combined process of text matching and geospatial analysis is effective in matching facilities and yielding monthly time‐series of water consumption. Our results suggest that median consumption in industrial (17%) and commercial (19%) facilities may be higher than median consumption coefficients in the literature (10%). Consumption estimates also demonstrated more variability across facilities and seasons than aggregate coefficients in the literature suggest. Combining this approach with institutional knowledge can assist in quantifying issues such as inter‐basin transfers and infiltration that impact consumption estimates, ultimately allowing for more accurate accounts of water use and availability. [ABSTRACT FROM AUTHOR]

Previous research found that seeds of I Dialium i spp. are particularly often re-ingested by chimpanzees and gorillas, suggesting their importance in the diet of both species (Payne et al., 2008; Rogers et al., 1998). Great apes in the wild have so far only been observed to perform autocoprophagy with some rare exceptions in chimpanzees, who occasionally ingested elephant dung (Krief et al., 2005), and notion of suggested gorilla allocoprophagy, although it is not fully clear whether faeces were ingested (Masi & Breuer, 2018). Although systematic focal and scan sampling were conducted since January 2018 (in the framework of other studies), this is the first observation of coprophagy at Mbeli Baï during the last 2.5 years, thus confirming previous notions about the rarity of this behaviour in gorillas (western gorilla: Masi & Breuer, 2018; mountain gorilla: Rothman et al., 2006). Coprophagy indicates stress in lowland gorillas (Gorilla gorilla). [Extracted from the article]

Objective: The purpose of this study was to understand the experiences of families, residents, and staff around visitor restriction policies in long‐term care during the COVID‐19 pandemic in Canada. Background: Beginning in March 2020, public health orders across Canada restricted visitors to long‐term care facilities to curb the spread of the infection. This included family caregivers who provide significant support to residents to meet their physical, psychological, social, and safety needs. Method: We collected data from publicly available news and social media. News articles, blogs, and tweets from Canada were collected from March 2020 to April 2021. In total, 40 news articles, eight blogs, and 23 tweets were analyzed using generic qualitative description. Results: Reports from family members indicate that some residents may have died from malnutrition, dehydration, and isolation, rather than from COVID‐19, because of the sudden and prolonged absence of family caregivers. There are long‐term impacts on family suffering and long‐term care worker burnout. Policy and structural issues were identified. Conclusion: Experiences in long‐term care reflected not only impacts of pandemic‐related visitor restrictions, but also long‐standing funding and workforce issues. Implications: Involvement of family, and specifically family caregivers, is crucial in policy decisions, even in unusual circumstances, such as the pandemic. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to validate and to determine the individual characteristics and demographic factors associated with parents' knowledge of hospital‐based pediatric falls and to identify parent populations more likely to report low levels of falls‐related knowledge. Design: Validation of a questionnaire and a cross‐sectional survey design. Methods: Parents (n = 200) of hospitalized children admitted to a tertiary specialist pediatric hospital in Australia completed an online questionnaire. Parents were asked to rate their hospital‐based falls knowledge using a Likert scale (1–5). The questionnaire was administered to parents across six hospital wards, 1 day a week, from May to August 2019. Validation of the questionnaire involved factor analyses and reliability tests. Finally, descriptive analysis measured parents' knowledge, and a multivariate logistic regression analysis reported factors associated with parents' falls knowledge. All data were analyzed in Statistical Package for the Social Sciences (V27). Ethical approval was received for all stages. Results: The final version of the parent knowledge of falls (PKOF) questionnaire consisted of 23 questions across five domains (Cronbach α =.929–.70). Parents' knowledge of hospital‐based falls ranged from 2.5 to 4.5, while knowledge that children may fall during parental presence rated the lowest score. Knowledge of inpatient falls was higher if their child had a high risk of falls (odds ratio [OR]: 2.1, p =.04) and they were Australian‐born parents (OR: 1.9, p =.05). Practice Implications: The PKOF questionnaire is an evidence‐based instrument developed for a pediatric hospital setting. Findings highlight knowledge gaps and parent groups with the highest risk of having inadequate hospital‐based falls knowledge. The questionnaire enables pediatric nurses and educators to measure parents' knowledge of hospital‐based falls accurately and consistently, and so to identify gaps and, subsequently, develop, implement, and evaluate falls education using an evidence‐based approach. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work was to evaluate the performance of colon capsule endoscopy (CCE) in a lower gastrointestinal diagnostic care pathway. Method: This large multicentre prospective clinical evaluation recruited symptomatic patients (patients requiring investigation of symptoms suggestive of colorectal pathology) and surveillance patients (patients due to undergo surveillance colonoscopy). Patients aged 18 years or over were invited to participate and undergo CCE by a secondary‐care clinician if they met the referral criteria for a colonoscopy. The primary outcome was the test completion rate (visualization of the whole colon and rectum). We also measured the need for further tests after CCE. Results: A total of 733 patients were invited to take part in this evaluation, with 509 patients undergoing CCE. Of these, 316 were symptomatic patients and 193 were surveillance patients. Two hundred and twenty‐eight of the 316 symptomatic patients (72%) and 137 of the 193 surveillance patients (71%) had a complete test. It was found that 118/316 (37%) of symptomatic patients required no further test following CCE, while 103/316 (33%) and 81/316 (26%) required a colonoscopy and flexible sigmoidoscopy, respectively. Fifty‐three of the 193 surveillance patients (28%) required no further test following CCE, while 104/193 (54%) and 30/193 (16%) required a colonoscopy and flexible sigmoidoscopy, respectively. No patient in this evaluation was diagnosed with colorectal cancer. Two patients experienced serious adverse events – one capsule retention with obstruction and one hospital admission with dehydration due to the bowel preparation. Conclusion: CCE is a safe, well‐tolerated diagnostic test which can reduce the proportion of patients requiring colonoscopy, but the test completion rate needs to be improved to match that of lower gastrointestinal endoscopy. [ABSTRACT FROM AUTHOR]

Small impoundments are numerous throughout river corridors. Limited data on their size and outflow have made it difficult to assess how these smaller impoundments cumulatively impact streamflow. This study combined rainfall‐runoff data from the Chesapeake Bay Watershed Model with a routing framework to develop a hydrologic model capable of analyzing flow alteration induced by cumulative impoundment. Using standard design processes and satellite imagery, simulations of impoundment hydraulics were assembled for both small and large impoundments. Eleven of the 170 impoundments in the Difficult Run watershed were modeled to assess their cumulative impact on downstream flow from 1984 to 2005. Multiple simulations were analyzed to determine incremental effects. We found that flow alteration increased with impoundment density. Impoundments prolonged storm hydrographs, increasing median and baseflows, and decreasing peak streamflow downstream. Impoundment size and location impacted downstream flow alteration as headwater channels ran dry and evaporation from impoundments with high surface area to storage ratios decreased extreme low flows. Large reservoirs had a greater impact on median flows, as small ponds dominated low flow alteration. Including a greater fraction of the watershed's 170 small impoundments may further increase flow alteration. These results suggest that small impoundments play a large role in determining water availability, particularly during droughts. [ABSTRACT FROM AUTHOR]

Objective: To assess the safety, tolerability, pharmacokinetics, and efficacy of rituximab (RTX) in pediatric patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA). Methods: The Pediatric Polyangiitis Rituximab Study was a phase IIa, international, open‐label, single‐arm study. During the initial 6‐month remission‐induction phase, patients received intravenous infusions of RTX (375 mg/m2 body surface area) and glucocorticoids once per week for 4 weeks. During the follow‐up period, patients could receive further treatment, including RTX, for GPA or MPA. The safety, pharmacokinetics, pharmacodynamics, and exploratory efficacy outcomes with RTX were evaluated. Results: Twenty‐five pediatric patients with new‐onset or relapsing disease were enrolled at 11 centers (19 with GPA [76%] and 6 with MPA [24%]). The median age was 14 years (range 6–17 years). All patients completed the remission‐induction phase. During the overall study period (≤4.5 years), patients received between 4 and 28 infusions of RTX. All patients experienced ≥1 adverse event (AE), mostly grade 1 or grade 2 primarily infusion‐related reactions. Seven patients experienced 10 serious AEs, and 17 patients experienced 31 infection‐related AEs. No deaths were reported. RTX clearance correlated with body surface area. The body surface area–adjusted RTX dosing regimen resulted in similar exposure in both pediatric and adult patients with GPA or MPA. Remission, according to the Pediatric Vasculitis Activity Score, was achieved in 56%, 92%, and 100% of patients by months 6, 12, and 18, respectively. Conclusion: In pediatric patients with GPA or MPA, RTX is well tolerated and effective, with an overall safety profile comparable to that observed in adult patients with GPA or MPA who receive treatment with RTX. RTX is associated with a positive risk/benefit profile in pediatric patients with active GPA or MPA. [ABSTRACT FROM AUTHOR]

Objectives: Existing data on bonobo and chimpanzee dental eruption timing are derived predominantly from captive individuals or deceased wild individuals. However, recent advances in noninvasive photographic monitoring of living, wild apes have enabled researchers to characterize dental eruption in relatively healthy individuals under naturalistic conditions. At present, such data are available for only one population of wild chimpanzees. We report data for an additional population of wild chimpanzees and the first dental eruption data for wild bonobos. Materials and Methods: We collected photographs and video footage of teeth from the open mouths of wild bonobos and East African chimpanzees of known age from LuiKotale, Democratic Republic of the Congo, and Gombe National Park, Tanzania, respectively. We scored the presence and absence of deciduous teeth from photographs and video footage to characterize deciduous dental eruption timing in these two populations. Results: Deciduous dental eruption ages in our sample fall within the range of variation previously documented for captive chimpanzees, but eruption ages are later in wild than in captive contexts. We found substantial variation in deciduous canine eruption timing, particularly among bonobos. One bonobo had a deciduous canine present by 227 days old while another did not have a deciduous canine present at 477 days old. Discussion Our data indicate that deciduous teeth erupt later in wild individuals than in captive individuals. We also found that deciduous dental eruption timing varies considerably between individuals within our study populations, a pattern that is consistent with previous studies. Future studies should consider sources of variation in deciduous canine eruption timing and relationships with other aspects of life history as additional data become available. [ABSTRACT FROM AUTHOR]

Questions: Grassland degradation due to agriculture, changing fire regimes, and invasive species negatively affects forb communities. Conserving forbs and the services they provide requires a better understanding of their responses to interacting disturbances. Although fire and livestock grazing are important disturbances, their effect on forb communities in the Pacific Northwest Bunchgrass Prairies is not fully understood. Our objectives were to: (a) determine how prescribed fire and livestock grazing influence forb community composition, cover, species richness, and diversity over a 10‐year span; (b) identify indicator species for each treatment; and (c) quantify forb responses to increasing cover of the invasive grass Ventenata dubia. Location: Pacific Northwest Bunchgrass Prairie, Oregon, USA. Methods: We monitored plant responses in a manipulative study established in 2004 with four treatments (prescribed fire, livestock grazing, both fire and grazing, and a control with no fire or grazing). Fall burns occurred in 2006 and 2016. Results: Forb communities changed significantly over 10 years and were influenced more by fire than cattle grazing. Treatments involving fire were more associated with annual forbs and fewer perennial species than treatments not burned. Although forb cover was lower in grazed compared to ungrazed treatments, richness and diversity did not differ among treatments. Several fire‐adapted forb species were associated with burned treatments. Forb cover and richness was negatively correlated with Ventenata dubia cover in 2016 and 2018 when cover of this invasive species reached 20%–37%. Conclusions: We found fall prescribed burns at a ten‐year return interval affected forb community composition and cover but not richness or diversity. Fire may promote annual and fire‐tolerant perennial forbs, but this relationship may be compromised by Ventenata dubia invasions. This study provides insights into management strategies aimed at conserving forb communities and emphasizes the need for continued monitoring of the Ventenata dubia invasion in this unique prairie. [ABSTRACT FROM AUTHOR]

Objective: Cyclophosphamide (CYC) is used in clinical practice off‐label for the induction of remission in childhood polyarteritis nodosa (PAN). Mycophenolate mofetil (MMF) might offer a less toxic alternative. This study was undertaken to explore the relative effectiveness of CYC and MMF treatment in a randomized controlled trial (RCT). Methods: This was an international, open‐label, Bayesian RCT to investigate the relative effectiveness of CYC and MMF for remission induction in childhood PAN. Eleven patients with newly diagnosed childhood PAN were randomized (1:1) to receive MMF or intravenous CYC; all patients received the same glucocorticoid regimen. The primary end point was remission within 6 months while compliant with glucocorticoid taper. Bayesian distributions for remission rates were established a priori for MMF and CYC by experienced clinicians and updated to posterior distributions on trial completion. Results: Baseline disease activity and features were similar between the 2 treatment groups. The primary end point was met in 4 of 6 patients (67%) in the MMF group and 4 of 5 patients (80%) in the CYC group. Time to remission was shorter in the MMF group compared to the CYC group (median 7.1 weeks versus 17.6 weeks). No relapses occurred in either group within 18 months. Two serious infections were found to be likely linked to MMF treatment. Physical and psychosocial quality‐of‐life scores were superior in the MMF group compared to the CYC group at 6 months and 18 months. Combining the prior expert opinion with results from the present study provided posterior estimates of remission of 71% for MMF (90% credibility interval [90% CrI] 51, 83) and 75% for CYC (90% CrI 57, 86). Conclusion: The present results, taken together with prior opinion, indicate that rates of remission induction in childhood PAN are similar with MMF treatment and CYC treatment, and MMF treatment might be associated with better health‐related quality of life than CYC treatment. [ABSTRACT FROM AUTHOR]

Aedes aegypti (L.) (Diptera: Culicidae) is a vector of several serious disease‐causing viruses including Dengue, Zika, chikungunya and yellow fever. Effective and efficient trapping methods are essential for meaningful mosquito population and disease‐presence surveillance and ultimately, vector control. The Fay‐Prince trap (FPT) was developed in the late 1960s as a daytime visual trap for male Ae. aegypti. Since then, its use has been expanded into the trapping of female Ae. aegypti, Aedes albopictus Skuse, other Ae. spp., and Culex spp. The efficiency of the FPT alone and with CO2 was tested under semi‐field conditions and the behaviour of responding female Ae. aegypti was characterized. The mean capture efficiency of the FPT with CO2 per 30 min in the greenhouse was 3.07% and the capture rate from the total number of mosquitoes in our semi‐field setup was slightly higher at 4.45%. Understanding the behaviours that mosquitoes exhibit during their encounter with particularly a visual trap may recommend trap improvements and contributes to our understanding of host‐seeking behaviour and how it might be exploited. [ABSTRACT FROM AUTHOR]

Researchers used a conjugate preparation to evaluate how response force changed based on participants' preferences for visual stimuli. First, researchers used a verbal preference assessment to evaluate each participant's preference for viewing for five object categories of visual stimuli; this process identified high preference (HP) stimuli and low preference stimuli for most participants. Thereafter, researchers exposed each participant to the five stimulus categories in a randomized order while using a force dynamometer to measure their response force to increase visual clarity of each stimulus. Results indicate the majority of participants' HP stimuli corresponded to the stimulus category for which they exerted the highest mean force. These preliminary findings suggest conjugate preparations involving response force may provide another option for measuring the relative value of some stimulus events. [ABSTRACT FROM AUTHOR]

Objective: Vasculopathy is considered central to the pathogenesis of juvenile dermatomyositis (DM) and is associated with severe extramuscular manifestations. We undertook this study to investigate the hypothesis that the vasculopathy of juvenile DM can be noninvasively tracked by examining biomarkers of endothelial injury, subclinical inflammation, hypercoagulability, and vascular arterial stiffness. Methods: The study population was a UK cohort of children with juvenile DM. Circulating endothelial cells (CECs) and microparticles (MPs) were identified using immunomagnetic bead extraction and flow cytometry, respectively. Plasma thrombin generation was determined using a fluorogenic assay. Cytokine and chemokine levels were measured by electrochemiluminescence. Arterial stiffness was assessed using pulse wave velocity (PWV). Results were expressed as the median and interquartile range (IQR), and statistical significance was assessed using nonparametric analyses. Results: Ninety patients with juvenile DM and 79 healthy control subjects were included. The median age of the patients was 10.21 years (IQR 6.68–13.40), and the median disease duration was 1.63 years (IQR 0.28–4.66). CEC counts were higher in all patients with juvenile DM compared to controls (median 96 cells/ml [IQR (40–192] and 12 cells/ml [IQR 8–24], respectively; P < 0.0001). Circulating MP numbers were also significantly higher in patients with active juvenile DM compared to controls (median 204.7 × 103/ml [IQR 87.9–412.6] and 44.3 × 103/ml [IQR 15.0–249.1], respectively; P < 0.0001). MPs were predominantly of platelet and endothelial origin. Enhanced plasma thrombin generation was demonstrated in patients with active juvenile DM compared to those with inactive disease (P = 0.0003) and controls (P < 0.0001). Carotid‐radial PWV adjusted for age was increased in patients with juvenile DM compared to controls (P = 0.003). Conclusion: We observed increased endothelial injury and increased levels of proinflammatory cytokines in patients with active juvenile DM. MP profiles reflected distinct disease activity status in juvenile DM and are markers of vascular pathology, platelet activation, and thrombotic propensity. Ongoing long‐term vascular injury may result in increased arterial stiffness in patients with juvenile DM. [ABSTRACT FROM AUTHOR]

The attainment of unit status or I AM is a crucial stage in Winnicott's theory of development and arguably ranks amongst Winnicott's more well known ideas, such as transitional object, true and false self, and primary maternal preoccupation. Using Winnicott's 1968 paper 'Sum, I am', the author traces the dangers inherent in attaining I AM and what might hamper this achievement, the personal significance of numbers and divisibility, and how this links with his subsequent ideas on monotheism and a radical revision of Freud's dual drive theory. Returning to the 'Sum, I am' paper, the author briefly explores the importance Winnicott places on play in pedagogy and the significance of an intermediate space followed by Winnicott's thoughts about death, dissociation, and the importance of a mouse! Four clinical examples are used to illustrate difficulties in achieving I AM. Finally, the author suggests the spatula game in 'Observation of infants in a set situation' published over a quarter of a century earlier is a prime example of an I AM experience, with a beginning, middle and end. [ABSTRACT FROM AUTHOR]

Many jurisdictions are currently transforming their juvenile probation systems to reflect research‐informed, developmentally based case management approaches. Training, developed through a community‐based, participatory action research (CBPAR) framework and guided by a community–academic partnership, may promote probation staff's readiness for such change. This paper examined whether such training could serve as an effective method to impact organizational culture by exploring shifts in probation staff's knowledge, attitudes, and beliefs about graduated response – a structured juvenile probation case management system that aligns with research on adolescent development and youth behavior change. Data came from 559 juvenile probation staff trained in graduated response theory and practice between 2016 and 2019. Results demonstrated that at the end of a 1‐day, CBPAR‐grounded training program, participating staff reported significantly more buy‐in to graduated response, greater knowledge of this new system, and attitudes more strongly in favor of graduated response and intended behaviors. Study findings revealed important shifts indicative of readiness for change within juvenile probation departments. Additional implementation strategies are needed to extend training gains and overcome organizational‐ and system‐level barriers to change. [ABSTRACT FROM AUTHOR]

The temperature sensitivity of vaccines and therapeutic proteins forces the distribution of life‐saving treatments to rely heavily on the temperature‐controlled (usually 2–8°C) supply and distribution network known as the cold chain. Here, using avidin as a model, we demonstrate how surface engineering could significantly increase the thermal stability of therapeutic proteins. A combination of spectroscopic (Fourier transform infrared, circular dichroism, and ultraviolet‐visible) and scattering techniques (dynamic light scattering, small‐angle, and wide‐angle X‐ray scattering) were deployed to probe the activity, structure, and stability of the model protein. Temperature‐dependent synchrotron radiation circular dichroism spectroscopy was used to demonstrate a significant increase in thermal stability, with a half denaturation temperature of 139.0°C and reversible unfolding with modified avidin returning to a 90% folded state when heated to temperatures below 100°C. Accelerated aging studies revealed that modified avidin retained its secondary structure after storage at 40°C for 56 days, equivalent to 160 days at 25°C. Furthermore, binding studies with multiple ligands revealed that the binding site remained functional after modification. As a result, this approach has potential as a storage technology for therapeutic proteins and the elimination of the cold chain, enabling the dissemination of life‐saving vaccines worldwide. [ABSTRACT FROM AUTHOR]

Research has shown that behavior contracts, a form of contingency management, can promote a wide range of behavior changes for individuals in varied populations; however, relatively few studies have been conducted in nonacademic settings. In the context of two service projects, we evaluated the extent to which behavior contracts improved problem behavior for 11 children and adolescents in residential treatment facilities and foster homes using nonconcurrent multiple baseline across participants' designs with three or more tiers and supplemental statistical analysis for each tier. Practitioners in each setting implemented individualized behavior contracts for 5 to 59 weeks. Results show that behavior improved substantially for six participants but was relatively unchanged for the other five participants. We discuss the limitations of this clinically driven study, as well as clinical implications of our mixed findings. [ABSTRACT FROM AUTHOR]

Following from smaller‐scale investigations of grid‐forming converter control applied to wind turbines in 2017–2018, this study describes a much larger trial involving an entire wind farm, owned and operated by ScottishPower Renewables. To the authors' knowledge, this was the first UK converter‐connected wind farm to operate in grid‐forming mode, and the largest in the world to date. The 23‐turbine, 69 MW farm ran in the grid‐forming mode for 6 weeks, exploring inertia contributions between H = 0.2 s and H = 8 s. A number of unscheduled frequency disturbances occurred due to interconnector, combined cycle gas turbine (CCGT) and other trips, to which un‐curtailed turbines were able to respond. In addition, several deliberate tests were carried out. The turbines were able to provide a stable and appropriate response at relatively high inertia levels to the frequency events commonly occurring today. The captured responses stimulated a debate as to whether external damping power might be required in a grid‐forming converter, or whether internal damping is sufficient to allow stable and robust power‐sharing with parallel devices in all grid event scenarios. Analysis in this study suggests that, practically, internal damping is probably appropriate, and that any deficiency in external damping power can be more than mitigated by reactance and/or droop‐slope response‐time management in the grid‐forming converters. [ABSTRACT FROM AUTHOR]

Some studies suggest that acquiring employment following release from prison may reduce recidivism; however, few studies have evaluated procedures for teaching job‐related skills to adolescents in residential detention facilities. Stocco et al. (2017) used behavioral skills training (BST) to improve interview skills of college students. The current study used a nonconcurrent multiple baseline design across participants to evaluate the extent to which BST improved interview skills for 7 adolescents who had been adjudicated for sexual offenses. Results show that BST increased appropriate responses to interview questions for 4 students and BST plus modifications (i.e., stimulus and response prompts) increased correct responding to questions for the other 3. In addition, BST increased appropriate questions, correct posture, and smiling, and decreased fidgeting for all 7 students. We briefly discuss the social implications of teaching interview skills to adjudicated adolescents, as well as the limitations of the findings. [ABSTRACT FROM AUTHOR]

The placental microvasculature is a conduit for fetal blood allowing solute exchange between the mother and the fetus. Serial block‐face scanning electron microscopy (SBF SEM) allows ultrastructure to be viewed in three dimensions and provides a new perspective on placental anatomy. This study used SBF SEM to study endothelial cells within the human placental microvasculature from uncomplicated pregnancies. Term human placental villi were aldehyde‐fixed and processed for imaging by SBF SEM. Manual segmentation was carried out on a terminal villous capillary and an intermediate villous arteriole and venule. Twenty‐seven SBF SEM stacks from terminal villi were analysed using stereological approaches to determine the volumes of microvascular components and the proportions of pericyte coverage. SBF SEM analysis of capillary endothelial cells revealed the presence of interendothelial protrusions (IEPs) originating from the donor cell at the endothelial junction and forming deep thin projections up to 7 μm into the adjacent endothelial cells. IEP density was estimated to be in the order of 35 million cm–3 placental tissue. Pericytes cover 15% of the fetal capillary surface area in terminal villi. In comparison, the cytotrophoblast covered 24% of the syncytiotrophoblast basal membrane. A trans‐endothelial channel was observed in a region of the vasculo‐syncytial capillary. Pericyte coverage was extensive in both arteriole and venule. Three‐dimensional imaging of the placental microvasculature identified novel ultrastructural features and provided an insight into factors that may influence capillary permeability and placental function. We hypothesise that the IEPs may allow mechanosensing between adjacent endothelial cells to assist in the maintenance of vessel integrity. The numbers of endothelial junctions, the presence of trans‐endothelial channels and the extent of pericyte coverage all provide an insight into the factors determining capillary permeability. [ABSTRACT FROM AUTHOR]

Microendemic species are of great conservation concern due to their vulnerability to stochastic events and environmental change. Therefore, understanding the basic ecology of such organisms is integral to future efforts to conserve them. Here, we present the first ecological study of the only known population of Ocyale ghost Jocque & Jocqué 2017 – the single species within this genus in Madagascar – located at a small lake shore in the north‐west of the island. We aimed to reveal spatial patterns of microhabitat selection and patch occupancy in relation to environmental covariates, including distance to lake edge, topography and sand coverage. We found microhabitat selection to be strong in our occupancy models, with plots closer to the lake edge and with a higher proportion of sand showing the highest estimated occupancy. We suggest decreases in prey availability and changes in the physical characteristics of the substrate in relation to the distance from lake shore and sand availability (important for burrowing and temperature regulation), respectively, as potential factors behind occupancy. We discuss our findings in the context of the proportional underrepresentation of invertebrates in conservation research, which threatens the persistence of endemic and microendemic invertebrates in the face of significant global and local environmental change. [ABSTRACT FROM AUTHOR]

Objective: To assess long‐term efficacy and safety of canakinumab and the response to vaccination in children ages ≤5 years with cryopyrin‐associated periodic syndrome (CAPS). Methods: CAPS patients (ages ≤5 years) received 2 mg/kg canakinumab subcutaneously every 8 weeks; patients with neonatal‐onset multisystem inflammatory disease (NOMID) received a starting dose of 4 mg/kg in this open‐label trial. Efficacy was evaluated using physician global assessment of disease activity and serum levels of C‐reactive protein (CRP) and amyloid A (SAA). Adverse events (AEs) were recorded. Vaccination response was evaluated using postvaccination antibody titers at 4 and 8 weeks after immunization. Results: Of the 17 patients enrolled, 12 (71%) had Muckle‐Wells syndrome, 4 (24%) had NOMID, and 1 (6%) had familial cold autoinflammatory syndrome. All 17 patients had a complete response to canakinumab. Disease activity improved according to the physician global assessment, and for 65% of the patients autoinflammatory disease was characterized as "absent" at the end of the study. Median CRP levels decreased over time. No such change was evident in SAA levels. During the extension study, postvaccination antibody titers increased above protective levels in 16 (94%) of 17 assessable vaccinations. Ten of the patients (59%) had AEs suspected to be related to canakinumab; 8 (47%) experienced at least 1 serious AE (SAE). None of the AEs or SAEs required interruption of canakinumab therapy. Conclusion: Our findings indicate that canakinumab effectively maintains efficacy through 152 weeks and appears to have no effect on the ability to produce antibodies against standard childhood non‐live vaccines. The safety profile of canakinumab was consistent with previous studies, supporting long‐term use of canakinumab for CAPS in children ≤5 years of age. [ABSTRACT FROM AUTHOR]

Objectives: Early treatment of HIV‐1 infection at all CD4 levels has demonstrated clinical and public health benefits. This analysis examined the costs, health outcomes, and cost‐effectiveness of increased HIV‐1 screening and early treatment initiation in the UK. Methods: A Markov model followed theoretical cohorts of men who have sex with men (MSM), heterosexuals, and people who inject drugs (PWID) with initially undiagnosed HIV‐1 infection over their remaining lifetimes. The analysis examined increased HIV‐1 screening (resulting in 10–50% improvements in diagnosis rates) versus current screening in sexual health services (SHS) and other settings, with all individuals initiating treatment within 3 months of diagnosis. Health status was modelled by viral load and CD4 cell count as individuals progressed to diagnosis and treatment. Individuals accrued quality‐adjusted life‐years (QALYs), incurred costs for screening and HIV‐related clinical management, and were at risk of transmitting HIV‐1 infection to their partners. Input parameter data were taken primarily from UK‐specific published sources. All outcomes were discounted at 3.5% annually. Results: The model estimated that increased screening and early treatment resulted in fewer onward HIV transmissions, more QALYs, and higher total costs. For SHS, incremental cost‐effectiveness ratios (ICERs) for heterosexuals (~£22 000/QALY gained) were within typical UK willingness‐to‐pay thresholds and were well below these thresholds for MSM (~£9500/QALY gained) and PWID (~£6500/QALY gained). Sensitivity analysis showed that model results were robust. Conclusions: Increased HIV‐1 screening and early treatment initiation may be a cost‐effective strategy to reduce HIV transmission and improve health for MSM, heterosexuals, and PWID in the UK. [ABSTRACT FROM AUTHOR]

The small hive beetle, Aethina tumida Murray (Coleoptera: Nitidulidae), is a significant pest of managed honeybees in the USA and eastern Australia. The beetle damages hives by feeding on hive products and leaving behind fermented wastes. The beetle is consistently associated with the yeast Kodamaea ohmeri (Etchells & Bell) Yamada et al. (Saccharomycetales: Metschnikowiaceae), and this yeast is the presumed agent of the fermentation. Previous work has noted that the small hive beetle is attracted to volatiles from hive products and those of the yeast K. ohmeri. In this study, we investigated how the volatile compounds from the fermenting hive products change depending upon the source of the hive material and also how these volatiles change through time. We used gas chromatography–mass spectrometry and choice‐test behavioural assays to investigate these changes using products sampled from apiaries across the established range of the beetle in eastern Australia. The starting hive products significantly affected the volatile composition of fermenting hive products, and this composition varied throughout time. We found 61.7% dissimilarity between attractive and non‐attractive fermenting hive products, and identified individual compounds that characterise each of these groups. Eleven of these individual compounds were then assessed for attractiveness, as well as testing a synthetic blend in the laboratory. In the laboratory bioassay, 82.1 ± 0.02% of beetles were trapped in blend traps. These results have strong implications for the development of an out‐of‐hive attractant trap to assist in the management of this invasive pest. [ABSTRACT FROM AUTHOR]

Aims: Rituximab is a chimeric IgG‐1 monoclonal antibody that depletes B cells, aiding in the treatment of several conditions including autoimmune diseases. It is not licensed for use in children. This study aimed to quantify the B cell‐related pharmacodynamics of rituximab in children with autoimmune disease. Methods: Routine electronic health record data were collected at a large paediatric tertiary hospital in London, UK. Dosing protocols were either 2 × 750 mg/m2 intravenous infusions of rituximab on days 1 and 15, or 4 × 375 mg/m2 infusions on days 1, 8, 15 and 22. Rituximab pharmacokinetics (PK) were not measured but CD19+ lymphocyte counts were taken before and after rituximab treatment. A dose–response model was constructed describing the life cycle of CD19+ lymphocytes, with rituximab assumed to increase the death rate. Rituximab effect was assumed to decay by first‐order kinetics. Results: In total, 258 measurements of CD19+ lymphocyte counts were collected from 39 children with 8 autoimmune diseases. The elimination rate constant (% relative standard error) of rituximab effect decay was 0.036 (22.7%) days−1 and CD19+ turnover was 0.02 (41%) days−1 corresponding to half‐lives of 19 and 35 days respectively. Rituximab increased CD19+ death rate 35‐fold, with methotrexate and cyclophosphamide associated with further increases. Simulations suggested that a single infusion of 750 mg/m2 provides similar 6‐month suppression of CD19+ lymphocytes to current dosing. Conclusions: Rituximab pharmacodynamics (PD) in paediatric autoimmune diseases has been described. Compared with rituximab alone, the additional effect of methotrexate or cyclophosphamide was statistically significant but small. [ABSTRACT FROM AUTHOR]

Insect stains produced by necrophagous flies are indistinguishable morphologically from human bloodstains. At present, no diagnostic tests exist to overcome this deficiency. As the first step toward developing a chemical test to recognize fly artifacts, polyclonal antisera were generated in rats against three distinct antigenic sequences of fly cathepsin D‐like proteinase, an enzyme that is structurally distinct in cyclorrhaphous Diptera from other animals. The resulting rat antisera bound to artifacts produced by Protophormia terraenovae and synthetic peptides used to generate the polyclonal antisera, but not with any type of mammalian blood tested in immunoassays. Among the three antisera, anti‐md3 serum displayed the highest reactivity for fly stains, demonstrated cross‐reactivity for all synthetic peptides representing antigenic sequences of the mature fly enzyme, and bound artifacts originating from the fly digestive tract. Further work is needed to determine whether the antisera are suitable for non‐laboratory conditions. [ABSTRACT FROM AUTHOR]

Winnicott's unique contributions to a psychoanalytic theory of depression are not as familiar as Freud and Klein's writings. I concentrate on six areas: depression as a developmental achievement which denotes unit status; the role of destruction which arises from love (as opposed to hate which for Winnicott is a more mature affect); the importance of contributing‐in and the response of the (m)other in recovery from depression; the startling idea that the patient seeks out the analyst's depression; some thoughts on the differences between Winnicott and Freud and Klein; and lastly, the effect of depression on the development of self, creativity and the capacity to play. Winnicott does not shirk the darker side of being human, but at the same time he offers us a hopeful picture. [ABSTRACT FROM AUTHOR]

Background: Preventing alcohol‐exposed pregnancies (AEPs) could reduce the incidence of fetal alcohol spectrum disorders. Previous face‐to‐face interventions significantly reduced risk for AEP, but a scalable intervention is needed to reach more women at risk. Methods: This study compared a 6 Core automated, interactive, and tailored Internet intervention, the Contraception and Alcohol Risk Reduction Internet Intervention (CARRII), to a static patient education (PE) website for its effect on AEP risk. Participants were recruited online to a pilot randomized clinical trial (RCT) with baseline, 9 weeks posttreatment, and 6‐month (6‐M) follow‐up assessments. Seventy‐one women completed online questionnaires and telephone interviews and were randomized to CARRII (n = 36) or PE (n = 35). Primary outcomes were rates of risky drinking, unprotected sex episodes, and AEP risk, collected from online prospective diaries. Results: CARRII participants showed significant reductions in rate of unprotected sex from pretreatment (88.9%) to posttreatment (70.6%) (p < 0.04) and to 6‐M follow‐up (51.5%) (p = 0.001); rate of risky drinking from pretreatment (75.0%) to posttreatment (50.0%) (p < 0.02), but insignificant change from pretreatment to 6‐M follow‐up (57.6%) (p < 0.09); and rate of AEP risk from pretreatment (66.7%) to posttreatment (32.4%) (p = 0.001) and to 6‐M follow‐up (30.3%) (p = 0.005). PE participants demonstrated no significant changes on all 3 variables across all time points. Intent‐to‐treat group‐by‐time tests were not significant, but power was limited by missing diaries. Over 72% of CARRII participants completed all 6 Cores. Exploratory analyses suggest that higher program utilization is related to change. Conclusions: These data show that CARRII was acceptable, feasible, promising to reduce AEP risk, and merits further testing in a fully powered RCT. [ABSTRACT FROM AUTHOR]

Court-involved youth engage in risky sex behaviors at higher rates than non-offending peers and are at particular risk for adverse sexual health outcomes. Parenting practices, such as parent-child sexual communication and parental monitoring, may protect court-involved youth from engaging in risky sexual behavior. Parent psychological distress and family dysfunction may, however, compromise parenting practices for court-involved youth. This study examined associations among parent mental health symptoms, family functioning, and parenting practices within 157 parent-youth dyads who were court-referred for mental health treatment. Results revealed that greater parent mental health symptoms were directly related to greater family dysfunction and indirectly associated with poorer parental monitoring through worse family functioning. Findings suggest that directly addressing parent mental health needs in family-based adolescent sexual health programming for court-involved youth may be effective in improving parent-child relationships and family processes that support long term sexual health outcomes for adolescents. [ABSTRACT FROM AUTHOR]

1. Much is known about how enriched environmental diversity affects ability to learn across the months and years that are the developmental periods of large animals. 2. Less is known about how diversity impacts learning across the minutes and hours during which sensory environments of small foraging animals such as insects may vary dramatically. 3. This study shows that Drosophila melanogaster exposed to a diversity of odour-taste associations over a few minutes subsequently learn standard associative learning tasks poorly. 4. This effect is robust to variation in odours used in all parts of experiments. 5. Findings may have an impact on at least three major research areas in ecology: the relationship between biodiversity and ecosystem functioning; the evolution of floral constancy in pollinators; and the pest-protective effects of mixed species crops. [ABSTRACT FROM AUTHOR]

In much of western United States destructive floods after wildfire are frequently caused by localized, short-duration convective thunderstorms; however, little is known about post-fire flooding from longer-duration, low-intensity mesoscale storms. In this study we estimate and compare peak flows from convective and mesoscale floods following the 2012 High Park Fire in the ungaged 15.5 km2 Skin Gulch basin in the northcentral Colorado Front Range. The convective storm on 6 July 2012 came just days after the wildfire was contained. Radar data indicated that the total rainfall was 20-47 mm, and the maximum rainfall intensities (upwards of 50 mm h−1) were concentrated over portions of the watershed that burned at high severity. The mesoscale storm on 9-15 September 2013 produced 220-240 mm of rain but had maximum 15-min intensities of only 25-32 mm h−1. Peak flows for each flood were estimated using three independent techniques. Our best estimate using a 2D hydraulic model was 28 m3 s−1 km−2 for the flood following the convective storm, placing it among the largest rainfall-runoff floods per unit area in the United States. In contrast, the flood associated with the mesoscale flood was only 6 m3 s−1 km−2, but the long-duration flood caused extensive channel incision and widening, indicating that this storm was much more geomorphically effective. The peak flow estimates for the 2013 flood had a higher relative uncertainty and this stemmed from whether we used pre- or post-flood channel topography. The results document the extent to which a high and moderate severity forest fire can greatly increase peak flows and alter channel morphology, illustrate how indirect peak flow estimates have larger errors than is generally assumed, and indicate that the magnitude of post-fire floods and geomorphic change can be affected by the timing, magnitude, duration, and sequence of rainstorms. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This research conducts an experiment on individuals' perceptions of natural gas pipeline incidents and the expansion of natural gas pipeline infrastructure in the United States. This work contributes to the literature on natural gas pipeline safety and risk by utilizing Kahneman and Tversky's Prospect Theory. This work is relevant from a public policy perspective because of the recent expansion of the U.S. natural gas pipeline network that has been underway since 2010. It provides policy makers with a better understanding of how the public perceives risks and benefits associated with pipeline expansion. Overall, the study results find that when individuals balanced the benefits and risks of pipeline expansion, a majority of all respondents (53.4 percent) picked safety over monetary gains. Further, a majority of respondents who received at least one treatment were more likely to choose safety and two-thirds of respondents who received a second treatment chose safety over material benefits associated with pipeline expansion. [ABSTRACT FROM AUTHOR]

Objective Finding medication to support treatment of anorexia nervosa has been difficult. Neuroscience-based approaches may help in this effort. Recent brain imaging studies in adults and adolescents with anorexia nervosa suggest that dopamine-related reward circuits are hypersensitive and could provide a treatment target. Methods Here, we present a retrospective chart review of 106 adolescents with anorexia nervosa some of whom were treated with the dopamine D2 receptor partial agonist aripiprazole during treatment in a specialized eating disorder program. Results The results show that aripiprazole treatment was associated with greater increase in body mass index (BMI) during treatment. Discussion The use of dopamine receptor agonists may support treatment success in anorexia nervosa and should be further investigated. [ABSTRACT FROM AUTHOR]

Background Electric stimulation (E-stim) has been found to be an effective treatment in improving wound healing rates. However, the wound healing trajectory and its related predictors for complete wound closure ( CWC) have not been reported with E-stim treatment. Materials and methods This was a retrospective study. Data on 159 patients treated at an outpatient wound clinic utilizing combined intervention of E-stim and conventional care were included. The Kaplan-Meier healing curve together with linear regression models depicted the percentage of patients with CWC against time. Results With 100, 112 and 140 days of treatment, the percentages of patients with CWC were 59·12%, 61·01% and 65·41%, respectively. Linear regression models predicted that all patients would achieve CWC by 21·55, 22·26 and 24·80 weeks, respectively. The speed for the increase in the number and percentage of patients with CWC peaked between 50-75 days of treatment. To optimize timely healing, referral to other treatment facilities or change of treatment protocol is warranted around the peak time. With the combined intervention of E-stim and conventional care, positive predictors for CWC included a shorter wound duration at initial evaluation ( P = 0·005, OR = 3·10), better compliance with appointments ( P = 0·007, OR = 3·38) and the diagnosis of venous leg ulcer ( P = 0·001, OR = 3·88). Conclusions This study provided preliminary data on wound healing trajectory and predictors with combined E-stim and conventional care. E-stim seemed to expedite wound healing; however, further research studies are needed. [ABSTRACT FROM AUTHOR]