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Objectives: Research samples that are representative of patient populations are needed to ensure the generalizability of study findings. The primary aim was to assess the efficacy of a study design and recruitment strategy in obtaining a participant sample that was representative of the broader cochlear implant (CI) patient population at the CI center. A secondary aim was to review whether the CI recipient population was representative of the state population. Methods: Demographic variables were compared for a research participant sample (n = 79) and the CI patient population (n = 338). The participant sample was recruited from the CI patient population. The study design included visits that were at the same location and frequency as the recommended clinical follow‐up intervals. The demographics for the combined group (participant sample and patient population) were then compared to the reported demographics for the population in North Carolina. Results: There were no significant differences between the participant sample and patient population for biological sex, age at implantation, racial distribution, socioeconomic position, degree of urbanization, or drive time to the CI center (p ≥ 0.086). The combined CI recipient population was significantly different from the North Carolina population for the distributions of race, ethnicity, and degree of urbanization (p < 0.001). Conclusion: The study design and recruitment strategy allowed for recruitment of a participant sample that was representative of the CI patient population. Disparities in access to cochlear implantation persist, as supported by the significant differences in the combined CI recipient population and the population for our state. Level of Evidence: 3 Laryngoscope, 134:4101–4110, 2024 [ABSTRACT FROM AUTHOR]

Background: Individuals with spinal cord injuries (SCIs) are at an increased risk of poor oral health compared to the general population. However, little is known about the related barriers and facilitators experienced by these individuals within the hospital setting. Objectives: Understand the oral health knowledge, attitudes and practices of people with SCIs, barriers and facilitators to managing their oral health, and recommendations to improve oral care at acute/rehabilitation hospital settings. Methods: Semi‐structured interviews were conducted with 11 participants, from a major metropolitan hospital in Sydney, Australia. The interviews were thematically analysed. Results: Three themes were constructed. Participants believed that the onus was on them to manage their oral health. Individuals also had limited knowledge of its importance to general health, and placed a lower priority on oral health compared to other aspects of health. All participants identified a combination of factors, such as cost, time, resources and prior negative experiences, that contributed to the neglect of their oral care. Participants also discussed the need of support from the multidisciplinary team and family/carers to facilitate oral care and identified various appropriate oral health education formats. Conclusion: This study highlighted some areas where oral health knowledge among people with SCIs could be improved. It also identified the need for oral health training for the multidisciplinary team, as well as carers, to better integrate oral care during rehabilitation in the hospital. The development of oral health interventions would need to utilise a co‐design approach to best support clients and their carers to facilitate oral care self‐management. [ABSTRACT FROM AUTHOR]

Coloniality may grant colony members an energetic advantage in the form of lower individual respiration rates as colony size increases. If this occurs it should be apparent as negative allometric scaling of respiration with colony size, and colonial organisms should have scaling factors < 1. However, colonial members from phylum Rotifera have yet to be examined. To test if colonial rotifers possess allometric scaling relationships between respiration rate and colony size, we measured respiration rates for four solitary and three colonial rotifer species; from these respiration rates we estimated scaling factors. We found mixed evidence for allometric scaling of respiration rate in colonial rotifers. Both rotifers with allometric scaling of respiration rate, Conochilus hippocrepis and Lacinularia flosculosa, have extensive mucilaginous coverings. These coverings may represent an investment of colony members into a shared structure, lowering individual metabolic costs and thus respiratory needs. Additionally, we determined which traits are associated with allometric scaling of respiration. We compiled known scaling factors for animal phyla from a wide phylogenetic spectrum with colonial representatives and conducted a hierarchical mixed regression that included attributes of colonies. Traits associated with allometric scaling in colonial animals included colony shape, the presence of shared extrazooidal structures, and planktonic lifestyle. There are many other colonial rotifers and animal taxa for which allometric scaling factors have yet to be estimated, knowing these may enhance our understanding of the benefits of coloniality in animals. [ABSTRACT FROM AUTHOR]

Access to high‐quality early music education programs may mitigate the effects of poverty on the hypothalamic–pituitary–adrenal (HPA) axis, but fundamental questions remain about the role of early educators in conveying these benefits. In the current study, we measured the basal or resting cortisol levels of 76 children (Mage = 4.17 years; 42% female) over the course of the school day while they attended a Head Start preschool that included early music education classes. The results of a series of hierarchical linear models (HLMs) indicated that child‐directed music and movement activities during these classes were associated with lower levels of cortisol (relative to teacher‐directed activities; B = −0.019, p =.013), as were higher quality teacher–child interactions (B = −0.018, p =.013); both associations were moderated by child age. We discuss the implications of these results for future educational neuroscience research that seeks to inform early education programs for young children placed at risk by poverty. We measured levels of the stress hormone cortisol over the course of the school day for 76 children attending a Head Start preschool. We were interested in the role of early educators in conveying the stress reducing benefits of music during early music education classes. Results suggested that child‐directed music and movement activities during these classes were associated with lower levels of cortisol, as were higher quality teacher‐child interactions. Child age influenced these associations. [ABSTRACT FROM AUTHOR]

Purpose: To estimate incidence rates of suicidal ideation and behavior following treatment initiation with gabapentinoids or dopamine agonists (DAs) in patients with newly diagnosed early‐onset idiopathic restless legs syndrome (RLS) and to examine suicidal behavior risk, comparing between those receiving gabapentinoids and DAs. Methods: A new user retrospective cohort study using MarketScan claims data from 2012 to 2019 was conducted. Exposures were monotherapy gabapentinoids or DAs initiated within 60 days of new RLS diagnosis. Three varying outcome measures of suicidality were examined and incidence rates were calculated for each. A log‐binomial regression model the estimated relative risk (RR) of the outcomes with gabapentinoids. Propensity score weighting adjusted for baseline covariates, including age, substance use disorders, hyperlipidemia, antipsychotic use, hypnotic/sedative use, and mood stabilizer use, which were most imbalanced before weighting. Results: The cohort included 6672 patients, with 4986 (74.7%) initiating a DA and 1686 (25.3%) initiating a gabapentinoid. Incidence rates for all outcome measures were higher in the gabapentinoid group (suicidality: 21.6 vs. 10.7 per 1000 person‐years; suicidality with self‐harm: 23.0 vs. 11.1 per 1000 person‐years; overdose‐ and suicide‐related events: 30.0 vs. 15.5 person‐years). Associated risk of suicidality (adjusted RR, 1.27 [95% CI, 0.86–1.88]); suicidality with self‐harm (adjusted RR, 1.30 [95% CI, 0.89–1.90]); or overdose‐ and suicide‐related events (adjusted RR, 1.30 [95% CI, 0.93–1.80]) was not significant with gabapentinoids. Conclusions: Incidence rates for suicidal ideation and behavior were higher among the gabapentinoid group, although increased risk was not detected after adjustment. A possible signal cannot be ruled out given limitations of the data and rarity of the outcome. [ABSTRACT FROM AUTHOR]

Contingency management is especially effective in supporting medication adherence and drug abstinence among people with opioid use disorder. However, the incorporation of contingency management into clinical practice has been slow. The present study was designed to evaluate the feasibility, acceptability, and usability of incentives for providers as a means of accelerating collaborative care with contingency management. Thirteen buprenorphine prescribers served as participants in a nonexperimental study. The prescribers who referred patients to a contingency‐management service received monetary incentives for reviewing patient performance data and describing their use of these data in treatment decisions. The results show that this approach is feasible, acceptable, and easy to use for everyone involved. Self‐reports indicate improved prescriber–patient relationships and more informed care. However, prescriber‐focused incentives did not appear to greatly enhance access to contingency‐management services for patients. Thus, provider incentives may be beneficial but further research is needed to advance adoption of contingency management. [ABSTRACT FROM AUTHOR]

Understanding the factors influencing species range limits is increasingly crucial in anticipating migrations due to human‐caused climate change. In the boreal biome, ongoing climate change and the associated increases in the rate, size, and severity of disturbances may alter the distributions of boreal tree species. Notably, Interior Alaska lacks native pine, a biogeographical anomaly that carries implications for ecosystem structure and function. The current range of lodgepole pine (Pinus contorta var. latifolia) in the adjacent Yukon Territory may expand into Interior Alaska, particularly with human assistance. Evaluating the potential for pine expansion in Alaska requires testing constraints on range limits such as dispersal limitations, environmental tolerance limits, and positive or negative biotic interactions. In this study, we used field experiments with pine seeds and transplanted seedlings, complemented by model simulations, to assess the abiotic and biotic factors influencing lodgepole pine seedling establishment and growth after fire in Interior Alaska. We found that pine could successfully recruit, survive, grow, and reproduce across our broadly distributed network of experimental sites. Our results show that both mammalian herbivory and competition from native tree species are unlikely to constrain pine growth and that environmental conditions commonly found in Interior Alaska fall well within the tolerance limits for pine. If dispersal constraints are released, lodgepole pine could have a geographically expansive range in Alaska, and once established, its growth is sufficient to support pine‐dominated stands. Given the impacts of lodgepole pine on ecosystem processes such as increases in timber production, carbon sequestration, landscape flammability, and reduced forage quality, natural or human‐assisted migration of this species is likely to substantially alter responses of Alaskan forest ecosystems to climate change. [ABSTRACT FROM AUTHOR]

Aims: The COVID‐19 pandemic caused significant disruption to routine activity in primary care. Medication reviews are an important primary care activity ensuring safety and appropriateness of prescribing. A disruption could have significant negative implications for patient care. Using routinely collected data, our aim was first to describe codes used to record medication review activity and then to report the impact of COVID‐19 on the rates of medication reviews. Methods: With the approval of NHS England, we conducted a cohort study of 20 million adult patient records in general practice, in‐situ using the OpenSAFELY platform. For each month, between April 2019 and March 2022, we report the percentage of patients with a medication review coded monthly and in the previous 12 months with breakdowns by regional, clinical and demographic subgroups and those prescribed high‐risk medications. Results: In April 2019, 32.3% of patients had a medication review coded in the previous 12 months. During the first COVID‐19 lockdown, monthly activity decreased (−21.1% April 2020), but the 12‐month rate was not substantially impacted (−10.5% March 2021). The rate of structured medication review in the last 12 months reached 2.9% by March 2022, with higher percentages in high‐risk groups (care home residents 34.1%, age 90+ years 13.1%, high‐risk medications 10.2%). The most used medication review code was Medication review done 314530002 (59.5%). Conclusions: There was a substantial reduction in the monthly rate of medication reviews during the pandemic but rates recovered by the end of the study period. Structured medication reviews were prioritized for high‐risk patients. [ABSTRACT FROM AUTHOR]

International guidance on bioanalytical method validation recommends the practice of partial validation when introducing a new matrix from the same species into a previously fully validated assay. Planning the partial validation protocol should include an evaluation of analyte chemistry, consideration of sample container materials, and a comparison of properties between the relevant biological matrices. Transition of a serum/plasma‐validated bioanalytical method to analysis from a low‐protein matrix, such as urine, cerebral spinal fluid, or oral fluid can result in inconsistent analyte recovery. The low recovery can potentially be mistaken for signal suppression or lack of drug stability and may be more pronounced in low‐concentration or low‐volume samples. In addition, adsorption and absorption interactions with containers may be exacerbated in low‐protein matrices. Several possibilities exist for mitigating the impact of non‐specific binding and low‐protein matrices, including surfactants, bovine serum albumin, and β‐cyclodextrin. Finally, higher matrix protein can facilitate analyte stability. Given all this, matrix protein content should not be overlooked when anticipating a partial bioanalytical method validation. [ABSTRACT FROM AUTHOR]

Fleas (Siphonaptera) are holometabolous insects with larval and adult stages that exhibit vastly different ecologies from each other. Adult fleas are parasitic and feed exclusively on the blood of a vertebrate host, whereas flea larvae do not live on hosts and consume dried faecal blood from adult fleas. Because flea larvae rely on adult flea faeces for food, excrement and eggs must fall in the same location; thus, larval density is likely high in these restricted habitats. However, the influence of larval density on the subsequent adult stage has not been examined. In the present study, we utilized egg density to investigate density‐dependent effects on larval development and adult body size in the cat flea (Ctenocephalides felis Bouché) (Siphonaptera: Pulicidae). Specifically, eggs were collected to create three different larval densities (n = 50, 100 and 150 per 56.7 cm2), and hatched larvae from all groups were fed an excess amount of adult faecal pellets. Larval development was measured by recording the proportion of eggs that developed to the pupal stage and the proportion of eggs that reached adulthood (eclosion). The body size of eclosed adults was quantified for both sexes using head length and length of the total body. We found that the number of eggs had no effect on the proportion of larvae that pupated or the proportion of larvae that eclosed; however, higher egg densities resulted in larger body sizes for both sexes. Overall, these data yield significant insight into how the ecology of larval fleas impacts the biology of the resultant adults. [ABSTRACT FROM AUTHOR]

Fetuses affected by intrauterine growth restriction have an increased risk of developing heart disease and failure in adulthood. Compared with controls, late gestation intrauterine growth‐restricted (IUGR) fetal sheep have fewer binucleated cardiomyocytes, reflecting a more immature heart, which may reduce mitochondrial capacity to oxidize substrates. We hypothesized that the late gestation IUGR fetal heart has a lower capacity for mitochondrial oxidative phosphorylation. Left (LV) and right (RV) ventricles from IUGR and control (CON) fetal sheep at 90% gestation were harvested. Mitochondrial respiration (states 1–3, LeakOmy, and maximal respiration) in response to carbohydrates and lipids, citrate synthase (CS) activity, protein expression levels of mitochondrial oxidative phosphorylation complexes (CI–CV), and mRNA expression levels of mitochondrial biosynthesis regulators were measured. The carbohydrate and lipid state 3 respiration rates were lower in IUGR than CON, and CS activity was lower in IUGR LV than CON LV. However, relative CII and CV protein levels were higher in IUGR than CON; CV expression level was higher in IUGR than CON. Genes involved in lipid metabolism had lower expression in IUGR than CON. In addition, the LV and RV demonstrated distinct differences in oxygen flux and gene expression levels, which were independent from CON and IUGR status. Low mitochondrial respiration and CS activity in the IUGR heart compared with CON are consistent with delayed cardiomyocyte maturation, and CII and CV protein expression levels may be upregulated to support ATP production. These insights will provide a better understanding of fetal heart development in an adverse in utero environment. Key points: Growth‐restricted fetuses have a higher risk of developing and dying from cardiovascular diseases in adulthood.Mitochondria are the main supplier of energy for the heart. As the heart matures, the substrate preference of the mitochondria switches from carbohydrates to lipids.We used a sheep model of intrauterine growth restriction to study the capacity of the mitochondria in the heart to produce energy using either carbohydrate or lipid substrates by measuring how much oxygen was consumed.Our data show that the mitochondria respiration levels in the growth‐restricted fetal heart were lower than in the normally growing fetuses, and the expression levels of genes involved in lipid metabolism were also lower. Differences between the right and left ventricles that are independent of the fetal growth restriction condition were identified.These results indicate an impaired metabolic maturation of the growth‐restricted fetal heart associated with a decreased capacity to oxidize lipids postnatally. [ABSTRACT FROM AUTHOR]

Vascular smooth muscle cell (vSMC) dysfunction is a critical contributor to cardiovascular diseases, including atherosclerosis, restenosis and vein graft failure. Recent advances have unveiled a fascinating range of non‐coding RNAs (ncRNAs) that play a pivotal role in regulating vSMC function. This review aims to provide an in‐depth analysis of the mechanisms underlying vSMC dysfunction and the therapeutic potential of various ncRNAs in mitigating this dysfunction, either preventing or reversing it. We explore the intricate interplay of microRNAs, long‐non‐coding RNAs and circular RNAs, shedding light on their roles in regulating key signalling pathways associated with vSMC dysfunction. We also discuss the prospects and challenges associated with developing ncRNA‐based therapies for this prevalent type of cardiovascular pathology. [ABSTRACT FROM AUTHOR]

In recent years considerable interest has been generated in a new approach known as resist–accept–direct, or RAD, for managing ecosystems in the face of climate change. Under RAD, strategic responses to climate change are described in terms of three broad categories: resisting climate transformation, accepting the transformation and continuing to manage as best one can, and directing the transformed system toward novel ecological conditions. In particular, the potential for integrating RAD and adaptive management has been broadly considered, though absent a decision‐making framework needed for implementation.We propose a hierarchical decision scheme for RAD that accounts for strategy selection among the three RAD options, as well as adaptive decision making within each option. We use stochastic models and uncertainties about ecosystem processes to account for the dynamics of climate‐transformed ecosystems, and show how these features can be used to inform RAD strategies. Operationally, the approach involves decisions at two levels: one level involves choosing a policy for each strategy, and the second level involves deciding which strategy has the greatest policy value.The structure described here extends recent work in climate change adaptation, by including Markovian decisions under climate change, strategy‐specific policies, and value functions for assessing and selecting RAD strategies. We provide a hierarchical accounting of decisions and responses, and develop rules for the timing of those decisions.Combining RAD and adaptive management can help to organize thinking about ecological conservation under climate change, and focus attention on mechanisms for making decisions. We believe the structure presented here can facilitate conservation efforts under the non‐stationary climate conditions we are sure to face for the foreseeable future. [ABSTRACT FROM AUTHOR]

Objective: To detail a modified surgical technique for implantation of the Osia 2 Bone Conduction Hearing Aid (BCHA) system and to assess intra‐ and postoperative outcomes of this technique. Methods: A retrospective review was performed for cases undergoing implantation of an Osia 2 BCHA at a tertiary academic medical center. Modifications were made to the surgical procedure including: horizontal or curvilinear incisions, placement of the osseointegrated screw slightly superior to the plane of the external auditory canal, and double layer wound closure. Data regarding outcomes including demographics, incision type, surgical time, drilling requirements, and complications were collected using the electronic medical record. Results: A total of twenty‐eight cases were evaluated with 57.1% and 42.9% utilizing horizontal and curved incisions, respectively. The median age for recipients was 43.1 years with six pediatric cases included in the study. Median operative time was 58 min (43–126 min). The majority of cases required minimal (60.7%) or no drilling (28.6%) with a significant increase in operative time for those requiring moderate drilling versus minimal to no drilling (F = 8.02, p = 0.002). There were no intraoperative complications. One (3.6%) postoperative seroma occurred which resolved with conservative management. Conclusion: The proposed modified surgical technique is a safe and effective method for implantation of the transcutaneous BCHA system with a low complication rate. Keys include incision design, implant placement, and two‐layered closure to minimize wound tension. These modifications can improve ease of the procedure and reduce operative time. These techniques also appear to be applicable to the pediatric population. Level of Evidence: 3 Laryngoscope, 134:2401–2404, 2024 [ABSTRACT FROM AUTHOR]

This article reflects on the potential value and many pitfalls of underpowered studies to help authors and readers consider whether and how they contribute meaningfully to the published literature. A basic introduction to power and sample size calculations is provided. Several problems that can arise in analysis and publication of underpowered studies are described. In addition, features of underpowered studies that may provide value are proposed, including when the hypothesis test of interest is a limited part of the story, the data is rich enough to showcase interesting features of the population of interest, when the rarity or ubiquity of events is an important finding, and when the study is preregistered to reduce the impact of publication bias. Several reporting guidelines for underpowered studies are also suggested. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusion The COVID‐19 pandemic created unprecedented pressure on healthcare services. This study investigates whether disease‐modifying antirheumatic drug (DMARD) safety monitoring was affected during the COVID‐19 pandemic.A population‐based cohort study was conducted using the OpenSAFELY platform to access electronic health record data from 24.2 million patients registered at general practices using TPP's SystmOne software. Patients were included for further analysis if prescribed azathioprine, leflunomide or methotrexate between November 2019 and July 2022. Outcomes were assessed as monthly trends and variation between various sociodemographic and clinical groups for adherence with standard safety monitoring recommendations.An acute increase in the rate of missed monitoring occurred across the study population (+12.4 percentage points) when lockdown measures were implemented in March 2020. This increase was more pronounced for some patient groups (70–79 year‐olds: +13.7 percentage points; females: +12.8 percentage points), regions (North West: +17.0 percentage points), medications (leflunomide: +20.7 percentage points) and monitoring tests (blood pressure: +24.5 percentage points). Missed monitoring rates decreased substantially for all groups by July 2022. Consistent differences were observed in overall missed monitoring rates between several groups throughout the study.DMARD monitoring rates temporarily deteriorated during the COVID‐19 pandemic. Deterioration coincided with the onset of lockdown measures, with monitoring rates recovering rapidly as lockdown measures were eased. Differences observed in monitoring rates between medications, tests, regions and patient groups highlight opportunities to tackle potential inequalities in the provision or uptake of monitoring services. Further research should evaluate the causes of the differences identified between groups. [ABSTRACT FROM AUTHOR]

Background: Optimization of atrial‐ventricular delay (AVD) during atrial sensing (SAVD) and pacing (PAVD) provides the most effective cardiac resynchronization therapy (CRT). We demonstrate a novel electrocardiographic methodology for quantifying electrical synchrony and optimizing SAVD/PAVD. Methods: We studied 40 CRT patients with LV activation delay. Atrial‐sensed to RV‐sensed (As‐RVs) and atrial‐paced to RV‐sensed (Ap‐RVs) intervals were measured from intracardiac electrograms (IEGM). LV‐only pacing was performed over a range of SAVD/PAVD settings. Electrical dyssynchrony (cardiac resynchronization index; CRI) was measured at each setting using a multilead ECG system placed over the anterior and posterior torso. Biventricular pacing, which included multiple interventricular delays, was also conducted in a subset of 10 patients. Results: When paced LV‐only, peak CRI was similar (93 ± 5% vs. 92 ± 5%) during atrial sensing or pacing but optimal PAVD was 61 ± 31 ms greater than optimal SAVD. The difference between As‐RVs and Ap‐RVs intervals on IEGMs (62 ± 31 ms) was nearly identical. The slope of the correlation line (0.98) and the correlation coefficient r (0.99) comparing the 2 methods of assessing SAVD‐PAVD offset were nearly 1 and the y‐intercept (0.63 ms) was near 0. During simultaneous biventricular (BiV) pacing at short AVD, SAVD and PAVD programming did not affect CRI, but CRI was significantly (p <.05) lower during atrial sensing at long AVD. Conclusions: A novel methodology for measuring electrical dyssynchrony was used to determine electrically optimal SAVD/PAVD during LV‐only pacing. When BiV pacing, shorter AVDs produce better electrical synchrony. [ABSTRACT FROM AUTHOR]

Objective: Determine variables that influence post‐activation performance for cochlear implant (CI) recipients who lost low‐frequency acoustic hearing. Methods: A retrospective review evaluated CNC word recognition for adults with normal to moderately severe low‐frequency hearing (preoperative unaided thresholds of ≤70 dB HL at 250 Hz) who were implanted between 2012 and 2021 at a tertiary academic center, lost functional acoustic hearing, and were fit with a CI‐alone device. Performance scores were queried from the 1, 3, 6, 12, and 24‐month post‐activation visits. A linear mixed model evaluated the effects of age at implantation, array length (long vs. mid/short), and preoperative low‐frequency hearing (normal to mild, moderate, and moderately severe) on speech recognition with a CI alone. Results: 113 patients met the inclusion criteria. There was a significant main effect of interval (p < 0.001), indicating improved word recognition post‐activation despite loss of residual hearing. There were significant main effects of age (p = 0.029) and array length (p = 0.038), with no effect of preoperative low‐frequency hearing (p = 0.171). There was a significant 2‐way interaction between age and array length (p = 0.018), indicating that older adults with mid/short arrays performed more poorly than younger adults with long lateral wall arrays when functional acoustic hearing was lost. Conclusion: CI recipients with preoperative functional low‐frequency hearing experience a significant improvement in speech recognition with a CI alone as compared to preoperative performance—despite the loss of low‐frequency hearing. Age and electrode array length may play a role in post‐activation performance. These data have implications for the preoperative counseling and device selection for hearing preservation candidates. Level of Evidence: 4 Laryngoscope, 134:1868–1873, 2024 [ABSTRACT FROM AUTHOR]

Objective Background Method Results Conclusion Implications This study elucidates relations among playtime, bedtime, and cortisol levels for children facing economic hardship.Poverty‐related stressors overburden physiological systems that respond to stress, with implications for child health and development. The family microsystem can offer protection, yet no prior published studies have explored whether time allocated to various home activities might relate to stress levels.The study included 130 children aged 3 to 5 years who attended a Head Start preschool, and their primary caregivers. Trained research assistants completed daily telephone interviews with the caregivers across 10 days near the start of the preschool year to assess activities at home and, at a midyear time point, collected child saliva samples upon preschool arrival on 2 weekdays to assess morning levels of the stress hormone cortisol.Zero‐order correlational and linear regression analyses indicated that a greater proportion of playtime and earlier bedtime relative to waketime (i.e., more sleep time) related to lower morning cortisol levels.Greater playtime and sleep time may mitigate the tax of poverty on physiological stress response systems.Implications concern family strengths that might be built upon to promote the well‐being of children facing economic hardship. [ABSTRACT FROM AUTHOR]

Leaky barriers have become an important mitigation option within natural flood management to reduce downstream flood risk. Modelling is a key tool to aid in the design of leaky barrier installations for flood mitigation, but there is limited evidence about the accuracy of model representations of the system. Here, the hydrological model SWAT was combined with a water routing model that simulates multiple leaky barriers as permeable sluice gates. Storage behind individual barriers was quantified using barrier dimensions and LIDAR topography. The model was applied to a series of 27 leaky barriers installed as part of a long‐term manipulation experiment into a 11‐km2 intensive lowland agricultural catchment in Leicestershire, England. Evaluation of the model against flow data collected before and after leaky barrier installation and time‐lapse photography taken across storm events at individual barriers demonstrated robust model performance (Nash‐Sutcliffe efficiency and R2 across 19 validation events were 0.84 ± 0.14 and 0.91 ± 0.08, respectively). Empirical and modelling data were then combined to demonstrate that the 17,700 m3 of water storage provided by the 27 leaky barriers reduced peak flows at the catchment outlet by 22 ± 6% and delayed the peak in flow by up to 5 h for 11 storm events recorded after all barriers had been installed. The volume of storage utilised prior to the flood event was a key factor influencing the reduction in peak flow, and a sensitivity analysis indicated that barriers should be permeable to accelerate drain‐down of the barrier and help to mitigate risk from multiple storm events occurring in sequence. [ABSTRACT FROM AUTHOR]

Reports suggest that cannabis potency has dramatically increased over the last decade in the USA and Europe. Cannabinoids are the terpeno‐phenolic compounds found in the cannabis plant and are responsible for its pharmacological activity. The two most prominent cannabinoids are delta‐9‐tetrahydrocannabinol (Δ9THC) and cannabidiol (CBD). Cannabis potency is measured not only by the Δ9THC levels but also by the ratio of Δ9THC to other non‐psychoactive cannabinoids, namely, CBD. Cannabis use was decriminalized in Jamaica in 2015, which opened the gates for the creation of a regulated medical cannabis industry in the country. To date, there is no information available on the potency of cannabis in Jamaica. In this study, the cannabinoid content of Jamaican‐grown cannabis was examined over the period 2014–2020. Two hundred ninety‐nine herbal cannabis samples were received from 12 parishes across the island, and the levels of the major cannabinoids were determined using gas chromatography–mass spectrometry. There was a significant increase (p < 0.05) in the median total THC levels of cannabis samples tested between 2014 (1.1%) and 2020 (10.2%). The highest median THC was detected in the central parish of Manchester (21.1%). During the period, THC/CBD ratios increased from 2.1 (2014) to 194.1 (2020), and there was a corresponding increase in the percent freshness of samples (CBN/THC ratios <0.013). The data show that a significant increase in the potency of locally grown cannabis has occurred in Jamaica during the last decade. [ABSTRACT FROM AUTHOR]

Objective: To assess the perceived benefit of cochlear implant (CI) use for children with unilateral hearing loss (UHL) and evaluate whether perceived abilities are associated with performance on measures of speech recognition and spatial hearing. Method: Nineteen children with moderate‐to‐profound UHL underwent cochlear implantation. The Speech Spatial and Qualities of Hearing Questionnaire modified for children (SSQ‐C) were completed by parental proxy pre‐operatively and at 3, 6, 9, 12, 18, and 24 months post‐activation. Linear mixed models evaluated perceived benefits over the study period. Pearson correlations assessed the association between subjective report and performance on measures of word recognition with the CI alone and spatial hearing (speech recognition in spatially‐separated noise and sound source localization) in the combined condition (CI plus contralateral ear). Results: For the SSQ‐C, parents reported significant improvements with CI use as compared to pre‐operative perceptions (p < 0.001); improved perceptions were either maintained or continued to improve over the 2‐year post‐activation period. Perceived benefit did not significantly correlate with word recognition with the CI alone or spatial hearing outcomes in the combined condition. Conclusion: Families of children with UHL observed benefits of CI use early after cochlear implantation that was maintained with long‐term device use. Responses to subjective measures may broaden our understanding of the experiences of pediatric CI users with UHL in addition to outcomes on typical measures of CI performance. Level of Evidence: 3 Laryngoscope, 134:919–925, 2024 [ABSTRACT FROM AUTHOR]

Current evidence on philanthropic giving to nonprofit organizations (NPOs) suggests that NPOs are not successfully cultivating relationships with prospective donors in the millennial generation; this has negative implications for the organizations' future financial sustainability. The current investigation employed a framework grounded in relationship management theory to explore how NPOs can better engage with this target audience. A series of focus groups revealed nuanced factors that facilitated relationship‐building between millennials and NPOs, rooted in the theoretical constructs of trust and openness. These results can be used to guide NPOs' donor‐engagement strategies focused specifically on millennials, thus guiding long‐term donor relations efforts. [ABSTRACT FROM AUTHOR]

Passive Acoustic Monitoring (PAM) is emerging as a solution for monitoring species and environmental change over large spatial and temporal scales. However, drawing rigorous conclusions based on acoustic recordings is challenging, as there is no consensus over which approaches are best suited for characterizing marine acoustic environments. Here, we describe the application of multiple machine‐learning techniques to the analysis of two PAM datasets. We combine pre‐trained acoustic classification models (VGGish, NOAA and Google Humpback Whale Detector), dimensionality reduction (UMAP), and balanced random forest algorithms to demonstrate how machine‐learned acoustic features capture different aspects of the marine acoustic environment. The UMAP dimensions derived from VGGish acoustic features exhibited good performance in separating marine mammal vocalizations according to species and locations. RF models trained on the acoustic features performed well for labeled sounds in the 8 kHz range; however, low‐ and high‐frequency sounds could not be classified using this approach. The workflow presented here shows how acoustic feature extraction, visualization, and analysis allow establishing a link between ecologically relevant information and PAM recordings at multiple scales, ranging from large‐scale changes in the environment (i.e., changes in wind speed) to the identification of marine mammal species. [ABSTRACT FROM AUTHOR]

Unveiling the tempo and mode of animal evolution is necessary to understand the links between environmental changes and biological innovation. Although the earliest unambiguous metazoan fossils date to the late Ediacaran period, molecular clock estimates agree that the last common ancestor (LCA) of all extant animals emerged ~850 Ma, in the Tonian period, before the oldest evidence for widespread ocean oxygenation at ~635–560 Ma in the Ediacaran period. Metazoans are aerobic organisms, that is, they are dependent on oxygen to survive. In low‐oxygen conditions, most animals have an evolutionarily conserved pathway for maintaining oxygen homeostasis that triggers physiological changes in gene expression via the hypoxia‐inducible factor (HIFa). However, here we confirm the absence of the characteristic HIFa protein domain responsible for the oxygen sensing of HIFa in sponges and ctenophores, indicating the LCA of metazoans lacked the functional protein domain as well, and so could have maintained their transcription levels unaltered under the very low‐oxygen concentrations of their environments. Using Bayesian relaxed molecular clock dating, we inferred that the ancestral gene lineage responsible for HIFa arose in the Mesoproterozoic Era, ~1273 Ma (Credibility Interval 957–1621 Ma), consistent with the idea that important genetic machinery associated with animals evolved much earlier than the LCA of animals. Our data suggest at least two duplication events in the evolutionary history of HIFa, which generated three vertebrate paralogs, products of the two successive whole‐genome duplications that occurred in the vertebrate LCA. Overall, our results support the hypothesis of a pre‐Tonian emergence of metazoans under low‐oxygen conditions, and an increase in oxygen response elements during animal evolution. [ABSTRACT FROM AUTHOR]

Objective: Comparison of acute speech recognition for cochlear implant (CI) alone and electric‐acoustic stimulation (EAS) users listening with default maps or place‐based maps using either a spiral ganglion (SG) or a new Synchrotron Radiation‐Artificial Intelligence (SR‐AI) frequency‐to‐place function. Methods: Thirteen adult CI‐alone or EAS users completed a task of speech recognition at initial device activation with maps that differed in the electric filter frequency assignments. The three map conditions were: (1) maps with the default filter settings (default map), (2) place‐based maps with filters aligned to cochlear SG tonotopicity using the SG function (SG place‐based map), and (3) place‐based maps with filters aligned to cochlear Organ of Corti (OC) tonotopicity using the SR‐AI function (SR‐AI place‐based map). Speech recognition was evaluated using a vowel recognition task. Performance was scored as the percent correct for formant 1 recognition due to the rationale that the maps would deviate the most in the estimated cochlear place frequency for low frequencies. Results: On average, participants had better performance with the OC SR‐AI place‐based map as compared to the SG place‐based map and the default map. A larger performance benefit was observed for EAS users than for CI‐alone users. Conclusion: These pilot data suggest that EAS and CI‐alone users may experience better performance with a patient‐centered mapping approach that accounts for the variability in cochlear morphology (OC SR‐AI frequency‐to‐place function) in the individualization of the electric filter frequencies (place‐based mapping procedure). Level of Evidence: 3 Laryngoscope, 133:3540–3547, 2023 [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic has propelled a global paradigm shift in how psychological support is delivered. Remote delivery, through phone and video calls, is now commonplace around the world. However, most adoption of remote delivery methods is occurring without any formal training to ensure safe and effective care. Objective: The purpose of this applied qualitative study was to determine practitioners' experiences of rapidly adapting to deliver psychological support remotely during COVID‐19. Design: We used a pragmatic paradigm and applied approach to gain perspectives related to the feasibility and perceived usefulness of synchronous remote psychological support, including views on how practitioners can be prepared. Methods: Key informant interviews were conducted remotely with 27 specialist and non‐specialist practitioners in Nepal, Perú and the USA. Interviewees were identified through purposeful sampling. Data were analysed using framework analysis. Results: Respondents revealed three key themes: (i) Remote delivery of psychological support raises unique safety concerns and interference with care, (ii) Remote delivery enhances skills and expands opportunities for delivery of psychological support to new populations, and (iii) New training approaches are needed to prepare specialist and non‐specialist practitioners to deliver psychological support remotely. Conclusions: Remote psychological support is feasible and useful for practitioners, including non‐specialists, in diverse global settings. Simulated remote role plays may be a scalable method for ensuring competency in safe and effective remotely‐delivered care. [ABSTRACT FROM AUTHOR]

The promise of applied developmental science is that we can use scientific methods to promote positive human development and improve the lives of children and families. However, the present political environment in the United States makes the creation of research‐informed federal policy difficult, even when the evidence supporting a given policy is unequivocal. In this essay, we hope to begin a conversation about how we, as applied developmental scientists, may modify our approach in order to best fulfill the promise of applied developmental science. To begin this conversation, we discuss the potential for establishing long‐term partnerships with smaller entities, including state and municipal governments and non‐governmental organizations to narrow the gap between what we know about children and families and the policies and programs that impact them. This 'bottom‐up' approach has a long lineage in applied developmental science, and is currently enjoying a renaissance through the burgeoning interest in researcher‐practitioner partnerships. Whether implicitly or explicitly, these partnerships often incorporate a systems perspective on children's development; here, we review why embracing a systems perspective may increase the likelihood of crafting policies and programs that can improve the lives of children and families. [ABSTRACT FROM AUTHOR]

Objectives: Assess the long‐term patterns of perceived tinnitus severity and subjective benefit for adult cochlear implant (CI) users with asymmetric or unilateral hearing loss (AHL or UHL). Methods: Forty adults underwent cochlear implantation as part of a prospective clinical trial assessing the outcomes of CI use in cases of AHL (n = 20) and UHL (n = 20). Subjective measures included the Tinnitus Handicap Inventory (THI), the Speech, Spatial, & Qualities of Hearing Scale (SSQ), and the Abbreviated Profile of Hearing Aid Benefit (APHAB). Responses were obtained preoperatively and at routine intervals out to 5 years post‐activation. Results: For subjective benefit, participants with AHL and UHL reported a significant improvement as compared to preoperative abilities, which was maintained with long‐term CI use. For perceived tinnitus severity, participants with AHL and UHL reported a significant reduction with CI use as compared to preoperative perceptions. The perceived tinnitus severity significantly differed for the AHL and UHL cohorts over time. This pattern of results is likely influenced by the worse perceived severity levels for the UHL cohort preoperatively and the fluctuating perceived severity levels for some participants in the AHL cohort post‐activation. Conclusion: Adults with AHL and UHL report an early, significant reduction in perceived tinnitus severity and improvement in quality of life with CI use that is generally maintained with long‐term device use. Questionnaires such as the THI, SSQ, and APHAB may contribute to a more holistic assessment of the benefits of cochlear implantation in this population. Level of Evidence: 2 Laryngoscope, 133:2792–2797, 2023 [ABSTRACT FROM AUTHOR]

While many Bayesian state‐space models for infectious disease processes focus on population infection dynamics (eg, compartmental models), in this work we examine the evolution of infection processes and the complexities of the immune responses within the host using these techniques. We present a joint Bayesian state‐space model to better understand how the immune system contributes to the control of Leishmania infantum infections over the disease course. We use longitudinal molecular diagnostic and clinical data of a cohort of dogs to describe population progression rates and present evidence for important drivers of clinical disease. Among these results, we find evidence for the importance of co‐infection in disease progression. We also show that as dogs progress through the infection, parasite load is influenced by their age, ectoparasiticide treatment status, and serology. Furthermore, we present evidence that pathogen load information from an earlier point in time influences its future value and that the size of this effect varies depending on the clinical stage of the dog. In addition to characterizing the processes driving disease progression, we predict individual and aggregate patterns of Canine Leishmaniasis progression. Both our findings and the application to individual‐level predictions are of direct clinical relevance, presenting possible opportunities for application in veterinary practice and motivating lines of additional investigation to better understand and predict disease progression. Finally, as an important zoonotic human pathogen, these results may support future efforts to prevent and treat human Leishmaniosis. [ABSTRACT FROM AUTHOR]

Policy PointsThe United States public health system relies on an inadequate and inefficient mix of federal, state, and local funding.Various state‐based initiatives suggest that a promising path to bipartisan support for increased public health funding is to gain the support of local elected officials by providing state (and federal) funding directly to local health departments, albeit with performance strings attached.Even with more funding, we will not solve the nation's public health workforce crisis until we make public health a more attractive career path with fewer bureaucratic barriers to entry. Context: The COVID‐19 pandemic exposed the shortcomings of the United States public health system. High on the list is a public health workforce that is understaffed, underpaid, and undervalued. To rebuild that workforce, the American Rescue Plan (ARP) appropriated $7.66 billion to help create 100,000 new public health jobs. As part of this initiative, the Centers for Disease Control and Prevention (CDC) distributed roughly $2 billion to state, local, tribal, and territorial health agencies for use between July 1, 2021, and June 30, 2023. At the same time, several states have enacted (or are considering enacting) initiatives to increase state funding for their local health departments with the goal of ensuring that these departments can deliver a core set of services to all residents. The differences in approach between this first round of ARP funding and theseparate state initiatives offer an opportunity to compare, contrast, and suggest lessons learned. Methods: After interviewing leaders at the CDC and other experts on the nation's public health workforce, we visited five states (Kentucky, Indiana, Mississippi, New York, and Washington) to examine, by means of interviews and documents, the implementation and impact of both the ARP workforce funds as well as the state‐based initiatives. Findings: Three themes emerged. First, states are not spending the CDC workforce funding in a timely fashion; although the specifics vary, there are several organizational, political, and bureaucratic obstacles. Second, the state‐based initiatives follow different political paths but rely on the same overarching strategy: gain the support of local elected officials by providing funding directly to local health departments, albeit with performance strings attached. These state initiatives offer their federal counterparts a political roadmap toward a more robust model of public health funding. Third, even with increased funding, we will not meet the nation's public health workforce challenges until we make public health a more attractive career path (with higher pay, improved working conditions, and more training and promotion opportunities) with fewer bureaucratic barriers to entry (most importantly, with less reliance on outdated civil service rules). Conclusion: The politics of public health requires a closer look at the role played by county commissioners, mayors, and other local elected officials. We need a political strategy to persuade these officials that their constituents will benefit from a better public health system. [ABSTRACT FROM AUTHOR]

The need to detect fentanyl and its analogs in the field is an important capability to help prevent unintentional exposure or overdose on these substances, which may result in death. Many portable methods historically used in the field by first responders and other field users to detect and identify other chemical substances, such as hazardous materials, have been applied to the detection and identification of these synthetic opioids. This paper describes field portable spectroscopic methods used for the detection and identification of fentanyl and its analogs. The methods described are automated colorimetric tests including lateral flow assays; vibrational spectroscopy (mid‐infrared and Raman); gas chromatography–mass spectrometry; ion mobility spectrometry, and high‐pressure mass spectrometry. In each case the background and key details of these technologies are outlined, followed by a discussion of the application of the technology in the field. Attention is paid to the analysis of complex mixtures and limits of detection, including the required spectral databases and algorithms used to interrogate these types of samples. There is also an emphasis on providing actionable information to the (likely) non‐scientist operators of these instruments in the field. [ABSTRACT FROM AUTHOR]

Negative differential resistance (NDR) in certain materials has been attributed to spontaneous emergence of symmetry‐breaking electrical current density localization from a previously homogeneous distribution, which is postulated to occur due to the nonequilibrium thermodynamic force of minimization of entropy production. However, this phenomenon has not been quantitatively predicted based on intrinsic material properties and an applied electrical stimulus. Herein an instability criterion is derived for localization of current density and temperature from a thermal fluctuation in a parallel conductor model of a thin film that is subject to Newton's law of cooling. The conditions for steady–state electro‐thermal localization is predicted, verifying a decrease in entropy production upon localization. Electro‐thermal localization accompanied by a decrease of entropy production is confirmed in a multiphysics simulation of current flow in a thin film. The instability criterion predicts conditions for spontaneous current density localization, relating symmetry breaking fundamentally to dynamical instability via Local Activity theory. [ABSTRACT FROM AUTHOR]

Background: Visible light (VL) induces varying photobiological responses between skin types, likely influenced by inherent melanization. Individual typology angle (ITA) objectively measures skin types. We hypothesize that epidermal melanin content and distribution determine VL response. Objectives: This study describes clinical and histologic responses to VL and examines the potential role of melanin in the underlying mechanistic pathways. Methods: We grouped enrolled participants by ITA (Light = 5, Intermediate = 4, Dark = 7) per colorimetry (CR‐400, Konica Minolta). Photoprotected sites were exposed daily to 480 J/cm2 of VL (Fiber‐Lite High Intensity Illuminator, Series 180, Dolan Jenner Industries Inc.) for 4 days (total = 1920 J/cm2), as tolerated. Treated and control sites were biopsied 96 h after first exposure. We used hematoxylin and eosin and Fontana‐Mason to assess histological changes and melanin deposition, respectively. p53 and Ki67 immunohistochemical stains were done to assess DNA damage and proliferation. Matrix metalloproteinase (MMP)‐1 expression was detected by immunohistochemical staining and immunofluorescence microscopy. Results: Darker skin did not tolerate the full VL regimen with blistering occurring in most subjects at doses of 220–880 J/cm2. Intermediate and Dark skin showed tanning. Light skin developed erythema. p53 counts were highest in Intermediate, followed by Light skin, although this was not statistically significant. VL treatment led to MMP‐1 expression and nuclear localization in keratinocytes in Dark and Intermediate but not in Light skin, however differences between groups were not statistically significant. Conclusions: Skin types demonstrate unique biological responses to VL. The role of melanin in photoprotection is well‐defined. However, given the pro‐apoptotic function of nuclear MMPs, we suggest a potential mechanism by which melanin may mediate VL‐induced phototoxicity. [ABSTRACT FROM AUTHOR]

Ideally, the panel should include non-technical decision makers so that students can practice telling convincing stories to non-pharmacometrics expertsConference attendance to sharpen scientific presentation skills and establish/expand scientific networkToastmastersNegotiation and influencing skills and leading drug development teams to consensusBecome aware of your presence and the impact of your presence with focus on drug development teamsLearn to "speak the language" of collaborators in interdisciplinary teamsSpecialized faculty or guest lecturer in a multiple day workshopVirtual internship/fellowships with regulatory agencies or pharmaceutical industry ht 1 I Note i : The individual starting point for each activity may differ between students/trainees based on their prior training and experience. The Center for Pharmacometrics and Systems Pharmacology (CPSP) at the University of Florida has been engaging stakeholders from industry and regulatory agencies in recent years to seek input on the requirements and expectations for next generation pharmacometricians in the workplace. [Extracted from the article]

Antimicrobial resistance is at an all‐time high and new drugs are required to overcome this crisis. Traditional approaches to drug discovery have failed to produce novel classes of antibiotics, with only a few currently in development. It is thought that novel classes will come from antibacterial drug discovery efforts that focus on unconventional targets. One such collection of antibacterial targets are those that comprise central carbon metabolism. Targets of this kind have been largely overlooked because conventional antibacterial testing media are ill‐suited for exploring carbon source utilization. Nevertheless, as a consequence of infection, bacteria must find a carbon source in order to survive. Here, we review what is known about the carbon sources available and used by bacteria in different host infection sites. We also look at discovery efforts targeting central carbon metabolism and evaluate how these processes can influence antibiotic efficacy. [ABSTRACT FROM AUTHOR]

Objective: To assess long‐term binaural hearing abilities for cochlear implant (CI) users with unilateral hearing loss (UHL) or asymmetric hearing loss (AHL). Methods: A prospective, longitudinal, repeated measures study was completed at a tertiary referral center evaluating adults with UHL or AHL undergoing cochlear implantation. Binaural hearing abilities were assessed with masked speech recognition tasks using AzBio sentences in a 10‐talker masker. Performance was evaluated as the ability to benefit from spatial release from masking (SRM). SRM was calculated as the difference in scores when the masker was presented toward the CI‐ear (SRMci) or the contralateral ear (SRMcontra) relative to the co‐located condition (0°). Assessments were completed pre‐operatively and at annual intervals out to 5 years post‐activation. Results: Twenty UHL and 19 AHL participants were included in the study. Linear Mixed Models showed significant main effects of interval and group for SRMcontra. There was a significant interaction between interval and group, with UHL participants reaching asymptotic performance early and AHL participants demonstrating continued growth in binaural abilities to 5 years post‐activation. The improvement in SRM showed a significant positive correlation with contralateral unaided hearing thresholds (p = 0.050) as well as age at implantation (p = 0.031). Conclusions: CI recipients with UHL and AHL showed improved SRM with long‐term device use. The time course of improvement varied by cohort, with the UHL cohort reaching asymptotic performance early and the AHL cohort continuing to improve beyond 1 year. Differences between cohorts could be driven by differences in age at implantation as well as contralateral unaided hearing thresholds. Level of Evidence: 3 Laryngoscope, 133:1480–1485, 2023 [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety and outcomes of cochlear implantation (CI) in patients with ventriculoperitoneal (VP) shunts to inform clinical practice. Study Design: Historical cohort study. Setting: Tertiary referral centers. Methods: A multi‐institutional historical cohort of patients with VP shunts and CI was identified and analyzed. Results: A total of 46 patients (median age 8 years [interquratile range, IQR: 2‐46]) with VP shunts and CI were identified. Of these, 41 (89%) patients had a VP shunt prior to CI. Based on institutional preference and individual patient factors, CI was performed contralateral to a pre‐existing VP shunt in 24 of these 41 cases (59%) and ipsilateral in 17 (41%). Furthermore, pre‐CI relocation of the VP shunt was performed in 3 cases (7%), and 2 patients (5%) underwent planned revision of their VP shunt concurrent with CI. In total, 2 of 27 pediatric patients (7%) required unanticipated revision shunt surgery, both contralateral to CI device placement, given VP shunt malfunction. One of 19 adult patients (5%) required shunt revision during CI due to shunt damage noted intraoperatively. Among 43 patients with available follow‐up, 38 (88%) are regular CI users, with a median consonant‐nucleus vowel‐consonant word: score of 58% (IQR: 28‐72). Conclusion: CI can be performed at low risk, either contralateral or ipsilateral, to a VP shunt, and does not mandate shunt revision in most cases. Additional considerations regarding CI receiver‐stimulator placement are necessary with programmable shunts to mitigate device interaction. Preoperative planning, including coordination of care with neurosurgery, is important to achieving optimal outcomes. [ABSTRACT FROM AUTHOR]

Conservation and management of biological systems involves decision‐making over time, with a generic goal of sustaining systems and their capacity to function in the future. We address four persistent and difficult conservation challenges: (1) prediction of future consequences of management, (2) uncertainty about the system's structure, (3) inability to observe ecological systems fully, and (4) nonstationary system dynamics. We describe these challenges in terms of dynamic systems subject to different sources of uncertainty, and we present a basic Markovian framework that can encompass approaches to all four challenges. Finding optimal conservation strategies for each challenge requires issue‐specific structural features, including adaptations of state transition models, uncertainty metrics, valuation of accumulated returns, and solution methods. Strategy valuation exhibits not only some remarkable similarities among approaches but also some important operational differences. Technical linkages among the models highlight synergies in solution approaches, as well as possibilities for combining them in particular conservation problems. As methodology and computing software advance, such an integrated conservation framework offers the potential to improve conservation outcomes with strategies to allocate management resources efficiently and avoid negative consequences. [ABSTRACT FROM AUTHOR]

Wrinkling is the hallmark of skin ageing. We previously reported that perioral wrinkling is more severe in females; however, the molecular basis is unknown. This study assessed sex differences in the molecular expression of key ageing regulators in perioral skin. Twelve subjects (n = 6 male/female) were enrolled in this cross‐sectional study and biopsies were taken from the perioral and periocular regions. RNA expression of collagen I, collagen III, cysteine‐rich angiogenic inducer 61 (CYR61) and insulin‐like growth factor 1 (IGF‐1) was assessed by qPCR. There was no difference between females' and males' Griffith's grades (6 and 5.67, respectively, p = 0.092) or periocular wrinkling grades (3.2 and 2.6, p = 0.421), but females had more severe perioral wrinkling grades than males (6.2 and 2.8, p = 0.020). Females not only expressed significantly more CYR61 (p = 0.018) in the perioral region than malesm but also expressed more collagen III (p = 0.016). There was no difference in collagen I (p = 0.115) or IGF‐1 (p = 0.124) expression in the perioral region between sexes. In the periocular region, there were no significant differences between sexes in the expression of all four markers. The significant molecular differences in the perioral region between the sexes may contribute to the greater perioral skin wrinkling seen clinically in females. [ABSTRACT FROM AUTHOR]

Highly porous, ferromagnetic glass‐ceramic P40‐Fe3O4 microspheres (125–212 µm) with enhanced cytocompatibility have been manufactured for the first time via a facile, rapid, single‐stage flame spheroidization process. Dispersions of Fe3O4 and Ca2Fe2O5 domains (≈10 µm) embedded within P40 (40P2O5‐16CaO‐24MgO‐20Na2O in mol%) phosphate‐based glass matrices show evidence for remanent magnetization (0.2 Am2 kg−1) and provide for controlled induction heating to a constant level of 41.9 °C, making these materials highly appropriate for localized magnetic hyperthermia applications. Complementary, cytocompatibility investigations confirm the suitability of P40‐Fe3O4 porous microspheres for biomedical applications. It is suggested that the flame‐spheroidization process opens up new opportunities for the development of innovative synergistic biomaterials, toward bone‐tissue regenerative applications. [ABSTRACT FROM AUTHOR]

Background and Purpose: During the coronavirus disease 2019 (COVID‐19) pandemic many countries reported a decline in stroke volumes. The aim of this study was to analyze if the decline was related to the intensity of the COVID‐19 pandemic. Methods: The first pandemic year (1 March 2020 to 28 February 2021) overall and during the three COVID‐19 waves were compared with the preceding year. Volumes of acute ischaemic stroke (AIS), subarachnoid hemorrhage, intracerebral hemorrhage and recanalization treatments (intravenous thrombolysis [IVT] and mechanical thrombectomy [MT]) were obtained from the National Register of Reimbursed Health Services. Door‐to‐needle time, onset‐to‐door time and National Institutes of Health Stroke Scale at admission were obtained from the Registry of Stroke Care Quality. Results: During the pandemic year compared to the preceding year there were 26,453 versus 28,771 stroke admissions, representing an 8.8% decline (p < 0.001). The declines (−10%, −11%, −19%) appeared in COVID‐19 waves (spring 2020, autumn 2020, winter 2021) except for an increase (2%) during summer 2020. Admissions for AIS declined by 10.2% (p < 0.001), whilst hemorrhagic stroke volumes were minimally decreased. The absolute volumes of IVT and MT decreased by 9.4% (p < 0.001) and 5.7% (p = 0.16), respectively. However, the proportions of ischaemic stroke patients receiving IVT (18% vs. 18%; p = 0.72) and MT (6% vs. 6%; p = 0.28) remained unchanged. Conclusions: There was a decline in stroke admissions, but such decline was not related to COVID‐19 incidence. The frequency of use of recanalization procedures (IVT, MT) and times (onset‐to‐door time, door‐to‐needle time) in AIS were preserved in the Czech Republic during the first year of the pandemic. [ABSTRACT FROM AUTHOR]

Aluminum (Al) and polyvinylidene fluoride (PVDF) composites can be used in many unique applications in the field of energetic materials. Due to their low melting point, many PVDF composites can be additively manufactured. However, more research is needed to better understand the ignition and combustion of these materials. Manipulating the size of aluminum (Al) particles in Al/PVDF composites can drastically alter the burning rate, ignition characteristics, and possibly flame temperatures. This study characterizes the ignition of additively manufactured micro‐ and nano‐ Al/PVDF composites through hotwire ignition tests. Both nAl and μAl particles were mixed in PVDF at 20 wt.% and additively manufactured into disks via fused filament fabrication. The nAl/PVDF printed disks ignited at a minimum ignition power (MIP) of 4.1 W compared to the 9.5 W required for ignition of μAl/PVDF disks. At identical powers, ignition delays were significantly shorter for nAl/PVDF disks. Additionally, while the nAl/PVDF disks reacted instantaneously at any power above their MIP, the μAl/PVDF disks exhibited smaller, localized flames before complete combustion, if the power was below 17.5 W. Flame temperatures were estimated through three‐color pyrometry and compared to thermochemical equilibrium calculations. While theoretical flame temperatures for nAl/PVDF and μAl/PVDF are 2023 K and 2314 K respectively, both samples burned near 2000 K when measured using pyrometry. [ABSTRACT FROM AUTHOR]