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Background Methods Findings Conclusions Medicine is recognised as a challenging course where exposure to potentially distressing content is inevitable. Some educators provide students with warnings before they encounter potentially upsetting content—trigger warnings. In this scoping review, we mapped the existing literature seeking to better understand how trigger warnings are implemented in medical schools and how they are influencing education within them.Bibliographic databases were searched to identify relevant literature, including searching for grey literature. Articles were included if they focussed on medical school education and were written in English. Data analysis was undertaken using both quantitative and qualitative approaches (thematic analysis).Searching generated 1284 potential records for inclusion. Articles not related to the primary research question were excluded. Abstracts of the remaining 841 articles were screened, and ultimately, 12 articles met criteria for full‐text review. Of these, there were three empirical research studies. Qualitative analysis identified five main themes: purpose, implementation, student distress, responsibility and problems with terminology.The use of trigger warnings within medical student education remains contentious. There is a lack of consensus as to their purpose and much diversity in how they are implemented. There was limited published empirical evidence to inform practice in this area. [ABSTRACT FROM AUTHOR]

Background: Pediatric patients from minoritized racial and ethnic groups receive red blood cell (RBC) transfusions more frequently while undergoing major surgical procedures. Our objective was to identify the contribution of preoperative anemia to racial and ethnic differences in RBC transfusion rates in adolescent spine surgery. Study Design and Methods: This is a multicenter, retrospective cohort study of the National Surgical Quality Improvement Program Pediatric database, 2016 to 2021 for patients in the United States and Canada. Results: Adolescents identifying as non‐Hispanic Black, Hispanic, and other race/ethnicity presented with higher rates of preoperative anemia than non‐Hispanic White adolescents (16.3%, 10.6%, and 9.9%, vs. 7.8%, respectively; p <.0001) and were transfused at higher rates (14.4%, 11.9%, 16.5%, vs. 10.0%, respectively; p <.0001). Minoritized groups demonstrated higher adjusted odds of RBC transfusion compared with non‐Hispanic Whites (non‐Hispanic Black: aOR 1.45 95% CI 1.26–1.65, Hispanic: aOR 1.17 95% CI 0.96–1.41, other race/ethnicity: aOR 1.63 95% CI 1.26–2.09). Of the total effect of minoritized race and/or ethnicity on RBC transfusion, 13.9% was attributed to the indirect effect through preoperative anemia. Discussion: In this cohort study, patients from minoritized racial and ethnic groups received RBC transfusions at a higher rate than non‐Hispanic White patients, and the difference was partially mediated by preoperative anemia. Future efforts to minimize transfusions and improve health equity should target this modifiable risk factor alongside other sources of disparity and discrimination. [ABSTRACT FROM AUTHOR]

According to some philosophers, a sentence's semantics can fail to constitute a complete propositional content, imposing mere constraints on such a content. Recently, Daniel Harris has begun developing a formal constraint semantics. He claims that the semantic values of sentences constrain what speakers can literally say with them—and what hearers can know about what was said. However, that claim is undermined by his conception of semantics as the study of a psychological module. I argue instead that semantic constraints should be understood as properties of public languages. [ABSTRACT FROM AUTHOR]

Purpose: To quantify the magnitude and recovery of central and limbal corneal oedema induced by short‐term unilateral eyelid closure without contact lens wear. Methods: The left eye of 10 adults with healthy corneas was patched using a folded eye pad for 30 min. High‐resolution optical coherence tomography images (which captured the limbal and central corneal regions simultaneously) were obtained before patching, immediately after eye opening and again at 1, 2, 5, 6, 9, 10, 14 and 15 mins after eyelid opening. Oedema was measured from the limbus (scleral spur) to the central cornea (thinnest corneal location) along the horizontal meridian. Results: A greater amount of limbal oedema was noted (mean [SD] 3.84 [1.79] %) compared to the central cornea (2.48 [0.61] %; p = 0.04) after 30 mins of unilateral eyelid closure. Both central and limbal corneal oedema recovered rapidly following eyelid opening, with no significant differences in the rate of corneal recovery between corneal locations (p = 0.90). Conclusions: Short‐term unilateral eyelid closure resulted in ~55% more relative oedema in the limbal region compared to the central cornea. Rapid recovery of oedema and corneal overshoot (thinning beyond the baseline corneal thickness) was observed within 1–2 min of eyelid opening for both central and peripheral regions. [ABSTRACT FROM AUTHOR]

Purpose: To quantify the impact of varying central fluid reservoir depth, lens thickness/mass and the addition of a peripheral fenestration upon scleral lens centration. Methods: Ten young, healthy adults participated in a series of repeated‐measures experiments involving short‐term (90 min) open eye scleral lens wear. Scleral lens parameters (material, back optic zone radius, diameter, back vertex power and landing zone) were controlled across all experiments, and the central fluid reservoir depth (ranging from 144 to 726 μm), lens thickness (ranging from 150 to 1200 μm), lens mass (101–241 mg) and lens design (with or without a single 0.3 mm peripheral fenestration) were altered systematically. Scleral lens decentration was quantified using over‐topography maps. Results: On average, scleral lens centration varied by <0.10 mm over 90 min of wear. Medium and high initial fluid reservoir conditions resulted in 0.17 mm more temporal and 0.55 mm more inferior lens decentration, compared to the low fluid reservoir depth (p < 0.001). Changes in lens thickness or the addition of a peripheral fenestration did not cause clinically significant changes in centration (<0.10 mm on average) when controlling for fluid reservoir depth. Central fluid reservoir depth was the best predictor of horizontal and vertical lens decentration, explaining 62–73% of the observed variation, compared to 40–44% for lens thickness and mass. Conclusion: Scleral lens decentration remained relatively stable over 90 min of lens wear. A greater initial central fluid reservoir depth resulted in significantly more lens decentration, particularly inferiorly. Large variations in lens thickness, mass or the addition of a single peripheral fenestration did not substantially affect lens centration. [ABSTRACT FROM AUTHOR]

Introduction: Early parenting services in Australia offer brief structured residential programs to address moderate to severe non‐psychotic mental health problems among women and unsettled infant/toddler behaviours. The aims were to (1) estimate the immediate and medium‐term impact of a five‐night psychoeducational residential early parenting program on postpartum depressive symptoms and (2) identify the factors associated with improvement or worsening of postpartum depressive symptoms after completing the program and six weeks post‐discharge. Methods: Audit of routinely collected medical record data from pre‐admission, pre‐discharge and post‐discharge assessments of a consecutive cohort of women admitted, with their infants/toddlers in a 15‐month period to Masada Private Hospital Early Parenting Centre. Data included structured questions assessing: demographic characteristics, access to family and social support, past and current mental health problems, reproductive and obstetric health, chronic health conditions, breastfeeding problems, coincidental major life events, health risk behaviours and infant/toddler feeding, sleeping and crying behaviours. Standardised instruments included the Partner Interaction after Birth Scale (PIBS), the MacLean Screening Instrument for Borderline Personality Disorder (MSI‐BPD), Modified Fatigue Assessment Scale (FAS) and selected items from the Karitane Parenting Confidence Scale. The primary outcomes were Edinburgh Postnatal Depression Scale scores at pre‐discharge and follow up assessments. Data were analysed using multinomial logistic regression models in which individual and psychosocial characteristics at pre‐admission were included as predictors of the likelihood of the changes of the outcomes from pre‐admission to pre‐discharge and follow up. Results: Complete data from 1220 of 1290 (95%) eligible women were available to assess pre‐admission to pre‐discharge and from 559 (45.8%) to assess pre‐discharge to six‐week follow‐up changes. The mean pre‐admission EPDS score was 11.7 (95% CI: 11.5; 12.0), pre‐discharge it was 7.1 (95% CI: 6.9; 7.4) and at six‐week follow up it was 5.7 (95% CI: 5.3; 6.1). We found that almost all women experienced a clinically meaningful and rapid improvement in depressive symptoms of at least this magnitude (reduction in mean EPDS scores of 4.6 points from pre‐admission to pre‐discharge (five nights) and a further reduction of 1.2 points pre‐discharge to follow up) (six weeks) and we identified an interpretable set of risk factors for symptoms that did not improve or worsened. The adverse outcomes were associated with having symptoms of borderline personality disorder, a partner experienced as lacking kindness and care, coincidental adverse events and having a child younger than six months. Conclusion: Residential early parenting programs, which take a psycho‐educational approach to strengthening caregiving skills, maximising agency, and reducing helplessness, have a rapid beneficial effect on women's postpartum depressive symptoms. These programs provide a valuable and effective component of comprehensive mental health services. Long‐term dialectical behaviour therapy is indicated for women with borderline personality disorder traits for whom early parenting programs alone are insufficient to improve depressive symptoms. [ABSTRACT FROM AUTHOR]

Preeclampsia (PE) is characterized by de novo hypertension (HTN) and is often associated with intrauterine growth restriction (IUGR). Hallmarks of PE are placental ischemia, decreased nitric oxide (NO) bioavailability, oxidative stress (OS), and organ damage in the kidneys and brain. This study aims to characterize a new model of PE using pregnant IUGR rats from hypertensive placental ischemic dams. It is hypothesized that pregnant IUGR rats from hypertensive placental ischemic dams will have elevated blood pressure (BP), OS, and organ damage. In this study, pregnant rats are divided into two groups: normal pregnant (NP) and hypertensive placental ischemic dams (RUPP). Offspring from NP and RUPP dams were mated at 10 weeks of age to generate pregnant IUGR (IUGR Preg) and pregnant control (CON Preg) rats. BP and other markers of PE were evaluated during late gestation. Pregnant IUGR rats had elevated BP and systemic OS. The maternal body weight of pregnant IUGR rats and their pups' weights were decreased, while the brains were enlarged with elevated OS. In summary, pregnant IUGR rats, born from hypertensive placental ischemic dams, have HTN and increased systemic and brain OS, with larger brain sizes and smaller pups. Furthermore, this study shows that pregnant IUGR rats exhibit a preeclamptic‐like phenotype, suggesting a new epigenetic model of PE. [ABSTRACT FROM AUTHOR]

A major challenge to implementing effective soil health assessments is how to distinguish the effects of management from underlying soil variability driven by inherent soil properties. This challenge has important consequences for the use of soil health indicators as tools for monitoring and assessment because soil‐forming factors constrain the range of indicator values and the magnitude of management‐induced changes. Here, we present results from a statewide survey of 15 soil health indicators measured on 30 fields on commercial farms across four major land resource areas in Minnesota. Fields included in the study differed in tillage, cover crop implementation, and crop rotation. Within each field, we collected samples from upper and lower hillslope positions to quantify the effect of topography. We consistently detected differences in soil health indicators between regions (13/15 indicators) and hillslope positions (8/15 indicators). However, only wet aggregate stability was sensitive to management across regions and years, highlighting the importance of physical indicators of soil health. This result was surprising in light of existing literature supporting the sensitivity of many soil health indicators to management, but it is consistent with other studies conducted in high organic matter soils in the Upper US Midwest. Our results highlight the need for regionally representative datasets to guide the development of interpretations and benchmarks for soil health indicators. This is particularly important when soil health indicators are applied outside traditional research contexts (such as in commercial soil health testing), where interpretation must take place without the benefit of historical baseline data. [ABSTRACT FROM AUTHOR]

The average cost to bring a new drug from its initial discovery to a patient's bedside is estimated to surpass $2 billion and requires over a decade of research and development. There is a need for new drug screening technologies that can parse drug candidates with increased likelihood of clinical utility early in development in order to increase the cost‐effectiveness of this pipeline. For example, during the COVID‐19 pandemic, resources were rapidly mobilized to identify effective therapeutic treatments but many lead antiviral compounds failed to demonstrate efficacy when progressed to human trials. To address the lack of predictive preclinical drug screening tools, PREDICT96‐ALI, a high‐throughput (n = 96) microphysiological system (MPS) that recapitulates primary human tracheobronchial tissue,is adapted for the evaluation of differential antiviral efficacy of native SARS‐CoV‐2 variants of concern. Here, PREDICT96‐ALI resolves both the differential viral kinetics between variants and the efficacy of antiviral compounds over a range of drug doses. PREDICT96‐ALI is able to distinguish clinically efficacious antiviral therapies like remdesivir and nirmatrelvir from promising lead compounds that do not show clinical efficacy. Importantly, results from this proof‐of‐concept study track with known clinical outcomes, demonstrate the feasibility of this technology as a prognostic drug discovery tool. [ABSTRACT FROM AUTHOR]

The Apollo 16 regolith breccia sample suite provides a record of lunar regolith formation from the basin‐forming epoch (~3.9 Ga) through to a time of declining impactor flux (~2 Ga). These rocks have been characterized into three groups: the "ancient," "young," and "soil‐like" regolith breccias on the basis of their petrographic characteristics, and, in the case of the "ancient" and "young" regolith breccias, noble gas inventory. This study investigates the as‐yet unexamined noble gas records of the "soil‐like" regolith breccias to understand more recent regolith evolution processes that occurred at the Apollo 16 landing site. The range of gas concentrations measured for each noble gas in these samples is comparable to those previously reported for the local Apollo 16 soils. The "soil‐like" regolith breccias were found to be more gas rich than the gas poor "young" and "ancient" regolith breccias, consistent with them having formed from comparatively mature soil(s). Our results further confirm the scientific value of lunar regolith breccias and bulk regolith samples as probes of the impact history and the space environment of the lunar surface across a wide range of time. [ABSTRACT FROM AUTHOR]

Background: In many centers, pediatric radiology‐performed ultrasound and/or POCUS fellowship training are not readily available. Objective: To present our experience using point of care ultrasound (POCUS) in a pediatric emergency medicine training program without POCUS fellowship‐trained staff, and to demonstrate that POCUS of the appendix is feasible outside the context for POCUS fellowship training. Methods: We identified children diagnosed with appendicitis or periappendiceal abscess from June 2016 to June 2024. Variables reviewed include details of PED visit such as presenting symptoms, laboratory and imaging results, and PED treatment, as well as surgical report and pathology result. We evaluated the frequency and performance characteristics of POCUS over the study period. Results: 999 children were diagnosed with appendicitis. POCUS was performed in 360 of 845 cases (43%) of histology‐confirmed appendicitis and in 19 of 69 cases (28%) in which histology was negative for appendicitis. Both the number of POCUS examinations for appendicitis and the percentage of examinations correctly identifying appendicitis steadily increased over the study period. Accuracy was highest in the 5–10‐year age range and lowest for females from 10 to 15 years. In 96% of cases with a pathology result of appendicitis and a positive POCUS examination, POCUS correctly identified appendicitis. However, only 6 of 19 POCUS examinations in children without appendicitis on histology found no appendicitis. Performance of POCUS for appendicitis was significantly associated with increased opioid administration and a 20‐min mean decrease in length of pediatric emergency department stay. Conclusions: POCUS for appendicitis within the context of PEM fellowship training is feasible and associated with decreased length of stay. [ABSTRACT FROM AUTHOR]

Attention‐deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with lifelong impairments. ADHD‐related behaviors have been observed as early as toddlerhood for children who later develop ADHD. Children with ADHD have disrupted connectivity in neural circuitry involved in executive control of attention, including the prefrontal cortex (PFC) and dorsal attention network (DAN). It is not known if these alterations in connectivity can be identified before the onset of ADHD. Children (N = 51) 1.5–3 years old were assessed using functional near‐infrared spectroscopy while engaging with a book. The relation between mother‐reported ADHD‐related behaviors and neural connectivity, computed using robust innovation‐based correlation, was examined. Task engagement was high across the sample and unrelated to ADHD‐related behaviors. Observed attention was associated with greater connectivity between the right lateral PFC and the right temporal parietal junction (TPJ). Children with greater ADHD‐related behaviors had greater frontoparietal connectivity, particularly between the PFC bilaterally and the right TPJ. Toddlers at risk for developing ADHD may require increased frontoparietal connectivity to sustain attention. Future work is needed to examine early interventions that enhance developing attention and their effect on neural connectivity between the PFC and attention networks. [ABSTRACT FROM AUTHOR]

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Background: When unaddressed, contamination in child maltreatment research, in which some proportion of children recruited for a nonmaltreated comparison group are exposed to maltreatment, downwardly biases the significance and magnitude of effect size estimates. This study extends previous contamination research by investigating how a dual‐measurement strategy of detecting and controlling contamination impacts causal effect size estimates of child behavior problems. Methods: This study included 634 children from the LONGSCAN study with 63 cases of confirmed child maltreatment after age 8 and 571 cases without confirmed child maltreatment. Confirmed child maltreatment and internalizing and externalizing behaviors were recorded every 2 years between ages 4 and 16. Contamination in the nonmaltreated comparison group was identified and controlled by either a prospective self‐report assessment at ages 12, 14, and 16 or by a one‐time retrospective self‐report assessment at age 18. Synthetic control methods were used to establish causal effects and quantify the impact of contamination when it was not controlled, when it was controlled for by prospective self‐reports, and when it was controlled for by retrospective self‐reports. Results: Rates of contamination ranged from 62% to 67%. Without controlling for contamination, causal effect size estimates for internalizing behaviors were not statistically significant. Causal effects only became statistically significant after controlling contamination identified from either prospective or retrospective reports and effect sizes increased by between 17% and 54%. Controlling contamination had a smaller impact on effect size increases for externalizing behaviors but did produce a statistically significant overall effect, relative to the model ignoring contamination, when prospective methods were used. Conclusions: The presence of contamination in a nonmaltreated comparison group can underestimate the magnitude and statistical significance of causal effect size estimates, especially when investigating internalizing behavior problems. Addressing contamination can facilitate the replication of results across studies. [ABSTRACT FROM AUTHOR]

Understanding tree transpiration variability is vital for assessing ecosystem water‐use efficiency and forest health amid climate change, yet most landscape‐level measurements do not differentiate individual trees. Using canopy temperature data from thermal cameras, we estimated the transpiration rates of individual trees at Harvard Forest and Niwot Ridge. PT‐JPL model was used to derive latent heat flux from thermal images at the canopy‐level, showing strong agreement with tower measurements (R2 = 0.70–0.96 at Niwot, 0.59–0.78 at Harvard at half‐hourly to monthly scales) and daily RMSE of 33.5 W/m2 (Niwot) and 52.8 W/m2 (Harvard). Tree‐level analysis revealed species‐specific responses to drought, with lodgepole pine exhibiting greater tolerance than Engelmann spruce at Niwot and red oak showing heightened resistance than red maple at Harvard. These findings show how ecophysiological differences between species result in varying responses to drought and demonstrate that these responses can be characterized by deriving transpiration from crown temperature measurements. Plain Language Summary: Understanding how forests use water, especially during droughts, is crucial for a changing climate. We developed a method using thermal cameras to estimate individual tree water loss (transpiration), something traditional methods lack. These cameras capture temperature data from the tree crown, which is then used to estimate transpiration rates. Tests in two forests showed this method aligns well with existing water use measurements. The study also revealed fascinating differences in how species handle drought. For instance, lodgepole pine outperformed Engelmann spruce in one forest, while red oak proved more resistant than red maple in the other. This shows that the thermal cameras can help assess how different trees resist drought conditions. This thermal camera technique has the potential to become a valuable tool for monitoring forest health as our climate evolves. Key Points: Canopy‐level evapotranspiration derived from thermal cameras agreed well with eddy covariance measurementsCrown temperature measurements facilitated the estimation of individual‐tree transpiration of co‐occurring species using the same approachThe results show interspecific differences in water use and response to drought that align with species traits [ABSTRACT FROM AUTHOR]

Social theory plays an important role in the nursing discipline and nursing inquiry as it helps conceptually embed nursing in the larger picture of the social world. For example, a broad category of critical theory provides a unique lens for uncovering social conditions of inequity and oppression. Among the sociological theories, actor‐network theory (ANT) is an approach to research and analysis that has recently gained interest among nurse philosophers and researchers. Studies guided by ANT seek to understand phenomena of interest as constituted within the relationships between human and nonhuman actors to understand how care practices are co‐created/enacted and how they can be made more humane. In this paper, we describe the benefits of ANT for examining healthcare access for incarcerated individuals with life‐limiting illnesses accessing palliative care and for people using illicit drugs. We argue that attention to the materiality of care practices can contribute to efforts of advancing health equity for these groups. [ABSTRACT FROM AUTHOR]

We are still largely reliant on pesticides for the suppression of arthropod pests which threaten human health and food production, but the recent rise of evolved resistance among important pest species has reduced pesticide efficacy. Despite this, our understanding of strategies that effectively limit the evolution of resistance remains weak. Male‐killing sex ratio distorting microbes (SRDMs), such as Wolbachia and Spiroplasma, are common among arthropod species. Previous theoretical work has suggested that they could limit adaptive potential in two ways: first, because by distorting sex ratios they reduce the effective population size, and second, because infected females produce no male offspring which restricts gene flow. Here we present the results of a novel experiment in which we test the extent by which these two mechanisms limit the adaptive response of arthropods to pesticide. Using a fully factorial design, we manipulated the adult sex ratio of laboratory populations of Drosophila melanogaster, both in the presence and absence of SRDMs, and exposed these populations to six generations of pesticide poisoning. This design allows the effects of SRDMs on sex ratio and their effects on gene flow to be estimated separately. After six generations, individuals from populations with even sex ratios displayed a higher resistance to pesticide relative to individuals from female‐biased populations. By contrast, we found no effect of the presence of SRDMs in host populations on pesticide resistance independent of sex ratio. In addition, males were more susceptible to pesticide than females—this was true of flies from both naïve and previously exposed populations. These findings provide the first empirical proof of concept that sex ratio distortion arising from SRDMs can limit adaptation to pesticides, but cast doubt on the theoretical effect of male‐killers limiting adaptation by disrupting gene flow. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety and depression in older adults (60+ years of age) are under‐diagnosed and under‐treated. Older adults are less likely to seek help for these problems due to a lack of awareness, difficulty accessing health care due to availability or disability and fear of loss of independence. Existing points of contact between older adults and non‐traditional services, for example, the Fire and Rescue Service (FRS), could provide opportunities to support help‐seeking for mental ill‐health. The FRS conduct Home Fire Safety Visits (HFSVs) with older adults and are well positioned to provide health‐related support. This study examines a range of perspectives on the potential role of the FRS in the identification of, and signposting for, anxiety and depression in older adults. Methods: This was a qualitative study carried out using mixed methods in West Midlands, UK. Semi‐structured interviews were conducted with older adults and health and social care providers (practitioners, managers, commissioners) to explore the acceptability of the FRS expanding its role to detect and signpost for anxiety and depression in older adults. Observations examined delivery of existing HFSVs to older adults. Data were combined and analysed using a reflexive thematic approach. Results: Eighteen health and social care providers and 8 older adults were interviewed; 10 HFSVs were observed. Two overarching themes were identified: (1) Potential role for the FRS and (2) Operationalising identification of mental health problems by FRS. Interviews and observations demonstrated how HFSVs offer a suitable opportunity to start conversations about mental health. All interview participants felt that although the FRS would be well placed to deliver an intervention, they would require training, support and a referral pathway co‐produced with and supported by health and social care partners. Conclusion: A whole‐system approach is needed if the FRS are to expand HFSVs to identify mental health problems in older adults and provide signposting to appropriate services. Patient or Public Contribution: J.S. is a public co‐investigator. A Patient Advisory Group contributed to the initial funding application, design and conduct of the study, including data analysis and advice on dissemination. [ABSTRACT FROM AUTHOR]

Generation X often receives less attention in generational analysis due to its perceived lack of distinctiveness compared to preceding and succeeding generations in the contemporary United States. Politically, there is little justification for distinguishing Generation X as it is commonly defined, yet it harbors significant political divergence between its older and younger cohorts. In terms of partisanship, ideology, and public policy preferences, Generation X is markedly divided, essentially comprising two distinct political generations. Generation X can thus be viewed as the in‐between generation representing the political dividing line between young and old. The dividing point is the birth year of 1973. Due to the considerable differences in the political climate during their formative years, those Gen Xers born before 1973 lean considerably more conservative and Republican than those born in 1973 and afterward. Related Articles: Fisher, Patrick. 2020. "Generational Replacement and the Impending Transformation of the American Electorate." Politics & Policy 48(1): 38–68. https://doi.org/10.1111/polp.12340. Shaykhutdinov, Renat. 2019. "Socialization, Rationality, and Age: Generational Gaps and the Attitudes toward the Chechen War in Russia." Politics & Policy 47(5): 931–55. https://doi.org/10.1111/polp.12323. Stockemer, Daniel. 2016. "Is the Turnout Function in Democracies and Nondemocracies Alike or Different?" Politics & Policy 44(5): 889–915. https://doi.org/10.1111/polp.12174. [ABSTRACT FROM AUTHOR]

The current study examined the Cognitive Interview (CI) for eliciting information about an overheard conversation (planning a future crime). Interviews were conducted either in‐person or via telephone. The CI elicited more information, and at a comparable accuracy level, in comparison to a structured interview (SI). The efficacy of the CI was not significantly influenced by whether the interview was conducted in‐person or via telephone. It took more time to conduct the CI than the SI. Finally, various measures of efficiency showed that the CI was as or more efficient than the SI. Suggestions are offered about adapting the CI for telephone interviews. [ABSTRACT FROM AUTHOR]

Posttransplantation primary cutaneous T‐cell lymphomas (PT‐CTCL) are a rare complication of sustained immunosuppression in the posttransplant setting. When present, PT‐CTCLs are typically EBV− and exhibit features of mycosis fungoides/Sézary syndrome or CD30+ lymphoproliferative disorders. We present a case of a 75‐year‐old individual who developed skin lesions 30 years after liver transplantation. Pathologic evaluation of the skin biopsy revealed involvement by a clonal, EBV+ T‐cell population of gamma/delta lineage with no evidence of systemic disease. Comprehensive genomic profiling was performed, confirming focal one‐copy loss of 6q23.3, altogether consistent with the extremely rare and unusual diagnosis of primary cutaneous EBV+ extranodal NK/T‐cell lymphoma of gamma/delta T‐cell lineage in the posttransplantation setting. [ABSTRACT FROM AUTHOR]

Issue Addressed: Women from refugee backgrounds have poorer health outcomes than host country populations. People from Myanmar, most of whom are from the Karen ethnic minority constitute one of the largest groups of humanitarian visa entrants to Australia since 2015. Barriers to and enablers of preventive sexual and reproductive health (SRH) for this group of women are poorly understood. The objective is to establish the preventive SRH care needs and experiences of Karen women from refugee backgrounds living in Australia. Methods: A qualitative study using semi‐structured interviews was conducted with a purposive sample of Karen women. A bi‐cultural worker assisted in recruitment and interpreting during data collection. All interviews were conducted in Karen language with a bi‐cultural worker interpreting into English during the interview. Audio recordings of English dialogue were transcribed verbatim. Thematic analysis was used to analyse and report data. Results: Thirteen women were interviewed. Five major themes were identified: (1) prevention awareness including lack of access to education and knowledge of services pre‐arrival; appreciation of the new health system; limited vaccination knowledge, (2) perceived need for prevention including consequences of not screening; health care provider (HCP) attendance, (3) health information seeking including providing a comprehensive approach to information delivery; trusted sources of information, (4) barriers including missed opportunities; communication, language, illiteracy; lack of continuity of care and, (5) enablers including HCP' characteristics; peer support and individual responsibility. Conclusion: Findings from this study indicate that to improve access to preventive SRH services a multi‐component strategy is needed. Provision of preventive SRH information using a multi‐pronged approach; peer and community support interventions; and HCPs offering services and information opportunistically would benefit Karen women unfamiliar with preventive SRH care. So What?: Primary prevention services and education codesigned with community members may be effective in improving Karen women's access to SRH care. [ABSTRACT FROM AUTHOR]

Baraitser–Winter cerebrofrontofacial syndrome (BWCFF) is a variable multiple congenital anomaly condition, typically presenting postnatally with neurocognitive delays, distinctive facial features, cortical brain malformations, and in some, a variety of additional congenital malformations. However, only a few cases have reported the prenatal presentation of this syndrome. Here, we report two cases of BWCFF and their associated prenatal findings. One case presented with non‐immune hydrops fetalis and a horseshoe kidney and was found to have a de novo heterozygous variant in ACTB (c.158A>G). The second case presented with gastroschisis, bilateral cleft lip and palate, and oligohydramnios, and was found to harbor a different de novo variant in ACTB (c.826G>A). Limited reports exist describing prenatally identified anomalies that include fetal growth restriction, increased nuchal fold, bilateral hydronephrosis, rocker bottom foot, talipes, cystic hygroma, omphalocele, and hydrops fetalis. In addition, only three of these cases have included detailed prenatal imaging findings. The two prenatal cases presented here demonstrate an expansion of the prenatal phenotype of BWCFF to include gastroschisis, lymphatic involvement, and oligohydramnios, which should each warrant consideration of this diagnosis in the setting of additional anomalies. [ABSTRACT FROM AUTHOR]

Seasonal variability in environmental conditions is a strong determinant of animal migrations, but warming temperatures associated with climate change are anticipated to alter this phenomenon with unknown consequences.We used a 40‐year fishery‐independent survey to assess how a changing climate has altered the migration timing, duration and first‐year survival of juvenile bull sharks (Carcharhinus leucas).From 1982 to 2021, estuaries in the western Gulf of Mexico (Texas) experienced a mean increase of 1.55°C in autumn water temperatures, and delays in autumn cold fronts by ca. 0.5 days per year. Bull shark migrations in more northern estuaries concomitantly changed, with departures 25–36 days later in 2021 than in 1982. Later, migrations resulted in reduced overwintering durations by up to 81 days, and the relative abundance of post‐overwintering age 0–1 sharks increased by >50% during the 40‐year study period.Yet, reductions in prey availability were the most influential factor delaying migrations. Juvenile sharks remained in natal estuaries longer when prey were less abundant. Long‐term declines in prey reportedly occurred due to reduced spawning success associated with climate change based on published reports. Consequently, warming waters likely enabled and indirectly caused the observed changes in shark migratory behaviour.As water temperatures continue to rise, bull sharks in the north‐western Gulf of Mexico could forgo their winter migrations in the next 50–100 years based on current trends and physiological limits, thereby altering their ecological roles in estuarine ecosystems and recruitment into the adult population. It is unclear if estuarine food webs will be able to support changing residency patterns as climate change affects the spawning success of forage species.We expect these trends are not unique to the western Gulf of Mexico or bull sharks, and migratory patterns of predators in subtropical latitudes are similarly changing at a global scale. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences (ACEs) are well‐established risk factors for self‐harm and depression. However, despite their high comorbidity, there has been little focus on the impact of developmental timing and the duration of exposure to ACEs on co‐occurring self‐harm and depression. Methods: Data were utilised from over 22,000 children and adolescents participating in three UK cohorts, followed up longitudinally for 14–18 years: the Avon Longitudinal Study of Parents and Children (ALSPAC), the Millennium Cohort Study (MCS) and the Environmental Risk (E‐Risk) Longitudinal Twin Study. Multinomial logistic regression models estimated associations between each ACE type and a four‐category outcome: no self‐harm or depression, self‐harm alone, depression alone and self‐harm with co‐occurring depression. A structured life course modelling approach was used to examine whether the accumulation (duration) of exposure to each ACE, or a critical period (timing of ACEs) had the strongest effects on self‐harm and depression in adolescence. Results: The majority of ACEs were associated with co‐occurring self‐harm and depression, with consistent findings across cohorts. The importance of timing and duration of ACEs differed across ACEs and across cohorts. For parental mental health problems, longer duration of exposure was strongly associated with co‐occurring self‐harm and depression in both ALSPAC (adjusted OR: 1.18, 95% CI: 1.10–1.25) and MCS (1.18, 1.11–1.26) cohorts. For other ACEs in ALSPAC, exposure in middle childhood was most strongly associated with co‐occurring self‐harm and depression, and ACE occurrence in early childhood and adolescence was more important in the MCS. Conclusions: Efforts to mitigate the impact of ACEs should start in early life with continued support throughout childhood, to prevent long‐term exposure to ACEs contributing to risk of self‐harm and depression in adolescence. [ABSTRACT FROM AUTHOR]

Terrestrial evapotranspiration is the second‐largest component of the land water cycle, linking the water, energy, and carbon cycles and influencing the productivity and health of ecosystems. The dynamics of ET across a spectrum of spatiotemporal scales and their controls remain an active focus of research across different science disciplines. Here, we provide an overview of the current state of ET science across in situ measurements, partitioning of ET, and remote sensing, and discuss how different approaches complement one another based on their advantages and shortcomings. We aim to facilitate collaboration among a cross‐disciplinary group of ET scientists to overcome the challenges identified in this paper and ultimately advance our integrated understanding of ET. Key Points: The main challenge in ET science is reconciling spatial data with point data from various sources across heterogeneous areasEach of the three general approaches to ET science (in situ measurements, partitioning, remote sensing) has strengths and weaknessesCommunication and translation across these disciplines are key to closing the gaps [ABSTRACT FROM AUTHOR]

This article highlights the work of Martin C. Mihm, MD, in the field of pediatric dermatology, specifically his contributions to caring for children with birthmarks and vascular anomalies. It focuses on a project that aimed to develop mouse models for testing strategies to treat giant congenital melanocytic nevi (GCMN) without surgery. Mihm's expertise as a dermatopathologist and his dedication to helping children made him an invaluable collaborator on this project. The article also discusses the establishment of clinics and enhanced therapies for children with GCMNs, as well as the research conducted using genetically engineered mouse models. Overall, Mihm's passion and expertise greatly contributed to the success of this project. [Extracted from the article]

Introduction Methods Results Conclusion The COVID‐19 pandemic challenged primary care to rapidly innovate. In response, the Western Victorian Primary Health Network (WVPHN) developed a COVID‐19 online Community of Practice comprising general practitioners (GPs), practice nurses, pharmacists, aged care and disability workers, health administrators, public health experts, medical specialists, and consumers. This Experience Report describes our progress toward a durable organizational learning health system (LHS) model through the COVID‐19 pandemic crisis and beyond.In March 2020, we commenced weekly Community of Practice sessions, adopting the Project ECHO (Extension of Community Health Outcomes) model for a virtual information‐sharing network that aims to bring clinicians together to develop collective knowledge. Our work was underpinned by the LHS framework proposed by Menear et al. and aligned with Kotter's eight‐step change model.There were four key phases in the development of our LHS: build a Community of Practice; facilitate iterative change; develop supportive organizational infrastructure; and establish a sustainable, ongoing LHS. In total, the Community of Practice supported 83 unique COVID‐19 ECHO sessions involving 3192 h of clinician participation and over 10 000 h of organizational commitment. Six larger sessions were run between March 2020 and September 2022 with 3192 attendances. New models of care and care pathways were codeveloped in sessions and network leaders contributed to the development of guidelines and policy advice. These innovations enabled WVPHN to lead the Australian state of Victoria on rates of COVID vaccine uptake and GP antiviral prescribing.The COVID‐19 pandemic created a sense of urgency that helped stimulate a regional primary care‐based Community of Practice and LHS. A robust theoretical framework and established change management theory supported the purposeful implementation of our LHS. Reflection on challenges and successes may provide insights to support the implementation of LHS models in other primary care settings. [ABSTRACT FROM AUTHOR]

Solid‐state electrolytes (SSEs) are key to unlocking the potential of lithium metal batteries (LMBs), but their high thickness (>100 µm) due to poor mechanical properties limits energy density improvements. Herein, an ultrathin (≈5 µm) polymer SSE with a high Young's modulus (10.6 GPa), made from a polyvinylidene fluoride‐hexafluoropropylene (PVDF‐HFP) matrix and an ethylene diamine tetraacetic acid (EDTA) additive is proposed. By virtue of the electron‐donating property, EDTA induces the conformation transformation of PVDF‐HFP, enhancing the mechanical strength by a fine‐grain strengthening mechanism. In addition, PVDF‐HFP with cis‐conformation shortens the pathway for Li+, promotes the Li+ dissociation and immobilizes the anions of lithium salt, thus increasing the ionic conductivity (2.47 × 10−4 S cm−1) and transfer number (0.59) of the electrolyte. Moreover, the electrolyte also possesses a wide voltage window (4.7 V) and good heat/flame resistance. The half cells and full cells with the electrolytes show good cycling and rate performance. Notably, a pouch cell based on the electrolyte exhibits impressive energy densities of 516 Wh kg−1 and 1520 Wh L−1 (excluding packages), showing great potential for practical use in LMBs. [ABSTRACT FROM AUTHOR]

Intra‐operative duplex ultrasound in renal transplantation was first described in 1998 and whilst reported in problematic cases, there are few reports of its routine use and no current published protocols. Since 2013, we have used intra‐operative ultrasound in all renal transplants. The formal protocol used since August 2020 is presented as a reference document for other transplant centres. A Canon Aplio 800 ultrasound system with an i22LH8 hockey‐stick transducer is used to image the renal cortex and major vessels, and an i8CX1 matrix transducer to image the graft during and after fascial closure. These transducers are fully sterilised with Sterrad and no sheathing of transducers is required. The transplant surgeon scans within the sterile field with the sonographer guiding imaging and adjusting machine settings. Ultrasound findings are discussed between team members including any requirement for interventions. Ultrasound is performed at three stages of the operation: Stage 1: after clamp release identifying issues of graft vascularity including otherwise unrecognised major vessel and anastomotic abnormalities. Stage 2: following ureteric implantation identifying compromised perfusion due to graft rotation or vessel kinking. Stage 3: after fascial closure identifying compromised perfusion due to external compression. Post‐operative scanning, including assessment of the collecting system and bladder, is performed routinely on days 1, 3, 7 and 30. The intervention is effective with no early graft losses or peri‐operative vascular thromboses. The requirements for service provision are significant including the availability of additional transducers, and sonographers with expertise in intra‐operative scanning able to attend after‐hours for extended periods. [ABSTRACT FROM AUTHOR]

People with disability are at heightened risk of violence, abuse, neglect and exploitation (VANE) with policy geared towards responding to and eliminating VANE harm. Yet not all harm experienced by people with disability is captured within the VANE harm. Many people also experience harm in everyday interactions that leave them feeling uncomfortable, devalued, disrespected, threatened or silenced. Our multi‐method study begins with the term 'everyday harm' to describe these subtle, difficult‐to‐define and easily overlooked experiences, with the proviso that a more appropriate vocabulary may emerge from subsequent fieldwork. This article presents the results of a policy review about the representation of everyday harm between people with disability and paid support workers in disability policies. Results show that everyday harm is acknowledged in some disability policies. However, this acknowledgement is neither consistent nor comprehensive and policies do not consider the cumulative impact of everyday harm nor the subjective experience of harm. This review suggests a gap in conceptualising this type of harm and having a vocabulary that people with disability, support workers and organisations can use to acknowledge, name and, ultimately, prevent this form of harm. Empirical research about their experience of everyday harm is needed to address this gap. [ABSTRACT FROM AUTHOR]

Purpose: Long COVID is a global health concern which has debilitating effects on the individual experiencing it. In the United Kingdom, psychological therapies are being offered to people with long COVID, although the evidence for these therapies is yet to be demonstrated. This research aimed to understand how therapists and clients define and understand recovery from long COVID, and use hope theory to interpret the results. Methods: An online Q‐methodology was employed, where participants sorted a range of statements pertaining to long COVID recovery based on their level of agreement with them. These arranged statements (Q‐sorts) were collated and factor analysed to explore and compare underlying perspectives. Results: Sixteen participants were recruited for the study, including eleven clients, four IAPT therapists and one therapist working in the broader long COVID pathway. A four‐factor model is reported, including (1) Psychological Pathways to Recovery, (2) Social Context and Agency, (3) Physiological Goals of Recovery and (4) Personal Meaning Making. All IAPT therapists loaded onto the psychological pathways factor, whereas the remaining participants shared more diverse perspectives. Conclusions: The belief that long COVID recovery was possible, taken as an indicator of hopefulness, was rated highest for Factor 1, Psychological Pathways to Recovery, and Factor 3, Physiological Recovery Goals. This suggested that having a clear definition of recovery, or clear guidance on how to intervene, promoted hopefulness and, theoretically, well‐being. However, clients reported experiences of being invalidated and disbelieved by health professionals, with psychological explanations sometimes being experienced as dismissive and invalidating. Clinical implications and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Rationale: The Black, Indigenous, and People of Colour populations in the United States are disproportionately affected by the emerging health threat SARS‐CoV‐2, which causes COVID‐19. Aims and Objectives: This paper aims to demonstrate the usefulness of critical systems thinking by using scenario planning based on epidemiological data and tying epidemiology with soft systems methodology to investigate COVID‐19 disparities among disproportionately affected Black, Indigenous, and People of Colour populations. Methods: Using a review of the COVID‐19 literature and publicly available US COVID‐19 data, critical systems thinking is applied in a scenario planning example and a call to link soft systems methodology with epidemiology. Results: According to the four plausible Endgame scenarios, levels of community transmission as well as the current state transmission are based on the driving forces of the scenarios. In addition, soft systems methodology explores the effect on stakeholders and strengthens the picture of disease burden beyond sole reliance on traditional data sources. Conclusion: This analysis underscores employing critical systems thinking to critically assess diverse methods appropriate for the ongoing complexity of global crises. It is argued that critically engaged subjectivity should be given space alongside data‐dependent objectivity. COVID‐19 disparities are reliant on the social determinants of health's effects as driving forces on disease transmission in Black, Indigenous, and People of Colour populations. It is moreover argued that critical systems thinking is demonstrated by linking epidemiological evidence with scenario planning and soft systems methodology. This in turn supports a critical systems thinking approach to uncover the state of health disparities among minoritized communities under COVID‐19. [ABSTRACT FROM AUTHOR]

Compound effects of anthropogenic disturbances on wildlife emerge through a complex network of direct responses and species interactions. Land‐use changes driven by energy and forestry industries are known to disrupt predator–prey dynamics in boreal ecosystems, yet how these disturbance effects propagate across mammal communities remains uncertain. Using structural equation modeling, we tested disturbance‐mediated pathways governing the spatial structure of multipredator multiprey boreal mammal networks across a landscape‐scale disturbance gradient within Canada's Athabasca oil sands region. Linear disturbances had pervasive direct effects, increasing site use for all focal species, except black bears and threatened caribou, in at least one landscape. Conversely, block (polygonal) disturbance effects were negative but less common. Indirect disturbance effects were widespread and mediated by caribou avoidance of wolves, tracking of primary prey by subordinate predators, and intraguild dependencies among predators and large prey. Context‐dependent responses to linear disturbances were most common among prey and within the landscape with intermediate disturbance. Our research suggests that industrial disturbances directly affect a suite of boreal mammals by altering forage availability and movement, leading to indirect effects across a range of interacting predators and prey, including the keystone snowshoe hare. The complexity of network‐level direct and indirect disturbance effects reinforces calls for increased investment in addressing habitat degradation as the root cause of threatened species declines and broader ecosystem change. [ABSTRACT FROM AUTHOR]

A multi‐year review of process safety event learning data revealed that procedure usability and human factors were leading the trends of performance deviations by front‐line personnel. These insights prompted an enterprise‐wide Agile project to build capability focused on effective written guidance using science‐based tools and advanced error reduction techniques. Application of the Agile methodology was critical to gaining stakeholder commitment and establishing a comprehensive procedure integrity lifecycle to drive continuous improvement. Chemours partnered with an external consultant to create a holistic framework applicable to vital process safety roles with an orientation toward operational excellence. We share preliminary learnings and best practices leveraged from the nuclear industry, including systemic drivers to procedural deviations, the "top five error drivers" in written guidance, human performance modes (mental models), and key principles to enable human reliability. [ABSTRACT FROM AUTHOR]

Objective: To describe the association between prenatal imaging and neurodevelopmental outcomes of fetuses with rhombencephalosynapsis (RES). Study design: Thirty‐four pregnancies complicated by RES were identified from our institutional databases based on US and/or MRI findings. Genetic testing results were gathered. In cases of termination of pregnancy, we studied the association between prenatal imaging and neuropathologic findings. For those who opted for expectant management, comprehensive developmental assessments and postnatal MRI imaging were evaluated. Results: Over one third of fetuses in our cohort had complete RES. Common intracranial anomalies identified were mesencephalosynapsis, aqueduct stenosis and diencephalosynapsis. The degree of RES was not associated with the frequency of additional central nervous system anomalies. MRI had a good correlation with neuropathologic findings with regard to the degree of RES, aqueduct stenosis and mesencephalosynapsis. Postmortem autopsy showed that one third of our cases had VACTERL‐H and almost all of those had complete RES. All liveborn neonates(n = 6) had aqueduct stenosis requiring ventriculoperitoneal shunting within days of delivery (median 5 days). While a large proportion of prenatally suspected complete RES were found to have partial RES on postnatal imaging, prenatal diagnosis of aqueduct stenosis remained unchanged. All children that were at least 2 years old (n = 3) had global developmental delay. Conclusion: Prenatal assessment of the RES severity is challenging and may be unreliable. Nevertheless, postnatal prognosis is poor for both complete and partial RES. Associated aqueductal stenosis, can be reliably assessed prenatally and this may contribute to worse postnatal prognosis than the degree of RES. Key points: What is already known about this topic?Rhombencephalosynapsis (RES) is a rare cerebellar abnormality which is characterized by midline fusion of the hemispheres with partial or complete loss of the vermis.Assessing the severity of RES postnatally is important as children with complete RES exhibit overall poorer outcomes than those with partial RES. What does this study add?A large proportion of prenatally suspected complete RES were found to have partial RES on postnatal imaging (80%).Precise assessment of the degree of RES prenatally is challenging and may be unreliable. However, associated anomalies, especially aqueduct stenosis, can be reliably assessed prenatally.Regardless of the imaging severity of RES, all neonates with associated aqueductal stenosis required ventriculoperitoneal shunting in the first month of life and exhibited global developmental delay at 2 years of age. [ABSTRACT FROM AUTHOR]

This study considers the relative benefits for vocabulary learning of exposure to two types of texts—literary or nonliterary—used with two teaching approaches. These approaches were termed functional and creative, respectively. In the former, learners' attention was drawn to factual information and linguistic features in order to develop their linguistic knowledge. In the latter, the aim was to stimulate learners' personal and emotional response, by drawing their attention to the text's emotional content and how language was used to express meaning. We analyzed data from 160 learners of French in eight schools in England. Learners in four schools studied French poems and those in another four studied French factual texts. Teachers in each text condition employed functional and creative methods of exploitation within a counterbalanced design. We assessed two types of vocabulary knowledge at pre‐ and posttest: meaning recall of vocabulary contained in the texts, and learners' general vocabulary size. Our results indicated learning gains across both text types. There were, however, important interactions between text type and teaching approach and between text type and the order in which the teaching approaches were used. Finally, we consider the implications of these findings for understanding of vocabulary learning through literature and for classroom practice. [ABSTRACT FROM AUTHOR]

Substantiated incidents of poor welfare affecting cattle, sheep and goats (livestock) in non‐dairy extensive farming systems continue to occur. This study sought to describe the common causes of poor welfare of livestock and the associated circumstances, by analysing 39 years of de‐identified, livestock welfare investigation records. There were a total of 2179 alleged offenders (AOff), defined as individual/s that had an incident of poor welfare affecting livestock on at least one occasion. Approximately 27% of AOff were found to have poor welfare on more than one occasion. The majority of livestock welfare incidents were associated with neglect, more specifically, inadequate nutrition (56%), treatment (65%) and management/husbandry (83%). Records of malicious acts were rare (1%). In the analysis, cases were allocated to 10 animal welfare severity categories (AWSC) based on the number of incidents and visits, whether the AOff reoffended, or if the incident was ongoing and whether the welfare issue was likely to affect the whole herd. A significantly higher proportion of cases in the most severe AWSC had a failure to shear, mark, dip/drench, draft and wean/cull, were overstocked or were not providing proper and sufficient feed, compared to the least severe AWSC (P ≤ 0.05). Reoffending was significantly more likely when animals were found to be injured/unwell, recumbent, stuck in mud/yard/pen or in poor body condition, or when there was a failure to wean/cull, mark, dip/drench and draft. Some of the issues identified here may be risk factors more commonly identified on farms with poor livestock welfare. [ABSTRACT FROM AUTHOR]

Moose (Alces alces) and woodland caribou (Ranger tarandus caribou) are the 2 large prey species for wolves (Canis lupus) in the Nearctic boreal forest in North America. Caribou have declined, with widespread anthropogenic disturbance as the ultimate cause and wolf predation as the proximal cause. To conserve caribou the government of Alberta, Canada initiated a wolf control program to reduce predation rates on caribou populations and contribute to caribou population recovery. Predators play an important role in shaping the structure and function of ecosystems through top‐down forces. We hypothesized that the strongest factors influencing moose occurrences would reflect changes in predation risk before and after the onset of wolf control. We weighed evidence for competing hypothesis by deploying cameras across a highly industrialized landscape in Alberta for 3 years after wolf control (2017–2020), capitalizing on 3 years of existing data before the onset of wolf control (2011–2014). We created generalized linear models representing competing hypotheses about moose response to natural and anthropogenic landscape features before and after wolf control, examining support for each in an information‐theoretic framework. Prior to wolf control, the model containing landscape features providing security cover was best‐supported, but this was scale‐dependent. After wolf control, the model containing landscape features that offer increased forage opportunities was best‐supported. Unexpectedly, the direction of effect was often opposite to predictions, with moose avoiding some features thought to provide security and forage. We demonstrate that lethal predator control affects the spatial distribution of its primary prey species but in ways we do not fully comprehend, highlighting the need for a better understanding of community dynamics following wolf control. [ABSTRACT FROM AUTHOR]

This case report describes an immune-mediated haemolytic anaemia associated with a well-differentiated hepatocellular carcinoma in a male neutered Rhodesian ridgeback. Initial presentation at the referring veterinary practice was for acute lethargy, anorexia and possible melaena. Immunosuppressive therapy was started, but the dog was later referred due to glucocorticoid adverse effects and worsening anaemia. Upon referral, a mild, macrocytic, normochromic, regenerative anaemia was seen, with positive in-saline agglutination and a moderate spherocytosis on blood film examination. An irregular, well-defined liver mass was identified on computed tomography at referral, but its significance was initially uncertain, thus immunosuppressive therapy was commenced. Weaning of medications resulted in immune-mediated haemolytic anaemia relapse, thus the hepatic neoplasm was removed via a right lateral liver lobectomy. Histology confirmed complete excision, and supported a well-differentiated hepatocellular carcinoma. All medication was successfully discontinued following surgery, with no relapse of clinical signs at the time of writing this report. [ABSTRACT FROM AUTHOR]

Using National Agricultural Workers Survey (NAWS) data, we examine which farmworkers are unionized and whether their status differs systematically from non‐unionized farmworkers. Logit results indicate farmworkers are less likely to be unionized if they are Black, unauthorized to work in the U.S., less educated, have English proficiency, work for farm labor contractors (versus growers), and cultivate field (vs. horticulture) crops. Blinder‐Oaxaca decomposition reveals that union members earn $0.87 more in hourly wages, are 4.8% points more likely to receive a bonus, and are 15.6% points more likely to have employer‐provided health insurance than comparable non‐unionized farmworkers. [ABSTRACT FROM AUTHOR]

Background: Cerebrovascular reactivity (CVR) is a measure of the change in cerebral blood flow (CBF) in response to a vasoactive challenge. It is a useful indicator of the brain's vascular health. Purpose: To evaluate the factors that influence successful and unsuccessful CVR examinations using precise arterial and end‐tidal partial pressure of CO2 control during blood oxygen level–dependent (BOLD) MRI. Study Type: Retrospective. Subjects: Patients that underwent a CVR between October 2005 and May 2021 were studied (total of 1162 CVR examinations). The mean (±SD) age was 46.1 (±18.8) years, and 352 patients (43%) were female. Field Strength/Sequence: 3 T; T1‐weighted images, T2*‐weighed two‐dimensional gradient‐echo sequence with standard echo‐planar readout. Assessment: Measurements were obtained following precise hypercapnic stimuli using BOLD MRI as a surrogate of CBF. Successful CVR examinations were defined as those where: 1) patients were able to complete CVR testing, and 2) a clinically useful CVR map was generated. Unsuccessful examinations were defined as those where patients were not able to complete the CVR examination or the CVR maps were judged to be unreliable due to, for example, excessive head motion, and poor PETCO2 targeting. Statistical Analysis: Successful and unsuccessful CVR examinations between hypercapnic stimuli, and between different patterns of stimulus were compared with Chi‐Square tests. Interobserver variability was determined by using the intraclass correlation coefficient (P < 0.05 is significant). Results: In total 1115 CVR tests in 662 patients were included in the final analysis. The success rate of generating CVR maps was 90.8% (1012 of 1115). Among the different hypercapnic stimuli, those containing a step plus a ramp protocol was the most successful (95.18%). Among the unsuccessful examinations (9.23%), most were patient related (89.3%), the most common of which was difficulty breathing. Data Conclusion: CO2‐BOLD MRI CVR studies are well tolerated with a high success rate. Evidence Level: 4 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]

Research institutions often lack policies addressing the risks and benefits of enrolling "invested parties" such as investigators, research staff, and patient, caregiver, and community representatives (groups most affected by a disease or intervention) in studies where they have direct involvement. Invested parties may have both strong motivations to study the condition or intervention and to participate as study subjects. More guidance is needed to promote appropriate access to research participation and mitigate potential risks. This article addresses the gap in guidance by presenting an ethical framework and practical guidelines for the enrollment of invested parties. Drawing from experiences with the Researching COVID to Enhance Recovery (RECOVER) Initiative, a large multisite observational cohort study, we argue that invested parties should not be categorically excluded from enrollment in their own research studies if certain criteria are met and appropriate safeguards are in place. We underscore the need to balance inclusion with fairness, promote valid voluntary informed consent, ensure data privacy, protect scientific validity, and mitigate unique risks to invested parties as participants. Additionally, we recommend regular reporting and empirical assessment to evaluate the impact of enrolling invested parties on participants and study outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Research indicates psychologists typically lack subjective understanding of voice hearing. Voice hearing simulation training has potential to improve understanding, empathy and confidence among clinicians, but psychologists have had limited input into its development. This study investigated psychologists' and a psychotherapist's clinical experience of working with people who hear voices and their views and recommendations for voice hearing simulation training. Design: This was a qualitative study. Methods: Clinical psychologists and one psychotherapist (N = 17) participated in semi‐structured interviews. Thematic analysis was used to analyse transcribed data. Results: The Clinical Experience theme comprised of subthemes Barriers to engagement, Diversity of voice hearing experiences, Lack of subjective understanding, Curiosity about voice hearing, Empathy for voice hearers, Using personal experiences to relate to voices, Clinical experience increases knowledge, Importance of supervision and colleague's support, Benefits of experiential training, Limited training in non‐psychosis settings and Clinical experience increases confidence. The Views on Voice Hearing Simulation Training theme comprised of subthemes Improves subjective understanding, Concern about distress, Discomfort as a strength of voice hearing simulations, Artificiality of simulation, Increases empathy and Over‐estimation of understanding. The Recommendations theme comprised of subthemes Discuss artificiality, Co‐production, Promote voice diversity, Support staff and Maximise inclusivity. Conclusions: Findings indicate that clinical experience improves psychologists' confidence and knowledge, yet participants reported a lack of subjective understanding of voice hearing. Co‐produced simulation training between individuals who hear voices and clinicians was anticipated to improve subjective understanding, empathy and therapeutic relationships, which could support a range of staff and improve quality of care delivered. [ABSTRACT FROM AUTHOR]

Background: Critical congenital heart defects (CCHDs) are associated with considerable morbidity and mortality. This study estimated survival of children with nonsyndromic CCHDs and evaluated relationships between exposures of interest and survival by CCHD severity (univentricular or biventricular function). Methods: This analysis included 4380 infants with CCHDs (cases) born during 1999–2011 and enrolled in the National Birth Defects Prevention Study, a multisite, population‐based case–control study of major birth defects. Cases were linked to state death files. Nonparametric Kaplan–Meier survival functions were used to estimate 1‐ and 5‐year survival probabilities overall and by severity group (univentricular/biventricular) stratified by demographic and clinical exposure variables of interest. The log‐rank test was used to determine whether stratified survival curves were equivalent. Survival and 95% confidence intervals (CIs) were also estimated using Cox proportional hazards modeling adjusted for maternal age, education, race/ethnicity, study site, and birth year. Results: One‐ and five‐year survival rates were 85.8% (CI 84.7–86.8) and 83.7% (CI 82.5–84.9), respectively. Univentricular 5‐year survival was lower than biventricular case survival [65.3% (CI 61.7–68.5) vs. 89.0% (CI 87.8–90.1; p < 0.001)]. Clinical factors (e.g. preterm birth, low birthweight, and complex/multiple defects) were associated with lower survival in each severity group. Sociodemographic factors (non‐Hispanic Black race/ethnicity,

Background: The New York State Birth Defects Registry (BDR) has passive and active components. As part of statewide passive ascertainment, the BDR receives reports of International Classification of Diseases, Tenth Revision (ICD‐10) codes and descriptive narratives on a wide range of birth defects. The BDR conducts enhanced active surveillance for selected birth defects in 14 counties, which includes medical record abstraction and clinician review. We sought to quantify agreement between the two surveillance approaches. Methods: The analysis included live‐born infants born with one of the 16 birth defects in 2018–2021 in the active surveillance counties (n = 1069 infants). We calculated positive predictive values (PPV) and 95% confidence intervals for each defect, defined as the percentage of cases confirmed in active surveillance among those in passive surveillance. Additionally, we calculated the percentage with each birth defect missed by passive surveillance. Results: The PPV varied greatly by birth defect. The PPV was >90% for gastroschisis and cleft lip, but <70% for spina bifida, diaphragmatic hernia, truncus arteriosus, tricuspid atresia, hypoplastic left heart syndrome, coarctation of the aorta, and pulmonary atresia. The percentage missed by passive surveillance ranged from 2% for tetralogy of Fallot to 39% for tricuspid atresia. Conclusions: Active surveillance is an important strategy for ruling out false positive case reports for certain birth defects that we assessed, but not all of them. Passive surveillance programs can use our findings to develop targeted strategies for improving data quality of specific birth defects using active surveillance methods, thus optimizing limited resources. [ABSTRACT FROM AUTHOR]