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Objectives: Living within a larger body brings unique challenges to exercise participation, which are poorly understood. This qualitative study explored the attitudes towards, and experiences of, exercise participation in adults with class III obesity. Design: Individual semi‐structured qualitative interviews. Methods: We recruited 30 adults with class III obesity (body mass index: 45.8 ± 8.6 kg/m2) from a specialist multidisciplinary weight management service. Participants took part in semi‐structured interviews while participating in a 6‐month home‐based aerobic and resistance exercise intervention. Open‐ended questions were used flexibly to explore their views and experiences of exercise, encompassing barriers, motives and perceived benefits. Transcripts were analysed using reflexive thematic analysis. Results: Three themes were developed: (1) a web of barriers; (2) tailored exercise facilitates positive experiences; and (3) a desire to live a normal life. People with class III obesity perceived that they were unable to do exercise; a view that was attributed to perceived judgement, low physical function, pain during everyday activities and failed weight loss attempts. These complex physical and psychosocial barriers to exercise were described as contributing to exercise avoidance. High value was placed on tailored exercise that accommodates the unique needs of moving in a larger body. A desire to carry out everyday tasks underpinned motivations for exercise. Conclusions: Our findings suggest that multi‐component obesity interventions should move away from generic exercise prescriptions designed to maximize energy expenditure, and instead move towards addressing the unique physical and psychosocial needs of people who have class III obesity with tailored person‐centred and weight‐neutral exercise prescriptions. [ABSTRACT FROM AUTHOR]

Impulsive choice describes a preference for a smaller‐sooner reward (SSR) over a larger‐later reward (LLR). A large body of research has examined different procedures for decreasing impulsive choice in nonhuman subjects. One limitation of these procedures is the extensive training duration required to achieve the desired results. To address this limitation, the current experiment examined the effects of a brief course of Pavlovian training, designed to establish a conditioned stimulus (CS) that could be strategically used to encourage LLR choices. Forty male Long‐Evans rats were randomly assigned to appetitive Pavlovian or unpaired training. A lever insertion signaled an upcoming unconditioned stimulus (i.e., food presentation) for Pavlovian rats and it acquired CS properties. The lever was uncorrelated with the US in the unpaired group, and it did not acquire CS properties. In the subsequent impulsive‐choice assessment, the lever from the training phase served as the lever rats pressed to choose the LLR. After an LLR choice, the lever remained in the chamber during the delay to the LLR, just as the SSR lever remained in the chamber until that reward was delivered. Pavlovian‐trained rats sign tracked toward the lever CS and made significantly fewer impulsive choices than did rats in the unpaired group. [ABSTRACT FROM AUTHOR]

Background: Congenital adrenal hyperplasia (CAH) encompasses a rare group of autosomal recessive disorders, characterised by enzymatic defects in steroidogenesis. Heterogeneity in management practices has been observed internationally. The International Congenital Adrenal Hyperplasia registry (I‐CAH, https://sdmregistries.org/) was established to enable insights into CAH management and outcomes, yet its global adoption by endocrine centres remains unclear. Design: We sought (1) to assess current practices amongst clinicians managing patients with CAH in the United Kingdom and Ireland, with a focus on choice of glucocorticoid, monitoring practices and screening for associated co‐morbidities, and (2) to assess use of the I‐CAH registry. Measurements: We designed and distributed an anonymised online survey disseminated to members of the Society for Endocrinology and Irish Endocrine Society to capture management practices in the care of patients with CAH. Results: Marked variability was found in CAH management, with differences between general endocrinology and subspecialist settings, particularly in glucocorticoid use, biochemical monitoring and comorbidity screening, with significant disparities in reproductive health monitoring, notably in testicular adrenal rest tumours (TARTs) screening (p =.002), sperm banking (p =.0004) and partner testing for CAH (p <.0001). Adoption of the I‐CAH registry was universally low. Conclusions: Differences in current management of CAH continue to exist. It appears crucial to objectify if different approaches result in different long‐term outcomes. New studies such as CaHASE2, incorporating standardised minimum datasets including replacement therapies and monitoring strategies as well as longitudinal data collection, are now needed to define best‐practice and standardise care. [ABSTRACT FROM AUTHOR]

The majority of available climate data in global digital archives consist of data only from the 1940s or 1950s onwards, and many of these series have gaps and/or are available for only a subset of the variables which were actually observed. However, there exist billions of historical weather observations from the 1700s, 1800s, and early 1900s that are still in hard‐copy form and are at risk of being lost forever due to deterioration. An assessment of changes in climate extremes in several IPCC regions was not possible in IPCC AR6 WGI owing, in many cases, to the lack of available data. One such region is Africa, where the climate impact research and the ability to predict climate change impacts are hindered by the paucity of access to consistent good‐quality historical observational data. The aim of this innovative project was to use classroom‐based participatory learning to help transcribe some of the many meteorological observations from Africa that are thus far unavailable to researchers. This project transcribed quickly and effectively station series by enrolling the help of second‐year undergraduate students at Maynooth University in Ireland. The newly digitized African data will increase the temporal and spatial coverage of data in this important data‐sparse region. Students gained new skills while helping the global scientific community unearth new insight into past African climate. The project managed to transcribe 79 months of data at Andapa in Madagascar and 56 months of data for Macenta in Guinea. The digitized data will be openly and freely shared with the scientific and wider community via the Pangaea data repository, the C3S Climate Data Store, and the National Oceanic and Atmospheric Administration's (NOAA) National Centers for Environmental Information (NCEI) data centre in the US. The project model has the potential for a broader roll‐out to other educational contexts and there is no shortage of data to be rescued. This paper provides details of the project, and all supporting information such as project guidelines and templates to enable other organizations to instigate similar programs. [ABSTRACT FROM AUTHOR]

A vast literature highlights the prevalence of impulsive decision making in maladaptive outcomes. Most research has focused on one form—delay discounting. Less research has focused on effort discounting, possibly because of a lack of a standardized task for assessment. In published effort‐discounting tasks, effort is conceptualized in many ways, making it difficult to compare findings across studies. Additionally, most effort‐discounting tasks do not control for the time inherent in completing the effortful task, which makes it difficult to disentangle effort discounting from delay discounting. The current study evaluated the validity of a novel hypothetical effort‐discounting task. The novel task was used to evaluate the influence of the effort‐delay confound on rates of effort discounting in humans. Participants were randomly assigned to complete a confounded or a controlled version of the novel effort‐discounting task. The effort‐discounting data were well described by hyperbolic and exponential functions. When effort and delay were confounded, effort‐discounting rates were significantly higher than when effort alone influenced discounting. The results suggest that data that are produced by effort‐discounting tasks that do not control the effort‐delay confound should be interpreted cautiously because they are also influenced by delay discounting. Task limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

Background and aims: Ukraine's Ministry of Health released urgent COVID‐19 guidelines, allowing for early implementation of take‐home dosing (THD) for opioid agonist therapies (OAT) such as methadone. Enrollment in OAT and retention in the program are the most effective HIV prevention strategies for people who inject drugs (PWID). This study aimed to evaluate the impact of Ukraine's COVID‐19 emergency guidance on OAT treatment enrollment, retention on treatment and mortality. Design and setting: Using Ukraine's national OAT registry for 252 governmental clinics across 25 regions, we conducted a 12‐month comparative prospective cohort survival analysis. This study compared newly enrolled methadone patients within the initial 6 months following the COVID‐19 guidance (COVID) with patients from the preceding year (pre‐COVID) in a country with high adult HIV prevalence (1.2%) that is concentrated in PWID. Participants: In the nation‐wide sample of newly enrolled PWID in Ukraine, comprising 2798 individuals, 1423 were in the COVID cohort and 1375 were in the pre‐COVID cohort. The majority were male (86.7%), with an average age of 39.3 years. Measurements: Primary outcomes were average monthly enrollment per cohort, treatment retention and mortality, with internal time‐dependent predictors, including THD and optimal (> 85 mg) methadone dosing. Results: Relative to the pre‐COVID period, the monthly average patient enrollment was statistically significantly higher during the COVID period (283.7 versus 236.0; P < 0.0001), where patients were more likely to transition to THD and achieve optimal dosing earlier. Significant differences were observed in the proportions of person‐months on THD (41 versus 13%, P < 0.0001) and optimal dosing (38 versus 31%, P < 0.0001) between the COVID and pre‐COVID cohorts. Predictors of treatment retention, expressed as adjusted hazard ratios (aHR), included early THD [aHR = 1.90, 95% confidence interval (CI) = 1.47–2.45], early optimal dosing (aHR = 1.71, 95% CI = 1.37–2.13) and prior methadone treatment (aHR = 1.39, 95% CI = 1.15–1.68). These factors persisted, respectively, in the pre‐COVID (aHR = 2.28, 95% CI = 1.41–3.70; aHR = 1.84, 95% CI = 1.32–2.56; and aHR = 1.36, 95% CI = 1.06–1.74) and COVID (aHR = 1.91, 95% CI = 1.40–2.59; aHR = 1.61, 95% CI = 1.20–2.16; and aHR = 1.49, 95% CI = 1.08–1.94) cohorts. Survival did not differ significantly between the two prospective cohorts. Conclusion: Ukraine's prompt adoption of early take‐home dosing for opioid agonist therapies, such as methadone, following the emergency COVID‐19 guidance appears to have increased enrollment into methadone and improved treatment retention for people who inject drugs without adverse effects on patient survival. [ABSTRACT FROM AUTHOR]

Background: Guidelines recommend enteral feeding via gastrostomy should be considered for adult survivors of stroke with dysphagia who cannot eat or drink sufficiently for >4 weeks. Many people continue long‐term tube‐feeding via this route in the community where healthcare professionals contribute to their care and nutritional management, although little is known about their experiences of or attitudes towards enteral feeding in this situation. The present study aimed to explore the experiences and attitudes of healthcare professionals working with this patient group. Methods: Healthcare professionals were invited to complete a questionnaire devised for the study which comprised closed and open questions about tube‐feeding including their patients' participation in feeding processes and mealtimes and how these might be improved. Responses to closed questions were analysed descriptively and free‐text responses analysed using thematic analysis. Results: Fifty‐seven participants met the inclusion criteria. They identified patients' quality of life (77% of respondents) and nutritional support (75%) as the most important aspects of tube‐feeding. Good communication and training with healthcare teams and carers were considered important. Their patients' participation in tube‐feed administration and mealtime involvement were described as variable and potentially beneficial, but both were related to patients' choice and health impairment. Blended tube‐feeding was considered an option by 89% provided practical and safety conditions were met. Conclusions: Participants' experiences of and attitudes towards tube feeding in adults living with stroke in the community in the sample in the present study are varied and focussed on individual patients' needs, safety and professional standards. Highlights: Quality of life and nutritional support are considered the most important aspects of tube‐feeding in adults living in the community following stroke.Patient choice should be considered in all aspects of decision‐making about tube‐feeding.Good communication and training are considered important for successful tube‐feeding in the community.Patients' participation in administering their own feed or involvement in mealtimes is variable and related to their choice and health impairment.Blended feeding is considered an option providing practical and safety consideration are addressed. [ABSTRACT FROM AUTHOR]

Despite the increasing numbers of genetic assistants (GAs) in the genomics workforce, their training needs and how to best prepare GAs for their role have not been well defined. We sought to identify the current educational status of GAs, opinions on their training needs, and attitudes about GA training programs (GATPs). Survey links were emailed to NSGC members, 17 state genetic counseling (GC) professional organizations, and genomic medicine researchers. Respondents (n = 411) included GCs (n = 231) and GAs (n = 136). Like other studies, we found that the GA position is filled by a range of education levels and career aspirations. Most respondents supported the creation of GATPs, with 63% endorsing that GATPs would be helpful and half endorsing a short‐term (3 months or less) program. Most believed GATPs should focus on general knowledge, with almost all practical skills learned on‐the‐job. If more GATPs are created, our survey provides evidence that graduates would be hired. Indeed, of those whose work setting required a bachelor's degree, the number of respondents who favored keeping that requirement was similar to the number who favored hiring a GA without a degree if they attended a GATP. However, there were concerns about GATPs. Many (44%) believed creating GATPs could discourage candidates from becoming GAs. We observed that there are two types of GAs: entry‐level and bachelor's‐level, with the entry‐level being those who do not have and are not working to obtain a bachelor's degree and the bachelor's‐level being those who do/are. GATPs could focus on the education of entry‐level GAs, while gaps in the knowledge base of bachelor's‐level GAs could be addressed by augmenting bachelor's curriculum or providing additional training after hire. Further research on the training needs of GAs and hiring practices of institutions will be vital to understanding their training needs and designing and implementing effective GATPs. [ABSTRACT FROM AUTHOR]

Background: Suicide is a major driver of mortality among college students and is the leading cause of death among American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) young adults. Methods: Data on suicidal ideation, suicide attempt, and self‐injury among AI/AN/NH college students (n = 8103) were analyzed via multivariable logistic regressions employing the American College Health Association National College Health Assessment survey from 2015 to 2019. Adjusted odds ratios (aORs) were used to assess how opioid misuse may act as a risk or protective factor for suicidality and self‐injury. Results: Between 2015 and 2019, suicidal ideation was the most prevalent dimension of suicidality affecting AI/AN/NH college students (ranges from 12.69% to 18.35%), followed by self‐injury (7.83%–11.41%) and suicide attempt (2.40%–4.10%). AI/AN/NH college students who reported opioid misuse were significantly more likely to experience suicidal ideation (aOR: 1.417; 95% confidence interval [CI]: 1.154–1.740) and self‐injury (aOR: 1.684; 95% CI: 1.341–2.116) than those who did not engage in such behavior. Conclusions: We identified opioid misuse as a potential risk factor for suicidal ideation and intentional self‐injury among populations of AI/AN/NH college students. Programs seeking to reduce suicide prevalence among Indigenous college students may benefit from the inclusion of evidence‐based interventions that prevent and treat issues related to opioid use. [ABSTRACT FROM AUTHOR]

The increasing ability of neuroscience to analyse and modulate human brain functions calls for a new regulatory approach to identify and deal with potential harmful applications in the early stages of development. [ABSTRACT FROM AUTHOR]

Methods of network meta‐analysis (NMA) can be classified as arm‐based and contrast‐based approaches. There are several arm‐based approaches, and some of these have been criticized because they recover inter‐study information and hence do not obey the principle of concurrent control. Here, we point out that recovery of inter‐study information in arm‐based NMA can be prevented by fitting a fixed main effect for studies. Advantages of arm‐based NMA are discussed. [ABSTRACT FROM AUTHOR]

Increasing plant diversity in agroecosystems is well‐known to strengthen natural pest suppression, yet reliably predicting which non‐crop management practices best support natural enemies remains a challenge. Farmers often supplement diversity with managed flower patches or by allowing weedy non‐crop plant growth, both of which may support diverse, abundant and balanced communities of insect predators that provide biocontrol.At the same time, evenness among predators and effectiveness of biocontrol may be compromised by dominant arthropod invaders that co‐benefit from non‐crop diversity.We examined whether floral resources or adjacent weeds had stronger effects on the evenness and abundance of natural enemies by surveying plants and insects on zucchini crops at 37 organic farms.Neither flower richness nor weed richness affected insect predator evenness. Instead, the abundance of an invasive predator, the red imported fire ant (Solenopsis invicta Buren), increased with floral resource diversity, which negatively predicted the evenness and abundance of non‐invasive predators.These results suggest that floral diversity might be a less reliable predictor of natural enemy diversity when invasive predators interfere. Habitat management recommendations for bolstering biocontrol services should consider and potentially mitigate unintended consequences of floral resource provisions on farms where invasive predators dominate. [ABSTRACT FROM AUTHOR]

Advances in bioinformatic tools paired with the ongoing accumulation of genetic knowledge and periodic reanalysis of genomic sequencing data have led to an improvement in genetic diagnostic rates. Candidate gene variants (CGVs) identified during sequencing or on reanalysis but not yet implicated in human disease or associated with a phenotypically distinct condition are often not revisited, leading to missed diagnostic opportunities. Here, we revisited 33 such CGVs from our previously published study and determined that 16 of them are indeed disease‐causing (novel or phenotype expansion) since their identification. These results emphasize the need to focus on previously identified CGVs during sequencing or reanalysis and the importance of sharing that information with researchers around the world, including relevant functional analysis to establish disease causality. [ABSTRACT FROM AUTHOR]

Behaviour change through voluntary action can be an important approach to reducing human impacts on biodiversity. One example is self‐regulation in hunting, potentially a vital contributory factor in improving the sustainability of wild bird harvest. There has been a growing realisation among woodcock Scolopax rusticola hunters, reinforced by advice from sector organisations, that components of the UK woodcock populations are declining and that some aspects of woodcock hunting, specifically timing of harvest, may contribute to these. This study utilised five qualitative and quantitative data sets, collected for different purposes, to assess the behaviour and attitudes of woodcock hunters, both currently and over the past century. In the UK, relatively few woodcock are harvested and few hunters or species‐specific shoots target them. An estimated 26%–29% of lowland shoots advertise or harvest woodcock, with fewer than 5% of shoots or hunters participating in 'woodcock specific' shoot days. The number of birds harvested has fallen in recent years and is estimated to be between 62,000 and 140,000. Qualitative data suggests that over 90% of hunters now report shooting woodcock only after the recommended date of 1st December, or not at all. This is reflected in bag data which shows that, since 2018, fewer than 3%–13% of woodcock shot were harvested prior to 1st December. Around a third of hunters have reported stopping shooting woodcock and it is likely the harvest will decline in coming years due to voluntary restraint. This work demonstrates both through self‐report data and independent harvest data that behaviour change among hunters can be effected. This provides a working example where self‐regulation in response to a collective sector‐led effort has the potential to conserve wild quarry. [ABSTRACT FROM AUTHOR]

Transcription factor dysregulation is associated with many diseases, including cancer. Peptide‐based molecules are increasingly recognised as important modulators of difficult intracellular protein–protein interaction targets, with peptide library screening consequently proven to be a viable strategy in developing inhibitors against a wide range of transcription factors (TFs). However, current strategies simply select the highest affinity of binding to a target TF rather than the ability to inhibit TF function. Here, we utilise our Transcription Block Survival (TBS) screening platform to enable high‐throughput identification of peptides that inhibit TFs from binding to cognate DNA sites, hence inhibiting functionality. In this study, we explore whether the TBS can be expanded to derive a potent and functional peptide inhibitor of the BZLF1 transcription factor. The library‐derived peptide, AcidicW, is shown to form a more stable dimer with BZLF1 than the BZLF1 homodimer, with a thermal denaturation temperature exceeding 80°C. AcidicW can also functionally inhibit the BZLF1:TRE DNA interaction with high potency and an IC50 of 612 nM. [ABSTRACT FROM AUTHOR]

Introduction: Antipsychotics are routinely prescribed off‐label for anorexia nervosa (AN) despite limited evidence. This article presents a protocol of a study aiming to assess the feasibility of a future definitive trial on olanzapine in young people with AN. Methods and analysis: In an open‐label, one‐armed feasibility study, 55 patients with AN or atypical AN, aged 12–24, receiving outpatient, inpatient or day‐care treatment who are considered for olanzapine treatment will be recruited from NHS sites based in England. Assessments will be conducted at screening, baseline and at 8‐, 16 weeks, 6‐ and 12 months. Primary feasibility parameters will be proportions of patients who agree to take olanzapine and who adhere to treatment and complete study assessments. Qualitative methods will be used to explore acceptability of the intervention and study design. Secondary feasibility parameters will be changes in body mass index, psychopathology, side effects, health‐related quality of life, carer burden and proportion of participants who would enrol in a future randomised controlled trial. The study is funded by the National Institute for Health Research via Health Technology Assessment programme. Discussion: Olanzapine for young PEople with aNorexia nervosa will inform a future randomised controlled trial on the efficacy and safety of prescribing olanzapine in young people with AN. Highlights: There is a lack of evidence for the use of pharmacological treatment in anorexia nervosa (AN).The Olanzapine for young PEople with aNorexia nervosa study will assess the feasibility of exploring the safety and efficacy of olanzapine in adolescents and young adults with AN.The study will inform a future randomised controlled trial on the efficacy and safety of prescribing olanzapine for AN. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension (PH) associated with left heart failure (LHF) (PH‐LHF) is one of the most common causes of PH. It directly contributes to symptoms and reduced functional capacity and negatively affects right heart function, ultimately leading to a poor prognosis. There are no specific treatments for PH‐LHF, despite the high number of drugs tested so far. This scientific document addresses the main knowledge gaps in PH‐LHF with emphasis on pathophysiology and clinical trials. Key identified issues include better understanding of the role of pulmonary venous versus arteriolar remodelling, multidimensional phenotyping to recognize patient subgroups positioned to respond to different therapies, and conduct of rigorous pre‐clinical studies combining small and large animal models. Advancements in these areas are expected to better inform the design of clinical trials and extend treatment options beyond those effective in pulmonary arterial hypertension. Enrichment strategies, endpoint assessments, and thorough haemodynamic studies, both at rest and during exercise, are proposed to play primary roles to optimize early‐stage development of candidate therapies for PH‐LHF. [ABSTRACT FROM AUTHOR]

Aims: To test differential outcomes between three 6‐month text‐messaging interventions to reduce at‐risk drinking in help‐seeking adults. Design: A three‐arm single‐blind randomized controlled trial with 1‐, 3‐, 6‐ and 12‐month follow‐ups. Setting: United States. A fully remote trial without human contact, with participants recruited primarily via social media outlets. Participants: Seven hundred and twenty‐three adults (mean = 39.9 years, standard deviation = 10.0; 62.5% female) seeking to reduce their drinking were allocated to 6 months of baseline 'tailored statically' messaging (TS; n = 240), 'tailored adaptive' messaging (TA; n = 239) or 'drink tracking' messaging (DT; n = 244). Interventions: TS consisted of daily text messages to reduce harmful drinking that were tailored to demographics and alcohol use. TA consisted of daily, tailored text messages that were also adapted based on goal achievement and proactive prompts. DT consisted of a weekly assessment for self‐reported drinking over the past 7 days. Measurements The primary outcome measure was weekly sum of standard drinks (SSD) at 6‐month follow‐up. Secondary outcome measures included drinks per drinking day (DDD), number of drinking days (NDD) per week and heavy drinking days (HDD) at 1‐, 3‐, 6‐ and 12‐month follow‐ups. Findings At 6 months, compared with DT, TA resulted in significant SSD reductions of 16.2 (from 28.7 to 12.5) drinks [adjusted risk ratio (aRR) = 0.80, 95% confidence interval (CI) = 0.71, 0.91] using intent‐to‐treat analysis. TA also resulted in significant improvements in DDD (aRR = 0.84; 95% CI = 0.77–0.92) and drinking days per week (b = −0.39; 95% CI = −0.67, –0.10), but not HDD compared with DT at 6 months. TA was not significantly different from TS at any time‐point, except DDD at 6 months. All groups made improvements in SSD at 12‐month follow‐up compared with baseline with an average reduction of 12.9 drinks per week across groups. Conclusions: Automated tailored mobile messaging interventions are scalable solutions that can reduce weekly alcohol consumption in remote help‐seeking drinkers over time. [ABSTRACT FROM AUTHOR]

We bring together insights from the sociology of diagnosis and the sociology of ignorance to examine the early diagnostic unfolding of 'Long COVID' (LC). Originally described by patient activists, researchers set out to ponder its unwieldy clinical boundaries. Using a scoping review method in tandem with qualitative content analytic techniques, we analyse medicine's initial struggles to construct a LC diagnosis. Paying attention to the dynamics of ignorance, we highlight three consequential conceptual manoeuvres in the early classifications of LC: causal agnosticism concerning the relationship between COVID‐19 and LC, evasion of lumping LC with similar conditions; and the predictable splitting off of medically explainable cases from the LC designation. These manoeuvres are not maleficent, inept or unreasonable. They are practical but impactful responses to the classificatory dilemmas present in the construction of diagnoses amidst ignorance. Although there are unique aspects to LC, we suggest that its early fate is nevertheless emblematic of medicine's diagnostic standardisation processes more generally. To varying degrees, diagnoses are ignorance management strategies; they create a pathway through the uncertainty at the core of disease realities. However, while diagnoses circumscribe some types of ignorance, they produce others through the creation of blind spots and paths not taken. [ABSTRACT FROM AUTHOR]

Background: Conditioned pain modulation (CPM) is an experimental paradigm, which describes the inhibition of responses to a noxious or strong‐innocuous stimulus, the test stimulus (TS), by the additional application of a second noxious or strong‐innocuous stimulus, the conditioning stimulus (CS). As inadequate CPM efficiency has been assumed to be predisposing for clinical pain, the search for moderating factors explaining inter‐individual variations in CPM is ongoing. Psychological factors have received credits in this context. However, research concerning associations between CPM and trait factors relating to negative emotions has yielded disappointing results. Yet, the influence of anxious or fearful states on CPM has not attracted much interest despite ample evidence that negative affective states enhance pain. Our study aimed at investigating the effect of fear induction by symbolic threat on CPM. Methods: Thirty‐seven healthy participants completed two experimental blocks: one presenting aversive pictures showing burn wounds (high‐threat block) and one presenting neutral pictures (low‐threat block). Both blocks contained a CPM paradigm with contact heat as TS and hot water as CS; subjective numerical ratings as well as contact‐heat evoked potentials (CHEPs) were assessed. Results: We detected an overall inhibitory CPM effect for CHEPs amplitudes but not for pain ratings. However, we found no evidence for a modulation of CPM by threat despite threat ratings indicating that our manipulation was successful. Discussion: These results suggest that heat/thermal CPM is resistant to this specific type of symbolic threat induction and further research is necessary to examine whether it is resistant to fearful states in general. Significance: The attempt of modulating heat conditioned pain modulation (CPM) by emotional threat (fear/anxiety state) failed. Thus, heat CPM inhibition again appeared resistant to emotional influences. Pain‐related brain potentials proved to be more sensitive for CPM effects than subjective ratings. [ABSTRACT FROM AUTHOR]

The invasive emerald ash borer (Agrilus planipennis) causes damage to street trees which is estimated to reach US$ 900 million over the next 30 years. Although millions of dollars are spent annually to control this species, spatiotemporal management plans are often based on rules of thumb that ignore future pest dispersal. Here, we reveal an optimal management strategy to protect urban trees in North America from A. planipennis. To achieve this, we embedded a pest dispersal model within a mixed integer programming framework. We discovered that optimized strategies consistently outperformed those based on rules of thumb, potentially resulting in the protection of an additional nearly 1 million street trees and savings of $ 629 million. Critically, the best management strategies always relied on quarantines and biological control (constituting 98–99% and 1–2% of the project budget, respectively), in contrast with current practices, where federal spending has been diverted to biological control. Our findings serve to inform future pest control efforts and can help protect many more trees from this invasive species. [ABSTRACT FROM AUTHOR]

This article is a special section in the Drug & Alcohol Review journal dedicated to honoring the life and work of Jude Byrne, a prominent advocate, policy influencer, and researcher in the alcohol and drug field. Jude's impact was significant and wide-reaching, both locally and globally. The collection of papers in this special section covers various topics, including community-researcher partnerships, parent and family advocacy, equitable and ethical research, gendered stigma, healthcare access for women who use drugs, and the importance of peer knowledge and expertise in research and policy. Jude's legacy is one of challenging inequalities, centering the experiences of people who use drugs, and advocating for human rights. [Extracted from the article]

Introduction: Stigma has undermined the scale‐up of evidence‐based HIV prevention and treatment. Negative beliefs influence clinicians' discriminatory behaviour and ultimately have wide‐ranging effects across the HIV prevention and treatment continuum. Stigma among clinicians can be mitigated in several ways, including through interpersonal contact. In this study, we test whether interactions with people who inject drugs (PWID) influence attitudes of both direct and indirect providers of opioid agonist therapies (OATs) within the same primary care clinics (PCCs) where OAT is newly introduced. Methods: In a cluster randomized controlled trial integrating OAT and HIV care into PCCs in Ukraine, clinicians at 24 integrated care sites (two sites in 12 regions) from January 2018 to August 2022 completed a structured survey at baseline, 12 and 24 months. The survey included feeling thermometers and standardized scales related to clinician attitudes towards patients and evidence‐based care. Nested linear mixed‐effects models were used to examine changes in mean scores over three timepoints for both direct and indirect clinicians. Results: There were fewer significant changes in any of the scales for direct providers (n = 87) than for indirect providers (n = 155). Direct providers became less tough‐minded about substance use disorders (p = 0.002), had less negative opinions about PWID (p = 0.006) and improved their beliefs regarding OAT maintenance (p<0.001) and medical information (p = 0.004). Indirect providers reported improvements in most stigma constructs, including a significant decrease in prejudice (p<0.001), discrimination (p = 0.001), shame (p = 0.007) and fear (p = 0.001) towards PWID. Conclusions: Integrating OAT services within primary settings was associated with significantly reduced stigma constructs and improved attitudes towards PWID, possibly through increased intergroup contact between PWID and general clinical staff. Unlike most stigma reduction interventions, re‐engineering clinical processes so that PWID receive their care in PCCs emerges as a multilevel stigma reduction intervention through the integration of specialized services in PCCs. Integration influences different types of stigma, and has positive effects not only on health outcomes, but also improves clinician attitudes and efficiently reduces clinician stigma. [ABSTRACT FROM AUTHOR]

Older adults spend significant time by themselves, especially since COVID‐19. Solitude has been associated with positive and negative outcomes. Partners need to balance social connectedness with time for one's own needs. This project examines how individual and partner solitude are associated with daily affect and relationship quality in dyads of older adults and a close other. One‐hundred thirty‐six older adults plus a close other rated their relationship quality and reported affect, solitude, and its characteristics (desired and bothersome) every evening for 10 days. Over and above overall associations, individual and partner effects emerged; when individual desired solitude was up, participants reported more positive affect and their partners less negative affect. When bothersome solitude was up, participants and their partners alike reported more negative affect and less positive affect. Desired solitude was associated with more support, whereas bothersome solitude was associated with less partner support. Findings provide further evidence on the potential benefits of solitude, highlighting the importance of considering the social context of what is often believed to be an individual‐level phenomenon. [ABSTRACT FROM AUTHOR]

Sea turtles are harvested in many small‐scale fisheries (SSFs), but few nations have quantified the impacts that SSFs are having on their sea turtle stocks. This study provides the first assessment on the catch composition, national harvest rates, and long‐term trends in sea turtle catches in the Solomon Islands SSFs.Between October 2016 and May 2018, 10 community monitors located in eight of the nine provinces of the Solomon Islands were trained and employed to work alongside fishers in their respective communities to document, photograph, and georeference the reefs where sea turtles were harvested. Local ecological knowledge (LEK) surveys were then conducted with 32 experienced fishers to infer whether the harvest rates of sea turtles had changed in recent decades.Community monitors recorded information on 1,132 sea turtles that were harvested on 529 fishing trips: 1,119 sea turtles were identified to species level, with harvests consisting of 73.3% (n = 818) green sea turtles (Chelonia mydas), 25.7% hawksbill sea turtles (n = 291) (Eretmochelys imbricata), and 0.9% (n = 10) olive ridley sea turtles (Lepidochelys olivacea).The great majority (92.6%) of sea turtles were captured by night‐time and daytime freedivers who use masks, snorkels, fins, hooks, spears, and underwater flashlights to target a wide range of fauna that inhabit coral reefs.A methodology that accounts for spatial heterogeneity in sea turtle catch rates was used to estimate that the SSFs of the Solomon Islands harvested 11,184 sea turtles per year, with a 95% confidence interval of 5,862–23,717 sea turtles.Experienced freedivers reported a 4.9‐fold decline in sea turtle harvest rates over the past 30 years, indicating that the sea turtle stocks of the Solomon Islands are being overfished.The results and recommendations from this study were integrated into the Solomon Islands National Plan of Action for Marine Turtles 2023–2027. [ABSTRACT FROM AUTHOR]

Background: In older adults, bed rest can occur because of chronic conditions, injury, surgery, or hospitalization. Extreme levels of physical inactivity due to bed rest initiate a downward spiral in several body systems. Exercise is a countermeasure to many of these changes; nonetheless, little is known about the effect of exercise on older adults' cognition during bed rest. We thus examined the effects of exercise on the intraindividual variability (IIV) of cognitive performance in older adults exposed to 14 days of experimental 6° head‐down bed rest (HDBR) and whether sex moderates its effects. We chose IIV as our outcome measure because it is more sensitive than traditional summary scores of cognitive performance, albeit no studies have explored exercise effects on older adults' IIV submitted to bed rest. Method: A non‐blinded, parallel‐group, randomised controlled trial. Twenty‐three healthy older adults aged 55‐65 were randomised to: 1) 14 days of HDBR (CON); or 2) 14 days of HDBR with daily aerobic and strength exercise (EX). Data were collected at baseline, HDBR completion, and end of seven‐day‐recovery. The National Institutes of Health Toolbox Cognitive Battery assessed executive function (Flanker Incongruent and Congruent and Dimensional Change Card Sort) and processing speed (Pattern Comparison). IIV was indexed by intraindividual coefficient of variation (ICV) and residual intraindividual standard deviation (R‐ISD), with R‐ISD as our primary measure of interest. Linear mixed models assessed group differences and the moderator role of sex. Result: At HDBR completion, EX had significantly lower (better) Flanker incongruent ICV (Estimated mean difference = ‐0.10, 95%CI ‐0.19;‐0.003, p = 0.022) and R‐ISD (Estimated mean difference = ‐3.63, 95%CI ‐6.10;‐1.17, p = 0.005) vs. CON. Sex moderated the effect of exercise; females in EX had significantly lower Flanker incongruent ICV vs. CON (Estimated mean difference = ‐0.23; 95%CI ‐0.34;‐0.12, p<0.001). At the end of the seven‐day recovery, EX had significantly lower Flanker incongruent R‐ISD vs. CON (Estimated mean difference = ‐3.11, 95%CI ‐5.70;‐0.052, p = 0.019). Summary scores and processing speed IIV changes were not statistically significant (ps>0.05). Conclusion: Exercise during HDBR preserved executive functioning, especially in females. Our findings support the delivery of exercises to older adults during bed rest to preserve their cognitive function. [ABSTRACT FROM AUTHOR]

Summary: The link between work and health outcomes for preconception, pregnant, and postpartum (PPP) working women is complex. Further, innovation and enhanced understanding are required to address the work‐related determinants of maternal obesity. However, workplace health promotion is not typically systems‐based nor attuned to the specific needs and context of individual PPP women. We propose that to improve health outcomes for PPP women, we must understand the pathways between paid work and health for the individual woman by taking a systems‐thinking approach. In this paper, we (a) outline the rationale for why the oversimplification or "dilution" of individual context may occur; (b) present a systems‐informed pathway model (the "Context‐Exposure‐Response" Model) and overview of potential work‐related impacts on health and wellbeing outcomes for PPP women using maternal obesity to provide context examples; (c) further investigate the role of motivational factors from a systems perspective; and (d) briefly examine the implications for policy, practice, and intervention design. It is anticipated that this research may act as a starting point to assist program developers, researchers, and policymakers to adopt a systems‐focused perspective while contributing to the health improvement and obesity prevention of PPP women. [ABSTRACT FROM AUTHOR]

The Australian Medical Council (AMC) has updated the National Framework for Prevocational Medical Training and the Standards for Assessment and Accreditation of Primary Medical Programs to include the recognition of the health impacts of climate change and the need for environmentally sustainable health practices. This development comes as climate and environmental health indicators worsen. The standards call for the integration of planetary health into medical education curricula to ensure that the medical profession is equipped to respond to the planetary health crisis and provide environmentally sustainable healthcare. The inclusion of planetary health in medical education is seen as essential to address the challenges posed by climate change and to promote sustainable practices within the healthcare sector. [Extracted from the article]

The article focuses on the need for sustainability in dietetics, addressing the challenge of finding dietetics-relevant research for more sustainable food systems and dietary patterns. Topics discussed include the role of nutritionists and dietitians in influencing institutions and individuals, the diversity in defining sustainable food systems and diets, and the importance of regionally specific research and contributions from diverse practice areas.

Invasive species cause severe threats to biodiversity and the economy, but often across multi‐actor landscapes. Therefore, collaboration among multiple actors across landscapes is often essential for managing invasive species. Deciding whether to collaborate depends on available resources and potential benefits. As such, it is vital to identify how different factors can influence the outcomes of collaborations.We developed and tested a conceptual model that integrates potential process factors and performance measures for outcomes of collaborative invasive species management. We surveyed professionals engaged in invasive species management in Queensland, Australia. We first assessed their perception of the presence of process factors and perception of the performance measures of collaborative invasive species management projects using descriptive methods. Then we tested the associations between process factors and performance measures using structural equation modelling.While confirming that a good collaboration of stakeholders (e.g. communication and trust) is essential to enhance performances, our results suggest that the way collaborative projects are structured (e.g. ability to participate in decision‐making, having shared goals) also significantly influences the performance of the projects, especially in achieving goals. Furthermore, results suggest that achieving long‐term collaborations and outcomes is directly influenced by the extent to which stakeholders support or oppose the collaboration. As such, our study contributes to a significant research gap by establishing a connection between the collaboration process and its outcomes.We conclude that decision‐makers should give equal importance to both designing favourable collaborative project structures and fostering collaborations with stakeholders through different means to enhance the benefits of collaboration in invasive species management. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

The Hudson River, New York, was contaminated with polychlorinated biphenyls (PCBs) from two manufacturing plants over a period of approximately 30 years, and PCBs are still present in sediment and biota today. The river provides habitat for a variety of plants and animals, including native freshwater mussels. A remediation programme, consisting of dredging followed by the placement of backfilled sediment and/or a subaqueous cap, was initiated in 2009 to remove PCB‐contaminated sediments, and managers were concerned about how remediation could affect the mussels.Quantitative surveys were conducted across nine reaches (pools) to estimate species composition, density, population size, population structure, and ecosystem services of mussel assemblages, pre‐ and post‐remediation. Surveys were stratified into remediated areas (targeted for dredging) and non‐remediated areas (not targeted for dredging).Pre‐remediation, the river contained a low diversity, and high, but variable, density of mussels that were strongly dominated by Elliptio complanata. The presence of few fresh dead mussels indicates low natural mortality. Frequent recruitment by many species, varied length classes, and high biomass also support robust assemblages that perform important ecosystem services, such as biofiltration.Remedial activity removed most of the mussels and the associated services that they perform: their density was reduced by 83% and their filtration capacity was reduced by 93%, relative to non‐remediated areas. Areas that were remediated were almost devoid of adult mussels, but the presence of small mussels indicates that natural recolonization is occurring. However, it is unknown whether these assemblages will persist. As mussels are generally long lived and slow growing, natural recovery is anticipated to be slow, in the order of decades. [ABSTRACT FROM AUTHOR]

Projection models are being increasingly used to manage threatened taxa by estimating their responses to climate change. Sea turtles are particularly susceptible to climate change as they have temperature‐dependent sex determination and increased sand temperatures on nesting beaches could result in the 'feminisation' of hatchling sex ratios for some populations. This study modelled likely long‐term trends in sand temperatures and hatchling sex ratios at an equatorial nesting site for endangered green turtles (Chelonia mydas) and critically endangered hawksbill turtles (Eretmochelys imbricata). A total of 1078 days of sand temperature data were collected from 28 logger deployments at nest depth between 2018 and 2022 in Papua New Guinea (PNG). Long‐term trends in sand temperature were generated from a model using air temperature as an environmental proxy. The influence of rainfall and seasonal variation on sand temperature was also investigated. Between 1960 and 2019, we estimated that sand temperature increased by ~0.6°C and the average hatchling sex ratio was relatively balanced (46.2% female, SD = 10.7). No trends were observed in historical rainfall anomalies and projections indicated no further changes to rainfall until 2100. Therefore, the sex ratio models were unlikely to be influenced by changing rainfall patterns. A relatively balanced sex ratio such as this is starkly different to the extremely female‐skewed hatchling sex ratio (>99% female) reported for another Coral Sea nesting site, Raine Island (~850 km West). This PNG nesting site is likely rare in the global context, as it is less threatened by climate‐induced feminisation. Although there is no current need for 'cooling' interventions, the mean projected sex ratios for 2020–2100 were estimated 76%–87% female, so future interventions may be required to increase male production. Our use of long‐term sand temperature and rainfall trends has advanced our understanding of climate change impacts on sea turtles. [ABSTRACT FROM AUTHOR]

At its core, fundraising is relationship building. Therefore, ethical fundraising requires cultivating genuine, care‐based relationships between various stakeholders by considering relational goals and communicative practices. We advance an ethics of care‐oriented approach toward fundraising based in nurturing authentic relationships with multiple organizational stakeholders, including donors, employees, beneficiaries, and volunteers. Drawing upon ethics of care and stewardship scholarship based in public relations, the purpose of this article is to propose relational care in communication through dialogue as an ethical springboard of nonprofit fundraising. [ABSTRACT FROM AUTHOR]

Porges' polyvagal theory (1991) proposes that the activity of the vagal nerve modulates moment‐by‐moment changes in adaptive behavior during stress. However, most work, including research with infants, has only examined vagal changes at low temporal resolutions, averaging 30+ s across phases of structured stressor paradigms. Thus, the true timescale of vagal regulation—and the extent to which it can be observed during unprompted crying—is unknown. The current study utilized a recently validated method to calculate respiratory sinus arrhythmia (RSA) dynamically at a high resolution of 5 Hz (updated every 200 ms) in a home‐based infant study. Using an event‐related analysis, we calculated the relative change in RSA around the onset of naturally occurring unprompted instances of n = 41 infants' 180 crying events. As predicted, RSA significantly decreased after the onset of crying compared to non‐crying chance changes in RSA. Decreasing trends in RSA were driven by infants with higher pre‐cry RSA values, infants rated lower in Negative Affectivity, and those rated both high and low in Orienting by their mothers. Our results display the timescale of RSA in spontaneous and naturalistic episodes of infant crying and that these dynamic RSA patterns are aligned with real‐time levels of RSA and also caregiver‐reported temperament. [ABSTRACT FROM AUTHOR]

Background: Although idiopathic episodic head tremor (IEHT) in dogs is well‐known, little is known about structural brain lesions causing structural episodic head tremor (SEHT). Hypothesis/Objectives: Describe semiology, magnetic resonance imaging (MRI) findings and outcome of dogs with IEHT or SEHT. We hypothesized that structural lesions affecting the middle cranial fossa or mesencephalic aqueduct could lead to SEHT. Animals: One hundred dogs with IEHT (n = 71) or SEHT (n = 29). Methods: Retrospective, multicenter, study of dogs with episodic (nonintentional) head tremor and brain MRI between 2004 and 2022. Results: Lesions on MRI in SEHT dogs were localized to the middle cranial fossa (15/29), cerebrocortex (3/29), brainstem (2/29), fourth ventricle (1/29) or multifocal (8/29) with thalamus involvement (6/8). Secondary compression of the mesencephalic aqueduct (19/29), third ventricle or interthalamic adhesion or both (14/29) was common. The most common underlying condition in dogs with SEHT was a pituitary mass. Dogs with SEHT were older, had additional neurological signs and were more likely to be euthanized after diagnosis (P <.001 for all) compared to IEHT dogs. Two SEHT dogs had only tremor. In IEHT dogs, 8/10 owners reported that the tremor decreased or abated over time (range, 106‐2315 days) without treatment. Tremor remission occurred in SEHT dogs treated for underlying meningoencephalitis. Conclusions and Clinical Importance: Presence of additional neurological signs and older age may indicate an underlying structural cause for episodic (nonintentional) head tremor involving the mesencephalic aqueduct, third ventricle, interthalamic adhesion or some combination of these. An intracranial structural abnormality cannot be excluded in dogs with normal neurological examination. [ABSTRACT FROM AUTHOR]

Background: Urine is routinely evaluated in dogs to assess health. Reference ranges for many urine properties are well established, but the scope of variation in these properties over time within healthy dogs is not well characterized. Objectives: Longitudinally characterize urine properties in healthy dogs over 3 months. Animals: Fourteen healthy client‐owned dogs. Methods: In this prospective study, dogs were evaluated for health; then, mid‐stream free‐catch urine was collected from each dog at 12 timepoints over 3 months. Urine pH, urine specific gravity (USG), protein, cultures, and antimicrobial resistance profiles were assessed at each timepoint. Results: Urine pH varied within and between dogs over time (Friedman's test: within P =.03; between P <.005). However, USG, protein, and bacterial diversity of urine were consistent within dogs over time, and only varied between dogs (Kruskal‐Wallis: between all P <.005). Antimicrobial resistant isolates were identified in 12 out of 14 dogs with 34 of 48 of the isolates demonstrating resistance to amoxicillin. Conclusions and Clinical Importance: Urine pH should be assessed at multiple timepoints via pH meter before making clinical decisions. Mid‐stream free‐catch urine with high concentrations of bacteria (>105 CFU/mL) should not be considered the only indicator of urinary tract infection. Bacterial isolates from dogs in this study had widespread resistance to amoxicillin/oxacillin underscoring the need for antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Objective: Anglers typically use stringers to keep fish intended for harvest from spoiling or for high‐grading purposes (i.e., culling). However, relatively few studies have examined the effects of temporary stringer retention on the physical condition and postrelease mortality of fish. In this study, our objective was to investigate the lethal and sublethal effects of temporarily retaining Northern Pike Esox lucius on stringers. Methods: We evaluated the blood physiology, reflex impairment, injury, and fate of 168 Northern Pike that were exposed for 2 h on one of five treatments: (1) cord stringer through the operculum, (2) cord stringer through the lower jaw, (3) metal stringer through the operculum, (4) metal stringer through the lower jaw, and (5) aerated tank control. Result: Immediately after retention, blood lactate concentrations of stringer treatments were on average 42% greater relative to controls. Fish from the stringer treatments exhibited injuries of varying severity, most of which (e.g., gill lesions, expanded puncture wounds, swelling) were still present on surviving fish 48 h later. Reflexes were impaired for all stringer fish, whereas control fish tended to have all reflexes intact. No fish died during the treatment period. The highest occurrence of mortality was within the first 8 h following retention for the cord–operculum (48%), metal–jaw (15%), and metal–operculum (19%) treatments. Stringers placed through the operculum had a higher mortality rate (37%) compared with stringers placed through the lower jaw (17%), regardless of stringer type. Overall, 27% of fish placed on stringers died and 68% of the remaining fish showed injuries related to stringers, while control fish showed low mortality (7%) and no meaningful injuries. Conclusion: Our results suggest that holding fish on stringers causes stress and injury levels that can result in postrelease mortality. As such, fisheries managers should consider restricting the release of fish placed on stringers, and once placed on a stringer, fish should be regarded as part of the daily harvest limit for a given angler. Impact statementThis research highlights the detrimental effects of releasing Northern Pike off stringers during culling. We discovered that this practice results in stress, injury, and frequently death in released fish. We encourage fisheries managers to consider implementing regulations explicitly disallowing this practice to avoid negative impacts on fish populations. [ABSTRACT FROM AUTHOR]

A survey-based needs assessment of barriers to optimal sickle cell disease care in the emergency department. 2007; 10 (1): 10 - 8. 7 Ross D, Sinha C, Bakshi N, Krishnamurti L. Educational needs of patients and caregivers living with sickle cell disease results in development of web-based patient decision aid. Sickle cell disease (SCD) is common throughout Jamaica.[[1]] The Sickle Cell Technical Working Group (SCTWG), led by the Ministry of Health and Wellness (MOHW), includes members from the Sickle Cell Unit (SCU), Sickle Cell Support Foundation of Jamaica (SCSFJ) and all the Regional Health Authorities. [Extracted from the article]

In Norway, there was considerable overlap between the poor house, the workhouse, and correctional facilities. An assemblage of human skeletal remains from Oslo's House of Correction cemetery, largely comprised of individuals disturbed during municipal development in 1989, consists of c. 314 individuals who died as inmates or residents; many were disabled or elderly. Although names were recorded at death, the cemetery lacked grave markers or a map, with no expectation families might one day reclaim relatives. All remains have been aged and sexed anthropologically, with samples collected for biomolecular investigations. Despite extensive archival documentation, including names recorded in the House of Correction church book, their identities are shrouded by time. Observations of age, injury, and disease can suggest why inmates ended up in the House of Correction cemetery. But there, individual stories end and identities are lost. [ABSTRACT FROM AUTHOR]

Process analytical technology (PAT) tools such as Raman Spectroscopy have become established tools for real time measurement of CHO cell bioreactor process variables and are aligned with the QbD approach to manufacturing. These tools can have a significant impact on process development if adopted early, creating an end‐to‐end PAT/QbD focused process. This study assessed the impact of Raman based feedback control on early and late phase development bioreactors by using a Raman based PLS model and PAT management system to control glucose in two CHO cell line bioreactor processes. The impact was then compared to bioreactor processes which used manual bolus fed methods for glucose feed delivery. Process improvements were observed in terms of overall bioreactor health, product output and product quality. Raman controlled batches for Cell Line 1 showed a reduction in glycation of 43.4% and 57.9%, respectively. Cell Line 2 batches with Raman based feedback control showed an improved growth profile with higher VCD and viability and a resulting 25% increase in overall product titer with an improved glycation profile. The results presented here demonstrate that Raman spectroscopy can be used in both early and late‐stage process development and design for consistent and controlled glucose feed delivery. [ABSTRACT FROM AUTHOR]

Background and Objectives: Minimal research has examined body image dissatisfaction (BID) among patients receiving methadone maintenance treatment (MMT). We tested associations between BID and MMT quality indicators (psychological distress, mental and physical health‐related quality of life [HRQoL]) and whether these associations varied by gender. Methods: One hundred and sixty‐four participants (n = 164) in MMT completed self‐report measures of body mass index (BMI), BID, and MMT quality indicators. General linear models tested if BID was associated with MMT quality indicators. Results: Patients were primarily non‐Hispanic White (56%) men (59%) with an average BMI in the overweight range. Approximately 30% of the sample had moderate or marked BID. Women and patients with a BMI in the obese range reported higher BID than men and patients with normal weight, respectively. BID was associated with higher psychological distress, lower physical HRQoL, and was unrelated to mental HRQoL. However, there was a significant interaction in which the association between BID and lower mental HRQoL was stronger for men than women. Discussion and Conclusions: Moderate or marked BID is present for about three in 10 patients. These data also suggest that BID is tied to important MMT quality indicators, and that these associations can vary by gender. The long‐term course of MMT may allow for assessing and addressing novel factors influencing MMT outcomes, including BID. Scientific Significance: This is one of the first studies to examine BID among MMT patients, and it highlights MMT subgroups most at risk for BID and reduced MMT quality indicators due to BID. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is a well‐known risk factor for atrial fibrillation (AF). We aim to evaluate the effect of baseline obesity on procedural complications, AF recurrence, and symptoms following catheter ablation (CA). Methods: All consecutive patients undergoing AF ablation (2013–2021) at our center were enrolled in a prospective registry. The study included all consecutive patients with available data on body mass index (BMI). Primary endpoint was AF recurrence based on electrocardiographic documentation. Patients were categorized into five groups according to their baseline BMI. Patients survey at baseline and at follow‐up were used to calculate AF symptom severity score (AFSS) as well as AF burden (mean of AF duration score and AF frequency score; scale 0: no AF to 10: continuous and 9 frequencies/durations in between). Patients were scheduled for follow‐up visits with 12‐lead electrocardiogram at 3, 6, and 12 months after ablation, and every 6 months thereafter. Results: A total of 5841 patients were included (17% normal weight, 34% overweight, 27% Class I, 13% Class II, and 9% Class III obesity). Major procedural complications were low (1.5%) among all BMI subgroups. At 3 years AF recurrence was the highest in Class III obesity patients (48%) followed by Class II (43%), whereas Class I, normal, and overweight had similar results with lower recurrence (35%). In multivariable analyses, Class III obesity (BMI ≥ 40) was independently associated with increased risk for AF recurrence (hazard ratio, 1.30; confidence interval, 1.06–1.60; p =.01), whereas other groups had similar risk in comparison to normal weight. Baseline AFSS was lowest in normal weight, and highest in Obesity‐III, median (interquartile range) 10 (5–16) versus 15 (10–21). In all groups, CA resulted in a significant improvement in their AFSS with a similar magnitude among the groups. At follow‐up, AF burden was minimal and did not differ significantly between the groups. Conclusion: AF ablation is safe with a low complication rate across all BMI groups. Morbid obesity (BMI ≥ 40) was significantly associated with reduced AF ablation success. However, ablation resulted in improvement in QoL including reduction of the AFSS, and AF burden regardless of BMI. [ABSTRACT FROM AUTHOR]

The origin and production of silt are key factors in the formation of loess deposits. Although many processes can potentially lead to silt generation, few are known to produce silt in the volumes and particle‐size modes required to form geologically significant loess deposits. Here, we investigate the hypothesis that soil‐associated weathering in tropical and Mediterranean climates can generate abundant in situ silt, and therefore contribute significantly to loess formation throughout geologic time. We utilize granulometric and geochemical data from two granitoid‐hosted soils formed in Puerto Rico (hot‐humid climate) and Southern California (hot‐arid climate) to discern whether the silt + clay fraction (<62.5 μm) is generated from bedrock weathering (autochthonous) or sourced from eolian contributions (allochthonous). Our study demonstrates that the PR soil contains abundant (up to 72%) silt‐ and clay‐sized particles compared to the Southern California soil (<6%). However, the silt fraction of the PR soil is at least partially derived from eolian inputs, and the silt fraction of the Southern California soil is geochemically indistinguishable from allochthonous dust sources. Furthermore, while intense chemical weathering in PR can produce abundant fines, the majority are significantly finer (average mode ∼15 μm) than the modes of most "typical" loess deposits (modes more than 20–30 μm). In contrast, weathering in the Southern California soil produces volumetrically sparse silt. Hence, weathering processes within these two profiles, representing hot‐humid and hot‐dry climates, appear to be ineffectual for producing the volume and size distributions of silt needed to generate significant loess deposits. Plain Language Summary: Global sediment movement is important to understand when reconstructing Earth's past climate. Terrestrial windblown silt, known as loess, is particularly useful for paleoclimate interpretation, but the origin of the silt that forms large loess accumulations remains controversial: glacial grinding produces silt, but does weathering in soils produce it? In this study, we aim to illuminate processes that generate silt (particles <62.5 μm in diameter) in large quantities by investigating whether significant silt forms within soils as underlying bedrock weathers, or if the silt in soils was delivered from elsewhere. We approached this study as geologists interested in how Earth's near‐time record can lend insight to deep‐time deposits. We compare silt in two soils—from a hot‐dry and a hot‐wet climate. Our findings demonstrate that the soil in the hot‐wet climate contains abundant silt, but of a size smaller than most loess deposits, whereas the soil in the hot‐dry climate contains minimal silt; furthermore, both show evidence for silt inputs from external sources. Neither soil in our study contains significant silt in size modes typical of common loess deposits, indicating that soil formation is ineffectual for the production of silt that contributes to loess deposits. Key Points: Chemical weathering associated with soil formation in a hot‐humid climate generates abundant fine silt‐ to clay‐sized particlesGeochemical and granulometric results indicate that silt in the soil of a hot‐arid site records eolian delivery rather than in situ formationThe two weathering profiles in this study do not contain significant silt in the size fractions typical of loess deposits [ABSTRACT FROM AUTHOR]