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In this paper, we discuss the reasons why agricultural and applied economics and similar departments are often stand‐alone academic units. The factors that affect and shape the relationship of agricultural and applied economics faculty and departments with those from general economics departments are discussed. We present case studies of three universities having different relationships with general economics faculty at their respective universities: a merged unit, an unmerged unit, and a never‐merged unit. We conclude with rationale for the existence and future trajectory of agricultural economics and related academic units at Land Grant Universities. [ABSTRACT FROM AUTHOR]

Bacterial synthesis of vitamin B2 generates a by‐product, 5‐(2‐oxopropylideneamino)‐d‐ribityl‐aminouracil (5‐OP‐RU), with potent immunological properties in mammals, but it is rapidly degraded in water. This natural product covalently bonds to the key immunological protein MR1 in the endoplasmic reticulum of antigen presenting cells (APCs), enabling MR1 refolding and trafficking to the cell surface, where it interacts with T cell receptors (TCRs) on mucosal associated invariant T lymphocytes (MAIT cells), activating their immunological and antimicrobial properties. Here, we strategically modify this natural product to understand the molecular basis of its recognition by MR1. This culminated in the discovery of new water‐stable compounds with extremely powerful and distinctive immunological functions. We report their capacity to bind MR1 inside APCs, triggering its expression on the cell surface (EC50 17 nM), and their potent activation (EC50 56 pM) or inhibition (IC50 80 nM) of interacting MAIT cells. We further derivatize compounds with diazirine‐alkyne, biotin, or fluorophore (Cy5 or AF647) labels for detecting, monitoring, and studying cellular MR1. Computer modeling casts new light on the molecular mechanism of activation, revealing that potent activators are first captured in a tyrosine‐ and serine‐lined cleft in MR1 via specific pi‐interactions and H‐bonds, before more tightly attaching via a covalent bond to Lys43 in MR1. This chemical study advances our molecular understanding of how bacterial metabolites are captured by MR1, influence cell surface expression of MR1, interact with T cells to induce immunity, and offers novel clues for developing new vaccine adjuvants, immunotherapeutics, and anticancer drugs. [ABSTRACT FROM AUTHOR]

ABSTRACT The aim of this study was to explore psychiatric nurse's experiences of caring for people with auditory hallucinations in an acute unit. A qualitative study was conducted using thematic analysis. The study involved semi‐structured interviews with 18 acute unit nurses all of whom provided interventions to patients with auditory hallucinations. Overall, participants identified their role in the management of risk within an acute unit, the importance of their therapeutic role and a perceived over‐reliance on medication administration as a primary nursing intervention. These findings thus demonstrate the personal and professional conflict that nurses face when working in an acute unit with patients who experience auditory hallucinations. Nurses are in a prime position to provide effective interventions and assistance for people with auditory hallucinations in an acute unit. The findings of this study indicate that mental health nurses may require additional support and education to provide care in a truly recovery‐based manner, with training in specific interventions and engagement skills for people who hear voices. Due to an unpredictable environment and sometimes high‐risk workplace, nurses may also benefit from organisational assistance in this area. [ABSTRACT FROM AUTHOR]

Societal Impact Statement Summary All US commercial maize (Zea mays) is a single race, “Corn Belt Dent,” and its genetic base has been in decline for at least 40 years. Independent genotyping can only be conducted after patent and licensing restrictions have expired, a period of 20 years. These restrictions also impede a molecular based assessment of the standing crop by the United States Department of Agriculture (USDA) as recommended by experts. Data blanks about landscape vulnerability put farmers at risk of crop failure and the public at risk of food insecurity. Understanding maize diversity experts' perspectives and analysis helps describe the contours of these data blanks and inform policy recommendations. Recommendations by the Maize Crop Germplasm Committee to the United States Department of Agriculture (USDA) for a molecular based vulnerability assessment on the US standing maize (Zea mays) crop have not been acted on because of intellectual property and licensing restrictions. This research explores maize diversity experts' access to data and perceptions and analysis of the standing crop. The data come from semi‐structured interviews conducted with 44 maize diversity experts in the public and private sectors. Experts explain that genetic data blanks restrict non‐industry research, describe public sector concerns that standing diversity is narrow(ing), and find historic sources of pedigree data in Plant Variety Protection and patent records are no longer reliable. Some interviewees perceive that industry monitoring of standing diversity is in their best financial interest. Industry participants describe concentration in US maize allows them to control diversity over time, while public researchers discuss efficiency of scale narrowing genetic diversity and global concentration spreading this trend. Knowledge gaps about genetic diversity in US commercial maize are designed through patents, contracts, non‐disclosure agreements, and confidentiality agreements by patent holders who do not want their inbred lines genotyped by competitors. This restricts research and knowledge flow about genetic information into public networks. The Maize Crop Germplasm Committee is a node for knowledge flow; however, the lack of mechanisms for action suggests it is performative. We recommend all protections used on seed include exemptions for research, breeding, and seed saving; an independent assessment of how industry monitors standing diversity; and a molecular analysis of the standing crop conducted by the USDA. [ABSTRACT FROM AUTHOR]

The Atmospheric Radiation Measurement Mobile Facility‐2 was installed onboard the research vessel Aurora Australis to measure aerosol properties during the 2017–2018 Measurement of Aerosols, Radiation, and CloUds over the pristine Southern ocean (MARCUS) Experiment, providing unique data on aerosols latitudinal and seasonal variation, including south of 60°S where previous observations are scarce. Data from a Cloud Condensation Nuclei (CCN) counter and Ultra‐High‐Sensitivity Aerosol Spectrometer show that both the number concentration (NCCN) and size distribution of CCN‐active aerosols, with diameters (D) between 60 nm < D < 1,000 nm are different over the North Southern Ocean (NSO) (50°S–60°S) and the South Southern Ocean (SSO) (62°S–68°S). The average NSO NCCN at 0.2% and 0.5% supersaturation were 28% and 49% less than that over the SSO. This increase of CCN over the SSO is caused by the increase of aerosols with 60 nm < D < 200 nm, consistent with calculations of Aerosol Scattering Angstrom Exponents derived from a nephelometer. Aerosol hygroscopicity growth factor measured by the Hygroscopic Tandem Differential Mobility Analyzer stayed close to 1.41 for aerosols with 50 nm < D < 250 nm over the SSO, but increased from 1.30 to 1.67 over the NSO, indicating different chemical compositions. Both CCN and Ice Nucleating Particles (INPs) showed a stronger variation with season than with latitude. The variation of heat‐labile and presumably proteinacous INPs suggests an increase of ice nucleating‐active microbes in summer. Plain Language Summary: The Atmospheric Radiation Measurement Mobile Facility‐2 was installed onboard an ice breaker to measure small particles suspended in the air (aerosols), particularly those with potential influences on cloud formation and evolution. The 2017–2018 Measurement of Aerosols, Radiation, and CloUds over the pristine Southern ocean (MARCUS) measurement campaign provides unique data on the latitudinal and seasonal variation of the suspended particles, including south of 60°S where previous observations are scarce. Data show that both the number concentration and size distribution of particles that serve as embryos of cloud droplets are different over the North Southern Ocean (NSO) (50°S–60°S) and the South Southern Ocean (SSO) (62°S–68°S). There are greater concentrations of these embryos over the SSO for increased total amount of suspended particles there. These observations are consistent with data collected by other instruments that show differences over the NSO and SSO in how these suspended particles scatter radiation and how they absorb water vapor, which shows the particles have different sizes and chemical compositions respectively. The concentrations of both particles that serve as embryos for cloud drops and ice crystals both vary more with season than latitude, which has an implication for the energy balance of the Southern Ocean. Key Points: Machine Learning is applied to identify ship stack contamination of ship‐borne aerosol measurementsSurface Cloud Condensation Nuclei number concentration and its seasonal variation over 62°S–68°S is higher than over 50°S–60°SIce Nucleating Particles over the Southern Ocean originate from primarily organic and biological sources during MARCUS [ABSTRACT FROM AUTHOR]

Sweet corn (Zea mays L.) cultivars must meet stringent quality standards to be accepted in the marketplace. Breeding for eating‐quality traits, such as sweetness, typically involves taste ratings or quantification of carbohydrate content. Total soluble solids (TSS) content is used as a proxy for sweetness in many fruit crops. Using a diallel of near‐isogenic corn lines for sugary1, shrunken2, waxy1, and wild‐type (WT) endosperm types, a combining ability analysis for carbohydrate traits and TSS content determined the relationship of these traits over three harvest dates. Variation existed for total sugar, sucrose, glucose, fructose, total polysaccharides, and starch content within and across endosperm types and harvest dates, but strong correlations with TSS content were present only when assessed across all endosperm types. Strong similarities existed among WT, waxy1, and sugary1 near‐isogenic lines for general combining ability for carbohydrate traits, while shrunken2 near‐isogenic lines had different desirable combiners. Line C40 was a desirable general combiner for carbohydrate traits among WT, waxy1, and sugary1 endosperm types, while Ia5125, P39, and Ia453 were desirable general combiners for shrunken2 endosperm. This experiment also determined that TSS content is not a useful trait in sweet corn breeding for quality traits. Core Ideas: Variation existed for carbohydrate traits among hybrids within and across endosperm types and harvest dates.Variation existed for total soluble solids (TSS) content across endosperm types and for hybrids within an endosperm type.TSS differed between 19 and 22 or 25 days after pollination for su1, sh2, and wx1 endosperm.TSS content correlates with soluble carbohydrates only when assessed across all endosperm types.Wild‐type, wx1, and su1 near‐isogenic lines exhibit strong similarities for carbohydrate trait general combining ability. [ABSTRACT FROM AUTHOR]

Urbanization is commonly associated with biodiversity loss and habitat fragmentation. However, urban environments often have greenspaces that can support wildlife populations, including rare species. The challenge for conservation planners working in these systems is identifying priority habitats and corridors for protection before they are lost. In a rapidly changing urban environment, this requires prompt decisions informed by accurate spatial information. Here, we combine several approaches to map habitat and assess connectivity for a diverse set of rare species in seven urban study areas across southern Michigan, USA. We incorporated multiple connectivity tools for a comprehensive appraisal of species‐habitat patterns across these urban landscapes. We observed distinct differences in connectivity by taxonomic group and site. The three turtle species (Blanding's, Eastern Box, and Spotted) consistently had more habitat predicted to be suitable per site than other evaluated species. This is promising for this at‐risk taxonomic group and allows conservation efforts to focus on mitigating threats such as road mortality. Grassland and prairie‐associated species (American Bumble Bee, Black and Gold Bumble Bee, and Henslow's Sparrow) had the least amount of habitat on a site‐by‐site basis. Kalamazoo and the northern Detroit sites had the highest levels of multi‐species connectivity across the entire study area based on the least cost paths. These connectivity results have direct applications in urban planning. Kalamazoo, one of the focal urban regions, has implemented a Natural Features Protection (NFP) plan to bolster natural area protections within the city. We compared our connectivity results to the NFP area and show where this plan will have an immediate positive impact and additional areas for potential consideration in future expansions of the protection network. Our results show that conservation opportunities exist within each of the assessed urban areas for maintaining rare species, a key benefit of this multi‐species and multi‐site approach. [ABSTRACT FROM AUTHOR]

Background: Free flap reconstruction for head and neck cancer is associated with a high risk of perioperative complications. One of the modifiable risk factors associated with perioperative morbidity is intraoperative hypotension (IOH). The main aim of this pilot study is to determine if the intraoperative use of goal‐directed hemodynamic therapy (GDHT) is associated with a reduction in the number of IOH events in this population. Methods: A before‐and‐after study design. The patients who had intraoperative GDHT were compared to patients from a previous period before the implementation of GDHT. The primary outcome was the number of IOH episodes defined as five or more successive minutes with a mean arterial pressure <65 mmHg. The secondary outcomes included major postoperative morbidity and 30‐day mortality. Results: A total of 414 patients were included. These were divided into two groups. The control group (n = 346; January 1, 2018, to December 31, 2019), and the monitored group (n = 68; January 1, 2020, to May 1, 2021). The median intraoperative administered fluid volume was similar between the control and monitored groups (2250 interquartile range [IQR] [1607–3050] vs. 2210 IQR [1700–2807] mL). The monitored group was found to have an increased use of norepinephrine and dobutamine (respectively, 1.2% vs. 5.9% and 2.4% vs. 30.9%; p < 0.05). When adjusting for confounders (comorbidities, estimated blood loss, and duration of anesthesia) the incidence rate ratio (95% confidence interval) of number of IOH events was 0.94 (0.86–1.03), p = 0.24. The rate of postoperative flap and medical complications did not differ between the two groups. Conclusions: Even though the use of vasopressors/inotropes was higher in the monitored group, the number of IOH episodes and postoperative morbidity and mortality were similar between the two groups. Further change in hemodynamic management will require the use of specific blood pressure targets in the GDHT fluid algorithm. [ABSTRACT FROM AUTHOR]

Supercooled liquid clouds are ubiquitous over the Southern Ocean (SO), even to temperatures below −20°C, and comprise a large fraction of the marine boundary layer (MBL) clouds. Earth system models and reanalysis products have struggled to reproduce the observed cloud phase distribution and occurrence of cloud ice in the region. Recent simulations found the microphysical representation of ice nucleation and growth has a large impact on these properties, however, measurements of SO ice nucleating particles (INPs) to validate simulations are sparse. This study presents measurements of INPs from simultaneous aircraft and ship campaigns conducted over the SO in austral summer 2018, which include the first in situ observations in and above cloud in the region. Our results confirm recent observations that INP concentrations are uniformly lower than measurements made in the late 1960s. While INP concentrations below and above cloud are similar, higher ice nucleation efficiency above cloud supports model simulations that the dominant INP composition varies with height. Model parameterizations based solely on aerosol properties capture the mean relationship between INP concentration and temperature but not the observed variability, which is likely related to the only modest correlations observed between INPs and environmental or aerosol metrics. Including wind speed in addition to activation temperature in a marine INP parameterization reduces bias but does not explain the large range of observed INP concentrations. Direct and indirect inference of marine INP size suggests MBL INPs, at least during Austral summer, are dominated by particles with diameters smaller than 500 nm. Plain Language Summary: Although Antarctica is remote, the continent and the Southern Ocean (SO) that surrounds it play a fundamental role in shaping regional and global climate. The clouds in this region are unique, with less ice and more liquid water present at low temperatures than in other areas. This is likely related to very low concentrations of rare aerosol particles called ice nucleating particles (INPs), which cause liquid water droplets in clouds to freeze. Largely due to a lack of observations, SO clouds are poorly represented in global models, and the interactions between aerosol particles and clouds are one of the largest remaining uncertainties. This study presents results of INP measurements from several recent field campaigns over the SO, including the first observations within and above clouds in the region. Our results suggest different types of particles are present below and above clouds, which have varying ability to nucleate ice. They also highlight the need for additional measurements of INP composition and size, which are key variables needed to improve model simulations. Key Points: First vertically resolved measurements of ice nucleating particles (INPs) over the Southern Ocean, including in‐cloud observationsCorrelation between normalized INP concentrations and wind speed suggests marine active site density is variableHigher ice nucleation efficiency observed above cloud, consistent with an increasing influence of mineral dust with height [ABSTRACT FROM AUTHOR]

Background: Posner Schlossman syndrome is a well‐defined uveitis entity that is characterised by relapsing remitting unilateral anterior uveitis with markedly raised intraocular pressure. The aim of this study was to determine the risk factors for progression in patients with Posner Schlossman syndrome. Methods: Ninety‐eight patients were enrolled in a retrospective case series. Progression was defined as a composite endpoint of any of development of permanent glaucoma (in patients with no evidence of glaucomatous loss on presentation), corneal failure, or chronic inflammation. Relapse was defined as a resolving episode of inflammation not meeting the criteria for progression. Results: Seventy seven percent of patients relapsed on average each 2.2 years. Forty percent of patients progressed. On univariate analysis, increased age at enrolment, immunocompromise at enrolment, the presence of glaucomatous optic neuropathy at enrolment, the performance of an anterior chamber tap and a positive anterior chamber tap were all associated with increased risk of progression. On multivariate analysis, age at enrolment, immunocompromise at enrolment, the performance of an anterior chamber tap, and the presence of glaucomatous optic neuropathy at enrolment were independently associated with increased risk of disease progression. Conclusions: Posner Schlossman syndrome is not a benign uveitis entity and risk of both relapse and progression are high. Older patients, immunocompromised patients, patients with glaucomatous optic neuropathy at enrolment and those with a positive anterior chamber tap are all at increased risk of progression. [ABSTRACT FROM AUTHOR]

Allopurinol (ALP) is a successful drug used in the treatment of gout. However, this drug has been implicated in hypersensitivity reactions that can cause severe to life‐threatening reactions such as Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Individuals who carry the human leukocyte antigen (HLA)‐B*58:01 allotype are at higher risk of experiencing a hypersensitivity reaction (odds ratios ranging from 5.62 to 580.3 for mild to severe reactions, respectively). In addition to the parent drug, the metabolite oxypurinol (OXP) is implicated in triggering T cell‐mediated immunopathology via a labile interaction with HLA‐B*58:01. To date, there has been limited information regarding the T‐cell receptor (TCR) repertoire usage of reactive T cells in patients with ALP‐induced SJS or TEN and, in particular, there are no reports examining paired αβTCRs. Here, using in vitro drug‐treated PBMCs isolated from both resolved ALP‐induced SJS/TEN cases and drug‐naïve healthy donors, we show that OXP is the driver of CD8+ T cell‐mediated responses and that drug‐exposed memory T cells can exhibit a proinflammatory immunophenotype similar to T cells described during active disease. Furthermore, this response supported the pharmacological interaction with immune receptors (p‐i) concept by showcasing (i) the labile metabolite interaction with peptide/HLA complexes, (ii) immunogenic complex formation at the cell surface, and (iii) lack of requirement for antigen processing to elicit drug‐induced T cell responsiveness. Examination of paired OXP‐induced αβTCR repertoires highlighted an oligoclonal and private clonotypic profile in both resolved ALP‐induced SJS/TEN cases and drug‐naïve healthy donors. [ABSTRACT FROM AUTHOR]

We investigate the importance of corruption in shaping the profit‐shifting behaviour of multinational firms. Using country‐level panel data, we find a significant and positive correlation between corruption and profit shifting. Our findings are consistent with several theoretical arguments predicting that corruption may both facilitate and provide an incentive to firm behaviour that deprives poorer countries of much needed tax revenues. Our findings are robust across a number of corruption and profit‐shifting measures, as well as to an instrumental variable approach that controls for the potential endogeneity between profit shifting and corruption. Our findings also indicate a negative and significant relationship between financial secrecy and outward profit shifting. We conclude that corruption and financial secrecy undermine global efforts to tackle profit shifting by multinational firms. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury (AKI) is a frequent adverse outcome following liver transplantation (LT) with a multifactorial etiology. It is critical to identify modifiable risk factors to mitigate the risk. One key area of interest is the role of intraoperative hypotension, which remains relatively unexplored in liver transplant cohorts. Methods: This was a retrospective observational cohort study of 1292 adult patients who underwent LT (between 2009 and 2019). Multivariable logistic regression analysis was used to explore the association between intraoperative hypotension, quantified by time duration (in min) under various mean arterial pressure (MAP) thresholds, and the primary outcome of early postoperative AKI according to the KDIGO criteria. Results: AKI occurred in 40% of patients and was independently associated with greater than 20 min spent below MAP thresholds of 55 mm Hg (adjusted OR = 1.866; 95% CI = 1.037–3.44; P = 0.041) and 50 mm Hg (adjusted OR = 1.801; 95% CI = 1.087–2.992; P = 0.023). Further sensitivity analyses demonstrated that the association between intraoperative hypotension and postoperative AKI was accentuated after restricting the analysis to patients with a normal preoperative renal function. Conclusions: Prolonged (>20 min) intraoperative hypotension (below a MAP of 55 mm Hg) was independently associated with AKI following LT, after adjusting for several known confounders. [ABSTRACT FROM AUTHOR]

Single‐ and multi‐layer clouds are commonly observed over the Southern Ocean in varying synoptic settings, yet few studies have characterized and contrasted their properties. This study provides a statistical analysis of the microphysical properties of single‐ and multi‐layer clouds using in‐situ observations acquired during the Southern Ocean Cloud‐Radiation Aerosol Transport Experimental Study. The relative frequencies of ice‐containing samples (i.e., mixed and ice phase) for multi‐layer clouds are 0.05–0.25 greater than for single‐layer clouds, depending on cloud layer height. In multi‐layer clouds, the lowest cloud layers have the highest ice‐containing sample frequencies, which decrease with increasing cloud layer height up to the third highest cloud layer. This suggests a prominent seeder‐feeder mechanism over the region. Ice nucleating particle (cloud condensation nuclei) concentrations are positively (negatively) correlated with ice‐containing sample frequencies in select cases. Differences in microphysical properties are observed for single‐ and multi‐layer clouds. Drop concentrations (size distributions) are greater (narrower) for single‐layer clouds compared with the lowest multi‐layer clouds. When differentiating cloud layers by top (single‐ and highest multi‐layer clouds) and non‐top layers (underlying multi‐layer clouds), total particle size distributions (including liquid and ice) are similarly broader for non‐top cloud layers. Additionally, drop concentrations in coupled environments are approximately double those in decoupled environments. Plain Language Summary: Weather and climate models continue to struggle simulating cloud microphysical properties over the Southern Ocean, including cloud phase occurrence frequencies. High resolution observations of Southern Ocean clouds are crucial toward improving model simulations. This paper uses in situ observations to compare and contrast microphysical properties and phase frequencies of single‐ and multi‐layer clouds, as well as relates phase frequencies with ice nucleating particle and cloud condensation nuclei number concentrations. In situ observations used in this study were acquired during the Southern Ocean Cloud‐Radiation Aerosol Transport Experimental Study. A suite of cloud probe instrumentation is used to classify 1 Hz cloud samples as either liquid, ice or mixed phase (i.e., liquid and ice particles in the same sample volume). The lowest occurrence frequency of liquid phase samples is observed in the lowest cloud layers of multi‐layer clouds, whereas the highest frequency is observed in single‐layer clouds. Ice nucleating particle number concentrations are negatively correlated with liquid phase occurrence frequencies in select cases. In contrast, cloud condensation nuclei number concentrations are positively correlated with liquid phase frequencies, although this is only observed for clouds above the boundary layer. Key Points: The occurrence frequency of ice is greater in multi‐layer clouds than in single‐layer cloudsDrop number size distributions are broader in multi‐layer clouds compared to single‐layer cloudsLiquid drop number concentrations are approximately double in environments coupled with the surface compared to decoupled environments [ABSTRACT FROM AUTHOR]

CTP synthases (CTPS) catalyze the de novo production of CTP using UTP, ATP, and l‐glutamine with the anticancer drug metabolite gemcitabine‐5′‐triphosphate (dF‐dCTP) being one of its most potent nucleotide inhibitors. To delineate the structural origins of this inhibition, we solved the structures of Escherichia coli CTPS (ecCTPS) in complex with CTP (2.0 Å), 2′‐ribo‐F‐dCTP (2.0 Å), 2′‐arabino‐F‐CTP (2.4 Å), dF‐dCTP (2.3 Å), dF‐dCTP and ADP (2.1 Å), and dF‐dCTP and ATP (2.1 Å). These structures revealed that the increased binding affinities observed for inhibitors bearing the 2′‐F‐arabino group (dF‐dCTP and F‐araCTP), relative to CTP and F‐dCTP, arise from interactions between the inhibitor's fluorine atom exploiting a conserved hydrophobic pocket formed by F227 and an interdigitating loop from an adjacent subunit (Q114‐V115‐I116). Intriguingly, crystal structures of ecCTPS•dF‐dCTP complexes in the presence of select monovalent and divalent cations demonstrated that the in crystallo tetrameric assembly of wild‐type ecCTPS was induced into a conformation similar to inhibitory ecCTPS filaments solely through the binding of Na+‐, Mg2+‐, or Mn2+•dF‐dCTP. However, in the presence of potassium, the dF‐dCTP‐bound structure is demetalated and in the low‐affinity, non‐filamentous conformation, like the conformation seen when bound to CTP and the other nucleotide analogues. Additionally, CTP can also induce the filament‐competent conformation linked to high‐affinity dF‐dCTP binding in the presence of high concentrations of Mg2+. This metal‐dependent, compacted CTP pocket conformation therefore furnishes the binding environment responsible for the tight binding of dF‐dCTP and provides insights for further inhibitor design. [ABSTRACT FROM AUTHOR]

Background: Pseudotumour cerebri (PTC) is the syndrome of intracranial hypertension without intracranial mass or hydrocephalus and is the commonest cause of papilloedema seen in many eye clinics. In the last 10 years, we have increasingly used TSS in patients whose papilloedema was not well controlled with medical treatment and have done fewer ONSFs. Here, we review our experience at Royal Prince Alfred Hospital Sydney with ONSF in 35 patients over the period 2002–2021. Methods: Retrospective case series of 35 patients, 30 of whom had primary PTC [i.e., idiopathic intracranial hypertension (IIH)] and 5 with secondary PTC. Results: Eighteen patients had bilateral ONSF and 17 patients unilateral ONSF, in each case of the worse eye. Thirteen patients then underwent transverse sinus stenting (TSS), in each case following ONSF. The primary outcome measures were visual acuity (VA) and mean deviation (MD) on visual field (VF) testing. MD improved by 5 dB or more in 34 of 70 total eyes (48.6%); VA improved by 0.2 logMAR (two lines on Snellen chart) or more in 21 eyes (30%), and by both in 15 eyes (21.4%). Final MD was −10 dB or better in 38 eyes (54.3%); final VA was 0.3 (6/12) or better in 54 eyes (77.1%), and both in 39 eyes (55.7%). Conclusions: The results confirm that ONSF can relieve papilloedoema in both eyes and improve both VF and VA, even in cases of fulminant PTC with severe acute visual impairment. [ABSTRACT FROM AUTHOR]

Southern Ocean (SO) low‐level mixed phase clouds have been a long‐standing challenge for Earth system models to accurately represent. While improvements to the Community Earth System Model version 2 (CESM2) resulted in increased supercooled liquid in SO clouds and improved model radiative biases, simulated SO clouds in CESM2 now contain too little ice. Previous observational studies have indicated that marine particles are major contributor to SO low‐level cloud heterogeneous ice nucleation, a process that initiates a number of cloud processes that govern cloud radiative properties. In this study, we utilize detailed aerosol and ice nucleating particle (INP) measurements from two recent measurement campaigns to assess simulated aerosol abundance, number size distributions, and composition and INP parameterizations for use in CESM2. Our results indicate that CESM2 has a positive bias in simulated surface‐level total aerosol surface area at latitudes north of 58°S. Measured INP populations were dominated by marine INPs and we present evidence of refractory INPs present over the SO assumed here to be mineral dust INPs. Results highlight a critical need to assess simulated mineral dust number and size distributions in CESM2 in order to adequately represent SO INP populations and their response to long‐term changes in atmospheric transport patterns and land use change. We also discuss important cautions and limitations in applying a commonly used mineral dust INP parameterization to remote regions like the pristine SO. Plain Language Summary: Clouds over the Southern Ocean play an important role in our climate by reflecting significant amounts of solar radiation that would otherwise be absorbed by the ocean. Earth system models used to simulate climate struggle to accurately represent Southern Ocean clouds, largely because there have been limited observations to evaluate and improve models. One specific process that may be important for modeling Southern Ocean clouds is ice nucleation, where ice nucleation active particles serve as "seeds" for ice formation in clouds. In this study, we use measurements from two recent field campaigns to test a state‐of‐the‐art Earth system model's representation of atmospheric particles. We also test three different methods for representing the concentrations of available ice nucleating particles. The results from this work highlight a need for increased knowledge of the quantities, sizes and altitudes of mineral dust particles transported from distant land sources to the Southern Ocean and also emphasizes that Earth system models need to include ice nucleation from marine particles in order to accurately represent aerosol‐cloud‐climate interactions in these remote regions. Key Points: Marine and mineral dust aerosol contributed to ice nucleating particle populations measured from ship and aircraft over the Southern OceanThe model predicts observed latitudinal variability in aerosol surface area concentrations at high southern latitudesModel‐predicted mineral dust ice nucleating particle number concentrations vary by 4 orders of magnitude over the Southern Ocean [ABSTRACT FROM AUTHOR]

The current study addresses the communication aspect of risk governance during the COVID‐19 pandemic by examining whether governors' tweets differ by political party, gender and crisis phase. Drawing on the Centers for Disease Control and Prevention's Crisis Emergency Risk Communication (CERC) model and framing literature, we examined the salience of five CERC's communication objectives, namely acknowledge crisis with empathy, promote protective actions, describe preparedness/response efforts, address rumours and misunderstanding and segment audience. Using a deductive and inductive approach, we analysed 7000 Twitter messages sent by the 50 US state governors during the period of 13 March 2020 to 17 August 2020. Our findings suggest that governors' tweets aligned with CERC's communication objectives to a varying degree. We found main and interaction effects of political party, gender and crisis phase on governors' communication objectives. New emergent communication objectives included attention to mental health, call for social influencers and promoting hope. Implications are discussed. [ABSTRACT FROM AUTHOR]

As a result of the availability of modern software and hardware, Bayesian analysis is becoming more popular in neutron and X‐ray reflectometry analysis. The understandability and replicability of these analyses may be harmed by inconsistencies in how the probability distributions central to Bayesian methods are represented in the literature. Herein advice is provided on how to report the results of Bayesian analysis as applied to neutron and X‐ray reflectometry. This includes the clear reporting of initial starting conditions, the prior probabilities, the results of any analysis and the posterior probabilities that are the Bayesian equivalent of the error bar, to enable replicability and improve understanding. It is believed that this advice, grounded in the authors' experience working in the field, will enable greater analytical reproducibility in the work of the reflectometry community, and improve the quality and usability of results. [ABSTRACT FROM AUTHOR]

Introduction/Aims: Risdiplam is the newest available treatment for patients with spinal muscular atrophy (SMA). There is little information on its use in adults. We present the clinical experience of adults with SMA treated with risdiplam through the Early Access to Medicines Scheme (EAMS) in Northern Ireland. Methods: All adults with Type 2 SMA attending the regional neuromuscular clinic were offered risdiplam treatment. Patients had assessments of respiratory function, the Epworth Sleepiness Scale (ESS), Quality of Life Measure for People with Slowly Progressive and Genetic Neuromuscular Disease (QOLM), and Egen Klassifikation 2 (EK2) every 3 mo and the Revised Upper Limb Module for SMA (RULM) at baseline and 6 mo. All assessments other than the RULM were carried out virtually. Results: Six of seven patients who were offered risdiplam consented to treatment through the EAMS (five female, one male, mean age 33.7 y). It was generally well tolerated other than skin photosensitivity in all patients. All patients remained on therapy at 9 mo. All reported meaningful improvements in overall strength, sense of wellbeing, and speech quality. There was no change in respiratory function, daytime hypersomnolence, or upper limb function (all p >.05). There was improvement in the QOLM (p =.027) and EK2 (p =.009). Discussion: Our study raises hopes that risdiplam may be efficacious in adults; however, more systematic studies in larger cohorts are needed before drawing any definitive conclusions. This study also demonstrated the feasibility of virtual assessments. [ABSTRACT FROM AUTHOR]

The uveitides are a collection of over 30 diseases characterised by intraocular inflammation. Previous work demonstrated that the agreement among uveitis experts on diagnosis was modest at best with some pairs of experts having chance alone agreement on selected diseases. The Standardisation of Uveitis Nomenclature (SUN) is a17‐year collaboration among experts in uveitis, ocular image grading, informatics, and machine learning to improve clinical and translational uveitis research. The SUN "Developing Classification Criteria for the Uveitides" project used a rigorous, multi‐phase approach to develop classification criteria for 25 of the most common uveitic diseases. The project's phases were: (1) informatics; (2) case collection; (3) case selection; (4) machine learning; and (5) consensus review and publication. The results were classification criteria with a high degree of accuracy (93.3%–99.3% depending on anatomic class of the uveitis), the goal of which is to form the basis for future uveitis research. [ABSTRACT FROM AUTHOR]

This article analyzes factors that predict the academic rank of Economics and Agricultural Economics faculty. While female faculties are under‐represented in both types of academic departments, we find that significant factors in predicting the academic rank of female faculty are primarily professional contributions represented by publications and experience. Agricultural Economics departments require more publications than Economics in order to achieve the same positive effect on the latent indicator of higher academic rank. The positive contribution of publications to higher academic rank status is larger for females than for males for both types of economists. The result is suggestive of potential benefits relating to policies that support women in their ability to publish. [ABSTRACT FROM AUTHOR]

The 2017 Advisory Opinion of the Inter‐American Court of Human Rights broke new ground in finding that States' failure to regulate with due diligence the activities taking place within its territory could constitute a breach of the human rights of persons located elsewhere. How might this finding inform the law on prevention of transboundary harm? Similarly, how might it inform an identification of the standard of care required of States in respect of climate change? This article argues that the law on transboundary harm should now be understood as requiring States to regulate the reduction of greenhouse gas emissions in accordance with stabilizing global warming at a temperature, which, at a minimum, prevents widespread threat to life around the globe. States' differing capacities to invest in mitigation strategies, their varying historic contributions to climate change and the urgency of reducing greenhouse gas emissions are also factors affecting a reasonable standard of care. [ABSTRACT FROM AUTHOR]

Vesicular stomatitis (VS) is a vector‐borne viral disease that causes lesions in livestock, premises, county and state quarantines, and important economic losses. We investigated vector–habitat characteristics for vectors associated with VS in regions of recurrent disease within the western United States (US) that consistently lead to the environment where vector, host, and pathogen populations intersect to enable pathogen transmission. We analyzed the habitats of previously identified insect vectors, including black flies (BFs) (Simulium vittatum complex), biting midges (BMs) (Culicoides variipennis complex, which includes Culicoides sonorensis), and sand flies (SFs) (Lutzomyia shannoni) in six regions of interest (ROIs) containing hotspots of VS ranging from Texas (TX) to Wyoming. This analysis broadened the understanding of (1) how regions of reoccurring VS differ from the broader western US, (2) how geographically separated regions and hotspots are similar across time, and (3) how vector–environment habitat a priori knowledge relates to observed hotspots. Analysis of watershed factors (livestock densities, land‐cover proportions, stream and lake densities, and irrigation methods) indicated a complex system separating areas with high, recurring VS from the broader western US. Although no single characteristic separated the six ROIs from other areas, we found two distinct emerging groups (northern ROI and TX). Hotspots, estimated from monthly VS concentrations, evolved northward throughout the year and most hotspots were closer to flowing water and agricultural land than the broader ROI. All ROIs contained environmental conditions suitable for multiple vectors at some point in the year, but BFs had the highest suitability scores, whereas BM scores were lower and varied annually with higher suitability in summer. SFs had the lowest suitability score in all ROIs, consistent with their low likelihood of being vectors. BM habitat patches were often orders of magnitude smaller than BF patches, and hotspot patches reinforce the likelihood that BF may be the most critical vector in northern ROI, whereas both BM and BF have similar likelihood in southern ROI. Given limited existing vector data, this analysis provides an alternate pathway for using habitat information to associate likely vectors responsible for transmission. Results could support early warning and mitigation efforts to reduce the incidence of VS. [ABSTRACT FROM AUTHOR]

Background: Early extubation in liver transplantation (LT) and its potential benefits such as reduction in pulmonary complications and enhanced postoperative recovery have been described. The extent of the effect of early extubation on short‐term outcomes after LT across the published literature is to the best of our knowledge unknown. Objectives: The objective of this systematic review and meta‐analysis was to determine whether early extubation improves immediate and short‐term outcomes after LT and to provide expert recommendations. Data Sources: Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central. Methods: A systematic review and meta‐analysis on short‐term outcomes after early extubation in LT was performed (CRD42021241402), following PRISMA guidelines and quality of evidence (QOE) and recommendations grading using the GRADE approach, derived from an international experts panel. Endpoints were reintubation rates, pulmonary and other complications/organ dysfunction, intensive care unit (ICU) and hospital length of stay (LOS). Results: Of 831 screened articles, 20 observational studies with a total of 3573 patients addressing early extubation protocols were included, of which 12 studies compared results after early versus deferred extubation. Reintubation and pulmonary complication rates were lower in the early versus deferred extubation groups (OR 0.29, CI 0.22–0.39; OR 0.17, CI 0.09–0.33, respectively). ICU and hospital LOS were shorter in eight out of eight and seven out of eight comparative studies, respectively. Conclusions: Early extubation after LT is associated with improved short‐term outcomes after LT and should be performed in the majority of patients (QOE; Moderate to low | Grade of Recommendation; Strong). Randomized controlled trials using standardized definitions of early extubation and short‐term outcomes are needed to demonstrate causality, validate and allow comparability of the results. [ABSTRACT FROM AUTHOR]

The recent bankruptcy of Dean Foods (DF) and subsequent acquisition of a major share by Dairy Farmers of America (DFA) raised an antitrust complaint which led to DF divesting some assets. The current article empirically analyzes the economic impact of a hypothetical merger between DF and DFA. We use retail scanner data of 2008–2018 under a random‐coefficient discrete choice framework. Assuming a constant marginal cost, we find that the merger may slightly increase retail prices of cow milk products‐‐especially organic ones‐‐across the market and the hypothetical market power of DFA in the long run. Related Content: Should we use antitrust policies on big agriculture? Related Content: Competition issues in the U.S. beef industry [ABSTRACT FROM AUTHOR]

Background and Aim: There is no gold‐standard and considerable heterogeneity in outcome measures used to evaluate treatments for opioid use disorder (OUD) along the opioid treatment cascade. The aim of this study was to develop the US National Institute on Drug Abuse (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) opioid use disorder core outcomes set (OUD–COS). Design: Four‐round, e‐Delphi expert panel consensus study and plenary research group discussion and targeted consultation. Setting: United States. Participants: A panel of 25 members including clinical practitioners, clinical researchers and administrative staff from the CTN, the network's affiliated clinical and community sites and the NIDA Centre for the CTN. Measurements From a pool of 24 candidate items in four domains (biomedical/disease status; behaviors, symptoms and functioning; opioid treatment cascade; and morbidity and mortality), the panel completed an on‐line questionnaire to rank items with defined specification on a 9‐point scale for importance, with a standard 70% consensus criterion. Findings After the fourth round of the questionnaire and subsequent discussion, consensus was reached for five outcomes: two patient‐reported (global impression of improvement and incident non‐fatal overdose); one clinician‐reported (illicit/non‐medical drug toxicology); and two from administrative records (duration of treatment and fatal opioid poisoning). Conclusions: An e‐Delphi consensus study has produced the US National Institute on Drug Abuse (NIDA) National Drug Abuse Treatment Clinical Trials Network opioid use disorder core outcomes set (version 1) for opioid use disorder treatment efficacy and effectiveness research. [ABSTRACT FROM AUTHOR]

Maritime boundary‐layer clouds over the Southern Ocean (SO) have a large shortwave radiative effect. Yet, climate models have difficulties in representing these clouds and, especially, their phase in this observationally sparse region. This study aims to increase the knowledge of SO cloud phase by presenting in‐situ cloud microphysical observations from the Southern Ocean Clouds, Radiation, Aerosol, Transport Experimental Study (SOCRATES). We investigate the occurrence of ice in summertime marine stratocumulus and cumulus clouds in the temperature range between 6 and −25°C. Our observations show that in ice‐containing clouds, maximum ice number concentrations of up to several hundreds per liter were found. The observed ice crystal concentrations were on average one to two orders of magnitude higher than the simultaneously measured ice nucleating particle (INP) concentrations in the temperature range below −10°C and up to five orders of magnitude higher than estimated INP concentrations in the temperature range above −10°C. These results highlight the importance of secondary ice production (SIP) in SO summertime marine boundary‐layer clouds. Evidence for rime splintering was found in the Hallett‐Mossop (HM) temperature range but the exact SIP mechanism active at lower temperatures remains unclear. Finally, instrument simulators were used to assess simulated co‐located cloud ice concentrations and the role of modeled HM rime‐splintering. We found that CAM6 is deficient in simulating number concentrations across the HM temperature range with little sensitivity to the model HM process, which is inconsistent with the aforementioned observational evidence of highly active SIP processes in SO low‐level clouds. Plain Language Summary: Clouds in the Southern Ocean are important for climate but not well represented in climate models. Observations in this remote region have been rare. This study presents results from a recent airborne campaign that took place in the Southern Ocean where low‐ and mid‐level clouds were investigated by detecting individual cloud particles within the clouds. Although large fraction of the observed clouds did not contain ice crystals, occasionally high amounts of ice crystals were observed that cannot be explained by ice formation on aerosol particles but were result of multiplication of existing ice crystals. We tested the capability of a commonly used climate model to represent the observed ice concentrations and their sensitivity to one ice multiplication process parameterized in the model. These investigations revealed that the in the model the ice multiplication process was not responsible for generation of ice, which is in contradiction with the observations. Key Points: Ice concentrations several orders of magnitude higher than ice nucleating particle concentrations were observedSecondary ice production was believed to be responsible for the observed high ice number concentrationsComparison with climate model indicated that secondary ice processes are still inadequately represented in the model [ABSTRACT FROM AUTHOR]

Mucosal‐associated invariant T (MAIT) cells are a major subset of innate‐like T cells mediating protection against bacterial infection through recognition of microbial metabolites derived from riboflavin biosynthesis. Mouse MAIT cells egress from the thymus as two main subpopulations with distinct functions, namely, T‐bet‐expressing MAIT1 and RORγt‐expressing MAIT17 cells. Previously, we reported that inducible T‐cell costimulator and interleukin (IL)‐23 provide essential signals for optimal MHC‐related protein 1 (MR1)‐dependent activation and expansion of MAIT17 cells in vivo. Here, in a model of tularemia, in which MAIT1 responses predominate, we demonstrate that IL‐12 and IL‐23 promote MAIT1 cell expansion during acute infection and that IL‐12 is indispensable for MAIT1 phenotype and function. Furthermore, we showed that the bias toward MAIT1 or MAIT17 responses we observed during different bacterial infections was determined and modulated by the balance between IL‐12 and IL‐23 and that these responses could be recapitulated by cytokine coadministration with antigen. Our results indicate a potential for tailored immunotherapeutic interventions via MAIT cell manipulation. [ABSTRACT FROM AUTHOR]

Objective: To compare fall incidence, and visual acuity and refractive status, before surgery and after first and second eye cataract surgery. Design, setting: Prospective observational study in eight tertiary referral ophthalmology clinics in public hospitals in Sydney, Melbourne, and Perth. Participants: People aged 65 years or more referred for bilateral age‐related cataract surgery during 2013–16, followed for maximum of 24 months after study entry or until six months after second eye surgery, whichever was shorter. Main outcome measures: Primary outcome: age‐ and sex‐adjusted incidence of falls. Secondary outcomes: visual acuity and refractive error. Results: The mean age of the 409 included participants was 75.4 years (SD, 5.4 years); 220 were women (54%). Age‐ and sex‐adjusted fall incidence prior to surgery was 1.17 (95% CI, 0.95–1.43) per year, 0.81 (95% CI, 0.63–1.04) per year after first eye surgery, and 0.41 (95% CI, 0.29–0.57) per year after second eye surgery. For the 118 participants who underwent second eye surgery and participated in all follow‐up visits, age‐ and sex‐adjusted incidence before (0.80 [95% CI, 0.55–1.15] falls per year) and after first eye surgery (0.81 [95% CI, 0.57–1.15] falls per year) was similar, but was lower after second eye surgery (0.32 [95% CI 0.21–0.50] falls per year). Mean habitual binocular visual acuity (logMAR) was 0.32 (SD, 0.21) before surgery, 0.15 (SD, 0.17) after first eye surgery, and 0.07 (SD, 0.15) after second eye surgery. Conclusions: First eye surgery substantially improves vision in older people with cataract, but second eye surgery is required to minimise fall incidence. Timely cataract surgery for both eyes not only optimises vision in older people with cataract, but also reduces their risk of injury from falls. [ABSTRACT FROM AUTHOR]

Summary: Intra‐operative hypotension is a risk factor for postoperative morbidity and mortality. Minimally invasive monitors that derive other haemodynamic parameters, such as stroke volume, may better inform the management of hypotension. As a prelude to a multicentre randomised controlled trial, we conducted a single‐centre feasibility trial of a protocol to treat hypotension as informed by minimally invasive haemodynamic monitoring during non‐cardiac surgery. We recruited adults aged ≥40 years with cardiovascular risk factors who underwent non‐cardiac surgery requiring invasive arterial pressure monitoring. Participants were randomly allocated to usual care, or a clinical protocol informed by an arterial waveform contour analysis monitor. Participants, outcome assessors, clinicians outside operating theatres and analysts were blinded to treatment allocation. Feasibility was evaluated based on: consent rate; recruitment rate; structured feedback from anaesthesia providers; and between‐group differences in blood pressure, processes‐of‐care and outcomes. The consent rate among eligible patients was 33%, with 30 participants randomly allocated to the protocol and 30 to usual care. Anaesthesia providers rated the protocol to be feasible and acceptable. The protocol was associated with reduced fluid balance and hypotension exposure in the peri‐operative setting. Postoperative complications included: acute myocardial injury in 18 (30%); acute kidney injury in 17 (28%); and surgical site infection in 7 (12%). The severity of complications was rated as moderate or severe in 25 (42%) participants. In summary, this single‐centre study confirmed the feasibility of a multicentre trial to assess the efficacy and safety of a physiologically guided treatment protocol for intra‐operative hypotension based on minimally invasive haemodynamic monitors. [ABSTRACT FROM AUTHOR]

Atmospheric ice-nucleating particles (INPs) play a critical role in cloud freezing processes, with important implications for precipitation formation and cloud radiative properties, and thus for weather and climate. Additionally, INP emissions respond to changes in the Earth System and climate, for example, desertification, agricultural practices, and fires, and therefore may introduce climate feedbacks that are still poorly understood. As knowledge of the nature and origins of INPs has advanced, regional and global weather, climate, and Earth system models have increasingly begun to link cloud ice processes to model-simulated aerosol abundance and types. While these recent advances are exciting, coupling cloud processes to simulated aerosol also makes cloud physics simulations increasingly susceptible to uncertainties in simulation of INPs, which are still poorly constrained by observations. Advancing the predictability of INP abundance with reasonable spatiotemporal resolution will require an increased focus on research that bridges the measurement and modeling communities. This review summarizes the current state of knowledge and identifies critical knowledge gaps from both observational and modeling perspectives. In particular, we emphasize needs in two key areas: (a) observational closure between aerosol and INP quantities and (b) skillful simulation of INPs within existing weather and climate models. We discuss the state of knowledge on various INP particle types and briefly discuss the challenges faced in understanding the cloud impacts of INPs with present-day models. Finally, we identify priority research directions for both observations and models to improve understanding of INPs and their interactions with the Earth System. [ABSTRACT FROM AUTHOR]

Living donor liver transplantation was first developed to mitigate the limited access to deceased donor organs in Asia in the 1990s. This alternative liver transplantation method has become a widely practiced and established transplantation option for adult patients suffering with end‐stage liver disease, and it has successfully helped address the shortage of deceased donors. The Society for the Advancement of Transplant Anesthesia and the Korean Society of Transplantation Anesthesiologists jointly reviewed published studies on the perioperative management of adult live liver donors undergoing donor hemi‐hepatectomy. The goal of the review is to offer transplant anesthesiologists and critical care physicians a comprehensive overview of the perioperative management of adult live donors. We featured the current status, donor selection process, outcomes and complications, surgical procedure, anesthetic management, Enhanced Recovery After Surgery protocols, avoidance of blood transfusion, and considerations for emergency donation. Recent surgical advances, including laparoscopic donor hemi‐hepatectomy and robotic laparoscopic donor surgery, are also addressed. [ABSTRACT FROM AUTHOR]

Objectives: HIV virological failure remains a major threat to programme success in sub‐Saharan Africa. While HIV drug resistance (HIVDR) and inadequate adherence are the main drivers of virological failure, the individual, clinical and health system characteristics that lead to poor outcomes are not well understood. The objective of this paper is to identify those characteristics among people failing first‐line antiretroviral therapy (ART). Methods: We enrolled a cohort of adults in HIV care experiencing virological failure on first‐line ART at five sites and used standard statistical methods to characterize them with a focus on three domains: individual/demographic, clinical, and health system, and compared each by country of enrolment. Results: Of 840 participants, 51% were women, the median duration on ART was 3.2 years [interquartile range (IQR) 1.1, 6.4 years] and the median CD4 cell count prior to failure was 281 cells/µL (IQR 121, 457 cells/µL). More than half of participants [53%; 95% confidence interval (CI) 49–56%] stated that they had > 90% adherence and 75% (95% CI 72–77%) took their ART on time all or most of the time. Conversely, the vast majority (90%; 95% CI 86–92%) with a completed genotypic drug resistance test had any HIV drug resistance. This population had high health system use, reporting a median of 3 (IQR 2.6) health care visits and a median of 1 (IQR 1.1) hospitalization in the preceding 6 months. Conclusions: Patients failing first‐line ART in sub‐Saharan Africa generally report high rates of adherence to ART, have extremely high rates of HIV drug resistance and utilize significant health care resources. Health systems interventions to promptly detect and manage treatment failure will be a prerequisite to establishing control of the HIV epidemic. [ABSTRACT FROM AUTHOR]

Objective: To investigate the management impact of non‐mydriatic fundus photography (NMFP) implementation for appropriate ED patients; compare the diagnostic accuracy of direct ophthalmoscopy (DO) and NMFP, and determine the prevalence of fundus pathology in a regional Australian ED. Methods: This before/after crossover study prospectively enrolled patients presenting with headache, neurological deficit, visual disturbance and/or hypertensive urgency. Patients received DO examination, then separate NMFP examination. Emergency clinicians (ECs) were surveyed on their patient management plans following both DO examination and NMFP imaging. Telemedicine review of NMFP images was performed by an ophthalmologist within 48 h, and any additional management changes were documented. Results: The use of NMFP influenced changes in management in 52 (39%) of 133 enrolled patients (95% confidence interval 31–48%). Of these, 65% were escalations of management due to acute fundus pathology, while 35% were de‐escalating changes following normal fundus findings. ECs diagnostic accuracy for acute fundus pathology improved from 0% to 29% sensitivity, and 59% to 84% specificity using DO and NMFP respectively, and telemedicine registrar review increased this to 50% sensitivity and 86% specificity. The period prevalence of acute fundus pathology was 10.5% (95% confidence interval 6–17%). Conclusion: The addition of NMFP images can significantly impact the management of ED patients requiring fundus examination, facilitating expedited and optimised patient care. NMFP improves ECs diagnostic acumen for fundus pathology over DO examination and telehealth specialist review is important for diagnostic accuracy. There is a clinically important prevalence of fundus pathology in this regional ED setting. [ABSTRACT FROM AUTHOR]

I Renaissance Religions i takes a fresh look at an old subject; namely, the beliefs, practices, and expression of religion in Renaissance Italy. I Renaissance Religions i demonstrates unequivocally that "religion worked as a permeating influence" (p. 20) in Italian society between the fourteenth and seventeenth centuries. Ultimately, I Renaissance Religions' i greatest merit is how it seamlessly weaves into the historical record the multifarious experiences of those who actually lived these "religions". [Extracted from the article]

Background and purpose: This study evaluates the incidence, prevalence and survival trends of motor neurone disease (MND) in Northern Ireland from 2015 to 2019. Methods: A capture–recapture analysis was performed using five independent data sources. Incidence and prevalence rates were standardized to the European Standard Population. Survival outcomes were analysed using Kaplan–Meier curves and Cox regression analysis. Results: Amongst 254 total cases of MND, capture–recapture analysis estimated three missing cases (case ascertainment 98.8%). Age standardized incidence of captured cases was 3.12 per 100,000 (2.73, 3.50) and standardized prevalence ranged from 9.45 to 6.49 per 100,000 from 2015 to 2019. Standardized incidence and prevalence rates in 2006 were 1.4 and 3.3 per 100,000 respectively. Of identified cases, 133 (52.4%) were male; 94.5% had amyotrophic lateral sclerosis; median age of onset was 67 years; median time to diagnosis was 12 months (95% confidence interval 11.2, 12.8); survival from diagnosis was 12 months (95% confidence interval 10.6, 15.4); 25 (9.8%) reported a family history of MND or frontotemporal dementia; and a known MND‐associated genetic mutation was identified in 7.9% of total cases, of which the most common was C9orf72 (5.7% of all patients). Factors associated with improved survival were younger age at onset, longer time to diagnosis, attendance at regional MND clinic, and initial neurology presentation as outpatient (all p < 0.001). Conclusion: The incidence and prevalence of MND in Northern Ireland has increased over the last 10 years, in line with increasing rates reported from other European countries. Improved survival was associated with younger age at onset, longer time to diagnosis, attendance at a regional MND clinic and outpatient presentation to a Neurology Department. [ABSTRACT FROM AUTHOR]

Introduction: To determine the impact of real‐time continuous glucose monitoring (RT‐CGM) in conjunction with 'Open loop'‐ continuous subcutaneous insulin infusion (CSII) as compared to conventional multiple daily injections (MDI) in type 1 diabetes. Methods: We explored the COCHRANE database, MEDLINE, WEB OF SCIENCE, GOOGLE SCHOLARS, PUBMED, EMBASE, and cited literature in articles retrieved (2010–2021) for all randomized controlled trials and real‐world trials of more than 6 months duration in patients with type 1 diabetes that compared RT‐CGM+CSII vs RT‐ CGM+MDI. A total of 1645 publications have been identified; however, only 3 trials fulfilled our inclusion criteria with a total number of 150 patients (72 patients using RT‐CGM+CSII and 78 patients on RT‐CGM+MDI). A Systematic Review and Meta‐analysis were carried out. Results: No statistically significant reduction in HbA1c was found on comparing RT‐CGM+CSII vs RT‐ CGM + MDI, with p‐value =.75. Likewise, impact on TIR, weight and insulin usage was found to be statistically insignificant with p‐value of 0.15, 0.75 and 0.20 respectively. There was an overall homogeneity between the 3 trials in respect to all previous variables with I2 being 0%. Conclusions: Real‐time continuous glucose monitors in conjunction with MDI open‐loop CSII had a similar impact on HbA1c, weight, insulin usage and TIR. In addition, RT‐CGM when combined with CSII was associated with higher costs and reduced quality of life, hence RT‐ CGM+MDI can be considered as a cheaper, safer yet equivalent substitute. Review Registration: This study was registered in PROSPERO (International prospective register of systematic reviews). Registration Name: RT‐CGM in conjunction with CSII vs MDI in optimizing glycaemic control in T1DM: a systematic review. Registration No: CRD42021255333. Accessible at: https://www.crd.york.ac.uk/prospero/display%5frecord.php?ID=CRD42021255333. Amendments: Few amendments to the above‐mentioned registration were made: (1) Title (Meta‐analysis was added). (2) Prof. Gleeson was added as an author. (3) Real‐world trials were included. (4) Outcomes required in studies as per our inclusion criteria amended to include at least 1 outcome. (5) Bias risk was assessed by the CASP tool. [ABSTRACT FROM AUTHOR]

Women entered agricultural economics in numbers starting in the 1980s, and their ranks are increasing over time. We make the case that women have increased the relevance in the field of agricultural economics through their diverse interests, perspectives, and experiences. We document how women have changed the profession of agricultural economics in both academia and government. In research, women have expanded the field's treatment of non‐traditional topics such as food safety and nutrition and environmental and natural resource economics. In this sense, women saved the profession from a future as a specialty narrowly focused on agricultural production and markets. Related Content: Contributions of women at the intersection of agricultural economics and environmental and natural resource economics Related Content: How women in agricultural economics expanded the profession's role in food safety and nutrition Related Content: Women agricultural economists in federal agencies: Making a difference [ABSTRACT FROM AUTHOR]

MHC‐related protein 1 (MR1) presents microbial riboflavin metabolites to mucosal‐associated invariant T (MAIT) cells for surveillance of microbial presence. MAIT cells express a semi‐invariant T‐cell receptor (TCR), which recognizes MR1–antigen complexes in a pattern‐recognition‐like manner. Recently, diverse populations of MR1‐restricted T cells have been described that exhibit broad recognition of tumor cells and appear to recognize MR1 in association with tumor‐derived self‐antigens, though the identity of these antigens remains unclear. Here, we have used TCR gene transfer and engineered MR1‐expressing antigen‐presenting cells to probe the MR1 restriction and antigen reactivity of a range of MR1‐restricted TCRs, including model tumor‐reactive TCRs. We confirm MR1 reactivity by these TCRs, show differential dependence on lysine at position 43 of MR1 (K43) and demonstrate competitive inhibition by the MR1 ligand 6‐formylpterin. TCR‐expressing reporter lines, however, failed to recapitulate the robust tumor specificity previously reported, suggesting an importance of accessory molecules for MR1‐dependent tumor reactivity. Finally, MR1‐mutant cell lines showed that distinct residues on the α1/α2 helices were required for TCR binding by different MR1‐restricted T cells and suggested central but distinct docking modes by the broad family of MR1‐restricted αβ TCRs. Collectively, these data are consistent with recognition of distinct antigens by diverse MR1‐restricted T cells. [ABSTRACT FROM AUTHOR]

Introduction: Liver transplant anesthesiology is an evolving and expanding subspecialty, and programs have, in the past, exhibited significant variations of practice at transplant centers across the United States. In order to explore current practice patterns, the Quality & Standards Committee from the Society for the Advancement of Transplant Anesthesia (SATA) undertook a survey of liver transplant anesthesiology program directors. Methods: Program directors were invited to participate in an online questionnaire. A total of 110 program directors were identified from the 2018 Scientific Registry of Transplant Recipients (SRTR) database. Replies were received from 65 programs (response rate of 59%). Results: Our results indicate an increase in transplant anesthesia fellowship training and advanced training in transesophageal echocardiography (TEE). We also find that the use of intraoperative TEE and viscoelastic testing is more common. However, there has been a reduction in the use of veno‐venous bypass, routine placement of pulmonary artery catheters and the intraoperative use of anti‐fibrinolytics when compared to prior surveys. Conclusion: The results show considerable heterogeneity in practice patterns across the country that continues to evolve. However, there appears to be a movement towards the adoption of specific structural and clinical practices. [ABSTRACT FROM AUTHOR]

Producing organic milk has been an alternative for conventional farmers who are struggling with low prices. However, organic dairy prices recently collapsed along with conventional prices when several large producers entered the organic market. The current study explores the patterns and determinants of organic dairy premiums. We estimate monthly price premiums for organic whole milk, other fluid milk, yogurt, and eggs over the period 2008–2017 using US retail scanner data. The premiums were 56%, 51%, 27%, and 38%, respectively, with annual compound growth rates of 8%, 7%, −1.42%, and −2.86%. We identify the determinants of price premiums with a vector autoregression to account for endogeneity and autocorrelation, and a machine‐learning algorithm—extreme gradient boost—for data‐driven insights. Holding the premiums fixed, growing input costs may induce organic sellers to sell more to compensate for costs. Holding organic sales fixed, organic premiums decrease in conventional share of organic, cost of diesel, electricity, and feed grains in general; but increase in the number of shoppers and wages. [EconLit citations: C55, Q130]. [ABSTRACT FROM AUTHOR]