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Abstract Volcano monitoring is constrained by the distribution of sensors that record activity. Here, we explore the role of crowdsourcing to broaden acoustic monitoring records by surveying people across Aotearoa New Zealand about the sounds they heard following the 2022 climactic eruption of Hunga volcano in Tonga. We compare the 1930 survey responses to geophysical records of the pressure waves and find that they align well, both recording ~5-7 audible signals of varying amplitude with a peak of 60-80 decibels, arriving in two 30-minute phases ~3 hours post-eruption, travelling North-to-South. The crowdsourced observations fill instrumental gaps regarding the wave’s audible frequencies and contribute insights into interactions between the far-field acoustic wave and the social and built environment. Descriptions of short-lived impacts reveal that pressure waves are capable of substantial disturbances thousands of kilometers from the vent. We demonstrate that crowdsourcing can support traditional monitoring as a reliable low-cost method to capture perishable data.

The Victorian Precision Oncology Summit, convened in 2023, was a joint initiative between the Victorian Comprehensive Cancer Centre Alliance (VCCC Alliance) and the Monash Partners Comprehensive Cancer Consortium (MPCCC) and was proposed to guide a coordinated state-wide conversation about how the oncology sector can overcome some of the current obstacles in achieving equity of access to clinical cancer genomics for Victorian patients. Themes that emerged from discussion groups at the Summit include standardisation, centralisation, funding, education and communication and insights across those themes are outlined in this manuscript. The event served as a large consultation piece for the development of a broader precision oncology roadmap, which explores equitable access to molecular testing for Victorian patients, currently in development by the VCCC Alliance and MPCCC in collaboration with other key Victorian and national stakeholders. While this symposium was a Victorian initiative, it is felt that the insights garnered from this consultation piece will be of interest to consumer groups, clinicians, researchers, educators, policy makers and other key stakeholders in other states of Australia as well as in other countries implementing comprehensive genomic profiling within complex health systems.

Type 2 cytokines like IL-4 are hallmarks of helminth infection and activate macrophages to limit immunopathology and mediate helminth clearance. In addition to cytokines, nutrients and metabolites critically influence macrophage polarization. Choline is an essential nutrient known to support normal macrophage responses to lipopolysaccharide; however, its function in macrophages polarized by type 2 cytokines is unknown. Using murine IL-4-polarized macrophages, targeted lipidomics revealed significantly elevated levels of phosphatidylcholine, with select changes to other choline-containing lipid species. These changes were supported by the coordinated up-regulation of choline transport compared to naïve macrophages. Pharmacological inhibition of choline metabolism significantly suppressed several mitochondrial transcripts and dramatically inhibited select IL-4-responsive transcripts, most notably, Retnla. We further confirmed that blocking choline metabolism diminished IL-4-induced RELMα (encoded by Retnla) protein content and secretion and caused a dramatic reprogramming toward glycolytic metabolism. To better understand the physiological implications of these observations, naïve or mice infected with the intestinal helminth Heligmosomoides polygyrus were treated with the choline kinase α inhibitor, RSM-932A, to limit choline metabolism in vivo. Pharmacological inhibition of choline metabolism lowered RELMα expression across cell-types and tissues and led to the disappearance of peritoneal macrophages and B-1 lymphocytes and an influx of infiltrating monocytes. The impaired macrophage activation was associated with some loss in optimal immunity to H. polygyrus, with increased egg burden. Together, these data demonstrate that choline metabolism is required for macrophage RELMα induction, metabolic programming, and peritoneal immune homeostasis, which could have important implications in the context of other models of infection or cancer immunity.

Silicic caldera volcanoes present major volcanic and seismic hazards but also host dynamic hydrothermal and groundwater systems and a rich but largely unexplored subsurface biosphere. Many of these volcanoes are hosted in rift settings. The intricate connections and feedbacks among magmatism, rifting, hydrothermal processes, and the biosphere in these complex systems remain poorly understood, necessitating subsurface joint observations that are only enabled by scientific drilling. The CALDERA (Connections Among Life, geo-Dynamics and Eruptions in a Rifting Arc caldera) project workshop funded by the International Continental Scientific Drilling Program (ICDP) gathered multi-disciplinary international experts in January 2023 to advance planning of a scientific drilling project within one of these dynamic, rift-hosted calderas, the Okataina Volcanic Centre (OVC), Aotearoa New Zealand. The OVC's high eruption rate, frequent unrest events and earthquake swarms, location in a densely faulted rapidly extending rift, abundant groundwater–geothermal fluid circulations, and diverse surface hot spring microbiota make it an ideal location for exploring a connected geo-hydro-biosphere via scientific drilling and developing a test bed for novel volcano monitoring approaches. Drilling configurations with at least two boreholes (∼ 200 and ∼ 1000–1500 m deep) were favoured to achieve the multi-disciplinary objectives of the CALDERA project. Decadal monitoring including biosphere activity and composition has the potential to evaluate the response of the hydro-bio system to volcano-tectonic activity. In addition to the OVC caldera-scale datasets already available, site surveys will be conducted to select the best drilling locations. The CALDERA project at the OVC would provide, for the first time, an understanding of volcanic–tectonic–hydrological–biological connections in a caldera–rift system and a baseline for global comparisons with other volcanoes, rifts, and hydrothermal systems. CALDERA would serve as an unprecedented model system to understand how and how quickly the subsurface biosphere responds to geologic activities. Discoveries will improve assessment of volcanic and seismic hazards, guide the sustainable management and/or conservation of groundwater and geothermal resources and microbial ecosystems, and provide a forum for interweaving mātauranga Māori and Western knowledge systems.

Traditionally, rubrics were used simply as grading tools to provide marking frameworks that were transparent to students. More recently, rubrics have been promoted as educational tools to inform students of good practice with the assumption that they engage with these rubrics to guide their learning. However, some tensions arise from this approach, including the assumption that students actually engage with assessment rubrics and, most notably, whether students understand the purpose of rubrics and the language used within. In response, this paper promotes the practice of teachers involving their students in the co-construction of rubrics by presenting a "Model of Collaborative Rubric Construction." This Model was informed by an extensive literature review, advice from international assessment experts, and both qualitative and quantitative data from students and teachers who worked in partnership to co-construct and use assessment rubrics across three higher education institutions. The Model, structured as three-tiers, offers background information about rubrics and their co-construction, strategies to guide collaboration in the rubric co-construction process, and shared scholarship associated with the project (i.e., research methods, recommendations for practice, and relevant references and publications) in which the Model was developed.

Dry deposition of ozone (O3) to the ocean surface and the ozonolysis of organics in the sea surface microlayer (SSML) are potential sources of volatile organic compounds (VOCs) to the marine atmosphere. We use a gas chromatography system coupled to a Vocus proton-transfer-reaction time-of-flight mass spectrometer to determine the chemical composition and product yield of select VOCs formed from ozonolysis of coastal seawater collected from Scripps Pier in La Jolla, California. Laboratory-derived results are interpreted in the context of direct VOC vertical flux measurements made at Scripps Pier. The dominant products of laboratory ozonolysis experiments and the largest non-sulfur emission fluxes measured in the field correspond to Vocus CxHy+ and CxHyOz+ ions. Gas chromatography (GC) analysis suggests that C5–C11 oxygenated VOCs, primarily aldehydes, are the largest contributors to these ion signals. In the laboratory, using a flow reactor experiment, we determine a VOC yield of 0.43–0.62. In the field at Scripps Pier, we determine a maximum VOC yield of 0.04–0.06. Scaling the field and lab VOC yields for an average O3 deposition flux and an average VOC structure results in an emission source of 10.7 to 167 Tg C yr−1, competitive with the DMS source of approximately 20.3 Tg C yr−1. This study reveals that O3 reactivity to dissolved organic carbon can be a significant carbon source to the marine atmosphere and warrants further investigation into the speciated VOC composition from different seawater samples and the reactivities and secondary organic aerosol (SOA) yields of these molecules in marine-relevant, low NOx conditions.

Abstract Introduction In the post‐COVID 19 environment, it has become increasingly important for healthcare services to optimise service delivery for the benefit of both patients and staff. The project purpose was to quantify and determine causes of throughput delays in a newly established outpatient angiography service in a public hospital setting. Methods This single‐centre study obtained quantitative and qualitative data for 81 consecutive outpatient interventional radiology (IR) examinations over a 3‐month period via survey and retrospective analysis of electronic medical records. Staff participating in data collection were able to record multiple causes for delay in a single case and were also able to include comments, allowing for more detailed descriptions of the delays that occurred. Results A total of 93 delay factors were identified in 73 of the 81 outpatient interventional examinations and grouped into six categories via thematic analysis. Availability of the IR room (40%), availability of the radiologist (28%) and insufficient documentation (18%) were identified as the most frequent causes for delay. Linear regression analysis showed that documentation (P = 0.0002) and room unavailability (P = 0.022) were independently associated with procedural starting delay. Conclusion Delays to the IR procedural start time occurred in 90% of cases (73/81). This study identified the causes for delays in outpatient interventional procedures. This information can be used to improve service delivery in IR departments.

Two critical questions arise in the context of mounting pressures to reduce carbon emissions from freight transportation. Is it possible to reconcile the emissions reductions goals of shippers and logistics service providers (LSPs)? How do factors such as consumer preferences, eco-efficiency, carbon tax policy, and sharing of green investment cost affect target emissions levels? We address these questions using game theory to model shippers and LSPs as economic agents, thereby gaining insight into how the carbon intensity of freight delivery operations can be reduced. Our novel contributions include (1) models that consider both the shipper’s and the LSP’s interests, and in particular the gap between their preferred environmental performance levels; and (2) a methodologically rigorous explanation why, as empirical studies suggest, LSPs and shippers rarely agree on how to share responsibility for environmental initiatives, or who should pay a carbon tax.

Background: Predictive biomarkers for immune checkpoint blockade in the second-line treatment of metastatic renal cell carcinoma (mRCC) are lacking. Materials and methods: Patients with histologically confirmed RCC who started nivolumab after at least 4 months of tyrosine kinase inhibitors (TKIs) were recruited for this study. Serial tissue and blood samples were collected for immune biomarker evaluation. The primary endpoint was to determine the association of specific T-cell subsets with clinical outcomes tested using Wilcoxon rank sum for clinical benefit rate (CBR) and log-rank test for progression-free survival (PFS). Results: Twenty patients were included in this trial with a median age of 64 years and followed-up for a median of 12 months. The median PFS for patients who received TKI was 13.8 months, while for those subsequently treated with nivolumab following TKI therapy, the median PFS was 2.6 months. CBR of nivolumab was 20% with two partial responses. Functionally active programmed cell death protein 1+ CD4+ T cells were enriched in non-responders (q = 0.003) and associated with worse PFS on nivolumab (P = 0.04). Responders showed a significant reduction in the effector CD4+T-cell (TEF) fraction compared to non-responders at 3 months on nivolumab (0.40 versus 0.80, P = 0.0005). CD127+CD4+ T cells were enriched in patients who developed immune-related adverse effects (q = 0.003). Using in-house validated multiplex immunohistochemistry for six markers, we measured tumour-associated immune cell densities in tissue samples. Responders to nivolumab showed a significantly higher mean of immune cell densities in tissue samples compared to non-responders (346 versus 87 cells/mm2, P = 0.04). Conclusions: In this small study, analysis of tissue-based and peripheral blood immune cell subsets predicted clinical outcomes of nivolumab. Further studies are warranted with larger populations to validate these observations.

Tissue engineering encompasses a range of techniques that direct the growth of cells into a living tissue construct for regenerative medicine applications, disease models, drug discovery, and safety testing. These techniques have been implemented to alleviate the clinical burdens of impaired healing of skin, bone, and other tissues. Construct development requires the integration of tissue-specific cells and/or an extracellular matrix-mimicking biomaterial for structural support. Production of such constructs is generally expensive and environmentally costly, thus eco-sustainable approaches should be explored. Pulsed electric field (PEF) technology is a nonthermal physical processing method commonly used in food production and biomedical applications. In this review, the key principles of PEF and the application of PEF technology for skin engineering will be discussed, with an emphasis on how PEF can be applied to skin cells to modify their behaviour, and to biomaterials to assist in their isolation or sterilisation, or to modify their physical properties. The findings indicate that the success of PEF in tissue engineering will be reliant on systematic evaluation of key parameters, such as electric field strength, and their impact on different skin cell and biomaterial types. Linking tangible input parameters to biological responses critical to healing will assist with the development of PEF as a sustainable tool for skin repair and other tissue engineering applications.

IntroductionCerebral palsy (CP) can now be diagnosed in infants with identified CP risk factors as early as three months of age; however, many barriers prevent equitable access to early detection pathways. The “Partnering Early to Provide for Infants At Risk of Cerebral Palsy” feasibility study (PĒPI ARC) seeks to trial a new approach to decrease inequitable health service in Aotearoa New Zealand for high-risk infants and their families. PĒPI ARC incorporates face-to-face clinics, an in-person and virtual Hub, and the use of telehealth to enable flexible access to CP assessments and support for health professionals in early CP detection.Methods and analysisA non-randomised feasibility study was conducted from a tertiary Neonatal Intensive Care Unit (NICU) in Wellington and included seven regional referral centres, servicing nearly 30% of the total population in New Zealand (NZ). The families of infants with a high risk of neurodevelopmental impairment and health professionals interacting with the Hub were invited to participate. Mixed methods were used to evaluate the (i) equitable implementation of an early detection pathway, (ii) acceptability, (iii) demand among families and health professionals, (iv) efficacy in relation to reducing the age of receipt of CP diagnosis, and (v) the experiences around communication and information sharing.Ethics and disseminationThe NZ Health and Disability Ethics Committee approved this study (HDEC: 2022 FULL 13434). The findings will be disseminated in peer-reviewed journals, in conference presentations, and via professional networks.Clinical trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12623000600640.

Abstract Introduction Two universities run a collaborative Medical Radiation Science program where students undertake study in Tasmania before transferring to a partner university in another state to complete their program. This study assessed rates and predictors of graduate radiographers, radiation therapists and nuclear medicine technologists (collectively classified as medical radiation practitioners according to AHPRA [https://www.medicalradiationpracticeboard.gov.au/About.aspx; ahpra.gov.au/registration/registers] contemporary classification) returning to Tasmania and rural locations to practice. Methods A cross‐sectional 22‐item online survey including open‐ended questions was administered via Facebook. Rates of graduates working in Tasmania and rural locations, work satisfaction, and program efficacy were assessed. Logistic regression was used to assess predictors of working in Tasmania and rural locations. Results 58 Facebook members from a total of 87 program graduates were invited to participate. Of these, 21 responded. Thirteen (62.0%) were currently working in Tasmania, of which the majority practised in regional (MMM2) areas. Most (90.5%) reported that they were happy at work, with all participants reporting the course prepared them well or very well for their first professional jobs. 71.4% stated that the provision of the first 2 years of the course in their home state influenced their decision to study medical radiation science. Being born in a rural region (MMM > 2) was a predictor for working in Tasmania (OR = 3.5) and rural locations (OR = 1.77). Males were twice as likely to work in Tasmania (OR = 2.3) and more rural locations (OR = 2.0). Conclusions Collaboration is beneficial in producing professionals in regions with smaller enrolments limit the ability to grow their own graduates independently. Interuniversity collaborative models are recommended for other rural regions to meet local health workforce needs.

The oxidation of dimethyl sulfide (DMS; CH3SCH3), emitted from the surface ocean, contributes to the formation of Aitken mode particles and their growth to cloud condensation nuclei (CCN) sizes in remote marine environments. It is not clear whether other less commonly measured marine-derived, sulfur-containing gases share similar dynamics to DMS and contribute to secondary marine aerosol formation. Here, we present measurements of gas-phase volatile organosulfur molecules taken with a Vocus proton-transfer-reaction high-resolution time-of-flight mass spectrometer during a mesocosm phytoplankton bloom experiment using coastal seawater. We show that DMS, methanethiol (MeSH; CH3SH), and benzothiazole (C7H5NS) account for on average over 90 % of total gas-phase sulfur emissions, with non-DMS sulfur sources representing 36.8 ± 7.7 % of sulfur emissions during the first 9 d of the experiment in the pre-bloom phase prior to major biological growth, before declining to 14.5 ± 6.0 % in the latter half of the experiment when DMS dominates during the bloom and decay phases. The molar ratio of DMS to MeSH during the pre-bloom phase (DMS: MeSH = 4.60 ± 0.93) was consistent with the range of previously calculated ambient DMS-to-MeSH sea-to-air flux ratios. As the experiment progressed, the DMS to MeSH emission ratio increased significantly, reaching 31.8 ± 18.7 during the bloom and decay. Measurements of dimethylsulfoniopropionate (DMSP), heterotrophic bacteria, and enzyme activity in the seawater suggest the DMS: MeSH ratio is a sensitive indicator of the bacterial sulfur demand and the composition and magnitude of available sulfur sources in seawater. The evolving DMS: MeSH ratio and the emission of a new aerosol precursor gas, benzothiazole, have important implications for secondary sulfate formation pathways in coastal marine environments.

The professional development of online teachers is now commonplace in higher education. Alongside the relatively straightforward decision to provide professional learning support for novice and experienced online educators within universities, decisions about the nature and content of such support are not always as clear cut. The study aimed to gather evidence about the online teaching and learning experiences and views of current students and staff which, in turn, informed a set of pedagogical guidelines that could be used as the basis of professional learning programs for novice online teachers. Using a mixed methods research design, data were gathered using questionnaires, reflective journals, and focus groups to determine the threshold concepts about online teaching and perceptions of ideal online learning environments. As well as identifying threshold concepts about online teaching and perceptions of teachers' and students' ideal views of online learning contexts (reported elsewhere), the study produced curricular guidelines to inform the design of professional development outputs for online teachers in higher education. This article reports on an example of how these professional development guidelines, based on identified threshold concepts of online pedagogy, were implemented at one higher education institution to provide wide-scale implementation of a professional development program for academic staff engaged in online teaching.

Abstract Introduction: The need to balance pain management and radiographic image quality is at the forefront of patient care in diagnostic radiography. This study aimed to identify the decision‐making that radiographers employ when undertaking planar diagnostic imaging for pain‐afflicted adult trauma patients and the factors that influence these decisions. Methods: A virtual focus group interview was undertaken with six experienced Australian radiographers using a realistic scenario and questions based on it. Thematic analysis was employed to explore how radiographers approached planar diagnostic imaging of trauma patients and what influenced decisions regarding patient movement. Results: Five key factors in radiographers' decision‐making were identified: assistance from the multidisciplinary team, understanding the patient, pain reduction methods, the patient being informed and radiographer competence. Radiographers were found to further utilise professional knowledge of image interpretation and anatomy and physiology, in conjunction with interpersonal capabilities, to undertake radiographic examinations. Conclusion: The decision‐making process that informs the movement of pain‐afflicted adult trauma patients is multifactorial, aligning with the broad healthcare principles of multidisciplinary teamwork, holistic management of the patient and professional knowledge and practice. Further research is needed to explore correlations with different patient groups to validate this research.

Objectives Brazil has high rates of COVID-19 and tuberculosis among healthcare workers (HCWs). Personal protective equipment (PPE) is essential for their protection. We aimed to evaluate PPE use, training, and preparedness among HCWs in the early months of the SARS-CoV-2 pandemic in Brazil.Methods A cross-sectional study was performed using questionnaires available to HCWs through a website created to provide PPE guidelines. χ2 test and robust Poisson regression identified factors associated with HCWs treating COVID-19 patients (TCOVID-19), lack of training on PPE use and N95 respirator reuse. The speech content of open-ended questions was analysed.Results We analysed 1410 questionnaires collected from April to July 2020 representing 526 Brazilian cities. HCWs-TCOVID-19 had fewer years of work experience, were more likely to reuse PPE, and reported higher stress levels and lower biosafety at the workplace than HCWs not TCOVID-19 patients. Fearful concerns, limited PPE access and pandemic unpreparedness were common among HCWs. Lack of PPE training was associated with the profession and no N95 respirator fit tests. N95 reuse during the pandemic, common to 78% of the HCWs, was associated with the reuse of PPE during the pandemic and reuse of N95 before the pandemic.Conclusions We report the unpreparedness of HCWs and institutions to handle the pandemic, with low rates of training and N95 respirator fit testing and high PPE reuse. N95 reuse was a pre-established practice. This chronic unpreparedness to deal with airborne pathogens may have contributed to one of the highest global rates of tuberculosis and COVID-19 among HCWs.

IntroductionUnderstanding genetic contributors to sarcopenia (age-related loss of muscle strength and mass) is key to finding effective therapies. Variants of the bradykinin receptor 2 (BDKRB2) have been linked to athletic and muscle performance. The rs1799722-9 and rs5810761 T alleles have been shown to be overrepresented in endurance athletes, possibly due to increased transcriptional rates of the receptor. These variants have been rarely studied in older people or people with sarcopenia.MethodsWe performed a post hoc sub-study of the Leucine and ACE (LACE) inhibitor trial, which enrolled 145 participants aged ≥70 years with low grip strength and low gait speed. Participants' blood samples were genotyped for rs179972 using TaqMan and rs5810761 by amplification through Hotstar Taq. Genotypes were compared with outcomes of physical performance and body composition measures.ResultsData from 136 individuals were included in the analysis. For rs1799722 the genotype frequency (TT: 17, CC: 48, CT: 71) remained in Hardy-Weinberg Equilibrium (HWE p = 0.248). There was no difference between the genotypes for six-Minute Walk Distance (6MWD) or Short Physical Performance Battery (SPPB). Men with the TT genotype had a significantly greater 6MWD than other genotypes (TT 400m vs CT 310m vs CC 314m, p = 0.027), and greater leg muscle mass (TT 17.59kg vs CT 15.04kg vs CC 15.65kg, p = 0.007). For rs5810761, the genotype frequency (-9-9: 31, +9+9: 43, -9+9: 60) remained in HWE (p = 0.269). The +9+9 genotype was associated with a significant change in SPPB score at 12 months (-9-9 0 vs -9+9 0 vs +9+9-1, pConclusionIn men, the rs1799722 TT genotype was associated with longer 6MWD and greater leg muscle mass, while the rs5810761 -9-9 genotype was associated with lower arm fat mass.

Abstract: A new episode of unrest and phreatic/phreatomagmatic/magmatic eruptions occurred at Ambae volcano, Vanuatu, in 2017–2018. We installed a multi-station seismo-acoustic network consisting of seven 3-component broadband seismic stations and four 3-element (26–62 m maximum inter-element separation) infrasound arrays during the last phase of the 2018 eruption episode, capturing at least six reported major explosions towards the end of the eruption episode. The observed volcanic seismic signals are generally in the passband 0.5–10 Hz during the eruptive activity, but the corresponding acoustic signals have relatively low frequencies (

Abstract Recyclable and biodegradable microelectronics, i.e., “green” electronics, are emerging as a viable solution to the global challenge of electronic waste. Specifically, flexible circuit boards represent a prime target for materials development and increasing the utility of green electronics in biomedical applications. Circuit board substrates and packaging are good dielectrics, mechanically and thermally robust, and are compatible with microfabrication processes. Poly(octamethylene maleate (anhydride) citrate) (POMaC) – a citric acid-based elastomer with tunable degradation and mechanical properties – presents a promising alternative for circuit board substrates and packaging. Here, we report the characterization of Elastomeric Circuit Boards (ECBs). Synthesis and processing conditions were optimized to achieve desired degradation and mechanical properties for production of stretchable circuits. ECB traces were characterized and exhibited sheet resistance of 0.599 Ω cm−2, crosstalk distance of

The exchange of trace gases between the biosphere and the atmosphere is an important process that controls both chemical and physical properties of the atmosphere with implications for air quality and climate change. The terrestrial biosphere is a major source of reactive biogenic volatile organic compounds (BVOCs) that govern atmospheric concentrations of the hydroxy radical (OH) and ozone (O3) and control the formation and growth of secondary organic aerosol (SOA). Common simulations of BVOC surface–atmosphere exchange in chemical transport models use parameterizations derived from the growing season and do not consider potential changes in emissions during seasonal transitions. Here, we use observations of BVOCs over a mixed temperate forest in northern Wisconsin during broadleaf senescence to better understand the effects of the seasonal changes in canopy conditions (e.g., temperature, sunlight, leaf area, and leaf stage) on net BVOC exchange. The BVOCs investigated here include the terpenoids isoprene (C5H8), monoterpenes (MTs; C10H16), a monoterpene oxide (C10H16O), and sesquiterpenes (SQTs; C15H24), as well as a subset of other monoterpene oxides and dimethyl sulfide (DMS). During this period, MTs were primarily composed of α-pinene, β-pinene, and camphene, with α-pinene and camphene dominant during the first half of September and β-pinene thereafter. We observed enhanced MT and monoterpene oxide emissions following the onset of leaf senescence and suggest that senescence has the potential to be a significant control on late-season MT emissions in this ecosystem. We show that common parameterizations of BVOC emissions cannot reproduce the fluxes of MT, C10H16O, and SQT during the onset and continuation of senescence but can correctly simulate isoprene flux. We also describe the impact of the MT emission enhancement on the potential to form highly oxygenated organic molecules (HOMs). The calculated production rates of HOMs and H2SO4, constrained by terpene and DMS concentrations, suggest that biogenic aerosol formation and growth in this region should be dominated by secondary organics rather than sulfate. Further, we show that models using parameterized MT emissions likely underestimate HOM production, and thus aerosol growth and formation, during early autumn in this region. Further measurements of forest–atmosphere BVOC exchange during seasonal transitions as well as measurements of DMS in temperate regions are needed to effectively predict the effects of canopy changes on reactive carbon cycling and aerosol production.

Background: Older adults living with cancer can experience significant challenges in managing their cancer treatment[s], care, and health. Cancer self-management is much discussed in the research literature, but less is known about the perceptions and experiences of older adults’, including their self-management capacities and challenges. This study explored the factors that supported and hindered cancer self-management for older Canadian adults living with cancer. Methods: We conducted a 17-item population-based telephone survey in the Canadian province of British Columbia among older adults (age ≥ 65) living with cancer. Descriptive and inferential statistics were used to analyze quantitative data and thematic analysis for open-text responses. Results: 129 older adults participated in the study (median age 76, range: 65–93), of which 51% were living with at least one other chronic illness. 20% reported challenges managing their cancer treatment and appointments, while only ~4% reported financial barriers to managing cancer. We organized the findings around enabling and encumbering factors to older adults cancer self-management. The main encumbering factors to self-management included health system and personal factors (physical and emotional challenges + travel). Whereas enablers included: access to interpersonal support, helpful care team, interpersonal support and individual mindset. Conclusions: Considering factors which enable or encumber older adults’ cancer self-management is critical to supporting the growing aging population in the work required to manage cancer treatment and navigate cancer services. Our findings may guide the development of tailored resources for bolstering effectual self-management for older Canadians living with cancer.

Abstract Background Maternity services have limited formalised guidance on planning new services such as midwifery group practice for vulnerable women, for example women with a history of substance abuse (alcohol, tobacco and other drugs), mental health challenges, complex social issues or other vulnerability. Continuity of care through midwifery group practice is mostly restricted to women with low-risk pregnancies and is not universally available to vulnerable women, despite evidence supporting benefits of this model of care for all women. The perception that midwifery group practice for vulnerable women is a high-risk model of care lacking in evidence may have in the past, thwarted implementation planning studies that seek to improve care for these women. We therefore aimed to identify the barriers and enablers that might impact the implementation of a midwifery group practice for vulnerable women. Methods A qualitative context analysis using the Consolidated Framework for Implementation Research was conducted at a single-site tertiary health facility in Queensland, Australia. An interdisciplinary group of stakeholders from a purposeful sample of 31 people participated in semi-structured interviews. Data were analysed using manual and then Leximancer computer assisted methods. Themes were compared and mapped to the Framework. Results Themes identified were the woman’s experience, midwifery workforce capabilities, identifying “gold standard care”, the interdisciplinary team and costs. Potential enablers of implementation included perceptions that the model facilitates a relationship of trust with vulnerable women, that clinical benefit outweighs cost and universal stakeholder acceptance. Potential barriers were: potential isolation of the interdisciplinary team, costs and the potential for vicarious trauma for midwives. Conclusion There was recognition that the proposed model of care is supported by research and a view that clinical benefits will outweigh costs, however supervision and support is required for midwives to manage and limit vicarious trauma. An interdisciplinary team structure is also an essential component of the service design. Attention to these key themes, barriers and enablers will assist with identification of strategies to aid successful implementation. Australian maternity services can use our results to compare how the perceptions of local stakeholders might be similar or different to the results presented in this paper.

Type 2 cytokines like IL-4 are hallmarks of helminth infection and activate macrophages to limit immunopathology and mediate helminth clearance. In addition to cytokines, nutrients and metabolites critically influence macrophage polarization. Choline is an essential nutrient known to support normal macrophage responses to lipopolysaccharide; however, its function in macrophages polarized by type 2 cytokines is unknown. Using murine IL-4-polarized macrophages, targeted lipidomics revealed significantly elevated levels of phosphatidylcholine, with select changes to other choline-containing lipid species. These changes were supported by the coordinated up-regulation of choline transport compared to naïve macrophages. Pharmacological inhibition of choline metabolism significantly suppressed several mitochondrial transcripts and dramatically inhibited select IL-4-responsive transcripts, most notably, Retnla. We further confirmed that blocking choline metabolism diminished IL-4-induced RELMα (encoded by Retnla) protein content and secretion and caused a dramatic reprogramming toward glycolytic metabolism. To better understand the physiological implications of these observations, naïve or mice infected with the intestinal helminth Heligmosomoides polygyrus were treated with the choline kinase α inhibitor, RSM-932A, to limit choline metabolism in vivo. Pharmacological inhibition of choline metabolism lowered RELMα expression across cell-types and tissues and led to the disappearance of peritoneal macrophages and B-1 lymphocytes and an influx of infiltrating monocytes. The impaired macrophage activation was associated with some loss in optimal immunity to H. polygyrus, with increased egg burden. Together, these data demonstrate that choline metabolism is required for macrophage RELMα induction, metabolic programming, and peritoneal immune homeostasis, which could have important implications in the context of other models of infection or cancer immunity.

Advancements in chimeric antigen receptor engineered T-cell (CAR-T) therapy have revolutionized treatment for several cancer types over the past decade. Despite this success, obstacles including the high price tag, manufacturing complexity, and treatment-associated toxicities have limited the broad application of this therapy. Chimeric antigen receptor engineered natural killer cell (CAR-NK) therapy offers a potential opportunity for a simpler and more affordable “off-the-shelf” treatment, likely with fewer toxicities. Unlike CAR-T, CAR-NK therapies are still in early development, with few clinical trials yet reported. Given the challenges experienced through the development of CAR-T therapies, this review explores what lessons we can apply to build better CAR-NK therapies. In particular, we explore the importance of optimizing the immunochemical properties of the CAR construct, understanding factors leading to cell product persistence, enhancing trafficking of transferred cells to the tumor, ensuring the metabolic fitness of the transferred product, and strategies to avoid tumor escape through antigen loss. We also review trogocytosis, an important emerging challenge that likely equally applies to CAR-T and CAR-NK cells. Finally, we discuss how these limitations are already being addressed in CAR-NK therapies, and what future directions may be possible.