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ObjectiveWorkplace sugar-sweetened beverage (SSB) sales bans can reduce SSB consumption. Because stress and anxiety can promote sugar consumption, we examined whether anxiety among hospital employees during the COVID-19 pandemic was associated with changes in SSB consumption and explored whether this relationship varied by exposure to a workplace SSB sales ban.DesignIn a prospective, controlled trial of workplace SSB sales bans, we examined self-reported anxiety (generalised anxiety disorder-7) and self-reported SSB consumption (fluid ounces/d) before (July 2019) and during (May 2020) the COVID-19 pandemic.SettingHospital sites in two conditions (four with SSB sales bans and three without sales bans) in Northern California.ParticipantsWe sampled 580 participants (hospital employees) from a larger trial of sales bans; all were regular consumers of SSB (minimum 3/week at main trial enrollment). This subsample was chosen based on having appropriately timed data for our study questions.ResultsAcross conditions, participants reduced SSB consumption over the study period. However, participants with higher pandemic-era anxiety scores experienced smaller reductions in SSB consumption after 9 months compared with those with lower anxiety scores (β = 0·65, P < 0·05). When the sample was disaggregated by sales ban condition, this relationship held for participants in the control group (access to SSB at work, β = 0·82, P < 0·05), but not for those exposed to an SSB sales ban (β = 0·42, P = 0·25).ConclusionsSSB sales bans likely reduce SSB consumption through multiple pathways; buffering stress-related consumption may be one mechanism.

BackgroundDuring the COVID pandemic, residency program's social media presence increased to aid in residency recruitment by attempting to increase engagement and readily available information for applicants across specialties. However, little information exists on what characteristics and content on obstetrics and gynecology (OBGYN) residency program accounts attract more followers or engagement.ObjectivesTo identify social media trends in OBGYN residencies and determine which aspects of programs influence the number of followers and interaction with content posted.MethodsWe performed a retrospective review of ACGME accredited OBGYN programs and determined their presence on Instagram and X in the fall of 2021. Content from the thirty programs with the most followers was analyzed independently by two authors. Multivariate analysis and a linear mixed model were used to characterize and evaluate content on Instagram and X.ResultsMost programs utilized Instagram (88.5%, N = 262/296) and were managed solely by residents (84.4%, N = 108/128). Number of followers on Instagram positively correlated with features such as program size, Instagram profile duration, and Doximity rankings (p < 0.0x01). Programs on X had more followers if their profile had a longer duration, followed more individuals, or were ranked higher on Doximity. The most posted Instagram content was biographical and social in nature. Instagram posts with the highest engagement were awards and/or the Match.ConclusionsUnderstanding what social media content attracts more followers and increases engagement is crucial as it likely impacts OBGYN resident recruitment. Professional groups should establish guidelines for social media use in recruitment for the protection of both residents and applicants.

OBJECTIVE: This study examined the relationship between age at diagnosis and disease characteristics and damage in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: Analysis of a prospective longitudinal cohort of patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic GPA (EGPA) in the Vasculitis Clinical Research Consortium (2013-2021). Disease cohorts were divided by age at diagnosis (years): children (65). Data included demographics, ANCA type, clinical characteristics, Vasculitis Damage Index (VDI) scores, ANCA Vasculitis Index of Damage (AVID) scores, and novel disease-specific and non-disease-specific damage scores built from VDI and AVID items. RESULTS: Analysis included data from 1020 patients with GPA/MPA and 357 with EGPA. Female predominance in GPA/MPA decreased with age at diagnosis. AAV in childhood was more often GPA and proteinase 3-ANCA positive. Children with GPA/MPA experienced more subglottic stenosis and alveolar hemorrhage; children and young adults with EGPA experienced more alveolar hemorrhage, need for intubation, and gastrointestinal involvement. Older adults (GPA/MPA) had more neurologic manifestations. After adjusting for disease duration, medications, tobacco, and ANCA, all damage scores increased with age at diagnosis for GPA/MPA (P

Abstract Migratory distances and stopover locations are changing for many passerines in response to climate change. Morphological changes have been linked to rising global temperatures in both migrants and residents, but the implications of these changes on fuel loads, and associated flight ranges are little studied. Wing length and body mass changes between 1964 and 2020 were calculated for 15 migrant and partially migrant passerines in Britain. Changes in fuel load and lean body mass were also estimated and used to predict flight ranges. Twelve of the species have undergone morphological changes and eight species, estimated fuel load changes. Nine species were estimated to have reduced flight ranges, indicating that the morphological changes have not compensated fully for the reduction in flight range experienced since 1964. Partial migrants showed greater decreases in flight ranges than did full migrants, which may indicate greater behavioural plasticity in the former. Those species which do not adapt morphologically or behaviourally may be unable to complete long migrations, resulting in restriction to sub-optimal breeding/wintering habitats, or a need for a sooner first stop and more stops en route. This highlights the importance of conserving migratory stopover sites, particularly in the Mediterranean and North Africa that immediately precede major geographical barriers, as-well-as breeding and wintering grounds.

There are urgent calls for new approaches to map the global urban conditions of complexity, diffuseness, diversity, and connectivity. However, existing methods mostly focus on mapping urbanized areas as bio physical entities. Here, based on the continuum of urbanity framework, we developed an approach for cross-scale urbanity mapping from town to city and urban megaregion with different spatial resolutions using the Google Earth Engine. This approach was developed based on multi-source remote sensing data, Points of Interest – Open Street Map (POIs-OSM) big data, and the random forest regression model. This approach is scale-independent and revealed significant spatial variations in urbanity, underscoring differences in urbanization patterns across megaregions and between urban and rural areas. Urbanity was observed transcending traditional urban boundaries, diffusing into rural settlements within non-urban locales. The finding of urbanity in rural communities far from urban areas challenges the gradient theory of urban-rural development and distribution. By mapping livelihoods, lifestyles, and connectivity simultaneously, urbanity maps present a more comprehensive characterization of the complexity, diffuseness, diversity, and connectivity of urbanized areas than that by land cover or population density alone. It helps enhance the understanding of urbanization beyond biophysical form. This approach can provide a multifaceted understanding of urbanization, and thereby insights on urban and regional sustainability.

Abstract Background Hemorrhagic enteritis, caused by Turkey Hemorrhagic Enteritis Virus (THEV), is a disease affecting turkey poults characterized by immunosuppression and bloody diarrhea. An avirulent THEV strain that retains the immunosuppressive ability is used as a live vaccine. Characterizing the splice map of THEV is an essential step that would allow studies of individual genes mediating its immunosuppressive functions. We used RNA sequencing to characterize the splice map of THEV for the first time, providing key insights into the THEV gene expression and mRNA structures. Methods After infecting a turkey B-cell line with the vaccine strain, samples in triplicates were collected at 4-, 12-, 24-, and 72-hours post-infection. Total RNA was extracted, and poly-A-tailed mRNA sequenced. Reads were mapped to the THEV genome after trimming and transcripts assembled with StringTie. We performed PCR of THEV cDNA, cloned the PCR products, and used Sanger sequencing to validate all identified splice junctions. Results Researchers previously annotated the THEV genome as encoding 23 open reading frames (ORFs). We identified 29 spliced transcripts from our RNA sequencing data, all containing novel exons although some exons matched some previously annotated ORFs. The three annotated splice junctions were also corroborated by our data. During validation we identified five additional unique transcripts, a subset of which were further validated by 3’ rapid amplification of cDNA ends (3’ RACE). Thus, we report that the genome of THEV contains 34 transcripts with the coding capacity for all annotated ORFs. However, we found six of the previously annotated ORFs to be truncated ORFs on the basis of the identification of an in-frame upstream start codon or the detection of additional coding exons. We also identified three of the annotated ORFs with longer or shorter isoforms, and seven novel unannotated ORFs that could potentially be translated; although it is beyond the scope of this manuscript to investigate whether they are translated. Conclusions Similar to human adenoviruses, all THEV transcripts are spliced and organized into five transcription units under the control of their cognate promoters. The genes are expressed under temporal regulation and THEV also produces multiple distinctly spliced transcripts that code for the same protein. Studies of the newly identified potential proteins should be urgently performed as these proteins may have roles in THEV-induced immunosuppression. Also, knowing the splicing of THEV genes should be invaluable to future research focusing on studying THEV genes, as this will allow accurate cloning of the mRNAs.

ObjectiveTo examine the effectiveness of a workplace sugar-sweetened beverage (SSB) sales ban on reducing SSB consumption in employees, including those with cardiometabolic disease risk factors.DesignA controlled trial of ethnically diverse, full-time employees who consumed SSB heavily (sales ban n 315; control n 342). Outcomes included standardised measures of change in SSB consumption in the workplace (primary) and at home between baseline and 6 months post-sales ban.SettingSutter Health, a large non-profit healthcare delivery system in Northern California.ParticipantsFull-time employees at Sutter Health screened for heavy SSB consumption.ResultsParticipants were 66·1 % non-White. On average, participants consumed 34·7 ounces (about 1 litre) of SSB per d, and the majority had an elevated baseline BMI (mean = 29·5). In adjusted regression analyses, those exposed to a workplace SSB sales ban for 6 months consumed 2·7 (95 % CI -4·9, -0·5) fewer ounces of SSB per d while at work, and 4·3 (95 % CI -8·4, -0·2) fewer total ounces per d, compared to controls. Sales ban participants with an elevated BMI or waist circumference had greater post-intervention reductions in workplace SSB consumption.ConclusionsWorkplace sales bans can reduce SSB consumption in ethnically diverse employee populations, including those at higher risk for cardiometabolic disease.

Estrogen receptor-positive (ER+) breast cancer is common among postmenopausal women and is frequently treated with Letrozole, which inhibits aromatase from synthesizing estrogen from androgens. Decreased estrogen slows the growth of tumors and can be an effective treatment. The increase in Letrozole resistance poses a unique problem for patients. To better understand the underlying molecular mechanism(s) of Letrozole resistance, we reanalyzed transcriptomic data by comparing individuals who responded to Letrozole therapy (responders) to those who were resistant to treatment (non-responders). We identified SOX11 and S100A9 as two significant differentially expressed genes (DEGs) between these patient cohorts, with “PLK1 signaling events” being the most significant signaling pathway. We also identified PRDX4 and E2F8 gene products as being the top mechanistic transcriptional markers for ER+ treatment resistance. Many of the significant DEGs that we identified play a known role in ER+ breast cancer or other types of cancer, which partially validate our results. Several of the gene products we identified are novel in the context of ER+ breast cancer. Many of the genes that we identified warrant further research to elucidate the more specific molecular mechanisms of Letrozole resistance in this patient population and could potentially be used as prognostic markers with further wet lab validation. We anticipate that these findings could contribute to improved detection and therapeutic outcomes in aromatase-resistant ER+ breast cancer patients.

Abstract Background E-cigarette use represents a contemporary mode of nicotine product use that may be changing the risk profile of participating adolescents. Understanding differences in sociodemographic characteristics of adolescents engaging in contemporary e-cigarette use and traditional cigarette use is important for effectively developing and targeting public health intervention programs. The objective of this study was to identify and compare sociodemographic risk profiles for exclusive e-cigarette use and dual-product use among a large sample of Canadian youth. Methods A survey of 46,666 secondary school students in the 2021-22 wave of the COMPASS study measured frequency of past month e-cigarette and cigarette use as well as age, sex, gender, racial or ethnic background, spending money, relative family affluence, and having one’s own bedroom. Rates of cigarette-only, e-cigarette-only, and dual product use were calculated, and separate classification trees were run using the CART algorithm to identify sociodemographic risk profiles for weekly dual-product use and weekly e-cigarette-only use. Results Over 13% of adolescents used only e-cigarettes at least weekly, 3% engaged in weekly dual e-cigarette and cigarette use, and less than 0.5% used only cigarettes. Available spending money was a common predictor of dual-product and e-cigarette-only use. Gender diverse youth and youth with lower perceived family affluence were at higher risk for dual-product use, while white and multiethnic adolescents were at greater risk of e-cigarette-only use. Two high-risk profiles were identified for e-cigarette-only use and four high-risk profiles were identified for dual product use. Conclusions This study used a novel modelling approach (CART) to identify combinations of sociodemographic characteristics that profile high-risk groups for exclusive e-cigarette and dual-product use. Unique risk profiles were identified, suggesting that e-cigarettes are attracting new demographics of adolescents who have not previously been considered as high-risk for traditional cigarette use.

Abstract The extracellular matrix (ECM) is a dynamic and complex microenvironment that modulates cell behavior and cell fate. Changes in ECM composition and architecture have been correlated with development, differentiation, and disease progression in various pathologies, including breast cancer [1]. Studies have shown that aligned fibers drive a pro-metastatic microenvironment, promoting the transformation of mammary epithelial cells into invasive ductal carcinoma via the epithelial-to-mesenchymal transition (EMT) [2]. The impact of ECM orientation on breast cancer metabolism, however, is largely unknown. Here, we employ two non-invasive imaging techniques, fluorescence-lifetime imaging microscopy (FLIM) and intensity-based multiphoton microscopy, to assess the metabolic states of cancer cells cultured on ECM-mimicking nanofibers in a random and aligned orientation. By tracking the changes in the intrinsic fluorescence of nicotinamide adenine dinucleotide and flavin adenine dinucleotide, as well as expression levels of metastatic markers, we reveal how ECM fiber orientation alters cancer metabolism and EMT progression. Our study indicates that aligned cellular microenvironments play a key role in promoting metastatic phenotypes of breast cancer as evidenced by a more glycolytic metabolic signature on nanofiber scaffolds of aligned orientation compared to scaffolds of random orientation. This finding is particularly relevant for subsets of breast cancer marked by high levels of collagen remodeling (e.g. pregnancy associated breast cancer), and may serve as a platform for predicting clinical outcomes within these subsets [3–6].

Endometriosis is a chronic disease associated with debilitating pain that affects many people assigned female at birth, from menarche through menopause, not just causing pain and infertility, but also negatively impacting quality of life, participation in daily activities, productivity and income. It is associated with increased incidence of obstetric and neonatal complications, depression, other chronic diseases, and substantial healthcare costs. Despite the profound negative impact of endometriosis on quality of life, current treatment options remain sub-optimal and many patients express dissatisfaction with current care. The prevailing acute-care, single-provider model in which the provider works in relative isolation and thus with limited therapeutic strategies readily available, proves inadequate for treating endometriosis. Patients would benefit from earlier diagnosis and referral to a center capable of providing a comprehensive and multi-modal management plan that utilizes a chronic care model. Often this can only be achieved through multidisciplinary teams of providers with expertise in endometriosis. Researchers need to agree on standardized core outcome measures, relevant to patients with endometriosis and the healthcare system as a whole. Only through increased education and recognition of endometriosis as a chronic disease can we achieve better treatment outcomes.

This report synthesizes critical gaps in coastal adaptation knowledge and technology for California that were identified through a review of the recent literature and policy documents, two workshops (one with adaptation practitioners, and one with scientists from the University of California, UC) and detailed analysis of selected case studies. It focuses on those gaps that if addressed, might best align future research with community coastal adaptation needs. The analysis is the result of a pilot multicampus collaboration on coastal resilience and adaptation between three UC campuses: Santa Cruz (UCSC), Santa Barbara (UCSB) and San Diego (UCSD). The goal of our collaboration was to generally identify current understandings of coastal hazard impacts and adaptation strategies along California’s heterogenous coastline.While communities have made significant progress beginning to address coastal vulnerabilities and adaptation strategies, efforts face multiple challenges going forward. This study identified some overall trends in adaptation planning and identified 7 guiding questions and 33 key needs and gaps for actionable science that could help advance adaptation:1) What is projected to happen? Targeted coastal science to (i) support prediction of climate change and related oceanographic forcing (sea level rise, wave energy, extreme conditions, etc.) prediction at the local level; and (ii) improve the characterization of climate change impacts on the coastal zone, such as changes in groundwater elevations and cascading impacts.2) How can we better communicate this change? Integrate and convey existing and future sea level rise guidance for practitioners.3) How can we center environmental justice, equity, and communities in adaptation investments? Improve community engagement with adaptation planning, and how to achieve more equitable outcomes in adaptation decisions.4) What works? Evaluate adaptation interventions to inform pathway planning is needed, such as social cost-benefit analysis and cost-effectiveness of different strategies.5) How can we effectively implement adaptation pathways, and avoid maladaptation? Integrate understanding of coastal change and engagement with community values, over different and varied time horizons and geographic scales.6) Monitoring and technology: when interventions should be implemented and how to measure their performance? Integrate monitoring of coastal change and interventions to support improved planning, and address feedback in the adaptation decision process to support connected pathway adaptation and implementation.7) How can we better integrate researcher and practitioner objectives to better support actionable adaptation plans? Align academic incentives and practices with the practical needs and timing of community and governmental decision processes. The report also includes extended technical annexes with a review of existing data and tools relevant for coastal adaptation, policy, and guidance notes, and details of identified needs and gaps (see organization summary).

Students possess informal, intuitive ways of reasoning about the world, including biological phenomena. Although useful in some cases, intuitive reasoning can also lead to the development of scientifically inaccurate ideas that conflict with central concepts taught in formal biology education settings, including evolution. Using antibiotic resistance as an example of evolution, we developed a set of reading interventions and an assessment tool to examine the extent to which differences in instructional language affect undergraduate student misconceptions and intuitive reasoning. We find that readings that confront intuitive misconceptions can be more effective in reducing those misconceptions than factual explanations of antibiotic resistance that fail to confront misconceptions. Overall, our findings build upon investigations of intuitive reasoning in biology, examine possible instructional interventions, and raise questions about effective implementation of reading interventions in addressing persistent misconceptions about biology.

Background: Pseudomyxoma peritonei (PMP) is a clinical syndrome characterised by intraperitoneal accumulation of mucus due to mucinous neoplasia. It is a rare condition affecting 1–2 per million individuals per year. The majority of PMP arises from a ruptured mucinous appendiceal tumour, with infrequent occurrences from other primary gastrointestinal tumours and mucinous ovarian tumours. PMP arising from a mature ovarian teratoma is a rare entity, with limited case reports in the literature. Given the infrequent and sporadic occurrences of these tumours, little is known about the tumour behaviour and prognosis. Case series and literature review: Herein, we report six cases of PMP arising from a mature ovarian teratoma who were treated with primary cytoreductive surgery (CRS), with one case of recurrence. Literature review identified 21 cases from 12 manuscripts. Nineteen patients were treated with CRS alone, with two patients receiving adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC). Follow up data were variably reported, with no recurrence in 20 patients during their follow up of 5–54 months. One patient reported to have died of disease at 49 months. Conclusion: Despite the lack of high-quality evidence and limitations of small case series, our review indicates that close surveillance after CRS could be considered as the preferred treatment over more morbid CRS and HIPEC, with HIPEC reserved for patients who recur or progress after CRS.

Objective Despite growing numbers of initiatives designed to address increasing diabetes prevalence in the U.S., the need remains for effective programs. Because family history is a diabetes risk factor, family focused programs may be a potential strategy to improve the health of the entire family. We present the development process and pretest results of a lifestyle change program for rural-dwelling mothers at risk for diabetes and their children. Methods We completed semistructured interviews with mothers ( N = 17) focusing on program content and activities. Findings informed program development by identifying specific barriers motivators and potential leverage points such as focusing on the intrinsic incentives of health activities. The resulting program was pretested with rural-dwelling mothers ( N = 5) who completed program activities with their families and provided feedback via semistructured interviews. All interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Results While pretest results showed that the program was generally acceptable and feasible, feedback was used to further refine the program. The revised program consists of 8 group sessions with family focused content around physical activity, healthy eating, and making connections while engaging in health activities. Between sessions, mothers tracked the family goals, activity levels, and mood, and documented barriers to discuss during the sessions. Conclusions Our development process engaged intended program users to codesign a program that focuses on wellness and intrinsic incentives of engaging in health-enhancing activities as a family. By providing strategies to change behaviors as a family, this program aims to improve the mother's health while developing healthy habits in their children.

Discrimination based on gender identity is unjust and wreaks havoc on individuals’ lives. Nonbinary Americans report experiencing extensive and daily experiences with discriminatory events. Yet experimental evidence on how employers and members of the public evaluate and react to individuals (e.g., job applicants, social acquaintances) with different gender identities remains limited and is mixed. Using experimental data from two conjoint analyses, which we conducted with two national samples—one of active hiring managers (Experiment 1: N = 12,934 applicant choices, N = 924 active hirers) and one of members of the public (Experiment 1: N = 32,908 neighbor choices, N = 2,057 respondents)—we document wide partisan differences in the proclivity to discriminate against people who are nonbinary. Republicans are over 10 percentage points more likely to hire a binary than a nonbinary applicant and are 16 to 20 points more likely to want someone as a neighbor if the person is binary compared to nonbinary.

IntroductionBovine mastitis caused by Escherichia coli compromises animal health and inflicts substantial product losses in dairy farming. It may manifest as subclinical through severe acute disease and can be transient or persistent in nature. Little is known about bacterial factors that impact clinical outcomes or allow some strains to outcompete others in the mammary gland (MG) environment. Mastitis-associated E. coli (MAEC) may have distinctive characteristics which may contribute to the varied nature of the disease. Given their high levels of intraspecies genetic variability, virulence factors of commonly used MAEC model strains may not be relevant to all members of this group.MethodsIn this study, we sequenced the genomes of 96 MAEC strains isolated from cattle with clinical mastitis (CM). We utilized clinical severity data to perform genome-wide association studies to identify accessory genes associated with strains isolated from mild or severe CM, or with high or low competitive fitness during in vivo competition assays. Genes associated with mastitis pathogens or commensal strains isolated from bovine sources were also identified.ResultsA type-2 secretion system (T2SS) and a chitinase (ChiA) exported by this system were strongly associated with pathogenic isolates compared with commensal strains. Deletion of chiA from MAEC isolates decreased their adherence to cultured bovine mammary epithelial cells.DiscussionThe increased fitness associated with strains possessing this gene may be due to better attachment in the MG. Overall, these results provide a much richer understanding of MAEC and suggest bacterial processes that may underlie the clinical diversity associated with mastitis and their adaptation to this unique environment.