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Abstract Background Indian adolescents experience body dissatisfaction. However, empirically supported interventions are lacking, particularly in lower socio-economic regions of India. This paper describes the acceptability testing of a six-session teacher-led comics-based intervention, aiming to improve body image and related outcomes among adolescents in Indian Hindi medium schools. Methods Thirty-five students (50% girls; Mage, girls = 12.3 years; Mage, boys = 13 years) and nine teachers (11% women) from Hindi medium schools in Rajasthan, India, completed a quantitative acceptability questionnaire regarding comics that target body dissatisfaction and associated risk factors. They also participated in online or telephone semi-structured interviews to share in-depth feedback, with teachers providing additional feedback on an accompanying teacher guide. The quantitative data were analysed descriptively, with the interviews analysed using qualitative codebook thematic analysis. Results Quantitative analyses revealed that 73% of students felt the comics made them feel good about themselves. Qualitative analyses revealed four themes: (1) body dissatisfaction is a concern; (2) the comics are powerful; (3) increasing ease of understanding; (4) a teacher guide to aid delivery. Conclusion This study demonstrates acceptability of a novel teacher-led comics-based body image intervention for adolescents in Indian Hindi medium schools from lower socio-economic settings. These findings are currently informing intervention optimizations, which will be evaluated in a randomized controlled effectiveness trial. If found to be effective, this intervention will be disseminated across eight Indian states by UNICEF. Trial registration. This trial has been registered with ClinicalTrials.gov; a database of privately and publicly funded studies conducted around the world. Registration date: 2nd May 2020; Registration ID: (NCT04317755). https://clinicaltrials.gov/ct2/show/NCT04317755?term=NCT04317755&draw=2&rank=1.

Most membrane protein molecules undergo conformational changes as they transition from one functional state to another one. An understanding of the mechanism underlying these changes requires the ability to resolve individual conformational states, whose changes often occur on millisecond and angstrom scales. Tracking such changes and acquiring a sufficiently large amount of data remain challenging. Here, we use the amino-acid transporter AdiC as an example to demonstrate the application of a high-resolution fluorescence-polarization-microscopy method in tracking multistate conformational changes of a membrane protein. We have successfully resolved four conformations of AdiC by monitoring the emission-polarization changes of a fluorophore label and quantified their probabilities in the presence of a series of concentrations of its substrate arginine. The acquired data are sufficient for determining all equilibrium constants that fully establish the energetic relations among the four states. The KD values determined for arginine in four individual conformations are statistically comparable to the previously reported overall KD determined using isothermal titration calorimetry. This demonstrated strong resolving power of the present polarization-microscopy method will enable an acquisition of the quantitative information required for understanding the expected complex conformational mechanism underlying the transporter’s function, as well as those of other membrane proteins.

Prior research has identified relations between prenatal testosterone exposure and various antisocial and criminal behaviors. However, less is known about the association between prenatal testosterone exposure and personality traits, such as psychopathy. This study used self-report and biometric data from a sample of undergraduates (n = 491) at a large southwestern university to examine the association between prenatal testosterone exposure (measured by the 2D:4D ratio) and three dimensions of psychopathy (i.e., callousness, egocentricity, and antisocial behavior). Analyses were stratified by sex to explore sex-specific biological underpinnings of psychopathy in young adulthood. Results showed that males scored significantly higher in psychopathic traits and reported significantly lower 2D:4D ratios, compared to females. Additionally, 2D:4D ratios were negatively associated with egocentricity in males, but not females. These findings contribute to a growing literature on the organizational effects that prenatal testosterone exposure may have on the development of different dimensions of psychopathy.

The interaction between waves, surges, and astronomical tides can lead to high coastal total water level (TWL), which can in turn trigger coastal flooding. Here, a high-resolution (1.5 km) simulation from a UK-focused regional coupled environmental prediction system is used to investigate the extreme events of winter 2013/4 around the UK and Irish coasts. The aim is to analyse the spatial distribution of coastal TWL and its components during this period by assessing (1) the relative contribution of different TWL components around the coast; (2) how extreme waves, surges, and tide interacted and if they occurred simultaneously; and (3) if this has implications in defining the severity of coastal hazard conditions. The TWL components' coastal distribution in winter 2013/4 was not constant in space, impacting differently over different regions. High (>90th percentile) waves and high surges occurred simultaneously at any tidal stage, including high tide (7.7 % of cases), but more often over the flood tide. During periods of high flood risk, a hazard proxy, defined as the sum of the sea surface height and half the significant wave height, at least doubled from average over three-quarters of the coast. These results have important implications for the risk management sector.

Abstract The Met Office held a testbed over winter 2020/2021 where a new numerical weather prediction (NWP) sub‐km ensemble was set up on‐demand in response to interesting weather phenomena in the United Kingdom. The domain for the model was chosen in real time by a community of Met Office Research Scientists and Operational Meteorologists and over a 4‐month period the ensemble was triggered for nine events. The purpose of the testbed was to investigate whether a real‐time weather regime‐based enhancement in NWP capability was feasible, to understand what benefits a testbed environment might give, and to explore the practicalities of running such an event. Case studies from the testbed demonstrated that forecast ensembles at 2.2 km and 300 m grid spacing were able to capture observed winter weather, with greater spatial detail apparent, especially over complex orography, in the 300‐m model. Ensemble spread appeared less influenced by resolution, potentially due to the size of the domains tested or the weather regimes of the case studies. The testbed also showcased underutilized observations and additional radiosonde ascents were conducted. All the testbed meetings were conducted virtually due to COVID‐19 restrictions, and decisions were made about when to trigger the event using an online message board. The winter 2020/2021 testbed provides ideas for how on‐demand weather‐dependent testbeds might be conducted in the future. However, several recommendations are made that would enhance testbed benefits further, including more dedicated resource, stronger technology and data visualization and greater participation from both academia and weather information users.

A stem relative of dragon- and damselflies, Brunellopteron norradi Béthoux, Deregnaucourt and Norrad gen. et sp. nov., is documented based on a specimen found at Robertson Point (Grand Lake, New Brunswick, Canada; Sunbury Creek Formation; early Moscovian, Pennsylvanian) and preserving the basal half of a hindwing. A comparative analysis of the evolution of wing venation in early odonates demonstrates that it belongs to a still poorly documented subset of species. Specifically, it displays a MP + CuA fusion, a CuA + CuP fusion, and a CuP + AA fusion, but it lacks the “extended” MP + Cu / CuA fusion and the “extended” (CuP / CuA + CuP) + AA fusion, the occurrence of which is typical of most Odonata, including Meganeura-like species. The occurrence of intercalary veins suggests that its closest relative might be Gallotypus oudardi Nel, Garrouste and Roques, 2008, from the Moscovian of northern France.

Aims: “Get It Right First Time” (GIRFT) and NHS England’s Best Practice Tariff (BPT) have published directives advising that patients over the ages of 65 (GIRFT) and 69 years (BPT) receiving total hip arthroplasty (THA) should receive cemented implants and have brought in financial penalties if this policy is not observed. Despite this, worldwide, uncemented component use has increased, a situation described as a ‘paradox’. GIRFT and BPT do, however, acknowledge more data are required to support this edict with current policies based on the National Joint Registry survivorship and implant costs. Methods: This study compares THA outcomes for over 1,000 uncemented Corail/Pinnacle constructs used in all age groups/patient frailty, under one surgeon, with identical pre- and postoperative pathways over a nine-year period with mean follow-up of five years and two months (range: nine months to nine years and nine months). Implant information, survivorship, and regular postoperative Oxford Hip Scores (OHS) were collected and two comparisons undertaken: a comparison of those aged over 65 years with those 65 and under and a second comparison of those aged 70 years and over with those aged under 70. Results: Overall revision rate was 1.3% (13/1,004). A greater number of revisions were undertaken in those aged over 65 years, but numbers were small and did not reach significance. The majority of revisions were implant-independent. Single component analysis revealed a 99.9% and 99.6% survival for the uncemented cup and femoral component, respectively. Mean patient-reported outcome measures (PROMs) improvement for all ages outperformed the national PROMs and a significantly greater proportion of those aged over 65/69 years reached and maintained a meaningful improvement in their OHS earlier than their younger counterparts (p < 0.05/0.01 respectively). Conclusion: This study confirms that this uncemented THA system can be used safely and effectively in patient groups aged over 65 years and those over 69 years, with low complication and revision rates.

BackgroundSurvivors of breast cancer with functional limitations have a 40% higher mortality rate than those without. Despite the known benefits of physical activity (PA),

Abstract Background There is limited real-world safety information on palbociclib for treatment of advanced stage HR+/HER2- breast cancer. Methods We conducted a cohort study of breast cancer patients initiating palbociclib and fulvestrant from February 2015 to September 2017 using the HealthCore Integrated Research Database (HIRD), a longitudinal claims database of commercial health plan members in the United States. The historical comparator cohort comprised patients initiating fulvestrant monotherapy from January 2011 to January 2015. Propensity score matching and Cox regression were used to estimate hazard ratios for various safety events. For acute liver injury (ALI), additional analyses and medical record validation were conducted. Results There were 2445 patients who initiated palbociclib including 566 new users of palbociclib-fulvestrant, and 2316 historical new users of fulvestrant monotherapy. Compared to these historical new users of fulvestrant monotherapy, new users of palbociclib-fulvestrant had a greater than 2-fold elevated risk for neutropenia, leukopenia, thrombocytopenia, stomatitis and mucositis, and ALI. Incidence of anemia and QT prolongation were more weakly associated, and incidences of serious infections and pulmonary embolism were similar between groups after propensity score matching. After adjustment for additional ALI risk factors, the elevated risk of ALI in new users of palbociclib-fulvestrant persisted (e.g. primary ALI algorithm hazard ratio (HR) = 3.0, 95% confidence interval (CI) = 1.1–8.4). Conclusions This real-world study found increased risks of several adverse events identified in clinical trials, including neutropenia, leukopenia, and thrombocytopenia, but no increased risk of serious infections or pulmonary embolism when comparing new users of palbociclib-fulvestrant to fulvestrant monotherapy. We observed an increased risk of ALI, extending clinical trial findings of significant imbalances in grade 3/4 elevations of alanine aminotransferase (ALT).

In a multinational placebo‐controlled phase III clinical trial in 2,185 patients with type 2 diabetes mellitus and stage 4 chronic kidney disease, treatment with the Nrf2 activator bardoxolone methyl increased estimated glomerular filtration rate, a measure of kidney function, but also resulted in increases in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyl transferase. These increases in liver enzyme level(s) were maximal after 4 weeks of treatment and reversible, trending back toward baseline through week 48. Total bilirubin concentrations did not increase, and no cases met Hy’s Law criteria, although two subjects had ALT concentrations that exceeded 10 × the upper limit of the population reference range leading to discontinuation of treatment. Animal and cell culture experiments suggested that the increases in ALT and AST induced by bardoxolone methyl may be related to its pharmacological activity. Bardoxolone methyl significantly induced the mRNA expression of ALT and AST isoforms in cultured cells. Expression of ALT and AST isoforms in liver and kidney also positively correlated with Nrf2 status in mice. Overall, these data suggest that the increases in ALT and AST observed clinically were, at least in part, related to the pharmacological induction of aminotransferases via Nrf2 activation, rather than to any intrinsic form of hepatotoxicity.

Summary Objective For every weight loss treatment, there are usually groups of people who lose less than expected. This study sought to determine if response rates to a total diet replacement (TDR) differed from those of a calorie‐restricted, food‐based (FB) diet. Methods Data from OPTIWIN, a 12‐month multicenter trial in adults with a BMI of 30–55 kg/m2, with 26‐week weight‐loss and weight‐maintenance phases, were utilized. Participants (n = 330) were randomized to the OPTIFAST programme (OP) or to a reduced‐energy FB diet. Treatment non‐responders were defined as those who lost

Background: Patients who present at night following penetrating abdominal trauma are thought to have more severe injuries and increased risk for morbidity and mortality. The current literature is at odds regarding this belief. The purpose of this study was to evaluate time of day on outcomes following laparotomy for penetrating abdominal trauma. Methods: Patients undergoing laparotomy following penetrating abdominal trauma over a 12-month period at a level I trauma center were stratified by age, sex, severity of shock, injury, operative complexity, and time of day (DAY = 0700–1900, NIGHT = 1901–0659). Outcomes of damage control laparotomy, ventilator days, intensive care unit length of stay, hospital length of stay, morbidity, and mortality were compared between DAY and NIGHT. Results: A total of 210 patients were identified: 145 (69%) comprised NIGHT, and 65 (31%) comprised DAY. Overall mortality was 2.9%. Both injury severity and intraoperative transfusions were increased with NIGHT with no difference in morbidity (37% vs 40%, P = 0.63) or mortality (2.1% vs 4.6%, P = 0.31). Adjusting for sex, time of day, injury severity, and operative complexity, only abdominal abbreviated injury severity (odds ratio 1.46; 95% confidence interval 1.07–1.99, P = .019) and operative transfusions (odds ratio 1.18; 95% confidence interval 1.09–1.28, P

Abstract Background Claims databases are generally considered inadequate for obesity research due to suboptimal capture of body mass index (BMI) measurements. This might not be true for bariatric surgery because of reimbursement requirements and changes in coding systems. We assessed the availability and validity of claims-based weight-related diagnosis codes among bariatric surgery patients. Methods We identified three nested retrospective cohorts of adult bariatric surgery patients who underwent adjusted gastric banding, Roux-en-Y gastric bypass, or sleeve gastrectomy between January 1, 2011 and June 30, 2018 using different components of OptumLabs® Data Warehouse, which contains linked de-identified claims and electronic health records (EHRs). We measured the availability of claims-based weight-related diagnosis codes in the 6-month preoperative and 1-year postoperative periods in the main cohort identified in the claims data. We created two claims-based algorithms to classify the presence of severe obesity (a commonly used cohort selection criterion) and categorize BMI (a commonly used baseline confounder or postoperative outcome). We evaluated their performance by estimating sensitivity, specificity, positive predictive value, negative predictive value, and weighted kappa in two sub-cohorts using EHR-based BMI measurements as the reference. Results Among the 29,357 eligible patients identified using claims only, 28,828 (98.2%) had preoperative weight-related diagnosis codes, either granular indicating BMI ranges or nonspecific denoting obesity status. Among the 27,407 patients with granular preoperative codes, 12,346 (45.0%) had granular codes and 9355 (34.1%) had nonspecific codes in the 1-year postoperative period. Among the 3045 patients with both preoperative claims-based diagnosis codes and EHR-based BMI measurements, the severe obesity classification algorithm had a sensitivity 100%, specificity 71%, positive predictive value 100%, and negative predictive value 78%. The BMI categorization algorithm had good validity categorizing the last available preoperative or postoperative BMI measurements (weighted kappa [95% confidence interval]: preoperative 0.78, [0.76, 0.79]; postoperative 0.84, [0.80, 0.87]). Conclusions Claims-based weight-related diagnosis codes had excellent validity before and after bariatric surgical operation but suboptimal availability after operation. Claims databases can be used for bariatric surgery studies of non-weight-related effectiveness and safety outcomes that are well-captured.

Aging plays a critical role in the incidence and severity of infection, with age emerging as an independent predictor of mortality in sepsis. Trained immunity reprograms immunocytes to respond more rapidly and effectively to pathogens and serves as a potential approach to improve immune function in aging and/or sepsis. However, there is very little data on trained immunity in the aging immune system or in the presence of sepsis. We examined the impact of β-glucan induced innate immune training on monocytes from aging healthy humans (>60 years old) as well as sepsis patients. We observed increased metabolic capacity, upregulated cytokine secretion, increased H3K27 acetylation, and upregulation of crucial intracellular signaling pathways in trained monocytes from healthy aging subjects. The response to trained immunity in healthy aging monocytes was equivalent to the response of monocytes from younger, i.e., 18 – 59 years, individuals. Additionally, we found that trained immunity induced a unique expression pattern of cell surface markers in monocytes that was consistent across age groups. Trained monocytes from sepsis patients also displayed enhanced metabolic capacity and increased cytokine production. These results indicate that immune training can be induced in aging monocytes as well as monocytes from critically ill sepsis patients.

Purpose The Bariatric Experience Long Term (BELONG) prospective study cohort was created to address limitations in the literature regarding the relationship between surgical weight loss and psychosocial, health, behaviour and environmental factors. The BELONG cohort is unique because it contains 70% gastric sleeve and 64% patients with non-white race/ethnicity and was developed with strong stakeholder engagement including patients and providers.Participants The BELONG cohort study included 1975 patients preparing to have bariatric surgery who completed a baseline survey in a large integrated health system in Southern California. Patients were primarily women (84%), either black or Hispanic (59%), with a body mass index (BMI) of 45.1±7.4 kg/m2, age 43.3±11.5 years old, and 32% had at least one comorbidity.Findings to date A total of 5552 patients were approached before surgery between February 2016 and May 2017, and 1975 (42%) completed a baseline survey. A total of 1203 (73%) patients completed the year 1 and 1033 (74%) patients completed the year 3 postoperative survey. Of these survey respondents, 1341 at baseline, 999 at year 1, and 951 at year 3 were included in the analyses of all survey and weight outcome data. A total of 803 (60% of eligible patients) had survey data for all time points. Data collected were self-reported constructs to support the proposed theoretical model. Height, weight and BMI were abstracted from the electronic medical record to obtain the main outcomes of the study: weight loss and regain.Future plans We will collect self-reported constructs and obtain height, weight and BMI from the electronic medical record 5 years after bariatric surgery between April 2022 and January 2023. We will also collect patient experiences using focus groups of 8–12 patients each throughout 2022.

Conventional magnetic annealing (MA) of the permanent magnet alloy alnico involves application of an external magnetic field at temperatures within the spinodal decomposition range. This field biases the growth of the Fe-Co rich, ferromagnetic α1-phase in an energetically favorable 〈001〉 direction in alignment with the applied field within an Al-Ni rich, paramagnetic α2-phase. Utilizing a magnetic field to bias the α1-phase may limit alnico from reaching theoretical coercivity due to (1) the field having maximum biasing ability at temperatures near the Curie temperature where large α1-phase nanorods form and (2) connectivity of the α1-phase occurs unavoidably during MA. Both decrease the effective shape anisotropy of the α1-phase, thereby reducing coercivity. Herein, we explore tensile-loading as a biasing mechanism to control and optimize the final alnico nanostructure beyond that achieved by MA. Two samples of melt-spun alnico were heat-treated at 860 °C for 5 minutes: one sample was subjected to 10 MPa tensile stress for comparison with a stress-free control sample. Structural and magnetic characterization revealed that the stress-annealed ribbon sample possessed expected phase assemblages, but was distinguished by a ∼2× larger grain diameter and an elongated anisotropic α1-phase within grains that were oriented to a shear stress along 〈001〉 directions at an angle of ∼45° relative to the loading direction. Both types of annealing produced a similar increase in the coercivity and remanence, but a decrease in saturation magnetization.

Mobile fitness applications (apps) allow for time-efficient opportunities for physical activity. Current research suggests that fitness apps do not accurately comply with the frequency, intensity, time, and type (FITT) principle. FITT is an important principle in exercise prescription as it applies scientific evidence to improve the quality of exercise. Based on app assessment using the Fitness Apps Scoring Instrument, most fitness apps adequately address FITT in their exercise plans. In particular, fitness apps do not adequately adhere to the FITT intensity guidelines. Many apps allow the users to track their heart rate as a method of assessing their exercise intensity, but few use that information to provide real-time feedback on the intensity of the workout. For app users, awareness and education of intensity standards should be put forth in coordination with exercise professionals, rather than relying on apps alone.

Purpose: There is a paucity of data analyzing the anatomic locations and dose volume metrics achieved for surgically transposed ovaries in patients desiring fertility or hormonal preservation receiving pelvic radiation therapy (RT), which were examined herein. Methods and Materials: This is a retrospective study including women who underwent ovarian transposition before pelvic RT between 2010 to 2020. The craniocaudal (CC) distance of the ovary centroid to the (1) plane of the sacral promontory, (2) iliac crest, and (3) the nearest distance between the ovary edge and RT planning target volume (PTV) were measured (cm). The area under the receiver operating characteristic curve and cut-point analysis estimating ovary location outside the PTV was performed. Results: Thirty-one ovaries were analyzed from 18 patients. Thirteen (72.2%) were treated with intensity modulated RT, and 5 (27.8%) were treated with 3-dimensional conformal radiation therapy. Most ovaries were located above the sacral promontory (64.5%, n = 20), below the iliac crest (96.8%, n = 30), and outside the PTV (64.5%, n = 20). The median distance from the ovaries to the sacral promontory, iliac crest, and PTV was 0.8 cm (interquartile range [IQR], −0.83 to 1.59 cm), −3.22 cm (IQR, −5.12 to −1.84 cm), and 0.9 cm (IQR, −1.0 to 1.9 cm), respectively. The area under the receiver operating characteristic curve and cut-point analysis demonstrated that distance from the iliac crest predicted an ovary to be outside the PTV with an optimal cut-point of −3.0 cm (C-index = 0.82). The median mean and maximum (Dmax) ovary doses were 15.5 Gy (IQR, 9.6-20.2 Gy) and 32.2 Gy (IQR 24.8-46.5 Gy), respectively. Conclusions: Despite most transposed ovaries being located outside the PTV, nearly all remained below the iliac crest and received RT doses associated with a high risk of ovarian failure. These findings deepen our understanding of the spatial relationship between transposed ovaries and dose to inform surgical and pre-RT planning and suggest that more aggressive ovary-sparing strategies are warranted.

The COVID-19 pandemic impacted the conduct of in-person physical activity (PA) interventions among older survivors of BC, who need such interventions to stay active and prevent functional decline. We tested the feasibility of virtually delivering an exergame-based PA intervention to older BC survivors. We enrolled 20 female BC survivors ≥55 years and randomly assigned them to two groups. The intervention group (Pink Warrior 2) received 12 weekly virtual exergame sessions with behavioral coaching, survivorship navigation support, and a Fitbit for self-monitoring. The control group received 12 weekly phone-based survivorship discussion sessions and wore a Mi Band 3. Feasibility was evaluated by rates of recruitment (≥0.92 participants/center/month), retention (≥80%), and group attendance (≥10 sessions), percentage of completed virtual assessments, and number of technology-related issues and adverse events. Intervention acceptability was measured by participants’ ratings on a scale of 1 (strongly disagree) to 5 (strongly agree). The recruitment rate was 1.93. The retention and attendance rates were 90% and 88% (≥10 sessions), respectively. Ninety-six percent completed virtual assessments without an adverse event. Acceptability was high (≥4). The intervention met benchmarks for feasibility. Additional research is needed to further understand the impact of virtually delivered PA interventions on older BC survivors.

Piezo1 is a mechanically activated ion channel involved in sensing forces in various cell types and tissues. Cryo-electron microscopy has revealed that the Piezo1 structure is bowl-shaped and capable of inducing membrane curvature via its extended footprint, which indirectly suggests that Piezo1 ion channels may bias each other’s spatial distribution and interact functionally. Here, we use cell-attached patch-clamp electrophysiology and pressure-clamp stimulation to functionally examine large numbers of membrane patches from cells expressing Piezo1 endogenously at low levels and cells overexpressing Piezo1 at high levels. Our data, together with stochastic simulations of Piezo1 spatial distributions, show that both at endogenous densities (1–2 channels/μm2), and at non-physiological densities (10–100 channels/μm2) predicted to cause substantial footprint overlap, Piezo1 density has no effect on its pressure sensitivity or open probability in the nominal absence of membrane tension. The results suggest that Piezo channels, at densities likely to be physiologically relevant, inherently behave as independent mechanotransducers. We propose that this property is essential for cells to transduce forces homogeneously across the entire cell membrane.

Purpose: Most radiomic studies use the features extracted from the manually drawn tumor contours for classification or survival prediction. However, large interobserver segmentation variations lead to inconsistent features and hence introduce more challenges in constructing robust prediction models. Here, we proposed an automatic workflow for glioblastoma (GBM) survival prediction based on multimodal magnetic resonance (MR) images. Methods and Materials: Two hundred eighty-five patients with glioma (210 GBM, 75 low-grade glioma) were included. One hundred sixty-three of the patients with GBM had overall survival data. Every patient had 4 preoperative MR images and manually drawn tumor contours. A 3-dimensional convolutional neural network, VGG-Seg, was trained and validated using 122 patients with glioma for automatic GBM segmentation. The trained VGG-Seg was applied to the remaining 163 patients with GBM to generate their autosegmented tumor contours. The handcrafted and deep learning (DL)–based radiomic features were extracted from the autosegmented contours using explicitly designed algorithms and a pretrained convolutional neural network, respectively. One hundred sixty-three patients with GBM were randomly split into training (n = 122) and testing (n = 41) sets for survival analysis. Cox regression models were trained to construct the handcrafted and DL-based signatures. The prognostic powers of the 2 signatures were evaluated and compared. Results: The VGG-Seg achieved a mean Dice coefficient of 0.86 across 163 patients with GBM for GBM segmentation. The handcrafted signature achieved a C-index of 0.64 (95% confidence interval, 0.55-0.73), whereas the DL-based signature achieved a C-index of 0.67 (95% confidence interval, 0.57-0.77). Unlike the handcrafted signature, the DL-based signature successfully stratified testing patients into 2 prognostically distinct groups. Conclusions: The VGG-Seg generated accurate GBM contours from 4 MR images. The DL-based signature achieved a numerically higher C-index than the handcrafted signature and significant patient stratification. The proposed automatic workflow demonstrated the potential of improving patient stratification and survival prediction in patients with GBM.

ABSTRACT Colorado Parks and Wildlife implemented a new statewide management policy in 1985 for nuisance black bears (Ursus americanus), known today as the 2‐strike directive. It allowed wildlife managers to assess the repeatability of nuisance bear behavior after translocating them to quality bear habitat away from human food sources. We evaluated this directive using 30 years (1987–2016) of nuisance black bear capture records. Statewide, 53% of 1,093 bears caught, marked, and moved (1st strike) were never reported again, while 25% were killed for a 2nd strike, and hunters harvested 17%. Subadult males committed 2nd strikes more quickly than adult males and females. Although time between strikes was greatest for adult females (496 days), they had the largest probability of committing a 2nd strike among all cohorts. We found that the number of 1st strike captures, from late summer through fall was greatest during years of poor mast production. We suggest that the 2‐strike policy has been an effective management tool for nuisance black bears in Colorado, USA, because of low rates of nuisance behavior following 1st‐strike translocation. If a state or local management objective is to increase black bear populations, wildlife managers may increase tolerance of adult bears that have received their 1st strike in years when fall mast crops largely fail because they are less likely to commit a 2nd strike. Lower tolerance of subadult males may be warranted in bad food years, especially in areas where reductions in bear populations are desired, because they tend to repeat nuisance behaviors more quickly than other bears. © 2019 The Wildlife Society.

ABSTRACT From 2014 to 2016, in the Front Range of Colorado, USA, we assessed noninvasive approaches to sampling cougar (Puma concolor) populations in an attempt to provide a new method that would be less field intensive, less expensive, and could be applied over large spatial extents compared with current methods. We assessed the use of predator calls to lure cougars to a site with remote camera traps for detection and also evaluated hair snags at sites to noninvasively identify individual animals. Predator calls effectively attracted cougars to specific sites with an average of 82 unique photographic detections of cougars per survey year (0.03 detections/trap‐night). However, obtaining hair samples from these animals was less effective because animals did not always pass through hair snags and ability to uniquely identify individuals by genotype was poor. We evaluated different approaches to estimating cougar density and found mark–resight to be a viable option in our study system. Mark–resight density estimate after correcting for partial use of the sampling area by cougars was 4.1 cougars/100 km2 (95% CI = 2.4, 5.8). Our results indicate that combining methods of noninvasive genetic sampling and auditory calls to monitor cougar populations can provide reliable density estimates over large geographic areas and areas with significant amounts of inaccessible private lands. © 2019 The Wildlife Society.

Functional neuroimaging modalities vary in spatial and temporal resolution. One major limitation of most functional neuroimaging modalities is that only neural activation taking place inside the scanner can be imaged. This limitation makes functional neuroimaging in many clinical scenarios extremely difficult or impossible. The most commonly used radiopharmaceutical in Single Photon Emission Tomography (SPECT) functional brain imaging is Technetium 99 m-labeled Ethyl Cysteinate Dimer (ECD). ECD is a lipophilic compound with unique pharmacodynamics. It crosses the blood brain barrier and has high first pass extraction by the neurons proportional to regional brain perfusion at the time of injection. It reaches peak activity in the brain 1 min after injection and is then slowly cleared from the brain following a biexponential mode. This allows for a practical imaging window of 1 or 2 h after injection. In other words, it freezes a snapshot of brain perfusion at the time of injection that is kept and can be imaged later. This unique feature allows for designing functional brain imaging studies that do not require the patient to be inside the scanner at the time of brain activation. Functional brain imaging during severe burn wound care is an example that has been extensively studied using this technique. Not only does SPECT allow for imaging of brain activity under extreme pain conditions in clinical settings, but it also allows for imaging of brain activity modulation in response to analgesic maneuvers whether pharmacologic or non-traditional such as using virtual reality analgesia. Together with its utility in extreme situations, SPECTS is also helpful in investigating brain activation under typical pain conditions such as experimental controlled pain and chronic pain syndromes.