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Background: Interpretation laboratory analyses are crucial when assessing the patient’s condition. Reference intervals from apparently healthy and disease-free individuals may cause problems when outcomes from elderly patients with chronic diseases and on medications are being interpreted. Elderly individuals are a heterogeneous group ranging from individuals managing their daily life independently to individuals with diseases and impairment, in need of nursing care around the clock, that is, frail; a term widely used although there is no consensus on the definition. Aims and Objectives: The aim of the study was to study the effect of classification of elderly into healthy, moderately healthy, and frail, based on activities of daily living (ADL) and Mini-Mental State Examination (MMSE) or frailty index (FI), on the interpretation of outcomes regarding: Albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, and gamma-glutamyltransferase (γ-GT) levels. Materials and Methods: Individuals ≥80 years (n=568) were classified either on ADL and MMSE or number of deficits, (FI). Results: Individuals classified as frail based on FI had lower mean levels for ALT, creatinine and γ-GT than individuals classified based on ADL and MMSE (P

Abstract Background Infection is more frequent, and serious in people aged > 65 as they experience non-specific signs and symptoms delaying diagnosis and prompt treatment. Monitoring signs and symptoms using decision support tools (DST) is one approach that could help improve early detection ensuring timely treatment and effective care. Objective To identify and analyse decision support tools available to support detection of infection in older people (> 65 years). Methods A scoping review of the literature 2010–2021 following Arksey and O’Malley (2005) framework and PRISMA-ScR guidelines. A search of MEDLINE, Cochrane, EMBASE, PubMed, CINAHL, Scopus and PsycINFO using terms to identify decision support tools for detection of infection in people > 65 years was conducted, supplemented with manual searches. Results Seventeen papers, reporting varying stages of development of different DSTs were analysed. DSTs largely focussed on specific types of infection i.e. urine, respiratory, sepsis and were frequently hospital based (n = 9) for use by physicians. Four DSTs had been developed in nursing homes and one a care home, two of which explored detection of non- specific infection. Conclusions DSTs provide an opportunity to ensure a consistent approach to early detection of infection supporting prompt action and treatment, thus avoiding emergency hospital admissions. A lack of consideration regarding their implementation in practice means that any attempt to create an optimal validated and tested DST for infection detection will be impeded. This absence may ultimately affect the ability of the workforce to provide more effective and timely care, particularly during the current covid-19 pandemic.

Background In patients undergoing neurosurgeries, inflammation and infection are strongly related; however, inflammation can be present without infection. Midregional proadrenomedullin (MR-proADM) is a relatively new sepsis biomarker that is rarely used clinically. Recently, the concept of DiffTemp was introduced, that is, a >1°C rise from individual normal temperature accompanied by malaise, as a more accurate definition of temperature assessed as fever. The aim of the present study was to examine the importance of C-reactive protein (CRP), white blood cells, procalcitonin, and MR-proADM levels and DiffTemp. Methods This prospective, comparative study had a quantitative approach. Forty-two patients, aged >18 years and presenting with severe cerebral trauma were included from a neurosurgical intensive care unit. The outcome variable was infection; group 0, no infection (n=11); group 1, suspected infection (n=15); and, group 2, confirmed infection (n=16). Group assignments were performed using biomarkers, medical records, bacterial cultures, and International Classification of Diseases-10, and by the clinical assessment of criteria for nosocomial infections by a neurosurgeon. Results On comparing groups 1 and 2, MR-proADM and DiffTemp were associated with a higher risk of confirmed infection (odds ratio, 5.41 and 17.14, respectively). Additionally, DiffTemp had a 90.9% specificity in patients with no infection and a 93.8% sensitivity in patients with confirmed infections. CRP and procalcitonin levels were not associated with an increased risk of confirmed infection. Conclusion Increased levels of MR-proADM were associated with a higher risk of confirmed infection. DiffTemp was associated with a higher risk of having a confirmed infection.

The Caribbean‐South America subduction zone is a flat subduction zone, with Laramide‐style thick‐skinned uplifts occurring in the Merida Andes, Sierra de Perija Range, and Santa Marta Massif. Geodetic measurements and historical seismicity show this region is storing strain energy and is capable of a mega‐thrust earthquake (M ≥ 8.0). Previous seismic investigations of the lithosphere and upper mantle in this area are either very large scale, very local, or only peripheral to this area; therefore, details of the Caribbean plate subduction geometry beneath the Maracaibo block remain unclear. In this study, we used a new data set acquired by the Caribbean‐Merida Andes seismic experiment (CARMA), which comprised 65 temporary broadband stations and 44 permanent stations from the Colombian and Venezuelan national seismic networks. We jointly inverted ambient noise Rayleigh wave Z/H ratios, phase velocities in the 8–30 s band and ballistic Rayleigh wave phase velocities in 30–80 s band to construct a 3‐D S‐wave velocity model in the area between 75°–65°W and 5°–12°N. The 3‐D model reveals a general increase in crust thickness from the trench to the southeast. An anomalous area is the Lake Maracaibo, which is underlaid by the thinnest crystalline crust in the region. This observation may indicate that the Maracaibo block is experiencing a contortion deformation within the crust. We also identified a high velocity anomaly above the subducting Caribbean slab, likely representing a detached piece of eclogitized Caribbean large igneous province from the base of the Maracaibo block. Additionally, our Vs model clearly indicates a slab tear within the subducted Caribbean slab, approximately beneath the Oca‐Ancon Fault. Plain Language Summary: The Caribbean‐South America subduction zone is a flat subduction zone that the South‐American plate subducts beneath the Maracaibo block, which can lead to destructive earthquakes (M ≥ 8.0) due to built‐up strain. This study used data from the Caribbean‐Merida Andes seismic experiment (CARMA), which included 65 temporary and 44 permanent seismic stations in Colombia and Venezuela, to build a 3‐D S‐wave velocity model. The model shows the crust thickens from the trench toward southeast, with the thinnest crust under Lake Maracaibo, indicating significant deformation in the Maracaibo block. The study also found high‐speed anomalies above the subducting plate, suggesting a detached fragment of the Caribbean large igneous province beneath the Maracaibo block. Additionally, a slab tear was identified beneath the Oca‐Ancon Fault, which could impact seismic activity in the region. These findings enhanced our understanding of the region's tectonic processes and potential earthquake risks. Key Points: The Maracaibo block is experiencing a contortion deformation within the crustHigh velocity anomalies above the subducting Caribbean slab indicate a detached piece of eclogitized Caribbean large igneous provinceA slab tear within the subducted Caribbean slab is found approximately beneath the Oca‐Ancon Fault [ABSTRACT FROM AUTHOR]

The high sensitivity of VP/VS to the presence of melt makes images of VP/VS structure particularly useful in magmatic systems, but detailed three‐dimensional models of VP/VS structure in magmatic systems are often restricted to the upper crust where there is a concentration of seismic sources used for imaging. Ps‐P tomography is a new technique that has been used to image three‐dimensional crustal‐scale variations in VP/VS in regions with limited seismic instrumentation. We apply the Ps‐P tomography technique to a well‐constrained, independently imaged magmatic setting, Mount St. Helens, to outline the efficacy and limitations of this imaging approach. Our Ps‐P tomography model reveals previously imaged high VP/VS upper crustal magma reservoirs beneath active volcanic systems at Mount St. Helens, Mount Adams and the Indian Heaven Volcanic Field and low VP/VS anomalies associated with crystallized plutons. Our model also provides new VP/VS constraints in the lower crust that reveal a high VP/VS anomaly connecting the Mount St. Helens and Mount Adams reservoirs and a low VP/VS anomaly associated with lower crustal cumulates or mafic accreted terranes. Decimation tests further show that first order VP/VS structure is recoverable using as few as four recording seismometers. These images resemble those of independent, higher resolution images from traditional techniques, highlighting the utility of Ps‐P tomography for imaging three‐dimensional variations of VP/VS throughout the crust, including in data‐poor settings or with arrays not designed for structural seismic investigations, such as many volcano monitoring networks. Plain Language Summary: There are a variety of ways that seismic waves can be used to infer the three‐dimensional distribution of physical properties of the Earth including parameters like composition, temperature and the presence of partially molten rock (magma), but there are some parts of the Earth that are more difficult to see than others. The lower crust is one region of the Earth that is both important and difficult to image, but many traditional imaging tools require extensive and expensive data collection to see it. However, a technique called receiver function analysis, which highlights the recording of waves that convert from compressional (P) waves to shear (S) waves at physical boundaries in the Earth, can be used to see the entire crust at relatively low cost. This paper tests a method for imaging three‐dimensional crustal structure, including the lower crust, using measurements of those converted waves. Importantly, the paper tests this method at a data‐rich setting, Mount St. Helens in Washington state, USA, to illustrate how well it can be used in other data‐poor settings. The results show that the method, called Ps‐P tomography, works well and can be applied to data‐poor settings with confidence despite known limitations in resolution. Key Points: We use Ps‐P tomography to image the relative VP/VS crustal structure in the region surrounding Mount St. Helens, Washington state, USAPs‐P tomography model is correlated with previously imaged structure around the volcano, highlighting the accuracy of the techniquePs‐P tomography reveals VP/VS structure throughout the crust and is shown to be effective with as few as four available seismic stations [ABSTRACT FROM AUTHOR]

This article develops knowledge about the meaning and value ascribed to educational proficiency in the recruitment of full professors. Hiring processes reflect standards that organize academia and notions of academic scholarship, its value and quality, and agents involved have an institutional gate-keeping function. The empirical data, external peer review letters, is drawn from an old comprehensive research-intensive university, offering educational programmes within a broad range of scientific domains. Although a large variety of aspects are ascribed to educational proficiency, and variations do occur across scientific domains and reviewers, the main finding is a restricted notion. A special value is assigned to the scope of doctoral supervision and teacher training. Internal individual classroom performance is focused, while scholarly interaction is less emphasized. Reviewers primarily serve as gatekeepers of disciplinary research, not the education thereof, thus educational proficiency is no game changer in the context of academic scholarship.

New approaches based on -omics technologies can identify biomarkers and processes regulated in response to xenobiotics, and thus support toxicological risk assessments. This is vital to meet the challenges associated with “cocktail effects”, i.e. combination effects of chemicals present simultaneously in a product, our environment, and/or our body. For plant protection products (PPPs), investigations largely focus on active ingredients such as herbicides and fungicides. In this study, we have analyzed agricultural chemicals, two surfactants (poly(oxy-1,2-ethanediyl), alpha-sulfo-omega-[2,4,6-tris(1-phenylethyl)phenoxy]-, ammonium salt, POL; N,N-dimethylcapramide, NND), and one preservative, 1,2-benzisothiazol-3(2 H)-one (BEN) used as adjuvants in PPPs, and further three fungicide PPPs, Proline EC 250, Shirlan, Folicur Xpert, containing the adjuvants, and other major individual constituents (fluazinam (FLU), prothioconazole (PRO), tebuconazole (TEB)) as well as defined mixtures (“mixes”) thereof using several in vitro approaches. All investigated single agricultural chemicals were predicted as skin sensitizers using an in vitro transcriptomic assay based on a dendritic cell model. For selected chemicals and mixes, also skin sensitization potency was predicted. The preservative BEN induced significant changes in cytokine secretion and dendritic cell activation marker CD86 expression. The surfactant NND changed cytokine secretion only and the POL only affected CD86 expression. Proteomic analyses revealed unique response profiles for all adjuvants, an oxidative stress pattern response in BEN-treated cells, and differentially abundant proteins associated with cholesterol homeostasis in response to POL. In summary, we find responses to agricultural chemicals and products consistent with the dendritic cell model reacting to chemical exposure with oxidative stress, ER stress, effects on autophagy, and metabolic changes especially related to cholesterol homeostasis. After exposure to certain mixes, novel proteins or transcripts were differentially expressed and these were not detected for any single constituents, supporting the occurrence of cocktail effects. This indicates that all chemicals in a PPP can contribute to the toxicity profile of a PPP, including their skin sensitizing/immunotoxic properties.

Dendritic cells are the sentinels of the immune system, linking the innate and adaptive immune response. Myeloid and dendritic cell models have been successfully used in in vitro approaches to predict adverse outcomes such as skin sensitization. We here exposed a well-characterized human dendritic cell-like cell line to agricultural chemicals, including fungicide formulations, active ingredients, adjuvants and defined mixtures for 24 h to profile induced changes on protein levels. Cell pellets were harvested and prepared for bottom-up label-free analysis with peptide separation on an EASY-nano LC system 1200 coupled online with a QExactive HF-X mass spectrometer with data-dependent acquisition (DDA). The raw data files and processed quantitative data have been deposited to ProteomeXchange with the data identification number PXD034624 and are described here. The data in this article may serve as a resource for researchers interested in e.g. human toxicology, immunology, cell biology and pharmacology.

Background: The COVID-19 pandemic presents challenges in participant recruitment strategies for clinical research involving people with opioid use disorders recently engaged in treatment. We describe challenges to participant recruitment in a trial comparing virtual buprenorphine treatment platform to office-based buprenorphine treatment. Methods: The parent study was a cohort trial of telehealth delivered buprenorphine treatment compared to office-based buprenorphine treatment, however, due to the pandemic potential participant recruitment for both arms became virtual. Between 9/27/2021 and 7/11/2022, telephone, email, flyers, and word-of-mouth were used to recruit study participants from each treatment setting. Recruitment tracking documents recorded the primary outcomes: number of outreach attempts and most effective contact methods. Results: Treatment settings provided contact information for 1485 potential study participants. Information was incorrect or disconnected for 282 (19%) individuals, 695 (47%) did not respond to outreach, and 508 (34%) responded to outreach. Of these responders, 369 were interested in study participation, 259 completed the online informed consent and screening assessment, and 148 met eligibility criteria and enrolled in the study. A total of 3804 virtual outreach attempts across 1485 potential participants were made, resulting in an average of 2.7 attempts per contact and a mean of 25.7 attempts per enrolled participant (n = 148). Conclusion: Conducting research during the COVID-19 pandemic required shifting from in-person to virtual recruitment strategies to contact and engage potential study participants. Virtual recruitment for this population during a pandemic appears to be less efficient and hindered efforts to meet recruitment goals.

Summary: Background: The COVID-19 Scenario Modeling Hub convened nine modeling teams to project the impact of expanding SARS-CoV-2 vaccination to children aged 5–11 years on COVID-19 burden and resilience against variant strains. Methods: Teams contributed state- and national-level weekly projections of cases, hospitalizations, and deaths in the United States from September 12, 2021 to March 12, 2022. Four scenarios covered all combinations of 1) vaccination (or not) of children aged 5–11 years (starting November 1, 2021), and 2) emergence (or not) of a variant more transmissible than the Delta variant (emerging November 15, 2021). Individual team projections were linearly pooled. The effect of childhood vaccination on overall and age-specific outcomes was estimated using meta-analyses. Findings: Assuming that a new variant would not emerge, all-age COVID-19 outcomes were projected to decrease nationally through mid-March 2022. In this setting, vaccination of children 5–11 years old was associated with reductions in projections for all-age cumulative cases (7.2%, mean incidence ratio [IR] 0.928, 95% confidence interval [CI] 0.880–0.977), hospitalizations (8.7%, mean IR 0.913, 95% CI 0.834–0.992), and deaths (9.2%, mean IR 0.908, 95% CI 0.797–1.020) compared with scenarios without childhood vaccination. Vaccine benefits increased for scenarios including a hypothesized more transmissible variant, assuming similar vaccine effectiveness. Projected relative reductions in cumulative outcomes were larger for children than for the entire population. State-level variation was observed. Interpretation: Given the scenario assumptions (defined before the emergence of Omicron), expanding vaccination to children 5–11 years old would provide measurable direct benefits, as well as indirect benefits to the all-age U.S. population, including resilience to more transmissible variants. Funding: Various (see acknowledgments).

Abstract Background In the United States, methadone for opioid use disorder (OUD) is highly regulated. Federal agencies announced guidelines in March 2020 allowing for relaxation of take-home methadone dispensing at opioid treatment programs (OTPs) to improve treatment access and reduce COVID-19 transmission risk during the public health emergency. We explored patient perspectives at three OTPs serving rural communities on how take-home policy changes were received and implemented and how these changes impacted their addiction treatment and recovery. Methods We completed semi-structured individual qualitative interviews in 2 phases: (1) August–October 2020 and (2) November 2020–January 2021 (total n = 46), anticipating possible policy changes as the pandemic progressed. We interviewed patients with OUD enrolled at 3 rural OTPs in Oregon. Participants received varying take-home methadone allowances following the COVID-19-related policy changes. All interviews were conducted via phone, audio-recorded, and transcribed. We conducted a thematic analysis, iteratively coding transcripts, and deductively and inductively generating codes. Results The 46 participants included 50% women and 89% had Medicaid insurance. Three main themes emerged in the analysis, with no differences between study phases: (1) Adapting to changing OTP policies throughout the pandemic; (2) Recognizing the benefits, and occasional struggles, with increased take-home methadone dosing; and (3) Continuing policies and procedures post-pandemic. Participants described fears and anxieties around ongoing methadone access and safety concerns prior to OTP policy changes, but quickly adapted as protocols soon seemed “natural.” The majority of participants acknowledged significant benefits to increased take-homes independent of reducing COVID-19 infection risk including feeling “more like a normal person,” improved recovery support, reduced time traveling, and having more time with family and for work. Looking to a post-pandemic future, participants thought some COVID-19-related safety protocols should continue that would reduce risk of other infections, make OTP settings less stressful, and result in more individualized care. Conclusions As the pandemic progressed, study participants adapted to rapidly changing OTP policies. Participants noted many unanticipated benefits to increased take-home methadone and other COVID-19 protocols including strengthened self-efficacy and recovery and reduced interpersonal conflict, with limited evidence of diversion. Patient perspectives should inform future policies to better address the ongoing overdose epidemic.

Abstract We used cross‐correlation of ambient noise records from seismic stations in the US, Mexico, and Cuba to extract dispersion data of Rayleigh surface wave. Our derived 3D shear‐wave velocity model of the greater Gulf of Mexico (GOM) region captures variations in the crustal and lithospheric structures across the continental margins of the US Gulf Coast and Yucatan, Mexico. The model shows a zone of reduced velocity in the mantle lithosphere underlying the extended continental margin of the northwestern GOM. We attributed this velocity reduction to extensional deformation and melt‐induced weakening of the lithosphere during the Triassic continental rifting that preceded the seafloor spreading that formed the GOM. Melt extraction might have been hindered by the greater lithospheric thickness in the western region along the US Gulf Coast margin that resulted in the westward decrease of rift‐related volcanism/magmatism reported from previous studies. The clear asymmetry between the US Gulf Coast and its conjugate Yucatan margin suggests extension along a shear‐zone that focused more deformation on the North American plate prior to breakup. In contrast to the counterclockwise rotation of the Yucatan block during seafloor‐spreading, our analyses using deformable plate models demonstrate that continental rifting occurred in a predominantly northwest‐southeast direction. This change in plate motion is attributed to the development of mantle shear‐zones in the western part of the rift. We estimated the depth of the lithosphere‐asthenosphere boundary and determined that the extended continental and oceanic lithospheres have mostly regained their thickness since the time of breakup.

Abstract A purpose of the Interior Exploration Using Seismic Investigations, Geodesy and Heat Transport (InSight) mission is to reveal the Martian interior structure with seismic data. In this work, ambient noise autocorrelation of the continuously recorded vertical‐component seismic signals has extracted the Rayleigh waves that propagate around Mars for one cycle, R2. The Mars orbiting surface waves are observed at a lag time of ∼6,000 s in the stacked autocorrelation series filtered between 0.005 and 0.01 Hz. Synthetic seismograms from a set of radially concentric velocity models were computed to find the best‐fitting one as the starting model for a Monte Carlo inversion. The starting model was randomly perturbed iteratively to increase the correlation coefficients and reduce the absolute time shifts between the synthetic and observed R2. An S‐wave low‐velocity layer in the inverted velocity model extends to ∼400 km depth, consistent with Marsquake observations, geophysical inversion, and high‐pressure experiments.

In Spring 2021, the highly transmissible SARS-CoV-2 Delta variant began to cause increases in cases, hospitalizations, and deaths in parts of the United States. At the time, with slowed vaccination uptake, this novel variant was expected to increase the risk of pandemic resurgence in the US in summer and fall 2021. As part of the COVID-19 Scenario Modeling Hub, an ensemble of nine mechanistic models produced 6-month scenario projections for July–December 2021 for the United States. These projections estimated substantial resurgences of COVID-19 across the US resulting from the more transmissible Delta variant, projected to occur across most of the US, coinciding with school and business reopening. The scenarios revealed that reaching higher vaccine coverage in July–December 2021 reduced the size and duration of the projected resurgence substantially, with the expected impacts was largely concentrated in a subset of states with lower vaccination coverage. Despite accurate projection of COVID-19 surges occurring and timing, the magnitude was substantially underestimated 2021 by the models compared with the of the reported cases, hospitalizations, and deaths occurring during July–December, highlighting the continued challenges to predict the evolving COVID-19 pandemic. Vaccination uptake remains critical to limiting transmission and disease, particularly in states with lower vaccination coverage. Higher vaccination goals at the onset of the surge of the new variant were estimated to avert over 1.5 million cases and 21,000 deaths, although may have had even greater impacts, considering the underestimated resurgence magnitude from the model.

Abstract Background Visual exploration of gene product behavior across multiple omic datasets can pinpoint technical limitations in data and reveal biological trends. Still, such exploration is challenging as there is a need for visualizations that are tailored for the purpose. Results The OmicLoupe software was developed to facilitate visual data exploration and provides more than 15 interactive cross-dataset visualizations for omics data. It expands visualizations to multiple datasets for quality control, statistical comparisons and overlap and correlation analyses, while allowing for rapid inspection and downloading of selected features. The usage of OmicLoupe is demonstrated in three different studies, where it allowed for detection of both technical data limitations and biological trends across different omic layers. An example is an analysis of SARS-CoV-2 infection based on two previously published studies, where OmicLoupe facilitated the identification of gene products with consistent expression changes across datasets at both the transcript and protein levels. Conclusions OmicLoupe provides fast exploration of omics data with tailored visualizations for comparisons within and across data layers. The interactive visualizations are highly informative and are expected to be useful in various analyses of both newly generated and previously published data. OmicLoupe is available at quantitativeproteomics.org/omicloupe

Little is known about the nature of educational proficiency in evaluation practices in academia. This is unfortunate, since excellence in teaching is increasingly seen as significant for the prosperity of contemporary higher education institutions. This study explores the meaning ascribed to educational proficiency in the recruitment of academic teachers, and draws on data from a comprehensive research-intensive university in Sweden offering educational programmes within a broad range of scientific domains. The data consists of 100 evaluation reports derived from 54 appointments. A thematic analysis and an analysis of reviewers’ strategies of intertextuality are carried out. The findings show that (1) although qualitatively distinct aspects are attributed to educational proficiency, the principal meaning ascribed to it is the mere act and experience of teaching; and (2) reviewers draw on the application files using distinct textual strategies that have significant consequences for their construction of educational proficiency. These strategies involve referring to existing information in the file in different ways (quoting/listing, paraphrasing/summarising, commenting/assessing), stressing the absence of information in the file (wanting), and disregarding information in the file (withdrawing). Reviewers’ dominant use of paraphrasing or summarising as a strategy of intertextuality is consistent with educational proficiency primarily being conceptualised as a matter of quantity.