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Disease susceptibility and resistance are important factors for the conservation of endangered species, including elephants. We analyzed pathology data from 26 zoos and report that Asian elephants have increased neoplasia and malignancy prevalence compared with African bush elephants. This is consistent with observed higher susceptibility to tuberculosis and elephant endotheliotropic herpesvirus (EEHV) in Asian elephants. To investigate genetic mechanisms underlying disease resistance, including differential responses between species, among other elephant traits, we sequenced multiple elephant genomes. We report a draft assembly for an Asian elephant, and defined 862 and 1,017 conserved potential regulatory elements in Asian and African bush elephants, respectively. In the genomes of both elephant species, conserved elements were significantly enriched with genes differentially expressed between the species. In Asian elephants, these putative regulatory regions were involved in immunity pathways including tumor-necrosis factor, which plays an important role in EEHV response. Genomic sequences of African bush, forest, and Asian elephant genomes revealed extensive sequence conservation at TP53 retrogene loci across three species, which may be related to TP53 functionality in elephant cancer resistance. Positive selection scans revealed outlier genes related to additional elephant traits. Our study suggests that gene regulation plays an important role in the differential inflammatory response of Asian and African elephants, leading to increased infectious disease and cancer susceptibility in Asian elephants. These genomic discoveries can inform future functional and translational studies aimed at identifying effective treatment approaches for ill elephants, which may improve conservation.

The application of evolutionary and ecological principles to cancer prevention and treatment, as well as recognizing cancer as a selection force in nature, has gained impetus over the last 50 years. Following the initial theoretical approaches that combined knowledge from interdisciplinary fields, it became clear that using the eco-evolutionary framework is of key importance to understand cancer. We are now at a pivotal point where accumulating evidence starts to steer the future directions of the discipline and allows us to underpin the key challenges that remain to be addressed. Here, we aim to assess current advancements in the field and to suggest future directions for research. First, we summarize cancer research areas that, so far, have assimilated ecological and evolutionary principles into their approaches and illustrate their key importance. Then, we assembled 33 experts and identified 84 key questions, organized around nine major themes, to pave the foundations for research to come. We highlight the urgent need for broadening the portfolio of research directions to stimulate novel approaches at the interface of oncology and ecological and evolutionary sciences. We conclude that progressive and efficient cross-disciplinary collaborations that draw on the expertise of the fields of ecology, evolution and cancer are essential in order to efficiently address current and future questions about cancer.

Abstract Cancers occur across species. Understanding what is consistent and varies across species can provide new insights into cancer initiation and evolution, with significant implications for animal welfare and wildlife conservation. We build a pan-species cancer digital pathology atlas (panspecies.ai) and conduct a pan-species study of computational comparative pathology using a supervised convolutional neural network algorithm trained on human samples. The artificial intelligence algorithm achieves high accuracy in measuring immune response through single-cell classification for two transmissible cancers (canine transmissible venereal tumour, 0.94; Tasmanian devil facial tumour disease, 0.88). In 18 other vertebrate species (mammalia = 11, reptilia = 4, aves = 2, and amphibia = 1), accuracy (range 0.57–0.94) is influenced by cell morphological similarity preserved across different taxonomic groups, tumour sites, and variations in the immune compartment. Furthermore, a spatial immune score based on artificial intelligence and spatial statistics is associated with prognosis in canine melanoma and prostate tumours. A metric, named morphospace overlap, is developed to guide veterinary pathologists towards rational deployment of this technology on new samples. This study provides the foundation and guidelines for transferring artificial intelligence technologies to veterinary pathology based on understanding of morphological conservation, which could vastly accelerate developments in veterinary medicine and comparative oncology.

The more than 200 years of chattel slavery in Canada is an example of the country's occluded history predicated on structural racism. This study of preservice elementary teachers in a social studies methods course helps to reveal how the history of Black enslavement in Canada has been effectively erased from the national consciousness. Using a symbolic interactionism/grounded theory methodology, I seek to make meaning from more than 70 preservice teachers' written responses to a reading on slavery and abolition in Canada. This study's findings help reveal some of the challenges to, and possibilities for, interrogating historical consciousness and national identity narratives as a process of learning within the contexts of methods courses.

Background. Organ donors supported by extracorporeal membrane oxygenation (ECMO) have historically been considered high-risk and are judiciously utilized. This study examines transplant outcomes using renal allografts from donors supported on ECMO for nondonation purposes. Methods. Retrospective review of the Gift of Life (Pennsylvania, New Jersey, Delaware) organ procurement organization database, cross-referenced to the Organ Procurement and Transplantation Network database, assessed kidney transplants using donors supported on venoarterial (VA) and venovenous (VV) ECMO for nondonation purposes. Transplants using VA- and VV-ECMO donors were compared with Kidney Donor Profile Index (KDPI)-stratified non-ECMO donors. Regression modeling of the entire ECMO and non-ECMO populations assessed ECMO as predictive of graft survival. Additional regression of the ECMO population alone assessed for donor features associated with graft survival. Results. Seventy-eight ECMO donors yielded 128 kidney transplants (VA: 80, VV: 48). Comparing outcomes using these donors to kidney transplants using organs from KDPI-stratified non-ECMO donors, VA- and VV-ECMO donor grafts conferred similar rates of delayed graft function and posttransplant renal function to KDPI-matched non-ECMO counterparts. VA-ECMO kidneys demonstrated superior graft survival compared with the lowest-quality (KDPI 86%–100%) non-ECMO kidneys and similar graft survival to KDPI

Diet and host phylogeny drive the taxonomic and functional contents of the gut microbiome in mammals, yet it is unknown whether these patterns hold across all vertebrate lineages. Here, we assessed gut microbiomes from ∼900 vertebrate species, including 315 mammals and 491 birds, assessing contributions of diet, phylogeny, and physiology to structuring gut microbiomes. In most nonflying mammals, strong correlations exist between microbial community similarity, host diet, and host phylogenetic distance up to the host order level. In birds, by contrast, gut microbiomes are only very weakly correlated to diet or host phylogeny. Furthermore, while most microbes resident in mammalian guts are present in only a restricted taxonomic range of hosts, most microbes recovered from birds show little evidence of host specificity. Notably, among the mammals, bats host especially bird-like gut microbiomes, with little evidence for correlation to host diet or phylogeny. This suggests that host-gut microbiome phylosymbiosis depends on factors convergently absent in birds and bats, potentially associated with physiological adaptations to flight. Our findings expose major variations in the behavior of these important symbioses in endothermic vertebrates and may signal fundamental evolutionary shifts in the cost/benefit framework of the gut microbiome.IMPORTANCE In this comprehensive survey of microbiomes of >900 species, including 315 mammals and 491 birds, we find a striking convergence of the microbiomes of birds and animals that fly. In nonflying mammals, diet and short-term evolutionary relatedness drive the microbiome, and many microbial species are specific to a particular kind of mammal, but flying mammals and birds break this pattern with many microbes shared across different species, with little correlation either with diet or with relatedness of the hosts. This finding suggests that adaptation to flight breaks long-held relationships between hosts and their microbes.

Aims: Frozen shoulder is a common, painful condition that results in impairment of function. Corticosteroid injections are commonly used for frozen shoulder and can be given as glenohumeral joint (GHJ) injection or suprascapular nerve block (SSNB). Both injection types have been shown to significantly improve shoulder pain and range of motion. It is not currently known which is superior in terms of relieving patients’ symptoms. This is the protocol for a randomized clinical trial to investigate the clinical effectiveness of corticosteroid injection given as either a GHJ injection or SSNB. Methods: The Therapeutic Injections For Frozen Shoulder (TIFFS) study is a single centre, parallel, two-arm, randomized clinical trial. Participants will be allocated on a 1:1 basis to either a GHJ corticosteroid injection or SSNB. Participants in both trial arms will then receive physiotherapy as normal for frozen shoulder. The primary analysis will compare the Oxford Shoulder Score (OSS) at three months after injection. Secondary outcomes include OSS at six and 12 months, range of shoulder movement at three months, and Numeric Pain Rating Scale, abbreviated Disabilities of Arm, Shoulder and Hand score, and EuroQol five-level five-dimension health index at three months, six months, and one year after injection. A minimum of 40 patients will be recruited to obtain 80% power to detect a minimally important difference of ten points on the OSS between the groups at three months after injection. The study is registered under ClinicalTrials.gov with the identifier NCT04965376. Conclusion: The results of this trial will demonstrate if there is a difference in shoulder pain and function after GHJ injection or SSNB in patients with frozen shoulder. This will help provide effective treatment to patients with frozen shoulder. Cite this article: Bone Jt Open 2023;4(3):205–209.

Abstract Approximately 20 TP53 retrogenes exist in the African and Asian elephant genomes (Loxodonta Africana, Elephas Maximus) in addition to a conserved TP53 gene that encodes a full-length protein. Elephant TP53-RETROGENE 9 (TP53-R9) encodes a p53 protein (p53-R9) that is truncated in the middle of the canonical DNA binding domain. This C-terminally truncated p53 retrogene protein lacks the nuclear localization signals and oligomerization domain of its full-length counterpart. When expressed in human osteosarcoma cells (U2OS), p53-R9 binds to Tid1, the chaperone protein responsible for mitochondrial translocation of human p53 in response to cellular stress. Tid1 expression is required for p53-R9-induced apoptosis. At the mitochondria, p53-R9 binds to the pro-apoptotic BCL-2 family member Bax, which leads to caspase activation, cytochrome c release, and cell death. Our data show, for the first time, that expression of this truncated elephant p53 retrogene protein induces apoptosis in human cancer cells. Understanding the molecular mechanism by which the additional elephant TP53 retrogenes function may provide evolutionary insight that can be utilized for the development of therapeutics to treat human cancers.

Stroke is a leading cause of death and disability around the world. To date, the majority of pre-clinical research has been performed using male lab animals and results are commonly generalized to both sexes. In clinical stoke cases females have a higher incidence of ischemic stroke and poorer outcomes, compared to males. Best practices for improving translatability of findings for stroke, encourage the use of both sexes in studies. Since estrogen and progesterone have recognized neuroprotective effects, it is important to compare the size, severity and biochemical composition of the brain tissue following stroke in female and male animal models. In this study a photothrombotic focal stroke was induced in male and female mice. Vaginal secretions were collected twice daily to track the stage of estrous. Mice were euthanized at 24 h post-stroke. Histological staining, Fourier transform infrared imaging and X-ray fluorescence imaging were performed to better define the size and metabolic markers in the infarct core and surrounding penumbra. Our results show while the female mice had a significantly lower body mass than males, the cross-sectional area of the brain and the size of infarct and penumbra were not significantly different between the groups. In addition to the general expected sex-linked differences of altered NADH levels between males and females, estrus females had significantly elevated glycogen in the penumbra compared with males and total phosphorus levels were noted to be higher in the penumbra of estrus females. Elevated glycogen reserves in the tissue bordering the infarct core in females may present alternatives for improved functional recovery in females in the early post-stroke phase.

Over-lithiation often causes structural transformation in electrodes and may lead to safety issues in Li-ion batteries. Here, authors investigate the over-discharged mechanism of LiCoO2/graphite pouch cells, and spatially resolve the morphological, surface phase, and local electronic structure of LiCoO2 electrode.

Tubercular tenosynovitis of the wrist with carpal tunnel syndrome (CTS) is a rare occurrence. The authors present a case of tubercular flexor tenosynovitis of the wrist with CTS. A 60-year-old female presented with complaints of swelling in the volar aspect of the right wrist with numbness of the first three fingers for the past 6 months. Clinical and radiological diagnosis of chronic flexor tenosynovitis with median nerve compression neuropathy was made. The patient was operated with carpal tunnel release and total tenosynovectomy. Histopathology showed features suggestive of Koch's etiology. The patient was started with antitubercular therapy (ATT) and followed up regularly. Carpal tunnel symptoms subsided immediately after surgery and there was no recurrence of swelling at the last follow-up. Carpal tunnel release and tenosynovectomy should be performed at the earliest possible and followed up with ATT for better outcomes in tubercular tenosynovitis of the wrist with CTS.

Cetaceans are a clade of highly specialized aquatic mammals that include the largest animals that have ever lived. The largest whales can have ∼1,000× more cells than a human, with long lifespans, leaving them theoretically susceptible to cancer. However, large-bodied and long-lived animals do not suffer higher risks of cancer mortality than humans-an observation known as Peto's Paradox. To investigate the genomic bases of gigantism and other cetacean adaptations, we generated a de novo genome assembly for the humpback whale (Megaptera novaeangliae) and incorporated the genomes of ten cetacean species in a comparative analysis. We found further evidence that rorquals (family Balaenopteridae) radiated during the Miocene or earlier, and inferred that perturbations in abundance and/or the interocean connectivity of North Atlantic humpback whale populations likely occurred throughout the Pleistocene. Our comparative genomic results suggest that the evolution of cetacean gigantism was accompanied by strong selection on pathways that are directly linked to cancer. Large segmental duplications in whale genomes contained genes controlling the apoptotic pathway, and genes inferred to be under accelerated evolution and positive selection in cetaceans were enriched for biological processes such as cell cycle checkpoint, cell signaling, and proliferation. We also inferred positive selection on genes controlling the mammalian appendicular and cranial skeletal elements in the cetacean lineage, which are relevant to extensive anatomical changes during cetacean evolution. Genomic analyses shed light on the molecular mechanisms underlying cetacean traits, including gigantism, and will contribute to the development of future targets for human cancer therapies.

ContextTransformative learning (TL) has been described as learning that challenges established perspectives, leading to new ways of being in the world. As a learning theory it has resonated with educators globally, including those in the health professions. Described as a complex metatheory, TL has evolved over time, eliciting divergent interpretations of the construct. This scoping review provides a comprehensive synthesis of how TL is currently represented in the health professions education literature, including how it influences curricular activities, to inform its future application in the field.MethodsArksey and O'Malley's six-step framework was adopted to review the period from 2006 to May 2018. A total of 10 bibliographic databases were searched, generating 1532 potential studies. After several rounds of review, first of abstracts and then of full texts, 99 studies were mapped by two independent reviewers onto the internally developed data extraction sheet. Descriptive information about included studies was aggregated. Discursive data were subjected to content analysis.ResultsA mix of conceptual and empirical research papers, which used a range of qualitative methodologies, were included. Studies from the USA, the UK and Australia were most prevalent. Insights relating to how opportunities for TL were created, how it manifests and influences behaviour, as well as how it is experienced, demonstrated much congruency. Conceptions of TL were seen to be clustered around the work of key theorists.ConclusionsThe training of health professionals often takes place in unfamiliar settings where students are encouraged to be active participants in providing care. This increases the opportunity for exposure to learning experiences that are potentially transformative, allowing for a pedagogy of uncertainty that acknowledges the complexity of the world we live in and questions what we believe we know about it. TL provides educators in the health professions with a theoretical lens through which they can view such student learning.

Abstract Hypoxia promotes aggressive tumor phenotypes and mediates the recruitment of suppressive T cells in invasive breast carcinomas. We investigated the role of hypoxia in relation to T-cell regulation in ductal carcinoma in situ (DCIS). We designed a deep learning system tailored for the tissue architecture complexity of DCIS, and compared pure DCIS cases with the synchronous DCIS and invasive components within invasive ductal carcinoma cases. Single-cell classification was applied in tandem with a new method for DCIS ductal segmentation in dual-stained CA9 and FOXP3, whole-tumor section digital pathology images. Pure DCIS typically has an intermediate level of colocalization of FOXP3+ and CA9+ cells, but in invasive carcinoma cases, the FOXP3+ (T-regulatory) cells may have relocated from the DCIS and into the invasive parts of the tumor, leading to high levels of colocalization in the invasive parts but low levels in the synchronous DCIS component. This may be due to invasive, hypoxic tumors evolving to recruit T-regulatory cells in order to evade immune predation. Our data support the notion that hypoxia promotes immune tolerance through recruitment of T-regulatory cells, and furthermore indicate a spatial pattern of relocalization of T-regulatory cells from DCIS to hypoxic tumor cells. Spatial colocalization of hypoxic and T-regulatory cells may be a key event and useful marker of DCIS progression.

The climate crisis has received a great deal of attention of late, yet its root causes go back to the last century and beyond. Also going back many years have been efforts to address the roots of the climate crisis. These efforts include the work of language teachers to research, create, trial, and share materials and pedagogical strategies for educating and mobilizing teachers, students, and other stakeholders to address the beliefs and practices that have led our species to the precipice of irredeemable disaster. This article seeks to serve as an annotated repository of works and collective wisdom of the author and colleagues, both near and far, as to how language teaching can accomplish its joint tasks of both facilitating student enjoyment of and expertise in their languages, and at the same time engaging students in fulfilling their responsibility as citizens of their home country and the world, a responsibility that has only grown more urgent due to the climate crisis. This repository is the result of 50 years of research, not with blinded control groups and statistical analysis (valuable though those methods can be), but of naturalistic investigation. The repository divides into three sections: Inspiration, Information, and Implementation. Strategies and ways that teachers have found useful for growing their own and their students’ knowledge of the causes of and possible solutions to the climate crisis are considered. The article ends with a poem by the author which addresses the important question of the role of the teacher in the classroom and beyond.

This research aims to present a synopsis of four eminent theoretical concepts that scholars have expended to help understand how digitalisation has changed the workplace as we used to know it. The research is based on a conceptual approach. It aims to critically synthesise the relevant literature as the principal methodology for analysing work in the selected four research domains where the perspective on digital work is most controversial. The study shows two central chronicles that have emerged due to workplace digitalisation - utopian and dystopian perspectives. The research sheds light on controversial discourses regarding changing nature of work in the digital era, particularly concerning work polarisation, non-standard employment, unemployment and platform work. The study also provides guidelines for change that help minimise the dark side and harm to the worker of digitalisation by developing appropriate capabilities for the new digital environment.

Our review of the literature shows anatomical variation of the submandibular gland is a rare entity, unlike the variation that can be seen in parotid glands. Specifically, bilateral submandibular abnormality has only been reported on one occasion with limited imaging in our review. We report a 78-year-old female with a history of sialadenitis and sialolithiasis who presents with swelling and pain in the right submandibular gland. Sialography of the right submandibular gland disclosed a second primary duct branching off the main duct to a second submandibular gland. Cannulation of the left submandibular duct was unsuccessful due to scarring of the duct orifice; however, subsequent MR sialography identified marked submandibular duct dilation and the incidental finding of a second anteriorly located left submandibular gland. The anatomic detail provided by conventional digital sialography is contrasted to the useful but less-defined imaging provided by MR sialography. To our knowledge, this is the first reported case of bilateral accessory submandibular glands that has been evaluated using both conventional and MR sialography.

Barrett’s esophagus is a pre-malignant condition that can progress to esophageal cancer. Here, the authors carry out whole genome sequencing of samples from patients who did or did not progress to cancer and find that mutations in many genes occur regardless of progression status, but also find features associated with progressive disease.

The growth of renewable energy sources presents a pressing challenge to the operation and maintenance of existing fossil fuel power plants, given that fossil fuel remains the predominant fuel source, responsible for over 60% of electricity generation in the United States. One of the main concerns within these fossil fuel power plants is the unpredictable failure of boiler tubes, resulting in emergency maintenance with significant economic and societal consequences. A reliable high-temperature sensor is necessary for in situ monitoring of boiler tubes and the safety of fossil fuel power plants. In this study, a comprehensive four-stage multi-physics computational framework is developed to assist the design, optimization installation, and operation of the high-temperature stainless-steel and quartz coaxial cable sensor (SSQ-CCS) for coal-fired boiler applications. With the consideration of various operation conditions, we predict the distributions of flue gas temperatures within coal-fired boilers, the temperature correlation between the boiler tube and SSQ-CCS, and the safety of SSQ-CCS. With the simulation-guided sensor installation plan, the newly designed SSQ-CCSs have been employed for field testing for more than 430 days. The computational framework developed in this work can guide the future operation of coal-fired plants and other power plants for the safety prediction of boiler operations.

Abstract Does asking students to apply concepts from evolution to a fictional context, compared to a novel biological context, improve their understanding, exam performance or enjoyment of the material? Or does it harm their education by taking time away from true biology? At our institution, we sometimes ask students to apply life history theory to species from fictional movies, television shows or books. Previously, we had used a factual article on life history theory, to supplement our textbook. We wrote an alternative introduction to life history theory (included in the additional files for educational use), using Tolkien’s fictional species from his Lord of the Rings books. We also introduce the biological species definition, sexual selection, sexual dimorphism, kin selection, and the handicap principle, as those concepts arose naturally in the discussion of the fictional species. Life history theory predicts strong correlations between traits affecting reproduction, growth and survival, which are all shaped by the ecology of the species. Thus, we can teach life history theory by asking students to infer traits and aspects of the ecology of a fictional species that have never been described, based on the partial information included in the fictional sources. In a large, third year undergraduate evolution course at Arizona State University, we randomized 16 tutorial sections of a total of 264 students to either read our article on the life history theory of Lord of the Rings, or the factual article we had used previously in the course. We found that the exam performance on life history questions for the two groups were almost identical, except that fans of The Lord of the Rings who had read our article did better on the exam. Enjoyment, engagement and interest in life history theory was approximately a full point higher on a 5-point Likert scale for the students that had read the fictional article, and was highly statistically significantly different (T-test p

Abstract More than 2 million years ago in East Africa, the earliest hominin stone tools evolved amidst changes in resource base, with pounding technology playing a key role in this adaptive process. Olduvai Gorge (now Oldupai) is a famed locality that remains paramount for the study of human evolution, also yielding some of the oldest battering tools in the world. However, direct evidence of the resources processed with these technologies is lacking entirely. One way to obtain this evidence is through the analysis of surviving residues. Yet, linking residues with past processing activities is not simple. In the case of plant exploitation, this link can only be established by assessing site-based reference collections inclusive of both anthropogenic and natural residues as a necessary first step and comparative starting point. In this paper, we assess microbotanical remains from rock clasts sourced at the same quarry utilized by Oldowan hominins at Oldupai Gorge. We mapped this signal and analysed it quantitatively to classify its spatial distribution objectively, extracting proxies for taxonomic identification and further comparison with freestanding soils. In addition, we used blanks to manufacture pounding tools for blind, controlled replication of plant processing. We discovered that stone blanks are in fact environmental reservoirs in which plant remains are trapped by lithobionts, preserved as hardened accretions. Tool use, on the other hand, creates residue clusters; however, their spatial distribution can be discriminated from purely natural assemblages by the georeferencing of residues and statistical analysis of resulting patterns. To conclude, we provide a protocol for best practice and a workflow that has the advantage of overcoming environmental noise, reducing the risk of false positive, delivering a firm understanding of residues as polygenic mixtures, a reliable use of controls, and most importantly, a stronger link between microbotanical remains and stone tool use.

Wind-driven upwelling is an important control on surface nutrients and water properties in stratified lakes and seas. In this study, a high-resolution biophysical coupled model is used to investigate upwelling in the Strait of Georgia on the Canadian Pacific coast. The model is forced with surface winds from a high-resolution atmospheric forecast and has been tuned in previous studies to reproduce extensive observations of water level, temperature, salinity, nutrients and chlorophyll with competitive skill relative to similar models of the study region. A total of 5 years of hourly surface nitrate and temperature fields are analyzed in order to characterize the dominant upwelling patterns of the basin. A prevailing along-axis wind pattern steered by mountainous topography produces episodic upwelling along the western shore during the spring and fall southeasterlies and along the eastern shore during the summer northwesterlies, as indicated by positive nitrate anomalies. Principal component analysis reveals that these cross-axis upwelling patterns account for nearly one-third of the surface nitrate variance during the summer productive season. By contrast, nearly half of the surface temperature variance over the same period is dominated by a single, combined mixing and diurnal heating–cooling pattern. The principal components associated with these patterns correlate with along-axis wind stress in a manner consistent with these physical interpretations. The cross-axis upwelling response to wind is similar to other dynamically wide basins where the baroclinic Rossby deformation radius is smaller than the basin width. However, the nitrate anomaly during upwelling along the eastern shore is stronger in the northern basin, which may be indicative of an along-axis pycnocline tilt or an effect of the background along-axis stratification gradient due to the Fraser River. Our findings highlight an important spatiotemporal consideration for future ecosystem monitoring.

Objectives To examine health behaviours of refugees and asylum seekers, in relation to their knowledge of public benefits and legal rights.Design Qualitative study, utilising an open-ended, semi-structured interview guide to ensure information-rich data collection. Thematic content was analysed using qualitative research software.Setting Participants were drawn from the Weill Cornell Center for Human Rights (WCCHR) in New York City, a single-center, human rights clinic with a globally representative patient population. All interviews were conducted at the Weill Cornell Medicine Clinical and Translational Science Center, a multidisciplinary space within an urban academic medical center.Participants Twenty-four refugees and asylum seekers currently living in the greater New York City area. Eligible participants were 18 years of age or older and had previously sought services from the WCCHR. The recruitment rate was 55%.Primary and secondary outcome measures Themes and concepts in participants’ health, knowledge, perceptions of and experiences with accessing healthcare and public benefits programmes.Results Twenty-four participants represented 18 countries of origin and 11 primary languages. Several impediments to accessing healthcare and public benefits were identified, including pragmatic barriers (such as prohibitive costs or lack of insurance), knowledge gaps and mistrust of healthcare systems.Conclusions There is low health engagement by refugees and asylum seekers, as a result of multiple, complex factors impeding the ability of refugee and asylum seekers to access healthcare and other public benefits for which they are eligible—with resultant detrimental health effects. However, there is an opportunity to utilise novel approaches, such as digital technologies, to communicate relevant information regarding legal rights and public benefits to advance the health of vulnerable individuals such as refugees and asylum seekers.

Chimerism is a widespread phenomenon across the tree of life. It is defined as a multicellular organism composed of cells from other genetically distinct entities. This ability to 'tolerate' non-self cells may be linked to susceptibility to diseases like cancer. Here we test whether chimerism is associated with cancers across obligately multicellular organisms in the tree of life. We classified 12 obligately multicellular taxa from lowest to highest chimerism levels based on the existing literature on the presence of chimerism in these species. We then tested for associations of chimerism with tumour invasiveness, neoplasia (benign or malignant) prevalence and malignancy prevalence in 11 terrestrial mammalian species. We found that taxa with higher levels of chimerism have higher tumour invasiveness, though there was no association between malignancy or neoplasia and chimerism among mammals. This suggests that there may be an important biological relationship between chimerism and susceptibility to tissue invasion by cancerous cells. Studying chimerism might help us identify mechanisms underlying invasive cancers and also could provide insights into the detection and management of emerging transmissible cancers.

Simulations are of growing interest within the social studies in terms of research and practice. Although the findings of early research were unfavorable to simulations in terms of student learning, recent research has revealed new and interesting findings related to different domains of student learning that earlier research did not. In light of these conceptual and practical findings, it is important that teachers be granted access to the growth of knowledge in this burgeoning area of inquiry. To date, few scholars have disseminated to teachers the findings of existing research about simulations as it pertains to student learning, and to practitioners' planning and practice. In this article, I provide an account of research on simulation that will be helpful to teachers. The paper includes five critical areas that seek to help teachers better understand what simulations are, their affordances and challenges, as well as suggestions relating to the implications for teachers' curricular planning and implementation of simulations in their classrooms.

Osteochondroma is the most common primary benign bone tumour frequently affecting the appendicular skeleton and rarely involves the spine and even more rarely involves the lower lumbar region. The present case report was a rare case of osteochondroma arising from spinous process of L2 vertebra. A 12-year-old male visited with his parents with complaints of progressive painless swelling in the lower back for six months. After thorough evaluation, osteochondroma arising from L2 spinous process was diagnosed. The patient was operated with extraperiosteal enbloc excision of the tumour along with L2 spinous process. Enbloc excision of axial exostosis should be considered owing to the risk factor of neurological involvement and rare malignant transformation.