Search

Inclusive sports have emerged as a potential tool for building social inclusion within diverse populations. The Special Olympics Unified Sports programs are an example of inclusion initiatives specific to students with intellectual disability and sports that can be reevaluated with new understandings of inclusion. This systematic mixed studies review aimed to capture athlete Unified Sports experiences and identify what athletes reported about their participation. The systematic review identified nine original studies conducted by six unrelated research groups. Results across the studies are synthesized and suggestions for future research are presented. Athletes in all nine studies reviewed reported positive experiences with Unified Sports leading to increased social inclusion and/or self-concepts. [ABSTRACT FROM AUTHOR]

Substance use is a perennial public health concern with associated health risks and economic impacts on society. In this article, we present a selective review of the epidemiological and clinical literatures on alcohol and substance use from a lifespan developmental perspective. We compare and contrast risk factors for the initiation of use and the development of a substance use disorder in adolescence, young adulthood, middle-age and later life. During adolescence, alcohol use experimentation is at its peak. Specific risk factors have been identified including trauma and parenting style that can increase the risk of substance use for teenagers. Emerging adults and college students are likely to experiment with other substances in addition to alcohol such as nicotine, marijuana, cocaine, and prescription medication such as Adderall. Middle-age and older adults with alcohol and substance use in their developmental histories may have an undiagnosed alcohol use disorder. Others will develop a late-onset substance use disorder in older age, possibly due to a dearth of social support, coping with bereavement, and medical complication. Based on Social Cognitive Theory, the roles of expectancies and self-efficacy are hypothesized to impact substance use and the risk of substance use disorder across the lifespan. Implications of the present review for future research on age-specific risk factors in alcohol use in relation to underlying developmental processes are considered. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this project was to increase compliance with rotation and documentation of rotation of oxygen saturation probes to reduce medical-device-related pressure injuries in children on a pediatric inpatient unit. Introduction: There are a multitude of factors that place hospitalized children at an increased risk for medicaldevice-related pressure injuries. Evidence supports the rotation of medical devices, if appropriate, at least twice daily to minimize the risk of medical-device-related pressure injuries in hospitalized children. Methods: The project used JBI's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for encouraging evidence-based practices. A baseline audit was conducted, followed by the implementation of targeted strategies. The project was completed with a follow-up audit to determine change in practice. Results: The baseline audit revealed significant deficits in two of the seven audit criteria. Barriers to the rotation of oxygen saturation probes and the assessment of skin under oxygen saturation probes were identified by the project team and an electronic health record (EHR) documentation change was implemented. Follow-up audits were not conducted on the five criteria that showed high compliance at baseline. For the remaining two audit criteria, data revealed no improvement in one of the criteria (3% compliance at both baseline and follow-up audits) and an increase from 0% compliance to 43% compliance in the second criterion. Conclusion: Optimizing EHR documentation, specifically ease and efficiency of EHR documentation, has the potential to positively impact clinical practice. Key words: evidence-based practice, hospitalized, implementation project, medical-device-related pressure injuries, pediatrics. [ABSTRACT FROM AUTHOR]

Background: Cervical vertebral compressive myelopathy (CVCM) and equine neuroaxonal dystrophy/degenerative myeloencephalopathy (eNAD/EDM) are leading causes of spinal ataxia in horses. The conditions can be difficult to differentiate, and there is currently no diagnostic modality that offers a definitive antemortem diagnosis. Objective: Evaluate novel proteomic techniques and machine learning algorithms to predict biomarkers that can aid in the antemortem diagnosis of noninfectious spinal ataxia in horses. Animals: Banked serum and cerebrospinal fluid (CSF) samples from necropsy‐confirmed adult eNAD/EDM (n = 47) and CVCM (n = 25) horses and neurologically normal adult horses (n = 45). Methods:. A subset of serum and CSF samples from eNAD/EDM (n = 5) and normal (n = 5) horses was used to evaluate the proximity extension assay (PEA). All samples were assayed by PEA for 368 neurologically relevant proteins. Data were analyzed using machine learning algorithms to define potential diagnostic biomarkers. Results: Of the 368 proteins, 84 were detected in CSF and 146 in serum. Eighteen of 84 proteins in CSF and 30/146 in serum were differentially abundant among the 3 groups, after correction for multiple testing. Modeling indicated that a 2‐protein test using CSF had the highest accuracy for discriminating among all 3 groups. Cerebrospinal fluid R‐spondin 1 (RSPO1) and neurofilament‐light (NEFL), in parallel, predicted normal horses with an accuracy of 87.18%, CVCM with 84.62%, and eNAD/EDM with 73.5%. Main Limitations: Cross‐species platform. Uneven sample size. Conclusions and Clinical Importance: Proximity extension assay technology allows for rapid screening of equine biologic matrices for potential protein biomarkers. Machine learning analysis allows for unbiased selection of highly accurate biomarkers from high‐dimensional data. [ABSTRACT FROM AUTHOR]

A 5‐year‐old imported Zangersheide gelding was evaluated for SC swellings over both forelimbs and lameness localized to the distal metacarpus. Ultrasound examination of the SC masses was compatible with verminous granulomas. Linear hyperechoic foci were present within the suspensory ligament branches of both forelimbs, suggestive of ligamentous parasitic infiltrates. A diagnosis of onchocerciasis was confirmed on biopsy of a SC mass. The gelding was treated with ivermectin and a tapering course of PO dexamethasone but was eventually euthanized. Necropsy confirmed the presence of SC eosinophilic granulomas and degenerative suspensory ligament desmitis, both with intralesional nematodes. Given the location and appearance of the nematode, a diagnosis of Onchocerca sp., most likely O. reticulata, was made. Onchocerciasis should be included as a differential diagnosis for multifocal suspensory ligament desmitis with these sonographic characteristics when paired with SC masses in imported European Warmbloods. [ABSTRACT FROM AUTHOR]

From the Rocky Mountains in the US to the Sea of Cortez in Mexico, the Colorado River is one of the most managed and monitored rivers in the world. As decreasing river flows from drought and climate change continue to impact the Colorado River Basin, the US federal government, seven US states, and Mexico have signed agreements that would reduce deliveries, including a Drought Contingency Plan (DCP), an agreement among the US states and the Bureau of Reclamation, and Minute 323 (a treaty agreement between the US and Mexico). As part of the DCP, the US Bureau of Reclamation (Reclamation) committed to increasing conservation efforts to augment storage in Lake Mead. This paper presents an analysis of Reclamation's Decree Accounting Reports that record water deliveries and conservation savings from 1964 to 2019. Overall, this analysis illustrates that (1) the agency has implemented significant conservation actions over the last three decades, (2) the agency has responded to increased accounting needs as dictated by national and international management agreements, (3) some actions have resulted in environmental costs, and (4) future actions could be designed to avoid environmental harms while also augmenting Lake Mead levels. As climate change continues to constrain Colorado River water supply, detailed accounting may help reveal areas for potential efficiencies or demonstrate where the greatest levels of savings have been reached while ensuring that environmental and social benefits are preserved. Over the last 100 years, humans have changed the path and personality of the Colorado River by distributing water to cities, communities, and agricultural fields to support over 40 million people. Throughout the twentieth century, the US federal government, seven US, and Mexico signed agreements enabling development of Colorado River water. By the early 21st century, as it became evident that water demands and climate change were reducing available supplies, these same governments signed agreements to reduce pressure on the river. All these agreements have, in part, been tracked by the US federal agency that manages the river, the Bureau of Reclamation (Reclamation), through Decree Accounting Reports. Since 1964, these reports have recorded how water is or is not accounted for that might be important to the future of the river. This paper examines those reports and reveals four main findings: (1) Reclamation has implemented numerous water conservation projects, (2) they have responded to new management agreements, (3) some of their actions have impacted the environment, and (4) there are proactive ways they can reduce environmental impacts and bolster water supplies in the future. [ABSTRACT FROM AUTHOR]

X-chromosome inactivation (XCI) silences one X in female cells to balance sex-differences in X-dosage. A subset of X-linked genes escape XCI, but the extent to which this phenomenon occurs and how it varies across tissues and in a population is as yet unclear. To characterize incidence and variability of escape across individuals and tissues, we conducted a transcriptomic study of escape in adipose, skin, lymphoblastoid cell lines and immune cells in 248 healthy individuals exhibiting skewed XCI. We quantify XCI escape from a linear model of genes' allelic fold-change and XIST-based degree of XCI skewing. We identify 62 genes, including 19 lncRNAs, with previously unknown patterns of escape. We find a range of tissue-specificity, with 11% of genes escaping XCI constitutively across tissues and 23% demonstrating tissue-restricted escape, including cell type-specific escape across immune cells of the same individual. We also detect substantial inter-individual variability in escape. Monozygotic twins share more similar escape than dizygotic twins, indicating that genetic factors may underlie inter-individual differences in escape. However, discordant escape also occurs within monozygotic co-twins, suggesting environmental factors also influence escape. Altogether, these data indicate that XCI escape is an under-appreciated source of transcriptional differences, and an intricate phenotype impacting variable trait expressivity in females. Author summary: The difference in the number of X-chromosomes between mammalian males and females is compensated by a process known as X-chromosome inactivation (XCI), which turns off one of a female's X chromosomes. XCI is incomplete: some sections of the silenced X chromosome escape inactivation. The 'escape' is complex, and can vary across tissues and potentially across individuals. Because the X chromosome is enriched of genes with immune and neurological functions, this phenomenon has high biomedical relevance. We studied the extent to which escape occurs and varies across tissues and individuals in a large population of twins. We identify novel candidate escape genes, and genes whose escape is specific to a tissue or immune cell type. There is also substantial variability in escape across individuals. Using data from twins, which enable the assessment of the influence of genetics and environment on a trait, we found that both genetic and environmental factors influence escape. Our results allow detailed characterization of escape, and suggest that escape may influence disease risk and phenotype differences between the sexes, and within females. [ABSTRACT FROM AUTHOR]

I gonorrhoeae i has the remarkable ability to produce outer membrane transporters that serve as receptors for the human metal-sequestering proteins described above, from which the transporters extract and import the cognate metals B (Fig 1) b . I gonorrhoeae i in metal-stripped chemically defined medium; conversely, calprotectin sequesters zinc in metal-replete tissue culture medium such that I N i . I gonorrhoeae i encode the periplasmic metal-binding proteins ZnuA and FbpA, as well as metabolic proteins not previously associated with metal homeostasis [[26]]. [Extracted from the article]

Primary sclerosing cholangitis (PSC) is a progressive liver disease for which there is no effective therapy. Hepatocytes and cholangiocytes from a PSC patient were cocultured with mesenchymal stem cells (MSCs) to assess in vitro change. A single patient with progressive PSC was treated with 150 million MSCs via direct injection into the common bile duct. Coculture of MSCs with cholangiocytes and hepatocytes showed in vitro improvement. Local delivery of MSCs into a single patient with progressive PSC was safe. Radiographic and endoscopic evaluation showed stable distribution of multifocal structuring in the early postoperative period. MSCs may be effective for the treatment of PSC. [ABSTRACT FROM AUTHOR]

Objective: Human papillomavirus vaccination coverage is suboptimal, especially among males. Social networks influence young adults' health behaviors and could be leveraged to promote vaccination. We sought to describe how young sexual minority men communicate about human papillomavirus (HPV) vaccination with their sexual partners. Participants: National (U.S.) sample of sexual minority men ages 18–26 (n = 42) from January 2019. Methods: We conducted four online focus groups and identified salient themes using inductive content analysis. Results: Across groups, participants described that HPV vaccination is not a focus of their conversations with sexual partners. Other key themes related to HPV vaccine communication included: varying discissions based on relationship type, and valuing conversations with partners about safer sex. Conclusions: Findings provide novel insight into how young sexual minority men communicate with their sexual partners about HPV vaccination and identify potential areas for interventions to promote communication. Future research is needed to investigate associations between partner communication and HPV vaccine uptake. [ABSTRACT FROM AUTHOR]

Skin irritancy to topically applied chemicals is a significant problem that affects millions of people worldwide. New or modified chemical entities must be tested for potential skin irritancy by industry as part of the safety and toxicity profiling process. Many of these tests have now moved to a non‐animal‐based format to reduce experiments on animals. However, these tests for irritancy potential often rely on monolayer cultures of keratinocytes that are not representative of the skin architecture or tissue‐engineered human skin equivalents (HSE) using complex multi‐gene expression panels that are often cumbersome and not amenable for high throughput. Here, we show that human skin equivalents increase abundance of several phosphorylated kinases (c‐Src, c‐Jun, p53, GSK3α/β) in response to irritant chemical stimulation by phosphokinase array analysis. Specific phosphorylation of c‐SrcY419 was confirmed by immunoblotting and was plasma membrane‐associated in basal/spinous cells by phospho‐specific immunohistochemistry. Moreover, c‐SrcY419 phosphorylation in response to the irritants lactic acid and capsaicin was inhibited by the c‐Src inhibitors KB‐SRC and betaine trimethylglycine. These data provide the first evidence for c‐Src specific activation in response to chemical irritants and point to the development of new modes of rapid testing by immunodetection for first‐pass screening of potential irritants. This study demonstrates that specific kinases, in particular c‐Src, are activated in HSE in response to chemical irritants. The rapid increase in specific phosphorylated signal transduction molecules upon exposure to irritants may prove ideal targets to rapidly identify and differentiate potential chemical irritants from non‐irritants. [ABSTRACT FROM AUTHOR]

Simple Summary: Best practice guidelines are available for the management of Maternal and Merino ewes across southern Australia; however, these are lacking for Composite and shedding breeds. Through a telephone interview, the management practices of a unique group of southern Australian sheep producers, and the motivations behind these practices, were explored. A large proportion of respondents reported mating and lambing practices that aligned with best practice guidelines; however, a smaller cohort did not see value in meeting the nutritional and mating length recommendations. Additionally, most producers are also seeking new information frequently and have implemented management changes within the last five years. Further work is required to understand the perceived barriers to best practice adoption, and for management guidelines to be developed for all sheep breeds to ensure sheep enterprises are operating in the most productive and profitable manner. The management of ewes across southern Australia may vary with breed and can change over time and, as such, a greater understanding of producer management practices and the motivations that influence these practices is required. A cross-sectional study was performed by telephone interview with sheep producers managing Composite, Maternal, Merino or shedding ewe breeds mated in either spring, summer, or autumn. The surveyed producers were a unique subset of southern Australian producers. A large proportion of the surveyed producers followed current best practice guidelines for ewe mating and lambing nutritional management; however, some producers did not align with these targets. Further, some producers did not see the value in attaining the current recommendations. Pregnancy scanning was widely practiced, likely an artefact of the recruitment process; however, a few producers did not utilize this information for nutritional management at lambing time. Finally, most producers were active in their search for new information, seeking information regularly from a wide range of sources and reported making management changes within the last five years. Further work is required to understand why some producers are not adopting best practice where possible and to understand current barriers for adoption. Management guidelines for all sheep breeds are required to best manage sheep across southern Australia. [ABSTRACT FROM AUTHOR]

Post‐transcriptional regulation of gene expression represents a critical regulatory step in the production of a functional proteome. Elevated expression of post‐transcriptional regulator RNA binding motif protein 3 (RBM3), an RNA binding protein in the cold‐shock family, is positively correlated with skeletal muscle growth in adult mice. However, mechanisms through which RBM3 exerts its effects are largely unknown. The purpose of this study was to perform RNA immunoprecipitation followed by RNA sequencing (RIP‐seq) and apply a network science approach to understand biological processes (BPs) most associated with RBM3‐bound mRNAs. In addition, through nucleotide‐sequence‐scanning of enriched transcripts, we predicted the motif for skeletal muscle RBM3 binding. Gene set enrichment analysis followed by enrichment mapping of RBM3‐bound transcripts (fold change >3; p.adj <0.01) revealed significant enrichment of BPs associated with "Contractile apparatus," "Translation initiation," and "Proteosome complex." Clusters were driven largely by enrichment of Myh1 (FC: 4.43), Eif4b (FC: 5.03), and Trim63 (FC: 5.84), respectively. Motif scanning of enriched sequences revealed a discrete 14 nucleotide‐wide motif found most prominently at the junction between the protein coding region's termination sequence and the start of the 3′ untranslated region (UTR; E‐Value: 1.1 e−015). Proof of concept investigation of motif location along enriched transcripts Myh1 and Myl4 revealed 3′ UTR binding, suggesting RBM3 involvement in transcript half‐life regulation. Together, these results demonstrate the potential influence of RBM3 in reshaping the skeletal muscle proteome through post‐transcriptional regulation of mRNAs crucial to muscle adaptations. [ABSTRACT FROM AUTHOR]

Understanding patterns of drug‐gene interactions (DGIs) is important for advancing the clinical implementation of pharmacogenetics (PGx) into routine practice. Prior studies have estimated the prevalence of DGIs, but few have confirmed DGIs in patients with known genotypes and prescriptions, nor have they evaluated clinician characteristics associated with DGI‐prescribing. This retrospective chart review assessed prevalence of DGI, defined as a medication prescription in a patient with a PGx phenotype that has a clinical practice guideline recommendation to adjust therapy or monitor drug response, for patients enrolled in a research genetic biorepository linked to electronic health records (EHRs). The prevalence of prescriptions for medications with pharmacogenetic (PGx) guidelines, proportion of prescriptions with DGI, location of DGI prescription, and clinical service of the prescriber were evaluated descriptively. Seventy‐five percent (57,058/75,337) of patients had a prescription for a medication with a PGx guideline. Up to 60% (n = 26,067/43,647) of patients had at least one DGI when considering recommendations to adjust or monitor therapy based on genotype. The majority (61%) of DGIs occurred in outpatient prescriptions. Proton pump inhibitors were the most common DGI medication for 11 of 12 clinical services. Almost 25% of patients (n = 10,706/43,647) had more than one unique DGI, and, among this group of patients, 61% had a DGI with more than one gene. These findings can inform future clinical implementation by identifying key stakeholders for initial DGI prescriptions, helping to inform workflows. The high prevalence of multigene interactions identified also support the use of panel PGx testing as an implementation strategy. [ABSTRACT FROM AUTHOR]

Early life adversity (ELA) tends to accelerate neurobiological ageing, which, in turn, is thought to heighten vulnerability to both major depressive disorder (MDD) and Alzheimer's disease (AD). The two conditions are putatively related, with MDD representing either a risk factor or early symptom of AD. Given the substantial environmental susceptibility of both disorders, timely identification of their neurocognitive markers could facilitate interventions to prevent clinical onset. To this end, we analysed multimodal data from the Adolescent Brain and Cognitive Development study (ages 9–10 years). To disentangle genetic from correlated genetic-environmental influences, while also probing gene-adversity interactions, we compared adoptees, a group generally exposed to substantial ELA, with children raised by their biological families via genetic risk scores (GRS) from genome-wide association studies. AD and MDD GRSs predicted overlapping and widespread neurodevelopmental alterations associated with superior fluid cognition. Specifically, among adoptees only, greater AD GRS were related to accelerated structural maturation (i.e., cortical thinning) and higher MDD GRS were linked to delayed functional neurodevelopment, as reflected in compensatory brain activation on an inhibitory control task. Our study identifies compensatory mechanisms linked to MDD risk and highlights the potential cognitive benefits of accelerated maturation linked to AD vulnerability in late childhood. [ABSTRACT FROM AUTHOR]

A benzo[rst]pentaphene (BPP) substituted by two bis(methoxyphenyl)amino (MeOPA) groups (BPP–MeOPA) was synthesized and clearly characterized by NMR and single-crystal X-ray analysis. Detailed investigations of its photophysical properties, including transient absorption spectroscopy analyses, revealed that the introduction of the MeOPA groups breaks the symmetry of the BPP core, improving its absorption and emission from an S1 state with both excitonic and charge-transfer character. [ABSTRACT FROM AUTHOR]

Legislation allows adolescents to access comprehensive contraceptive care; however, provider practices remain unclear. We examined predictors of provider knowledge and comfort surrounding the provision of contraceptive care to adolescents. We mailed a survey to Illinois contraceptive providers (n = 251). Study outcomes include 1) knowledge of adolescent consent laws, 2) comfort asking for time alone with adolescents, 3) comfort providing contraception to adolescents without parental consent, and 4) comfort providing long-acting reversible contraception (LARC) to adolescents without parental consent. Using multivariable logistic regression, we estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Most providers are knowledgeable of consent laws (90%) and report being comfortable asking for time alone with adolescents (94%) and comfortable providing contraception to adolescents without parental consent (88%). Having a large proportion of patients who are eligible for family planning services was associated with increased comfort asking for time alone with adolescents (aOR, 7.03; 95% CI, 1.58–31.3) and providing contraception to adolescents (aOR, 4.0; 95% CI, 1.4–11.1). Only one-half (54%) were comfortable providing LARC methods to adolescents, with higher comfort among providers who: received more than 2 days of formal family planning training (aOR, 2.77; 95% CI, 1.2–6.2), specialized in obstetrics-gynecology (aOR, 5.64; 95% CI, 2.1–15.1), and had a patient population with more than 50% patients from minoritized racial/ethnic groups (aOR, 2.9; 95% CI, 1.2–6.6). Although knowledge of consent laws was high, gaps remain. Only one-half of our sample indicated comfort with the provision of LARC methods without parental consent. Additional efforts to increase provider comfort with all contraceptive methods and training on adolescent-centered practices may be required to meet the needs of adolescent patients. [ABSTRACT FROM AUTHOR]

Although New Zealand's 2020 biodiversity strategy, Te Mana o Te Taiao, places a high priority on protecting indigenous ecosystems, it provides minimal detail on how this will be accomplished. Using spatial data and a conservation prioritisation tool we demonstrate the implementation of a comprehensive framework for the systematic conservation of New Zealand's terrestrial ecosystems, as proposed in a pioneering paper by Kelly (1980). Working within the Horizons Region (Manawatū-Whanganui, lower North Island), we analyse the extent of losses of 65 terrestrial ecosystems since human settlement by combining maps of their potential distribution and current land cover. Two-thirds of the original indigenous cover has been lost, with lowland ecosystems suffering greatest losses; much surviving cover is substantially modified. Our prioritisation analyses identify various options for siting conservation management to maintain the integrity of a full range of indigenous ecosystems in a highly modified landscape, given varying degrees of constraint on the availability of land for conservation. Restricting management to DOC-administered land would severely constrain ecosystem representation, but dramatic improvements in ecosystem representation would result from protecting and managing a relatively small number of sites on land of other tenures, mostly at lower elevations. Results such as these could play a crucial role in supporting achievement of New Zealand's high-level goals for ecosystem conservation and meeting international conservation obligations. They could be used to (1) assess the conservation status of individual terrestrial ecosystems, (2) develop national and regional policies specifically targeting protection of at-risk ecosystems, (3) design and implement strategies that explicitly target management across a full range of ecosystems, (4) support processes designed to coordinate management among different conservation actors, and (5) inform individual landowners of the conservation value of indigenous ecosystems on their land. Obstacles to implementing such an approach include a range of technical, institutional, and social factors. [ABSTRACT FROM AUTHOR]

Whereas emergencies used to be the exception to the rule, they now seem to be the norm. Wildfires, hurricanes, flooding, and contagious diseases dominate our daily lives. Although these are not the traditional types of military emergencies of our past, these non-wartime emergencies can trigger some of the same emergency powers. And with their use comes some of the same concerns about abuses of such emergency powers. Much ink has been spilled analyzing the tradeoffs associated with necessary emergency powers and frequent abuses in the context of foreign threats--resulting in reduced privacy, civil liberties, and freedoms. This Article is not here to rehash that debate, but to shift our focus from the use of emergencies to address foreign threats to the use of emergencies to address domestic ones. Importantly, despite mounting evidence cautioning against the abuse of emergency powers, public actors have expanded their use from foreign contexts to domestic contexts. Specifically, public actors have used domestic emergencies as pretext for several unrelated actions impacting marginalized communities, limiting environmental protections, abolishing low-income housing, and even restricting abortion rights. Although both foreign and domestic threats are subject to manipulation to be marketed as "emergencies," the frequency and proliferation of domestic threats lend themselves to particular scrutiny. To aid in this effort, this Article identifies several instances where public actors are using both legitimate and questionable domestic emergencies to achieve unrelated policy goals. It argues that emergency actions that can be classified as domestic should be designated as such. Recognizing this critical distinction may allow for enhanced scrutiny that is lacking when challenging emergency actions related to national security. Domestic emergency actions, in contrast, may be less deserving of deference, be less susceptible to secrecy claims, and be easier to demonstrate as disconnected from the actual emergency at hand. It sets forth strategies to prevent, remedy, and penalize such abuses, recognizing that emergency powers were intended to be used sparingly. When every day presents a new emergency, we run the risk of living under perpetual emergency powers and perpetual abuses. [ABSTRACT FROM AUTHOR]

Children adopted from public care are more likely to experience emotional and behavioural problems. We investigated two aspects of emotion recognition that may be associated with these outcomes, including discrimination accuracy of emotions and response bias, in a mixed-method, multi-informant study of 4-to-8-year old children adopted from local authority care in the UK (N = 42). We compared adopted children's emotion recognition performance to that of a comparison group of children living with their birth families, who were matched by age, sex, and teacher-rated total difficulties on the Strengths and Difficulties Questionnaire (SDQ, N = 42). We also examined relationships between adopted children's emotion recognition skills and their pre-adoptive histories of early adversity (indexed by cumulative adverse childhood experiences), their parent- and teacher-rated emotional and behavioural problems, and their parents' coded warmth during a Five Minute Speech Sample. Adopted children showed significantly worse facial emotion discrimination accuracy of sad and angry faces than non-adopted children. Adopted children's discrimination accuracy of scared and neutral faces was negatively associated with parent-reported behavioural problems, and discrimination accuracy of angry and scared faces was associated with parent- and teacher-reported emotional problems. Contrary to expectations, children who experienced more recorded pre-adoptive early adversity were more accurate in identifying negative emotions. Warm adoptive parenting was associated with fewer behavioural problems, and a lower tendency for children to incorrectly identify faces as angry. Study limitations and implications for intervention strategies to support adopted children's emotion recognition and psychological adjustment are discussed. [ABSTRACT FROM AUTHOR]

Upholding critical race theory (CRT)'s transdisciplinary approach to unveil the educational violence against Students of Color, we apply W.E.B. Du Bois's story of John from the chapter "Of the Coming of John" in The Souls of Black Folk. In doing so, we expose the problematic ideological and practical structures used for the identification and retention of Students of Color within gifted and talented programming. Examining the concepts of the Veil and double consciousness through the analogous relationship of Du Bois's John to a contemporary John, we parallel the insidious educational experiences of Students of Color that has remained relatively constant over time. [ABSTRACT FROM AUTHOR]

Purpose: Correction of refractive error in children is important for visual and educational development. The aim of this questionnaire‐based study was to explore paediatric refractive correction by optometrists in England. Methods: An online questionnaire was piloted and distributed to optometrists in England. The questionnaire asked about respondents' characteristics (such as type of practice), management of refractive error in 1‐ and 3‐year‐old children and sources of information used as a basis for decisions on prescribing refractive error in children. Results: Two hundred and ninety‐three questionnaires were returned, although only 139 (47%) were fully completed. In an average month, about half of respondents examined no children between 0 and 2 years of age, and about half examined no more than five children aged 3–4 years. A significant proportion indicated they would refer children aged 1 or 3 years with refractive error and no other signs or symptoms into the hospital eye service. Almost a quarter would prescribe in full or in part an isometropic refractive correction of +2.00 D for a 3‐year‐old (within the normal range) with no other signs or symptoms, suggesting a degree of unnecessary prescribing. Almost all would act in cases of clinically significant refractive error. Respondents made similar use of their colleagues, optometric or postgraduate/continuing education, professional guidance and peer‐reviewed research as sources of evidence on which to base decisions about prescribing for paediatric refractive errors. Most reported 'never' or 'rarely' using Cochrane reviews. Conclusions: These results suggest optometrists often defer management of paediatric refractive error to the hospital eye service, with implications in terms of underutilisation of community optometric expertise and burden on the National Health Service. In some cases, the results indicate a mismatch between respondents' reported management and existing guidance/guidelines on paediatric prescribing. [ABSTRACT FROM AUTHOR]

The United States has a higher rate of teen pregnancy than any other developed country with 30% of American girls becoming pregnant before the age of 20. Laws regarding the inclusion and content of sexuality education vary across the country, which are associated with differences in pregnancy and sexually transmitted infection (STI) rates between states. This systematic review aims to determine whether comprehensive sexuality education (CSE) is more effective than abstinence-only or no sexuality education at reducing teenage pregnancy. Secondary objectives include analyzing the effect of CSE on STI incidence, sexual activity, safe-sex behaviors, and social discomfort. We searched multiple databases for studies published from 1990 to 2021. Twenty-nine studies met our inclusion criteria. Seven included pregnancy as an outcome, with three fitting our meta-analysis criteria. There was a decrease in pregnancy rates for participants in the CSE intervention compared to the control (n = 3, risk ratio = 0.89, 95%CI 0.79–1.00, I2 = 0%). We found that CSE is likely to reduce pregnancy rates; however, there was limited data available on this outcome. CSE increased safe-sex behaviors but did not have a notable impact on sexual activity or STIs. This review can serve as evidence for the implementation of CSE in the US. [ABSTRACT FROM AUTHOR]

In the face of widespread habitat destruction and forest fragmentation, it is critical to understand primate demography to assess population viability across populations inhabiting continuous forests and fragmented landscapes. While mantled howler monkeys (Alouatta palliata) have traditionally been considered resilient to habitat destruction, their populations are declining and are now rated “Vulnerable” on the IUCN Red List of Threatened Species. In this study, we assessed the demography of the mantled howler monkey population at La Selva Research Station, a protected forest in northeastern Costa Rica— providing the first systematic study of population structure in 30 years. In 2022, we conducted a howler census to ascertain the number of groups at La Selva and recorded group size and composition for a subset of the groups. We then compared population density, group size and composition with a population in a nearby protected forest (La Suerte Biological Research Station, LSBRS) to help assess the viability of mantled howlers in a small forest fragment. The mantled howler population at La Selva has grown substantially since 1992 with, at the time of the survey, 25 groups and a population density of 23.4 individuals/km². Mean group size was 14.3 with a sex ratio of 1:2.2 and immature to adult ratio of 0.7—in line with mantled howler monkey populations throughout the species’ range. The population density at La Selva was, however, almost five times lower than the forest fragment at LSBRS, although group size and composition did not differ across sites. Overall, our results highlight the importance of forest protection for mantled howler monkeys. [ABSTRACT FROM AUTHOR]

Graphic facilitation is a creative, robust visual communication process and tool that can be used by researchers for several benefits including improving data integrity; mitigating barriers between researchers and participants; promoting participants' ownership of data, decision-making, and creativity; and, co-creating knowledge, which is of particular interest among certain cultures and in some contexts. For Indigenous Peoples who traditionally use visual, oral, and narrative modalities as primary forms of communication, graphic facilitation is a methodology that aligns well with these modes of communicating. In this article, we describe our use of graphic facilitation in a community-led project exploring Indigenous parents' perceptions of community strengths, needs and priorities related to healthy early childhood development and optimal parenting. In collaboration with the Indigenous Friendship Centre in Hamilton, Canada, we held a Community Gathering that was facilitated by a graphic artist experienced in working with the Indigenous community; the findings resulting from the Gathering are presented. We discuss how researchers can use graphic facilitation as a tool to ensure adherence to the OCAP® principles of data ownership, control, access, and possession for the Indigenous community and describe the potential for mitigating power imbalances. Finally, considerations for researchers contemplating using graphic facilitation as a tool for research projects with Indigenous people and communities are presented. [ABSTRACT FROM AUTHOR]

Purpose: Families and professionals often consider augmentative and alternative communication (AAC) a “last resort” for persons with communication challenges; however, speaking autistic adults have reported that they would have benefited from access to AAC as children. This tutorial discusses the history of this “last resort” practice and its perpetuation within the medical model of disability. The tutorial focuses on communication access, choice, and agency for autistic students. Method: We provide a brief overview of the AAC community and their preferred terminology, review the history of traditional approaches to research on AAC and autism, and then examine the relationship between disability models and ableism to views of spoken language as a priority of intervention. Studies on this topic are rare, and resisting ableism requires acknowledging and honoring disabled people’s experiences and expertise. Therefore, we promote autistic expertise within the framework of evidence-based practice and discuss the experiences of autistic people and spoken language. Finally, we consider the role of the speech-language pathologist (SLP) in assessment and offer autisticbased strategies and recommendations for communication support. Conclusions: Speaking autistic students who could benefit from AAC may not have access to AAC due to the prioritization of spoken language and lack of awareness of the benefit of AAC. We recommend that SLPs and school-based professionals support and facilitate access, communicative choice, and agency by implementing multimodal communication strategies to include AAC use for autistic students regardless of their spoken language status. Promoting all types of communication and ensuring opportunities for communication across multiple modalities are paramount to a child’s agency and self-determination, as is normalization of AAC. [ABSTRACT FROM AUTHOR]

With data breaches on the exponential rise,1 organizations must get their heads out of the sand and embrace the (nearly) inevitable: a breach is coming. Conclusion No organization is impervious to a cyberattack -- no organization is too small, too large, too obscure, or even too prepared -- so every organization should take practical steps to further minimize its risk of a breach. In 2022, nearly 2,000 breaches in the U.S. resulted in the exposure of over 400 million individuals' data.2 Today, hackers attempt a new attack every 39 seconds.3 And lest anyone believe that their organization is too small to contend with data breaches, 43% of organizations breached are small businesses.4 Rather than getting caught flat-footed, organizations of all stripes and sizes should lean into this eventuality, steeling themselves in advance. [Extracted from the article]

Habitat modification and introduced mammalian predators are linked to global species extinctions and declines, but their relative influences can be uncertain, often making conservation management difficult. Using landscape-scale models, we quantified the relative impacts of habitat modification and mammalian predation on the range contraction of a threatened New Zealand riverine duck. We combined 38 years of whio (Hymenolaimus malacorhynchos) observations with national-scale environmental data to predict relative likelihood of occurrence (RLO) under two scenarios using bootstrapped boosted regression trees (BRT). Our models used training data from contemporary environments to predict the potential contemporary whio distribution across New Zealand riverscapes in the absence of introduced mammalian predators. Then, using estimates of environments prior to human arrival, we used the same models to hindcast potential pre-human whio distribution prior to widespread land clearance. Comparing RLO differences between potential pre-human, potential contemporary and observed contemporary distributions allowed us to assess the relative impacts of the two main drivers of decline; habitat modification and mammalian predation. Whio have undergone widespread catastrophic declines most likely linked to mammalian predation, with smaller declines due to habitat modification (range contractions of 95% and 37%, respectively). We also identified areas of potential contemporary habitat outside their current range that would be suitable for whio conservation if mammalian predator control could be implemented. Our approach presents a practical technique for estimating the relative importance of global change drivers in species declines and extinctions, as well as providing valuable information to improve conservation planning. [ABSTRACT FROM AUTHOR]

Assembly processes are highly dynamic with biotic filters operating more intensely at local scales, yet the strength of biotic interactions can vary across time and latitude. Predation, for example, can be stronger at lower latitudes, while competition can intensify at later stages of assembly due to resource limitation. Since biotic filters act upon functional traits of organisms, we explored trait-mediated community assembly in diverse marine assemblages from four regions along the Pacific coast of North and Central America. Using predator exclusion experiments and two assembly stages, we tested the hypotheses that non-random trait patterns would emerge during late assembly at all regions due to competition and at lower latitude regions regardless of assembly stage due to predation. As expected, trait divergence occurred in late assembly but only at higher latitude regions, while in tropical Panama, relaxed predation caused trait divergence during late assembly. Moreover, colonizing trait strategies were common during early assembly while competitive strategies were favoured during late assembly at higher latitude regions. Predation-resistant traits were only favoured in Panama during both assembly stages. Our large-scale manipulative study demonstrates that different biotic interactions across time and latitude can have important consequences for trait assembly. [ABSTRACT FROM AUTHOR]

Abstract Prior research has shown that the COVID-19 pandemic has negatively impacted American college students; however, few studies have focused on first-year students and their experiences with attending college during unprecedented circumstances. To address this gap, first-year college students (N = 268) completed online questionnaires assessing their perceptions of the extent to which the COVID-19 pandemic had impacted them in terms of access to resources and psychological well-being. Students also completed a measure of college-specific adjustment in the relational, psychological, and educational domains. Greater perceived COVID-19-specific resources impact was associated with lower educational adjustment. Greater perceived COVID-19-specific psychological impact was associated with lower levels of relational college adjustment and lower levels of psychological college adjustment. A multi-group analysis indicated that although the association between perceived psychological impact and college-specific psychological adjustment was significant for both White students and Black students, it was stronger among White students. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the association of traumatic brain injury (TBI) with mortality in military veterans and whether this association differs as a function of TBI severity, timing, and cause of death. This national cohort study used U.S. Department of Veterans Affairs' (VA) data of patients 18 years and older with TBI diagnoses (N = 213,290) and 1:1 propensity-matched comparison random sample of patients without TBI (N = 213,290). The main outcome measure was mortality within 6 months of TBI diagnosis and longer-term (after 6 months). Cox proportional hazards models were used to examine risk of all-cause mortality according to TBI severity and Fine-Gray proportional hazards regression to examine time to cause-specific mortality, accounting for competing risk of other deaths. For patients with moderate-to-severe TBI (compared with no TBI), hazard ratios (HRs) for mortality were highest within first 6 months of injury (fully-adjusted HR: 2.42, 95% CI: 2.32–2.53); for mild TBIs, HRs for mortality were lower and relatively constant over time (fully-adjusted HR within first 6 months: 1.33, 95% CI: 1.26–1.39). Veterans with mild and moderate-to-severe TBI had higher risk of future death over short term for 9 out 10 of the U.S. leading causes of death, with only unintentional injury, stroke, and suicide showing differences by TBI severity. Associations attenuated significantly from within to after 6 months TBI diagnosis. These findings indicate that adults with TBI are at increased risk of majority of leading causes of death, with differential risk by TBI severity and timing of death. • Propensity-matched cohort study of over 400,000 adults. • Traumatic brain injury (TBI) and risk of mortality differ by TBI severity. • Risk of death higher within 6 months of TBI diagnosis. • Differential risk by TBI severity for unintentional, stroke, and suicide death. [ABSTRACT FROM AUTHOR]

In zebrafish, sensory epithelia and neuroblasts of the inner ear form simultaneously in abutting medial and lateral domains, respectively, in the floor of the otic vesicle. Previous studies support regulatory roles for Fgf and Wnt, but how signaling is coordinated is poorly understood. We investigated this problem using pharmacological and transgenic methods to alter Fgf or Wnt signaling from early placodal stages to evaluate later changes in growth and patterning. Blocking Fgf at any stage reduces proliferation of otic tissue and terminates both sensory and neural specification. Wnt promotes proliferation in the otic vesicle but is not required for sensory or neural development. However, sustained overactivation of Wnt laterally expands sensory epithelia and blocks neurogenesis. pax2a , sp5a and sp5l are coregulated by Fgf and Wnt and show overlapping expression in the otic placode and vesicle. Gain- and loss-of-function studies show that these genes are together required for Wnt's suppression of neurogenesis, as well as some aspects of sensory development. Thus, pax2a , sp5a and sp5l are critical for mediating Fgf and Wnt signaling to promote spatially localized sensory and neural development. [Display omitted] • Sensory & neural fates arise simultaneously in abutting regions of the otic vesicle. • Fgf is required for both fates while Wnt promotes sensory & blocks neural fates. • Downstream factors pax2a , sp5a and sp5l help facilitate precise spatial patterning. [ABSTRACT FROM AUTHOR]

Prior studies suggest that men with good erectile function shortly after radical prostatectomy (RP) can subsequently have worsened erectile function. To determine the prevalence and predictors of early erectile function recovery post-RP and of worsening erectile function after initial erectile function recovery. We retrospectively queried our institutional database. Men who underwent RP during 2008–2017 and who completed the International Index of Erectile Function erectile function domain both pre-RP and serially post-RP, constituted the population. Functional erections were defined as International Index of Erectile Function (IIEF)-6 erectile function domain scores ≥24. We analyzed factors predicting functional erections at 3 months post-RP as well as factors predicting a decrease in functional erections between 3 and 6 months, defined as ≥2-point drop in the erectile function domain. Multivariable logistic regression models were used to identify predictors of early erectile function recovery and also of subsequent decline. Erectile function recovery rates at 3 months post-RP and predictive factors; rates of erectile function decline between 3-6 months and associated predictors. Eligible patients comprised 1,655 men with median age of 62 (IQR 57, 67) years. Bilateral nerve-sparing (NS) surgery was performed in 71% of men, unilateral NS in 19%, and no NS in 10%. Of this population, 224 men (14%; 95% CI 12%, 15%) had functional erections at 3 months post-RP. On multivariable analysis, significant predictors of early erectile function recovery included: younger age (OR 0.93, P <.001), higher baseline erectile function domain score (OR 1.14, P <.001) and bilateral NS (OR 3.81, P =.002). The presence of diabetes (OR 0.43, P =.028) and a former smoking history (OR 0.63, P =.008; reference group: never smoker) was associated with the erectile dysfunction at 3 months post-RP. Of the men with early functional erections, 41% (95% CI 33%, 48%) had a ≥ 2-point decline in erectile function between 3 and 6 months. No factors were identified as predictors for this decline. Only a small proportion of men have functional erections at 3 months post-RP and a notable number of them will experience a decline in erectile function between 3 and 6 months. Strengths: large patient population and the use of validated questionnaire. Limitations: single-center retrospective study. A minority of men had functional erections 3 months post-RP, about half of whom had a decline in erectile function by month 6. We recommend appropriately counseling post-RP patients on the risk of such a decline in erectile function. Salter CA, Tin AL, Bernie HL, et al. Predictors of Worsening Erectile Function in Men with Functional Erections Early After Radical Prostatectomy. J Sex Med 2022;19:1790–1796. [ABSTRACT FROM AUTHOR]

Background: Although patients with ulcerative colitis (UC) are at increased risk of rectal cancer compared to the general population, it remains unclear whether their oncologic outcomes are different than sporadic rectal cancer (S‐RC).We aimed to compare survival and oncologic outcomes in S‐RC versus UC‐associated rectal cancer (UC‐RC). Methods: We performed a retrospective case‐control study of patients who underwent surgical resection for rectal cancer between 2005 and 2015. Data collected included patient demographics, intraoperative variables, postoperative outcomes, and oncological outcomes. Results: A total of 138 patients were included; 92 patients with S‐RC and 46 with UC‐RC. Both groups were comparable in terms of demographics, oncologic characteristics, oncologic treatment strategies, perioperative complications and operative factors except for preoperative radiotherapy. At a median follow‐up time of 3.7 years the 3‐and 5‐year OS rates; the 1‐and 3‐year DFS rates were comparable between the groups. Conclusion: Ulcerative colitis‐associated rectal cancer patients have similar survival and oncologic outcomes as sporadic rectal cancer patients. [ABSTRACT FROM AUTHOR]

Adults born preterm (birth <37 weeks' gestation) have a two-fold increased risk of early cardiovascular mortality. With 10% of the U.S. population born prematurely and perinatal advancements dramatically improving survival rates, millions of survivors are now reaching adulthood. This phenomenon has introduced a whole new population of individuals with a history of preterm birth. Although the prevailing notion has been that preterm birth is a condition confined only to infancy and early childhood, we now know preterm birth is a risk for lifelong chronic health conditions. Despite almost a decade of epidemiological evidence showing increased cardiovascular risk for those born preterm, this has not yet been translated into clinical practice. As a result, clinicians are caring for adults born prematurely without screening and treatment guidelines for this at-risk population and few inquire about birth history during clinical encounters. This brief report presents growing evidence about disrupted cardiogenesis and consequential structural and functional modifications. By asking the question "Were you born preterm?," nurse practitioners can take the first step of increasing their awareness of this at-risk population and mitigate adverse cardiovascular outcomes by using preterm birth as a risk factor when determining health promotion and treatment decisions. [ABSTRACT FROM AUTHOR]

Under global environmental change, understanding the interactions between people and nature has become critical for human survival. Comparative research can identify trends within social-ecological systems providing key insights for both environmental and developmental research. Island systems, with clear land boundaries, have been proposed as ideal case studies for comparative research, but it is unclear to what extent their potential has been fulfilled. To summarize existing research and identify potential gaps and new directions, we reviewed comparative environmental and developmental research on Pacific Large Ocean States. A diversity of case study locations and research themes were addressed within the sample of reviewed studies. Within the reviewed literature climate change, energy infrastructure, trade and fisheries were key themes of environmental and developmental research compared between island systems. Research was biased towards wealthier Pacific Large Ocean States and those with a relatively higher degree of socio-economic development. Our review highlights the potential value of a stronger a priori inclusion of spatial scale and conceptual frameworks, such as spatial resilience, to facilitate generalization from case studies. [ABSTRACT FROM AUTHOR]

Objective: While health podcasts can be effective in reducing stigma and increasing knowledge, we know little about their mechanisms of action. This qualitative study explored the mechanisms of how women connected with the podcast 'menopause: unmuted', which presented menopause information in a storytelling format.Methods: A diverse sample of 30 women aged 40-60 years were interviewed after listening to the podcast. Interviews covered participant's views and perceptions of the stories presented. Transcripts were analyzed thematically.Findings: Two overarching themes were identified. 'Openness and authenticity' describes the value of personal stories told in an authentic way by real experts-by-experience. 'Relatability and representation' explores participants' emotional reaction to the podcast, influenced by the extent to which they identified with the stories and storytellers on the podcast.Conclusions: Authenticity and relatability were identified as key mechanisms through which participants connected with audio stories, consistent with Fisher's narrative theory. These findings have important implications for the application of storytelling in podcasts designed to influence health behaviors.Practice Implications: Diverse stories representing a range of demographic characteristics and experiences are needed when creating podcasts about health information to increase listener's relatability and connection. [ABSTRACT FROM AUTHOR]

Silver is a well-established antimicrobial agent. Conjugation of organic ligands with silver nanoparticles has been shown to create antimicrobial nanoparticles with improved pharmacodynamic properties and reduced toxicity. Twelve novel organic ligand functionalized silver nanoparticles (AgNPs) were prepared via a light-controlled reaction with derivatives of benzothiazole, benzoxazine, quinazolinone, 2-butyne-1,4-diol, 3-butyne-1-ol, and heptane-1,7-dioic. UV-vis, Fourier-transform infrared (FTIR) spectroscopy, and energy-dispersive X-ray (EDAX) analysis were used to confirm the successful formation of ligand-functionalized nanoparticles. Dynamic light scattering (DLS) revealed mean nanoparticle diameters between 25 and 278 nm. Spherical and nanotube-like morphologies were observed using transmission electron microscopy (TEM) and scanning electron microscopy (SEM). Seven of the twelve nanoparticles exhibited strong antimicrobial activity and five of the twelve demonstrated significant antibacterial capabilities against E. coli in a zone-of-inhibition assay. The synthesis of functionalized silver nanoparticles such as the twelve presented is critical for the further development of silver-nanoconjugated antibacterial agents. [ABSTRACT FROM AUTHOR]

Information on factors contributing to the morbidity and mortality of the Bering–Chukchi–Beaufort seas stock of bowhead whales (Balaena mysticetus) is fundamental to its successful management and recovery. The Alaska Arctic coastline is remote and expansive, making monitoring for and gross examination of carcasses difficult. However, sighting data and imagery collected during aerial surveys in the eastern Chukchi (EC) and western Beaufort (WB) seas from 2009 through 2019 provide information on bowhead whale mortality. We present bowhead whale carcass data from the 2019 aerial surveys that add to the long series of consistent information on floating and beach-cast bowhead whale carcasses. The 2019 carcass data suggest an increased occurrence of probable killer whale (Orcinus orca) predation on bowhead whales in the WB. Eleven bowhead whale carcasses were photo-documented from July to October 2019 in the EC and WB study areas. Of the 11 carcasses documented, 7 had injuries consistent with probable killer whale predation—2 in the EC and 5 in the WB. Probable cause of death could not be assigned to four carcasses. No carcasses were associated with aboriginal subsistence hunting. Despite similar annual survey effort from 2009 to 2019, several compelling deviations in carcass numbers and locations were observed in 2019. Compared to 2009–2018, 2019 had the highest yearly number of documented carcasses and the most categorized as probable killer whale predation. Carcass locations exhibited a striking shift from the EC to the WB. Lastly, more carcasses were categorized as probable killer whale predation in the WB during 2019 than in 2009–2018 combined. [ABSTRACT FROM AUTHOR]

Objective: Distress tolerance (DT) has been found to be implicated in the development and maintenance of depressive symptomatology and various other significant psychological conditions. As such, it is critical to have measures of DT that are effective and easy to administer. This study aimed to examine the factor structure, psychometric properties, and clinical utility of the Distress Tolerance Scale (DTS) and the short‐form version, the Distress Tolerance Scale Short‐form (DTS‐SF), in a large population of individuals with varying levels of self‐reported depressive symptoms. Method: A total of 959 participants completed an online battery of questionnaires which included an assessment of depressive symptoms as well as the DTS and related measures. Results: Confirmatory factor analyses validated the four‐factor structure of the DTS and the one‐factor structure of the DTS‐SF. Good construct validity and good internal consistency were observed across both the DTS and DTS‐SF. Conclusion: Overall, this paper provides new evidence for the validity, reliability and discriminative ability of the DTS and the brief version of the questionnaire, the DTS‐SF. [ABSTRACT FROM AUTHOR]

The article describes case studies of patients with central hypothyroidism from a clinic at Sydney Children's Hospital in Randwick, Sydney, New South Wales. The first had treatment for acute lymphoblastic leukemia complicated by seizures treated with carbamazepine. Another underwent full treatment that necessitates modifications due to complications and intensive care admission. Another was diagnosed with a primitive neuroectodermal tumour in the right cervical thoracic paravertebral area.

Extremes in temperature and precipitation are associated with damaging floods, prolonged drought, destructive wildfires, agricultural challenges, compromised human health, vulnerable infrastructure, and threatened ecosystems and species. Often, the steady and progressive trends (or presses) of rising global temperature are the central focus in how climate impacts are described. However, observations of extreme weather events (or pulses) increasingly show that the intensity, duration and/or frequency of acute events are also changing, resulting in greater impacts on communities and the environment. Describing how the influence of extreme events may shape water management in the Colorado River Basin in clear terms is critical to sound future planning and efforts to manage risk. Three scenario planning workshops in 2019 and 2020 were held as part of a Colorado River Conversations series, identifying potential impacts from multiple intersecting extreme events. Water managers identified climate‐related events of concern in the Colorado River Basin that necessitate greater attention and adaptive responses. To support efforts to include consideration of climate‐change‐driven extremes in water management and planning, we explore the current state of knowledge at the confluence of long‐term climate shifts and extreme weather in the Colorado River Basin related to the events of concern that were identified by scenario planning participants. [ABSTRACT FROM AUTHOR]

Background: Ageing is a heterogenous process characterised by cellular and molecular hallmarks, including changes to haematopoietic stem cells and is a primary risk factor for chronic diseases. X chromosome inactivation (XCI) randomly transcriptionally silences either the maternal or paternal X in each cell of 46, XX females to balance the gene expression with 46, XY males. Age acquired XCI-skew describes the preferential selection of cells across a tissue resulting in an imbalance of XCI, which is particularly prevalent in blood tissues of ageing females, and yet its clinical consequences are unknown. Methods: We assayed XCI in 1575 females from the TwinsUK population cohort using DNA extracted from whole blood. We employed prospective, cross-sectional, and intra-twin study designs to characterise the relationship of XCI-skew with molecular and cellular measures of ageing, cardiovascular disease risk, and cancer diagnosis. Results: We demonstrate that XCI-skew is independent of traditional markers of biological ageing and is associated with a haematopoietic bias towards the myeloid lineage. Using an atherosclerotic cardiovascular disease risk score, which captures traditional risk factors, XCI-skew is associated with an increased cardiovascular disease risk both cross-sectionally and within XCI-skew discordant twin pairs. In a prospective 10 year follow-up study, XCI-skew is predictive of future cancer incidence. Conclusions: Our study demonstrates that age acquired XCI-skew captures changes to the haematopoietic stem cell population and has clinical potential as a unique biomarker of chronic disease risk. Funding: KSS acknowledges funding from the Medical Research Council [MR/M004422/1 and MR/R023131/1]. JTB acknowledges funding from the ESRC [ES/N000404/1]. MM acknowledges funding from the National Institute for Health Research (NIHR)-funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London. TwinsUK is funded by the Wellcome Trust, Medical Research Council, European Union, Chronic Disease Research Foundation (CDRF), Zoe Global Ltd and the National Institute for Health Research (NIHR)-funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London. [ABSTRACT FROM AUTHOR]

Trained immunity is an innate immune memory response that is induced by a primary inflammatory stimulus that sensitizes monocytes and macrophages to a secondary pathogenic challenge, reprogramming the host response to infection and inflammatory disease. Dietary fatty acids can act as inflammatory stimuli, but it is unknown if they can act as the primary stimuli to induce trained immunity. Here we find mice fed a diet enriched exclusively in saturated fatty acids (ketogenic diet; KD) confer a hyper-inflammatory response to systemic lipopolysaccharide (LPS) and increased mortality, independent of diet-induced microbiome and hyperglycemia. We find KD alters the composition of the hematopoietic stem cell compartment and enhances the response of bone marrow macrophages, monocytes, and splenocytes to secondary LPS challenge. Lipidomics identified enhanced free palmitic acid (PA) and PA-associated lipids in KD-fed mice serum. We found pre-treatment with physiologically relevant concentrations of PA induces a hyper-inflammatory response to LPS in macrophages, and this was dependent on the synthesis of ceramide. In vivo, we found systemic PA confers enhanced inflammation and mortality in response to systemic LPS, and this phenotype was not reversible for up to 7 days post-PA-exposure. Conversely, we find PA exposure enhanced clearance of Candida albicans in Rag1-/- mice. Lastly, we show that oleic acid, which depletes intracellular ceramide, reverses PA-induced hyper-inflammation in macrophages and enhanced mortality in response to LPS. These implicate enriched dietary SFAs, and specifically PA, in the induction of long-lived innate immune memory and highlight the plasticity of this innate immune reprogramming by dietary constituents. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence suggests that access to chiropractic care may reduce the likelihood of initiating an opioid prescription for spinal pain; however, the impact of chiropractic care for patients already prescribed opioids is uncertain. We undertook a sequential explanatory mixed methods study to evaluate the association between initiating chiropractic care and continued opioid use among adult patients attending an Ontario community health centre (CHC) and receiving opioid therapy for chronic non-cancer spinal pain. Methods: We conducted a retrospective cohort study of 210 patient records between January 1, 2014 and December 31, 2020. We used generalized estimating equations, adjusted for patient demographics, co-morbidities, visit frequency, and calendar year, to evaluate the association between receipt versus non-receipt of chiropractic services and continued opioid use (e.g., unique opioid fills, number of refills, and dosages) up to one year following the index chiropractic visit. We also completed follow-up interviews with 14 patients and nine general practitioners from the CHC and integrated these data with our quantitative findings. Results: Over 12-month follow-up, there were lower rates of opioid fills (incidence rate ratio [IRR] = 0.66; 95% confidence interval [CI], 0.52–0.83) and refills (IRR = 0.27; 95% CI, 0.17–0.42) among chiropractic recipients (n = 49) versus non-recipients (n = 161). Although patients who did and did not receive chiropractic care began the study with the same dose of opioids, recipients were less likely to be prescribed higher-dose opioids (i.e., ≥ 50 mg morphine equivalents daily) compared to non-recipients at three months (odds ratio [OR] = 0.14; 95% CI, 0.04–0.47), six months (OR = 0.14; 95% CI, 0.05–0.40), nine months (OR = 0.19; 95% CI, 0.07–0.57), and 12 months (OR = 0.22; 95% CI, 0.08–0.62). Interviews suggested that patient self-efficacy, limited effectiveness of opioids for chronic pain, stigma regarding use of opioids, and access to chiropractic treatment were important influencing factors. Conclusion: We found that continued prescription opioid use among patients with chronic non-cancer spinal pain who received chiropractic care was lower than in patients who did not receive chiropractic care. Four themes emerged in our qualitative interviews to help provide a richer understanding of this association. Randomized controlled trials are needed to establish the effect of chiropractic care on opioid use for chronic spinal pain. [ABSTRACT FROM AUTHOR]

This review provides an overview of pediatric dyslipidemia emphasizing screening and treatment recommendations. The presence of risk factors for cardiovascular disease in childhood poses significant risk for the development of atherosclerotic cardiovascular disease and cardiovascular events in adulthood. While atherogenic dyslipidemia is the most common dyslipidemia seen in children and can be suspected based on the presence of risk factors (such as obesity), familial hypercholesterolemia can be found in children with no risk factors. As such, universal cholesterol screening is recommended to identify children with these disorders in order to initiate treatment and reduce the risk of future cardiovascular disease. Treatment of pediatric dyslipidemia begins with lifestyle modifications, but primary genetic dyslipidemias may require medications such as statins. As pediatric lipid disorders often have genetic or familial components, it is important that all physicians are aware that cardiovascular risk begins in childhood, and can both identify these disorders in pediatric patients and counsel their adult patients with dyslipidemia to have their children screened. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine whether secondary student engagement was predictive of college attendance. Data were drawn from the High School Longitudinal Study of 2009 9th grade (n = 21,444) and 11th grade (n = 20,549) cohorts. Multilevel modeling was used to analyze whether demographic, academic, financial, and engagement variables predicted postsecondary enrollment. Demographic (higher SES, attending a Catholic or private school) and academic (English and Math GPA) variables were predictive of college enrollment across both cohorts, as were participants' thoughts on the affordability of college. For ninth grade students, the engagement scales of family support for learning and future goals and aspirations remained significant predictors of enrollment after accounting for other variables. Among 11th grade students, peer support for learning, future goals and aspirations, and behavioral engagement remained significant predictors of enrollment. Student engagement is thought to underlie high school and college completion efforts but little research connects these levels of schooling. This study suggests providing support for students' engagement in high school could positively affect college enrollment. Financial education about the costs and options for paying for college may also be beneficial. Practitioner points: Students' engagement in both 9th and 11th grades was predictive of college enrollment.Students' beliefs about the affordability of college in 9th and 11th grades was associated with enrollment in college.Support for students' engagement and education regarding costs and financial options for college while in high school may positively affect college enrollment. [ABSTRACT FROM AUTHOR]

Simple Summary: The conditions and management practices imposed during mating can influence the success of a sheep production enterprise. However, the impact of mating practices across southern Australian sheep production systems are relatively unknown. Mating liveweight and body condition score data were collected at mating from four sheep breeds and during three seasons of mating across southern Australia. Further, the seasonal conditions during mating were ranked by the producers and ram percentage and region were also recorded. Bayesian Network analysis was used to explore the relationships between these variables and pregnancy and fetal number at scanning. The results of this survey study emphasize the interrelatedness of the explored mating conditions and practices and the importance of understanding their interactions for optimizing sheep reproduction and nutrition from mating. Sheep production in southern Australia may vary by breed, time of year, production output (wool, meat, or both), region and seasonal influence. Sheep producers with flocks of approximately 300–500 ewes (n = 58) were recruited across southern Australia to take part in a survey and mating variables were collected from over 30,000 ewes between October 2020 and August 2021. A Bayesian Network (BN) was developed to identify the interrelatedness and most influential variable on pregnancy and fetal number (of pregnant ewes) outcomes under different scenarios. The BN analysis indicated a low association between the variables explored, however, were breed dependent. In wool-based breeds a mating liveweight of 60–69.5 kg predicted the lowest non-pregnant and greatest number of fetuses, and in shedding ewes 70–79.5 kg predicted the lowest non-pregnant rate and 90–99.5 kg the greatest number of fetuses. Pregnancy rate and fetuses per ewe were optimized at ram percentages of 1.5% for Composite and Merino ewes and 2% for Maternal ewes. A mating BCS 4 resulted in greatest pregnancy rate and number of fetuses across all breeds. Curvilinear relationships between mating liveweight, BCS and ram percentage were observed with pregnancy rate and fetal number. Practically, reproductive potential is best managed on a breed basis and with consideration of all variables explored. [ABSTRACT FROM AUTHOR]

Background: Among the most intense adversity experiences for infants is premature birth. Early birth marks the beginning of a life course that broadly affects families, healthcare, education, social systems, and the survivors themselves. For many, the transition to adulthood is challenging and often hampered by cognitive, physical and mental health, and motor and independence difficulties. Objectives: The aim of this study was to share a comprehensive protocol of a 10th follow-up study of premature infants in their 30s. The protocol accounts for stress during the neonatal period, the cumulative context (risk and protection) of development, biological and epigenetic mechanisms, and individual resilience. Methods: The prospective, five-group longitudinal design includes 215 term-born and preterm-born individuals with various neonatal morbidities at ages 30–35 years. Adult outcomes include health, adaptive, executive function, work, and social competence. Novel measures are four system indicators of allostatic load (AL) and epigenetics. Contextual measures include socioeconomic risk and individual resilience. All measures were selected based on coherence with constructs of the scientific aims, strong psychometrics, continuity for repeated measures, and minimal subject burden. Objective assessments include body composition imaging, exercise testing, blood and saliva collection, and actigraphy. The two-phase protocol takes approximately 8 hours. Discussion: After an 11-month COVID-19 pause, participant response has been strong. As of May 2022, 75 participants have completed the full protocol, and 99 have consented to participate. When socioeconomic risk is controlled, we hypothesize that life course trajectories in physical and psychological health, adaptive function, and executive function will differ between term and preterm neonatal morbidity groups. AL will vary across groups and contribute to outcomes. We expect proximal protection and resilience to mediate the cumulative medical and socioeconomic risk and AL. Epigenome-wide DNA methylation, with estimates of age acceleration, will be examined across groups and explored in longitudinal associations with medical risk, socioeconomic status, and protection. To our knowledge, this is the only U.S. study of premature infants aged 30–35 years. With millions of preterm-born individuals reaching adulthood, the protocol incorporates molecular and genetic biomarkers in a life course developmental examination to inform the timing and content of interventions. [ABSTRACT FROM AUTHOR]

Aim: There have been no studies into the direct injection of mesenchymal stem cells (MSCs) for luminal ulcerative colitis (UC). Our aim was to investigate the efficacy of MSCs delivered locally via endoscopic delivery, as is done in the setting of perianal disease, to treat the local site of inflammation directly. Method: A phase IB/IIA randomized control clinical trial of remestemcel‐L, an ex vivo expanded allogeneic bone marrow‐derived MSC product, at a dose of 150 million MSCs versus placebo (2:1 fashion) delivered via direct injection using a 23‐gauge sclerotherapy needle at the time of colonoscopy was designed to assess the safety and efficacy of endoscopic delivery of MSCs for UC. The main outcome measures were adverse events, Mayo score and Mayo endoscopic severity score at 2 weeks, 6 weeks and 3 months post‐MSC delivery. Results: Six patients were enrolled and treated; four received MSCs and two placebo. All had been on prior anti‐tumour necrosis factor or anti‐integrin therapy. There were no adverse events related to MSCs. In the treatment group (n = 4), the Mayo endoscopic severity score decreased in all patients by 2 weeks after MSC delivery. At 3 months, all patients were extremely satisfied or satisfied with their MSC treatment based on the inflammatory bowel disease patient‐reported treatment impact (IBD‐PRTI), and treatment response was described as excellent or good in all patients. In the control group (n = 2), the Mayo endoscopic severity score did not increase as a result of being off alternative therapy. At 3 months, patients were dissatisfied according to the IBD‐PRTI, and treatment response was poor or unchanged. Conclusion: MSCs may offer a safe therapeutic option for the treatment of medically refractory UC. Early data suggest improved clinical and endoscopic scores by 2 weeks after MSC delivery. [ABSTRACT FROM AUTHOR]