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Abstract Modern, highly evolved nucleoside-processing enzymes are known to exhibit perfect regioselectivity over the glycosylation of purine nucleobases at N9. We herein report an exception to this paradigm. Wild-type nucleoside phosphorylases also furnish N7-xanthosine, a “non-native” ribosylation regioisomer of xanthosine. This unusual nucleoside possesses several atypical physicochemical properties such as redshifted absorption spectra, a high equilibrium constant of phosphorolysis and low acidity. Ultimately, the biosynthesis of this previously unknown natural product illustrates how even highly evolved, essential enzymes from primary metabolism are imperfect catalysts.

The mouthparts and protarsi of adult rove-beetles of the Staphylinine group are examined in detail. We provide descriptions and image plates based on scanning electron micrographs taken from 36 species representing all 10 subfamilies comprising this large staphylinid subunit. We establish groundplan features of the mouthparts for the Staphylinine group and discuss, in detail, aspects and functions of structures that compose the feeding apparatus. A phylogenetic scheme is used to conduct an ancestral character reconstruction of the morphological characters. The potential groundplan features of the characters rendered in our parsimony analysis for the Staphylinine group are: labrum subquadrate or longer than wide; mandible without subapical teeth and retinaculum, with prostheca present, not forming lobe-like projection, and with a mola; maxillary palpomere 4 well-developed, fully sclerotized, similar in width to palpomere 3; ‘glossa’ integrated with prementum plate, sometimes represented by pairs of sensilla basiconica; ‘paraglossa’ with unmodified antero-lateral lobes; labial palpomere 3 from as wide to half as wide as penultimate palpomere. To explain the shape variation of the mandibles, a geometric morphometric analysis was carried out. A character mapping analysis of mandible shapes revealed a trend in the Staphylinine group toward a falcate shape with a narrow base, typically present in some predatory species.

Abstract Building a representative model of a complex dynamical system from empirical evidence remains a highly challenging problem. Classically, these models are described by systems of differential equations that depend on parameters that need to be optimized by comparison with data. In this tutorial, we introduce the most common multi-parameter estimation techniques, highlighting their successes and limitations. We demonstrate how to use the adjoint method, which allows efficient handling of large systems with many unknown parameters, and present prototypical examples across several fields of physics. Our primary objective is to provide a practical introduction to adjoint optimization, catering for a broad audience of scientists and engineers.

Abstract Vaccination with infectious Plasmodium falciparum (Pf) sporozoites (SPZ) administered with antimalarial drugs (PfSPZ-CVac), confers superior sterilizing protection against infection when compared to vaccination with replication-deficient, radiation-attenuated PfSPZ. However, the requirement for drug administration constitutes a major limitation for PfSPZ-CVac. To obviate this limitation, we generated late liver stage-arresting replication competent (LARC) parasites by deletion of the Mei2 and LINUP genes (mei2 – /linup – or LARC2). We show that Plasmodium yoelii (Py) LARC2 sporozoites did not cause breakthrough blood stage infections and engendered durable sterilizing immunity against various infectious sporozoite challenges in diverse strains of mice. We next genetically engineered a PfLARC2 parasite strain that was devoid of extraneous DNA and produced cryopreserved PfSPZ-LARC2. PfSPZ-LARC2 liver stages replicated robustly in liver-humanized mice but displayed severe defects in late liver stage differentiation and did not form liver stage merozoites. This resulted in complete abrogation of parasite transition to viable blood stage infection. Therefore, PfSPZ-LARC2 is the next-generation vaccine strain expected to unite the safety profile of radiation-attenuated PfSPZ with the superior protective efficacy of PfSPZ-CVac.

Abstract Malaria-causing Plasmodium parasites first replicate as liver stages (LS), which then seed symptomatic blood stage (BS) infection. Emerging evidence suggests that these stages impact each other via perturbation of host responses, and this influences the outcome of natural infection. We sought to understand whether the parasite stage interplay would affect live-attenuated whole parasite vaccination, since the efficacy of whole parasite vaccines strongly correlates with their extend of development in the liver. We thus investigated the impact of BS infection on LS development of genetically attenuated and wildtype parasites in female rodent malaria models and observed that for both, LS infection suffered severe suppression during concurrent BS infection. Strikingly and in contrast to previously published studies, we find that the BS-induced iron-regulating hormone hepcidin is not mediating suppression of LS development. Instead, we demonstrate that BS-induced host interferons are the main mediators of LS developmental suppression. The type of interferon involved depended on the BS-causing parasite species. Our study provides important mechanistic insights into the BS-mediated suppression of LS development. This has direct implications for understanding the outcomes of live-attenuated Plasmodium parasite vaccination in malaria-endemic areas and might impact the epidemiology of natural malaria infection.

Abstract Background Suicide, especially by firearm, remains a leading cause of death in military populations in the USA. Reducing access to firearms, especially during high risk times, may help prevent suicide and other forms of violence. The purpose of this study was to adapt a promising existing lethal means safety intervention (Project Safe Guard, PSG) for cross-cutting violence prevention and peer support in active-duty service communities using community engagement methods. Methods A two-pronged community-engaged research approach was employed, including the Community Translation (CT) process that engaged 15 Service Members from one installation to help adapt PSG successfully. In addition, qualitative data was collected from 40 active-duty service members and military violence prevention specialists through in-depth interviews and focus group discussions. Results Qualitative data and CT feedback led to site-specific PSG adaptations. Participants emphasized the importance of peer-to-peer discussions and highlighted resource allocation, leadership support, and stigma on firearm ownership as potential implementation challenges. Conclusions Findings demonstrate the feasibility of community-engaged research to adapt lethal means safety interventions within military populations. PSG implementation should consider resource allocation, leadership support, and addressing stigma. This study has implications for future policies and standards for performing research on sensitive topics, particularly among military populations.

We show a long-term erosion monitoring of several geomorphologically active gully systems on Little Ice Age lateral moraines in the European Central–Eastern Alps, covering a total time period from 1953 to 2019 and including several survey periods in order to identify corresponding morphodynamic trends. For the implementation, DEM (digital elevation model) of Differences (DoDs) were calculated, based on multitemporal high-resolution digital elevation models from historical aerial images (generated by structure from motion photogrammetry with multi-view stereo) and light detection and ranging from airborne platforms. Two approaches were implemented to achieve the corresponding objectives. First, by calculating linear regression models using the accumulated sediment yield and the corresponding catchment area (on a log–log scale), the range of the variability in the spatial distribution of erosion values within the sites. Second, we use volume calculations to determine the total and the mean sediment yield (as well as erosion rates) of the entire sites. Subsequently, both the sites and the different time periods of both approaches are compared. Based on the slopes of the calculated regression lines, it can be shown that the highest variability in the sediment yield at the sites occurs in the first time period (mainly 1950s to 1970s). This can be attributed to the fact that within some sites the sediment yield per square metre increases clearly more strongly (regression lines with slopes up to 1.5). In contrast, in the later time periods (1970s to mid-2000s and mid-2000s to 2017/2019), there is generally a decrease in 10 out of 12 cases (regression lines with slopes around 1). However, even at sites with an increase in the variability in the sediment yield over time, the earlier high variabilities are no longer reached. This means that the spatial pattern of erosion in the gully heads changes over time as it becomes more uniform. Furthermore, using sediment volume calculations and corresponding erosion rates, we show a generally decreasing trend in geomorphic activity (amount of sediment yield) between the different time periods in 10 out of 12 sites, while 2 sites show an opposite trend, where morphodynamics increase and remain at the same level. Finally, we summarise the results of long-term changes in the morphodynamics of geomorphologically active areas on lateral moraines by presenting the “sediment activity concept”, which, in contrast to theoretical models, is based on actually calculated erosion. The level of geomorphic activity depends strongly on the characteristics of the sites, such as size, slope length, and slope gradient, some of which are associated with deeply incised gullies. It is noticeable that especially areas with influence of dead ice over decades in the lower slope area show high geomorphic activity. Furthermore, we show that system internal factors, as well as the general paraglacial adjustment process, have a greater influence on long-term morphodynamics than changing external weather and climate conditions, which, however, had a slight impact mainly in the last, i.e. most recent, time period (mid-2000s to 2017/2019) and may have led to an increase in erosion at the sites.

The moment distribution method is considered one of the easiest and most reliable analysis methods. However, little attention has been given to modelling the stiffness of each member separately, as currently only one factor is being used to model all structural members without taking into account the loading conditions and curvature of the member. This can significantly influence the results when modelling columns, since unlike beams, which are usually bent in a single curvature configuration, columns can be bent in either a single or double curvature configuration. This paper presents a new set of stiffness factors to model each structural member separately depending on its boundary conditions and curvature. To validate this modification, an example concrete frame was modelled and analysed using the structural analysis software ETABS, and then the results were compared with that obtained from the standard moment distribution method and the modified moment distribution method. The results have revealed a significant enhancement in the accuracy of the obtained results when using the modified moment distribution method compared with the original moment distribution method, especially the values of the columns’ bending moments.

Women have more protectionist trade preferences than men do. We assess whether this well-documented relationship between gender and protectionism in the mass public carries over into a relationship between women’s political representation and (a) party platforms, and (b) governments’ trade policy choices. Looking across countries and over time, we demonstrate that with an increase in women’s representation, political party trade policy positions become more protectionist. For government trade policy choices, we identify more nuanced results. The protectionist effect of women’s representation is limited to the most visible products: consumption goods. Women’s representation has no effect on intermediate inputs, where firm demands for trade liberalization are more pronounced and policy makers are thus constrained in implementing a protectionist agenda. These findings contribute to scholarship on the descriptive–substantive representation link, add a new dimension to our understanding of trade politics, and demonstrate the importance of applying a gendered lens to international political economy research.

This report describes a two-year effort to survey the internal 137Cs and external β-emitter contamination present in the feral dog population near the Chernobyl nuclear power plant (ChNPP) site, and to understand the potential for human radiation exposure from this contamination. This work was performed as an integral part of the radiation safety and control procedures of an animal welfare oriented trap-neuter-release (TNR) program. The measurement program focused on external contamination surveys using handheld β-sensitive probes, and internal contamination studies using a simple whole-body counter. Internal 137Cs burden was measured non-invasively during post-surgical observation and recovery. External β contamination surveys performed during intake showed that 21/288 animals had significant, removable external contamination, though not enough to pose a large hazard for incidental contact. Measurements with the whole-body counter indicated internal 137Cs body burdens ranging from undetectable (minimum detection level ∼100 Bq/kg in 2017, ∼30 Bq/kg in 2018) to approximately 30,000 Bq/kg. A total of 33 animals had 137Cs body-burdens above 1 kBq/kg, though none posed an external exposure hazard. The large variation in the 137Cs concentration in these animals is not well-understood, could be due to prey selection, access to human food scraps, or extended residence in highly contaminated areas. The small minority of animals with external contamination may pose a contamination risk allowing exposures in excess of regulatory standards.

BackgroundLarge-scale trials of multidomain interventions show that modifying lifestyle and psychological risk factors can slow cognitive decline. We aim to determine if a lower intensity, personally tailored secondary dementia prevention programme for older people with subjective or mild objective memory decline, informed by behaviour change theory, reduces cognitive decline over 2 years.MethodsA multi-site, single-blind randomised controlled trial recruiting 704 older adults at high dementia risk due to mild cognitive impairment (MCI) or subjective cognitive decline (SCD). Participants are randomised using 1:1 allocation ratio to the APPLE Tree intervention versus control arm (dementia prevention information), stratified by site. The intervention explores and implements strategies to promote healthy lifestyle, increase pleasurable activities and social connections and improve long-term condition self-management. Two facilitators trained and supervised by a clinical psychologist deliver ten, 1-h group video call sessions over 6 months (approximately every fortnight), video-call 'tea breaks' (less structured, facilitated social sessions) in intervening weeks and individual goal-setting phone calls every 2 weeks. From 6 to 12 months, participants meet monthly for 'tea breaks', with those not attending receiving monthly goal-setting phone calls. Participants receive a food delivery, pedometer and website access to cognitive training and information about lifestyle modification. Follow-ups for all outcome measures are at 12 and 24 months. The primary outcome is cognition (Neuropsychological Test Battery (NTB) score) at 24 months. Secondary outcomes are quality of life, cost per quality-adjusted life year (QALY) and wellbeing and lifestyle factors the intervention targets (diet, vascular risk, body weight, activity, sleep, anxiety, depression, social networks and loneliness, alcohol intake and smoking). Participants from purposively selected sites participate in qualitative process evaluation interviews, which will be analysed using thematic analytic methods.DiscussionIf effective, the intervention design, involving remote delivery and non-clinical facilitators, would facilitate intervention roll-out to older people with memory concerns.Trial registrationISRCTN17325135 . Registration date 27 November 2019.

Purpose: Interprofessional practice within early intervention is underscored by policy, research, and recommended practices. The purpose of this study was to explore the impact of a brief interprofessional training on preservice speech-language pathology, early intervention/early childhood special education, physical therapy, and occupational therapy students' knowledge, beliefs, and attitudes about teaming and collaboration. Students' satisfaction with and perspectives of the training were also examined. Method: A one-group, pretest-posttest design was used to examine differences in 36 students' knowledge, attitudes, and beliefs around interprofessional practice after the training. Descriptive approaches were used to analyze student satisfaction data and focus group data in order to evaluate student perceptions of the interprofessional training. Results: A paired-samples t test showed preservice students demonstrated increased scores in self-perceived ability, value, and comfort in working with others after the training institute. Descriptive analyses illustrated students gained a richer knowledge and appreciation for other disciplines and perceived the practice of interprofessional collaboration as a valuable learning experience. Conclusion: The interprofessional training procedures, evaluation of impacts, and future directions are discussed.

Background/aims To examine demographic and clinical factors associated with ocular pain 1 day after refractive surgery.Methods Prospective study of individuals undergoing refractive surgery. Participants rated their ocular pain on a 0–10 numerical rating scale (NRS) presurgery and 1 day after surgery. Presurgery, participants completed questionnaires on demographics, comorbidities, medications and dry eye and ocular pain symptoms; and an anaesthetised Schirmer test was performed. Acute ocular pain 1 day after surgery was defined as an NRS score of worst pain since surgery ≥3 and this group was compared with individuals with NRS scores

The structural behaviour of textile-reinforced concrete (TRC) components under uniaxial compressive loading has already been studied. However, for practical applications, multi-axial loading conditions are often of great importance. It is well known from steel-reinforced concrete that multiaxial compressive stresses lead to increased compressive strength. The extent to which this assumption can be transferred to TRC components should be investigated. This paper investigates the influence of textile carbon grid reinforcement on the compressive capacity of disc-shaped concrete specimens. The specimens were subjected to a biaxial compressive load in the plane of the reinforcement. Emphasis was placed on the influence parameters of production type of the disc specimens (laminated or poured), impregnation material of the carbon textile (polystyrene or epoxy resin) and number of reinforcement layers. It was found that the general presence of a textile reinforcement as a two-dimensional interference plane had the greatest influence on the compressive capacity of the specimens, while the other parameters investigated played a minor role. Depending on the load ratio in the two compression axes, there were increases or decreases in capacity compared to the uniaxial tests. This has to be taken into account in the design of the corresponding components. Finally, an outlook is given on future investigations planned to support and extend the results presented in this paper.

Key Clinical Message A plunging ranula may present initially as an extensive vallecular cyst and correct diagnosis may be reached with the use of ultrasound, fluid aspiration for amylase detection, and MRI imaging. Abstract The ranula is a pseudocyst of the sublingual salivary gland and can be divided into two known subtypes. The simple ranula and plunging ranula. While the simple type can be found in the floor of the mouth, the plunging ranula usually pervades the mylohoid muscle and presents as a cervical swelling. The presented case should outline the difficulties in diagnostic and treatment of an uncommon expression of a mucocele above the mylohoid muscle without presenting either a cervical or an intraoral swelling, only extending towards the vallecula. We present a previously unreported clinical manifestation of a ranula of an 18‐year old male, which extends posteriorly, remaining confined in the supramylohyoid muscle space. The cystic lesion protrudes in the oropharynx, and clinically appears as an extensive vallecular cyst. On magnetic resonance imaging the initial suspected diagnosis of a vallecular cyst was changed to the final diagnosis of a plunging ranula. The marsupialization of the cyst sac was performed. Outpatient follow‐up revealed a persisting ostium, indicating a continuous extravasation of the sublingual gland. The present case report describes an unusual clinical presentation of a plunging ranula, remaining above the mylohyoid muscle and protruding into the oropharynx, misdirecting to the first suspected diagnosis of a vallecular cyst. The case highlights the useful contribution of the MRI imaging for differential diagnoses and the need for criteria to indicate further investigations.

IntroductionNew diagnostic techniques are a substantial research focus in degenerative cervical myelopathy (DCM). This cross-sectional study determined the significance of cardiac-related spinal cord motion and the extent of spinal stenosis as indicators of mechanical strain on the cord.MethodsEighty-four DCM patients underwent MRI/clinical assessments and were classified as MRI+ [T2-weighted (T2w) hyperintense lesion in MRI] or MRI− (no T2w-hyperintense lesion). Cord motion (displacement assessed by phase-contrast MRI) and spinal stenosis [adapted spinal canal occupation ratio (aSCOR)] were related to neurological (sensory/motor) and neurophysiological readouts [contact heat evoked potentials (CHEPs)] by receiver operating characteristic (ROC) analysis.ResultsMRI+ patients (N = 31; 36.9%) were more impaired compared to MRI− patients (N = 53; 63.1%) based on the modified Japanese Orthopedic Association (mJOA) subscores for upper {MRI+ [median (Interquartile range)]: 4 (4–5); MRI−: 5 (5–5); p

This publication is a fact sheet intended for individuals who are interested in learning basic information about identity theft, victimization, and ways to navigate the process. The publication aims to inform readers and to help victims of identity theft minimize financial and personal setbacks. Written by Axton Betz-Hamilton, Randall A. Cantrell, and Heidi Liss Radunovich, and published by the UF/IFAS Department of Family, Youth and Community Sciences, June 2024.

The software RPExpand, implemented in MATLAB®, provides modal expansions of physical observables in resonant systems, based on contour integrals. Version 2.0 improves the workflow and adds new features. In addition to the poles corresponding to eigenmodes of the systems, zeros of various quantities can be computed. Their derivatives are evaluated if the required information is supplied at the integration points. Furthermore, expansions based on quasinormal modes are supported.

OBJECTIVES: To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research. DESIGN: Systematic scoping review. SETTINGS AND PARTICIPANTS: PLWD and their care partners in the ED setting. METHODS: Informed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for PLWD compared with persons without dementia? Are there specific communication strategies that improve the outcomes of ED care? Future research areas were prioritized. RESULTS: From 5451 studies identified for PICO-1, 21 were abstracted. From 2687 studies identified for PICO-2, 3 were abstracted. None of the included studies directly evaluated communication differences between PLWD and other populations, nor the effectiveness of specific communication strategies. General themes emerging from the scoping review included perceptions by PLWD/care partners of rushed ED communication, often exacerbated by inconsistent messages between providers. Care partners consistently reported limited engagement in medical decision-making. In order, the research priorities identified included: (1) Barriers/facilitators of effective communication; (2) valid outcome measures of effective communication; (3) best practices for care partner engagement; (4) defining how individual-, provider-, and system-level factors influence communication; and (5) understanding how each member of ED team can ensure high-quality communication. CONCLUSIONS AND IMPLICATIONS: Research exploring ED communication with PLWD is sparse and does not directly evaluate specific communication strategies. Defining barriers and facilitators of effective communication was the highest-ranked research priority, followed by validating outcome measures associated with improved information exchange.

ObjectivesWe aimed to describe emergency department (ED) care transition interventions delivered to older adults with cognitive impairment, identify relevant patient-centered outcomes, and determine priority research areas for future investigation.DesignSystematic scoping review.Setting and participantsED patients with cognitive impairment and/or their care partners.MethodsInformed by the clinical questions, we conducted systematic electronic searches of medical research databases for relevant publications following published guidelines. The results were presented to a stakeholder group representing ED-based and non-ED-based clinicians, individuals living with cognitive impairment, care partners, and advocacy organizations. After discussion, they voted on potential research areas to prioritize for future investigations.ResultsFrom 3848 publications identified, 78 eligible studies underwent full text review, and 10 articles were abstracted. Common ED-to-community care transition interventions for older adults with cognitive impairment included interdisciplinary geriatric assessments, home visits from medical personnel, and telephone follow-ups. Intervention effects were mixed, with improvements observed in 30-day ED revisit rates but most largely ineffective at promoting connections to outpatient care or improving secondary outcomes such as physical function. Outcomes identified as important to adults with cognitive impairment and their care partners included care coordination between providers and inclusion of care partners in care management within the ED setting. The highest priority research area for future investigation identified by stakeholders was identifying strategies to tailor ED-to-community care transitions for adults living with cognitive impairment complicated by other vulnerabilities such as social isolation or economic disadvantage.Conclusions and implicationsThis scoping review identified key gaps in ED-to-community care transition interventions delivered to older adults with cognitive impairment. Combined with a stakeholder assessment and prioritization, it identified relevant patient-centered outcomes and clarifies priority areas for future investigation to improve ED care for individuals with impaired cognition, an area of critical need given the current population trends.

Our research introduces a modular motion planning framework for autonomous vehicles using a sampling-based trajectory planning algorithm. This approach effectively tackles the challenges of solution space construction and optimization in path planning. The algorithm is applicable to both real vehicles and simulations, offering a robust solution for complex autonomous navigation. Our method employs a multi-objective optimization strategy for efficient navigation in static and highly dynamic environments, focusing on optimizing trajectory comfort, safety, and path precision. The algorithm is used to analyze the algorithm performance and success rate in 1750 virtual complex urban and highway scenarios. Our results demonstrate fast calculation times (8ms for 800 trajectories), a high success rate in complex scenarios (88%), and easy adaptability with different modules presented. The most noticeable difference exhibited was the fast trajectory sampling, feasibility check, and cost evaluation step across various trajectory counts. We demonstrate the integration and execution of the framework on real vehicles by evaluating deviations from the controller using a test track. This evaluation highlights the algorithm’s robustness and reliability, ensuring it meets the stringent requirements of real-world autonomous driving scenarios. The code and the additional modules used in this research are publicly available as open-source software and can be accessed at the following link: https://github.com/TUM-AVS/Frenetix-Motion-Planner.

Abstract Background Patient-reported outcomes (PROs) play a crucial role in assessing rheumatic diseases, offering insights into disease evaluation and treatment efficacy. This study focuses on PRO assessment in large vessel vasculitides, including Takayasu Arteritis and Giant Cell Arteritis (GCA). Methods We retrospectively analyzed routine data from patients treated at our rheumatology clinic over a 10-year span. Patient and physician-rated global disease activity scale (G-DAS) scores, measured on a numeric rating scale (0–10 points), were collected at each visit. Clinical variables like age, sex, body mass index (BMI), disease duration, lab values, pain perception, and questionnaire responses were recorded. Linear regression and generalized additive linear regression (GAM analysis) examined associations between PROs and these factors. Results The study included 138 patients, primarily diagnosed with GCA (94.4%). Mean follow-up was 2.5 years (0-7.7). Patient and physician G-DAS exhibited a moderate correlation (Pearson R 0.19, CI 0.14–0.24, p

Abstract Background The perioperative antibiotic prophylaxis with 1st or 2nd generation cephalosporins is evidence-based in orthopedic surgery. There are, however, situations with a high risk of prophylaxis-resistant surgical site infections (SSI). Methods We perform a superiority randomized controlled trial with a 10% margin and a power of 90% in favor of the broad-spectrum prophylaxis. We will randomize orthopedic interventions with a high risk for SSI due to selection of resistant pathogens (open fractures, surgery under therapeutic antibiotics, orthopedic tumor surgery, spine surgery with American Society of Anesthesiologists (ASA) score ≥ 3 points) in a prospective-alternating scheme (1:1, standard prophylaxis with cefuroxime versus a broad-spectrum prophylaxis of a combined single-shot of vancomycin 1 g and gentamicin 5 mg/kg parenterally). The primary outcome is “remission” at 6 weeks for most orthopedic surgeries or at 1 year for surgeries with implant. Secondary outcomes are the risk for prophylaxis-resistant SSI pathogens, revision surgery for any reason, change of antibiotic therapy during the treatment of infection, adverse events, and the postoperative healthcare-associated infections other than SSI within 6 weeks (e.g., urine infections or pneumonia). With event-free surgeries to 95% in the broad-spectrum versus 85% in the standard prophylaxis arm, we need 2 × 207 orthopedic surgeries. Discussion In selected patients with a high risk for infections due to selection of prophylaxis-resistant SSI, a broad-spectrum combination with vancomycin and gentamycin might prevent SSIs (and other postoperative infections) better than the prophylaxis with cefuroxime. Trial registration ClinicalTrial.gov NCT05502380. Registered on 12 August 2022. Protocol version: 2 (3 June 2022)

Abstract The conserved SR-like protein Npl3 promotes splicing of diverse pre-mRNAs. However, the RNA sequence(s) recognized by the RNA Recognition Motifs (RRM1 & RRM2) of Npl3 during the splicing reaction remain elusive. Here, we developed a split-iCRAC approach in yeast to uncover the consensus sequence bound to each RRM. High-resolution NMR structures show that RRM2 recognizes a 5´-GNGG-3´ motif leading to an unusual mille-feuille topology. These structures also reveal how RRM1 preferentially interacts with a CC-dinucleotide upstream of this motif, and how the inter-RRM linker and the region C-terminal to RRM2 contribute to cooperative RNA-binding. Structure-guided functional studies show that Npl3 genetically interacts with U2 snRNP specific factors and we provide evidence that Npl3 melts U2 snRNA stem-loop I, a prerequisite for U2/U6 duplex formation within the catalytic center of the Bact spliceosomal complex. Thus, our findings suggest an unanticipated RNA chaperoning role for Npl3 during spliceosome active site formation.

This study evaluates potential associations between the perioperative urinary catheter (UC) carriage and (Gram-negative) surgical site infections (SSIs) after spine surgery. It is a retrospective, single-center, case-control study stratifying group comparisons, case-mix adjustments using multivariate logistic regression analyses. Around half of the patients (2734/5485 surgeries) carried a UC for 1 day (median duration) (interquartile range, 1–1 days). Patients with perioperative UC carriage were compared to those without regarding SSI, in general, and Gram-negative, exclusively. The SSI rate was 1.2% (67/5485), yielding 67 revision surgeries. Gram-negative pathogens caused 16 SSIs. Seven Gram-negative episodes revealed the same pathogen concomitantly in the urine and the spine. In the multivariate analysis, the UC carriage duration was associated with SSI (OR 1.1, 95% confidence interval 1.1–1.1), albeit less than classical risk factors like diabetes (OR 2.2, 95%CI 1.1–4.2), smoking (OR 2.4, 95%CI 1.4–4.3), or higher ASA-Scores (OR 2.3, 95%CI 1.4–3.6). In the second multivariate analysis targeting Gram-negative SSIs, the female sex (OR 3.8, 95%CI 1.4–10.6) and a UC carriage > 1 day (OR 5.5, 95%CI 1.5–20.3) were associated with Gram-negative SSIs. Gram-negative SSIs after spine surgery seem associated with perioperative UC carriage, especially in women. Other SSI risk factors are diabetes, smoking, and higher ASA scores.

Background: Biomechanical analysis of the sagittal alignment of the lumbar spine and pelvis on radiographs is common in clinical practices including chiropractic, physical therapy, scoliosis-related thoraco-lumbo-sacral orthosis (TLSO) management, orthopedics, and neurosurgery. Of specific interest is the assessment of pelvic morphology and the relationship between angle of pelvic incidence, sacral slope, and lumbar lordosis to pain, disability, and clinical treatment of spine conditions. The current state of the literature on the reliability of common methods quantifying these parameters on radiographs is limited. Methods: The objective of this systematic review is to identify and review the available studies on the reliability of different methods of biomechanical analysis of sagittal lumbo-pelvic parameters used in clinical practice. Our review followed the recommendations of the preferred reporting items for systematic reviews and meta-analyses (PRISMA). The design of this systematic review was registered with PROSPERO (CRD42023379873). Results: The search strategy yielded a total of 2387 articles. A total of 1539 articles were screened after deduplication and exclusion by automation tools, leaving 473 full-text articles that were retrieved. After exclusion, 64 articles met the inclusion criteria. The preponderance of the evidence showed good to excellent reliability for biomechanical assessment of sagittal lumbo-pelvic spine alignment. Conclusions: The results of this systematic review of the literature show that sagittal radiographic analysis of spinal biomechanics and alignment of the human lumbo-pelvic spine is a reliable tool for aiding diagnosis and management in clinical settings.

Young children's communication is dependent upon caregivers' responsiveness to their behaviors; however, little is known about the responsiveness of toddler teachers to children in their classrooms. To increase teachers' responsiveness to children's behavior, a peer-coaching model was implemented in three Early Head Start classrooms. The peer-coaching model was developed to (a) increase frequency of appropriate infant/toddler teacher responses to children in their classroom, (b) increase engagement of children, and (c) support early communication of infants and toddlers. This study documented toddlers' communication with their teachers to examine trends in toddler communication and teacher responsiveness. Results of this descriptive study suggest a pattern whereby child communication acts were higher when teachers' responsiveness was higher. This finding supports the need for future research regarding best practices in increasing quality interactions between toddlers and caregivers to support communication development in early care and education settings.

Background: It is highly recommended that professionals promote caregivers' capacity-building to use intervention strategies to support children with developmental delays or disabilities in natural learning environments, particularly in the earliest years of life. There is a gap, however, in understanding the extent to which these professionals may feel supported in tailoring outreach to support parents with Intellectual Disability and/or mental health conditions (MHCs). Methods: We surveyed providers (n = 55) who work with families of infants and toddlers in Early Intervention programs across the United States. Results: Most had at least one family with intellectual disability (87%) or a MHC (92%). At least half felt parents with intellectual disability or MHCs warranted more time/resources (64% or 50%, respectively) and half were "extremely interested" in trainings to support parents with intellectual disability (48%) or MHCs (56%). Conclusions: Findings and implications are discussed.

An early diagnosis of autism spectrum disorder (ASD) can improve outcomes for children and assist families in accessing services. Part C providers are often tasked with screening for ASD. The purpose of this study was to survey Part C providers nationwide to understand their ASD screening practices and training needs and extend a survey conducted by Tomlin and colleagues. A total of 327 providers participated. Results indicated a majority of respondents (75.8%) screen for ASD using a variety of different measures, while only 26.9% are required by their program to conduct universal screenings. Most participants reported feeling confident in screening for ASD, discussing a child's red flags with a family, referring a child for further evaluation, and discussing recent evidence surrounding ASD. An area where providers were less confident was working with interpreters to screen for ASD or discuss screening results and ASD with families with cultural or linguistic diversity. Despite high confidence levels in screening for ASD, a vast majority of participants reported they would be interested in attending a training on screening for ASD. Professional development surrounding screening for ASD and discussing ASD with families from diverse backgrounds may assist in improving Part C provider screening practices.