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Introduction Ambient particulate matter (PM) pollution has been identified as a leading risk factor for global disease burden. (1) Evaluating the risks attributable to PM with aerodynamic diameter [less than [...], BACKGROUND: Studies across the globe generally reported increased mortality risks associated with particulate matter with aerodynamic diameter [less than or equal to]2.5 [micro]m (P[M.sub.2.5]) exposure with large heterogeneity in the magnitude of reported associations and the shape of concentration-response functions (CRFs). We aimed to evaluate the impact of key study design factors (including confounders, applied exposure model, population age, and outcome definition) on P[M.sub.2.5] effect estimates by harmonizing analyses on three previously published large studies in Canada [Mortality-Air Pollution Associations in Low Exposure Environments (MAPLE), 1991-2016], the United States (Medicare, 2000-2016), and Europe [Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), 2000-2016] as much as possible. METHODS: We harmonized the study populations to individuals 65+ years of age, applied the same satellite-derived P[M.sub.2.5] exposure estimates, and selected the same sets of potential confounders and the same outcome. We evaluated whether differences in previously published effect estimates across cohorts were reduced after harmonization among these factors. Additional analyses were conducted to assess the influence of key design features on estimated risks, including adjusted covariates and exposure assessment method. A combined CRF was assessed with meta-analysis based on the extended shape-constrained health impact function (eSCHIF). RESULTS: More than 81 million participants were included, contributing 692 million person-years of follow-up. Hazard ratios and 95% confidence intervals (CIs) for all-cause mortality associated with a 5-[micro]g/[m.sup.3] increase in P[M.sub.2.5] were 1.039 (1.032, 1.046) in MAPLE, 1.025 (1.021, 1.029) in Medicare, and 1.041 (1.014, 1.069) in ELAPSE. Applying a harmonized analytical approach marginally reduced difference in the observed associations across the three studies. Magnitude of the association was affected by the adjusted covariates, exposure assessment methodology, age of the population, and marginally by outcome definition. Shape of the CRFs differed across cohorts but generally showed associations down to the lowest observed P[M.sub.2.5] levels. A common CRF suggested a monotonically increased risk down to the lowest exposure level. https://doi.org/10.1289/EHP12141

The Berkeley MET5, funded by EUREKA, is a 0.5-NA EUV projection lithography tool located at the Advanced Light Source at Berkeley National Lab. Wavefront measurements of the MET5 optic have been performed using a custom in-situ lateral shearing interferometer suitable for high-NA interferometry. In this paper, we report on the most recent characterization of the MET5 optic demonstrating an RMS wavefront 0.31 nm, and discuss the specialized mask patterns, gratings, and illumination geometries that were employed to accommodate the many challenges associated with high-NA EUV interferometry.

BackgroundPsychiatric diagnostic manuals recognise the importance of local expressions of distress in culturally diverse settings [i.e. idioms/cultural concepts of distress (CCDs)], yet there is a lack of consensus on how these should be incorporated into mental health related research.AimsTo perform a narrative synthesis and critical review of research exploring how idioms/CCDs have been integrated into assessment measures and interventions.MethodA systematic review was conducted in accordance with PRISMA guidelines. An adapted version of the COSMIN checklist was used to assess the quality of the linguistic translation of the idioms/CCDs.ResultsTwenty-nine papers were included in the final review. Primary qualitative research was the most common method of gathering information about idioms/CCDs. The majority of studies described integrating idioms/CCDs into assessment measures as opposed to interventions. Some studies used information relating to idioms/CCDs to develop novel assessment measures, while others adapted pre-existing assessment measures. The measures generated moderate to high levels of validity. Information relating to the linguistic translation conducted in the completion of the studies tended to be inadequately reported.ConclusionsIntegrating information about idioms/CCDs into assessment measures can enhance the validity of these assessments. Allocating greater research attention to idioms/CCDs can also promote more equitable exchanges of knowledge about mental health and wellbeing between the Global North and the Global South.

The Berkeley MET5, funded by EUREKA, is a 0.5-NA EUV projection lithography tool located at the Advanced Light Source at Berkeley National Lab. Wavefront measurements of the MET5 optic have been performed using a custom in-situ lateral shearing interferometer suitable for high-NA interferometry. In this paper, we report on the most recent characterization of the MET5 optic demonstrating an RMS wavefront 0.31 nm, and discuss the specialized mask patterns, gratings, and illumination geometries that were employed to accommodate the many challenges associated with high-NA EUV interferometry.

BackgroundWashing hands with soap and lukewarm water for 20 s is a fundamental measure advocated especially within the UK to help control the spread of viral disease. However, these practices can induce irritant contact dermatitis, particularly in healthcare professionals (HCPs). HCPs typically manage their condition by replacing soap or alcohol-based hand sanitizers with cleansers containing mild surfactants and/or emollient ingredients [skin-friendly cleansers (SFCs)] to mitigate skin damage and/or using topical emollients after washing for repair. Despite this widespread practice, there is very limited evidence supporting the efficacy of these interventions in the prevention of viral propagation.MethodologyWithin this study a range of viruses comprising human coronavirus (HCoV), herpes simplex virus (HSV)-1, influenza (IVA), adenovirus (Ad), and murine norovirus (MNV) were tested against multiple hand wash products, including SFCs. In vitro analysis using plaque assays and tissue culture infectious dose 50 (TCID50) were used to assess virus infectability after incubation with the test products (soaps and SFCs) over a range of concentrations and time points. Transmission electron microscopy (TEM) was used to determine virus architecture and size, while viral replication genes were measured by reverse transcription-polymerase chain reaction (RT-PCR).Results/conclusionsEnveloped viruses demonstrated greater susceptibility over a range of test products, suggesting some SFCs are a suitable alternative to soap (depending on the presence of a viral envelope). However, no virucidal activity was observed for non-enveloped viruses. Water type (i.e., soft/hard) and pre-exposed hand hygiene conditions (i.e., clean/dirty) made little difference to the effectiveness of both soaps and SFCs. Therefore, new hand hygiene regimens should be implemented based on trying to encompass all viruses with varying structures, with specific emphasis on the absence of a viral envelope.

Multiple mini interviews (MMIs) have become the mainstay of medical school admission interviews in the United Kingdom. During the COVID-19 pandemic, Government imposed restrictions on the meeting of people indoors precipitated a move towards conducting interviews online. Thus, the development of methodologies to conduct robust MMI style interviews remotely was required. In this article, a validated method for conducting remote MMIs is described. This method of delivery produced comparable candidate scores compared with pre-pandemic in-person interviews and maintained reliability.

Introduction 594 I. Background 594 II. Employment Drug Laws and Policies 596 A. Federal Level 596 1. Drug-Free Workplace Act 597 2. Occupational Health and Safety Act 599 3. Other [...]

Abstract Background GA2LEN‐ADCARE is a branch of the largest multidisciplinary network of research centres and clinical care in allergy and asthma, GA2LEN, focussing on the field of atopic dermatitis (AD). AD is a chronic inflammatory skin disease with high burden and many comorbidities requiring different levels of treatment. The need for aligned information from all involved healthcare providers led to the discussion of an integrated care pathway (ICP) plan for AD patient care involving all stakeholders and considering the complexity and variability of the disease, with a particular focus placed on the large number of patients with milder forms of AD. Methods The GA2LEN ADCARE network and all stakeholders, abbreviated the AD‐ICPs working group, were involved in the discussion and preparation of the AD‐ICPs during a series of subgroup workshops and meetings in years 2020 and 2021. Results Here we discuss the unmet needs in AD, the methodology for devising an AD‐ICP and the ICP action plan. Conclusion The GA2LEN ADCARE network has outlined the unmet needs in AD and provided an action plan for devising AD‐ICPs, considering the complexity and variability of the disease.

This case report is a reflective narrative, documenting the methods used to develop a policy framework for a National Strategy on Climate, Health and Well-being for Australia. The report aims to guide advocates, communities of practice, and governments in developing a comprehensive policy response to climate change and its health impacts.

Infectious bronchitis virus (IBV) is an avian coronavirus that causes a disease in chickens known as infectious bronchitis (IB). The pathogenesis of IBV and the host immune responses against it depend on multiple factors such as the IBV variant, breed and age of the chicken, and the environment provided by the management. Since there is limited knowledge about the influence of the sex of chickens in the pathogenesis of IBV, in this study we aim to compare IBV pathogenesis and host immune responses in young male and female chickens. One-week-old specific pathogen-free (SPF) White Leghorn male and female chickens were infected with Canadian Delmarva (DMV)/1639 IBV variant at a dose of 1 × 106 embryo infectious dose (EID)50 by the oculo-nasal route while maintaining uninfected controls, and these chickens were euthanized and sampled 4- and 11-days post-infection (dpi). No significant difference was observed between the infected male and female chickens in IBV shedding, IBV genome load in the trachea, lung, kidney, bursa of Fabricius (BF), thymus, spleen, and cecal tonsils (CT), and IBV-induced lesion in all the examined tissues at both 4 and 11 dpi. In addition, there was no significant difference in the percentage of IBV immune-positive area observed between the infected male and female chickens in all tissues except for the kidney, which expressed an increased level of IBV antigen in infected males compared with females at both 4 and 11 dpi. The percentage of B lymphocytes was not significantly different between infected male and female chickens in all the examined tissues. The percentage of CD8+ T cells was not significantly different between infected male and female chickens in all the examined tissues except in the trachea at 11 dpi, where female chickens had higher recruitment when compared with male chickens. Overall, although most of the findings of this study suggest that the sex of chickens does not play a significant role in the pathogenesis of IBV and the host immune response in young chickens, marginal differences in viral replication and host responses could be observed to indicate that IBV-induced infection in male chickens is more severe.

Infectious bronchitis virus (IBV) causes infectious bronchitis disease in chickens. IBV primarily infects the upper respiratory tract and then disseminates to other body systems including gastrointestinal, reproductive, and urinary systems. Unlike original IBV serotypes, the novel IBV variants target lymphoid organs, but information on this is scarce. In this study, we aim to evaluate the impact of the presence of maternal antibodies on IBV infection in primary and secondary lymphoid organs. Maternal antibody free, specific pathogen free (SPF) hens were divided into vaccinated and non-vaccinated groups. The progeny male chicks from these hens were divided into four groups; vaccinated challenged (VC), non-vaccinated challenged (NVC), vaccinated non-challenged (VNC), and non-vaccinated non-challenged (NVNC). The challenge groups were given 1 × 106 embryo infectious dose (EID)50 of IBV Delmarva (DMV)/1639 by the oculo-nasal route and non-challenge groups were given saline. The serum anti-IBV antibody titer was significantly higher in challenged groups compared to non-challenged groups. The IBV genome load was significantly lower in the VC group than NVC group in oropharyngeal and cloacal swabs and in bursa of Fabricius (BF) and cecal tonsils (CT). The histopathological lesion scores were significantly lower in VC group than NVC group in BF and CT. These findings suggest that the presence of maternal antibody in chicks could provide some degree of protection against IBV infection in BF and CT.

In this article we explore the United Kingdom context of apprenticeships and the history of development of the use of the term apprentice in medicine. We describe the development of the Medical Doctor Degree Apprenticeship (MDDA) in England and how Anglia Ruskin University (ARU) has approached the development of the MDDA. We explore the rationale for developing the MDDA in Essex, the structure of the apprenticeship at ARU (which comprises 20% of employed time in NHS work and 80% in education undertaking the medical degree), the challenges and issues we encountered and mitigations we put in place. We describe the importance of stakeholder engagement (especially with direct entry medical students, medical professionals, and members of the university staff). The role of the employer is critical to the development and delivery of MDDA. The important role of regulators in developing and monitoring MDDA is the complexity of funding arrangements. Finally, we offer reflections on the development journey thus far. [ABSTRACT FROM AUTHOR]

This comprehensive integrated literature review provides evidence-based information on mindfulness meditation as a primary care treatment for anxiety. A variety of databases were utilized for article collection including MEDLINE Complete, CINAHL Plus with full text, Cochrane library, APA PsycInfo, APA PsycTests, Health Source: Nursing/Academic Edition, and PsycARTICLES. Research suggests anxiety can be treated effectively with a minimum of 8 weeks of meditation practice. Meditation is a cost effective and safe treatment modality that can be incorporated into the care of patients struggling with anxiety. [ABSTRACT FROM AUTHOR]

Purpose: Diffusion encoding gradient waveforms can impart intra‐voxel and inter‐voxel dephasing owing to bulk motion, limiting achievable signal‐to‐noise and complicating multishot acquisitions. In this study, we characterize improvements in phase consistency via gradient moment nulling of diffusion encoding waveforms. Methods: Healthy volunteers received neuro (N=10$$ N=10 $$) and cardiac (N=10$$ N=10 $$) MRI. Three gradient moment nulling levels were evaluated: compensation for position (M0$$ {M}_0 $$), position + velocity (M1$$ {M}_1 $$), and position + velocity + acceleration (M1+M2$$ {M}_1+{M}_2 $$). Three experiments were completed: (Exp‐1) Fixed Trigger Delay Neuro DWI; (Exp‐2) Mixed Trigger Delay Neuro DWI; and (Exp‐3) Fixed Trigger Delay Cardiac DWI. Significant differences (p<0.05$$ p<0.05 $$) of the temporal phase SD between repeated acquisitions and the spatial phase gradient across a given image were assessed. Results: M0$$ {M}_0 $$ moment nulling was a reference for all measures. In Exp‐1, temporal phase SD for Gz$$ {G}_z $$ diffusion encoding was significantly reduced with M1$$ {M}_1 $$ (35% of t‐tests) and M1+M2$$ {M}_1+{M}_2 $$ (68% of t‐tests). The spatial phase gradient was reduced in 23% of t‐tests for M1$$ {M}_1 $$ and 2% of cases for M1+M2$$ {M}_1+{M}_2 $$. In Exp‐2, temporal phase SD significantly decreased with M1+M2$$ {M}_1+{M}_2 $$ gradient moment nulling only for Gz$$ {G}_z $$ (83% of t‐tests), but spatial phase gradient significantly decreased with only M1$$ {M}_1 $$ (50% of t‐tests). In Exp‐3, M1+M2$$ {M}_1+{M}_2 $$ gradient moment nulling significantly reduced temporal phase SD and spatial phase gradients (100% of t‐tests), resulting in less signal attenuation and more accurate ADCs. Conclusion: We characterized gradient moment nulling phase consistency for DWI. Using M1 for neuroimaging and M1 + M2 for cardiac imaging minimized temporal phase SDs and spatial phase gradients. [ABSTRACT FROM AUTHOR]

Background The main conventional systemic treatments for atopic dermatitis (AD) are methotrexate (MTX) and ciclosporin (CyA). Dupilumab was the first novel systemic agent to enter routine clinical practice. There are no head-to-head randomized controlled trials or real-world studies comparing these agents directly. Network meta-analyses provide indirect comparative efficacy and safety data and have shown strong evidence for dupilumab and CyA. Objectives To compare the real-world clinical effectiveness and safety of CyA, dupilumab and MTX in AD. Methods We compared the effectiveness and safety of these systemic agents in a prospective observational cohort study of adult and paediatric patients recruited into the UK–Irish Atopic eczema Systemic TherApy Register (A-STAR). Treatment effectiveness measures included Eczema Area and Severity Index (EASI), Patient-Oriented Eczema Measure (POEM), Peak Pruritus Numerical Rating Scale (PP-NRS), Dermatology Life Quality Index (DLQI) and children's DLQI (cDLQI). The minimum duration of treatment was 28 days and follow-up was 12 months. Adjusted Cox-regression analysis was used to compare the hazard ratios of achieving EASI-50, EASI-75 and EASI-90 over time, and linear mixed-effects models were used to estimate changes in efficacy scores. Treatment safety was assessed by examining adverse events (AEs) at follow-up visits. Results We included 488 patients (311 adults and 177 children/adolescents) on dupilumab (n = 282), MTX (n = 149) or CyA (n = 57). CyA and MTX were primarily used as the first-line treatment, while dupilumab was mainly a second-line systemic treatment as per UK National Institute of Clinical and Care Excellence (NICE) recommendations. EASI-50, EASI-75 and EASI-90 were achieved more rapidly in the dupilumab and CyA groups compared with MTX. After adjustment for previous severity, the reduction in EASI, POEM, PP-NRS and DLQI was greater for patients treated with dupilumab compared with MTX. In patients with severe disease the reduction in EASI, POEM and PP-NRS was even greater with CyA. The incidence rates of AEs were similar across groups (734, 654 and 594 per 10 000 person-month on CyA, dupilumab and MTX, respectively). Conclusions This real-world comparison of CyA, dupilumab and MTX in AD suggests that dupilumab is consistently more effective than MTX and that CyA is most effective in very severe disease within 1 year of follow-up. [ABSTRACT FROM AUTHOR]

Objective: This study aims to assess the efficacy and safety of combining the 308-nm Excimer lamp with Tacrolimus 0.1% ointment, compared to Tacrolimus 0.1% ointment monotherapy, for treating pediatric vitiligo involving less than 10% of the body surface area. Methods: Fifty pediatric patients with vitiligo were randomly assigned to two groups. Group A received Tacrolimus 0.1% ointment twice daily and Excimer light at 308-nm twice weekly, while Group B received Tacrolimus 0.1% ointment alone, administered twice daily. Repigmentation percentages were evaluated after 30, 90, and 180 days using the rule of nine. Results: Group A exhibited a significant improvement in repigmentation, increasing from 10% after one month to 65% after six months. In contrast, Group B observed an increase from 10% to 30% over the same timeframe. The efficacy of the treatment was significantly higher in Group A at both the 3-month and 6-month follow-up points (p-value <.001). Moreover, Group A achieved notably higher repigmentation rates in the face, trunk, and lower limbs. Conclusion: The combination of Tacrolimus and the 308-nm excimer lamp yielded superior repigmentation results compared to Tacrolimus monotherapy in pediatric vitiligo patients. This combined approach may offer an effective new treatment protocol for pediatric vitiligo. [ABSTRACT FROM AUTHOR]

The demand for nurses working in general practice settings is rapidly outstripping supply. This article outlines an initiative aimed at hosting students in general practice. Workforce shortages in primary care are widely recognised and reported. Increasing student nurses in primary care is seen as a key strategy for encouraging nursing students to opt for a career in primary care. However the organisation of placements generally means that adult nursing students are hosted by secondary care in acute NHS Trusts. Consequently, the majority of placements occur within the acute Trust and while adult nursing students may undertake placements in primary care, these are usually one-off rotational, elective or spoke placements. As a consequence completing students are far more likely to take up a post in secondary care, usually within their host Trust. This paper reports on a project which aimed to introduce general practice as a host organisation and in so doing 'flipping' the placement pattern allowing students to spend the majority of their placement time in primary care placements. [ABSTRACT FROM AUTHOR]

In 2019, sales of American agricultural products to China nearly dried up as Beijing retaliated against U.S. tariffs on Chinese imports. We solicited farmers' perceptions of risks engendered by the trade dispute through a survey of 304 corn and soybean growers in the states of Iowa, Illinois, and Minnesota. We found that farmers' risk perceptions were affected more by psychometric factors. That is, they expressed fear and dread about the trade war fallout in the perceived absence of credible information regarding government plans of action, updates on trade negotiations, and expert recommendations. Findings point to the value of including farmers' perspectives to help navigate negotiations regarding future trade disputes. [ABSTRACT FROM AUTHOR]

Ovarian torsion during pregnancy is a fairly uncommon complication with a high patient morbidity and fetal mortality if not immediately treated. Ovarian torsion should be considered a clinical diagnosis, and a high level of clinical suspicion is needed by the practitioner to ensure that this diagnosis is not missed. We present an unusual case of intermittent ovarian torsion discussing both the presentation and the operative and post-operative management.