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Abstract People affected by rare diseases want to be involved in research and the search for new treatments. Randomized controlled trials remain the best way of finding new interventions, but many elements of traditional study design are not best suited for rare diseases. Barriers to patients and families include the use of specialist hospital sites for recruitment, requiring frequent site-based study visits for data collection, and a high burden of tests and outcome measures in research. While decentralized clinical trial (DCT) designs have been developed in some rare disease trials, changes necessitated by the COVID-19 pandemic present an opportunity for them to become a standard approach. DCT approaches have been shown to be more resilient to changes in enrolment and attrition during COVID-19 than traditional designs and offer benefits in terms of patient burden, convenience, inclusion, and data quality. Digital tools such as wearable devices and electronic clinical outcome assessments may also provide more convenient and environmentally valid measures of how a condition affects the life of an individual in their regular environment (e.g. mobility around the home versus a hospital corridor). Digital solutions have greater ability to support language localization, accessibility, and may lead to increase access to global rare disease trials. In parallel, challenges exist, such as the technical support, the digital divide, ensuring high quality data, and delivering safe trials.

Abstract The success of conservation initiatives often depends on the inclusion of diverse stakeholder interests in the decision‐making process. Yet, there is a paucity of empirical knowledge concerning the factors that explain why stakeholders do—or do not— believe that they are meaningfully represented by government agencies. Our study provides insight into the relationship between trust and stakeholder perceptions of inclusivity in public land management decisions. Here, we focus on the U.S. state of Alaska, where almost two‐thirds of the land area are managed by the federal government. We used structural equation modelling to test whether an individual's trust and the information sources used to learn about land management positively influenced perceived inclusivity. We conceptualized trust in terms of four dimensions that reflected an individual's disposition to trust, trust in the federal government, trust in shared values and trust that agencies adhere to a moral code. We found that survey respondents across the U.S. state of Alaska had a limited disposition to trust others, did not trust federal land management agencies, did not believe agencies shared their values pertaining to protected area management and did not believe that agencies adhered to a moral code. Beliefs about the morality of agencies were the primary driver of perceived inclusivity in land management decisions, indicating that agencies should focus on solving problems through deliberation and discussion about moral principles rather than by force. Information acquired from professional, community‐based or environmental advocacy exchanges also positively influenced perceived levels of involvement among stakeholders in resource management decisions. These results provide a roadmap for how land management agencies can improve public relations and work towards a model of inclusive conservation around protected areas. Read the free Plain Language Summary for this article on the Journal blog.

IntroductionThis paper examines the relationship between gender-based violence (GBV) and religion in a range of forced displacement contexts. While it has been acknowledged that religion frequently shapes experiences of GBV survivors, little is known about the influences of religion on GBV experiences in forced displacement and its potential role in strengthening interventions.MethodsUtilizing empirical evidence from 58 interviews from the SEREDA project with forced migrants in Sweden, UK, Turkey and Australia, we outline the interactions between religious resources and GBV in migrants' forced displacement experiences. We conceptualise religious resources as comprising religious ideas, religious practices, religious experience and religious organization.ResultsSurvivors talked about religion spontaneously when responding to questions relating to resilience, coping mechanisms, and risk factors. Religion acted as both a “protective” and “risk” factor for GBV experiences. Religious beliefs were assets in coping with GBV experiences, but also contributed to creating an environment in which violence was normalized, exposing women to further harm. Religious practices supported survivors emotionally to cope with GBV but also some practices posed risks. Religious organizations in many cases served as a lifeline for many displaced women, offering practical and emotional support, however religious leaders at times encouraged survivors to stay in abusive relationships. Religious experiences “empowered” and “disempowered” survivors across the processes of forced migration.DiscussionWe demonstrate the relevance and importance of acknowledging the role of religion in the experiences of GBV in forced displacement. Our analysis advances the understanding of religious resources as both protective and risk factors that affect forced migrants' experiences of GBV over time and place. We suggest a way forward for practitioners and researchers to account for the roles of religion in experiences of GBV and forced displacement, as opportunities and barriers to GBV prevention and response, and to work with religious leaders and local faith communities to strengthen protection of survivors.

The functionality and performance of public health programmes at all levels of government play a critical role in preventing, detecting, mitigating and responding to public health threats, including infectious disease outbreaks. Multiple and concurrent outbreaks in recent years, such as COVID-19, Ebola and Zika, have highlighted the importance of documenting lessons learnt from public health responses of national and global agencies. In February 2020, the US Centers for Disease Control and Prevention (CDC) Center for Global Health (CGH) activated the Measles Incident Management System (MIMS) to accelerate the ability to detect, mitigate and respond to measles outbreaks globally and advance progress towards regional measles elimination goals. The activation was triggered by a global resurgence in reported measles cases during 2018–2019 and supported emergency response activities conducted by partner organisations and countries. MIMS leadership decided early in the response to form an evaluation team to design and implement an evaluation approach for producing real-time data to document progress of response activities and inform timely decision-making. In this manuscript, we describe how establishing an evaluation unit within MIMS, and engaging MIMS leadership and subject matter experts in the evaluation activities, was critical to monitor progress and document lessons learnt to inform decision making. We also explain the CDC’s Framework for Evaluation in Public Health Practice applied to evaluate the dynamic events throughout the MIMS response. Evaluators supporting emergency response should use a flexible framework that can be adaptable in dynamic contexts and document response activities in real-time.

Funded through a grant from Texas Workforce Commission, DesignHER Code Camps were created to use the fashion interests of underserved middle school girls as springboards to interest them in science, technology, engineering, and math (STEM). Results were generally consistent with the achievement of camp goals--(a) increase the interest of middle school girls in coding and other STEM fields, and (b) provide hands-on experiences related to the fashion industry that simultaneously foster interest in STEM-related careers--although changes in interest in STEM careers were not statistically significant. This type of experience contributes to the growing recognition that FCS content can play a vital role in the development of STEM concepts for youth.

In education, looping is defined as a continuous movement where a student has the same teacher for multiple years in a row. This strategy began in the 20th century by an Australian educator, Rudolf Steiner. This type of teaching was a success in Europe and was eventually called the Waldorf School Movement. This movement was founded on his reality and innovative teachings of the social pedagogy. He was insistent that the teacher and child accompany each other through a full eight years of school to make sure that their relationship was fully developed. He believes that building a relationship was more essential than the instructional components in a classroom. There are approximately 1,000 privately operated Waldorf schools, Steiner schools, or Steiner-Waldorf schools located worldwide in various countries that use looping. (waldorfeducation.org, 2015) Even though this type of education is common in other parts of the world, the Unites States has not fully embraced this style of teaching.

Abstract It is increasingly recognized that involving patients and the public in the design of clinical trials can lead to better recruitment, retention, and satisfaction. A recent scoping review determined that between 1985 and 2018, just 23 articles meeting quality criteria obtained feedback from clinical trial participants after a trial had been completed. In a timespan that presumably included thousands of trials across hundreds of indications, the paucity of the literature seems surprising, if not outright disappointing. By contrast, practitioners in the life sciences industry are increasingly incorporating patient research into their trial design process before, during, and after trial completion. Examples of approaches used include recruitment of “look alike” participant samples through online communities, surveys, and the use of smartphone apps to directly record participants’ spoken reactions to trial materials like recruitment materials, site visit schedules, or informed consent materials. However, commercial organizations tend not to publish their findings, leading to a potential two-tier experience for trial participants depending on whether the trial they participate in will be industry-funded or government-funded. This seems problematic on a number of levels. Increasing regulatory, funder, and publisher interest in improving the inclusivity of clinical trial participants may act as a timely lever to spur patient-centered coproduction of trials. Until continuous feedback processes are the mandated, funded, and published norm, participating in a clinical trial will be more arduous than it needs to be.

Abstract Traditional clinical trials have often failed to recruit representative participant populations. Just 5% of eligible patients participate in clinical research. Participants, particularly those from minority groups, cite geographical constraints, mistrust, miscommunication, and discrimination as barriers. Here, an intersectional view of inclusion in clinical trials provides significant insights into the complex and counterintuitive challenges of trial design and participant recruitment. The US FDA have recently proposed that decentralized clinical trials (DCTs) might reduce barriers and appeal to a wider range of participants by reducing the costs and commitments required for patients to participate. While common sense and early evidence suggests that allowing participants to take part in trials at or near home has advantages in terms of convenience, travel, and perhaps even infection control, it remains to be seen if DCT approaches will yield significant improvements on participant inclusivity. Some digital studies aiming to be more inclusive on a single element of inclusion, such as race, have experienced unintended consequences in other elements, like education or gender. Implementing DCTs presents new challenges including the digital divide, the exclusion of certain tests and procedures, complexities of at-home medication delivery, and the need to build new infrastructure. We present a range of challenges and opportunities for researchers to adopt and adapt DCT approaches to create reliable evidence that applies to all of us.

The gut microbiota prevents harmful microbes from entering the body, a function known as colonization resistance. The enteric pathogen Salmonella enterica serovar (S.) Typhimurium uses its virulence factors to break colonization resistance through unknown mechanisms. Using metabolite profiling and genetic analysis, we show that the initial rise in luminal pathogen abundance was powered by a combination of aerobic respiration and mixed acid fermentation of simple sugars, such as glucose, which resulted in their depletion from the metabolome. The initial rise in the abundance of the pathogen in the feces coincided with a reduction in the cecal concentrations of acetate and butyrate and an increase in epithelial oxygenation. Notably, these changes in the host environment preceded changes in the microbiota composition. We conclude that changes in the host environment can weaken colonization resistance even in the absence of overt compositional changes in the gut microbiota. [Display omitted] • Glucose fuels virulence factor-driven growth of Salmonella in the murine cecum • Colonization resistance becomes impaired when microbiota is compositionally intact • Colonization resistance is compromised when inflammation disrupts epithelial hypoxia • Aerobic respiration and fermentation of sugars support Salmonella outgrowth Rogers et al. show that Salmonella overcomes colonization resistance when the microbiota is compositionally intact by disrupting epithelial hypoxia. Pathogen outgrowth is fueled by catabolizing simple sugars, such as glucose, using a combination of aerobic respiration and mixed acid fermentation. [ABSTRACT FROM AUTHOR]

Venezuelan equine encephalitis virus (VEEV) outbreaks occur sporadically. Additionally, VEEV has a history of development as a biothreat agent. Yet, no FDA-approved vaccine or therapeutic exists for VEEV disease. The sporadic outbreaks present a challenge for testing medical countermeasures (MCMs) in humans; therefore, well-defined animal models are needed for FDA Animal Rule licensure. The cynomolgus macaque (CM) model has been studied extensively at high challenge doses of the VEEV Trinidad donkey strain (>1.0 × 108 plaque-forming units [PFU]), doses that are too high to be a representative human dose. Based on viremia of two subtypes of VEEV, IC, and IAB, we found the CM infectious dose fifty (ID50) to be low, 12 PFU, and 6.7 PFU, respectively. Additionally, we characterized the pattern of three clinical parameters (viremia, temperature, and lymphopenia) across a range of doses to identify a challenge dose producing consistent signs of infection. Based on these studies, we propose a shift to using a lower challenge dose of 1.0 × 103 PFU in the aerosol CM model of VEEV disease. At this dose, NHPs had the highest viremia, demonstrated a fever response, and had a measurable reduction in complete lymphocyte counts—biomarkers that can demonstrate MCM efficacy.

The purpose of our study was twofold: (1) to review the literature on high-stakes accountability testing and English learners (ELs) in the USA, applying qualitative systematic review methodology, and (2) to draw substantive conclusions about the impact of high-stakes accountability testing on ELs, reported in studies published between 2001 and 2016. Thirty-seven studies (n = 37) meeting the eligibility criteria were evaluated using the Methodological Quality Questionnaire. Findings indicate construct irrelevant variance (non-random factors that systematically affect ELs' test performance) challenges the appropriateness of inferences drawn about ELs' content knowledge based on assessment performance. Further, language policy in schools, driven by high-stakes tests, promotes increased instructional time for basic skills tutorials with fewer opportunities for problem solving and other higher-order learning activities. Moreover, theory utilization was rare (n = 8, 22%). Among studies that utilized theory, few explicitly referenced it to discuss study findings.

This paper focuses on nostalgia in the narratives of vocational teachers. The aim is to understand the role of nostalgia as a mechanism for adapting to or resisting educational change. The paper is based on the secondary analysis of semi-structured interviews with 30 Estonian vocational teachers. In the teachers' narratives, the nostalgia for the former vocational education system, which provided more autonomy and empowerment for teachers in their work, was overlaid with the nostalgia for a society with more stable family and work-life patterns and trusting attitudes towards vocational teachers. Although there were examples where the nostalgic narratives were strategically used to legitimize resistance to change, in most cases, nostalgia tends to serve as the mechanism for making sense of the educational changes teachers have been faced with. Nostalgia also contributes to making sense of oneself as a teacher in a new situation and collective identity building. It is argued in the paper that we should acknowledge the positive functions of nostalgia and create support mechanisms to facilitate sense-making and critical reflection upon the changes for teachers. Nostalgia should be recognized as a productive force indicating the contradictions in present reforms and practices and opening up new directions.

This study investigated performance variability when graduate students critically appraised original studies from a systematic review. Fourteen doctoral students from different academic programs, with no systematic review experience, received training on the Methodological Quality Questionnaire (MQQ) rating scale. Participants were mostly male (71%) and non-native English speakers (79%). Each rater was randomly assigned one original study to independently assess using the MQQ. Their scores were compared to an expert rater. Statistical analysis comprised the following: percentage of agreement (POA), Kappa coefficient, and Kendall's tau-b correlation. On the completed MQQ rating scale, 43% of the novice raters had a POA of 78% or higher with the expert rater. From this case study, a guide for improving training on methodological quality assessment was developed. Benefits include the following: (a) developing and supporting critical reasoning as well as problem-solving skills and (b) increasing research skills and competencies in the systematic review process.

Follow-up studies of clustering by academic major, the dynamic of 25% or more of the student-athletes on a roster pursuing the same academic major, indicate that it still occurs in revenue-generating sports. Research on clustering is absent in member institutions of different NCAA divisions, institutions with unique missions, specifically historically Black colleges and universities (HBCUs). This study examined the academic majors of student-athletes in football and basketball at select HBCUs by obtaining data about academic majors from institutional media guides. The results revealed that clustering occurred at eighteen of the twenty-two. From these results, clustering by academic major is not just an issue at "big time" institutions, but potentially a widespread issue across collegiate athletics.

Depression is one of the most common, disabling, and lethal (e.g., suicide) forms of psychopathology. Nearly 300 million people struggle with depression worldwide, and it is the leading cause of disability for people ages 15-44. Unfortunately, most people with depression do not receive the treatment they need. There is limited access to mental health services, and when services are available, the treatments used tend to have limited scientific support. This is because many mental health professionals are not trained in empirically supported treatments, are ambivalent about the role of science in clinical practice, and have limited access to scientific research (e.g., journal paywalls). The purpose of this special issue article is to provide a free and easy to use primer on Cognitive Behavioral Therapy (CBT) for depression. CBT is the most studied form of psychotherapy, has a strong theoretical basis, can be implemented by therapists of varying experience levels, and is as effective or more effective than existing treatments, including medication. CBT may not work for every client, but it is the best place to start. In this article, we discuss: a) why CBT should be the first-line treatment for depression, b) the theoretical basis of CBT for depression, and c) a basic overview of how to administer 12 sessions of CBT for depression. We also provide a reading list and supplemental open-access materials (e.g., a cognitive skills workbook) for further education.

PTSD is a chronic and disabling condition associated with psychiatric and medical comorbidity and diminished quality of life. Military Veterans are at increased risk for developing PTSD, and combat-related PTSD may be more difficult to treat than civilian PTSD. Both Prolonged Exposure and Cognitive Processing Therapy are empirically supported treatments for PTSD in military populations with a strong empirical foundation. However, they require considerable resources to implement and can be difficult for providers and patients to learn. To address these limitations, we created Behavioral Therapy for Anxiety and PTSD (BTAP), which is a simple, behavior-based therapy rooted in learning theory. Building on empirically established therapies such as Prolonged Exposure, BTAP has a singular focus on identifying, reducing, and countering safety behaviors that maintain PTSD. Because it only focuses on safety behaviors, it is simple to learn and implement; therapist trainings are one day, and follow-up consultation provided as needed. In this special issue article, we describe the BTAP protocol as well as provide real world case examples from Veterans to illustrate key components of the treatment. We also present data from five Veteran patients that demonstrate feasibility, acceptance, and preliminary evidence of effectiveness. Patients reported significant reductions in PTSD symptoms, depressive symptoms, intrusions, and safety behaviors. This work suggests that BTAP for treating PTSD merits further investigation.

The objective of this study was to evaluate the association between exposure to heavy metals and oxidative DNA damage among residents living in the potentially more polluted downstream (Akaki-Kality) area of Addis Ababa, in comparison to the upstream area (Gullele). For this, 8-hydroxy-2′-deoxyguanosine (8-OHdG) was used as a biomarker for oxidative DNA damage and heavy metals (Fe, Zn, Mn, Cu, Ni, Cr, Pb, As) as indicators of exposure. The concentrations of heavy metals in nails were determined using inductively coupled plasma optical emission spectroscopy (ICP-OES), and 8-OHdG in urine using Enzyme-Linked with Immunosorbent Assay (ELISA), from 95 residents of the two areas, upstream and downstream. The urinary 8-OHdG concentration was not significantly different (p = 0.05) between the two Sub-Cities, with mean of 18.50 ± 4.37 ng/mg Creatinine in Akaki-Kality and 17.30 ± 5.83 ng/mg Creatinine in Gullele. Also, there were no statistically significant (p = 0.05) difference among the different demographic groups according to gender, age, educational status, body mass index or habit of alcohol consumption. However, the interactions of sex with age, sex with alcohol consumption and alcohol consumption with education were found to affect the urinary 8-OHdG levels of residents of the two Sub-Cities. The mean concentrations (µg/g) of the elements were 488 and 1035 for Fe, 106 and 251 for Zn, 13.0 and 31.2 for Mn, 5.23 and 6.63 for Cu, 11.2 and 7.39 for Ni, 2.23 and 2.02 for Cr, 0.09 and 0.63 for Pb; and 0.16 and 0.25 for As, in nail samples from Akaki-Kality and Gullele, respectively. The determined concentrations of the heavy metals in nails were not significantly associated (p = 0.05) with the corresponding urinary levels of 8-OHdG. Hence, the observed 8-OHdG might have been caused by environmental exposure to toxic substances other than the analyzed heavy metals.

Objective Synthesising evidence of the effects of interventions to improve work participation among people with health problems is currently difficult due to heterogeneity in outcome measurements. A core outcome set for work participation is needed.Study design and setting Following the Core Outcome Measures in Effectiveness Trials methodology, we used a five-step approach to reach international multistakeholder consensus on a core outcome set for work participation. Five subgroups of stakeholders took part in two rounds of discussions and completed two Delphi voting rounds on 26 outcomes. A consensus of ≥80% determined core outcomes and 50%–80% consensus was required for candidate outcomes.Results Fifty-eight stakeholders took part in the Delphi rounds. Core outcomes were: ‘any type of employment including self-employment’, ‘proportion of workers that return to work after being absent because of illness’ and ‘time to return to work’. Ten candidate outcomes were proposed, among others: ‘sustainable employment’, ‘work productivity’ and ‘workers’ perception of return to work’.Conclusion As a minimum, all studies evaluating the impact of interventions on work participation should include one employment outcome and two return to work outcomes if workers are on sick leave prior to the intervention.

IntroductionChildhood diarrhea is one of the major contributors to the morbidity of under-five children in Ethiopia. Although researchers determine the risk factors varyingly, the exposure route to the pathogens is usually complicated. This study aims to investigate the prevalence and risk factors of diarrhea among children under the age of five among wastewater irrigation farming households in Addis Ababa, Ethiopia.MethodsCross-sectional study was conducted among 402 farming households from November 2021 to February 2022. Data was collected using a face-to-face interviewer-administered questionnaire. Stata version 14 software was used to analyze data. Factors associated with the prevalence of diarrhea was identified using binary logistic regression. Multivariable analysis was carried out to determine an adjusted odds ratio at a confidence level of 95% and level of significance at 0.05.ResultsThe overall prevalence of under-five children diarrheal cases was 22.3%. The odds of diarrhea are associated with a multitude of variables. Major wastewater-related determinants associated with diarrhea are body washing with irrigation water [AOR: 37.7, 95%CI (3.1, 358)], contaminated cloth with irrigation water [AOR:10.8,95%CI(0.6, 205)], use of protective clothing during farm work [28.9,95%CI (3.9, 215)], use of farm work cloths at home [AOR: 31.7, 95%CI (4.4, 226)], and bringing unwashed farm tools to home [94 (5.7, 1575)].ConclusionThe high prevalence of under-five children diarrheal disease among wastewater irrigation households was strongly associated with factors related to occupational exposure. Thus, to decrease childhood diarrheal among urban agriculture farmers, appropriate precautions need to be taken.

BackgroundPaediatric trials must contend with many challenges that adult trials face but often bring additional obstacles. Decentralised trials, where some or all trial methods occur away from a centralised location, are a promising strategy to help meet these challenges. This scoping review aims to (a) identify what methods and tools have been used to create and conduct entirely online-decentralised trials with children and (b) determine the gaps in the knowledge in this field. This review will describe the methods used in these trials to identify their facilitators and the gaps in the knowledge.MethodsThe methods were informed by guidance from the Joanna Briggs Institute and the PRISMA extension for scoping reviews. We systematically searched MEDLINE, CENTRAL, CINAHL, and Embase databases, trial registries, pre-print servers, and the internet. We included randomised and quasi-randomised trials conducted entirely online with participants under 18 published in English. A risk of bias assessment was completed for all included studies.ResultsTwenty-one trials met our inclusion criteria. The average age of participants was 14.6 years. Social media was the most common method of online recruitment. Most trials employed an external host website to store and protect their data. Duration of trials ranged from single-session interventions up to ten weeks. Fourteen trials compensated participants. Eight trials involved children in their trial design process; none reported compensation for this. Most trials had a low risk of bias in "random sequence generation", "selective reporting", and "other". Most trials had a high risk of bias in "blinding participants and personnel", "blinding of outcome assessment", and "incomplete outcome data". "Allocation concealment" was unclear in most studies.ConclusionsThere was a lack of transparent reporting of the recruitment, randomisation, and retention methods used in many of the trials included in this review. Patient and public involvement (PPI) was not common, and the compensation of PPI partners was not reported in any study. Consent methods and protection against fraudulent entries to trials were creative and thoroughly discussed by some trials and not addressed by others. More work and thorough reporting of how these trials are conducted is needed to increase their reproducibility and quality.Ethics and disseminationEthical approval was not necessary since all data sources used are publicly available.

Community-engaged research partnerships promote health equity through incorporation of regional contexts to inform partnership dynamics that shape research and interventions that reflect community voice and priorities. Long-term partnerships build trusted relationships and promote capacity building among community and academic partners, but there are many structural barriers to sustaining long-term partnerships. Here we describe lessons learned from sustaining Rochester Healthy Community Partnership (RHCP), an 18-year community-based participatory research (CBPR) partnership in Southeast Minnesota. RHCP collaborates with immigrant and refugee populations to co-create interventions that promote health equity for community health priorities. Challenges to sustainability include a tension between project-based funding and the needs of long-term community-based research infrastructure. These challenges can be met with a focus on shared CBPR principles, operating norms, partnership dynamics, and governance. RHCP began in 2004 through identification of a community health priority, defining the community, and establishment of CBPR principles. It grew through identification of broader community health priorities, capacity building for community and academic partners, and integration of diverse learners. We describe the capacity for RHCP to respond to new societal contexts, the importance of partnership dynamics as a barometer for partnership health, and lessons learned about sustainability of the CBPR partnership.

Summary: An estimated 70% of the electricity in the United States currently passes through power conversion electronics, and this percentage is projected to increase eventually to up to 100%. At a global scale, wide adoption of highly efficient power electronics technologies is thus anticipated to have a major impact on worldwide energy consumption. As described in this perspective, for power conversion, outstanding thermal management for semiconductor devices is one key to unlocking this potentially massive energy savings. Integrated microscale cooling has been positively identified for such thermal management of future high-heat-flux, i.e., 1 kW/cm2, wide-bandgap (WBG) semiconductor devices. In this work, we connect this advanced cooling approach to the energy impact of using WBG devices and further present a techno-economic analysis to clarify the projected status of performance, manufacturing approaches, fabrication costs, and remaining barriers to the adoption of such cooling technology.

The ability to actively regulate heat flow at the nanoscale could be a game changer for applications in thermal management and energy harvesting. Such a breakthrough could also enable the control of heat flow using thermal circuits, in a manner analogous to electronic circuits. Here we demonstrate switchable thermal transistors with an order of magnitude thermal on/off ratio, based on reversible electrochemical lithium intercalation in MoS2 thin films. We use spatially-resolved time-domain thermoreflectance to map the lithium ion distribution during device operation, and atomic force microscopy to show that the lithiated state correlates with increased thickness and surface roughness. First principles calculations reveal that the thermal conductance modulation is due to phonon scattering by lithium rattler modes, c-axis strain, and stacking disorder. This study lays the foundation for electrochemically-driven nanoscale thermal regulators, and establishes thermal metrology as a useful probe of spatio-temporal intercalant dynamics in nanomaterials.

As a continuous source of hormonal stimulation, environmentally ubiquitous estrogenic chemicals, ie, xenoestrogens (XEs), are a potential risk factor for breast carcinogenesis. Given their wide distribution in the environment and the fact that bisphenol-A (BPA), methylparaben (MP), and perfluorooctanoic acid (PFOA) are uniformly detected in unselected body fluid samples, it must be assumed that humans are simultaneously exposed to these chemicals almost daily. We studied the effects of a ternary mixture of BPA, MP, and PFOA on benign breast epithelial cells at the range of concentrations observed for single chemicals in human samples. Measurements of exposure impact relevant to the breast were based on endpoints associated with "hallmarks" of cancer and "key characteristics" of carcinogens. These included modulation of total estrogen receptor (ER)α, phosphorylated ERα (pERα), total ERβ, S-phase induction, and apoptotic evasion. Data from live cell measurements were fit to a log-linear dose-response model. Concentration-dependent reduction of ERβ and apoptosis evasion was observed concurrently with the induction of ERα, pERα, and S-phase fraction, and an increased rate of cell proliferation. Beyond additive effects predicted by the sum of individual test XEs, mixture treatment demonstrated synergism for the ERβ and apoptosis suppression phenotypes (p > .001). Nonmalignant breast cells were more sensitive than commonly used breast cancer lines to XE treatment in 3 of 5 endpoints. All observations were validated with cells isolated from the normal breast tissue of 14 individuals. At relatively low concentrations, a chemical mixture has striking effects on normal cell function that are missed by evaluation of single components.

This article explores the intersection of place-based reading practices of rural working-class males and reading practices in school. Life story interviews have been conducted with six men in different ages (age 19-63) living in a rural region in Sweden, focusing on their reflections on their own relation to reading across a life span from the standpoint of the present. The analysis shows that there is a unique combination of factors at work when rural working-class men culturally re-appropriate written culture in ways that are sympathetic, and socially acceptable to a manual working-class culture. These factors include the processes of oralising and manualising and are often related to things learned in specific ancestral heartlands.

Rationale & Objective: Recent studies evaluated and proposed new race-neutral, creatinine-based glomerular filtration rate (GFR) estimation equations. The performance of these equations in diverse potential living kidney donors requires study. Study Design: Cross-sectional study. Setting & Participants: 637 potential living kidney donors from one tertiary hospital with serum creatinine concentration measurement and GFR measurement by iohexol plasma clearance between October 2016 and December 2020. Exposure: Creatinine-based estimation of GFR by Chronic Kidney Disease Epidemiology Collaboration (2009, CKDEPI09; 2021, CKDEPI21) and Modification of Diet in Renal Disease equations with and without inclusion of race coefficient, where applicable. Outcomes: Equation bias, precision, accuracy, and accurate classification of GFR as equal to and above or below 80 mL/min/1.73 m2. Analytical Approach: GFR estimation equation performance compared to measured GFR (mGFR) by iohexol clearance. Results: The median bias of the CKDEPI21 equation underestimated mGFR by 2.8 mL/min/1.73 m2. The bias in the Black subgroup underestimated mGFR by 9.0 mL/min/1.73 m2. Compared to CKDEPI09 with and without race adjustment, the accuracy of CKDEPI21 increased across all subgroups. On average, 3.9% of individuals were misclassified by CKDEPI21 as having a GFR greater than, and 8.9% misclassified less than, 80 mL/min/1.73 m2, compared to 3.1% and 13.2% for CKDEPI09 with race adjustment, respectively. Total misclassification (either above or below 80 mL/min/1.73 m2) was 16.3% for CKDEPI21 and 16.0% for CKDEPI09 (with race adjustment). Limitations: Limited sample of individuals identifying as Black. Lack of cystatin C data. Conclusions: In our potential living donor sample, GFR estimation by creatinine-based CKDEPI21 is less biased and more accurate than previous creatinine-based estimated GFR equations. When evaluated by race, this summative improvement remains in individuals identifying as Asian, Hispanic, or White. More external validation is needed to assess whether the new equation is an improvement over the previous CKDEPI equation with a race coefficient.

As of March 2021, coronavirus disease (COVID-19) had led to >500,000 deaths in the United States, and the state of Tennessee had the fifth highest number of cases per capita. We reviewed the Tennessee Department of Health COVID-19 surveillance and chart-abstraction data during March 15‒August 15, 2020. Patients who died from COVID-19 were more likely to be older, male, and Black and to have underlying conditions (hereafter comorbidities) than case-patients who survived. We found 30.4% of surviving case-patients and 20.3% of deceased patients had no comorbidity information recorded. Chart-abstraction captured a higher proportion of deceased case-patients with >1 comorbidity (96.3%) compared with standard surveillance deaths (79.0%). Chart-abstraction detected higher rates of each comorbidity except for diabetes, which had similar rates among standard surveillance and chart-abstraction. Investing in public health data collection infrastructure will be beneficial for the COVID-19 pandemic and future disease outbreaks.

To efficiently unlock the cooling power of sweat for human body remains a great challenge for next-generation textiles. Here the authors report an integrated cooling (i-Cool) textile showing high evaporation ability and sweat evaporation cooling efficiency for personal perspiration management.

A "knowledge survey" and a formative evaluation process led to major changes in an instructor's course and teaching methods over a 5-year period. Design of the survey incorporated several innovations, including: a) using "confidence survey" rather than "knowledge survey" as the title; b) completing an instructional task analysis with an instructional designer's perspective of the Gagné framework rather than Bloom's taxonomy; and c) using a rating scale based on established measurement practices for self-efficacy surveys. Results included increased instructor-student interactions; gains in confidence scores from before to after study of course units; high value of the survey for students; changes in grades and confidence scores across teaching methods; and advancement of Chickering and Gamson's principles of good practice in undergraduate education.

The concept of psychological literacy has grown in importance within psychology education at all levels, in the UK and globally, in recent years. Increasingly, psychology educators and policy makers are seeking to emphasise the relevance and usefulness of psychology within everyday life, within the workplace, and as an element of global citizenship. The Division of Academics, Researchers and Teachers in Psychology (DART-P), recognising this recent development, hosted a symposium at the British Psychological Society (BPS) Annual Conference 2015, at which the concept of psychological literacy was explored within the context of higher and pre-tertiary psychology education. The aim of the symposium, reflected in this article, was to explore current thinking, developments and practice within contemporary psychology education, with a view to stimulating critical discussion and reflection on psychological literacy and its delivery within both pre-tertiary and higher education contexts. Ultimately, the symposium, and this article, are intended to facilitate exploration of the opportunities provided by psychology education, at all levels, to develop students as psychologically literate citizens. This article summarises the talks and discussions which occurred during the symposium. Firstly, we introduce the concept and literature surrounding psychological literacy and its importance to modern psychology education. This is followed by a case study illustrating one way in which psychological literacy has been embedded into the curriculum within a university undergraduate programme. We move to consider the development of thinking about psychological literacy in a historical context, linking it to societal benefits and Miller's (1969) concept of "giving psychology away." This raises the question of the extent to which pre-tertiary psychology education can equip students with psychological literacy, and the impact of the growing numbers of people who have studied psychology upon society. In England and Wales, the most popular pre-tertiary psychology qualification is the A level, which has undergone recent revisions, and so we consider the contribution of the new A level psychology specifications to psychological literacy. In conclusion, this paper offers some thoughts about the implications of the growth in emphasis on education for psychological literacy, reflecting the discussions held during the plenary session at the end of the symposium.