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Plasmodium vivax, the most widely geographically distributed species of the Plasmodium genus, causes malaria in humans and is transmitted through the bite of infectious Anopheles mosquitoes. P. vivax is the [...]

Abstract 2023 was the warmest year on record, influenced by multiple warm ocean basins. This has prompted speculation of an acceleration in surface warming, or a stronger than expected influence from loss of aerosol induced cooling. Here we use a recent Green’s function-based method to quantify the influence of sea surface temperature patterns on the 2023 global temperature anomaly, and compare them to previous record warm years. We show that the strong deviation from recent warming trends is consistent with previously observed sea surface temperature influences, and regional forcing. This indicates that internal variability was a strong contributor to the exceptional 2023 temperature evolution, in combination with steady anthropogenic global warming.

Abstract Background There is little to no data evaluating long term usage of point of care ultrasound (POCUS) after a training intervention for medical students. The purpose of this study was to examine the impact of an intensive POCUS training program on medical student’s usage at 9-months post-program. Methods This was a prospective cross-sectional study of rising second year medical students who participated in a 2-week summer POCUS training program. Instruction consisted of 8 h of asynchronous online didactic material, 2–4 h of daily hands-on instructor-led and independent scanning, and instruction on how to teach POCUS. Students were assessed pre- and post-program, and again at 9 months post-program to evaluate POCUS usage. Results A total of 56 students participated in the program over 2 summers; 52 (92.9%) responded to the 9-month post-program survey. At 9 months, 49 (94.2%) of students taught POCUS after the program to peers or faculty. Students reported serving as a POCUS instructor in 283 subsequent teaching sessions accounting for 849 h of POCUS instruction time. Six (11.5%) students were involved in the creation of a POCUS interest group on their regional campus, 7 (13%) created a POCUS curriculum for their student interest group, and 4 (7.7%) created an opt-in co-curricular POCUS program for students at their regional campus. Three (5.8%) students did not serve as educators after the program and only one student reported not using POCUS again after the program. Conclusion After a 2-week intensive POCUS training program for medical students, the majority of students demonstrated continued involvement in POCUS learning and education at 9-month follow-up including serving as peer instructors and assisting with limitations in financial resources and trained faculty.

Abstract Antibiotics may alter the gut microbiome, and this is one of the mechanisms by which antimicrobial resistance may be promoted. Suboptimal antimicrobial stewardship in Asia has been linked to antimicrobial resistance. We aim to examine the relationship between oral antibiotic use and composition and antimicrobial resistance in the gut microbiome in 1093 Bangladeshi infants. We leverage a trial of 8-month-old infants in rural Bangladesh: 61% of children were cumulatively exposed to antibiotics (most commonly cephalosporins and macrolides) over the 12-month study period, including 47% in the first 3 months of the study, usually for fever or respiratory infection. 16S rRNA amplicon sequencing in 11-month-old infants reveals that alpha diversity of the intestinal microbiome is reduced in children who received antibiotics within the previous 7 days; these samples also exhibit enrichment for Enterococcus and Escherichia/Shigella genera. No effect is seen in children who received antibiotics earlier. Using shotgun metagenomics, overall abundance of antimicrobial resistance genes declines over time. Enrichment for an Enterococcus-related antimicrobial resistance gene is observed in children receiving antibiotics within the previous 7 days, but not earlier. Presence of antimicrobial resistance genes is correlated to microbiome composition. In Bangladeshi children, community use of antibiotics transiently reprofiles the gut microbiome.

Objective: We aimed to determine if machine learning can predict acute brain injury and to identify modifiable risk factors for acute brain injury in patients receiving venoarterial extracorporeal membrane oxygenation. Methods: We included adults (age ≥18 years) receiving venoarterial extracorporeal membrane oxygenation or extracorporeal cardiopulmonary resuscitation in the Extracorporeal Life Support Organization Registry (2009-2021). Our primary outcome was acute brain injury: central nervous system ischemia, intracranial hemorrhage, brain death, and seizures. We used Random Forest, CatBoost, LightGBM, and XGBoost machine learning algorithms (10-fold leave-1-out cross-validation) to predict and identify features most important for acute brain injury. We extracted 65 total features: demographics, pre-extracorporeal membrane oxygenation/on-extracorporeal membrane oxygenation laboratory values, and pre-extracorporeal membrane oxygenation/on-extracorporeal membrane oxygenation settings. Results: Of 35,855 patients receiving venoarterial extracorporeal membrane oxygenation (nonextracorporeal cardiopulmonary resuscitation) (median age of 57.8 years, 66% were male), 7.7% (n = 2769) experienced acute brain injury. In venoarterial extracorporeal membrane oxygenation (nonextracorporeal cardiopulmonary resuscitation), the area under the receiver operator characteristic curves to predict acute brain injury, central nervous system ischemia, and intracranial hemorrhage were 0.67, 0.67, and 0.62, respectively. The true-positive, true-negative, false-positive, false-negative, positive, and negative predictive values were 33%, 88%, 12%, 67%, 18%, and 94%, respectively, for acute brain injury. Longer extracorporeal membrane oxygenation duration, higher 24-hour extracorporeal membrane oxygenation pump flow, and higher on-extracorporeal membrane oxygenation partial pressure of oxygen were associated with acute brain injury. Of 10,775 patients receiving extracorporeal cardiopulmonary resuscitation (median age of 57.1 years, 68% were male), 16.5% (n = 1787) experienced acute brain injury. The area under the receiver operator characteristic curves for acute brain injury, central nervous system ischemia, and intracranial hemorrhage were 0.72, 0.73, and 0.69, respectively. Longer extracorporeal membrane oxygenation duration, older age, and higher 24-hour extracorporeal membrane oxygenation pump flow were associated with acute brain injury. Conclusions: In the largest study predicting neurological complications with machine learning in extracorporeal membrane oxygenation, longer extracorporeal membrane oxygenation duration and higher 24-hour pump flow were associated with acute brain injury in nonextracorporeal cardiopulmonary resuscitation and extracorporeal cardiopulmonary resuscitation venoarterial extracorporeal membrane oxygenation.

Despite their emerging use, the in vivo behaviour of dual-mobility (DM) total hip replacements (THRs) is not well understood. Therefore, the purpose of this study was to assess the articulating surfaces of 20 early-retrieved DM polyethylene liners (mean length of implantation 20.0 ± 18.8 months) for damage to improve the current understanding of their in vivo functional mechanisms. The internal and external surfaces of each liner were visually and geometrically assessed, and the material composition of embedded debris particles were further characterized. Scratching and pitting were the most common modes of damage identified on either surface, and a high incidence of burnishing (50%) and embedded debris (65%) were observed on the internal and external surfaces, respectively. Embedded debris particles were commonly titanium- or iron-based, although other materials such as cobalt-chrome and tantalum were also identified. The geometric assessment demonstrated highly variable damage patterns across the liners, with the internal surfaces commonly presenting with crescent-shaped, circumferential, or circular regions of penetration whilst the external surfaces commonly presented with regions of deep pitting or gouging. This study demonstrates that DM-THRs primarily articulate at the head/liner junction, and that polyethylene liners are capable of rotating about the femoral neck axis, although the extent of this may be limited in some cases. Additionally, this study suggests that intra-prosthetic dislocation and edge loading may remain pertinent failure mechanisms of DM implants despite the advent of highly crosslinked polyethylene and design features, thus highlighting the need for enhanced monitoring of these devices.

Abstract In our changing world, understanding plant community responses to global change drivers is critical for predicting future ecosystem composition and function. Plant functional traits promise to be a key predictive tool for many ecosystems, including grasslands; however, their use requires both complete plant community and functional trait data. Yet, representation of these data in global databases is sparse, particularly beyond a handful of most used traits and common species. Here we present the CoRRE Trait Data, spanning 17 traits (9 categorical, 8 continuous) anticipated to predict species’ responses to global change for 4,079 vascular plant species across 173 plant families present in 390 grassland experiments from around the world. The dataset contains complete categorical trait records for all 4,079 plant species obtained from a comprehensive literature search, as well as nearly complete coverage (99.97%) of imputed continuous trait values for a subset of 2,927 plant species. These data will shed light on mechanisms underlying population, community, and ecosystem responses to global change in grasslands worldwide.

The springtime atmosphere over the southeast Atlantic Ocean (SEA) is subjected to a consistent layer of biomass burning (BB) smoke from widespread fires on the African continent. An elevated humidity signal is coincident with this layer, consistently proportional to the amount of smoke present. The combined humidity and BB aerosol has potentially significant radiative and dynamic impacts. Here, we use aircraft-based observations from the NASA ORACLES (ObseRvations of Aerosols above CLouds and their intEractionS) deployments in conjunction with reanalyses to characterize covariations in humidity and BB smoke across the SEA. The observed plume–vapor relationship, and its agreement with the European Centre for Medium-Range Weather Forecasts (ECMWF) Reanalysis version 5 (ERA5) and Copernicus Atmosphere Monitoring Service (CAMS) reanalysis, persists across all observations, although the magnitude of the relationship varies as the season progresses. Water vapor is well represented by the reanalyses, while CAMS tends to underestimate carbon monoxide especially under high BB. While CAMS aerosol optical depth (AOD) is generally overestimated relative to ORACLES AOD, the observations show a consistent relationship between carbon monoxide (CO) and aerosol extinction, demonstrating the utility of the CO tracer to understanding vertical aerosol distribution. We next use k-means clustering of the reanalyses to examine multi-year seasonal patterns and distributions. We identify canonical profile types of humidity and of CO, allowing us to characterize changes in vapor and BB atmospheric structures, and their impacts as they covary. While the humidity profiles show a range in both total water vapor concentration and in vertical structure, the CO profiles primarily vary in terms of maximum concentration, with similar vertical structures in each. The distribution of profile types varies spatiotemporally across the SEA region and through the season, ranging from largely one type in the northeast and southwest to more evenly distributed between multiple types where air masses meet in the middle of the SEA. These distributions follow patterns of transport from the humid, smoky source region (greatest influence in the northeast of the SEA) and the seasonal changes in both humidity and smoke (increasing and decreasing through the season, respectively). With this work, we establish a framework for a more complete analysis of the broader radiative and dynamical effects of humid aerosols over the SEA.

Abstract Vincristine (VCR) is one of the most widely used chemotherapy agents in treating pediatric cancer. Nonetheless, it is known to cause dose-dependent neurotoxicity which can impact virtually every organ system. Despite its widespread use, the precise impact of VCR on the lower urinary tract (LUT) remains inadequately elucidated. Our initial clinical and translational investigations suggest a sex-specific influence of childhood VCR exposure on LUT function. Thus, the current study aimed to investigate the late effects of systemic VCR exposure on LUT physiology and the underlying mechanisms, focusing on dosage and male-sex, employing juvenile CD-1 mice as a model. Male mice subjected to VCR exhibited augmented functional bladder capacity accompanied by frequent non-void contractions during awake cystometry, alongside mast cell accumulation within the bladder, compared to the saline-treated control group. Noteworthy functional changes were observed in bladder strips from the VCR group, including decreased nerve-mediated contraction, heightened contractile responses to cholinergic and purinergic agonists, enhanced responsiveness to histamine—primarily via histamine receptor 1 (Hrh1)—and an augmented relaxation effect with compound 48/80 (a mast cell degranulator), relative to the control group. Significant changes in gene expression levels associated with neuroinflammation and nociception were observed in both the bladder and lumbosacral dorsal root ganglia (Ls-DRG) of the VCR group. These findings suggest that VCR exposure during childhood, particularly in males, triggers neuroimmune responses in the bladder and Ls-DRG, amplifying responsiveness to neurotransmitters in the bladder, thereby contributing to LUT dysfunction characterized by a mixed bladder phenotype as a late effect during survivorship.

Abstract Background With an increasing proportion of older adults and the associated risk of Alzheimer’s Disease and Related Dementias (ADRD) around the globe, there is an urgent need to engage in ADRD risk reduction efforts. African American (AA) older adults in the U.S. are disproportionally impacted by ADRD compared to other races and ethnicities. Mindful walking integrates two potentially protective factors of ADRD by elevating mindfulness and physical activity (i.e., walking), resulting in a synergistic behavioral strategy that is feasible and safe for older adults. However, the efficacy of applying this intervention for cognitive health outcomes has not been evaluated using experimental designs. Methods This paper documents the goal and protocol of a community-based, mindful walking randomized controlled trial to examine the short- and longer-term efficacy on cognitive and other health-related outcomes in ADRD at-risk AA older adults. The study outcomes include various brain health determinants, including cognitive function, quality of life, psychological well-being, physical activity, mindfulness, sleep, and overall health status. In addition, the estimated costs of program implementation are also collected throughout the study period. This study will recruit 114 older adults (ages 60+ years) with elevated ADRD risk from the Midlands region of South Carolina. Older adults are randomly assigned to participate in 24 sessions of outdoor mindful walking over three months or a delayed mindful walking group (n=57 in each group). Participants in both groups follow identical measurement protocols at baseline, after 12 weeks, after 18 weeks, and after 24 weeks from baseline. The outcome measures are administered in the lab and in everyday settings. Costs per participant are calculated using micro-costing methods. The eliciting participant costs for mindful walking engagement with expected results are reported using the payer and the societal perspectives. Discussion This study will generate evidence regarding the efficacy of mindful walking on sustaining cognitive health in vulnerable older adults. The results can inform future large-scale effectiveness trials to support our study findings. If successful, this mindful walking program can be scaled up as a low-cost and viable lifestyle strategy to promote healthy cognitive aging in diverse older adult populations, including those at greatest risk. Trial registration ClinicalTrials.gov number NCT06085196 (retrospectively registered on 10/08/2023).

Abstract Background The transdermal patch of bisoprolol available in Japan has been reported to demonstrate superior efficacy in preventing postoperative atrial fibrillation, possibly surpassing its oral counterpart. However, there has been no systematic review and meta‐analysis assessing the efficacy of transdermal bisoprolol. Methods A comprehensive systematic literature search was conducted on PubMed, Embase, and Cochrane to identify all relevant studies assessing the efficacy of transdermal bisoprolol in preventing postoperative atrial fibrillation. The search covered studies from inception up to December 4, 2023. For data analysis, Review Manager (RevMan) 5.4 software was employed, using a random‐effects model to calculate risk ratios (RR) and 95% confidence intervals (CI). Results Three studies, comprising a total of 551 patients (transdermal bisoprolol 228 and control 323), were included. There was a decreased risk of postoperative atrial fibrillation or atrial tachyarrhythmias in patients treated with transdermal bisoprolol (RR 0.43, 95% CI 0.27–0.67, p = .0002, I2 = 0%). Conclusion Transdermal administration of bisoprolol has consistently shown efficacy, and this pooled analysis supports its effectiveness. The heterogeneity of the included studies limits certain interpretations. Future randomized clinical trials may elucidate the superiority of transdermal administration over oral administration.

Reliable attribution of Asian summer monsoon variations to aerosol forcing is critical to reducing uncertainties in future projections of regional water availability, which is of utmost importance for risk management and adaptation planning in this densely populated region. Yet, simulating the monsoon remains a challenge for climate models that suffer from long-standing biases, undermining their reliability in attributing anthropogenically forced changes. We analyze a suite of climate model experiments to identify a link between model biases and monsoon responses to Asian aerosols and associated physical mechanisms, including the role of large-scale circulation changes. The aerosol impact on monsoon precipitation and circulation is strongly influenced by a model's ability to simulate the spatio-temporal variability in the climatological monsoon winds, clouds, and precipitation across Asia, which modulates the magnitude and efficacy of aerosol–cloud–precipitation interactions, an important component of the total aerosol response. There is a strong interplay between South Asia and East Asia monsoon precipitation biases and their relative predominance in driving the overall monsoon response. We found a striking contrast between the early- and late-summer aerosol-driven changes ascribable to opposite signs and seasonal evolution of the biases in the two regions. A realistic simulation of the evolution of the large-scale atmospheric circulation is crucial to realize the full extent of the aerosol impact over Asia. These findings provide important implications for better understanding and constraining the diversity and inconsistencies of model responses to aerosol changes over Asia in historical simulations and future projections.

Emerging research has shown that the COVID-19 pandemic impacted the working conditions of educators and led to increased levels of stress, burnout, and turnover. Few studies, however, have examined changes in collegiality during the pandemic despite scholarship noting that educators experienced isolation as support systems weakened and collaboration with colleagues in school settings was reduced. In this essay, we discuss the impacts of the pandemic on educator collegiality by drawing upon survey data gathered from 758 educators in 38 public schools in New York State. Survey results show that COVID-19 related disruptions negatively impacted educators' collegiality although these impacts differed in intensity by educator gender, role, mode of instruction, and years of experience. As educator collegiality is related to a range of positive influences on educators and students and has been shown to potentially mitigate burnout and turnover, it is crucial to better understand the impacts of the pandemic on collegiality and discuss strategies to support educator collegiality in the future.

Background: teen Mental Health First Aid (tMHFA) is an Australian school-based universal program for grade 10 to 12 students. tMHFA teaches teens how to recognize and respond to a peer in crisis or experiencing mental health concerns. Methods: Schools implementing tMHFA in 2019 and 2020 were propensity score matched, yielding a sample of instructors (n = 130) and students (n = 1915) in 44 high schools in 24 American states. Effectiveness and acceptability were assessed with student surveys at baseline and after implementation. Results: There were significant findings for primary outcomes, including improved helpful first aid intentions (Cohen ds = 0.57 to 0.58), confidence supporting a peer (ds = 0.19 to 0.31); the number of adults rated as helpful (ds = 0.37 to 0.44); and reductions in stigmatizing beliefs (ds = 0.21 to 0.40) and "harmful first aid intentions" (ds = 0.11 to 0.42). Instructors and students rated the program favorably with students sharing improvements on their recognition and responses to mental health problems and crises. Conclusion: tMHFA is an effective, feasible, and scalable training program for increasing mental health literacy and decreasing mental health stigma in adolescents in the short term, consistent with trials of tMHFA in Australian adolescents.

Evidence-based practice is foundational to school psychology; as a field, we have contributed a great deal of evidence for specific practices. However, school psychologists must continue to find ways to more effectively reduce the gap between research and practice, supporting educational outcomes for all students. Two interconnected strategies that may help bridge this gap include implementation and de-implementation science. Implementation science focuses on adopting practices that have a strong evidence base, and there is some evidence of this practice in school psychology research. However, we identified no research in school psychology in the area of de-implementation science, which focuses on identifying and removing practices that do not have a strong evidence base. We urge school psychology researchers to actively engage not only in implementation but also in de-implementation in order to inform practice and to reach these goals. We provide two examples where school psychology can contribute to this area: reading instruction and mental health services. We conclude with recommendations to extend the evidence base for de-implementation in school psychology.

Private religious schools are widely seen as value-laden communities that mold the character of their students. Thus, we expect adults who attended religious schools as children to demonstrate more favorable family outcomes related to stable marriages and childbearing. We further expect Protestant schooling to have a more powerful effect on marital outcomes than Catholic schooling, given the heavier focus of Protestantism on marriage. Finally, we expect stronger positive associations between religious schooling and marital outcomes for adults who grew up in difficult circumstances compared to adults who grew up in advantaged circumstances. We test these hypotheses using survey data from the Understanding America Study. Our three outcome variables are ever marrying and never divorcing, ever divorcing, and conceiving a child out-of-wedlock. Most of the results confirm our hypotheses. Protestant schooling is associated with more positive marital outcomes across all three measures. Catholic schooling is significantly correlated with a lower likelihood of having a child outside of marriage. The associations between religious schooling and desirable marriage outcomes are strongest for adults who grew up poor and for those raised in intact families.

Clostridioides difficile is a One Health pathogen found in humans, animals, and environment, with food representing a potential transmission route. One Health studies are often limited to single country or selected reservoirs and ribotypes. This study provides a varied and accessible collection of C. difficile isolates and sequencing data derived from human, animal, and food sources across thirteen European countries. A total of 441 strains (human hospital and community associated cases n = 280, animal n = 96, food n = 65) were analysed by ribotyping, toxinotyping and whole genome sequencing (WGS). We detected 83 sequence types (STs), with ST11 (n = 80 isolates) and ST1 (n = 54 isolates) being the most represented. Several STs included strains originating from all source combinations. Further genomic analysis confirmed close genetic relatedness in some of the STs. Additionally, genomic analysis identified ten strains from cryptic clades (C-I to C-III) and four of them were mono-toxigenic possessing only a variant form of tcdA gene. Amongst 106 ribotypes, ten were shared between all three sources and 68 were source specific. Some ribotypes were only found at intersection of human and food source (RT023, RT027), or between human and animal source (RT009, RT045, RT046). C. difficile ribotypes and STs in Europe were diverse. In this collection some ribotypes showed potential association with food or animal transmission routes. C. difficile strains from divergent clades CI-III, currently emerging in human population, were rare and mostly food associated.

Killer whales occur in the Gulf of Mexico (GoMex) and the North Atlantic, including off the southeastern United States (SEUS). Data from cetacean surveys during 1990 – 2021 and other sources were combined to assess killer whale biology, including spatial and temporal distribution, social structure, genetics, morphology, acoustics, and predatory behavior. GoMex records occurred predominantly in oceanic waters (>200 m) during spring and summer. SEUS records occurred primarily in winter and spring off the North Carolina region along the shelf-edge and deeper waters, and off the east coast of Florida. Photo-identification analysis of GoMex killer whales resulted in 49 individuals sighted up to seven times with sighting histories up to 26 years, and social analysis provided evidence of long-term relationships up to 16 years. The GoMex genetic samples revealed two mtDNA haplotypes, one of which does not match any outside the GoMex. Most GoMex whales had wide non-faint saddle patches and many had cookiecutter shark scars while no scars were noted on SEUS whales. Three groups recorded in the GoMex made few calls, but a group harassing sperm whales produced many. Cetaceans and tuna are known prey in the GoMex and SEUS, respectively. Directed studies of killer whales in the GoMex areas would be difficult to implement as this species is very rare. It is therefore important to pursue ongoing efforts to collect behavioral, acoustic and any biological samples that will contribute to improve our understanding of the biology and ecology of killer whales in tropical and subtropical regions.

We report a proof-of-principle lattice QCD simulation of the electric and magnetic polarizabilities for a neutral pion in the four-point function method. The results are based on the same quenched Wilson ensembles on a 243×48 lattice at β=6.0 with pion mass from 1100 to 370 MeV previously used for a charged pion. For electric polarizability, the results are largely consistent with those from the background field method and ChPT. In contrast, there are significant differences for magnetic polarizability among the four-point function method, the background field method, and ChPT. The situation points to the important role of disconnected diagrams for a neutral pion. We elucidate a transparent quark decomposition in the four-point function method that can be used to shed light on the issue.

CONTEXT:. Conventional MRI is incompatible with extracorporeal membrane oxygenation (ECMO) cannulas and pumps. Ultra-low-field portable MRI (ULF-pMRI) with 0.064 Tesla may provide a solution, but its safety and compatibility is unknown. HYPOTHESIS:. ULF-pMRI does not cause significant displacement and heating of ECMO cannulas and does not affect ECMO pump function. METHODS AND MODELS:. ECMO cannulas in various sizes were tested ex vivo using phantom models to assess displacement force and heating according to the American Society for Testing and Materials criteria. ECMO pump function was assessed by pump flow and power consumption. In vivo studies involved five female domestic pigs (20–42 kg) undergoing different ECMO configurations (peripheral and central cannulation) and types of cannulas with an imaging protocol consisting of T2-weighted, T1-weighted, FLuid-Attenuated Inversion Recovery, and diffusion-weighted imaging sequences. RESULTS:. Phantom models demonstrated that ECMO cannulas, both single lumen with various sizes (15–24-Fr) and double lumen cannula, had average displacement force less than gravitational force within 5 gauss safety line of ULF-pMRI and temperature changes less than 1°C over 15 minutes of scanning and ECMO pump maintained stable flow and power consumption immediately outside of the 5 gauss line. All pig models showed no visible motion due to displacement force or heating of the cannulas. ECMO flow and the animals’ hemodynamic status maintained stability, with no changes greater than 10%, respectively. INTERPRETATION AND CONCLUSIONS:. ULF-pMRI is safe and feasible for use with standard ECMO configurations, supporting its clinical application as a neuroimaging modality in ECMO patients.

Background: FebriDx is a single-use, analyser-free, point-of-care test with markers for bacterial (C-reactive protein [CRP]) and viral (myxovirus resistance protein A [MxA]) infection, measured on a finger-prick blood sample. Aim: As part of a larger feasibility study, we explored the views of healthcare professionals (HCPs) and patients on the use of FebriDx to safely reduce antibiotic prescriptions for lower respiratory tract infections (LRTIs) in primary care. Design & setting: Remote semi-structured qualitative interviews were conducted in South England. Method: In total, 22 individuals (12 patients who underwent FebriDx testing and 10 HCPs from general practices that conducted testing) participated in interviews, which were analysed thematically. Results: Patients and HCPs expressed positive views about use of the test. They felt FebriDx was a useful tool to inform prescribing decisions and provided a visual aid to support shared decision making and appropriate antibiotic use. Most felt it would be feasible to integrate use into routine primary care consultations. Some practical difficulties with blood collection and interpreting results, which impacted on usability, were identified. Some patients’ reactions to negative test results suggested the need for better communication alongside use of the test. Conclusion: FebriDx was perceived as a useful tool to guide antibiotic prescribing and support shared decision making. Initial practical problems with testing and communicating results are potential barriers to use. Training and practice on using the test and effective communication are likely to be important elements in ensuring patient understanding and satisfaction, and successful adoption.

Abstract Objective Prior research has found that plant‐based diets (PBDs) are rated as acceptable and have similar levels of adherence as compared to other therapeutic dietary approaches; however, previous studies were mostly among white populations. Plant‐based diets can produce clinically meaningful weight loss, but outcomes may vary by level of adherence. The goal of this study was to examine the differences in weight and lipids among participants in the Nutritious Eating with Soul study based on adherence to their diet assignment. Methods African American adults (n = 159; 79% female) with overweight or obesity (mean BMI 36.9 ± 6.9 kg/m2) were recruited to participate in a 24‐month intervention. Participants were randomized to a plant‐based vegan (n = 77) or a low‐fat omnivorous (n = 82) diet, both emphasizing soul food cuisine. Participants attended nutrition classes and had dietary intake/adherence (three 24‐h recalls; adherence score 1–5), body weight, lipids, and other secondary outcomes assessed at baseline, 6‐, 12‐, and 24 months. Participants who met at least half of the adherence criteria (≥2.5 out of 5) were categorized as adherents. Results At 24 months, adherent vegans lost 5% of their body weight, non‐adherent vegans lost −0.005%, adherent omnivores lost −0.03%, and non‐adherent omnivores lost −0.02%. Adherent vegans lost more weight (kg) than all other participants at both 6‐ (−3.32 ± 0.92 (−5.14, −1.49), p

Objective To determine whether a chemokine receptor type 2 antagonist, DMX-200 (repagermanium), in combination with an angiotensin receptor blocker, candesartan, improves clinical outcomes in people with COVID-19.Design Prospective, multicentre, double-blind, placebo-controlled trial.Setting Ten acute care hospitals in India.Participants Adults

The reality of human-induced climate change is unequivocal and exerts an ever-increasing global impact. Access to the latest scientific information on current climate change and projection of future trends is important for planning adaptation measures and for informing international efforts to reduce emissions of greenhouse gases (GHGs). Identification of hazards and risks may be used to assess vulnerability, determine limits to adaptation, and enhance resilience to climate change. This article highlights how recent research programs are continuing to elucidate current processes and advance projections across major climate systems and identifies remaining knowledge gaps. Key findings include projected future increases in monsoon rainfall, resulting from a changing balance between the rainfall-reducing effect of aerosols and rainfall-increasing GHGs; a strengthening of the storm track in the North Atlantic; an increase in the fraction of precipitation that falls as rain at both poles; an increase in the frequency and severity of El Niño Southern Oscillation (ENSO) events, along with changes in ENSO teleconnections to North America and Europe; and an increase in the frequency of hazardous hot-humid extremes. These changes have the potential to increase risks to both human and natural systems. Nevertheless, these risks may be reduced via urgent, science-led adaptation and resilience measures and by reductions in GHGs.

Summary: Background: While many patients seem to recover from SARS-CoV-2 infections, many patients report experiencing SARS-CoV-2 symptoms for weeks or months after their acute COVID-19 ends, even developing new symptoms weeks after infection. These long-term effects are called post-acute sequelae of SARS-CoV-2 (PASC) or, more commonly, Long COVID. The overall prevalence of Long COVID is currently unknown, and tools are needed to help identify patients at risk for developing long COVID. Methods: A working group of the Rapid Acceleration of Diagnostics-radical (RADx-rad) program, comprised of individuals from various NIH institutes and centers, in collaboration with REsearching COVID to Enhance Recovery (RECOVER) developed and organized the Long COVID Computational Challenge (L3C), a community challenge aimed at incentivizing the broader scientific community to develop interpretable and accurate methods for identifying patients at risk of developing Long COVID. From August 2022 to December 2022, participants developed Long COVID risk prediction algorithms using the National COVID Cohort Collaborative (N3C) data enclave, a harmonized data repository from over 75 healthcare institutions from across the United States (U.S.). Findings: Over the course of the challenge, 74 teams designed and built 35 Long COVID prediction models using the N3C data enclave. The top 10 teams all scored above a 0.80 Area Under the Receiver Operator Curve (AUROC) with the highest scoring model achieving a mean AUROC of 0.895. Included in the top submission was a visualization dashboard that built timelines for each patient, updating the risk of a patient developing Long COVID in response to clinical events. Interpretation: As a result of L3C, federal reviewers identified multiple machine learning models that can be used to identify patients at risk for developing Long COVID. Many of the teams used approaches in their submissions which can be applied to future clinical prediction questions. Funding: Research reported in this RADx® Rad publication was supported by the National Institutes of Health. Timothy Bergquist, Johanna Loomba, and Emily Pfaff were supported by Axle Subcontract: NCATS-STSS-P00438.

Summary: Background: The HVTN 705 Imbokodo trial of 2636 people without HIV and assigned female sex at birth, conducted in southern Africa, evaluated a heterologous HIV-1 vaccine regimen: mosaic adenovirus 26-based vaccine (Ad26.Mos4.HIV) at Months 0, 3, 6, 12 and alum-adjuvanted clade C gp140 at Months 6, 12. Per-protocol vaccine efficacy (VE) against HIV-1 diagnosis from seven to 24 months was 14.1% (95% CI: −22.0% to 39.5%). Immune correlates analysis was performed for markers selected based on prior evidence in efficacy trials and/or nonhuman primate models. Methods: Humoral and cellular immune response markers at Month 7 were evaluated as immune correlates of risk and of protection in a breakthrough case–control cohort (n = 52 cases, 246 non-cases). Primary markers were IgG binding to vaccine-strain gp140, IgG3 binding to diverse Env antigens (IgG3 Env breadth), IgG3 binding to diverse V1V2 antigens (IgG3 V1V2 breadth), antibody-dependent phagocytosis against the vaccine-strain gp140, Env-specific CD4+ and CD8+ T-cell responses, and multi-epitope functions. Findings: No immune markers were statistically significant correlates of risk. IgG3 V1V2 breadth trended toward an inverse association: hazard ratio 0.70 (95% CI: 0.36 to 1.35; p = 0.29) per 10-fold increase and 0.51 (95% CI: 0.21 to 1.24; p = 0.14) in a Cox model with all primary markers. The VE estimate was 11.8% (95% CI: −17.9% to 34.0%) at all IgG3 V1V2 breadth values below 667 weighted geometric mean net MFI; just above this value, the VE estimate sharply increased to 62.6% (95% CI: −17.9% to 89.6%), and further increased to 80.9% (95% CI: −17.9% to 99.5%) at 1471 MFI, the 95th percentile of the marker distribution. Mediation analysis yielded a VE of 35.7% (95% CI: 15.0% to 51.3%) attributable to the vaccine's impact on this marker. Interpretation: The trend in association of greater IgG3 V1V2 antibody breadth with lower likelihood of HIV acquisition is consistent with the identification of antibodies against V1V2 as immune correlates in three other HIV vaccine efficacy trials and suggests that a greater emphasis should be placed on studying this region in the HIV-1 envelope as a vaccine immunogen. Funding: National Institute of Allergy and Infectious Diseases and Janssen Vaccines & Prevention BV.

Abstract We have constructed a new, simplified constant‐head infiltrometer automated with a self‐contained water level datalogger (HOBO U20L‐01) repurposed to measure changes in gas pressure inside an inverted bottle reservoir. Our field tests of six of these infiltrometers confirmed that recorded changes in gas pressure were strongly correlated with changes in water level in the infiltrometer reservoir (R2 = 0.9998). Further, by using the derived experimental calibration function, we were able to obtain accurate near‐steady‐state infiltration rates. This infiltrometer is cheaper and lighter than current commercially available infiltrometers. It can be easily assembled with materials readily available in most hardware stores, and its user‐friendly datalogger does not require any programming knowledge. This infiltrometer is compatible with various ponding infiltration methods, and its generic design allows for modifications with locally available materials to meet diverse research needs.

Summary: Given expanding studies in epidemiology and disease-oriented human studies offering hundreds of associations between the human “ome” and disease, prioritizing molecules relevant to disease mechanisms among this growing breadth is important. Here, we link the circulating proteome to human heart failure (HF) propensity (via echocardiographic phenotyping and clinical outcomes) across the lifespan, demonstrating key pathways of fibrosis, inflammation, metabolism, and hypertrophy. We observe a broad array of genes encoding proteins linked to HF phenotypes and outcomes in clinical populations dynamically expressed at a transcriptional level in human myocardium during HF and cardiac recovery (several in a cell-specific fashion). Many identified targets do not have wide precedent in large-scale genomic discovery or human studies, highlighting the complementary roles for proteomic and tissue transcriptomic discovery to focus epidemiological targets to those relevant in human myocardium for further interrogation.

IntroductionThe purpose was to examine the prevalence of low energy availability (LEA), explore dietary behaviors in men collegiate gymnasts (n = 14), and investigate the relationships between energy availability (EA), body composition, and plyometric performance.MethodsBody composition was measured using air displacement plethysmography. Lower- and upper-body peak power (PWRpeak) and modified reactive strength index (RSImod) were calculated from countermovement jump (CMJ) and plyometric push-up (PP) assessments. Energy expenditure was tracked over 3 days, while daily energy and macronutrient intake were recorded. EA was calculated and used to categorize athletes into LEA and non-LEA groups. Pearson correlation coefficients were used to examine relationships between EA, body composition, and performance metrics.Results85.7% of athletes (n = 12) exhibited LEA (20.98 ± 5.2 kcals/kg FFM), with non-LEA athletes (n = 2) marginally surpassing the

The observation of lightning from space can have several advantages, including views of the tops of clouds, that can facilitate the study of in-cloud lightning as well as the world-wide access provided by the orbital parameters of a satellite. Given the brief duration of lightning, current space-based lighting monitors are necessarily complex in order to resolve both the spatial and temporal features of lighting discharges. Event-based sensors provide a new low-cost way of using a commercial camera to study lightning from space. The Falcon Neuro mission comprises two event-based vision sensors attached to the Columbus Module of the International Space Station. Its mission is to detect lightning and related electrical discharges in the Earth’s atmosphere. We report here on initial data collection and analysis of lightning by the United States Air Force Academy and Western Sydney University.