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This paper describes two new records of Kershaw's Panda-snail Pygmipanda kershawi (Brazier, 1872) (Pulmonata: Caryodidae) from New South Wales, both representing new localities for the species. There have been very few records of this native land snail from the state in the last century. A record from the Khancoban area represents a northern extension of the species' known range in New South Wales and a record from the Running Waters area in the Snowy River valley is the southernmost in the state. Pygmipanda kershawi is considered to be of conservation concern in New South Wales. [ABSTRACT FROM AUTHOR]

Holistic ethics education in the professions is never fully served by a reliance on regulatory compliance alone. Data obtained from penalties due to corporate non-compliance in specific professions rarely describe the underlying ethical failures that are the foundation for "rule-breaking" in the professions. However, "violations" data may serve as a springboard for an educational discussion and approach that helps professionals (and those studying to become professionals) to understand the basic moral reasoning that underlies the "good" that is served by adhering to professional Codes of Conduct, Codes of Practice, Codes of Ethics, and the professional regulatory environment. We here use data obtained from the US FDA, US DOJ, and from Violations Tracker and compare these data with the IFPMA (International Federation of Pharmaceutical Manufacturing Association) Ethos and guiding principles. These side-by-side linkages serve as a mechanism to help students assess which ethical principles are at the core of each such violation in the pharmaceutical industry. We further recommend that this approach be incorporated into ethics education, especially beginning at the undergraduate level, as prophylaxis to ethical lapses in later professional life. [ABSTRACT FROM AUTHOR]

Our findings demonstrate the persistence and widening of geographic disparities in dupilumab access over time and may provide a useful baseline for evaluating the future impact of newly approved therapies on the AD treatment landscape. Our study is limited in that geographic and specialty data were only available for prescribers with >=10 dupilumab claims submitted to Medicare and that the Medicare population may not be the main users of dupilumab in the USA. Trends in the total number of prescribers, beneficiaries, claims, and total cost of dupilumab in the Medicare population from 2017 to 2019. [Extracted from the article]

This paper summarises information on the occurrence of the Common Wombat in the Pilliga Forest, based on 12 years of observations and collation of records from additional sources. The core of the species' distribution in the Pilliga Forest appears to coincide with the most topographically rugged areas, which contain forested hillslopes providing suitable burrow sites and a slightly more mesic microclimate than the broader Pilliga Forest. Outlying records are located where higher quality soils occur in proximity to topographically rugged areas. The paper also notes the regional conservation significance of this edge-of-range population and highlights the local climate refuge value of the south-eastern Pilliga Forest for wombats and other mesic-dependent fauna in the Pilliga Forest. [ABSTRACT FROM AUTHOR]

Background: The risk of type 2 diabetes is increasing in teenage girls, and is associated with their greater insulin resistance (IR). Hypothesis: We hypothesized that the adverse metabolic profile of girls (compared with boys) would persist from childhood through adolescence. Patients and Methods: Community‐based longitudinal cohort of 292 children (147 boys) studied annually from 9 to 16 years. Measures: IR (homeostasis‐model‐assessment‐2), high‐density lipoprotein‐cholesterol (HDL‐C), triglycerides, % body‐fat (dual‐energy x‐ray absorptiometry), pubertal stage (age at peak height velocity), physical activity (accelerometry). Multi‐level modelling established the age‐related trends in IR and lipids and the influence of covariates. Results: Each year from 9 to 15 years, girls had 21% to 63% higher IR than boys (girls mean IR 0.73‐1.33, boys 0.51‐0.89, P < .005). At 16 years the gender difference was not significant (girls IR 0.60, boys 0.56, P = .45). Girls had lower HDL‐C from 9 to 12 years, higher triglycerides from 9 to 14 years, greater adiposity throughout, and earlier puberty, but boys were more active than girls (all P < .05). After adjustment for %‐fat, puberty and activity, the gender difference in IR between girls and boys aged 9 to 15 years became non‐significant (IR girls 0.66‐1.01, boys 0.65‐1.04, P > .07). However, after adjustment at 16 years, girls’ IR was 25% lower than boys’ (girls 0.44, boys 0.63, P = .001), and they had 22% higher HDL‐C (P < .001) and 20% lower triglycerides (P = .003). Conclusions: The higher IR of prepubertal and early pubertal girls diminishes during late puberty, and boys begin to exhibit greater metabolic risk. Despite being leaner and more active, boys at 16 years have higher IR than girls, suggesting future higher risk for diabetes, thus we reject our hypothesis. [ABSTRACT FROM AUTHOR]

Key points: Optogenetics has emerged as a potential alternative to electrotherapy for treating heart rhythm disorders, but its applicability for terminating atrial arrhythmias remains largely unexplored. We used computational models reconstructed from clinical MRI scans of fibrotic patient atria to explore the feasibility of optogenetic termination of atrial tachycardia (AT), comparing two different illumination strategies: distributed vs. targeted. We show that targeted optogenetic stimulation based on automated, non‐invasive flow‐network analysis of patient‐specific re‐entry morphology may be a reliable approach for identifying the optimal illumination target in each individual (i.e. the critical AT isthmus). The above‐described approach yields very high success rates (up to 100%) and requires dramatically less input power than distributed illumination We conclude that simulations in patient‐specific models show that targeted light pulses lasting longer than the AT cycle length can efficiently and reliably terminate AT if the human atria can be successfully light‐sensitized via gene delivery of ChR2. Abstract: Optogenetics has emerged as a potential alternative to electrotherapy for treating arrhythmia, but feasibility studies have been limited to ventricular defibrillation via epicardial light application. Here, we assess the efficacy of optogenetic atrial tachycardia (AT) termination in human hearts using a strategy that targets for illumination specific regions identified in an automated manner. In three patient‐specific models reconstructed from late gadolinium‐enhanced MRI scans, we simulated channelrhodopsin‐2 (ChR2) expression via gene delivery. In all three models, we attempted to terminate re‐entrant AT (induced via rapid pacing) via optogenetic stimulation. We compared two strategies: (1) distributed illumination of the endocardium by multi‐optrode grids (number of optrodes, Nopt = 64, 128, 256) and (2) targeted illumination of the critical isthmus, which was identified via analysis of simulated activation patterns using an algorithm based on flow networks. The illuminated area and input power were smaller for the targeted approach (19–57.8 mm2; 0.6–1.8 W) compared to the sparsest distributed arrays (Nopt = 64; 124.9 ± 6.3 mm2; 3.9 ± 0.2 W). AT termination rates for distributed illumination were low, ranging from <5% for short pulses (1/10 ms long) to ∼20% for longer stimuli (100/1000 ms). When we attempted to terminate the same AT episodes with targeted illumination, outcomes were similar for short pulses (1/10 ms long: 0% success) but improved for longer stimuli (100 ms: 54% success; 1000 ms: 90% success). We conclude that simulations in patient‐specific models show that light pulses lasting longer than the AT cycle length can efficiently and reliably terminate AT in atria light‐sensitized via gene delivery. We show that targeted optogenetic stimulation based on analysis of AT morphology may be a reliable approach for defibrillation and requires less power than distributed illumination. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, causing morbidity and mortality in millions worldwide. The atria of patients with persistent AF (PsAF) are characterized by the presence of extensive and distributed atrial fibrosis, which facilitates the formation of persistent reentrant drivers (RDs, i.e., spiral waves), which promote fibrillatory activity. Targeted catheter ablation of RD-harboring tissues has shown promise as a clinical treatment for PsAF, but the outcomes remain sub-par. Personalized computational modeling has been proposed as a means of non-invasively predicting optimal ablation targets in individual PsAF patients, but it remains unclear how RD localization dynamics are influenced by inter-patient variability in the spatial distribution of atrial fibrosis, action potential duration (APD), and conduction velocity (CV). Here, we conduct simulations in computational models of fibrotic atria derived from the clinical imaging of PsAF patients to characterize the sensitivity of RD locations to these three factors. We show that RDs consistently anchor to boundaries between fibrotic and non-fibrotic tissues, as delineated by late gadolinium-enhanced magnetic resonance imaging, but those changes in APD/CV can enhance or attenuate the likelihood that an RD will anchor to a specific site. These findings show that the level of uncertainty present in patient-specific atrial models reconstructed without any invasive measurements (i.e., incorporating each individual's unique distribution of fibrotic tissue from medical imaging alongside an average representation of AF-remodeled electrophysiology) is sufficiently high that a personalized ablation strategy based on targeting simulation-predicted RD trajectories alone may not produce the desired result. [ABSTRACT FROM AUTHOR]

This article describes a record of the White-footed Dunnart Sminthopsis leucopus (Gray, 1842) north of the Shoalhaven River near Nowra in New South Wales in 1995. Two decades later this remains the most northerly record of S. leucopus in New South Wales. The Nowra site was in dry open forest with very sparse understorey and ground cover, unlike the wetter, more heavily vegetated habitats where the species is typically found in Victoria. [ABSTRACT FROM AUTHOR]

A field survey of the freshwater fishes of the Bomaderry Creek catchment in 1994-1995 recorded nine native species and one introduced species. One of the species recorded, Climbing Galaxias Galaxias brevipinnis, is of conservation concern in New South Wales. A report of an additional four native species was obtained from secondary sources. A concrete weir on Bomaderry Creek was found to represent a discontinuity in the distribution of some fish species. Four out of the six diadromous species recorded in the field survey were found only below the weir, while the two potamodromous species recorded were both found above and below the weir. The subsequent decommissioning of this weir in 1998 may substantially increase the potential habitat available for diadromous fish species in the Bomaderry Creek catchment. [ABSTRACT FROM AUTHOR]

Background: The unique health care needs of the homeless population have been well-documented in the literature. However, fewer studies are available assessing the prevalent dermatologic conditions that impact this population. Objective: The purpose of our study was to assess the frequency of dermatologic conditions occurring in a shelter-based homeless population, to understand patient demographic characteristics, and determine the suspected skin malignancy rate. Methods: We completed a retrospective chart review of patients seen at the free dermatology clinic held at the South Park Inn (SPI) homeless shelter in Hartford. Two-hundred-seventy-three patient paper charts from August 2008 to February 2016 were reviewed. Results: The most common dermatologic conditions included acne vulgaris (18.7%), atopic dermatitis (10.6%), tinea pedis (9.2%), xerosis (8.1%), and folliculitis (5.1%). The rate of suspected skin malignancies in this population was 2.5%. Conclusions: Some of our findings mirror the frequency of dermatologic conditions identified in sheltered homeless populations in previous studies. Differences seen may be attributed to geographic and demographic variability. The suspected skin cancer rate, which has been rarely studied, is of particular interest due to this population's risk for chronic sun exposure, lack of consistent sunscreen use, and poor access to dermatologic screening, and should be more thoroughly investigated in future studies. [ABSTRACT FROM AUTHOR]