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Abstract: The coastal, unconfined aquifer at Huntington Beach, California contains saline groundwater (33psu) adjacent to the water line, and a brackish groundwater (BGW) mixing zone (3–9psu) approximately 50m from the water line. According to salinity and water isotope analyses, the BGW composition varies spatially in the alongshore direction. Measurements obtained from two BGW wells indicate this water is a mixture of seawater and a freshwater end member (likely infiltrated runoff); results from a third more southerly well suggest the BGW is composed of seawater, freshwater, and water from the confined Talbert Aquifer. Saline groundwater, on the other hand, shares similar salinity and water isotopic composition with seawater. The saline groundwater is enriched with short- and long-lived radium isotopes relative to the surf zone, which in turn is enriched relative to waters further offshore. We derive eddy diffusion coefficients for the nearshore using 223Ra and 224Ra, and in conjunction with 226Ra activities, estimate a submarine groundwater discharge (SGD) rate between 4.2 and 8.9Lmin−1m−1 of shoreline, respectively. Using analytical models, we estimate that between 74 and 100% of this discharge represents seawater than has been forced by tides and waves through the beach aquifer. Under one set of model assumptions, results indicate that a portion (up to 56%) of seawater pumped into the beach aquifer by waves and tides is not discharged suggesting salt water intrusion may be occurring. Because saline groundwater is enriched with dissolved inorganic nitrogen and soluble reactive phosphate relative to the coastal ocean, our results suggest that tidally and wave-driven seawater circulated through the beach aquifer represents an important mechanism for nutrient input to the nearshore environment in dry weather. Estimates of nutrient flux to the coastal ocean via SGD along 16–17km of shoreline are equivalent to nutrient fluxes from two salt water wetlands near the study site during the dry season. [Copyright &y& Elsevier]

Using radium (Ra) isotopes and nutrient analyses, we found that submarine groundwater discharge (SGD) is an important source of "new" nutrients, particularly nitrogen, to coral reefs around the world. Nitrogen input estimates associated with SGD range from 3 to 800 mmol h-1 per meter of shoreline. The use of Ra isotopes allows us to quantify the inorganic nitrogen input from this source of nutrients. Increasing coastal population and land use practices may enhance anthropogenic nutrient loading from submarine groundwater contributing to reef degradation. [ABSTRACT FROM AUTHOR]

A 2 °C increase in global temperature above pre-industrial levels is considered a reasonable target for avoiding the most devastating impacts of anthropogenic climate change. In June 2015, sea surface temperature (SST) of the South China Sea (SCS) increased by 2 °C in response to the developing Pacific El Niño. On its own, this moderate, short-lived warming was unlikely to cause widespread damage to coral reefs in the region, and the coral reef 'Bleaching Alert' alarm was not raised. However, on Dongsha Atoll, in the northern SCS, unusually weak winds created low-flow conditions that amplified the 2 °C basin-scale anomaly. Water temperatures on the reef flat, normally indistinguishable from open-ocean SST, exceeded 6 °C above normal summertime levels. Mass coral bleaching quickly ensued, killing 40% of the resident coral community in an event unprecedented in at least the past 40 years. Our findings highlight the risks of 2 °C ocean warming to coral reef ecosystems when global and local processes align to drive intense heating, with devastating consequences. [ABSTRACT FROM AUTHOR]

This article delves into the intricacies of leadership development through the lens of the leadership learning framework (LLF); challenging conventional notions by emphasizing self-awareness, relational dynamics, and values as key elements of the leadership development process. We first explore how the LLF reshapes traditional paradigms, redirecting focus from skills acquisition to personal growth rooted in self-awareness, relational dynamics, and values acquisition. Through recommendations and examples, the discussion seeks to clarify the implications of this perspective for leadership educators, advocating for programs that foster not only task proficiency but also critical reflection and a deep sense of interdependency in relationships with others in the leadership process. Ultimately, it underscores the importance of integrating self-reflection, social awareness, and value-centered approaches into leadership development programming to cultivate leaders capable of navigating the complexities of modern society., (© 2024 The Authors. New Directions for Student Leadership published by Wiley Periodicals LLC.)

Context/objective: Excess weight has the potential to carry a substantial physical and emotional burden. A better understanding of perceived consequences of excess weight may facilitate the development of patient-centered programs and interventions to promote weight management efforts in persons with spinal cord injury (SCI). The study objective was to describe consequences of excess weight from the personal perspectives of individuals with SCI., Design: Descriptive qualitative design using in-depth semi-structured interviews and thematic analysis., Setting: Veterans Health Administration (VHA) SCI System of Care., Participants: Individuals with SCI (n-33)., Outcome Measures: Key themes from thematic analysis., Results: Participants were male (61%), ranged from 29 to 84 years of age, and about half had tetraplegia (55%). Five themes were identified that demonstrate negative consequences of excess weight experienced by individuals with SCI, including: (1) physical health conditions (including chronic conditions and SCI secondary conditions), (2) physical symptoms (such as pain, discomfort, and fatigue), (3) movement challenges, (4) appearance-related concerns, and (5) emotional impacts., Conclusions: Carrying excess weight is concerning to individuals with SCI and in terms of consequences such onset or exacerbation of chronic conditions, SCI secondary conditions, physical symptoms, e.g. pain, movement impairment (including hampered mobility, difficult transfers and self-care), image/appearance concerns ( e.g. body image, clothing misfit), and negative emotions ( e.g. unhappy, sad, depressed). Our findings may inform SCI healthcare providers about the consequences of excess weight as experienced by individuals with SCI, highlighting what matters most to persons with SCI and guiding a patient-centered approach to weight management in this population.

Purpose/objective: Nutrition knowledge, beliefs, and behaviors have important implications for managing and preventing chronic and injury-related secondary conditions in persons with spinal cord injuries and disorders (SCI/D). Yet, the unique dietary and nutritional needs and recommendations specific to individuals with SCI/D and their eating beliefs and behaviors have been understudied. Aim is to describe nutrition and eating beliefs and behaviors from the perspectives of individuals with SCI/D., Research Method/design: Descriptive qualitative design using in-depth semistructured interviews with a national sample of veterans with SCI/D ( n = 33). Audio-recorded and transcribed verbatim transcripts were coded and analyzed using thematic analysis., Results: Participants were male (61%), aged 29-84 years, and 55% had tetraplegia. Five key themes were identified: extreme fasting/caloric restriction, perceived healthy eating behaviors, perceived unhealthy eating behaviors, modified eating behaviors due to SCI/D-related symptoms, and food/preparation choices based on abilities/independence and access., Conclusions/implications: Nutrition among veterans with SCI/D may be impacted by many factors, such as nutrition knowledge and beliefs/behaviors about "healthy" and "unhealthy" nutrition, fasting, caloric restriction, imbalanced intake of macro- and micronutrients, overconsumption relative to energy needs, injury-related secondary complications, postinjury body composition and function changes, impairments related to satiety and hunger signals, and difficulty in obtaining and preparing food. Study findings provide many areas that would benefit from intervention. Findings can be used to inform ideal nutrition and healthy eating beliefs and behaviors which are important because nutritional inadequacies can lead to diet-related diseases, may exacerbate SCI secondary conditions, and lead to poor overall health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose: We sought to describe factors influencing reduced rates of obesity screening for patients with spinal cord injury (SCI) in the United States Veterans Health Administration (VA) and to foster potential solutions., Materials and Methods: Semi-structured interviews with healthcare providers and patients with SCI who were recruited nationally from diverse VAs. We performed rapid qualitative analysis using content analysis of interview data., Results: There were 36 providers and 37 patients. We identified provider, patient, and system level barriers to obesity screening for individuals with SCI. Overarching barriers involved provider and patient perceptions that obesity screening is a low priority compared to other health conditions, and body mass index is of low utility. Other obesity screening barriers were related to measuring weight (i.e., insufficient equipment, unknown wheelchair weight, staffing shortages, measurement errors, reduced access to annual screening, insufficient time, patient preference not to be weighed) and measuring height (i.e., insufficient guidance and equipment to this population, measurement errors)., Conclusions: Barriers to obesity screenings exist for patients with SCI receiving care in VA. Healthcare provider and patient interviews suggest possible solutions, including standardizing height and weight measurement processes, ensuring equipment availability in clinics, clarifying guidelines, and offering support to providers and patients.IMPLICATIONS FOR REHABILITATIONIndividuals with spinal cord injury (SCI) have higher rates of obesity, but are often overlooked for annual obesity screening, even in clinic settings designed to care for individuals with SCI.Results may help tailor guidelines/education for healthcare and rehabilitation providers offering them guidance for improving obesity screening for individuals with SCI by standardizing weight and height measurement and documentation. To facilitate this, findings highlight the need for resources, such as ensuring clinics have necessary equipment, and increasing patient access to support and equipment.Improving the provision of obesity screening for individuals with SCI is necessary to improve health outcomes and patient satisfaction with care.

Harmful algal blooms (HABs) are increasing globally, causing economic, human health, and ecosystem harm. In spite of the frequent occurrence of HABs, the mechanisms responsible for their exceptionally high biomass remain imperfectly understood. A 50-y-old hypothesis posits that some dense blooms derive from dinoflagellate motility: organisms swim upward during the day to photosynthesize and downward at night to access deep nutrients. This allows dinoflagellates to outgrow their nonmotile competitors. We tested this hypothesis with in situ data from an autonomous, ocean-wave-powered vertical profiling system. We showed that the dinoflagellate Lingulodinium polyedra 's vertical migration led to depletion of deep nitrate during a 2020 red tide HAB event. Downward migration began at dusk, with the maximum migration depth determined by local nitrate concentrations. Losses of nitrate at depth were balanced by proportional increases in phytoplankton chlorophyll concentrations and suspended particle load, conclusively linking vertical migration to the access and assimilation of deep nitrate in the ocean environment. Vertical migration during the red tide created anomalous biogeochemical conditions compared to 70 y of climatological data, demonstrating the capacity of these events to temporarily reshape the coastal ocean's ecosystem and biogeochemistry. Advances in the understanding of the physiological, behavioral, and metabolic dynamics of HAB-forming organisms from cutting-edge observational techniques will improve our ability to forecast HABs and mitigate their consequences in the future.

Purpose/objective: To explore the impact of the COVID-19 pandemic as experienced and reported by individuals living with a spinal cord injury (SCI)., Research Method/design: Descriptive qualitative design using in-depth semistructured interviews with individuals with SCI ( n = 33) followed by thematic analysis., Results: Three main themes described impacts of the COVID-19 pandemic. (a) Impact on health care use; subthemes elaborated that this was attributable to in-person health care facility restrictions or individual decisions to delay care. Individuals with SCI experienced lapses in primary and SCI-specialty care, rehabilitation/therapy services, and home care, but some made use of telehealth services. (b) Impact on weight and/or weight management lifestyle behaviors; subthemes discussed that engagement in physical activity declined because of fitness center closures, recreational activity cancellations, and safety precautions limiting community-based and outdoor activities. The pandemic disrupted participants' independence in purchasing and making preferred food selections which impacted healthy eating. Participants ate due to boredom, at nonmealtimes, and consumed unhealthy foods during the pandemic. (c) Impact on psychosocial factors; included subthemes noting reduced social interactions, social participation, and ability to pursue pastimes with family, friends, and groups they belonged to. The pandemic also triggered emotional reactions such as worry, fear, doubt, demotivation, and feelings of social isolation., Conclusions: Our findings highlight the magnitude of consequences faced by individuals with SCI when restrictions to health care, healthy lifestyle endeavors, and social participation occurred during the COVID-19 pandemic. Findings may inform SCI health care providers on what is needed in response to future public health or natural disaster crises. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Animals alter their behavior in manners that depend on environmental conditions as well as their developmental and metabolic states. For example, C. elegans is quiescent during larval molts or during conditions of satiety. By contrast, worms enter an exploration state when removed from food. Sensory perception influences movement quiescence (defined as a lack of body movement), as well as the expression of additional locomotor states in C. elegans that are associated with increased or reduced locomotion activity, such as roaming (exploration behavior) and dwelling (local search). Here we find that movement quiescence is enhanced, and exploration behavior is reduced in G protein-coupled receptor kinase grk-2 mutant animals. grk-2 was previously shown to act in chemosensation, locomotion, and egg-laying behaviors. Using neuron-specific rescuing experiments, we show that GRK-2 acts in multiple ciliated chemosensory neurons to control exploration behavior. grk-2 acts in opposite ways from the cGMP-dependent protein kinase gene egl-4 to control movement quiescence and exploration behavior. Analysis of mutants with defects in ciliated sensory neurons indicates that grk-2 and the cilium-structure mutants act in the same pathway to control exploration behavior. We find that GRK-2 controls exploration behavior in an opposite manner from the neuropeptide receptor NPR-1 and the neuropeptides FLP-1 and FLP-18. Finally, we show that secretion of the FLP-1 neuropeptide is negatively regulated by GRK-2 and that overexpression of FLP-1 reduces exploration behavior. These results define neurons and molecular pathways that modulate movement quiescence and exploration behavior., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Davis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Net-zero greenhouse gas (GHG) emissions targets are driving interest in opportunities for biomass-based negative emissions and bioenergy, including from marine sources such as seaweed. Yet the biophysical and economic limits to farming seaweed at scales relevant to the global carbon budget have not been assessed in detail. We use coupled seaweed growth and technoeconomic models to estimate the costs of global seaweed production and related climate benefits, systematically testing the relative importance of model parameters. Under our most optimistic assumptions, sinking farmed seaweed to the deep sea to sequester a gigaton of CO 2 per year costs as little as US$480 per tCO 2 on average, while using farmed seaweed for products that avoid a gigaton of CO 2 -equivalent GHG emissions annually could return a profit of $50 per tCO 2 -eq. However, these costs depend on low farming costs, high seaweed yields, and assumptions that almost all carbon in seaweed is removed from the atmosphere (that is, competition between phytoplankton and seaweed is negligible) and that seaweed products can displace products with substantial embodied non-CO 2 GHG emissions. Moreover, the gigaton-scale climate benefits we model would require farming very large areas (>90,000 km 2 )-a >30-fold increase in the area currently farmed. Our results therefore suggest that seaweed-based climate benefits may be feasible, but targeted research and demonstrations are needed to further reduce economic and biophysical uncertainties., (© 2022. The Author(s).)

Background: The prevalence of obesity and comorbidities is high in the population with spinal cord injury (SCI). We sought to determine the effect of SCI on the functional form of the relationship between body mass index (BMI) and risk of developing nonalcoholic fatty liver disease (NAFLD), and assess whether SCI-specific mapping of BMI to risk of developing NAFLD is needed., Methods: Longitudinal cohort study comparing Veterans Health Administration patients with a diagnosis of SCI to a 1:2 matched control group without SCI. The relationship between BMI and development of NAFLD at any time was assessed with propensity score matched Cox regression models; NAFLD development at 10-year with a propensity score matched logistic model. The positive predictive value of developing NAFLD at 10 years was calculated for BMI 19-45 kg/m 2 ., Results: 14,890 individuals with SCI met study inclusion criteria, and 29,780 Non-SCI individuals in matched control group. Overall, 9.2% in SCI group and 7.3% in Non-SCI group developed NAFLD during the study period. A logistic model assessing the relationship between BMI and the probability of developing a diagnosis of NAFLD demonstrated that the probability of developing disease increased as BMI increased in both cohorts. The probability was significantly higher in the SCI cohort at each BMI threshold ( p  < 0.01), and increased at a higher rate compared with the Non-SCI cohort as BMI increased 19-45 kg/m 2 . Positive predictive value for developing a diagnosis of NAFLD was higher in the SCI group for any given BMI threshold from 19 kg/m 2 to BMI 45 kg/m 2 ., Conclusions: The probability of developing NAFLD is greater in individuals with SCI than without SCI, at every BMI level 19 kg/m 2 to 45 kg/m 2 . Individuals with SCI may warrant a higher level of suspicion and closer screening for NAFLD. The association of SCI and BMI is not linear., Competing Interests: The contents do not represent the views of the VA or the United States Government. The authors have no conflicts of interest to disclose., (© 2022 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Background: PROS disorders are driven by somatic, gain-of-function mutations in PIK3CA that result in hyperactivation of the phosphatidylinositol-3-kinase (PI3K) signaling pathway. PROS encompasses a broad spectrum of overlapping phenotypes (including overgrowth and vascular malformations) that vary significantly in their severity; every case is unique, leading to different, complex experiences. Here, we aim to describe the PROS experience from the patients' and caregivers' points of view, from onset to diagnosis to treatment and support., Results: The PROS patient journey was developed using a literature review, an ethnography study, health care professional (HCP) research, and social listening. It was then validated with patients, caregivers, and patient advocates. Physician research included 94 PROS centers and other vascular anomaly centers throughout the United States and Europe. Ethnographic research included 24 patients, caregivers, and/or advocates; selected data from 223 patients were reviewed. Key priority areas of need were identified, along with barriers to and potential enablers of quality care. Visual mapping of the PROS patient and family journey was developed to identify key personal health and system issues, and opportunities for improvements throughout patients' lifespans. Maps were also developed for 3 specific conditions: Klippel-Trénaunay syndrome (K-T); congenital lipomatous overgrowth, vascular malformations, epidermal nevi, scoliosis/skeletal and spinal anomalies (CLOVES) syndrome; and megalencephaly-capillary malformation syndrome (M-CM). Overall, most patients with PROS conditions and their families struggle with a long path to diagnosis, access to genetic testing, and finding qualified specialists. Following diagnosis, patients and families are frequently challenged with major medical events, comorbidities, unpredictability, frequent hospitalization, impact on school and work, the need for multidisciplinary care, unwanted attention, adverse impact on mental and emotional health, and financial pressures. Lack of effective pain management emerged as a substantial issue. Challenges and barriers to quality care shift throughout patients' lifespans; transition from pediatric to adult care can be especially difficult., Conclusions: This patient journey in PROS was created in collaboration with patients, caregivers, and advocates as key partners. This novel methodology, which could be applied elsewhere, can more accurately identify areas of unmet need, barriers to care, education topics, and assist HCPs to understand the patient and family perspective., (© 2022. The Author(s).)

Introduction: Individuals with spinal cord injury (SCI) are vulnerable to obesity. Annual obesity screening using body mass index (BMI) is the standard of care mandated by US Veterans Health Administration (VHA) guidelines. Our objective was to determine the rates, variability, and predictors of guideline-concordant annual screening for obesity, given potential challenges of height and weight measurements in individuals with SCI., Methods: This is a cross-sectional retrospective study using US national VA databases. We identified all VHA patients with chronic SCI in the fiscal year (FY) 2019, their treating facility and frequency of recorded height and weight. We applied mixed-effects logistic regression models to assess associations between annual BMI screening and patient- and facility-level characteristics., Results: Of 20,978 individuals with chronic SCI in VHA in FY19, guideline-concordant annual BMI screening was lacking in 37.9%. Accounting for facility-level factors (geographic region, SCI facility type, volume of patients with SCI treated at the facility), a mixed-effects logistic regression model demonstrated that lack of annual obesity screening was significantly associated with older patient age (p < 0.001) and fewer outpatient encounters (p < 0.001) but not other patient-level factors such as sex, race, level of injury, or rurality. The rate of obesity screening among different facilities within VHA varied widely from 11.1% to 75.7%., Conclusion: A large proportion of persons with SCI receiving care in VHA do not receive guideline-concordant annual obesity screening, an especially acute problem in some facilities. Older patients with fewer outpatient encounters are more likely to be missed. To inform the design of interventions to improve identification and documentation of obesity, further study is needed to assess potential barriers to obesity screening in the population with SCI., (© 2022 The Author(s). Published by S. Karger AG, Basel.)

The interaction of coral reefs, both chemically and physically, with the surrounding seawater is governed, at the smallest scales, by turbulence. Here, we review recent progress in understanding turbulence in the unique setting of coral reefs-how it influences flow and the exchange of mass and momentum both above and within the complex geometry of coral reef canopies. Flow above reefs diverges from canonical rough boundary layers due to their large and highly heterogeneous roughness and the influence of surface waves. Within coral canopies, turbulence is dominated by large coherent structures that transport momentum both into and away from the canopy, but it is also generated at smaller scales as flow is forced to move around branches or blades, creating wakes. Future work interpreting reef-related observations or numerical models should carefully consider the influence that spatial variation has on momentum and scalar flux.

Sleep is nearly universal among animals, yet remains poorly understood. Recent work has leveraged simple model organisms, such as Caenorhabditis elegans and Drosophila melanogaster larvae, to investigate the genetic and neural bases of sleep. However, manual methods of recording sleep behavior in these systems are labor intensive and low in throughput. To address these limitations, we developed methods for quantitative imaging of individual animals cultivated in custom microfabricated multiwell substrates, and used them to elucidate molecular mechanisms underlying sleep. Here, we describe the steps necessary to design, produce, and image these plates, as well as analyze the resulting behavioral data. We also describe approaches for experimentally manipulating sleep. Following these procedures, after ~2 h of experimental preparation, we are able to simultaneously image 24 C. elegans from the second larval stage to adult stages or 20 Drosophila larvae during the second instar life stage at a spatial resolution of 10 or 27 µm, respectively. Although this system has been optimized to measure activity and quiescence in Caenorhabditis larvae and adults and in Drosophila larvae, it can also be used to assess other behaviors over short or long periods. Moreover, with minor modifications, it can be adapted for the behavioral monitoring of a wide range of small animals.

The original version of the Article was missing an acknowledgement of a funding source. The authors acknowledge that A. Safaie and K.Davis were supported by National Science Foundation Award No. 1436254 and G. Pawlak was supported by Award No. 1436522. This omission has now been corrected in the PDF and HTML versions of the Article.

Coral bleaching is the detrimental expulsion of algal symbionts from their cnidarian hosts, and predominantly occurs when corals are exposed to thermal stress. The incidence and severity of bleaching is often spatially heterogeneous within reef-scales (<1 km), and is therefore not predictable using conventional remote sensing products. Here, we systematically assess the relationship between in situ measurements of 20 environmental variables, along with seven remotely sensed SST thermal stress metrics, and 81 observed bleaching events at coral reef locations spanning five major reef regions globally. We find that high-frequency temperature variability (i.e., daily temperature range) was the most influential factor in predicting bleaching prevalence and had a mitigating effect, such that a 1 °C increase in daily temperature range would reduce the odds of more severe bleaching by a factor of 33. Our findings suggest that reefs with greater high-frequency temperature variability may represent particularly important opportunities to conserve coral ecosystems against the major threat posed by warming ocean temperatures.

Cells composing the mammary secretory compartment have evolved a high capacity to secrete not only proteins but also triglycerides and carbohydrates. This feature is illustrated by the mouse, which can secrete nearly twice its own weight in milk proteins, triglycerides and lactose over a short 20-day lactation. The coordination of synthesis and export of products in other secretory cells is orchestrated in part by the transcription factor X-box binding protein 1 (XBP1). To assess the role of XBP1 in mammary epithelial cells (MEC), we studied floxed XBP1 female mice lacking (wild type; WT) or expressing the Cre recombinase under the control of the ovine β-lactoglobulin promoter (ΔXBP1(MEC)). Pregnant ΔXBP1(MEC) females had morphologically normal mammary development and gave birth to the same number of pups as WT mice. Their litters, however, suffered a weight gain deficit by lactation day 3 (L3)3 that grew to 80% by L14. ΔXBP1(MEC) dams had only modest changes in milk composition (-21% protein, +24% triglyceride) and in the expression of associated genes in isolated MEC. By L5, WT glands were fully occupied by dilated alveoli, whereas ΔXBP1(MEC) glands contained fewer, mostly unfilled alveoli and retained a prominent adipocyte population. The smaller epithelial compartment in ΔXBP1(MEC) glands was explained by lower MEC proliferation and increased apoptosis. Finally, endoplasmic reticulum ribbons were less abundant in ΔXBP1(MEC) at pregnancy day 18 and failed to increase in abundance by L5. Collectively, these results show that XBP1 is required for MEC population expansion during lactation and its ability to develop an elaborate endoplasmic reticulum compartment.

Background: Sipuleucel-T, an autologous cellular immunotherapy, is approved for the treatment of certain patients with metastatic castration-resistant prostate cancer (mCRPC). Sipuleucel-T is the first personalized treatment for prostate cancer to be manufactured using the immune system of each individual patient. Patient preparation and compliance are critical because patients undergo serial leukapheresis and reinfusion procedures within a relatively short time period, which may result in transient reactions., Objectives: The study aims to identify patients best suited for sipuleucel-T treatment, provide an overview of treatment, and encourage infusion sites to consider a primary contact model for the efficient coordination of care., Methods: Treatment experiences were evaluated from 124 patients with mCRPC who received sipuleucel-T from January 2010 to August 2013 according to current best practices. Feedback was collected from reflective interdisciplinary discussion within the sipuleucel-T delivery team (nurses, advanced practice providers, urologists, and medical oncologists)., Findings: Early patient identification and education on treatment rationale, delivery, and expectations help ensure a successful sipuleucel-T treatment experience. A multidisciplinary coordinated-care process can facilitate proficient sipuleucel-T delivery, and the selection of a primary contact for care coordination offers benefits, such as clear and efficient education.

The Muller F element (4.2 Mb, ~80 protein-coding genes) is an unusual autosome of Drosophila melanogaster; it is mostly heterochromatic with a low recombination rate. To investigate how these properties impact the evolution of repeats and genes, we manually improved the sequence and annotated the genes on the D. erecta, D. mojavensis, and D. grimshawi F elements and euchromatic domains from the Muller D element. We find that F elements have greater transposon density (25-50%) than euchromatic reference regions (3-11%). Among the F elements, D. grimshawi has the lowest transposon density (particularly DINE-1: 2% vs. 11-27%). F element genes have larger coding spans, more coding exons, larger introns, and lower codon bias. Comparison of the Effective Number of Codons with the Codon Adaptation Index shows that, in contrast to the other species, codon bias in D. grimshawi F element genes can be attributed primarily to selection instead of mutational biases, suggesting that density and types of transposons affect the degree of local heterochromatin formation. F element genes have lower estimated DNA melting temperatures than D element genes, potentially facilitating transcription through heterochromatin. Most F element genes (~90%) have remained on that element, but the F element has smaller syntenic blocks than genome averages (3.4-3.6 vs. 8.4-8.8 genes per block), indicating greater rates of inversion despite lower rates of recombination. Overall, the F element has maintained characteristics that are distinct from other autosomes in the Drosophila lineage, illuminating the constraints imposed by a heterochromatic milieu., (Copyright © 2015 Leung et al.)

Female mammals call on hormonally driven metabolic adaptations to meet the energy demand of late pregnancy and lactation. These maternal adaptations preserve limiting nutrients and promote their transfer to the uterus during pregnancy or mammary gland during lactation. The novel metabolic hormone fibroblast growth factor-21 (FGF21) was recently shown to increase suddenly at the onset of lactation in dairy cows, but whether FGF21 is induced during the reproductive cycle of other mammals is unknown. To start addressing this question, we studied subsets of mice when virgin (V), on day 18 of pregnancy (P18) and on lactation day 1 (L1), L5 and L14. Plasma FGF21 increased from nearly undetectable levels to over 8 ng/ml between V and P18 and returned to V levels by L1. Gene expression studies showed that liver was the major source of plasma FGF21 at P18 with little or no contribution from other known expressing tissues or from the developing placenta and mammary epithelial cells. The increased FGF21 production at P18 was dissociated from plasma nonesterified fatty acids and liver lipids, unlike that seen in fasted V mice. Changes in FGF21 signaling components in target tissues were modest except for reduced β-Klotho and FGFR1c expression in P18 adipose tissue. The placenta expressed both β-Klotho and FGFR1c, raising the possibility that it responds to FGF21. In conclusion, maternal FGF21 is increased when products of conception account for ∼ 40% of maternal weight, suggesting that FGF21 orchestrates some of the adaptations needed to meet the energy demand of late pregnancy., (Copyright © 2014 the American Physiological Society.)

This study examined the association of victimization in a physically violent dating relationship with risk behaviors, age of risk behavior initiation, and co-occurrence of risk behaviors among students in grades 9 through 12 in the United States. Data were from the 2003 national Youth Risk Behavior Survey (YRBS). Nearly 9% of students reported experiencing dating violence victimization. Dating violence victimization was associated with alcohol use, marijuana use, and having ever had sexual intercourse among female students and having ever had sexual intercourse among male students. Dating violence victimization also was associated with early initiation of alcohol use among female students. The odds of dating violence victimization increased as the number of risk behaviors increased and as the number of lifetime sexual partners increased. These risk behavior patterns should serve as warning signs of elevated risk for dating violence victimization and may be helpful in identifying adolescents who could benefit from targeted, preventive interventions.

The authors analyzed data from the School Health Policies and Programs Study 2000 to assess the associations between the presence of a district physical education coordinator and district-level physical education policies and practices recommended by federal government agencies and national organizations. The authors also examined the relationship between teacher qualifications and staff development related to physical education and self-reported implementation of recommended teachingpractices. District-level data were collected by self-administered mail questionnaires from a nationally representative sample of school districts. Classroom-level data were collected by computer-assisted personal interviews with teachers of randomly selected classes in elementary schools and randomly selected required physical education courses in middle/junior high and senior high schools. Nearly two thirds (62.2%) of districts had a physical education coordinator, and those were generally more likely than other districts to report having policies and practices that corresponded with national recommendations for high-quality physical education programs. More than two thirds of teachers (66.9%) met the criteria for teacher qualifications based on their education and certification. These teachers were more likely than others to report use of certain recommended physical education teaching practices. Teachers who participated in staff development also were more likely to use recommended teaching practices in their classrooms. Using a district physical education coordinator and teachers with appropriate qualifications as well as offering staff development opportunities on physical education may enhance school physical education programs.