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Mutations in five canonical Ras pathway genes (NF1, NRAS, KRAS, PTPN11 and CBL) are detected in nearly 90% of patients with juvenile myelomonocytic leukemia (JMML), a frequently fatal malignant neoplasm of early childhood. In this report, we describe seven patients diagnosed with SH2B3-mutated JMML, including five patients who were found to have initiating, loss-of-function mutations in the gene. SH2B3 encodes the adaptor protein LNK, a negative regulator of normal hematopoiesis upstream of the Ras pathway. These mutations were identified to be germline, somatic or a combination of both. Loss of function of LNK, which has been observed in other myeloid malignancies, results in abnormal proliferation of hematopoietic cells due to cytokine hypersensitivity and activation of the JAK/STAT signaling pathway. In vitro studies of induced pluripotent stem cell-derived JMML-like hematopoietic progenitor cells also demonstrated sensitivity of SH2B3-mutated hematopoietic progenitor cells to JAK inhibition. Lastly, we describe two patients with JMML and SH2B3 mutations who were treated with the JAK1/2 inhibitor ruxolitinib. This report expands the spectrum of initiating mutations in JMML and raises the possibility of targeting the JAK/STAT pathway in patients with SH2B3 mutations.

The Pseudomonas syringae species complex is a heterogeneous group of plant pathogenic bacteria associated with a wide distribution of plant species. Advances in genomics are revealing the complex evolutionary history of this species complex and the wide array of genetic adaptations underpinning their diverse lifestyles. Here, we genomically characterize two P. syringae isolates collected from diseased Callery pears (Pyrus calleryana) in Berkeley, California in 2019 and 2022. We also isolated a lytic bacteriophage, which we characterized and evaluated for biocontrol efficiency. Using a multilocus sequence analysis and core genome alignment, we classified the P. syringae isolates as members of phylogroup 2, related to other strains previously isolated from Pyrus and Prunus. An analysis of effector proteins demonstrated an evolutionary conservation of effectoromes across isolates classified in PG2 and yet uncovered unique effector profiles for each, including the two newly identified isolates. Whole-genome sequencing of the associated phage uncovered a novel phage genus related to Pseudomonas syringae pv. actinidiae phage PHB09 and the Flaumdravirus genus. Finally, using in planta infection assays, we demonstrate that the phage was equally useful in symptom mitigation of immature pear fruit regardless of the Pss strain tested. Overall, this study demonstrates the diversity of P. syringae and their viruses associated with ornamental pear trees, posing spill-over risks to commercial pear trees and the possibility of using phages as biocontrol agents to reduce the impact of disease.IMPORTANCEGlobal change exacerbates the spread and impact of pathogens, especially in agricultural settings. There is a clear need to better monitor the spread and diversity of plant pathogens, including in potential spillover hosts, and for the development of novel and sustainable control strategies. In this study, we characterize the first described strains of Pseudomonas syringae pv. syringae isolated from Callery pear in Berkeley, California from diseased tissues in an urban environment. We show that these strains have divergent virulence profiles from previously described strains and that they can cause disease in commercial pears. Additionally, we describe a novel bacteriophage that is associated with these strains and explore its potential to act as a biocontrol agent. Together, the data presented here demonstrate that ornamental pear trees harbor novel P. syringae pv. syringae isolates that potentially pose a risk to local fruit production, or vice versa-but also provide us with novel associated phages, effective in disease mitigation.

Artificial light at night (ALAN) is increasing in extent and intensity across the globe. It has been shown to interfere with animal sensory systems, orientation and distribution, with the potential to cause significant ecological impacts. We analysed the locations of 102 mountain lions (Puma concolor) in a light-polluted region in California. We modelled their distribution relative to environmental and human-disturbance variables, including upward radiance (nearby lights), zenith brightness (sky glow) and natural illumination from moonlight. We found that mountain lion probability of presence was highly related to upward radiance, that is, related to lights within approximately 500 m. Despite a general pattern of avoidance of locations with high upward radiance, there were large differences in degree of avoidance among individuals. The amount of light from artificial sky glow was not influential when included together with upward radiance in the models, and illumination from moonlight was not influential at all. Our results suggest that changes in visibility associated with lunar cycles and sky glow are less important for mountain lions in their selection of light landscapes than avoiding potential interactions with humans represented by the presence of nearby lights on the ground. This article is part of the theme issue Light pollution in complex ecological systems.

Very little is known about mental health service utilization among Arab and Middle Eastern American (AMEA) college students. We aimed to document AMEA college students' mental health service utilization behaviors and how known predictors shape this utilization. Using data from the 2015-2020 Healthy Minds Study, we examined self-reported diagnosis of depression or anxiety, lifetime use of therapy/psychotropic medications, and current use of therapy/medications among AMEA and non-AMEA white college students. Survey-weighted logistic regression models were fit with AMEA ethnicity as the main exposure and interaction terms to examine effect modification by religiosity, knowledge, beliefs, and stigma around treatment. Compared to non-AMEA white students, AMEA students had reduced odds of reporting diagnosis of depression (adjusted odds ratio, AOR: 0.84, 95% confidence interval, CI: 0.75, 0.94) or anxiety (AOR: 0.79, 95% CI: 0.71, 0.88), of ever attending therapy (AOR: 0.72, 95% CI: 0.65, 0.79), currently attending therapy (AOR: 0.88, 95% CI: 0.77, 0.99), and receiving medication for a mental health diagnosis (AOR: 0.79, 95% CI: 0.71, 0.88). The relationships between Arab ethnicity and mental health service utilization were modified by religiosity, knowledge, beliefs, and personal stigma about treatment. Better documentation on mental health service utilization in AMEA populations is needed in order to improve prevention efforts and service delivery.

John D Rodriguez,1,2 Samantha Kerti,3 Adam Hamm,3 George W Ousler,1 Ethan Bensinger,1,2 Sadie Burnham,1,2 Mark B Abelson1,2,4,5 1Ora, Inc, Andover, MA, USA; 2Andover Eye Institute, Andover, MA, USA; 3Statistics and Data Corporation, Tempe, AZ, USA; 4Ophthalmology, Harvard Medical School, Cambridge, MA, USA; 5Mass Eye and Ear, Boston, MA, USACorrespondence: John D Rodriguez, Email jrodriguez@oraclinical.comPurpose: The absence of a standardized diagnostic method for clinical signs of Dry Eye Disease (DED) complicates clinical trials for future treatments. This paper evaluated Lissamine Green (LG) conjunctival staining as a valid, stable and modifiable endpoint for both clinical practice and clinical trials.Methods: Screening and pre-randomization data from two identically designed clinical trials for DED resulted in a pooled dataset of 494 subjects. Inclusion was based on reported symptoms, lissamine green (LG) conjunctival staining, Fluorescein (Fl) corneal and conjunctival staining, and Schirmer’s Test (ST). Outcome measures were assessed based on the modifiability of LG staining to exposure to a Controlled Adverse Environment (CAE®), correlation of LG to Fl staining, relative variation of LG staining scores and Schirmer test scores, and the correlation of LG staining with symptom scores.Results: The modifiability of LG conjunctival staining to environmental exposure was demonstrated, with nasal LG and FL staining displaying the most similar percent change. Nasal LG conjunctival staining scores for subjects with ST scores of less than 8mm were significantly higher than for subjects with ST greater than 8mm. LG staining scores were more consistent (25% change from baseline threshold) than ST scores. Finally, statistically significant correlations were found between LG staining and a number of symptom scores.Conclusion: This evaluation demonstrates the superiority of the utilization of a clinical endpoint focused on ocular surface damage. The reproducibility and modifiability of LG conjunctival staining to controlled adverse environment, coupled with its significant correlation with symptoms, positions it as an exemplary clinical sign endpoint for clinical management and in clinical trials. Our findings advocate for the adoption of LG conjunctival staining as a primary endpoint in both clinical research and drug development, offering a more effective means of identifying and addressing ocular surface damage in the realm of DED.Keywords: dry eye, conjunctiva, stain, lissamine green clinical trials, controlled adverse environment, disease models, drug screening, dry eye disease, efficacy endpoints

Abstract Engagement of patients and the public in health research is crucial for ensuring research relevance and alignment with community needs. However, there is a lack of nuanced evaluations and examples that promote collaborative and reflective learning about partnerships with partners. The aim of this paper is to provide a case example of a participatory evaluation of the engagement of older adult partners in an aging-focused research centre. We outline our process of co-planning and implementing an evaluation of the McMaster Collaborative for Health and Aging’s engagement strategy through the use of multiple methods, including a standardized tool and qualitative approaches. The team chose to explore and capture the engagement experiences and perspectives of the older adult partners within the Collaborative using a survey (the Public and Patient Engagement Evaluation Tool (PPEET)), an art-based method (photovoice), and a focus group. We present a brief summary of the findings but primarily focus this paper on the experiences of using each methodology and tool, with an emphasis on promoting dialogue on the benefits, limitations, and challenges. We reflect on the process of co-planning and the integration of both standardized tools and qualitative approaches to adopt a holistic approach to evaluating partnership within the Collaborative. Ultimately, this case example aims to provide practical guidance for other research groups navigating the complexities of partnership engagement and evaluation, thereby promoting meaningful partnerships in research.

OBJECTIVE: Exposure-based therapy (EXP) and behavioral activation (BA) are empirically-supported behavioral intervention techniques that target avoidance and approach behavior to alleviate symptoms. Although EXP is an established treatment for generalized anxiety disorder (GAD), the effectiveness of BA for GAD has not been directly tested or compared with that of EXP. This study examined the efficacy of EXP and BA for adults with GAD. METHOD: In a randomized clinical trial (clinicaltrials.gov: NCT02807480) with partial blinding in Tulsa, OK, 102 adults with GAD were allocated to manualized, 10-session EXP or BA between April 2016-April 2021. Primary analyses were intention-to-treat and included the 94 (46 EXP, 48 BA) participants who started treatment. The GAD-7 self-report scale was the primary outcome measure. RESULTS: Similar GAD-7 declines were observed at post-treatment for EXP (d=-0.97 [95% CI -1.40 to -0.53]) and BA (d=-1.14 [95% CI -1.57 to -0.70]), and were maintained through 6-month follow-up (EXP: d=-2.13, BA: d=-1.98). Compared to EXP, BA yielded more rapid declines in anxiety and depression scores during therapy (d=0.75-0.77), as well as lower anxiety and depression scores (d=0.13-0.14) and greater participant-rated improvement (d=0.64) at post-treatment. Bayesian analyses indicated 74-99% probability of greater change in BA than EXP at post-treatment. CONCLUSIONS: BA and EXP are both effective in treating GAD, and BA may confer greater benefit during treatment. Future research is warranted to inform personalized treatment approaches.

The purpose of this study was to design a curriculum of artificial intelligence (AI) application for secondary schools. The learning objective of the curriculum was to allow students to learn the application of conversational AI on a block-based programming platform. Moreover, the empirical study actually implemented the curriculum in the formal learning of a secondary school for a period of six weeks. The study evaluated the learning performance of students who were taught with the cycle of experiential learning in one class, while also evaluating the learning performance of students who were taught with the conventional instruction, which was called the cycle of doing projects. Two factors, learning approach and gender, were taken into account. The results showed that females' learning effectiveness was significantly better than that of males regardless of whether they used experiential learning or the conventional projects approach. Most of the males tended to be distracted from the conversational AI curriculum because they misbehaved during the conversational AI process. In particular, in their performance using the Voice User Interface with the conventional learning approach, the females outperformed the males significantly. The results of two-way ANCOVA revealed a significant interaction between gender and learning approach on computational thinking concepts. Females with the conventional learning approach of doing projects had the best computational thinking concepts in comparison with the other groups.

Automated remote sensing has revolutionized the fields of wildlife ecology and environmental science. Yet, a cost-effective and flexible approach for large scale monitoring has not been fully developed, resulting in a limited collection of high-resolution data. Here, we describe BioSense, a low-cost and fully programmable automated sensing platform for applications in bioacoustics and environmental studies. Our design offers customization and flexibility to address a broad array of research goals and field conditions. Each BioSense is programmed through an integrated Raspberry Pi computer board and designed to collect and analyze avian vocalizations while simultaneously collecting temperature, humidity, and soil moisture data. We illustrate the different steps involved in manufacturing this sensor including hardware and software design and present the results of our laboratory and field testing in southwestern United States.

Epitaxially-fused superlattices of colloidal quantum dots (QD epi-SLs) may exhibit electronic minibands and high-mobility charge transport, but electrical measurements of epi-SLs have been limited to large-area, polycrystalline samples in which superlattice grain boundaries and intragrain defects suppress/obscure miniband effects. Systematic measurements of charge transport in individual, highly-ordered epi-SL grains would facilitate the study of minibands in QD films. Here, we demonstrate the air-free fabrication of microscale field-effect transistors (μ-FETs) with channels consisting of single PbSe QD epi-SL grains (2-7 μm channel dimensions) and analyze charge transport in these single-grain devices. The eight devices studied show p-channel or ambipolar transport with a hole mobility as high as 3.5 cm2 V-1 s-1 at 290 K and 6.5 cm2 V-1 s-1 at 170-220 K, one order of magnitude larger than that of previous QD solids. The mobility peaks at 150-220 K, but device hysteresis at higher temperatures makes the true mobility-temperature curve uncertain and evidence for miniband transport inconclusive.

ABSTRACT Introduction As the world's population ages, there has been increasing attention to developing health policies to support older adults. Engaging older adults in policy‐making is one way to ensure that policy decisions align with their needs and priorities. However, ageist stereotypes often underestimate older adults' ability to participate in such initiatives. This scoping review aims to describe the characteristics and impacts of public engagement initiatives designed to help inform health policy‐making for older adults. Methods A systematic search of peer‐reviewed and grey literature (English only) describing public engagement initiatives in health policy‐making for older adults was conducted using six electronic databases, Google and the Participedia website. No geographical, methodological or time restrictions were applied to the search. Eligibility criteria were purposefully broad to capture a wide array of relevant engagement initiatives. The outcomes of interest included participants, engagement methods and reported impacts. Results This review included 38 papers. The majority of public engagement initiatives were funded or initiated by governments or government agencies as a formal activity to address policy issues, compared to initiatives without a clear link to a specific policy‐making process (e.g., research projects). While most initiatives engaged older adults as target participants, there was limited reporting on efforts to achieve participant diversity. Consultation‐type engagement activities were most prevalent, compared to deliberative and collaborative approaches. Impacts of public engagement were frequently reported without formal evaluations. Notably, a few articles reported negative impacts of such initiatives. Conclusion This review describes how public engagement practices have been conducted to help inform health policy‐making for older adults and the documented impacts. The findings can assist policymakers, government staff, researchers and seniors' advocates in supporting the design and execution of public engagement initiatives in this policy sector. Patient or Public Contribution Older adult partners from the McMaster University Collaborative for Health and Aging provided strategic advice throughout the key phases of this review, including developing a review protocol, data charting and synthesis and interpreting and presenting the review findings. This collaborative partnership was an essential aspect of this review, enhancing its relevance and meaningfulness for older adults.

Summary: Crimean-Congo hemorrhagic fever virus can cause lethal disease in humans yet there are no approved medical countermeasures. Viral glycoprotein GP38, exclusive to Nairoviridae, is a target of protective antibodies and is a key antigen in preclinical vaccine candidates. Here, we isolate 188 GP38-specific antibodies from human survivors of infection. Competition experiments show that these antibodies bind across 5 distinct antigenic sites, encompassing 11 overlapping regions. Additionally, we show structures of GP38 bound with 9 of these antibodies targeting different antigenic sites. Although these GP38-specific antibodies are non-neutralizing, several display protective efficacy equal to or better than murine antibody 13G8 in two highly stringent rodent models of infection. Together, these data expand our understanding regarding this important viral protein and may inform the development of broadly effective CCHFV antibody therapeutics.

Anxiety and impulsivity often co-occur, but due to broad conceptualizations of impulsive behavior, it remains unclear whether anxiety could be positively associated with global impulsivity or specific facets of impulsivity. Negative urgency, or rash behavior that specifically occurs during negative emotional states, may provide common ground to examine the overlap between high anxiety and high impulsivity. Limited work has examined relationships between negative urgency and behavioral processes that are often associated with both anxiety and global impulsivity, such as experiential avoidance. In this study, we examined self-report data collected from a non-clinical sample of adult participants (n = 589) to test relationships between anxiety and experiential avoidance through both negative urgency and global impulsivity. Contrary to hypotheses, we found that negative urgency alone did not alter the relationship between anxiety and experiential avoidance. However, follow-up analyses including data-driven factors of impulsivity revealed that in combination, anxiety and both emotion-based impulsivity (i.e. negative and positive urgency) and hyperactivity were linked to greater experiential avoidance. By contrast, anxiety and non-planning were associated with lower experiential avoidance. These results provide targets for future studies to examine individual differences in profiles of co-occurring anxiety and impulsivity.

Abstract The urinary bladder harbors a community of microbes termed the urobiome, which remains understudied. In this study, we present the urobiome of healthy infant males from samples collected by transurethral catheterization. Using a combination of enhanced culture and amplicon sequencing, we identify several common bacterial genera that can be further investigated for their effects on urinary health across the lifespan. Many genera were shared between all samples suggesting a consistent urobiome composition among this cohort. We note that, for this cohort, early life exposures including mode of birth (vaginal vs. Cesarean section), or prior antibiotic exposure did not influence urobiome composition. In addition, we report the isolation of culturable bacteria from the bladders of these infant males, including Actinotignum spp., a bacterial genus that has been associated with urinary tract infections in older male adults. Herein, we isolate and sequence 9 distinct strains of Actinotignum spp. enhancing the genomic knowledge surrounding this genus and opening avenues for delineating the microbiology of this urobiome constituent. Furthermore, we present a framework for using the combination of culture-dependent and sequencing methodologies for uncovering mechanisms in the urobiome.

Abstract Background Increasingly researchers are partnering with citizens and communities in research; less is known about research impacts of this engagement. EMBOLDEN is an evidence-informed, mobility-promoting intervention for older adults co-designed by a 26-person Strategic Guiding Council (SGC) of health/social service providers and older adult citizens. This study evaluated research partners’ perceptions of engagement strategies, the engagement context, strengths, areas for improvement, as well as the impacts of the guiding council on older-adult identified priority areas. Methods This study was guided by developmental evaluation, working in partnership with four older adult SGC members who helped to set evaluation priorities, decide methods, and adapt patient-centred evaluation tools. Data sources included a questionnaire, focus groups and document analysis of meeting notes from 16 SGC meetings that took place between December 2019 and February 2022. A thematic approach to analysis guided the coding of focus group transcripts and SGC meeting notes. Convergent mixed methods guided the integration and presentation of qualitative and quantitative data sources in a joint display of evaluation results. Results Of 26 SGC members, nine completed the evaluation squestionnaire, and five participated in focus groups. Around two thirds of the SGC commonly attended each meeting. EMBOLDEN’s SGC was structured to include a diverse group (across gender, ethnicity and discipline) of older adults and service providers, which was perceived as a strength. Engagement processes were perceived as inclusive and well-facilitated, which stimulated discussion at meetings. Advantages and disadvantages of engaging with the SGC virtually, as compared to in-person (as was the case for the first 3 SGC meetings) were also discussed. Impacts of the SGC were identified across preparatory, execution phase and translational stages of research. Impacts of SGC involvement on members were also described. Conclusion Older adult research partners played an important role designing, implementing, and evaluating co-design approaches in this study. Older adults and service providers can make important contributions to the design, delivery and sharing results of health research through their lived expertise and connections to community. This project contributes to the growing field of citizen and community engagement in research by offering a participatory approach to engagement evaluation that considers diversity, satisfaction, and impact.

Research on LGBTQ + youth often portrays them as either as victims whose lives are defined by violence and discrimination, or as inspirational success stories whose ability to thrive is attributable to external interventions and policies. Drawing on theories of situated agency, minority stress, and queer monstrosity, this participatory qualitative interview project with LGBTQ + young adults illustrates instead how LGBTQ + youth actively shape their coming-of-age experiences and develop unique strategies to survive and thrive in the spaces they occupy. Rather than wholly traumatic or ecstatic, most participants reported mixed experiences with varying support from the people and spaces they encountered. Youth had to regularly engage in the labor of evaluating and responding to this mixed support and mistreatment in everyday situations and relationships. Based on these evaluations participants reported self-regulating their sexual and gender identities and behaviors, shifting tactics between spaces, seeking out and creating queer spaces, embracing their own difference, and engaging in direct resistance. Implications for research and practice suggest that refusing to center deficit-based narratives and recognizing the full range of young people's queer expressions will produce a more accurate picture of LGBTQ + coming of age and the supports that allow more youth to thrive.