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This comment aims to contribute to agenda-setting for the study of interpersonal violence over the years to come. Interpersonal violence is a high-profile topic not only in the domain of criminology, but also in public health, medicine, and epidemiology, and across the social sciences (sociology; psychology; economics; and political science). However, interdisciplinary integration between the different perspectives is lacking. This comment takes up the question of how scholars and practitioners in the field of violence can work towards greater integration with other perspectives. It outlines five key priorities for the field going forward, which are intended to contribute to a more comprehensive understanding of interpersonal violence. Importantly, the view outlined here arose from a collaboration of researchers from a wide range of academic fields, and as such represents interdisciplinary consensus on the steps required to ensure that the study of interpersonal violence remains an effective and productive research field.

Diabetes mellitus (DM) is a disorder of carbohydrate, fat, and protein metabolism caused by impaired insulin secretion, insulin action, or both characterized by hyperglycemia. Hyperglycemic condition is associated with inflammation process leading to complications. Food supplements play an important role in controlling protein metabolism and have anti-inflammatory properties such as Channa micropeltes (CM). This study aimed to analyze the effect of CM extract on the levels of molecular markers Nuclear factor kappa beta (NF-κB) and Tumor Necrosis Factor alfa (TNF-α) in normal and diabetic rats. The experimental design of this investigation was a post-test-only control group design and the samples were the diabetic model group given CM extract at 16 mL/kgBB dose, and negative control group for 14 days, respectively. Serum concentrations of NF-κB and TNF-α were measured by ELISA. DM-CM group showed decreasing levels of NF-κB. TNF- α was detected with the lowest level in the N-CM group. The levels of TNF- α declined close to normal levels in the DM-CM group. Hence, the conclusion was the CM at a dose of 16 mL/kg BW for 14 days in Wistar rats can reduce Nf-κB and TNF-α in groups of normal and diabetic rats.

Background: Demineralization of dentin is a condition of dissolving minerals in peritubular dentin due to exposure to acids that release hydroxyapatite ions. To prevent dentin demineralization, a therapeutic agent that can inhibit the dissolution ability of hydroxyapatite ions is needed. One therapeutic agent that can be used is the Mauli banana (MB) stem gel. Purpose: To observe the characteristics of dentin demineralization after the use of MB stem extract gel. Method: Mandibular incisor bovine teeth were demineralized with lactic acid pH 4.5 for 72 hours and then treated with 25%; 37.5%; 50%; and 62.5% MB gel and Chlorhexidine 2% for one minute. All samples were soaked in artificial saliva with 1 mg/ml saliva of collagenase enzyme for 24 hours. The characteristic of dentin demineralization was observed by using scanning electron microscope/electron dispersive X-ray spectroscopy (SEM-EDX). Results: The SEM image in the control, Chlorhexidine, 25%; 37.5%; 50%; and 62.5% MB gel groups showed dentinal tubules of about 3.67–4.94 µm; 3.55–4 µm; 4.18–5.6 µm; 2.28–2.86 µm; 3.29–3.81 µm; and 2.42–3.17 µm in size. The EDX test found carbon (C), nitrogen (N), oxygen (O), sodium (Na), phosphorous (P), chlorine (Cl), and calcium (Ca) in all groups. The one-way Analysis of Variance (ANOVA) test results showed significant differences in the levels of C, N, O, Cl, and Ca between all groups, while the Na showed no significant differences. Conclusion: The MB can inhibit the demineralization of bovine dentin based on the decrease in the size of the dentinal tubules and increasing the C, O, P, and Ca.

Rationale: Cigarette smoke exposure is associated with an increased risk of developing acute respiratory distress syndrome (ARDS) in trauma, transfusion, and nonpulmonary sepsis. It is unknown whether this relationship exists in the general sepsis population. Furthermore, it is unknown if patients with ARDS have differences in underlying biology based on smoking status. Objectives: To assess the relationship between cigarette smoke exposure and ARDS in sepsis and identify tobacco-related biomarkers of lung injury. Methods: We studied a prospective cohort of 592 patients with sepsis from 2009 to 2017. Plasma cotinine and urine NNAL [urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol] were measured to categorize smoking status. Plasma biomarkers of inflammation and lung injury were measured, including in a smaller cohort of trauma patients with ARDS to increase generalizability.Measurements and Main Results: Passive and active smoking were associated with increased odds of developing ARDS in patients with sepsis. Among patients with sepsis and ARDS, active cigarette smokers were younger and had lower severity of illness than nonsmokers. Patients with ARDS with cigarette smoke exposure had lower plasma levels of IL-8 (P = 0.01) and sTNFR-1 (soluble tumor necrosis factor 1; P = 0.01) compared with those without exposure. Similar biomarker patterns were observed in blunt trauma patients with ARDS. Conclusions: Passive and active smoking are associated with an increased risk of developing ARDS in patients with pulmonary and nonpulmonary sepsis. Among patients with ARDS, those with cigarette smoke exposure have less systemic inflammation, while active smokers also have lower severity of illness compared with nonsmokers, suggesting that smoking contributes to biological heterogeneity in ARDS. [ABSTRACT FROM AUTHOR]

Over the last decade, utilization of clinical genetics services has grown rapidly, putting increasing pressure on the workforce available to deliver genetic healthcare. To highlight the policy challenges facing Canadian health systems, a needs-based workforce requirements model was developed to determine the number of Canadian patients in 2030 for whom an assessment of hereditary cancer risk would be indicated according to current standards and the numbers of genetic counsellors, clinical geneticists and other physicians with expertise in genetics needed to provide care under a diverse set of scenarios. Our model projects that by 2030, a total of 90 specialist physicians and 326 genetic counsellors (1.7-fold and 1.6-fold increases from 2020, respectively) will be required to provide Canadians with indicated hereditary cancer services if current growth trends and care models remain unchanged. However, if the expansion in eligibility for hereditary cancer assessment accelerates, the need for healthcare providers with expertise in genetics would increase dramatically unless alternative care models are widely adopted. Increasing capacity through service delivery innovation, as well as mainstreaming of cancer genetics care, will be critical to Canadian health systems’ ability to meet this challenge.

Abstract Genomic medicine is being implemented on a global scale, requiring a genomic-competent health workforce. To inform education as part of implementation strategies to optimize adoption of genomics by non-genetics physicians, we investigated current practices, perceptions and preferences relating to genomic testing and education. Australian non-genetics physicians completed an online survey; we conducted univariate and multivariate analyses of determinants of confidence and engagement with genomic medicine. Confident or engaged respondents were more likely to be pediatricians, have completed continuing genomics education (CGE) and/or have genomics research experience. Confident or engaged respondents were also more likely to prefer to request genomic testing with support from genetics services than other models. Respondents who had completed CGE and were engaged reported higher confidence than those who were not engaged. We propose a progression of genomic competence aligned with service delivery models, where education is one enabler of mastery or independence to facilitate genomic tests (from referral to requesting with or without clinical genetics support). Workplace learning could provide additional impetus for adoption.

Survey research typically measures contact and experiences with police cross-sectionally and retrospectively. These retrospective measures may suffer from recall biases and are relatively limited in capturing the variety of experiences that may occur in daily life. The current study explores the feasibility and application of experience sampling techniques to measure day-to-day experiences with the police and variation in attitudes towards the police. Data for the study were collected over a period of 21 days from a convenience sample of 206 young people (aged 18–30 years) living in the Netherlands. After completing a baseline questionnaire, participants completed daily questionnaires measuring attitudes towards the police and any experiences with the police or other authorities that have occurred. A total of 3042 daily questionnaires were completed out of a possible 4389 (69% response rate). An analysis of participation and attrition suggests that individuals with more positive views of the police are more likely to complete most or all of the daily surveys. The descriptive results show that the number and type of experiences can vary substantially across individuals and time and that overall experiences with the police are prevalent in everyday life. The most prevalent reported experiences were observing the police ‘on the job’ and through the media. In addition, while attitudes towards the police were largely stable across the study period, there was still a non-negligible amount of variation over time. These pilot results raise questions about how we measure experiences with the police, and what role different experiences have in shaping individual attitudes. Experience sampling techniques may help to capture these other forms of exposure and understand how these experiences might influence attitudes towards police.

Abstract: Patients with diabetes mellitus (DM) may experience vascular impairment, wounds that emerged from dental practice require special attention in people who suffer from DM. Toman fish has the potential as an alternative medicine to accelerate the healing process in normal and diabetic wound. Erythrocyte and hemoglobin are two components of blood profile which can be used as the parameter to identify the effect of material toxicity. This study aims to test the acute toxicity of Toman fish extract at 16 mL/Kg BW dosage on the number of erythrocyte and the level of hemoglobin in normal and diabetic Wistar rat model after 14 days treatment. This is a true experimental study with post-test only and control group design. Samples were comprised of 21 male Wistar rats allocated to three different groups; normal rats given Toman fish extract (A), diabetic rats given Toman fish extract (B), and diabetic rats given BR2 feed only (C). The results showed that in group A, the number of erythrocytes was 8.67x106/mm3 and the level of hemoglobin was 17.30 g/dL. In group B, the number of erythrocytes was 7.39x106/mm3 and the level of hemoglobin was 16.32 g/dL. In group C, the erythrocyte number was 4.88x106/ mm3 and the hemoglobin level was 11.54 g/dL. It can be concluded that Toman fish extract at the dosage of 16 mL/Kg BW after 14 days administration is not toxic which was indicated by erythrocyte number and hemoglobin level in the blood of normal and diabetic Wistar rats models.

ABSTRACT Introduction: The approximate prevalence of Recurrent Aphthous Stomatitis (RAS) was 45.42% at Gusti Hasan Aman Dental Hospital Banjarmasin. Bacillus sp. is a bacterium that can form spores that can be transmitted through air, dust, water and food. Poor oral conditions will increase the possibility of bacterial contamination, especially for ulcers found in RAS. This study aimed to analyzed correlation between the presence of Bacillus species and OHI-S in the oral ulceration of RAS patients. Methods: This was an analytical cross-sectional study conducted among Oral Medicine Department outpatients at Gusti Hasan Aman Dental Hospital, Banjarmasin, Indonesia. A total of 38 subjects were examined to assess Oral Hygiene Index Simplified and obtained bacteria samples using the swabs technique. Bacteria were then inoculated in blood agar base media and concurrently presented with gram staining. Bacteria were then identified using the catalase test, urease test, and oxidase test. Results: Bacillus species were predominantly identified in oral ulceration of RAS patients at Gusti Hasan Aman Dental Hospital Banjarmasin. Bacillus sp. (60,5%), Streptococcus sp. (34,2%), Neisseria sp. (2,6%), and Lactobacillus sp. (2,6%) were found in ulcerated RAS lesions. Spearman test resulted in p = 0.862 (p > 0.05), where no significant difference was obtained between presence of bacillus species and OHI-s in recurrent aphthous stomatitis patients. Conclusion: Bacillus species were predominantly identified in oral ulceration of RAS patients a. However, the presence of Bacillus sp. was not associated with OHI-S in RAS patients. Keywords: bacillus sp.; oral hygiene index simplified; recurrent aphthous stomatitis

Abstract Understanding and communicating genomic results can be challenging for families and health professionals without genetic specialty training. Unlike modifying existing laboratory reports, plain language genomic test reports provide an opportunity for patient/family-centered approaches. However, emerging examples generally lack co-design and/or evaluation in real-world settings. Through co-design involving patient groups, plain language experts, educators, and genetic health professionals, plain language genomic test report templates were produced for common test outcomes in rare diseases. Eight plain language genomic test report templates were developed. These reports were piloted and evaluated as part of a national pediatric ultra-rapid genomic testing program. Family and genetic health professional experiences with report layout, content, and use were explored using surveys. Of 154 families and 107 genetic health professionals issued with reports, 51 families and 57 clinicians responded (RR = 33% and 53%, respectively). Most families (82%) found their report helpful in understanding the result. Reports were shared by 63% of families, predominantly with family members (72%), or health professionals (68%). Clinicians (15%) adapted the reports for other settings. Through co-design, plain language genomic test reports implemented in a real-world setting can facilitate patient/family and caregiver understanding and communication of genomic test purpose, outcome, and potential clinical implications.

Abstract Background The current Coronavirus disease pandemic reveals political and structural inequities of the world’s poorest people who have little or no access to health care and yet the largest burdens of poor health. This is in parallel to a more persistent but silent global health crisis, antimicrobial resistance (AMR). We explore the fundamental challenges of health care in humans and animals in relation to AMR in Tanzania. Methods We conducted 57 individual interviews and focus groups with providers and patients in high, middle and lower tier health care facilities and communities across three regions of Tanzania between April 2019 and February 2020. We covered topics from health infrastructure and prescribing practices to health communication and patient experiences. Results Three interconnected themes emerged about systemic issues impacting health. First, there are challenges around infrastructure and availability of vital resources such as healthcare staff and supplies. Second, health outcomes are predicated on patient and provider access to services as well as social determinants of health. Third, health communication is critical in defining trusted sources of information, and narratives of blame emerge around health outcomes with the onus of responsibility for action falling on individuals. Conclusion Entanglements between infrastructure, access and communication exist while constraints in the health system lead to poor health outcomes even in ‘normal’ circumstances. These are likely to be relevant across the globe and highly topical for addressing pressing global health challenges. Redressing structural health inequities can better equip countries and their citizens to not only face pandemics but also day-to-day health challenges.

Elastic nucleon-pion scattering amplitudes are computed using lattice QCD on a single ensemble of gauge field configurations with Nf=2+1 dynamical quark flavors and mπ=200MeV. The s-wave scattering lengths with both total isospins I=1/2 and I=3/2 are inferred from the finite-volume spectrum below the inelastic threshold together with the I=3/2 p-wave containing the Δ(1232) resonance. The amplitudes are well-described by the effective range expansion with parameters constrained by fits to the finite-volume energy levels, enabling a determination of the I=3/2 scattering length with statistical errors below 5%, while the I=1/2 scattering length is somewhat less precisely evaluated. Systematic errors due to excited states and the influence of higher partial waves are controlled, providing a step toward future computations down to physical light quark masses with multiple lattice spacings and volumes.

Science, technology, engineering, mathematics, and medicine (STEMM) fields change rapidly and are increasingly interdisciplinary. Commonly, STEMM practitioners use short-format training (SFT) such as workshops and short courses for upskilling and reskilling, but unaddressed challenges limit SFT's effectiveness and inclusiveness. Education researchers, students in SFT courses, and organizations have called for research and strategies that can strengthen SFT in terms of effectiveness, inclusiveness, and accessibility across multiple dimensions. This paper describes the project that resulted in a consensus set of 14 actionable recommendations to systematically strengthen SFT. A diverse international group of 30 experts in education, accessibility, and life sciences came together from 10 countries to develop recommendations that can help strengthen SFT globally. Participants, including representation from some of the largest life science training programs globally, assembled findings in the educational sciences and encompassed the experiences of several of the largest life science SFT programs. The 14 recommendations were derived through a Delphi method, where consensus was achieved in real time as the group completed a series of meetings and tasks designed to elicit specific recommendations. Recommendations cover the breadth of SFT contexts and stakeholder groups and include actions for instructors (e.g., make equity and inclusion an ethical obligation), programs (e.g., centralize infrastructure for assessment and evaluation), as well as organizations and funders (e.g., professionalize training SFT instructors; deploy SFT to counter inequity). Recommendations are aligned with a purpose-built framework-"The Bicycle Principles"-that prioritizes evidenced-based teaching, inclusiveness, and equity, as well as the ability to scale, share, and sustain SFT. We also describe how the Bicycle Principles and recommendations are consistent with educational change theories and can overcome systemic barriers to delivering consistently effective, inclusive, and career-spanning SFT.

Background: Melanoma genetic testing reportedly increases preventative behaviour without causing psychological harm. Genetic testing for familial melanoma risk is now available, yet little is known about dermatologists’ perceptions regarding the utility of testing and genetic testing ordering behaviours.Objectives: To survey Australasian Dermatologists on the perceived utility of genetic testing, current use in practice, as well as their confidence and preferences for the delivery of genomics education.Methods: A 37-item survey, based on previously validated instruments, was sent to accredited members of the Australasian College of Dermatologists in March 2021. Quantitative items were analysed statistically, with one open-ended question analysed qualitatively. Results: The response rate was 56% (256/461), with 60% (153/253) of respondents between 11 and 30 years post-graduation. While 44% (112/252) of respondents agreed, or strongly agreed, that genetic testing was relevant to their practice today, relevance to future practice was reported significantly higher at 84% (212/251) (t = -9.82, p < 0.001). Ninety three percent (235/254) of respondents reported rarely or never ordering genetic testing. Dermatologists who viewed genetic testing as relevant to current practice were more likely to have discussed (p < 0.001) and/or offered testing (p < 0.001). Respondents indicated high confidence in discussing family history of melanoma, but lower confidence in ordering genetic tests and interpreting results. Eighty four percent (207/247) believed that genetic testing could negatively impact life insurance, while only 26% (63/244) were aware of the moratorium on using genetic test results in underwriting in Australia. A minority (22%, 55/254) reported prior continuing education in genetics. Face-to-face courses were the preferred learning modality for upskilling.Conclusion: Australian Dermatologists widely recognise the relevance of genetic testing to future practice, yet few currently order genetic tests. Future educational interventions could focus on how to order appropriate genetic tests and interpret results, as well as potential implications on insurance.

Contemporary descriptions of ‘feral’ children generally preclude any insightful inference about the language deficits exhibited by these children, as well as the ultimate causes of their problems with language. However, they have been regularly used to support the view that language acquisition requires a proper social environment in order to occur. In this paper, we revisit the case for ‘feral’ children with the viewpoint that human evolution entailed a process of self-domestication that parallels what we find in domesticated animals. Because feralization commonly occurs in nature and because it entails a partial reversion of features of domestication, this self-domestication approach to the evolution of language reassesses the case for ‘feral’ children, particularly when compared with present-day conditions involving abnormal patterns of socialization, whether they are genetically-triggered as in autism spectrum disorder, or environmentally-triggered, as in reactive attachment disorder.

Abstract Background Consumer genomic testing for nutrition and wellness, (nutritional genomics), is becoming increasingly popular. Concurrently, health‐care practitioners (HPs) working in private practice (including doctors interested in integrative medicine, private genetic counsellors, pharmacists, dieticians, naturopaths and nutritionists) are involved as test facilitators or interpreters. Objective To explore Australian consumers’ and HPs’ experiences with nutrigenomic testing. Method Semi‐structured in‐depth interviews were conducted using predominantly purposive sampling. The two data sets were analysed individually, then combined, using a constant comparative, thematic approach. Results Overall, 45 interviews were conducted with consumers (n = 18) and HPs (n = 27). Many of the consumer interviewees experienced chronic ill‐health. Nutrigenomic testing was perceived as empowering and a source of hope for answers. While most made changes to their diet/supplements post‐test, self‐reported health improvements were small. A positive relationship with their HP appeared to minimize disappointment. HPs’ adoption and views of nutrigenomic testing varied. Those enthusiastic about testing saw the possibilities it could offer. However, many felt nutrigenomic testing was not the only ‘tool’ to utilize when offering health care. Discussion This research highlights the important role HPs play in consumers’ experiences of nutrigenomics. The varied practice suggests relevant HPs require upskilling in this area to at least support their patients/clients, even if nutrigenomic testing is not part of their practice. Patient or public contribution Advisory group included patient/public group representatives who informed study design; focus group participants gave feedback on the survey from which consumer interviewees were sourced. This informed the HP data set design. Interviewees from HP data set assisted with snowball sampling.

Introduction: Human Immunodeficiency Virus (HIV) exhibits the capability to weaken human immune system. The infected subject will later be more susceptible to suffer from opportunistic diseases when the CD4 cell count is lesser than 200 cell/µL. Oral thrush, periodontal disease and xerostomia are common oral manifestations in AIDS patient which initially indicate the presence of HIV infection. This study was aimed to analyse the correlation between the socio-demographic characteristics and clinical profile with oral manifestations of HIV/AIDS patients. Methods: An analytic study with cross-sectional approach was conducted towards the clinical profile and oral manifestation data of HIV/AIDS patients, which obtained from secondary data in the form of medical record. The 55 samples were taken with total sampling technique. Results: The chi-square test found no significant correlation between HIV/AIDS patients socio-demographic and oral manifestations and several significant correlation of the HIV/AIDS patients' clinical profile with the oral manifestation as follows: the total number of CD4 and ARV therapy duration was significantly correlated with the HIV/AIDS patients with candidiasis and oral thrush (p=0.01); while in patients with periodontal disease was only significantly correlated with the total number of CD4 (p=0.02); and no significant correlation found in HIV/AIDS patients with xerostomia. Conclusion: There is no correlation between HIV/AIDS patients socio-demographic and oral manifestations. There is a correlation between several HIV/AIDS patients clinical profile with the oral manifestation. The number of CD4 cells and the ARV therapy duration was correlated with patients with candidiasis and oral thrush, while in patients with periodontal disease on correlated with the number and CD4 cells. HIV/AIDS patients with xerostomia have no correlation with any of their clinical profile.

Introduction: Genomic testing is becoming widely available as a diagnostic tool, although widespread implementation is not yet established in nephrology. Methods: An anonymous electronic survey was administered to investigate experience and confidence with genomic tests, perceived clinical utility of genomic services, preferences for service delivery models, and readiness for implementation among nephrologists. Questions were guided by a comprehensive literature review and published tools, including a validated theoretical framework for implementation of genomic medicine: Consolidated Framework for Implementation Research (CFIR). Results: Responses were received from 224 clinicians, of which 172 were eligible for analysis. Most clinicians (132 [76%]) had referred at least one patient to a genetics clinic. Despite most clinicians (136 [85%]) indicating that they believed genetic testing would be useful, only 39 (23%) indicated they felt confident to use results of genomic testing, with pediatric clinicians feeling more confident compared with adult clinicians (12 of 20 [60%] vs. 27 of 149 [18%]), P < 0.01, Fisher exact). A multidisciplinary renal genetics clinic was the preferred model among clinicians surveyed (98 of 172 [57%]). A key implementation barrier highlighted related to the hospital or organizational culture and/or environment. Specific barriers noted in quantitative and qualitative responses included inadequate staffing, learning resources, and funding. Conclusions: Our findings suggest support for genomic testing among nephrologists, with a strong preference for a multidisciplinary model (involving a nephrologist, clinical geneticist, and genetic counselor). Broad-ranging interventions are urgently required to shift the current culture and ensure successful implementation of genomics in nephrology, including reducing knowledge gaps, increased funding and resources, disease-specific guidelines, and streamlining of testing processes.

Abstract Enumeration Areas (EAs) are the operational geographic units for the collection and dissemination of census data and are often used as a national sampling frame for various types of surveys. In many poor or conflict-affected countries, EA demarcations are incomplete, outdated, or missing. Even for countries that are stable and prosperous, creating and updating EAs is one of the most challenging yet essential tasks in the preparation for a national census. Commonly, EAs are created by manually digitising small geographic units on high-resolution satellite imagery or physically walking the boundaries of units, both of which are highly time, cost, and labour intensive. In addition, creating EAs requires considering population and area size within each unit. This is an optimisation problem that can best be solved by a computer. Here, for the first time, we produce a semi-automatic mapping of pre-defined census EAs based on high-resolution gridded population and settlement datasets and using publicly available natural and administrative boundaries. We demonstrate the approach in generating rural EAs for Somalia where such mapping is not existent. In addition, we compare our automated approach against manually digitised EAs created in urban areas of Mogadishu and Hargeysa. Our semi-automatically generated EAs are consistent with standard EAs, including having identifiable boundaries for field teams to follow on the ground, and appropriate sizing and population for coverage by an enumerator. Furthermore, our semi-automated urban EAs have no gaps, in contrast, to manually drawn urban EAs. Our work shows the time, labour and cost-saving value of automated EA delineation and points to the potential for broadly available tools suitable for low-income and data-poor settings but applicable to potentially wider contexts.

BackgroundThe research marketplace has seen a flood of open-source or commercial mobile health (mHealth) platforms that can collect and use user data in real time. However, there is a lack of practical literature on how these platforms are developed, integrated into study designs, and adopted, including important information around cost and effort considerations. ObjectiveWe intend to build critical literacy in the clinician-researcher readership into the cost, effort, and processes involved in developing and operationalizing an mHealth platform, focusing on Intui, an mHealth platform that we developed. MethodsWe describe the development of the Intui mHealth platform and general principles of its operationalization across sites. ResultsWe provide a worked example in the form of a case study. Intui was operationalized in the design of a behavioral activation intervention in collaboration with a mental health service provider. We describe the design specifications of the study site, the developed software, and the cost and effort required to build the final product. ConclusionsStudy designs, researcher needs, and technical considerations can impact effort and costs associated with the use of mHealth platforms. Greater transparency from platform developers about the impact of these factors on practical considerations relevant to end users such as clinician-researchers is crucial to increasing critical literacy around mHealth, thereby aiding in the widespread use of these potentially beneficial technologies and building clinician confidence in these tools.

Abstract: Toman fish contains albumin and omega-6 fatty acid that are instrumental in the healing process of diabetes mellitus (DM) wound. People with DM usually have a prolonged wound healing process. Albumin controls the osmotic pressure, the development of granulation tissue, gives the energy to re-epithelialisation process and collagen base material. Omega-6 fatty acid interrupts phagocytosis induced by neutrophil cells. It increases the action of machropage cell, so that Toman fish can be used as an alternative in accelerating the DM wound healing process. The purpose of this research is to prove the effect of Toman fish extract at 16 mL/ KgBW rat dosage per oral on wound length and contraction on the back of wistar rat (Rattus novergiucs) with DM for 14 days. It was the experimental with a posttest only with control group design used 12 wistar rat that were divided into 3 groups; the group of Toman fish extract with dose 16 mL/ Kg BW rat, positive control group using Haruan extract with dose 13,54 mL/ Kg BW rat and negative control group using Comfeed BR2 feed. One-way ANOVA test result for wound length and contraction (p= 0,000). The result Post-hoc Least Significant Difference test for wound length and contraction shows that there are significant differences between the group of Toman fish extract and Haruan fish extract (p= 0,000). There is also significant difference between the group of Toman fish extract and Comfeed BR2 feed (p= 0,000). There is no significant difference between the group of Haruan fish extract and Comfeed BR2 feed (p= 0,930). The research concluded that Toman fish extract at 16 mL/ Kg BW rat dosage affects the length and contraction of diabetic mellitus wound. Keywords: Channa micropeltes, clinical analysis, diabetes mellitus, wound

Abstract Background Household surveys are the main source of demographic, health and socio-economic data in low- and middle-income countries (LMICs). To conduct such a survey, census population information mapped into enumeration areas (EAs) typically serves a sampling frame from which to generate a random sample. However, the use of census information to generate this sample frame can be problematic as in many LMIC contexts, such data are often outdated or incomplete, potentially introducing coverage issues into the sample frame. Increasingly, where census data are outdated or unavailable, modelled population datasets in the gridded form are being used to create household survey sampling frames. Methods Previously this process was done by either sampling from a set of the uniform grid cells (UGC) which are then manually subdivided to achieve the desired population size, or by sampling very small grid cells then aggregating cells into larger units to achieve a minimum population per survey cluster. The former approach is time and resource-intensive as well as results in substantial heterogeneity in the output sampling units, while the latter can complicate the calculation of unbiased sampling weights. Using the context of Somalia, which has not had a full census since 1987, we implemented a quadtree algorithm for the first time to create a population sampling frame. The approach uses gridded population estimates and it is based on the idea of a quadtree decomposition in which an area successively subdivided into four equal size quadrants, until the content of each quadrant is homogenous. Results The quadtree approach used here produced much more homogeneous sampling units than the UGC (1 × 1 km and 3 × 3 km) approach. At the national and pre-war regional scale, the standard deviation and coefficient of variation, as indications of homogeneity, were calculated for the output sampling units using quadtree and UGC 1 × 1 km and 3 × 3 km approaches to create the sampling frame and the results showed outstanding performance for quadtree approach. Conclusion Our approach reduces the manual burden of manually subdividing UGC into highly populated areas, while allowing for correct calculation of sampling weights. The algorithm produces a relatively homogenous population counts within the sampling units, reducing the variation in the weights and improving the precision of the resulting estimates. Furthermore, a protocol of creating approximately equal-sized blocks and using tablets for randomized selection of a household in each block mitigated potential selection bias by enumerators. The approach shows labour, time and cost-saving and points to the potential use in wider contexts.

Introduction: Recurrent aphthous stomatitis (SAR) is a recurrent ulceration lesion where many Streptococcus sanguis bacteria are found. Streptococcus sanguis bacteria can be killed by compounds that contain antibacterial. Kapul fruit (Baccaurea macrocarpa) is a typical Kalimantan fruit, has antioxidant and antibacterial activity which serves to kill Streptococcus sanguis. Method: Performed a quantitative phytochemical test on the kapul fruit peel and continued with the antibacterial activity test using the disc diffusion method of kapul fruit peel extract at the concentrations 20%, 40%, 60%, 80%, 100%,Chlorhexidine as a positive control and aquades as a negative (n=4/group). Result: From the phytochemical test, Kapul fruit peel extracts contain 35,851% of alkaloid, 23,225% of saponin, 2,395mg of tannin and 21,000mg of flavonoids. Kapul fruit peel extracts has the potential as an antibacterial against Streptococcus sanguis at concentration of 40%, 60%, 80% and 100%. The concentration at 100% has an equivalent to chlorhexidine as an antibacterial potential. Conclusion: The potential of Kapul peel Extract as antibacterial to Streptococcus sanguis bacteria on 40%, 60%, 80%, 100% concentration. The concentration at 100% has an equivalent to chlorhexidine as an antibacterial potential.

Summary: The Global Alliance for Genomics and Health (GA4GH) aims to accelerate biomedical advances by enabling the responsible sharing of clinical and genomic data through both harmonized data aggregation and federated approaches. The decreasing cost of genomic sequencing (along with other genome-wide molecular assays) and increasing evidence of its clinical utility will soon drive the generation of sequence data from tens of millions of humans, with increasing levels of diversity. In this perspective, we present the GA4GH strategies for addressing the major challenges of this data revolution. We describe the GA4GH organization, which is fueled by the development efforts of eight Work Streams and informed by the needs of 24 Driver Projects and other key stakeholders. We present the GA4GH suite of secure, interoperable technical standards and policy frameworks and review the current status of standards, their relevance to key domains of research and clinical care, and future plans of GA4GH. Broad international participation in building, adopting, and deploying GA4GH standards and frameworks will catalyze an unprecedented effort in data sharing that will be critical to advancing genomic medicine and ensuring that all populations can access its benefits.

Objective Even as genomic medicine is implemented globally, there remains a lack of rigorous, national assessments of physicians’ current genomic practice and continuing genomics education needs. The aim of this study was to address this gap.Design A cross-sectional survey, informed by qualitative data and behaviour change theory, to assess the current landscape of Australian physicians’ genomic medicine practice, perceptions of proximity and individual preparedness, and preferred models of practice and continuing education. The survey was advertised nationally through 10 medical colleges, 24 societies, 62 hospitals, social media, professional networks and snowballing.Results 409 medical specialists across Australia responded, representing 30 specialties (majority paediatricians, 20%), from mainly public hospitals (70%) in metropolitan areas (75%). Half (53%) had contacted their local genetics services and half (54%) had ordered or referred for a gene panel or exome/genome sequencing test in the last year. Two-thirds (67%) think genomics will soon impact their practice, with a significant preference for models that involved genetics services (p

Play remains a topic for discussion, debate, and research within the education community. Zigler and Bishop-Josef (2004) provide an historical overview of early childhood; one of their main findings is play is under siege in many educational circles. The authors indicate, through time, there is a move away from play-oriented learning activities to a narrow focus on academics. Outside of the United States, and in many other countries, shifts occurred toward education focusing on academic skills that “deepen the damage and [make] more permanent the ‘achievement’ gap” between many children (Meier, 2009, p. 12). In opposition to this trend, advocates continue to call for more play-oriented and holistic approaches to learning, arguing the play vs. academics debate with academic support for and against the role of play in early childhood (Miller, 2008). Although this work provides important contributions to the field, prior research often gives little voice to teachers’ perceptions about play, especially from varied and diverse cultural backgrounds. In this article, we argue for a broader view of education in line with Plato’s observation (gender not withstanding) that “The direction in which education starts a man will determine his future life” (Jowett, 1874, p. 249). The current approach draws on the recommendation that we move beyond the typical developmental research view to use an interpretivist analysis that considers history, culture, and context (Swadener & Kessler, 1991). We begin with a short overview of the potential and traditional developmental and academic benefits of play. Our argument then focuses on a less common consideration of the holistic benefit of play: We explore teachers’ cultural reflections about the nature and worth of play through the authors’ personal accounts of playful childhood in Armenia, Great Britain, Kuwait, Saudi Arabia, and the United States of America. Finally, we provide recommendations for the value of play as part of a whole child education.

Objectives: Young adults are essential to the effective mitigation of the novel coronavirus (SARS-CoV-2/COVID-19) given their tendency toward greater frequency of social interactions. Little is known about vaccine willingness during pandemics in European populations. This study examined young people’s attitudes toward COVID-19 vaccines in Fall 2020.Methods: Data came from an ongoing longitudinal study’s online COVID-19-focused supplement among young adults aged 22 in Zurich, Switzerland (N = 499) in September 2020. Logistic regressions examined young adults’ likelihood of participating in COVID-19 immunization programs.Results: Approximately half of respondents reported being unlikely to get vaccinated against COVID-19. Compared to males, females were more likely to oppose COVID-19 vaccination (p < 0.05). In multivariate models, Sri Lankan maternal background and higher socioeconomic status were associated with a greater likelihood of getting vaccinated against COVID-19 (p < 0.05). Respondents were more likely to report a willingness to get vaccinated against COVID-19 when they perceived 1) an effective government response (p < 0.05) and 2) their information sources to be objective (p < 0.05).Conclusion: This study communicates aspects important to the development of targeted information campaigns to promote engagement in COVID-19 immunization efforts.

Despite some early implementation of genomic medicine globally, there is a lack of rigorous, large-scale assessments of medical specialists' current practice and continuing education needs. As a first step to addressing this gap, we describe the development of a robust, expert-reviewed, survey using a mixed-methods sequential study design. We conducted semi-structured qualitative interviews with 32 education providers and 86 non-genetic medical specialists about current genomic medicine practice and need for continuing education. Key concepts were identified and used as an initial framework for the survey. These were: personal characteristics (medical specialty, years of practice); current practice of genomics in clinical and research settings; perception of how proximal genomic medicine is to practice; perception of preparedness (competence and confidence); and, preferences for future roles and models of care in genomic medicine and for continuing education. Potential survey questions that related to at least one of these concepts were identified from the literature or were created if no suitable question existed. Using a modified, reactive Delphi approach, questions were reviewed by a panel of 22 experts. Experts were selected purposefully representing four areas of expertise: non-genetic medical specialties; clinical genetics; genetic/genomic education and evaluation; and implementation science. Three Delphi rounds assessed relevance, clarity and importance of each question. The questions were also mapped to the behaviour change wheel theoretical framework which encompasses capability, opportunity and motivation (COM-B). The survey (included as supplementary material) was then tested with a small group of non-genetic medical specialists and feedback was written or verbal in ‘talk-aloud', cognitive interviews. The final survey was then piloted with a further 29 specialists. We describe the methodology to create a robust, data- and theory-informed survey. The final survey captures not only levels of experience, practice of genomics and preferences for education but also the challenges around engaging with education. Survey data will provide evidence for education providers to inform development of education which meets learner needs and contributes to a medical workforce that is literate in genomics and more confident to competently practice genomic medicine.

Zoological institutions often use immersive, naturalistic exhibits to create an inclusive atmosphere that is inviting for visitors while providing for the welfare of animals in their collections. In this study, we investigated physiological changes in salivary cortisol and blood pressure, as well as psychological changes among visitors before and after a walk through the River's Edge, an immersive, naturalistic exhibit at the Saint Louis Zoo. Study participants had a significant reduction in salivary cortisol and blood pressure after walking through the exhibit. Psychological assessments of mood found that most visitors felt happier, more energized, and less tense after the visit. Additionally, participants who spent more time in River's Edge, had visited River's Edge prior to the study, and had seen more exhibits at the Zoo prior to entering River's Edge experienced greater psychological and/or physiological benefits. We conclude that immersive, naturalistic exhibits in zoos can elicit positive changes in physiological and psychological measures of health and well-being and argue for a greater scientific focus on the role of zoos and other green spaces in human health.

Comprehensive assessment of food insecurity across all college community members is lacking. This research surveyed a random sample of an entire campus population at a Northeast University in two surveys (spring 2017, n = 1,037 and fall 2017, n = 1,123). Analysis of variance, t-tests, and multivariable logit models were used to understand food insecurity outcomes and comparisons among groups. The overall rate of food insecurity on campus was 19.6% (spring) and 15.0% (fall). Food insecurity rates were highest among undergraduates, graduate and medical students, and staff as compared to faculty. First generation students and off-campus students were also more likely to be food insecure in both surveys, while people of color were more likely to be food insecure in the spring survey. Findings suggest university members beyond undergraduates also face high rates of food insecurity, which has important implications for efforts to reduce food insecurity on college campuses.

Penelitian ini bertujuan untuk menghasilkan media pembelajaran berbantuan internet. Secara khusus penelitian ini bertujuan mendesain dan mengembangkan e-learning berbasis Moodle V.3.1. untuk meningkatkan pemahaman konsep mata kuliah Belajar dan Pembelajaran Program Studi Pendidikan Jasmani Kesehatan dan Rekreasi IKIP Budi Utomo Malang. Langkah yang ditempuh adalah menggunakan prosedur pengembangan yang merupakan kombinasi antara prosedur-prosedur pengembangan dari Alessi dan Trollip. Prosedur pengembangan meliputi 4 tahap utama yaitu perecanaan, desain, pengembangan dan evaluasi sumatif. Teknik pengumpulan data yang digunakan untuk mengolah maupun dan menginterpretasikan hasil tinjauan dan uji coba produk pengembangan bahan ajar yaitu teknik analisis kuantitatif. Analisis data kuantiatif digunakan untuk menguji validitas dan reliabilitas instrumen tes pemahaman konsep. Analisis data dijadikan acuan untuk memperbaiki atau merevisi produk. Hasil pengembangan produk e-learning berupa manajemen pembelajaran online dengan software aplikasi moodle versi 3.1 dengan revisi versi 3.5.7 dengan alamat https://widyapradipta.com. Kelayakan produk e-learning pada aspek materi mendapatkan nilai 76,34 % dan termasuk dalam kategori baik, pada aspek media mendapatkan nilai sebesar 81,83 % dan termasuk dalam kategori sangat baik, aspek respon mahasiswa mendapatkan nilai 88% dalam kategori baik dan pemahaman onsep mahasiswa meningkat 23,6% menjad 83,6% kategori sangat baik.

Abstract: One phase of wound healing is the inflammatory phase. Haruan fish extract has shown to accelerate the healing process up because it has anti-inflammatory effects. Toman fish originates from the same genus as the Haruan fish, but its anti-inflammatory effect remains unknown. It was done to analyzed anti-inflammatory effects of Toman fish extract. This study was true experimental design with posttest-only control design. Twenty-seven male mice of Balb-C strain were divided into 3 groups. Incision wound of 1 cm was made along the back of the mice. Nine mice in each group were sacrificed on 3rd days, then histopathology examination was conducted with Haematoxylin eosin. There were significant differences between treatment group given Toman fish extract and positive control group given Haruan fish extract, and also compared to the negative control group in PMN cell examination. There were significant differences between treatment group given Toman fish extract and positive control group given Haruan fish extract compared to negative controls on the number of macrophage cells. Toman fish extract could lower the number of PMN cells and was able to increase the number of macrophages on the 3rd days. Toman fish has anti-inflammatory effects on the wound healing process. Keywords: Anti-inflammatory effects, haruan fish extract, macrophages, PMN cells, toman fish extract

Background: Peutz-Jeghers syndrome (PJS) is an inherited autosomal dominant disease determined by a mutation localized at 19p13.3 characterized by the occurrence of gastrointestinal hamartomatous polyps in association with mucocutaneous hyperpigmentation. The manifestation of PJS may first be encountered by a dentist during routine examination due to the presence of pigmented spots in the oral cavity. Purpose: To prevent a high risk of PJS, the dentist must establish its oral manifestation through early detection. Case: A 14-year-old male patient attended complaining of a week-long pain at the corners of the lips. An extra-oral exam revealed fissure lesions, redness, white crust and pain. The patient had experienced bleeding in his bowel movements, abdominal pain, nausea and vomiting since childhood. A number of black, painless, macular lesions, some 1-3 mm in diameter, were present on the upper lips, lower lips, fingers and palms. Case management: The patient was referred for a complete blood count check. The results obtained confirmed him to be suffering from severe anemia and he was, therefore, referred to an internist for treatment for PJS. Conclusion: It can be concluded that the early detection of PJS is crucial in order that the patient receives prompt treatment.

We present a determination of nucleon-nucleon scattering phase shifts for ℓ≥0. The S, P, D and F phase shifts for both the spin-triplet and spin-singlet channels are computed with lattice Quantum ChromoDynamics. For ℓ>0, this is the first lattice QCD calculation using the Lüscher finite-volume formalism. This required the design and implementation of novel lattice methods involving displaced sources and momentum-space cubic sinks. To demonstrate the utility of our approach, the calculations were performed in the SU(3)-flavor limit where the light quark masses have been tuned to the physical strange quark mass, corresponding to mπ=mK≈800 MeV. In this work, we have assumed that only the lowest partial waves contribute to each channel, ignoring the unphysical partial wave mixing that arises within the finite-volume formalism. This assumption is only valid for sufficiently low energies; we present evidence that it holds for our study using two different channels. Two spatial volumes of V≈(3.5 fm)3 and V≈(4.6 fm)3 were used. The finite-volume spectrum is extracted from the exponential falloff of the correlation functions. Said spectrum is mapped onto the infinite volume phase shifts using the generalization of the Lüscher formalism for two-nucleon systems.

Targeted genomic education and training of professionals have been identified as core components of strategies and implementation plans for the use of genomics in health care systems. Education needs to be effective and support the sustained and appropriate use of genomics in health care. Evaluation of education programs to identify effectiveness is challenging. Furthermore, those responsible for development and delivery are not necessarily trained in education and/or evaluation. Program logic models have been used to support the development and evaluation of education programs by articulating a logical explanation as to how a program intends to produce the desired outcomes. These are highly relevant to genomic education programs, but do not appear to have been widely used to date. To assist those developing and evaluating genomic education programs, and as a first step towards enabling identification of effective genomic education approaches, we developed a consensus program logic model for genomic education. We drew on existing literature and a co-design process with 24 international genomic education and evaluation experts to develop the model. The general applicability of the model to the development of programs was tested by program convenors across four diverse settings. Conveners reported on the utility and relevance of the logic model across development, delivery and evaluation. As a whole, their feedback suggests that the model is flexible and adaptive across university award programs, competency development and continuing professional development activities. We discuss this program logic model as a potential best practice mechanism for developing genomic education, and to support development of an evaluation framework and consistent standards to evaluate and report genomic education program outcomes and impacts.

Developing a competent workforce will be crucial to realizing the promise of genomic medicine. The preparedness of medical specialists without specific genetic qualifications to play a role in this workforce has long been questioned, prompting widespread calls for education across the spectrum of medical training. Adult learning theory indicates that for education to be effective, a perceived need to learn must first be established. Medical specialists have to perceive genomic medicine as relevant to their clinical practice. Here, we review what is currently known about medical specialists’ perceptions of genomics, compare these findings to those from the genetics era, and identify areas for future research. Previous studies reveal that medical specialists’ views on the clinical utility of genomic medicine are mixed and are often tempered by several concerns. Specialists generally perceive their confidence and understanding to be lacking; subsequently, they welcome additional educational support, although specific needs are rarely detailed. Similar findings from the genetics era suggest that these challenges are not necessarily new but on a different scale and relevant to more specialties as genomic applications expand. While existing strategies developed for genetic education and training may be suitable for genomic education and training, investigating the educational needs of a wider range of specialties is critically necessary to determine if tailored approaches are needed and, if so, to facilitate these. Other interventions are also required to address some of the additional challenges identified in this review, and we encourage readers to see education as part of a broader implementation strategy.

Language evolution resulted from changes in our biology, behavior, and culture. One source of these changes might be human self-domestication. Williams syndrome (WS) is a clinical condition with a clearly defined genetic basis which results in a distinctive behavioral and cognitive profile, including enhanced sociability. In this paper we show evidence that the WS phenotype can be satisfactorily construed as a hyper-domesticated human phenotype, plausibly resulting from the effect of the WS hemideletion on selected candidates for domestication and neural crest (NC) function. Specifically, we show that genes involved in animal domestication and NC development and function are significantly dysregulated in the blood of subjects with WS. We also discuss the consequences of this link between domestication and WS for our current understanding of language evolution.

Zoological institutions play an important role in promoting the goals of the One Health movement. We launched the Institute for Conservation Medicine (ICM) at the Saint Louis Zoo in 2011 to advance the goals of One Health. In 2016, we distributed a survey to Zoo members to evaluate member awareness and understanding of One Health and to provide direction for future communication and actions from the ICM. We hypothesized that Zoo members would be aware of One Health and care about infectious disease issues. Survey results showed Zoo members primarily cared about chronic, non-infectious diseases and their associated economic costs, with participants ranking their top three health issues of concern for humans as nutrition/obesity/diet (49%), costs of health care (48%), and cancer (37%). Zoo members were interested in the roles of zoos in One Health and found them important, but were less aware of the Saint Louis Zoo’s actions that did not directly relate to animal welfare. Only 6% of members had awareness of the term “One Health” and 16% were aware of the term “Conservation Medicine.” These results suggest that zoos may do better to tailor One Health messaging to align with member interests. Messaging and programming from the Saint Louis Zoo will now include the direct benefits to human health that zoos offer, in addition to the ICM’s more ecologically focused activities. This study offered valuable insight into how Zoo members view One Health and may serve as a template to help zoological institutions develop and promote One Health.

Initiated in 2016, End Hep C SF is a comprehensive initiative to eliminate hepatitis C (HCV) infection in San Francisco. The introduction of direct-acting antivirals to treat and cure HCV provides an opportunity for elimination. To properly measure progress, an estimate of baseline HCV prevalence, and of the number of people in various subpopulations with active HCV infection, is required to target and measure the impact of interventions. Our analysis was designed to incorporate multiple relevant data sources and estimate HCV burden for the San Francisco population as a whole, including specific key populations at higher risk of infection.Our estimates are based on triangulation of data found in case registries, medical records, observational studies, and published literature from 2010 through 2017. We examined subpopulations based on sex, age and/or HCV risk group. When multiple sources of data were available for subpopulation estimates, we calculated a weighted average using inverse variance weighting. Credible ranges (CRs) were derived from 95% confidence intervals of population size and prevalence estimates.We estimate that 21,758 residents of San Francisco are HCV seropositive (CR: 10,274-42,067), representing an overall seroprevalence of 2.5% (CR: 1.2%- 4.9%). Of these, 16,408 are estimated to be viremic (CR: 6,505-37,407), though this estimate includes treated cases; up to 12,257 of these (CR: 2,354-33,256) are people who are untreated and infectious. People who injected drugs in the last year represent 67.9% of viremic HCV infections.We estimated approximately 7,400 (51%) more HCV seropositive cases than are included in San Francisco's HCV surveillance case registry. Our estimate provides a useful baseline against which the impact of End Hep C SF can be measured.

[This corrects the article DOI: 10.1371/journal.pone.0195575.].

Background: Making travel easier can improve people’s access to opportunities, but motor transport also incurs substantial undesirable health and social impacts. Aims: To assess how a new urban motorway affected travel and activity patterns, road accidents and well-being in local communities, and how these impacts were experienced and brought about. Design: The Traffic and Health in Glasgow study, a mixed-method controlled before-and-after study. Setting: Glasgow, UK. Participants: Repeat cross-sectional survey samples of 1345 and 1343 adults, recruited in 2005 and 2013, respectively. Of these, 365 formed a longitudinal cohort, 196 took part in a quantitative substudy using accelerometers and global positioning system receivers and 30, living within 400 m of the new motorway, took part in a qualitative substudy along with 12 other informants. Complementary analyses used police STATS19 road traffic accident data (1997–2014) and Scottish Household Survey travel diaries (2009–13). Intervention: A new 5-mile, six-lane section of the M74 motorway, opened in 2011 and running through predominantly deprived neighbourhoods in south-east Glasgow, with associated changes to the urban landscape. Main outcome measures: Differences in self-reported travel behaviour (1-day travel record), physical activity (short International Physical Activity Questionnaire) and well-being [Short Form 8 Health Survey (SF-8) and a short version of the Warwick–Edinburgh Mental Well-being Scale], and in the incidence of road traffic accidents. Methods: A combination of multivariable cohort, cross-sectional, repeat cross-sectional and interrupted time series regression analyses comparing residents of the ‘M74 corridor’ intervention area and two matched control areas, complemented by novel qualitative spatial methods. Graded measures of the proximity of the motorway to each participant’s home served as a further basis for controlled comparisons. Results: Both benefits and harms were identified. Cohort participants living closer to the new motorway experienced significantly reduced mental well-being (mental component summary of the SF-8 scale) over time compared with those living further away [linear regression coefficient –3.6, 95% confidence interval (CI) –6.6 to –0.7]. In the area surrounding an existing motorway, this association was concentrated among those with chronic conditions. In repeat cross-sectional analyses, participants living closer to a new motorway junction were more likely to report using a car at follow-up than those living further away (odds ratio 3.4, 95% CI 1.1 to 10.7). We found weaker quantitative evidence of a decline in physical activity participation and no quantitative evidence of an overall change in either active travel or accidents associated with motorway exposure. Qualitative evidence suggested that, although the new motorway improved connectivity for those with dispersed social networks and access to motor vehicles, the impacts were more complex for others, some of whom found the motorway to be a cause of severance. Changes in community composition and cohesion, and perceptions of personal safety, were widely perceived as more important to local people. Limitations: A key limitation of natural experimental studies is that the risk of residual confounding cannot be eliminated. Conclusions: Overall, these findings highlight the potential for urban infrastructural projects of this kind to add further burdens to already disadvantaged communities, exacerbating inequalities and contributing to poorer health outcomes. The health and social impacts of such initiatives should be more fully taken into account in planning and research. Funding: The National Institute for Health Research Public Health Research programme.

Synovial plica syndrome (SPS) occurs in the knee, when an otherwise normal structure becomes a source of pain due to injury or overuse. Patients may present to general practitioners, physiotherapists, or surgeons with anterior knee pain with or without mechanical symptoms, and the diagnosis can sometimes be difficult. Several studies have examined the epidemiology, diagnosis, and treatment of SPS. We review these resources to provide an evidence-based guide to the diagnosis and treatment of SPS of the knee.

Thyroid hormone is a critical regulator of cardiac growth and development, both in fetal life and postnatally. Here we review the role of thyroid hormone in postnatal cardiac development, given recent insights into its role in stimulating a burst of cardiomyocyte proliferation in the murine heart in preadolescence; a response required to meet the massive increase in circulatory demand predicated by an almost quadrupling of body weight during a period of about 21 days from birth to adolescence. Importantly, thyroid hormone metabolism is altered by chronic diseases, such as heart failure and ischemic heart disease, as well as in very sick children requiring surgery for congenital heart diseases, which results in low T3 syndrome that impairs cardiovascular function and is associated with a poor prognosis. Therapy with T3 or thyroid hormone analogs has been shown to improve cardiac contractility; however, the mechanism is as yet unknown. Given the postnatal cardiomyocyte mitogenic potential of T3, its ability to enhance cardiac function by promoting cardiomyocyte proliferation warrants further consideration.

Accounting for climate change in invasive species risk assessments improves our understanding of potential future impacts and enhances our preparedness for the arrival of new non-native species. We combined traditional risk assessment for invasive species with habitat suitability modeling to assess risk to biodiversity based on climate change. We demonstrate our method by assessing the risk for 15 potentially new invasive plant species to Alberta, Canada, an area where climate change is expected to facilitate the poleward expansion of invasive species ranges. Of the 15 species assessed, the three terrestrial invasive plant species that could pose the greatest threat to Alberta's biodiversity are giant knotweed (Fallopia sachalinensis), tamarisk (Tamarix chinensis), and alkali swainsonpea (Sphaerophysa salsula). We characterise giant knotweed as 'extremely invasive', with 21 times the suitable habitat between baseline and future projected climate. Tamarisk is 'extremely invasive' with a 64% increase in suitable habitat, and alkali swainsonpea is 'highly invasive' with a 21% increase in suitable habitat. Our methodology can be used to predict and prioritise potentially new invasive species for their impact on biodiversity in the context of climate change.