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Berish Y Rubin, Sylvia L Anderson Department of Biological Sciences, Fordham University, Bronx, NY, USA Abstract: The successful completion of the Human Genome Project led to the discovery of the molecular basis of thousands of genetic disorders. The identification of the mutations that cause familial dysautonomia (FD), an autosomal recessive disorder that impacts sensory and autonomic neurons, was aided by the release of the human DNA sequence. The identification and characterization of the genetic cause of FD have changed the natural history of this disease. Genetic testing programs, which were established shortly after the disease-causing mutations were identified, have almost completely eliminated the birth of children with this disorder. Characterization of the principal disease-causing mutation has led to the development of therapeutic modalities that ameliorate its effect, while the development of mouse models that recapitulate the impact of the mutation has allowed for the in-depth characterization of its impact on neuronal development and survival. The intense research focus on this disorder, while clearly benefiting the FD patient population, also serves as a model for the positive impact focused research efforts can have on the future of other genetic diseases. Here, we present the research advances and scientific breakthroughs that have changed and will continue to change the natural history of this centuries-old genetic disease. Keywords: HSAN, splicing, MAO, tocotrienol, EGCG, Ashkenazi

Jessica L Norman, Sarah L Anderson Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA Abstract: Insomnia, a highly prevalent disorder, can be detrimental to patients’ overall health and worsen existing comorbidities. Patients may have acute episodes of insomnia related to a traumatic event, but more commonly insomnia occurs chronically. While proper sleep hygiene and behavioral therapy play important roles in the nonpharmacologic management of short-term and chronic insomnia, medications may also be required. Historically, insomnia has been treated with agents such as benzodiazepines, nonbenzodiazepine receptor agonists, and melatonin agonists. Dual orexin receptor antagonists represent a new class of medications for the treatment of insomnia, which block the binding of wakefulness-promoting neuropeptides orexin A and orexin B to their respective receptor sites. Suvorexant (Belsomra) is the first dual orexin receptor antagonist to be approved in the US and Japan and has demonstrated efficacy in decreasing time to sleep onset and increasing total sleep time. Its unique mechanism of action, data to support efficacy and safety over 12 months of use, and relative lack of withdrawal effects when discontinued may represent an alternative for patients with chronic insomnia who cannot tolerate or do not receive benefit from more traditional sleep agents. Suvorexant is effective and well tolerated, but precautions exist for certain patient populations, including females, obese patients, and those with respiratory disease. Suvorexant has only been studied vs placebo, and hence it is unknown how it directly compares with other medications approved by the US Food and Drug Administration for insomnia. Suvorexant is not likely to replace benzodiazepines or nonbenzodiazepine receptor antagonists as a first-line sleep agent but does represent a novel option for the treatment of patients with chronic insomnia. Keywords: insomnia, orexin antagonist, suvorexant

Heather N Woodward,1 Sarah L Anderson21Centura St. Anthony’s Hospital, Lakewood, CO, USA; 2Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA Abstract: This review describes the pharmacologic, pharmacokinetic, and pharmacodynamic properties of albiglutide, as well as its clinical efficacy and safety. Albiglutide is a novel, once-weekly, injectable glucagon-like peptide-1 receptor agonist for the treatment of type 2 diabetes. The European Commission recently granted marketing authorization for the drug in the European Union and on April 15, 2014, the US Food and Drug Administration approved albiglutide (Tanzeum™ [GlaxoSmithKline LLC, Wilmington, DE, USA]) to improve glycemic control in adults with type 2 diabetes. Albiglutide has been studied in Phase I, II, and III clinical trials. In the Phase III clinical trials, known as the Harmony series, weekly dosing of albiglutide demonstrated reductions in fasting plasma glucose, postprandial plasma glucose, and glycated hemoglobin, and was associated with weight loss. In all phases of the clinical trials, albiglutide administered once weekly showed a safety and tolerability profile similar to that of placebo, with mild gastrointestinal-related complaints and injection site erythema being the most commonly encountered adverse effects. Compared with pioglitazone and liraglutide, albiglutide has been shown to be clinically less effective. However, it offers the benefit of weight loss that pioglitazone does not, with fewer gastrointestinal side effects than liraglutide. As guidelines continue to advocate for patient-centered treatment strategies, once-weekly albiglutide will be an important addition to the growing armamentarium of treatment options for adults with type 2 diabetes needing target glycemic control.Keywords: albiglutide, glucagon-like peptide 1 receptor agonist, drug therapy, type 2 diabetes mellitus

The intensity and effort of bodybuilding training suggest an overinvestment in body shape and physical appearance, which has been suggested to be a risk factor for developing eating disorders. The purpose of this study was to investigate the prevalence of eating disorder tendencies among a sample of collegiate male bodybuilders (BB, n = 68) and controls (C, n = 50) (nonbodybuilders), using the Eating Disorders Inventory 2 (EDI-2). T tests were used to test the hypothesis that bodybuilders' scores would be higher than those of controls. The mean scores on the EDI-2 did not indicate the presence of eating disorder tendencies for either group. Controls scored significantly higher than bodybuilders on the Body Dissatisfaction scale. Results indicate that when the EDI-2 is used, college-age male bodybuilders are not shown to be more likely to have eating disorders than a group of college-age male controls. [ABSTRACT FROM AUTHOR]

What right does a teenager have to confidential health care? What influence does HIPAA have on that right? How you apply the answers in your practice could determine whether an adolescent seeks health services -- or forgoes necessary care. [ABSTRACT FROM AUTHOR]

What right does a teenager have to confidential health care? What influence does HIPAA exert on that right? How you apply the answers in your practice could determine whether an adolescent seeks health services--or forgoes necessary care. [ABSTRACT FROM AUTHOR]

All Missouri hospitals that offer maternity services were assessed to measure their compliance with WHO\UNICEF Baby Friendly Hospital Initiative (BFHI). Representatives from seventy six hospitals responded to a telephone survey relating to hospital breastfeeding practices and policies as defined by BFHI's Ten Steps to Successful Breastfeeding. No hospital fully supported the Ten Steps. Compliance with the WHO\UNICEF criteria varied greatly. The least support was for Step I, only 28% of hospitals had a written breastfeeding policy that was communicated to all staff. The greatest support was for Step 3, 93% of hospitals had staff who informed all pregnant women of breastfeeding benefits. In order to increase breastfeeding rates and duration, administrators of hospitals that offer maternity services must increase their efforts to consistently implement the Ten Steps, to become more baby friendly, and to more fully establish a breastfeeding culture within their institutions. [ABSTRACT FROM AUTHOR]

Badging or micro-credentialing programs have been used in higher education to allow students to pursue additional skills training helpful to their intended career path. These programs, overseen by faculty members and tracked using digital certification software, create an incorruptible ledger of student learning and achievement that can be shared with potential employers and providers of advanced training at the student's discretion. This teaching tip describes the implementation of a voluntary badging program for students at one veterinary college, including faculty member and student engagement in the badging program during its first year of implementation. During that year, five faculty members created seven unique badges, each with three levels of achievement (bronze, silver, and gold). During the first year, 10 badges were awarded to 8 students, and numerous other students were in the process of completing badge requirements. Students reported participating in the program to gain more skill in an area of interest and because they thought the program would be beneficial in getting a job or into an advanced training program. The majority of students participating during the program's first year reported planning to continue working on badges in the next year. An additional cohort of students who did not participate in the first year also expressed interest in starting to work on badges. The badging program allowed students to document their progress in learning skills of interest. The college intends to develop additional badges in areas of high student interest and continue research into stakeholders' opinions of the badges received.

Numerous colleges use distributed veterinary education (DVE) to deliver most or all their students' clinical education. This study explored students' experiences and development of competence in a DVE program. Veterinarians evaluated 120 final-year students' performances at the end of each 4-week clinical rotation using a four-point RIME (Reporter, Interpreter, Manager, Educator) scale. Evaluation items linked to 16 competencies, including the AVMA's Council on Education's (COE) 9 competencies and the North American Veterinary Medical Education Consortium's (NAVMEC) 7 competencies. Students were surveyed at graduation about their clinical year experience and preparedness for an expanded set of 21 competencies/subcompetencies derived from those published by the AVMA COE, NAVMEC, and the American Association of Veterinary Medical Colleges (AAVMC). Students logged 56,305 cases in ePortfolios during the year, averaging 469 cases per student. Competency scores increased during clinical year ( p < .001); scores rose most quickly in the middle third of the year. Students scored higher on some competencies than others ( p < .001), though different competencies improved at a similar rate. Seven students required remediation, which consisted of repeating one or more rotations with individualized goals and oversight; all remediated successfully. Students reported diverse spectrum of care experiences and praised the amount of hands-on experience. Students suggested additional oversight for some clinical affiliates. In conclusion, the DVE program provided a robust number and diversity of cases. Students demonstrated longitudinal gains in competency scores and reported confidence in performing competencies upon graduation. The DVE program appeared effective at meeting programmatic competency goals.

Background: Accurate radiographic interpretation is an important day one skill. A case-based radiology course (CBC) demonstrated better learning outcomes than a lecture-based course (LBC) immediately and after a one-semester period. The aim of this study was to compare long-term learning outcomes of both groups., Methods: Veterinary students who took both the CBC and LBC during their fourth or fifth semesters (n = 21) were compared to students who only completed the LBC (n = 17) regarding their ability to interpret small animal radiographs and write radiology reports at graduation (end of ninth semester)., Results: Students who completed the CBC scored better on both radiology reports than LBC students. All students reported similar frequency and role in interpreting radiographs during clinical training. However, students who took the CBC were more confident in their ability to interpret radiographs., Limitations: Students who completed the CBC may have had more interest in radiology or may have been more self-motivated to learn radiology. However, there were no measured differences in CBC and LBC students' self-reported role or frequency of reading radiographs during clinical training., Conclusions: Introducing a CBC in students' fourth or fifth semester improved students' competency in radiographic interpretation and report writing upon graduation 2 years later. This study supports active learning methods in teaching radiology and the use of case-based learning in the preclinical phase., (© 2025 British Veterinary Association.)

Objective: To determine if surgical skills instructors' experience and qualifications influence students' learning of small animal ovariohysterectomy on a model (mOVH)., Sample Population: Second-year veterinary students (n = 105)., Methods: Students were randomized to three groups, taught by: (1) residency-trained surgeons with over 3 years' experience teaching mOVH, (2) general practitioners with over 3 years' experience teaching mOVH (GP >3), and (3) general practitioners with under 3 years' experience (GP <3). Students completed four 3-h laboratories where they performed mOVH under the supervision of one of the three types of instructors. Students were assessed performing mOVH using a validated 22-item rubric and completed a survey about their experience., Results: GP <3 group students achieved lower total rubric scores than GP >3 group students (p = .021). Surgeon-taught students' scores did not differ from those taught by GP >3 (p = .685) or GP <3 (p = .052). GP <3 group students were more likely to require remediation than those taught by surgeons (p = .001); there were no differences between the other groups (surgeons vs. GP >3 p = .44; GP <3 vs. GP >3 p = .11). Students reported similar satisfaction with their instruction. Instructors with over 3 years' experience teaching mOVH had better student learning outcomes compared to instructors with under 3 years of experience. While mOVH teaching experience did influence learning, the instructor's completion of a surgical residency did not., Conclusion: The results of the study indicate a need for more extensive training for new surgical skills instructors and demonstrates that GPs with experience teaching surgical skills are suitable instructors for teaching ovariohysterectomy on a model., Clinical Relevance: This study indicates a need for more extensive training for new surgical skills instructors and demonstrates that GPs with experience teaching surgical skills are suitable instructors for teaching ovariohysterectomy on a model., (© 2025 American College of Veterinary Surgeons.)

Castration is one of the most common surgeries performed in equine practice. Veterinary students require deliberate practice to reach competence in surgical procedures including equine castration, but availability of patients limits students' practice opportunities. A recumbent equine castration model was created and evaluated using a validation framework consisting of content evidence (expert opinion), internal structure evidence (reliability of scores produced by the accompanying rubric), and evidence of relationship with other variables, specifically the difference in scores between experts and students. A convenience sample of third-year students who had never performed equine castration ( n = 24) and veterinarians who had performed equine castration ( n = 25) performed surgery on the model while being video recorded. Participants completed a post-operative survey about the model. All veterinarians (100%) agreed or strongly agreed that the model was suitable for teaching students the steps to perform equine castration and for assessing students' skill. The checklist produced scores with good internal consistency ( α = 0.805). Veterinarians performed the castration faster than the students ( p = .036) and achieved a higher total global rating score ( p = .003). There was no significant difference between groups in total checklist score or individual checklist items, except veterinarians were more likely to check both sides for bleeding ( p = .038). The equine castration model and rubric validated in this study can be used in a low-stress clinical skills environment to improve students' skills to perform what is otherwise a challenging field procedure. Model use should be followed with live animal practice to complete the learning process.

Inclisiran is a synthetic small interfering RNA (siRNA) that inhibits the production of proprotein convertase subtilisin/kexin 9 (PCSK9) in hepatocytes by silencing the translation of PCSK9 mRNA. The result of this mechanism is a decrease in PCSK9 synthesis resulting in decreased degradation of the LDL receptor, leading to more LDL receptors being available to clear LDL cholesterol (LDL-C) from the circulation. Inclisiran received FDA approval in 2021 and EMA approval in 2020. The indication for inclisiran use is as an adjunct to diet and statin therapy for the treatment of adults with primary hyperlipidaemia, including those with heterozygous familial hypercholesterolaemia to reduce LDL-C. Inclisiran has demonstrated consistent LDL-C lowering in the range of 44-54%. Furthermore, inclisiran has been demonstrated to be a safe medication with indications of significant or serious adverse events when compared to placebo. Inclisiran is given as an initial subcutaneous dose followed by a repeat dose at 3 months and every 6 months thereafter. The 2022 American College of Cardiology Expert Consensus Decision Pathway includes inclisiran as an option for non-statin therapy in addition to maximally tolerated statin therapy in those at very high risk of atherosclerotic cardiovascular disease or those with LDL-C >190 mg/dL. The ORION-4, VICTORION-1 PREVENT and VICTORION-2 PREVENT trials are ongoing and designed to evaluate the ability of inclisiran to reduce major cardiovascular events in addition to LDL-C lowering but will not be completed for a few years., Competing Interests: Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2024/10/dic.2023-12-3-COI.pdf, (Copyright © 2024 Marrs JC, Anderson SL.)

Ru is a metal of interest in catalysis. Monodisperse Ru 3 clusters as catalytic sites are relevant for the development of catalysts because clusters use significantly lower amounts of precious materials for forming active sites due to the small size of the cluster. However, retaining the mono-dispersity of the cluster size after deposition is a challenge because surface energy could drive both agglomeration and encapsulation of the clusters. In the present work Ru 3 clusters are deposited by chemical vapor deposition (CVD) of Ru 3 (CO) 12 and cluster source depositions of bare Ru 3 onto radio frequency sputter-deposited TiO 2 (RF-TiO 2 ) substrates, TiO 2 (100), and SiO 2 . When supported on RF-TiO 2 , bare Ru 3 is encapsulated by a layer of titania substrate material during deposition with a cluster source. Ligated Ru 3 (CO) 12 is also encapsulated by a layer of titania when deposited onto sputter-treated RF-TiO 2 , but only through heat treatment which is required to remove most of the ligands. The titania overlayer thickness was determined to be 1-2 monolayers for Ru 3 (CO) 12 clusters on RF-TiO 2 , which is thin enough for catalytic or photocatalytic reactions to potentially occur even without clusters being part of the very outermost layer. The implication for catalysis of the encapsulation of Ru 3 into the RF-TiO 2 is discussed. Temperature-dependent X-ray photoelectron spectroscopy (XPS), angle-resolved XPS, and temperature-dependent low energy ion scattering (TD-LEIS) are used to probe how the cluster-surface interaction changes due to heat treatment and scanning transmission electron microscopy (STEM) was used to image the depth of the surface from side-on.

A surgical residency trains veterinary graduates to a higher level of expertise in surgical procedures than is possible during veterinary school and prepares a resident to pursue board certification in surgery. The education of veterinary surgical residents has changed minimally since its inception in the twentieth century, and there are insufficient studies to determine if residency programs are producing surgeons with competence in each of the necessary procedural categories. The aims of this review were to report the current theory and methods used to provide surgical education to residents, to discuss the training most likely to create a competent, board-certified surgeon and to review assessment methods used during training. Several literature searches using broad terms such as "veterinary surgery residency," "veterinary surgery resident," and "veterinary surgical training" were performed using PubMed, CAB abstracts, and Google Scholar. Literature pertinent to theory, methods, training, and assessment of veterinary surgical residents was included. The reviewed literature demonstrated the need for research-based learning curves for specific procedures. Simulation training is known to facilitate deliberate practice and should be leveraged where possible to reach competency. The creation of validated assessment methods should be pursued as it enables assessment of competency instead of inferring its development from case logs. Understanding and supporting learner cognition and providing sufficient feedback remain important issues in the field. Surgical educators are urged to continue to search for innovative and evidence-based ways to train competent surgical residents., (© 2024 American College of Veterinary Surgeons.)

Simulation-based surgical training allows students to learn skills through deliberate practice without the patient risk and stress of operating on a live animal. This study sought to determine the ideal distribution of training sessions to improve short- and long-term retention of the skills necessary to perform a simulated ovariohysterectomy (OVH). Fourth-semester students ( n = 102) were enrolled. Students in the weekly instruction group ( n = 57) completed 10 hours of training on the OVH simulator, with sessions held at approximately weekly intervals. Students in the monthly instruction group ( n = 45) completed the same training with approximately monthly sessions. All students were assessed 1 week (short-term retention test) and 5 months following the last training session (long-term retention test). Students in the weekly instruction group scored higher on their short-term assessment than students in the monthly instruction group ( p < .001). However, students' scores in the weekly instruction group underwent a significant decrease between their short- and long-term assessments ( p < .001), while the monthly group did not experience a decrease in scores ( p < .001). There was no difference in long-term assessment scores between weekly and monthly instruction groups. These findings suggest that if educators are seeking maximal performance at a single time point, scheduling instructional sessions on a weekly basis prior to that time would be superior to monthly sessions, but if educators are concerned with long-term retention of skills, scheduling sessions on either a weekly or monthly basis would accomplish that purpose.

Accurate interpretation of radiographs is necessary for the correct diagnosis and treatment of patients. Research has shown that active learning methods, including case-based learning, are superior to passive learning methods, such as lectures. Short-term learning outcomes were compared between two groups by enrolling 80 fourth-semester veterinary students in either an online case-based radiology course ( n = 40) or a virtual lecture-based course ( n = 40). Long-term learning outcomes were compared among three groups: one group completed case-based instruction in the fourth semester, followed by lecture-based instruction in the fourth semester ( n = 19); the second group completed only lecture-based instruction in the fourth semester ( n = 22), and the third group completed lecture-based instruction in the fourth semester, followed by case-based instruction in the fifth semester ( n = 9). Learning was assessed using a multiple-choice examination and two independently written small animal radiograph reports. In the fourth semester, students completing the case-based course had higher examination scores and radiograph report scores than students who took the lecture-based course. Students completing the lecture-based course in the fourth semester and the case-based course in the fifth semester wrote better radiograph reports than students who completed both courses in the fourth semester; both groups wrote better reports than students who did not take the case-based course. A case-based diagnostic imaging course may be better than a lecture-based course for both short- and long-term retention of knowledge; however, there is a significant loss of knowledge following an instructional gap, and spaced refreshers may boost retention.

High-throughput phenotyping (HTP) has expanded the dimensionality of data in plant research; however, HTP has resulted in few novel biological discoveries to date. Field-based HTP (FHTP), using small unoccupied aerial vehicles (UAVs) equipped with imaging sensors, can be deployed routinely to monitor segregating plant population interactions with the environment under biologically meaningful conditions. Here, flowering dates and plant height, important phenological fitness traits, were collected on 520 segregating maize recombinant inbred lines (RILs) in both irrigated and drought stress trials in 2018. Using UAV phenomic, single nucleotide polymorphism (SNP) genomic, as well as combined data, flowering times were predicted using several scenarios. Untested genotypes were predicted with 0.58, 0.59, and 0.41 prediction ability for anthesis, silking, and terminal plant height, respectively, using genomic data, but prediction ability increased to 0.77, 0.76, and 0.58 when phenomic and genomic data were used together. Using the phenomic data in a genome-wide association study, a heat-related candidate gene (GRMZM2G083810; hsp18f) was discovered using temporal reflectance phenotypes belonging to flowering times (both irrigated and drought) trials where heat stress also peaked. Thus, a relationship between plants and abiotic stresses belonging to a specific time of growth was revealed only through use of temporal phenomic data. Overall, this study showed that (i) it is possible to predict complex traits using high dimensional phenomic data between different environments, and (ii) temporal phenomic data can reveal a time-dependent association between genotypes and abiotic stresses, which can help understand mechanisms to develop resilient plants., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

One in ten adults worldwide is living with diabetes, with 95% having type 2 diabetes (T2D). Sustained glycaemic control in people with T2D is difficult to achieve despite recent advances in T2D management with the advent of glucagon-like peptide 1 receptor agonists (GLP1RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i). Tirzepatide represents a first-in-class agent as a dual glucose-dependent insulinotropic polypeptide (GIP)/GLP1RA to be approved in the USA and Europe for the treatment of T2D. This narrative review intends to list and discuss the glycaemic efficacy, key safety and weight loss outcomes related to the treatment of T2D with tirzepatide. Tirzepatide has been evaluated in five published clinical trials ( n =6278) within the SURPASS clinical trial programme, with a focus on glycaemic control and weight loss. These trials have demonstrated significant improvements in glycosylated haemoglobin (-1.24% to -2.11% versus placebo and -0.6% to -1.14% versus active comparator) and weight (up to 15.5 kg versus placebo or active comparator) in patients with T2D. Notably, tirzepatide exhibited superior glycaemic control and weight loss when compared directly with a GLP1RA. Adverse events with the use of tirzepatide are similar to other approved GLP1RA and are predominantly gastrointestinal (nausea, vomiting). The tirzepatide cardiovascular outcomes trial (SURPASS-CVOT) is in progress and is expected to be completed in the fall of 2024. Tirzepatide represents an attractive new option and first-in-class agent for the treatment of T2D in people unable to achieve their glycaemic or weight management goals., Competing Interests: Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2023/08/dic.2023-6-1-COI.pdf, (Copyright © 2023 Anderson SL, Marrs JC.)

Absolute kinetics for reactions of C2H2 with a series of ∼60 individual carbon nanoparticles (NPs) from graphite, graphene, graphene oxide, carbon black, diamond, and nano-onion feedstocks were measured for temperatures (TNP) ranging from 1200 to 1700 K. All the NPs were observed to gain mass by carbon addition under conditions that varied with feedstock but with large variations in initial growth rate. Long reaction periods were studied to allow the evolution of growth rates over time to be observed. Diamond NPs were found to passivate against C2H2 addition if heated above ∼1400 K, and the highly variable initial reactivity for carbon nano-onions was found to depend on the presence of non-onion-structure surface carbon. For graphitic and carbon black NPs, three distinct growth modes were observed, correlated with the initial NP mass (Minitial). Smallest graphitic and carbon black NPs, with masses <∼25 MDa, initially grew rapidly but also passivated quickly after adding <4% of Minitial. NPs in the 20-50 MDa range also passivated but only after multiple waves of fast growth separated by periods of low reactivity, with up to ∼11% total mass gain before passivation. The largest carbon black and graphitic NPs, with Minitial >50 MDa, grew rapidly and continuously, adding up to ∼300% of Minitial with no sign of rate slowing as long as C2H2 was present. The efficiencies for C2H2 addition and etching by O2 are strongly correlated, but the correlation changes as the NPs passivate. Growth and passivation mechanisms are discussed., (© 2023 Author(s). Published under an exclusive license by AIP Publishing.)

We report the size-dependent activity and stability of supported Pt 1,4,7,8 for electrocatalytic hydrogen evolution reaction, and show that clusters outperform polycrystalline Pt in activity, with size-dependent stability. To understand the size effects, we use DFT calculations to study the structural fluxionality under varying potentials. We show that the clusters can reshape under H coverage and populate an ensemble of states with diverse stoichiometry, structure, and thus reactivity. Both experiment and theory suggest that electrocatalytic species are hydridic states of the clusters (≈2 H/Pt). An ensemble-based kinetic model reproduces the experimental activity trend and reveals the role of metastable states. The stability trend is rationalized by chemical bonding analysis. Our joint study demonstrates the potential- and adsorbate-coverage-dependent fluxionality of subnano clusters of different sizes and offers a systematic modeling strategy to tackle the complexities., (© 2023 Wiley-VCH GmbH.)

A combination of density functional theory (DFT) and experiments with atomically size-selected Pt n clusters deposited on indium-tin oxide (ITO) electrodes was used to examine the effects of applied potential and Pt n size on the electrocatalytic activity of Pt n ( n = 1, 4, 7, and 8) for the hydrogen evolution reaction (HER). Activity is found to be negligible for isolated Pt atoms on ITO, increasing rapidly with Pt n size such that Pt 7 /ITO and Pt 8 /ITO have roughly double the activity per Pt atom compared to atoms in the surface layer of polycrystalline Pt. Both the DFT and experiment find that hydrogen under-potential deposition (H upd ) results in Pt n /ITO ( n = 4, 7, and 8) adsorbing ∼2H atoms/Pt atom at the HER threshold potential, equal to ca. double the H upd observed for Pt bulk or nanoparticles. The cluster catalysts under electrocatalytic conditions are hence best described as a Pt hydride compound, significantly departing from a metallic Pt cluster. The exception is Pt 1 /ITO, where H adsorption at the HER threshold potential is energetically unfavorable. The theory combines global optimization with grand canonical approaches for the influence of potential, uncovering the fact that several metastable structures contribute to the HER, changing with the applied potential. It is hence critical to include reactions of the ensemble of energetically accessible Pt n H x /ITO structures to correctly predict the activity vs Pt n size and applied potential. For the small clusters, spillover of H ads from the clusters to the ITO support is significant, resulting in a competing channel for loss of H ads , particularly at slow potential scan rates.

Introduction: Despite routine implementation of cleaning and disinfection practices in clinical healthcare settings, high-touch environmental surfaces and contaminated equipment often serve as reservoirs for the transmission of pathogens associated with healthcare-associated infections (HAIs)., Methods: The current study involved the analysis of high-touch surface swabs using a metatranscriptomic sequencing workflow (CSI-Dx™) to assess the efficacy of cleanSURFACES® technology in decreasing microbial burden by limiting re-contamination. This is a non-human single center study conducted in the Emergency Department (ED) and on an inpatient Oncology Ward of Walter Reed National Military Medical Center that have followed hygienic practices during the COVID-19 pandemic environment., Results: Although there was no difference in observed microbial richness (two-tailed Wilcoxon test with Holm correction, P > 0.05), beta diversity findings identified shifts in microbial community structure between surfaces from baseline and post-intervention timepoints (Day 1, Day 7, Day 14, and Day 28). Biomarker and regression analyses identified significant reductions in annotated transcripts for various clinically relevant microorganisms' post-intervention, coagulase-negative staphylococci and Malassezia restricta , at ED and Oncology ward, respectively. Additionally, post-intervention samples predominantly consisted of Proteobacteria and to a lesser extent skin commensals and endogenous environmental microorganisms in both departments., Discussion: Findings support the value of cleanSURFACES®, when coupled with routine disinfection practices, to effectively impact on the composition of active microbial communities found on high-touch surfaces in two different patient care areas of the hospital (one outpatient and one inpatient) with unique demands and patient-centered practices., Competing Interests: RL and JRW are owners of Contamination Source Identification, LLC. TTL, CJB, JRCS, SLCA, JP, LP, CYW, and AJS were employed by Contamination Source Identification, LLC. AJS serves as a consultant for AIONX®. JB was employed by AIONX®. ACW was employed by Nextflex. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Wright, Ly, Cromwell, Brislawn, Chen See, Anderson, Pellegrino, Peachey, Walls, Lloyd, Jones, Lawrence, Bess, Wall, Shope and Lamendella.)

Accurate interpretation of radiographic images is critical to diagnosing clinical patients. Remote instruction in radiology has become more common at veterinary colleges as academic institutions struggle to fill open veterinary radiologist positions and as a result of the COVID-19 pandemic. This study sought to gather the feedback of fourth-year veterinary students via pre- and post-study surveys ( n = 45) and focus groups ( n = 7) about a newly implemented 2-week long radiology rotation. Ninety-eight percent of students reported having taken an online course before, and on both pre- and post-study surveys, students commonly reported feeling interested, determined, and attentive. On average, students reported that they were neither more nor less engaged than they would have been in an in-person course and that they understood the material neither better nor worse than they would have in an in-person course. Students reported that the key to their success was primarily hard work; secondarily, instructor availability and student ability were important. Students did not rate luck as having much influence on their success. Although diagnostic imaging can be a challenging subject to master, students effectively learned this subject through online instruction. They provided feedback for the course's continued improvement; their comments centered around improved interactivity, including providing automated quiz questions' answers and increased instructor availability. Data collected in this study will help to guide further development of the radiology course.

A major challenge of genetic improvement and selection is to accurately predict individuals with the highest fitness in a population without direct measurement. Over the last decade, genomic predictions (GP) based on genome-wide markers have become reliable and routine. Now phenotyping technologies, including unoccupied aerial systems (UAS also known as drones), can characterize individuals with a data depth comparable to genomics when used throughout growth. This study, for the first time, demonstrated that the prediction power of temporal UAS phenomic data can achieve or exceed that of genomic data. UAS data containing red-green-blue (RGB) bands over 15 growth time points and multispectral (RGB, red-edge and near infrared) bands over 12 time points were compared across 280 unique maize hybrids. Through cross-validation of untested genotypes in tested environments (CV2), temporal phenomic prediction (TPP), outperformed GP (0.80 vs 0.71); TPP and GP performed similarly in 3 other cross-validation scenarios. Genome-wide association mapping using area under temporal curves of vegetation indices (VIs) revealed 24.5% of a total of 241 discovered loci (59 loci) had associations with multiple VIs, explaining up to 51% of grain yield variation, less than GP and TPP predicted. This suggests TPP, like GP, integrates small effect loci well improving plant fitness predictions. More importantly, TPP appeared to work successfully on unrelated individuals unlike GP., (© The Author(s) 2022. Published by Oxford University Press on behalf of Genetics Society of America.)

Maternal warmth has been identified as a contributing factor to the development of child anxiety; however, no studies to date have examined observed maternal warmth longitudinally in this relationship. The present study addressed this knowledge gap by examining the simultaneous development of maternal warmth and child anxiety over time (between-person effects using latent growth curve modeling) and the directionality of associations (within-person effects using autoregressive latent trajectory modeling). Participants included 753 mothers and children. Between-person effects indicated that lower initial levels of anxiety were related to greater levels of maternal warmth over time. Within-person effects showed that maternal warmth in grade 1 predicted subsequent decreases in child anxiety in grade 2 (i.e., a parent effect). Present findings demonstrate the importance of maternal warmth in the early school-age years for decreasing subsequent child anxiety., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Subnano cluster catalysts, while highly promising due to unique activity, selectivity, and atom-efficiency, are limited in wider applications, as they are prone to deactivation via sintering. Even size-selection, which was previously shown to reduce sintering of nanoparticles, cannot reduce the sintering of highly fluxional subnano clusters due to their inherent isomeric diversity. Here, we use a combination of theory and experiment to show that Pt clusters on Al 2 O 3 exhibit size-dependent sintering resistance. We furthermore show that Pt 4 /Al 2 O 3 and Pt 7 /Al 2 O 3 are "magic" sinter-resistant cluster sizes. Their stability is attributed to the greater degree of bulk-like crystallinity of the dominant isomers. In addition, we identify different spatial signatures characteristic of the sintering of clusters with differing sintering stabilities.

Purpose: This systematic review aimed to identify the characteristics and determine the effects of exercise interventions on improving health-related physical fitness in adults with asthma., Review Methods: A systematic search was completed in MEDLINE, CINAHL, Embase, and SPORTDiscus for peer-reviewed publications of experimental studies that investigated the effects of an exercise training intervention on performance-based health-related physical fitness outcomes in adults with asthma. Two reviewers independently screened studies for inclusion according to predetermined criteria and performed data extraction and quality assessment of included studies., Summary: Forty-five articles were included, in which results for 39 unique studies were reported. Subjects (n = 2135) were aged 22 ± 4 to 71 ± 11 yr with mild-severe asthma. Most exercise programs used aerobic exercise, either alone or in combination with resistance or breathing/stretching exercises. The most common exercise program characteristics were supervised moderate-to-vigorous intensity aerobic exercise performed for 30-45 min 3 d/wk. Meta-analyses revealed significant improvements in cardiorespiratory fitness (V˙o2peak: unstandardized mean difference [MD] 3.1 mL/kg/min, 95% CI, 1.9-4.3), functional fitness (walking distance: MD 41 m, 95% CI, 27-54), and overall health-related physical fitness (standardized mean difference [SMD] 0.67, 95% CI, 0.46-0.89) in favor of groups who underwent experimental exercise training interventions. Aerobic exercise elicited superior improvements in health-related physical fitness compared with breathing/stretching exercise (SMD 0.47, 95% CI, 0.14-0.81).Supervised exercise training programs, particularly those aerobic in nature, are effective in eliciting clinically meaningful improvements in cardiorespiratory and functional fitness in adults with asthma.PROSPERO registration ID number = CRD42018092828., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Recent research on familial dysautonomia (FD) has focused on the development of therapeutics that facilitate the production of the correctly spliced, exon 20-containing, transcript in cells and individuals bearing the splice-altering, FD-causing mutation in the elongator acetyltransferase complex subunit I (ELP1) gene. We report here the ability of carnosol, a diterpene present in plant species of the Lamiaceae family, including rosemary, to enhance the cellular presence of the correctly spliced ELP1 transcript in FD patient-derived fibroblasts by upregulating transcription of the ELP1 gene and correcting the aberrant splicing of the ELP1 transcript. Carnosol treatment also elevates the level of the RNA binding motif protein 24 (RBM24) and RNA binding motif protein 38 (RBM38) proteins, two multifunctional RNA-binding proteins. Transfection-mediated expression of either of these RNA binding motif (RBMs) facilitates the inclusion of exon 20 sequence into the transcript generated from a minigene-bearing ELP1 genomic sequence containing the FD-causing mutation. Suppression of the carnosol-mediated induction of either of these RBMs, using targeting siRNAs, limited the carnosol-mediated inclusion of the ELP1 exon 20 sequence. Carnosol treatment of FD patient peripheral blood mononuclear cells facilitates the inclusion of exon 20 into the ELP1 transcript. The increased levels of the ELP1 and RBM38 transcripts and the alternative splicing of the sirtuin 2 (SIRT2) transcript, a sentinel for exon 20 inclusion in the FD-derived ELP1 transcript, are observed in RNA isolated from whole blood of healthy adults following the ingestion of carnosol-containing rosemary extract. These findings and the excellent safety profile of rosemary together justify an expedited clinical study of the impact of carnosol on the FD patient population., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: The emergence of COVID-19 exacerbated the existing epidemic of opioid use disorder (OUD) across the United States due to the disruption of in-person treatment and support services. Increased use of technology including telehealth and the development of new partnerships may facilitate coordinated treatment interventions that comprehensively address the health and well-being of individuals with OUD., Objective: The analysis of this pilot program aimed to determine the feasibility of delivering a COVID-19 telehealth care management program using SMS text messages for patients receiving OUD treatment., Methods: Eligible individuals were identified from a statewide opioid treatment program (OTP) network. Those who screened positive for COVID-19 symptoms were invited to connect to care management through a secure SMS text message that was compliant with Health Insurance Portability and Accountability Act standards. Care management monitoring for COVID-19 was provided for a period of up to 14 days. Monitoring services consisted of daily SMS text messages from the care manager inquiring about the participant's physical health in relation to COVID-19 symptoms by confirming their temperature, if the participant was feeling worse since the prior day, and if the participant was experiencing symptoms such as coughing or shortness of breath. If COVID-19 symptoms worsened during this observation period, the care manager was instructed to refer participants to the hospital for acute care services. The feasibility of the telehealth care management intervention was assessed by the rates of adoption in terms of program enrollment, engagement as measured by the number of SMS text message responses per participant, and retention in terms of the number of days participants remained in the program., Results: Between January and April 2021, OTP staff members referred 21 patients with COVID-19 symptoms, and 18 (82%) agreed to be contacted by a care manager. Participants ranged in age from 27 to 65 years and primarily identified as female (n=12, 67%) and White (n=15, 83%). The majority of participants were Medicaid recipients (n=14, 78%). There were no statistically significant differences in the demographic characteristics between those enrolled and not enrolled in the program. A total of 12 (67%) patients were enrolled in the program, with 2 (11%) opting out of SMS text message communication and choosing instead to speak with a care manager verbally by telephone. The remaining 10 participants answered a median of 7 (IQR 4-10) SMS text messages and were enrolled in the program for a median of 9 (IQR 7.5-12) days. No participants were referred for acute care services or hospitalized during program enrollment., Conclusions: These results demonstrate the feasibility of a novel telehealth intervention to monitor COVID-19 symptoms among OTP patients in treatment for OUD. Further research is needed to determine the applicability of this intervention to monitor patients with comorbid chronic conditions in addition to the acceptability among patients and providers using the SMS text messaging modality., (©Kimberly D Williams, Claudine T Jurkovitz, Mia A Papas, Ann Kathryn Muther, Sharon L Anderson, Tammy L Anderson. Originally published in JMIR Formative Research (https://formative.jmir.org), 30.08.2022.)

Veterinary surgical education is improved by studying the relevant literature. The aim of this literature review was to report the theory and methods used to provide surgical education to veterinary students; to discuss the training most likely to create a competent general practitioner; and to review assessment methods for simulated and live surgeries. The literature reviewed demonstrates that new graduates are expected to perform small animal sterilization, dental extraction, onychectomy, abscess treatment, aural hematoma repair, and mass removal with little or no supervision. Students require repetitive practice to reach competence; some practice can take place in a clinical skills laboratory on models or cadavers. When training novices, distributing practice over a longer time improves retention, but months without practice causes skills to decay. Suturing skills may be taught on models at a ratio of 1 instructor per 10 students. Veterinary students require 6-10 repetitions of each small animal sterilization surgery to reach competence; however, learning curves for other surgeries have not been established. Assessment of surgical skills has been undertaken using objective structured clinical examinations (OSCEs) and observed model and live surgeries. Additional validated rubrics are needed in the field. Surgical educators are urged to continue to search for innovative ways to foster deliberate practice, assess skill, and provide feedback for students., (© 2022 American College of Veterinary Surgeons.)

Atherosclerotic cardiovascular disease (ASCVD) commonly affects people with type 2 diabetes (T2D). Historically, traditional cardiovascular (CV) risk-lowering therapies in patients with T2D and ASCVD have included antiplatelet agents, blood pressure-lowering therapies, lipid-lowering therapies and healthy lifestyle modifications. In the past decade, multiple antihyperglycaemic agents have emerged as CV risk-lowering therapies in this population as well. This article provides a narrative review on the current non-glycaemic and glycaemic treatment options for CV risk reduction in patients with T2D and ASCVD. The FDA requirement that all new antihyperglycaemic agents undergo cardiovascular outcomes trials has demonstrated increasing evidence to support the role of glucagon-like peptide 1 (GLP1) receptor agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors as first-line agents for both glycaemic control and CV risk reduction in this population., Competing Interests: Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2022/01/dic.2021-10-1-COI.pdf, (Copyright © 2022 Anderson SL, Marrs JC.)

Technological advances are enabling roles for machines that present novel ethical challenges. The study of 'AI ethics' has emerged to confront these challenges, and connects perspectives from philosophy, computer science, law, and economics. Less represented in these interdisciplinary efforts is the perspective of cognitive science. We propose a framework - computational ethics - that specifies how the ethical challenges of AI can be partially addressed by incorporating the study of human moral decision-making. The driver of this framework is a computational version of reflective equilibrium (RE), an approach that seeks coherence between considered judgments and governing principles. The framework has two goals: (i) to inform the engineering of ethical AI systems, and (ii) to characterize human moral judgment and decision-making in computational terms. Working jointly towards these two goals will create the opportunity to integrate diverse research questions, bring together multiple academic communities, uncover new interdisciplinary research topics, and shed light on centuries-old philosophical questions., Competing Interests: Declaration of interests The authors declare no conflicts of interest., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)