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This article adopts the perspective of Sen's capability approach to examine elite athletes' environment and their capability to plan and prepare a career transition out of sport. Interviews were conducted with 14 elite athletes in Canada and results from the thematic analysis reveal that discrepancies exist in the athletes' environment. Three types of environments emerged from the findings: enabling, restricting, or hindering athletes' capabilities to plan and prepare their transition out of sport to a career they value. The difficulties reside more specifically in the possibilities they have to prepare an education path of their choice while being part of the national team. The results highlight that even though support from family and teammates is essential, it is not sufficient, as the support of coaching staff was shown to be crucial. The role of Game Plan advisors varies according to athletes' type of environment and underline the importance of going beyond their role of individual counseling in certain types of environments.

Abstract Background and methods The Zéro allergie research clinic (Saguenay, Canada) is a clinical and research initiative in oral immunotherapy (OIT) for managing IgE-mediated food allergy (FA). A total of 183 children with FA and 27 non-allergic siblings were recruited to date in the Zéro allergie cohort (ZAC) to better understand biological mechanisms underlying FA and OIT prognosis. The primary aims are to (a) better understand the genetic, epigenetic, transcriptomic, metabolomic, and microbial diversity associated with FA; (b) establish the multi-omics and microbial diversity profiles of children following OIT to identify predictive prognosis biomarkers, (c) make OIT more accessible to the population of the Saguenay–Lac-Saint-Jean region, and (d) build a biobank of data and biological material. Results The ZAC constitutes a unique and rich biobank of biological samples (blood, buccal swabs, microbiota samples [intestinal, buccal, nasal, and cutaneous]) combined with clinical data and more than 75 phenotypic characteristics. Conclusions This represents an innovative interdisciplinary initiative by researchers, allergists, and paediatricians to make FA care accessible to a greater number of children with IgE-mediated FA. Ultimately, it will contribute to provide more accessible treatment options with greater chances of success through a better understanding of the biological nature of FA and OIT.

Abstract A given dose of hypoxia causes a greater increase in pulmonary ventilation during physical exercise than during rest, representing an exercise‐induced potentiation of the acute hypoxic ventilatory response (HVR). This phenomenon occurs independently from hypoxic blood entering the contracting skeletal muscle circulation or metabolic byproducts leaving skeletal muscles, supporting the contention that neural mechanisms per se can mediate the HVR when humoral mechanisms are not at play. However, multiple neural mechanisms might be interacting intricately. First, we discuss the neural mechanisms involved in the ventilatory response to hypoxic exercise and their potential interactions. Current evidence does not support an interaction between the carotid chemoreflex and central command. In contrast, findings from some studies support synergistic interactions between the carotid chemoreflex and the muscle mechano‐ and metaboreflexes. Second, we propose hypotheses about potential mechanisms underlying neural interactions, including spatial and temporal summation of afferent signals into the medulla, short‐term potentiation and sympathetically induced activation of the carotid chemoreceptors. Lastly, we ponder how exercise‐induced potentiation of the HVR results in hyperventilation‐induced hypocapnia, which influences cerebral blood flow regulation, with multifaceted potential consequences, including deleterious (increased central fatigue and impaired cognitive performance), inert (unchanged exercise) and beneficial effects (protection against excessive cerebral perfusion).

Abstract Whole genome sequencing (WGS) has become a gold standard for diagnosing genomic variation. Peripheral blood is a common sample source for the extraction of nucleic acids for Next-Generation Sequencing (NGS) applications. Here, we present an integrated and fully automated device design that uses new concepts of fluid mechanics, heat-mass transfer, and thermodynamics of enzymatic reactions to extract nucleic acids from the blood and perform DNA library preparation from a pre-filled plate. We demonstrate that the presented device effectively extracts dsDNA with an average of 25.03 µg/mL and 25.91 µg/mL yield from citrate-stabilized human peripheral blood stored in Fresh (4 °C) and Frozen (-20 °C) conditions, respectively. Furthermore, our method automatically extracts nucleic acids and creates a high-quality sequence-ready DNA library from blood stabilized with citrate and EDTA for 8 samples simultaneously in a single run with a total operation time of ~ 7 h. Our results show the required coverage and depth of the genome, highlighting an essential application of this device in processing blood samples for genome sequencing. Graphical Abstract

Few studies have examined the relationship between attention problems (AP) and observed parenting in families of children with autism spectrum disorder (ASD). Participants were 41 mother-child dyads with ASD recruited from an Applied Behavior Analysis (ABA) U.S. preschool and whose behaviors were observed during parent-child interactions. Children with ASD and elevated AP (n = 19) on the Child Behavior Checklist had significantly lower verbal ability, and mothers reported significantly more stress than children with ASD only (n = 22). Causal modeling was used to examine the directionality of the expected relationship between AP and parenting behavior as partially or wholly mediated by parenting stress. Mothers who exhibited less positive parenting experienced higher parenting stress and their children demonstrated increased AP and decreased engagement during dyadic interactions. The strength of this relationship varied according to child verbal ability. These findings have practical implications for identifying and implementing appropriate intervention.

PURPOSE: To report the clinical and histopathologic features of necrobiosis lipoidica and associated retinal vasculitis and describe successful treatment of both skin and eye manifestations with adalimumab, a tumor necrosis factor (TNF)-alpha inhibitor. OBSERVATIONS: A 35-year-old patient with bipolar disorder and ocular hypertension was referred for evaluation of bilateral retinal vasculitis. Fluorescein angiography revealed bilateral occlusive retinal vasculitis. Physical exam was notable for multiple annular and round erythematous hyperpigmented and atrophic patches and plaques on both lower extremities. Skin biopsy revealed a diagnosis of necrobiosis lipoidica, a rare granulomatous skin disease. Both the patients retinal vasculitis and skin patches responded favorably to treatment with adalimumab, a TNF-alpha inhibitor. CONCLUSIONS AND IMPORTANCE: This case highlights the importance of obtaining a complete history and physical exam in patients who present with ocular inflammation, as extraocular manifestations of disease may be present. It also demonstrates the effectiveness of a multidisciplinary approach to evaluation and management of these patients, as both skin and eye involvement were successfully treated with adalimumab, a TNF-alpha inhibitor.

The Early Learner Curriculum and Achievement Record (ELCAR, Greer et al., 2020) is a criterion-referenced curriculum and assessment of children's development of language and social repertoires from the earliest foundational observing responses to advanced verbal repertoires. The developmental cusps or stages identified in the ELCAR have been validated and replicated through rigorous single-subject studies, but the assessment's convergent and divergent validity with traditional psychometric measures of similar and dissimilar constructs have not been investigated. In the present study, we compared one component of the ELCAR, the Verbal Behavior Development Assessment--Revised (VBDA-R), to four traditional psychometric measures as well as observed joint attention between 42 mother-child dyads within a free play setting. The preschoolers attended a full day applied behavior analysis (ABA) school that served children with autism spectrum and related disorders. The VBDA-R demonstrated convergent validity with the Vineland Adaptive Behavior Scale--3 (Vineland-3) Teacher Rating Form Communication domain, Autism Diagnostic Observation Schedule--2 (ADOS-2) module, and observed child-initiated joint attention (IJA). It demonstrated divergent validity with the Sensory Experience Questionnaire (SEQ), Child Behavior Checklist externalizing scale (CBCL/1.5-5), and child response to mother-initiated joint attention (RJA).

Self-sampling for oncogenic human papillomavirus (HPV) offers an alternative to the Papanicolaou (Pap) test for cervical cancer screening. We aimed to assess Inuit women’s cervical cancer screening preferences. Eligible Inuit women aged between 25 and 65 in 2022–2023 were given the choice between self-sampling, sampling performed solely by the nurse or the Pap test and were administered a questionnaire on screening preference. Thematic analysis was performed on qualitative data collected through a questionnaire asking if and why women prefer HPV self-sampling or the Pap test for cervical cancer screening. A total of 103 women agreed to participate. Of these, 12 (11.6%) chose to have the nurse perform the HPV test rather than self-collect. Among the 91 left for analysis, 80.2% (73) of women who self-sampled preferred self-sampling to the Pap test and 82.4% (75) would prefer self-sampling in the future. The most common reason given was comfortability (54.9%) and privacy (25.2%). Participants that did not prefer self-sampling (n = 7) expressed desire for a physical exam by the nurse or a lack of confidence in their ability to collect the sample. Eleven either did not indicate a preference, were unsure, or indifferent to cervical cancer screening method. This represents an improvement from a previously conducted study in 2012 among the same population who reported a preference for HPV self-sampling of 56%.

Abstract Plasma RNAemia, delayed antibody responses and inflammation predict COVID-19 outcomes, but the mechanisms underlying these immunovirological patterns are poorly understood. We profile 782 longitudinal plasma samples from 318 hospitalized patients with COVID-19. Integrated analysis using k-means reveals four patient clusters in a discovery cohort: mechanically ventilated critically-ill cases are subdivided into good prognosis and high-fatality clusters (reproduced in a validation cohort), while non-critical survivors segregate into high and low early antibody responders. Only the high-fatality cluster is enriched for transcriptomic signatures associated with COVID-19 severity, and each cluster has distinct RBD-specific antibody elicitation kinetics. Both critical and non-critical clusters with delayed antibody responses exhibit sustained IFN signatures, which negatively correlate with contemporaneous RBD-specific IgG levels and absolute SARS-CoV-2-specific B and CD4+ T cell frequencies. These data suggest that the “Interferon paradox” previously described in murine LCMV models is operative in COVID-19, with excessive IFN signaling delaying development of adaptive virus-specific immunity.

BackgroundLong-term sequelae are frequent and often disabling after epidermal necrolysis (Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)). However, consensus on the modalities of management of these sequelae is lacking.ObjectivesWe conducted an international multicentric DELPHI exercise to establish a multidisciplinary expert consensus to standardize recommendations regarding management of SJS/TEN sequelae.MethodsParticipants were sent a survey via the online tool "Survey Monkey" consisting of 54 statements organized into 8 topics: general recommendations, professionals involved, skin, oral mucosa and teeth, eyes, genital area, mental health, and allergy workup. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). Results were analyzed according to the RAND/UCLA Appropriateness Method.ResultsFifty-two healthcare professionals participated. After the first round, a consensus was obtained for 100% of 54 initially proposed statements (disagreement index

Using the forward modeling approach and a new parameterization for the core chemical stratification in ZZ Ceti stars, we test several situations typical of the usually limited constraints available, such as small numbers of observed independent modes, to carry out asteroseismology of these stars. We find that, even with a limited number of modes, the core chemical stratification (in particular, the location of the steep chemical transitions expected in the oxygen profile) can be determined quite precisely due to the significant sensitivity of some confined modes to partial reflexion (trapping) effects. These effects are similar to the well known trapping induced by the shallower chemical transitions at the edge of the core and at the bottom of the H-rich envelope. We also find that success to unravel the core structure depends on the information content of the available seismic data. In some cases, it may not be possible to isolate a unique, well-defined seismic solution and the problem remains degenerate. Our results establish that constraining the core chemical stratification in white dwarf stars based solely on asteroseismology is possible, an opportunity that we have started to exploit.

Abstract In-sensor computing could become a fundamentally new approach to the deployment of machine learning in small devices that must operate securely with limited energy resources, such as wearable medical devices and devices for the Internet of Things. Progress in this field has been slowed by the difficulty to find appropriate computing devices that operate using physical degrees of freedom that can be coupled directly to degrees of freedom that perform sensing. Here we leverage reservoir computing as a natural framework to do machine learning with the degrees of freedom of a physical system, to show that a micro-electromechanical system can implement computing and the sensing of accelerations by coupling the displacement of suspended microstructures. We present a complete wearable system that can be attached to the foot to identify the gait patterns of human subjects in real-time. The computing efficiency and the power consumption of this in-sensor computing system is then compared to a conventional system with a separate sensor and digital computer. For similar computing capabilities, a much better power efficiency can be expected for the highly-integrated in-sensor computing devices, thus providing a path for the ubiquitous deployment of machine learning in edge computing devices.

IntroductionProfessional and student-athletes are at risk of developing symptoms of eating disorders (ED), including drive for thinness and muscularity due to personal risk factors (e.g., low self-esteem) and sport-specific characteristics (e.g., sport requirements). However, limited studies have focused on ED symptoms among NextGen athletes (identified in Canada as élite or relève) who compete at the provincial, national, and international levels but are not yet part of national teams. As such, they have access to fewer financial resources and support from their sport federations, which can create additional stress for these athletes. The present study aimed to identify personal risk factors and types of sports associated with (a) drive for thinness and (b) drive for muscularity in NextGen athletes.MethodsThese athletes (n = 254) aged between 14 and 25 years old completed an online questionnaire. Perfectionism, self-esteem in sport, drive for thinness, and drive for muscularity were, respectively, assessed by the Multidimensional Inventory of Perfectionism in Sport, the Sport State Self-Esteem Scale, the Eating Attitude Test-26, and the Drive for Muscularity Scale. Other personal risk factor (e.g., athletic status) were measured using in-house questions. Each personal risk factor was included in two multiple linear regressions, respectively, to determine which factors were most associated with drive for thinness and drive for muscularity.ResultsAnalyses revealed that perfectionist aspirations during training were linked to a stronger desire for thinness. In addition, not being in school or not having a job were also linked to a stronger desire for thinness. Several variables were found to be associated with a greater desire for muscularity: being a male athlete, playing team sport, weight category sport or endurance sport (as opposed to esthetic sport), having elite status, being less satisfied with one’s current sporting performance and having higher perfectionist aspirations during training.DiscussionThis study offers initial insights into the factors influencing EDs among NextGen athletes, which provides a foundation for deeper exploration and the creation or modification of targeted interventions. These findings can guide sport organizations in creating guidelines and programs to better support the next generation of national athletes (e.g., create programs to help athletes maintain investments outside).

We present the first self-consistent seismic analysis of a white dwarf star, GD 1212, in the Kepler2 field. We precisely establish the fundamental parameters of the star using the forward method based on physically sound models. We unravel the internal structure as well as the rotation profile of GD1212 deeper than in any other ZZCeti stars studied so far. This opens up interesting prospects for future analyses of the white dwarf pulsators monitored in the Kepler and Kepler2 fields.

Abstract Therapeutic angiogenesis represents a promising avenue to revascularize the ischemic heart. Its limited success is partly due to our poor understanding of the cardiac stroma, specifically mural cells, and their response to ischemic injury. Here, we combine single-cell and positional transcriptomics to assess the behavior of mural cells within the healing heart. In response to myocardial infarction, mural cells adopt an altered state closely associated with the infarct and retain a distinct lineage from fibroblasts. This response is concurrent with vascular rarefaction and reduced vascular coverage by mural cells. Positional transcriptomics reveals that the infarcted heart is governed by regional-dependent and temporally regulated programs. While the remote zone acts as an important source of pro-angiogenic signals, the infarct zone is accentuated by chronic activation of anti-angiogenic, pro-fibrotic, and inflammatory cues. Together, our work unveils the spatiotemporal programs underlying cardiac repair and establishes an association between vascular deterioration and mural cell dysfunction.

The COVID-19 pandemic has caused significant psychological distress worldwide. It is important to enhance our understanding of the interpersonal and intrapersonal processes that can be addressed to promote psychological well-being after experiencing an adverse event like a pandemic. Therefore, to understand the direct and indirect associations between distress tolerance and diverse psychological outcomes following the onset of the COVID-19 pandemic, we examined whether perceived COVID-19 threat mediates the association between distress tolerance and several psychological outcomes (i.e., psychological well-being, depression, anxiety, and stress). We also investigated whether social support moderates the indirect associations between distress tolerance and these psychological outcomes. We collected online survey data between April and July 2020 from individuals living in Canada (N = 139). Moderated mediation analyses indicated higher distress tolerance was associated with lower perceived COVID-19 threat which in turn was associated with higher psychological well-being, and lower depression and stress. Additionally, social support satisfaction enhanced the indirect association between distress tolerance and psychological well-being. Our findings may inform the design of interventions that promote psychological well-being after the onset of an adversity like the COVID-19 pandemic by presenting distress tolerance, perceived threat, and social support as targets for intervention. Future research should investigate the moderating role of different types of social support on the association between distress tolerance and psychological outcomes.

We have previously shown that blood levels of B-cell Activating Factor (BAFF) rise relatively to disease progression status in the context of HIV-1 infection. Excess BAFF was concomitant with hyperglobulinemia and the deregulation of blood B-cell populations, notably with increased frequencies of a population sharing characteristics of transitional immature and marginal zone (MZ) B-cells, which we defined as marginal zone precursor-like” (MZp). In HIV-uninfected individuals, MZp present a B-cell regulatory (Breg) profile and function, which are lost in classic-progressors. Moreover, RNASeq analyses of blood MZp from classic-progressors depict a hyperactive state and signs of exhaustion, as well as an interferon signature similar to that observed in autoimmune disorders such as Systemic Lupus Erythematosus (SLE) and Sjögren Syndrome (SS), in which excess BAFF and deregulated MZ populations have also been documented. Based on the above, we hypothesize that excess BAFF may preclude the generation of HIV-1-specific IgG responses and drive polyclonal responses, including those from MZ populations, endowed with polyreactivity/autoreactivity. As such, we show that the quantity of HIV-1-specific IgG varies with disease progression status. In vitro, excess BAFF promotes polyclonal IgM and IgG responses, including those from MZp. RNASeq analyses reveal that blood MZp from classic-progressors are prone to Ig production and preferentially make usage of IGHV genes associated with some HIV broadly neutralizing antibodies (bNAbs), but also with autoantibodies, and whose impact in the battle against HIV-1 has yet to be determined.