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IntroductionPositive mental health is an essential part of youth’s healthy development. For instance, positive mental health is associated with greater self-reported physical health, closer relationships and fewer conduct problems in youth. As positive mental health promotion is a public health priority, examining its potential determinants is important. MethodsWe analyzed data from students in Grades 7–12 (secondary I–V in Quebec), from nine Canadian provinces, who participated in the 2016/2017 Canadian Student Tobacco, Alcohol and Drugs Survey. Psychological and social well-being (PSWB) was assessed using the Children’s Intrinsic Needs Satisfaction Scale (CINSS). We conducted linear regression analyses to determine associations of sociodemographic, psychosocial and substance use variables with overall CINSS scores (n = 37 897). ResultsIn general, youth in Canada reported fairly high PSWB. After adjusting for all included variables, being in a higher grade, being bullied, bullying others, reporting more behavioural problems and using cigarettes, e-cigarettes or cannabis at least once in the past 30 days were associated with lower overall CINSS scores for both male and female students. Reporting more prosocial behaviours was associated with higher overall scores for both sexes. ConclusionA number of sociodemographic, psychosocial and substance use factors are associated with PSWB among youth in Canada. Prospective longitudinal and intervention studies could examine whether changes in these potential risk/protective factors are accompanied by changes in positive mental health.

IntroductionUne santé mentale positive est un élément essentiel du développement sain des jeunes. Par exemple, une santé mentale positive est associée à une meilleure santé physique autodéclarée, à des relations plus étroites et à moins de problèmes de comportement chez les jeunes. La promotion d’une santé mentale positive est une priorité de santé publique, il est donc important d’en examiner les facteurs déterminants potentiels. MéthodologieNous avons analysé les données d’élèves de la 7e à la 12e année (1re à 5e année du secondaire au Québec) de neuf provinces canadiennes ayant participé à l’Enquête canadienne sur le tabac, l’alcool et les drogues chez les élèves de 2016­2017. Le bien­être psychologique et social a été évalué à l’aide de l’Échelle de satisfaction des besoins intrinsèques des enfants (questionnaire CINSS). Nous avons effectué des analyses de régression linéaire pour déterminer les associations des variables sociodémographiques, psychosociales et liées à la consommation de substances avec les scores globaux du questionnaire CINSS (n = 37 897). RésultatsEn général, les jeunes au Canada ont fait état d’un bien-être psychologique et social assez élevé. Après correction pour toutes les variables incluses, le fait d’être dans un niveau scolaire supérieur, le fait d’être victime d’intimidation, le fait d’intimider les autres, le signalement de problèmes de comportement et le fait d’avoir fumé la cigarette, vapoté ou consommé du cannabis au moins une fois au cours des 30 derniers jours sont associés à des scores globaux inférieurs au questionnaire CINSS chez les élèves des deux sexes. Le signalement de comportements prosociaux a été associé à des scores globaux élevés pour les deux sexes. ConclusionUn certain nombre de facteurs sociodémographiques, psychosociaux et liés à la consommation de substances sont associés au bien-être psychologique et social chez les jeunes au Canada. Des études prospectives longitudinales et d’intervention pourraient examiner si les changements dans ces facteurs potentiels de risque et de protection se répercutent sur la santé mentale positive.

Objective/Research Question: States have increasingly used merit-based criteria to distribute scholarships and grants, and the dominant conversation on merit-aid programs centers on students attending 4-year colleges and universities. This study examines the characteristics of state-funded merit-aid programs for community college students and provides implications for policymaking to promote educational equity. Methods: With a newly collected dataset capturing a variety of program-level features of state-funded merit-aid policies between 2003 and 2021, we used latent class analysis to identify different types of merit-aid programs for community college students. We present a 3-class model based on model fit indices and practical interpretation of policy designs. Results: Findings indicate three classes of merit-aid programs that extended support to community college students: The Community College Marginalizing Programs (n = 47), The Community College Targeted Programs (n = 4), and The Balanced Programs (n = 17). Conclusions/Contributions: Drawing on Mettler's notion of the policyscape, we discuss the characteristics of the three types of merit-aid programs and provide implications for designing merit-aid programs to better support community college students and promote educational equity.

BACKGROUND AND PURPOSE: Intravoxel-incoherent-motion (IVIM) magnetic-resonance-imaging (MRI) and positron-emission-tomography (PET) have been investigated independently but not voxel-wise to evaluate tumor microenvironment in cervical carcinoma patients. Whether regionally combined information of IVIM and PET offers additional predictive benefit over each modality independently has not been explored. Here, we investigated parametric-response-mapping (PRM) of co-registered PET and IVIM in cervical cancer patients to identify sub-volumes that may predict tumor shrinkage to concurrent-chemoradiation-therapy (CCRT). MATERIALS AND METHODS: Twenty cervical cancer patients (age: 63[41-85]) were retrospectively evaluated. Diffusion-weighted-images (DWIs) were acquired on 3.0 T MRIs using a free-breathing single-shot-spin echo-planar-imaging (EPI) sequence. Pre- and on-treatment (∼after four-weeks of CCRT) MRI and pre-treatment FDG-PET/CT were acquired. IVIM model-fitting on the DWIs was performed using a Bayesian-fitting simplified two-compartment model. Three-dimensional rigidly-registered maps of PET/CT standardized-uptake-value (SUV) and IVIM diffusion-coefficient (D) and perfusion-fraction (f) were generated. Population-means of PET-SUV, IVIM-D and IVIM-f from pre-treatment-scans were calculated and used to generate PRM via a voxel-wise joint-histogram-analysis to classify voxels as high/low metabolic-activity and with high/low (hi/lo) cellular-density. Similar PRM maps were generated for SUV and f. RESULTS: Tumor-volume (p

Sedimentary basins provide a deep time archive of tectonic and Earth-surface processes that can be leveraged by detrital mineral U-Pb dating and geochemistry to track paleogeography, magmatism, and crustal evolution. Zircon preserves the long-term (billions of years) record of supercontinent cycles; however, it is biased toward preserving felsic crustal records. Detrital rutile complements the detrital zircon record by providing constraints on the time and temperature of rifting and mafic magmatism, metamorphism, exhumation of the middle and lower crust, subduction, and amagmatic orogenesis. We use detrital zircon U-Pb and detrital rutile U-Pb geochronology and trace element analysis of Permian to Eocene siliciclastic rocks in the southern Pyrenees to capture supercontinent cycles of ocean basins opening and closing. Detrital rutile age spectra show peaks at ca. 100 Ma associated with rifting and hyperextension in the Pyrenean realm, 200 Ma associated with the Central Atlantic Magmatic Province, and 330 Ma, 375 Ma, and 400 Ma associated with subduction and Rheic Ocean crust formation. Zr-in-rutile thermometry and rutile Cr-Nb systematics provide further insight into metamorphic facies (peak metamorphic temperatures) and source rock lithology (mafic versus felsic affinity). Detrital zircon age spectra have peaks at ca. 300 Ma, 450 Ma, and 600 Ma associated with major orogenic events and felsic magmatism, and Th/U ratios provide information on relative zircon formation temperatures. Comparison of these independent records shows that detrital rutile reflects rifting, magma-poor orogenesis, and oceanic lithospheric processes, while detrital zircon detects continental lithospheric processes. Integrated detrital zircon and rutile data sets archive past geological events across multiple Wilson cycles.

BACKGROUND: Adverse radiation effect (ARE) following stereotactic radiosurgery (SRS) for brain metastases is challenging to distinguish from tumor progression. This study characterizes the clinical implications of radiologic uncertainty (RU). METHODS: Cases reviewed retrospectively at a single-institutional, multi-disciplinary SRS Tumor Board between 2015-2022 for RU following SRS were identified. Treatment history, diagnostic or therapeutic interventions performed upon RU resolution, and development of neurologic deficits surrounding intervention were obtained from the medical record. Differences in lesion volume and maximum diameter at RU onset versus resolution were compared with paired t-tests. Median time from RU onset to resolution was estimated using the Kaplan-Meier method. Univariate and multivariate associations between clinical characteristics and time to RU resolution were assessed with Cox proportional-hazards regression. RESULTS: Among 128 lesions with RU, 23.5% had undergone ≥ 2 courses of radiation. Median maximum diameter (20 vs. 16 mm, p  6 and > 12 months in 25% and 7% of cases, respectively. Higher total EQD2 prior to RU onset (HR = 0.45, p = 0.03) and use of MR perfusion (HR = 0.56, p = 0.001) correlated with shorter time to resolution; larger volume (HR = 1.05, p = 0.006) portended longer time to resolution. Most lesions (57%) were diagnosed as ARE. Most patients (58%) underwent an intervention upon RU resolution; of these, 38% developed a neurologic deficit surrounding intervention. CONCLUSIONS: RU resolution took > 6 months in > 25% of cases. RU may lead to suboptimal outcomes and symptom burden. Improved characterization of post-SRS RU is needed.

BACKGROUND: Brain radiosurgery treatments require multiple quality-assurance (QA) procedures to ensure accurate and precise treatment delivery of ablative doses. As single-isocenter multitarget radiosurgery treatments become more popular for treating patients with multiple brain metastases, quantifying off-axis accuracy of linear accelerators is crucial. In this study, we developed a novel brain radiosurgery integrated phantom and validated this phantom at multiple institutions to enable radiosurgery QA with a single phantom to facilitate implementation of a frameless single-isocenter, multitarget radiosurgery program. The phantom combines multiple independent verification system tests including the Winston-Lutz test, off-axis accuracy evaluation (i.e., off-axis Winston-Lutz), as well as dosimetric measurements utilizing both point dose and film measurement. METHODS AND MATERIALS: A novel 3D-printed phantom, coined OneIso, was designed with a movable insert which can switch between Winston-Lutz test targets and dose measurement without moving the phantom itself. In total, four phantoms were printed, and eight institutions participated in this study, which included both Varian TrueBeam (n=6) and Elekta Versa (n=2) linear accelerators. For off-axis Winston-Lutz measurements, a row of off-axis ball-bearings (BBs) was integrated into the OneIso. To quantify the spatial accuracy versus distance from isocenter, two-dimensional displacements were calculated between the planned and delivered BB locations relative to their respective MLC-defined field borders. For dose verification, brain radiosurgery clinical treatment plans previously treated were delivered at multiple cancer centers (six of eight centers). Radiochromic film and pinpoint ion chamber comparison measurements were obtained with OneIso. RESULTS: Dose verification performed using the OneIso phantom across the different centers were all within on average 3% agreement, for both film and point-dose measurements. OneIso identified a reduction in spatial accuracy further away from isocenter for all eight radiosurgery machines. Differences increased as distance from isocenter increased, exceeding recommended radiosurgery accuracy tolerances (

IntroductionPsychological well-being (PWB) is an important component of positive mental health (PMH) and an asset for population health. This study examined correlates of PWB among community-dwelling adults (18+ years) in the 10 Canadian provinces. MethodsUsing data from the 2019 Canadian Community Health Survey Rapid Response on PMH, we conducted linear regression analyses with sociodemographic, mental health, physical health and substance use variables as predictors of PWB. PWB was measured using six questions from the Mental Health Continuum—Short Form, which asked about feelings of self-acceptance, personal growth, environmental mastery, autonomy, positive relations and purpose in life during the past month. ResultsIn unadjusted and adjusted analyses, older age, being married or in a commonlaw relationship and having a BMI in the overweight category (25.00–29.99) were associated with higher PWB, while reporting a mood disorder, anxiety disorder, high perceived life stress, engaging in heavy episodic drinking and frequent cannabis use were associated with lower PWB. Sex, having children living at home, immigrant status, racialized group membership, educational attainment, household income tertile, having a BMI in the obese category (≥30.00), major chronic disease and smoking status were not significantly associated with PWB. ConclusionThis research identifies sociodemographic, mental health, physical health and substance use factors associated with PWB among adults in Canada. These findings highlight groups and characteristics that could be the focus of future research to promote PMH.

IntroductionLe bien-être psychologique est une composante importante de la santé mentale positive et un atout qui favorise la santé de la population. Notre étude a permis d’analyser les corrélats du bien-être psychologique chez les adultes (18 ans et plus) vivant dans la collectivité dans les 10 provinces canadiennes. MéthodologieÀ l’aide des données de l’Enquête sur la santé dans les collectivités canadiennes – Composante de réponse rapide sur la santé mentale positive de 2019, nous avons effectué des analyses de régression linéaire dans lesquelles diverses variables relatives aux caractéristiques sociodémographiques, à la santé mentale, à la santé physique et à la consommation de substances ont été étudiées en tant que prédicteurs du bien-être psychologique. Le bien-être psychologique a été mesuré en fonction de six questions du Continuum de santé mentale – Questionnaire abrégé. Celles-ci évaluaient les perceptions des répondants, pour le mois précédant l’enquête, en lien avec l’acceptation de soi, l’épanouissement personnel, la maîtrise de l’environnement, l’autonomie, les rapports positifs avec les autres et le but dans la vie. RésultatsDans les analyses de régression linéaire simple et de régression linéaire multiple, un âge plus avancé, le fait d’être marié ou de vivre en union libre et le fait d’avoir un IMC correspondant à un excès de poids (25,00 à 29,99) ont été associés à un bienêtre psychologique supérieur, tandis que les facteurs associés à un bien-être psychologique inférieur ont été la présence signalée d’un trouble de l’humeur ou d’un trouble d’anxiété, un haut degré de stress perçu dans la vie, une forte consommation épisodique d’alcool et une consommation fréquente de cannabis. Il n’y a eu aucune association significative entre le bien-être psychologique et le sexe, le fait d’avoir des enfants à la maison, le statut vis-à-vis de l’immigration, l’appartenance à un groupe racisé, le niveau de scolarité, le tertile de revenu du ménage, le fait d’avoir un IMC dans la catégorie de l’obésité (≥ 30,00), les maladies chroniques majeures et le tabagisme. ConclusionCette recherche révèle les caractéristiques sociodémographiques et les facteurs relatifs à la santé mentale, à la santé physique et à la consommation de substances qui sont associés au bien-être psychologique chez les adultes au Canada. Les constats qu’elle a permis de dégager mettent en évidence les groupes et les caractéristiques qui pourraient faire l’objet de recherches futures dans l’objectif de promouvoir le bien-être psychologique.

Abstract Background Tissue fibrosis is a common pathway to failure in many organ systems and is the cellular and molecular driver of myriad chronic diseases that are incompletely understood and lack effective treatment. Recent studies suggest that gut microbe-dependent metabolites might be involved in the initiation and progression of fibrosis in multiple organ systems. Main body of the manuscript In a meta-organismal pathway that begins in the gut, gut microbiota convert dietary precursors such as choline, phosphatidylcholine, and L-carnitine into trimethylamine (TMA), which is absorbed and subsequently converted to trimethylamine N-oxide (TMAO) via the host enzyme flavin-containing monooxygenase 3 (FMO3) in the liver. Chronic exposure to elevated TMAO appears to be associated with vascular injury and enhanced fibrosis propensity in diverse conditions, including chronic kidney disease, heart failure, metabolic dysfunction-associated steatotic liver disease, and systemic sclerosis. Conclusion Despite the high prevalence of fibrosis, little is known to date about the role of gut dysbiosis and of microbe-dependent metabolites in its pathogenesis. This review summarizes recent important advances in the understanding of the complex metabolism and functional role of TMAO in pathologic fibrosis and highlights unanswered questions.

BackgroundBrain radiosurgery treatments require multiple quality-assurance (QA) procedures to ensure accurate and precise treatment delivery of ablative doses. As single-isocenter multitarget radiosurgery treatments become more popular for treating patients with multiple brain metastases, quantifying off-axis accuracy of linear accelerators is crucial. In this study, we developed a novel brain radiosurgery integrated phantom and validated this phantom at multiple institutions to enable radiosurgery QA with a single phantom to facilitate implementation of a frameless single-isocenter, multitarget radiosurgery program. The phantom combines multiple independent verification system tests including the Winston-Lutz test, off-axis accuracy evaluation (i.e., off-axis Winston-Lutz), as well as dosimetric measurements utilizing both point dose and film measurement.Methods and materialsA novel 3D-printed phantom, coined OneIso, was designed with a movable insert which can switch between Winston-Lutz test targets and dose measurement without moving the phantom itself. In total, four phantoms were printed, and eight institutions participated in this study, which included both Varian TrueBeam (n=6) and Elekta Versa (n=2) linear accelerators. For off-axis Winston-Lutz measurements, a row of off-axis ball-bearings (BBs) was integrated into the OneIso. To quantify the spatial accuracy versus distance from isocenter, two-dimensional displacements were calculated between the planned and delivered BB locations relative to their respective MLC-defined field borders. For dose verification, brain radiosurgery clinical treatment plans previously treated were delivered at multiple cancer centers (six of eight centers). Radiochromic film and pinpoint ion chamber comparison measurements were obtained with OneIso.ResultsDose verification performed using the OneIso phantom across the different centers were all within on average 3% agreement, for both film and point-dose measurements. OneIso identified a reduction in spatial accuracy further away from isocenter for all eight radiosurgery machines. Differences increased as distance from isocenter increased, exceeding recommended radiosurgery accuracy tolerances (

Las cepas de levaduras producen atributos distintivos en los vinos, como así también, la uva proveniente de diferentes zonas puede modificar el flavour del vino. El objetivo del presente trabajo fue evaluar el efecto producido por levaduras comerciales (EC1118, Tango Malbec, Flavia e Ionys) e indígenas sobre vinos Malbec provenientes de Ugarteche, El Cepillo y Gualtallary (Mendoza, Argentina). Se determinaron perfiles fermentativos, controles de implantación, parámetros físico-químicos y cromáticos generales y análisis sensorial de los vinos. Se aplicó ANAVA de dos vías con test LSD Fisher sobre los parámetros y se graficó un ACP. Las levaduras comerciales se implantaron en un 100%, mientras que los perfiles genéticos de las fermentaciones espontáneas fueron diferentes entre sí. El factor región, evidenció un importante efecto, destacándose los vinos de Ugarteche con altos niveles de pH y bajos valores de alcohol, intensidad colorante, IPT y antoncianos totales. El factor levadura reveló efectos significativos respecto a la levadura Ionys, la cual en las tres regiones, finalizó su fermentación dos días después que el resto de las levaduras y en sus vinos se destacó la nota a fruta fresca y la baja intensidad de astringencia y amargo. Sumado a esto, produjo 0.5 % menos grados de alcohol, 0.2 menos de pH.

IntroductionPhysical activity (PA) promotes significant physical and psychosocial benefits for breast cancer survivors. While evidence exists regarding recommendations for the frequency, duration and intensity of exercise that optimise PA benefits for cancer survivors, the role of the environment in achieving optimal outcomes has yet to be determined. This paper presents a protocol for a clinical trial to evaluate the feasibility of a 3-month nature-based walking programme for breast cancer survivors. Secondary outcomes assessed include the impact of the intervention on fitness, quality of life outcomes, and biomarkers of ageing and inflammation.Methods and analysisThe trial is a 12-week single-arm pilot study. Twenty female breast cancer survivors will engage in a supervised moderate intensity walking intervention in small groups in a nature reserve for 50 minutes three times per week. Data will be collected at baseline and end of study, and include assessment of inflammatory cytokines and anti-inflammatory myokines (TNF-α, IL-1ß, IL-6, CRP, TGF-ß, IL-10, IL-13), as well as ageing (DNA methylation, ageing genes) biomarkers; surveys (Patient-Reported Outcomes Measurement Information System-29, Functional Assessment of Cancer Therapy-General, Post-Traumatic Growth Inventory); and fitness assessments (6 min Walk Test, Grip-Strength, One Repetition-Maximum Leg Press). Participants will also complete weekly surveys assessing social support and participate in an exit interview. This is an important first step for future research on the influence of exercise environment on cancer survivor PA outcomes.Ethics and disseminationThis study was approved by the Cedars Sinai Medical Center Institutional Review Board (IIT2020-20). Findings will be disseminated through academic manuscripts, conferences, and community presentations.Trial registration numberNCT04896580.

IntroductionThe goal of this study was to examine potential disparities in positive mental health (PMH) among adults in Canada by sexual orientation and gender modality. MethodsUsing 2019 Canadian Community Health Survey (CCHS) Annual Component data (N = 57 034), we compared mean life satisfaction and the prevalence of high selfrated mental health (SRMH), happiness and community belonging between heterosexual and sexual minority adults, and between cisgender and gender minority adults. We used 2019 CCHS Rapid Response on PMH data (N = 11 486) to compare the prevalence of high psychological well-being between heterosexual and sexual minority adults. Linear and logistic regression analyses examined the between-group differences in mean life satisfaction and the other PMH outcomes, respectively. ResultsSexual minority (vs. heterosexual) adults reported lower mean life satisfaction (B = −0.7, 95% CI: −0.8, −0.5) and were less likely to report high SRMH (OR = 0.4, 95% CI: 0.3, 0.5), happiness (OR = 0.4, 95% CI: 0.3, 0.5), community belonging (OR = 0.6, 95% CI: 0.5, 0.7) and psychological well-being (OR = 0.4, 95% CI: 0.3, 0.6). Differences were not always significant for specific sexual minority groups in sexstratified analyses. Gender minority adults reported lower mean life satisfaction and were less likely to report high SRMH and happiness than cisgender adults. ConclusionFuture research could investigate how these PMH disparities arise, risk and protective factors in these populations, how other sociodemographic factors interact with sexual orientation and gender identity to influence PMH and changes in disparities over time.

IntroductionL’objectif de cette étude était d’examiner les disparités potentielles en matière de santé mentale positive chez les adultes au Canada selon leur orientation sexuelle et leur modalité de genre. MéthodologieÀ l’aide des données de la composante annuelle de l’Enquête sur la santé dans les collectivités canadiennes (ESCC) de 2019 (N = 57 034), nous avons comparé la satisfaction moyenne à l’égard de la vie et la prévalence d’un niveau élevé de santé mentale auto-évaluée (SMAE), de bonheur et de sentiment d’appartenance à la communauté entre les adultes hétérosexuels et les adultes faisant partie d’une minorité sexuelle, ainsi qu’entre les adultes cisgenres et les adultes faisant partie d’une minorité de genre. Nous avons utilisé les données de la composante de réponse rapide sur la santé mentale positive de l’ESCC de 2019 (N = 11 486) pour comparer la prévalence d’un niveau élevé de bien-être psychologique chez les adultes hétérosexuels et les adultes faisant partie d’une minorité sexuelle. Des analyses de régression linéaire nous ont permis de relever les différences entre ces groupes en ce qui concerne la satisfaction moyenne à l’égard de la vie et des analyses de régression logistique en ce qui concerne les autres paramètres de la santé mentale positive. RésultatsPar rapport aux adultes hétérosexuels, les adultes faisant partie d’une minorité sexuelle ont fait état d’une moins grande satisfaction moyenne à l’égard de la vie (B = −0,7, IC à 95 % : −0,8 à −0,5) et étaient moins susceptibles de déclarer un niveau élevé de SMAE (RC = 0,4, IC à 95 % : 0,3 à 0,5), de bonheur (RC = 0,4, C à 95 % : 0,3 à 0,5), de sentiment d’appartenance à la communauté (RC = 0,6, IC à 95 % : 0,5 à 0,7) et de bien-être psychologique (RC = 0,4, IC à 95 % : 0,3 à 0,6). Les différences n’étaient pas toujours statistiquement significatives pour certains groupes de minorités sexuelles dans les analyses stratifiées selon le sexe. Les adultes faisant partie d’une minorité de genre ont fait état d’une moins grande satisfaction moyenne à l’égard de la vie et étaient moins susceptibles de déclarer un niveau élevé de SMAE et de bonheur que les adultes cisgenres. ConclusionLes travaux de recherche ultérieurs pourraient porter sur l’origine de ces disparités en matière de santé mentale positive, sur les facteurs de risque et les facteurs de protection au sein de ces populations, sur la façon dont d’autres facteurs sociodémographiques interagissent avec l’orientation sexuelle et l’identité de genre et influent sur la santé mentale positive, et sur l’évolution de ces disparités au fil du temps.

Background and Purpose: Intravoxel-incoherent-motion (IVIM) magnetic-resonance-imaging (MRI) and positron-emission-tomography (PET) have been investigated independently but not voxel-wise to evaluate tumor microenvironment in cervical carcinoma patients. Whether regionally combined information of IVIM and PET offers additional predictive benefit over each modality independently has not been explored. Here, we investigated parametric-response-mapping (PRM) of co-registered PET and IVIM in cervical cancer patients to identify sub-volumes that may predict tumor shrinkage to concurrent-chemoradiation-therapy (CCRT). Materials and Methods: Twenty cervical cancer patients (age: 63[41–85]) were retrospectively evaluated. Diffusion-weighted-images (DWIs) were acquired on 3.0 T MRIs using a free-breathing single-shot-spin echo-planar-imaging (EPI) sequence. Pre- and on-treatment (∼after four-weeks of CCRT) MRI and pre-treatment FDG-PET/CT were acquired. IVIM model-fitting on the DWIs was performed using a Bayesian-fitting simplified two-compartment model. Three-dimensional rigidly-registered maps of PET/CT standardized-uptake-value (SUV) and IVIM diffusion-coefficient (D) and perfusion-fraction (f) were generated. Population-means of PET-SUV, IVIM-D and IVIM-f from pre-treatment-scans were calculated and used to generate PRM via a voxel-wise joint-histogram-analysis to classify voxels as high/low metabolic-activity and with high/low (hi/lo) cellular-density. Similar PRM maps were generated for SUV and f. Results: Tumor-volume (p

IntroductionThe perceived mental health of individuals in Canada who faced health care barriers during the COVID-19 pandemic is underexplored. MethodsWe analyzed data collected March to June 2021 from adults who reported needing health care services within the past 12 months in the Survey on Access to Health Care and Pharmaceuticals during the Pandemic. Unadjusted and adjusted logistic regression analyses examined the associations between health care barriers (appointment scheduling problems, delaying contacting health care) and high self-rated mental health and perceived worsening mental health compared to before the pandemic, overall and stratified by gender, age group, number of chronic health conditions and household income tertile. ResultsIndividuals who experienced pandemic-related appointment changes or had appointments not yet scheduled were less likely to have high self-rated mental health (aOR = 0.81 and 0.64, respectively) and more likely to have perceived worsening mental health (aOR = 1.50 and 1.94, respectively) than those with no scheduling problems. Adults who delayed contacting health care for pandemic-related reasons (e.g. fear of infection) or other reasons were less likely to have high self-rated mental health (aOR = 0.52 and 0.45, respectively) and more likely to have perceived worsening mental health (aOR = 2.31 and 2.43, respectively) than those who did not delay. Delaying contacting health care for pandemic-related reasons was associated with less favourable perceived mental health in all subgroups, while the association between perceived mental health and pandemic-related appointment changes was significant in some groups. ConclusionHealth care barriers during the pandemic were associated with less favourable perceived mental health. These findings could inform health care resource allocation and public health messaging.

IntroductionLa santé mentale perçue des personnes au Canada ayant rencontré des obstacles en matière de soins de santé pendant la pandémie de COVID-19 est sous-explorée. MéthodologieNous avons analysé les données collectées entre mars et juin 2021 sur les adultes ayant déclaré avoir eu besoin de services de santé au cours des 12 derniers mois dans le cadre de l’Enquête sur l’accès aux soins de santé et aux produits pharmaceutiques pendant la pandémie. Des analyses de régression logistique non ajustées et ajustées ont été menées pour explorer les associations entre les obstacles en matière de soins de santé (problèmes liés à la prise de rendez-vous, report de la communication avec un professionnel de la santé) et un niveau élevé de santé mentale autoévaluée ainsi que la perception d’une détérioration de la santé mentale par rapport à la période précédant la pandémie, de façon globale et avec stratification en fonction du sexe, du groupe d’âge, du nombre de problèmes de santé chroniques et du tertile de revenu du ménage. RésultatsLes personnes ayant subi des changements de rendez-vous en raison de la pandémie ou dont le rendez-vous n’avait pas encore été fixé étaient moins susceptibles d’avoir un niveau élevé de santé mentale autoévaluée (RCa = 0,81 et 0,64 respectivement) et plus susceptibles de percevoir une détérioration de leur santé mentale (RCa = 1,50 et 1,94 respectivement) que les personnes sans problème lié aux rendez-vous. Les personnes ayant tardé à communiquer avec un professionnel de la santé en raison de la pandémie (par exemple parce qu’elles craignaient d’être infectées) ou pour d’autres raisons étaient moins susceptibles d’avoir un niveau élevé de santé mentale autoévaluée (RCa = 0,52 et 0,45 respectivement) et plus susceptibles de percevoir une détérioration de leur santé mentale (RCa = 2,31 et 2,43 respectivement) que les personnes qui n’avaient pas tardé à communiquer avec un professionnel de la santé. Le report de la communication avec un professionnel de la santé pour des raisons liées à la pandémie était associé à une perception moins favorable de la santé mentale dans tous les sousgroupes, tandis que l’association entre la santé mentale perçue et les changements de rendez-vous liés à la pandémie était importante dans certains groupes seulement. ConclusionLes obstacles en matière de soins de santé pendant la pandémie ont été associés à une perception moins favorable de la santé mentale. Ces résultats pourraient orienter l’affectation des ressources en soins de santé et les messages de santé publique.

Abstract: Convergent plate boundaries show sharp variations in orogenic width and extent of intraplate deformation. Analysis of late Cenozoic contractile deformation along the Andean mountain front and adjacent foreland highlights the contrasting degrees of deformation advance toward the plate interior. The retroarc positions of the Andean topographic front (marked by frontal thrust-belt structures) and foreland deformation front (defined by isolated basement block uplifts) range from 300 to 900 km inboard of the trench axis. Over the ~8000 km arcuate length of the Andes (10°N to 55°S), four discrete maxima of inboard deformation advance are spatially co-located with the Peruvian (5°S–14°S) and Pampean (27°S–33°S) zones of flat slab subduction, the subducted Chile Ridge (45°S–48°S), and the anomalously thick Paleozoic stratigraphic wedge of Bolivia (17°S –23°S). The spatial correspondence of retroarc shortening with specific geodynamic configurations demonstrates the mechanical role of flat slab subduction, slab window development, and combined structural and stratigraphic geometries in shaping the orogenic architecture of Cordilleran margins, largely through lithospheric strengthening, weakening, and/or tectonic inheritance.

PurposeThe RefleXion X1 is a novel radiotherapy machine designed for image-guided radiotherapy (IGRT) and biology-guided radiotherapy (BgRT). Its treatment planning system (TPS) generates IMRT and SBRT plans for a 6MV-FFF beam delivered axially via 50 firing positions with the couch advancing every 2.1 mm. The purpose of this work is to report the TPS commissioning results for the first clinical installation of RefleXion™ X1.MethodsCT images of multiple phantoms were imported into the RefleXion TPS to evaluate the accuracy of data transfer, anatomical modeling, plan evaluation, and dose calculation. Comparisons were made between the X1, Eclipse™, and MIM™. Dosimetric parameters for open static fields were evaluated in water and heterogeneous slab phantoms. Representative clinical IMRT and SBRT cases were planned and verified with ion chamber, film, and ArcCHECK@ measurements. The agreement between TPS and measurements for various clinical plans was evaluated using Gamma analysis with a criterion of 3%/2 mm for ArcCHECK@ and film. End-to-end (E2E) testing was performed using anthropomorphic head and lung phantoms.ResultsThe average difference between the TPS-reported and known HU values was -1.4 ± 6.0 HU. For static fields, the agreements between the TPS-calculated and measured PDD10 , crossline profiles, and inline profiles (FWHM) were within 1.5%, 1.3%, and 0.5 mm, respectively. Measured output factors agreed with the TPS within 1.3%. Measured and calculated dose for static fields in heterogeneous phantoms agreed within 2.5%. The ArcCHECK@ mean absolute Gamma passing rate was 96.4% ± 3.4% for TG 119 and TG 244 plans and 97.8% ± 3.6% for the 21 clinical plans. E2E film analysis showed 0.8 mm total targeting error for isocentric and 1.1 mm for off-axis treatments.ConclusionsThe TPS commissioning results of the RefleXion X1 TPS were within the tolerances specified by AAPM TG 53, MPPG 5.a, TG 119, and TG 148. A subset of the commissioning tests has been identified as baseline data for an ongoing QA program.

Child sexual exploitation and abuse (CSEA) is a pervasive issue affecting children globally, cutting across socio-economic, ethnic, and cultural lines. While much research has historically emphasized the victimization of girls, emerging studies highlight the vulnerability of boys and underscore the neglected intersections of CSEA with LGBTQI​+ ​statuses. LGBTQI​+ ​youth are particularly susceptible to CSEA due to societal discrimination, stigmatization, and biases stemming from socio-cultural, religious, and family contexts. Notably, transgender children and youth face exacerbated risks, marked by alarming rates of stigma, violence, and discrimination, often termed transphobia. From an examination of the academic, evidence-based literature, this discussion paper sheds light on harmful cultural practices (such as the ‘dancing boys’ of South Asia who may exhibit feminine characteristics and are frequently exposed to the risk of sexual violence); myths (surrounding homosexuality); religious doctrines (which generally approach these issues within a discourse of morality and sin); and socio-ecological factors that collectively increase the risk of CSEA for LGBTQI​+ ​children - with a focus on the developing world. Furthermore, while the socio-ecological and resilience frameworks offer promising avenues for understanding and addressing these vulnerabilities, glaring data gaps persist, especially beyond developed countries. The paper concludes with identifying the compelling need for robust research and a comprehensive understanding of how CSEA impacts LGBTQI​+ ​children worldwide, which can guide targeted interventions and support.

This study reports the beam commissioning results for the first clinical RefleXion Linac.MethodsThe X1 produces a 6 MV photon beam and the maximum clinical field size is 40 × 2 cm2 at source-to-axis distance of 85 cm. Treatment fields are collimated by a binary multileaf collimator (MLC) system with 64 leaves with width of 0.625 cm and y-jaw pairs to provide either a 1 or 2 cm opening. The mechanical alignment of the radiation source, the y-jaw, and MLC were checked with film and ion chambers. The beam parameters were characterized using a diode detector in a compact water tank. In-air lateral profiles and in-water percentage depth dose (PDD) were measured for beam modeling of the treatment planning system (TPS). The lateral profiles, PDDs, and output factors were acquired for field sizes from 1.25 × 1 to 40 × 2 cm2 field to verify the beam modeling. The rotational output variation and synchronicity were tested to check the gantry angle, couch motion, and gantry rotation.ResultsThe source misalignments were 0.049 mm in y-direction, 0.66% out-of-focus in x-direction. The divergence of the beam axis was 0.36 mm with a y-jaw twist of 0.03°. Clinical off-axis treatment fields shared a common center in y-direction were within 0.03 mm. The MLC misalignment and twist were 0.57 mm and 0.15°. For all measured fields ranging from the size from 1.25 × 1 to 40 × 2 cm2 , the mean difference between measured and TPS modeled PDD at 10 cm depth was -0.3%. The mean transverse profile difference in the field core was -0.3% ± 1.1%. The full-width half maximum (FWHM) modeling was within 0.5 mm. The measured output factors agreed with TPS within 0.8%.ConclusionsThis study summarizes our specific experience commissioning the first novel RefleXion linac, which may assist future users of this technology when implementing it into their own clinics.