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Abstract The extraction of gold from refractory gold mineral deposits is becoming increasingly necessary. The presence of gold encapsulated within the crystalline matrix of iron sulfide minerals, such as pyrite, pyrrhotite, and arsenopyrite significantly reduces the efficiency of cyanidation. Therefore, the use of oxidative pretreatments, such as calcination, pressure oxidation, or bacterial leaching, enables a high gold recovery from refractory deposits. Calcination has been widely employed. However, it has a high energy cost and environmental issues due to the release of toxic gases containing arsenic. In the treatment of refractory gold ores containing arsenic, pressure oxidation (POX) represents an attractive approach for arsenic immobilization, since the conditions are suitable for both sulfide oxidation and the formation of stable arsenates. In the present study, tests of alkaline and acidic pressure oxidation followed by sodium cyanide leaching were conducted on a composite sample of the Faina Project, owned by Jaguar Mining Inc., located in de northwest portion of the Iron Quadrangle, Minas Gerais, Brazil. The mineralization is hosted by metabasalts and komatiitics metabasalts of an archean metavulcano sedimentary sequence, in the Greenstonebelt Pitangui. The tests demonstrated that it is possible to achieve a 98.40% gold recovery using a concentrate initially containing 12% sulfur, which underwent acidic oxidation with a 0.28 M H2SO4 solution at a temperature of 220°C, oxygen pressure of 500 kPa, and a residence time of three hours. This result was 19.19% higher than that obtained in an alkaline medium using a 3.0 M NaOH solution.

OBJECTIVE: People who experience marginalization, including Black, Indigenous, People of Color (BIPOC) and Lesbian, Gay, Bisexual, Transgender, Queer, Plus (ie, all other marginalized genders and sexual orientations) people (LGBTQ+) experience discrimination during healthcare interactions, which negatively impacts patient-provider communication and care. Yet, scarce research examines the lived experience of unfair treatment among patients from marginalized groups to guide patient-centered tools that improve healthcare equity. MATERIALS AND METHODS: We interviewed 25 BIPOC and/or LGBTQ+ people about their experiences of unfair treatment and discrimination when visiting healthcare providers. Through thematic analysis, we describe participants immediate reactions and longer-term consequences of those experiences. RESULTS: We identified 4 ways that participants reacted to discrimination in the moment: Fighting, Fleeing, Excusing, and Working Around Bias. Long-term consequences reflect 6 ways they coped: Delaying or Avoiding Care, Changing Healthcare Providers, Self-prescribing, Covering Behaviors, Experiencing Health Complications, and Mistrusting Healthcare Institutions. DISCUSSION: By describing how patients react to experiences of unfair treatment and discrimination, our findings enhance the understanding of health disparities as patients cope and struggle to speak out.To combat these problems, we identify 3 future directions for informatics interventions that improve provider behavior, support patient advocacy, and address power dynamics in healthcare. CONCLUSIONS: BIPOC and LGBTQ+ patients perspectives on navigating unfair treatment and discrimination in healthcare offers critical insight into their experiences and long-term consequences of those experiences. Understanding the circumstances and consequences of unfair treatment, discrimination, and the impact of bias through this patient-centered lens is crucial to inform informatics technologies that promote health equity.

RESUMO Introdução: A expectativa de vida mundial vem aumentando nas últimas décadas, e, para atender a essa demanda, é necessário formar e capacitar profissionais de saúde para o atendimento adequado da população geriátrica no Brasil. Nesse contexto, a literatura traz o podcast como uma possível ferramenta complementar para a educação médica, visto o potencial da comunicação digital em transformar o ensino mundial. Objetivo: Este estudo teve como objetivo avaliar o aprendizado em saúde do idoso por meio da ferramenta podcast em alunos de graduação em Medicina. Método: Trata-se de um estudo descritivo, longitudinal, quantitativo, ocorrido entre janeiro e dezembro de 2022, realizado com 59 discentes de Medicina da Universidade do Estado do Pará. Os estudantes responderam ao questionário-teste, no período de agosto a outubro de 2022, antes e depois de escutarem os episódios do podcast criado para esta pesquisa, com perguntas específicas sobre saúde do idoso, divididas em cinco domínios (anamnese do idoso, exame físico no idoso, relação médico-paciente, quedas e imunização no idoso). Resultado: Na avaliação geral de cada domínio, identificou-se estatisticamente diferença em quatro dos cinco grupos, assim como no valor geral, em que os discentes aumentaram seus acertos de 70,7% para 80,6%, uma melhora de quase 10 pontos percentuais após o podcast. O domínio imunização foi o que teve maiores ganhos percentuais (de 45,2% para 74,0%), seguido do domínio que tratou sobre quedas em idoso: de 79,1% antes do podcast para 91,0% na segunda avaliação. Conclusão: Os alunos obtiveram melhores resultados nos testes objetivos após escutarem os episódios de podcast sobre saúde do idoso. O podcasting tem o potencial de se tornar formal ou informalmente um componente central da educação médica. Estudos adicionais devem investigar também como os podcasts podem ser construídos a fim de que se possa otimizar a retenção de conhecimento por parte dos ouvintes.

Bias toward historically marginalized patients affects patient-provider interactions and can lead to lower quality of care and poor health outcomes for patients who are Black, Indigenous, People of Color (BIPOC) and Lesbian, Gay, Bisexual, Transgender and Gender Diverse (LGBTQ+). We gathered experiences with biased healthcare interactions and suggested solutions from 25 BIPOC and LGBTQ+ people. Through qualitative thematic analysis of interviews, we identified ten themes. Eight themes reflect the experience of bias: Transactional Care, Power Inequity, Communication Casualties, Bias-Embedded Medicine, System-level problems, Bigotry in Disguise, Fight or Flight, and The Aftermath. The remaining two themes reflect strategies for improving those experiences: Solutions and Good Experiences. Characterizing these themes and their interconnections is crucial to design effective informatics solutions that can address biases operating in clinical interactions with BIPOC and LGBTQ+ patients, improve the quality of patient-provider interactions, and ultimately promote health equity.

Training deep learning models for object detection usually requires a large amount of data, a condition that is not common for most real-world applications, especially in the context of aerial imagery. One possible solution is the use of simulators to generate synthetic data. For a good generalization, the model must be able to learn on the simulated data and perform correctly on the real data, process known as sim-to-real transfer. In this work, we analyze the generation of synthetic data to account for a data-scarce real-world scenario, which includes aerial imagery and object detection of transmission towers and their components. We evaluate the impact of image-to-image translation methods as domain adaptation techniques. In this analysis, we explore training strategies to mitigate the domain shift between synthetic and real data. According to our experimental results, the use of domain-adapted data through image-to-image translation could slightly improve the detection performance in real test data when compared to training with raw synthetic images only or with small datasets of real data, although it was noted through a visual analysis that objects with small bounding boxes, like clamp, anchoring clamp and ball link, could be distorted or vanished by the application of image-to-image translation methods. Additionally, when only a small subset of real data is available, training with both real and synthetic data at once led to better detection results, surpassing combinations of pre-training on synthetic and fine-tuning on real data.

This animated movie presents the mechanism of macroautophagy, hereafter autophagy, by showing the molecular features of the formation of autophagosomes, the hallmark organelle of this intracellular catabolic pathway. It is based on our current knowledge and it also illustrates how autophagosomes can recognize and eliminate selected cargoes.

Archaea are key players in many critical ecological processes. In comparison to eukaryotes and bacteria, however, our understanding of both the cell biology and diversity of archaea remains limited. While archaea inhabit a wide range of environmental conditions, many species are extremophiles, surviving in extreme temperature, salt or pH conditions, making their cell biology hard to study. Recently, our understanding of archaeal cell biology has been advanced significantly by the advent of live cell imaging in extremis as well as the development of genetic tools to exogenously express fluorescent proteins in some mesophilic archaeal model systems, e.g., Haloferax volcanii. However, for most archaeal species, especially thermophilic species or emerging model systems without well characterized genetic tools, live cell imaging remains dependent on fluorescent chemical probes to label and track the dynamics of living cells. While a wide range of fluorescent stains and markers that label different components of the cell are available commercially, their use has usually been optimized for use in a small number of eukaryotic cell systems. Here we report the successes and failures of the application of membrane, DNA, S-layer and cytoplasm markers in live cell imaging of archaea, as well as the optimization of fixation and immunolabelling approaches. We have applied these markers to the thermoacidophilic archaeon Sulfolobus acidocaldarius, but expect some to work in other archaeal species. Furthermore, those procedures that failed in S. acidocaldarius may still prove useful for imaging archaea that grow at a more neutral pH and/or at a less extreme temperature.

BackgroundPain management racial disparities exist, yet it is unclear whether disparities exist in pain management in advanced cancer.ObjectiveTo examine the effect of race on physicians' pain assessment and treatment in advanced lung cancer and the moderating effect of patient activation.DesignRandomized field experiment. Physicians consented to see two unannounced standardized patients (SPs) over 18 months. SPs portrayed 4 identical roles-a 62-year-old man with advanced lung cancer and uncontrolled pain-differing by race (black or white) and role (activated or typical). Activated SPs asked questions, interrupted when necessary, made requests, and expressed opinions.ParticipantsNinety-six primary care physicians (PCPs) and oncologists from small cities, and suburban and rural areas of New York, Indiana, and Michigan. Physicians' mean age was 52 years (SD = 27.17), 59% male, and 64% white.Main measuresOpioids prescribed (or not), total daily opioid doses (in oral morphine equivalents), guideline-concordant pain management, and pain assessment.Key resultsSPs completed 181 covertly audio-recorded visits that had complete data for the model covariates. Physicians detected SPs in 15% of visits. Physicians prescribed opioids in 71% of visits; 38% received guideline-concordant doses. Neither race nor activation was associated with total opioid dose or guideline-concordant pain management, and there were no interaction effects (p > 0.05). Activation, but not race, was associated with improved pain assessment (ẞ, 0.46, 95% CI 0.18, 0.74). In post hoc analyses, oncologists (but not PCPs) were less likely to prescribe opioids to black SPs (OR 0.24, 95% CI 0.07, 0.81).ConclusionsNeither race nor activation was associated with opioid prescribing; activation was associated with better pain assessment. In post hoc analyses, oncologists were less likely to prescribe opioids to black male SPs than white male SPs; PCPs had no racial disparities. In general, physicians may be under-prescribing opioids for cancer pain.Trial registrationNCT01501006.

Abstract Ca2+-activated K+ channels of intermediate conductance (IK) are frequently overexpressed in breast cancer (BC) cells, while IK channel depletion reduces BC cell proliferation and tumorigenesis. This raises the question, of whether and mechanistically how IK activity interferes with the metabolic activity and energy consumption rates, which are fundamental for rapidly growing cells. Using BC cells obtained from MMTV-PyMT tumor-bearing mice, we show that both, glycolysis and mitochondrial ATP-production are reduced in cells derived from IK-deficient breast tumors. Loss of IK altered the sub-/cellular K+- and Ca2+- homeostasis and mitochondrial membrane potential, ultimately resulting in reduced ATP-production and metabolic activity. Consequently, we find that BC cells lacking IK upregulate AMP-activated protein kinase activity to induce autophagy compensating the glycolytic and mitochondrial energy shortage. Our results emphasize that IK by modulating cellular Ca2+- and K+-dynamics contributes to the remodeling of metabolic pathways in cancer. Thus, targeting IK channel might disturb the metabolic activity of BC cells and reduce malignancy.

Objective: This community‐engaged codesign project identified the changes needed to tailor a family resilience‐building program, the Families Tackling Tough Times Together (FT), into a community setting. Background: There is a need for low‐burden resources to help families mitigate stressful times and build resilience. Guided by Walsh's family resilience framework, FT aims to improve families' ability to cope, recover, and build resilience. Due to the success of FT during the COVID‐19 pandemic, the program is now being modified to help families in the state of Indiana. Method: Three codesign workshops were held with community service providers (CSP) and families. Participants engaged with the FT materials and discussions related to program usability and feasibility. Data were analyzed using a rapid analysis approach. Results: CSPs stated that FT program materials fit with their goals and workload. Families felt the FT program aligned with their personal needs and day‐to‐day lives. Challenges and concerns with the FT materials included activities that required additional resources or that may be intimidating for families to complete. Both CSPs and families provided helpful suggestions on how to modify the materials. Conclusion: The FT program was well received by participants and was viewed as a valuable addition to the services CSPs offer. Modifications will be made to the FT materials based on knowledge gained from the workshops. Implications: This work highlights the collaborative nature of the codesign process as well as the insights gained from participants regarding the use of the FT materials by CSPs as part of their routine service delivery with families in the community. [ABSTRACT FROM AUTHOR]

The uneven diffusion of local and state laws restricting the use of electronic nicotine delivery systems (ENDS) in the United States may be a function of inconclusive scientific evidence and lack of guidance from the federal government. The objective of this study was to assess whether the rationale for amending clean indoor air acts (CIAAs) is being conflated by issues that are not directly relevant to protecting the health of ENDS non-users. Online sources were used in identifying bills (n = 25) that were presented in U.S. state legislatures from January 2009 to December 2015. The bills were categorized into one of three groups: 1) bills amending comprehensive CIAAs (n = 11), 2) bills prohibiting use of ENDS in places frequented by youth (n = 5), and 3) remaining bills that varied between the two categories (n = 9). Arguments presented in committee hearings were coded as scientific, public health, economic, enforcement, freedom, or regulatory. Arguments pertaining to amendment of clean indoor air acts spanned several categories, many of which were not directly relevant to the aims of the legislation. This finding could assist lawmakers and expert witnesses in making arguments that yield greater success in amending legislation. Alternatively, inconclusive scientific data on the hazards of ENDS aerosols might encourage lawmakers to propose legislation that prohibits ENDS use in places frequented by youths.

BackgroundRacial disparities exist in the care provided to advanced cancer patients. This article describes an investigation designed to advance the science of healthcare disparities by isolating the effects of patient race and patient activation on physician behavior using novel standardized patient (SP) methodology.Methods/designThe Social and Behavioral Influences (SBI) Study is a National Cancer Institute sponsored trial conducted in Western New York State, Northern/Central Indiana, and lower Michigan. The trial uses an incomplete randomized block design, randomizing physicians to see patients who are either black or white and who are "typical" or "activated" (e.g., ask questions, express opinions, ask for clarification, etc.). The study will enroll 91 physicians.DiscussionThe SBI study addresses important gaps in our knowledge about racial disparities and methods to reduce them in patients with advanced cancer by using standardized patient methodology. This study is innovative in aims, design, and methodology and will point the way to interventions that can reduce racial disparities and discrimination and draw links between implicit attitudes and physician behaviors.Trial registrationhttps://clinicaltrials.gov/ , #NCT01501006, November 30, 2011.

Abstract Background Retroperitoneal germ cell tumors (GCTs) are rare, commonly large tumors, often diagnosed in infancy. Complete surgical resection may pose a serious challenge as encasement of major vessels and organ displacement can lead to perioperative complications. This study aims to illustrate the surgical challenges of excising retroperitoneal GCTs. Results Nine patients were included: six patients with a teratoma, two patients with a mixed GCT with a yolk sac tumor component, and one patient with a pure yolk sac tumor. Six were males and seven were younger than 1 year of age at time of presentation. In all cases, perioperative vascular or organ-related complications occurred in one patient; this resulted in short bowel syndrome. There was no recurrence or mortality during the follow-up period. Relevant literature is reviewed and described. Conclusions The anatomical relation of a retroperitoneal GCT to the major vessels and organs is unpredictable. Preoperative radiological evaluation can help to improve the understanding of the vascular anatomy and to plan accordingly. Anteriorly displaced veins may appear insignificant and arteries, such as the superior mesenteric artery may be encased. Preoperative imaging may prevent perioperative complications, leading to safer surgical procedures. Level IV evidence Therapeutic study

Objective: To evaluate outcomes after primary surgery (PS) or neoadjuvant treatment followed by surgery (NAT/S) in cT2 staged adenocarcinomas of the esophagus (EAC) and gastroesophageal junction (GEJ), a multinational high-volume center study was undertaken. Background: The optimal treatment approach with either NAT/S or PS for clinically staged cT2cNany or cT2N0 EAC and GEJ remains unknown due to the lack of randomized controlled trials. Methods: A retrospective analysis of prospectively maintained databases from 10 centers was performed. Between January 2012 and August 2023, 645 patients who fulfilled inclusion criteria of GEJ Siewert type I, II, or EAC with cT2 status at diagnosis underwent PS or NAT/S with curative intent. The primary endpoint was overall survival (OS). Results: In the cT2cNany cohort, 192 patients (29.8%) underwent PS and 453 (70.2%) underwentNAT/S. In all cT2cN0 patients (n = 333),NAT/s remained the more frequent treatment (56.2%). Patients undergoing PS were in both cT2 cohorts older (P < 0.001) and had a higher American Society of Anesthesiologists classification (P < 0.05). R0 resection showed no differences between NAT/S and PS in both cT2 cohorts (P > 0.4).Median OS was 51.0 months in the PS group (95% CI: 31.6--70.4) versus 114.0 months (95% CI: 53.9--174.1) in the NAT/S group (P = 0.003) of cT2cNany patients. For cT2cN0 patients,NAT/S was associated with longer OS (P = 0.002) and disease-free survival (P = 0.001). After propensity score matching of the cT2N0 patients, survival benefit for NAT/S remained (P = 0.004). Histopathology showed that 38.1% of cT2cNany and 34.2% of cT2cN0 patients were understaged. Conclusions: Due to the unreliable identification of cT2N0 disease, all patients should be offered a multimodal therapeutic approach. [ABSTRACT FROM AUTHOR]

We report a scalable hydrogenation method for nitriles based on cost-effective materials in a very simple two-electrode setup under galvanostatic conditions. All components are commercially and readily available. The method is very easy to conduct and applicable to a variety of nitrile substrates, leading exclusively to primary amine products in yields of up to 89% using an easy work-up protocol. Importantly, this method is readily transferable from the milligram scale in batch-type screening cells to the multi-gram scale in a flow-type electrolyser. The transfer to flow electrolysis enabled us to achieve a notable 20 g day−1 productivity of phenylethylamine at a geometric current density of 50 mA cm−2 in a flow-type electrolyser with 48 cm2 electrodes. It is noteworthy that this method is sustainable in terms of process safety and reusability of components. [ABSTRACT FROM AUTHOR]

Since first identified as a separate domain of life in the 1970s, it has become clear that archaea differ profoundly from both eukaryotes and bacteria. In this review, we look across the archaeal domain and discuss the diverse mechanisms by which archaea control cell cycle progression, DNA replication, and cell division. While the molecular and cellular processes archaea use to govern these critical cell biological processes often differ markedly from those described in bacteria and eukaryotes, there are also striking similarities that highlight both unique and common principles of cell cycle control across the different domains of life. Since much of the eukaryotic cell cycle machinery has its origins in archaea, exploration of the mechanisms of archaeal cell division also promises to illuminate the evolution of the eukaryotic cell cycle. [ABSTRACT FROM AUTHOR]

Aim: This study reports surgical treatment and its outcome for boys with a testicular tumor, in order to analyze the considerations of testis-sparing surgery (TSS) and investigate whether, in retrospect, treatment was according to a recently developed algorithm. Methods: We retrospectively reviewed boys with testicular tumors who underwent surgical treatment between January 2000 and June 2020 at the Wilhelmina’s Children’s Hospital and the Princess Máxima Center for Pediatric Oncology, The Netherlands. Medical records were searched for clinical characteristics and outcome. Results: We identified 31 boys (median age = 5.5 years) with a testicular tumor, 26 germ cell tumors (GCTs), four sex cord-stromal tumors, and one gonadoblastoma. Seventeen boys (median age = 1.5 years) had malignant and 14 (median age = 3.6 years) had benign tumors. Four boys with benign GCTs were treated with TSS, 25 with radical inguinal orchiectomy (RIO), and 2 with scrotal orchiectomy. No recurrence or testicular atrophy was reported. All boys with benign testicular tumors were treated as suggested by the algorithm, except for one boy treated with RIO. Conclusion: Retrospective analysis of surgical treatment of prepubertal boys with benign testicular tumors showed that TSS appears to be safe, and should be considered based on clinicoradiological data, in line with our algorithm.