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In this article, I share ways in which my professional journey, from admissions and enrollment to diversity, equity, and inclusion, intersect with my evolution as a scholar-practitioner through CANDEL, the doctorate in educational leadership program at the University of California Davis. I further share how I have leveraged my experience in the EdD program as a scholar-practitioner to challenge systems of higher education through storytelling and counter narratives as a means to reroute narratives that institutions create around the experiences of marginalized communities, including the African diaspora.

Students' sense of belonging impacts their affect, motivation, well-being, and academic success. Sense of belonging is considered context-dependent as what determines one's belonging differs across contexts. This study explores how sense of belonging manifests among post-secondary, introductory chemistry students. This context is important given the threats to belonging that may arise from the transition into post-secondary studies and the pivotal role introductory courses play in student success. To carry out this investigation, 19 post-secondary students from introductory chemistry courses were interviewed following a semi-structured approach. Qualitative analyses were conducted that led to a conceptualization of belonging. Belonging can be situational, dependent on the occurrences within the setting, or dispositional, representing long-standing tendencies. It is also acceptance-based, such as friendships and support, or value-based, where contributions are recognized or acted upon. These traits are combined into four dimensions: Situational Acceptance, Dispositional Acceptance, Situational Value, and Dispositional Value. This nuanced understanding can guide instructional and research efforts to improve students' sense of belonging.

School connectedness is associated with a broad range of positive academic and mental health outcomes. A dimension of school connectedness, student-teacher connectedness, is related to improved academic progress and may be an important protective factor against risk-taking behaviors, particularly for low-income students and for those with limited parental support. The purpose of this qualitative secondary data analysis was to explore teacher perceptions of parental involvement in a low-income, rural middle school serving a diverse student population and the influence on student-teacher connectedness. Data were taken from transcripts from five focus groups comprised of middle school teachers, administrators, and clinicians (n = 26). Thematic analysis included first and second cycle coding followed by developing Venn diagrams to depict categories and patterns before reaching consensus on themes. Three themes were identified: (1) parental support of students; (2) parental modeling for students; and (3) parental interaction with teachers. Overall, teachers perceived a lack of parental involvement in this low-income diverse middle school which led to missed connections between students and teachers. This disconnect may be the result of multiple factors, including perceived low levels of parental support for students, differing expectations between parents and teachers, and perceived poor quality interactions between parents and teachers. When formulating strategies to enhance student--teacher connectedness, consideration should be given to the extent and importance of the role of parental involvement.

Studies investigating chemistry students' understanding of intermolecular forces have listed alternative conceptions; however, there is a call to investigate why students might have these alternative conceptions. This study describes how second semester general chemistry students predict the location of dipole-dipole forces between two molecules from a resource activation perspective. During interviews, 18 students were asked to describe the location of forces between four pairs of molecules. Students relied on one or more of the following approaches in determining location: (1) attraction between opposite charges, (2) electronegativity differences, (3) biggest electronegativity values, (4) largest atomic size, and (5) molecular shape. Each student's approach is characterized by the resources being activated and, in particular, students' use of electronegativity. Students' use of electronegativity varied, including comparing electronegativity values between unbonded atoms within a molecule and between atoms present on different molecules. The findings suggest future research directions and teaching implications that could improve students' understanding of intermolecular forces including the explicit integration and assessment of the concepts of electronegativity and intermolecular forces.

Given the rise in extremist radicalization using digital media, antifascist education must develop its own philosophy of digital technologies. The first half of this paper turns to Leo Löwenthal and Norbert Guterman's theory of the American agitator as well as Max Horkheimer and Theodor Adorno's notion of fascist projection and paranoia to provide groundwork for this project. Though written in the 1940s, Frankfurt School essays on agitation and projection can be thought of as early indications of the importance of affect in fascist politics, which has only become intensified with the advent of digital media. The paper then proceeds to apply a critical concept of "agitational aesthetics" to chan culture in the present day, highlighting the affective economy of memes in the radicalization process. In conclusion, a series of questions are posed to educators to help them think through the complexities of intervening before, during, and after the online agitation of proto-fascist tendencies in youth.

This article argues that hope is not an adequate affective response to dread. Indeed, hope and dread are more closely aligned than either critical or postcritical forms of educational philosophy would like to admit. The article proposes a shift from hope to joy as an under appreciated educational affect. To make this claim, the author pivots to Spinoza's emphasis on joy as an affect that increases one's potential to think and act in a world with others as a new starting point for education in dreadful times. The article also offers a Spinozian reading of Freire that unlocks the joyful dimensions of his work, especially through his reflections on laughter. In conclusion, a hopelessly joyful affective orientation is called for as a form of passionate educational experimentation with the potentiality of the world.

Representations in chemistry are the tools by which students, instructors, and chemists reason with chemical concepts that are abstract. Although representations are regularly used within the chemistry classroom, there is more to uncover regarding the ways students interact with representations when given chemistry tasks. This study aimed to address this gap in knowledge. In this study, eighteen students enrolled in second semester general chemistry were recruited for data collection. Semi-structured interviews were utilized to observe how students approached a similar set of dipole-dipole interaction tasks when given four distinct representations. Analysis of the data revealed that students' approaches to these tasks were affected by the newly explicit features present within each representation. Additionally, the ordering in which the representations were presented to the students influenced the specific features students took notice of and implemented into their approaches to the tasks. These findings can better inform instruction and future research involving chemical representations such that students will form a solid foundation in working with and pulling relevant information from various representations when solving chemistry tasks.

This qualitative study delves into the intricate landscape of general chemistry students' study strategy decision-making processes, examining the guiding factors that shape their choices. Past work in chemistry education has shown that students' study behaviors are dynamic in nature. Employing self-regulation theory, the study aims to provide a deeper understanding of how students decide to maintain or change their study behaviors. Semi-structured interviews were conducted to capture the study processes of nine students enrolled in first-semester general chemistry classroom. The results indicated these students' study behavior decision-making process was either driven by metacognition or affect. Students who adopted metacognitive decision-making showed evidence of enactment of declarative, procedural, and conditional knowledge which could be influenced by either the nature of the content studied (content-driven), or the time-efficiency of the strategies employed (time-driven) during their self-regulation. On the contrary, students who adopted affective decision-making based their choices regarding their study behaviors on the emotional aspects and the value they attribute to the study strategies (intrinsic-value or instrumental-value driven). The findings of the study are foundational yet highlight the nuanced nature of changes and constancy within the study strategy decision-making process. This suggests a one-size-fits-all approach to improve student study behaviors may not yield fruitful outcomes and therefore, distinct methods should be devised to reach students with different decision-making processes.

Education in organic chemistry is highly reliant on molecular representations. Students abstract information from representations to make sense of submicroscopic interactions. This study investigates relationships between differing representations: bond-line structures, ball-and-stick, or electrostatic potential maps (EPMs), and predicting partial charges, nucleophiles, and electrophiles. The study makes use of students' answers in hot-spot question format, where they select partially charged atoms on the image of a molecule and explanations. Analysis showed no significant difference among students when predicting a partially positive atom with each representation; however, more students with EPMs were able to correctly predict the partially negative atom. No difference was observed across representations in students predicting electrophilic character; while representations did influence students identifying nucleophilic character. The affordance of EPMs was that they cued more students to cite relative electronegativity indicating that such students were able to recognize the cause for electron rich/poor areas. This recognition is central to rationalizing mechanisms in organic chemistry. This study offers implications on incorporating EPMs during instruction and provides evidence-based support in how EPMs could be useful in promoting learning on topics that relate to an uneven charge distribution.

A “healthy” soil can be thought of as one that functions well, both agronomically and ecologically, and one in which soil biodiversity and crop management work in synergy to suppress pests and diseases. UC researchers have pioneered many ways of managing soil biology for pest management, including strategies such as soil solarization, steam treatment and anaerobic soil disinfestation, as well as improvements on traditional methods, such as reducing tillage, amending soil with organic materials, and cover cropping. As managing for soil health becomes more of an explicit focus due to restrictions on the use of soil fumigants, integrated soil health tests will be needed that are validated for use in California. Other research needs include breeding crops for disease resistance and pest suppressive microbial communities as well as knowledge of how beneficial organisms influence plant health.

Mindset theory describes a context-dependent belief system on the degree that intelligence can change with effort. Students' chemistry mindsets may predict students' behavioral responses to challenges they experience within a chemistry course. This study was designed to investigate whether challenges mediate the relationship between chemistry mindset and academic performance. 745 first-semester general chemistry students participated in the study. The students were surveyed on their mindset at the beginning and challenges they experienced through the end of the semester. Factor analyses were performed to characterize commonalities in students' perception of challenges, and structural equation modeling was used to examine whether challenges mediate the relationship between chemistry mindset and academic performance. To gain more insight, students reporting fixed and growth mindsets were compared regarding challenges and how challenges relate to their final grades. Analysis of data revealed that challenges can be perceived in concert with others, which resulted in three fundamental challenges: individual challenges, teaching-related challenges, and chemistry-related challenges. Chemistry-related challenges mediated the relationship between mindset and academic performance. Further, students reporting a growth mindset and earning a grade of C+ or lower rated the three fundamental challenges as relatively high. These challenges may explain why some students who report a growth mindset can earn a low grade. Among students reporting a fixed mindset earning a grade of C+ or lower, only chemistry-related challenges were rated highly. Understanding the nature of challenges and their role in success provides potential opportunities to modify instruction to support all students' success in chemistry.

Objective: The purpose of this analysis was to explore adolescent and adult women's interest in public health messaging around bladder health and perceptions of its usefulness. Materials and Methods: Directed content analysis of focus group data from the Study of Habits, Attitudes, Realities, and Experiences, which explored adolescent and adult women's experiences, perceptions, beliefs, knowledge, and behaviors related to bladder health across the life course. This article reports an analysis of the "Public Health Messaging" code, which included participants' desire or need for information about bladder health and recommendations for appropriate priority audiences. Results: Forty-four focus groups were conducted with 360 participants organized into six age groups (11-93 years). There was consensus across age groups that more information about the bladder is wanted and needed throughout the life course, as there is currently a lack of reliable educational resources. Information on bladder health was seen as useful and important because it enables people to anticipate negative changes in bladder health and act to prevent these. Several priority audiences were identified based on their risk of developing symptoms, but participants also saw value in educating the general public regardless of risk status. They also recommended education for parents and teachers who are in positions to control bathroom access. Conclusions: Results indicate a uniform desire for information on women's bladder health and a need for more research to develop individual prevention strategies and public health messaging for women of all ages, as well as guidance for organizations with a role in supporting bladder health.

The Brønsted-Lowry acid-base model is fundamental when discussing acid and base strength in organic chemistry as many of the reactions include a competing proton transfer reaction. This model requires evaluating chemical stability "via" a consideration of electronic granularity. The purpose of this study is to identify students' mental models on acid and base strength in terms of granularity and stability. Fourteen students enrolled in organic chemistry participated in this case study. Data were collected through semi-structured interviews including total case comparison tasks on stability, acidity, and basicity. Analysis of data revealed that there were four groups of students differentiated by their reasoning: (1) acid and base strength through structure without association to stability, (2) acid and base strength through electronics without association to stability, (3) acid strength associated with electronically centered stability, and (4) acid and base strength associated with electronically centered stability. This characterization can support teaching and research to promote reasoning that leads to a more consistent mental model across acid and base strength.

Background Neonatal healthcare-associated infection (HAI) globally is the leading preventable cause of neonatal mortality. Neonatal mortality in India is also very high. Considering that HAIs can be prevented globally, there are disparities in resources; the current study aimed at developing locally feasible and effective prevention bundles for neonatal HAIs. Methods A mixed-method study was conducted at one tertiary care teaching hospital's level IV Neonatal Intensive Care Unit. The study explores the causes of neonatal HAIs, current processes, benchmark practices, gaps in current practices with HAIs, root-cause analysis and system process mapping, and failure mode effect analysis. Observations, interviews, brainstorming activities, and a survey were conducted. Written and audio-video recorded prevention bundle was developed and implemented using a quasi-experimental study design. Results Process standardisation, healthcare worker training, hand hygiene practices, nursing care process and vascular access process were identified as key improvement areas to prevent neonatal HAIs. Out of eighteen identified processes, three processes were standardised. All the healthcare providers were trained at three-time intervals of three months each. After implementing the prevention bundle, there was a significant decline in the rate of HAIs, reducing it from 9.6 to 7.0 per 100 admissions >48 hours. The bacteraemia rate fell from 5.2 per 1000 patient days to 2.6 per 1000 patient days and was statistically significant on a two-tailed student t-test with 95% CI with p-value=0.00073. Conclusions Our developed prevention bundle for neonatal HAIs was significantly effective and reproducible for healthcare workers' training and development. Considering variations in global infection control practices and resources constraint, it is effective to develop a local prevention bundle for neonatal HAIs.

Utility value interventions (UVIs) are brief assignments designed to promote students' perceived utility value of the content they are learning. UVIs have been shown to improve students' academic performance in varying STEM courses; however, the use of UVIs in either chemistry courses or upper-level courses has not been well explored. This study evaluated a UVI in an upper-level chemistry course on student performance using an experimental design. Students were randomly assigned to either a utility value group or a content summary group. The first group received prompts asking students to describe the utility of what they are learning toward their career plans; the second group received prompts asking students to summarize what they are learning. Each student received three prompts over the semester and was tasked to write a short essay in response to each prompt. To evaluate the UVI, independent sample t tests were conducted on exam scores between the two groups, and effect sizes indicated that the UVI has no impact on one exam and a positive impact on two exams. In addition to the quantitative evaluation, the study qualitatively characterized student engagement in the intervention, namely how students' responses demonstrated an internalization of the perceived utility value of chemistry topics. The results suggest that the majority of students perceived a personal utility of chemistry topics as the intervention intended. Furthermore, students' responses provided details on their career plans, which can provide instructors' insight in designing curricula responsive to students' plans. In summary, enacting UVIs has low instructional costs and may benefit student performance and provide valuable insights for the instructors. Therefore, UVIs are recommended for consideration in instructional practices of upper-level chemistry courses.

This longitudinal study examines the responses of student sat two different institutions to creative exercises related to models of chemical bonding. Questions in the form of creative exercises required students to provide relevant, accurate, and distinct statements about two compounds for which they were provided only the formula and electronegativity values: SCl2 and CaCl2. Students responded to the questions at the end of general chemistry, six months later, and one year later. Their responses were analyzed qualitatively and quantitatively to explore patterns in application of bonding ideas and change overtime. The data reveal extensive application of covalent bonding ideas to an ionic compound, regardless of whether a student identified the substance as ionic or not, and that this is consistent over a year out. Implications for instruction of bonding models in general chemistry(and beyond) are discussed.

Background: Anastomotic leak (AL) after minimally invasive esophagectomy (MIE) is a well-described source of morbidity for patients undergoing surgical treatment of esophageal neoplasm. With improved early recognition and endoscopic management techniques, the long-term impact remains unclear. Methods: A retrospective review was conducted of patients who underwent MIE for esophageal neoplasm between January 2015 and June 2021 at a single institution. Cohorts were stratified by development of AL and subsequent management. Baseline demographics, perioperative data, and post-operative outcomes were examined. Results: During this period, 172 MIEs were performed, with 35 of 172 (20.3%) complicated by an AL. Perioperative factors independently associated with AL were post-operative blood transfusion (leak rate 52.9% versus 16.8%; p = 0.0017), incompleteness of anastomotic rings (75.0% vs 19.1%; p = 0.027), and receiving neoadjuvant therapy (18.5% vs 30.8%; p < 0.0001). Inferior short-term outcomes associated with AL included number of esophageal dilations in the first post-operative year (1.40 vs 0.46, p = 0.0397), discharge disposition to a location other than home (22.9% vs 8.8%, p = 0.012), length of hospital stay (17.7 days vs 9.6 days; p = 0.002), and time until jejunostomy tube removal (134 days vs 79 days; p = 0.0023). There was no significant difference in overall survival between patients with or without an AL at 1 year (79% vs 83%) or 5 years (50% vs 47%) (overall log rank p = 0.758). Conclusions: In this large single-center series of MIEs, AL was associated with inferior short-term outcomes including hospital length of stay, discharge disposition other than to home, and need for additional endoscopic procedures, without an accompanying impact on 1-year or 5-year survival. Key message: In this large, single-center series of minimally invasive esophagectomies, anastomotic leak was associated with worse short-term outcomes including hospital length of stay, discharge disposition other than to home, and need for additional endoscopic procedures, but was not associated with worse long-term survival. The significant association between neoadjuvant therapy and decreased leak rates is difficult to interpret, given the potential for confounding factors, thus careful attention to modifiable pre- and peri-operative patient factors associated with anastomotic leak is warranted.

Abstract Gait alterations in those with mild unilateral knee pain during walking may provide clues to modifiable alterations that affect progression of knee pain and osteoarthritis (OA). To examine this, we applied machine learning (ML) approaches to gait data from wearable sensors in a large observational knee OA cohort, the Multicenter Osteoarthritis (MOST) study. Participants completed a 20-m walk test wearing sensors on their trunk and ankles. Parameters describing spatiotemporal features of gait and symmetry, variability and complexity were extracted. We used an ensemble ML technique (“super learning”) to identify gait variables in our cross-sectional data associated with the presence/absence of unilateral knee pain. We then used logistic regression to determine the association of selected gait variables with odds of mild knee pain. Of 2066 participants (mean age 63.6 [SD: 10.4] years, 56% female), 21.3% had mild unilateral pain while walking. Gait parameters selected in the ML process as influential included step regularity, sample entropy, gait speed, and amplitude dominant frequency, among others. In adjusted cross-sectional analyses, lower levels of step regularity (i.e., greater gait variability) and lower sample entropy(i.e., lower gait complexity) were associated with increased likelihood of unilateral mild pain while walking [aOR 0.80 (0.64–1.00) and aOR 0.79 (0.66–0.95), respectively].

Abstract Flux balance analysis (FBA) is an optimization based approach to find the optimal steady state of a metabolic network, commonly of microorganisms such as yeast strains and Escherichia coli. However, the resulting solution from an FBA is typically not unique, as the optimization problem is, more often than not, degenerate. Flux variability analysis (FVA) is a method to determine the range of possible reaction fluxes that still satisfy, within some optimality factor, the original FBA problem. The resulting range of reaction fluxes can be utilized to determine metabolic reactions of high importance, amongst other analyses. In the literature, this has been done by solving $$2n+1$$ 2 n + 1 linear programs (LPs), with n being the number of reactions in the metabolic network. However, FVA can be solved with less than $$2n+1$$ 2 n + 1 LPs by utilizing the basic feasible solution property of bounded LPs to reduce the number of LPs that are needed to be solved. In this work, a new algorithm is proposed to solve FVA that requires less than $$2n+1$$ 2 n + 1 LPs. The proposed algorithm is benchmarked on a problem set of 112 metabolic network models ranging from single cell organisms (iMM904, ect) to a human metabolic system (Recon3D). Showing a reduction in the number of LPs required to solve the FVA problem and thus the time to solve an FVA problem.

Smallholder agriculture is the bedrock of the food production system in sub-Saharan Africa. Yields in Africa are significantly below potentially attainable yields for a number of reasons, and they are particularly vulnerable to climate change impacts. Monitoring of these highly heterogeneous landscapes is needed to respond to farmer needs, develop an appropriate policy and ensure food security, and Earth observation (EO) must be part of these efforts, but there is a lack of ground data for developing and testing EO methods in western Africa, and in this paper, we present data on (i) crop locations, (ii) biophysical parameters and (iii) crop yield, and biomass was collected in 2020 and 2021 in Ghana and is reported in this paper. In 2020, crop type was surveyed in more than 1800 fields in three different agroecological zones across Ghana (the Guinea Savannah, Transition and Deciduous zones). In 2021, a smaller number of fields were surveyed in the Guinea Savannah zone, and additionally, repeated measurements of leaf area index (LAI) and leaf chlorophyll concentration were made on a set of 56 maize fields. Yield and biomass were also sampled at harvesting. LAI in the sampled fields ranged from 0.1 to 5.24 m2 m−2, whereas leaf chlorophyll concentration varied between 6.1 and 60.3 µg cm−2. Yield varied between 190 and 4580 kg ha−1, with an important within-field variability (average per-field standard deviation 381 kg ha−1). The data are used in this paper to (i) evaluate the Digital Earth Africa 2019 cropland masks, where 61 % of sampled 2020/21 cropland is flagged as cropland by the data set, (ii) develop and test an LAI retrieval method from Earth observation Planet surface reflectance data (validation correlation coefficient R=0.49, root mean square error (RMSE) 0.44 m2 m−2), (iii) create a maize classification data set for Ghana for 2021 (overall accuracy within the region tested: 0.84), and (iv) explore the relationship between maximum LAI and crop yield using a linear model (correlation coefficient R=0.66 and R=0.53 for in situ and Planet-derived LAI, respectively). The data set, made available here within the context of the Group on Earth Observations Global Agricultural Monitoring (GEOGLAM) initiative, is an important contribution to understanding crop evolution and distribution in smallholder farming systems and will be useful for researchers developing/validating methods to monitor these systems using Earth observation data. The data described in this paper are available from https://doi.org/10.5281/zenodo.6632083 (Gomez-Dans et al., 2022).

Abstract Background Indigenous populations across the world are more likely to suffer from poor health outcomes when compared to other racial and ethnic groups. Although these disparities have many sources, one protective factor that has become increasingly apparent is the continued use and/or revitalization of traditional Indigenous lifeways: Indigenous language in particular. This realist review is aimed at bringing together the literature that addresses effects of language use and revitalization on mental and physical health. Methods Purposive bibliographic searches on Scopus were conducted to identify relevant publications, further augmented by forward citation chaining. Included publications (qualitative and quantitative) described health outcomes for groups of Indigenous people who either did or did not learn and/or use their ancestral language. The geographical area studied was restricted to the Americas, Australia or New Zealand. Publications that were not written in English, Spanish, French, Portuguese or German were excluded. A realist approach was followed to identify positive, neutral or negative effects of language use and/or acquisition on health, with both qualitative and quantitative measures considered. Results The bibliographic search yielded a total of 3508 possible publications of which 130 publications were included in the realist analysis. The largest proportion of the outcomes addressed in the studies (62.1%) reported positive effects. Neutral outcomes accounted for 16.6% of the reported effects. Negative effects (21.4%) were often qualified by such issues as possible cultural use of tobacco, testing educational outcomes in a student’s second language, and correlation with socioeconomic status (SES), health access, or social determinants of health; it is of note that the positive correlations with language use just as frequently occurred with these issues as the negative correlations did. Conclusions Language use and revitalization emerge as protective factors in the health of Indigenous populations. Benefits of language programs in tribal and other settings should be considered a cost-effective way of improving outcomes in multiple domains.

Mitigating the impact of atmospheric effects on optical remote sensing data is critical for monitoring intrinsic land processes and developing Analysis Ready Data (ARD). This work develops an approach to this for the NERC NCEO medium resolution ARD Landsat 8 (L8) and Sentinel 2 (S2) products, called Sensor Invariant Atmospheric Correction (SIAC). The contribution of the work is to phrase and solve that problem within a probabilistic (Bayesian) framework for medium resolution multispectral sensors S2/MSI and L8/OLI and to provide per-pixel uncertainty estimates traceable from assumed top-of-atmosphere (TOA) measurement uncertainty, making progress towards an important aspect of CEOS ARD target requirements. A set of observational and a priori constraints are developed in SIAC to constrain an estimate of coarse resolution (500 m) aerosol optical thickness (AOT) and total column water vapour (TCWV), along with associated uncertainty. This is then used to estimate the medium resolution (10–60 m) surface reflectance and uncertainty, given an assumed uncertainty of 5 % in TOA reflectance. The coarse resolution a priori constraints used are the MODIS MCD43 BRDF/Albedo product, giving a constraint on 500 m surface reflectance, and the Copernicus Atmosphere Monitoring Service (CAMS) operational forecasts of AOT and TCWV, providing estimates of atmospheric state at core 40 km spatial resolution, with an associated 500 m resolution spatial correlation model. The mapping in spatial scale between medium resolution observations and the coarser resolution constraints is achieved using a calibrated effective point spread function for MCD43. Efficient approximations (emulators) to the outputs of the 6S atmospheric radiative transfer code are used to estimate the state parameters in the atmospheric correction stage. SIAC is demonstrated for a set of global S2 and L8 images covering AERONET and RadCalNet sites. AOT retrievals show a very high correlation to AERONET estimates (correlation coefficient around 0.86, RMSE of 0.07 for both sensors), although with a small bias in AOT. TCWV is accurately retrieved from both sensors (correlation coefficient over 0.96, RMSE g cm−2). Comparisons with in situ surface reflectance measurements from the RadCalNet network show that SIAC provides accurate estimates of surface reflectance across the entire spectrum, with RMSE mismatches with the reference data between 0.01 and 0.02 in units of reflectance for both S2 and L8. For near-simultaneous S2 and L8 acquisitions, there is a very tight relationship (correlation coefficient over 0.95 for all common bands) between surface reflectance from both sensors, with negligible biases. Uncertainty estimates are assessed through discrepancy analysis and are found to provide viable estimates for AOT and TCWV. For surface reflectance, they give conservative estimates of uncertainty, suggesting that a lower estimate of TOA reflectance uncertainty might be appropriate.

Abstract Objective Obesity in pregnancy and gestational diabetes (GDM) increase cardiometabolic disease risk but are difficult to disentangle. This study aimed to test the hypothesis that 4–10 years after a pregnancy complicated by overweight/obesity and GDM (OB‐GDM), women and children would have greater adiposity and poorer cardiometabolic health than those with overweight/obesity (OB) or normal weight (NW) and no GDM during the index pregnancy. Methods In this cross‐sectional study, mother‐child dyads were stratified into three groups based on maternal health status during pregnancy (OB‐GDM = 67; OB = 76; NW = 76). Weight, height, waist and hip circumferences, and blood pressure were measured, along with fasting glucose, insulin, HbA1c, lipids, adipokines, and cytokines. Results Women in the OB and OB‐GDM groups had greater current adiposity and poorer cardiometabolic health outcomes than those in the NW group (p

Background: Neonatal healthcare-associated infection (HAI) globally is the leading preventable cause of neonatal mortality. Neonatal mortality in India is also very high. Considering that HAIs can be prevented globally, there are disparities in resources; the current study aimed at developing locally feasible and effective prevention bundles for neonatal HAIs. Methods: A mixed-method study was conducted at one tertiary care teaching hospital's level IV Neonatal Intensive Care Unit. The study explores the causes of neonatal HAIs, current processes, benchmark practices, gaps in current practices with HAIs, root-cause analysis and system process mapping, and failure mode effect analysis. Observations, interviews, brainstorming activities, and a survey were conducted. Written and audio-video recorded prevention bundle was developed and implemented using a quasi-experimental study design. Results: Process standardisation, healthcare worker training, hand hygiene practices, nursing care process and vascular access process were identified as key improvement areas to prevent neonatal HAIs. Out of eighteen identified processes, three processes were standardised. All the healthcare providers were trained at three-time intervals of three months each. After implementing the prevention bundle, there was a significant decline in the rate of HAIs, reducing it from 9.6 to 7.0 per 100 admissions >48 hours. The bacteraemia rate fell from 5.2 per 1000 patient days to 2.6 per 1000 patient days and was statistically significant on a two-tailed student t-test with 95% CI with p-value=0.00073. Conclusions: Our developed prevention bundle for neonatal HAIs was significantly effective and reproducible for healthcare workers' training and development. Considering variations in global infection control practices and resources constraint, it is effective to develop a local prevention bundle for neonatal HAIs.

Abstract Background Although physical activity is generally protective of cardiovascular disease (CVD), less is known about how young adult physical activity relates to premature CVD events. The objective of this study was to determine the association between level and change in physical activity from young adulthood to middle age and incidence of premature CVD events before age 60. Methods We analyzed data collected across four urban sites from nine visits over 30 years of follow-up (1985–2016) from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective community-based cohort study of 5115 Black and White women and men aged 18–30 years at baseline (1985–1986). Linear mixed models were used to develop individualized moderate-to-vigorous intensity self-reported physical activity trajectories per participant. Fatal and nonfatal coronary heart disease (CHD), heart failure, and stroke outcomes were analyzed separately and as a combined CVD event outcome. Results Overall, physical activity declined in young adults as they progressed through middle age. Lower physical activity scores (per 100 exercise units) in 18 year-olds were associated with higher odds of premature CHD (AOR 1.14, 95% CI 1.02–1.28), heart failure (AOR 1.21, 95% CI 1.05–1.38), stroke (AOR 1.20, 95% CI 1.04–1.39), and any CVD (AOR 1.15, 95% CI 1.06–1.24) events. Each additional annual 1-unit reduction in the physical activity score was associated with a higher annual odds of incident heart failure (1.07, 95% CI 1.02–1.13), stroke (1.06, 95% CI 1.00–1.13), and CVD (1.04, 95% CI 1.01–1.07) events. Meeting the minimum (AOR 0.74, 95% CI 0.0.57–0.96) and twice the minimum (AOR 0.55, 95% CI 0.34–0.91) Department of Health and Human Services physical activity guidelines through follow up was protective of premature CVD events. Conclusions Given recent trends in declining physical activity with age and associated premature CVD events, the transition from young adult to midlife is an important time period to promote physical activity.

Physical rehabilitation is essential for enhancing recovery in individuals with spinal cord injury (SCI); however, aside from early surgical intervention and hemodynamic management, there are no proven interventions for promoting recovery in the acute phase. In general, early rehabilitation is considered beneficial, but optimal parameters and potential contraindications for implementing rehabilitation at very early time points are unclear. Moreover, clinical trials to date are limited to studies initiating rehabilitation 2 weeks after injury and later. To address these gaps, this article reviews the preclinical literature on physical interventions initiated within the first 8 days postinjury. Effects of early rehabilitation on molecular and structural nervous system changes, behavioral function, and body systems are considered. Most studies utilized treadmill or cycle training as the primary intervention. Treadmill training initiated within the first 3 days and terminated by 1 week after injury worsened autonomic function, inflammation, and locomotor outcomes, while swim training during this period increased microvascular dysfunction. In contrast, lower-intensity rehabilitation such as reach training, ladder training, or voluntary wheel or ball training showed benefits when implemented during the first 3 days. Rehabilitation initiated at 4 days postinjury was also associated with enhanced motor recovery. Cycling appears to have the greatest risk-benefit ratio; however, the effects of cycle training in the first 3 days were not investigated. Overall, research suggests that lower intensity or voluntary rehabilitation during the hyperacute phase is more appropriate until at least 4 days postinjury, at which point higher-intensity activity becomes safer and more beneficial for recovery.

Acute traumatic spinal cord injury (SCI) can be a devastating and costly event for individuals, their families, and the health system as a whole. Prognosis is heavily dependent on the physical extent of the injury and the severity of neurological dysfunction. If not treated urgently, individuals can suffer exacerbated secondary injury cascades that may increase tissue injury and limit recovery. Initial recognition and rapid treatment of acute SCI are vital to limiting secondary injury, reducing morbidity, and providing the best chance of functional recovery. This article aims to review the pathophysiology of SCI and the most up-to-date management of the acute traumatic SCI, specifically examining the modern approaches to surgical treatments along with the ethical limitations of research in this field.

Abstract Background Change strategies may leverage interpersonal relationships and conversations to spread teaching innovations among science faculty. Knowledge sharing refers to the process by which individuals transfer information and thereby spread innovative ideas within an organization. We use knowledge sharing as a lens for identifying factors that encourage productive teaching-related conversations between individuals, characterizing the context and content of these discussions, and understanding how peer interactions may shape instructional practices. In this study, we interview 19 science faculty using innovative teaching practices about the teaching-focused conversations they have with different discussion partners. Results This qualitative study describes characteristics of the relationship between discussion partners, what they discuss with respect to teaching, the amount of help-seeking that occurs, and the perceived impacts of these conversations on their teaching. We highlight the role of office location and course overlap in bringing faculty together and characterize the range of topics they discuss, such as course delivery and teaching strategies. We note the tendency of faculty to seek out partners with relevant expertise and describe how faculty perceive their discussion partners to influence their instructional practices and personal affect. Finally, we elaborate on how these themes vary depending on the relationship between discussion partners. Conclusions The knowledge sharing framework provides a useful lens for investigating how various factors affect faculty conversations around teaching. Building on this framework, our results lead us to propose two hypotheses for how to promote sharing teaching knowledge among faculty, thereby identifying productive directions for further systematic inquiry. In particular, we propose that productive teaching conversations might be cultivated by fostering collaborative teaching partnerships and developing departmental structures to facilitate sharing of teaching expertise. We further suggest that social network theories and other examinations of faculty behavior can be useful approaches for researching the mechanisms that drive teaching reform.

Purpose:Purpose: The success of vasectomy is determined by the outcome of a post-vasectomy semen analysis (PVSA). This article describes a step-by-step procedure to perform PVSA accurately, report data from patients who underwent post vasectomy se-men analysis between 2015 and 2021 experience, along with results from an international online survey on clinical practice. Materials and Methods:Materials and Methods: We present a detailed step-by-step protocol for performing and interpretating PVSA testing, along with recommendations for proficiency testing, competency assessment for performing PVSA, and clinical and laboratory sce-narios. Moreover, we conducted an analysis of 1,114 PVSA performed at the Cleveland Clinic’s Andrology Laboratory and an online survey to understand clinician responses to the PVSA results in various countries. Results:Results: Results from our clinical experience showed that 92.1% of patients passed PVSA, with 7.9% being further tested. A total of 78 experts from 19 countries participated in the survey, and the majority reported to use time from vasectomy rather than the number of ejaculations as criterion to request PVSA. A high percentage of responders reported permitting unpro-tected intercourse only if PVSA samples show azoospermia while, in the presence of few non-motile sperm, the majority of responders suggested using alternative contraception, followed by another PVSA. In the presence of motile sperm, the major-ity of participants asked for further PVSA testing. Repeat vasectomy was mainly recommended if motile sperm were observed after multiple PVSA’s. A large percentage reported to recommend a second PVSA due to the possibility of legal actions. Conclusions:Conclusions: Our results highlighted varying clinical practices around the globe, with controversy over the significance of non-motile sperm in the PVSA sample. Our data suggest that less stringent AUA guidelines would help improve test compli-ance. A large longitudinal multi-center study would clarify various doubts related to timing and interpretation of PVSA and would also help us to understand, and perhaps predict, recanalization and the potential for future failure of a vasectomy.

Abstract Background Many institutional and departmentally focused change efforts have sought to improve teaching in STEM through the promotion of evidence-based instructional practices (EBIPs). Even with these efforts, EBIPs have not become the predominant mode of teaching in many STEM departments. To better understand institutional change efforts and the barriers to EBIP implementation, we developed the Cooperative Adoption Factors Instrument (CAFI) to probe faculty member characteristics beyond demographic attributes at the individual level. The CAFI probes multiple constructs related to institutional change including perceptions of the degree of mutual advantage of taking an action (strategic complements), trust and interconnectedness among colleagues (interdependence), and institutional attitudes toward teaching (climate). Results From data collected across five STEM fields at three large public research universities, we show that the CAFI has evidence of internal structure validity based on exploratory and confirmatory factor analysis. The scales have low correlations with each other and show significant variation among our sampled universities as demonstrated by ANOVA. We further demonstrate a relationship between the strategic complements and climate factors with EBIP adoption through use of a regression analysis. In addition to these factors, we also find that indegree, a measure of opinion leadership, correlates with EBIP adoption. Conclusions The CAFI uses the CACAO model of change to link the intended outcome of EBIP adoption with perception of EBIPs as mutually reinforcing (strategic complements), perception of faculty having their fates intertwined (interdependence), and perception of institutional readiness for change (climate). Our work has established that the CAFI is sensitive enough to pick up on differences between three relatively similar institutions and captures significant relationships with EBIP adoption. Our results suggest that the CAFI is likely to be a suitable tool to probe institutional change efforts, both for change agents who wish to characterize the local conditions on their respective campuses to support effective planning for a change initiative and for researchers who seek to follow the progression of a change initiative. While these initial findings are very promising, we also recommend that CAFI be administered in different types of institutions to examine the degree to which the observed relationships hold true across contexts.

One electron reduction of nitrite (NO2−) has been determined to be a significant, noncanonical source of nitric oxide (NO) with molybdopterin enzymes being identified as critical to this process. Of the molybdopterin enzymes identified as NO2− reductases, xanthine oxidoreductase (XOR) is the most extensively studied. Paradoxically, XOR generates oxidants and thus can contribute to oxidative stress under inflammatory conditions when the oxidase form (XO) of XOR is abundant. However, under similar inflammatory conditions XO has been associated with NO generation, especially when NO2− levels are elevated which begs the question: if reaction of nitrite with XO consumes electrons, then does it subsequently reduce oxidant generation? To address this question, electron paramagnetic resonance (EPR) was used, under controlled O2 tensions, to assess superoxide (O2·−) generation by endothelial-bound XO plus xanthine and the resultant impact of introducing NO2−. Nitrite diminished XO-derived O2·− under hypoxia (1% O2) whereas at 21% O2, it had no impact. To confirm these results and discount contributions from the reaction of NO with O2·−, molecular O2 consumption was assessed. The presence of NO2− decreased the rate of XO/xanthine-dependent O2 consumption in a concentration-dependent manner with greater impact under hypoxic conditions (1% O2) compared to 21% O2. In a more biologic setting, NO2− also diminished XO-dependent H2O2 formation in murine liver homogenates supplemented with xanthine. Interestingly, nitrate (NO3−) did not alter XO-dependent O2 consumption at either 21% or 1% O2; yet it did slightly impact nitrite-mediated effects when present at 2:1 ratio vs. NO2−. When combined, these data: 1) show a significant indirect antioxidant function for NO2− by decreasing oxidant generation from XO, 2) demonstrate that both XO-derived H2O2 and O2·− production are diminished by the presence of NO2− and 3) incentivize further exploration of the difference between XO reaction with NO2− vs. NO3−.

Background: Financial trading is often categorized separately from traditional forms of gambling (e.g., blackjack, poker, lottery, slot machines), as it is often viewed from an investing lens. However, the arbitrary line separating investing from gambling has become increasingly questioned, especially as it relates to high-risk trading behaviors (e.g., day trading, trading on margin) and riskier financial assets (e.g., options, cryptocurrencies). Further, the risk of gambling-related harms among financial traders appears to be amplified by new financial technologies, which have increased access to riskier financial assets and have encouraged riskier trading behaviors. Thus, the aim of the present study is to systematically review the literature assessing problem gambling among financial traders as well as the association between financial trading frequency and problem gambling. Methods: Twelve articles from three databases ( SCOPUS, PsycINFO, and Web of Science) met the inclusion criteria, and were reviewed. Results: The prevalence of problem gambling was generally higher among individuals who engage in trading financial products, but rates varied substantially (1.4% to 47.2%) due in large part to differences in the study population, the problem gambling measures used, and the cutoff scores employed. Similarly, financial trading frequency was consistently associated with more severe problem gambling, but the strength of these associations ranged across studies. Conclusion: Collectively, while findings from these studies suggest that financial traders are at greater risk for problem gambling, it is evident that trading riskier assets and engaging in riskier trading behaviors place individuals at a substantially greater risk for problem gambling. Recommendations for future research include focusing on at-risk populations, practical implications for the intervention and policy, and emerging issues of digital technologies.

Cellular contexts such as disease state, organismal life stage and tissue microenvironment, shape intercellular communication, and ultimately affect an organism’s phenotypes. Here, the authors present Tensor-cell2cell, an unsupervised method for deciphering context-driven intercellular communication.

Objective: The study objective was to determine the relationship between lung resection and the development of postoperative hiatal hernia. Methods: Preoperative and postoperative computed tomography imaging from 373 patients from the International Early Lung Cancer Action Program and the Initiative for Early Lung Cancer Research on Treatment were compared at a median of 31.1 months of follow-up after resection of clinical early-stage non–small cell lung cancer. Incidence of new hiatal hernia or changes to preexisting hernias were recorded and evaluated by patient demographics, surgical approach, extent of resection, and resection site. Results: New hiatal hernias were seen in 9.6% of patients after lung resection (5.6% after wedge or segmentectomy and 12.4% after lobectomy; P = .047). The median size of new hernias was 21 mm, and the most commonly associated resection site was the left lower lobe (24.2%; P = .04). In patients with preexisting hernias, 53.5% demonstrated a small but significant increase in size from 21 to 22 mm (P

Human milk oligosaccharides are fundamental to infant health. Here the authors deploy a multi-omics systems biology approach to elucidate their biosynthetic network, including the associated enzymes and likely structures of ambiguous oligosaccharides.

CD28 costimulatory signalling can be suppressed by immune checkpoints, such as CTLA-4 and PD-1. Here the authors describe the design of the fusion therapeutic davoceticept (ALPN-202), based on a variant CD80 extracellular domain engineered to bind PD-L1 as well as CD28 and CTLA-4, providing direct T cell costimulation and dual checkpoint inhibition to enable anti-tumor immune responses.