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Systemic racism is pervasive in US society and disproportionately limits opportunities for education, work, and health for historically marginalized and minoritized racial and ethnic groups, making it an urgent issue of social justice. Because systemic racism is a social determinant of health prevalent across multiple social and institutional structures, it requires multilevel intervention approaches using effective designs and analytic methods to measure and evaluate outcomes. Racism is a fundamental cause of poor health outcomes, including mental health outcomes; thus, mental health services and programs that address racism and discrimination are key to promoting positive mental health of racial and ethnic minority youth. While multilevel interventions are well-suited for improving outcomes like youth mental health disparities, their evaluation poses unique methodological challenges, requiring specialized design and analytic approaches. There has been limited methodological guidance provided to researchers on how to test multilevel interventions using approaches that balance methodological rigor, practicality, and acceptability across stakeholder groups, especially within communities most affected by systemic racism. This paper addresses this gap by providing an example of how to rigorously evaluate a hypothetical, theoretically based, multilevel intervention promoting mental health equity in three US school systems using an anti-racist approach intervening at the macro- (i.e., school system), meso- (i.e., school), and micro- (i.e., family and student) levels to improve mental health in adolescents. We describe the design, sample size considerations, and analytic methods to comprehensively evaluate its effectiveness while exploring the extent to which the components interact synergistically to improve outcomes. The methodological approach proposed can be adapted to other multilevel interventions that include strategies addressing macro-, meso-, and micro-levels of influence.

We present unprecedented datasets of current and future projected weather files for building simulations in 15 major cities distributed across 10 climate zones worldwide. The datasets include ambient air temperature, relative humidity, atmospheric pressure, direct and diffuse solar irradiance, and wind speed at hourly resolution, which are essential climate elements needed to undertake building simulations. The datasets contain typical and extreme weather years in the EnergyPlus weather file (EPW) format and multiyear projections in comma-separated value (CSV) format for three periods: historical (2001-2020), future mid-term (2041-2060), and future long-term (2081-2100). The datasets were generated from projections of one regional climate model, which were bias-corrected using multiyear observational data for each city. The methodology used makes the datasets among the first to incorporate complex changes in the future climate for the frequency, duration, and magnitude of extreme temperatures. These datasets, created within the IEA EBC Annex 80 "Resilient Cooling for Buildings", are ready to be used for different types of building adaptation and resilience studies to climate change and heatwaves.

Abstract Non-typhoidal Salmonella (NTS) is one of the leading causes of foodborne outbreaks worldwide, especially in low- and middle-income countries such as Peru. To understand the dynamics of NTS serotypes circulating in the country, the whole genomes of 1122 NTS strains from 1998 to 2018 were analyzed using phylogenomic and comparative genomics tools. A total of 40 different Sequences Type (STs) were identified, the five most frequent being ST-32 (S. Infantis, 37.25%), ST-11 (S. Enteritidis, 23.8%), ST-19 (S. Typhimurium, 14.17%), ST-31 (S. Newport, 6.77%), and ST-413 (S. Mbandaka, 4.72%). Furthermore, the maximum likelihood phylogeny showed high clonality between strains from the same ST recovered from different isolation sources, as well as a variable recombination rate, when comparing each ST individually. Moreover, several virulence factors involved in adherence and invasion, as well as plasmids and prophages, are strongly associated with the most frequent STs, while multidrug resistance markers are mostly linked to ST-32. This work provides an overview of the main genomic characteristics linked to the high-frequency ST, which have undergone few genetic modifications over time, suggesting a high adaptation of these NTS circulating clones in Peru.

Purpose: To summarize the results of Chile's 2022 Report Card (RC) on physical activity (PA) for Children and Adolescents. Methods: Chile's 2022 RC included ten core PA indicators common to the Global Matrix 4.0. Evidence from scientific articles, reports, and databases published between 2018 and January 2022 was included for each indicator. The data were collected and analyzed by a national scientific committee, which assigned letter grades (A to F) using a consensus based on benchmarks defined and revised by the Active Healthy Kids Global Alliance. Results: The committee assigned the following grades: Overall PA, D−; Organized Sports and Physical Activity Participation, C−; Active Play, Incomplete; Active Transportation, D; Sedentary Behavior, D−; Physical Fitness, Incomplete; Family and Peers, D; School, C; Community and Environment, D+; Government, A−. Conclusions: Chile's 2022 RC, like its previous versions, shows persistently low grades for most indicators. Overall PA remained nearly unchanged, while Community and Environment scored lower. Slight improvements were seen in Organized Sports, Family and Peers, and School Environment. While Chile has endeavored to increase children's activity levels, policies require implementation through a systemic, coherent framework to promote sustainable changes and reach a larger portion of children and youth.

Abstract Background Anorexia nervosa (AN) is a severe psychiatric disorder, from which recovery is often protracted. The role of prior specialized inpatient treatment on subsequent treatment attempts for adults with chronic AN and predictors of treatment response for severe and enduring AN (SE-AN) are needed to improve outcomes. Method Participants (N = 135) with chronic AN (ill ≥7 years) admitted to an integrated inpatient-partial hospitalization eating disorders (ED) unit with prior ED hospitalization(s) (+ PH; n = 100) were compared to those without prior ED hospitalizations (-PH; n = 35) on admission characteristics (BMI, length of illness, outpatient ED treatment history, symptomatology (ED, anxiety, and depressive), history of suicide attempts or non-suicidal self-injury (NSSI)), treatment motivation and recovery self-efficacy, and discharge outcomes (discharge BMI, rate of weight gain, length of stay, clinical improvement). Results Groups were similar with regard to age, years ill, and admission BMI. The + PH group had lower desired weight, lifetime nadir BMI and self-efficacy for normative eating, and higher state and trait anxiety than the -PH group. +PH were also more likely to endorse history of NSSI and suicide attempt. Regarding discharge outcomes, most patients achieved weight restoration at program discharge (mean discharge BMI = 19.8 kg/m2). Groups did not differ on rate of weight gain, likelihood of attending partial hospital, partial hospital length of stay, program discharge BMI, or likelihood of clinical improvement (p’s > 0.05) although inpatient length of stay was longer for the + PH group. Conclusions Participants with chronic AN + PH exhibited more severe psychiatric comorbidity and lower self-efficacy for normative eating than AN -PH, however short-term discharge outcomes were similar. Future research should determine whether weight restoration and targeting comorbidities impacts relapse risk or need for rehospitalization among chronic and severe + PH. Despite similar illness durations, those with chronic AN -PH may be able to transition to partial hospital earlier. Conversely there is risk of undertreatment of chronic AN + PH given the recent shift promoting briefer self-directed admissions for adults with SE-AN. Research comparing + PH and -PH adults with chronic AN may facilitate efforts to individualize care and characterize relapse risk following intensive treatment.

Abstract Background The purpose of this study is to increase understanding of the forms of systemic racism experienced by Latinx communities in North Carolina during the COVID-19 pandemic as identified by Latinx community health workers (CHWs) and community-based organization (CBO) leaders. Methods We held three focus groups in July 2022 (N = 16) with CHWs and CBO leaders in Spanish to discuss policy and community interventions that improved access to resources during the COVID-19 pandemic; policy or community interventions needed to improve care of Latinx communities; and lessons learned to improve the health of Latinx communities in the future. We performed directed and summative qualitative content analysis of the data in the original language using the Levels of Racism Framework by Dr. Camara Jones to identify examples of implicitly and explicitly discussed forms of systemic racism. Results Latinx CHWs and CBO leaders implicitly discussed numerous examples of all levels of racism when seeking and receiving health services, such as lack of resources for undocumented individuals and negative interactions with non-Latinx individuals, but did not explicitly name racism. Themes related to institutionalized racism included: differential access to resources due to language barriers; uninsured or undocumented status; exclusionary policies not accounting for cultural or socioeconomic differences; lack of action despite need; and difficulties obtaining sustainable funding. Themes related to personally-mediated racism included: lack of cultural awareness or humility; fear-inciting misinformation targeting Latinx populations; and negative interactions with non-Latinx individuals, organizations, or institutions. Themes related to internalized racism included: fear of seeking information or medical care; resignation or hopelessness; and competition among Latinx CBOs. Similarly, CHWs and CBO leaders discussed several interventions with systems-level impact without explicitly mentioning policy or policy change. Conclusion Our research demonstrates community-identified examples of racism and confirms that Latinx populations often do not name racism explicitly. Such language gaps limit the ability of CHWs and CBOs to highlight injustices and limit the ability of communities to advocate for themselves. Although generally COVID-19 focused, themes identified represent long-standing, systemic barriers affecting Latinx communities. It is therefore critical that public and private policymakers consider these language gaps and engage with Latinx communities to develop community-informed anti-racist policies to sustainably reduce forms of racism experienced by this unique population.

Abstract The recent adoption of deep learning-based models for the processing and coding of multimedia signals has brought noticeable gains in performance, which have established deep learning-based solutions as the uncontested state-of-the-art both for computer vision tasks, targeting machine consumption, as well as, more recently, coding applications, targeting human visualization. Traditionally, applications requiring both coding and computer vision processing require first decoding the bitstream and then applying the computer vision methods to the decompressed multimedia signals. However, the adoption of deep learning-based solutions enables the use of compressed domain computer vision processing, with gains in performance and computational complexity over the decompressed domain approach. For point clouds (PCs), these gains have been demonstrated in the single available compressed domain computer vision processing solution, named Compressed Domain PC Classifier, which processes JPEG Pleno PC coding (PCC) compressed streams using a PC classifier largely compatible with the state-of-the-art spatial domain PointGrid classifier. However, the available Compressed Domain PC Classifier presents strong limitations by imposing a single, specific input size which is associated to specific JPEG Pleno PCC configurations; this limits the compression performance as these configurations are not ideal for all PCs due to their different characteristics, notably density. To overcome these limitations, this paper proposes the first Adaptive Compressed Domain PC Classifier solution which includes a novel adaptive bridge model that allows to process the JPEG Pleno PCC encoded bit streams using different coding configurations, now maximizing the compression efficiency. Experimental results show that the novel Adaptive Compressed Domain PC Classifier allows JPEG PCC to achieve better compression performance by not imposing a single, specific coding configuration for all PCs, regardless of its different characteristics. Moreover, the added adaptability power can achieve slightly better PC classification performance than the previous Compressed Domain PC Classifier and largely better PC classification performance (and lower number of weights) than the PointGrid PC classifier working in the decompressed domain.

Sickle cell anemia (SCA) is a hemolytic disorder characterized by reduced red blood cell lifespan due to repeated sickling processes. Patients have complications as a consequence of hemolysis, vaso-occlusion, inflammation, and endothelial dysfunction. Disease management consists of laboratory monitoring of biomarkers and further medical assistance for clinical manifestations. We aimed to investigate laboratory parameters associated with pain crises in SCA patients. In this cross-sectional analysis, we included 63 SCA patients, of whom 27 were female, with a mean age of 14.6 ±3.6 (median: 15) years. Eleven patients received blood transfusions, none were taking hydroxyurea, and all were in steady state. Laboratory investigation was carried out, and clinical data was assessed using a standardized and confidential questionnaire and confirmed by the medical records. All patients were followed at the Bahia Hemotherapy and Hematology Foundation (Hemoba). This study received approval from the Institutional Research Board (protocol number 1400535) and was conducted in compliance with the ethical principles established by the revised Declaration of Helsinki. We grouped the patients into pain crisis + (patients who experienced at least 1 pain crisis in the past six months) and pain crisis – (patients who did not experience at least 1 pain crisis in the past six months) to perform the analysis. We found that 38 patients experienced painful crises in the last six months (pain crisis +), while 25 did not experience (pain crisis -). Regarding laboratory parameters, pain crisis patients + presented increased red blood cells, monocytes, and absolute reticulocyte counts, as well as increased HDL-C and decreased NOm levels. We drew a receiver operating characteristic (ROC) curve to test whether these parameters helped distinguish the patient groups. All the ROC curves were statistically significant (red blood cell counts: AUC = 0.647, p = 0.05; monocyte counts: AUC = 0.657, p = 0.036; absolute reticulocyte counts: AUC = 0.708, p = 0.006; HDL-C: AUC = 0.648, p = 0.015; NOm: AUC = 0.687, p = 0.012). We classified the laboratory parameters according to the median value of each variable and performed a Fisher's Exact Test (χ²). We found no statistical significance for red blood cell and monocyte counts or HDL-C levels. In contrast, pain crisis patients + had increased reticulocyte counts (p = 0.019) and decreased NOm levels (p = 0.008). Finally, we designed a multivariate linear regression model with pain crisis as a dependent variable. Our model was statistically significant (p = 0.006), and absolute reticulocyte counts were independently associated with pain crises in SCA (p = 0.039, β = 0.261, R²= 0.248). Increased reticulocyte counts in SCA are a common finding associated with hemolysis, stress-induced erythropoiesis, bone marrow response, and red blood cell turnover. A pain crisis in SCA may start due to a vaso-occlusive episode, which is a hallmark of the disease. Therefore, the identification of accessible laboratory biomarkers is helpful in clinical management. Due to the small sample size and cross-sectional design, our results should be interpreted cautiously. However, our findings may guide further studies in which reticulocyte counts are an essential endpoint for SCA. Our results suggest that absolute reticulocyte counts are an important biomarker for pain crisis in SCA.

Rigid polypropylene is mechanically recycled but flexible polypropylene is mostly used in energetic valorization because of the poor properties of the recycled polymer. A recycled polypropylene-based composite with outstanding properties for flexible food packaging was developed. For the first time, the influence of maleated polypropylene copolymer addition and the fumed silica/copolymer ratio on the packaging properties of recycled flexible polypropylene under the effects of silica hydrophilicity was investigated. The structural, morphological, thermal, mechanical, melt flow, overall migration, water vapor barrier and sealing properties of the developed nanocomposites were analyzed. Prominently, the addition of 1:1 maleated polypropylene and hydrophobic nanosilica improved the global performance of all tested methods. The recycled polypropylene had an overall migration to olive oil of 17 mg dm−2, exceeding the limit allowed for food packaging, but the developed added-value composite reduced it to the tolerance limit according EU legislation. The seal strength was drastically increased by 50 % with adhesive peeling, high thermal stability, and well-dispersed particles without affecting the ductility.

Abstract We present unprecedented datasets of current and future projected weather files for building simulations in 15 major cities distributed across 10 climate zones worldwide. The datasets include ambient air temperature, relative humidity, atmospheric pressure, direct and diffuse solar irradiance, and wind speed at hourly resolution, which are essential climate elements needed to undertake building simulations. The datasets contain typical and extreme weather years in the EnergyPlus weather file (EPW) format and multiyear projections in comma-separated value (CSV) format for three periods: historical (2001–2020), future mid-term (2041–2060), and future long-term (2081–2100). The datasets were generated from projections of one regional climate model, which were bias-corrected using multiyear observational data for each city. The methodology used makes the datasets among the first to incorporate complex changes in the future climate for the frequency, duration, and magnitude of extreme temperatures. These datasets, created within the IEA EBC Annex 80 “Resilient Cooling for Buildings”, are ready to be used for different types of building adaptation and resilience studies to climate change and heatwaves.

This study investigated variations in ground temperatures in four cities in Mato Grosso, considering the emission scenario SSP5-8.5 from the Sixth IPCC Assessment Report. Using computational simulations and historical and future climatic data, the research revealed significant changes in average ground temperatures. In Alta Floresta, simulations indicated a notable increase, especially in the months of April, May, and June, contrasting with estimates based on the EPW climatic file. Alto Taquari showed a distinct response, while Campo Verde and Sinop exhibited significant temperature increases until 2080. The research highlights the importance of considering specific soil characteristics for accurate projections, providing crucial insights for climate change adaptation strategies. There is an emphasis on the need to implement passive cooling strategies in buildings, especially in hot regions, to adapt to future conditions.

Vulvar lichen sclerosus is a chronic inflammatory condition characterized by the thinning and atrophy of the skin and mucosa surrounding the vulva and anus. This study evaluates the efficacy of a treatment protocol utilizing blue-diode laser photobiomodulation in managing vulval lichen sclerosus symptoms in a cohort of 12 female patients. The treatment protocol consisted of laser sessions for 3 times a week for 2 weeks, and follow-up sessions over a 16-week period. Objective and subjective parameters were assessed before treatment, at the end of treatment, and at 4-month follow-up visits. Results demonstrated significant reductions in subjective symptoms such as itching and pain, as well as improvements in objective signs including erythema and fissures. No side effects were observed, indicating the safety and tolerability of laser treatment. These findings suggest that photobiomodulation can be an effective therapeutic option for patients with vulval lichen sclerosus, with future research aimed at refining treatment protocols and evaluating its long-term benefits.

Nowadays, numerical models are considered powerful design tools, which are largely used in several engineering applications. When applied to heat transfer applications, they have already been shown to be reliable, especially in single phase systems. When considering two-phase heat transfer, and in particular solid-liquid phase change processes, the numerical tools must be carefully handled. Thus, this paper follows the critical literature on the application of numerical methods to simulate and optimize latent thermal energy storages to show how, in most cases, the common geometrical and numerical approximations should not be applied because they might lead to misleading solutions. Starting from reliable experimental results collected during melting process of a paraffin wax inside 3D periodic structures, different simulation approaches are proposed, and their advantages and disadvantages are discussed. The results show that, when dealing with certain complex 3D structures, 2D approximations cannot reliably capture the phase-change phenomenon. The validated tool also allowed to identify the optimum pore size to maximize the solid-liquid phase change. This work can be considered as a reference for future numerical studies on the solid-liquid process inside 3D structures.

ABSTRACT Objectives: to understand the process of adapting to childbirth during the COVID-19 pandemic from the perspective of a group of pregnant women. Methods: a qualitative, descriptive-exploratory study was conducted with 23 women. Data were collected between October and December 2021 through documentation and semi-structured interviews, which were analyzed using Minayo’s methodology and Roy’s Adaptation Model. Results: various types of stimuli - focal, contextual, and residual - were identified as influencing childbirth preparation. The online group was essential for facilitating pregnant women’s adaptation, offering significant support and generating positive feedback for childbirth preparation. Final Considerations: the importance of pregnant women’s groups as a strategy for improving adaptation to childbirth was identified, underscoring the effectiveness of this support among professionals and participants, as well as among pregnant women. This support network strengthened preparation for childbirth during a challenging period like the pandemic.