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Climate change disproportionately affects Indigenous Peoples because of strong connections between environmental, cultural, and spiritual well-being. While much of the global discourse surrounding climate change is founded in Western science, the holistic, place-based knowledge of Indigenous Peoples offers a complementary way of understanding and mitigating climate change impacts. The goal of this research was to elevate Anishinaabe concerns, observations, and perspectives about climate change impacts and future research needs. We organized a workshop called “Connecting Guardians in a Changing World” where participants shared concerns about animal and plant life cycles, water cycles and water quality, and impacts to ways of life, including reduced capacity to perform cultural practices and erosion of their knowledge. Participants highlighted the challenge of prioritizing a single impact of climate change, emphasizing that impacts to the environment and ways of life are interconnected. Participants also expressed the need for research and policy that move beyond interdisciplinarity to include intercultural philosophy and research that better reflects Indigenous worldviews and incorporates Indigenous methodologies. Moving forward, meaningful partnerships and opportunities for knowledge sharing should be prioritized in climate change discourse to ensure solutions are generated together, with all of the tools and knowledge available.

Abstract The plant community in roadside right‐of‐ways is an important component of transportation infrastructure. Revegetation after construction is an opportunity to improve the plant community and create pollinator habitat. However, native seed mixes are substantially more expensive than those used in conventional roadside plantings, and transportation agencies often lack resources for management. Here, we compare the actively flowering plant community across a growing season in roadside plots seeded with native seed mixes versus non‐native seed mixes in Minnesota, USA. Plots varied in age from 2 to 20 years old. We demonstrate that native seeded plots had more native flowering forbs than non‐native seeded plots, as native flowers were rare in the non‐native seeded plots. However, despite some native species establishing well, many species in native seed mixes had poor or non‐existent establishment. Furthermore, the native and non‐native seeded plots converged in the makeup of their floral communities after a few years; part of this pattern is due to colonisation of species that were never seeded at either type of plot. Practical implication. If the goal of revegetation is to produce diverse, native dominated floral communities in roadsides, agencies must invest more in long‐term management. Managers could also alter seed mixes to remove species that fail to establish, which would reduce the cost of the seed mix, but not the diversity of the plant community that ultimately establishes. The use of such streamlined seed mixes across more land area would increase the availability of pollinator habitat without substantially altering current budgets or management plans.

Article processing charges (APCs) for open access (OA) journals perpetuate inequities in scientific knowledge. High APCs systematically restrict low- and middle-income country (LMIC) researchers from contributing to research knowledge, preventing the dissemination of high-value, high-quality, and sustainable LMIC-driven solutions. Otolaryngology journals are no exception. The authors propose solutions to rectify the inequities in academic publishing because of APCs, including innovative solutions adopted by several major journals. Addressing these inequities requires medical society and journal editorial board leadership to ensure equitable APC policies.

3,5-Diphenyl-4H-1,2,6-thiadiazin-4-one treated with meta-chloroperoxybenzoic acid undergoes an oxidative ring contraction to give 2-benzoyl-4-phenyl-1,2,5-thiadiazol-3(2H)-one 1,1-dioxide in a 29% yield, the structure of which is supported by single-crystal X-ray diffraction analysis and the available spectroscopic data.

Emotional distress has been rising since before the COVID-19 pandemic and the public is told that depression is a major public health problem. For example, in 2017 depressive disorders were ranked as the third leading cause of “years lost to disability” and the World Health Organization now ranks depression as the single largest contributor to global disability. Although critical appraisals of the epidemiological data raise questions about the accuracy of population-based depression estimates, the dominance of the medical model and the marketing of psychotropics as “magic bullets,” have contributed to a dramatic rise in the prescription of psychiatric drugs. Unfortunately, the pharmaceutical industry’s influence on psychiatric research and practice has resulted in over-estimates of the effectiveness of psychotropic medications and an under-reporting of harms. This is because the principles that govern commercial entities are incongruent with the principles that guide public health research and interventions. In order to conduct mental health research and develop interventions that are in the public’s best interest, we need non-reductionist epistemological and empirical approaches that incorporate a biopsychosocial perspective. Taking depression as a case example, we argue that the socio-political factors associated with emotional distress must be identified and addressed. We describe the harms of industry influence on mental health research and show how the emphasis on “scaling up” the diagnosis and treatment of depression is an insufficient response from a public health perspective. Solutions for reform are offered.

The term treatment-resistant depression (TRD) has been the focus of hundreds of studies and clinical trials, though it is not a diagnosable mental health condition according to current clinical standards. The term implies depression that is particularly difficult to treat. However, as we illustrate here, the use of the TRD construct creates significant concerns regarding patient welfare and optimal distribution of resources. First, TRD is frequently defined as depression that failed to respond to antidepressant medication. Therefore, patients may be labeled with TRD after having tried just one medication, without consideration of effective non-pharmacological treatments such as psychotherapy or holistic interventions to improve sleep, nutrition, and exercise. Second, TRD implicitly contextualizes depression as a problem within an individual's brain, ignoring larger systemic, developmental, and sociological factors known to be depressogenic. Important structural determinants of health such as social isolation, environmental stressors, systemic oppression, unmet basic needs for shelter, food, and safety are excluded. Third, TRD does a disservice to patients when it rapidly escalates treatment decisions to increasingly risky and experimental options. And finally, the existing concept of TRD is used to justify enormous financial investment – on the order of billions of dollars - in research aimed at identifying precise biological treatment targets. The quest for biomedical treatments struggles to provide the anticipated return on investment in the form of decreased depression burden despite over 50 years of costly effort. Drawing from historical perspectives, we highlight these issues and propose recommendations to address them.

On the basis of their training, medical students are considered “the best case scenario” among university students in knowledge of the human papillomavirus (HPV). We evaluated differences in knowledge of HPV, HPV vaccine, and head and neck cancer (HNC) among medical students. A previously validated questionnaire was completed by 247 medical students at a Midwestern university. Outcomes of interest were knowledge score for HPV and HPV vaccine, and HNC, derived from combining questionnaire items to form HPV knowledge and HNC scores, and analyzed using multivariate linear regression. Mean scores for HPV knowledge were 19.4 out of 26, and 7.2 out of 12 for HNC knowledge. In the final multivariate linear regression model, sex, race, and year of study were independently associated with HPV and HPV vaccine knowledge. Males had significantly lower HPV vaccine knowledge than females (β = −1.53; 95% CI: −2.53, −0.52), as did nonwhite students (β = −1.05; 95% CI: −2.07, −0.03). There was a gradient in HPV vaccine knowledge based on the year of study, highest among fourth year students (β = 6.75; 95% CI: 5.17, 8.33). Results were similar for factors associated with HNC knowledge, except for sex. HNC knowledge similarly increased based on year of study, highest for fourth year students (β = 2.50; 95% CI: 1.72, 3.29). Among medical students, gaps remain in knowledge of HPV, HPV vaccine, and HPV-linked HNC. Male medical students have significantly lower knowledge of HPV. This highlights the need to increase medical student knowledge of HPV and HPV-linked HNC.

Objectives This study aimed to report household catastrophic spending on surgery and the experiences of patients and families seeking surgical care in rural Haiti.Design The study used an explanatory, sequential mixed-methods approach. We collected both quantitative and qualitative data from the participants through interviews.Setting A rural tertiary hospital (St. Boniface Hospital) in southern Haiti.Participants There were 200 adult Haitian surgical patients who entered the study. Of these, 41 were excluded due to missing variables or health expenditure outliers. The final sample included 159 participants.Primary and secondary outcome measures The primary outcomes were (1) direct and indirect payments for surgical care; (2) the rate of catastrophic health expenditure (CHE) (as defined by the Sustainable Development Goals (10% of total household expenditure) and WHO (10%, 20%, 30% and 40% of household capacity to pay)) due to surgical care; and (3) common themes across the lived experiences of households of surgical patients seeking care.Results The median household expenditure on surgery-related expenses was US$385.6, slightly more than half of per capita gross domestic product in Haiti (US$729.3). Up to 86% of households experienced CHE, as defined by the Sustainable Development Goals, due to receiving surgical care. Patients commonly paid for surgical costs through loans and donations (69.8%). The qualitative analysis revealed prominent themes related to barriers to care including the burden of initiating care-seeking, care-seeking journeys and social suffering.Conclusions CHE is common for Haitian surgical patients, and the associated care-seeking experiences are often arduous. These findings suggest that low, flat fees in non-profit hospital settings may not be sufficient to mitigate the costs of surgical care or the resulting challenges that patients experience.

Performing homo-FRET measurements in cells using a fluorescence microscope is challenging, especially when using high numerical aperture objective lenses. Here the authors present a method for improved homo-FRET measurements based on anisotropy changes in photoswitchable fluorescent proteins.

Summary: Nucleocapsid (N) protein of the SARS-CoV-2 virus packages the viral genome into well-defined ribonucleoprotein particles, but the molecular pathway is still unclear. N-protein is dimeric and consists of two folded domains with nucleic acid (NA) binding sites, surrounded by intrinsically disordered regions that promote liquid-liquid phase separation. Here, we use biophysical tools to study N-protein interactions with oligonucleotides of different lengths, examining the size, composition, secondary structure, and energetics of the resulting states. We observe the formation of supramolecular clusters or nuclei preceding growth into phase-separated droplets. Short hexanucleotide NA forms compact 2:2 N-protein/NA complexes with reduced disorder. Longer oligonucleotides expose additional N-protein interactions and multi-valent protein-NA interactions, which generate higher-order mixed oligomers and simultaneously promote growth of droplets. Phase separation is accompanied by a significant change in protein secondary structure, different from that caused by initial NA binding, which may contribute to the assembly of ribonucleoprotein particles within macromolecular condensates.

Abstract Most nuclear-encoded mitochondrial proteins traffic from the cytosol to mitochondria. Some of these proteins localize at mitochondria-associated membranes (MAM), where mitochondria are closely apposed with the endoplasmic reticulum (ER). We have previously shown that the human cytomegalovirus signal-anchored protein known as viral mitochondria-localized inhibitor of apoptosis (vMIA) traffics from the ER to mitochondria and clusters at the outer mitochondrial membrane (OMM). Here, we have examined the host pathways by which vMIA traffics from the ER to mitochondria and clusters at the OMM. By disruption of phosphofurin acidic cluster sorting protein 2 (PACS-2), mitofusins (Mfn1/2), and dynamin related protein 1 (Drp1), we find these conventional pathways for ER to the mitochondria trafficking are dispensable for vMIA trafficking to OMM. Instead, mutations in vMIA that change its hydrophobicity alter its trafficking to mitochondria. Superresolution imaging showed that PACS-2- and Mfn-mediated membrane apposition or hydrophobic interactions alter vMIA’s ability to organize in nanoscale clusters at the OMM. This shows that signal-anchored MAM proteins can make use of hydrophobic interactions independently of conventional ER-mitochondria pathways to traffic from the ER to mitochondria. Further, vMIA hydrophobic interactions and ER-mitochondria contacts facilitate proper organization of vMIA on the OMM.

Background: Natural and man-made disasters can overwhelm the capacity of surgical systems in low-income and middle-income countries (LMICs). Most studies addressing peri-disaster surgical care focus on international relief efforts rather than on how disasters stress local surgical capacity. Our understanding of factors that affect the ability of health systems to absorb increased volume and case-complexity is poor. We conducted a structured literature review to identify whether components of capacity were reported as part of surge response in local surgical care after disasters. Methods: We searched PubMed and Medline databases for articles published between January, 2008, and August, 2018, using English language search terms for LMICs, surgery, and disasters. We extracted information about the WHO region, disaster classification, and the components of surge capacity using the 4S framework: Staff (human resources), Stuff (equipment/supplies), Space (infrastructure), and Systems (logistics). The 4S components were further classified by data quality into the following categories: quantitative description, qualitative description, or no description. Findings: We identified 7704 articles but after applying exclusion criteria, including foreign aid response, we selected 84 articles for analysis. Most articles (59/84 [70%]) described earthquakes and 40/84 (48%) reported events in the Western Pacific region. Using the 4S framework, we identified articles that reported quantitative data: 16 (19%) for Staff, 3 (4%) for Stuff, 21 (25%) for Space, and 9 (11%) for Systems. Despite a low threshold for quantitative categorisation, only 1/84 (1%) articles described all four components with quantitative data. By comparison, 51/84 (61%) articles provide no quantitative data on any of the four components. Interpretation: There is no organised framework for evaluation of surgical surge capacity in disasters. Our analysis shows that there are very few descriptions of capacity within disaster literature and a limited understanding of LMIC health system response to surges in surgical volume. Without a structured framework to collect data on health system response, we miss opportunities to identify and strengthen areas of insufficient capacity. We encourage the incorporation of quantitative surgical metrics when reporting outcomes after disaster response, and propose the 4S framework as a conceptual model for reporting such metrics and understanding the surgical system response to disasters. Funding: None.