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Photodetachment spectra of anionic species provide significant insights into the energies and nature of ground and excited states of both the anion and resultant neutral molecules. Direct detachment of the excess electron to the continuum may occur via formally allowed or forbidden transitions (perhaps as the result of intensity borrowing through vibronic coupling). However, alternate indirect pathways are also possible and often overlooked. Here, we report a two-dimensional photoelectron spectral study, combined with correlated electronic structure calculations, to elucidate the nature of photodetachment from NiO2−. The spectra are comprised of allowed and forbidden transitions, in excellent agreement with previously reported slow electron velocity mapped imaging spectra of the same system, which were interpreted in terms of direct detachment. In the current work, the contributions of indirect processes are revealed. Measured oscillations in the branching ratios of the spectral channels clearly indicate non-direct detachment processes, and the electronic structure calculations suggest that excited states of the appropriate symmetry and degeneracy lie slightly above the neutral ground state. Taken together, the results suggest that the origin of the observed forbidden transitions is the result of anion excited states mediating the electron detachment process. [ABSTRACT FROM AUTHOR]

The cell envelope fortifies bacterial cells against antibiotics and other insults. Species in the Mycobacteriales order have a complex envelope that includes an outer layer of mycolic acids called the mycomembrane (MM) and a cell wall composed of peptidoglycan and arabinogalactan. This envelope architecture is unique among bacteria and contributes significantly to the virulence of pathogenic Mycobacteriales like Mycobacterium tuberculosis. Characterization of pathways that govern envelope biogenesis in these organisms is therefore critical in understanding their biology and for identifying new antibiotic targets. To better understand MM biogenesis, we developed a cell sorting-based screen for mutants defective in the surface exposure of a porin normally embedded in the MM of the model organism Corynebacterium glutamicum. The results revealed a requirement for the conserved σD envelope stress response in porin export and identified MarP as the site-1 protease, respectively, that activate the response by cleaving the membrane-embedded anti-sigma factor. A reporter system revealed that the σD pathway responds to defects in mycolic acid and arabinogalactan biosynthesis, suggesting that the stress response has the unusual property of being induced by activating signals that arise from defects in the assembly of two distinct envelope layers. Our results thus provide new insights into how C. glutamicum and related bacteria monitor envelope integrity and suggest a potential role for members of the σD regulon in protein export to the MM. Author summary: Bacteria within the Mycobacteriales order, which includes the pathogen Mycobacterium tuberculosis, have a unique multilayered cell surface architecture. How they sense and respond to defects in the construction of this distinct envelope to maintain homeostasis remains poorly understood. Here, we used the model organism Corynebacterium glutamicum to reveal that the conserved σD envelope stress response pathway responds to two distinct signals resulting from defects in different envelope layers. The results provide new insight into how members of the Mycobacteriales monitor the integrity of their surface and pave the way for the identification of novel vulnerabilities in envelope biogenesis that may be useful for targeting with antibiotics. [ABSTRACT FROM AUTHOR]

Background: The IMPACT survey aimed to elucidate the humanistic, clinical and economic burden of osteogenesis imperfecta (OI) on individuals with OI, their families, caregivers and wider society. Research methodology, demographics and initial insights from the survey have been previously reported. The cost of illness (healthcare resource use, productivity loss, out-of-pocket spending) and drivers of the economic impact of OI are reported here. Methods: IMPACT was an international mixed-methods online survey in eight languages (fielded July–September 2021) targeting adults (aged ≥ 18 years) or adolescents (aged ≥ 12–17 years) with OI, caregivers with or without OI and other close relatives. Survey domains included demographics, socioeconomic factors, clinical characteristics, treatment patterns, quality of life and health economics. The health economic domain for adults, which included questions on healthcare resource use, productivity loss and out-of-pocket spending, was summarised. Regression and pairwise analyses were conducted to identify independent drivers and associations with respondent characteristics. Results: Overall, 1,440 adults with OI responded to the survey. Respondents were mostly female (70%) and from Europe (63%) with a median age of 43 years. Within a 12-month period, adults with OI reported visiting a wide range of healthcare professionals. Two-thirds (66%) of adults visited a hospital, and one-third (33%) visited the emergency department. The mean total number of diagnostic tests undergone by adults within these 12 months was 8.0. Adults had undergone a mean total of 11.8 surgeries up to the time point of the survey. The proportions of adults using queried consumables or services over 12 months ranged from 18–82%, depending on the type of consumable or service. Most adults (58%) were in paid employment, of which nearly one-third (29%) reported missing a workday. Of the queried expenses, the mean total out-of-pocket spending in 4 weeks was €191. Respondent characteristics such as female sex, more severe self-reported OI and the experience of fractures were often associated with increased economic burden. Conclusion: IMPACT provides novel insights into the substantial cost of illness associated with OI on individuals, healthcare systems and society at large. Future analyses will provide insights into country-specific economic impact, humanistic impact and the healthcare journey of individuals with OI. [ABSTRACT FROM AUTHOR]

Introduction: Religion is a salient aspect of patient background in treatment (The psychology of religion and coping: Theory, research, practice; Guilford Press). However, research investigating the role of religion in suicide is lacking and inconsistent (Journal of Religion and Health, 57, 2478–2499). The current study (1) clarifies the association between religious identity and fearlessness about death in a psychiatric sample and (2) tests whether religious identity moderates the association between fearlessness about death and suicidal ideation. Methods: Participants were 155 patients seeking treatment in a partial hospital program. Religious identity was assessed using the Identities in Treatment Scale (The Behavior Therapist). Fearlessness about death was assessed with two relevant items from the acquired capability with rehearsal for suicide scale (Psychological Assessment, 28, 1452–1464), as in prior studies (Suicide & Le‐Threatening Behavior, 50, 1230–1240; Journal of Affective Disorders Reports, 12, 100492). Results: Fearlessness about death interacted with religious identity to predict suicidal ideation, b = 0.47, 95% C.I. [0.02, 0.91], p = 0.042. Conditional effects showed that greater fearlessness about death was associated with greater suicidal ideation among non‐religious patients, b = −0.56, 95% C.I. [−0.88, −0.24], p = 0.001, but not in religious patients, b = −0.09, 95% C.I. [−0.41, 0.22], p = 0.559. Conclusions: Our results suggest that fearlessness about death is a risk factor for suicidal ideation, but only among those who do not identify as religious. Results from this study inform theories of suicide and elucidate the influence of religious identity on links among suicide risk factors and suicide‐related outcomes. [ABSTRACT FROM AUTHOR]

Giardia is a prevalent single-celled microaerophilic intestinal parasite causing diarrheal disease and significantly impacting global health. Double diploid (essentially tetraploid) Giardia trophozoites have presented a formidable challenge to the development of molecular genetic tools to interrogate gene function. High sequence divergence and the high percentage of hypothetical proteins lacking homology to proteins in other eukaryotes have limited our understanding of Giardia protein function, slowing drug target validation and development. For more than 25 years, Giardia A and B assemblages have been readily amenable to transfection with plasmids or linear DNA templates. Here, we highlight the utility and power of genetic approaches developed to assess protein function in Giardia , with particular emphasis on the more recent clustered regularly interspaced palindromic repeats/Cas9-based methods for knockdowns and knockouts. Robust and reliable molecular genetic approaches are fundamental toward the interrogation of Giardia protein function and evaluation of druggable targets. New genetic approaches tailored for the double diploid Giardia are imperative for understanding Giardia 's unique biology and pathogenesis. [ABSTRACT FROM AUTHOR]

Background and aims: Cerebral microbleeds are magnetic imaging resonance (MRI) markers of hemorrhage-prone cerebral small vessel disease that predict future risk of ischemic stroke and intracranial hemorrhage (ICrH). There exist concerns about the net benefit of antithrombotic therapy in patients with microbleeds. We aimed to investigate the effects of an oral factor-XIa inhibitor (asundexian), that is hypothesized to inhibit thrombosis without compromising hemostasis, on the development of new microbleeds over time and interactions between microbleeds and asundexian treatment on clinical outcomes. We additionally assessed associations between baseline microbleeds and the risks of clinical and neuroimaging outcomes in patients with non-cardioembolic ischemic stroke. Methods: This is a secondary analysis of the PACIFIC-STROKE, international, multi-center Phase 2b double-blind, randomized clinical trial. PACIFIC-STROKE enrolled patients aged ⩾ 45 years with mild-to-moderate non-cardioembolic ischemic stroke who presented within 48 h of symptom onset for whom antiplatelet therapy was intended. Microbleeds were centrally adjudicated, and participants with an interpretable T2*-weighted sequence at their baseline MRI were included in this analysis. Patients were randomized to asundexian (10/20/50 mg daily) versus placebo plus standard antiplatelet treatment. Regression models were used to estimate the effects of (1) all pooled asundexian doses and (2) asundexian 50 mg daily on new microbleed formation on 26-week MRIs. Cox proportional hazards or regression models were additionally used to estimate interactions between treatment assignment and microbleeds for ischemic stroke/transient ischemic attack (TIA) (primary outcome), and ICrH, all-cause mortality, hemorrhagic transformation (HT), and new microbleeds (secondary outcomes). Results: Of 1746 participants (mean age, 67.0 ± 10.0; 34% female) with baseline MRIs, 604 (35%) had microbleeds. During a median follow-up of 10.6 months, 7.0% (n = 122) had ischemic stroke/TIA, 0.5% (n = 8) ICrH, and 2.1% (n = 37) died. New microbleeds developed in 10.3% (n = 155) of participants with adequate follow-up MRIs and HT in 31.4% (n = 345). In the total sample of patients with adequate baseline and 26-week follow-up MRIs (n = 1507), new microbleeds occurred in 10.2% of patients assigned to any asundexian dose and 10.5% of patients assigned to placebo (OR, 0.96; 95% CI, 0.66–1.41). There were no interactions between microbleeds and treatment assignment for any of the outcomes (p for interaction > 0.05). The rates of new microbleeds, HT, and ICrH were numerically less in patients with microbleeds assigned to asundexian relative to placebo. The presence of microbleeds was associated with a higher risk of HT (aOR, 1.6; 95% CI, 1.2–2.1) and new microbleeds (aOR, 4.4; 95% CI, 3.0–6.3). Conclusion: Factor XIa inhibition with asundexian appears safe in patients with non-cardioembolic ischemic stroke and hemorrhage-prone cerebral small vessel disease marked by microbleeds on MRI. These preliminary findings will be confirmed in the ongoing OCEANIC-STROKE randomized trial. Trial Registration: ClinicalTrials.gov Identifier: NCT04304508. [ABSTRACT FROM AUTHOR]

Objective: Sadistic pleasure presumably incorporates processes that support an authentic enjoyment of others' pain. However, antagonism confirmation theory, grounded in social‐psychological theorizing on identity maintenance and the notion of ego‐syntonicity, suggests that individuals higher in sadism report greater pleasure in response to others' pain because such reports are immoral responses that confirm their self‐views. This alternative conception has yet to be tested. Method: In two preregistered experiments (total N = 968), participants completed measures of sadism, read about situations involving others' pain, and rated their pleasure. We manipulated the extent to which pleasure from others' pain could be used to signal morality or antagonism. Results: We found that relatively sadistic people indicated greater pleasure across the studies but, like relatively non‐sadistic people, they altered their pleasure ratings to signal greater morality or less antagonism. Conclusions: The findings fail to support antagonism confirmation theory, but they support recent perspectives on sadism that suggest that sadistic people may occasionally care about seeming moral (or not seeming antagonistic) and that sadism may be somewhat ego‐dystonic in this respect. [ABSTRACT FROM AUTHOR]

In response to cancer, patients may be thrown into precarious processes of remaking their purpose, identity, and connections to the world around them. Thoughtful and thorough responses to these issues can be supported by person-centered phenomenological approaches to caring for patients. The importance of perspectives on illness offered by theoretical phenomenology will become apparent through the example of the experience of nausea, or perhaps more accurately put—chemo sickness. The focus here is on how chemo sickness alters one's way of relating to the world. I will examine the phenomenon of nausea through the lens of the phenomenological concept of mood—an existential feeling that engenders a diffused tone permeating through one's world and shapes the envisioned possibilities on one's horizon. [ABSTRACT FROM AUTHOR]

The article focuses on the discovery and significance of ancient terracotta sculptures from Sierra Leone, examining their stylistic connections with nomoli stone sculptures and their cultural and historical implications for the region. It discusses the acquisition of a notable terracotta figure by the Sierra Leone National Museum in 2013, highlighting its distinctive features and contextualizing it within the broader landscape of West African art history. It also touches upon the interpretation of the figure's iconography, particularly its depiction of a man grasping snakes.

Aims Methods Results Conclusions The DAFNEplus programme seeks to promote sustained improvements in glycaemic management by incorporating techniques from behavioural science. It includes five sessions of structured individual support delivered over 12 months following group education. As part of a broader evaluation, and to inform decision‐making about roll‐out in routine care, we explored participants' experiences of, and engagement with, that individual support.We interviewed DAFNEplus participants (n = 28) about their experiences of receiving individual support and the impact they perceived it as having on their self management practices. We analysed data thematically.Participants described several important ways individual support had helped strengthen their self management, including: consolidating and expanding their understandings of flexible intensive insulin therapy; promoting ongoing review and refinement of behaviour; encouraging continued and effective use of data; and facilitating access to help from healthcare professionals to pre‐empt or resolve emergent difficulties. Participants characterised themselves as moving towards independence in self management over the time they received individual support, with their accounts suggesting three key stages in that journey: ‘Working with healthcare professionals’; ‘Growing sense of responsibility’; and, ‘Taking control’. Whilst all portrayed themselves as changed, participants' progress through those stages varied; a few continued to depend heavily on DAFNEplus facilitators for advice and/or direction at 12 months.While all participants benefited from individual support, our findings suggest that some may need, or gain further benefit from, longer‐term, tailored support. This has important implications for decision‐making about roll‐out of DAFNEplus post‐trial and for the development of future programmes seeking to bring about sustainable changes in self management practices. [ABSTRACT FROM AUTHOR]

Interrupted blood flow in the brain due to ischemic injuries such as ischemic stroke or traumatic brain injury results in irreversible brain damage, leading to cognitive impairment associated with inflammation, disruption of the blood–brain barrier (BBB), and cell death. Since the BBB only allows entry to a small class of drugs, many drugs used to treat ischemia in other tissues have failed in brain-related disorders. The administration of mesenchymal stem cell (MSC)-derived extracellular vesicles (EVs) has shown promise in improving the functional recovery of the brain following cerebral ischemia by inducing blood vessel formation. To facilitate such a treatment approach, it is necessary to develop bioprocesses that can produce therapeutically relevant MSC-EVs in a reproducible and scalable manner. This study evaluated the feasibility of using stirred suspension bioreactors (SSBs) to scale-up the serum-free production of pro-angiogenic MSC-EVs under clinically relevant physioxic conditions. It was found that MSCs grown in SSBs generated EVs that stimulated angiogenesis in cerebral microvascular endothelial cells, supporting the use of SSBs to produce MSC-EVs for application in cerebral ischemia. These properties were impaired at higher cell confluency, outlining the importance of considering the time of harvest when developing bioprocesses to manufacture EV populations. [ABSTRACT FROM AUTHOR]

• Dopamine release in dorsomedial striatum tracks learning, movement and motivation. • Bilateral dopamine release at the time of reward reflects the current action value. • Bilateral dopamine release at the time of reward reflects the prediction error. • Dopamine release becomes increasingly lateralized during goal-directed learning. • Dopamine laterization reflects the strength of the action-outcome association. Evidence suggests that dopamine activity provides a US-related prediction error for Pavlovian conditioning and the reinforcement signal supporting the acquisition of habits. However, its role in goal-directed action is less clear. There are currently few studies that have assessed dopamine release as animals acquire and perform self-paced instrumental actions. Here we briefly review the literature documenting the psychological, behavioral and neural bases of goal-directed actions in rats and mice, before turning to describe recent studies investigating the role of dopamine in instrumental learning and performance. Plasticity in dorsomedial striatum, a central node in the network supporting goal-directed action, clearly requires dopamine release, the timing of which, relative to cortical and thalamic inputs, determines the degree and form of that plasticity. Beyond this, bilateral release appears to reflect reward prediction errors as animals experience the consequences of an action. Such signals feedforward to update the value of the specific action associated with that outcome during subsequent performance, with dopamine release at the time of action reflecting the updated predicted action value. More recently, evidence has also emerged for a hemispherically lateralised signal associated with the action; dopamine release is greater in the hemisphere contralateral to the spatial target of the action. This effect emerges over the course of acquisition and appears to reflect the strength of the action-outcome association. Thus, during goal-directed action, dopamine release signals the action, the outcome and their association to shape the learning and performance processes necessary to support this form of behavioral control. [ABSTRACT FROM AUTHOR]

While the COVID-19 pandemic necessitated the short-term use of online courses, colleges’ experiences with COVID-era online course delivery may also affect the way that they offer and approach online courses going forward. We draw on interviews with 35 distance education leaders from the California Community Colleges system to provide insights into how the use of online education may change in the system going forward. Leaders predicted that post-pandemic, colleges would increase their online course offerings, and that many instructional innovations to online courses from the pandemic—such as the use of synchronous courses—would persist. We discuss implications for practitioners, policymakers, and researchers. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions In psychotherapy, clients and therapists work together to forge a path towards better mental health. Key to this process is genuine and honest communication. However, much previous research suggests that clients are not always fully truthful with their therapists. In this study, we make a preliminary examination of the relationship between client deception in therapy, the quality of the therapeutic relationship and therapeutic outcomes.Participants who had been involved in psychotherapy completed a variety of measures that assessed their use of dishonesty in therapy. They also completed measures of the quality of the client–therapist relationship and measures of their perceived therapeutic outcomes. We hypothesised that client dishonesty would negatively correlate with the perceived quality of the therapeutic relationship and the therapeutic outcomes. Furthermore, we predicted that the quality of the therapeutic relationship would mediate the relationship between client dishonesty and perceived therapeutic outcomes.The results of correlation and mediation analyses supported these hypotheses. Client dishonesty was associated with poorer therapeutic relationships and worse perceived therapeutic outcomes. Additionally, therapeutic relationship quality partially mediated the relationship between client dishonesty and therapeutic outcomes.This initial study provides important tentative insights into the possible negative correlates of client dishonesty in the therapeutic environment. [ABSTRACT FROM AUTHOR]

Abiotic resource limitation presents organisms with a dilemma about how to use resources when they become available. Characterizing how resource allocation affects investment in growth or defensive traits that affect organismal survival strategies allows us to understand the environmental contexts in which species interact. Our goal was to measure how macronutrient availability drives nitrogen and phosphorus allocation towards functional growth and defensive chemical traits of the Neotropical passion vine, Passiflora biflora.We investigated this question with a paired field study in La Selva, Costa Rica and a full factorial greenhouse experiment to determine whether the concentration of a key secondary chemical defence is driven by nitrogen availability. We correlated defensive chemical concentration with soil nitrogen availability in naturally occurring plants, measured the effects of nitrogen and phosphorus availability on growth and secondary chemical defence traits in the greenhouse and characterized the P. biflora leaf metabolome to assess how nutrient availability affected shifts in metabolism related to plant fitness.We found that nutrient allocation increased the magnitude of both growth and defence traits. Increased nitrogen availability resulted in higher concentrations of toxic leaf secondary chemicals, longer vines, greater biomass and more leaves with a superior ability to capture sunlight. In addition, plants from high nitrogen environments had metabolomes with significantly greater secondary metabolite richness and biochemical pathway diversity, as well as increases in the number of metabolites from several chemical classes related to basic cell function and defence. Nutrient availability had no significant effect on the richness and diversity of primary metabolites involved in basic cell functions. A direct comparison of the relative strength of quantitative growth and secondary defence traits indicated that P. biflora favours nutrient allocation to growth at low nitrogen levels but invests in both strategies more evenly as nitrogen availability increases.These findings lead us to predict that passion vines are better prepared to tolerate and resist herbivory when nutrients are plentiful and experience a trade‐off between growth and chemical defence against natural enemies when they are scarce. These findings are consistent with both the 'escape' and 'defend' syndromes that are often used to describe tropical plant survival strategies. This is one of the only studies to measure nutrient allocation in vines, a group comprising a significant percentage of global plant diversity. Moreover, this work demonstrated the power of leveraging untargeted metabolomics to characterize how nutrient addition affects plant growth and defence, highlighting its potential for understanding functional trait variation. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Purpose: People with advanced or metastatic cancer and their caregivers may have different care goals and face unique challenges compared to those with early-stage disease or those nearing the end-of-life. These MASCC-ASCO standards and practice recommendations seek to establish consistent provision of quality survivorship care for people affected by advanced or metastatic cancer. Methods: An expert panel comprising MASCC and ASCO members was formed. Standards and recommendations relevant to the provision of quality survivorship care for people affected by advanced or metastatic cancer were developed through conducting: (1) a systematic review of unmet supportive care needs; (2) a scoping review of cancer survivorship, supportive care, and palliative care frameworks and guidelines; and (3) an international modified Delphi consensus process. Results: A systematic review involving 81 studies and a scoping review of 17 guidelines and frameworks informed the initial standards and recommendations. Subsequently, 77 experts (including 8 people with lived experience) across 33 countries (33% were low-to-middle resource countries) participated in the Delphi study and achieved ≥ 94.8% agreement for seven standards (1. Person-Centred Care; 2. Coordinated and Integrated Care; 3. Evidence-Based and Comprehensive Care; 4. Evaluated and Communicated Care; 5. Accessible and Equitable Care; 6. Sustainable and Resourced Care; 7. Research and Data-Driven Care) and ≥ 84.2% agreement across 45 practice recommendations. Conclusion: Standards of survivorship care for people affected by advanced or metastatic cancer are provided. These MASCC-ASCO standards will support optimization of health outcomes and care experiences by providing guidance to stakeholders in cancer care (healthcare professionals, leaders, and administrators; governments and health ministries; policymakers; advocacy agencies; cancer survivors and caregivers. Practice recommendations may be used to facilitate future research, practice, policy, and advocacy efforts. [ABSTRACT FROM AUTHOR]

Foundation species are being restored into inherently variable landscapes with multiple, interspersed habitats. However, understanding of the influence of different neighbouring habitats on community assembly and the survival of restored species is limited, despite their significant potential to affect restoration outcomes. We tested how habitat‐setting (being next to seagrass, seagrass and mangroves, or unvegetated sediments) and predation (by meso‐ and/or large predators) influenced macroinvertebrate community assembly and the survival of juvenile Sydney rock oysters (Saccostrea glomerata) on experimental oyster reef units in the Port Hacking estuary, New South Wales, Australia. Each habitat‐setting produced a distinct macroinvertebrate community on experimental reefs, whereas predation had limited effects on community structure. Juvenile oysters were instead highly predated everywhere, and oyster predation was dominated by the large, transient fish Acanthropagrus australis. Our findings allow practitioners to predict and tailor the communities which establish on restored oyster reefs by strategically placing them next to different habitats. If sites have a high predation risk but require seeding for reefs to establish, then caging or complex substrates must be used to increase seeded oyster survival. [ABSTRACT FROM AUTHOR]

Wastewater surveillance has been a tool for public health officials throughout the COVID-19 pandemic. Universities established pandemic response committees to facilitate safe learning for students, faculty, and staff. These committees met to analyze both wastewater and clinical data to propose mitigation strategies to limit the spread of COVID-19. This paper reviews the initial efforts of utilizing campus data inclusive of wastewater surveillance for SARS-CoV-2 RNA concentrations, clinical case data from university response teams, and mitigation strategies from Grand Valley State University in West Michigan (population 21,648 students) and Oakland University in East Michigan (population 18,552 students) from November 2020 to April 2022. Wastewater positivity rates for both universities ranged from 32.8 to 46.8%. Peak viral signals for both universities directly corresponded to variant points of entry within the campus populations from 2021 to 2022. It was found that the organization of clinical case data and variability of wastewater testing data were large barriers for both universities to effectively understand disease dynamics within the university population. We review the initial efforts of onboarding wastewater surveillance and provide direction for structuring ongoing surveillance workflows and future epidemic response strategies based on those that led to reduced viral signals in campus wastewater. [ABSTRACT FROM AUTHOR]

Tremendous plant metabolic diversity arises from phylogenetically restricted specialized metabolic pathways. Specialized metabolites are synthesized in dedicated cells or tissues, with pathway genes sometimes colocalizing in biosynthetic gene clusters (BGCs). However, the mechanisms by which spatial expression patterns arise and the role of BGCs in pathway evolution remain underappreciated. In this study, we investigated the mechanisms driving acylsugar evolution in the Solanaceae. Previously thought to be restricted to glandular trichomes, acylsugars were recently found in cultivated tomato roots. We demonstrated that acylsugars in cultivated tomato roots and trichomes have different sugar cores, identified root-enriched paralogs of trichome acylsugar pathway genes, and characterized a key paralog required for root acylsugar biosynthesis, SlASAT1-LIKE (SlASAT1-L), which is nested within a previously reported trichome acylsugar BGC. Last, we provided evidence that ASAT1-L arose through duplication of its paralog, ASAT1, and was trichome-expressed before acquiring root-specific expression in the Solanum genus. Our results illuminate the genomic context and molecular mechanisms underpinning metabolic diversity in plants. [ABSTRACT FROM AUTHOR]

People correct for movement errors when acquiring new motor skills (de novo learning) or adapting well-known movements (motor adaptation). While de novo learning establishes new control policies, adaptation modifies existing ones, and previous work have distinguished behavioral and underlying brain mechanisms for each motor learning type. However, it is still unclear whether learning in each type interferes with the other. In study 1, we use a within-subjects design where participants train with both 30° visuomotor rotation and mirror reversal perturbations, to compare adaptation and de novo learning respectively. We find no perturbation order effects, and find no evidence for differences in learning rates and asymptotes for both perturbations. Explicit instructions also provide an advantage during early learning in both perturbations. However, mirror reversal learning shows larger inter-participant variability and slower movement initiation. Furthermore, we only observe reach aftereffects following rotation training. In study 2, we incorporate the mirror reversal in a browser-based task, to investigate under-studied de novo learning mechanisms like retention and generalization. Learning persists across three or more days, substantially transfers to the untrained hand, and to targets on both sides of the mirror axis. Our results extend insights for distinguishing motor skill acquisition from adapting well-known movements. [ABSTRACT FROM AUTHOR]

• 60% of the SCFA receptor mRNA in the hippocampus colocalize with activated microglia. • 80% of SCFA receptor mRNA in the dorsal raphe colocalize with serotonergic neurons. • In the dorsal raphe, SCFA receptor expression is driven by dietary fiber solubility. • In the hippocampus, SCFA receptor expression is driven by dietary fiber amount. • High dietary fiber decreases tyrosine hydroxylase gene expression. Short-chain fatty acids (SCFAs) are bioactive lipids that are released into the colon as a metabolite of bacterial fermentation of dietary fibers. Beyond their function in the gastrointestinal tract, SCFAs can also have effects in the brain, as a part of the gut-brain axis. Recent investigations into potential therapeutic interventions via the manipulation of the gut microbiome—and thus their SCFA metabolites—has been emerging as a new branch of personalized medicine, especially for mental health conditions. The current study sought to measure and localize SCFA receptors in the mouse brain. Two cell types have been implicated in the gut-brain axis: microglia and serotonergic neurons. We used fluorescent in situ hybridization in brain sections from mice fed diets with different compositions of fat and fiber to quantify the mRNA levels of known gene markers of these two cell types and colocalize each with mRNA for free fatty acid receptors that bind SCFAs. We focused on microglia in the hippocampus and the serotonergic neurons of the dorsal raphe. We found high colocalization of SCFA receptors in both microglia and serotonergic neurons and discovered that SCFA receptor expression in the dorsal raphe is driven by fiber solubility, while SCFA receptor expression in the hippocampus is driven by fiber amount. Higher dietary fiber was associated with decreased tyrosine hydroxylase expression. Thus, our results indicate that the amount and solubility of dietary fiber can change gene expression in the brain's microglia and serotonin neurons, potentially via sensitivity to circulating levels of SCFAs produced in the gut. [ABSTRACT FROM AUTHOR]

There has recently been a growing interest in social justice language education, with the goal of challenging entrenched social, cultural and economic hierarchies within educational institutions and the society at large. Contributing to this line of research, the present study focused on an online conversation club that aimed to develop EFL learners’ communicative skills and critical literacy through the discussion of social justice issues which have traditionally been deemed ‘taboo’ and ‘controversial’. Data were collected online via demographic information survey, the recordings of the conversation club sessions, facilitator’s field notes and reflective journals, and student interviews. The results revealed several discursive moves adopted by EFL learners, which mostly revolved around that's our responsibility vs others in relation to environmental issues; and that’s the government’s-job when it comes to themes related to immigration. The findings illustrated the potential of social justice-oriented conversation clubs to foster diverse perspectives and authentic conversation in language classrooms, and to cultivate EFL learners’ critical literacy. The study provides insights into how language educators can integrate social justice issues into the language curriculum in ways that help language learners question their already-existing beliefs and take action for a socially just world. [ABSTRACT FROM AUTHOR]

Aims: To share lessons learned from an evidence-based practice (EBP) initiative that implemented near-infrared (NIR) technology in a large US hospital system. A Clinical Technology Implementation Model (CTIM©) that can be adapted for use in other health institutions is presented. Background: EBP implementation, including the adoption of new cutting-edge technologies, is crucial to improving patient care. Yet there are significant delays in changes to clinical practice, often due to organisational challenges that stifle the implementation process. The evidence−practice gap is increasingly evident in peripheral intravenous access (PIV). Implementation science offers new insights into the challenges of updating clinical practice, which can support EBP implementation. Evaluation: Recent literature on implementation science, change theory, PIV access, NIR technology, and patient outcomes were reviewed. A model that can help nurse managers implement technology that aligns with EBP is presented, drawing on experience from the adoption of NIR vein visualisation to enhance PIV access in a large US hospital system. Key issue: A pervasive hesitancy in healthcare to embrace technology, coupled with the challenges of implementing a change to practice, has led to limited application of EBP PIV access guidelines and a stagnant standard of care. Conclusion: This article provides nurse managers with the tools necessary to successfully implement EBP, drawing on the experience from implementing NIR in a large US hospital. Nurse managers are uniquely positioned to lead the way in embracing technology to improve care and reduce the evidence−practice gap. [ABSTRACT FROM AUTHOR]

To create favorable impressions and receive credit, individuals need to share information about their past accomplishments. Broadcasting one's past accomplishments or claiming credit to demonstrate competence, however, can harm perceptions of warmth and likability. In fact, prior work has conceptualized self-promotion as a hydraulic challenge: tactics that boost perceptions along one dimension (e.g., competence) harm perceptions along other dimensions (e.g., warmth). In this work, we identify a novel approach to self-promotion: We show that by combining self-promotion with other-promotion (complimenting or giving credit to others), which we term "dual-promotion," individuals can project both warmth and competence to make better impressions on observers than they do by only self-promoting. In seven preregistered studies, including analyses of annual reports from members of Congress and experiments using social network, workplace, and political contexts (total N = 1,448), we show that individuals who engage in dual-promotion create more favorable impressions of warmth and competence than those who only engage in self-promotion. The beneficial effects of dual-promotion are robust to both competitive and noncompetitive contexts and extend to behavioral intentions. [ABSTRACT FROM AUTHOR]

A range of physical and emotional health benefits to people are reported to be associated with owning and walking a dog. However, the experiences of dog ownership are not always equivalent, and owners of reactive dogs may face additional challenges that could affect their experience of pet ownership. The aims of this qualitative study were to understand the lived experience of self-identified owners of reactive dogs, to identify key issues and themes that affect their daily lives, and to establish important future research questions. Thirty-seven UK residents completed an online survey containing 14 open-ended questions. Free-text responses were analyzed using reflexive thematic analysis. Five main themes were constructed: lack of understanding, situational control, learning and progress, guardianship, and emotions felt. The biggest challenge that all respondents reported was that other people did not understand their needs, which caused them to act, or their dogs to act, inappropriately. Other people's off-lead dogs were highlighted as being especially problematic, which sometimes brought owners into conflict with members of the public. On walks, many owners attempted to control the situation by avoiding places frequented by others or walking at antisocial times. The emotions most commonly expressed regarding walking a reactive dog were stress and anxiety. These results suggest that self-identified owners of reactive dogs experience a number of challenges, particularly related to walking their dog, which negatively impact their experience of dog ownership. Suggestions about how the needs of reactive-dog owners and their dogs can be better catered for in society are highlighted, as well as strategies to improve awareness about reactive dogs and how other people can help them and their owners. [ABSTRACT FROM AUTHOR]

Purpose: To identify and characterise appropriate comparison groups for population studies of health outcomes in ART-conceived births: ovulation induction (OI), subfertile untreated and fertile natural conceptions. Our secondary objective was to examine whether known risks of pregnancy complications and adverse birth outcomes in ART births are elevated in comparison with subfertile (untreated and OI) conception groups. Methods: We linked State and Commonwealth datasets to identify all live and stillbirths (≥ 20 weeks) in Western Australia from 2003 to 2014 by method of conception. Demographic characteristics, maternal pre-existing conditions, adverse obstetric history and pregnancy complications were compared across conception groups. Generalised estimating equations were used to estimate adjusted risk ratios (aRRs) and 95% confidence intervals (CI) for pregnancy complications and birth outcomes in singletons. Results: We identified 9456 ART, 3870 OI, 11,484 subfertile untreated and 303,921 fertile naturally conceived deliveries. OI and subfertile untreated groups more closely resembled the ART group than the fertile group; however, some differences remained across parity, maternal age, pre-existing conditions and obstetric history. In multivariate analyses, ART singletons had greater risks of placental problems (e.g. placenta praevia aRR 2.42 (95% CI 1.82–3.20)) and adverse birth outcomes (e.g. preterm birth aRR 1.38 (95% CI 1.25–1.52)) than the subfertile untreated group, while OI singletons were more similar to the subfertile group with higher risk of preeclampsia and gestational diabetes. Conclusion: OI and subfertile untreated conception groups offer improved options for interpreting health outcomes in ART births. Pregnancy complications (particularly placental disorders) and adverse outcomes at delivery are more common following ART. [ABSTRACT FROM AUTHOR]

Skin is a major site of cortisol bioconversion by 11β‐hydroxysteroid dehydrogenase type 1 (11β‐HSD1) enzymes which catalyze intracellular inactive cortisone into physiologically active cortisol. 11β‐HSD1 is highly expressed in skin, especially in dermal fibroblasts, epidermal keratinocytes, melanocytes, and hair follicles, and plays important roles in regulating keratinocytes, fibroblast proliferation, and has roles in skin aging. Inhibition of 11β‐HSD1 may reverse decreased collagen levels observed in extrinsically and intrinsically aged skin. Inhibitors of 11β‐HSD1 may also have the potential to reverse decreased collagen observed in skin atrophy induced by glucocorticoid treatment. This systematic review aimed to summarize the current knowledge of roles for 11β‐HSD1 inhibitor in skin physiology and potential for future use in medications. Studies have demonstrated that immediately following experimental insult in an animal model, there is increased expression of 11β‐HSD1, and that topical application of an 11β‐HSD1 inhibitor increases the rate of healing, increases skin collagen content, increases dermal fibroblasts, and increases dermal thickness. Furthermore, in patients with type 2 diabetes mellitus, 11β‐HSD1 inhibitors reduce wound diameter after injury. Further development of 11β‐HSD1 inhibitors appears to be a promising area for treating aging skin, aiding wound healing, and mitigating effects of systemic glucocorticoid use. Both topically and orally administered 11β‐HSD1 inhibitors appear to be viable avenues for future research. [ABSTRACT FROM AUTHOR]

The article informs about Thomas Pfau's exploration of "incomprehensible certainty" as articulated by G.M. Hopkins, focusing on the phenomenology of the image and its mediation through metaphysics and hermeneutics. Topic include Pfau's work delves into the notion of "saturated phenomena" and Husserlian phenomenology, examining the interplay between formal and material ontologies while emphasizing the importance of ordinary language in understanding truth and meaning.

Hip and knee replacement have been marked by racial and ethnic disparities in both utilization and postoperative adverse events among Medicare beneficiaries, but limited knowledge exists regarding racial and ethnic differences in joint replacement care among Medicaid beneficiaries. To close this gap, this study used Medicaid claims in 2018 and described racial and ethnic differences in the utilization and postoperative adverse events of elective joint replacements among Medicaid beneficiaries. Among the 2,260,272 Medicaid beneficiaries, 5987 had an elective joint replacement in 2018. Asian (0.05%, 95% confidence interval [CI]: 0.03%–0.07%) and Hispanic beneficiaries (0.12%, 95% CI: 0.07%–0.18%) received joint replacements less frequently than American Indian and Alaska Native (0.41%, 95% CI: 0.27%–0.55%), Black (0.33%, 95% CI: 0.19%–0.48%), and White (0.37%, 95% CI: 0.25%–0.50%) beneficiaries. Black patients demonstrated the highest probability of 90-day emergency department visits (34.8%, 95% CI: 32.7%–37.0%) among all racial and ethnic groups and a higher probability of 90-day readmission (8.0%, 95% CI: 6.9%–9.0%) than Asian (3.4%, 95% CI: 0.7%–6.0%) and Hispanic patients (4.4%, 95% CI: 3.4%–5.3%). These findings indicate evident disparities in postoperative adverse events across racial and ethnic groups, with Black patients demonstrating the highest probability of 90-day emergency department visits. This study represents an initial exploration of the racial and ethnic differences in joint replacement care among Medicaid beneficiaries and lay the groundwork for further investigation into contributing factors of the observed disparities. [ABSTRACT FROM AUTHOR]

In order to model the propagation of light through a sand cloud, it is critical to have accurate data for the optical constants of the sand particles that comprise it. The same holds true for modeling propagation through particles of any type suspended in a medium. Few methods exist, however, to measure these quantities with high accuracy. In this paper, a characterization method based on spectroscopic ellipsometry (SE) that can be applied to a particulate material is presented. In this method, a polished disc of an adhesive compound is prepared, and its optical constants are measured. Next, a mixture of the adhesive and a sand sample is prepared and processed into a polished disc, and SE is performed. By treating the mixture as a Bruggeman effective medium, the optical constants of the particulate material are extracted. For verification of the proposed method, it is first applied to pure silica powder, demonstrating good agreement between measured optical constants and literature values. It is then applied to Arizona road dust, a standard reference material, as well as real desert sand samples. The resulting optical constant data is input into a rigorous scattering model to predict extinction coefficients for various types of sand. Modeling results are compared to spectroscopic measurements on static sand samples, demonstrating good agreement between predicted and measured spectral properties including the presence of a Christiansen feature near a wavelength of 8 µm. [ABSTRACT FROM AUTHOR]

Purpose: Developmental stuttering is a complex and multifaceted neurodevelopmental disorder that may cause pervasive negative consequences for adults who stutter (AWS). Historically, intervention for AWS has primarily addressed speech fluency, with less focus on the covert psychosocial aspects of the disorder. The purpose of this article is to report on a feasibility trial evaluating a novel integrated intervention that combines traditional stuttering management techniques with Acceptance and Commitment Therapy (ACT) for AWS. Method: Twenty-nine AWS participated in the feasibility trial. All participants successfully completed a combined fluency and ACT intervention, titled the fluency and Acceptance and Commitment Therapy for Stuttering (fACTS) Program. As this was a feasibility study, no control group was included. Intervention was administered by two certified practicing speech-language pathologists, over eight 60- to 90-min sessions. Results: Generalized linear mixed modeling was used to determine change from pre- to post-intervention and follow-up. Significant pre- and post-intervention improvements in self-efficacy, psychosocial functioning, and psychological flexibility were observed, along with significant reductions in observable stuttering behaviors (i.e., stuttered speech frequency). Intervention gains for all variables of interest were maintained 3 and 6 months post-intervention. Conclusions: The fACTS Program was created to be a holistic and flexible intervention to promote self-efficacy beliefs and address stuttering-related psychosocial impacts and speech fluency goals of AWS. Preliminary results indicated positive improvement in all psychosocial outcomes (i.e., self-efficacy, psychosocial impact, and psychological flexibility) and observable speech fluency following completion of the program. Future clinical trials of the fACTS Program with an included control group will further investigate the mechanisms of change for the positive effects observed. [ABSTRACT FROM AUTHOR]

For much of human evolution, the average lifespan was <40 years, due in part to disease, infant mortality, predators, food insecurity, and, for females, complications of childbirth. Thus, for much of evolution, many females did not reach the age of menopause (45–50 years of age) and it is mainly in the past several hundred years that the lifespan has been extended to >75 years, primarily due to public health advances, medical interventions, antibiotics, and nutrition. Therefore, the underlying biological mechanisms responsible for disease risk following menopause must have evolved during the complex processes leading to Homo sapiens to serve functions in the pre-menopausal state. Furthermore, as a primary function for the survival of the species is effective reproduction, it is likely that most of the advantages of having such post-menopausal risks relate to reproduction and the ability to address environmental stresses. This opinion/perspective will be discussed in the context of how such post-menopausal risks could enhance reproduction, with improved survival of offspring, and perhaps why such risks are preserved. Not all post-menopausal females exhibit risk for this set of diseases, and those who do develop such diseases do not have all of the conditions. The diseases of the post-menopausal state do not operate as a unified complex, but as independent variables, with the potential for some overlap. The how and why there would be such heterogeneity if the risk factors serve essential functions during the reproductive years is also discussed and the concept of sets of reversible epigenetic changes associated with puberty, pregnancy, and lactation is offered to explain the observations regarding the distribution of post-menopausal conditions and their potential roles in reproduction. While the involvement of an epigenetic system with a dynamic "modification-demodification-remodification" paradigm contributing to disease risk is a hypothesis at this point, validation of it could lead to a better understanding of post-menopausal disease risk in the context of reproduction with commonalities may also lead to future improved interventions to control such risk after menopause. [ABSTRACT FROM AUTHOR]

Purpose: Cardiorespiratory fitness (CRF) is critical for cardiovascular health. Normal-weight obesity (NWO) and metabolically healthy obesity (MHO) may be at increased risk for cardiovascular disease, but a comparison of CRF and submaximal exercise dynamics against rigorously defined low- and high-risk groups is lacking. Methods: Four groups (N = 40; 10/group) based on body mass index (BMI), body fat %, and metabolic syndrome (MetS) risk factors were recruited: healthy controls (CON; BMI 18.5–24.9 kg/m2, body fat < 25% [M] or < 35% [F], 0–1 risk factors), NWO (BMI 18.5–24.9 kg/m2, body fat ≥ 25% [M] or ≥ 35% [F]), MHO (BMI > 30 kg/m2, body fat ≥ 25% [M] or ≥ 35% [F], 0–1 risk factors), or metabolically unhealthy obesity (MUO; BMI > 30 kg/m2, body fat ≥ 25% [M] or ≥ 35% [F], 2 + risk factors). All participants completed a V ˙ O2peak test on a cycle ergometer. Results: V ˙ O2peak was similarly low in NWO (27.0 ± 4.8 mL/kg/min), MHO (25.4 ± 6.7 mL/kg/min) and MUO (24.6 ± 10.0 mL/kg/min) relative to CON (44.2 ± 11.0 mL/kg/min) when normalized to total body mass (p's < 0.01), and adjusting for fat mass or lean mass did not alter these results. This same differential V ˙ O2 pattern was apparent beginning at 25% of the exercise test (PGroup*Time < 0.01). Conclusions: NWO and MHO had similar peak and submaximal CRF to MUO, despite some favorable health traits. Our work adds clarity to the notion that excess adiposity hinders CRF across BMI categories. Clinicaltrials.gov registration: NCT05008952. [ABSTRACT FROM AUTHOR]

In their recent paper, Williams et al. (2022) evaluated salinity management in the Murray-Darling Basin (MDB) as 'unsustainable', and a risk to water availability and quality in the Basin. However, this evaluation was weakened first by a failure to analyse the Basin salinity strategies of the last thirty-five years, noting that these have led to Basin salinity target being met since 2010; and second to not providing Basin-specific data to support their evaluation. Contrary to Williams et al. comments, existing evidence indicates that infrastructure intended to improve water use efficiency (e.g. salt leaching, salt disposal basins) will generally reduce stream salinity. The requirement for a leaching efficiency means that there is a lower limit to water use efficiency improvements, but this is unlikely itself to be a major risk. We agree that the changes that have occurred over the last twenty years would warrant a review of salt storage options in the MDB that better matches future needs. [ABSTRACT FROM AUTHOR]

This paper continues the analysis of the management of urban waterways in Greater Melbourne, Australia, commenced with our first paper. We focus first on the increasing emphasis on waterways and their corridors as part of Melbourne's liveability, and then on the future management of waterways and their corridors in the face of the three most pressing future challenges – climate change, population increase, and urban expansion and densification. The long history of the development of parks, gardens and open spaces in Melbourne is reviewed. These open-spaces initially occurred with quite strong linkage to the waterways, enabled by the city's unique institutional arrangements, but were substantially weakened as a result of policy and governance reforms in the 1990s. Melbourne will need to substantially improve the integration of the management of urban waterways and their corridors with the planning, development and management of the city's associated green spaces if it is to achieve the expected community liveability standards in the face of the above three future challenges. Additionally, if waterway management remains with the existing agency (Melbourne Water), the authorising environment and the culture and mindset of this agency will need to change its focus from the current 'city servicing' institutional model to a 'city shaping' model. [ABSTRACT FROM AUTHOR]

This study explored clinical nurse specialists and their research role. Aims: The aim of this research was to understand what influences specialist palliative care nurses working in a community setting to engage with research. Methods: Qualitative research using interviews with community based clinical nurse specialists (CNS). Findings: A total of five themes were identified: research negativity and enthusiasm, clinical focus, audits, organisational support and keeping up to date. Conclusion: Except for audit activity, CNS do not view the research pillar as an integral part of their clinical role. Previous research education may not give the CNS the breadth of research skills that they require. The advance professional apprenticeship may resolve these education issues. Managers and organisations need to prioritise EBP skills; supporting nurses with both education and EBP mentors to develop these skills. Nurses require ongoing time to engage with research activity and use these skills to improve both their own clinical practice and those who use them as a research resource. [ABSTRACT FROM AUTHOR]

This paper explores the challenge of establishing a meaningful connection between a neurotypical therapist and a neurodiverse patient who inhabit different Umwelts, that is, perceptual worlds.1 It discusses how addressing anxiety is crucial in preventing communication difficulties from escalating for individuals with autism who may have heightened stress due to an overgrown amygdala. Embodied mirroring is introduced to focus on perceptions and reduce stress. Furthermore, the potential for epigenetic changes due to unaddressed anxiety is raised. The paper emphasises the importance of responding to individual differences in sensory and perceptual experiences to promote effective communication and positive outcomes in therapy. [ABSTRACT FROM AUTHOR]

Reservoir computing is a machine learning framework that has been shown to be able to replicate the chaotic attractor, including the fractal dimension and the entire Lyapunov spectrum, of the dynamical system on which it is trained. We quantitatively relate the generalized synchronization dynamics of a driven reservoir during the training stage to the performance of the trained reservoir computer at the attractor reconstruction task. We show that, in order to obtain successful attractor reconstruction and Lyapunov spectrum estimation, the maximal conditional Lyapunov exponent of the driven reservoir must be significantly more negative than the most negative Lyapunov exponent of the target system. We also find that the maximal conditional Lyapunov exponent of the reservoir depends strongly on the spectral radius of the reservoir adjacency matrix; therefore, for attractor reconstruction and Lyapunov spectrum estimation, small spectral radius reservoir computers perform better in general. Our arguments are supported by numerical examples on well-known chaotic systems. [ABSTRACT FROM AUTHOR]

Background: Nocardia is a ubiquitous saprophyte capable of causing human disease. Disease is primarily respiratory or cutaneous, usually acquired via inhalation or inoculation. Under the influence of environmental and host factors, Nocardia incidence and species distribution demonstrate geographical variation. Aims: To examine for differences in Nocardia incidence within Western Australia (WA) and analyse species distribution in the context of prior published studies. To analyse antibiogram data from a nationwide passive antimicrobial resistance surveillance program. Methods: Retrospective extraction of laboratory data for Western Australian Nocardia isolates over a 21‐year period. Analysis of Nocardia antimicrobial susceptibility testing data submitted to the Australian Passive Antimicrobial Resistance Surveillance (APAS) program between 2005 and 2022. Results: Nine hundred sixty WA isolates were identified, giving an annual incidence of 3.03 per 100 000 population with apparent latitudinal variation. The four most common species identified within WA and amongst APAS isolates were N. nova, N. cyriacigeorgica, N. brasiliensis and N. farcinica. APAS data demonstrated that all species exhibited high rates of susceptibility to linezolid (100%) and trimethoprim‐sulfamethoxazole (98%). Amikacin (>90% susceptibility for all species except N. transvalensis) was the next most active parenteral agent, superior to both carbapenems and third‐generation cephalosporins. Susceptibility to oral antimicrobials (other than linezolid) demonstrated significant interspecies variation. Conclusions: We demonstrate geographical variation in the distribution of Nocardia incidence. Four species predominate in the Australian setting, and nationwide data confirm a high in vitro susceptibility to trimethoprim‐sulphamethoxazole and linezolid, justifying their ongoing role as part of first‐line empiric therapy. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a major determinant of health outcomes. Trauma patients are disproportionately from lower socioeconomic status, where lack of access to health care prevents timely treatment. Trauma centers could play a role in identifying patients in need of improved glucose management, but the current burden of disease is not known. We assessed the incidence of patients in need of intervention that presented to a level 1 trauma center over a 6-month period. Methods: A retrospective chart review over 6 months of all trauma patients admitted to a level 1 trauma center was performed. Patients' past medical history (PMH), medication reconciliation, and hemoglobin A1c (HbA1c) were recorded on initial assessment; patients <18 years old, lacking an HbA1c, or missing PMH were excluded. Patients with PMH of diabetes or antihyperglycemic use were classified by HbA1c: well-controlled ≤8.0% or poorly controlled >8.0%. Patients with no history of diabetes or antihyperglycemic use were classified based on their HbA1c: non-diabetic <5.7%, pre-diabetic 5.7-6.4%, and undiagnosed diabetic ≥6.5%. Results: Overall, 1377 patients were identified. After exclusion criteria, 903 patients were classified as follows: 593 (66%) non-diabetics, 160 (18%) pre-diabetics, and 150 (17%) diabetics. Fifteen diabetics were undiagnosed; 39 of the diagnosed diabetics were poorly controlled. Including pre-diabetics, a total of 214 (24%) trauma patients were in need of improved glycemic control. Discussion: One in four trauma patients would benefit from improved outpatient glycemic management, representing a missed opportunity for preventative health care. Trauma centers should develop strategies to meet this need as part of their post-discharge care. [ABSTRACT FROM AUTHOR]

Objective: Brief and accessible therapies for people with an eating disorder is an important health target. Ten‐session cognitive behavioural therapy (CBT‐T) is a brief treatment evaluated in people with a non‐underweight eating disorder. This study aimed to evaluate the feasibility and preliminary effectiveness of CBT‐T for young people in primary care. Method: This cohort pilot study used group (adolescents vs. young adults) by time (over four time points) Generalised Linear Mixed Model analysis. Participants included 13–25‐year‐olds attending an early intervention mental health service, receiving 10 sessions of CBT‐T. Feasibility was assessed using recruitment, retention and satisfaction. Eating and other pathology measures were administered at baseline, weeks four and 10, and 12‐week follow‐up. Results: Of the 63 commencing treatment, 38 completed 10 CBT‐T sessions (60%). Most (94%) reported high treatment satisfaction. Significant reductions in eating pathology, depression and stress were found. Age group did not yield differences in CBT‐T outcome, with large to very large effect sizes across outcome variables. Anxiety was associated with attrition. Conclusion: This study provides preliminary support for the use of CBT‐T in primary care, across adolescence and early adulthood. Findings require replication in other clinical settings and comparison to other clinical approaches and control populations. Highlights: Brief cognitive behavioural therapy for eating disorders appears feasible and acceptable when working with adolescents and young adults with eating disorders treated in non‐specialist services.Ten‐session cognitive behavioural therapy (CBT‐T) was equally effective for adolescents and young adults.Baseline levels of anxiety were associated with attrition in CBT‐T. [ABSTRACT FROM AUTHOR]

Portable data collection devices and machine learning (ML) have been combined in autonomous movement analysis models for resistance training (RT) movements. However, input features for these models were mostly extracted empirically and subsequent models demonstrated limited interpretability and generalisability to real-world settings. This study aimed to investigate the utility of interpretable and generalisable modelling techniques and several data-driven feature extraction (FE) methods. This was achieved by developing machine learning movement analysis models for the barbell back squat and deadlift using markerless motion capture. 61 participants performed submaximal and maximal repetitions of both RT movements. Movement data was collected using two Azure Kinect cameras. Joint and segment kinematic variables were calculated from the collected depth imaging, and input features were extracted using traditional, manual FE methods and novel data-driven techniques. Classifiers were developed for several predefined technical deviations for both movements. Many of the addressed technical deviations could be classified with good levels of accuracy (≥70%) while the remainder were poor (55%–60%). Additionally, data-driven FE techniques were comparable to previous, traditional FE methods. Interpretable and generalisable modelling techniques can be utilised to good effect for certain classification tasks while data-driven FE techniques did not provide a consistent advantage over traditional FE methods. [ABSTRACT FROM AUTHOR]

Background: Osteogenesis imperfecta (OI) is a rare, heritable connective tissue disorder associated with a variety of symptoms, that affect individuals' quality of life (QoL) and can be associated with increased healthcare resource use. While some aspects of OI are well studied, others remain poorly understood. Therefore, the IMPACT survey aimed to elucidate the humanistic, clinical and economic burden of OI on individuals with OI, their families, caregivers and wider society. Methods: We developed an international mixed methods online survey in eight languages (fielded July–September 2021), aimed at adults (aged ≥ 18 years) or adolescents (aged ≥ 12–17 years) with OI, caregivers (with or without OI) of individuals with OI and other close relatives. All respondents provided data on themselves; caregivers additionally provided data on individuals in their care by proxy. Data were cleaned, coded, and analysed using the pandas Python software package and Excel. Results: IMPACT collected 2208 eligible questionnaires (covering 2988 individuals of whom 2312 had OI) including 1290 non-caregiver adults with OI, 92 adolescents with OI, 150 caregiver adults with OI, 560 caregivers for individuals with OI, 116 close relatives and 780 proxy care-recipients with OI. Most individuals with OI (direct or proxy) described their OI as moderate (41–52% across populations) and reported OI type 1 (33–38%). Pain (72–82%) was the most reported clinical condition experienced in the past 12 months and was also most frequently rated as severely or moderately impactful. Further, among adults, 67% reported fatigue, 47% scoliosis, and 46% sleep disturbance; in adolescents, fatigue affected 65%, scoliosis and other bone problems 60%, and mental health problems 46%; in children, fractures were common in 67%, fatigue in 47%, and dental problems in 46%. Conclusion: IMPACT has generated an extensive dataset on the experience of individuals with OI, their caregivers and relatives. We found that, irrespective of age, individuals with OI experience numerous and evolving symptoms that affect their QoL; however, pain and fatigue are consistently present. Upcoming analyses will provide further insights into the economic impact, healthcare journey and caregiver wellbeing, aiming to contribute to improved treatment and care for the OI community. [ABSTRACT FROM AUTHOR]

In the United States, schools provide a large portion of child and adolescent mental health services; however, systems are restricted by resource and workforce shortages while the need for services steadily increases. This discrepancy leads to unmanageable caseloads for providers and reduced access to quality services for youth, and highlights a need to expand the school-based workforce to meet student needs. Herein, we propose a novel mental health service-delivery framework to offset these challenges by integrating mentors within the context of multitiered systems of support (MTSS) through task-shifting. We review and synthesize the literature in community and school psychology on the promises and challenges of youth mentoring and MTSS. We discuss the importance of diversifying school psychology, including the importance of increasing access to and benefit from educational supports for minoritized students, and the promise of mentoring within this context. We propose that by systematically integrating youth mentoring within MTSS there are several systems-level and individual-level benefits for youth, school staff, and mentoring nonprofits. We conclude by providing ethical, evaluation, and implementation considerations surrounding the proposed model. Impact Statement Restructuring the school-based mental health workforce by integrating community mentors into MTSS frameworks provides an innovative, powerful way to engage with diverse student populations. We propose a novel model that expands and strengthens this workforce, thereby increasing the quality and reach of school-based services. [ABSTRACT FROM AUTHOR]

While popularly known for his works of literature and poetry, Johann Wolfgang von Goethe viewed his lesser-known scientific pieces as his most enduring achievement. I will argue that Goethe's unique scientific methodology is informed by a metaphysical commitment to a form of Platonism and that Goethe provides an intriguing alternative paradigm that unifies science, philosophy, theology, and ethics. I begin by demonstrating how Goethe's concept of the Urphänomen offers a Platonic conception of natural beings. I then briefly outline how this alternative scientific approach ultimately derives from his Platonic commitments. Next, I demonstrate the ethical and spiritual implications of Goethean science, establishing that Goethe's approach bridges the divide between our scientific endeavors and spiritual formation. There is, then, a continued relevance for Goethe in conversations regarding ecological ethics and our perception of nature. [ABSTRACT FROM AUTHOR]

Background: Transanal endoscopic microsurgery (TEM) is an established technique for the resection of rectal adenomas and selected malignant tumours. It avoids the morbidity of radical resection for tumours not amenable to endoscopic resection. An important marker of quality is the local recurrence rate. The primary objective was to determine local recurrence rates for benign and malignant rectal tumours. Methods: We identified index TEM excisions of rectal adenomas and adenocarcinomas in patients age 18 and over at Dunedin Hospital, New Zealand, between 2000 and 2020, from a prospective database. Surveillance data were collected via chart review. The primary outcome was recurrence rate for adenomas and adenocarcinomas. Secondary outcomes included time to recurrence, association of recurrence with recognized risk factors, and adverse event rates. Results: We identified 100 patients for analysis. Of 75 benign cases, 11 (14.7%) developed local recurrence, with 63.6% identified within 1 year. Of the 25 malignant cases (19 T1, 5 T2, 1 T3), 9 (36%) developed recurrence, with 77.8% identified within 2 years. Adverse events occurred in 26% of patients, with no reoperations or deaths. Conclusion: Our adenoma recurrence rate was at the higher end of the reported range of 2.4–16%. Minor complications were common, but not major morbidity. The propensity for rectal tumours to recur commonly and early reinforces the importance of regular standardized endoscopic surveillance. [ABSTRACT FROM AUTHOR]

Gait classification is a clinically helpful task performed after a stroke in order to guide rehabilitation therapy. Gait disorders are commonly identified using observational gait analysis in clinical settings, but this approach is limited due to low reliability and accuracy. Data-driven gait classification can quantify gait deviations and categorise gait patterns automatically possibly improving reliability and accuracy; however, the development and clinical utility of current data driven systems has not been reviewed previously. The purpose of this systematic review is to evaluate the literature surrounding the methodology used to develop automatic gait classification systems, and their potential effectiveness in the clinical management of stroke-affected gait. The database search included PubMed, IEEE Xplore, and Scopus. Twenty-one studies were identified through inclusion and exclusion criteria from 407 available studies published between 2015 and 2022. Development methodology, classification performance, and clinical utility information were extracted for review. Most of gait classification systems reported a classification accuracy between 80%–100%. However, collated studies presented methodological errors in machine learning (ML) model development. Further, many studies neglected model components such as clinical utility (e.g., predictions don't assist clinicians or therapists in making decisions, interpretability, and generalisability). We provided recommendations to guide development of future post-stroke automatic gait classification systems to better assist clinicians and therapists. Future automatic gait classification systems should emphasise the clinical significance and adopt a standardised development methodology of ML model. • Gait classification systems achieved mixed results regarding performance. • Methodological errors were present in development of gait classification systems. • The scarcity of clinical utility limit application in clinical settings. • Recommendations can guide development and clinical utility of models. [ABSTRACT FROM AUTHOR]

Nitrothiazole derivatives have been reported to exhibit activity against aerobic, anaerobic, and microaerophilic bacteria. This activity profile makes the nitrothiazole compound class an ideal lead source against Mycobacterium tuberculosis, which flourishes in varied environments with different oxygen concentrations. In this work, we investigated six nitrothiazole derivatives for antitubercular activity. The compounds exhibited potent activity, with compounds 9 and 10 possessing an equipotent MIC90 value of 0.24 µM. The compounds were investigated for cytotoxicity against HEK293 cells and hemolysis against red blood cells, and they demonstrated no cytotoxicity nor hemolytic effects, suggesting they possess inherent antitubercular activity. [ABSTRACT FROM AUTHOR]