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Interdisciplinary service-learning (IDSL) has become a staple of healthcare education over the last two decades as a mechanism of training students to provide cohesive, team-based health care in a complicated and sometimes fragmented health care system. This case study describes the perceived learning of Doctor of Physical Therapy (DPT) students from [Blinded] University who attended a week-long interdisciplinary, interuniversity service-learning trip in rural [Blinded]. Qualitative data from two consecutive year teams (n = 26) were collected via surveys and focus groups and thematically analyzed for motivation to attend the trip and perceived learning. Intrinsic motivation to "give back" and desire to hone professional skills were the primary drivers for desiring to attend the trip. Three themes of perceived learning that emerged were: 1) impact on core values, 2) perceived improvement in para-clinical (soft) skills including interdisciplinary fluency and cultural competence, and 3) improvement of clinical (hard) skills. The dominant theme was the impact the trip had on students' core values. The learning occurred predominantly in Bloom's affective domain and aligned with the physical therapy profession's Core Values and Code of Ethics.

Abstract The Bellagio Group for Accelerating AMR Action met in April 2024 to develop the ambitious but achievable 1–10-100 unifying goals to galvanize global policy change and investments for antimicrobial resistance mitigation: 1 Health; 10 million lives saved; and 100% sustainable access to effective antimicrobials. High profile political goals such as the Paris Agreement’s objective to keep global warming well below 2° Celsius compared to pre-industrial levels, UNAIDS’ 90–90-90 goal, and the Sustainable Development Goals challenge global norms, direct attention towards relevant activities, and serve an energizing function to motivate action over an extended period of time. The 1–10-100 unifying goals propose to unite the world through a One Health approach to safeguard human health, animal welfare, agrifood systems, and the environment from the emergence and spread of drug-resistant microbes and infections; save over 10 million lives by 2040 through concerted efforts to prevent and appropriately treat infections while preserving the vital systems and services that depend on sustained antimicrobial effectiveness; and commit to ensuring that antimicrobials are available and affordable for all, used prudently, and secured for the future through innovation. Compared to existing technical targets, these unifying goals offer advantages of focusing on prevention, encouraging multisectoral action and collaboration, promoting health equity, recognizing the need for innovation, and integrating with Sustainable Development Goals. By committing to 1 Health, 10 million lives saved, and 100% sustainable access to effective antimicrobials, we can protect lives and livelihoods today and safeguard options for tomorrow.

Some ocean modeling studies have identified a potential tipping point from a low to a high basal melt regime beneath the Filchner–Ronne Ice Shelf (FRIS), Antarctica, with significant implications for subsequent Antarctic ice sheet mass loss. To date, investigation of the climate drivers and impacts of this possible event have been limited because ice-shelf cavities and ice-shelf melting are only now starting to be included in global climate models. Using a global ocean–sea-ice configuration of the Energy Exascale Earth System Model (E3SM) that represents both ocean circulations and melting within ice-shelf cavities, we explore freshwater triggers (iceberg melt and ice-shelf basal melt) of a transition to a high-melt regime at FRIS in a low-resolution (30 km in the Southern Ocean) global ocean–sea-ice model. We find that a realistic spatial distribution of iceberg melt fluxes is necessary to prevent the FRIS melt regime change from unrealistically occurring under historical-reanalysis-based atmospheric forcing. Further, improvement of the default parameterization for mesoscale eddy mixing significantly reduces a large regional fresh bias and weak Antarctic Slope Front structure, both of which precondition the model to melt regime change. Using two different stable model configurations, we explore the sensitivity of FRIS melt regime change to regional ice-sheet freshwater fluxes. Through a series of sensitivity experiments prescribing incrementally increasing melt rates from the smaller, neighboring ice shelves in the eastern Weddell Sea, we demonstrate the potential for an ice-shelf melt “domino effect” should the upstream ice shelves experience increased melt rates. The experiments also reveal that modest ice-shelf melt biases in a model, especially at coarse ocean resolution where narrow continental shelf dynamics are not well resolved, can lead to an unrealistic melt regime change at downstream ice shelves. Thus, we find that remote connections between melt fluxes at different ice shelves are sensitive to baseline model conditions. Our results highlight both the potential and the peril of simulating prognostic Antarctic ice-shelf melt rates in a low-resolution global model.

Background Microbial Keratitis (MK) is a leading cause of corneal blindness due to infection and its consequences, with a higher incidence in resource-limited nations. Hospital-based patient records from different parts of Nepal suggest patients often use traditional eye medicine to treat MK. Traditional healers (TH) within the community are often the first point of care for MK management. Little is known of their practice, perceptions, and knowledge around MK management. We aimed to understand the role of traditional healers in the management of MK in south-eastern Nepal. Methods A cross-sectional, mixed method, descriptive study was conducted in the Siraha district of Nepal. A total of 109 traditional healers consented to participate in a survey of knowledge, attitude, and practices. Some participants were also invited to participate in in-depth interviews and focus group discussions. Interviews and focus groups were conducted and recorded in the Maithili language by a native speaking interviewer and transcribed into English. Descriptive analysis was performed for the survey. Data saturation was considered the endpoint for qualitative data collection, and a thematic was analysis applied. Results Traditional healers believe that infection of the eye can be caused by trauma, conjunctivitis, or evil spirits. They were unclear about differentiating MK from other eye conditions. They provided various types of treatment. Some were confident that they could treat severe ulcers that had not responded to medical therapy, while others thought treating larger diameter ulcers would be difficult. Although there were mixed responses in referring patients with MK, the majority of TH were willing to refer. Conclusion In a weak health system, traditional healers may help address barriers to healthcare access and reduce delays to definitive care, upon integration into the formal health system and referral pathway.

The Montreal Protocol has played a critical role in promoting global collective action to phase out the use of ozone-depleting substances, ultimately preventing millions of cases of skin cancer, cataracts and other health issues related to ultraviolet radiation exposure. This success entails transferable lessons for coordinated action required to improve the global governance of other challenges. Like ozone depletion, antimicrobial resistance (AMR) is a challenge of the global commons, requiring coordinated actions across human, animal and environmental sectors. We identify equity, flexibility and accountability as three core governance principles that underlie the success of the protocol and employ the 3-i framework to understand how interests, ideas and institutions contributed to the protocol’s success. Equity-promoting strategies consisted of an inclusive negotiation process, supporting developing countries with multilateral funding and a progressive compliance model. Flexibility was built into the protocol through the development of country-specific strategies, reorienting incentive structures for industry and facilitating regular amendments in response to emerging scientific evidence. Accountability was promoted by mobilising public advocacy, establishing targets and enforcement mechanisms and conducting independent scientific and technical assessments. Applying our proposed principles presents an opportunity to improve the global governance of AMR. Finally, we acknowledge limitations to our analysis, including our focus on a single environmental treaty, significantly greater funding requirements and multifacetted stakeholder involvement in the case of AMR, differing market and incentives structures in antibiotic development and distribution, and ethical concerns with using trade restrictions as a policy tool.

Abstract The Ice Sheet Model Intercomparison Project for CMIP6 (ISMIP6) is the primary effort of CMIP6 (Coupled Model Intercomparison Project–Phase 6) focusing on ice sheets, designed to provide an ensemble of process‐based projections of the ice‐sheet contribution to sea‐level rise over the twenty‐first century. However, the behavior of the Antarctic Ice Sheet beyond 2100 remains largely unknown: several instability mechanisms can develop on longer time scales, potentially destabilizing large parts of Antarctica. Projections of Antarctic Ice Sheet evolution until 2300 are presented here, using an ensemble of 16 ice‐flow models and forcing from global climate models. Under high‐emission scenarios, the Antarctic sea‐level contribution is limited to less than 30 cm sea‐level equivalent (SLE) by 2100, but increases rapidly thereafter to reach up to 4.4 m SLE by 2300. Simulations including ice‐shelf collapse lead to an additional 1.1 m SLE on average by 2300, and can reach 6.9 m SLE. Widespread retreat is observed on that timescale in most West Antarctic basins, leading to a collapse of large sectors of West Antarctica by 2300 in 30%–40% of the ensemble. While the onset date of retreat varies among ice models, the rate of upstream propagation is highly consistent once retreat begins. Calculations of sea‐level contribution including water density corrections lead to an additional ∼10% sea level and up to 50% for contributions accounting for bedrock uplift in response to ice loading. Overall, these results highlight large sea‐level contributions from Antarctica and suggest that the choice of ice sheet model remains the leading source of uncertainty in multi‐century projections.

This case study describes the design, implementation, and evaluation of an initiative to increase COVID-19 vaccine confidence and uptake among refugee and immigrant women in Clarkston, Georgia. Applying the principles and practices of human-centered design, Mothers x Mothers was co-created by Refugee Women’s Network and IDEO.org as a series of gatherings for refugee and immigrant mothers to discuss health issues, beginning with the COVID-19 vaccine. The gatherings included both vaccinated and unvaccinated mothers and used a peer support model, with facilitation focused on creating a trusting environment and supporting mothers to make their own health decisions. The facilitators for Mothers x Mothers gatherings were community health workers (CHWs) recruited and trained by Refugee Women’s Network. Notably, these CHWs were active in every phase of the initiative, from design to implementation to evaluation, and the CHWs’ professional development was specifically included among the initiative’s goals. These elements and others contributed to an effective public health intervention for community members who, for a variety of reasons, did not get sufficient or appropriate COVID-19 vaccine information through other channels. Over the course of 8 Mothers x Mothers gatherings with 7 distinct linguistic/ethnic groups, 75% of the unvaccinated participants decided to get the COVID-19 vaccine and secured a vaccine referral.

In the early months of the COVID-19 pandemic The National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM) was established. NRC-RIM initially sought to rapidly identify promising case investigation and contact tracing (CICT) practices within refugee, immigrant, and migrant communities. Between September 2020 and April 2021, the team conducted 60 interviews with individuals from cross-sector organizations (i.e., public health, health systems, community experts/organizations) working with refugee, immigrant and migrant communities in health and public health capacities related to COVID-19. The overarching aim was to identify and amplify innovative promising and best practices for CICT with refugee, immigrant, and migrant communities, including an exploration of barriers and facilitators. We utilized layered methods to rapidly assess, summarize and disseminate promising practices while simultaneously completing four thematic analyses including: (1) public health organizations; (2) health system organizations; (3) community leaders and organizations; and (4) vaccine planning and access across the three sectors. The primary objective of this article is to describe the project design, applied methods, and team science approach we utilized. We found that rapid identification and dissemination of promising practices, and barriers and facilitators for CICT with refugee, immigrant and migrant communities was feasible during a public health emergency. This approach was essential for identifying and widely sharing culturally and linguistically concordant public health practices.

The Antarctic Ice Sheet represents the largest source of uncertainty in future sea level rise projections, with a contribution to sea level by 2100 ranging from −5 to 43 cm of sea level equivalent under high carbon emission scenarios estimated by the recent Ice Sheet Model Intercomparison for CMIP6 (ISMIP6). ISMIP6 highlighted the different behaviors of the East and West Antarctic ice sheets, as well as the possible role of increased surface mass balance in offsetting the dynamic ice loss in response to changing oceanic conditions in ice shelf cavities. However, the detailed contribution of individual glaciers, as well as the partitioning of uncertainty associated with this ensemble, have not yet been investigated. Here, we analyze the ISMIP6 results for high carbon emission scenarios, focusing on key glaciers around the Antarctic Ice Sheet, and we quantify their projected dynamic mass loss, defined here as mass loss through increased ice discharge into the ocean in response to changing oceanic conditions. We highlight glaciers contributing the most to sea level rise, as well as their vulnerability to changes in oceanic conditions. We then investigate the different sources of uncertainty and their relative role in projections, for the entire continent and for key individual glaciers. We show that, in addition to Thwaites and Pine Island glaciers in West Antarctica, Totten and Moscow University glaciers in East Antarctica present comparable future dynamic mass loss and high sensitivity to ice shelf basal melt. The overall uncertainty in additional dynamic mass loss in response to changing oceanic conditions, compared to a scenario with constant oceanic conditions, is dominated by the choice of ice sheet model, accounting for 52 % of the total uncertainty of the Antarctic dynamic mass loss in 2100. Its relative role for the most dynamic glaciers varies between 14 % for MacAyeal and Whillans ice streams and 56 % for Pine Island Glacier at the end of the century. The uncertainty associated with the choice of climate model increases over time and reaches 13 % of the uncertainty by 2100 for the Antarctic Ice Sheet but varies between 4 % for Thwaites Glacier and 53 % for Whillans Ice Stream. The uncertainty associated with the ice–climate interaction, which captures different treatments of oceanic forcings such as the choice of melt parameterization, its calibration, and simulated ice shelf geometries, accounts for 22 % of the uncertainty at the ice sheet scale but reaches 36 % and 39 % for Institute Ice Stream and Thwaites Glacier, respectively, by 2100. Overall, this study helps inform future research by highlighting the sectors of the ice sheet most vulnerable to oceanic warming over the 21st century and by quantifying the main sources of uncertainty.

Abstract Background CXCR3 is a chemokine receptor and is expressed in innate and adaptive immune cells. It promotes the recruitment of T-lymphocytes and other immune cells to the inflammatory site in response to the binding of cognate chemokines. Upregulation of CXCR3 and its chemokines has been found during atherosclerotic lesion formation. Therefore, detection of CXCR3 by positron emission tomography (PET) radiotracer can be a useful tool for detecting the development of atherosclerosis in a noninvasive manner. Herein, we report the synthesis, radiosynthesis, and characterization of a novel fluorine-18 (F-18, 18F) labeled small-molecule radiotracer for the imaging of the CXCR3 receptor in mouse models of atherosclerosis. Results The reference standard 1 and its precursor 9 were synthesized over 5 steps from starting materials in good to moderate yields. The measured Ki values of CXCR3A and CXCR3B were 0.81 ± 0.02 nM and 0.31 ± 0.02 nM, respectively. [18F]1 was prepared by a two-step radiosynthesis with a decay-corrected radiochemical yield of 13 ± 2%, radiochemical purity > 99%, and specific activity of 44.4 ± 3.7 GBq/µmol at the end of synthesis (n = 6). The baseline studies showed that [18F]1 displayed high uptake in the atherosclerotic aorta and brown adipose tissue in Apolipoprotein E (ApoE) knockout (KO) mice fed with a high-fat diet over 12 weeks. The uptake of [18F]1 in these regions was reduced significantly in self-blocking studies, demonstrating CXCR3 binding specificity. Contrary to this, no significant differences in uptake of [18F]1 in the abdominal aorta of C57BL/6 control mice fed with a normal diet were observed in both baseline and blocking studies, indicating increased CXCR3 expression in atherosclerotic lesions. Immunohistochemistry studies demonstrated that [18F]1-positive regions were correlated with CXCR3 expression, but some atherosclerotic plaques with significant size were not detected by [18F]1, and their CXCR3 expressions were minimal. Conclusion [18F]1 was synthesized with good radiochemical yield and high radiochemical purity. In PET imaging studies, [18F]1 displayed CXCR3-specific uptake in the atherosclerotic aorta in ApoE KO mice. [18F]1 visualized CXCR3 expression in different regions in mice aligned with the tissue histology studies. Taken together, [18F]1 is a potential PET radiotracer for imaging CXCR3 in atherosclerosis.

Abstract Near-perfect light absorbers (NPLAs), with absorbance, $${{{{{{{\mathcal{A}}}}}}}}$$ A , of at least 99%, have a wide range of applications ranging from energy and sensing devices to stealth technologies and secure communications. Previous work on NPLAs has mainly relied upon plasmonic structures or patterned metasurfaces, which require complex nanolithography, limiting their practical applications, particularly for large-area platforms. Here, we use the exceptional band nesting effect in TMDs, combined with a Salisbury screen geometry, to demonstrate NPLAs using only two or three uniform atomic layers of transition metal dichalcogenides (TMDs). The key innovation in our design, verified using theoretical calculations, is to stack monolayer TMDs in such a way as to minimize their interlayer coupling, thus preserving their strong band nesting properties. We experimentally demonstrate two feasible routes to controlling the interlayer coupling: twisted TMD bi-layers and TMD/buffer layer/TMD tri-layer heterostructures. Using these approaches, we demonstrate room-temperature values of $${{{{{{{\mathcal{A}}}}}}}}$$ A =95% at λ=2.8 eV with theoretically predicted values as high as 99%. Moreover, the chemical variety of TMDs allows us to design NPLAs covering the entire visible range, paving the way for efficient atomically-thin optoelectronics.

IntroductionDifferentiated service delivery models for HIV treatment can minimize unnecessary burdens on health systems and promote efficient delivery of antiretroviral therapy (ART). Under the PODI+ (poste de distribution communautaire) model, ART multi-month dispensation (MMD) was provided by lay workers (peers) in communities. We compared outcomes among clinically stable adults living with HIV receiving MMD via PODI+ or health facility (HF).MethodsClients receiving MMD at nine HFs and two PODI+ sites in Kinshasa were followed prospectively for one year (2018-2020). Medication possession ratio (MPR) was measured as proportion of total days with medication during the study through record abstraction at 3-month intervals. Viral load was assessed at enrollment and 12 months. We compared MPR and viral load suppression by arm and examined associations and potential confounders using unadjusted and adjusted odds ratios (AOR). Likert-style client satisfaction was collected during 12-month interviews and described by arm.ResultsOdds of maintaining viral load suppression at 12 months for PODI+ participants were two times that for HF participants. In adjusted models, PODI+ participants had 1.89 times the odds of being suppressed at 12 months compared to HF participants (95% CI: 1.10, 3.27). No significant differences in MPR were found between groups (OR: 0.86, 0.38-1.99). Older participants had significantly higher odds of MPR (AOR: 1.02, 95% CI: 1.01, 1.03) and viral suppression (AOR: 1.03, 95% CI: 1.00, 1.07). Satisfaction with services was ≥87% overall, but PODI+ participants rated time spent at site, provider attributes and other care aspects more favorably.ConclusionsParticipants receiving MMD via peer-run community distribution points had similar MPR, but better virological outcomes and greater satisfaction with care than clinically similar participants receiving MMD through facilities. PODI+ could be a useful model for expansion to serve larger clinic populations from overburdened health facilities, particularly as policy shifts towards more inclusive MMD eligibility requirements.

Summary: Here, we present Brain Registration and Evaluation for Zebrafish (BREEZE)-mapping, a user-friendly pipeline for the registration and analysis of whole-brain images in larval zebrafish. We describe steps for pre-processing, registration, quantification, and visualization of whole-brain phenotypes in zebrafish mutants of genes associated with neurodevelopmental and neuropsychiatric disorders. By utilizing BioImage Suite Web, an open-source software package originally developed for processing human brain imaging data, we provide a highly accessible whole-brain mapping protocol developed for users with general computational proficiency.For complete details on the use and execution of this protocol, please refer to Weinschutz Mendes et al. (2023).1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Maternal history of depression is a strong predictor of depression in offspring and linked to structural and functional alterations in the developing brain. However, very little work has examined differences in white matter in adolescents at familial risk for depression. In a sample aged 9–14 (n = 117), we used tract-based spatial statistics (TBSS) to examine differences in white matter microstructure between adolescents with (n = 42) and without (n = 75) maternal history of depression. Microstructure was indexed using fractional anisotropy (FA). Threshold-free cluster enhancement was applied and cluster maps were thresholded at whole-brain family-wise error

Multi-meter sea level rise (SLR) is thought to be possible within the next few centuries, with most of the uncertainty originating from the Antarctic land ice contribution. One source of uncertainty relates to the ice sheet model initialization. Since ice sheets have a long response time (compared to other Earth system components such as the atmosphere), ice sheet model initialization methods can have significant impacts on how the ice sheet responds to future forcings. To assess this, we generated 25 different ice sheet spin-ups, using the Community Ice Sheet Model (CISM) at a 4 km resolution. During each spin-up, we varied two key parameters known to impact the sensitivity of the ice sheet to future forcing: one related to the sensitivity of the ice shelf melt rate to ocean thermal forcing (TF) and the other related to the basal friction. The spin-ups all nudge toward observed thickness and enforce a no-advance calving criterion, such that all final spin-up states resemble observations but differ in their melt and friction parameter settings. Each spin-up was then forced with future ocean thermal forcings from 13 different CMIP6 models under the Shared Socioeconomic Pathway (SSP)5-8.5 emissions scenario and modern climatological surface mass balance data. Our results show that the effects of the ice sheet and ocean parameter settings used during the spin-up are capable of impacting multi-century future SLR predictions by as much as 2 m. By the end of this century, the effects of these choices are more modest, but still significant, with differences of up to 0.2 m of SLR. We have identified a combined ocean and ice parameter space that leads to widespread mass loss within 500 years (low friction and high melt rate sensitivity). To explore temperature thresholds, we also ran a synthetically forced CISM ensemble that is focused on the Amundsen region only. Given certain ocean and ice parameter choices, Amundsen mass loss can be triggered with thermal forcing anomalies between 1.5 and 2 ∘C relative to the spin-up. Our results emphasize the critical importance of considering ice sheet and ocean parameter choices during spin-up for SLR predictions and suggest the importance of including glacial isostatic adjustment in ice sheet simulations.

Abstract Phenotypic plasticity is an important avenue by which organisms may persist in the face of rapid environmental change. Environmental cues experienced by the mother can also influence the phenotype of offspring, a form of plasticity called maternal effects. Maternal effects can adaptively prepare offspring for the environmental conditions they will likely experience; however, their ability to buffer offspring against environmental stressors as embryos is understudied. Using captive zebra finches, we performed a maternal‐offspring environmental match‐mismatch experiment utilizing a 2 × 2 × 2 factorial design. Mothers were exposed to a mild heat conditioning (38°C) or control (22°C) treatment as juveniles, an acute high heat (42°C) or control (22°C) treatment as adults, then paired for breeding. The eggs produced by those females were incubated at a hyperthermic (38.5°C) or optimal temperature (37.2°C). We found that when mothers were exposed to a mild heat conditioning as juveniles, their embryos exhibited reduced water loss, longer development times, and produced hatchlings with heavier pectoralis muscles when incubated at high incubation temperatures, compared to embryos from control mothers. Mothers exposed to both the mild heat conditioning as juveniles and a high heat stressor as adults produced eggs with a higher density of shell pores and embryos with lower heart rates during development. However, there was a cost when there was a mismatch between maternal and embryo environment. Embryos from these conditioned and heat‐stressed mothers had reduced survival at control incubation temperatures, indicating the importance of offspring environment when interpreting potential adaptive effects.

Abstract Background The quality of caregiving and the parent-child relationship is critical for early child development (ECD) and has been shown to be modifiable. This study evaluated an ECD project in Tanzania, assessing the effectiveness of radio messaging (RM) alone and a combined radio messaging/video job aids/ECD (RMV-ECD) intervention. Methods This two-arm pre-post evaluation study enrolled a cohort of caregivers of children 0–24 months in four districts of Tabora region, following them for 9 months. ECD radio messages were broadcast on popular stations at least 10 times/day reaching all study districts. In two districts, community health workers (CHW), trained in UNICEF’s Care for Child Development package, used ECD videos in home- and facility-based sessions with caregivers. We used McNemar’s testing (pre-post pairs) within intervention group to describe how the intervention was associated with change in five outcomes: ECD knowledge, early stimulation, father engagement, responsive care, and environment safety. Logistic regression was used to describe the relative benefits of the combined intervention package (RMV-ECD) compared to radio messaging (RM). Results In the RMV-ECD arm, all outcomes at endline except environment safety significantly improved after the intervention with the largest change seen in ECD knowledge (35.8% increase, p

Abstract Despite numerous published studies on the wear of dental composites, few have considered the influence of temperature on the two‐body wear process. Additionally, no previous work has considered the influence of temperature on dominant wear mechanisms during the consumption of hot substances, hence the focus of this study. Reciprocating wear tests were carried out at varying artificial saliva lubricant temperatures (37 and 57°C) and material loss was quantified using profilometry. The wear tracks were analysed using FIB/SEM/TEM. Results reveal that the wear rate of a dental composite can significantly increase with temperature, with fatigue/delamination and ploughing acting as dominant mechanisms.

Humboldt Glacier, northern Greenland, has retreated and accelerated through the 21st century, raising concerns that it could be a significant contributor to future sea-level rise. We use a data-constrained ensemble of three-dimensional higher-order ice sheet model simulations to estimate the likely range of sea-level rise from the continued retreat of Humboldt Glacier. We first solve for basal traction using observed ice thickness, bed topography, and ice surface velocity from the year 2007 in a PDE-constrained (partial differential equation) optimization. Next, we impose calving rates to match mean observed retreat rates from winter 2007–2008 to winter 2017–2018 in a transient calibration of the exponent in the power-law basal friction relationship. We find that power-law exponents in the range of 1/7–1/5 – rather than the commonly used 1/3–1 – are necessary to reproduce the observed speedup over this period. We then tune an iceberg calving parameterization based on the von Mises stress yield criterion in another transient-calibration step to approximate both observed ice velocities and terminus position in 2017–2018. Finally, we use the range of basal friction relationship exponents and calving parameter values to generate the ensemble of model simulations from 2007–2100 under three climate forcing scenarios from CMIP5 (two RCP8.5 forcings, Representative Concentration Pathway) and CMIP6 (one SSP5-8.5 forcing, Shared Socioeconomic Pathway). Our simulations predict 5.2–8.7 mm of sea-level rise from Humboldt Glacier, significantly higher than a previous estimate (∼ 3.5 mm) and equivalent to a substantial fraction of the 40–140 mm predicted by ISMIP6 from the whole Greenland Ice Sheet. Our larger future sea-level rise prediction results from the transient calibration of our basal friction law to match the observed speedup, which requires a semi-plastic bed rheology. In many simulations, our model predicts the growth of a sizable ice shelf in the middle of the 21st century. Thus, atmospheric warming could lead to more retreat than predicted here if increased surface melt promotes hydrofracture of the ice shelf. Our data-constrained simulations of Humboldt Glacier underscore the sensitivity of model predictions of Greenland outlet glacier response to warming to choices of basal shear stress and iceberg calving parameterizations. Further, transient calibration of these parameterizations, which has not typically been performed, is necessary to reproduce observed behavior. Current estimates of future sea-level rise from the Greenland Ice Sheet could, therefore, contain significant biases.

Abstract Background Benzodiazepines (BZD) are widely prescribed to older adults despite their association with increased fall injury. Our aim is to better characterize risk-elevating factors among those prescribed BZD. Methods A retrospective cohort study using a 20% sample of Medicare beneficiaries with Part D prescription drug coverage. Patients with a BZD prescription (“index”) between 1 April 2016 and 31 December 2017 contributed to incident (n=379,273) and continuing (n=509,634) cohorts based on prescriptions during a 6-month pre-index baseline. Exposures were index BZD average daily dose and days prescribed; baseline BZD medication possession ratio (MPR) (for the continuing cohort); and co-prescribed central nervous system-active medications. Outcome was a treated fall-related injury within 30 days post-index BZD, examined using Cox proportional hazards adjusting for demographic and clinical covariates and the dose prescribed. Results Among incident and continuing cohorts, 0.9% and 0.7% experienced fall injury within 30 days of index. In both cohorts, injury risk was elevated immediately post-index among those prescribed the lowest quantity: e.g., for

Subglacial hydrology is a leading control on basal friction and the dynamics of glaciers and ice sheets. At low discharge, subglacial water flows through high-pressure, sheet-like systems that lead to low effective pressures. However, at high discharge, subglacial water melts the overlying ice into localized channels that efficiently remove water from the bed, thereby increasing effective pressure and basal friction. Recent observations suggest channelized subglacial flow exists beneath Thwaites Glacier, yet it remains unclear if stable channelization is feasible in West Antarctica, where surface melting is nonexistent and water at the bed is limited. Here, we use the MPAS-Albany Land Ice model to run a suite of over 130 subglacial hydrology simulations of Thwaites Glacier across a wide range of physical parameter choices to assess the likelihood of channelization. We then narrow our range of viable simulations by comparing modeled water thicknesses to previously observed radar specularity content, which indicates flat, spatially extensive water bodies at the bed. In all of our data-compatible simulations, stable channels reliably form within 100–200 km of the grounding line and reach individual discharge rates of 35–110 m3 s−1 at the ice–ocean boundary. While only one to two channels typically form across the 200 km width of the glacier in our simulations, their high efficiency drains water across the entire lateral extent of the glacier. We posit the large catchment size of Thwaites Glacier, its funnel-like geometry, and high basal melt rates together accumulate enough water to form stable channels. No simulations resembled observed specularity content when channelization was disabled. Our results suggest channelized subglacial hydrology has two consequences for Thwaites Glacier dynamics: (i) amplifying submarine melting of the terminus and ice shelf while (ii) simultaneously raising effective pressure within 100 km of the grounding line and increasing basal friction. The distribution of effective pressure implied from our modeling differs from parameterizations typically used in large-scale ice sheet models, suggesting the development of more process-based parameterizations may be necessary.

Integrated modeling of plasma-surface interactions provides a comprehensive and self-consistent description of the system, moving the field closer to developing predictive and design capabilities for plasma facing components. One such workflow, including descriptions for the scrape-off-layer plasma, ion-surface interactions and the sub-surface evolution, was previously used to address steady-state scenarios and has recently been extended to incorporate time-dependence and two-way information flow. The new model can address dynamic recycling in transient scenarios, such as the application presented in this paper: the evolution of W samples pre-damaged by helium and exposed to ELMy H-mode plasmas in the DIII-D DiMES. A first set of simulations explored the effect of ELM frequency. This study was discussed in detail in this conference’s proceedings and is summarized here. The 2nd set of simulations, which is the focus of this paper, explores the effect of code-coupling frequency. These simulations include initial SOLPS solutions converged to the inter-ELM state, ion impact energy ( E _in ) and angles ( A _in ) calculated by hPIC2, and an improved heat transfer description in Xolotl. The model predicts increases in particle fluxes and decreases in heat fluxes by 10%–20% with the coupling time-step. Compared with the first set of simulations, the less shallow impact angle leads to smaller reflection rates and significant D implantation. The higher fraction of implanted flux (and deeper), in particular during ELMs, increases the accumulated D content in the W near-surface region. Future expansion of the workflow includes coupling to hPIC2 and GITR to ensure accurate descriptions of E _in and A _in , and W impurity transport.

Plastic debris is a growing threat in freshwater ecosystems and transport models predict that many plastics will sink to the benthos. Among the most common plastics found in the Laurentian Great Lakes sediments are polyethylene terephthalate (especially fibers; PET), polyvinylchloride (particles; PVC), and styrene-butadiene rubber resulting from tire wear (“crumb rubber”; SBR). These materials vary substantially in physical and chemical properties, and their impacts on benthic biogeochemistry and microbial community structure and function are largely unknown. We used a microcosm approach to evaluate the impact of these three plastics on benthic-pelagic coupling, sediment properties, and sediment microbial community structure and function using sediments from Irondequoit Bay, a major embayment of Lake Ontario in Rochester, New York, USA. Benthic metabolism and nitrogen and phosphorous cycling were all uniquely impacted by the different polymers. PET fibers and PVC particles demonstrated the most unique effects, with decreased ecosystem metabolism in sediments containing PET and greater nutrient uptake in sediments with PVC. Microbial diversity was reduced in all treatments containing plastic, but SBR had the most substantial impact on microbial community function, increasing the relative importance of metabolic pathways such as hydrocarbon degradation and sulfur metabolism. Our results suggest that individual polymers have unique impacts on the benthos, with divergent implications for ecosystem function. This provides deeper insight into the myriad ways plastic pollution may impact aquatic ecosystems and will help to inform risk assessment and policy interventions by highlighting which materials pose the greatest risk.

Abstract Device life time is a significant consideration in the cost of ownership of quantum cascade lasers (QCLs). The life time of QCLs beyond an initial burn-in period has been studied previously; however, little attention has been given to predicting premature device failure where the device fails within several hundred hours of operation. Here, we demonstrate how standard electrical and optical device measurements obtained during an accelerated burn-in process can be used in a simple support vector machine to predict premature failure with high confidence. For every QCL that fails, at least one of the measurements is classified as belonging to a device that will fail prematurely—as much as 200 h before the actual failure of the device. Furthermore, for devices that are operational at the end of the burn-in process, the algorithm correctly classifies all the measurements. This work will influence future device analysis and could lead to insights on the physical mechanisms of premature failure in QCLs.

IntroductionNutrition security continues to worsen in sub-Saharan Africa. Current research is limited on how seasonality may influence the impact of nutrition, culinary, and production interventions on food security, diet quality, and consumption of African Indigenous Vegetables (AIV); a culturally accepted source of micro-and-macronutrients that are easily produced due to their adaptation to the local environment. The objective of this study was to evaluate the programmatic impact of AIV interventions on nutrition security among smallholder farmers.MethodsIn a randomized control trial, five target counties in Western Kenya were randomly assigned to one of four treatments: (1) control; (2) production intervention (PI); (3) nutrition and culinary intervention (NCI); and (4) NCI and PI (NCI/PI). After the counties were randomly assigned to a treatment, 503 smallholder farmers (18–65 years) were selected from participatory farmer groups. The PI consisted of five agricultural production modules delivered between 2016 and 2019. The NCI was delivered twice: (1) household nutrition education (2017) and (2) community culinary training (2019). The NCI/PI included communities receiving both interventions at these time periods. Baseline and endline surveys were administered to all participants once in October 2016 (harvest season) and to all available participants (n = 250) once in June to July 2019 (dry season), respectively. The impact evaluation was analyzed by Household Hunger Scale (HHS), Women’s Dietary Diversity Score (WDDS), AIV consumption frequency, and AIV market availability. Statistical tests included descriptive statistics (means and frequencies), paired t-test, McNemar’s test, Wilcoxon Signed-Rank test, ANOVA test with Tukey post hoc, and χ2 test. Open-ended questions were aggregated, and responses were selected based on relevancy and thoroughness of the response to provide context to the quantitative data. A value of p

Metal-halide perovskites (MHPs) exhibit excellent properties for application in optoelectronic devices. The bottleneck for their incorporation is the lack of long-term stability such as degradation due to external conditions (heat, light, oxygen, moisture, and mechanical stress), but the occurrence of phase transitions also affects their performance. Structural phase transitions are often influenced by phonon modes. Hence, an insight into both the structure and lattice dynamics is vital to assess the potential of MHPs. In this study, GIWAXS and Raman spectroscopy are applied, supported by density functional theory calculations, to investigate the apparent manifestation of structural phase transitions in the MHP CsPbBr3. Macroscopically, CsPbBr3 undergoes phase transitions between a cubic (α), tetragonal (β), and orthorhombic (γ) phase with decreasing temperature. However, microscopically, it has been argued that only the γ phase exists, while the other phases exist as averages over length and time scales within distinct temperature ranges. Here, direct proof is provided for this conjecture by analyzing both theoretical diffraction patterns and the evolution of the tilting angle of the PbBr6 octahedra from molecular dynamics simulations. Moreover, sound agreement between experimental and theoretical Raman spectra allowed to identify the Raman active phonon modes and to investigate their frequency as a function of temperature. As such, this work increases the understanding of the structure and lattice dynamics of CsPbBr3 and similar MHPs.

Seminal work in the 1990’s found alterations in the cerebellum of individuals with social disorders including autism spectrum disorder and schizophrenia. In neurotypical populations, distinct portions of the posterior cerebellum are consistently activated in fMRI studies of social cognition and it has been hypothesized that the cerebellum plays an essential role in social cognition, particularly in theory of mind. Here we review the lesion literature and find that the effect of cerebellar damage on social cognition is strongly linked to the age of insult, with dramatic impairments observed after prenatal insult, strong deficits observed after childhood damage, and mild and inconsistent deficits observed following damage to the adult cerebellum. To explain the developmental gradient, we propose that early in life, the forward model dominates cerebellar computations. The forward model learns and uses errors to help build schemas of our interpersonal worlds. Subsequently, we argue that once these schemas have been built up, the inverse model, which is the foundation of automatic processing, becomes dominant. We provide suggestions for how to test this, and also outline directions for future research.

This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict’IntroductionRefugee, immigrant and migrant (hereafter referred to as “immigrant”) communities have been inequitably affected by the COVID-19 pandemic. There is little data to help us understand the perspectives of health systems on their role, in collaboration with public health and community-based organizations, in addressing inequities for immigrant populations. This study will address that knowledge gap.MethodsThis qualitative study used semi-structured video interviews of 20 leaders and providers from health systems who cared for immigrant communities during the pandemic. Interviewees were from across the US with interviews conducted between November 2020–March 2021. Data was analyzed using thematic analysis methods.ResultsTwenty individuals representing health systems participated with 14 (70%) community health centers, three (15%) county hospitals and three (15%) academic systems represented. The majority [16 health systems (80%)] cared specifically for immigrant communities while 14 (70%) partnered with refugee communities, and two (10%) partnered with migrant farm workers. We identified six themes (with subthemes) that represent roles health systems performed with clinical and public health implications. Two foundational themes were the roles health systems had building and maintaining trust and establishing intentionality in working with communities. On the patient-facing side, health systems played a role in developing communication strategies and reducing barriers to care and support. On the organizational side, health systems collaborated with public health and community-based organizations, in optimizing pre-existing systems and adapting roles to evolving needs throughout the pandemic.ConclusionHealth systems should focus on building trusting relationships, acting intentionally, and partnering with community-based organizations and public health to handle COVID-19 and future pandemics in effective and impactful ways that center disparately affected communities. These findings have implications to mitigate disparities in current and future infectious disease outbreaks for immigrant communities who remain an essential and growing population in the US.

Summary: Advancing from gene discovery in autism spectrum disorders (ASDs) to the identification of biologically relevant mechanisms remains a central challenge. Here, we perform parallel in vivo functional analysis of 10 ASD genes at the behavioral, structural, and circuit levels in zebrafish mutants, revealing both unique and overlapping effects of gene loss of function. Whole-brain mapping identifies the forebrain and cerebellum as the most significant contributors to brain size differences, while regions involved in sensory-motor control, particularly dopaminergic regions, are associated with altered baseline brain activity. Finally, we show a global increase in microglia resulting from ASD gene loss of function in select mutants, implicating neuroimmune dysfunction as a key pathway relevant to ASD biology.

IntroductionThe media’s recent focus on possible negative health outcomes following sports- related concussion has increased awareness as well as anxiety among parents and athletes. However, the literature on concussion outcomes is equivocal and limited by a variety of diagnostic approaches.MethodsThe current study used a rigorous, open- access concussion identification method—the Ohio State University Traumatic Brain Injury Identification method (OSU TBI-ID) to identify concussion and periods of repeated, subclinical head trauma in 108 young adult athletes who also underwent a comprehensive protocol of cognitive tests, mood/anxiety questionnaires, and high-angular-resolution diffusion-weighted brain imaging to evaluate potential changes in white matter microstructure.ResultsAnalyses showed that athletes with a history of repetitive, subclinical impacts to the head performed slightly worse on a measure of inhibitory impulse control and had more anxiety symptoms compared to those who never sustained any type of head injury but were otherwise the same as athletes with no history of concussion. Importantly, there were no group differences in cerebral white matter as measured by tract- based spatial statistics (TBSS), nor were there any associations between OSU TBI-ID measures and whole-brain principal scalars and free-water corrected scalars.DiscussionOur results provide support for the hypothesis that it is not concussion per se, but repetitive head impacts that beget worse outcomes.

Abstract Background Several countries allocate official development assistance (ODA) for research on global health and development issues that is initiated in the donor country. The integration of such research within domestic research systems aligns with efforts to coordinate ODA investments with science, technology and innovation policies towards achieving the Sustainable Development Goals (SDGs). Methods Through a document synthesis and interviews with research funders in ODA donor and recipient countries, we evaluated the performance of this funding approach across seven donor-country programmes from five donor countries and examined the institutional design elements that increase its chances of advancing development goals and addressing global challenges. Results We found that carefully designed programmes provide a promising pathway to producing valuable and contextually relevant knowledge on global health and development issues. To achieve these outcomes and ensure they benefit ODA-receiving countries, programmes should focus on recipient-country priorities and absorptive capacity; translate research on global public goods into context-appropriate technologies; plan and monitor pathways to impact; structure equitable partnerships; strengthen individual and institutional capacity; and emphasize knowledge mobilization. Conclusions Global health and development research programmes and partnerships have an important role to play in achieving the SDGs and addressing global challenges. Governments should consider the potential of ODA-funded research programmes to address gaps in their global health and development frameworks. In the absence of concrete evidence of development impact, donor countries should consider making increases in ODA allocations for research additional to more direct investments that have demonstrated effectiveness in ODA-receiving countries.

Motor stereotypies are common in children with autism spectrum disorder (ASD), intellectual disability, or sensory deprivation, as well as in typically developing children ("primary" stereotypies, pCMS). The precise pathophysiological mechanism for motor stereotypies is unknown, although genetic etiologies have been suggested. In this study, we perform whole-exome DNA sequencing in 129 parent-child trios with pCMS and 853 control trios (118 cases and 750 controls after quality control). We report an increased rate of de novo predicted-damaging DNA coding variants in pCMS versus controls, identifying KDM5B as a high-confidence risk gene and estimating 184 genes conferring risk. Genes harboring de novo damaging variants in pCMS probands show significant overlap with those in Tourette syndrome, ASD, and those in ASD probands with high versus low stereotypy scores. An exploratory analysis of these pCMS gene expression patterns finds clustering within the cortex and striatum during early mid-fetal development. Exploratory gene ontology and network analyses highlight functional convergence in calcium ion transport, demethylation, cell signaling, cell cycle and development. Continued sequencing of pCMS trios will identify additional risk genes and provide greater insights into biological mechanisms of stereotypies across diagnostic boundaries.

During the COVID-19 pandemic, young people have been exposed to distressing content about COVID-19 without knowing whether they can trust such content. This indicates a need to examine the effects of social media use on mental health and well-being. Existing research provides an inconsistent impression of such effects. Thus, we examined the relation between exposure to COVID-19 information on social media and well-being and assessed if trust in COVID-19 information on social media moderated this relationship. The sample consisted of 168 adolescents and young adults from the U.K. and U.S. (Mage = 17.4 years). Participants completed measures of exposure to, and trust in, COVID-19 information on social media platforms, and measures of emotional, psychological, and social well-being. Results revealed a null to positive relation between exposure to COVID-19 information on social media and well-being across measures. However, when trust was added to the models as a moderator, results indicated that, for adolescents with higher levels of trust in COVID-19 information found on social media, the relation between information encountered on social media and well-being was positive. In contrast, for adolescents with lower levels of trust, the association between information encountered on social media and well-being was null or sometimes negative. Given the lack of consensus about the impact of social media use on well-being, these results point to the importance of trust when assessing the relationship between exposure to COVID-19 information and well-being.

With over 200 pandemic threats emerging every year, the efficacy of closing national borders to control the transmission of disease in the first months of a pandemic remains a critically important question. Previous studies offer conflicting evidence for the potential effects of these closures on COVID-19 transmission and no study has yet empirically evaluated the global impact of border closures using quasi-experimental methods and real-world data. We triangulate results from interrupted time-series analysis, meta-regression, coarsened exact matching, and an extensive series of robustness checks to evaluate the effect of 166 countries' national border closures on the global transmission of COVID-19. Total border closures banning non-essential travel from all countries and (to a lesser extent) targeted border closures banning travel from specific countries had some effect on temporarily slowing COVID-19 transmission in those countries that implemented them. In contrast to these country-level impacts, the global sum of targeted border closures implemented by February 5, 2020 was not sufficient to slow global COVID-19 transmission, but the sum of total border closures implemented by March 19, 2020 did achieve this effect. Country-level results were highly heterogeneous, with early implementation and border closures so broadly targeted that they resemble total border closures improving the likelihood of slowing the pandemic's spread. Governments that can make productive use of extra preparation time and cannot feasibly implement less restrictive alternatives might consider enacting border closures. However, given their moderate and uncertain impacts and their significant harms, border closures are unlikely to be the best policy response for most countries and should only be deployed in rare circumstances and with great caution. All countries would benefit from global mechanisms to coordinate national decisions on border closures during pandemics.

This paper compares the performance of three competing corridors serving landlocked SADC countries (Beira, Dar es Salaam, and Durban) based on total economic cost from the perspective of transporters, retailers, and manufacturers. The motivation for the research is the paradox that, while Beira is closest to the hinterland served by these corridors, it attracts the least cargo. Historical research compares corridors in terms of both direct costs and time delays, but without translating time delays and variability in time delays into the economic costs experienced by corridor users. Unpredictable time delays reduce the competitiveness of cargo owners forming part of global just-in-time value chains. Our novel TEC model includes direct costs and the cost impact of delays and variability in delays and quantifies the relative contributions of ports, border posts, and road travel. The Port’s efficiency proved to be the biggest differentiator between these corridors, followed by border posts and road links. We found that while the Beira corridor has the lowest cost if only average travel time is considered, the Durban corridor proves to be the most competitive when variability in time delays is also considered, explaining why Durban enjoys the largest share of cargo transported to the landlocked hinterland.