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Background Implementation of the cardiovascular disease (CVD) prevention guidelines in the UK has been repeatedly evaluated under the auspices of the British Cardiovascular Society in three Action on Secondary and Primary Prevention by Intervention to Reduce Events (ASPIRE) surveys in 1994–1995, 2008–2010 and 2017–2019. The primary care arm of ASPIRE-2-PREVENT (A-3-P) was conducted to evaluate lifestyle and medical risk factor management in people at high risk of atherosclerotic CVD in everyday clinical practice.Methods A-3-P was a cross-sectional survey in 27 general practices and health centres across 5 English National Health Service regions. Patients with no history of atherosclerotic CVD started on blood pressure and/or lipid and/or glucose lowering treatments were identified retrospectively and interviewed at least 6 months after the initiation of medication.Results 557 patients attended the interview and examination (45.8% women; mean age 61.7±10.8 years). The risk factor control was poor: 9.3% of patients were smokers, 38.1% obese (body mass index≥30 kg/m2) and 53.5% centrally obese (waist circumference≥88 cm for women, ≥102 cm for men). Only 37.8% of patients on blood pressure-lowering therapies achieved the target of

Objective Alcohol-related liver disease (ALD) is the most common cause of liver-related ill health and liver-related deaths in the UK, and deaths from ALD have doubled in the last decade. The management of ALD requires treatment of both liver disease and alcohol use; this necessitates effective and constructive multidisciplinary working. To support this, we have developed quality standard recommendations for the management of ALD, based on evidence and consensus expert opinion, with the aim of improving patient care.Design A multidisciplinary group of experts from the British Association for the Study of the Liver and British Society of Gastroenterology ALD Special Interest Group developed the quality standards, with input from the British Liver Trust and patient representatives.Results The standards cover three broad themes: the recognition and diagnosis of people with ALD in primary care and the liver outpatient clinic; the management of acutely decompensated ALD including acute alcohol-related hepatitis and the posthospital care of people with advanced liver disease due to ALD. Draft quality standards were initially developed by smaller working groups and then an anonymous modified Delphi voting process was conducted by the entire group to assess the level of agreement with each statement. Statements were included when agreement was 85% or greater. Twenty-four quality standards were produced from this process which support best practice. From the final list of statements, a smaller number of auditable key performance indicators were selected to allow services to benchmark their practice and an audit tool provided.Conclusion It is hoped that services will review their practice against these recommendations and key performance indicators and institute service development where needed to improve the care of patients with ALD.

Memories are easier to relearn than learn from scratch. This advantage, known as savings, has been widely assumed to result from the reemergence of stable long-term memories. In fact, the presence of savings has often been used as a marker for whether a memory has been consolidated. However, recent findings have demonstrated that motor learning rates can be systematically controlled, providing a mechanistic alternative to the reemergence of a stable long-term memory. Moreover, recent work has reported conflicting results about whether implicit contributions to savings in motor learning are present, absent, or inverted, suggesting a limited understanding of the underlying mechanisms. To elucidate these mechanisms, we investigate the relationship between savings and long-term memory by experimentally dissecting the underlying memories based on short-term (60-s) temporal persistence. Components of motor memory that are temporally-persistent at 60 s might go on to contribute to stable, consolidated long-term memory, whereas temporally-volatile components that have already decayed away by 60 s cannot. Surprisingly, we find that temporally-volatile implicit learning leads to savings, whereas temporally-persistent learning does not, but that temporally-persistent learning leads to long-term memory at 24 h, whereas temporally-volatile learning does not. This double dissociation between the mechanisms for savings and long-term memory formation challenges widespread assumptions about the connection between savings and memory consolidation. Moreover, we find that temporally-persistent implicit learning not only fails to contribute to savings, but also that it produces an opposite, anti-savings effect, and that the interplay between this temporally-persistent anti-savings and temporally-volatile savings provides an explanation for several seemingly conflicting recent reports about whether implicit contributions to savings are present, absent, or inverted. Finally, the learning curves we observed for the acquisition of temporally-volatile and temporally-persistent implicit memories demonstrate the coexistence of implicit memories with distinct time courses, challenging the assertion that models of context-based learning and estimation should supplant models of adaptive processes with different learning rates. Together, these findings provide new insight into the mechanisms for savings and long-term memory formation.

For centuries, humans occupying arid regions of North America have maintained an intricate relationship with Agave (Agavoideae, Asparagaceae). Today Agave cultivation, primarily for beverage production, provides an economic engine for rural communities throughout Mexico. Among known dryland-farming methods, the use of rock piles and cattle-grazed areas stand out as promising approaches for Agave cultivation. Identifying new cultivation areas to apply these approaches in Arizona, USA and Sonora, Mexico warrants a geographic assessment of areas outside the known ranges of rock piles and grasslands. The objective of this study was to predict areas for dryland-farming of Agave and develop models to identify potential areas for Agave cultivation. We used maximum entropy (MaxEnt) ecological-niche-modeling algorithms to predict suitable areas for Agave dryland farming. The model was parameterized using occurrence records of Hohokam rock piles in Arizona and grassland fields cultivated with Agave in Sonora. Ten environmental-predictor variables were used in the model, downloaded from the WorldClim 2 climate database. The model identified potential locations for using rock piles as dryland-farming methods from south-central Arizona to northwestern Sonora. The Agave-grassland model indicated that regions from central to southern Sonora have the highest potential for cultivation of Agave, particularly for the species Agave angustifolia. Results suggest that there are many suitable areas where rock piles can be used to cultivate Agave in the Sonoran Desert, particularly in the border of southeastern Arizona and northwest Sonora. Likewise, cattle-grazing grasslands provide a viable environment for cultivating Agave in southern Sonora, where the expanding bacanora-beverage industry continues to grow and where different Agave products (e.g., syrups, fructans, saponins, and medicinal compounds) can potentially strengthen local economies.

The motor system demonstrates an exquisite ability to adapt to changes in the environment and to quickly reset when these changes prove transient. If similar environmental changes are encountered in the future, learning may be faster, a phenomenon known as savings. In studies of sensorimotor learning, a central component of savings is attributed to the explicit recall of the task structure and appropriate compensatory strategies. Whether implicit adaptation also contributes to savings remains subject to debate. We tackled this question by measuring, in parallel, explicit and implicit adaptive responses in a visuomotor rotation task, employing a protocol that typically elicits savings. While the initial rate of learning was faster in the second exposure to the perturbation, an analysis decomposing the 2 processes showed the benefit to be solely associated with explicit re-aiming. Surprisingly, we found a significant decrease after relearning in aftereffect magnitudes during no-feedback trials, a direct measure of implicit adaptation. In a second experiment, we isolated implicit adaptation using clamped visual feedback, a method known to eliminate the contribution of explicit learning processes. Consistent with the results of the first experiment, participants exhibited a marked reduction in the adaptation function, as well as an attenuated aftereffect when relearning from the clamped feedback. Motivated by these results, we reanalyzed data from prior studies and observed a consistent, yet unappreciated pattern of attenuation of implicit adaptation during relearning. These results indicate that explicit and implicit sensorimotor processes exhibit opposite effects upon relearning: Explicit learning shows savings, while implicit adaptation becomes attenuated.

Retrovirus assembly is driven by the multidomain structural protein Gag. Interactions between the capsid domains (CA) of Gag result in Gag multimerization, leading to an immature virus particle that is formed by a protein lattice based on dimeric, trimeric, and hexameric protein contacts. Among retroviruses the inter- and intra-hexamer contacts differ, especially in the N-terminal sub-domain of CA (CANTD). For HIV-1 the cellular molecule inositol hexakisphosphate (IP6) interacts with and stabilizes the immature hexamer, and is required for production of infectious virus particles. We have used in vitro assembly, cryo-electron tomography and subtomogram averaging, atomistic molecular dynamics simulations and mutational analyses to study the HIV-related lentivirus equine infectious anemia virus (EIAV). In particular, we sought to understand the structural conservation of the immature lentivirus lattice and the role of IP6 in EIAV assembly. Similar to HIV-1, IP6 strongly promoted in vitro assembly of EIAV Gag proteins into virus-like particles (VLPs), which took three morphologically highly distinct forms: narrow tubes, wide tubes, and spheres. Structural characterization of these VLPs to sub-4Å resolution unexpectedly showed that all three morphologies are based on an immature lattice with preserved key structural components, highlighting the structural versatility of CA to form immature assemblies. A direct comparison between EIAV and HIV revealed that both lentiviruses maintain similar immature interfaces, which are established by both conserved and non-conserved residues. In both EIAV and HIV-1, IP6 regulates immature assembly via conserved lysine residues within the CACTD and SP. Lastly, we demonstrate that IP6 stimulates in vitro assembly of immature particles of several other retroviruses in the lentivirus genus, suggesting a conserved role for IP6 in lentiviral assembly.

Aim/Purpose: The teaching of appropriate problem-solving techniques to novice learners in undergraduate software development education is often poorly defined when compared to the delivery of programming techniques. Given the global need for qualified designers of information technology, the purpose of this research is to produce a foundational template for an educational software development methodology grounded in the established literature. This template can be used by third-level educators and researchers to develop robust educational methodologies to cultivate structured problem solving and software development habits in their students while systematically teaching the intricacies of software creation. Background: While software development methodologies are a standard approach to structured and traceable problem solving in commercial software development, educational methodologies for inexperienced learners remain a neglected area of research due to their assumption of prior programming knowledge. This research aims to address this deficit by conducting an integrative review to produce a template for such a methodology. Methodology: An integrative review was conducted on the key components of Teaching Software Development Education, Problem Solving, Threshold Concepts, and Computational Thinking. Systematic reviews were conducted on Computational Thinking and Software Development Education by employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) process. Narrative reviews were conducted on Problem Solving and Threshold Concepts. Contribution: This research provides a comprehensive analysis of problem solving, software development education, computational thinking, and threshold concepts in computing in the context of undergraduate software development education. It also synthesizes review findings from these four areas and combines them to form a research-based foundational template methodology for use by educators and researchers interested in software development undergraduate education. Findings: This review identifies seven skills and four concepts required by novice learners. The skills include the ability to perform abstraction, data representation, decomposition, evaluation, mental modeling, pattern recognition, and writing algorithms. The concepts include state and sequential flow, non-sequential flow control, modularity, and object interaction. The teaching of these skills and concepts is combined into a spiral learning framework and is joined by four development stages to guide software problem solving: understanding the problem, breaking into tasks, designing, coding, testing, and integrating, and final evaluation and reflection. This produces the principal finding, which is a research-based foundational template for educational software development methodologies. Recommendations for Practitioners: Focusing introductory undergraduate computing courses on a programming syllabus without giving adequate support to problem solving may hinder students in their attainment of development skills. Therefore, providing a structured methodology is necessary as it equips students with essential problem-solving skills and ensures they develop good development practices from the start, which is crucial to ensuring undergraduate success in their studies and beyond. Recommendation for Researchers: The creation of educational software development methodologies with tool support is an under-researched area in undergraduate education. The template produced by this research can serve as a foundational conceptual model for researchers to create concrete tools to better support computing undergraduates. Impact on Society: Improving the educational value and experience of software development undergraduates is crucial for society once they graduate. They drive innovation and economic growth by creating new technologies, improving efficiency in various industries, and solving complex problems. Future Research: Future research should concentrate on using the template produced by this research to create a concrete educational methodology adapted to suit a specific programming paradigm, with an associated learning tool that can be used with first-year computing undergraduates.

Pedagogical partnerships are rarely used to explore how students develop agency through Work Integrated Learning (WIL). This study contributes to this gap by exploring how pedagogical partnerships between students, industry experts and subject leaders in a postgraduate online WIL capstone assisted students to gain clarity about their professional identities as careers practitioners. To further scholarly understanding and appreciation for pedagogical partnerships in WIL, we use narrative methods to provide insight into how careers counselling students learned the process of narrative counselling. We emphasise students' learning as a re-storying of their professional identities as careers practitioners. We discuss the significant role pedagogical partnerships played in the development of co-constructed narratives that enabled student participants in this study to re-story their professional identities as careers practitioners. The paper concludes with observations about the implications of our findings, including resources needed for the pedagogical design.

We aim to evaluate hysterectomy-recovery related videos on YouTube. This cross-sectional study analyzed videos available through the YouTube interface. We calculated the views-per-day and interactions (comments, “thumbs up or down”) per 1,000 views for relevant videos. The publishers were categorized into patients, physicians, hospitals, media, industry, nonprofit, government and “other”. Video characteristics were compared between these categories using non-parametric tests. We analyzed 2,092 YouTube videos related to hysterectomy recovery; 959 relevant videos published from August 30, 2006 to June 16, 2017 were included. The largest number of relevant videos were published by patients (48.6%), followed by physicians (15.8%), hospitals (12.7%), media (7.8%), and industry (7.6%). Views per day were similar between videos published by patients and physicians (median 2.1, vs median 2.6, p = 0.31). Videos published by patients had more interaction in the form of “thumbs up” votes (median 8.6/1,000 views, p

Complex behavioral traits, such as those making up a migratory phenotype, are regulated by multiple environmental factors and multiple genes. We investigated possible relationships between microsatellite variation at two candidate genes implicated in the control of migratory behavior, Clock and Adcyap1, and several aspects of migratory life-history and evolutionary divergence in the Painted Bunting (Passerina ciris), a species that shows wide variation in migratory and molting strategies across a disjunct distribution. We focused on Clock and Adcyap1 microsatellite variation across three Painted Bunting populations in Oklahoma, Louisiana, and North Carolina, and for the Oklahoma breeding population we used published migration tracking data on adult males to explore phenotypic variation in individual migratory behavior. We found no correlation between microsatellite allele size within either Clock and Adcyap1 relative to the initiation or duration of fall migration in adult males breeding in Oklahoma. We also show the lack of significant correlations with aspects of the migratory phenotype for the Louisiana population. Our research highlights the limitations of studying microsatellite allelic mutations that are of undetermined functional influence relative to complex behavioral phenotypes.

The authors investigate how race and political partisanship affected variations in workplace and non-workplace mobility at three COVID-19 phases—lockdown (2020), reopening (2021), and endemic COVID (2022). They theorize that structural racism compelled relatively greater workplace mobility rates in Black communities during lockdown, and reduced Black workplace mobility during reopening and endemic COVID. By contrast, they posit elite-level anti-science skepticism and its amplification resulted in Trump-voting communities experiencing relatively higher workplace and non-workplace mobility rates than non-Trump-voting areas throughout the pandemic. Regressions primarily using county-level Google Mobility Reports data support the hypotheses, conditioning on state-level fixed effects and county-level urbanity, COVID job-type sorting, demographics, and socioeconomics. The county-level results are complemented by outcomes from novel individual-level COVID lockdown survey data, helping connect the proposed individual-level mechanisms to the county-level findings. The authors conclude that work mobility during COVID was racialized and politicized, offering empirical insights into how systematic disadvantages can lead to increased and unequal precarity during periods of acute economic or social crisis. [ABSTRACT FROM AUTHOR]

Research, media sources, and polls have identified negative effects associated with presidential elections. The aim of this research was to investigate associations between US presidential election results and mental health outcomes in university students. This investigation consisted of two independent studies. Study 1 analyzed data collected between the years 2000 and 2016 from students who utilized counseling services (N = 32,506) at a large, private, conservative institution in the western United States. Study 2 analyzed data collected between the years 2010 and 2016 from over 100 university counseling centers across the United States. Upon analyzing the quantitative and qualitative data, the results did not support the findings that presidential elections negatively impact the mental health outcomes of students who receive university counseling services. Furthermore, there was no detectable increase in student distress regardless of election year, age, ethnicity, gender, religion, relationship status, sexual orientation, geographic region, citizenship, and first-generation student status.

BackgroundThe Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC) study aims to characterize the frequency and time course of acute and long-term cardiac and non-cardiac sequelae in multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C), which are currently poorly understood.MethodsThis multicenter observational cohort study will enroll at least 600 patients