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All species of large whales are susceptible to vessel strikes, but the true scale and geographical extent of such strikes is not known. This paper provides a qualitative assessment of the range-wide risks posed to gray whales Eschrichtius robustus by vessels, by comparing patterns of whale distribution with the density of vessel traffic seasonally throughout the North Pacific in 2019. Areas of very high vessel density were evident year-round near many coastlines, along inter-continental trade routes, and at hubs of commercial shipping near port entrances. Gray whales were exposed to vessel strikes throughout their range and in their feeding, southbound migration, wintering, and northbound migration periods. Areas of apparently high risk were in the Russian Far East (Kamchatka peninsula and Okhotsk Sea), Bering Sea (including the Aleutian Islands), Gulf of Alaska, and along the entire west coast of North America. Risk appeared greatest during south- and northbound migration when much of the gray whale population is moving through waters near shore. Tanker, container, and bulk-carrier ships represent considerable risk to whales in the North Pacific Ocean, but the large geographical extent of commercial fishing activities suggests that fisheries are also a substantial source of risk. Vessel-strike risk maps indicate the relative extent of exposure of gray (and other) whales to underwater vessel noise. The number of gray whales killed by ship strikes each year may be in the tens, or perhaps the low hundreds. Additional analyses, including quantitative assessments, are warranted to further clarify the risk of vessel strikes to gray whales.

Vessel strikes are a critical threat to endangered North Atlantic right whales (Eubalaena glacialis), significantly contributing to their elevated mortality. Accurate estimates of these mortality rates are essential for developing effective management strategies to aid in the species' recovery. This study enhances existing vessel strike models by incorporating detailed regional data on vessel traffic characteristics as well as whale distribution and behavior. Our model assesses the spatial and temporal variability in vessel strike risk along the U.S. east coast apportioned into three vessel length classes (26-65 feet, 65-350 feet, > 350 feet). By including regional right whale depth distributions and parameterizing potential whale avoidance based on factors such as descent rate, bottom depth, and vessel speed and size, the model provides a refined estimation of mortality risk. We also address the underrepresentation of smaller vessel activity via a correction factor, offering a more accurate annual mortality risk estimate for each vessel size class. These findings highlight that vessels > 350 feet in length pose the greatest risk to right whales. Simulations of reduced vessel speeds indicate that speed measures can mitigate mortality rates; however, residual risk remains even at speeds of 10 knots or less suggesting limitations to this mitigation approach., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Electromicrobial production (EMP), where electrochemically generated substrates (e.g., H 2 ) are used as energy sources for microbial processes, has garnered significant interest as a method of producing fuels and other value-added chemicals from CO 2 . Combining these processes with direct air capture (DAC) has the potential to enable a truly circular carbon economy. Here, we analyze the economics of a hypothetical system that combines adsorbent-based DAC with EMP to produce n -butanol, a potential replacement for fossil fuels. First-principles-based modeling is used to predict the performance of the DAC and bioprocess components. A process model is then developed to map material and energy flows, and a techno-economic assessment is performed to determine the minimum fuel selling price. Beyond assessing a specific set of conditions, this analytical framework provides a tool to reveal potential pathways toward the economic viability of this process. We show that an EMP system utilizing an engineered knallgas bacterium can achieve butanol production costs of <$6/gal ($1.58/L) if a set of optimistic assumptions can be realized.

Protected areas are typically managed as a network of sites exposed to varying anthropogenic conditions. Managing these networks benefits from monitoring of conditions across sites to help prioritize coordinated efforts. Monitoring marine vessel activity and related underwater radiated noise impacts across a network of protected areas, like the U.S. National Marine Sanctuary system, helps managers ensure the quality of habitats used by a wide range of marine species. Here, we use underwater acoustic detections of vessels to quantify different characteristics of vessel noise at 25 locations within eight marine sanctuaries including the Hawaiian Archipelago and the U.S. east and west coasts. Vessel noise metrics, including temporal presence and sound levels, were paired with Automatic Identification System (AIS) vessel tracking data to derive a suite of robust vessel noise indicators for use across the network of marine protected areas. Network-wide comparisons revealed a spectrum of vessel noise conditions that closely matched AIS vessel traffic composition. Shifts in vessel noise were correlated with the decrease in vessel activity early in the COVID-19 pandemic, and vessel speed reduction management initiatives. Improving our understanding of vessel noise conditions in these protected areas can help direct opportunities for reducing vessel noise, such as establishing and maintaining noise-free periods, enhancing port efficiency, engaging with regional and international vessel quieting initiatives, and leveraging co-benefits of management actions for reducing ocean noise., (© 2024. The Author(s).)

Objectives: To describe outcomes following humerus aseptic nonunion surgery in patients whose initial fracture was treated operatively and to identify risk factors for nonunion surgery failure in the same population., Design: Retrospective case series., Setting: Eight, academic, level 1 trauma centers., Patients Selection Criteria: Patients with aseptic humerus nonunion (OTA/AO 11 and 12) after the initial operative management between 1998 and 2019., Outcome Measures and Comparisons: Success rate of nonunion surgery., Results: Ninety patients were included (56% female; median age 50 years; mean follow-up 21.2 months). Of 90 aseptic humerus nonunions, 71 (78.9%) united following nonunion surgery. Thirty patients (33.3%) experienced 1 or more postoperative complications, including infection, failure of fixation, and readmission. Multivariate analysis found that not performing revision internal fixation during nonunion surgery (n = 8; P = 0.002) and postoperative de novo infection (n = 9; P = 0.005) were associated with an increased risk of recalcitrant nonunion. Patient smoking status and the use of bone graft were not associated with differences in the nonunion repair success rate., Conclusions: This series of previously operated aseptic humerus nonunions found that more than 1 in 5 patients failed nonunion repair. De novo postoperative infection and failure to perform revision internal fixation during nonunion surgery were associated with recalcitrant nonunion. Smoking and use of bone graft did not influence the success rate of nonunion surgery. These findings can be used to give patients a realistic expectation of results and complications following humerus nonunion surgery., Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence., Competing Interests: Dr. J.R. Hsu reports consultancy for Globus Medical and personal fees from Smith & Nephew speakers' bureau. The remaining authors report no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The safety and effectiveness of the RelayPro endograft (Terumo Aortic) was assessed for the treatment of acute, complicated type B aortic dissection (TBAD)., Methods: A prospective pivotal trial analyzed a primary end point of all-cause mortality at 30 days. Secondary end points included technical success, major adverse events (disabling stroke, renal failure, and paraplegia/paralysis), endoleaks, patency, rupture, device integrity, false lumen perfusion, reinterventions, aortic expansion, and migration evaluated to 5 years., Results: The study involved 22 United States centers and enrolled 56 patients (mean age, 59.5 ± 11.4 years) from 2017 to 2021; of whom, 73.2% were men and 53.6% were African American. TBAD was complicated by malperfusion of the kidneys (51.8%), lower extremities (35.7%), and viscera (33.9%), and rupture (10.7%). Dissection extended proximally to zones 1/2 (14.3%) and zone 3 (78.6%) and distally to the iliac arteries (67.3%). Most procedures were percutaneous (85.5%). Technical success was 100%. Median hospitalization was 7 days (interquartile range, 5-12 days). All-cause mortality at 30 days was 1.8% (1 of 56; upper 95% CI, 8.2%; P < .0001). Seven major adverse events occurred in 6 patients (10.7%), consisting of paraplegia (n = 3), paraparesis (n = 2), disabling stroke (n = 1), and renal failure (n = 1). All paraplegia/paraparesis resolved with lumbar drainage. Kaplan-Meier analysis estimated a freedom from major adverse events of 89.1% at each interval from 30 days to 3 years. There was 1 endoleak (Type Ia), 2 retrograde dissections, and aortic diameter growth occurred in 2. There has been no rupture, fistula, component separation, patency loss, stenosis, kinking, twisting, bird beak, loss of device integrity, or fracture., Conclusions: RelayPro is safe and effective in acute, complicated TBAD. Follow-up is ongoing to evaluate longer-term outcomes and durability., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: To evaluate the rate of reoperation in patients without sagittal plane malalignment who underwent percutaneous screw fixation of a valgus-impacted femoral neck fracture., Design: Retrospective case series., Setting: Two Level 1 academic trauma centers., Patients and Intervention: Two hundred seven patients >50 years of age with valgus-impacted femoral neck fractures treated with at least 3 large-diameter (>6.5 mm) cancellous screws from 2013 to 2019. Patients were excluded if there was a sagittal plane fracture deformity., Main Outcome Measurements: The primary outcome was reoperation. Secondary outcomes considered "major complications" included: avascular necrosis, varus collapse or implant cutout, nonunion, deep infection, and hematoma requiring reoperation. Surgical fixation strategies (screw configuration, aim) and implant type (partial vs. fully threaded cancellous screws) were secondarily compared., Results: Average patient age was 77 years, and median clinical follow-up was 658 days. Thirty-one patients (15%) required reoperation, and the major complication rate was 17.3% (36 complications in 33 patients). Logistic regression analysis demonstrated a higher risk of reoperation with constructs consisting of all partially threaded screws (17.0%) compared with the use of at least 1 fully threaded screw (7.5%) when an inverted triangle configuration was used (odds ratio, 2.50; 95% CI, 0.81-7.77)., Conclusions: This study demonstrated a relatively high rate of reoperation and major complications in patients with valgus-impacted femoral neck fractures without sagittal malalignment treated with in situ percutaneous screw fixation., Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence., Competing Interests: The authors report no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: To investigate the correlation between a screw's radiographic relationship to the piriformis fossa with position on CT in the clinical setting., Methods: Intraoperative fluoroscopic images of patients treated with cannulated screw fixation of a femoral neck fracture, who also had a postoperative CT scan, were retrospectively evaluated by 4 fellowship-trained orthopaedic trauma surgeons. The posterosuperior screw on the AP fluoroscopic view was determined to be above the piriformis fossa (APF) or below the piriformis fossa (BPF). Using CT scan to determine IOI placement, the ability to predict IOI position based on fluoroscopic imaging was evaluated by calculating accuracy, sensitivity, specificity, and interobserver reliability., Results: 73 patients met inclusion criteria. The incidence of IOI screw placement was 59% on CT evaluation. The use of the PF landmark accurately predicted CT findings in 89% of patients. A screw placed APF was 90% sensitive and 88% specific in predicting cortical breach, with near-perfect interobserver agreement (κ = 0.81)., Conclusion: The use of the PF radiographic landmark is highly sensitive and specific in predicting the placement of an IOI posterosuperior femoral neck screw., Level of Evidence: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Intracellular biomacromolecules, such as industrial enzymes and biopolymers, represent an important class of bio-derived products obtained from bacterial hosts. A common key step in the downstream separation of these biomolecules is lysis of the bacterial cell wall to effect release of cytoplasmic contents. Cell lysis is typically achieved either through mechanical disruption or reagent-based methods, which introduce issues of energy demand, material needs, high costs, and scaling problems. Osmolysis, a cell lysis method that relies on hypoosmotic downshock upon resuspension of cells in distilled water, has been applied for bioseparation of intracellular products from extreme halophiles and mammalian cells. However, most industrial bacterial strains are non-halotolerant and relatively resistant to hypoosmotic cell lysis., Results: To overcome this limitation, we developed two strategies to increase the susceptibility of non-halotolerant hosts to osmolysis using Cupriavidus necator, a strain often used in electromicrobial production, as a prototypical strain. In one strategy, C. necator was evolved to increase its halotolerance from 1.5% to 3.25% (w/v) NaCl through adaptive laboratory evolution, and genes potentially responsible for this phenotypic change were identified by whole genome sequencing. The evolved halotolerant strain experienced an osmolytic efficiency of 47% in distilled water following growth in 3% (w/v) NaCl. In a second strategy, the cells were made susceptible to osmolysis by knocking out the large-conductance mechanosensitive channel (mscL) gene in C. necator. When these strategies were combined by knocking out the mscL gene from the evolved halotolerant strain, greater than 90% osmolytic efficiency was observed upon osmotic downshock. A modified version of this strategy was applied to E. coli BL21 by deleting the mscL and mscS (small-conductance mechanosensitive channel) genes. When grown in medium with 4% NaCl and subsequently resuspended in distilled water, this engineered strain experienced 75% cell lysis, although decreases in cell growth rate due to higher salt concentrations were observed., Conclusions: Our strategy is shown to be a simple and effective way to lyse cells for the purification of intracellular biomacromolecules and may be applicable in many bacteria used for bioproduction., (© 2023. The Author(s).)

Purpose: Recent studies suggest that 24-h urine osmolality (UOsm) for optimal water intake should be maintained < 500 mmol·kg -1 . The purpose of this study was to determine the total water intake (TWI) requirement for healthy adults to maintain optimal hydration as indicated by 24-h urine osmolality < 500 mmol·kg -1 ., Methods: Twenty-four-hour UOsm was assessed in 49 men and 50 women residing in the United States (age: 41 ± 14 y, body mass index: 26.3 ± 5.2 kg·m -2 ). TWI was assessed from 7-day water turnover, using a dilution of deuterium oxide, corrected for metabolic water production. The diagnostic accuracy of TWI to identify UOsm < 500 mmol·kg -1 was evaluated using receiver operating characteristic (ROC) analysis in men and women separately., Results: Twenty-four-hour UOsm was 482 ± 229 and 346 ± 182 mmol·kg -1 and TWI was 3.57 ± 1.10 L·d -1 and 3.20 ± 1.27 L·d -1 in men and women, respectively. ROC analysis for TWI detecting 24-h UOsm < 500 mmol·kg -1 in men yielded an area under the curve (AUC) of 77.4% with sensitivity, specificity, and threshold values of 83.3%, 64.5%, and 3.39 L·d -1 , respectively. The AUC was 82.4% in women with sensitivity, specificity, and threshold values of 85.7%, 72.1%, and 2.61 L·d -1 ., Conclusion: Considering threshold values in men and women of 3.4 L·d -1 and 2.6 L·d -1 , respectively, maintaining TWI in line with National Academy of Medicine guidelines of 3.7 L·d -1 in men and 2.7 L·d -1 in women should be sufficient for most individuals in the United States to maintain 24-h UOsm < 500 mmol·kg -1 ., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

An 84-year-old presented with a large, symptomatic juxtarenal abdominal aortic aneurysm. Owing to severe angulation of the infrarenal neck, advancement of the distal bifurcated component caused dramatic lateral movement of the proximal physician-modified endovascular graft (PMEG) fenestrated device. This procedure risked aneurysm sac perforation and possible PMEG device displacement. To avoid this complication, the distal aspect of the PMEG device was tethered in place using endoscopic forceps to provide countertraction, similar to pulling a tightrope. This technique allowed for the uneventful placement of the distal bifurcated component without complication. This technique can overcome device placement challenges within an angulated aorta caused by large aneurysms., (© 2022 The Author(s).)

The objectives of the current process improvement project were to improve access to health care and enhance care for older adults living in rural areas and to decrease morbidity and mortality. This project implemented an evidence-based screening tool, the Rapid Geriatric Assessment (RGA), as a routine screening in a patient-centered medical home for older adults in rural areas. Z-testing was used to measure the change, defined as scoring positive for at least one of four geriatric syndromes, as a result of using the RGA tool. Approximately one third had at least one such change following implementation of the RGA. In addition to the change in geriatric conditions, a significant change (48%) was noted in the number of patients who implemented an advance directive. We recommend the RGA be integrated in routine screening as it can help providers establish a targeted treatment plan for older adults who may be at increased risk for burden of disease. [ Journal of Gerontological Nursing, 48 (9), 47-51.].

Background: The rs7903146 variant in the TCF7L2 gene is associated with defects in postprandial insulin and glucagon secretion and increased risk of type 2 diabetes. However, it is unclear if this variant has effects on glucose metabolism that are independent of islet function. Methods: We studied 54 nondiabetic subjects on two occasions where endogenous hormone secretion was inhibited by somatostatin. Twenty-nine subjects were homozygous for the diabetes-associated allele (TT) and 25 for the diabetes-protective allele (CC) at rs7903146, but otherwise matched for anthropometric characteristics. On 1 day, glucagon infused at a rate of 0.65 ng/kg/min, and at 0 min prevented a fall in glucagon (nonsuppressed day). On the contrary, infusion commenced at 120 min to create a transient fall in glucagon (suppressed day). Subjects received glucose (labeled with [3- 3 H]-glucose) infused to mimic the systemic appearance of oral glucose. Insulin was infused to mimic a prandial insulin response. Endogenous glucose production (EGP) was measured using the tracer dilution technique. Results: Lack of glucagon suppression increased postchallenge glucose concentrations and impaired EGP suppression. However, in the presence of matched insulin and glucagon concentrations, genetic variation in TCF7L2 did not alter glucose metabolism. Conclusion: These data suggest that genetic variation in TCF7L2 alters glucose metabolism through changes in islet hormone secretion.

The regulation of cell growth has fundamental physiological, biotechnological and medical implications. However, methods that can continuously monitor individual cells at sufficient mass and time resolution hardly exist. Particularly, detecting the mass of individual microbial cells, which are much smaller than mammalian cells, remains challenging. Here, we modify a previously described cell balance ('picobalance') to monitor the proliferation of single cells of the budding yeast, Saccharomyces cerevisiae, under culture conditions in real time. Combined with optical microscopy to monitor the yeast morphology and cell cycle phase, the picobalance approaches a total mass resolution of 0.45 pg. Our results show that single budding yeast cells (S/G2/M phase) increase total mass in multiple linear segments sequentially, switching their growth rates. The growth rates weakly correlate with the cell mass of the growth segments, and the duration of each growth segment correlates negatively with cell mass. We envision that our technology will be useful for direct, accurate monitoring of the growth of single cells throughout their cycle., (© 2022. The Author(s).)

The objective of this study was to determine if the implementation of an opioid stewardship initiative involving early conversion to oral opioids improves outcomes in postoperative orthopaedic patients. This single-center retrospective chart review compared adult patients undergoing lower extremity orthopaedic procedures during a specified six-month time period. The primary outcome was total opioid utilization in morphine milligram equivalence (MME) at 48-hours post-surgery. Four hundred ninety-five patients were included in the study, 233 in the intervention group and 262 in the pre-intervention group. The average pain scores at 12, 24 and 48 hours postoperatively were similar among the two groups. After a multivariate linear regression was performed, a 22.9 MME reduction was estimated in the post-implementation group compared to the pre-implementation group (p = 0.003). Based on these results, it appears that converting from intravenous to oral narcotics 24-hours post-orthopaedic surgery reduces total mean MMEs while providing similar pain control. (Journal of Surgical Orthopaedic Advances 31(2):086-089, 2022).

Elevated body mass index (BMI) has been associated with elevated urine osmolality (UOsm), despite having higher total water intake, but it is unclear if overweight/obese individuals have reduced thirst. In this observational study, we found that overweight/obese individuals had higher UOsm compared to normal-weight individuals (749 ± 37 vs. 624 ± 35 mmol•kg -1 ; P < 0.01) while possessing similar thirst ratings (56.4 ± 3 vs. 51.6 ± 3 mm; P = 0.3). In this observational study, overweight/obese individuals possessed more concentrated urine in the absence of higher thirst perception., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The purpose of this investigation was to quantify the effects of storage temperature and duration on the assessment of urine electrolytes. Twenty-one separate human urine specimens were analyzed as baseline and with the remaining specimen separated into eight vials, two in each of the following four temperatures: 22, 7, -20, and -80 °C. Each specimen was analyzed for urine electrolytes (sodium, potassium, and chloride) after 24 and 48 hr. After 24 hr, no significant difference was detected from baseline in urine sodium, potassium, and chloride at all four storage temperatures (p > .05). Similarly, after 48 hr, urine sodium, potassium, and chloride were not significantly different from baseline in all four storage temperatures (p > .05). In conclusion, these data show that urine specimens analyzed for urine sodium, chloride, and potassium are stable up to 48 hr in temperatures ranging from deep freezing to room temperature.

The main focus of this paper is to put forward an argument about the value of asset-based, culturally relevant/responsive and sustaining pedagogies in science education, especially in former colonial contexts. Countering the framing hegemony of science education through a historically Euro-dominant lens, we call for a critical analysis of the state of science education in the Netherlands by exploring, specifically, the Dutch Caribbean community which includes Suriname and the former Dutch Antilles and Aruba and the need to respond with a more culturally relevant and sustaining pedagogical stance. In doing so, we provide a concrete example of a CR-SP-focused community-based STEAM program for young children and their parents in the north of the Netherlands. We hope that this paper will provide the foundation to springboard conversations among educators and researchers with an interest in designing, enacting and researching CR-SP-informed programs and curricula geared for historically marginalized families and children., (© The Author(s) 2022.)

With the global pandemic educators have had to move their courses to virtual spaces, and this quick change has brought up concerns, especially in STEM education where there are ongoing discussions of adapting laboratories and shifting lecture and assessment practices to online learning. One issue that has become more pressing, beyond the financial and technological implications, is that of academic integrity violations. This position paper looks at the intersection academic integrity and equity and social justice in STEM higher education, where there is a lack of research and publications exploring the inequities that exist. The researchers have expertise in these areas and hold positions in as faculty, student, and advisor. The paper's main focus represents a review of the current literature and calls educators to action to change the narratives in STEM and higher education, taking into account the impact of COVID-19 and the shift in the education conversations that have happened due to the pandemic., Competing Interests: Conflict of interestWe have no conflict of interests to disclose., (© The Author(s), under exclusive licence to Springer Nature B.V. 2022.)

Atomic force microscopy is a powerful technique for measurement and mapping of nanoscale topography and electrical and mechanical sample properties. The Nanosurf DriveAFM is a new generation instrument that combines ease of use and high performance through full motorization, CleanDrive photothermal excitation, and a mechanical and electrical design that allows for both high-resolution and large-range imaging.

Type 2 diabetes is a disease characterized by impaired insulin secretion and defective glucagon suppression in the postprandial period. We examined the effect of impaired glucagon suppression on glucose concentrations and endogenous glucose production (EGP) at different degrees of insulin secretory impairment. The contribution of anthropometric characteristics, peripheral, and hepatic insulin action to this variability was also examined. To do so, we studied 54 nondiabetic subjects on two occasions in which endogenous hormone secretion was inhibited by somatostatin, with glucagon infused at a rate of 0.65 ng/kg/min, at 0 min to prevent a fall in glucagon (nonsuppressed day) or at 120 min to create a transient fall in glucagon (suppressed day). Subjects received glucose (labeled with [3- 3 H]-glucose) infused to mimic the systemic appearance of 50-g oral glucose. Insulin was infused to mimic a prandial insulin response in 18 subjects, another 18 received 80% of the dose, and the remaining 18 received 60%. EGP was measured using the tracer-dilution technique. Decreased prandial insulin resulted in greater % increase in peak glucose but not in integrated glucose concentrations attributable to nonsuppressed glucagon. The % change in integrated EGP was unaffected by insulin dose. Multivariate regression analysis, adjusted for age, sex, weight, and insulin dose, did not show a relationship between the EGP response to impaired suppression of glucagon and insulin action as measured at the time of screening by oral glucose tolerance. A similar analysis for hepatic insulin action also did not show a relationship with the EGP response. These data indicate that the effect of impaired glucagon suppression on EGP is independent of anthropometric characteristics and insulin action. NEW & NOTEWORTHY In prediabetes, anthropometric characteristics as well as insulin action do not alter the hepatic response to glucagon. The postprandial suppression or lack of suppression of glucagon secretion is an important factor governing postprandial glucose tolerance independent of insulin secretion.

We describe an implantable sensor developed to measure synovial fluid pH for noninvasive early detection and monitoring of hip infections using standard-of-care plain radiography. The sensor was made of a pH responsive polyacrylic acid-based hydrogel, which expands at high pH and contracts at low pH. A radiodense tantalum bead and a tungsten wire were embedded in the two ends of the hydrogel in order to monitor the change in length of the hydrogel sensor in response to pH via plain radiography. The effective pK a of the hydrogel-based pH sensor was 5.6 with a sensitivity of 3 mm/pH unit between pH 4 and 8. The sensor showed a linear response and reversibility in the physiologically relevant pH range of pH 6.5 and 7.5 in both buffer and bovine synovial fluid solutions with a 30-minute time constant. The sensor was attached to an explanted prosthetic hip and the pH response determined from the X-ray images by measuring the length between the tantalum bead and the radiopaque wire. Therefore, the developed sensor would enable noninvasive detection and studying of implant hip infection using plain radiography.

Parkinson's disease, in most patients, is possibly caused by natural oxidative stress in dopaminergic neurons, insufficient exercise and galactose induced oxidative stress. Dopamine oxidizes to produce oxygen radicals that damage neurons. Exercise generates lactic acid and myokines that are essential for brain health. Galactose produces oxidative stress in the brain. These factors change with age and lifestyle. It is likely that lifestyle interventions, including daily exercise and much less alcohol and milk consumption, can delay or prevent Parkinson's disease., (© 2021 The Author(s). Published by BRI.)

Background/objectives: To test the diagnostic ability of two combined practical markers for elevated urine osmolality (underhydration) in free-living adults and children., Subjects/methods: One hundred and one healthy adults (females n = 52, 40 ± 14 y, 1.70 ± 0.95 m, 76.7 ± 17.4 kg, 26.5 ± 5.5 kg/m 2 ) and 210 children (females = 105, 1.49 ± 0.13 m, 43.4 ± 12.6 kg, 19.2 ± 3.2 kg m -2 ) collected urine for 24-h. Urine was analyzed for urine osmolality (UOsm), color (UC), while the number of voids (void) was also recorded. Receiver Operating Characteristic (ROC) analysis was performed for UC, void, and combination of UC and void, to determine markers' diagnostic ability for detecting underhydration based on elevated UOsm (UOsm ≥ 800 mmol kg -1 )., Results: Linear regression analysis revealed that UC was significantly associated with UOsm in both adults (R 2  = 0.38; P < 0.001) and children (R 2  = 0.45; P < 0.001). Void was significantly associated with UOsm in both adults (R 2  = 0.13; P < 0.001) and children (R 2  = 0.15; P < 0.001). In adults, when UC > 3 and void <7 were combined, the overall diagnostic ability for underhydration was 97% with sensitivity and specificity of 100% and 88%, respectively. In children, UC > 3 and void <5 had an overall diagnostic ability for underhydration of 89% with sensitivity and specificity of 100% and 62%, respectively., Conclusions: Urine color alone and the combination of urine color with void number can a valid and simple field-measure to detect underhydration based on elevated urine osmolality., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Tranexamic acid (TXA) use has expanded across many surgical specialties. It has been shown to reduce blood loss, decrease transfusion rates, and, in some cases, improve mortality. Within orthopaedic surgery, its popularity has primarily grown within arthroplasty and spinal surgery. It has only recently gained traction within the field of orthopaedic trauma and fracture care. At this time, most literature focuses on hip fracture and pelvic trauma surgery. For hip fractures, the results are encouraging and generally support the claim that TXA may lower overall blood loss and decrease transfusions. Conversely, less support exists for TXA use in fractures of the acetabulum or pelvic ring. Based on the current fracture-related studies, TXA does not seem to carry an increased risk of thromboembolism or other complications. In addition, few studies have been noted discussing the route of administration, timing, or dosage. This article reviews the most current literature regarding TXA use in fracture care and expands on the need for further research to evaluate the role of TXA in orthopaedic trauma populations who carry a high risk for transfusion., (Copyright © 2021 by the American Academy of Orthopaedic Surgeons.)

The purpose of this investigation was to assess the validity and reliability of a seven-day water frequency questionnaire (TWI-FQ) to estimate daily total water intake (TWI) in comparison to a water turnover objective reference value via deuterium oxide (D 2 O). Data collection occurred over 3 weeks, with a wash-out period during week two. Healthy adults ( n = 98; 52% female; 41 ± 14 y; BMI, 26.4 ± 5.5 kg·m -2 ) retrospectively self-reported consumption frequencies of 17 liquids and 35 foods with specified volumes/amounts for weeks one and three via TWI-FQ. Standard water content values were utilized to determine the volume of water consumed from each liquid and food for calculation of mean daily TWI for each week. Diet records were completed daily during week two to estimate metabolic water production. To assess validity of the TWI-FQ, participants consumed D 2 O at the start of each week and provided urine samples immediately before ingestion, the following day, and at the end of the week to calculate water turnover. Metabolic water was subtracted from water turnover to estimate TWI. TWI-FQ validity was assessed via Bland-Altman plot for multiple observations. Reliability was assessed via intraclass correlation and Pearson's correlation between weeks. TWI-FQ significantly underestimated D 2 O TWI by -350 ± 1,431 mL·d -1 (95% confidence interval (CI): -551, -149 mL·d -1 ). TWI-FQ TWI was significantly correlated ( r = 0.707, P <0.01) and not different (198 ± 1,180 mL·d -1 , 95% CI: -38, 435 mL·d -1 ) between weeks. TWI-FQ intraclass correlation = 0.706 was significant [95% CI: 0.591, 0.793; F (97, 98) = 5.799], indicating moderate test-retest reliability. While this tool would not be suitable for individual TWI assessment, the magnitude of bias may be acceptable for assessment at the sample-level., Competing Interests: EJ had received grants from Danone Research and FP had served as member of the scientific advisory board of Danone Research. IG and EP were Danone Research employees. SK had served as scientific consultant for Quest Diagnostics and Standard Process and had served as a member of the scientific advisory board of Danone Research, and had active grants with Danone Research and Standard Process. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Colburn, Johnson, Péronnet, Jansen, Capitan-Jimenez, Adams, Guelinckx, Perrier, Mauromoustakos and Kavouras.)

Effective mentoring promotes the development and success of graduate students. Yet mentoring, like other relationships, can have negative elements. Little knowledge exists about the problematic mentoring that graduate students experience despite its potentially detrimental impacts. To begin to address this gap, we conducted an exploratory interview study to define and characterize negative mentoring experiences of 40 life science doctoral students. Students attributed their negative mentoring experiences to interacting factors at multiple levels-from interpersonal differences and poor relationship quality to issues at the research group, departmental, organizational, and discipline levels-all of which they perceived as harmful to their development. We found that doctoral students experienced forms of negative mentoring similar to those reported in workplace and undergraduate research settings, but they also experienced negative mentoring that was unique to academic research and their stage of development. Our results are useful to mentors for reflecting on ways their behaviors might be perceived, to mentees for avoiding situations that might be conducive to negative mentoring, and to programs and institutions for improving structures and processes to prevent negative mentoring. Our findings also serve as a foundation for future research on the prevalence and impacts of negative mentoring experiences in graduate education.

It is unclear if mild-to-moderate dehydration independently affects mood without confounders like heat exposure or exercise. This study examined the acute effect of cellular dehydration on mood. Forty-nine adults (55 % female, age 39 (sd 8) years) were assigned to counterbalanced, crossover trials. Intracellular dehydration was induced with 2-h (0·1 ml/kg per min) 3 % hypertonic saline (HYPER) infusion or 0·9 % isotonic saline (ISO) as a control. Plasma osmolality increased in HYPER (pre 285 (sd 3), post 305 (sd 4) mmol/kg; P < 0·05) but remained unchanged in ISO (pre 285 (sd 3), post 288 (sd 3) mmol/kg; P > 0·05). Mood was assessed with the short version of the Profile of Mood States Questionnaire (POMS). The POMS sub-scale (confusion-bewilderment, depression-dejection, fatigue-inertia) increased in HYPER compared with ISO (P < 0·05). Total mood disturbance score (TMD) assessed by POMS increased from 10·3 (sd 0·9) to 16·6 (sd 1·7) in HYPER (P < 0·01), but not in ISO (P > 0·05). When TMD was stratified by sex, the increase in the HYPER trial was significant in females (P < 0·01) but not in males (P > 0·05). Following infusion, thirst and copeptin (surrogate for vasopressin) were also higher in females than in males (21·3 (sd 2·0), 14·1 (sd 1·4) pmol/l; P < 0·01) during HYPER. In conclusion, cellular dehydration acutely degraded specific aspects of mood mainly in women. The mechanisms underlying sex differences may be related to elevated thirst and vasopressin.

Patch repair is the preferred method for arteriotomy closure following femoral or carotid endarterectomy. Choosing among available patch options remains a clinical challenge, as current evidence suggests roughly comparable outcomes between autologous grafts and synthetic and biologic materials. Biologic patches have potential advantages over other materials, including reduced risk for infection, mitigation of an excessive foreign body response, and the potential to remodel into healthy, vascularized tissue. Here we review the use of decellularized extracellular matrix (ECM) for cardiovascular applications, particularly endarterectomy repair, and the capacity of these materials to remodel into native, site-appropriate tissues. Also presented are data from two post-market observational studies of patients undergoing iliofemoral and carotid endarterectomy patch repair as well as one histologic case report in a challenging iliofemoral endarterectomy repair, all with the use of small intestine submucosa (SIS)-ECM. In alignment with previously reported studies, high patency was maintained, and adverse event rates were comparable to previously reported rates of patch angioplasty. Histologic analysis from one case identified constructive remodeling of the SIS-ECM, consistent with the histologic characteristics of the endarterectomized vessel. These clinical and histologic results align with the biologic potential described in the academic ECM literature. To our knowledge, this is the first histologic demonstration of SIS-ECM remodeling into site-appropriate vascular tissues following endarterectomy. Together, these findings support the safety and efficacy of SIS-ECM for patch repair of femoral and carotid arteriotomy., Competing Interests: The authors declare that this study received funding from Aziyo Biologics, Inc. The funder had the following involvement with the study: study design, data collection and analysis, and supported preparation of the manuscript., (Copyright © 2021 Allen, Adams, Badylak, Garrett, Mouawad, Oweida, Parikshak and Sultan.)

The purpose of this technique paper is to outline a minimally invasive technique using dual suspensory fixation with adjustable-loop devices for reconstruction of the superficial medial collateral ligament. The femoral fixation is performed through a limited approach at the anatomic origin of the medial collateral ligament, a socket is prepared, and the graft is docked using the adjustable-loop suspensory fixation. The tibial socket is prepared through a separate incision just distal to the pes anserine tendons and drilled medially to laterally perpendicular to the tibial shaft. The graft is tunneled and docked into the tibial tunnel using adjustable-loop cortical suspensory fixation on the far cortex. The knee is cycled through a full arc of motion and stressed in valgus to take initial creep out of the construct. The knee is placed in 30° of flexion and slight varus and final tension is applied to both the femoral and tibial side. With this technique, fixation can be completed with a minimally invasive incision and it allows the ability to tension the graft both on the femoral and tibial side to the desired level, providing a significant advantage over previously used interference screw techniques., (© 2020 by the Arthroscopy Association of North America. Published by Elsevier.)

Impaired glucose tolerance arises out of impaired postprandial insulin secretion and delayed suppression of glucagon. These defects occur early and independently in the pathogenesis of prediabetes. Quantification of the contribution of α-cell dysfunction to glucose tolerance has been lacking because knowledge of glucagon kinetics in humans is limited. Therefore, in a series of experiments examining the interaction of glucagon suppression with insulin secretion we studied 51 nondiabetic subjects (age = 54 ± 13 yr, BMI = 28 ± 4 kg/m 2 ). Glucose was infused to mimic the systemic appearance of an oral challenge. Somatostatin was used to inhibit endogenous hormone secretion. 120 min after the start of the experiment, glucagon was infused at 0.65 ng/kg/min. The rise in glucagon concentrations was used to estimate its kinetic parameters [volume of distribution (V d ), half-life (t 1/2 ), and clearance rate (CL)]. A single-exponential model provided the best fit for the data, and individualized kinetic parameters were estimated: V d = 8.2 ± 2.7 L, t 1/2 = 4  ± 1.1 min, CL = 1.4 ± 0.33 L/min. Stepwise linear regression was used to correlate V d with BMI and sex ( R 2 adj = 0.44), whereas CL similarly correlated with lean body mass or BSA (both R 2 = 0.28). This enabled the development of a population-based model using anthropometric characteristics to predict V d and CL. These data demonstrate that it is feasible to derive glucagon kinetic parameters from anthropometric characteristics, thereby enabling quantitation of the rate of glucagon appearance in the systemic circulation in large populations. NEW & NOTEWORTHY State-of-the-art measurement of insulin secretion in humans is accomplished by deconvolution of peripheral C-peptide concentrations using population-derived parameters of C-peptide kinetics. In contrast, knowledge of the kinetic parameters of glucagon in humans is lacking so that measurement of glucagon secretion to date is largely qualitative. This series of experiments enabled measurement of glucagon kinetics in 51 subjects, and subsequently, stepwise linear regression was used to correlate these parameters with anthropometric characteristics. This enabled the development of a population-based model using anthropometric characteristics to predict the volume of distribution and the rate of clearance. This is a necessary first step in the development of a model to quantitate of glucagon secretion and action (and its contribution to glucose tolerance) in large populations.

Background: Thirst is a sensation normally aroused by a lack of water and associated with a desire to drink more fluid., Aim: The aims of this brief review are twofold: (a) to summarize the thirst mechanism in how it is initiated and diminished, and (b) to describe techniques to assess human thirst accurately in a variety of situations., Discussion: Thirst is maintained via a feedback-controlled mechanism, regulated by central and peripheral factors, as well as social and psychological cues. Most studies of thirst have focused on the initiation of water intake and the neural mechanisms responsible for this vital behavior. Less attention has been paid to the stimuli and mechanisms that terminate a bout of drinking and limit fluid ingestion, such as oropharyngeal and gastric signals, coupled with osmotic sensations. Thirst perception is typically assessed by subjective ratings using a variety of questionnaires, rankings, or visual analog scales. However, the appropriate perceptual tool may not always be used for the correct assessment of thirst perception., Conclusions: In considering the many factors involved in thirst arousal and inhibition, similar questions need to be considered for the correct assessment of this ingestive behavior.

Background: Proper hydration is vital for both exercise and general health. Although various methods for hydration assessment exist, many are not valid for either use or never tested. Introduction: The purpose of this study was to determine whether the uChek © smart phone application can be used to diagnose underhydration based on elevated urine specific gravity (USG) assessed by refractometry. Methods: One hundred forty-seven (n = 147) fresh human urine samples from young and middle-age adults were analyzed for USG with a refractometer and the uChek © application by reading the Siemens Multistix 10G urine reagent strip. Results: Bland-Altman analysis showed agreement of the two methods of assessment. Overall diagnostic ability of the uChek © to identify underhydration was fair (area under the curve 79%). However, the sensitivity to correctly identify underhydration was poor (60%) as well as the specificity of correctly identifying euhydration (53%). Conclusion: The uChek © application does not accurately detect underhydration.

Purpose: Abnormal glucagon concentrations are a feature of prediabetes but it is uncertain if α-cell dysfunction contributes to a longitudinal decline in β-cell function. We therefore sought to determine if a decline in β-cell function is associated with a higher nadir glucagon in the postprandial period or with higher fasting glucagon., Methods: This was a longitudinal study in which 73 non-diabetic subjects were studied on 2 occasions 6.6 ± 0.3 years apart using a 2-hour, 7-sample oral glucose tolerance test. Disposition Index (DI) was calculated using the oral minimal model applied to the measurements of glucose, insulin, C-peptide concentrations during the studies. We subsequently examined the relationship of glucagon concentrations at baseline with change in DI (used as a measure of β-cell function) after adjusting for changes in weight and the baseline value of DI., Results: After adjusting for covariates, nadir postprandial glucagon concentrations were not associated with changes in β-cell function as quantified by DI. On the other hand, fasting glucagon concentrations during the baseline study were inversely correlated with longitudinal changes in DI., Conclusions: Defects in α-cell function, manifest as elevated fasting glucagon, are associated with a subsequent decline in β-cell function. It remains to be ascertained if abnormal α-cell function contributes directly to loss of β-cell secretory capacity in the pathogenesis of type 2 diabetes., Competing Interests: Declaration of competing interest Dr. Vella is an investigator in an investigator-initiated study sponsored by Novo Nordisk. He has consulted for XOMA, vTv Therapeutics, Sanofi-Aventis, Novartis and Bayer in the past 5 years. None of the other authors have relevant disclosures., (Copyright © 2020 Elsevier Inc. All rights reserved.)

We present an autocatalytic system for the detection and amplification of thiols termed the Methionase Chain Reaction (MCR). MCR is based on the reversible modification of the thiol producing enzyme Methionine Gamma-Lyase (MGL). MCR was able to amplify the concentration of thiols by a factor of 560 and was able to visually detect thiols at concentrations as low as 50 nM.

This study evaluated the frequency in which a hip dislocation is first diagnosed by computed tomography (CT) scan. A retrospective review was conducted of orthopaedic trauma patients presenting with hip dislocation to a Level 1 trauma center over three years. We recorded whether the patient first received pelvic radiograph (PXR) or CT scan of the pelvis, if the patient underwent closed reduction of the hip prior to CT scan, and if repeat pelvis CT scan was done. Of 83 hip dislocations, 64 patients were sent to CT scanner dislocated; 19 patients first had PXR and underwent closed reduction of the hip prior to CT scan. By obtaining a PXR, reducing the hip prior to CT, the incidence of repeat CT scan decreased from 37% to 11% (p = 0.046). By diagnosing hip dislocation, reducing prior to CT scan, repeat scans can be reduced, thus decreasing cost and radiation exposure to patients. (Journal of Surgical Orthopaedic Advances 29(1):4345, 2020).

Using a mixed-methods approach, we examined how participants' memories of socialization regarding death might influence their self-reported coping with losses in childhood and adulthood. We recruited 318 adults to complete an online survey. Path analyses indicated that participants who remembered their parents shielding them less from issues related to death reported better coping as children and adults. Qualitative responses suggested participants wanted to receive more information about death from their parents as they went through the grieving process. We highlight the potential benefits of socializing children about death, and how it may aid in their coping with death-related events.

Inflammatory states are among the most common and most treated medical conditions. Inflammation comes along with swelling, pain and uneasiness in using the affected area. Inflammation is not always a simple symptom; more often is part of a defensive response of the body to an external threat or is a sign that the damaged tissue has not healed yet and needs to rest. The management of the pain associated with an inflammatory state could be a tricky task. In fact, most remedies simply quench the pain, leaving the inflammatory state unaltered. This review focuses on sesquiterpene lactones, a class of natural compounds, that represents a future promise in the treatment of inflammation. Sesquiterpene lactones are efficient inhibitors of multiple targets of the inflammatory process. Their natural sources are often ancient remedies with relevant traditional uses in folk medicines. This work also aims to elucidate how these compounds may represent the starting material for the development of new anti-inflammatory drugs., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Epidemiological studies in humans show increased concentrations of copeptin, a surrogate marker of arginine vasopressin (AVP), to be associated with increased risk for type 2 diabetes., Objectives: To examine the acute and independent effect of osmotically stimulated AVP, measured via the surrogate marker copeptin, on glucose regulation in healthy adults., Methods: Sixty subjects (30 females) participated in this crossover design study. On 2 trial days, separated by ≥7 d (males) or 1 menstrual cycle (females), subjects were infused for 120 min with either 0.9% NaCl [isotonic (ISO)] or 3.0% NaCl [hypertonic (HYPER)]. Postinfusion, a 240-min oral-glucose-tolerance test (OGTT; 75 g) was administered., Results: During HYPER, plasma osmolality and copeptin increased (P < 0.05) and remained elevated during the entire 6-h protocol, whereas renin-angiotensin-aldosterone system hormones were within the lower normal physiological range at the beginning of the protocol and declined following infusion. Fasting plasma glucose did not differ between trials (P > 0.05) at baseline and during the 120 min of infusion. During the OGTT the incremental AUC for glucose from postinfusion baseline (positive integer) was greater during HYPER (401.5 ± 190.5 mmol/L·min) compared with the ISO trial (354.0 ± 205.8 mmol/L·min; P < 0.05). The positive integer of the AUC for insulin during OGTT did not differ between trials (HYPER 55,850 ± 36,488 pmol/L·min compared with ISO 57,205 ± 31,119 pmol/L·min). Baseline values of serum glucagon were not different between the 2 trials; however, the AUC of glucagon during the OGTT was also significantly greater in HYPER (19,303 ± 3939 ng/L·min) compared with the ISO trial (18,600 ± 3755 ng/L·min; P < 0.05)., Conclusions: The present data indicate that acute osmotic stimulation of copeptin induced greater hyperglycemic responses during the oral glucose challenge, possibly due to greater glucagon concentrations.This study was registered at clinicaltrials.gov as NCT02761434., (Copyright © American Society for Nutrition 2019.)